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Sample records for adult general intensive

  1. Intensive Care Society's APACHE II study in Britain and Ireland--I: Variations in case mix of adult admissions to general intensive care units and impact on outcome.

    PubMed Central

    Rowan, K M; Kerr, J H; Major, E; McPherson, K; Short, A; Vessey, M P

    1993-01-01

    OBJECTIVES--To describe the extent of variation in the case mix of adult admissions to general intensive care units in Britain and Ireland and investigate the impact of such variation on outcome. DESIGN--Prospective, cohort study of consecutive admissions to intensive care units. SETTING--26 general intensive care units in Britain and Ireland. SUBJECTS--9099 admissions to the intensive care units studied. MAIN OUTCOME MEASURE--Death or survival at discharge before and after adjustment of case mix (age, history of chronic conditions, surgical status, diagnosis, and severity of illness) according to the APACHE II method. RESULTS--Important differences in case mix were found, with large variations between the units. Hospital mortality was significantly associated with most of the case mix factors investigated. CONCLUSIONS--Comparing crude death rates in hospital between intensive care units may be misleading indicators of performance. The collection of data on case mix needs to be standardised and differences in case mix adjusted for when comparing outcome between different intensive care units. PMID:8241908

  2. The experience of registered nurses nursing in the general adult intensive care unit. A phenomenological qualitative research study.

    PubMed

    Pope, E; Nel, E; Poggenpoel, M

    1998-06-01

    In this article a phenomenological qualitative research study is discussed. More attention will be given to the methodology of the research. The objectives of the study are two-fold: firstly to explore and describe the experience of registered nurses nursing in the adult intensive care unit (this is the first phase of the research) and to describe guidelines based on the information obtained in the first phase to support the nurses in the form of a support programme in the second phase. The units of research are the registered nurses in the intensive care unit. The characteristics of the unit of research led to the emergence of a qualitative phenomenological research design of an explorative, descriptive and contextual nature. In the discussion of research methodology attention will be given to phase one: data gathering (ethical considerations and informed consent; purposive selection, phenomenological interviews and field notes); data analysis (Tesch's method of data analysis, methods to ensure trustworthiness, organisation of raw data and integration of findings supported by literature. Five themes were identified through the data analysis: impaired communication with management; discrimination: white on black racism; lack of fair, competitive remuneration and disregard for professional worth; non-conducive physical environment, and stressful working environment. Phase two: Guidelines were described to support the registered nurses in the intensive care unit based on the information obtained in phase one of the research.

  3. General Information about Adult Hodgkin Lymphoma

    MedlinePlus

    ... Adult Hodgkin Lymphoma Treatment (PDQ®)–Patient Version General Information About Adult Hodgkin Lymphoma Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  4. General Information about Adult Acute Lymphoblastic Leukemia

    MedlinePlus

    ... Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Lymphoblastic Leukemia Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  5. General Information about Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  6. General Information about Adult Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft Tissue Sarcoma Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  7. General Information about Adult Primary Liver Cancer

    MedlinePlus

    ... Primary Liver Cancer Treatment (PDQ®)–Patient Version General Information About Adult Primary Liver Cancer Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  8. Generalized phase diffraction gratings with tailored intensity.

    PubMed

    Albero, Jorge; Moreno, Ignacio; Davis, Jeffrey A; Cottrell, Don M; Sand, David

    2012-10-15

    We report the generation of continuous phase masks designed to generate a set of target diffraction orders with defined relative intensity weights. We apply a previously reported analytic calculation that requires resolving a single equation with a set of parameters defining the target diffraction orders. Then the same phase map is extended to other phase patterns such as vortex generating/sensing gratings. Results are demonstrated experimentally with a parallel-aligned spatial light modulator.

  9. Adult Hippocampal Neurogenesis, Fear Generalization, and Stress.

    PubMed

    Besnard, Antoine; Sahay, Amar

    2016-01-01

    The generalization of fear is an adaptive, behavioral, and physiological response to the likelihood of threat in the environment. In contrast, the overgeneralization of fear, a cardinal feature of posttraumatic stress disorder (PTSD), manifests as inappropriate, uncontrollable expression of fear in neutral and safe environments. Overgeneralization of fear stems from impaired discrimination of safe from aversive environments or discernment of unlikely threats from those that are highly probable. In addition, the time-dependent erosion of episodic details of traumatic memories might contribute to their generalization. Understanding the neural mechanisms underlying the overgeneralization of fear will guide development of novel therapeutic strategies to combat PTSD. Here, we conceptualize generalization of fear in terms of resolution of interference between similar memories. We propose a role for a fundamental encoding mechanism, pattern separation, in the dentate gyrus (DG)-CA3 circuit in resolving interference between ambiguous or uncertain threats and in preserving episodic content of remote aversive memories in hippocampal-cortical networks. We invoke cellular-, circuit-, and systems-based mechanisms by which adult-born dentate granule cells (DGCs) modulate pattern separation to influence resolution of interference and maintain precision of remote aversive memories. We discuss evidence for how these mechanisms are affected by stress, a risk factor for PTSD, to increase memory interference and decrease precision. Using this scaffold we ideate strategies to curb overgeneralization of fear in PTSD.

  10. General Information about Adult Non-Hodgkin Lymphoma

    MedlinePlus

    ... Non-Hodgkin Lymphoma Treatment (PDQ®)–Patient Version General Information About Adult Non-Hodgkin Lymphoma Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  11. 20 CFR 663.200 - What are intensive services for adults and dislocated workers?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What are intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers?...

  12. 20 CFR 663.200 - What are intensive services for adults and dislocated workers?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What are intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers?...

  13. 20 CFR 663.200 - What are intensive services for adults and dislocated workers?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What are intensive services for adults and..., DEPARTMENT OF LABOR (CONTINUED) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers?...

  14. 20 CFR 663.200 - What are intensive services for adults and dislocated workers?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are intensive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a)...

  15. 20 CFR 663.200 - What are intensive services for adults and dislocated workers?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are intensive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.200 What are intensive services for adults and dislocated workers? (a)...

  16. Generalized Potential of Adult Neural Stem Cells

    NASA Astrophysics Data System (ADS)

    Clarke, Diana L.; Johansson, Clas B.; Wilbertz, Johannes; Veress, Biborka; Nilsson, Erik; Karlström, Helena; Lendahl, Urban; Frisén, Jonas

    2000-06-01

    The differentiation potential of stem cells in tissues of the adult has been thought to be limited to cell lineages present in the organ from which they were derived, but there is evidence that some stem cells may have a broader differentiation repertoire. We show here that neural stem cells from the adult mouse brain can contribute to the formation of chimeric chick and mouse embryos and give rise to cells of all germ layers. This demonstrates that an adult neural stem cell has a very broad developmental capacity and may potentially be used to generate a variety of cell types for transplantation in different diseases.

  17. Instantiation of general terms in young and older adults.

    PubMed

    Light, L L; Valencia-Laver, D; Zavis, D

    1991-09-01

    Instantiation of general terms in discourse requires inference from general world knowledge and use of linguistic context to particularize meaning. According to the semantic deficit hypothesis, older adults should be less likely than young adults to generate or to store such inferences. In Experiments 1 and 2 an indirect measure, relatedness judgment, was used to assess immediate comprehension and memory for inferences. In Experiment 3 a direct measure, cued recall, was used to tap memory for inferences. No age differences in immediate or delayed memory were observed in Experiments 1 or 2. In Experiment 3 older adults recalled fewer sentences, but there was no evidence for a specific decrement in storage of inferential material. Older adults are not impaired in ability to draw inferences based on general world knowledge, nor are they more likely than young adults to encode linguistic information in a general, stereotypic fashion.

  18. Epidemiology of nosocomial infections in adult intensive care units.

    PubMed

    Trilla, A

    1994-07-01

    Patients in intensive care units (ICUs) are a small subgroup of all hospitalized patients, but they account for approximately 25% of all hospital infections. Nosocomial infection rates among ICU patients are 5-10 times higher than among general ward patients. ICU infection rates are higher due to complex interactions between the patients' underlying disease, severity of illness, type of ICU, duration of stay, and invasive devices used. Antimicrobial resistance is a major clinical problem despite potent and newer antibiotics. Organisms that pose a clinically significant resistance problem among ICU patients include methicillin-resistant staphylococci, enterococci, a wide variety of enterobacteriaceae, Pseudomonas aeruginosa, Pseudomonas cepacia, Xanthomonas maltophila, Acinetobacter and Candida species. Traditional infection control measures include identification of reservoirs, halting transmission between patients, stopping progression from colonization to infection and modifying host risk. In addition, sound selection procedures and guidelines for antibiotic usage are necessary to control the spread of multi-resistant micro-organisms.

  19. Intravenous fish oil in adult intensive care unit patients.

    PubMed

    Heller, Axel R

    2015-01-01

    Omega-3 fatty acids contained in fish oils have shown efficacy in the treatment of chronic and acute inflammatory diseases due to their pleiotropic effects on inflammatory cell signalling pathways. In a variety of experimental and clinical studies, omega-3 fatty acids attenuated hyperinflammatory conditions and induced faster recovery. This chapter will shed light on the effects of intravenous fish oil in adult intensive care unit (ICU) patients and will discuss clinical data and recent meta-analyses on the topic. While significant beneficial effects on infection rates and the lengths of ICU and hospital stays have concordantly been identified in three recent meta-analyses on non-ICU surgical patients, the level of evidence is not so clear for critically ill patients. Three meta-analyses published in 2012 or 2013 explored data on the ICU population. Although the present data suggest the consideration of enteral nutrition enriched with fish oil, borage oil and antioxidants in mild to severe acute respiratory distress syndrome, only one of the three meta-analyses found a trend (p = 0.08) of lower mortality in ICU patients receiving intravenous omega-3 fatty acids. Two of the meta-analyses indicated a significantly shorter hospital stay (5.17-9.49 days), and one meta-analysis found a significant reduction in ICU days (1.92). As a result of these effects, cost savings were postulated. Unlike in surgical patients, the effects of fish oil on infection rates were not found to be statistically significant in ICU patients, and dose-effect relationships were not established for any cohort. Thus, obvious positive secondary outcome effects with intravenous fish oil have not yet been shown to transfer to lower mortality in critically ill patients. There is a need for adequately powered, well-planned and well-conducted randomized trials to give clear recommendations on the individual utility and dosage of intravenous omega-3 fatty acids in critical illness. PMID:25471809

  20. The negative event scale: measuring frequency and intensity of adult hassles.

    PubMed

    Maybery, D J; Neale, Jason; Arentz, Alex; Jones-Ellis, Jenny

    2007-06-01

    This study examined the structure, concurrent validity, and reliability of a hassle measure for middle-aged adults in both event frequency and intensity recordings. The measure included a range of interpersonal day-to-day events and re-examined aspects of the primary appraisal confounding debate between Lazarus and colleagues (Lazarus, Delongis, Folkman, & Gruen, 1985) and Dohrenwend and Shrout (1985). Of the 373 participants, 73% were female, 72% were in paid work, 69% were in permanent relationships and 62% had children. Principal component analyses of separate hassle frequency and intensity scores highlighted components consistent with previous research. There were seven interpersonal and four non-interpersonal subscales associated with negative events with family and friends, work, health, money, and household. The subscales had very good reliability and concurrent validity and there were generally strong correlations (i.e. up .84) between frequency and intensity scores for each subscale. Given some important sampling limitations (e.g. female overrepresentation) the findings show a psychometrically sound hassle scale for adults. PMID:17999222

  1. MRI correlates of general intelligence in neurotypical adults.

    PubMed

    Malpas, Charles B; Genc, Sila; Saling, Michael M; Velakoulis, Dennis; Desmond, Patricia M; O'Brien, Terence J

    2016-02-01

    There is growing interest in the neurobiological substrate of general intelligence. Psychometric estimates of general intelligence are reduced in a range of neurological disorders, leading to practical application as sensitive, but non-specific, markers of cerebral disorder. This study examined estimates of general intelligence in neurotypical adults using diffusion tensor imaging and resting-state functional connectivity analysis. General intelligence was related to white matter organisation across multiple brain regions, confirming previous work in older healthy adults. We also found that variation in general intelligence was related to a large functional sub-network involving all cortical lobes of the brain. These findings confirm that individual variance in general intelligence is related to diffusely represented brain networks.

  2. Usefulness of a Perceived Exertion Scale for Monitoring Exercise Intensity in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Stanish, Heidi I.; Aucoin, Michael

    2007-01-01

    In order to gain physical fitness and health, exercise must be performed at a sufficient level of intensity. Exercise intensity can be monitored with rated perceived exertion (RPE) scales to promote safe and effective programming. The usefulness of the Children's OMNI Scale as a subjective measure of intensity for adults with intellectual…

  3. Long-term survival following intensive care: subgroup analysis and comparison with the general population.

    PubMed

    Wright, J C; Plenderleith, L; Ridley, S A

    2003-07-01

    This study aimed to compare the very long-term survival of critically ill patients with that of the general population, and examine the association among age, sex, admission diagnosis, APACHE II score and mortality. In a retrospective observational cohort study of prospectively gathered data, 2104 adult patients admitted to the intensive care unit (ICU) of a teaching hospital in Glasgow from 1985 to 1992, were followed until 1997. Vital status at five years was compared with that of an age- and sex-matched Scottish population. Five-year mortality for the ICU patients was 47.1%, 3.4 times higher than that of the general population. For those surviving intensive care the five-year mortality was 33.4%. Mortality was greater than that of the general population for four years following intensive care unit admission (95% confidence interval included 1.0 at four years). Multivariate analysis showed that risk factors for mortality in those admitted to ICU were age, APACHE II score on admission and diagnostic category. Mortality was higher for those admitted with haematological (87.5%) and neurological diseases (61.7%) and septic shock (62.9%). A risk score was produced: Risk Score = 10 (age hazard ratio + APACHE II hazard ratio + diagnosis hazard ratio). None of the patients with a risk score > 100 survived more than five years and for those who survived to five years the mean risk score was 57. Long-term survival following intensive care is not only related to age and severity of illness but also diagnostic category. The risk of mortality in survivors of critical illness matches that of the normal population after four years. Age, severity of illness and diagnosis can be combined to provide an estimate of five-year survival.

  4. Suggesting a General ESP Model for Adult Learners

    ERIC Educational Resources Information Center

    Al-Jumaily, Samir

    2011-01-01

    The study suggests a general model that could guarantee the cooperation between teachers and their students to overcome the difficulties encountered in ESP learning. It tries to join together different perspectives in the research of adult education, specifically in the teaching of English for Specific Purposes. It also provides some sort of trust…

  5. Generalization of Adult's Stimulus Control of Children's Behavior

    ERIC Educational Resources Information Center

    Redd, William H.

    1970-01-01

    Generalization of stimulus control in different situations and with novel adults occurred with those children who were trained by contingent reinforcement, but not with those trained by both contingent and noncontingent reinforcement. This research was submitted as part of the author's dissertation. (MH)

  6. Defining and Treating Older Adults with Acute Myeloid Leukemia Who Are Ineligible for Intensive Therapies

    PubMed Central

    Pettit, Kristen; Odenike, Olatoyosi

    2015-01-01

    Although acute myeloid leukemia (AML) is primarily a disease of older adults (age ≥60 years), the optimal treatment for older adults remains largely undefined. Intensive chemotherapy is rarely beneficial for frail older adults or those with poor-risk disease, but criteria that define fitness and/or appropriateness for intensive chemotherapy remain to be standardized. Evaluation of disease-related and patient-specific factors in the context of clinical decision making has therefore been largely subjective. A uniform approach to identify those patients most likely to benefit from intensive therapies is needed. Here, we review currently available objective measures to define older adults with AML who are ineligible for intensive chemotherapy, and discuss promising investigational approaches. PMID:26697412

  7. Leaving home: how older adults prepare for intensive volunteering.

    PubMed

    Cheek, Cheryl; Piercy, Kathleen W; Grainger, Sarah

    2015-03-01

    Using the concepts in the Fogg Behavioral Model, 37 volunteers aged 50 and older described their preparation for intensive volunteering with faith-based organizations. Their multistage preparation process included decision points where respondents needed to choose whether to drop out or continue preparation. Ability was a stronger determinant of serving than motivation, particularly in terms of health and finances. This model can facilitate understanding of the barriers to volunteering and aid organizations in tailoring support at crucial points for potential older volunteers in intensive service.

  8. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991.

    PubMed

    Campbell, N N; Tooley, M A; Willatts, S M

    1994-02-01

    In this paper we present a detailed analysis of the use of the APACHE II (acute physiological and chronic health evaluation) scoring system on all of the patients admitted to the general intensive care unit at the Bristol Royal Infirmary over a 20-month period. The 6-month survival of 691 adult medical and surgical patients following intensive care was recorded and this data was analysed with admission and daily APACHE II scores using a relational database. Our data confirms the relationship between admission APACHE II scores and outcome, with mean scores decreasing as duration of survival increases. We also demonstrate that the best day one scores are approximately 50% less than the admission score, irrespective of outcome, indicating the benefit of intensive care. By contrast, however, the scores on day one have either not improved or have worsened since admission, reflecting the importance of the pre-morbid health status of the patient in determining outcome from intensive care.

  9. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991.

    PubMed Central

    Campbell, N N; Tooley, M A; Willatts, S M

    1994-01-01

    In this paper we present a detailed analysis of the use of the APACHE II (acute physiological and chronic health evaluation) scoring system on all of the patients admitted to the general intensive care unit at the Bristol Royal Infirmary over a 20-month period. The 6-month survival of 691 adult medical and surgical patients following intensive care was recorded and this data was analysed with admission and daily APACHE II scores using a relational database. Our data confirms the relationship between admission APACHE II scores and outcome, with mean scores decreasing as duration of survival increases. We also demonstrate that the best day one scores are approximately 50% less than the admission score, irrespective of outcome, indicating the benefit of intensive care. By contrast, however, the scores on day one have either not improved or have worsened since admission, reflecting the importance of the pre-morbid health status of the patient in determining outcome from intensive care. PMID:8196033

  10. APACHE II scoring system on a general intensive care unit: audit of daily APACHE II scores and 6-month survival of 691 patients admitted to a general intensive care unit between May 1990 and December 1991.

    PubMed

    Campbell, N N; Tooley, M A; Willatts, S M

    1994-02-01

    In this paper we present a detailed analysis of the use of the APACHE II (acute physiological and chronic health evaluation) scoring system on all of the patients admitted to the general intensive care unit at the Bristol Royal Infirmary over a 20-month period. The 6-month survival of 691 adult medical and surgical patients following intensive care was recorded and this data was analysed with admission and daily APACHE II scores using a relational database. Our data confirms the relationship between admission APACHE II scores and outcome, with mean scores decreasing as duration of survival increases. We also demonstrate that the best day one scores are approximately 50% less than the admission score, irrespective of outcome, indicating the benefit of intensive care. By contrast, however, the scores on day one have either not improved or have worsened since admission, reflecting the importance of the pre-morbid health status of the patient in determining outcome from intensive care. PMID:8196033

  11. Patient stress in intensive care: comparison between a coronary care unit and a general postoperative unit

    PubMed Central

    Dias, Douglas de Sá; Resende, Mariane Vanessa; Diniz, Gisele do Carmo Leite Machado

    2015-01-01

    Objective To evaluate and compare stressors identified by patients of a coronary intensive care unit with those perceived by patients of a general postoperative intensive care unit. Methods This cross-sectional and descriptive study was conducted in the coronary intensive care and general postoperative intensive care units of a private hospital. In total, 60 patients participated in the study, 30 in each intensive care unit. The stressor scale was used in the intensive care units to identify the stressors. The mean score of each item of the scale was calculated followed by the total stress score. The differences between groups were considered significant when p < 0.05. Results The mean ages of patients were 55.63 ± 13.58 years in the coronary intensive care unit and 53.60 ± 17.47 years in the general postoperative intensive care unit. For patients in the coronary intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “being bored”. For patients in the general postoperative intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “not being able to communicate”. The mean total stress scores were 104.20 ± 30.95 in the coronary intensive care unit and 116.66 ± 23.72 (p = 0.085) in the general postoperative intensive care unit. When each stressor was compared separately, significant differences were noted only between three items. “Having nurses constantly doing things around your bed” was more stressful to the patients in the general postoperative intensive care unit than to those in the coronary intensive care unit (p = 0.013). Conversely, “hearing unfamiliar sounds and noises” and “hearing people talk about you” were the most stressful items for the patients in the coronary intensive care unit (p = 0.046 and 0.005, respectively). Conclusion The perception of major stressors and the total stress score were similar between patients

  12. The provision of adult intensive care in Northern Ireland with reference to the role of high dependency care.

    PubMed

    Morrow, B C; Lavery, G G; Blackwood, B M; Ball, I M; McLeod, H N; Fee, J P

    1996-05-01

    In 1991 an audit of Intensive Care Services was carried out by the Northern Ireland Intensive Care Group. In conjunction with this regional overview, all patients in the Regional Intensive Care Unit, (RICU) in the Royal Victoria Hospital were assessed daily, over a 10 month period in 1990-91 and classified as conforming to either intensive care or high dependency status. These data were then used to compare adult intensive care service in Northern Ireland with recent national and international recommendations on intensive care. Ten units in Northern Ireland were surveyed. In regard to national or international guidelines, all ten were deficient to some degree. Four units had significant deficiencies; small patient numbers, lack of 'dedicated' 24 hr medical cover and or deficiencies in the provision of appropriate monitoring and or equipment. There was a large diversity in casemix among the ten units surveyed which suggested differing admission criteria. The bed occupancy of RICU was 100%. Refused admissions constituted a further 13% of unresourced workload. The lack of physically separate, dedicated high dependency unit facilities meant that 26% of bed days were devoted to HDU care (usually for "improved" intensive care unit patients not yet ready for discharge to a general ward. Achieving nationally recommended intensive care standards (on a regional basis) is probably only possible if a number of the smaller intensive care units are redesignated as high dependency units, and patients requiring intensive care are concentrated in a smaller number of larger ICUs. This will increase the frequency of interhospital transfer of critically ill patients.

  13. Generalized Hypertrichosis Induced by Topical Minoxidil in an Adult Woman.

    PubMed

    Chellini, Patrícia Rocha; Pirmez, Rodrigo; Raso, Paula; Sodré, Celso T

    2015-01-01

    Hypertrichosis is a common side effect of topical minoxidil and has been reported to occur mainly close to the areas of application. In this paper, we present a case of a 26-year-old woman who developed generalized hypertrichosis 8 weeks after treatment with 5% topical minoxidil solution for alopecia areata. Generalized hypertrichosis is a rare side effect and has been described mainly in children and adolescents. Even though minoxidil is commonly prescribed for alopecia areata, there is insufficient evidence to support its systematic use and the occurrence of adverse effects should prompt drug interruption. Nonetheless, topical minoxidil has been shown to be a safe medication for adult patients, and we believe that the present case was an isolated one, possibly resulting from the misuse of the drug. PMID:26903750

  14. Generalized Hypertrichosis Induced by Topical Minoxidil in an Adult Woman

    PubMed Central

    Chellini, Patrícia Rocha; Pirmez, Rodrigo; Raso, Paula; Sodré, Celso T

    2015-01-01

    Hypertrichosis is a common side effect of topical minoxidil and has been reported to occur mainly close to the areas of application. In this paper, we present a case of a 26-year-old woman who developed generalized hypertrichosis 8 weeks after treatment with 5% topical minoxidil solution for alopecia areata. Generalized hypertrichosis is a rare side effect and has been described mainly in children and adolescents. Even though minoxidil is commonly prescribed for alopecia areata, there is insufficient evidence to support its systematic use and the occurrence of adverse effects should prompt drug interruption. Nonetheless, topical minoxidil has been shown to be a safe medication for adult patients, and we believe that the present case was an isolated one, possibly resulting from the misuse of the drug. PMID:26903750

  15. Recognition of Facial Expressions and Prosodic Cues with Graded Emotional Intensities in Adults with Asperger Syndrome

    ERIC Educational Resources Information Center

    Doi, Hirokazu; Fujisawa, Takashi X.; Kanai, Chieko; Ohta, Haruhisa; Yokoi, Hideki; Iwanami, Akira; Kato, Nobumasa; Shinohara, Kazuyuki

    2013-01-01

    This study investigated the ability of adults with Asperger syndrome to recognize emotional categories of facial expressions and emotional prosodies with graded emotional intensities. The individuals with Asperger syndrome showed poorer recognition performance for angry and sad expressions from both facial and vocal information. The group…

  16. Use of Technology in an Adult Intensive English Program: Benefits and Challenges

    ERIC Educational Resources Information Center

    Fuchs, Carolin; Akbar, Farah Sultana

    2013-01-01

    This exploratory study presents results of an online survey on student teachers' technology proficiencies and uses of various tools in an adult Intensive English Program (IEP) in the United States. The ultimate goal was to identify areas of improvement for teacher education programs with regard to technology-enhanced language teaching and student…

  17. Network of Spaces and Interaction-Related Behaviors in Adult Intensive Care Units

    PubMed Central

    Rashid, Mahbub; Boyle, Diane K.; Crosser, Michael

    2014-01-01

    Using three spatial network measures of “space syntax”, this correlational study describes four interaction-related behaviors among three groups of users in relation to visibility and accessibility of spaces in four adult intensive care units (ICUs) of different size, geometry, and specialty. Systematic field observations of interaction-related behaviors show significant differences in spatial distribution of interaction-related behaviors in the ICUs. Despite differences in unit characteristics and interaction-related behaviors, the study finds that when nurses and physicians “interact while sitting” they prefer spaces that help maintain a high level of environmental awareness; that when nurses “walk” and “interact while walking” they avoid spaces with better global access and visibility; and that everyone in ICUs “walk” more in spaces with higher control over neighboring spaces. It is argued that such consistent behavioral patterns occur due to the structural similarities of spatial networks over and above the more general functional similarities of ICUs. PMID:25469838

  18. Supraspinal fatigue impedes recovery from a low-intensity sustained contraction in old adults.

    PubMed

    Yoon, Tejin; Schlinder-Delap, Bonnie; Keller, Manda L; Hunter, Sandra K

    2012-03-01

    This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, respectively, P < 0.001). The time to failure was associated with initial peak rates of relaxation of muscle fibers and pressor response (P < 0.05). Increments in torque (superimposed twitch; SIT) generated by transcranial magnetic stimulation (TMS) during brief MVCs, increased during the fatiguing contraction (P < 0.001) and then decreased during recovery (P = 0.02). The increase in the SIT was greater for the old adults than the young adults during the fatiguing contraction and recovery (P < 0.05). Recovery of MVC torque was less for old than young adults at 10 min post-fatiguing contraction (75.1 ± 8.7 vs. 83.6 ± 7.8% of control MVC, respectively, P = 0.01) and was associated with the recovery of the SIT (r = -0.59, r(2) = 0.35, P < 0.001). Motor evoked potential (MEP) amplitude and the silent period elicited during the fatiguing contraction increased less for old adults than young adults (P < 0.05). The greater fatigue resistance with age during a low-intensity sustained contraction was attributable to mechanisms located within the muscle. Recovery of maximal strength after the low-intensity fatiguing contraction however, was impeded more for old adults than young because of greater supraspinal fatigue. Recovery of strength could be an important variable to consider in exercise prescription of old populations.

  19. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  20. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities.

    PubMed

    Hove, Oddbjørn; Assmus, Jörg; Havik, Odd E

    2016-09-01

    This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying. PMID:27611352

  1. Potential for intensive volunteering to promote the health of older adults in fair health.

    PubMed

    Barron, Jeremy S; Tan, Erwin J; Yu, Qilu; Song, Meilin; McGill, Sylvia; Fried, Linda P

    2009-07-01

    Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served > or =15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported "good" and 12% "fair" or "poor" health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.

  2. The Impact of Moderate Intensity Physical Activity on Cardiac Structure and Performance in Older Sedentary Adults

    PubMed Central

    Suboc, Tisha B.; Strath, Scott J.; Dharmashankar, Kodlipet; Harmann, Leanne; Couillard, Allison; Malik, Mobin; Haak, Kristoph; Knabel, Daniel; Widlansky, Michael E.

    2014-01-01

    Background Sedentary aging leads to adverse changes in vascular function and cardiac performance. We published improvements in vascular function with moderate intensity physical activity (PA) in continuous bouts. Whether moderate intensity PA also impacts cardiac structure and cardiovascular performance of the aging left ventricle (LV) is unknown. Methods We recruited and analyzed results from 102 sedentary older adults ages ≥ 50 from a randomized controlled trial with 3 study groups: control (group 1), a pedometer-only intervention (group 2), or a pedometer with an interactive website employing strategies to increase habitual physical activity (PA, group 3) for 12 weeks. Transthoracic echocardiograms were performed prior to and following the 12 week intervention period to assess cardiac morphology, left ventricular (LV) systolic performance, LV diastolic function, arterial and LV ventricular elastance. Step count and PA intensity/distribution were measured by pedometer and accelerometer. Results We found no significant changes in cardiac morphology. Further, we found no improvement in the aforementioned cardiac functional parameters. Comparing those who achieved the following benchmarks to those who did not showed no significant changes in cardiac structure or performance: 1)10,000 steps/day, 2) ≥ 30 minutes/day of moderate intensity physical activity, or 3) moderate intensity PA in bouts ≥ 10 minutes for ≥ 20 minutes/day Conclusions In sedentary older adults, increasing moderate intensity PA to currently recommend levels does not result in favorable changes in LV morphology or performance over 12 weeks. More prolonged exposure, higher PA intensity, or earlier initiation of PA may be necessary to see benefits. PMID:25530947

  3. Low-intensity daily walking activity is associated with hippocampal volume in older adults.

    PubMed

    Varma, Vijay R; Chuang, Yi-Fang; Harris, Gregory C; Tan, Erwin J; Carlson, Michelle C

    2015-05-01

    Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using Functional Magnetic Resonance Imaging of the Brain's Software Library (FSL), and daily walking activity was assessed using a step activity monitor on 92, nondemented, older adult participants. After controlling for age, education, body mass index, cardiovascular disease risk factors, and the Mini Mental State Exam, we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not among men. These relationships were specific to hippocampal volume, compared with the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult population. Findings

  4. Low-intensity daily walking activity is associated with hippocampal volume in older adults

    PubMed Central

    Varma, Vijay R.; Chuang, Yi-fang; Harris, Gregory C.; Tan, Erwin J.; Carlson, Michelle C.

    2014-01-01

    Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using FMRIB's Software Library (FSL) and daily walking activity was assessed using a step activity monitor (SAM) on 92, non-demented, older adult participants. After controlling for age, education, body mass index (BMI), cardiovascular disease risk factors, and the Mini Mental State Exam (MMSE), we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not men. These relationships were specific to hippocampal volume, compared to the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult sample. Findings suggest the importance of better

  5. Comparison of high and moderate intensity of strength training on mood and anxiety in older adults.

    PubMed

    Tsutsumi, T; Don, B M; Zaichkowsky, L D; Takenaka, K; Oka, K; Ohno, T

    1998-12-01

    This study was designed to examine the psychological benefits of anaerobic exercise for older adults. Specifically, strength training was employed to examine the effects on mood and anxiety in a group of healthy but sedentary older women. 36 women (mean age = 68.5 yr.) were randomly assigned to groups given high intensity or moderate intensity strength training or to a control group. Strength training was conducted three days a week for 12 weeks. After the training period, both high and moderate strength-training programs produced marked improvements in muscle strength and body composition compared to the control subjects. The average improvements in the high and moderate intensity strength-training groups for muscle strength were 40.5 and 35.5%, respectively, and for percent body fat 1.52 and 2.50%, respectively. As for psychological changes, both training groups significantly improved positive mood (vigor), and the moderate intensity group significantly reduced trait anxiety compared to means of the control group. Also, both training groups showed some decrease in tension and state anxiety after the training period. These findings provide evidence for the effectiveness of anaerobic training to enhance perception of psychological well-being in older women. A moderate intensity rather than high intensity of training regimen may be more beneficial for sedentary older women to improve psychological health.

  6. Exercise intensities of gardening tasks within older adult allotment gardeners in Wales.

    PubMed

    Hawkins, Jemma L; Smith, Alexander; Backx, Karianne; Clayton, Deborah A

    2015-04-01

    Previous research has suggested that gardening activity could be an effective form of regular exercise for improving physical and psychological health in later life. However, there is a lack of data regarding the exercise intensities of various gardening tasks across different types of gardening and different populations. The purpose of this study was to examine the exercise intensity of gardening activity for older adult allotment gardeners in Wales, United Kingdom following a similar procedure used in previous studies conducted in the United States and South Korea by Park and colleagues (2008a; 2011). Oxygen consumption (VO2) and energy expenditure for six gardening tasks were measured via indirect calorimetery using the portable Oxycon mobile device. From these measures, estimated metabolic equivalent units (METs) were calculated. Consistent with Park et al. (2008a; 2011) the six gardening tasks were classified as low to moderate-high intensity physical activities based on their metabolic values (1.9-5.7 METs).

  7. GENERAL STRAIN THEORY, PERSISTENCE, AND DESISTANCE AMONG YOUNG ADULT MALES

    PubMed Central

    Eitle, David

    2010-01-01

    Purpose Despite the surge in scholarly activity investigating the criminal career, relatively less attention has been devoted to the issue of criminal desistance versus persistence (until recently). The present study contributed to our understanding of this process by exploring the suitability of General Strain Theory (GST) for predicting changes in criminal activity across time. Methods Data from a longitudinal study of males in South Florida are examined using robust regression analyses. Results The core GST relationship, that changes in strain should predict changes in criminal activity, was supported, even after controlling for important adult social roles such as marriage, labor force participation, and education. While no support for the proposition that changes in self-esteem and social support moderate the strain-criminal desistance association was evinced, evidence was found that angry disposition, a measure of negative emotionality, moderated the association between change in chronic stressors and change in criminal activity. Conclusions While exploratory in nature, these findings demonstrate the utility of employing GST principles in studies of criminal desistance. PMID:21499526

  8. Social cognitive theory correlates of moderate-intensity exercise among adults with type 2 diabetes.

    PubMed

    Heiss, Valerie J; Petosa, R L

    2016-01-01

    The purpose of this study was to identify social cognitive theory (SCT) correlates of moderate- to vigorous-intensity exercise (MVPA) among adults with type 2 diabetes. Adults with type 2 diabetes (N = 181) participated in the study. Participants were recruited through ResearchMatch.org to complete an online survey. The survey used previously validated instruments to measure dimensions of self-efficacy, self-regulation, social support, outcome expectations, the physical environment, and minutes of MVPA per week. Spearman Rank Correlations were used to determine the relationship between SCT variables and MVPA. Classification and Regression Analysis using a decision tree model was used to determine the amount of variance in MVPA explained by SCT variables. Due to low levels of vigorous activity, only moderate-intensity exercise (MIE) was analyzed. SCT variables explained 42.4% of the variance in MIE. Self-monitoring, social support from family, social support from friends, and self-evaluative outcome expectations all contributed to the variability in MIE. Other contributing variables included self-reward, task self-efficacy, social outcome expectations, overcoming barriers, and self-efficacy for making time for exercise. SCT is a useful theory for identifying correlates of MIE among adults with type 2 diabetes. The SCT correlates can be used to refine diabetes education programs to target the adoption and maintenance of regular exercise.

  9. Care of severe head injury patients in the Sarawak General Hospital: intensive care unit versus general ward.

    PubMed

    Sim, S K; Lim, S L; Lee, H K; Liew, D; Wong, A

    2011-06-01

    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.

  10. Operator Priming and Generalization of Practice in Adults' Simple Arithmetic

    ERIC Educational Resources Information Center

    Chen, Yalin; Campbell, Jamie I. D.

    2016-01-01

    There is a renewed debate about whether educated adults solve simple addition problems (e.g., 2 + 3) by direct fact retrieval or by fast, automatic counting-based procedures. Recent research testing adults' simple addition and multiplication showed that a 150-ms preview of the operator (+ or ×) facilitated addition, but not multiplication,…

  11. Generalization of Conditioned Fear along a Dimension of Increasing Fear Intensity

    ERIC Educational Resources Information Center

    Dunsmoor, Joseph E.; Mitroff, Stephen R.; LaBar, Kevin S.

    2009-01-01

    The present study investigated the extent to which fear generalization in humans is determined by the amount of fear intensity in nonconditioned stimuli relative to a perceptually similar conditioned stimulus. Stimuli consisted of graded emotionally expressive faces of the same identity morphed between neutral and fearful endpoints. Two…

  12. Recognition of facial expressions and prosodic cues with graded emotional intensities in adults with Asperger syndrome.

    PubMed

    Doi, Hirokazu; Fujisawa, Takashi X; Kanai, Chieko; Ohta, Haruhisa; Yokoi, Hideki; Iwanami, Akira; Kato, Nobumasa; Shinohara, Kazuyuki

    2013-09-01

    This study investigated the ability of adults with Asperger syndrome to recognize emotional categories of facial expressions and emotional prosodies with graded emotional intensities. The individuals with Asperger syndrome showed poorer recognition performance for angry and sad expressions from both facial and vocal information. The group difference in facial expression recognition was prominent for stimuli with low or intermediate emotional intensities. In contrast to this, the individuals with Asperger syndrome exhibited lower recognition accuracy than typically-developed controls mainly for emotional prosody with high emotional intensity. In facial expression recognition, Asperger and control groups showed an inversion effect for all categories. The magnitude of this effect was less in the Asperger group for angry and sad expressions, presumably attributable to reduced recruitment of the configural mode of face processing. The individuals with Asperger syndrome outperformed the control participants in recognizing inverted sad expressions, indicating enhanced processing of local facial information representing sad emotion. These results suggest that the adults with Asperger syndrome rely on modality-specific strategies in emotion recognition from facial expression and prosodic information.

  13. Effects of linoleic acid on sweet, sour, salty, and bitter taste thresholds and intensity ratings of adults.

    PubMed

    Mattes, Richard D

    2007-05-01

    Evidence supporting a taste component for dietary fat has prompted study of plausible transduction mechanisms. One hypothesizes that long-chain, unsaturated fatty acids block selected delayed-rectifying potassium channels, resulting in a sensitization of taste receptor cells to stimulation by other taste compounds. This was tested in 17 male and 17 female adult (mean +/- SE age = 23.4 +/- 0.7 yr) propylthiouracil tasters with normal resting triglyceride concentrations (87.3 +/- 5.6 mg/day) and body mass index (23.3 +/- 0.4 kg/m(2)). Participants were tested during two approximately 30-min test sessions per week for 8 wk. Eight stimuli were assessed in duplicate via an ascending, three-alternative, forced-choice procedure. Qualities were randomized over weeks. Stimuli were presented as room-temperature, 5-ml portions. They included 1% solutions of linoleic acid with added sodium chloride (salty), sucrose (sweet), citric acid (sour), and caffeine (bitter) as well as solutions of these taste compounds alone. Participants also rated the intensity of the five strongest concentrations using the general labeled magnitude scale. The suprathreshold samples were presented in random order with a rinse between each. Subjects made the ratings self-paced while wearing nose clips. It was hypothesized that taste thresholds would be lower and absolute intensity ratings or slopes of intensity functions would be higher for the stimuli mixed with the linoleic acid. Thresholds were compared by paired t-tests and intensity ratings by repeated measures analysis of variance. Thresholds were significantly higher (i.e., lower sensitivity) for the sodium chloride, citric acid, and caffeine solutions with added fatty acid. Sweet, sour, and salty intensity ratings were lower or unchanged by the addition of a fatty acid. The two highest concentrations of caffeine were rated as weaker in the presence of linoleic acid. These data do not support a mechanism for detecting dietary fats whereby fatty

  14. Cord Blood Transplantation Following Reduced-intensity Conditioning for Adult-onset Inherited Hemophagocytic Lymphohistiocytosis.

    PubMed

    Kuriyama, Takuro; Kato, Koji; Sakamoto, Keiji; Hayashi, Masayasu; Takashima, Shuichiro; Mori, Yasuo; Takenaka, Katsuto; Iwasaki, Hiromi; Teshima, Takanori; Harada, Naoki; Nagafuji, Koji; Miyamoto, Toshihiro; Akashi, Koichi

    2016-01-01

    Inherited hemophagocytic lymphohistiocytosis (HLH) is a genetic anomaly disorder in which abnormally activated cytotoxic T lymphocytes cannot induce the apoptosis of target cells and antigen-presenting cells, leading to hemophagocytosis, pancytopenia, and a variety of symptoms such as a high fever. The present patient with adult-onset HLH developed refractory disease despite receiving immunosuppressive treatments. He underwent a reduced-intensity conditioning (RIC) regimen that comprised antithymocyte globulin (ATG) followed by cord blood transplantation (RIC-CBT). He achieved and maintained a complete donor type. The incorporation of ATG into RIC-CBT may prevent graft failure and control hemophagocytosis, however, further efforts are necessary to reduce infectious complications. PMID:26984088

  15. [Can new technologies reduce the rate of medications errors in adult intensive care?].

    PubMed

    Benoit, E; Beney, J

    2011-09-01

    In the intensive care environment, technology is omnipresent to ensure the monitoring and the administration of critical drugs to unstable patients. Since the early 2000's computerized physician order entry (CPOE), bar code assisted medication administration (BCMA), "smart" infusion pumps (SIP), electronic medication administration record (eMAR) and automated dispensing systems (ADS) have been recommended to reduce medication errors. About ten years later, their implementation rises but remains modest. The objective of this study is to determine the impact of these technologies on the rate of medication errors (ME) in adult intensive care. CPOE allows a strong and significant reduction of ME, especially the least critical ones. Only when adding a clinical decision support system (CDSS), CPOE could allow a reduction of serious errors. Used alone, it could even increase them. The available studies do not have the sufficient power to demonstrate the benefits of SIP or BCMA on ME. However, these devices, reveal practices, such as overriding of alerts. Power or methodology problems and conflicting results do not allow to determine the ability of ADS to reduce the incidence of ME in the intensive care. The studies, investigating these technologies, are not very recent, of limited number and present lacks in their methodology, which does not allow to determine whether they can reduce the incidence of MEs in the adult intensive care. Currently, the benefits appear to be limited which may be explained by the complexity of their integration into the care process. Special attention should be given to the communication between caregivers, the human-computer interface and the caregivers' training.

  16. Beyond pleasure and pain: Facial expression ambiguity in adults and children during intense situations.

    PubMed

    Wenzler, Sofia; Levine, Sarah; van Dick, Rolf; Oertel-Knöchel, Viola; Aviezer, Hillel

    2016-09-01

    According to psychological models as well as common intuition, intense positive and negative situations evoke highly distinct emotional expressions. Nevertheless, recent work has shown that when judging isolated faces, the affective valence of winning and losing professional tennis players is hard to differentiate. However, expressions produced by professional athletes during publicly broadcasted sports events may be strategically controlled. To shed light on this matter we examined if ordinary people's spontaneous facial expressions evoked during highly intense situations are diagnostic for the situational valence. In Experiment 1 we compared reactions with highly intense positive situations (surprise soldier reunions) versus highly intense negative situations (terror attacks). In Experiment 2, we turned to children and compared facial reactions with highly positive situations (e.g., a child receiving a surprise trip to Disneyland) versus highly negative situations (e.g., a child discovering her parents ate up all her Halloween candy). The results demonstrate that facial expressions of both adults and children are often not diagnostic for the valence of the situation. These findings demonstrate the ambiguity of extreme facial expressions and highlight the importance of context in everyday emotion perception. (PsycINFO Database Record

  17. Beyond pleasure and pain: Facial expression ambiguity in adults and children during intense situations.

    PubMed

    Wenzler, Sofia; Levine, Sarah; van Dick, Rolf; Oertel-Knöchel, Viola; Aviezer, Hillel

    2016-09-01

    According to psychological models as well as common intuition, intense positive and negative situations evoke highly distinct emotional expressions. Nevertheless, recent work has shown that when judging isolated faces, the affective valence of winning and losing professional tennis players is hard to differentiate. However, expressions produced by professional athletes during publicly broadcasted sports events may be strategically controlled. To shed light on this matter we examined if ordinary people's spontaneous facial expressions evoked during highly intense situations are diagnostic for the situational valence. In Experiment 1 we compared reactions with highly intense positive situations (surprise soldier reunions) versus highly intense negative situations (terror attacks). In Experiment 2, we turned to children and compared facial reactions with highly positive situations (e.g., a child receiving a surprise trip to Disneyland) versus highly negative situations (e.g., a child discovering her parents ate up all her Halloween candy). The results demonstrate that facial expressions of both adults and children are often not diagnostic for the valence of the situation. These findings demonstrate the ambiguity of extreme facial expressions and highlight the importance of context in everyday emotion perception. (PsycINFO Database Record PMID:27337681

  18. 20 CFR 416.920 - Evaluation of disability of adults, in general.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Evaluation of disability of adults, in general. 416.920 Section 416.920 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY... § 416.920 Evaluation of disability of adults, in general. (a) General—(1) Purpose of this section....

  19. 20 CFR 416.920 - Evaluation of disability of adults, in general.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Evaluation of disability of adults, in general. 416.920 Section 416.920 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY... § 416.920 Evaluation of disability of adults, in general. (a) General—(1) Purpose of this section....

  20. 20 CFR 416.920 - Evaluation of disability of adults, in general.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Evaluation of disability of adults, in general. 416.920 Section 416.920 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY... § 416.920 Evaluation of disability of adults, in general. (a) General—(1) Purpose of this section....

  1. 20 CFR 416.920 - Evaluation of disability of adults, in general.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evaluation of disability of adults, in general. 416.920 Section 416.920 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY... § 416.920 Evaluation of disability of adults, in general. (a) General—(1) Purpose of this section....

  2. The M-Integral for Computing Stress Intensity Factors in Generally Anisotropic Materials

    NASA Technical Reports Server (NTRS)

    Warzynek, P. A.; Carter, B. J.; Banks-Sills, L.

    2005-01-01

    The objective of this project is to develop and demonstrate a capability for computing stress intensity factors in generally anisotropic materials. These objectives have been met. The primary deliverable of this project is this report and the information it contains. In addition, we have delivered the source code for a subroutine that will compute stress intensity factors for anisotropic materials encoded in both the C and Python programming languages and made available a version of the FRANC3D program that incorporates this subroutine. Single crystal super alloys are commonly used for components in the hot sections of contemporary jet and rocket engines. Because these components have a uniform atomic lattice orientation throughout, they exhibit anisotropic material behavior. This means that stress intensity solutions developed for isotropic materials are not appropriate for the analysis of crack growth in these materials. Until now, a general numerical technique did not exist for computing stress intensity factors of cracks in anisotropic materials and cubic materials in particular. Such a capability was developed during the project and is described and demonstrated herein.

  3. Effects of Exercise Intensity on Postprandial Improvement in Glucose Disposal and Insulin Sensitivity in Prediabetic Adults

    PubMed Central

    Rynders, Corey A.; Weltman, Judy Y.; Jiang, Boyi; Breton, Marc; Patrie, James; Barrett, Eugene J.

    2014-01-01

    Background: A single bout of exercise improves postprandial glycemia and insulin sensitivity in prediabetic patients; however, the impact of exercise intensity is not well understood. The present study compared the effects of acute isocaloric moderate (MIE) and high-intensity (HIE) exercise on glucose disposal and insulin sensitivity in prediabetic adults. Methods: Subjects (n = 18; age 49 ± 14 y; fasting glucose 105 ± 11 mg/dL; 2 h glucose 170 ± 32 mg/dL) completed a peak O2 consumption/lactate threshold (LT) protocol plus three randomly assigned conditions: 1) control, 1 hour of seated rest, 2) MIE (at LT), and 3) HIE (75% of difference between LT and peak O2 consumption). One hour after exercise, subjects received an oral glucose tolerance test (OGTT). Plasma glucose, insulin, and C-peptide concentrations were sampled at 5- to 10-minute intervals at baseline, during exercise, after exercise, and for 3 hours after glucose ingestion. Total, early-phase, and late-phase area under the glucose and insulin response curves were compared between conditions. Indices of insulin sensitivity (SI) were derived from OGTT data using the oral minimal model. Results: Compared with control, SI improved by 51% (P = .02) and 85% (P < .001) on the MIE and HIE days, respectively. No differences in SI were observed between the exercise conditions (P = .62). Improvements in SI corresponded to significant reductions in the glucose, insulin, and C-peptide area under the curve values during the late phase of the OGTT after HIE (P < .05), with only a trend for reductions after MIE. Conclusion: These results suggest that in prediabetic adults, acute exercise has an immediate and intensity-dependent effect on improving postprandial glycemia and insulin sensitivity. PMID:24243632

  4. The Effects of Intensive Nutrition Education on Late Middle-Aged Adults with Type 2 Diabetes

    PubMed Central

    Li, Ye; Xu, Meihong; Fan, Rui; Ma, Xiaotao; Gu, Jiaojiao; Cai, Xiaxia; Liu, Rui; Chen, Qihe; Ren, Jinwei; Mao, Ruixue; Bao, Lei; Zhang, Zhaofeng; Wang, Junbo; Li, Yong

    2016-01-01

    no statistical significance between groups. Conclusions: Intensive nutrition education has significant effects on blood glucose control in late middle-aged adults with type 2 diabetes. Intensive education can cultivate good diet habits and increase physical activity, which are important for diabetes patients in the short and long terms. These findings may contribute to improving education methodology and nutrition therapy in patients with type 2 diabetes. PMID:27618080

  5. Sex difference in substrate oxidation during low-intensity isometric exercise in young adults.

    PubMed

    Sarafian, Delphine; Schutz, Yves; Montani, Jean-Pierre; Dulloo, Abdul G; Miles-Chan, Jennifer L

    2016-09-01

    Low-intensity physical activity is increasingly promoted as an alternative to sedentary behavior. However, much research to date has focused on moderate- to vigorous-intensity physical activity, and in particular dynamic work, with the effect of low-intensity isometric exercise (<4 METs) on substrate utilization yet to be explored. Here we investigate the effects of such exercise on respiratory quotient (RQ) and determine the extent of intra- and inter-individual variability in response. Energy expenditure, RQ, and substrate oxidation were measured by ventilated-hood indirect calorimetry at rest and in response to standardized, intermittent, low-level isometric leg-press exercises at 5 loads (+5, +10, +15, +20, +25 kg) in 26 healthy, young adults. Nine participants repeated the experiment on 3 separate days to assess within-subject, between-day variability. There was no significant difference in energy cost and heart rate responses to low-intensity isometric exercise (<2 METs) between men and women. However, a sex difference was apparent in terms of substrate oxidation - with men increasing both fat and carbohydrate oxidation, and women only increasing fat oxidation while maintaining carbohydrate oxidation at baseline, resting levels. This sex difference was repeatable and persisted when substrate oxidation was adjusted for differences in body weight or body composition. Individual variability in RQ was relatively low, with both intra- and inter-individual coefficients of variation in the range of 3%-6% in both sexes. These results suggest that women preferentially increase fat oxidation during low-level isometric exercise. Whether such physical activity could be incorporated into treatment/prevention strategies aimed at optimizing fat oxidation in women warrants further investigation.

  6. Sex difference in substrate oxidation during low-intensity isometric exercise in young adults.

    PubMed

    Sarafian, Delphine; Schutz, Yves; Montani, Jean-Pierre; Dulloo, Abdul G; Miles-Chan, Jennifer L

    2016-09-01

    Low-intensity physical activity is increasingly promoted as an alternative to sedentary behavior. However, much research to date has focused on moderate- to vigorous-intensity physical activity, and in particular dynamic work, with the effect of low-intensity isometric exercise (<4 METs) on substrate utilization yet to be explored. Here we investigate the effects of such exercise on respiratory quotient (RQ) and determine the extent of intra- and inter-individual variability in response. Energy expenditure, RQ, and substrate oxidation were measured by ventilated-hood indirect calorimetry at rest and in response to standardized, intermittent, low-level isometric leg-press exercises at 5 loads (+5, +10, +15, +20, +25 kg) in 26 healthy, young adults. Nine participants repeated the experiment on 3 separate days to assess within-subject, between-day variability. There was no significant difference in energy cost and heart rate responses to low-intensity isometric exercise (<2 METs) between men and women. However, a sex difference was apparent in terms of substrate oxidation - with men increasing both fat and carbohydrate oxidation, and women only increasing fat oxidation while maintaining carbohydrate oxidation at baseline, resting levels. This sex difference was repeatable and persisted when substrate oxidation was adjusted for differences in body weight or body composition. Individual variability in RQ was relatively low, with both intra- and inter-individual coefficients of variation in the range of 3%-6% in both sexes. These results suggest that women preferentially increase fat oxidation during low-level isometric exercise. Whether such physical activity could be incorporated into treatment/prevention strategies aimed at optimizing fat oxidation in women warrants further investigation. PMID:27540628

  7. Intensity of bouted and sporadic physical activity and the metabolic syndrome in adults

    PubMed Central

    Robson, Jordan

    2015-01-01

    Background. Physical activity guidelines for adults only recognize the health benefits of accumulating bouted moderate-to-vigorous physical activity (MVPA), or MVPA occurring over at least 10 consecutive minutes. There is a lack of evidence supporting the health benefits of other patterns and intensities of activity including sporadic MVPA (i.e., MVPA occurring in periods of fewer than 10 consecutive minutes) and light intensity physical activity (LIPA). The objective of this study was to examine the health benefits associated with physical activity that does not meet the physical activity guidelines criteria for bouted MVPA. Specifically, we examined the association between sporadic MVPA and bouted and sporadic LIPA with the metabolic syndrome. Methods. We studied a representative cross-sectional sample of 1,974 adults aged 20 years and older from the 2003–2006 US National Health and Nutrition Examination Survey. Physical activity was measured over 7 days using Actigraph AM-7164 accelerometers. Each minute over the 7-day measurement period was classified as being of a sedentary, light, or moderate-to-vigorous intensity. A 10 min threshold differentiated bouted activity from sporadic activity. Average minutes/day of sporadic LIPA, sporadic MVPA, bouted LIPA, bouted MVPA, and embedded MVPA (MVPA occurring within bouts of primarily LIPA) were calculated. Metabolic syndrome status was determined using established criteria. Associations were examined using logistic regression and controlled for relevant covariates. Results. For every 30 min/day of physical activity, the odds ratio (95% confidence interval) of the metabolic syndrome was reduced by 4% (1–7%) for bouted LIPA, 64% (51–71%) for bouted MVPA, and 57% (45–67%) for embedded MVPA. Sporadic LIPA was not independently associated with the metabolic syndrome. We could not examine the association between sporadic MVPA and the metabolic syndrome because participants accumulated such a marginal amount of this

  8. Body Pain Intensity and Interference in Adults (45–53 Years Old): A Cross-Sectional Survey in Chongqing, China

    PubMed Central

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05). Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help

  9. Body Pain Intensity and Interference in Adults (45-53 Years Old): A Cross-Sectional Survey in Chongqing, China.

    PubMed

    Xu, Xianglong; Li, Bing; Liu, Lingli; Zhao, Yong

    2016-01-01

    Culture and national care models matter both in reporting and treatment of pain status. However, most findings on body pain intensity and interference in adults are from Western studies, with little reliable evidence from China. This study aimed to assess body pain intensity and interference and its associations with demographic, socioeconomic characteristics, and health behaviors in adults. A cross-sectional survey was performed to collect data from 1224 adults, who were recruited via multistage stratified random sampling. The SF-36 quality-of-life instrument was used to investigate body pain intensity and interference. Ordinal logistic regression analysis was used in this study. Our results showed that 64.1% of the participants (males: 687; females: 537) reported body pain, and 45.7% of the participants reported body pain interference. Middle-aged respondents who were female, were unmarried/divorced or separated/widowed, had a negative relationship with their family, had poor sleep quality, and were not satisfied with their current living conditions had a higher body pain intensity rating (ordered logistic regression/six-level pain intensity criterion; odds ratios, p < 0.05). Respondents who were unmarried/divorced or separated/widowed, with a low education level, were unemployed, had lower incomes, had a negative relationship with their family, and were not satisfied with their current living conditions had a higher body pain interference rating (ordered logistic regression/five-level pain interference criterion; odds ratios, p < 0.05). In conclusion, an estimated 64.1% of middle-aged adults reported body pain, and 45.7% of middle-aged adults reported body pain interference. These results provide a clue for possible interventions for improving body pain intensity and interference in adults, especially among middle-aged people. These factors should be taken into consideration in the prevention of pain, pain management and treatment planning in order to help

  10. High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.

    PubMed

    Shah, Manish N; Gillespie, Suzanne M; Wood, Nancy; Wasserman, Erin B; Nelson, Dallas L; Dozier, Ann; McConnochie, Kenneth M

    2013-11-01

    Accessing timely acute medical care is a challenge for older adults. This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. This program, based in a primary care geriatrics practice that cares for SLC residents, is designed to offer acute care through telemedicine for complaints that are felt to need attention before the next available outpatient visit but not to require emergency department (ED) resources. This option gives residents access to care in their residence. Measures used to evaluate the program include successful completion of telemedicine visits, satisfaction of residents and caregivers with telemedicine care, and site of care that would have been recommended had telemedicine been unavailable. During the first 2 years of the program's operation, 281 of 301 requested telemedicine visits were completed successfully. Twelve residents were sent to an ED for care after the telemedicine visit. Ninety-four percent of residents reported being satisfied or very satisfied with telemedicine care. Had telemedicine not been available, residents would have been sent to an ED (48.1%) or urgent care center (27.0%) or been scheduled for an outpatient visit (24.4%). The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use. Continuation of the program will require evaluation demonstrating equal or better resident-level outcomes and the development of sustainable business models.

  11. Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

    PubMed

    Jurewicz, Izabela

    2015-04-01

    In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults.

  12. Continuous Exercise but Not High Intensity Interval Training Improves Fat Distribution in Overweight Adults

    PubMed Central

    Keating, Shelley E.; Machan, Elizabeth A.; O'Connor, Helen T.; Gerofi, James A.; Sainsbury, Amanda; Caterson, Ian D.; Johnson, Nathan A.

    2014-01-01

    Objective. The purpose of this study was to assess the effect of high intensity interval training (HIIT) versus continuous aerobic exercise training (CONT) or placebo (PLA) on body composition by randomized controlled design. Methods. Work capacity and body composition (dual-energy X-ray absorptiometry) were measured before and after 12 weeks of intervention in 38 previously inactive overweight adults. Results. There was a significant group × time interaction for change in work capacity (P < 0.001), which increased significantly in CONT (23.8 ± 3.0%) and HIIT (22.3 ± 3.5%) but not PLA (3.1 ± 5.0%). There was a near-significant main effect for percentage trunk fat, with trunk fat reducing in CONT by 3.1 ± 1.6% and in PLA by 1.1 ± 0.4%, but not in HIIT (increase of 0.7 ± 1.0%) (P = 0.07). There was a significant reduction in android fat percentage in CONT (2.7 ± 1.3%) and PLA (1.4 ± 0.8%) but not HIIT (increase of 0.8 ± 0.7%) (P = 0.04). Conclusion. These data suggest that HIIT may be advocated as a time-efficient strategy for eliciting comparable fitness benefits to traditional continuous exercise in inactive, overweight adults. However, in this population HIIT does not confer the same benefit to body fat levels as continuous exercise training. PMID:24669314

  13. A Survey of Rounding Practices in Canadian Adult Intensive Care Units

    PubMed Central

    Holodinsky, Jessalyn K.; Hebert, Marilynne A.; Zygun, David A.; Rigal, Romain; Berthelot, Simon; Cook, Deborah J.; Stelfox, Henry T.

    2015-01-01

    Objective To describe rounding practices in Canadian adult Intensive Care Units (ICU) and identify opportunities for improvement. Design Mixed methods design. Cross sectional survey of Canadian Adult ICUs (n = 180) with purposefully sampled follow-up interviews (n = 7). Measurements and Main Results Medical directors representing 111 ICUs (62%) participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds (81%) that employed an open (94%) and collaborative (86%) approach, occurred at the patient’s bedside (82%), and started at a standard time (79%) and standard location (56%). Most participants reported that patients (83%) and family members (67%) were welcome to attend rounds. Approximately half of ICUs (48%) used tools to facilitate rounds. Interruptions during rounds were reported to be common (i.e., ≥1 interruption for ≥50% of patients) in 46% of ICUs. Four themes were identified from qualitative analysis of participant responses to open-ended survey questions and interviews: multidisciplinarity, patient and family involvement, factors influencing productivity, and teaching and learning. Conclusions There is considerable variation in current rounding practices in Canadian medical/surgical ICUs. Opportunities exist to improve ICU rounds including ensuring the engagement of essential participants, clearly defining participant roles, establishing a standardized approach to the rounding process, minimizing interruptions, modifying the role of teaching, utilizing a structured rounding tool, and developing a metric for measuring rounding quality. PMID:26700860

  14. General Education Development (GED®) Credential Attainment, Externalizing Disorders, and Substance Use Disorders in Disconnected Emerging Adults

    ERIC Educational Resources Information Center

    Bergman, Andrea; Kong, Grace; Pope, Alice

    2014-01-01

    There are many benefits for emerging adults, both financial and personal, in obtaining a General Education Development (GED®) credential (Ou, 2008). However, little is known about the correlates of GED® credential attainment in "disconnected" emerging adults attending GED® programs. Our goal was to examine whether externalizing…

  15. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  16. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  17. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  18. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  19. Prevalence of Chronic Medical Conditions in Adults with Mental Retardation: Comparison with the General Population.

    ERIC Educational Resources Information Center

    Kapell, Deborah; Nightingale, Beryle; Rodriguez, Ana; Lee, Joseph H.; Zigman, Warren B.; Schupf, Nicole

    1998-01-01

    A study interviewed caregivers and reviewed medical records of 278 adults with mental retardation with and without Down syndrome. The adults with mental retardation had age-related disorders comparable to those in the general population, but there was an increased frequency of thyroid disorders, nonischemic heart disorders, and sensory impairment.…

  20. General intensive care for patients with traumatic brain injury: An update

    PubMed Central

    Chowdhury, Tumul; Kowalski, Stephen; Arabi, Yaseen; Dash, Hari Hara

    2014-01-01

    Background: Traumatic brain injury (TBI) is a growing epidemic throughout the world and may present as major global burden in 2020. Some intensive care units throughout the world still have no access to specialized monitoring methods, equipments and other technologies related to intensive care management of these patients; therefore, this review is meant for providing generalized supportive measurement to this subgroup of patients so that evidence based management could minimize or prevent the secondary brain injury. Methods: Therefore, we have included the PubMed search for the relevant clinical trials and reviews (from 1 January 2007 to 31 March 2013), which specifically discussed about the topic. Results: General supportive measures are equally important to prevent and minimize the effects of secondary brain injury and therefore, have a substantial impact on the outcome in patients with TBI. The important considerations for general supportive intensive care unit care remain the prompt reorganization and treatment of hypoxemia, hypotension and hypercarbia. Evidences are found to be either against or weak regarding the use of routine hyperventilation therapy, tight control blood sugar regime, use of colloids and late as well as parenteral nutrition therapy in patients with severe TBI. Conclusion: There is also a need to develop some evidence based protocols for the health-care sectors, in which there is still lack of specific management related to monitoring methods, equipments and other technical resources. Optimization of physiological parameters, understanding of basic neurocritical care knowledge as well as incorporation of newer guidelines would certainly improve the outcome of the TBI patients. PMID:24843343

  1. Drug incompatibilities in the adult intensive care unit of a university hospital

    PubMed Central

    Marsilio, Naiane Roveda; da Silva, Daiandy; Bueno, Denise

    2016-01-01

    Objectives This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs. Methods This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system. A pharmaceutical intervention was performed using the guidelines on the preparation and administration of incompatible drugs. Adherence to those guidelines was subsequently assessed among the nursing staff. Results A total of 100 prescriptions were analyzed; 68 were incompatible with the intravenous drugs prescribed. A total of 271 drug incompatibilities were found, averaging 4.0 ± 3.3 incompatibilities per prescription. The most commonly found drug incompatibilities were between midazolam and hydrocortisone (8.9%), between cefepime and midazolam (5.2%), and between hydrocortisone and vancomycin (5.2%). The drugs most commonly involved in incompatibilities were midazolam, hydrocortisone, and vancomycin. The most common incompatibilities occurred when a drug was administered via continuous infusion and another was administered intermittently (50%). Of the 68 prescriptions that led to pharmaceutical guidelines, 45 (66.2%) were fully adhered to by the nursing staff. Conclusion Patients under intensive care were subjected to a high rate of incompatibilities. Drug incompatibilities can be identified and eliminated by the pharmacist on the multidisciplinary team, thereby reducing undesirable effects among patients. PMID:27410410

  2. UNUSUAL PRESENTATION OF GENERALIZED MACULAR AMYLOIDOSIS IN A YOUNG ADULT

    PubMed Central

    Kudur, Mohan H; B, Sathish Pai; H, Sripathi; Prabhu, Smitha

    2008-01-01

    Macular amyloidosis is a common problem seen dermatology out-patient department. Generalized macular amyloidosis presenting with a poikilodermatous appearance is rare. In our case, an 18-year-old male presented with generalized hypopigmented macules with a poikilodermatous appearance of 10-year duration. His developmental milestones were normal with negative family history of similar complaints. Histopathology of hyperpigmented lesions revealed hyperkeratosis and acanthosis of epidermis and hypopigmented lesion showing only hyperkeratosis. Both lesions were showing the deposition of amorphous, hazy material in the tips of papillary dermis with perivascular inflammatory infiltrate. Congo red staining of the amorphous material was positive for amyloid. PMID:19882037

  3. General Welfare Assistance: Barriers to Mentally Disabled Homeless Adults.

    ERIC Educational Resources Information Center

    Robertson, Marjorie J.

    The present study describes specific conditions which are thought to interfere with application for general welfare assistance by homeless persons with mental disabilities. This report summarizes the observations and recommendations of direct-service providers who serve the target population in the Skid Row area of Los Angeles. In-depth structured…

  4. Application of Jean Piaget's theory of human development for nursing children in an adult intensive therapy unit.

    PubMed

    Green, A

    1991-12-01

    Piaget (1964) believed that interaction with the environment has a large part to play in human development. Matthew (1986) states that in an ideal world critically ill children should be cared for by staff trained in paediatrics, within designated paediatric intensive therapy units. Unfortunately, there are only 28 paediatric intensive therapy units in Great Britain (CMA Medical Data, 1987), consequently each year a third of children requiring intensive care are admitted to adult intensive therapy units (ITU). A knowledge and understanding of developmental psychology can therefore be beneficial to nurses in assessing which stage of development a child has reached, in order to plan the correct level of stimulation, and hence facilitate progress rather than regression in the accomplishment of developmental tasks. The psychological and social processes involved in Jean Piaget's (1896-1980) theory of human development are discussed with regard to nursing children requiring intubation and ventilation in an adult ITU.

  5. Application of Jean Piaget's theory of human development for nursing children in an adult intensive therapy unit.

    PubMed

    Green, A

    1991-12-01

    Piaget (1964) believed that interaction with the environment has a large part to play in human development. Matthew (1986) states that in an ideal world critically ill children should be cared for by staff trained in paediatrics, within designated paediatric intensive therapy units. Unfortunately, there are only 28 paediatric intensive therapy units in Great Britain (CMA Medical Data, 1987), consequently each year a third of children requiring intensive care are admitted to adult intensive therapy units (ITU). A knowledge and understanding of developmental psychology can therefore be beneficial to nurses in assessing which stage of development a child has reached, in order to plan the correct level of stimulation, and hence facilitate progress rather than regression in the accomplishment of developmental tasks. The psychological and social processes involved in Jean Piaget's (1896-1980) theory of human development are discussed with regard to nursing children requiring intubation and ventilation in an adult ITU. PMID:1765639

  6. How to Study the Influence of Intensity of Treatment on Generalized Skill and Knowledge Acquisition in Students with Disabilities

    PubMed Central

    Yoder, Paul J.; Woynaroski, Tiffany

    2014-01-01

    Seven empirical studies from this special issue and an overview chapter are reviewed to illustrate several points about studying the possible effects of treatment intensity manipulations on generalized skill or knowledge acquisition in students with disabilities. First, we make a case in favor of studying intensity as separate from complexity and expense of treatment. Second, we encourage researchers to define dependent variables in a way that allows us to determine whether treatment intensity effects on child skills and knowledge are highly generalized versus potentially context bound. Third, we acknowledge that effects of treatment intensity on generalized knowledge and skills likely vary according to student characteristics. Finally, we discuss important research design and measurement issues that are relevant to isolating the likely conditional effects of treatment intensity on generalized outcomes. PMID:25914513

  7. Measuring the effectiveness of an intensive IPV training program offered to Greek general practitioners and residents of general practice

    PubMed Central

    2013-01-01

    Background The need for effective training of primary care physicians in the prevention, detection and handling of intimate partner violence (IPV) has been widely acknowledged, given its frequency in daily practice. The current intervention study aimed to measure changes in the actual IPV knowledge, perceived knowledge, perceived preparedness and detection ability of practicing general practitioners (GPs) and general practice residents, following an intensive IPV training program. Methods A pre/post-test design with a control group was employed to compare changes in baseline measures of IPV at the post intervention stage and at 12 months. A total of 40 participants provided full data; 25 GPs (11 in the intervention and 14 in the control) and 15 residents (intervention only). Three scales of the PREMIS survey were used to draw information on the study outcomes. Results The training program met high acceptance by both groups of participants and high practicality in clinical practice. The GPs in the intervention group performed better than the GPs in the control group on “Perceived preparedness” and “Perceived knowledge” in both the post-intervention (p = .012, r = .50 and p = .001, r = .68) and the 12-month follow-up (p = .024, r = .45 and p = .007, r = .54) as well as better than the residents in “Perceived preparedness” at post-intervention level (p = .037, r = .41). Residents on the other hand, performed better than the GPs in the intervention group on “Actual knowledge” at the 12-month follow-up (p = .012, r = .49). No significant improvements or between group differences were found in terms of the self-reported detection of IPV cases. Conclusion Further studies are needed to decide whether residency training could serve as an early intervention stage for IPV training. PMID:23537186

  8. Complications and benefits of intrahospital transport of adult Intensive Care Unit patients

    PubMed Central

    Harish, M. M.; Janarthanan, S.; Siddiqui, Suhail Sarwar; Chaudhary, Harish K.; Prabu, Natesh R.; Divatia, Jigeeshu V.; Kulkarni, Atul Prabhakar

    2016-01-01

    Background: The transport of critically ill patients for procedures or tests outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. Plenty of data is available on pre- and inter-hospital transport of patients; the data on intrahospital transport of patients are limited. We audited the complications and benefits of intrahospital transport of critically ill patients in our tertiary care center over 6 months. Materials and Methods: One hundred and twenty adult critically ill cancer patients transported from the ICU for either diagnostic or therapeutic procedure over 6 months were included. The data collected include the destination, the accompanying person, total time spent outside the ICU, and any adverse events and adverse change in vitals. Results: Among the 120 adult patients, 5 (4.1%) required endotracheal intubation, 5 (4.1%) required intercostal drain placement, and 20 (16.7%) required cardiopulmonary resuscitation (CPR). Dislodgement of central venous catheter occurred in 2 (1.6%) patients, drain came out in 3 (2.5%) patients, orogastric tube came out in 1 (0.8%) patient, 2 (1.6%) patients self-extubated, and in one patient, tracheostomy tube was dislodged. The adverse events were more in patients who spent more than 60 min outside the ICU, particularly requirement of CPR (18 [25%] vs. 2 [4.2%], ≤60 min vs. >60 min, respectively) with P < 0.05. Transport led to change in therapy in 32 (26.7%) patients. Conclusion: Transport in critically ill cancer patients is more hazardous and needs adequate pretransport preparations. Transport in spite being hazardous may lead to a beneficial change in therapy in a significant number of patients. PMID:27630455

  9. Predictors of reintegration to normal living in older adults discharged from an intensive rehabilitation program.

    PubMed

    Bourdeau, Isabelle; Desrosiers, Johanne; Gosselin, Suzanne

    2008-12-01

    The objective of this study was to explore which of many personal and environmental variables are the best predictors of reintegration to normal living in older adults discharged from an inpatient rehabilitation unit. A few days before discharge from rehabilitation, more than 15 biopsychosocial characteristics of 94 people over 60 years were evaluated with reliable and valid tests. The participants' reintegration to normal living was evaluated 3 months later (n=86) with the reintegration to normal living index. This questionnaire comprises 11 items covering physical, social, and psychological dimensions of daily living. From multivariate regression analyses, functional independence, balance, grip strength, and general well-being are the best predictors and explain 26 and 27% of the variance in reintegration to normal living. This study suggests that by increasing efforts to maximize functional independence, balance, grip strength, and well-being, rehabilitation professionals can expect older adults to achieve a greater degree of reintegration in their activities and social roles and may contribute to their quality of life. PMID:19008674

  10. Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units

    PubMed Central

    Larsson, Mattias; Nadjm, Behzad; Dinh, Quynh-Dao; Nilsson, Lennart E.; Rydell, Ulf; Le, Tuyet Thi Diem; Trinh, Son Hong; Pham, Hung Minh; Tran, Cang Thanh; Doan, Hanh Thi Hong; Tran, Nguyen Thua; Le, Nhan Duc; Huynh, Nhuan Van; Tran, Thao Phuong; Tran, Bao Duc; Nguyen, Son Truong; Pham, Thao Thi Ngoc; Dang, Tam Quang; Nguyen, Chau Van Vinh; Lam, Yen Minh; Thwaites, Guy; Van Nguyen, Kinh; Hanberger, Hakan

    2016-01-01

    Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. PMID:26824228

  11. Impact of the Protection and Advocacy Subscale on the Factorial Validity of the Supports Intensity Scale-Adult Version.

    PubMed

    Shogren, Karrie A; Seo, Hyojeong; Wehmeyer, Michael L; Thompson, James R; Little, Todd D

    2016-01-01

    The Supports Intensity Scale-Adult Version is a standardized assessment of support needs. This study examined the factorial validity of the standardized portion of the scale, finding that the six-factor model (Home Living, Community Living, Lifelong Learning, Employment, Health and Safety, Social Activities) demonstrated good fit, and that the inclusion of the Protection and Advocacy Scale did not affect fit and contributed unique information. Age and gender impacted intensity of support needs, with those of transition age and in late adulthood having the highest intensities. Gender also impacted support needs, but in fewer instances. Implications for future research are discussed. PMID:26701074

  12. Low Intensive Lifestyle Modification in Young Adults With Metabolic Syndrome A Community-Based Interventional Study in Taiwan

    PubMed Central

    Liu, Yi-Lien; Lu, Chia-Wen; Shi, Leiyu; Liou, Yiing-Mei; Lee, Long-Teng; Huang, Kuo-Chin

    2015-01-01

    Abstract The study aims to find whether a low intensity lifestyle modification (LILM) program was effective to achieve weight reduction and improves metabolic syndrome in young adults. Our study prospectively enrolled young adults aged 30 to 45 years with metabolic syndrome in northeastern Taiwan from June 1, 2008 to December 31, 2009. The participants in the intervention group attended a LILM program for 6 months, which included 4 interactive group discussion sessions and weekly phone contact with volunteer counselors. Participants in the comparison group, however, attended only 1 noninteractive session on diet and physical activity. The main outcomes measured the weight reduction and prevalence of metabolic syndrome in intervention and comparison groups. Generalized estimating equation modeling was used to analyze the effects at baseline, during the study, and postcompletion of the program. Compared with comparison group, the intervention group showed significantly greater reductions in body weight (−2.95 ± 3.52 vs −0.76 ± 2.76 kg, P < 0.0001) and body mass index (−1.03 ± 1.25 vs −0.30 ± 1.16 kg/m2, P < 0.0001). After adjustment for potential confounders, a modest decrease in body weight resulted in a statistically significant 43.32% resolution in the prevalence of metabolic syndrome in the intervention group compared with 33.64% in the comparison group (P < 0.01). The 6-month LILM program is not only effective in weight reduction but also an efficient intervention tool of metabolic syndrome in a community setting. The program with restricted manpower and limited medical resources can be practically transferred into primary care in rural area. PMID:26039125

  13. Little Relation of Adult Age with Cognition after Controlling General Influences

    ERIC Educational Resources Information Center

    Salthouse, Timothy A.

    2016-01-01

    Both general (i.e., shared across different cognitive measures) and specific (i.e., unique to particular cognitive measures) influences can be postulated to contribute to the relations between adult age and measures of cognitive functioning. Estimates of general and specific influences on measures of memory, speed, reasoning, and spatial…

  14. Assess the clinical applicability of transthoracic echocardiography in laparotomy patients in a general intensive care unit

    PubMed Central

    Abbasi, Saeed; Fazel, Kamran; Esfahani, Morteza Abdar; Kashefi, Parviz; Harandi, Samaneh Alami

    2014-01-01

    Background: Echocardiography is one of the diagnostic tools that can be applied at the bedside, along with avoiding transporting critically ill patients. This prospective observational study was designed to assess the clinical applicability of the transthoracic echocardiography (TTE) device by noncardiologist intensivists. Materials and Methods: Intensivists performed a limited TTE examination on critically ill patients admitted to the surgical intensive care unit (ICU). After initial cardiac clinical assessment in 85 critically ill adult patients, a limited TTE was performed by an intensivist to assess left ventricular (LV) function and LV volume status as well as valvular function and qualitative factors. Data were analyzed and presented in proportions using descriptive statistics. The setting was in surgical ICU of an academic medical center. Results: Valvular abnormalities (44.8%) as well as qualitative indices (68.3%) were the most frequently detected abnormalities. The ejection fraction was the only alteration, which was affected by the risk factors (P = 0.05, mean = 55.57). Conclusion: Transthoracic approach can provide useful information on cardiac anatomy and function in most ICU patients along with detecting severe previously unknown conditions in some patients. PMID:25097620

  15. Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population

    PubMed Central

    Hosking, Fay J.; Shah, Sunil M.; Harris, Tess; DeWilde, Stephen; Beighton, Carole; Cook, Derek G.

    2016-01-01

    Objectives. To describe mortality among adults with intellectual disability in England in comparison with the general population. Methods. We conducted a cohort study from 2009 to 2013 using data from 343 general practices. Adults with intellectual disability (n = 16 666; 656 deaths) were compared with age-, gender-, and practice-matched controls (n = 113 562; 1358 deaths). Results. Adults with intellectual disability had higher mortality rates than controls (hazard ratio [HR] = 3.6; 95% confidence interval [CI] = 3.3, 3.9). This risk remained high after adjustment for comorbidity, smoking, and deprivation (HR = 3.1; 95% CI = 2.7, 3.4); it was even higher among adults with intellectual disability and Down syndrome or epilepsy. A total of 37.0% of all deaths among adults with intellectual disability were classified as being amenable to health care intervention, compared with 22.5% in the general population (HR = 5.9; 95% CI = 5.1, 6.8). Conclusions. Mortality among adults with intellectual disability is markedly elevated in comparison with the general population, with more than a third of deaths potentially amenable to health care interventions. This mortality disparity suggests the need to improve access to, and quality of, health care among people with intellectual disability. PMID:27310347

  16. Effects of cannabinoids (marijuana) on taste intensity and hedonic ratings and salivary flow of adults.

    PubMed

    Mattes, R D; Shaw, L M; Engelman, K

    1994-04-01

    Cannabinoids purportedly improve taste responsiveness and enhance the sensory appeal of foods. These properties and a commonly cited oral drying effect were evaluated in a series of studies with 'light' marijuana users. The first was a double-blind, placebo-controlled, acute oral dosing trial, involving an age and gender stratified sample of 57 adults. An influence of route of drug delivery was explored in another 11 individuals who were administered a single dose orally, sublingually and via cigarette. To explore effects following chronic administration, six additional individuals were dosed twice per day for 3 days orally and by rectal suppository. Taste intensity and hedonic responses for sweet, sour, salty and bitter food stimuli were monitored at baseline, 2, 4 and 6 hours post-dosing in the acute studies, and daily in the chronic study. Stimulated saliva samples were collected at these same times. Salivary flow rate was significantly negatively correlated with plasma drug levels, and reported 'high' 2 and 4 h post-dosing. No effects of the drug were observed on taste responses. Self-reported shifts in taste responsiveness and hedonics may be related to alterations of memory and cognition, rather than gustatory function. PMID:8055263

  17. Urinary tract infections in adult general practice patients.

    PubMed Central

    Hummers-Pradier, Eva; Kochen, Michael M

    2002-01-01

    Urinary tract infections (UTIs) are symptomatic infections of the urinary tract, mainly caused by the bacterium Escherichia coli. One in two women suffers from a UTI at least once in her life. The young and sexually active are particulaly affected, but it is also seen in elderly, postmenopausal women. The likelihood of recurrence is high. Diagnosis is made with regard to typical complaints and the presence of leucocytes and nitrites in the urine. A culture is unnecessary in most cases. Uncomplicated UTI should be distinguished from complicated UTI, which has a risk of severe illness. The treatment of choice--short-term therapy with trimethoprim or nitrofurantoin--is successful in over 80% of the cases. Co-trimoxazol fluoroquinolones or cephalsporins are not considered first-choice drugs. There are indications that general practitioners' (GPs') management of UTI is not always optimal, specifically concerning diagnostic tests, the application of second-choice antibiotics, and the length of prescribed treatment courses. Many points relevant to GPs requirefurther research, such as epidemiology and resistance of urinary pathogens in the community and natural history of UTI, as well as optimal management in elderly or complicated patients and men. PMID:12236281

  18. How to Study the Influence of Intensity of Treatment on Generalized Skill and Knowledge Acquisition in Students with Disabilities

    ERIC Educational Resources Information Center

    Yoder, Paul J.; Woynaroski, Tiffany

    2015-01-01

    Seven empirical studies from this special issue and an overview chapter are reviewed to illustrate several points about studying the possible effects of treatment intensity manipulations on generalized skill or knowledge acquisition in students with disabilities. First, we make a case in favor of studying intensity as separate from complexity and…

  19. High-Intensity Interval Training as an Efficacious Alternative to Moderate-Intensity Continuous Training for Adults with Prediabetes

    PubMed Central

    Jung, Mary E.; Bourne, Jessica E.; Beauchamp, Mark R.; Robinson, Emily; Little, Jonathan P.

    2015-01-01

    Aims. High-intensity interval training (HIIT) leads to improvements in various markers of cardiometabolic health but adherence to HIIT following a supervised laboratory intervention has yet to be tested. We compared self-report and objective measures of physical activity after one month of independent exercise in individuals with prediabetes who were randomized to HIIT (n = 15) or traditional moderate-intensity continuous training (MICT, n = 17). Method. After completing 10 sessions of supervised training participants were asked to perform HIIT or MICT three times per week for four weeks. Results. Individuals in HIIT (89 ± 11%) adhered to their prescribed protocol to a greater extent than individuals in MICT (71 ± 31%) as determined by training logs completed over one-month follow-up (P = 0.05, Cohen's d = 0.75). Minutes spent in vigorous physical activity per week measured by accelerometer were higher in HIIT (24 ± 18) as compared to MICT (11 ± 10) at one-month follow-up (P = 0.049, Cohen's d = 0.92). Cardiorespiratory fitness and systolic blood pressure assessed at one-month follow-up were equally improved (P's < 0.05). Conclusions. This study provides preliminary evidence that individuals with prediabetes can adhere to HIIT over the short-term and do so at a level that is greater than MICT. PMID:25918728

  20. E. coli outbreak in a neonate intensive care unit in a general hospital in Mexico City.

    PubMed

    Carrillo-Casas, Erika Margarita; Suástegui-Urquijo, Zaydy; Arroyo-Escalante, Sara; Morales-Espinosa, Rosario; Moncada-Barrón, David; Hernández-Delgado, Lorena; Méndez-Sánchez, José Luis; Delgado-Sapién, Gabriela; Navarro-Ocaña, Armando; Manjarrez-Hernández, Ángel; Xicohtencatl-Cortes, Juan; Hernández-Castro, Rigoberto

    2013-05-01

    Nosocomial infections are a major cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The aim of this paper was to describe an outbreak of Escherichia coli among infants admitted to the NICU of the General Hospital "Dr. Manuel Gea Gonzalez" in May of 2008. The isolated E. coli strains were identified using standard biochemical methods. The susceptibilities of these strains were analysed by determining their minimal inhibitory concentrations. Following this, their molecular relationships to each other were assessed by pulsed field gel electrophoresis (PFGE) analysis and corroborated by serology. Twelve E. coli strains were isolated from blood, urine, or indwelling catheter samples from five cases of preterm infants within a 3-day period. Patients were admitted to the NICU of the general hospital and, during the outbreak, developed sepsis caused by E. coli. For four of the patients, the average age was 23 days, while one patient was a 3-month-old infant. Prior to sepsis, the infants had received assisted ventilation and hyperalimentation through a central venous catheter. Two profiles were observed by PFGE; profile A was identified as the outbreak's cause and an outcome of cross-infection, while profile B showed genetic differences but serologically it was identified as part of the same serotype. We conclude that E. coli colonised the patients through horizontal transmission. A focal source of the microorganism in this outbreak was not identified, but cross-transmission through handling was the most probable route.

  1. Lower survival probabilities for adult Florida manatees in years with intense coastal storms

    USGS Publications Warehouse

    Langtimm, C.A.; Beck, C.A.

    2003-01-01

    The endangered Florida manatee (Trichechus manatus latirostris) inhabits the subtropical waters of the southeastern United States, where hurricanes are a regular occurrence. Using mark-resighting statistical models, we analyzed 19 years of photo-identification data and detected significant annual variation in adult survival for a subpopulation in northwest Florida where human impact is low. That variation coincided with years when intense hurricanes (Category 3 or greater on the Saffir-Simpson Hurricane Scale) and a major winter storm occurred in the northern Gulf of Mexico. Mean survival probability during years with no or low intensity storms was 0.972 (approximate 95% confidence interval = 0.961-0.980) but dropped to 0.936 (0.864-0.971) in 1985 with Hurricanes Elena, Kate, and Juan; to 0.909 (0.837-0.951) in 1993 with the March "Storm of the Century"; and to 0.817 (0.735-0.878) in 1995 with Hurricanes Opal, Erin, and Allison. These drops in survival probability were not catastrophic in magnitude and were detected because of the use of state-of-the-art statistical techniques and the quality of the data. Because individuals of this small population range extensively along the north Gulf coast of Florida, it was possible to resolve storm effects on a regional scale rather than the site-specific local scale common to studies of more sedentary species. This is the first empirical evidence in support of storm effects on manatee survival and suggests a cause-effect relationship. The decreases in survival could be due to direct mortality, indirect mortality, and/or emigration from the region as a consequence of storms. Future impacts to the population by a single catastrophic hurricane, or series of smaller hurricanes, could increase the probability of extinction. With the advent in 1995 of a new 25- to 50-yr cycle of greater hurricane activity, and longer term change possible with global climate change, it becomes all the more important to reduce mortality and injury

  2. Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Worldwide prevalence of generalized anxiety disorder (GAD) is considered high; in Europe lifetime prevalence has been estimated at 4.3 to 5.9%. High levels of anxiety disorders have been reported in university students, affecting 25 to 30% of the population. Young adults are some of the most vulnerable for the onset of mental health disorders and any stressors may act as a catalyst for their onset. The absence of resources can often mean that many do not seek treatment. Other factors that impede access to resources include such things as a lack of trained professionals, personal stigma, and waiting lists. Anxiety disorders can be treated successfully; indeed brief forms of cognitive-behavior therapy have been recommended. One potential avenue for research and development is that of delivering low-intensity interventions online for students with GAD. Therefore, the current study seeks to investigate the potential effectiveness for a low-intensity online CBT-based treatment for GAD in a service-based setting; implemented as one step in a stepped-care model. Methods/Design The research is a service-based effectiveness study utilizing a randomized waiting-list controlled design. The active intervention consists of six weekly modules of online CBT. Participants are assigned a supporter who provides weekly post-session feedback on progress and exercises. Participants will complete the GAD-7 as the primary outcome measure. Secondary outcomes include pathological worry, depression and measures of well-being. At three-months follow-up data will be collected using the GAD-7, BDI-II, PSWQ, ED-Q5 and WSAS. Post-session data will be collected on significant in-session events in treatment (HAT). A satisfaction with treatment measure will be administered post-treatment (SAT). Discussion The study will be a contribution to the potential for a low-intensity internet-delivered program implemented in a service-based setting; implemented as one step in a stepped-care model

  3. Prospective independent validation of APACHE III models in an Australian tertiary adult intensive care unit.

    PubMed

    Cook, D A; Joyce, C J; Barnett, R J; Birgan, S P; Playford, H; Cockings, J G L; Hurford, R W

    2002-06-01

    Evaluation of the performance of the APACHE III (Acute Physiology and Chronic Health Evaluation) ICU (intensive care unit) and hospital mortality models at the Princess Alexandra Hospital, Brisbane is reported. Prospective collection of demographic, diagnostic, physiological, laboratory, admission and discharge data of 5681 consecutive eligible admissions (1 January 1995 to 1 January 2000) was conducted at the Princess Alexandra Hospital, a metropolitan Australian tertiary referral medical/surgical adult ICU ROC (receiver operating characteristic) curve areas for the APACHE III ICU mortality and hospital mortality models demonstrated excellent discrimination. Observed ICU mortality (9.1%) was significantly overestimated by the APACHE III model adjusted for hospital characteristics (10.1%), but did not significantly differ from the prediction of the generic APACHE III model (8.6%). In contrast, observed hospital mortality (14.8%) agreed well with the prediction of the APACHE III model adjusted for hospital characteristics (14.6%), but was significantly underestimated by the unadjusted APACHE III model (13.2%). Calibration curves and goodness-of-fit analysis using Hosmer-Lemeshow statistics, demonstrated that calibration was good with the unadjusted APACHE III ICU mortality model, and the APACHE III hospital mortality model adjusted for hospital characteristics. Post hoc analysis revealed a declining annual SMR (standardized mortality rate) during the study period. This trend was present in each of the non-surgical, emergency and elective surgical diagnostic groups, and the change was temporally related to increased specialist staffing levels. This study demonstrates that the APACHE III model performs well on independent assessment in an Australian hospital. Changes observed in annual SMR using such a validated model support an hypothesis of improved survival outcomes 1995-1999. PMID:12075637

  4. Developmental aspects of fear: Comparing the acquisition and generalization of conditioned fear in children and adults

    PubMed Central

    Schiele, Miriam A.; Reinhard, Julia; Reif, Andreas; Domschke, Katharina; Romanos, Marcel; Deckert, Jürgen

    2016-01-01

    ABSTRACT Most research on human fear conditioning and its generalization has focused on adults whereas only little is known about these processes in children. Direct comparisons between child and adult populations are needed to determine developmental risk markers of fear and anxiety. We compared 267 children and 285 adults in a differential fear conditioning paradigm and generalization test. Skin conductance responses (SCR) and ratings of valence and arousal were obtained to indicate fear learning. Both groups displayed robust and similar differential conditioning on subjective and physiological levels. However, children showed heightened fear generalization compared to adults as indexed by higher arousal ratings and SCR to the generalization stimuli. Results indicate overgeneralization of conditioned fear as a developmental correlate of fear learning. The developmental change from a shallow to a steeper generalization gradient is likely related to the maturation of brain structures that modulate efficient discrimination between danger and (ambiguous) safety cues. © 2016 The Authors. Developmental Psychobiology Published by Wiley Periodicals, Inc. Dev Psychobiol 58: 471–481, 2016. PMID:26798984

  5. Generalized Kapchinskij-Vladimirskij Distribution and Envelope Equation for High-intensity Beams in a Coupled Transverse Focusing Lattice

    SciTech Connect

    Hong Qin, Moses Chung, and Ronald C. Davidson

    2009-11-20

    In an uncoupled lattice, the Kapchinskij-Vladimirskij (KV) distribution function first analyzed in 1959 is the only known exact solution of the nonlinear Vlasov-Maxwell equations for high- intensity beams including self-fields in a self-consistent manner. The KV solution is generalized here to high-intensity beams in a coupled transverse lattice using the recently developed generalized Courant-Snyder invariant for coupled transverse dynamics. This solution projects to a rotating, pulsating elliptical beam in transverse configuration space, determined by the generalized matrix envelope equation.

  6. [Invasive candidiasis in non-neutropenic adults : Guideline-based management in the intensive care unit].

    PubMed

    Glöckner, A; Cornely, O A

    2013-12-01

    Invasive Candida infections represent a diagnostic and therapeutic challenge for clinicians particularly in the intensive care unit (ICU). Despite substantial advances in antifungal agents and treatment strategies, invasive candidiasis remains associated with a high mortality. Recent guideline recommendations on the management of invasive candidiasis by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) from 2012, the German Speaking Mycological Society and the Paul Ehrlich Society for Chemotherapy (DMykG/PEG) from 2011 and the Infectious Diseases Society of America (IDSA) from 2009 provide valuable guidance for diagnostic procedures and treatment of these infections but need to be interpreted in the light of the individual situation of the patient and the local epidemiology of fungal pathogens. The following recommendations for management of candidemia are common to all three guidelines. Any positive blood culture for Candida indicates disseminated infection or deep organ infection and requires antifungal therapy. Treatment should be initiated as soon as possible. Removal or changing of central venous catheters or other foreign material in the bloodstream is recommended whenever possible. Ophthalmological examination for exclusion of endophthalmitis and follow-up blood cultures during therapy are also recommended. Duration of therapy should be 14 days after clearance of blood cultures and resolution of symptoms. Consideration of surgical options and a prolonged antifungal treatment (weeks to months) are required when there is organ involvement. During the last decade several new antifungal agents were introduced into clinical practice. These innovative drugs showed convincing efficacy and favorable safety in randomized clinical trials. Consequently, they were integrated in recent therapeutic guidelines, often replacing former standard drugs as first-line options. Echinocandins have emerged as the generally preferred primary treatment in

  7. Posttraumatic Stress Disorder in General Intensive Care Unit Survivors: A Systematic Review

    PubMed Central

    Davydow, Dimitry S.; Gifford, Jeneen M.; Desai, Sanjay V.; Needham, Dale M.; Bienvenu, O. Joseph

    2008-01-01

    Objective Our objective was to summarize and critically review data on the prevalence of posttraumatic stress disorder (PTSD) in general intensive care unit (ICU) survivors, risk factors for post-ICU PTSD, and the impact of post-ICU PTSD on health-related quality of life (HRQOL). Methods We conducted a systematic literature review using Medline, EMBASE, Cochrane Library, CINAHL, PsycINFO, and a hand-search of thirteen journals. Results Fifteen studies were eligible. The median point prevalence of questionnaire-ascertained “clinically significant” PTSD symptoms was 22% (n = 1,104), and the median point prevalence of clinician-diagnosed PTSD was 19% (n = 93). Consistent predictors of post-ICU PTSD included prior psychopathology, greater ICU benzodiazepine administration, and post-ICU memories of in-ICU frightening and/or psychotic experiences. Female sex and younger age were less consistent predictors, and severity of critical illness was consistently not a predictor. Post-ICU PTSD was associated with substantially lower HRQOL. Conclusions The prevalence of PTSD in ICU survivors is high and negatively impacts survivors’ HRQOL. Future studies should comprehensively address how patient-specific factors (e.g., pre-ICU psychopathology), ICU management factors (e.g., administration of sedatives), and ICU clinical factors (e.g., in-ICU delirium) relate to one another and to post-ICU PTSD. Clinicians caring for the growing population of ICU survivors should be aware of PTSD risk factors and monitor patients’ needs for early intervention. PMID:18774425

  8. Reaction of cells to local, regional, and general low-intensive laser irradiation

    NASA Astrophysics Data System (ADS)

    Baibekov, Iskander M.; Kasymov, A. S.; Musaev, Erkin S.; Vorojeikin, V. M.; Artikov, S. N.

    1993-07-01

    Local influence of low intensive laser irradiation (LILI) of Helium-Neon (HNL), Copper vapor (CVL), Nitrogen (UVL) and Arsenic Gallium (AGL) lasers cause stimulation of processes of physiological and reparative regeneration in intact skin, and mucous membrane of stomach and duodenum, dermatome wounds and gastroduodenal ulcers. Structural bases of these effects are the acceleration of cell proliferation and differentiation and also the activation of intracellular structures and intensification of cell secretion. Regional influence of the pointed types of LILI on hepar in cirrhosis and hepatitis causes decreasing of the inflammatory and cirrhotic changes. After endo- and exo-vascular laser irradiations of blood the decreasing of the number of pathological forms of erythrocytes and the increasing of their catalase activity, are indicated. General (total) laser irradiation of the organism--laser shower, increases the bone marrow cells proliferation, especially myeloid series. It is accompanied with acceleration of their differentiation and migration in circulation. It was revealed, that HNL to a considerable extent influences the epithelial cells and CVL the connective tissue cells. UVL increases the amount of microorganisms on cell surfaces (membrane bound microorganisms). Regional irradiation of the LILI causes both direct and indirect influence of cells. Structural changes of bone marrow cells and gut mucous membrane cells indicate intersystemic interaction.

  9. Evaluation of a Rural-Based Community Aged Intensive Recovery Program for Older Adults With Severe Mental Illness.

    PubMed

    Sadler, Paul; McIlvena, Andrea

    2015-09-01

    Community Aged Intensive Recovery (CAIR) programs are an integral part of Aged Persons Mental Health Services (APMHS); however, no study has investigated whether a rural-based intensive program benefits older clients with severe mental illness. The current sample comprised 119 older adults who were being managed by a CAIR program from July 2011 to June 2013. Three key results were found: (a) approximately three quarters of clients admitted to the CAIR program remained treated in the community; (b) the program assisted in significantly reducing the level of psychiatric symptom severity from CAIR entry to CAIR exit; and (c) the APMHS team with the CAIR program had a lower psychiatric inpatient rate compared to the APMHS team without the program. The current study highlights the importance of delivering effective rural-based CAIR programs to older adults experiencing severe mental illness.

  10. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    PubMed

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P < 0.001) and lowered plasma fructosamine (P < 0.05). Toll-like receptor (TLR) 4 (TLR4) expression was reduced on lymphocytes and monocytes after both HIIT and MICT (P < 0.05) and on neutrophils after MICT (P < 0.01). TLR2 on lymphocytes was reduced after HIIT and MICT (P < 0.05). Plasma inflammatory cytokines were unchanged after training in both groups, but MICT led to a reduction in fasting plasma glucose (P < 0.05, 5.9 ± 1.0 vs. 5.6 ± 1.0 mmol/l, pre vs. post). Ten days of either HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose.

  11. General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

    ERIC Educational Resources Information Center

    Chaplin, R.

    2004-01-01

    Adults with intellectual disability (ID) and mental illness may use general or specialist psychiatric services. This review aims to assess if there is evidence for a difference in outcome between them. A literature review was conducted using a variety of electronic databases and hand-search strategies to identify all studies evaluating the outcome…

  12. New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

    ERIC Educational Resources Information Center

    Chaplin, R.

    2009-01-01

    Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

  13. Why Some Adults with Intellectual Disability Consult Their General Practitioner More Than Others

    ERIC Educational Resources Information Center

    Turk, V.; Kerry, S.; Corney, R.; Rowlands, G.; Khattran, S.

    2010-01-01

    Background: This research identifies factors affecting why some adults with intellectual disability (AWIDs) consult their general practitioner (GP) more than others. Little is known about these factors, despite AWIDs having higher health needs and reduced longevity. Current barriers to accessing health care need to be understood and overcome to…

  14. Checklists for General Practitioner Diagnosis of Depression in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Torr, J.; Iacono, T.; Graham, M. J.; Galea, J.

    2008-01-01

    Background: In Australia, diagnosis and management of depression in adults with intellectual disability (ID) often occurs within the primary care setting. Few tools are available to assist general practitioners (GPs) in the diagnostic process. The study aim was to assess properties of carer and GP checklists developed to address this problem.…

  15. Evaluation of a Peer-Led, Low-Intensity Physical Activity Program for Older Adults

    ERIC Educational Resources Information Center

    Werner, Danilea; Teufel, James; Brown, Stephen L.

    2014-01-01

    Background: Physical inactivity is a primary contributor to decreasing functional physical fitness and increasing chronic disease in older adults. Purpose: This study assessed the health-related benefits of ExerStart for Lay Leaders, a 20-week, community based, peer-led, low-impact exercise program for older adults. ExerStart focuses on aerobic…

  16. A Class Of Generalized Kapchinskij-Vladimirskij Solutions And Associated Envelope Equations For High-intensity Charged Particle Beams

    SciTech Connect

    Hong Qin and Ronald C. Davidson

    2012-04-25

    A class of generalized Kapchinskij-Vladimirskij solutions of the nonlinear Vlasov-Maxwell equations and the associated envelope equations for high-intensity beams in a periodic lattice is derived. It includes the classical Kapchinskij-Vladimirskij solution as a special case. For a given lattice, the distribution functions and the envelope equations are specified by eight free parameters. The class of solutions derived captures a wider range of dynamical envelope behavior for high-intensity beams, and thus provides a new theoretical tool to investigate the dynamics of high-intensity beams.

  17. Stressors, social support, religious practice, and general well-being among Korean adult immigrants.

    PubMed

    Lee, Kyoung Hag; Woo, Hyeyoung

    2013-10-01

    Through this cross-sectional study the authors explore how stressors, social support, and religious practice are associated with the general well-being of 147 Korean adult immigrants through interviews. Hierarchical regression analysis reveals that low English proficiency and financial hardship are significantly related to low general well-being. However, high social support and religious practice are significantly associated with high general well-being. Social service and health care providers need to carefully assess stressors, social support systems, and spiritual issues for providing appropriate services/programs for English, culture, or social activities as well as spiritual intervention to maximize the strengths of Korean immigrants coping with health issues.

  18. On-Farm Welfare Assessment Protocol for Adult Dairy Goats in Intensive Production Systems

    PubMed Central

    Battini, Monica; Stilwell, George; Vieira, Ana; Barbieri, Sara; Canali, Elisabetta; Mattiello, Silvana

    2015-01-01

    Simple Summary The Animal Welfare Indicators (AWIN) project developed a practical welfare assessment protocol for lactating dairy goats in intensive husbandry systems, using animal-based indicators that cover the whole multidimensional concept of animal welfare. The strict collaboration between scientists and stakeholders resulted in an easy-to-use protocol that provides farmers or veterinarians with comprehensive but clear feedback on the welfare status of the herd in less than three hours. The protocol, which highlights key points and motivates farmers to achieve improvements, has received much attention from interested parties. Abstract Within the European AWIN project, a protocol for assessing dairy goats’ welfare on the farm was developed. Starting from a literature review, a prototype including animal-based indicators covering four welfare principles and 12 welfare criteria was set up. The prototype was tested in 60 farms for validity, reliability, and feasibility. After testing the prototype, a two-level assessment protocol was proposed in order to increase acceptability among stakeholders. The first level offers a more general overview of the welfare status, based on group assessment of a few indicators (e.g., hair coat condition, latency to the first contact test, severe lameness, Qualitative Behavior Assessment), with no or minimal handling of goats and short assessment time required. The second level starts if welfare problems are encountered in the first level and adds a comprehensive and detailed individual evaluation (e.g., Body Condition Score, udder asymmetry, overgrown claws), supported by an effective sampling strategy. The assessment can be carried out using the AWIN Goat app. The app results in a clear visual output, which provides positive feedback on welfare conditions in comparison with a benchmark of a reference population. The protocol may be a valuable tool for both veterinarians and technicians and a self-assessment instrument for

  19. Professionalisation in General Adult Education in Germany--An Attempt to Cut a Path through a Jungle

    ERIC Educational Resources Information Center

    Dausien, Bettina; Schwendowius, Dorothee

    2009-01-01

    The article summarizes the findings of a study on adult learning professions in Europe (ALPINE) commissioned by DG Education and Culture. It explores the current professional and social situation of staff in non-vocational adult education in Germany. It describes the structures and organisations of general adult education in Germany and…

  20. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    ERIC Educational Resources Information Center

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (<40; >60) and genetic taste status…

  1. The immediate impact of opening an adult high dependency unit on intensive care unit occupancy.

    PubMed

    Fox, A J; Owen-Smith, O; Spiers, P

    1999-03-01

    We assessed the hourly occupancy of our intensive care and high dependency units over an 8-week period commencing on the day our high dependency unit opened. Using criteria established by the working group on 'Guidelines on Admission to and Discharge from Intensive Care and High Dependency Units' published by the National Health Service Executive, we defined each patient daily as intensive care or high dependency status. Compared with hourly occupancy figures obtained before the high dependency unit opened, occupancy of the intensive care unit by high dependency patients has been shown to decrease significantly from 21.6% to 11.2%. Use of intensive care beds became more appropriate, their occupancy increasing significantly from 63.7% to 73.4%. A significant decrease in readmissions occurred, supporting the hypothesis that having high dependency beds reduces the number of patients discharged prematurely to the wards.

  2. Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults.

    PubMed

    Little, Jonathan P; Jung, Mary E; Wright, Amy E; Wright, Wendi; Manders, Ralph J F

    2014-07-01

    The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m(2)) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day's breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = Δ2.1 ± 0.9, CMI = Δ3.0 ± 0.9, control = Δ3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI.

  3. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.

    PubMed

    Wetherell, Julie Loebach; Petkus, Andrew J; White, Kamila S; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J

    2013-07-01

    OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy. PMID:23680817

  4. Antidepressant Medication Augmented With Cognitive-Behavioral Therapy for Generalized Anxiety Disorder in Older Adults

    PubMed Central

    Wetherell, Julie Loebach; Petkus, Andrew J.; White, Kamila S.; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J.

    2014-01-01

    Objective Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. Method Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions:16 weeks of escitalopram (10–20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. Results Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. Conclusions This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy. PMID:23680817

  5. An Evaluation of the Educational Benefits and Cost Analysis of the Adult General Education/Basic Education Mobile Van Project.

    ERIC Educational Resources Information Center

    DuVall, Charles R.; And Others

    A study examined the educational benefits and costs of the adult general education/basic education mobile van project designed to provide access to adult basic education and general education programs for citizens of Indiana. An evaluation team interviewed all available persons (including Indiana Office of Occupational Development directors;…

  6. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    PubMed

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P < 0.001) and lowered plasma fructosamine (P < 0.05). Toll-like receptor (TLR) 4 (TLR4) expression was reduced on lymphocytes and monocytes after both HIIT and MICT (P < 0.05) and on neutrophils after MICT (P < 0.01). TLR2 on lymphocytes was reduced after HIIT and MICT (P < 0.05). Plasma inflammatory cytokines were unchanged after training in both groups, but MICT led to a reduction in fasting plasma glucose (P < 0.05, 5.9 ± 1.0 vs. 5.6 ± 1.0 mmol/l, pre vs. post). Ten days of either HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose. PMID:26139217

  7. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes

    PubMed Central

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E.; Bourne, Jessica E.; Voth, Elizabeth

    2015-01-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P < 0.001) and lowered plasma fructosamine (P < 0.05). Toll-like receptor (TLR) 4 (TLR4) expression was reduced on lymphocytes and monocytes after both HIIT and MICT (P < 0.05) and on neutrophils after MICT (P < 0.01). TLR2 on lymphocytes was reduced after HIIT and MICT (P < 0.05). Plasma inflammatory cytokines were unchanged after training in both groups, but MICT led to a reduction in fasting plasma glucose (P < 0.05, 5.9 ± 1.0 vs. 5.6 ± 1.0 mmol/l, pre vs. post). Ten days of either HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose. PMID:26139217

  8. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    PubMed Central

    Mazzeffi, Michael; Johnson, Kyle; Paciullo, Christopher

    2015-01-01

    Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review. PMID:25849690

  9. [Increasing immunization coverage in adults and elderly by creating structural relationships with general practitioners].

    PubMed

    Conversano, M; Busatta, M; Cipriani, R; Battista, T; Sponselli, G M; Caputi, G; Pesare, A

    2012-01-01

    In order to reach vaccination coverage in adults, the elderly and in high risk subjects, a tight network of collaboration between preventive medicine specialists and general practitioners must be created in the same way that they must be created with pediatricians. In fact, this strategy has brought about very high coverage rates in childhood vaccinations. The solution to propose once again would thus be to develop partnerships between the protagonists of the network (community health district, department of prevention, general practitioners, primary care physicians) so that synergies may be created which permit the realisation of common and specific training programs.

  10. Long-Term Outcome After Static Intensity-Modulated Total Body Radiotherapy Using Compensators Stratified by Pediatric and Adult Cohorts

    SciTech Connect

    Schneider, Ralf A. Schultze, Juergen; Jensen, J. Martin; Hebbinghaus, Dieter; Galalae, Razvan M.

    2008-01-01

    Purpose: To report the long-term outcome after total body irradiation with intensity-modulating compensators and allogeneic/autologous transplantation, especially in terms of therapy-related toxicity in pediatric and adult cohorts. Methods and Materials: A total of 257 consecutive patients (40 children and 217 adults) have been treated since 1983 with TBI using static intensity-modulated radiotherapy for hematologic malignancies. The total dose of 12 Gy was applied in six fractions within 3 days before allogeneic (n = 174) or autologous (n = 83) transplantation. The median follow-up was 9.2 years. Results: The 5-year overall survival rate was 47.9% (49.8% for the adults and 37.5% for the children, p = 0.171). The 5-year tumor-related mortality rate was 23%, and the 5-year treatment-related mortality rate 29.2% (29.5% in the adults and 27.5% in the pediatric patients). Interstitial pneumonitis developed in 28 (10.9%) of 257 patients and in 12.5% of the pediatric cohort. The interstitial pneumonitis rate was 25% in pediatric patients treated with a 12-Gy lung dose compared with 4.2% for those treated to an 11-Gy lung dose. The overall survival rate stratified by lung dose was 26.7% for 12 Gy and 52.4% for 11 Gy (p = 0.001). The incidence of veno-occlusive disease and cataract was 5.8% and 6.6% in all patients and 12.5% and 15% in the pediatric patients, respectively (p < 0.05). Secondary malignancies were found in 4.3% of all patients, all in the adult cohort at transplantation. Conclusion: Static intensity-modulated total body irradiation with a total dose of 12 Gy before allogeneic/autologous transplantation is a successful treatment with good long-term outcome and acceptable therapy-related toxicities. Constraining the lung dose to 11 Gy substantially lowered the actuarial treatment-related mortality. This effect was especially striking in the pediatric patients.

  11. Affective and Enjoyment Responses to High-Intensity Interval Training in Overweight-to-Obese and Insufficiently Active Adults.

    PubMed

    Martinez, Nic; Kilpatrick, Marcus W; Salomon, Kristen; Jung, Mary E; Little, Jonathan P

    2015-04-01

    High-intensity interval training (HIIT) has many known physiological benefits, but research investigating the psychological aspects of this training is limited. The purpose of the current study is to investigate the affective and enjoyment responses to continuous and high-intensity interval exercise sessions. Twenty overweight-to-obese, insufficiently active adults completed four counterbalanced trials: a 20-min trial of heavy continuous exercise and three 24-min HIIT trials that used 30-s, 60-s, and 120-s intervals. Affect declined during all trials (p < .05), but affect at the completion of trials was more positive in the shorter interval trials (p < .05). Enjoyment declined in the 120-s interval and heavy continuous conditions only (p < .05). Postexercise enjoyment was higher in the 60-s trial than in the 120-s trial and heavy continuous condition (p < .05). Findings suggest that pleasure and enjoyment are higher during shorter interval trials than during a longer interval or heavy continuous exercise.

  12. Expectations and needs of persons with family members in an intensive care unit as opposed to a general ward.

    PubMed

    Foss, K R; Tenholder, M F

    1993-04-01

    The positive effect of family support on the outcome from serious illness that requires intensive care has been recognized by clinicians for decades. We have all seen that family visitation and an intensive care environment more similar to that of a general ward (sunlight, radio, television) can benefit patients with psychosis related to intensive care. The severity of illness of the individual patient exerts a powerful stress on the family unit, but it has been difficult to measure this effect. We used a 40-question family needs survey with a degree of importance scale to compare the intensive care unit (ICU) with the general ward in terms of impact on the family. Five needs were found to discriminate these two environments. The family members of patients in an ICU considered it very important (1) for staff to give directions on what to do at the bedside, (2) to receive more support from their own family unit, (3) to have a place to be alone as a family unit in the hospital, (4) to be informed in advance of any transfer plan, and (5) to have flexibility in the time allowed for visitation. Family members are willing to accept decreased visitation time if the physicians and nurses can equate this decrease with the complexity of care in the ICU. The results of this survey have helped us modify and individualize our approach based on family expectations especially when patients are transferred from the general ward to the ICU or from the ICU to the ward.

  13. Effects of intensive physical rehabilitation on neuromuscular adaptations in adults with poststroke hemiparesis.

    PubMed

    Andersen, Lars L; Zeeman, Peter; Jørgensen, Jørgen R; Bech-Pedersen, Daniel T; Sørensen, Janne; Kjær, Michael; Andersen, Jesper L

    2011-10-01

    Hemiparesis-disability and muscle weakness of 1 side of the body-is a common consequence of stroke. High-intensity strength training may be beneficial to regain function, but strength coaches in the field of rehabilitation need evidence-based guidelines. The purpose of this study was to evaluate the effect of intensive physical rehabilitation on neuromuscular and functional adaptations in outpatients suffering from hemiparesis after stroke. A within-subject repeated-measures design with the paretic leg as the experimental leg and the nonparetic leg as the control leg was used. Eleven outpatients with hemiparesis after stroke participated in 12 weeks of intensive physical rehabilitation comprising unilateral high-intensity strength training with near-maximal loads (4-12 repetition maximum) and body weight supported treadmill training. At baseline and 12-week follow-up, the patients went through testing consisting of isokinetic muscle strength, neuromuscular activation measured with electromyography (EMG), electrically evoked muscle twitch contractile properties, and gait performance (10-m Walk Test and 6-min Walk Test). After the 12-week conditioning program, knee extensor and flexor strength increased during all contraction modes and velocities in the paretic leg. Significant increases were observed for agonist EMG amplitude at slow concentric and slow eccentric contraction. Twitch torque increased, whereas twitch time-to-peak tension remained unchanged. By contrast, no significant changes were observed in the nonparetic control leg. Gait performance increased 52-68%. In conclusion, intensive physical rehabilitation after stroke leads to clinically relevant neuromuscular improvements, leading to increased voluntary strength during a wide range of contraction modes and velocities, and improved gait velocity. Strength training coaches working in the field of rehabilitation can use this knowledge to safely and efficiently add high-intensity strength training to

  14. Effect of moderate-intensity exercise training on the cognitive function of young adults with intellectual disabilities.

    PubMed

    Pastula, Robert M; Stopka, Christine B; Delisle, Anthony T; Hass, Chris J

    2012-12-01

    In addition to cognitive impairment, young adults with intellectual disabilities (IDs) are also more likely to be in poor health. Exercise may help ameliorate both of these deficits. While the health benefits of exercise are well documented and understood, the cognitive benefits of exercise are emerging. Exercise has been shown to improve the cognitive function of young, old, and diseased populations but few studies have evaluated the effect of exercise training on the cognitive functioning of individuals with IDs. The purpose of this study was to determine the effect of moderate-intensity exercise training on the cognitive function of young adults with IDs. Fourteen students (age, 19.4 ± 1.3 years) with mild to moderate IDs participated in an 8-week comprehensive exercise intervention program based on circuit training, aerobic dancing, and adapted sport activities. Sessions lasted 45 minutes, and intensity was maintained at 60-70% of maximum heart rate (HR(max)). Aerobic fitness was assessed via the Young Men's Christian Association (YMCA) step test, and intellectual functioning was assessed via 3 subtests from the Woodcock-Johnson III Tests of Cognitive Abilities once before and after the intervention. Performance was significantly improved on all 3 cognitive tests (all, p < 0.002). Aerobic fitness also significantly improved (p < 0.002). The mean percent increase in processing speed, a measure taking into account each individual's performance on the 3 subtests, was 103%. The mean individual improvement in aerobic fitness was 17.5%. Moderate-intensity exercise training can yield robust improvements in the cognitive functioning and aerobic fitness of young adults with IDs. These effects support the inclusion of exercise into the lives of young adults with ID to promote their physical and cognitive health. Fourteen students (age, 19.4 ± 1.3 years) with mild to moderate IDs participated in an 8-week comprehensive exercise intervention program based on circuit

  15. Effects of high-intensity interval training and moderate-intensity continuous training on endothelial function and cardiometabolic risk markers in obese adults.

    PubMed

    Sawyer, Brandon J; Tucker, Wesley J; Bhammar, Dharini M; Ryder, Justin R; Sweazea, Karen L; Gaesser, Glenn A

    2016-07-01

    We hypothesized that high-intensity interval training (HIIT) would be more effective than moderate-intensity continuous training (MICT) at improving endothelial function and maximum oxygen uptake (V̇o2 max) in obese adults. Eighteen participants [35.1 ± 8.1 (SD) yr; body mass index = 36.0 ± 5.0 kg/m(2)] were randomized to 8 wk (3 sessions/wk) of either HIIT [10 × 1 min, 90-95% maximum heart rate (HRmax), 1-min active recovery] or MICT (30 min, 70-75% HRmax). Brachial artery flow-mediated dilation (FMD) increased after HIIT (5.13 ± 2.80% vs. 8.98 ± 2.86%, P = 0.02) but not after MICT (5.23 ± 2.82% vs. 3.05 ± 2.76%, P = 0.16). Resting artery diameter increased after MICT (3.68 ± 0.58 mm vs. 3.86 ± 0.58 mm, P = 0.02) but not after HIIT (4.04 ± 0.70 mm vs. 4.09 ± 0.70 mm; P = 0.63). There was a significant (P = 0.02) group × time interaction in low flow-mediated constriction (L-FMC) between MICT (0.63 ± 2.00% vs. -2.79 ± 3.20%; P = 0.03) and HIIT (-1.04 ± 4.09% vs. 1.74 ± 3.46%; P = 0.29). V̇o2 max increased (P < 0.01) similarly after HIIT (2.19 ± 0.65 l/min vs. 2.64 ± 0.88 l/min) and MICT (2.24 ± 0.48 l/min vs. 2.55 ± 0.61 l/min). Biomarkers of cardiovascular risk and endothelial function were unchanged. HIIT and MICT produced different vascular adaptations in obese adults, with HIIT improving FMD and MICT increasing resting artery diameter and enhancing L-FMC. HIIT required 27.5% less total exercise time and ∼25% less energy expenditure than MICT. PMID:27255523

  16. Generalized in-line digital holographic technique based on intensity measurements at two different planes

    NASA Astrophysics Data System (ADS)

    Situ, Guohai; Ryle, James P.; Gopinathan, Unnikrishnan; Sheridan, John T.

    2008-02-01

    In-line digital holography based on two-intensity measurements [Zhang et al. Opt. Lett. 29, 1787 (2004)], is modified by introducing a π shifting in the reference phase. Such an improvement avoids the assumption that the object beam must be much weaker than the reference beam in strength and results in a simplified experimental implementation. Computer simulations and optical experiments are carried out to validate the method, which we refer to as position-phase-shifting digital holography.

  17. End-of-Life Care Intensity among Adolescent and Young Adult Cancer Patients in Kaiser Permanente Southern California

    PubMed Central

    Mack, Jennifer W.; Chen, Lie H.; Cannavale, Kimberley; Sattayapiwat, Olivia; Cooper, Robert M.; Chao, Chun R.

    2015-01-01

    Importance Cancer is the leading disease-related cause of death among adolescents and young adults (AYAs), but little is known about the care that AYA patients with cancer receive at the end of life (EOL). Objective To evaluate the intensity of EOL care among AYA cancer patients. Design Cross-sectional study using cancer registry and electronic health record data. Setting Kaiser Permanente Southern California (KSPC), an integrated health care delivery system. Participants 663 AYA patients with either (1) stage I-III cancer and evidence of cancer recurrence or (2) stage IV cancer at diagnosis who received care in KPSC and died in the years 2001–2010. Patients were eligible if they were aged 15–39 at death. Main Outcome Measures Chemotherapy use in the last 14 days of life, intensive care unit (ICU) care in the last 30 days of life, more than one emergency room (ER) visit in the last 30 days of life, hospitalization in the last 30 days of life, and a composite measure of medically intensive EOL care comprising any of the aforementioned measures. Results 11% of patients (72/663) received chemotherapy within 14 days of death. In the last 30 days of life, 22% of patients (144/663) were admitted to the ICU; 22% (147/663) had >1 ER visit; and 62% (413/663) were hospitalized. Overall, 68% (449/663) of subjects received at least one medically intensive EOL care measure. Conclusions and Relevance Most AYA patients receive at least one form of medically intensive EOL care. These findings suggest the need to better understand EOL care preferences and decision-making in this young population. PMID:26181778

  18. Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia.

    PubMed

    Chalandon, Yves; Thomas, Xavier; Hayette, Sandrine; Cayuela, Jean-Michel; Abbal, Claire; Huguet, Françoise; Raffoux, Emmanuel; Leguay, Thibaut; Rousselot, Philippe; Lepretre, Stéphane; Escoffre-Barbe, Martine; Maury, Sébastien; Berthon, Céline; Tavernier, Emmanuelle; Lambert, Jean-François; Lafage-Pochitaloff, Marina; Lhéritier, Véronique; Chevret, Sylvie; Ifrah, Norbert; Dombret, Hervé

    2015-06-11

    In this study, we randomly compared high doses of the tyrosine kinase inhibitor imatinib combined with reduced-intensity chemotherapy (arm A) to standard imatinib/hyperCVAD (cyclophosphamide/vincristine/doxorubicin/dexamethasone) therapy (arm B) in 268 adults (median age, 47 years) with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). The primary objective was the major molecular response (MMolR) rate after cycle 2, patients being then eligible for allogeneic stem cell transplantation (SCT) if they had a donor, or autologous SCT if in MMolR and no donor. With fewer induction deaths, the complete remission (CR) rate was higher in arm A than in arm B (98% vs 91%; P = .006), whereas the MMolR rate was similar in both arms (66% vs 64%). With a median follow-up of 4.8 years, 5-year event-free survival and overall survival (OS) rates were estimated at 37.1% and 45.6%, respectively, without difference between the arms. Allogeneic transplantation was associated with a significant benefit in relapse-free survival (hazard ratio [HR], 0.69; P = .036) and OS (HR, 0.64; P = .02), with initial white blood cell count being the only factor significantly interacting with this SCT effect. In patients achieving MMolR, outcome was similar after autologous and allogeneic transplantation. This study validates an induction regimen combining reduced-intensity chemotherapy and imatinib in Ph+ ALL adult patients and suggests that SCT in first CR is still a good option for Ph+ ALL adult patients. This trial was registered at www.clinicaltrials.gov as #NCT00327678. PMID:25878120

  19. Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia.

    PubMed

    Chalandon, Yves; Thomas, Xavier; Hayette, Sandrine; Cayuela, Jean-Michel; Abbal, Claire; Huguet, Françoise; Raffoux, Emmanuel; Leguay, Thibaut; Rousselot, Philippe; Lepretre, Stéphane; Escoffre-Barbe, Martine; Maury, Sébastien; Berthon, Céline; Tavernier, Emmanuelle; Lambert, Jean-François; Lafage-Pochitaloff, Marina; Lhéritier, Véronique; Chevret, Sylvie; Ifrah, Norbert; Dombret, Hervé

    2015-06-11

    In this study, we randomly compared high doses of the tyrosine kinase inhibitor imatinib combined with reduced-intensity chemotherapy (arm A) to standard imatinib/hyperCVAD (cyclophosphamide/vincristine/doxorubicin/dexamethasone) therapy (arm B) in 268 adults (median age, 47 years) with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). The primary objective was the major molecular response (MMolR) rate after cycle 2, patients being then eligible for allogeneic stem cell transplantation (SCT) if they had a donor, or autologous SCT if in MMolR and no donor. With fewer induction deaths, the complete remission (CR) rate was higher in arm A than in arm B (98% vs 91%; P = .006), whereas the MMolR rate was similar in both arms (66% vs 64%). With a median follow-up of 4.8 years, 5-year event-free survival and overall survival (OS) rates were estimated at 37.1% and 45.6%, respectively, without difference between the arms. Allogeneic transplantation was associated with a significant benefit in relapse-free survival (hazard ratio [HR], 0.69; P = .036) and OS (HR, 0.64; P = .02), with initial white blood cell count being the only factor significantly interacting with this SCT effect. In patients achieving MMolR, outcome was similar after autologous and allogeneic transplantation. This study validates an induction regimen combining reduced-intensity chemotherapy and imatinib in Ph+ ALL adult patients and suggests that SCT in first CR is still a good option for Ph+ ALL adult patients. This trial was registered at www.clinicaltrials.gov as #NCT00327678.

  20. A visit to the intensive cares unit: a family-centered culture change to facilitate pediatric visitation in an adult intensive care unit.

    PubMed

    Hanley, Julie Boyer; Piazza, Julie

    2012-01-01

    To guide family adjustment, an effort was made to facilitate pediatric visitation in an adult intensive care unit (ICU). Goals were to improve customer satisfaction and to raise staff comfort level with child visitation. After implementing an open visitation policy, concerns around pediatric visitation in the ICU remained. Fears centered on risks to both patient and child. Literature was reviewed before a book was written entitled A Visit to the ICU. It contained information about what a child visiting the ICU would see, hear, and feel when visiting a loved one. The book provided reassurance for caregivers and children, informing them about what to expect when visiting. The goal of the book was to provide caregivers with a framework for age-appropriate education. Staff education was provided on developmental stages, including a child's understandings of illness and death. Nursing interventions were reviewed and resources provided. A survey demonstrated that the book increased staff comfort level with children visiting the unit, was a positive tool for patients and families, and eased fears among children while helping to facilitate coping mechanisms. The article will describe the practice change of pediatric visitation in an ICU and how it could be applied to other critical care settings. PMID:22157497

  1. Parasites and carotenoid-based signal intensity: how general should the relationship be?

    PubMed

    Shykoff, J A; Widmer, A

    1996-03-01

    Evidence that selection by parasites maintains heritable variation in sexually selected signals (Hamilton-Zuk model) has proved equivocal. Bright individuals do not always have fewer parasites in intraspecific comparisons. Because the lymphocyte-based defence system and the production of some colors used in sexual signaling require carotenoids, we consider a trade-off between defence against parasites and sexual signals. The nature and the sign of the covariance between defence and signal brightness can vary. Depending on carotenoid availability and allocation, and the type of sexual signal, various relationships between parasite load and signal intensity are expected.

  2. The Hygroscopic Condenser Humidifier. A new device for general use in anaesthesia and intensive care.

    PubMed

    Gedeon, A; Mebius, C

    1979-01-01

    The design and performance of the Hygroscopic Condenser Humidifier (HCH) are described. In principle the HCH consists of two parts, a conventional Heat-Moisture-Exchanger (HME) and a hygroscopic unit. The hygroscopic action is shown to improve the water retention efficiency of the device by about a factor of two as compared with optimal HME designs. As a result, humidification levels corresponding to around 80% relative humidity at 37 degrees C are obtained in the trachea and this is also achieved when completely dry gases are delivered to the patient. The unit can therefore be used for all procedures in anaesthesia and in intensive care. PMID:539642

  3. A prospective study of the modified Atkins diet for adults with idiopathic generalized epilepsy.

    PubMed

    Kverneland, Magnhild; Selmer, Kaja K; Nakken, Karl O; Iversen, Per O; Taubøll, Erik

    2015-12-01

    For children with pharmacoresistant epilepsy, the ketogenic diet is an established treatment option worldwide. However, for adults, this treatment is less frequently offered, and its efficacy less well-documented. The aim of this study was to examine efficacy and tolerability of such a diet as an adjuvant therapy to antiepileptic drugs for adult patients with pharmacoresistant generalized epilepsy. Thirteen patients (12 women) aged 16-57 years were included prospectively. They were treated with a modified Atkins diet for 12 weeks. Nine of the 13 participants had juvenile myoclonic epilepsy (JME), two had childhood absence epilepsy, one had Jeavons syndrome, and one had generalized epilepsy of unknown type. Six participants, all with JME, completed the 12-week study period. Among these six, four had >50% seizure reduction. Their seizure severity, using the revised Liverpool Seizure Severity Scale, was reduced by 1, 5, 57.5, and 70 points, respectively (scale: 1-100 points). In three of these four responders, quality of life, assessed by QOLIE-89, increased more than 20 points (scale: 0-100 points). Mean reduction of body weight after 12 weeks on diet was 6.5 (range: 4.3-8.1) kg. Lack of motivation, poor compliance, and seizure aggravation were the main reasons for premature termination of the diet. Apart from one patient who developed gallstones when ending the treatment after 10 months, no adverse effects were noted. In conclusion, using a modified Atkins diet for 12 weeks led to a clinically relevant reduction of seizure frequency in four of thirteen adult patients with pharmacoresistant generalized epilepsy. All responders were diagnosed with JME. In three of the four, the benefits of diet were so considerable that they chose to continue the treatment.

  4. Assessment of intensity effort of middle-aged adults practicing regular walking

    PubMed Central

    Silva, Anderson A.; Lima, Daniela A.; Vieira, Gabriella F.; Fernandes, Aline A.; Pereira, Danielle A. G.

    2015-01-01

    Background: Walking is one of the most commonly recommended activities for sedentary individuals. When performed at the correct intensity, it can provide cardiovascular, respiratory, metabolic, and other benefits by providing a training effect in addition to reducing the risk of death from cardiovascular diseases and other chronic health conditions. Objectives: The primary aim of this study was to assess whether individuals who practiced regular unsupervised walking carry out the activity safely and with sufficient effort intensity parameters to have a positive physiological (training) effect. The secondary objective was to compare the training heart rate (HR) and the stability of the HR within the ideal range of training between the sexes. Method: Individuals were selected from walking tracks within the city of Belo Horizonte, Brazil. The study included subjects from 40 to 60 years of age who had practiced walking for at least two months prior to the study, walking at least three times a week. Individuals who agreed to participate in the survey were asked to walk 15 minutes at their usual pace with their HR measured every 5 minutes using a heart rate monitor. Their average walking HR was compared to the average training HR based on the formula: (220 - age) × 70 to 80% that would result in a positive physiological training effect. Results: Of the 142 individuals evaluated, 25.4% achieved the average training HR. This result was significantly lower than those who did not achieve the average training HR while walking (p=0.002). There were significant differences between men and women who had reached the training HR (p=0.0001). Conclusion: The authors found that individuals who walk regularly performed outside the range of the ideal HR intensity that would cause a positive physiological effect and therefore would probably not achieve a beneficial training effect while walking. PMID:26647751

  5. Personalised Prescription of Scalable High Intensity Interval Training to Inactive Female Adults of Different Ages

    PubMed Central

    Mair, Jacqueline L.

    2016-01-01

    Stepping is a convenient form of scalable high-intensity interval training (HIIT) that may lead to health benefits. However, the accurate personalised prescription of stepping is hampered by a lack of evidence on optimal stepping cadences and step heights for various populations. This study examined the acute physiological responses to stepping exercise at various heights and cadences in young (n = 14) and middle-aged (n = 14) females in order to develop an equation that facilitates prescription of stepping at targeted intensities. Participants completed a step test protocol consisting of randomised three-minute bouts at different step cadences (80, 90, 100, 110 steps·min-1) and step heights (17, 25, 30, 34 cm). Aerobic demand and heart rate values were measured throughout. Resting metabolic rate was measured in order to develop female specific metabolic equivalents (METs) for stepping. Results revealed significant differences between age groups for METs and heart rate reserve, and within-group differences for METs, heart rate, and metabolic cost, at different step heights and cadences. At a given step height and cadence, middle-aged females were required to work at an intensity on average 1.9 ± 0.26 METs greater than the younger females. A prescriptive equation was developed to assess energy cost in METs using multilevel regression analysis with factors of step height, step cadence and age. Considering recent evidence supporting accumulated bouts of HIIT exercise for health benefits, this equation, which allows HIIT to be personally prescribed to inactive and sedentary women, has potential impact as a public health exercise prescription tool. PMID:26848956

  6. Personalised Prescription of Scalable High Intensity Interval Training to Inactive Female Adults of Different Ages.

    PubMed

    Mair, Jacqueline L; Nevill, Alan M; De Vito, Giuseppe; Boreham, Colin A

    2016-01-01

    Stepping is a convenient form of scalable high-intensity interval training (HIIT) that may lead to health benefits. However, the accurate personalised prescription of stepping is hampered by a lack of evidence on optimal stepping cadences and step heights for various populations. This study examined the acute physiological responses to stepping exercise at various heights and cadences in young (n = 14) and middle-aged (n = 14) females in order to develop an equation that facilitates prescription of stepping at targeted intensities. Participants completed a step test protocol consisting of randomised three-minute bouts at different step cadences (80, 90, 100, 110 steps·min-1) and step heights (17, 25, 30, 34 cm). Aerobic demand and heart rate values were measured throughout. Resting metabolic rate was measured in order to develop female specific metabolic equivalents (METs) for stepping. Results revealed significant differences between age groups for METs and heart rate reserve, and within-group differences for METs, heart rate, and metabolic cost, at different step heights and cadences. At a given step height and cadence, middle-aged females were required to work at an intensity on average 1.9 ± 0.26 METs greater than the younger females. A prescriptive equation was developed to assess energy cost in METs using multilevel regression analysis with factors of step height, step cadence and age. Considering recent evidence supporting accumulated bouts of HIIT exercise for health benefits, this equation, which allows HIIT to be personally prescribed to inactive and sedentary women, has potential impact as a public health exercise prescription tool. PMID:26848956

  7. A Case of Biotinidase Deficiency in an Adult with Respiratory Failure in the Intensive Care Unit

    PubMed Central

    Demirtürk, Zerrin; Şentürk, Evren; Köse, Abbas; Özcan, Perihan Ergin; Telci, Lütfi

    2016-01-01

    Background: Biotinidase deficiency (BD) is a rare, inherited autosomal recessive disorder that is treatable within childhood. We present a patient with pneumonia and respiratory acidosis who was not diagnosed with any systemic disorders; the patient was finally diagnosed as BD. Case Report: A thirty-year-old woman was admitted to the emergency department with respiratory failure that had persisted for a few days and progressively weakening over the previous six months. Then, the patient was admitted to the intensive care unit with marked respiratory acidosis, respiratory failure and alterations in consciousness. At the follow-up, the patient was not diagnosed with a systematic disorder. Rather, the patient’s historical clinical findings suggested a metabolic disorder. Finally, the patient was diagnosed with biotinidase deficiency. Conclusion: Even though biotinidase deficiency is not frequently seen in the intensive care unit, metabolic syndromes such as biotinidase deficiency should be considered. Patients should be evaluated holistically with attention to medical history, family history and clinical findings. PMID:27761288

  8. Evaluation of Dose-Intense Ifosfamide, with and Without Edatrexate, in Adults with Sarcoma

    PubMed Central

    Schwartz, Gary M.; Leung, Denis; Sugarman, Alison; Bertino, Joseph R.

    1999-01-01

    Purpose. To define the maximally tolerated dose (MTD) of ifosfamide when given with G-CSF on an every other week schedule, and to define the MTD of edatrexate that can be given every two weeks with an intense schedule of ifosfamide. Patients and Methods. Forty-one patients with metastatic or unresectable, locally advanced sarcoma participated in this 2-step phase I trial.The starting dose of ifosfamide was 10 gm/m2 given by continuous intravenous infusion over 4 days every 2 weeks.When the MTD was defined, edatrexate, beginning at a dose of 40 mg/m2 intravenously every 2 weeks was added in subsequent cohorts of patients. Results. Myelosuppression was the most prominent toxicity. Fatigue, nausea, and vomiting were observed in the majority of patients. Ifosfamide 12 gm/m2 given every 2 weeks approached or exceeded the MTD. Edatrexate 100 mg/m2 could be given safety as an intravenous bolus with ifosfamide 10 gm/m2 every 2 weeks. Therapeutic responses were observed in patients with measurable disease. Conclusions. This study demonstrates the feasibility of administering a dose-intense schedule of ifosfamide alone or ifosfamide with edatrexate that might be applied in the adjuvant or neo-adjuvant setting. PMID:18521274

  9. Developmental neurotoxicity of PHAHs: Endocrine-mediated and general behavioral endpoints in adult male rats.

    PubMed

    Lilienthal, Hellmuth; Roth-Härer, Astrid; Hack, Alfons; Altmann, Lilo; Winneke, Gerhard

    2005-05-01

    During development, gonadal steroids exert effects on the nervous system which are long-lasting or organizational, in contrast to the transient activational actions in adulthood. Therefore, disturbance of neuroendocrine functions by developmental exposure to polyhalogenated aromatic hydrocarbons (PHAHs) is likely to affect sex-dependent behavior in adults. Our previous data revealed effects of maternal PCB exposure on sexual differentiation of the brain and subsequent sweet preference as sexually dimorphic behavior in adult offspring. Present research is focused on brominated flame retardants because of their wide-spread use and accumulation in human breast milk. Pregnant Long Evans rats were SC injected with PBDE 99 (2,2',4,4',5-PBDE) daily from gestational day 10 to 18. For comparison, an additional group was exposed to Aroclor 1254. Preliminary results indicate a dose-related increase in sweet preference in adult male offspring exposed to PBDE. Exposure also led to decreases in testosterone and estradiol serum levels. Additional decreases were detected in male anogenital distance. There were no changes of locomotor activity in the open field. On haloperidol-induced catalepsy, latencies were prolonged in all exposed males. In summary, PBDE induced endocrine effects and concomitant changes of sex-dependent behavior similar to PCBs. Outcome of general behavior suggests an involvement of dopaminergic processes in developmental PBDE exposure.

  10. Continuous EEG monitoring in adults in the intensive care unit (ICU).

    PubMed

    André-Obadia, N; Parain, D; Szurhaj, W

    2015-03-01

    Continuous EEG monitoring in the ICU is different from planned EEG due to the rather urgent nature of the indications, explaining the fact that recording is started in certain cases by the clinical team in charge of the patient's care. Close collaboration between neurophysiology teams and intensive care teams is essential. Continuous EEG monitoring can be facilitated by quantified analysis systems. This kind of analysis is based on certain signal characteristics, such as amplitude or frequency content, but raw EEG data should always be interpreted if possible, since artefacts can sometimes impair quantified EEG analysis. It is preferable to work within a tele-EEG network, so that the neurophysiologist has the possibility to give an interpretation on call. Continuous EEG monitoring is thus useful in the diagnosis of non-convulsive epileptic seizures or purely electrical discharges and in the monitoring of status epilepticus when consciousness disorders persist after initial treatment. A number of other indications are currently under evaluation.

  11. Continuous EEG monitoring in adults in the intensive care unit (ICU).

    PubMed

    André-Obadia, N; Parain, D; Szurhaj, W

    2015-03-01

    Continuous EEG monitoring in the ICU is different from planned EEG due to the rather urgent nature of the indications, explaining the fact that recording is started in certain cases by the clinical team in charge of the patient's care. Close collaboration between neurophysiology teams and intensive care teams is essential. Continuous EEG monitoring can be facilitated by quantified analysis systems. This kind of analysis is based on certain signal characteristics, such as amplitude or frequency content, but raw EEG data should always be interpreted if possible, since artefacts can sometimes impair quantified EEG analysis. It is preferable to work within a tele-EEG network, so that the neurophysiologist has the possibility to give an interpretation on call. Continuous EEG monitoring is thus useful in the diagnosis of non-convulsive epileptic seizures or purely electrical discharges and in the monitoring of status epilepticus when consciousness disorders persist after initial treatment. A number of other indications are currently under evaluation. PMID:25639999

  12. What is the magnitude of blood pressure response to a programme of moderate intensity exercise? Randomised controlled trial among sedentary adults with unmedicated hypertension.

    PubMed Central

    Cooper, A R; Moore, L A; McKenna, J; Riddoch, C J

    2000-01-01

    BACKGROUND: Current guidelines for the management of hypertension recommend regular, moderate intensity aerobic exercise such as brisk walking as a means of blood pressure reduction. However, there is a lack of consistent evidence regarding the magnitude of blood pressure response to such a prescription. In particular, no well designed studies have investigated the efficacy of a programme of exercise meeting current guidelines. AIM: To investigate the effect of a six-week programme of moderate intensity exercise on daytime ambulatory blood pressure (10.00 am to 10.00 pm) among unmedicated, sedentary adults aged 25 years to 63 years with office blood pressure of 150 mmHg to 180 mmHg systolic and/or 91 mmHg to 110 mmHg diastolic. METHOD: Randomised controlled trial of participants carrying out 30 minutes of moderate intensity exercise (brisk walking or equivalent) five days per week for six weeks compared with controls who maintained existing levels of physical activity. RESULTS: Compliance with the exercise programme was high. The reduction in mean daytime ambulatory blood pressure between baseline and six-week follow-up was greater in the intervention group than in the control group for both systolic and diastolic blood pressure. However, this net hypotensive effect was not statistically significant (systolic = -3.4 mmHg, 95% CI = -7.4 to 0.6; diastolic = -2.8 mmHg, 95% CI = -5.8 to 0.2). Adjusting for baseline differences in mean ambulatory blood pressure in an analysis of covariance led to a reduction in the estimated magnitude of the effect (systolic = -1.9 mmHg, 95% CI = -5.4 to 1.7, P = 0.31; diastolic = -2.2 mmHg, 95% CI = -4.9 to 0.5, P = 0.11). CONCLUSION: Despite high compliance with the exercise programme, the magnitude of the hypotensive effect of moderate intensity exercise was not as great as that found in studies of higher intensity exercise among hypertensives. Expectations of general practitioners and patients that a programme of moderate intensity

  13. Recognition of Intensive Valence and Arousal Affective States via Facial Electromyographic Activity in Young and Senior Adults

    PubMed Central

    Li, Hang; Walter, Steffen; Hrabal, David; Rukavina, Stefanie; Limbrecht-Ecklundt, Kerstin; Hoffman, Holger; Traue, Harald C.

    2016-01-01

    Background Research suggests that interaction between humans and digital environments characterizes a form of companionship in addition to technical convenience. To this effect, humans have attempted to design computer systems able to demonstrably empathize with the human affective experience. Facial electromyography (EMG) is one such technique enabling machines to access to human affective states. Numerous studies have investigated the effects of valence emotions on facial EMG activity captured over the corrugator supercilii (frowning muscle) and zygomaticus major (smiling muscle). The arousal emotion, specifically, has not received much research attention, however. In the present study, we sought to identify intensive valence and arousal affective states via facial EMG activity. Methods Ten blocks of affective pictures were separated into five categories: neutral valence/low arousal (0VLA), positive valence/high arousal (PVHA), negative valence/high arousal (NVHA), positive valence/low arousal (PVLA), and negative valence/low arousal (NVLA), and the ability of each to elicit corresponding valence and arousal affective states was investigated at length. One hundred and thirteen participants were subjected to these stimuli and provided facial EMG. A set of 16 features based on the amplitude, frequency, predictability, and variability of signals was defined and classified using a support vector machine (SVM). Results We observed highly accurate classification rates based on the combined corrugator and zygomaticus EMG, ranging from 75.69% to 100.00% for the baseline and five affective states (0VLA, PVHA, PVLA, NVHA, and NVLA) in all individuals. There were significant differences in classification rate accuracy between senior and young adults, but there was no significant difference between female and male participants. Conclusion Our research provides robust evidences for recognition of intensive valence and arousal affective states in young and senior adults. These

  14. Use of generalized population ratios to obtain Fe XV line intensities and linewidths at high electron densities

    NASA Technical Reports Server (NTRS)

    Kastner, S. O.; Bhatia, A. K.

    1980-01-01

    A generalized method for obtaining individual level population ratios is used to obtain relative intensities of extreme ultraviolet Fe XV emission lines in the range 284-500 A, which are density dependent for electron densities in the tokamak regime or higher. Four lines in particular are found to attain quite high intensities in the high-density limit. The same calculation provides inelastic contributions to linewidths. The method connects level populations and level widths through total probabilities t(ij), related to 'taboo' probabilities of Markov chain theory. The t(ij) are here evaluated for a real atomic system, being therefore of potential interest to random-walk theorists who have been limited to idealized systems characterized by simplified transition schemes.

  15. Penetration of High Intensity Radiated Fields (HIRF) Into General Aviation Aircraft

    NASA Technical Reports Server (NTRS)

    Balanis, Constantine A.; Birtcher, Craig R.; Georgakopoulos, Stavros V.; Panaretos, Anastasios H.

    2004-01-01

    The ability to design and achieve electromagnetic compatibility is becoming more challenging with the rapid development of new electronic products and technologies. The importance of electromagnetic interference (EMI) and electromagnetic compatibility (EMC) issues stems from the fact that the ambient electromagnetic environment has become very hostile; that is, it increases both in density and intensity, while the current trend in technology suggests the number of electronic devices increases in homes, businesses, factories, and transportation vehicles. Furthermore, the operating frequency of products coming into the market continuously increases. While cell phone technology has exceeded 1 GHz and Bluetooth operates at 2.4 GHz, products involving satellite communications operate near 10 GHz and automobile radar systems involve frequencies above 40 GHz. The concern about higher frequencies is that they correspond to smaller wavelengths, therefore electromagnetic waves are able to penetrate equipment enclosure through apertures or even small cracks more easily. In addition, electronic circuits have become small in size, and they are usually placed on motherboards or housed in boxes in very close proximity. Cosite interference and coupling in all electrical and electronic circuit assemblies are two essential issues that have to be examined in every design.

  16. General anesthesia for the provision of dental treatment to adults with developmental disability.

    PubMed Central

    Ananthanarayan, C.; Sigal, M.; Godlewski, W.

    1998-01-01

    The management of the behavior of mentally challenged adults when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Our institution has a designated program to provide required dental care to this group of patients. Because of the high incidence of poor cooperation, which may include aggressive antagonistic behavior, many of these patients are scheduled for dental care under general anesthesia with an incomplete preoperative medical assessment. The purpose of this study was to determine the impact and limitations that an incomplete medical assessment may present in the delivery of dental care under general anesthesia to these adults with developmental disability. After approval from the institutional review board, the medical records of 139 patients treated in this program between 1992 and 1994 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental and radiographic examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. There were 149 procedures performed on these patients, some more than once. The mean age was 29.5 yr. Males predominated females by a ratio of 2:1. All had multiple diagnoses, medical problems, and medications. Twenty-three patients had Down's Syndrome, four had schizophrenia disorders, 42 had seizure disorders, 11 had hypothyroidism, seven had heart disease, and 14 had central nervous system and neuromuscular disorders. The remainder had a variety of diagnoses, including rare syndromes. One hundred had intravenous (i.v.), 25 had mask inhalation, and 24 had intramuscular ketamine (Ketalar) induction. Nasotracheal intubation was uneventful in 139 patients, five had difficult visualization of the larynx and intubation. Ten patients experienced intraoperative complications, including nonfatal ventricular arrhythmia, slight fall in blood pressure and

  17. Adult language use and infant comprehension of English: associations with encoding and generalization across cues at 20 months.

    PubMed

    Phung, Janice N; Milojevich, Helen M; Lukowski, Angela F

    2014-11-01

    Adult-provided language shapes event memory in children who are preverbal and in those who are able to discuss the past using language. The research conducted to date, however, has not yet established whether infant language comprehension abilities moderate the extent to which preverbal infants benefit from adult-provided supportive language. The present study was conducted to address this question by examining immediate imitation and 1-week delayed generalization across cues in 20-month-old infants as a function of (a) variability in adult-provided linguistic support at encoding and test, (b) infant language comprehension abilities, and (c) their interaction. The provision of supportive adult language at encoding and test was associated with delayed generalization across cues although supportive adult language at encoding did not influence performance at immediate imitation. Infant language comprehension abilities were associated with performance at immediate imitation and delayed generalization across cues. In addition, infant language comprehension abilities moderated the extent to which infants benefited from adult-provided supportive language at encoding and test. The findings contribute to the literature by demonstrating that adult language use and infant language comprehension are independently and differentially associated with immediate imitation and 1-week delayed generalization across cues but also serve to jointly structure event memory in the second year of life. PMID:24983506

  18. Reduced intensity conditioning followed by peripheral blood stem cell transplantation for adult patients with high-risk acute lymphoblastic leukemia

    PubMed Central

    Stein, Anthony S.; Palmer, Joycelynne M.; O'Donnell, Margaret R.; Kogut, Neil M.; Spielberger, Ricardo T.; Slovak, Marilyn L.; Tsai, Ni-Chun; Senitzer, David; Snyder, David S.; Thomas, Sandra H.; J.Forman, Stephen

    2009-01-01

    Acute lymphoblastic leukemia (ALL) with high-risk features has a poor prognosis in adults despite aggressive chemotherapy. Reduced-intensity conditioning (RIC) is a lower toxicity alternative for high-risk patients requiring hematopoietic cell transplantation (HCT), however it has not been widely used for ALL. We conducted a retrospective study of 24 high-risk adult ALL patients who received an RIC regimen of fludarabine/melphalan prior to allogeneic peripheral blood stem cell transplant between 6/14/02 and 6/15/07 at City of Hope. Indications for the RIC regimen were: 1) age 50 or older (42%), 2) compromised organ function (54%), or 3) recipient of a previous HCT (37.5%). Patients had a median age of 47.5 years and the median follow-up was 28.5 months for living patients. Both overall survival and disease-free survival at two years was 61.5%. Relapse incidence was 21.1% and non-relapse mortality was 21.5% at two years. cGVHD developed in 86% of evaluable patients. In this series, no significant correlations were made between outcomes and patient age, presence of Philadelphia chromosome, relatedness of donor source or prior HCT. These high survival rates for high-risk ALL patients following RIC HCT may offer a promising option for patients not eligible for a standard myeloablative transplant. PMID:19822300

  19. Reduced-intensity conditioning using fludarabine, melphalan and thiotepa for adult patients undergoing haploidentical SCT

    PubMed Central

    Ciurea, SO; Saliba, R; Rondon, G; Pesoa, S; Cano, P; Fernandez-Vina, M; Qureshi, S; Worth, LL; McMannis, J; Kebriaei, P; Jones, RB; Korbling, M; Qazilbash, M; Shpall, EJ; Giralt, S; de Lima, M; Champlin, RE; Gajewski, J

    2014-01-01

    Haploidentical SCT (HaploSCT) has been most commonly performed using a myeloablative, TBI-based preparative regimen; however, the toxicity with this approach remains very high. We studied the feasibility of a reduced-intensity conditioning regimen in a phase II clinical trial using fludarabine, melphalan and thiotepa and antithymocyte globulin (ATG) for patients with advanced hematological malignancies undergoing T-cell depleted HaploSCT. Twenty-eight patients were entered in the study. Engraftment with donor-derived hematopoiesis was achieved in 78% of patients after a median of 13 days. Six patients experienced primary graft failure, three out of four tested patients had donor-specific anti-HLA antibodies (DSA) (P = 0.001). Toxicity included mostly infections. A total of 21 out of 22 patients with AML/myelodysplastic syndrome (MDS) achieved remission after transplant (16 with relapsed/refractory AML). Five out of the 12 patients (42%) with AML/MDS with <15% BM blasts survived long term as compared with none with more advanced disease (P = 0.03). HaploSCT with this fludarabine, melphalan and thiotepa and ATG RIC is an effective, well-tolerated conditioning regimen for patients with AML/MDS with low disease burden at the time of transplant and allowed a high rate of engraftment in patients without DSA. Patients with overt relapse fared poorly and require novel treatment strategies. PMID:19668237

  20. Acute high-intensity exercise-induced cognitive enhancement and brain-derived neurotrophic factor in young, healthy adults.

    PubMed

    Hwang, Jungyun; Brothers, R Matthew; Castelli, Darla M; Glowacki, Elizabeth M; Chen, Yen T; Salinas, Mandy M; Kim, Jihoon; Jung, Yeonhak; Calvert, Hannah G

    2016-09-01

    Acute exercise can positively impact cognition. The present study examined the effect of acute high-intensity aerobic exercise on prefrontal-dependent cognitive performance and brain-derived neurotrophic factor (BDNF). Fifty-eight young adults were randomly assigned to one of two experimental groups: (a) an acute bout of high-intensity exercise (n=29) or (b) a non-exercise control (n=29). Participants in the exercise group improved performance on inhibitory control in Stroop interference and on cognitive flexibility in Trail Making Test (TMT) Part-B compared with participants in the control group and increased BDNF immediately after exercise. There was a significant relationship between BDNF and TMT Part-B on the pre-post change following exercise. These findings provide support for the association between improved prefrontal-dependent cognitive performance and increased BDNF in response to acute exercise. We conclude that the changes in BDNF concentration may be partially responsible for prefrontal-dependent cognitive functioning following an acute bout of exercise. PMID:27450438

  1. Effect of a high intensity quadriceps fatigue protocol on knee joint mechanics and muscle activation during gait in young adults.

    PubMed

    Murdock, Gillian Hatfield; Hubley-Kozey, Cheryl L

    2012-02-01

    The purpose of this study was to determine the effect of impaired quadriceps function on knee joint biomechanics and neuromuscular function during gait. Surface electromyograms, three-dimensional motion and ground reaction forces were collected during gait before and after 20 healthy adults completed a high intensity quadriceps fatigue protocol. Pattern recognition techniques were utilized to examine changes in amplitude and temporal characteristics of all gait variables. The fatigue protocol resulted in decreased knee extensor torque generation and quadriceps median power frequencies for 18 of 20 participants (p < 0.05). The gait data from these 18 participants was analyzed. The knee external rotation angle increased (p < 0.05), the net external flexion and external rotation moments decreased (p < 0.05), and the net external adduction moment increased (p < 0.05). Post-fatigue changes in periarticular muscle activation patterns were consistent with the biomechanical changes, but were not significantly altered. Even for this low demand task of walking the knee motion and loading characteristics were altered following a high intensity fatigue protocol in a manner that may place the knee joint at greater risk for joint pathology and injury.

  2. Acute high-intensity exercise-induced cognitive enhancement and brain-derived neurotrophic factor in young, healthy adults.

    PubMed

    Hwang, Jungyun; Brothers, R Matthew; Castelli, Darla M; Glowacki, Elizabeth M; Chen, Yen T; Salinas, Mandy M; Kim, Jihoon; Jung, Yeonhak; Calvert, Hannah G

    2016-09-01

    Acute exercise can positively impact cognition. The present study examined the effect of acute high-intensity aerobic exercise on prefrontal-dependent cognitive performance and brain-derived neurotrophic factor (BDNF). Fifty-eight young adults were randomly assigned to one of two experimental groups: (a) an acute bout of high-intensity exercise (n=29) or (b) a non-exercise control (n=29). Participants in the exercise group improved performance on inhibitory control in Stroop interference and on cognitive flexibility in Trail Making Test (TMT) Part-B compared with participants in the control group and increased BDNF immediately after exercise. There was a significant relationship between BDNF and TMT Part-B on the pre-post change following exercise. These findings provide support for the association between improved prefrontal-dependent cognitive performance and increased BDNF in response to acute exercise. We conclude that the changes in BDNF concentration may be partially responsible for prefrontal-dependent cognitive functioning following an acute bout of exercise.

  3. Changes in the Bispectral Index in Response to Experimental Noxious Stimuli in Adults under General Anesthesia

    PubMed Central

    Coleman, Robin Marie; Gélinas, Céline; Choinière, Manon; Parenteau-Goudreault, Elizabeth; Bourgault, Patricia

    2013-01-01

    Objective. Pain assessment is a major challenge in nonverbal patients in the intensive care unit (ICU). Recent studies suggest a relationship between the Bispectral Index (BIS) and nociceptive stimuli. This study was designed to examine changes in BIS in response to experimental noxious stimuli. Methods. Thirty participants under general anesthesia were in this quasiexperimental, within subject, pre- and poststudy. In the operating room (OR), BIS was monitored during moderate and severe noxious stimuli, induced by a thermal probe on the participants' forearm, after induction of general anesthesia, prior to surgery. Results. Significant increases in BIS occurred during moderate (increase from 35.00 to 40.00, P = 0.003) and severe noxious stimuli (increase from 37.67 to 40.00, P = 0.007). ROC showed a sensitivity (Se) of 40.0% and a specificity (Sp) of 73.3% at a BIS value > 45, in distinguishing a moderate from a severe noxious stimuli. Conclusion. BIS increased in response to moderate and severe noxious stimuli. The Se and Sp of the BIS did not support the use of the BIS for distinction of different pain intensities in the context of deep sedation in the OR. However, the results justify further studies in more lightly sedated patients such as those in the ICU. PMID:27335878

  4. Sustainability of lifestyle changes following an intensive lifestyle intervention in insulin resistant adults: Follow-up at 2-years.

    PubMed

    Dale, Kelly S; Mann, Jim I; McAuley, Kirsten A; Williams, Sheila M; Farmer, Victoria L

    2009-01-01

    The objective of this study was to determine whether overweight insulin resistant individuals who lost weight and improved cardiovascular risk factors during a 4-month lifestyle intervention could sustain these lifestyle changes in the long-term. Seventy-nine insulin resistant adults were randomised to a control group or either a modest or intensive lifestyle intervention group for 4-months. Thereafter the two intervention groups were combined and all participants were followed-up at 8, 12 and 24 months. Anthropometry, blood pressure, fasting glucose, lipids, insulin and aerobic fitness were measured and dietary intake was assessed. An interview was conducted to determine factors which participants perceived facilitated or hindered maintenance of healthy lifestyle habits. Seventy-two (91.1%), sixty-nine (87.3%) and sixty-two (78.5%) participants were retained at 8, 12 and 24-month respectively. At 4-months the adjusted difference in weight between the modest and control groups was -3.4 kg (95% CI -5.4, -1.3) p=0.002 and intensive and control groups was -4.7 kg (-6.9, -2.4) p=0.0001 respectively. At 2-years there were no significant differences for weight when the initial 3 groups were compared or when the combined intervention group was compared with the control group. At 2-years, 64% of participants reported that more frequent follow-up would have helped them to maintain healthy lifestyle habits. Even intensive counselling for 4-months with 4-monthly and then yearly monitoring were not enough for maintaining lifestyle changes sufficient to sustain weight loss. More frequent monitoring for an indefinite period was perceived by two-thirds of participants as necessary for them to maintain their initial lifestyle changes.

  5. A facile and general route to synthesize silica-coated SERS tags with the enhanced signal intensity

    NASA Astrophysics Data System (ADS)

    Zhang, Youlin; Li, Xiaokun; Xue, Bin; Kong, Xianggui; Liu, Xiaomin; Tu, Langping; Chang, Yulei

    2015-10-01

    Silica-coated SERS tags have been attracting greater attention in recent years. However, the reported methods to synthesize these tags are tedious, and often subjected to the limited signal intensity. Here, we report a facile and general method to prepare the silica-coated Ag SERS tags with the enhanced signal intensity by no introducing the primers. This approach mainly depends on the colloidal stability of the Ag NPs in alcohol solution. By decreasing the concentration of salt in Ag NP solution, the citrate-stabilized Ag NPs can be well dispersed in alcohol solution. Based on this, the Ag SERS tags can be directly coated with thickness-controlled and homogeneous silica shells. This approach is highly reproducible for silica shell growth and signal intensity, not depending on the properties of Raman molecules, proved by 7 kinds of the Raman molecules. Moreover, this kind of SERS tags coated with silica hold the stronger SERS signals than the traditional method due to no interference from the priming molecules.

  6. A facile and general route to synthesize silica-coated SERS tags with the enhanced signal intensity

    PubMed Central

    Zhang, Youlin; Li, Xiaokun; Xue, Bin; Kong, Xianggui; Liu, Xiaomin; Tu, Langping; Chang, Yulei

    2015-01-01

    Silica-coated SERS tags have been attracting greater attention in recent years. However, the reported methods to synthesize these tags are tedious, and often subjected to the limited signal intensity. Here, we report a facile and general method to prepare the silica-coated Ag SERS tags with the enhanced signal intensity by no introducing the primers. This approach mainly depends on the colloidal stability of the Ag NPs in alcohol solution. By decreasing the concentration of salt in Ag NP solution, the citrate-stabilized Ag NPs can be well dispersed in alcohol solution. Based on this, the Ag SERS tags can be directly coated with thickness-controlled and homogeneous silica shells. This approach is highly reproducible for silica shell growth and signal intensity, not depending on the properties of Raman molecules, proved by 7 kinds of the Raman molecules. Moreover, this kind of SERS tags coated with silica hold the stronger SERS signals than the traditional method due to no interference from the priming molecules. PMID:26450559

  7. Conditional discrimination in mentally retarded adults: the development of generalized skills.

    PubMed Central

    Saunders, K J; Spradlin, J E

    1990-01-01

    The development of generalized conditional discrimination skills was examined in adults with retardation. Two subjects with histories of failure to acquire arbitrary matching under trial-and-error procedures were successful under procedures that trained one or more prerequisite skills. The successive discrimination between the sample stimuli was established by training the subjects to name the stimuli. The simultaneous discrimination between the comparison stimuli was established using either (a) standard simple discrimination training with reversals or (b) a procedure in which each of the two sample-comparison relations in the conditional discrimination was presented in blocks of trials, with the size of the blocks decreasing gradually until sample presentation was randomized. The amount of prerequisite training required varied across subjects and across successive conditional discriminations. After acquiring either two or three conditional discriminations with component training, both subjects learned new conditional discriminations under trial-and-error procedures. In general, each successive conditional discrimination was acquired more rapidly. Tests showed that conditional responding had become a generalized skill. Symmetry was shown for almost all trained relations. Symmetry trial samples were ultimately named the same as the stimuli to which they were related in training. PMID:2103584

  8. Cognitive Behavioral Treatment for Older Adults with Generalized Anxiety Disorder: A Therapist Manual for Primary Care Settings

    ERIC Educational Resources Information Center

    Stanley, Melinda A.; Diefenbach, Gretchen J.; Hopko, Derek R.

    2004-01-01

    At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project…

  9. Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults.

    PubMed

    Yu, Canqing; Shi, Zumin; Lv, Jun; Du, Huaidong; Qi, Lu; Guo, Yu; Bian, Zheng; Chang, Liang; Tang, Xuefeng; Jiang, Qilian; Mu, Huaiyi; Pan, Dongxia; Chen, Junshi; Chen, Zhengming; Li, Liming

    2015-07-15

    Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30-79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03-1.08) and central obesity (PR: 1.07, 95% CI: 1.06-1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02-1.09) and 1.17 (1.25-1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships.

  10. Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults

    PubMed Central

    Yu, Canqing; Shi, Zumin; Lv, Jun; Du, Huaidong; Qi, Lu; Guo, Yu; Bian, Zheng; Chang, Liang; Tang, Xuefeng; Jiang, Qilian; Mu, Huaiyi; Pan, Dongxia; Chen, Junshi; Chen, Zhengming; Li, Liming

    2015-01-01

    Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30–79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03–1.08) and central obesity (PR: 1.07, 95% CI: 1.06–1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02–1.09) and 1.17 (1.25–1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships. PMID:26184308

  11. Season of birth and population schizotypy: Results from a large sample of the adult general population.

    PubMed

    Konrath, Lisa; Beckius, Danièle; Tran, Ulrich S

    2016-08-30

    Although the last years have seen an increasing interest in schizotypy and its pathogenesis, there exist only a handful of studies examining the possible interaction between season of birth (SOB) and schizotypic personality structure. Available research used differing screening instruments, rendering comparisons between studies difficult, and sample sizes in adult populations may have been too small to detect a mild effect. The current study examined the association between SOB and psychometric schizotypy in the so far single-largest sample from the adult general population (N=8114), balanced for men and women, and utilizing a valid and reliable instrument for the assessment of schizotypy. Using the 12 most informative items of the Schizotypal Personality Questionnaire Brief, we obtained evidence of a small, but significant, effect of late winter and early spring births (February/March) on psychometric schizotypy. The effect was not constrained to women, but affected men and women alike. The observed association between SOB and schizotypy appears compatible with seasonal variations of temperature and influenza prevalence, and with recent evidence on seasonal variability in the activity of the human immune system. Our findings lend support to the continuum hypothesis of schizotypy and schizophrenia, for which SOB effects have been previously established. PMID:27310922

  12. More than words: fast acquisition and generalization of orthographic regularities during novel word learning in adults.

    PubMed

    Laine, Matti; Polonyi, Tünde; Abari, Kálmán

    2014-08-01

    In literates, reading is a fundamental channel for acquiring new vocabulary both in the mother tongue and in foreign languages. By using an artificial language learning task, we examined the acquisition of novel written words and their embedded regularities (an orthographic surface feature and a syllabic feature) in three groups of university students with different exposures (Group 1 saw 2 words once, Group 2 saw 20 words once, Group 3 saw 20 words three times). Recognition memory results for Groups 2 and 3 indicated that adults can learn novel written words even with just a single exposure, albeit repeated exposure improved target detection. A generalization task revealed that even the minimal exposure in Group 1 was enough for acquisition of the two embedded regularities. More exemplars and repeated exposure provided more robust effects for the syllable regularity. Finally, post-test interview showed that repeated exposure was needed to become aware of the regularities. The present results show that adults learn novel written words and their inherent regularities in a fast and effective fashion.

  13. Retinal Microvasculature Is Associated With Long-Term Survival in the General Adult Dutch Population.

    PubMed

    Mutlu, Unal; Ikram, M Kamran; Wolters, Frank J; Hofman, Albert; Klaver, Caroline C W; Ikram, M Arfan

    2016-02-01

    Retinal vascular diameters are associated with (sub)clinical cardiovascular disease and short-term cardiovascular mortality, but their association with long-term mortality is uncertain. We studied the association of retinal vascular diameters with cause-specific mortality in the general adult Dutch population during 25 years of follow-up. From 1990 to 1993, arteriolar and venular diameters were measured semiautomatically on digitized images in 5674 persons (mean age 68.0 years, 59% women) from the population-based Rotterdam study. Follow-up for mortality was complete till March 2015. Associations between vascular diameters and mortality were examined using Cox proportional hazards models, adjusting for age, sex, cardiovascular risk factors, and the fellow vessel diameter. During 85 770 person-years (mean±SD: 15.1±6.67), 3794 (66.8%) persons died, of whom 1034 due to cardiovascular causes. We found that narrower arterioles and wider venules were associated with higher risk of mortality (adjusted hazard ratio [95% confidence interval] per SD decrease 1.04 [1.00-1.08] and increase 1.07 [1.03-1.12], respectively). For arterioles, these associations were strongest for cardiovascular mortality, whereas venules showed consistent associations for cardiovascular and noncardiovascular mortality. Importantly, these associations remained unchanged after excluding the first 10 years of follow-up as immortal person-time. We found evidence for effect modification with stronger associations in persons <70 years (venules only) and smokers (P value for interaction<0.01). We replicated our findings in another independent cohort from the Rotterdam Study of 3106 persons with 19 880 person-years of follow-up and 144 deaths (hazard ratio for venules 1.22 [1.00-1.49]). Markers of retinal microvasculature are associated with long-term mortality in the general adult Dutch population. PMID:26628677

  14. Intestinal helminth infections amongst HIV-infected adults in Mthatha General Hospital, South Africa

    PubMed Central

    Yogeswaran, Parimalaranie; Wright, Graham

    2015-01-01

    Background In South Africa, studies on the prevalence of intestinal helminth co-infection amongst HIV-infected patients as well as possible interactions between these two infections are limited. Aim To investigate the prevalence of intestinal helminth infestation amongst adults living with HIV or AIDS at Mthatha General Hospital. Setting Study participants were recruited at the outpatient department of Mthatha General Hospital, Mthatha, South Africa. Methods This cross-sectional study was conducted between October and December 2013 amongst consecutive consenting HIV-positive adult patients. Socio-demographic and clinical information were obtained using data collection forms and structured interviews. Stool samples were collected to investigate the presence of helminths whilst blood samples were obtained for the measurement of CD4+ T-cell count and viral load. Results Data were obtained on 231 participants, with a mean age of 34.9 years, a mean CD4 count of 348 cells/µL and a mean viral load of 4.8 log10 copies/mL. Intestinal helminth prevalence was 24.7%, with Ascaris Lumbricoides (42.1%) the most prevalent identified species. Statistically significant association was found between CD4 count of less than 200 cells/µL and helminth infection (p = 0.05). No statistically significant association was found between intestinal helminth infection and the mean CD4 count (p = 0.79) or the mean viral load (p = 0.98). Conclusion A high prevalence of intestinal helminth infections was observed amongst the study population. Therefore, screening and treatment of helminths should be considered as part of the management of HIV and AIDS in primary health care. PMID:26842519

  15. The activity intensities reached when playing active tennis gaming relative to sedentary gaming, tennis game-play, and current activity recommendations in young adults.

    PubMed

    Scanlan, Aaron T; Arkinstall, Hayley; Dalbo, Vincent J; Humphries, Brendan J; Jennings, Cameron T; Kingsley, Michael I C

    2013-09-01

    Although active gaming is popular and can increase energy expenditure in young adults, its efficacy as a prescriptive exercise tool is not well understood. This study aimed to: (a) compare the activity intensities experienced by young adults while playing active tennis gaming with conventional sedentary gaming, tennis game-play, and current activity recommendations for health; and (b) identify changes in activity intensities across playing time. After habitualization, 10 active young adults (age: 20.2 ± 0.4 years; stature: 1.74 ± 0.03 m; body mass: 67.7 ± 3.3 kg) completed 3 experimental trials (sedentary gaming, active tennis gaming, and tennis game-play) on separate days in a randomized order. Heart rate (HR) and metabolic equivalents (METs) were averaged across 5 minutes and 10 minutes intervals, and the entire 20 minutes bout within each condition. Active gaming produced greater intensities across 5-10, 10-15, and 15-20 minutes time intervals compared with sedentary gaming (p < 0.01). Tennis game-play elicited greater HR (67 ± 5% HR(max)) and METs (5.0 ± 0.2) responses than both sedentary (40 ± 2% HR(max), 1.1 ± 0.1 METs) and active gaming (45 ± 2% HR(max), 1.4 ± 0.1 METs) (p < 0.001). Only tennis game-play produced activity intensities meeting current recommendations for health benefit. Lower HR intensities were reached across 0-5 minutes than during later time intervals during active gaming (6%) and tennis game-play (9%) (p < 0.01). Activity intensities elicited by active gaming were greater than sedentary gaming but less than tennis game-play and insufficient to contribute toward promoting and maintaining good health in young adults. These data suggest that active tennis gaming should not be recommended by exercise professionals as a substitute for actual sports participation in young adults.

  16. Brain responses before and after intensive second language learning: proficiency based changes and first language background effects in adult learners.

    PubMed

    White, Erin Jacquelyn; Genesee, Fred; Steinhauer, Karsten

    2012-01-01

    This longitudinal study tracked the neuro-cognitive changes associated with second language (L2) grammar learning in adults in order to investigate how L2 processing is shaped by a learner's first language (L1) background and L2 proficiency. Previous studies using event-related potentials (ERPs) have argued that late L2 learners cannot elicit a P600 in response to L2 grammatical structures that do not exist in the L1 or that are different in the L1 and L2. We tested whether the neuro-cognitive processes underlying this component become available after intensive L2 instruction. Korean- and Chinese late-L2-learners of English were tested at the beginning and end of a 9-week intensive English-L2 course. ERPs were recorded while participants read English sentences containing violations of regular past tense (a grammatical structure that operates differently in Korean and does not exist in Chinese). Whereas no P600 effects were present at the start of instruction, by the end of instruction, significant P600s were observed for both L1 groups. Latency differences in the P600 exhibited by Chinese and Korean speakers may be attributed to differences in L1-L2 reading strategies. Across all participants, larger P600 effects at session 2 were associated with: 1) higher levels of behavioural performance on an online grammaticality judgment task; and 2) with correct, rather than incorrect, behavioural responses. These findings suggest that the neuro-cognitive processes underlying the P600 (e.g., "grammaticalization") are modulated by individual levels of L2 behavioural performance and learning.

  17. Is it important to maintain high-dose intensity chemotherapy in the treatment of adults with osteosarcoma?

    PubMed

    Kushnir, I; Kolander, Y; Bickels, J; Gortzak, Y; Flusser, G; Issakov, J; Merimsky, O

    2014-05-01

    Neoadjuvant chemotherapy for osteosarcoma is the standard of care, but there is still confusion regarding the best chemotherapy regimen and the optimal intensity. This retrospective study intends to evaluate whether there is a clear correlation between the chemotherapy dose intensity (DI) and the percentage of tumor necrosis, the risk of tumor recurrence after surgery and patient survival. The medical records of all adult patients with localized osteosarcoma that received treatment between the years of 1998 and 2009 at the Tel Aviv Sourasky Medical Center were analyzed. We used multiple logistic/linear regression models to test the effect of the neoadjuvant chemotherapy relative DI (RDI) on histological response, recurrence and time to recurrence. A Cox regression analysis was conducted for the effects of neoadjuvant chemotherapy RDI, histological response, tumor location, gender and age on patient survival. Thirty medical records were analyzed. Survival, histological response, recurrence and time to recurrence were not affected by the chemotherapy RDI. The 5-year overall survival of the patient's population was found to be 63% with a median survival of 9.4 years. Patients with a good histological response had a longer survival than those with a bad response (mean survival times 11.0 vs. 6.6 years, log-rank test, P = 0.046). High DI is not a prognostic factor in osteosarcoma and maintaining it should not be a prime priority. Histological response is a prognostic but possibly not a reliable predictive factor, and further research is needed in order to find other reliable factors. PMID:24719037

  18. Brain Responses before and after Intensive Second Language Learning: Proficiency Based Changes and First Language Background Effects in Adult Learners

    PubMed Central

    White, Erin Jacquelyn; Genesee, Fred; Steinhauer, Karsten

    2012-01-01

    This longitudinal study tracked the neuro-cognitive changes associated with second language (L2) grammar learning in adults in order to investigate how L2 processing is shaped by a learner’s first language (L1) background and L2 proficiency. Previous studies using event-related potentials (ERPs) have argued that late L2 learners cannot elicit a P600 in response to L2 grammatical structures that do not exist in the L1 or that are different in the L1 and L2. We tested whether the neuro-cognitive processes underlying this component become available after intensive L2 instruction. Korean- and Chinese late-L2-learners of English were tested at the beginning and end of a 9-week intensive English-L2 course. ERPs were recorded while participants read English sentences containing violations of regular past tense (a grammatical structure that operates differently in Korean and does not exist in Chinese). Whereas no P600 effects were present at the start of instruction, by the end of instruction, significant P600s were observed for both L1 groups. Latency differences in the P600 exhibited by Chinese and Korean speakers may be attributed to differences in L1–L2 reading strategies. Across all participants, larger P600 effects at session 2 were associated with: 1) higher levels of behavioural performance on an online grammaticality judgment task; and 2) with correct, rather than incorrect, behavioural responses. These findings suggest that the neuro-cognitive processes underlying the P600 (e.g., “grammaticalization”) are modulated by individual levels of L2 behavioural performance and learning. PMID:23300641

  19. Effectiveness of Guided and Unguided Low-Intensity Internet Interventions for Adult Alcohol Misuse: A Meta-Analysis

    PubMed Central

    Riper, Heleen; Blankers, Matthijs; Hadiwijaya, Hana; Cunningham, John; Clarke, Stella; Wiers, Reinout; Ebert, David; Cuijpers, Pim

    2014-01-01

    Background Alcohol misuse ranks within the top ten health conditions with the highest global burden of disease. Low-intensity, Internet interventions for curbing adult alcohol misuse have been shown effective. Few meta-analyses have been carried out, however, and they have involved small numbers of studies, lacked indicators of drinking within low risk guidelines, and examined the effectiveness of unguided self-help only. We therefore conducted a more thorough meta-analysis that included both guided and unguided interventions. Methods Systematic literature searches were performed up to September 2013. Primary outcome was the mean level of alcohol consumption and drinking within low risk guidelines for alcohol consumption at post-treatment. Findings We selected 16 randomised controlled trials (with 23 comparisons and 5,612 participants) for inclusion. Results, showed a small but significant overall effect size in favour of Internet interventions (g = 0.20, 95% CI: 0.13–0.27, p<.001). Participants in Internet interventions drunk on average 22 grams of ethanol less than controls and were significantly more likely to be adhering to low-risk drinking guidelines at post-treatment (RD 0.13, 95% CI: 0.09–0.17, p<.001). Subgroup analyses revealed no significant differences in potential moderators for the outcome of alcohol consumption, although there was a near-significant difference between comparisons with waitlist control and those with assessment-only or alcohol information control conditions (p = .056). Conclusions Internet interventions are effective in reducing adult alcohol consumption and inducing alcohol users to adhere to guidelines for low-risk drinking. This effect is small but from a public health point of view this may warrant large scale implementation at low cost of Internet interventions for adult alcohol misuse. Moderator analyses with sufficient power are, however, needed in order to assess the robustness of these overall results and to

  20. Machiavellianism and Adult Attachment in General Interpersonal Relationships and Close Relationships

    PubMed Central

    Ináncsi, Tamás; Láng, András; Bereczkei, Tamás

    2015-01-01

    Up to the present, the relationship between Machiavellianism and adult attachment has remained a question to be answered in the psychological literature. That is why this study focused on the relationship between Machiavellianism and attachment towards significant others in general interpersonal relationships and in intimate-close relationships. Two attachment tests (Relationship Questionnaire and long-form of Experiences in Close Relationship) and the Mach-IV test were conducted on a sample consisting of 185 subjects. Results have revealed that Machiavellian subjects show a dismissing-avoidant attachment style in their general interpersonal relationships, while avoidance is further accompanied by some characteristics of attachment anxiety in their intimate-close relationships. Our findings further refine the relationship between Machiavellianism and dismissing-avoidant attachment. Machiavellian individuals not only have a negative representation of significant others, but they also tend to seek symbiotic closeness in order to exploit their partners. This ambitendency in distance regulation might be particularly important in understanding the vulnerability of Machiavellian individuals. PMID:27247647

  1. Effect of Exercise Intensity on Percent Body Fat Determined by Leg-to-Leg and Segmental Bioelectrical Impedance Analyses in Adults

    ERIC Educational Resources Information Center

    Andreacci, Joseph L.; Nagle, Trisha; Fitzgerald, Elise; Rawson, Eric S.; Dixon, Curt B.

    2013-01-01

    Purpose: We examined the impact that cycle ergometry exercise had on percent body fat (%BF) estimates when assessed using either leg-to-leg or segmental bioelectrical impedance analysis (LBIA; SBIA) and whether the intensity of the exercise bout impacts the %BF magnitude of change. Method: Seventy-four college-aged adults participated in this…

  2. Hoarding behaviors among nonclinical elderly adults: correlations with hoarding cognitions, obsessive-compulsive symptoms, and measures of general psychopathology.

    PubMed

    Reid, Jeannette M; Arnold, Elysse; Rosen, Sabra; Mason, Greg; Larson, Michael J; Murphy, Tanya K; Storch, Eric A

    2011-12-01

    This study examines correlates of hoarding behaviors among nonclinical elderly adults, focusing upon hoarding cognitions, obsessive-compulsive symptoms, and measures of general psychopathology. Two hundred and sixty-nine adults aged 56-93 years (M=72.49 years) completed the Saving Inventory-Revised, Savings Cognitions Inventory-Revised, Obsessive Compulsive Inventory-Revised, Social Interaction Anxiety Scale, Penn State Worry Questionnaire, and Beck Depression Inventory. Our geriatric sample evidenced significantly greater severity of hoarding behaviors than did a younger community sample (24-72 years; M=44.4 years; Frost, Steketee, & Grishman, 2004). Within our sample, moderate correlations were found between hoarding behaviors and hoarding cognitions; however, controlling for obsessive-compulsive and depressive symptoms resulted in reduced-magnitude associations. As well, relationships between obsessive-compulsive symptoms and both hoarding behaviors and hoarding cognitions were generally strong, with most relationships diminishing after controlling for depressive symptoms. Associations between hoarding symptoms and symptoms of social anxiety, general worry, and depression were generally moderate. A significant regression model showed depressive symptoms explaining the most unique variance in hoarding behaviors. Findings confirm a relatively greater severity of hoarding behaviors in older adults (as compared to younger adults) and suggest that related psychopathology plays a critical role in hoarding expression among older adults. As well, the current study contributes to the ongoing investigation of the diagnostic categorization of compulsive hoarding.

  3. Sex Differences in the Effects of Mental Work and Moderate-Intensity Physical Activity on Energy Intake in Young Adults

    PubMed Central

    Drapeau, Vicky; Sénécal, Caroline; Tremblay, Angelo

    2013-01-01

    The aim of this study was to examine the acute effects of mental work and moderate-intensity physical activity on various components of energy balance in young and healthy adults. With the use of a randomized crossover design, 35 participants aged 24 ± 3 years completed three 45-min conditions, namely, (i) resting in a sitting position (control), (ii) reading and writing (mental work (MW)), and (iii) exercising on a treadmill at 40% of peak oxygen uptake (exercise), followed by an ad libitum lunch. The endpoints were spontaneous energy intake (EI), energy expenditure (EE), appetite sensations, and EI for the remainder of the day. We observed that the energy cost of the control and MW conditions was about the same whereas the exercise condition increased EE to a greater extent in men than women. Exercise induced a decrease in EI relative to EE compared to the control condition that was more pronounced in men than women. However, women tended to increase their energy intake after the MW condition compared to the control one whereas an opposite trend was observed in men. None of the appetite sensation markers differed significantly between both sexes. In conclusion, men and women have specific food intake patterns when submitted to cognitive and physical stimuli. PMID:24967260

  4. Hippocampal structure, metabolism, and inflammatory response after a 6-week intense aerobic exercise in healthy young adults: a controlled trial.

    PubMed

    Wagner, Gerd; Herbsleb, Marco; de la Cruz, Feliberto; Schumann, Andy; Brünner, Franziska; Schachtzabel, Claudia; Gussew, Alexander; Puta, Christian; Smesny, Stefan; Gabriel, Holger W; Reichenbach, Jürgen R; Bär, Karl-Jürgen

    2015-10-01

    Interventional studies suggest that changes in physical fitness affect brain function and structure. We studied the influence of high intensity physical exercise on hippocampal volume and metabolism in 17 young healthy male adults during a 6-week exercise program compared with matched controls. We further aimed to relate these changes to hypothesized changes in exercised-induced brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). We show profound improvement of physical fitness in most subjects and a positive correlation between the degree of fitness improvement and increased BDNF levels. We unexpectedly observed an average volume decrease of about 2%, which was restricted to right hippocampal subfields CA2/3, subiculum, and dentate gyrus and which correlated with fitness improvement and increased BDNF levels negatively. This result indicates that mainly those subjects who did not benefit from the exercise program show decreased hippocampal volume, reduced BDNF levels, and increased TNF-α concentrations. While spectroscopy results do not indicate any neuronal loss (unchanged N-acetylaspartate levels) decreased glutamate-glutamine levels were observed in the right anterior hippocampus in the exercise group only. Responder characteristics need to be studied in more detail. Our results point to an important role of the inflammatory response after exercise on changes in hippocampal structure. PMID:26082010

  5. Malaria is related to decreased nutritional status among male adolescents and adults in the setting of intense perennial transmission.

    PubMed

    Friedman, Jennifer F; Kurtis, Jonathan D; Mtalib, Ramadhan; Opollo, Malachi; Lanar, David E; Duffy, Patrick E

    2003-08-01

    We studied the impact of Plasmodium falciparum on nutritional status in a longitudinal cohort of 147 young men in western Kenya, where malaria transmission is intense and perennial. All volunteers received treatment to eradicate parasitemia and then provided weekly blood smears during a 16-week transmission season. We measured body mass index (BMI), pubertal development, frequency and density of parasitemia, and tumor necrosis factor (TNF)-alpha production by peripheral blood mononuclear cells. During early puberty, mean parasite density had a strong negative effect on the natural increase in BMI. Among older individuals, TNF-alpha production in response to malarial antigen predicted a significantly lower BMI (P<.03), equal to 4.6 kg for a man of average height. Our data indicate that burden of parasitemia has a detrimental effect on the nutritional status of early adolescents and that malaria may continue to influence nutritional status among older adolescents and adults via host elaboration of proinflammatory cytokines. These effects of malaria may have pervasive health and socioeconomic consequences in areas where malaria is endemic.

  6. Hippocampal structure, metabolism, and inflammatory response after a 6-week intense aerobic exercise in healthy young adults: a controlled trial.

    PubMed

    Wagner, Gerd; Herbsleb, Marco; de la Cruz, Feliberto; Schumann, Andy; Brünner, Franziska; Schachtzabel, Claudia; Gussew, Alexander; Puta, Christian; Smesny, Stefan; Gabriel, Holger W; Reichenbach, Jürgen R; Bär, Karl-Jürgen

    2015-10-01

    Interventional studies suggest that changes in physical fitness affect brain function and structure. We studied the influence of high intensity physical exercise on hippocampal volume and metabolism in 17 young healthy male adults during a 6-week exercise program compared with matched controls. We further aimed to relate these changes to hypothesized changes in exercised-induced brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). We show profound improvement of physical fitness in most subjects and a positive correlation between the degree of fitness improvement and increased BDNF levels. We unexpectedly observed an average volume decrease of about 2%, which was restricted to right hippocampal subfields CA2/3, subiculum, and dentate gyrus and which correlated with fitness improvement and increased BDNF levels negatively. This result indicates that mainly those subjects who did not benefit from the exercise program show decreased hippocampal volume, reduced BDNF levels, and increased TNF-α concentrations. While spectroscopy results do not indicate any neuronal loss (unchanged N-acetylaspartate levels) decreased glutamate-glutamine levels were observed in the right anterior hippocampus in the exercise group only. Responder characteristics need to be studied in more detail. Our results point to an important role of the inflammatory response after exercise on changes in hippocampal structure.

  7. Treatment of ununited femoral neck fractures in young adults using low-intensity pulsed ultrasound: Report of 2 cases

    PubMed Central

    Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kuroda, Ryosuke; Kurosaka, Masahiro

    2016-01-01

    Introduction Delayed union and non-union of displaced femoral neck fractures remains a difficult clinical problem for orthopaedic surgeons. In the physiologically young patient, every effort should be made to preserve the native hip joint. We present two cases of ununited femoral neck fractures in young adults who were successfully treated with low-intensity pulsed ultrasound (LIPUS) and showed satisfactory results. Presentation of case 1 A 41-year-old woman was involved in a motor vehicle crash and was diagnosed with displaced femoral neck fracture. Eleven months after internal fixation, a computed tomography (CT) scan revealed the presence of non-union of the femoral neck. LIPUS treatment was therefore initiated. After eight months, the fracture was completely consolidated. Presentation of case 2 A 39-year-old man was involved in a cycling accident and was diagnosed with displaced femoral neck fracture. Thirteen weeks after internal fixation, a CT scan revealed delayed union of the femoral neck. LIPUS treatment was therefore initiated. After six months, the fracture was completely consolidated. Conclusion We suggest use of LIPUS as a possible treatment approach for delayed union and non-union of displaced femoral neck fractures in young patients before considering further surgical intervention. PMID:26942332

  8. Lifestyle and genetic determinants of folate and vitamin B12 levels in a general adult population.

    PubMed

    Thuesen, Betina H; Husemoen, Lise Lotte N; Ovesen, Lars; Jørgensen, Torben; Fenger, Mogens; Linneberg, Allan

    2010-04-01

    Danish legislation regarding food fortification has been very restrictive resulting in few fortified food items on the Danish market. Folate and vitamin B12 deficiency is thought to be common due to inadequate intakes but little is known about the actual prevalence of low serum folate and vitamin B12 in the general population. The aim of the present study was to evaluate the folate and vitamin B12 status of Danish adults and to investigate associations between vitamin status and distinct lifestyle and genetic factors. The study included a random sample of 6784 individuals aged 30-60 years. Information on lifestyle factors was obtained by questionnaires and blood samples were analysed for serum folate and vitamin B12 concentrations and several genetic polymorphisms. The overall prevalence of low serum folate ( < 6.8 nmol/l) was 31.4 %. Low serum folate was more common among men than women and the prevalence was lower with increasing age. Low serum folate was associated with smoking, low alcohol intake, high coffee intake, unhealthy diet, and the TT genotype of the methylenetetrahydrofolate reductase (MTHFR)-C677T polymorphism. The overall prevalence of low serum vitamin B12 ( < 148 pmol/l) was 4.7 %. Low serum vitamin B12 was significantly associated with female sex, high coffee intake, low folate status, and the TT genotype of the MTHFR-C677T polymorphism. In conclusion, low serum folate was present in almost a third of the adult population in the present study and was associated with several lifestyle factors whereas low serum concentrations of vitamin B12 were less common and only found to be associated with a few lifestyle factors.

  9. GENERALIZED CYTOMEGALIC INCLUSION-BODY DISEASE ASSOCIATED WITH PNEUMOCYSTIS PNEUMONIA IN ADULTS

    PubMed Central

    Symmers, W. St. C.

    1960-01-01

    Three cases of generalized cytomegalic inclusion-body disease (salivary virus disease) in adults are reported, bringing the number of published cases up to 34. The infection is very rare in adults although well known in infants. As is often found in infants with this disease, pneumonia due to Pneumocystis carinii was also present in each case. The first patient had Wegener's granulomatosis, which presented with acute otitis media: a review of histological material obtained at mastoidectomy eight weeks before death showed that inclusion-body cytomegaly was already present then. Various antibiotics and prednisolone were given, and the lesions in the respiratory organs and the arteritis healed to a considerable extent. Renal failure, however, was progressive and led to death. The second patient had thrombotic purpura and died after a few weeks' illness, during which oxytetracycline and hydrocortisone were given. Congenital absence of the spleen was found at laparotomy, which was performed with the object of doing a splenectomy. Focal cryptococcal pneumonia was present post mortem: six years before death a solitary cryptococcal granuloma of one lung had been treated by lobectomy. The third patient had had Hodgkin's disease for 18 years. During the first 12 years the disease had the characteristics of the so-called indolent form (“Hodgkin's paragranuloma”) and it then passed into the typical form. Deep x-ray therapy and cytotoxic drugs were used during the course of the disease at various times, and streptomycin and tuberculostatic drugs were given because of intercurrent tuberculous meningitis which developed three months before death. In all three cases it seems likely that the underlying disease, or the drugs used in its treatment, predisposed to cytomegalic inclusion-body disease and concomitant pneumocystis pneumonia by lowering the patients' resistance. Just as some unusual types of fungal and bacterial infections have become less rare since the introduction

  10. CIRCULAR INTENSITY DIFFERENTIAL SCATTERING OF LIGHT BY HELICAL STRUCTURES. III. A GENERAL POLARIZABILITY TENSOR AND ANOMALOUS SCATTERING

    SciTech Connect

    Bustamante, Carlos; Maestre, Marcos F.; Tinoco, Jr., Ignacio

    1980-11-01

    Numerical calculations of the circular intensity differential scattering of light by oriented helical structures made of units with general polarizability tensors are presented. The effects on the scattering patterns of both absorptive and dispersive properties of the units are illustrated. The differential scattering and the total scattering both show anomalous scattering phenomena; the differential scattering pattern is asymmetric when the wavelength of incident light is within an absorption band. Equations for bi-axial polarizabilities are used to derive the symmetry properties of the differential scattering pattern and to show how this symmetry can be used to determine the right- or left-handed sense of the helical structure. The wavelength dependence of the scattering pattern is obtained for a Lorentzian polarizability.

  11. Use of novel psychoactive substances by inpatients on general adult psychiatric wards

    PubMed Central

    Stanley, Jack L; Mogford, Daniel V; Lawrence, Rebecca J; Lawrie, Stephen M

    2016-01-01

    Objectives Non-illicit alternatives to controlled drugs, known as novel psychoactive substances (NPS), have recently risen to prominence. They are readily available, with uncertain pharmacology and no widely available assay. Given that psychiatric patients are at risk of comorbid substance abuse, we hypothesised that NPS use would be present in the psychiatric population, and sought to determine its prevalence and investigate the characteristics of those who use these drugs with a retrospective review of discharge letters. Setting General adult inpatient wards of a psychiatric hospital in a Scottish city. Participants All adult inpatients (18–65) discharged from general psychiatric wards between 1 July 2014 and 31 December 2014. Of the 483 admissions identified, 46 were admissions for maintenance electroconvulsive therapy (ECT) and were excluded. Of the remaining 437 admissions, 49 discharge letters were unobtainable, leaving 388 admissions to analyse. Primary outcome measure The mention, or lack thereof, of NPS use in discharge letters was our planned primary outcome measure and was also the primary outcome measure we used in our analysis. Results NPS use was identified in 22.2% of admissions, contributing to psychiatric symptoms in 59.3%. In comparison to non-users, NPS users were younger (p<0.01), male and more likely to have a forensic history ((p<0.001) for both). The diagnosis of drug-induced psychosis was significantly more likely in NPS users (p<0.001, OR 18.7, 95% CI 8.1 to 43.0) and the diagnosis of depression was significantly less likely (p<0.005, OR 0.133, CI 0.031 to 0.558). Use of cannabis was significantly more likely in NPS users (p<0.001, OR 4.2, CI 2.5 to 7.1), as was substitute opiate prescribing (p<0.001, OR 3.7, CI 1.8 to 7.4). Conclusions NPS use was prevalent among young, male psychiatric inpatients, in particular those with drug-induced psychosis and often occurred alongside illicit drug use. PMID:27165643

  12. Mental-Physical Comorbidity in Korean Adults: Results from a Nationwide General Population Survey in Korea

    PubMed Central

    Kim, Ji-Hyun; Bae, Jae Nam; Cho, Seong-Jin; Lee, Jun-Young; Kim, Byung-Soo; Cho, Maeng Je

    2016-01-01

    Objective The aims of this study were to estimate the prevalence of mental-physical comorbidity and health-threatening risk factors in subjects with mental disorders, and the risks of mental disorders in those with physical diseases for the last 12 months in the general Korean population. Methods Korean Epidemiologic Catchment Area study replication (KECA-R) was conducted for 6,510 adults between August 2006 and April 2007. The Korean version of Composite International Diagnostic Interview 2.1 (K-CIDI) was used in the survey. Prevalence of mental and physical disorders, and risk factors for physical health were calculated, and their associations were evaluated with adjustment for age and sex. Results Subjects with any mental disorder showed significantly higher prevalence of chronic physical conditions (adjusted odds ratio, AOR=1.5 to 2.8, p<0.001) and medical risk factors including smoking, heavy drinking, overweight, and hypertension (AOR=1.5 to 4.0, p<0.001). Of those with chronic physical conditions, 21.6% had one or more comorbid mental disorder compared with 10.5% of the subjects without chronic physical disorders (AOR=2.6, p<0.001). Contrary to expectations, depressive disorders did not show significant association with hypertension and prevalence of obesity was not influenced by presence of mental disorders. Further studies should assess these findings. Conclusion This is the first identification of significant mental-physical comorbidity in the general Korean population. Clinicians and health care officials should keep in mind of its potential adverse effects on treatment outcome and aggravated disease-related socioeconomic burden. PMID:27757127

  13. Effects of Social Reinforcement Contingent on Conventional or Unconventional Responses on Generalized Creativity by Older Adults in Residential Care

    ERIC Educational Resources Information Center

    Polenick, Courtney Allyn; Flora, Stephen Ray

    2012-01-01

    The effects of social praise contingent on either usual (conventional) or unusual (unconventional) responses during an object uses task were assessed on measures of generalized creativity in two novel, unrelated tasks. Participants were 20 older adults, ages 63 to 89 years (M = 80.90), who were recruited from a joint skilled nursing and assisted…

  14. Positive influence of long-lasting and intensive weight-bearing physical activity on hip structure of young adults.

    PubMed

    Bréban, Sophie; Chappard, Christine; Jaffre, Christelle; Khacef, Farida; Briot, Karine; Benhamou, Claude-Laurent

    2011-01-01

    The aim was to analyze the associations between high-intensity and long-lasting weight-bearing sports with hip structure in young adults. One hundred and seventy-two subjects aged 17-28 yr were divided into 4 groups: 40 athlete women (10.2 ± 2.2 h/wk), 30 control women, 67 athlete men (11.4 ± 3.6 h/wk), and 35 control men. The nondominant femur, lumbar spine, and whole body were scanned by dual-energy X-ray absorptiometry to assess bone mineral content (BMC) and bone mineral density (BMD). Hip structure analysis (HSA) software was applied to evaluate cross-sectional area, cross-sectional moment of inertia, and section modulus at the femoral neck, intertrochanter, and femoral shaft regions. All the BMC and BMD values were significantly higher in athletes of both sexes compared with controls (p < 0.05). Most of the hip structural parameters were significantly higher (p < 0.05) in athletes compared with controls. Most of the differences were maintained after adjustments for height, weight, and calcium intake. Positively significant correlations were observed between HSA parameters and physical activity variables in both sexes (r > 0.32; p < 0.05). Partial correlation suggested that the hours of practice appeared to have a greater influence than the years of practice on hip bone geometry. These results suggest that external mechanical loading is a strong determinant of hip bone structure when weight-bearing physical activity is commenced before puberty and maintained during adulthood.

  15. Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD trial.

    PubMed

    Foy, Capri G; Lewis, Cora E; Hairston, Kristen G; Miller, Gary D; Lang, Wei; Jakicic, John M; Rejeski, W Jack; Ribisl, Paul M; Walkup, Michael P; Wagenknecht, Lynne E

    2011-01-01

    Lifestyle interventions have resulted in weight loss or improved physical fitness among individuals with obesity, which may lead to improved physical function. This prospective investigation involved participants in the Action for Health in Diabetes (Look AHEAD) trial who reported knee pain at baseline (n = 2,203). The purposes of this investigation were to determine whether an Intensive Lifestyle Intervention (ILI) condition resulted in improvement in self-reported physical function from baseline to 12 months vs. a Diabetes Support and Education (DSE) condition, and whether changes in weight or fitness mediated the effect of the ILI. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function subscales, and WOMAC summary score. ILI participants exhibited greater adjusted mean weight loss (s.e.) vs. DSE participants (-9.02 kg (0.48) vs. -0.78 kg (0.49); P < 0.001)). ILI participants also demonstrated more favorable change in WOMAC summary scores vs. DSE participants (β (s.e.) = -1.81 (0.63); P = 0.004). Multiple regression mediation analyses revealed that weight loss was a mediator of the effect of the ILI intervention on change in WOMAC pain, function, and summary scores (P < 0.001). In separate analyses, increased fitness also mediated the effect of the ILI intervention upon WOMAC summary score (P < 0.001). The ILI condition resulted in significant improvement in physical function among overweight and obese adults with diabetes and knee pain. The ILI condition also resulted in significant weight loss and improved fitness, which are possible mechanisms through which the ILI condition improved physical function.

  16. Intensive Lifestyle Intervention Improves Physical Function Among Obese Adults With Knee Pain: Findings From the Look AHEAD Trial

    PubMed Central

    Foy, Capri G.; Lewis, Cora E.; Hairston, Kristen G.; Miller, Gary D.; Lang, Wei; Jakicic, John M.; Rejeski, W. Jack; Ribisl, Paul M.; Walkup, Michael P.; Wagenknecht, Lynne E.

    2011-01-01

    Lifestyle interventions have resulted in weight loss or improved physical fitness among individuals with obesity, which may lead to improved physical function. This prospective investigation involved participants in the Action for Health in Diabetes (Look AHEAD) trial who reported knee pain at baseline (n = 2,203). The purposes of this investigation were to determine whether an Intensive Lifestyle Intervention (ILI) condition resulted in improvement in self-reported physical function from baseline to 12 months vs. a Diabetes Support and Education (DSE) condition, and whether changes in weight or fitness mediated the effect of the ILI. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function subscales, and WOMAC summary score. ILI participants exhibited greater adjusted mean weight loss (s.e.) vs. DSE participants (−9.02 kg (0.48) vs. −0.78 kg (0.49); P < 0.001)). ILI participants also demonstrated more favorable change in WOMAC summary scores vs. DSE participants (β (s.e.) = −1.81 (0.63); P = 0.004). Multiple regression mediation analyses revealed that weight loss was a mediator of the effect of the ILI intervention on change in WOMAC pain, function, and summary scores (P < 0.001). In separate analyses, increased fitness also mediated the effect of the ILI intervention upon WOMAC summary score (P < 0.001). The ILI condition resulted in significant improvement in physical function among overweight and obese adults with diabetes and knee pain. The ILI condition also resulted in significant weight loss and improved fitness, which are possible mechanisms through which the ILI condition improved physical function. PMID:20559303

  17. Comparative Cost-Effectiveness of Conservative or Intensive Blood Pressure Treatment Guidelines in Adults Aged 35-74 Years: The Cardiovascular Disease Policy Model.

    PubMed

    Moise, Nathalie; Huang, Chen; Rodgers, Anthony; Kohli-Lynch, Ciaran N; Tzong, Keane Y; Coxson, Pamela G; Bibbins-Domingo, Kirsten; Goldman, Lee; Moran, Andrew E

    2016-07-01

    The population health effect and cost-effectiveness of implementing intensive blood pressure goals in high-cardiovascular disease (CVD) risk adults have not been described. Using the CVD Policy Model, CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs were simulated over 2016 to 2026 for hypertensive patients aged 35 to 74 years. We projected the effectiveness and costs of hypertension treatment according to the 2003 Joint National Committee (JNC)-7 or 2014 JNC8 guidelines, and then for adults aged ≥50 years, we assessed the cost-effectiveness of adding an intensive goal of systolic blood pressure <120 mm Hg for patients with CVD, chronic kidney disease, or 10-year CVD risk ≥15%. Incremental cost-effectiveness ratios <$50 000 per quality-adjusted life years gained were considered cost-effective. JNC7 strategies treat more patients and are more costly to implement compared with JNC8 strategies. Adding intensive systolic blood pressure goals for high-risk patients prevents an estimated 43 000 and 35 000 annual CVD events incremental to JNC8 and JNC7, respectively. Intensive strategies save costs in men and are cost-effective in women compared with JNC8 alone. At a willingness-to-pay threshold of $50 000 per quality-adjusted life years gained, JNC8+intensive had the highest probability of cost-effectiveness in women (82%) and JNC7+intensive the highest probability of cost-effectiveness in men (100%). Assuming higher drug and monitoring costs, adding intensive goals for high-risk patients remained consistently cost-effective in men, but not always in women. Among patients aged 35 to 74 years, adding intensive blood pressure goals for high-risk groups to current national hypertension treatment guidelines prevents additional CVD deaths while saving costs provided that medication costs are controlled.

  18. Moderation of adult depression by the serotonin transporter promoter variant (5-HTTLPR), childhood abuse and adult traumatic events in a general population sample.

    PubMed

    Grabe, Hans Jörgen; Schwahn, Christian; Mahler, Jessie; Schulz, Andrea; Spitzer, Carsten; Fenske, Kristin; Appel, Katja; Barnow, Sven; Nauck, Matthias; Schomerus, Georg; Biffar, Reiner; Rosskopf, Dieter; John, Ulrich; Völzke, Henry; Freyberger, Harald Jürgen

    2012-04-01

    The impact of the promoter polymorphisms of the serotonin transporter (5-HTTLPR) on mood has been studied by two-way interaction models comprising one environmental factor and genotype variants. However, childhood abuse is assumed to be associated with different psychobiological long-term effects than adult traumatic events. Both types of trauma may interact on an individual basis throughout the lifespan moderating the impact of the 5-HTTLPR s allele on depressive disorders. Therefore, the hypothesis of a three-way interaction among the 5-HTTLPR, childhood abuse and adult traumatic experience was tested. Caucasian subjects (1,974) from the general population in Germany (Study of Health in Pomerania (SHIP)) were analyzed. Depressive symptoms were measured with the Beck Depression Inventory (BDI-II). Childhood abuse was assessed with the Childhood Trauma Questionnaire. Adult traumatic events were derived from the SCID interview (DSM-IV) on posttraumatic stress disorder (PTSD). Global three-way interactions among the 5-HTTLPR, adult traumatic experiences and childhood abuse (P = 0.0007) were found. Carriers of the ss or sl genotypes who had been exposed to childhood abuse and to more than two adult traumatic events had higher mean BDI-II scores (16.0 [95% CI 8.4-23.6]) compared to those carrying the ll genotype (7.6 [4.5-10.7]). These results were supported using a second, more severe definition of childhood abuse (P = 0.02). No two-way interactions were observed (P > 0.05). Childhood abuse and adult traumatic events may act synergistically in interaction with the s allele of the 5-HTTLPR to increase the risk for depressive symptoms independently from the lifetime diagnosis of PTSD.

  19. A randomized controlled trial of guided internet-delivered cognitive behaviour therapy for older adults with generalized anxiety.

    PubMed

    Jones, Shannon L; Hadjistavropoulos, Heather D; Soucy, Joelle N

    2016-01-01

    This study aimed to establish the efficacy of guided Internet-delivered cognitive-behaviour therapy (ICBT) for older adults with generalized anxiety disorder (GAD) or subclinical GAD. Participants were randomized to receive seven modules of ICBT (n=24) or to a waiting list condition (WLC; n=22). Faster improvements in symptoms of anxiety and depression were observed for participants in the ICBT condition relative to the WLC, with large between-group effect sizes on the Generalized anxiety disorder-7 (d=.85) and the Patient health questionnaire (d=1.17) obtained at post-treatment. Further reduction in generalized anxiety symptoms was reported over the one-month follow-up. Treatment effects were replicated when control participants subsequently underwent treatment. Higher ratings of treatment credibility, but not expectancy, prior to ICBT predicted improvements over time. The results support the efficacy of ICBT as treatment for older adults with GAD.

  20. Tension-type headache in Parma's adult general population: a focus on age of onset.

    PubMed

    Taga, Arens; Russo, Marco; Manzoni, Gian C; Torelli, Paola

    2015-01-01

    In the present paper, we focus on the age of onset for tension-type headache in a population-based sample in the Parma, distinguishing its different subtypes and considering definite and probable diagnoses. Age of headache onset is a useful clinical feature for differential diagnosis between primary headaches and between primary and secondary headache forms. A total of 904 subjects representative of the Parma's adult general population were interviewed face to face by a physician from the Parma Headache Centre, using a validated questionnaire specially designed for the diagnosis of primary headaches according to the ICHD-II criteria. In the majority of subjects diagnosed with definite tension-type headache, age of onset was 39 years or less, while mean age of onset was 29.7 years (SD 16.3 years, range 5-79 years), the median being 25 years. Both infrequent and frequent episodic definite tension-type headache first occurred in the majority of cases in the second, third and fourth decades. Subjects with chronic definite tension-type headache reported a later onset in life (i.e. fourth, fifth and sixth decades). In our study, mean age of onset for probable tension-type headache was 23.7 years (SD 9.2 years, range 10-40 years) and the median was 22 years. In no case did we find significant gender differences. Our study results are similar to most of those reported in the literature. Further research needs to be done in the Italian epidemiological context, given the lack of literature reports on this topic.

  1. Streaming Physiological Data: General Public Perceptions of Secondary Use and Application to Research in Neonatal Intensive Care.

    PubMed

    McGregor, Carolyn; Heath, Jennifer; Choi, Yvonne

    2015-01-01

    High speed physiological data represents one of the most untapped resources in healthcare today and is a form of Big Data. Physiological data is captured and displayed on a wide range of devices in healthcare environments. Frequently this data is transitory and lost once initially displayed. Researchers wish to store and analyze these datasets, however, there is little evidence of any engagement with citizens regarding their perceptions of physiological data capture for secondary use. This paper presents the findings of a self-administered household survey (n=165, response rate = 34%) that investigated Australian and Canadian citizens' perceptions of such physiological data capture and re-use. Results indicate general public support for the secondary use of physiological streaming data. Discussion considers the potential application of such data in neonatal intensive care contexts in relation to our Artemis research. Consideration of the perceptions of secondary use of the streaming data as early as possible will assist in building appropriate use models, with a focus on parents in the neonatal context.

  2. [Japanese adults' general beliefs about changes in the ability to remember from childhood to old age as measured by the General Beliefs about Memory Instrument (GBMI)].

    PubMed

    Kinjo, Hikari; Shimizu, Hiroyuki

    2012-12-01

    This study examined and compared beliefs about the ability to remember of three groups of adults: 99 young, 97 middle-aged, and 104 older adults. The beliefs were assessed by asking participants to indicate the expected trajectory over the lifespan on a graphic rating scale, the General Beliefs about Memory Instrument (GBMI) (Lineweaver & Hertzog, 1998). The results showed the following. Although all age groups expect a decline in the ability to remember with age with the peak around 20-30 years old, older adults perceive an age-related sharp decline later in life than the other age groups do. All age groups perceive that remembering names is more affected by age than any other memory abilities. The trajectory of age decline in remembering in general coincides with that in remembering trivia. All age groups believe that the ability to remember at the age of 10 is as good as at the age of 40. All age groups responded to the scales based mainly on the abilities based on their experiences.

  3. Physical, lifestyle, psychological, and social determinants of pain intensity, pain disability, and the number of pain locations in depressed older adults.

    PubMed

    Hanssen, Denise J C; Naarding, Paul; Collard, Rose M; Comijs, Hannie C; Oude Voshaar, Richard C

    2014-10-01

    Late-life depression and pain more often co-occur than can be explained by chance. Determinants of pain in late-life depression are unknown, even though knowledge on possible determinants of pain in depression is important for clinical practice. Therefore, the objectives of the present study were 1) to describe pain characteristics of depressed older adults and a nondepressed comparison group, and 2) to explore physical, lifestyle, psychological, and social determinants of acute and chronic pain intensity, disability, and multisite pain in depressed older adults. Data from the Netherlands Study of Depression in Older Persons cohort, consisting of 378 depressed persons, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, and 132 nondepressed persons aged 60 years and older, were used in a cross-sectional design. Pain characteristics were measured by the Chronic Graded Pain Scale. Multiple linear regression analyses were performed to explore the contribution of physical, lifestyle, psychological, and social determinants to outcomes pain intensity, disability, and the number of pain locations. Depressed older adults more often reported chronic pain and experienced their pain as more intense and disabling compared to nondepressed older adults. Adjusted for demographic, physical, and lifestyle characteristics, multinomial logistic regression analyses showed increased odds ratios (OR) for depression in acute pain (OR 3.010; P=0.005) and chronic pain (OR 4.544, P<0.001). In addition, linear regression analyses showed that acute and chronic pain intensity, disability, and multisite pain were associated with several biopsychosocial determinants, of which anxiety was most pronounced. Further research could focus on the temporal relationship between anxiety, late-life depression, and pain.

  4. Acute rhinosinusitis (ARS). Diagnosis and treatment of adults in general practice.

    PubMed

    Hansen, Jens Georg

    2014-02-01

    The idea behind this thesis is to present how ARS and especially acute maxillary sinusitis in adults is diagnosed and treated in general practice. The study extends over many years, beginning with the first survey in 1991. Based on doctors' answers, we then investigated the diagnostic values ​​of the symptoms, signs and examinations which the doctors reported using. All patients over 18 years suspected of acute maxillary sinusitis were included consecutively and only once and, after a clinical examination with the GP, they were offered the opportunity to enter into the prospective study referred to acute CT scan and by changes in the CT, immediately referred to sinus puncture. Both examinations were conducted at Aalborg Hospital. The disease was found most frequently in younger and 2/3 were women. The reason for this gender difference is unknown. We have assessed the diagnostic values of the symptoms, objective findings and investigations ​​using 3 different reference standards: sinus puncture, microbiological diagnosis and CT scan described in three articles. In all examinations, it appeared that the usual signs and symptoms of acute maxillary sinusitis occur almost equally often and with a few exceptions in patients, with and without pus in the sinus cavities. Pain in the sinus cavities occurring in 95% of patients, and only elevated levels of CRP and ESR are significantly and independently associated with pus in the sinus cavities. This finding is surprising, because they are two nonspecific markers. CRP tested by near-patient testing has, within the investigations period, been introduced in general practice, and from 1999 the doctors also get reimbursed for performing the test. We have on this background originally defined a clinical criterion with pain over the sinuses accompanied by elevated values ​​of CRP and/or ESR giving a sensitivity of 0.82, specificity 0.57, ppv 0.68 and npv 0.74. But looking at the ROC curve we suggest that a more clinical

  5. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    PubMed

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice. PMID:26714808

  6. Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

    PubMed

    Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

    2015-12-01

    Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

  7. The Effect of Training Intensity on VO2max in Young Healthy Adults: A Meta-Regression and Meta-Analysis

    PubMed Central

    SCRIBBANS, TRISHA D.; VECSEY, STEPHAN; HANKINSON, PAUL B.; FOSTER, WILLIAM S.; GURD, BRENDON J.

    2016-01-01

    Exercise training at a variety of intensities increases maximal oxygen uptake (VO2max), the strongest predictor of cardiovascular and all-cause mortality. The purpose of the present study was to perform a systematic review, meta-regression and meta-analysis of available literature to determine if a dose-response relationship exists between exercise intensity and training-induced increases in VO2max in young healthy adults. Twenty-eight studies involving human participants (Mean age: 23±1 yr; Mean VO2max: 3.4±0.8 l·min−1) were included in the meta-regression with exercise training intensity, session dose, baseline VO2max, and total training volume used as covariates. These studies were also divided into 3 tertiles based on intensity (tertile 1: ~60–70%; 2: ~80–92.5%; 3: ~100–250%VO2max), for comparison using separate meta-analyses. The fixed and random effects meta-regression models examining training intensity, session dose, baseline VO2max and total training volume was non-significant (Q4=1.36; p=0.85; R2=0.05). There was no significant difference between tertiles in mean change in VO2max (tertile 1:+0.29±0.15 l/min, ES (effect size) =0.77; 2:+0.26±0.10 l/min, ES=0.68; 3:+0.35±0.17 l/min, ES=0.80), despite significant (p<0.05) reductions in session dose and total training volume as training intensity increased. These data suggest that exercise training intensity has no effect on the magnitude of training-induced increases in maximal oxygen uptake in young healthy human participants, but similar adaptations can be achieved in low training doses at higher exercise intensities than higher training doses of lower intensity (endurance training). PMID:27182424

  8. Airway turbulence and changes in upper airway hydraulic diameter can be estimated from the intensity of high frequency inspiratory sounds in sleeping adults

    PubMed Central

    Rembold, Christopher M; Suratt, Paul M

    2014-01-01

    Obstructive sleep disordered breathing can cause death and significant morbidity in adults and children. We previously found that children with smaller upper airways (measured by magnetic resonance imaging while awake) generated loud high frequency inspiratory sounds (HFIS, defined as inspiratory sounds > 2 kHz) while they slept. The purpose of this study was (1) to determine what characteristics of airflow predicted HFIS intensity, and (b) to determine if we could calculate changes in hydraulic diameter (D) in both an in vitro model and in the upper airways of sleeping humans. In an in vitro model, high frequency sound intensity was an estimate of airflow turbulence as reflected by the Reynold's number (Re). D of the in vitro model was calculated using Re, the pressure gradient, Swamee–Jain formula and Darcy formula. D was proportional to but smaller than the actual diameters (r2 = 0.94). In humans, we measured HFIS intensity and the pressure gradient across the upper airway (estimated with oesophageal pressure, Pes) during polysomnography in four adult volunteers and applied the same formulae to calculate D. At apnoea termination when the airway opens, we observed (1) an increase in HFIS intensity suggesting an increase in turbulence (higher Re), and (2) a larger calculated D. This method allows dynamic estimation of changes in relative upper airway hydraulic diameter (D) in sleeping humans with narrowed upper airways. PMID:24973405

  9. One size does not fit all: why universal decolonization strategies to prevent methicillin-resistant Staphylococcus aureus colonization and infection in adult intensive care units may be inappropriate for neonatal intensive care units.

    PubMed

    Nelson, M U; Bizzarro, M J; Dembry, L M; Baltimore, R S; Gallagher, P G

    2014-09-01

    The REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus), a large multicenter, randomized controlled trial in adult intensive care units (ICUs), found universal decolonization to be more effective than surveillance and isolation procedures with or without targeted decolonization for reducing rates of MRSA-positive clinical cultures. The Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention subsequently published protocols for implementing universal decolonization in ICUs based on the trial's methods. Caution should be exercised before widely adopting these procedures in neonatal intensive care units (NICUs), particularly strategies that involve bathing with chlorhexidine and mupirocin application due to the potential for adverse events in their unique patient population, especially preterm infants. Large multicenter trials in the NICUs are needed to evaluate the efficacy, short- and long-term safety, and cost effectiveness of these strategies prior to their widespread implementation.

  10. The prevalence of mental disorders in adults in different level general medical facilities in Kenya: a cross-sectional study

    PubMed Central

    Ndetei, David M; Khasakhala, Lincoln I; Kuria, Mary W; Mutiso, Victoria N; Ongecha-Owuor, Francisca A; Kokonya, Donald A

    2009-01-01

    Background The possibility that a significant proportion of the patients attending a general health facility may have a mental disorder means that psychiatric conditions must be recognised and managed appropriately. This study sought to determine the prevalence of common psychiatric disorders in adult (aged 18 years and over) inpatients and outpatients seen in public, private and faith-based general hospitals, health centres and specialised clinics and units of general hospitals. Methods This was a descriptive cross-sectional study conducted in 10 health facilities. All the patients in psychiatric wards and clinics were excluded. Stratified and systematic sampling methods were used. Informed consent was obtained from all study participants. Data were collected over a 4-week period in November 2005 using various psychiatric instruments for adults. Descriptive statistics were generated using SPSS V. 11.5. Results A total of 2,770 male and female inpatients and outpatients participated in the study. In all, 42% of the subjects had symptoms of mild and severe depression. Only 114 (4.1%) subjects had a file or working diagnosis of a psychiatric condition, which included bipolar mood disorder, schizophrenia, psychosis and depression. Conclusion The 4.1% clinician detection rate for mental disorders means that most psychiatric disorders in general medical facilities remain undiagnosed and thus, unmanaged. This calls for improved diagnostic practices in general medical facilities in Kenya and in other similar countries. PMID:19144164

  11. Contextual Constraint Treatment for coarse coding deficit in adults with right hemisphere brain damage: Generalization to narrative discourse comprehension

    PubMed Central

    Blake, Margaret Lehman; Tompkins, Connie A.; Scharp, Victoria L.; Meigh, Kimberly M.; Wambaugh, Julie

    2014-01-01

    Coarse coding is the activation of broad semantic fields that can include multiple word meanings and a variety of features, including those peripheral to a word’s core meaning. It is a partially domain-general process related to general discourse comprehension and contributes to both literal and non-literal language processing. Adults with damage to the right cerebral hemisphere (RHD) and a coarse coding deficit are particularly slow to activate features of words that are relatively distant or peripheral. This manuscript reports a pre-efficacy study of Contextual Constraint Treatment (CCT), a novel, implicit treatment designed to increase the efficiency of coarse coding with the goal of improving narrative comprehension and other language performance that relies on coarse coding. Participants were four adults with RHD. The study used a single-subject controlled experimental design across subjects and behaviors. The treatment involves pre-stimulation, using a hierarchy of strong- and moderately-biased contexts, to prime the intended distantly-related features of critical stimulus words. Three of the four participants exhibited gains in auditory narrative discourse comprehension, the primary outcome measure. All participants exhibited generalization to untreated items. No strong generalization to processing nonliteral language was evident. The results indicate that CCT yields both improved efficiency of the coarse coding process and generalization to narrative comprehension. PMID:24983133

  12. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

    PubMed

    Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

    2016-09-01

    Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001), respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. PMID:27346646

  13. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

    PubMed

    Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

    2016-09-01

    Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001), respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance.

  14. Are Irish adult general practice consultation rates as low as official records suggest? A cross sectional study at six general practices.

    PubMed

    Behan, W; Molony, D; Beamer, C; Cullen, W

    2013-01-01

    Accurate data on primary care activity is key to health services planning and reconfiguration. Official data estimate general practice adult consultation rates to be 3.2 visits annually, based on patient self reports. We aim to estimate the consultation rate using practice based data and compare this to official estimates. We interrogated six general practices' information systems and estimated consultation rates based on practice, telephone, domiciliary and out of hours consultations by patients aged 18 years or older. The study population (20,706 patients) was representative of the national population in terms of age and GMS status. The mean consultation rate was 5.17, though this was higher among GMS-eligible patients and among older age groups. Estimates of consultation rates derived from practice based data are likely to be higher than that derived from other approaches. Using multiple sources of data will enhance accuracy of workload estimates and this will benefit service planning. PMID:24579407

  15. Participation in the 2005 General Election by Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Keeley, H.; Redley, M.; Holland, A. J.; Clare, I. C. H.

    2008-01-01

    Background: International and UK legislation confirms and supports the right of adults with intellectual disabilities (ID) to vote. It is widely accepted, although not previously empirically confirmed, that citizens with ID are under-represented at the polls. Method: To document the extent of their under-representation at the polls, the names and…

  16. Learned Attention in Adult Language Acquisition: A Replication and Generalization Study and Meta-Analysis

    ERIC Educational Resources Information Center

    Ellis, Nick C.; Sagarra, Nuria

    2011-01-01

    This study investigates associative learning explanations of the limited attainment of adult compared to child language acquisition in terms of learned attention to cues. It replicates and extends Ellis and Sagarra (2010) in demonstrating short- and long-term learned attention in the acquisition of temporal reference in Latin. In Experiment 1,…

  17. Educational Values of Adult Rural Disadvantaged Students: An Affective Evaluation Report. General Report No. 2.

    ERIC Educational Resources Information Center

    Conrad, Rowan W.

    Sixteen educational aims were rank ordered by 188 adult rural disadvantaged family members who were student participants in the Mountain-Plains Program. Results were examined by factor analysis and by the Thurstone (unweighted) scaling method; the factor structure was weak, indicating considerable independence for the individual items. Students…

  18. Ramelteon for Insomnia Symptoms in a Community Sample of Adults with Generalized Anxiety Disorder: An Open Label Study

    PubMed Central

    Gross, Paul K.; Nourse, Rosemary; Wasser, Thomas E.

    2009-01-01

    Objective: Prior research confirms the relationship between insomnia and psychiatric disorders, particularly anxiety and depression. The effectiveness and tolerability of ramelteon was examined in adult generalized anxiety disorder (GAD) patients with insomnia symptoms. Methods: Twenty-seven adults with sleep disturbance meeting DSM-IV diagnostic criteria for GAD and partially responsive on an SSRI or SNRI by randomization visit (as signified by a Hamilton Anxiety scale [HAMA] maximum score of 15 and minimum of 8, Clinical Global Impressions Severity of Illness [CGI-S] scale of ≤ 4 and ≥ 2 [measuring anxiety symptoms], CGI-S of ≥ 4 [measuring insomnia symptoms], ≥ 5 on the Pittsburgh Sleep Quality Index [PSQI], and ≥ 10 on the Epworth Sleepiness Scale [ESS]) were treated openly for 10 weeks on ramelteon 8 mg at bedtime. Analysis was conducted using repeated measures methodology. Patient reported sleep diaries were maintained throughout the study. Results: Significant symptom reduction was observed on all scales (HAMA, ESS, CGI-I, CGI-S), with subjects falling asleep faster and sleeping longer. Headache upon stopping ramelteon, daytime tiredness, agitation, and depression were the most commonly reported side effects and were cited as transient. Conclusion: Data from this 12-week open-label study suggests ramelteon is an effective and generally well tolerated treatment for insomnia symptoms in this community sample of adults with GAD. Citation: Gross PK; Nourse R; Wasser TE. Ramelteon for insomnia symptoms in a community sample of adults with generalized anxiety disorder: an open label study. J Clin Sleep Med 2009;5(1):28–33. PMID:19317378

  19. The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

    PubMed Central

    Kanai, Yoshiaki; Takaesu, Yoshikazu; Nakai, Yukiei; Ichiki, Masahiko; Sato, Mitsuhiko; Matsumoto, Yasunori; Ishikawa, Jun; Ono, Yasuyuki; Murakoshi, Akiko; Tanabe, Hajime; Kusumi, Ichiro; Inoue, Takeshi

    2016-01-01

    Background Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect) and ill-being (negative affect). We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI); Life Experiences Survey (LES); Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A); and the Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus). Results Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations The subjects of this study were nonclinical volunteers. The findings might not be generalizable to psychiatric patients. Conclusion This study demonstrated that childhood abuse, particularly neglect, indirectly worsened the well-being of individuals through cyclothymic, anxious, and irritable affective temperaments. An important “mediator” role of affective temperaments in the effect of childhood abuse on well-being was suggested. PMID:27110116

  20. Mechanical ventilation in patients in the intensive care unit of a general university hospital in southern Brazil: an epidemiological study

    PubMed Central

    Fialkow, Léa; Farenzena, Maurício; Wawrzeniak, Iuri Christmann; Brauner, Janete Salles; Vieira, Sílvia Regina Rios; Vigo, Alvaro; Bozzetti, Mary Clarisse

    2016-01-01

    OBJECTIVES: To determine the characteristics, the frequency and the mortality rates of patients needing mechanical ventilation and to identify the risk factors associated with mortality in the intensive care unit (ICU) of a general university hospital in southern Brazil. METHOD: Prospective cohort study in patients admitted to the ICU who needed mechanical ventilation for at least 24 hours between March 2004 and April 2007. RESULTS: A total of 1,115 patients admitted to the ICU needed mechanical ventilation. The mortality rate was 51%. The mean age (± standard deviation) was 57±18 years, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 22.6±8.3. The variables independently associated with mortality were (i) conditions present at the beginning of mechanical ventilation, age (hazard ratio: 1.01; p<0.001); the APACHE II score (hazard ratio: 1.01; p<0.005); acute lung injury/acute respiratory distress syndrome (hazard ratio: 1.38; p=0.009), sepsis (hazard ratio: 1.33; p=0.003), chronic obstructive pulmonary disease (hazard ratio: 0.58; p=0.042), and pneumonia (hazard ratio: 0.78; p=0.013) as causes of mechanical ventilation; and renal (hazard ratio: 1.29; p=0.011) and neurological (hazard ratio: 1.25; p=0.024) failure, and (ii) conditions occurring during the course of mechanical ventilation, acute lung injuri/acute respiratory distress syndrome (hazard ratio: 1.31; p<0.010); sepsis (hazard ratio: 1.53; p<0.001); and renal (hazard ratio: 1.75; p<0.001), cardiovascular (hazard ratio: 1.32; p≤0.009), and hepatic (hazard ratio: 1.67; p≤0.001) failure. CONCLUSIONS: This large cohort study provides a comprehensive profile of mechanical ventilation patients in South America. The mortality rate of patients who required mechanical ventilation was higher, which may have been related to the severity of illness of the patients admitted to our ICU. Risk factors for hospital mortality included conditions present at the start of mechanical

  1. Generalized Courant-Snyder Theory and Kapchinskij-Vladimirskij Distribution For High-intensity Beams In A Coupled Transverse Focusing Lattice

    SciTech Connect

    Hong QIn, Ronald Davidson

    2011-07-18

    The Courant-Snyder (CS) theory and the Kapchinskij-Vladimirskij (KV) distribution for high-intensity beams in a uncoupled focusing lattice are generalized to the case of coupled transverse dynamics. The envelope function is generalized to an envelope matrix, and the envelope equation becomes a matrix envelope equation with matrix operations that are non-commutative. In an uncoupled lattice, the KV distribution function, first analyzed in 1959, is the only known exact solution of the nonlinear Vlasov-Maxwell equations for high-intensity beams including self-fields in a self-consistent manner. The KV solution is generalized to high-intensity beams in a coupled transverse lattice using the generalized CS invariant. This solution projects to a rotating, pulsating elliptical beam in transverse configuration space. The fully self-consistent solution reduces the nonlinear Vlasov-Maxwell equations to a nonlinear matrix ordinary differential equation for the envelope matrix, which determines the geometry of the pulsating and rotating beam ellipse. These results provide us with a new theoretical tool to investigate the dynamics of high-intensity beams in a coupled transverse lattice. A strongly coupled lattice, a so-called N-rolling lattice, is studied as an example. It is found that strong coupling does not deteriorate the beam quality. Instead, the coupling induces beam rotation, and reduces beam pulsation.

  2. Generalized Courant-Snyder theory and Kapchinskij-Vladimirskij distribution for high-intensity beams in a coupled transverse focusing lattice

    SciTech Connect

    Qin Hong; Davidson, Ronald C.

    2011-05-15

    The Courant-Snyder (CS) theory and the Kapchinskij-Vladimirskij (KV) distribution for high-intensity beams in an uncoupled focusing lattice are generalized to the case of coupled transverse dynamics. The envelope function is generalized to an envelope matrix, and the envelope equation becomes a matrix envelope equation with matrix operations that are noncommutative. In an uncoupled lattice, the KV distribution function, first analyzed in 1959, is the only known exact solution of the nonlinear Vlasov-Maxwell equations for high-intensity beams including self-fields in a self-consistent manner. The KV solution is generalized to high-intensity beams in a coupled transverse lattice using the generalized CS invariant. This solution projects to a rotating, pulsating elliptical beam in transverse configuration space. The fully self-consistent solution reduces the nonlinear Vlasov-Maxwell equations to a nonlinear matrix ordinary differential equation for the envelope matrix, which determines the geometry of the pulsating and rotating beam ellipse. These results provide us with a new theoretical tool to investigate the dynamics of high-intensity beams in a coupled transverse lattice. A strongly coupled lattice, a so-called N-rolling lattice, is studied as an example. It is found that strong coupling does not deteriorate the beam quality. Instead, the coupling induces beam rotation and reduces beam pulsation.

  3. Model VESL Program Guide, Office Information Systems, International: One Semester Intensive Training Certificate of Achievement Programs in General, Medical, and Legal Office.

    ERIC Educational Resources Information Center

    Alvarez, Irma J.

    The Office Information Systems-International Program at Southwestern College, in California, was designed to provide Hispanic students with training for entry-level office employment. This model program guide stems from a project to improve curricula and delivery and focuses on changes in three intensive bilingual programs in general, medical, and…

  4. Influence of the Perceived Taste Intensity of Chemesthetic Stimuli on Swallowing Parameters Given Age and Genetic Taste Differences in Healthy Adult Women

    ERIC Educational Resources Information Center

    Pelletier, Cathy A.; Steele, Catriona M.

    2014-01-01

    Purpose: This study examined whether the perceived taste intensity of liquids with chemesthetic properties influenced lingua-palatal pressures and submental surface electromyography (sEMG) in swallowing, compared with water. Method: Swallowing was studied in 80 healthy women, stratified by age group and genetic taste status. General Labeled…

  5. Elevated cortisol in older adults with Generalized Anxiety Disorder is reduced by treatment: a placebo-controlled evaluation of escitalopram

    PubMed Central

    Lenze, Eric J.; Mantella, Rose C.; Shi, Peichang; Goate, Alison M.; Nowotny, Petra; Butters, Meryl A.; Andreescu, Carmen; Thompson, Paul A.; Rollman, Bruce L.

    2012-01-01

    Background Generalized Anxiety Disorder (GAD) is a common disorder in older adults which has been linked to hyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis in this age group. We examined whether treatment of GAD in older adults with a selective serotonin reuptake inhibitor (SSRI) corrects this HPA axis hyperactivity. Methods We examined adults aged 60 and above with GAD in a 12-week randomized controlled trial comparing the SSRI escitalopram to placebo. We collected salivary cortisol at six daily timepoints for two consecutive days to assess peak and total (area under the curve) cortisol, both at baseline and post-treatment. Results Compared with placebo-treated subjects, SSRI-treated subjects had a significantly greater reduction in both peak and total cortisol. This reduction in cortisol was limited to subjects with elevated (above the median) baseline cortisol, in whom SSRI-treated subjects showed substantially greater reduction in cortisol than did placebo-treated subjects. Reductions in cortisol were associated with improvements in anxiety. Additionally, genetic variability at the serotonin transporter promoter predicted cortisol changes. Conclusions SSRI treatment of GAD in older adults reduces HPA axis hyperactivity. Further research should determine whether these treatment-attributable changes are sustained and beneficial. PMID:20808146

  6. Prevalence of tension-type headache in adult general population: the PACE study and review of the literature.

    PubMed

    Ferrante, T; Manzoni, G C; Russo, M; Camarda, C; Taga, A; Veronesi, L; Pasquarella, C; Sansebastiano, G; Torelli, P

    2013-05-01

    The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE (PArma CEfalea, or "Headache in Parma"), aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma's adult general population. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9), namely 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3). Our study results indicate a TTH prevalence rate (19.4 %) at the lower limit of data ranges currently available for Western countries, and prevalence rates for infrequent forms (9 %) do not appear much different from those of frequent forms (9.8 %).

  7. Generalized Linear Models of home activity for automatic detection of mild cognitive impairment in older adults.

    PubMed

    Akl, Ahmad; Snoek, Jasper; Mihailidis, Alex

    2014-01-01

    With a globally aging population, the burden of care of cognitively impaired older adults is becoming increasingly concerning. Instances of Alzheimer's disease and other forms of dementia are becoming ever more frequent. Earlier detection of cognitive impairment offers significant benefits, but remains difficult to do in practice. In this paper, we develop statistical models of the behavior of older adults within their homes using sensor data in order to detect the early onset of cognitive decline. Specifically, we use inhomogenous Poisson processes to model the presence of subjects within different rooms throughout the day in the home using unobtrusive sensing technologies. We compare the distributions learned from cognitively intact and impaired subjects using information theoretic tools and observe statistical differences between the two populations which we believe can be used to help detect the onset of cognitive decline.

  8. Generalized Linear Models of home activity for automatic detection of mild cognitive impairment in older adults.

    PubMed

    Akl, Ahmad; Snoek, Jasper; Mihailidis, Alex

    2014-01-01

    With a globally aging population, the burden of care of cognitively impaired older adults is becoming increasingly concerning. Instances of Alzheimer's disease and other forms of dementia are becoming ever more frequent. Earlier detection of cognitive impairment offers significant benefits, but remains difficult to do in practice. In this paper, we develop statistical models of the behavior of older adults within their homes using sensor data in order to detect the early onset of cognitive decline. Specifically, we use inhomogenous Poisson processes to model the presence of subjects within different rooms throughout the day in the home using unobtrusive sensing technologies. We compare the distributions learned from cognitively intact and impaired subjects using information theoretic tools and observe statistical differences between the two populations which we believe can be used to help detect the onset of cognitive decline. PMID:25570050

  9. Drought reduces chytrid fungus (Batrachochytrium dendrobatidis) infection intensity and mortality but not prevalence in adult crawfish frogs (Lithobates areolatus).

    PubMed

    Terrell, Vanessa C K; Engbrecht, Nathan J; Pessier, Allan P; Lannoo, Michael J

    2014-01-01

    To fully understand the impacts of the chytrid fungus Batrachochytrium dendrobatidis (Bd) on amphibians it is necessary to examine the interactions between populations and their environment. Ecologic variables can exacerbate or ameliorate Bd prevalence and infection intensity, factors that are positively related when Bd is acting on naive amphibian populations as an epidemic disease. In crawfish frogs (Lithobates areolatus), a North American species with a complex life history, we have shown that Bd acts as an endemic disease with impacts that vary seasonally; the highest infection prevalences and intensities and highest frog mortality occurred during late spring in postbreeding individuals. In this study, conducted between 28 February and 23 August 2011 in southwestern Indiana on the same population, we report an uncoupling of the previously observed relationship between Bd prevalence and intensity following an extreme drought. Specifically, there was a postdrought reduction in Bd infection intensity and mortality, but not in infection prevalence. This result suggests that the relationship between prevalence and intensity observed in Bd epidemics can be uncoupled in populations harboring endemic infections. Further, constant prevalence rates suggest either that crawfish frogs are being exposed to Bd sources independent of ambient moisture or that low-level infections below detection thresholds persist from year to year. Drought has several ecologically beneficial effects for amphibians with complex life histories, including eliminating fish and invertebrate populations that feed on larvae. To these ecologic benefits we suggest another, that drought can reduce the incidence of the severe skin disease (chytridiomycosis) due to Bd infection.

  10. [Role of the general practitioner or primary care physician in the management of adult congenital heart disease].

    PubMed

    Thambo, Jean-Benoît

    2013-03-01

    Congenital heart diseases are the most common inborn defect, occurring approximately 0.8% according to the last European Union count. This rate is stable for decades. Nowadays, up to 90% of children born with congenital heart diseases underwent surgical correction and reach adulthood, gratefully to the surgery and interventional cardiology advances, in conjunction to the post-surgery and following cares improvement. Both of this facts results to a growing population of adults with congenital heart diseases, actually exceeding the infant population. This arising population will lead general practitioners and primary care physicians to face more often this kind of patient. The needed cares are specifics, regarding the typical evolutions of this pathologies, as well as because congenital heart diseases wil impact other pathologies or usual cares. The need of an extended knowledge of the adult patients with congenital heart diseases is clearly emerging, and should lead the whole medical corps to work in close network. PMID:23687765

  11. Generalized probabilistic seimsic hazard estimates in terms of macroseismic intensity as a tool for risk assessment in urban areas

    NASA Astrophysics Data System (ADS)

    Albarello, Dario; D'Amico, Vera; Rotondi, Renata; Varini, Elsa; Zonno, Gaetano

    2013-04-01

    The use of macroseismic intensity to parameterize earthquakes effects allows a direct link of hazard assessment with risk estimates in urban areas. This is particularly true in most of European countries where long lasting documentary history is available about the effects of past earthquakes. This is why the use of the computational code SASHA (Site Approach to Seismic Hazard Assessment), on purpose developed for a coherent probabilistic analysis of intensity data locally available (site seismic histories) to provided hazard estimates in terms of intensity by taking into account the specific nature of intensity (ordinal, discrete, finite in range, site-dependent) and relevant uncertainty (completeness, ill-definition of the oldest earthquakes, etc.), resulted of specific interest in the frame of the EU research project UPStratMAFA "Urban Disaster Prevention Strategies Using MAcroseismic Fields and FAult Sources" (Grant Agreement n. 230301/2011/613486/SUB/A5). In order to extend the application of this approach to sites and countries where local seismic histories are relatively poor, a new implementation of the code was provided, allowing to include in the hazard assessment information coming from different branches (historical studies, seismological instrumental information and numerical simulations). In particular, macroseismic information related to the seismic history locally documented, that represents the bulk of the considered information, can be integrated with "virtual" intensities deduced from epicentral data (via earthquake-specific probabilistic attenuation relationships) and "simulated" intensities deduced via physical/stochastic simulations from data concerning seismogenic faults activated during past earthquakes. This allows a more complete reconstruction of local seismic history and also reducing uncertainty affecting macroseismic data relative to older earthquakes. Results of some applications of the new release of the SASHA code will be described.

  12. Mode of Transmission of Pseudomonas aeruginosa in a Burn Unit and an Intensive Care Unit in a General Hospital

    PubMed Central

    Kominos, Spyros D.; Copeland, Charles E.; Grosiak, Barbara

    1972-01-01

    The transmission of Pseudomonas aeruginosa was studied in the burn unit and the intensive care unit of a 650-bed hospital. There was a tendency among patients in the burn unit to yield more than one type of P. aeruginosa, and several patients shared the same types at a particular point in time, suggesting cross-contamination among patients. Similar observations were made in the intensive care unit. Cultures from the hands of nurses caring for these patients yielded the same types of P. aeruginosa, suggesting the direct handling of patients by the nursing personnel to be the principal mode of transmission. PMID:4622827

  13. INFLUENCE OF THE PERCEIVED TASTE INTENSITY OF CHEMESTHETIC STIMULI ON SWALLOWING PARAMETERS GIVEN AGE AND GENETIC TASTE DIFFERENCES IN HEALTHY ADULT WOMEN

    PubMed Central

    Pelletier, Cathy A.; Steele, Catriona M.

    2015-01-01

    Purpose This study examined whether the perceived taste intensity of liquids with chemesthetic properties influenced lingua-palatal pressures and submental surface electromyography (sEMG) in swallowing, compared to water. Method Swallowing behaviors were studied in 80 healthy women, stratified by age-group and genetic taste-status. General Labeled Magnitude Scale ratings of taste intensity were collected for deionized water; carbonated water; 2.7 % w/v citric acid; and diluted ethanol. These stimuli were swallowed, with measurement of tongue-palate pressures and submental sEMG. Path analysis differentiated stimulus, genetic taste-status, age, and perceived taste intensity effects on swallowing. Signal amplitude during effortful saliva swallowing served as a covariate accounting for differences in participant strength. Results Significant differences in taste intensity were seen across liquids: citric acid > ethanol > carbonated water > water. Supertasters perceived greater taste intensity than nontasters. Lingua-palatal pressure and sEMG amplitudes were correlated with the strength covariate. Anterior palate pressures and sEMG amplitudes were significantly higher for the citric acid stimulus. Perceived taste intensity was a significant mediator of stimulus differences. Conclusions These data support the idea that sensory input transmitted via chorda tympani and trigeminal afferent pathways may lead to cortical facilitation and/or modulation of swallowing. PMID:24687466

  14. Comparison of Younger and Older Adults' Acceptability of Treatment for Generalized Anxiety Disorder Co-Occurring with Parkinson's Disease

    ERIC Educational Resources Information Center

    Lundervold, Duane A.; Ament, Patrick A.; Holt, Peter S.; Hunt, Lauren S.

    2013-01-01

    Acceptability ratings of medication or Behavioral Relaxation Training (BRT), for general anxiety disorder (GAD) co-occurring with Parkinson's Disease (PD) were obtained from younger ("n" = 79) and older ("n" = 54) adults. Participants read a case description of an older adult with PD and comorbid GAD followed by a…

  15. A Study of Dropouts in an Adult Basic Education Program and A General Education Development Program and Suggestions for Improving the Holding Power of These Programs.

    ERIC Educational Resources Information Center

    Hawkins, Dorothy Lee

    This investigation sought to discover why adults dropped out of the adult basic education program and the General Education Development program in the New Orleans public schools, and to suggest ways of reducing the number of dropouts. A specially constructed interview schedule was used to obtain data from a 10% random sample of 1965-67 dropouts…

  16. Evidence for aggressive mimicry in an adult brood parasitic bird, and generalized defences in its host.

    PubMed

    Feeney, W E; Troscianko, J; Langmore, N E; Spottiswoode, C N

    2015-07-01

    Mimicry of a harmless model (aggressive mimicry) is used by egg, chick and fledgling brood parasites that resemble the host's own eggs, chicks and fledglings. However, aggressive mimicry may also evolve in adult brood parasites, to avoid attack from hosts and/or manipulate their perception of parasitism risk. We tested the hypothesis that female cuckoo finches (Anomalospiza imberbis) are aggressive mimics of female Euplectes weavers, such as the harmless, abundant and sympatric southern red bishop (Euplectes orix). We show that female cuckoo finch plumage colour and pattern more closely resembled those of Euplectes weavers (putative models) than Vidua finches (closest relatives); that their tawny-flanked prinia (Prinia subflava) hosts were equally aggressive towards female cuckoo finches and southern red bishops, and more aggressive to both than to their male counterparts; and that prinias were equally likely to reject an egg after seeing a female cuckoo finch or bishop, and more likely to do so than after seeing a male bishop near their nest. This is, to our knowledge, the first quantitative evidence for aggressive mimicry in an adult bird, and suggests that host-parasite coevolution can select for aggressive mimicry by avian brood parasites, and counter-defences by hosts, at all stages of the reproductive cycle. PMID:26063850

  17. Evidence for aggressive mimicry in an adult brood parasitic bird, and generalized defences in its host

    PubMed Central

    Feeney, W. E.; Troscianko, J.; Langmore, N. E.; Spottiswoode, C. N.

    2015-01-01

    Mimicry of a harmless model (aggressive mimicry) is used by egg, chick and fledgling brood parasites that resemble the host's own eggs, chicks and fledglings. However, aggressive mimicry may also evolve in adult brood parasites, to avoid attack from hosts and/or manipulate their perception of parasitism risk. We tested the hypothesis that female cuckoo finches (Anomalospiza imberbis) are aggressive mimics of female Euplectes weavers, such as the harmless, abundant and sympatric southern red bishop (Euplectes orix). We show that female cuckoo finch plumage colour and pattern more closely resembled those of Euplectes weavers (putative models) than Vidua finches (closest relatives); that their tawny-flanked prinia (Prinia subflava) hosts were equally aggressive towards female cuckoo finches and southern red bishops, and more aggressive to both than to their male counterparts; and that prinias were equally likely to reject an egg after seeing a female cuckoo finch or bishop, and more likely to do so than after seeing a male bishop near their nest. This is, to our knowledge, the first quantitative evidence for aggressive mimicry in an adult bird, and suggests that host–parasite coevolution can select for aggressive mimicry by avian brood parasites, and counter-defences by hosts, at all stages of the reproductive cycle. PMID:26063850

  18. Evidence for aggressive mimicry in an adult brood parasitic bird, and generalized defences in its host.

    PubMed

    Feeney, W E; Troscianko, J; Langmore, N E; Spottiswoode, C N

    2015-07-01

    Mimicry of a harmless model (aggressive mimicry) is used by egg, chick and fledgling brood parasites that resemble the host's own eggs, chicks and fledglings. However, aggressive mimicry may also evolve in adult brood parasites, to avoid attack from hosts and/or manipulate their perception of parasitism risk. We tested the hypothesis that female cuckoo finches (Anomalospiza imberbis) are aggressive mimics of female Euplectes weavers, such as the harmless, abundant and sympatric southern red bishop (Euplectes orix). We show that female cuckoo finch plumage colour and pattern more closely resembled those of Euplectes weavers (putative models) than Vidua finches (closest relatives); that their tawny-flanked prinia (Prinia subflava) hosts were equally aggressive towards female cuckoo finches and southern red bishops, and more aggressive to both than to their male counterparts; and that prinias were equally likely to reject an egg after seeing a female cuckoo finch or bishop, and more likely to do so than after seeing a male bishop near their nest. This is, to our knowledge, the first quantitative evidence for aggressive mimicry in an adult bird, and suggests that host-parasite coevolution can select for aggressive mimicry by avian brood parasites, and counter-defences by hosts, at all stages of the reproductive cycle.

  19. Error-related brain activity in youth and young adults before and after treatment for generalized or social anxiety disorder.

    PubMed

    Kujawa, Autumn; Weinberg, Anna; Bunford, Nora; Fitzgerald, Kate D; Hanna, Gregory L; Monk, Christopher S; Kennedy, Amy E; Klumpp, Heide; Hajcak, Greg; Phan, K Luan

    2016-11-01

    Increased error monitoring, as measured by the error-related negativity (ERN), has been shown to persist after treatment for obsessive-compulsive disorder in youth and adults; however, no previous studies have examined the ERN following treatment for related anxiety disorders. We used a flanker task to elicit the ERN in 28 youth and young adults (8-26years old) with primary diagnoses of generalized anxiety disorder (GAD) or social anxiety disorder (SAD) and 35 healthy controls. Patients were assessed before and after treatment with cognitive-behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRI), and healthy controls were assessed at a comparable interval. The ERN increased across assessments in the combined sample. Patients with SAD exhibited an enhanced ERN relative to healthy controls prior to and following treatment, even when analyses were limited to SAD patients who responded to treatment. Patients with GAD did not significantly differ from healthy controls at either assessment. Results provide preliminary evidence that enhanced error monitoring persists following treatment for SAD in youth and young adults, and support conceptualizations of increased error monitoring as a trait-like vulnerability that may contribute to risk for recurrence and impaired functioning later in life. Future work is needed to further evaluate the ERN in GAD across development, including whether an enhanced ERN develops in adulthood or is most apparent when worries focus on internal sources of threat.

  20. Error-related brain activity in youth and young adults before and after treatment for generalized or social anxiety disorder.

    PubMed

    Kujawa, Autumn; Weinberg, Anna; Bunford, Nora; Fitzgerald, Kate D; Hanna, Gregory L; Monk, Christopher S; Kennedy, Amy E; Klumpp, Heide; Hajcak, Greg; Phan, K Luan

    2016-11-01

    Increased error monitoring, as measured by the error-related negativity (ERN), has been shown to persist after treatment for obsessive-compulsive disorder in youth and adults; however, no previous studies have examined the ERN following treatment for related anxiety disorders. We used a flanker task to elicit the ERN in 28 youth and young adults (8-26years old) with primary diagnoses of generalized anxiety disorder (GAD) or social anxiety disorder (SAD) and 35 healthy controls. Patients were assessed before and after treatment with cognitive-behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRI), and healthy controls were assessed at a comparable interval. The ERN increased across assessments in the combined sample. Patients with SAD exhibited an enhanced ERN relative to healthy controls prior to and following treatment, even when analyses were limited to SAD patients who responded to treatment. Patients with GAD did not significantly differ from healthy controls at either assessment. Results provide preliminary evidence that enhanced error monitoring persists following treatment for SAD in youth and young adults, and support conceptualizations of increased error monitoring as a trait-like vulnerability that may contribute to risk for recurrence and impaired functioning later in life. Future work is needed to further evaluate the ERN in GAD across development, including whether an enhanced ERN develops in adulthood or is most apparent when worries focus on internal sources of threat. PMID:27495356

  1. Have I Ever Done Anything Like This Before? Older Adults Solving Ill-Defined Problems in Intensive Volunteering.

    PubMed

    Cheek, Cheryl; Piercy, Kathleen W; Kohlenberg, Meranda

    2015-01-01

    This study examined the ways in which individuals over 50 years old solved problems while volunteering in intensive humanitarian and disaster relief service. Thirty-seven men and women in the sample were sponsored by three religious organizations well known for providing humanitarian and disaster relief service. Semistructured interviews yielded data that were analyzed qualitatively, using McCracken's five-step process for analysis. We found that volunteers used three different abilities to solve problems: drawing upon experience to create strategies, maintaining emotional stability in the midst of trying circumstances, and applying strategies in a context-sensitive manner. These findings illustrate that these factors, which are comparable to those used in solving everyday problems, are unique in the way they are applied to intensive volunteering. The volunteers' sharing of knowledge, experience, and support with each other were also noticeable in their accounts of their service. This sharing contributed strongly to their sense of emotional stability and effectiveness in solving problems.

  2. Validity of two brief measures: the General Abilities Measure for Adults and the Shiple Institute of Living Scale.

    PubMed

    Matthews, T D; Lassiter, K; Habedank, H

    2001-06-01

    The present investigation examined the concurrent validity of the General Ability Measure for Adults by Naglieri and Bardos (1997) and the Shipley Institute of Living Scale by Zachary (1991). These scales were administered to 129 college students who ranged in age from 18 to 55 years (M age=24.8 yr.). Pearson correlations were computed to evaluate the association of scores on these measures. Significant small correlations were found for GAMA IQ scores with scores on the Shipley Verbal (r = .29) and Total scales (r = .28) but not with scores on the Shipley Abstraction subscale (r=.11). Although the GAMA has been presented as a measure of general intelligence, only partial support for this view was found.

  3. Pilot study comparing multi-family therapy to single family therapy for adults with anorexia nervosa in an intensive eating disorder program.

    PubMed

    Dimitropoulos, Gina; Farquhar, Jamie C; Freeman, Victoria Emily; Colton, Patricia Anne; Olmsted, Marion Patricia

    2015-07-01

    Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN. PMID:25823423

  4. Pilot study comparing multi-family therapy to single family therapy for adults with anorexia nervosa in an intensive eating disorder program.

    PubMed

    Dimitropoulos, Gina; Farquhar, Jamie C; Freeman, Victoria Emily; Colton, Patricia Anne; Olmsted, Marion Patricia

    2015-07-01

    Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN.

  5. [Video games: are the motivations and intensity of use changing with age? Comparison between a population of adolescent and adult gamers].

    PubMed

    Caillon, J; Bouju, G; Grall-Bronnec, M

    2014-03-01

    Despite the popularity of video games, few studies have been conducted in France on their use. The objective of this study was to gather data from a sample of French video game players to learn more about this population. This approach also aimed to examine whether differences exist between adolescent and adult gamers in terms of their motivations to play and whether this practice met the criteria for problem video game playing. A questionnaire collecting sociodemographic data and assessing the problems associated with the use of video games, as well as motivations to play, was distributed during a video game festival and on the Internet. A total of 778 people responded to the questionnaire. The results showed that there were few differences between adolescent and adult gamers. Both groups had an intense video game habit. The majority of them sometimes had the feeling of losing control of their use and sacrificed other activities to play video games. This last dimension was most frequently cited by adults. The feeling of spending more time playing was most frequently cited by adolescents. Concerning motivations to play, the two groups differed only on the score of the "social" dimension, significantly higher among adolescents.

  6. Two decades (1993-2012) of adult intensive care unit design: a comparative study of the physical design features of the best practice examples.

    PubMed

    Rashid, Mahbub

    2014-01-01

    In 2006, Critical Care Nursing Quarterly published a study of the physical design features of a set of best practice example adult intensive care units (ICUs). These adult ICUs were awarded between 1993 and 2003 by the Society of Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses, and the American Institute of Architects/Academy of Architecture for Health for their efforts to promote the critical care unit environment through design. Since 2003, several more adult ICUs were awarded by the same organizations for similar efforts. This study includes these newer ICUs along with those of the previous study to cover a period of 2 decades from 1993 to 2012. Like the 2006 study, this study conducts a systematic content analysis of the materials submitted by the award-winning adult ICUs. On the basis of the analysis, the study compares the 1993-2002 and 2003-2012 adult ICUs in relation to construction type, unit specialty, unit layout, unit size, patient room size and design, support and service area layout, and family space design. The study also compares its findings with the 2010 Guidelines for Design and Construction of Health Care Facilities of the Facility Guidelines Institute and the 2012 Guidelines for Intensive Care Unit Design of the SCCM. The study indicates that the award-winning ICUs of both decades used several design features that were associated with positive outcomes in research studies. The study also indicates that the award-winning ICUs of the second decade used more evidence-based design features than those of the first decades. In most cases, these ICUs exceeded the requirements of the Facility Guidelines Institute Guidelines to meet those of the SCCM Guidelines. Yet, the award-winning ICUs of both decades also used several features that had very little or no supporting research evidence. Since they all were able to create an optimal critical care environment for which they were awarded, having knowledge of the physical

  7. Emotional effect of physical aggression among adults in the general population in a Canadian province.

    PubMed

    Wells, Samantha; Graham, Kathryn

    2003-02-01

    The emotional effect of personal involvement in physical aggression was examined in a random sample of 1,753 adults from Ontario, Canada, using Computer Assisted Telephone Interviewing (response rate of 67%). Respondents reported a range of emotional responses from feeling good or justified to feeling angry, upset, terrified, disgusted, hurt, and embarrassed. Open-ended responses regarding emotional response were rated by the authors for 149 incidents of aggression, which yielded five categories: (1) positive impact 4%, (2) no feeling or no effect 31%, (3) mildly negative 20%, (4) moderately negative 28%, and (5) severely negative 17% (Kappa statistic of interrater agreement=.77). The substantial proportion of incidents involving positive or no emotional response suggests that a greater understanding of aggression among individuals can be gained by the development and application of a quantitative measure of emotional response that reflects the full range of emotions (positive and negative), using dimensions identified in this study such as feeling upset, fear, and anger.

  8. Long-Term Mild, rather than Intense, Exercise Enhances Adult Hippocampal Neurogenesis and Greatly Changes the Transcriptomic Profile of the Hippocampus.

    PubMed

    Inoue, Koshiro; Okamoto, Masahiro; Shibato, Junko; Lee, Min Chul; Matsui, Takashi; Rakwal, Randeep; Soya, Hideaki

    2015-01-01

    Our six-week treadmill running training (forced exercise) model has revealed that mild exercise (ME) with an intensity below the lactate threshold (LT) is sufficient to enhance spatial memory, while intense exercise (IE) above the LT negates such benefits. To help understand the unrevealed neuronal and signaling/molecular mechanisms of the intensity-dependent cognitive change, in this rat model, we here investigated plasma corticosterone concentration as a marker of stress, adult hippocampal neurogenesis (AHN) as a potential contributor to this ME-induced spatial memory, and comprehensively delineated the hippocampal transcriptomic profile using a whole-genome DNA microarray analysis approach through comparison with IE. Results showed that only IE had the higher corticosterone concentration than control, and that the less intense exercise (ME) is better suited to improve AHN, especially in regards to the survival and maturation of newborn neurons. DNA microarray analysis using a 4 × 44 K Agilent chip revealed that ME regulated more genes than did IE (ME: 604 genes, IE: 415 genes), and only 41 genes were modified with both exercise intensities. The identified molecular components did not comprise well-known factors related to exercise-induced AHN, such as brain-derived neurotrophic factor. Rather, network analysis of the data using Ingenuity Pathway Analysis algorithms revealed that the ME-influenced genes were principally related to lipid metabolism, protein synthesis and inflammatory response, which are recognized as associated with AHN. In contrast, IE-influenced genes linked to excessive inflammatory immune response, which is a negative regulator of hippocampal neuroadaptation, were identified. Collectively, these results in a treadmill running model demonstrate that long-term ME, but not of IE, with minimizing running stress, has beneficial effects on increasing AHN, and provides an ME-specific gene inventory containing some potential regulators of this

  9. Long-Term Mild, rather than Intense, Exercise Enhances Adult Hippocampal Neurogenesis and Greatly Changes the Transcriptomic Profile of the Hippocampus

    PubMed Central

    Inoue, Koshiro; Okamoto, Masahiro; Shibato, Junko; Lee, Min Chul; Matsui, Takashi; Rakwal, Randeep; Soya, Hideaki

    2015-01-01

    Our six-week treadmill running training (forced exercise) model has revealed that mild exercise (ME) with an intensity below the lactate threshold (LT) is sufficient to enhance spatial memory, while intense exercise (IE) above the LT negates such benefits. To help understand the unrevealed neuronal and signaling/molecular mechanisms of the intensity-dependent cognitive change, in this rat model, we here investigated plasma corticosterone concentration as a marker of stress, adult hippocampal neurogenesis (AHN) as a potential contributor to this ME-induced spatial memory, and comprehensively delineated the hippocampal transcriptomic profile using a whole-genome DNA microarray analysis approach through comparison with IE. Results showed that only IE had the higher corticosterone concentration than control, and that the less intense exercise (ME) is better suited to improve AHN, especially in regards to the survival and maturation of newborn neurons. DNA microarray analysis using a 4 × 44 K Agilent chip revealed that ME regulated more genes than did IE (ME: 604 genes, IE: 415 genes), and only 41 genes were modified with both exercise intensities. The identified molecular components did not comprise well-known factors related to exercise-induced AHN, such as brain-derived neurotrophic factor. Rather, network analysis of the data using Ingenuity Pathway Analysis algorithms revealed that the ME-influenced genes were principally related to lipid metabolism, protein synthesis and inflammatory response, which are recognized as associated with AHN. In contrast, IE-influenced genes linked to excessive inflammatory immune response, which is a negative regulator of hippocampal neuroadaptation, were identified. Collectively, these results in a treadmill running model demonstrate that long-term ME, but not of IE, with minimizing running stress, has beneficial effects on increasing AHN, and provides an ME-specific gene inventory containing some potential regulators of this

  10. Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

    PubMed Central

    Gimeno-Gracia, Mercedes; Crusells-Canales, María José; Armesto-Gómez, Francisco Javier; Compaired-Turlán, Vicente; Rabanaque-Hernández, María José

    2016-01-01

    Background The percentage of older HIV-positive patients is growing, with an increase in age-related comorbidities and concomitant medication. Objectives To quantify polypharmacy and profile types of non-antiretroviral drugs collected at community pharmacies in 2014 by HIV-positive individuals on antiretroviral therapy and to compare these findings with those of the general population. Methods HIV-positive patients (n=199) were compared with a group of patients from the general population (n=8,172), aged between 50 and 64 years. The factors compared were prevalence of polypharmacy (≥5 comedications with cumulative defined daily dose [DDD] per drug over 180), percentage of patients who collected each therapeutic class of drug, and median duration for each drug class (based on DDD). Results were stratified by sex. Results Polypharmacy was more common in HIV-positive males than in the male general population (8.9% vs 4.4%, P=0.010). Polypharmacy was also higher in HIV-positive females than in the female general population (11.3% vs 3.4%, P=0.002). Percentage of HIV-positive patients receiving analgesics, anti-infectives, gastrointestinal drugs, central nervous system (CNS) agents, and respiratory drugs was higher than in the general population, with significant differences between male populations. No differences were observed in proportion of patients receiving cardiovascular drugs. The estimated number of treatment days (median DDDs) were higher in HIV-positive males than in males from the general population for anti-infectives (32.2 vs 20.0, P<0.001) and CNS agents (238.7 vs 120.0, P=0.002). A higher percentage of HIV-positive males than males from the general population received sulfonamides (17.1% vs 1.5%, P<0.001), macrolides (37.1% vs 24.9%, P=0.020), and quinolones (34.3% vs 21.2%, P=0.009). Conclusion Polypharmacy is more common in HIV-positive older males and females than in similarly aged members of the general population. HIV-positive patients received

  11. Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population

    PubMed Central

    Gimeno-Gracia, Mercedes; Crusells-Canales, María José; Armesto-Gómez, Francisco Javier; Compaired-Turlán, Vicente; Rabanaque-Hernández, María José

    2016-01-01

    Background The percentage of older HIV-positive patients is growing, with an increase in age-related comorbidities and concomitant medication. Objectives To quantify polypharmacy and profile types of non-antiretroviral drugs collected at community pharmacies in 2014 by HIV-positive individuals on antiretroviral therapy and to compare these findings with those of the general population. Methods HIV-positive patients (n=199) were compared with a group of patients from the general population (n=8,172), aged between 50 and 64 years. The factors compared were prevalence of polypharmacy (≥5 comedications with cumulative defined daily dose [DDD] per drug over 180), percentage of patients who collected each therapeutic class of drug, and median duration for each drug class (based on DDD). Results were stratified by sex. Results Polypharmacy was more common in HIV-positive males than in the male general population (8.9% vs 4.4%, P=0.010). Polypharmacy was also higher in HIV-positive females than in the female general population (11.3% vs 3.4%, P=0.002). Percentage of HIV-positive patients receiving analgesics, anti-infectives, gastrointestinal drugs, central nervous system (CNS) agents, and respiratory drugs was higher than in the general population, with significant differences between male populations. No differences were observed in proportion of patients receiving cardiovascular drugs. The estimated number of treatment days (median DDDs) were higher in HIV-positive males than in males from the general population for anti-infectives (32.2 vs 20.0, P<0.001) and CNS agents (238.7 vs 120.0, P=0.002). A higher percentage of HIV-positive males than males from the general population received sulfonamides (17.1% vs 1.5%, P<0.001), macrolides (37.1% vs 24.9%, P=0.020), and quinolones (34.3% vs 21.2%, P=0.009). Conclusion Polypharmacy is more common in HIV-positive older males and females than in similarly aged members of the general population. HIV-positive patients received

  12. Effects of priming exercise on the speed of adjustment of muscle oxidative metabolism at the onset of moderate-intensity step transitions in older adults.

    PubMed

    De Roia, Gabriela; Pogliaghi, Silvia; Adami, Alessandra; Papadopoulou, Christina; Capelli, Carlo

    2012-05-15

    Aging is associated with a functional decline of the oxidative metabolism due to progressive limitations of both O(2) delivery and utilization. Priming exercise (PE) increases the speed of adjustment of oxidative metabolism during successive moderate-intensity transitions. We tested the hypothesis that such improvement is due to a better matching of O(2) delivery to utilization within the working muscles. In 21 healthy older adults (65.7 ± 5 yr), we measured contemporaneously noninvasive indexes of the overall speed of adjustment of the oxidative metabolism (i.e., pulmonary Vo(2) kinetics), of the bulk O(2) delivery (i.e., cardiac output), and of the rate of muscle deoxygenation (i.e., deoxygenated hemoglobin, HHb) during moderate-intensity step transitions, either with (ModB) or without (ModA) prior PE. The local matching of O(2) delivery to utilization was evaluated by the ΔHHb/ΔVo(2) ratio index. The overall speed of adjustment of the Vo(2) kinetics was significantly increased in ModB compared with ModA (P < 0.05). On the contrary, the kinetics of cardiac output was unaffected by PE. At the muscle level, ModB was associated with a significant reduction of the "overshoot" in the ΔHHb/ΔVo(2) ratio compared with ModA (P < 0.05), suggesting an improved O(2) delivery. Our data are compatible with the hypothesis that, in older adults, PE, prior to moderate-intensity exercise, beneficially affects the speed of adjustment of oxidative metabolism due to an acute improvement of the local matching of O(2) delivery to utilization.

  13. Risk It: A Youth Curriculum Resource for the Certificates in General Education for Adults.

    ERIC Educational Resources Information Center

    2000

    This document is a youth curriculum resource designed to accommodate learners in Australia's Certificates in General Education (CGEA) program. The document begins by discussing the following topics: the curriculum framework; the curriculum's content and its relationship to the CGEA program's numeracy learning outcomes and criteria; successful…

  14. Use of caries preventive agents on adult patients compared to pediatric patients by general practitioners: findings from The Dental Practice-Based Research Network

    PubMed Central

    Riley, Joseph L.; Gordan, Valeria V.; Rindal, D. Brad; Fellows, Jeffrey L.; Williams, O. Dale; Ritchie, Lloyd K.; Gilbert, Gregg H.

    2010-01-01

    Background Evidence suggests that caries prevention reduces caries in adults. This study tested the frequency of recommended caries prevention agents for children compared to adult patients. Methods This study surveyed 467 Dental Practice-Based Research Network general dentists who practice within the United States and treat both pediatric and adult patients. Dentists were asked the percentage of their patients who are administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse, and xylitol gum. Results Adults were less likely to receive in-office caries preventive agents compared to pediatric patients. However, the rate of recommendation for at-home preventive regimens was very similar. Dentists with a conservative approach to caries treatment were the most likely to use caries prevention at similar rates in adults as in children. In addition, practices with a greater number of patients with dental insurance were significantly less likely to provide in-office fluoride or sealants to adult patients than to their pediatric patients. Conclusion In-office caries prevention agents are more commonly used by general dentists for their pediatric patients compared to their adult patients. Practice Implications Some general dentists should consider providing additional in-office prevention agents for their adult patients who are at increased risk for dental caries. PMID:20516100

  15. Have I Ever Done Anything Like This Before? Older Adults Solving Ill-Defined Problems in Intensive Volunteering.

    PubMed

    Cheek, Cheryl; Piercy, Kathleen W; Kohlenberg, Meranda

    2015-01-01

    This study examined the ways in which individuals over 50 years old solved problems while volunteering in intensive humanitarian and disaster relief service. Thirty-seven men and women in the sample were sponsored by three religious organizations well known for providing humanitarian and disaster relief service. Semistructured interviews yielded data that were analyzed qualitatively, using McCracken's five-step process for analysis. We found that volunteers used three different abilities to solve problems: drawing upon experience to create strategies, maintaining emotional stability in the midst of trying circumstances, and applying strategies in a context-sensitive manner. These findings illustrate that these factors, which are comparable to those used in solving everyday problems, are unique in the way they are applied to intensive volunteering. The volunteers' sharing of knowledge, experience, and support with each other were also noticeable in their accounts of their service. This sharing contributed strongly to their sense of emotional stability and effectiveness in solving problems. PMID:26243327

  16. Associations between cortical thickness and general intelligence in children, adolescents and young adults

    PubMed Central

    Menary, Kyle; Collins, Paul F.; Porter, James N.; Muetzel, Ryan; Olson, Elizabeth A.; Kumar, Vipin; Steinbach, Michael; Lim, Kelvin O.; Luciana, Monica

    2013-01-01

    Neuroimaging research indicates that human intellectual ability is related to brain structure including the thickness of the cerebral cortex. Most studies indicate that general intelligence is positively associated with cortical thickness in areas of association cortex distributed throughout both brain hemispheres. In this study, we performed a cortical thickness mapping analysis on data from 182 healthy typically developing males and females ages 9 to 24 years to identify correlates of general intelligence (g) scores. To determine if these correlates also mediate associations of specific cognitive abilities with cortical thickness, we regressed specific cognitive test scores on g scores and analyzed the residuals with respect to cortical thickness. The effect of age on the association between cortical thickness and intelligence was examined. We found a widely distributed pattern of positive associations between cortical thickness and g scores, as derived from the first unrotated principal factor of a factor analysis of Wechsler Abbreviated Scale of Intelligence (WASI) subtest scores. After WASI specific cognitive subtest scores were regressed on g factor scores, the residual score variances did not correlate significantly with cortical thickness in the full sample with age covaried. When participants were grouped at the age median, significant positive associations of cortical thickness were obtained in the older group for g-residualized scores on Block Design (a measure of visual-motor integrative processing) while significant negative associations of cortical thickness were observed in the younger group for g-residualized Vocabulary scores. These results regarding correlates of general intelligence are concordant with the existing literature, while the findings from younger versus older subgroups have implications for future research on brain structural correlates of specific cognitive abilities, as well as the cognitive domain specificity of behavioral

  17. Dizziness in the older adult, Part 1. Evaluation and general treatment strategies.

    PubMed

    Eaton, Deborah A; Roland, Peter S

    2003-04-01

    Dizziness is one of the most common complaints among patients age 50 and older who present to primary care physicians. The evaluation of dizziness is challenging due to the wide range of diagnostic possibilities, including four symptom categories each with multiple potential underlying causes. Although each cause has specific treatment options, general management strategies can be applied to all patients presenting with dizziness. These strategies include use of medications to control acute vestibular and autonomic symptoms as well as vestibular rehabilitation exercises. Difficult cases that do not respond to treatment efforts should be referred to an otolaryngologist for further evaluation and treatment. PMID:12708153

  18. [Moderate asthma in adults: diagnosis and management in general medical practice].

    PubMed

    Vernejoux, J M; Tunon De Lara, J M; Guizard, A V; Villanueva, P; Taytard, A

    1996-10-01

    Moderate asthma is a frequent disorder in general medicine. In 1990, the British Thoracic Society published their first guidelines on the management of asthma. Three years later, we have studied, using a questionnaire, the diagnosis and therapeutic criteria of moderate asthma used by general physicians, and comparing these to the guideline recommendations. Out of 46 physicians questioned in Bordeaux, 40 (87 per cent) agreed to participate in the study. Thirty two physicians (80 per cent) described as moderate an asthma which was mild according to the guidelines; eight physicians (20 per cent) described a moderate asthma according to the guidelines; twenty five (63 per cent) considered as severe a moderate asthma according to the recommendations, although eleven (28 per cent) considered it as moderate and four (10 per cent) did not give an opinion. In total, four (10 per cent) judged asthma severity according to the guidelines (Group R), twenty one (52 per cent) over-estimated the severity of moderate asthma (Group S), and fifteen (37 per cent) gave an inconsistent assessment (Group 1). Twenty six (65 per cent) prescribed an association of beta-2-agonists and inhaled corticosteroids for moderate asthma. Although most of the questioned physicians gave an appropriate treatment for moderate asthma treatment adapted to the severity of the situation, their therapeutic approach did not seem to be based upon the same criteria than that recommended in the guidelines.

  19. High-intensity interval training on an aquatic treadmill in adults with osteoarthritis: effect on pain, balance, function, and mobility.

    PubMed

    Bressel, Eadric; Wing, Jessica E; Miller, Andrew I; Dolny, Dennis G

    2014-08-01

    Although aquatic exercise is considered a potentially effective treatment intervention for people with osteoarthritis (OA), previous research has focused primarily on calisthenics in a shallow pool with the inherent limitations on regulating exercise intensity. The purpose of this study was to quantify the efficacy of a 6-week aquatic treadmill exercise program on measures of pain, balance, function, and mobility. Eighteen participants (age = 64.5 ± 10.2 years) with knee OA completed a non-exercise control period followed by a 6-week exercise period. Outcome measures included visual analog scales for pain, posturography for balance, sit-to-stand test for function, and a 10-m walk test for mobility. The exercise protocol included balance training and high-intensity interval training (HIT) in an aquatic treadmill using water jets to destabilize while standing and achieve high ratings of perceived exertion (14-19) while walking. In comparison with pretests, participants displayed reduced joint pain (pre = 50.3 ± 24.8 mm vs. post = 15.8 ± 10.6 mm), improved balance (equilibrium pre = 66.6 ± 11.0 vs. post = 73.5 ± 7.1), function (rising index pre = 0.49 ± 0.19% vs. post = 0.33 ± 0.11%), and mobility (walk pre = 8.6 ± 1.4 s vs. post = 7.8 ± 1.1 s) after participating in the exercise protocol (p = 0.03-0.001). The same benefits were not observed after the non-exercise control period. Adherence to the exercise protocol was exceptional and no participants reported adverse effects, suggesting that aquatic treadmill exercise that incorporates balance and HIT training was well tolerated by patients with OA and may be effective at managing symptoms of OA.

  20. Cognitive control adjustments in healthy older and younger adults: Conflict adaptation, the error-related negativity (ERN), and evidence of generalized decline with age.

    PubMed

    Larson, Michael J; Clayson, Peter E; Keith, Cierra M; Hunt, Isaac J; Hedges, Dawson W; Nielsen, Brent L; Call, Vaughn R A

    2016-03-01

    Older adults display alterations in neural reflections of conflict-related processing. We examined response times (RTs), error rates, and event-related potential (ERP; N2 and P3 components) indices of conflict adaptation (i.e., congruency sequence effects) a cognitive control process wherein previous-trial congruency influences current-trial performance, along with post-error slowing, correct-related negativity (CRN), error-related negativity (ERN) and error positivity (Pe) amplitudes in 65 healthy older adults and 94 healthy younger adults. Older adults showed generalized slowing, had decreased post-error slowing, and committed more errors than younger adults. Both older and younger adults showed conflict adaptation effects; magnitude of conflict adaptation did not differ by age. N2 amplitudes were similar between groups; younger, but not older, adults showed conflict adaptation effects for P3 component amplitudes. CRN and Pe, but not ERN, amplitudes differed between groups. Data support generalized declines in cognitive control processes in older adults without specific deficits in conflict adaptation.

  1. Vigorous, Aerobic Exercise versus General Motor Training Activities: Effects on Maladaptive and Stereotypic Behaviors of Adults with Both Autism and Mental Retardation.

    ERIC Educational Resources Information Center

    Elliott, Reed O., Jr.; And Others

    1994-01-01

    Six adults with both autism and moderate/profound mental retardation were assessed in a controlled environment for changes in frequency of maladaptive and stereotypic behaviors following nonexercise activities, general motor training activities, and aerobic exercise. Although antecedent aerobic exercise reduced undesirable behaviors, general motor…

  2. Prevalence and comorbidity of nocturnal wandering in the US adult general population

    PubMed Central

    Mahowald, M.W.; Dauvilliers, Y.; Krystal, A.D.; Léger, D.

    2012-01-01

    Objective: To assess the prevalence and comorbid conditions of nocturnal wandering with abnormal state of consciousness (NW) in the American general population. Methods: Cross-sectional study conducted with a representative sample of 19,136 noninstitutionalized individuals of the US general population ≥18 years old. The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental, and organic disorders (DSM-IV-TR; International Classification of Sleep Disorders, version 2; International Classification of Diseases–10). Results: Lifetime prevalence of NW was 29.2% (95% confidence interval [CI] 28.5%–29.9%). In the previous year, NW was reported by 3.6% (3.3%–3.9%) of the sample: 1% had 2 or more episodes per month and 2.6% had between 1 and 12 episodes in the previous year. Family history of NW was reported by 30.5% of NW participants. Individuals with obstructive sleep apnea syndrome (odds ratio [OR] 3.9), circadian rhythm sleep disorder (OR 3.4), insomnia disorder (OR 2.1), alcohol abuse/dependence (OR 3.5), major depressive disorder (MDD) (OR 3.5), obsessive-compulsive disorder (OCD) (OR 3.9), or using over-the-counter sleeping pills (OR 2.5) or selective serotonin reuptake inhibitor (SSRI) antidepressants (OR 3.0) were at higher risk of frequent NW episodes (≥2 times/month). Conclusions: With a rate of 29.2%, lifetime prevalence of NW is high. SSRIs were associated with an increased risk of NW. However, these medications appear to precipitate events in individuals with a prior history of NW. Furthermore, MDD and OCD were associated with significantly greater risk of NW, and this was not due to the use of psychotropic medication. These psychiatric associations imply an increased risk due to sleep disturbance. PMID:22585435

  3. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study.

    PubMed

    López-Sobaler, Ana M; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18-64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415-2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045-1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m(2), WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m(2), WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future.

  4. The Relation between Early Maladaptive Schemas, Depression, and Generalized Anxiety among Adults Seeking Residential Treatment for Substance Use Disorders

    PubMed Central

    Shorey, Ryan C.; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    Objective Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, little work has examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. Method We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N = 122). Results The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Conclusions Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes. PMID:26099037

  5. The Relationship Between Early Maladaptive Schemas, Depression, and Generalized Anxiety among Adults Seeking Residential Treatment for Substance Use Disorders.

    PubMed

    Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L

    2015-01-01

    Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, few studies have examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N=122). The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD, even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes.

  6. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study.

    PubMed

    López-Sobaler, Ana M; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18-64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415-2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045-1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m(2), WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m(2), WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  7. Assessing the impact of the duration and intensity of inhalation exposure on the magnitude of the variability of internal dose metrics in children and adults.

    PubMed

    Valcke, Mathieu; Krishnan, Kannan

    2011-12-01

    The objective of this study was to assess the impact of the exposure duration and intensity on the human kinetic adjustment factor (HKAF). A physiologically based pharmacokinetic model was used to compute target dose metrics (i.e. maximum blood concentration (C(max)) and amount metabolized/L liver/24  h (Amet)) in adults, neonates (0-30 days), toddlers (1-3 years), and pregnant women following inhalation exposure to benzene, styrene, 1,1,1-trichloroethane and 1,4-dioxane. Exposure scenarios simulated involved various concentrations based on the chemical's reference concentration (low) and six of U.S. EPA's Acute Exposure Guideline Levels (AEGLs) (high), for durations of 10  min, 60  min, 8  h, and 24  h, as well as at steady-state. Distributions for body weight (BW), height (H), and hepatic CYP2E1 content were obtained from the literature or from P3M software, whereas blood flows and tissue volumes were calculated from BW and H. The HKAF was computed based on distributions of dose metrics obtained by Monte Carlo simulations [95th percentile in each subpopulation/median in adults]. At low levels of exposure, ranges of C(max)-based HKAF were 1-6.8 depending on the chemical, with 1,4-dioxane exhibiting the greatest values. At high levels of exposure, this range was 1.1-5.2, with styrene exhibiting the greatest value. Neonates were always the most sensitive subpopulation based on C(max), and pregnant women were most sensitive based on Amet in the majority of the cases (1.3-2.1). These results have shown that the chemical-specific HKAF varies as a function of exposure duration and intensity of inhalation exposures, and sometimes exceeds the default value used in risk assessments. PMID:22084919

  8. Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) among Patients Admitted to Adult Intensive Care Units: the STAR*ICU Trial

    PubMed Central

    Nair, Nisha; Kourbatova, Ekaterina; Poole, Katharine; Huckabee, Charmaine M.; Murray, Patrick; Huskins, W. Charles; Blumberg, Henry M.

    2014-01-01

    Background The multi-center cluster-randomized Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) trial was carried out in 18 U.S. adult intensive care units (ICUs) and evaluated the effectiveness of infection control strategies in reducing transmission of methicillin-resistant Staphylococcus aureus (MRSA) colonization and/or infection. Our study objective was to examine the molecular epidemiology of MRSA and assess the prevalence and risk factors for community acquired (CA)-MRSA genotype nasal carriage at the time of ICU admission. Methods Selected MRSA isolates were subjected to molecular typing using pulsed-field gel electrophoresis. Results Among 5,512 ICU patient-admissions in the STAR*ICU trial during the intervention period, 626 (11%) had a positive nares culture for MRSA. 210/626 (34%) available isolates were selected by weighted random sampling for molecular typing. Of 210 patients, 123 (59%) were male; mean age was 63 years. Molecular typing revealed that 147 isolates (70%) were the USA100 clone; 26 (12%) USA300; 12 (6%) USA500; 8 (4%) USA800; 17 (8%) other. In multivariate analysis, patients with CA-MRSA genotype (USA300, USA400, or USA1000) colonization were less likely to have been hospitalized during the previous 12 months (PR=0.39; 95% C.I. 0.21–0.73) and less likely to have an older age (PR=0.97 per year; 0.95–0.98) compared to patients with a HA-MRSA genotype. Conclusion CA-MRSA genotypes have emerged as a cause of MRSA nares colonization among patients admitted to adult ICUs in the U.S. During the study period (2006), the predominant site of CA-MRSA genotype acquisition appeared to be in the community. PMID:22011531

  9. Bad Dream Frequency in Older Adults with Generalized Anxiety Disorder: Prevalence, Correlates, and Effect of Cognitive Behavioral Treatment for Anxiety

    PubMed Central

    Nadorff, Michael R.; Porter, Ben; Rhoades, Howard M.; Greisinger, Anthony J.; Kunik, Mark E.; Stanley, Melinda A.

    2012-01-01

    This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy for anxiety (CBT) to enhanced usual care (EUC), it assessed bad dream frequency at baseline, post-treatment (3 months), and 6, 9, 12 and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post-treatment and throughout follow-up compared to EUC. PMID:23470116

  10. Maintaining connections: some thoughts on the value of intensive care unit rounding for general medicine ward teams.

    PubMed

    Howell, Joel D

    2011-09-01

    When established ward patients are unexpectedly transferred to an intensive care unit (ICU), the ward team should continue to follow them. Although there may be reasons not to do so, the advantages outweigh the obstacles. Great pedagogic value can be gained from following patients after acute decompensation, but a more important reason is that by following patients into the ICU, the ward team can enact for both patients and their families the twin virtues of caring and continuity. Doing so also demonstrates the highest ideals of medicine-that we are focused not on defined areas of turf, but on our patient's well-being. It shows that we are not merely doing narrowly defined "shift work," but that we truly care about our patients. Rounding on established patients who have been transferred into the ICU is the sort of behavior that undergirds the fundamental bases of professionalism. It takes a few minutes from a busy day, but it can be incredibly beneficial for families, patients, and the ideals of medicine.

  11. Control of an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) by hygienic measures in a general intensive care unit.

    PubMed

    Lingnau, W; Allerberger, F

    1994-01-01

    Infections are a major cause of death in critically ill patients. As gram-positive organisms are more widespread and methicillin-resistant staphylococci (MRSA, MRSE) are easily distributed in overcrowded Intensive Care Units (ICU), extended hygienic procedures for infection control are most important. We hypothesize that strict regulations and educational programs for medical and nursing personnel are able to control the spread of resistant bacteria. In a four-room 16-bed medico-surgical ICU, we reinforced hygienic procedures and introduced the separation of clean postoperative and multiply injured patients from those with infectious complications, subsequent to an outbreak of MRSA in 1991. MRSA and MRSE isolated from surveillance cultures of bronchial secretions were reduced from an annual rate of 60.0% to 37.7% and 36.4% to 6.2% respectively between the years 1991 and 1992. Accordingly, the number of lower respiratory tract infections and the crude mortality could be reduced. We conclude that prompt implementation of control measures and continuous education of medical personnel are able to control an outbreak of infection with resistant staphylococci in an ICU setting.

  12. Intensity-modulated radiation therapy and volumetric-modulated arc therapy for adult craniospinal irradiation—A comparison with traditional techniques

    SciTech Connect

    Studenski, Matthew T.; Shen, Xinglei; Yu, Yan; Xiao, Ying; Shi, Wenyin; Biswas, Tithi; Werner-Wasik, Maria; Harrison, Amy S.

    2013-04-01

    Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are compared with classic conformal planning in adults for both cranial and spine fields to develop a clinically feasible technique that is both effective and efficient. Ten adult patients treated with CSI were retrospectively identified. For the cranial fields, 5-field IMRT and dual 356° VMAT arcs were compared with opposed lateral 3D conformal radiotherapy (3D-CRT) fields. For the spine fields, traditional posterior-anterior (PA) PA fields were compared with isocentric 5-field IMRT plans and single 200° VMAT arcs. Two adult patients have been treated using this IMRT technique to date and extensive quality assurance, especially for the junction regions, was performed. For the cranial fields, the IMRT technique had the highest planned target volume (PTV) maximum and was the least efficient, whereas the VMAT technique provided the greatest parotid sparing with better efficiency. 3D-CRT provided the most efficient delivery but with the highest parotid dose. For the spine fields, VMAT provided the best PTV coverage but had the highest mean dose to all organs at risk (OAR). 3D-CRT had the highest PTV and OAR maximum doses but was the most efficient. IMRT provides the greatest OAR sparing but the longest delivery time. For those patients with unresectable disease that can benefit from a higher, definitive dose, 3D-CRT–opposed laterals are the most clinically feasible technique for cranial fields and for spine fields. Although inefficient, the IMRT technique is the most clinically feasible because of the increased mean OAR dose with the VMAT technique. Quality assurance of the beams, especially the junction regions, is essential.

  13. Blood pressure in relation to general and central adiposity among 500 000 adult Chinese men and women

    PubMed Central

    Chen, Zhengming; Smith, Margaret; Du, Huaidong; Guo, Yu; Clarke, Robert; Bian, Zheng; Collins, Rory; Chen, Junshi; Qian, Yijian; Wang, Xiaoping; Chen, Xiaofang; Tian, Xiaocao; Wang, Xiaohuan; Peto, Richard; Li, Liming

    2015-01-01

    Background: Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations. Methods: We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004–08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education. Results: The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m2 and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m2 greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/−0.2; WHR: 0.6/0.6). Conclusion: In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations. PMID:25747585

  14. Structural Invariance of General Behavior Inventory (GBI) Scores in Black and White Young Adults

    PubMed Central

    Pendergast, Laura L.; Youngstrom, Eric A.; Brown, Christopher; Jensen, Dane; Abramson, Lyn Y.; Alloy, Lauren B.

    2014-01-01

    In the United States, Black and White individuals show discrepant rates of diagnosis of bipolar disorder versus schizophrenia and antisocial personality disorder, as well as disparate access to and utilization of treatment for these disorders (e.g., Alegria, Chatterji et al., 2008; Chrishon et al., 2012). Such diagnostic discrepancies might stem from racially-related cognitive biases in clinical judgment or from racial biases in measurements of bipolar disorder. The General Behavior Inventory (GBI) is among the most well-validated and widely used measures of bipolar mood symptoms, but the psychometric properties of the GBI have been examined primarily in predominantly White samples. This study used multi-group confirmatory factor analyses (CFA) to examine the invariance of GBI scores across racial groups with a non-clinical sample. Fit was acceptable for tests of configural invariance, equal factor loadings, and equal intercepts, but not invariance of residuals. Findings indicate that GBI scores provide functionally invariant measurement of mood symptoms in both Black and White samples. The use of GBI scores may contribute consistent information to clinical assessments and could potentially reduce diagnostic discrepancies and associated differences in access to and utilization of mental health services. PMID:25222430

  15. The relationship between general causality orientation and treatment outcome among marijuana-dependent adults.

    PubMed

    Blevins, Claire E; Banes, Kelsey E; Walker, Denise D; Stephens, Robert S; Roffman, Roger A

    2016-02-01

    General causality orientations are motivational styles that are indicative of a person's belief about personal change and their motivation to change. The purpose of the current study was to investigate whether causality orientations were associated with marijuana treatment outcomes in a sample of marijuana-dependent individuals. A total of 74 participants (66% male) were recruited from the Seattle, Washington area and randomly assigned to receive a combination of motivational enhancement and cognitive behavioral therapy or the combination treatment plus additional "check-up" sessions. Follow-up assessments evaluated frequency of use, use-related problems, and marijuana use disorder symptoms through 9months. Causality orientations were relatively stable over time. Posttreatment Autonomy orientations were associated with lower frequency of use and Controlled orientations were associated with a reduction in use, problems, and marijuana use disorder symptoms. Autonomy and Controlled orientations were associated with readiness to change. Results suggest that both autonomous and controlled orientations have implications for response to treatment; perhaps for different reasons. Causality orientations may be a promising avenue of research to predict treatment response and outcome.

  16. A cross-sectional study assessing the self-reported weight loss strategies used by adult Australian general practice patients

    PubMed Central

    2012-01-01

    Background Obesity is a significant public health concern. General practitioners (GPs) see a large percentage of the population and are well placed to provide weight management advice. There has been little examination of the types of weight loss strategies used in Australian general practice patients. This cross-sectional study aimed to describe the proportion of normal weight, overweight and obese general practice patients who report trying to lose weight in the past 12 months, the types of weight loss strategies and diets used as well as the proportion consulting their GP prior to trying to lose weight. Methods Adult patients completed a touchscreen computer survey while waiting for their appointment. Responses from 1335 patients in twelve Australian practices are reported. Results A larger proportion of obese patients had tried to lose weight in the past 12 months (73%) compared to those who were overweight (55%) and normal weight (33%). The most commonly used strategy used was changing diet and increasing exercise in all BMI categories. Less than 10% used strategies such as prescription medication, over the counter supplements and consulted a weight loss specialist. Low calorie and low fat diets were the most frequently reported diets used to lose weight in those who were normal weight, overweight and obese. Overall, the proportion seeking GP advice was low, with 12% of normal weight, 15% of overweight and 43% of obese patients consulting their GP prior to trying to lose weight. Conclusions A large proportion of overweight or obese patients have tried to lose weight and utilized strategies such as changing diet and increasing exercise. Most attempts however were unassisted, with low rates of consultation with GPs and weight loss specialists. Ways to assist overweight and obese general practice patients with their weight loss attempts need to be identified. PMID:22646972

  17. Hormonal, metabolic, and cardiorespiratory responses of young and adult athletes to a single session of high-intensity cycle exercise.

    PubMed

    Engel, Florian; Härtel, Sascha; Wagner, Matthias Oliver; Strahler, Jana; Bös, Klaus; Sperlich, Billy

    2014-11-01

    This study aimed to determine the effects of a single high-intensity interval training (HIIT) session on salivary cortisol (SC) levels, physiological responses, and performance in trained boys and men. Twenty-three boys (11.5 ± 0.8 years) and 25 men (29.7 ± 4.6 years) performed HIIT (4 consecutive Wingate Anaerobic Tests). SC in boys and men increased after HIIT from 5.55 ± 3.3 nmol/l to 15.13 ± 9.7 nmol/l (+173%) and from 7.07 ± 4.7 nmol/l to 19.19 ± 12.7 nmol/l (+171%), respectively (p < .01). Pretest SC as well as posttest changes were comparable in both groups (both p < .01). Peak blood lactate concentration was significantly lower in boys (12.6 ± 3.5 mmol/l) than in men (16.3 ± 3.1 mmol/l; p < .01). Throughout the HIIT, mean heart rates in boys were higher (p < .001) but relative peak oxygen uptake (ml·min-1·kg-1; p < .05) and performance were lower (p < .001) in boys than in men. HIIT in young athletes is associated with a higher activation of the hormonal stress axis than other types of exercise regimes as described in the literature. This study is the first to show a pronounced SC increase to HIIT in trained boys accompanied by elevated levels of blood lactate concentrations and heart rate suggesting a high cardio-respiratory, metabolic, and hormonal response to HIIT in 11-year-old boys.

  18. Light Intensity Physical Activity and Sedentary Behavior in Relation to Body Mass Index and Grip Strength in Older Adults: Cross-Sectional Findings from the Lifestyle Interventions and Independence for Elders (LIFE) Study

    PubMed Central

    Bann, David; Hire, Don; Manini, Todd; Cooper, Rachel; Botoseneanu, Anda; McDermott, Mary M.; Pahor, Marco; Glynn, Nancy W.; Fielding, Roger; King, Abby C.; Church, Timothy; Ambrosius, Walter T.; Gill, Thomas

    2015-01-01

    Background Identifying modifiable determinants of fat mass and muscle strength in older adults is important given their impact on physical functioning and health. Light intensity physical activity and sedentary behavior are potential determinants, but their relations to these outcomes are poorly understood. We evaluated associations of light intensity physical activity and sedentary time—assessed both objectively and by self-report—with body mass index (BMI) and grip strength in a large sample of older adults. Methods We used cross-sectional baseline data from 1130 participants of the Lifestyle Interventions and Independence for Elders (LIFE) study, a community-dwelling sample of relatively sedentary older adults (70-89 years) at heightened risk of mobility disability. Time spent sedentary and in light intensity activity were assessed using an accelerometer worn for 3–7 days (Actigraph GT3X) and by self-report. Associations between these exposures and measured BMI and grip strength were evaluated using linear regression. Results Greater time spent in light intensity activity and lower sedentary times were both associated with lower BMI. This was evident using objective measures of lower-light intensity, and both objective and self-reported measures of higher-light intensity activity. Time spent watching television was positively associated with BMI, while reading and computer use were not. Greater time spent in higher but not lower intensities of light activity (assessed objectively) was associated with greater grip strength in men but not women, while neither objectively assessed nor self-reported sedentary time was associated with grip strength. Conclusions In this cross-sectional study, greater time spent in light intensity activity and lower sedentary times were associated with lower BMI. These results are consistent with the hypothesis that replacing sedentary activities with light intensity activities could lead to lower BMI levels and obesity

  19. Rapidly controlled outbreak of Serratia marcescens infection/colonisations in a neonatal intensive care unit, Pescara General Hospital, Pescara, Italy, April 2011.

    PubMed

    Polilli, E; Parruti, G; Fazii, P; D'Antonio, D; Palmieri, D; D'Incecco, C; Mangifesta, A; Garofalo, G; Del Duca, L; D'Amario, C; Scimia, M; Cortesi, V; Fortunato, V

    2011-01-01

    In April 2011, an outbreak of Serratia marcescens infection/ colonisations occurred in the neonatal intensive care unit of Pescara General Hospital. Rapid microbiological investigations lead to identification of five cases of likely cross-transmission from a neonate hospitalised for S. marcescens sepsis: four infections and one neonate colonised post-mortem. Two low birth weight neonates died. The environmental investigation detected S. marcescens from two soap dispensers. Strict hygiene measures lead to early interruption of the outbreak, without recurrences to date. PMID:21699768

  20. Secondary stroke in patients with polytrauma and traumatic brain injury treated in an Intensive Care Unit, Karlovac General Hospital, Croatia.

    PubMed

    Belavić, M; Jančić, E; Mišković, P; Brozović-Krijan, A; Bakota, B; Žunić, J

    2015-11-01

    Traumatic brain injury (TBI) is divided into primary and secondary brain injury. Primary brain injury occurs at the time of injury and is the direct consequence of kinetic energy acting on the brain tissue. Secondary brain injury occurs several hours or days after primary brain injury and is the result of factors including shock, systemic hypotension, hypoxia, hypothermia or hyperthermia, intracranial hypertension, cerebral oedema, intracranial bleeding or inflammation. The aim of this retrospective analysis of a prospective database was to determine the prevalence of secondary stroke and stroke-related mortality, causes of secondary stroke, treatment and length of stay in the ICU and hospital. This study included patients with TBI with or without other injuries who were hospitalised in a general ICU over a five-year period. The following parameters were assessed: demographics (age, sex), scores (Glasgow Coma Score, APACHE II, SOFA), secondary stroke (prevalence, time of occurrence after primary brain injury, causes of stroke and associated mortality), length of stay in the ICU and hospital, vital parameters (state of consciousness, cardiac function, respiration, circulation, thermoregulation, diuresis) and laboratory values (leukocytes, C-reactive protein [CRP], blood glucose, blood gas analysis, urea, creatinine). Medical data were analysed for 306 patients with TBI (median age 56 years, range 18-93 years) who were treated in the general ICU. Secondary stroke occurred in 23 patients (7.5%), 10 of whom died, which gives a mortality rate of 43.4%. Three patients were excluded as the cause of the injury was missile trauma. The study data indicate that inflammation is the most important cause of secondary insults. Levels of CRP were elevated in 65% of patients with secondary brain injury; leukocytosis was present in 87% of these patients, and blood glucose was elevated in 73%. The lungs and urinary tract were the most common sites of infection. In conclusion

  1. The African Adult Education Movement in Blossom. Report of the Secretary General to the Second General Assembly on the 1987-90 Period.

    ERIC Educational Resources Information Center

    African Association for Literacy and Adult Education, Nairobi (Kenya).

    Since 1987, many activities have been undertaken by the African Association for Literacy and Adult Education (AALAE). Perhaps the most important program activity has been the building of institutional capacities in the adult education movement. Important elements are organizational development, networking and solidarity, management development…

  2. Stacking sequence determines Raman intensities of observed interlayer shear modes in 2D layered materials--A general bond polarizability model.

    PubMed

    Luo, Xin; Lu, Xin; Cong, Chunxiao; Yu, Ting; Xiong, Qihua; Quek, Su Ying

    2015-01-01

    2D layered materials have recently attracted tremendous interest due to their fascinating properties and potential applications. The interlayer interactions are much weaker than the intralayer bonds, allowing the as-synthesized materials to exhibit different stacking sequences, leading to different physical properties. Here, we show that regardless of the space group of the 2D materials, the Raman frequencies of the interlayer shear modes observed under the typical z(xx)z configuration blue shift for AB stacked materials, and red shift for ABC stacked materials, as the number of layers increases. Our predictions are made using an intuitive bond polarizability model which shows that stacking sequence plays a key role in determining which interlayer shear modes lead to the largest change in polarizability (Raman intensity); the modes with the largest Raman intensity determining the frequency trends. We present direct evidence for these conclusions by studying the Raman modes in few layer graphene, MoS2, MoSe2, WSe2 and Bi2Se3, using both first principles calculations and Raman spectroscopy. This study sheds light on the influence of stacking sequence on the Raman intensities of intrinsic interlayer modes in 2D layered materials in general, and leads to a practical way of identifying the stacking sequence in these materials. PMID:26469313

  3. Overweight and General and Abdominal Obesity in a Representative Sample of Spanish Adults: Findings from the ANIBES Study

    PubMed Central

    López-Sobaler, Ana M.; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M.

    2016-01-01

    Objective. To analyze the anthropometric parameters from a representative sample of Spanish adults participating in ANIBES study and the prevalence of general and abdominal obesity. Methods. This cross-sectional study focused on 1655 adults aged 18–64 years. Weight, height, and waist circumference (WC) were evaluated, and body mass index (BMI) and waist to height ratio (WHtR) were calculated. A composite index combining BMI and WHtR was designed to establish five groups with different anthropometric status. Results. The prevalence of overweight (OW) was 35.8% and that of obesity was 19.9%. Obesity (OB) was higher among men (OR 1.725, 1.415–2.104; p = 0.000) and each year of age increased the risk of obesity (OR 1.054, 1.045–1.064; p = 0.000). The prevalence of abdominal obesity (WHtR ≥ 0.5) was 58.4%. Only 36.1% of the population had an optimal anthropometric situation (BMI < 25 kg/m2, WHtR < 0.5), whereas 50.1% had weight excess and high WHtR (BMI ≥ 25 kg/m2, WHtR ≥ 0.5). Conclusions. More than half of Spanish population has weight excess and cardiometabolic risk. The results of this study provide an understanding of the current anthropometric situation in the Spanish population, as a first step toward planning interventions and assessing their effectiveness in the future. PMID:27382572

  4. Early Response to Psychotherapy and Long-term Change in Worry Symptoms in Older Adults with Generalized Anxiety Disorder

    PubMed Central

    Bradford, Andrea; Cully, Jeffrey; Rhoades, Howard; Kunik, Mark; Kraus-Schuman, Cynthia; Wilson, Nancy; Stanley, Melinda

    2010-01-01

    Objectives To determine the association of early and long-term reductions in worry symptoms after cognitive behavioral therapy for generalized anxiety disorder (GAD) in older adults. Design Substudy of larger randomized controlled trial Setting Family medicine clinic and large multi-specialty health organization in Houston, TX, between March 2004 and August 2006 Participants Patients (N=76) 60 years or older with a principal or coprincipal diagnosis of GAD, excluding those with significant cognitive impairment, bipolar disorder, psychosis or active substance abuse. Intervention Cognitive behavioral therapy, up to 10 sessions over 12 weeks, or enhanced usual care (regular, brief telephone calls and referrals to primary care provider as needed) Measurements Penn State Worry Questionnaire (PSWQ) administered by telephone at baseline, 1 month (mid-treatment), 3 months (post-treatment), and at 3-month intervals through 15 months (1-year follow-up). We used binary logistic regression analysis to determine the association between early (1-month) response and treatment responder status (reduction of more than 8.5 points on the PSWQ) at 3 and 15 months. We also used hierarchical linear modeling to determine the relationship of early response to the trajectory of score change after post-treatment. Results Reduction in PSWQ scores after the first month predicted treatment response at post-treatment and follow-up, controlling for treatment arm and baseline PSWQ score. The magnitude of early reduction also predicted the slope of score change from post-treatment through the 15-month assessment. Conclusions Early symptom reduction is associated with long-term outcomes after psychotherapy in older adults with GAD. PMID:21427643

  5. Cost utility analysis of reduced intensity hematopoietic stem cell transplantation in adolescence and young adult with severe thalassemia compared to hypertransfusion and iron chelation program

    PubMed Central

    2013-01-01

    Background Hematopoieticic stem cell transplantation is the only therapeutic option that can cure thalassemia disease. Reduced intensity hematopoietic stem cell transplantation (RI-HSCT) has demonstrated a high cure rate with minimal complications compared to other options. Because RI-HSCT is very costly, economic justification for its value is needed. This study aimed to estimate the cost-utility of RI-HSCT compared with blood transfusions combined with iron chelating therapy (BT-ICT) for adolescent and young adult with severe thalassemia in Thailand. Methods A Markov model was used to estimate the relevant costs and health outcomes over the patients’ lifetimes using a societal perspective. All future costs and outcomes were discounted at a rate of 3% per annum. The efficacy of RI-HSCT was based a clinical trial including a total of 18 thalassemia patients. Utility values were derived directly from all patients using EQ-5D and SF-6D. Primary outcomes of interest were lifetime costs, quality adjusted life-years (QALYs) gained, and the incremental cost-effectiveness ratio (ICER) in US ($) per QALY gained. One-way and probabilistic sensitivity analyses (PSA) were conducted to investigate the effect of parameter uncertainty. Results In base case analysis, the RI-HSCT group had a better clinical outcomes and higher lifetime costs. The incremental cost per QALY gained was US $ 3,236 per QALY. The acceptability curve showed that the probability of RI-HSCT being cost-effective was 71% at the willingness to pay of 1 time of Thai Gross domestic product per capita (GDP per capita), approximately US $ 4,210 per QALY gained. The most sensitive parameter was utility of severe thalassemia patients without cardiac complication patients. Conclusion At a societal willingness to pay of 1 GDP per capita, RI-HSCT was a cost-effective treatment for adolescent and young adult with severe thalassemia in Thailand compared to BT-ICT. PMID:23379888

  6. A decade of adult intensive care unit design: a study of the physical design features of the best-practice examples.

    PubMed

    Rashid, Mahbub

    2006-01-01

    This article reports a study of the physical design characteristics of a set of adult intensive care units (ICUs), built between 1993 and 2003. These ICUs were recognized as the best-practice examples by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, and the American Institute of Architects. This study is based on a systematic analysis of the materials found on these ICUs in the booklet and videos jointly published by the above organizations in 2005. The study finds that most of these examples of best-practice adult ICUs have the following negative characteristics: (1) they are built as renovation projects with more health and safety hazards during construction; (2) most of them are mixed-service units with more safety and staffing problems; (3) the overall layout and the layout of staff work areas in these ICUs do not have any common design solutions for improved patient and staff outcomes; and (4) in these ICUs, family space is often located outside the unit, and family access to the patient room is restricted, even though family presence at the bedside may be important for improved patient outcomes. Some of these negative characteristics are offset by the following positive characteristics in most ICUs: (1) they have only private patient rooms for improved patient care, safety, privacy, and comfort; (2) most patient beds are freestanding for easy access to patients from all sides; (3) they have handwashing sinks and waste disposal facilities in the patient room for improved safety; and (4) most patient rooms have natural light to help patients with circadian rhythms. The article discusses, in detail, the implications of its findings, and the role of the ICU design community in a very complicated design context. PMID:17063097

  7. Intensive Group Learning and On-Site Services to Improve Sexual and Reproductive Health Among Young Adults in Liberia: A Randomized Evaluation of HealthyActions

    PubMed Central

    Firestone, Rebecca; Moorsmith, Reid; James, Simon; Urey, Marilyn; Greifinger, Rena; Lloyd, Danielle; Hartenberger-Toby, Lisa; Gausman, Jewel; Sanoe, Musa

    2016-01-01

    ABSTRACT Introduction: Young Liberians, particularly undereducated young adults, face substantial sexual and reproductive health (SRH) challenges, with low uptake of contraceptive methods, high rates of unintended pregnancy, and low levels of knowledge about HIV status. The purpose of this study was to assess the impact of a 6-day intensive group learning intervention combined with on-site SRH services (called HealthyActions) among out-of-school young adults, implemented through an existing alternative education program, on uptake of contraception and HIV testing and counseling (HTC). Methods: The intervention was implemented among young women and men ages 15–35 who were enrolled in alternative basic education learning sites in 5 counties of Liberia. We conducted a randomized evaluation to assess program impact. Baseline data were collected in January–March 2014, and endline data in June–July 2014. Key outcomes of condom use, contraceptive use, and HTC were estimated with difference-in-difference models using fixed effects. All analyses were conducted in Stata 13. Results: We assessed outcomes for 1,157 learners at baseline and 1,052 learners at endline, across 29 treatment and 26 control sites. After adjusting for potential confounders, learners in the HealthyActions intervention group were 12% less likely to report never using a condom with a regular partner over the last month compared with the control group (P = .02). Female learners who received HealthyActions were 13% more likely to use any form of modern contraception compared with learners in control sites (P<.001), with the greatest increase in the use of contraceptive implants. Learners in HealthyActions sites were 45% more likely to have received HTC (P<.001). Conclusion: Providing intensive group learning in a supportive environment coupled with on-site health services improved SRH outcomes among participating learners. The focus of HealthyActions on participatory learning for low

  8. Genome-Wide Association Study of Autistic-Like Traits in a General Population Study of Young Adults

    PubMed Central

    Jones, Rachel Maree; Cadby, Gemma; Melton, Phillip E.; Abraham, Lawrence J.; Whitehouse, Andrew J.; Moses, Eric K.

    2013-01-01

    Lay abstract: It has been proposed that autistic-like traits in the general population lie on a continuum, with clinical Autism Spectrum Disorder (ASD), representing the extreme end of this distribution. The current study undertook a genome-wide association (GWA) scan of 965 young Western Australian adults to identify novel risk variants associated with autistic-like traits. No associations reached genome-wide significance; however, a review of nominally associated single nucleotide polymorphisms (SNPs) indicated two positional candidate loci that have been previously implicated in autistic-like trait etiology. Scientific abstract: Research has proposed that autistic-like traits in the general population lie on a continuum, with clinical ASD representing the extreme end of this distribution. Inherent in this proposal is that biological mechanisms associated with clinical ASD may also underpin variation in autistic-like traits within the general population. A GWA study using 2,462,046 SNPs was undertaken for ASD in 965 individuals from the Western Australian Pregnancy Cohort (Raine) Study. No SNP associations reached genome-wide significance (p < 5.0 × 10−8). However, investigations into nominal observed SNP associations (p < 1.0 × 10−5) add support to two positional candidate genes previously implicated in ASD etiology, PRKCB1, and CBLN1. The rs198198 SNP (p = 9.587 × 10−6), is located within an intron of the protein kinase C, beta 1 (PRKCB1) gene on chromosome 16p11. The PRKCB1 gene has been previously reported in linkage and association studies for ASD, and its mRNA expression has been shown to be significantly down regulated in ASD cases compared with controls. The rs16946931 SNP (p = 1.78 × 10−6) is located in a region flanking the Cerebellin 1 (CBLN1) gene on chromosome 16q12.1. The CBLN1 gene is involved with synaptogenesis and is part of a gene family previously implicated in ASD. This GWA study is only the second

  9. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial

    PubMed Central

    Stergiopoulos, Vicky; Gozdzik, Agnes; Misir, Vachan; Skosireva, Anna; Connelly, Jo; Sarang, Aseefa; Whisler, Adam; Hwang, Stephen W.; O’Campo, Patricia; McKenzie, Kwame

    2015-01-01

    Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  10. Accuracy and Acceptability of Oral Fluid HIV Self-Testing in a General Adult Population in Kenya.

    PubMed

    Kurth, Ann E; Cleland, Charles M; Chhun, Nok; Sidle, John E; Were, Edwin; Naanyu, Violet; Emonyi, Wilfred; Macharia, Stephen M; Sang, Edwin; Siika, Abraham M

    2016-04-01

    We evaluated performance, accuracy, and acceptability parameters of unsupervised oral fluid (OF) HIV self-testing (HIVST) in a general population in western Kenya. In a prospective validation design, we enrolled 240 adults to perform rapid OF HIVST and compared results to staff administered OF and rapid fingerstick tests. All reactive, discrepant, and a proportion of negative results were confirmed with lab ELISA. Twenty participants were video-recorded conducting self-testing. All participants completed a staff administered survey before and after HIVST to assess attitudes towards OF HIVST acceptability. HIV prevalence was 14.6 %. Thirty-six of the 239 HIVSTs were invalid (15.1 %; 95 % CI 11.1-20.1 %), with males twice as likely to have invalid results as females. HIVST sensitivity was 89.7 % (95 % CI 73-98 %) and specificity was 98 % (95 % CI 89-99 %). Although sensitivity was somewhat lower than expected, there is clear interest in, and high acceptability (94 %) of OF HIV self-testing. PMID:26438487

  11. Writing Our Practice. Support Documents for the Reading & Writing and the Oral Communication Streams of the "Certificates of General Education for Adults within the Victorian Adult English Language, Literacy and Numeracy Accreditation Framework."

    ERIC Educational Resources Information Center

    Adult, Community, and Further Education Board, Melbourne (Australia).

    This collection of 14 articles focuses on the Reading and Writing and Oral Communication Streams of the Certificates of General Education (CGE) for Adults in the context of literacy teaching practices. Section 1 contains 11 case studies and articles with a practical focus. Practitioners discuss aspects of their curriculum development related to…

  12. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults.

    PubMed

    Gerber, Markus; Brand, Serge; Herrmann, Christian; Colledge, Flora; Holsboer-Trachsler, Edith; Pühse, Uwe

    2014-08-01

    The role of physical activity as a factor that protects against stress-related mental disorders is well documented. Nevertheless, there is still a dearth of research using objective measures of physical activity. The present study examines whether objectively assessed vigorous physical activity (VPA) is associated with mental health benefits beyond moderate physical activity (MPA). Particularly, this study examines whether young adults who accomplish the American College of Sports Medicine's (ACSM) vigorous-intensity exercise recommendations differ from peers below these standards with regard to their level of perceived stress, depressive symptoms, perceived pain, and subjective and objective sleep. A total of 42 undergraduate students (22 women, 20 men; M=21.24years, SD=2.20) volunteered to take part in the study. Stress, pain, depressive symptoms, and subjective sleep were assessed via questionnaire, objective sleep via sleep-EEG assessment, and VPA via actigraphy. Meeting VPA recommendations had mental health benefits beyond MPA. VPA was associated with less stress, pain, subjective sleep complaints and depressive symptoms. Moreover, vigorous exercisers had more favorable objective sleep pattern. Especially, they had increased total sleep time, more stage 4 and REM sleep, more slow wave sleep and a lower percentage of light sleep. Vigorous exercisers also reported fewer mental health problems if exposed to high stress. This study provides evidence that meeting the VPA standards of the ACSM is associated with improved mental health and more successful coping among young people, even compared to those who are meeting or exceeding the requirements for MPA.

  13. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults.

    PubMed

    Gerber, Markus; Brand, Serge; Herrmann, Christian; Colledge, Flora; Holsboer-Trachsler, Edith; Pühse, Uwe

    2014-08-01

    The role of physical activity as a factor that protects against stress-related mental disorders is well documented. Nevertheless, there is still a dearth of research using objective measures of physical activity. The present study examines whether objectively assessed vigorous physical activity (VPA) is associated with mental health benefits beyond moderate physical activity (MPA). Particularly, this study examines whether young adults who accomplish the American College of Sports Medicine's (ACSM) vigorous-intensity exercise recommendations differ from peers below these standards with regard to their level of perceived stress, depressive symptoms, perceived pain, and subjective and objective sleep. A total of 42 undergraduate students (22 women, 20 men; M=21.24years, SD=2.20) volunteered to take part in the study. Stress, pain, depressive symptoms, and subjective sleep were assessed via questionnaire, objective sleep via sleep-EEG assessment, and VPA via actigraphy. Meeting VPA recommendations had mental health benefits beyond MPA. VPA was associated with less stress, pain, subjective sleep complaints and depressive symptoms. Moreover, vigorous exercisers had more favorable objective sleep pattern. Especially, they had increased total sleep time, more stage 4 and REM sleep, more slow wave sleep and a lower percentage of light sleep. Vigorous exercisers also reported fewer mental health problems if exposed to high stress. This study provides evidence that meeting the VPA standards of the ACSM is associated with improved mental health and more successful coping among young people, even compared to those who are meeting or exceeding the requirements for MPA. PMID:24905432

  14. Impact of an Intensive Lifestyle Intervention on Use and Cost of Medical Services Among Overweight and Obese Adults With Type 2 Diabetes: The Action for Health in Diabetes

    PubMed Central

    Glick, Henry A.; Bertoni, Alain; Brancati, Frederick L.; Bray, George A.; Clark, Jeanne M.; Curtis, Jeffrey M.; Egan, Caitlin; Evans, Mary; Foreyt, John P.; Ghazarian, Siran; Gregg, Edward W.; Hazuda, Helen P.; Hill, James O.; Hire, Don; Horton, Edward S.; Hubbard, Van S.; Jakicic, John M.; Jeffery, Robert W.; Johnson, Karen C.; Kahn, Steven E.; Killean, Tina; Kitabchi, Abbas E.; Knowler, William C.; Kriska, Andrea; Lewis, Cora E.; Miller, Marsha; Montez, Maria G.; Murillo, Anne; Nathan, David M.; Nyenwe, Ebenezer; Patricio, Jennifer; Peters, Anne L.; Pi-Sunyer, Xavier; Pownall, Henry; Redmon, J. Bruce; Rushing, Julia; Ryan, Donna H.; Safford, Monika; Tsai, Adam G.; Wadden, Thomas A.; Wing, Rena R.; Yanovski, Susan Z.; Zhang, Ping

    2014-01-01

    OBJECTIVE To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial. RESEARCH DESIGN AND METHODS A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years. RESULTS ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P < 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P < 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385–7,175); however, these were not evident among individuals with a history of cardiovascular disease. CONCLUSIONS Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs. PMID:25147253

  15. Adult and Continuing Education: Noncredit Activities in Institutions of Higher Education. Higher Education General Information Survey (HEGIS) [machine-readable data file].

    ERIC Educational Resources Information Center

    Center for Education Statistics (ED/OERI), Washington, DC.

    The Adult and Continuing Education: Noncredit Activities in Institutions of Higher Education machine-readable data file (MRDF) is a periodically obtained subfile of the larger Higher Education General Information Survey (HEGIS). Its purpose is to obtain a measure of the extent to which individuals beyond compulsory school age (but that are not…

  16. Computer-Based Video Instruction to Teach Young Adults with Moderate Intellectual Disabilities to Perform Multiple Step, Job Tasks in a Generalized Setting

    ERIC Educational Resources Information Center

    Mechling, Linda C.; Ortega-Hurndon, Fanny

    2007-01-01

    This study evaluated the effectiveness of computer-based video instruction (CBVI) to teach three young adults with moderate intellectual disabilities to perform complex, multiple step, job tasks in a generalized setting. A multiple probe design across three job tasks and replicated across three students was used to evaluate the effectiveness of…

  17. Modelo Pedagogico de Educacion Primaria para Adultos: Guia General de Apoyo para el Estudiante de Primaria (Pedagogical Model for Adult Primary Education: General Guide for the Student).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This book, part of a Mexican series of instructional materials, is directed toward people over the age of 15 who are interested in beginning, continuing or finishing their basic education. It explains the pedagogical model developed for adult education in Mexico based on the following features: (1) the content of the textbooks must be useful for…

  18. Filling the Frame. Adult Education and Vocational Training Institute Guidelines for the Implementation of Integrated Curricula within the Certificates of General Education for Adults Framework.

    ERIC Educational Resources Information Center

    New South Wales Dept. of Corrective Services, Sydney (Australia).

    This document contains learning modules for adult basic education courses in Australia, along with teacher information for integrating curricula, using integrated themes, and planning curricula. The learning modules contain learning activities in the following areas: job search skills; occupational health and safety; life skills; ceramics;…

  19. Relation of serotonin transporter genetic variation to efficacy of escitalopram for Generalized Anxiety Disorder in older adults

    PubMed Central

    Lenze, Eric J.; Goate, Alison M.; Nowotny, Petra; Dixon, David; Shi, Peichang; Bies, Robert R.; Lotrich, Francis K.; Rollman, Bruce L.; Shear, M. Katherine; Thompson, Paul A.; Andreescu, Carmen; Pollock, Bruce G.

    2011-01-01

    Objective Generalized Anxiety Disorder (GAD) is common in older adults and can be treated with SSRIs. Genetic variation in the serotonin transporter gene promoter region is posited to be associated with SSRI efficacy: two polymorphisms (5HTTLPR s/l and rs25531 g/a) form a haplotype with the La combination having higher transcription activity than other haplotypes. We hypothesized that GAD patients with no La haplotypes (La-) have lower SSRI treatment efficacy than those with 1-2 La haplotypes (La+). Method The study enrolled subjects aged 60 and older with a principal diagnosis of GAD, into a twelve-week, randomized trial of escitalopram vs. placebo. One hundred-fifty subjects were genotyped for the serotonin transporter promoter region haplotype and were divided into La- and La+ genotype groups; the primary analyses were done in European-Americans only (N=125; 59 escitalopram and 66 placebo). Results Escitalopram had no efficacy in the La- group versus moderate efficacy in the La+ group. This genetic moderation of SSRI efficacy was due to a higher placebo response in La- subjects, compared to La+ subjects. Drug concentration did not affect the genetic results. Exploratory analyses suggest that La- subjects had greater variability of anxiety symptoms unrelated to treatment. Conclusions The serotonin transporter promoter haplotype is associated with variability in SSRI efficacy for late-life GAD. The variability may result from a genetic effect on anxiety symptom variability unrelated to treatment, rather than a pharmacodynamic effect that has been previously assumed. Further research is needed to understand the pharmacogenetic mechanism of this haplotype. PMID:21105279

  20. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review

    PubMed Central

    Briggs, Andrew M; Smith, Anne J; Straker, Leon M; Bragge, Peter

    2009-01-01

    Background Thoracic spine pain (TSP) is experienced across the lifespan by healthy individuals and is a common presentation in primary healthcare clinical practice. However, the epidemiological characteristics of TSP are not well documented compared to neck and low back pain. A rigorous evaluation of the prevalence, incidence, correlates and risk factors needs to be undertaken in order for epidemiologic data to be meaningfully used to develop evidence-based prevention and treatment recommendations for TSP. Methods A systematic review method was followed to report the evidence describing prevalence, incidence, associated factors and risk factors for TSP among the general population. Nine electronic databases were systematically searched to identify studies that reported either prevalence, incidence, associated factors (cross-sectional study) or risk factors (prospective study) for TSP in healthy children, adolescents or adults. Studies were evaluated for level of evidence and method quality. Results Of the 1389 studies identified in the literature, 33 met the inclusion criteria for this systematic review. The mean (SD) quality score (out of 15) for the included studies was 10.5 (2.0). TSP prevalence data ranged from 4.0–72.0% (point), 0.5–51.4% (7-day), 1.4–34.8% (1-month), 4.8–7.0% (3-month), 3.5–34.8% (1-year) and 15.6–19.5% (lifetime). TSP prevalence varied according to the operational definition of TSP. Prevalence for any TSP ranged from 0.5–23.0%, 15.8–34.8%, 15.0–27.5% and 12.0–31.2% for 7-day, 1-month, 1-year and lifetime periods, respectively. TSP associated with backpack use varied from 6.0–72.0% and 22.9–51.4% for point and 7-day periods, respectively. TSP interfering with school or leisure ranged from 3.5–9.7% for 1-year prevalence. Generally, studies reported a higher prevalence for TSP in child and adolescent populations, and particularly for females. The 1 month, 6 month, 1 year and 25 year incidences were 0–0.9%, 10.3%, 3

  1. Sex differences in resilience to childhood maltreatment: effects of trauma history on hippocampal volume, general cognition and subclinical psychosis in healthy adults.

    PubMed

    Samplin, Erin; Ikuta, Toshikazu; Malhotra, Anil K; Szeszko, Philip R; Derosse, Pamela

    2013-09-01

    Recent data suggests that a history of childhood maltreatment is associated with reductions in hippocampal volume in healthy adults. Because this association is also evident in adults with psychiatric illness, it has been suggested that reductions in hippocampal volume associated with childhood maltreatment may be a risk factor for psychiatric illness. Such an interpretation suggests that healthy adults with a history of childhood maltreatment are more resilient to the effects of maltreatment. Current models of resilience suggest, however, that resiliency should be measured across multiple domains of functioning. The present study sought to investigate childhood maltreatment in relationship to hippocampal volumes in healthy adults and to address the question of whether the putative resiliency extends to other domains of functioning. Sixty-seven healthy Caucasian adults were assessed for a history of childhood emotional abuse, emotional neglect and physical abuse and received high resolution structural MR imaging scans. Participants with and without histories of abuse or neglect were compared on measures of total hippocampal volume, general cognitive ability and subclinical psychopathology. Our results suggest that childhood emotional abuse is associated with reduced hippocampus volume in males, but not in females. However, emotional abuse was associated with higher levels of subclinical psychopathology in both males and females. These data suggest that while females may be more resilient to the neurological effects of childhood maltreatment, they are not more resilient to the psychiatric symptoms associated with childhood maltreatment. Further research is needed to elucidate the mechanisms involved in these different levels of resilience.

  2. Sex Differences in Resilience to Childhood Maltreatment: Effects of trauma history on hippocampal volume, general cognition and subclinical psychosis in healthy adults

    PubMed Central

    Samplin, Erin; Ikuta, Toshikazu; Malhotra, Anil K.; Szeszko, Philip R.; DeRosse, Pamela

    2013-01-01

    Recent data suggests that a history of childhood maltreatment is associated with reductions in hippocampal volume in healthy adults. Because this association is also evident in adults with psychiatric illness, it has been suggested that reductions in hippocampal volume associated with childhood maltreatment may be a risk factor for psychiatric illness. Such an interpretation suggests that healthy adults with a history of childhood maltreatment are more resilient to the effects of maltreatment. Current models of resilience suggest, however, that resiliency should be measured across multiple domains of functioning. The present study sought to investigate childhood maltreatment in relationship to hippocampal volumes in healthy adults and to address the question of whether the putative resiliency extends to other domains of functioning. Sixty-seven healthy Caucasian adults were assessed for a history of childhood emotional abuse, emotional neglect and physical abuse and received high resolution structural MR imaging scans. Participants with and without histories of abuse or neglect were compared on measures of total hippocampal volume, general cognitive ability and subclinical psychopathology. Our results suggest that childhood emotional abuse is associated with reduced hippocampus volume in males, but not in females. However, emotional abuse was associated with higher levels of subclinical psychopathology in both males and females. These data suggest that while females may be more resilient to the neurological effects of childhood maltreatment, they are not more resilient to the psychiatric symptoms associated with childhood maltreatment. Further research is needed to elucidate the mechanisms involved in these different levels of resilience. PMID:23726669

  3. Incidence of inferior vena cava thrombosis detected by transthoracic echocardiography in the immediate postoperative period after adult cardiac and general surgery.

    PubMed

    Saranteas, T; Kostopanagiotou, G; Tzoufi, M; Drachtidi, K; Knox, G M; Panou, F

    2013-11-01

    Venous thromboembolism is an important complication after general and cardiac surgery. Using transthoracic echocardiography, this study assessed the incidence of inferior vena cava (IVC) thrombosis among a total of 395 and 289 cardiac surgical and major surgical patients in the immediate postoperative period after cardiac and major surgery, respectively. All transthoracic echocardiography was performed by a specialist intensivist within 24 hours after surgery with special emphasis on using the subcostal view in the supine position to visualise the IVC. Of the 395 cardiac surgical patients studied, the IVC was successfully visualised using the subcostal view in 315 patients (79.8%) and eight of these patients (2.5%) had a partially obstructive thrombosis in the IVC. In 250 out of 289 (85%) general surgical patients, the IVC was also clearly visualised, but only one patient (0.4%) had an IVC thrombosis (2.5 vs 0.4%, P <0.05). In summary, visualisation of the IVC was feasible in most patients in the immediate postoperative period after both adult cardiac and major surgery. IVC thrombosis appeared to be more common after adult cardiac surgery than general surgery. A large prospective cohort study is needed to define the risk factors for IVC thrombus and whether early thromboprophylaxis can reduce the incidence of IVC thrombus after adult cardiac surgery.

  4. Valproic Acid versus Lamotrigine as First-line Monotherapy in Newly Diagnosed Idiopathic Generalized Tonic –Clonic Seizures in Adults – A Randomized Controlled Trial

    PubMed Central

    Giri, Om Prakash; Khan, Farhan Ahmad; Kumar, Narendra; Kumar, Ajay; Haque, Ataul

    2016-01-01

    Introduction Idiopathic Generalized Tonic-Clonic Seizures (GTCS) are frequently encountered in adults. Their successful control is necessary to improve the quality of life of these patients. Valproic acid is a simple branched-chain carboxylic acid and lamotrigine is a phenyltriazine derivative. Opinions differ in regards to their effectiveness in idiopathic GTCS. Aim To compare the effectiveness of valproic acid and lamotrigine in newly diagnosed adults with idiopathic generalized tonic-clonic seizures. Materials and Methods The present prospective randomized study was conducted on 60 patients suffering from idiopathic GTCS. Thirty patients received valproic acid and rest 30 patients received lamotrigine. All patients were followed regularly monthly for one year for treatment response and adverse effects. Results After 12 months follow-up, 76.67% patients taking valproic acid and 56.67% patients taking lamotrigine were seizure-free. Common adverse effects recorded were nausea, dyspepsia, headache and skin rash. Conclusion Valproic acid is more effective than lamotrigine as first-line drug in the treatment of adults with newly diagnosed idiopathic generalized tonic-clonic seizures.

  5. Valproic Acid versus Lamotrigine as First-line Monotherapy in Newly Diagnosed Idiopathic Generalized Tonic –Clonic Seizures in Adults – A Randomized Controlled Trial

    PubMed Central

    Giri, Om Prakash; Khan, Farhan Ahmad; Kumar, Narendra; Kumar, Ajay; Haque, Ataul

    2016-01-01

    Introduction Idiopathic Generalized Tonic-Clonic Seizures (GTCS) are frequently encountered in adults. Their successful control is necessary to improve the quality of life of these patients. Valproic acid is a simple branched-chain carboxylic acid and lamotrigine is a phenyltriazine derivative. Opinions differ in regards to their effectiveness in idiopathic GTCS. Aim To compare the effectiveness of valproic acid and lamotrigine in newly diagnosed adults with idiopathic generalized tonic-clonic seizures. Materials and Methods The present prospective randomized study was conducted on 60 patients suffering from idiopathic GTCS. Thirty patients received valproic acid and rest 30 patients received lamotrigine. All patients were followed regularly monthly for one year for treatment response and adverse effects. Results After 12 months follow-up, 76.67% patients taking valproic acid and 56.67% patients taking lamotrigine were seizure-free. Common adverse effects recorded were nausea, dyspepsia, headache and skin rash. Conclusion Valproic acid is more effective than lamotrigine as first-line drug in the treatment of adults with newly diagnosed idiopathic generalized tonic-clonic seizures. PMID:27630862

  6. [Preoperative evaluation of adult patients prior to elective, non-cardiac surgery. Joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine].

    PubMed

    2011-09-01

    Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest-x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate and publish recommendations on the preoperative evaluation of adult patients prior to elective, non-cardiac and non-lung resection surgery. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

  7. On the Plasticity of Semantic Generalizations: Children and Adults Modify Their Verb Lexicalization Biases in Response to Changing Input

    ERIC Educational Resources Information Center

    Shafto, Carissa L.; Havasi, Catherine; Snedeker, Jesse

    2014-01-01

    Languages differ in how they package the components of an event into words to form sentences. For example, while some languages typically encode the manner of motion in the verb (e.g., running), others more often use verbs that encode the path (e.g., ascending). Prior research has demonstrated that children and adults have lexicalization biases;…

  8. Teaching Generalized Reading of Product Warning Labels to Young Adults with Autism Using the Constant Time Delay Procedure

    ERIC Educational Resources Information Center

    Dogoe, Maud S.; Banda, Devender R.; Lock, Robin H.; Feinstein, Rita

    2011-01-01

    This study examined the effectiveness of the constant timed delay procedure for teaching two young adults with autism to read, define, and state the contextual meaning of keywords on product warning labels of common household products. Training sessions were conducted in the dyad format using flash cards. Results indicated that both participants…

  9. Illinois Community College Board FY 2006 Adult Education and Family Literacy Report to the Governor and General Assembly

    ERIC Educational Resources Information Center

    Illinois Community College Board, 2007

    2007-01-01

    Economic and demographic changes are dramatically increasing the need for adult education, basic literacy, and English-as-a-Second Language (ESL) programs. Millions of Illinois residents lack the level of literacy skills needed to obtain good jobs, perform well on the job, and function well in an increasingly complex society. Addressing the scope…

  10. Task Engagement in Young Adults with High-Functioning Autism Spectrum Disorders: Generalization Effects of Behavioral Skills Training

    ERIC Educational Resources Information Center

    Palmen, Annemiek; Didden, Robert

    2012-01-01

    This study evaluated the effectiveness of a behavioral skills training package on task engagement in six young adults with high-functioning ASD who worked in a regular job-training setting. Experimental sessions were implemented in a small-group training format in a therapy room using unknown tasks. Data were collected on participant's off-task…

  11. Secondary Education Systems and the General Skills of Less- and Intermediate-Educated Adults: A Comparison of 18 Countries

    ERIC Educational Resources Information Center

    Heisig, Jan Paul; Solga, Heike

    2015-01-01

    We investigate the impact of external differentiation and vocational orientation of (lower and upper) secondary education on country variation in the mean numeracy skills of, and skills gaps between, adults with low and intermediate formal qualifications. We use data on 30- to 44-year-olds in 18 countries from the 2011-12 round of the Program for…

  12. A Cross-sectional Study on Posttraumatic Stress Disorder and General Psychiatric Morbidity Among Adult Survivors 3 Years After the Wenchuan Earthquake, China.

    PubMed

    Zhang, Wei; Duan, Guangfeng; Xu, Qin; Jia, Zhaobao; Bai, Zhengyang; Liu, Weizhi; Pan, Xiao; Tian, Wenhua

    2015-11-01

    After the Wenchuan earthquake, a large number of studies have focused on postearthquake psychological disorders among survivors; however, most of these studies were conducted within a relatively short period. This study was conducted to examine the symptoms of posttraumatic stress disorder (PTSD) and general psychiatric morbidity among adult survivors 3 years after the Wenchuan earthquake, China. Through a multistage systematic sampling approach, a cross-sectional survey of 360 participants, 18 years or older, was conducted. The prevalence of PTSD and general psychiatric morbidity was 10.3% and 20.6%, respectively. Multivariate analysis revealed significant predictors for PTSD, including female gender and having felt guilt concerning someone's death or injury. Significant predictors for general psychiatric morbidity included unmarried status and having been in serious danger. These results suggest that mental health services should be continuously available to earthquake survivors.

  13. Memory and comprehension for health information among older adults: distinguishing the effects of domain-general and domain-specific knowledge.

    PubMed

    Chin, Jessie; Payne, Brennan; Gao, Xuefei; Conner-Garcia, Thembi; Graumlich, James F; Murray, Michael D; Morrow, Daniel G; Stine-Morrow, Elizabeth A L

    2015-01-01

    While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60-88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.

  14. Occupational stress and mental health among nurses in a medical intensive care unit of a general hospital in Bandar Abbas in 2013

    PubMed Central

    Tajvar, Abdolhamid; Saraji, Gebraeil Nasl; Ghanbarnejad, Amin; Omidi, Leila; Hosseini, Seyed Sodabeh Seyed; Abadi, Ali Salehi Sahl

    2015-01-01

    Background: Many nurses have reported experiencing high levels of occupational stress in their work environment. Stress, as an outcome of stressful workplaces and tasks, affects nursing behavior in hospital wards. The objectives of this research were to determine the prevalence of occupational stress and mental health problems in nurses in the intensive care unit (ICU) at Shahid Mohammadi Hospital in Bandar Abbas in 2013 and to determine the relationship between occupational stress and mental health. Methods: This cross-sectional study was conducted in 2013 on all of the nurses working in ICU at Shahid Mohammadi Hospital located in Bandar Abbas, Iran. Seventy-two nurses were selected as the population for this study, and all of them were female. Two questionnaires were used in this study, i.e., General Health Questionnaire-28 (GHQ-28) for assessing mental health and an occupational stress test for assessing job stress. Furthermore, the relationship between occupational stress and mental health was examined. One-way analysis of variance (ANOVA), independent samples t-test, and Pearson’s product-moment correlation test were used to analyze the data. Results: High and moderate levels of occupational stress were experienced by 83.9% and 10.7% of ICU nurses, respectively. The prevalence of mental disorders, somatic symptoms, anxiety, social dysfunction, and depression were 58.9, 60.7, 62.5, 71.4, and 10.7%, respectively. The findings of the independent samples t-test showed that somatic symptoms had significant relationships with age and working experience (p = 0.01). According to the independent samples t-test, there were no significant differences between somatic symptoms and working different shifts (p > 0.05). Conclusions: There was a high prevalence of occupational stress among ICU nurses. There was a significant relationship between occupational stress and mental health. Future interventions are needed to codify a comprehensive health program in this field to

  15. Evaluation of safety and efficacy of zonisamide in adult patients with partial, generalized, and combined seizures: an open labeled, noncomparative, observational Indian study

    PubMed Central

    Dash, Amitabh; Ravat, Sangeeta; Srinivasan, Avathvadi Venkatesan; Shetty, Ashutosh; Kumar, Vivek; Achtani, Renu; Mathur, Vivek Narain; Maramattom, Boby Varkey; Bajpai, Veeresh; Manjunath, Nanjappa C; Narayana, Randhi Venkata; Mehta, Suyog

    2016-01-01

    A prospective, multicentric, noncomparative open-label observational study was conducted to evaluate the safety and efficacy zonisamide in Indian adult patients for the treatment of partial, generalized, or combined seizures. A total of 655 adult patients with partial, generalized, or combined seizures from 30 centers across India were recruited after initial screening. Patients received 100 mg zonisamide as initiating dose as monotherapy/adjunctive therapy for 24 weeks, with titration of 100 mg every 2 weeks if required. Adverse events, responder rates, and seizure freedom were observed every 4 weeks. Efficacy and safety were also assessed using Clinicians Global Assessment of Response to Therapy and Patients Global Assessment of Tolerability to Therapy, respectively. Follow-up was conducted for a period of 24 weeks after treatment initiation. A total of 655 patients were enrolled and received the treatment and 563 completed the evaluation phase. A total of 20.92% of patients received zonisamide as monotherapy or alternative monotherapy and 59.85% patients received zonisamide as first adjunctive therapy. Compared with baseline, 41.22% of patients achieved seizure freedom and 78.6% as responder rate at the end of 24 week study. Most commonly reported adverse events were loss of appetite, weight loss, sedation, and dizziness, but discontinuation due to adverse events of drug was seen in 0.92% of patients. This open label real-world study suggests that zonisamide is an effective and well-tolerated antiepileptic drug in Indian adults for treatment of partial, generalized as well as combined seizures type. No new safety signals were observed. PMID:27013882

  16. Reduced intensity conditioning allogeneic hematopoietic cell transplantation for adult acute myeloid leukemia in complete remission - a review from the Acute Leukemia Working Party of the EBMT

    PubMed Central

    Sengsayadeth, Salyka; Savani, Bipin N.; Blaise, Didier; Malard, Florent; Nagler, Arnon; Mohty, Mohamad

    2015-01-01

    Acute myeloid leukemia is the most common indication for an allogeneic hematopoietic cell transplant. The introduction of reduced intensity conditioning has expanded the recipient pool for transplantation, which has importantly made transplant an option for the more commonly affected older age groups. Reduced intensity conditioning allogeneic transplantation is currently the standard of care for patients with intermediate or high-risk acute myeloid leukemia and is now most often employed in older patients and those with medical comorbidities. Despite being curative for a significant proportion of patients, post-transplant relapse remains a challenge in the reduced intensity conditioning setting. Herein we discuss the studies that demonstrate the feasibility of reduced intensity conditioning allogeneic transplants, compare the outcomes of reduced intensity conditioning versus chemotherapy and conventional myeloablative conditioning regimens, describe the optimal donor and stem cell source, and consider the impact of post-remission consolidation, comorbidities, center experience, and more intensive (reduced toxicity conditioning) regimens on outcomes. Additionally, we discuss the need for further prospective studies to optimize transplant outcomes. PMID:26130513

  17. On the plasticity of semantic generalizations: Children and adults modify their verb lexicalization biases in response to changing input

    PubMed Central

    Shafto, Carissa L.; Havasi, Catherine; Snedeker, Jesse

    2014-01-01

    Languages differ in how they package the components of an event into words to form sentences. For example, while some languages typically encode the manner of motion in the verb (e.g., running), others more often use verbs that encode the path (e.g., ascending). Prior research has demonstrated that children and adults have lexicalization biases; i.e. they assume that novel motion verbs will reflect the dominant pattern of their own language. These experiments explored the plasticity of these biases. In Experiments 1 and 2 we taught English-speaking adults motion verbs, varying the proportion of manner and path verbs in the training set; their interpretation of subsequent verbs closely reflected the probabilistic variation in the input. In Experiments 3 and 4, five-year-old children also systematically shifted their lexicalization biases to reflect the verbs that they were taught. We conclude that lexicalization biases are adaptive inferences about verb meaning that are updated on the basis of experience. PMID:24001149

  18. Generalized Anxiety Disorder: A Comparison of Symptom Change in Adults Receiving Cognitive-Behavioral Therapy or Applied Relaxation

    ERIC Educational Resources Information Center

    Donegan, Eleanor; Dugas, Michel J.

    2012-01-01

    Objective: Generalized anxiety disorder (GAD) is characterized by excessive worry and somatic symptoms of anxiety (e.g., restlessness, muscle tension). Several psychological treatments lead to significant reductions in GAD symptoms by posttreatment. However, little is known about how GAD symptoms change over time. Our main goal was to examine how…

  19. Parent Inclusion in Early Intensive Behavioral Intervention: The Influence of Parental Stress, Parent Treatment Fidelity and Parent-Mediated Generalization of Behavior Targets on Child Outcomes

    ERIC Educational Resources Information Center

    Strauss, Kristin; Vicari, Stefano; Valeri, Giovanni; D'Elia, Lidia; Arima, Serena; Fava, Leonardo

    2012-01-01

    Although early intensive behavior interventions have been efficient in producing positive behavior outcome in young children with Autism Spectrum Disorder, there is a considerable variety in the children's progress. Research has suggested that parental and treatment factors are likely to affect children's response to treatment. The purpose of the…

  20. Estimated nutrient intakes from food generally do not meet dietary reference intakes among adult members of Pacific Northwest tribal nations.

    PubMed

    Fialkowski, Marie K; McCrory, Megan A; Roberts, Sparkle M; Tracy, J Kathleen; Grattan, Lynn M; Boushey, Carol J

    2010-05-01

    Diet is influential in the etiology of chronic diseases in many populations including Native Americans. The objective of this report is to present the first comprehensive dietary survey, to our knowledge, of a representative sample of nonpregnant adults from Pacific Northwest tribal nations participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort. Only participants who completed 1-4 d of dietary records and had weights and heights measured in the laboratory were eligible for this analysis (n = 418). Mean nutrient intakes were stratified by gender for the total sample, those with plausibly reported energy intakes (rEI), and those with implausibly rEI. Estimates of nutrient intakes were compared with Dietary Reference Intakes (DRI). Nutrient estimates from NHANES 2001-2002 were used as a reference. Among both men and women, total fat contributed 34-37% of energy intake and saturated fat contributed 11-12% of energy intake. Daily cholesterol intakes ranged from 262 to 442 mg. A majority of men and women were not meeting recommendations for vitamins A, C, and E, magnesium, and sodium. For a majority of the nutrients examined, plausibility resulted in higher mean estimates. The CoASTAL cohort nutrient profile is similar to NHANES 2001-2002, with a majority of DRI recommendations not being met. Adequate dietary intake information may be more important for this population, because Native Americans experience a disproportionate burden for diseases.

  1. Estimated nutrient intakes from food generally do not meet dietary reference intakes among adult members of Pacific Northwest tribal nations.

    PubMed

    Fialkowski, Marie K; McCrory, Megan A; Roberts, Sparkle M; Tracy, J Kathleen; Grattan, Lynn M; Boushey, Carol J

    2010-05-01

    Diet is influential in the etiology of chronic diseases in many populations including Native Americans. The objective of this report is to present the first comprehensive dietary survey, to our knowledge, of a representative sample of nonpregnant adults from Pacific Northwest tribal nations participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort. Only participants who completed 1-4 d of dietary records and had weights and heights measured in the laboratory were eligible for this analysis (n = 418). Mean nutrient intakes were stratified by gender for the total sample, those with plausibly reported energy intakes (rEI), and those with implausibly rEI. Estimates of nutrient intakes were compared with Dietary Reference Intakes (DRI). Nutrient estimates from NHANES 2001-2002 were used as a reference. Among both men and women, total fat contributed 34-37% of energy intake and saturated fat contributed 11-12% of energy intake. Daily cholesterol intakes ranged from 262 to 442 mg. A majority of men and women were not meeting recommendations for vitamins A, C, and E, magnesium, and sodium. For a majority of the nutrients examined, plausibility resulted in higher mean estimates. The CoASTAL cohort nutrient profile is similar to NHANES 2001-2002, with a majority of DRI recommendations not being met. Adequate dietary intake information may be more important for this population, because Native Americans experience a disproportionate burden for diseases. PMID:20237069

  2. Gambling and Substance Use: Co-occurrence among Adults in a Recent General Population Study in the United States

    PubMed Central

    Barnes, Grace M.; Welte, John W.; Tidwell, Marie-Cecile O.; Hoffman, Joseph H.

    2014-01-01

    This study is an up-to-date examination of gambling behaviors as well as gambling problems and their relationships to substance use and abuse. Further, the co-occurrence between problem gambling and substance abuse is studied using a large-scale, representative sample of adults aged 18 years and older in the United States. This random-digit-dial national survey was carried out in 2011–2013 with completed interviews from 2,963 respondents. Of the four gambling and substance use behaviors considered, past year gambling was the most prevalent (76.9%), followed by alcohol use (67.6%), tobacco use (28.7%) and marijuana use (11.2%). Problem gambling and the three substance abuse measures were highly related. Current problem gambling (3+ DIS criteria) was predicted by being male, being black, having low socioeconomic status and by alcohol abuse/dependence, tobacco dependence, and marijuana abuse/dependence. Thus, problem gambling is linked to other problem behaviors, especially substance abuse. Consequently, effective treatment approaches should screen and intervene for both problem gambling as well as co-occurring substance abuse. PMID:25914605

  3. Association between Self-Reported General and Mental Health and Adverse Outcomes: A Retrospective Cohort Study of 19 625 Scottish Adults

    PubMed Central

    Ul-Haq, Zia; Mackay, Daniel F.; Pell, Jill P.

    2014-01-01

    Objective Self-reported general health and mental health are independent predictors of all-cause mortality. This study examines whether they are also independent predictors of incident cancer, coronary heart disease and psychiatric hospitalisation. Methods We conducted a retrospective, population cohort study by linking the 19 625 Scottish adults who participated in the Scottish Health Surveys 1995–2003, to hospital admissions, cancer registration and death certificate records. We conducted Cox proportional hazard models adjusting for potential confounders including age, sex, socioeconomic status, alcohol, smoking status, body mass index, hypertension and diabetes. Results Poor general health was reported by 1215 (6.2%) participants and was associated with cancer registrations (adjusted Hazard Ratio [HR] 1.30, 95% CI 1.10, 1.55), coronary heart disease events (adjusted HR 2.30, 95% CI 1.86, 2.84) and psychiatric hospitalisations (adjusted HR 2.42, 95% CI 1.65, 3.56). There was evidence of dose relationships and the associations remained significant after adjustment for mental health. 3172 (16%) participants had poor mental health (GHQ ≥4). After adjustment for general health, the associations between poor mental health and coronary heart disease events (adjusted HR 1.36, 95% CI 1.13, 1.63) and all-cause death (adjusted HR 1.38, 95% CI 1.23, 1.55) became non-significant, but mental health remained associated with psychiatric hospitalisations (fully adjusted HR 2.02, 95% CI 1.48, 2.75). Conclusion Self-reported general health is a significant predictor of a range of clinical outcomes independent of mental health. The association between mental health and non-psychiatric outcomes is mediated by general health but it is an independent predictor of psychiatric outcome. Individuals with poor general health or mental health warrant close attention. PMID:24705574

  4. The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults

    PubMed Central

    Lee, Y.

    2000-01-01

    OBJECTIVE—To examine the extent to which older people's self assessments of general health, physical health, and mental health predict functional decline and mortality.
DESIGN—The study uses population-based secondary data from the US Longitudinal Study of Aging (LSOA).
PARTICIPANTS—A total of 7527 persons aged 70 years or above living in the community.
METHODS—Eight different measures on self reported general, physical, and mental health were used. Change in functional status was measured using a composite index of ADLs and IADLs over a period of six years. Duration of survival was calculated over a period of seven years. Adjusting for age and gender, multiple logistic regression was used in analysing functional decline, and Cox proportional hazard model, for mortality. Then all of the self assessed health measures were incorporated into the final model—controlling for baseline sociodemographic characteristics, functional status, disease/conditions, and use of health and social services—to assess the independent contribution of each measure in predicting future health outcomes.
MAIN RESULTS—Overall, older people's self assessed general, physical, and mental health were predictive of functional decline and mortality. In multivariate analyses, older people who assessed their global health, self care ability, and physical activity less favourably were more likely to experience poor health outcomes. Gender disparity, however, was observed with poor global health affecting functional decline in men only. Self care ability was predictive of functioning in women only, whereas it was predictive of mortality in men only.
CONCLUSIONS—Self assessed global health, as well as, specific dimensions of health act as significant, independent predictors of functioning and mortality in a community dwelling older people.


Keywords: age; self assessed health; functional status; mortality PMID:10715745

  5. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: a randomized, double-blind, placebo-controlled trial

    PubMed Central

    Alaka, Karla J; Noble, William; Montejo, Angel; Dueñas, Héctor; Munshi, Autar; Strawn, Jeffrey R; Lenox-Smith, Alan; Ahl, Jonna; Bidzan, Leszek; Dorn, Brita; Ball, Susan

    2014-01-01

    Objective This was a flexible-dosed study to evaluate the efficacy and safety of duloxetine 30–120 mg once daily in the treatment of generalized anxiety disorder (GAD) in older adult patients. Methods Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140). The primary efficacy measure was the Hamilton Anxiety Rating Scale (HAM-A) total score, and the primary endpoint was at week 10. Global functioning was assessed by the Sheehan Disability Scale (SDS). Safety and tolerability was assessed by the occurrence of treatment-emergent adverse events, serious adverse events, laboratory analyses, and vital signs. Analyses were conducted on an intent-to-treat basis. Results The overall baseline mean HAM-A total score was 24, and SDS global score was 14. Completion rates were 75% for placebo and 76% for duloxetine. At week 10, duloxetine was superior to placebo on mean changes from baseline in HAM-A total scores (−15.9 vs. −11.7, p < 0.001) and in SDS global scores (−8.6 vs. −5.4, p < 0.001). Treatment-emergent adverse events occurred in ≥5% of duloxetine-treated patients and twice the rate than with placebo including constipation (9% vs. 4%, p = 0.06), dry mouth (7% vs. 1%, p = 0.02), and somnolence (6% vs. 2%, p = 0.14). Conclusion Duloxetine treatment was efficacious in the improvement of anxiety and functioning in older adult patients with GAD, and the safety profile was consistent with previous GAD studies. © 2014 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. Key points Treatment with duloxetine versus placebo can significantly reduce symptoms of generalized anxiety disorder and was associated with improved global function and increased enjoyment and satisfaction with life in patients 65 years and older. The safety and tolerability profile for duloxetine in this older adult patient population

  6. Science in the General Educational Development (GED) curriculum: Analyzing the science portion of GED programs and exploring adult students' attitudes toward science

    NASA Astrophysics Data System (ADS)

    Hariharan, Joya Reena

    The General Educational Development (GED) tests enable people to earn a high school equivalency diploma and help them to qualify for more jobs and opportunities. Apart from this main goal, GED courses aim at enabling adults to improve the condition of their lives and to cope with a changing society. In today's world, science and technology play an exceedingly important role in helping people better their lives and in promoting the national goals of informed citizenship. Despite the current efforts in the field of secondary science education directed towards scientific literacy and the concept of "Science for all Americans", the literature does not reflect any corresponding efforts in the field of adult education. Science education research appears to have neglected a population that could possibly benefit from it. The purpose of this study is to explore: the science component of GED programs, significant features of the science portion of GED curricula and GED science materials, and adult learners' attitudes toward various aspects of science. Data collection methods included interviews with GED students and instructors, content analysis of relevant materials, and classroom observations. Data indicate that the students in general feel that the science they learn should be relevant to their lives and have direct applications in everyday life. Student understanding of science and interest in it appears to be contingent to their perceiving it as relevant to their lives and to society. Findings indicate that the instructional approaches used in GED programs influence students' perceptions about the relevance of science. Students in sites that use strategies such as group discussions and field trips appear to be more aware of science in the world around them and more enthusiastic about increasing this awareness. However, the dominant strategy in most GED programs is individual reading. The educational strategies used in GED programs generally focus on developing reading

  7. Entrance surface dose and image quality: comparison of adult chest and abdominal X-ray examinations in general practitioner clinics, public and private hospitals in Malaysia.

    PubMed

    Hambali, Ahmad Shariff; Ng, Kwan-Hoong; Abdullah, Basri Johan Jeet; Wang, Hwee-Beng; Jamal, Noriah; Spelic, David C; Suleiman, Orhan H

    2009-01-01

    This study was undertaken to compare the entrance surface dose (ESD) and image quality of adult chest and abdominal X-ray examinations conducted at general practitioner (GP) clinics, and public and private hospitals in Malaysia. The surveyed facilities were randomly selected within a given category (28 GP clinics, 20 public hospitals and 15 private hospitals). Only departmental X-ray units were involved in the survey. Chest examinations were done at all facilities, while only hospitals performed abdominal examinations. This study used the x-ray attenuation phantoms and protocols developed for the Nationwide Evaluation of X-ray Trends (NEXT) survey program in the United States. The ESD was calculated from measurements of exposure and clinical geometry. An image quality test tool was used to evaluate the low-contrast detectability and high-contrast detail performance under typical clinical conditions. The median ESD value for the adult chest X-ray examination was the highest (0.25 mGy) at GP clinics, followed by private hospitals (0.22 mGy) and public hospitals (0.17 mGy). The median ESD for the adult abdominal X-ray examination at public hospitals (3.35 mGy) was higher than that for private hospitals (2.81 mGy). Results of image quality assessment for the chest X-ray examination show that all facility types have a similar median spatial resolution and low-contrast detectability. For the abdominal X-ray examination, public hospitals have a similar median spatial resolution but larger low-contrast detectability compared with private hospitals. The results of this survey clearly show that there is room for further improvement in performing chest and abdominal X-ray examinations in Malaysia.

  8. Screening instruments for a population of older adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7).

    PubMed

    Vasiliadis, Helen-Maria; Chudzinski, Veronica; Gontijo-Guerra, Samantha; Préville, Michel

    2015-07-30

    Screening tools that appropriately detect older adults' mental disorders are of great public health importance. The present study aimed to establish cutoff scores for the 10-item Kessler Psychological Distress (K10) and the 7-item Generalized Anxiety Disorder (GAD-7) scales when screening for depression and anxiety. We used data from participants (n = 1811) in the Enquête sur la Santé des Aînés-Service study. Depression and anxiety were measured using DSM-V and DSM-IV criteria. Receiver operating characteristic (ROC) curve analysis provided an area under the curve (AUC) of 0.767 and 0.833 for minor and for major depression when using K10. A cutoff of 19 was found to balance sensitivity (0.794) and specificity (0.664) for minor depression, whereas a cutoff of 23 was found to balance sensitivity (0.692) and specificity (0.811) for major depression. When screening for an anxiety with GAD-7, ROC analysis yielded an AUC of 0.695; a cutoff of 5 was found to balance sensitivity (0.709) and specificity (0.568). No significant differences were found between subgroups of age and gender. Both K10 and GAD-7 were able to discriminate between cases and non-cases when screening for depression and anxiety in an older adult population of primary care service users. PMID:25956759

  9. Obese children, adults and senior citizens in the eyes of the general public: results of a representative study on stigma and causation of obesity.

    PubMed

    Sikorski, Claudia; Luppa, Melanie; Brähler, Elmar; König, Hans-Helmut; Riedel-Heller, Steffi G

    2012-01-01

    Obese individuals are blamed for their excess weight based on causal attribution to the individual. It is unclear whether obese individuals of different age groups and gender are faced with the same amount of stigmatization. This information is important in order to identify groups of individuals at risk for higher stigmatization and discrimination. A telephone interview was conducted in a representative sample of 3,003 participants. Experimental manipulation was realized by vignettes describing obese and normal-weight children, adults and senior citizens. Stigmatizing attitudes were measured by semantic differential. Causal attribution was assessed. Internal factors were rated with highest agreement rates as a cause for the vignette's obesity. Lack of activity behavior and eating too much are the most supported causes. Importance of causes differed for the different vignettes. For the child, external causes were considered more important. The overweight vignette was rated consistently more negatively. Higher educational attainment and personal obesity were associated with lower stigmatizing attitudes. The vignette of the obese child was rated more negatively compared to that of an adult or senior citizen. Obesity is seen as a controllable condition, but for children external factors are seen as well. Despite this finding, they are faced with higher stigmatizing attitudes in the general public, contradicting attribution theory assumptions. Internal and external attribution were found to be inter-correlated. Obese children are the population most at risk for being confronted with stigmatization, making them a target point in stigma-reduction campaigns. PMID:23071664

  10. Impact of dental treatment under general anesthesia on the oral health-related quality of life of adolescents and adults with special needs.

    PubMed

    Chang, Juhea; Patton, Lauren L; Kim, Hae-Young

    2014-12-01

    This study aimed to assess the perception of the family's primary caregiver on the oral health-related quality of life (OHRQoL), and the impact on family dynamics, of dental treatment under general anesthesia (GA) in adolescent and adult patients with intellectual and developmental disabilities (IDD) and neurocognitive disorders. Self-administered questionnaires were completed, before dental treatment, by 116 primary family caregivers of patients who received dental treatment under GA, and 102 (88%) of these caregivers completed the same questionnaires within 4 wk after treatment. The Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were shortened to a 14-item COHIP (COHIP-14) and a 12-item FIS (FIS-12) based on the limitations of patients' communication. The COHIP-14 and FIS-12 scores and each subscale improved after treatment. The baseline scores varied based on certain characteristics of the patients, such as age, disabilities, medications, caregivers, meal types, cooperation levels, and treatment needs. The postoperative improvement in OHRQoL was significant in the patients who were older than 30 yr of age, originally eating soft meals, displaying no or very low levels of cooperation, or receiving endodontic treatment. Based on the primary caregiver perceptions, the OHRQoL of adolescents and adults with IDD and neurocognitive disorders was improved by dental treatment under GA.

  11. Heterogeneous responses of personalised high intensity interval training on type 2 diabetes mellitus and cardiovascular disease risk in young healthy adults.

    PubMed

    Higgins, Timothy P; Baker, Matthew D; Evans, Shelley-Ann; Adams, Rachel A; Cobbold, Christian

    2015-01-01

    Hypertension, decreased glucose tolerance, adverse lipid profiles and low physical activity levels are associated with increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. High intensity interval training (HIIT), a low volume, reduced time, high intensity programme, may be a useful alternative to current government guidelines which specify a minimum of 150 minutes of physical activity per week. We describe a personalised programme of high intensity exercise which provides significant improvements in CVD risk markers. Healthy volunteers undertook 6 weeks of HIIT. T2DM and CVD risk predictors including glucose tolerance, VO2max, blood pressure (BP), and lipids were measured before and after HIIT. HIIT training was associated with beneficial changes in a range of predictors of blood flow and cardiovascular risk. There was a heterogeneous response to HIIT, with some subjects responding with favourable changes and others being non-responders to HIIT. In responders, HIIT was associated with a statistically significant (p = 0.023) increase in VO2max, from 45.4 (38.4,52.5) to 56.9 (51.2,65.7) (median (interquartile range)(ml/min/kg)). In responders HIIT resulted in a decrease in systolic BP from 127 (126,129) to 116 (106,122) (mmHg) with p = 0.026 and a decrease is diastolic blood pressure from 72 (69,74) to 57 (56,66) with p = 0.026. There was also some evidence of a beneficial change in blood lipid and glucose concentrations with HIIT. In conclusion, personalised HIIT has potential as an intervention to improve blood flow and cardiovascular health.

  12. Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing

    PubMed Central

    Lai, Jin Shei; Bode, Rita; Choi, Seung; Moy, Claudia; Bleck, Tom; Miller, Deborah; Peterman, Amy; Cella, David

    2013-01-01

    Purpose Neuro-QOL provides a clinically relevant and psychometrically robust health-related quality of life (HRQL) assessment tool for both adults and children with common neurological disorders. We now report the psychometric results for the adult tools. Methods An extensive research, survey and consensus process was used to produce a list of 5 priority adult neurological conditions (stroke, multiple sclerosis, Parkinson’s disease, epilepsy and ALS). We identified relevant health related quality of life (HRQL) domains through multiple methods and data sources including a comprehensive review of the literature and literature search, expert interviews and surveys and patient and caregiver focus groups. The final domain framework consisted of 17 domains of Physical, Mental and Social health. There were five phases of item development: (1) identification of 3,482 extant items, (2) item classification and selection, (3) item review and revision, (4) cognitive interviews with 63 patients to assess their understanding of individual items and (5) field testing of 432 representative items. Participants and Procedures Participants were drawn from the US general population and clinical settings, and included both English and Spanish speaking subjects (N = 3,246). Confirmatory factor analysis (CFA) was used to evaluate the dimensionality of unidimensional domains. Where the domain structure was previously unknown, the dataset was split and first analyzed with exploratory factor analysis and then CFA. Samejima’s graded response model (GRM) was used to calculate IRT parameters. We further evaluated differential item functioning (DIF) on gender, education and age. Results Thirteen unidimensional calibrated item banks consisting of 297 items were developed. All of the tested item banks had high reliability and few or no locally dependent items. The range of item slopes and thresholds with good information are reported for each of the item banks. The banks can support CAT and

  13. The general practitioner's role in promoting physical activity to older adults: a review based on program theory.

    PubMed

    Hinrichs, Timo; Brach, Michael

    2012-02-01

    Positive influences of physical activity both on many chronic diseases and on preservation of mobility are well documented. But chronically ill or mobility restricted elderly living in their own homes are difficult to reach for interventions. The general practitioner's (GP) surgery offers one of the few opportunities to give advice for physical activity to those people. We used program theory to sound out knowledge on GP-centered physical activity counseling. The "conceptual theory" (evidence for training effects in old age) and the "implementation theory" (unique position of the GP) were reviewed narratively. The "action theory" (effects of GP counseling) was reviewed systematically. According to program theory, appropriate MeSH (Medical subject headings) concepts were Aged OR Aged, 80 and over (Target group), Physicians, Family OR Primary Health Care (Implementation/Setting), Counseling OR Patient Education as Topic OR Disease Management OR Health promotion (Intervention), Exercise OR Motor Activity OR Physical Fitness OR Sports (Determinants). The resulting six review papers (Pubmed, 2000-2009) were presented using the STARLITE mnemonic. Authors agree, that the GP plays a central role in the promotion of physical activity to elderly people, but there is conflicting evidence concerning counseling effectiveness. Utilizing behavioral change strategies and the collaboration between GPs and specialised professions are recommended and currently under research.

  14. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola.

    PubMed

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91-52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ (2) = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69-3.21) and 1.42 (95% CI: 0.64-3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  15. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    PubMed Central

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ2 = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21) and 1.42 (95% CI: 0.64–3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  16. 20 CFR 663.220 - Who may receive intensive services?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.220 Who may receive intensive services? There are two categories of adults and dislocated workers who may receive intensive services: (a) Adults and dislocated workers who are unemployed,...

  17. 20 CFR 663.220 - Who may receive intensive services?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.220 Who may receive intensive services? There are two categories of adults and dislocated workers who may receive intensive services: (a) Adults and dislocated workers who are unemployed,...

  18. Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia

    PubMed Central

    Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

    2016-01-01

    Objectives To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Design Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Setting Residential care facilities, Umeå, Sweden. Participants Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). Intervention Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Measurements Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Results Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. Conclusion In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. PMID:26782852

  19. First results about recovery of walking function in patients with intensive care unit-acquired muscle weakness from the General Weakness Syndrome Therapy (GymNAST) cohort study

    PubMed Central

    Mehrholz, Jan; Mückel, Simone; Oehmichen, Frank; Pohl, Marcus

    2015-01-01

    Objectives To describe the time course of recovery of walking function and other activities of daily living in patients with intensive care unit (ICU)-acquired muscle weakness. Design This is a cohort study. Participants We included critically ill patients with ICU-acquired muscle weakness. Setting Post-acute ICU and rehabilitation units in Germany. Measures We measured walking function, muscle strength, activities in daily living, motor and cognitive function. Results We recruited 150 patients (30% female) who fulfilled our inclusion and exclusion criteria. The primary outcome recovery of walking function was achieved after a median of 28.5 days (IQR=45) after rehabilitation onset and after a median of 81.5 days (IQR=64) after onset of illness. Our final multivariate model for recovery of walking function included two clinical variables from baseline: the Functional Status Score ICU (adjusted HR=1.07 (95% CI 1.03 to 1.12) and the ability to reach forward in cm (adjusted HR=1.02 (95% CI 1.00 to 1.04). All secondary outcomes but not pain improved significantly in the first 8 weeks after study onset. Conclusions We found good recovery of walking function for most patients and described the recovery of walking function of people with ICU-acquired muscle weakness. Trials registrations number Sächsische Landesärztekammer EK-BR-32/13-1; DRKS00007181, German Register of Clinical Trials. PMID:26700274

  20. Association between Body Mass Index and Health-Related Quality of Life: The "Obesity Paradox" in 21,218 Adults of the Chinese General Population

    PubMed Central

    Zhu, Yanbo; Wang, Qi; Pang, Guoming; Lin, Lin; Origasa, Hideki; Wang, Yangyang; Di, Jie; Shi, Mai; Fan, Chunpok; Shi, Huimei

    2015-01-01

    Background There was no consistent recognition of the association between high or low body mass index (BMI) and health related quality of life (HRQL). The aim of this research was to study the association between BMI and HRQL in Chinese adults, and to further explore the stability of that association in the subgroup analysis stratified by status of chronic conditions. Methods A total of 21,218 adults aged 18 and older were classified as underweight, normal weight, overweight, class I obese, and class II obese based on their BMI. HRQL was measured by the SF-36 Health Survey. The independent impact of each BMI category on HRQL was examined through standard least squares regression by comparing the difference of SF-36 scores and the minimum clinically important differences (MCID), which was defined as 3 points. Results Compared to the normal weight, the class I obese was significantly associated with better HRQL scores in the mental component summary (MCS) (75.1 vs. 73.4, P<0.001). The underweight had the lowest score in both the physical components summary (PCS) (75.4 vs. 77.5, P<0.001) and mental components summary (MCS) (71.8 vs. 73.4, P<0.001). For the MCID, the HRQL score was reduced by more than 3 points in the physical functioning for the class II obese (D=-3.43) and the general health for the underweight (D=-3.71). Stratified analyses showed a similar result in the health subjects and chronic conditions, and it was significant in the chronic conditions. Conclusions The class I obese showed the best HRQL, especially in the mental domain. The worst HRQL was found in the underweight. The class II obese reduced HRQL in the physical functioning only. “Obesity paradox” was more obvious in the participants with chronic conditions. PMID:26087128

  1. Higher Early Monocyte and Total Lymphocyte Counts Are Associated with Better Overall Survival after Standard Total Body Irradiation, Cyclophosphamide, and Fludarabine Reduced-Intensity Conditioning Double Umbilical Cord Blood Allogeneic Stem Cell Transplantation in Adults.

    PubMed

    Le Bourgeois, Amandine; Peterlin, Pierre; Guillaume, Thierry; Delaunay, Jacques; Duquesne, Alix; Le Gouill, Steven; Moreau, Philippe; Mohty, Mohamad; Campion, Loïc; Chevallier, Patrice

    2016-08-01

    This single-center retrospective study aimed to report the impact of early hematopoietic and immune recoveries after a standard total body irradiation, cyclophosphamide, and fludarabine (TCF) reduced-intensity conditioning (RIC) regimen for double umbilical cord blood (dUCB) allogeneic stem cell transplantation (allo-SCT) in adults. We analyzed 47 consecutive patients older than 17 years who engrafted after a dUCB TCF allo-SCT performed between January 2006 and April 2013 in our department. Median times for neutrophil and platelet recoveries were 17 (range, 6 to 59) and 37 days (range, 0 to 164), respectively. The 3-year overall (OS) and disease-free survivals, relapse incidence, and nonrelapse mortality were 65.7%, 57.2%, 27.1%, and 19%, respectively. In multivariate analysis, higher day +30 monocyte (≥615/mm(3); hazard ratio [HR], .04; 95% confidence interval [CI], .004 to .36; P < .01) and day +42 lymphocyte (≥395/mm(3); HR, .16; 95% CI, .03 to .78; P = .02) counts were independently associated with better OS. These results suggest that early higher hematopoietic and immune recovery is predictive of survival after dUCB TCF RIC allo-SCT in adults. Factors other than granulocyte colony-stimulating factor, which was used in all cases, favoring expansion of monocytes or lymphocytes, should be tested in the future as part of the UCB transplantation procedure. PMID:27118570

  2. Initial fluconazole prophylaxis may not be required in adults with acute leukemia or myelodysplastic/myeloproliferative disorders after reduced intensity conditioning peripheral blood stem cell allogeneic transplantation.

    PubMed

    Brissot, Eolia; Cahu, Xavier; Guillaume, Thierry; Delaunay, Jacques; Ayari, Sameh; Peterlin, Pierre; Le Bourgeois, Amandine; Harousseau, Jean-Luc; Milpied, Noel; Bene, Marie-Christine; Moreau, Philippe; Mohty, Mohamad; Chevallier, Patrice

    2015-04-01

    In the myeloablative transplant setting, the early use of fluconazole prophylaxis provides a benefit in overall survival. Recent changes in transplantation practices, including the use of peripheral blood stem cells (PBSC) and/or reduced intensity conditioning (RIC) regimen may have favorably impacted the epidemiology of invasive fungal infections (IFI) after allogeneic stem cell transplantation (allo-SCT). Yet, the impact of removing fluconazole prophylaxis after RIC PBSC allotransplant is ill known. Here, a retrospective analysis was performed comparing patients who received fluconazole as antifungal prophylaxis (n = 53) or not (n = 56) after allo-SCT for acute leukemia or myelodysplastic/myeloproliferative syndrome. Sixteen IFI were documented (14 %) at a median time of 103 days after transplantation, including eight before day +100, at a similar rate, whether the patients received fluconazole prophylaxis (13 %) or not (16 %). IFI were due mainly to Aspergillus species (87 %), and only two Candida-related IFI (13 %) were documented in the non-fluconazole group before day +100. The incidences of IFI (overall, before or after day +100) as well as 3-year overall and disease-free survival, non-relapse mortality, or acute and chronic graft-versus-host disease (GVHD) were similar between both groups. In conclusion, this study suggests that fluconazole may not be required at the initial phase of RIC allo-SCT using PBSC. This result has to be confirmed prospectively while Aspergillus prophylaxis should be discussed in this particular setting.

  3. Evaluation of Bacillus subtilis R0179 on gastrointestinal viability and general wellness: a randomised, double-blind, placebo-controlled trial in healthy adults.

    PubMed

    Hanifi, A; Culpepper, T; Mai, V; Anand, A; Ford, A L; Ukhanova, M; Christman, M; Tompkins, T A; Dahl, W J

    2015-03-01

    A probiotic formulation of Enterococcus faecium R0026 and Bacillus subtilis R0179 has been evaluated in previous clinical trials. However, B. subtilis R0179 has not been evaluated as a single probiotic strain or in combination with other strains at doses higher than 0.1×109 cfu. To establish oral dose-response tolerance and gastrointestinal (GI) viability of B. subtilis R0179, a randomised, double-blind, placebo-controlled trial in healthy adults (n=81; 18-50 years old) was conducted. Participants received B. subtilis R0179 at 0.1, 1.0 or 10×109 cfu/capsule/day or placebo for four weeks. General wellness was assessed using a daily questionnaire evaluating GI, cephalic, ear-nose-throat, behavioural, emetic, and epidermal symptoms. GI symptoms were further evaluated using a weekly gastrointestinal symptom rating scale (GSRS). GI transit viability of B. subtilis R0179 was assessed by plating and microbiota analysis by 16S rRNA at baseline, week 4 of the intervention and washout. General wellness and GI function were not affected by oral consumption of B. subtilis R0179 at any dose. Daily questionnaire syndrome scores were not different from baseline and did not exceed a clinically significant score of 1. GSRS syndrome scores were not different from baseline and ranged from 1.1±0.1 to 1.9±0.2. Faecal viable counts of B. subtilis R0179 demonstrated a dose response: the placebo group (1.1±0.1 log10 cfu/g) differed from 0.1×109 (4.6±0.1 log10 cfu/g), 1×109 (5.6±0.1 log10 cfu/g) and 10×109 (6.4±0.1 log10 cfu/g) (P<0.0001). No significant changes in phyla were observed, but sequence reads binned to multiple operational taxonomic units matching closest to Ruminococci increased during probiotic supplementation. B. subtilis R0179 survives passage through the human GI tract and is well tolerated by healthy adults at intakes from 0.1 to 10×109 cfu/day. The trial has been registered at www.clinicaltrials.gov under NCT01802151. PMID:25062611

  4. Low 25(OH) Vitamin D3 Levels Are Associated with Adverse Outcome in Newly-Diagnosed Intensively-Treated Adult Acute Myeloid Leukemia Patients

    PubMed Central

    Lee, Hun Ju; Muindi, Josephia R.; Tan, Wei; Hu, Qiang; Wang, Dan; Liu, Song; Wilding, Gregory E.; Ford, Laurie A.; Sait, Sheila N.J.; Block, Annemarie W.; Adjei, Araba A.; Barcos, Maurice; Griffiths, Elizabeth A; Thompson, James E.; Wang, Eunice S.; Johnson, Candace S; Trump, Donald L.; Wetzler, Meir

    2013-01-01

    Background Several studies suggest that low 25(OH) vitamin D3 levels may be prognostic in some malignancies, but no studies have evaluated their impact on treatment outcome in acute myeloid leukemia (AML). Methods VD levels were evaluated in 97 consecutive newly diagnosed, intensively-treated AML patients. MicroRNA-expression profiles and single nucleotide polymorphisms (SNPs) in the 25(OH) vitamin D3 pathway genes were evaluated and correlated with 25(OH) vitamin D3 levels and treatment outcome. Results Thirty-four (35%) patients had normal 25(OH) vitamin D3 levels (32–100 ng/ml), 34 (35%) insufficient (20–31.9 ng/ml) and 29 (30%) deficient levels (<20 ng/ml). Insufficient/deficient 25(OH) vitamin D3 levels were associated with worse relapse-free survival (RFS) compared to normal vitamin D3 levels. In multivariate analyses, deficient 25(OH) vitamin D3, smoking, European LeukemiaNet Genetic Groups and white blood cell count retained their statistical significance for RFS. A number of microRNAs and SNPs were found to be associated with 25(OH) vitamin D3 level, although none remained significant after multiple test corrections; one 25(OH) vitamin D3 receptor SNP, rs10783219, was associated with lower complete remission rate (p=0.0442), shorter RFS (p=0.0058) and overall survival (p=0.0011). Conclusions It remains to be determined what role microRNA and SNP profiles play in contributing to low 25(OH) vitamin D3 level and/or outcome and whether supplementation will improve AML outcome. PMID:24166051

  5. Health-Promoting Physical Activity of Adults with Mental Retardation

    ERIC Educational Resources Information Center

    Stanish, Heidi I.; Temple, Viviene A.; Frey, Georgia C.

    2006-01-01

    This literature review describes the physical activity behavior of adults with mental retardation consistent with the U.S. Surgeon General's recommendation of 30 minutes of moderate intensity physical activity on 5 or more days per week. The proportion of participants achieving this criterion ranges from 17.5 to 33%. These data are likely to be…

  6. Rich Environments for Adult Learners

    ERIC Educational Resources Information Center

    Bentham, Renee

    2008-01-01

    Unaware of the messages a bare adult learning environment sends and its effect on adult learners, a trainer attends an intensive Reggio Emilia course and learns that the physical environment is the "third teacher"--for adults as well as for children. Using principles of Reggio, she offers suggestions for enhancing adult learning spaces and…

  7. Current sources of lead exposure and their relative contributions to the blood lead levels in the general adult population of Northern France: The IMEPOGE Study, 2008-2010.

    PubMed

    Tagne-Fotso, Romuald; Leroyer, Ariane; Howsam, Mike; Dehon, Betty; Richeval, Camille; Nisse, Catherine

    2016-01-01

    There is justification for limiting lead (Pb) exposure as much as possible, given its impact on health at low concentrations. Consequently, the aim of this study was to measure blood lead levels (BLL) and examine exposure factors related to BLL variations in the general adult population of northern France, a current and past industrial area. Two thousand inhabitants of northern France, aged between 20 and 59 years, were recruited using the quota method with caution. Blood lead levels were quantified by inductively coupled plasma-mass spectroscopy (ICP-MS), and variation factors were studied separately in men and women using multivariate stepwise linear and logistic regression models. The geometric mean of the BLL was 18.8 μg/L (95% confidence interval [CI]: 18.3-19.3). Occupational factors affected BLL only in men and represented 14% of total explained variance of BLL. External occupational factors significantly increasing mean levels of BLL were tobacco, consumption of some beverages (wine, coffee, tea, and/or tap water), raw vegetables, housing characteristics (built prior to 1948, Pb piping in the home) and do-it-yourself or leisure activities (paint stripping or rifle shooting). Consumption habits accounted together for 25% and 18% of the total explained variance, respectively, in men and women. Industrial environment did not significantly contribute to BLL variations. Blood lead levels observed in the general population of this industrial part of France did not appear to be excessively elevated compared to values found internationally. Nonetheless, these BLL remain a public health issue in regard to nonthreshold toxicity attributed to Pb. PMID:27074096

  8. Current sources of lead exposure and their relative contributions to the blood lead levels in the general adult population of Northern France: The IMEPOGE Study, 2008-2010.

    PubMed

    Tagne-Fotso, Romuald; Leroyer, Ariane; Howsam, Mike; Dehon, Betty; Richeval, Camille; Nisse, Catherine

    2016-01-01

    There is justification for limiting lead (Pb) exposure as much as possible, given its impact on health at low concentrations. Consequently, the aim of this study was to measure blood lead levels (BLL) and examine exposure factors related to BLL variations in the general adult population of northern France, a current and past industrial area. Two thousand inhabitants of northern France, aged between 20 and 59 years, were recruited using the quota method with caution. Blood lead levels were quantified by inductively coupled plasma-mass spectroscopy (ICP-MS), and variation factors were studied separately in men and women using multivariate stepwise linear and logistic regression models. The geometric mean of the BLL was 18.8 μg/L (95% confidence interval [CI]: 18.3-19.3). Occupational factors affected BLL only in men and represented 14% of total explained variance of BLL. External occupational factors significantly increasing mean levels of BLL were tobacco, consumption of some beverages (wine, coffee, tea, and/or tap water), raw vegetables, housing characteristics (built prior to 1948, Pb piping in the home) and do-it-yourself or leisure activities (paint stripping or rifle shooting). Consumption habits accounted together for 25% and 18% of the total explained variance, respectively, in men and women. Industrial environment did not significantly contribute to BLL variations. Blood lead levels observed in the general population of this industrial part of France did not appear to be excessively elevated compared to values found internationally. Nonetheless, these BLL remain a public health issue in regard to nonthreshold toxicity attributed to Pb.

  9. Confirmation of the factorial structure of the Japanese short version of the TEMPS-A in psychiatric patients and general adults

    PubMed Central

    Nakato, Yasuya; Inoue, Takeshi; Nakagawa, Shin; Kitaichi, Yuji; Kameyama, Rie; Wakatsuki, Yumi; Kitagawa, Kan; Omiya, Yuki; Kusumi, Ichiro

    2016-01-01

    Background The Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) is a 110-item questionnaire that assesses five affective temperaments. However, a valid shortened version is desired for large-scale investigations to enhance the compliance of respondents. Methods A confirmatory factor analysis was conducted among 320 psychiatric patients and 61 general adults. The participants completed the Japanese 39-item short version of the TEMPS-A, and a portion of the participants completed the 110-item version. An exploratory factor analysis with the principal factor method and varimax rotation was conducted to identify a more suitable model of the short version of the TEMPS-A. Results The confirmatory factor analysis revealed that the 39-item version exhibited a poor model fit. However, we found that the 18-item version exhibited a firm five-factor structure based on the exploratory factor analysis, and this model exhibited an acceptable model fit. It had good or acceptable internal consistency (Cronbach’s αs: 0.672–0.819). Limitations The majority of the subjects in the present study were patients, and the temperament data may have been affected by psychiatric symptoms. Conclusion A firm five-factor structure was not found in the 39-item short version of the Japanese TEMPS-A. Therefore, an 18-item version was proposed. This new 18-item version of the TEMPS-A might be useful for clinical applications and large-scale investigations.

  10. Triple Comorbid Trajectories of Tobacco, Alcohol, and Marijuana Use as Predictors of Antisocial Personality Disorder and Generalized Anxiety Disorder Among Urban Adults

    PubMed Central

    Brook, Judith S.; Lee, Jung Yeon; Rubenstone, Elizabeth; Brook, David W.; Finch, Stephen J.

    2014-01-01

    Objectives. We modeled triple trajectories of tobacco, alcohol, and marijuana use from adolescence to adulthood as predictors of antisocial personality disorder (ASPD) and generalized anxiety disorder (GAD). Methods. We assessed urban African American and Puerto Rican participants (n = 816) in the Harlem Longitudinal Development Study, a psychosocial investigation, at 4 time waves (mean ages = 19, 24, 29, and 32 years). We used Mplus to obtain the 3 variable trajectories of tobacco, alcohol, and marijuana use from time 2 to time 5 and then conducted logistic regression analyses. Results. A 5-trajectory group model, ranging from the use of all 3 substances (23%) to a nonuse group (9%), best fit the data. Membership in the trajectory group that used all 3 substances was associated with an increased likelihood of both ASPD (adjusted odds ratio [AOR] = 6.83; 95% CI = 1.14, 40.74; P < .05) and GAD (AOR = 4.35; 95% CI = 1.63, 11.63; P < .001) in adulthood, as compared with the nonuse group, with control for earlier proxies of these conditions. Conclusions. Adults with comorbid tobacco, alcohol, and marijuana use should be evaluated for use of other substances and for ASPD, GAD, and other psychiatric disorders. Treatment programs should address the use of all 3 substances to decrease the likelihood of comorbid psychopathology. PMID:24922120

  11. Confirmation of the factorial structure of the Japanese short version of the TEMPS-A in psychiatric patients and general adults

    PubMed Central

    Nakato, Yasuya; Inoue, Takeshi; Nakagawa, Shin; Kitaichi, Yuji; Kameyama, Rie; Wakatsuki, Yumi; Kitagawa, Kan; Omiya, Yuki; Kusumi, Ichiro

    2016-01-01

    Background The Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) is a 110-item questionnaire that assesses five affective temperaments. However, a valid shortened version is desired for large-scale investigations to enhance the compliance of respondents. Methods A confirmatory factor analysis was conducted among 320 psychiatric patients and 61 general adults. The participants completed the Japanese 39-item short version of the TEMPS-A, and a portion of the participants completed the 110-item version. An exploratory factor analysis with the principal factor method and varimax rotation was conducted to identify a more suitable model of the short version of the TEMPS-A. Results The confirmatory factor analysis revealed that the 39-item version exhibited a poor model fit. However, we found that the 18-item version exhibited a firm five-factor structure based on the exploratory factor analysis, and this model exhibited an acceptable model fit. It had good or acceptable internal consistency (Cronbach’s αs: 0.672–0.819). Limitations The majority of the subjects in the present study were patients, and the temperament data may have been affected by psychiatric symptoms. Conclusion A firm five-factor structure was not found in the 39-item short version of the Japanese TEMPS-A. Therefore, an 18-item version was proposed. This new 18-item version of the TEMPS-A might be useful for clinical applications and large-scale investigations. PMID:27601911

  12. Ad Hoc Conference on the Education of Migrants: Introductory Report on Theme III, "Opportunities for Vocational and Technical Training and General Education for Adults and Adolescents" (Strasbourg, France, November 5-8, 1974).

    ERIC Educational Resources Information Center

    Egger, Eugene

    Theme III of the Ad Hoc Conference on the Education of Migrants was "measures to secure the satisfactory provision of opportunities for vocational and technical training and general education for adults and adolescents". This report briefly summarizes the situation in member countries regarding the vocational and technical training and general…

  13. Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part R. ACE Competency Based Job Descriptions: #95--Bus Driver; #98--General Loader; #99--Forklift Operator; #100--Material Handler.

    ERIC Educational Resources Information Center

    San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

    This fifteenth of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Bus Driver, General Loader, Forklift Operator, and Material Handler. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T.…

  14. Industrial and Practical Arts, Vocational Education, and General Adult Education, Leflore County School District, Mississippi. Reports of Consultants and Advisory Specialists under Planning Grant, Title III, Elementary and Secondary Education Act of 1965.

    ERIC Educational Resources Information Center

    Roberts, Roy W.; Hunt, Elizabeth E.

    Descriptions of vocational, practical arts, and general adult education programs for an exemplary school curriculum, grades K-12 in Leflore County, Mississippi, are given in this 1969 document. Suggestions include development of an area vocational-technical school designed to supply partially the anticipated manpower needs of this rural county. It…

  15. Adult Education and the Elderly. Case Studies from Latin America, Africa, Asia and Europe. Background Materials. The Literacy Debate. General Discussion. Literacy and Women. Literacy and Health-Programmes. Adult Education and Development. Number 24.

    ERIC Educational Resources Information Center

    Adult Education and Development, 1985

    1985-01-01

    This journal issue contains 18 solicited articles on two major topics: adult education and the elderly, and the literacy debate. The articles on adult education and the elderly include "A Ripe Old Age," republished from a newsletter of the British aid organization OXFAM; "Special Programme for Retirees: A Model Project in Cali, Colombia," by…

  16. Baby, you light-up my face: culture-general physiological responses to infants and culture-specific cognitive judgements of adults.

    PubMed

    Esposito, Gianluca; Nakazawa, Jun; Ogawa, Shota; Stival, Rita; Kawashima, Akiko; Putnick, Diane L; Bornstein, Marc H

    2014-01-01

    Infants universally elicit in adults a set of solicitous behaviors that are evolutionarily important for the survival of the species. However, exposure, experience, and prejudice appear to govern adults' social choice and ingroup attitudes towards other adults. In the current study, physiological arousal and behavioral judgments were assessed while adults processed unfamiliar infant and adult faces of ingroup vs. outgroup members in two contrasting cultures, Japan and Italy. Physiological arousal was investigated using the novel technique of infrared thermography and behavioral judgments using ratings. We uncovered a dissociation between physiological and behavioral responses. At the physiological level, both Japanese and Italian adults showed significant activation (increase of facial temperature) for both ingroup and outgroup infant faces. At the behavioral level, both Japanese and Italian adults showed significant preferences for ingroup adults. Arousal responses to infants appear to be mediated by the autonomic nervous system and are not dependent on direct caregiving exposure, but behavioral responses appear to be mediated by higher-order cognitive processing based on social acceptance and cultural exposure.

  17. Baby, You Light-Up My Face: Culture-General Physiological Responses to Infants and Culture-Specific Cognitive Judgements of Adults

    PubMed Central

    Esposito, Gianluca; Nakazawa, Jun; Ogawa, Shota; Stival, Rita; Kawashima, Akiko; Putnick, Diane L.; Bornstein, Marc H.

    2014-01-01

    Infants universally elicit in adults a set of solicitous behaviors that are evolutionarily important for the survival of the species. However, exposure, experience, and prejudice appear to govern adults' social choice and ingroup attitudes towards other adults. In the current study, physiological arousal and behavioral judgments were assessed while adults processed unfamiliar infant and adult faces of ingroup vs. outgroup members in two contrasting cultures, Japan and Italy. Physiological arousal was investigated using the novel technique of infrared thermography and behavioral judgments using ratings. We uncovered a dissociation between physiological and behavioral responses. At the physiological level, both Japanese and Italian adults showed significant activation (increase of facial temperature) for both ingroup and outgroup infant faces. At the behavioral level, both Japanese and Italian adults showed significant preferences for ingroup adults. Arousal responses to infants appear to be mediated by the autonomic nervous system and are not dependent on direct caregiving exposure, but behavioral responses appear to be mediated by higher-order cognitive processing based on social acceptance and cultural exposure. PMID:25353362

  18. Food Assistance: Efforts To Control Fraud and Abuse in the Child and Adult Care Food Program Should Be Strengthened. United States General Accounting Office Report to Congressional Committees.

    ERIC Educational Resources Information Center

    Robertson, Robert E.

    The Child and Adult Care Food Program provides over $1.5 billion in benefits annually to children and adults in day care. In order to address the longstanding problems of fraud and abuse present in the program, state agencies have been charged with the responsibility for implementing Food and Nutrition Service's (FNS) regulations to prevent and…

  19. Design and participant characteristics for a randomized effectiveness trial of an intensive lifestyle intervention to reduce cardiovascular risk in adults with type 2 diabetes: The I-D-HEALTH study.

    PubMed

    Liss, David T; Finch, Emily A; Gregory, Dyanna L; Cooper, Andrew; Ackermann, Ronald T

    2016-01-01

    Intervening in Diabetes with Healthy Eating, Activity and Linkages To Healthcare (I-D-HEALTH) is a community-based randomized trial evaluating the effectiveness of a group-based adaption of the Look AHEAD intensive lifestyle intervention. Most potentially eligible patients were identified through electronic medical record queries or referral to a diabetes resource hub. Trial enrollees had a usual source of primary care, elevated body mass index (BMI) and type 2 diabetes. I-D-HEALTH participants were randomized to either standard care alone or standard care plus free-of-charge access to a group-based lifestyle intervention (GLI) offered by the YMCA. GLI participation was encouraged, but not required, for the latter group. The primary outcome is percent weight change over 6, 12 and 24months. Secondary outcomes include direct intervention costs and direct medical and non-medical expenditures, as well as changes in systolic blood pressure, hemoglobin A1c and cholesterol. Among 331 I-D-HEALTH participants, 167 were randomized to standard care and 164 to GLI. The mean age (±standard deviation) in each group was 57.1years (±12.2) and 57.6years (±10.5), respectively. Mean BMI was 34.9kg/m(2) (±7.3) among standard care participants and 36.2kg/m(2) (±7.8) among GLI participants. In both groups, approximately one third of participants were non-Hispanic Whites. We detected no significant differences between groups in mean systolic blood pressure, hemoglobin A1c or total cholesterol (P >0.05 for all characteristics above). The I-D-HEALTH study enrolled a diverse sample of adults with diabetes and offers a unique opportunity to evaluate the effectiveness of offering a community-based intensive lifestyle intervention.

  20. General Healthcare Maintenance of IBD

    MedlinePlus

    ... health care provider about other important issues including: Vaccinations: Adults with IBD should generally follow the same vaccination schedules as the general population. The only exceptions ...

  1. Comparison of outcomes after two standards-of-care reduced-intensity conditioning regimens and two different graft sources for allogeneic stem cell transplantation in adults with hematologic diseases: a single-center analysis.

    PubMed

    Le Bourgeois, Amandine; Mohr, Catherine; Guillaume, Thierry; Delaunay, Jacques; Malard, Florent; Loirat, Marion; Peterlin, Pierre; Blin, Nicolas; Dubruille, Viviane; Mahe, Beatrice; Gastinne, Thomas; Le Gouill, Steven; Moreau, Philippe; Mohty, Mohamad; Planche, Lucie; Lode, Laurence; Bene, Marie-Christine; Chevallier, Patrice

    2013-06-01

    Recent advances in allogeneic stem cell transplantation (allo-HSCT) have included the advent of reduced-intensity conditioning (RIC) regimens to decrease the toxicity of myeloablative allo-SCT and the use of double umbilical cord blood (dUCB) units as a graft source in adults lacking a suitable donor. The FB2A2 regimen (fludarabine 30 mg/kg/day for 5-6 days + i.v. busulfan 3.6 mg/kg/day for 2 days + rabbit antithymocyte globulin 2.5 mg/kg/day for 2 days) supported by peripheral blood stem cells (PBSCs) and the TCF regimen (fludarabine 200 mg/m² for 5 days + cyclophosphamide 50 mg/kg for 1 day + low-dose [2 Gy] total body irradiation) supported by dUCB units are currently the most widely used RIC regimens in many centers and could be considered standard of care in adults eligible for an RIC allo-SCT. Here we compared, retrospectively, the outcomes of adults patients who received the FB2A2-PBSC RIC regimen (n = 52; median age, 59 years; median follow-up, 19 months) and those who received the dUCB-TCF RIC regimen (n = 39; median age, 56 years; median follow-up, 20 months) for allo-SCT between January 2007 and November 2010. There were no significant between-group differences in patient and disease characteristics. Cumulative incidences of engraftment, acute grade II-IV and chronic graft-versus-host disease were similar in the 2 groups. The median time to platelet recovery, incidence of early death (before day +100), and 2-year nonrelapse mortality were significantly higher in the dUCB-TCF group (38 days versus 0 days [P <.0001]; 20.5% versus 4% [P = .05], and 26.5% versus 6% [P = .02], respectively). The groups did not differ in terms of 2-year overall survival (62% for FB2A2-PBSC versus 61% for dUCB-TCF), disease-free survival (59% versus 50.5%), or relapse incidence (35.5% versus 23%). In multivariate analysis, the presence of a lymphoid disorder was associated with a significantly higher 2-year overall survival (hazard ratio, 0.42; 95% confidence interval, 0

  2. Adult intussusception.

    PubMed Central

    Azar, T; Berger, D L

    1997-01-01

    OBJECTIVE: The objectives were to review adult intussusception, its diagnosis, and its treatment. SUMMARY BACKGROUND DATA: Adult intussusception represents 1% of all bowel obstructions, 5% of all intussusceptions, and 0.003%-0.02% of all hospital admissions. Intussusception is a different entity in adults than it is in children. METHODS: The records of all patients 18 years and older with the postoperative diagnosis of intussusception at the Massachusetts General Hospital during the years 1964 through 1993 were reviewed retrospectively. The 58 patients were divided into those with benign enteric, malignant enteric, benign colonic, and malignant colonic lesions associated with their intussusception. The diagnosis and treatment of each were reviewed. RESULTS: In 30 years at the Massachusetts General Hospital, there are 58 cases of surgically proven adult intussusception. The patients' mean age was 54.4 years. Most patients presented with symptoms consistent with bowel obstruction. There were 44 enteric and 14 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Forty-eight percent of the enteric lesions were malignant and 52% were benign. Forty-three percent of the colonic lesions were malignant and 57% were benign. CONCLUSIONS: Intussusception occurs rarely in adults. It presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. Computed tomography scanning proved to be the most useful diagnostic radiologic method. The diagnosis and treatment of adult intussusception are surgical. Surgical resection of the intussusception without reduction is the preferred treatment in adults, as almost half of both colonic and enteric intussusceptions are associated with malignancy. PMID:9296505

  3. Adult Education in Hungary.

    ERIC Educational Resources Information Center

    Csoma, Gyula; And Others

    Beginning with a brief survey of the national system, this work covers provisions since 1945 for adult education in Hungary. Educational objectives and other theoretical aspects of adult education in Hungarian society are described, together with the eight year elementary program, technical and vocational adult schools, general and professional…

  4. Adult Education in Greece

    ERIC Educational Resources Information Center

    Kokkos, Alexios

    2008-01-01

    The central aim of this article is to analyse the current situation of adult education in Greece. The article focuses on the following points: (a) the degree of participation in programmes of continuing professional training and general adult education courses, (b) the quality and the outcomes of the adult education provision in Greece, and (c)…

  5. Binge Drinking Intensity

    PubMed Central

    Esser, Marissa B.; Kanny, Dafna; Brewer, Robert D.; Naimi, Timothy S.

    2015-01-01

    Background Binge drinking (≥4 drinks for women; ≥5 drinks for men, per occasion) is responsible for more than half of the estimated 80,000 U.S. deaths annually and three-quarters of the $223.5 billion in costs in 2006. Binge drinking prevalence is assessed more commonly than binge drinking intensity (i.e., number of drinks consumed per binge episode). Risk of binge drinking–related harm increases with intensity, and thus it is important to monitor. The largest number of drinks consumed is assessed in health surveys, but its usefulness for assessing binge intensity is unknown. Purpose To assess the agreement between two potential measures of binge drinking intensity: the largest number of drinks consumed by binge drinkers (maximum-drinks) and the total number of drinks consumed during their most recent binge episode (drinks-per-binge). Methods Data were analyzed from 7909 adult binge drinkers from 14 states responding to the 2008 Behavioral Risk Factor Surveillance System (BRFSS) binge drinking module. Mean and median drinks-per-binge from that module were compared to mean and median maximum-drinks. Analyses were conducted in 2010–2011. Results Mean (8.2) and median (5.9) maximum-drinks were strongly correlated with mean (7.4) and median (5.4) drinks-per-binge (r=0.57). These measures were also strongly correlated across most sociodemographic and drinking categories overall and within states. Conclusions The maximum-drinks consumed by binge drinkers is a practical method for assessing binge drinking intensity and thus can be used to plan and evaluate Community Guide–recommended strategies for preventing binge drinking (e.g., increasing the price of alcoholic beverages and regulating alcohol outlet density). PMID:22608381

  6. A General Practice-Based Prevalence Study of Epilepsy among Adults with Intellectual Disabilities and of Its Association with Psychiatric Disorder, Behaviour Disturbance and Carer Stress

    ERIC Educational Resources Information Center

    Matthews, T.; Weston, N.; Baxter, H.; Felce, D.; Kerr, M.

    2008-01-01

    Background: Although the elevated occurrence of epilepsy in people with intellectual disabilities (ID) is well recognized, the nature of seizures and their association with psychopathology and carer strain are less clearly understood. The aims were to determine the prevalence and features of epilepsy in a community-based population of adults with…

  7. Personality and Biography: Proceedings of the Sixth International Conference on the History of Adult Education. Volume I: General, Comparative, and Synthetic Studies.

    ERIC Educational Resources Information Center

    Friedenthal-Haase, Martha, Ed.

    This volume includes the following papers: "Foreword: The Standing International Conference on the History of Adult Education (AE)" (Franz Poeggeler); "Editor's Introduction: Perspectives on the Sixth International Conference on the History of AE" (Martha Friedenthal-Haase); two special addresses by Joerg Prinzhausen and Ursula Giere; "History of…

  8. Effect of the Web-Based Intervention MyPlan 1.0 on Self-Reported Fruit and Vegetable Intake in Adults Who Visit General Practice: A Quasi-Experimental Trial

    PubMed Central

    Crombez, Geert; Van der Mispel, Celien; Verloigne, Maite; Van Stappen, Vicky; De Bourdeaudhuij, Ilse

    2016-01-01

    Background Web-based interventions typically have small intervention effects on adults’ health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention (“MyPlan 1.0”) to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change. Objective The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers. Methods Adults (≥18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers’ intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were

  9. Internal exposure from the ingestion of foods contaminated by 137Cs after the Chernobyl accident. Report 1. General model: ingestion doses and countermeasure effectiveness for the adults of Rovno Oblast of Ukraine.

    PubMed

    Likhtarev, I A; Kovgan, L N; Vavilov, S E; Gluvchinsky, R R; Perevoznikov, O N; Litvinets, L N; Anspaugh, L R; Kercher, J R; Bouville, A

    1996-03-01

    The Chernobyl accident, which occurred in April 1986, resulted in the atmospheric release of about 70--100 PBq of 137Cs. This paper examines the doses to the adult population of the northern part of Rovno Oblast, Ukraine, from ingestion of 137Cs. Fallout of 137Cs in these regions was lower than in other regions of Ukraine. However, the transfer of 137Cs from soil to milk in the region considered is high (up to 20 Bq L-1 per kBq m-2) and results in the predominance of internal doses compared to those from external exposure. Numerous measurements of 137Cs soil deposition, 137Cs milk contamination, and 137Cs body burden have been made in the area and form the basis of a general model of internal exposure from the ingestion of foods contaminated by 137Cs. This paper has two main purposes. The first is to develop the general phenomenological description of the process leading to internal exposure from the ingestion of 137Cs contaminated foods in the situation where different countermeasures are realized. The second is to apply the model for the adult population of the northern part of the Rovno Oblast (first report) for the limited time period of up to six years after the accident. The doses actually received by the adults are estimated to be four to eight times smaller than the doses calculated for the situation without countermeasures.

  10. A non-comparative phase II study of dose intensive chemotherapy with doxorubicin and ifosfamide followed by high dose ICE consolidation with PBSCT in non-resectable, high grade, adult type soft tissue sarcomas.

    PubMed

    Hartmann, Jörg Thomas; Horger, M; Kluba, T; Königsrainer, A; de Zwart, P; von Weyhern, C Hann; Eckert, F; Budach, W; Bokemeyer, C

    2013-12-01

    The objective was to determine the role of dose intensive induction chemotherapy in patients with soft tissue sarcomas (STS) that were considered unresectable. Treatment consisted of 2-3 cycles of doxorubicin (Dox) and ifosfamide (Ifo) followed by high dose chemotherapy with ifosfamide, carboplatin, etoposide (HD-ICE) plus peripheral blood stem cell transplantation (PBSCT). 30 out of 631 consecutive patients, median age 46 years (21-62), with high grade STS were included. 29 patients completed at least 2 cycles of Dox/Ifo. HD-ICE was withheld because of progressive disease (PD) in 5 patients, neurotoxicity in 6 cases, insufficient peripheral blood stem cell (PBSC) mobilization, complete remission (CR) and refusal in 1 patient each. HD-ICE was associated with non-haematological grade III toxicity including emesis, mucositis, fever, neurotoxicity, and transaminase level elevation. Two additional patients attained a partial response after HD-ICE. Overall, 24 of 30 (80%) patients underwent surgery, with complete tumor resections in 19 patients (63% of all patients, 79% of the operated subgroup); however, 2 of these required amputation. After a median follow up period of 50 months in surviving patients (range, 26-120), 5-year PFS and OS rates were 39% and 48%, respectively. Induction chemotherapy plus consolidation HD-ICE is generally feasible, but is associated with significant neurotoxicity. The advantage of HD-ICE over conventional dose chemotherapy plus external beam radiation therapy (EBRT) in non-resectable disease remains unproven.

  11. Adult Books for Young Adults.

    ERIC Educational Resources Information Center

    Carter, Betty

    1997-01-01

    Considers the differences between young adult and adult books and maintains that teachers must be familiar with young adults' tastes for both. Suggests that traffic between these publishing divisions is a two-way street, with young adults reading adult books and adults reading young adult books. (TB)

  12. Treatment Options for Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  13. Stages of Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  14. Treatment Option Overview (Adult Acute Myeloid Leukemia)

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  15. Idaho Habitat/Natural Production Monitoring, Part II: Intensive Monitoring Subproject : Annual Progress Report 1990.

    SciTech Connect

    Kiefer, Russell B.; Forster, Katharine A.

    1992-04-01

    Project 83-7 was established under the Northeast Power Planning Council's 1982 Fish and Wildlife Program, Measure 704 (d) (1) to monitor natural production of anadromous fish, evaluate Bonneville Power Administration habitat improvement project, and develop a credit record for off-site mitigation projects in Idaho. Project 83-7 is divided into two sub-projects: general and intensive monitoring. Results of the intensive monitoring sub-project are reported here. Results from the general monitoring sub-project will be reported in a separate document. The purpose of this intensive monitoring project is to determine the number of returning chinook and steelhead adults necessary to achieve optimal smolt production, and develop mitigation accounting based on increases in smolt production. Two locations are being intensively studied to meet these objectives. Information from this research will be applied to parr monitoring streams statewide to develop escapement objectives and determine success of habitat enhancement projects. Field work began in 1987 in upper Salmon River and Crooked River (South Fork Clearwater River tributary). Methods include using weirs to trap adults, conducting ground and aerial redd counts, snorkeling to estimate parr populations, PIT-tagging juveniles to determine parr-tosmolt survival, trapping fall and spring downstream emigrants with scoop traps, and outplanting adults to determine juvenile carrying capacity. PIT tags also provide a wide range of other information such as migration timing, effects of flow and passage conditions on smolt survival, other factors affecting smolt survival, and growth.

  16. The differences between providing oral health care to HIV-infected children and HIV-infected adults: a general dentist's guide.

    PubMed

    Gonzales, Cara B; Smith, Stacey; Galvan, Alicia; Mabry, Jeffrey

    2010-01-01

    People with HIV and AIDS are living much longer today, thanks to a better understanding of the disease process and the development of effective antiviral drugs and multidrug therapies. Consequently, HIV is now considered a chronic disease, one that affects nearly 40 million people worldwide. Highly active anti-retroviral therapy (HAART), first instituted in 1996, has led to a dramatic reduction in the number of perinatally infected children; however, in 2004, there were still 640,000 children under the age of 15 living with HIV worldwide.1 This population of patients faces more mature health issues compared to most children their age. For example, rampant dental decay is common among children with HIV and requires advanced treatment planning that needs to be closely coordinated with members of the medical team. Maintaining good oral health in combination with medication compliance leads to sustained overall health in HIV-infected children; however, many of the medications these children take have severe adverse effects on their oral health. Furthermore, these medications may interfere with other medications that are prescribed or administered in connection with oral health care. Lastly, the systemic and oral manifestations of HIV and AIDS are different for children than they are for adults; as a result, the prognosis and treatment options for these manifestations vary, depending on the patient's age. This article will address factors that affect the oral health of HIV-infected children and adults, as well as common oral manifestations of HIV and AIDS. Key differences in treatment planning for HIV-infected children and HIV-infected adults will be outlined.

  17. Helical Tomotherapy vs. Intensity-Modulated Proton Therapy for Whole Pelvis Irradiation in High-Risk Prostate Cancer Patients: Dosimetric, Normal Tissue Complication Probability, and Generalized Equivalent Uniform Dose Analysis

    SciTech Connect

    Widesott, Lamberto; Pierelli, Alessio; Fiorino, Claudio; Lomax, Antony J.; Amichetti, Maurizio; Cozzarini, Cesare; Soukup, Martin; Schneider, Ralf; Hug, Eugen; Di Muzio, Nadia; Calandrino, Riccardo; Schwarz, Marco

    2011-08-01

    Purpose: To compare intensity-modulated proton therapy (IMPT) and helical tomotherapy (HT) treatment plans for high-risk prostate cancer (HRPCa) patients. Methods and Materials: The plans of 8 patients with HRPCa treated with HT were compared with IMPT plans with two quasilateral fields set up (-100{sup o}; 100{sup o}) and optimized with the Hyperion treatment planning system. Both techniques were optimized to simultaneously deliver 74.2 Gy/Gy relative biologic effectiveness (RBE) in 28 fractions on planning target volumes (PTVs)3-4 (P + proximal seminal vesicles), 65.5 Gy/Gy(RBE) on PTV2 (distal seminal vesicles and rectum/prostate overlapping), and 51.8 Gy/Gy(RBE) to PTV1 (pelvic lymph nodes). Normal tissue calculation probability (NTCP) calculations were performed for the rectum, and generalized equivalent uniform dose (gEUD) was estimated for the bowel cavity, penile bulb and bladder. Results: A slightly better PTV coverage and homogeneity of target dose distribution with IMPT was found: the percentage of PTV volume receiving {>=}95% of the prescribed dose (V{sub 95%}) was on average >97% in HT and >99% in IMPT. The conformity indexes were significantly lower for protons than for photons, and there was a statistically significant reduction of the IMPT dosimetric parameters, up to 50 Gy/Gy(RBE) for the rectum and bowel and 60 Gy/Gy(RBE) for the bladder. The NTCP values for the rectum were higher in HT for all the sets of parameters, but the gain was small and in only a few cases statistically significant. Conclusions: Comparable PTV coverage was observed. Based on NTCP calculation, IMPT is expected to allow a small reduction in rectal toxicity, and a significant dosimetric gain with IMPT, both in medium-dose and in low-dose range in all OARs, was observed.

  18. Recruiting Adult Education Students.

    ERIC Educational Resources Information Center

    Learning Resources Network, Manhattan, KS.

    This document is the first nationwide compilation of successful recruiting techniques for students in adult basic education, literacy, General Educational Development classes, and adult high school degree programs. Information for the publication was gathered from a literature search and other sources, especially "Reaching the Least Educated," a…

  19. General Information about Melanoma

    MedlinePlus

    ... Screening Research Melanoma Treatment (PDQ®)–Patient Version General Information About Melanoma Go to Health Professional Version Key ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  20. Wise Choices: Nutrition and Exercise for Older Adults: A Community-Based Health Promotion Intervention.

    PubMed

    Turk, Melanie T; Elci, Okan U; Resick, Lenore K; Kalarchian, Melissa A

    2016-01-01

    Effective interventions for older adults are needed to address lifestyle behaviors linked to chronic illnesses. We implemented a 12-week group behavioral intervention for 118 racially diverse older adults at 6 community-based senior centers to improve eating and physical activity. Assessments were completed pre- and postintervention, with 85.6% retention. We documented increases in fruit, vegetable, and whole grain intake; pace of walking; number of city blocks walked; daily steps walked; functional mobility; and self-rated general health (P < .05). Findings indicate that a relatively low-intensity lifestyle intervention can effectively be implemented for community-dwelling older adults. Further development of this approach is warranted.

  1. Wise Choices: Nutrition and Exercise for Older Adults: A Community-Based Health Promotion Intervention.

    PubMed

    Turk, Melanie T; Elci, Okan U; Resick, Lenore K; Kalarchian, Melissa A

    2016-01-01

    Effective interventions for older adults are needed to address lifestyle behaviors linked to chronic illnesses. We implemented a 12-week group behavioral intervention for 118 racially diverse older adults at 6 community-based senior centers to improve eating and physical activity. Assessments were completed pre- and postintervention, with 85.6% retention. We documented increases in fruit, vegetable, and whole grain intake; pace of walking; number of city blocks walked; daily steps walked; functional mobility; and self-rated general health (P < .05). Findings indicate that a relatively low-intensity lifestyle intervention can effectively be implemented for community-dwelling older adults. Further development of this approach is warranted. PMID:27536931

  2. Data-Intensive Benchmarking Suite

    2008-11-26

    The Data-Intensive Benchmark Suite is a set of programs written for the study of data-or storage-intensive science and engineering problems, The benchmark sets cover: general graph searching (basic and Hadoop Map/Reduce breadth-first search), genome sequence searching, HTTP request classification (basic and Hadoop Map/Reduce), low-level data communication, and storage device micro-beachmarking

  3. Recruitment for a clinical trial of chronic disease self-management for older adults with multimorbidity: a successful approach within general practice

    PubMed Central

    2013-01-01

    Background A robust research base is required in General Practice. The research output for General Practice is much less than those of other clinical disciplines. A major impediment to more research in this sector is difficulty with recruitment. Much of the research in this area focuses on barriers to effective recruitment and many projects have great difficulty with this process. This paper seeks to describe a systematic approach to recruitment for a randomized controlled trial that allowed the study team to recruit a substantial number of subjects from General Practice over a brief time period. Methods A systematic approach to recruitment in this setting based on prior literature and the experience of the investigator team was incorporated into the design and implementation of the study. Five strategies were used to facilitate this process. These included designing the study to minimize the impact of the research on the day-to-day operations of the clinics, engagement of general practitioners in the research, making the research attractive to subjects, minimizing attrition and ensuring recruitment was a major focus of the management of the study. Outcomes of the recruitment process were measured as the proportion of practices that agreed to participate, the proportion of potentially eligible subjects who consented to take part in the trial and the attrition rate of subjects. Qualitative interviews with a subset of successfully recruited participants were done to determine why they chose to participate in the study; data were analyzed using thematic analysis. Results Five out of the six general practices contacted agreed to take part in the study. Thirty-eight per cent of the 1663 subjects who received a letter of invitation contacted the university study personnel regarding their interest in the project. Recruitment of the required number of eligible participants (n = 256) was accomplished in seven months. Thematic analysis of interviews with 30 participants

  4. General energetics

    SciTech Connect

    Smil, V.

    1991-01-01

    This book is a comprehensive sourcebook for planetary management and strategies for sustainable development. Coupling biospheric and civilizational aspects, the book features thorough treatments of all critical energy storages, flows, and conversions. Measurements of energy and power densities and intensities are used throughout the book to provide an integrated framework of analysis for all segments of energetics from planetary and bioenergetics to the human energetics of hunting-gathering and agricultural societies through modern industrial civilization. Coverage also examines the environmental and socio-economic implication of the general patterns and trends of modern energy use.

  5. Measurement of Itch Intensity.

    PubMed

    Reich, Adam; Szepietowski, Jacek C

    2016-01-01

    Measurement of itch intensity is essential to properly evaluate pruritic disease severity, to understand the patients' needs and burden, and especially to assess treatment efficacy, particularly in clinical trials. However, measurement of itch remains a challenge, as, per definition, it is a subjective sensation and assessment of this symptom represents significant difficulty. Intensity of itch must be considered in relation to its duration, localization, course of symptoms, presence and type of scratch lesions, response to antipruritic treatment, and quality of life impairment. Importantly, perception of itch may also be confounded by different cofactors including but not limited to patient general condition and other coexisting ailments. In the current chapter we characterize the major methods of itch assessments that are used in daily clinical life and as research tools. Different methods of itch assessment have been developed; however, so far none is without limitations and any data on itch intensity should always be interpreted with caution. Despite these limitations, it is strongly recommended to implement itch measurement tools in routine daily practice, as it would help in proper assessment of patient clinical status. In order to improve evaluation of itch in research studies, it is recommended to use at least two independent methods, as such an approach should increase the validity of achieved results. PMID:27578068

  6. Adult Development. What do Teachers of Adults Need To Know?

    ERIC Educational Resources Information Center

    Whiting, Susan; And Others

    The first part of this two-part paper provides a general review of adult development and is premised on an understanding of andragogy. Andragogy is the art and science of helping adults learn. It is based on the following four assumptions about adults: (1) as people mature they become less dependent and more self-directed; (2) experiences serve as…

  7. The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use.

    PubMed

    Talley, Amelia E; Tomko, Rachel L; Littlefield, Andrew K; Trull, Timothy J; Sher, Kenneth J

    2011-09-01

    Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence. Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance. The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents. The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals.

  8. The mixed amphetamine salt extended release (Adderall XR, Max-XR) as an adjunctive to SSRIS or SNRIS in the treatment of adult ADHD patients with comorbid partially responsive generalized anxiety: an open-label study.

    PubMed

    Gabriel, Adel

    2010-06-01

    To examine the changes in partially responsive anxiety symptoms utilizing adjunctive treatment with the mixed amphetamine salt extended release (Adderall XR, MAX-XR) in the treatment of adult ADHD patients, with comorbid refractory anxiety. Consenting adult patients (n = 32) with confirmed diagnosis of generalized anxiety (GA) and comorbid (ADHD) participated in this open-label study. All patients had significant comorbid anxiety symptoms (HAM-A > 7) and failed to respond to 8-week trials of Serotonin Reuptake Inhibitors (SSRIs) or Norepinephrine Reuptake inhibitors (SNRIs). All patients were treated with the "Mixed Amphetamine salts Extended Release Adderall XR, (MAS-XR), as adjunctive to SSRIs or to SNRIs and were followed for at least 12 weeks. The primary effectiveness measure was the Clinical Global Impression severity subscale (CGI-S). Other scales included the Hamilton Anxiety Scale (HAM-A), the adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist, and Sheehan's disability scale. Baseline measures prior to the treatment with MAS-XR were compared to those at 4, 8, and at 12 weeks of treatment. Monitoring for pulse, blood pressure, and weight changes was carried out at baseline and at end point. All patients completed this open-label trial. There was significant and robust resolution of symptoms of all effectiveness measures, including the symptoms of anxiety, as shown by changes from baseline in HAM-A, ASRS-v1.1, and CGI at 8 weeks. Also there was significant reduction in the disability score at 12 weeks. Patients tolerated the treatment, and there were no significant cardiovascular changes at 12 weeks. There was decrease in mean weight at 12 weeks by 2.2 kg (P < .001). Mixed amphetamine salts MAS-XR can be used in adult patients with ADHD and comorbid anxiety symptoms. Larger controlled studies are needed to support the effectiveness of mixed amphetamine salts in patients with comorbid anxiety symptoms. Treatments need to include the targeting of the

  9. [Management of adult's renal and ureteral stones. Update of the Lithiasis Committee of the French Association of Urology (CLAFU). General considerations].

    PubMed

    Chabannes, É; Bensalah, K; Carpentier, X; Bringer, J-P; Conort, P; Denis, É; Dore, B; Estrade, V; Gautier, J-R; Hadjadj, H; Hubert, J; Hoznek, A; Lechevallier, É; Meria, P; Mozer, P; Saussine, C; Yonneau, L; Traxer, O

    2013-12-01

    The Lithiasis Committee of the French Association of Urology (CLAFU) aimed to update the current knowledge about urolithiasis. This update will be divided into four parts: 1) general considerations; 2) the management of ureteral stones; 3) the management of kidney stones; 4) metabolic assessment and medical treatment of urolithiasis. Recent technicals advances helped the urologists to improve stones management: new extracorporeal shockwave lithotripsy (ESWL) devices, new flexible ureterorenoscopes, development of laser fragmentation. ESWL, semi-rigid and flexible ureteroscopy and the percutaneous nephrolithotomy (PCNL) remain currently the main therapeutic options. The first part of this update deals with the description and classification of stones, preoperative assessment, post-operative management and clinical follow-up. Main criteria of therapeutic choices are stone location, stone composition and stone size. Stone composition is assessed with infrared spectrophotometry analysis and its hardness is correlated with U.H. density on CT scan assessment. Preoperative assessment consists in urinary cytobacteriological examine, urinary PH, blood creatininemia, hemostasis. Low-dose CT scan is recommended before urological treatment. The result of the treatment must be done 1 or 3 months later with plain abdominal film and ultrasonography. Medical management of urolithiasis will be based on stone composition, metabolic and nutritional evaluation. Treatment success is definited by absence of residual fragments. Annual follow-up is recommended and based either on plain abdominal film and ultrasonography or low-dose CT scan.

  10. Internet-based self-management support for adults with asthma: a qualitative study among patients, general practitioners and practice nurses on barriers to implementation

    PubMed Central

    van Gaalen, Johanna L; van Bodegom-Vos, Leti; Bakker, Moira J; Snoeck-Stroband, Jiska B; Sont, Jacob K

    2016-01-01

    Objectives The aim of this study was to explore barriers among patients, general practitioners (GPs) and practice nurses to implement internet-based self-management support as provided by PatientCoach for asthma in primary care. Setting Primary care within South Holland, the Netherlands. Participants Twenty-two patients (12 women, mean age 38 years), 21 GPs (6 women, mean age 52 years) and 13 practice nurses (all women, mean age 41 years). Design A qualitative study using focus groups and interviews. Outcomes Barriers as perceived by patients, GPs and practice nurses to implementation of PatientCoach. Methods 10 focus groups and 12 interviews were held to collect data: 4 patient focus groups, 4 GP focus groups, 2 practice nurse focus group, 2 patient interviews, 5 GP interviews and 5 practice nurse interviews. A prototype of PatientCoach that included modules for coaching, personalised information, asthma self-monitoring, medication treatment plan, feedback, e-consultations and a forum was demonstrated. A semistructured topic guide was used. Directed content analysis was used to analyse data. Reported barriers were classified according to a framework by Grol and Wensing. Results A variety of barriers emerged among all participant groups. Barriers identified among patients include a lack of a patient–professional partnership in using PatientCoach and a lack of perceived benefit in improving asthma symptoms. Barriers identified among GPs include a low sense of urgency towards asthma care and current work routines. Practice nurses identified a low level of structured asthma care and a lack of support by colleagues as barriers. Among all participant groups, insufficient ease of use of PatientCoach, lack of financial arrangements and patient characteristics such as a lack of asthma symptoms were reported as barriers. Conclusions We identified a variety of barriers to implementation of PatientCoach. An effective implementation strategy for internet-based self

  11. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults

    PubMed Central

    Kim, Hee-jae; Park, Ilhyoek; Lee, Hyo joo; Lee, On

    2016-01-01

    [Purpose] Gait speed is an important objective values associated with several health-related outcomes including functional mobility in aging people. However, walking test methodologies and descriptions are not standardized considering specific aims of research. This study examine the reliability and validity of gait speed measured at various distances and paces in elderly Koreans. [Methods] Fifty-four female participants ≥70 years of age were recruited from a local retirement community. Gait speed was assessed at 4, 6 and 10 meters, and at usual- and fast-pace walking mode. The short physical performance battery (SPPB) that estimates senior fitness includes three tests of lower-body function. Data concerning for the chronic conditions and self-perceived health of the participants was collected using questionnaires. Concurrent validity of gait speed using the aforementioned test protocols was determined by calculating the Pearson correlation coefficients. [Results] Significant positive correlations were evident between skeletal muscle mass and maximal pace walking regardless of distance (r=.301~.308; p<.05), but not with body fat. All gait tests significantly positively correlated with self-rated health (normal pace r=.328~.346, p<.05; maximal pace r=.427~.472, p<.001) and depression (normal pace r=.279~.430, p<.05; maximal pace r=.413~.456, p<.001). [Conclusion] Walking test at the normal pace appears suitable for estimating physical function and deterioration due to chronic disease. Walking test at a maximum pace might be useful for estimating subjective general health and skeletal muscle mass. PMID:27757387

  12. Prevalence of acute post-operative pain in patients in adult age-group undergoing inpatient abdominal surgery and correlation of intensity of pain and satisfaction with analgesic management: A cross-sectional single institute-based study

    PubMed Central

    Singh, Prashant Kumar; Saikia, Priyam; Lahakar, Mangala

    2016-01-01

    Background and Aims: Considering the paucity of regional data, this study was designed to investigate the prevalence of post-operative pain and determine if there exists any correlation between the intensity of post-operative pain and patient's level of satisfaction with their pain management after inpatient abdominal surgery at an academic tertiary care government centre. Methods: Pain intensity was measured in 120 patients with numeric rating scale at the fifth post-operative hour, second and third post-operative day. A questionnaire was used to measure the level of satisfaction with nurse's and doctor's response to their pain and overall pain management. Results: The prevalence of post-operative pain was 84.17%, 92.5% and 96.66% at the fifth post-operative hour, second and third post-operative day, respectively. Less number of patients experienced severe intensity pain on the third post-operative day (P = 0.00046), whereas the number of patients experiencing mild pain increased (P < 0.000) compared to the fifth post-operative hour. The number of patients with complete analgesia decreased on the third post-operative day (P = 0.001 compared to fifth post-operative day). The Spearman correlation coefficient between pain score on the third post-operative day and level of satisfaction with nurse's response, doctor's response to pain and the overall pain management was − 0.0218 (P = 0.8107), 0.1307 (P = 0.1553) and 0.0743 (P = 0.4195), respectively. Conclusion: There is a high prevalence of acute post-operative pain in patients undergoing inpatient abdominal surgery at our institute. There is a weak correlation between the intensity of pain and level of satisfaction with pain management. PMID:27761037

  13. Brainstem Glioma in Adults

    PubMed Central

    Hu, Jethro; Western, Stephen; Kesari, Santosh

    2016-01-01

    Brainstem gliomas are not nearly as common in adults as they are in children. They are likely the final common consequence not of a single disease process but of several. They can be difficult to diagnose, and are challenging to treat. Clinical studies of this diagnosis are few and generally small. Because of these factors, our understanding of the biology of adult brainstem glioma is incomplete. However, the knowledge base is growing and progress is being made. In this article, we review the current state of knowledge for brainstem glioma in adults and identify key areas for which additional information is required. PMID:27556016

  14. Luminous efficiency functions at higher intensities

    NASA Astrophysics Data System (ADS)

    Harrington, Lawrence Kent

    Two psychophysical measurement techniques, flicker photometry and successive heterochromatic brightness matching, were used to measure changes in luminance efficiency functions with increasing levels of light adaptation. Both measurement techniques were performed using the same optical system and the same seven healthy adults as subjects. Measurements were taken at four reference stimulus intensities, 1, 10, 100 and 1000 foot-lamberts. Luminous efficiency was found to depend on both the technique and the reference stimulus intensity with which the measurements were taken. For heterochromatic brightness matching, luminous efficiency increased for longer wavelengths as reference intensity increased. Peak luminous efficiency shifted from approximately 540nm to greater than 600nm with increasing intensity for all seven subjects. Peak luminous efficiency was constant for flicker photometry across all intensities but the function narrowed slightly at 100 foot-lamberts.

  15. Adult Attachment as a Moderator of Treatment Outcome for Generalized Anxiety Disorder: Comparison Between Cognitive–Behavioral Therapy (CBT) Plus Supportive Listening and CBT Plus Interpersonal and Emotional Processing Therapy

    PubMed Central

    Newman, Michelle G.; Castonguay, Louis G.; Jacobson, Nicholas C.; Moore, Ginger A.

    2016-01-01

    Objective To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive–behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Method Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician’s Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Results Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. Conclusions When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. PMID:26052875

  16. 14 CFR 25.1389 - Position light distribution and intensities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Position light distribution and intensities... light distribution and intensities. (a) General. The intensities prescribed in this section must be... normal operating voltage of the airplane. The light distribution and intensity of each position...

  17. 14 CFR 29.1389 - Position light distribution and intensities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Position light distribution and intensities... Position light distribution and intensities. (a) General. The intensities prescribed in this section must... source at the normal operating voltage of the rotorcraft. The light distribution and intensity of...

  18. Adult immunization

    PubMed Central

    Mehta, Bharti; Chawla, Sumit; Kumar Dharma, Vijay; Jindal, Harashish; Bhatt, Bhumika

    2014-01-01

    Vaccination is recommended throughout life to prevent vaccine-preventable diseases and their sequel. The primary focus of vaccination programs has historically been directed to childhood immunizations. For adults, chronic diseases have been the primary focus of preventive and medical health care, though there has been increased emphasis on preventing infectious diseases. Adult vaccination coverage, however, remains low for most of the routinely recommended vaccines. Though adults are less susceptible to fall prey to traditional infectious agents, the probability of exposure to infectious agents has increased manifold owing to globalization and increasing travel opportunities both within and across the countries. Thus, there is an urgent need to address the problem of adult immunization. The adult immunization enterprise is more complex, encompassing a wide variety of vaccines and a very diverse target population. There is no coordinated public health infrastructure to support an adult immunization program as there is for children. Moreover, there is little coordination among adult healthcare providers in terms of vaccine provision. Substantial improvement in adult vaccination is needed to reduce the health consequences of vaccine-preventable diseases among adults. Routine assessment of adult patient vaccination needs, recommendation, and offer of needed vaccines for adults should be incorporated into routine clinical care of adults. PMID:24128707

  19. Fungal microbiota in air-conditioning installed in both adult and neonatal intensive treatment units and their impact in two university hospitals of the central western region, Mato Grosso, Brazil.

    PubMed

    Simões, Sara de Almeida Alves; Leite Júnior, Diniz Pereira; Hahn, Rosane Christine

    2011-08-01

    To evaluate fungal microbiota in air-conditioning units installed in intensive care units in two university hospitals in Cuiaba city, Mato Grosso, central western region of Brazil, 525 solid environmental samples were collected, 285 from Hospital A and 240 from Hospital B. Collections were performed using sterile swabs on air-conditioning unit components: cooling coils, ventilators, and filters. Mycelial fungi identification was achieved by observation of the macroscopic and micromorphological characteristics in different culture mediums (maize meal, oatmeal and potato dextrose agars and malt extract) using the Ridell technique. Eleven genera and 27 distinct species belonging to the hyphomycetes and ascomycetes classes were isolated and identified. The most frequently detected genera in both hospitals were Aspergillus spp, Penicillium spp, and Cladosporium spp. Values for colony-forming units per gram were 64 and 75%, well above the limits recommended by Health Ministry resolution 176/00 at the locations selected for analysis in Hospitals A and B, respectively. In conclusion, evaluation of fungal microbiota in the air-conditioning units indirectly determined that the air quality was compromised in both university hospitals analyzed, which constitutes a risk factor for the acquisition of infection in the intensive care units. PMID:21424438

  20. General Information about Adult Brain Tumors

    MedlinePlus

    ... professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate ...

  1. [MELAS: diagnostic keys and treatment in the Intensive Care Unit].

    PubMed

    Gómez Seijo, A; Castro Orjales, M J; Pastor Benavent, J A

    2008-04-01

    Cerebrovascular accident in young adults is not rare and the most common causes are: cardiac embolism, arterial dissection and migraine. The unknown etiology, in spite of extensive studies, is described in the literature in about one third of patients under 45 years of age. The mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) may occur with symptoms that simulate a stroke. The episodes generally affect the posterior part of the brain and the basic insult mechanisms may be metabolic more than ischemic. We describe the case of an 18-year old patient who was admitted to the Intensive Care Unit due to a sudden picture of blindness. The ophthalmologic study was normal and the neuroimaging studies showed infarction in both occipital lobules. We explain the different clinical features, diagnostic, therapeutic and prognostic methods of the disease.

  2. Young Adults' Implicit and Explicit Attitudes towards the Sexuality of Older Adults.

    PubMed

    Thompson, Ashley E; O'Sullivan, Lucia F; Byers, E Sandra; Shaughnessy, Krystelle

    2014-09-01

    Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults' explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18-24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.

  3. Prior Infections With Seasonal Influenza A/H1N1 Virus Reduced the Illness Severity and Epidemic Intensity of Pandemic H1N1 Influenza in Healthy Adults

    PubMed Central

    Atmar, Robert L.; Franco, Luis M.; Quarles, John M.; Niño, Diane; Wells, Janet M.; Arden, Nancy; Cheung, Sheree; Belmont, John W.

    2012-01-01

    Background. A new influenza A/H1N1 (pH1N1) virus emerged in April 2009, proceeded to spread worldwide, and was designated as an influenza pandemic. A/H1N1 viruses had circulated in 1918–1957 and 1977–2009 and were in the annual vaccine during 1977–2009. Methods. Serum antibody to the pH1N1 and seasonal A/H1N1 viruses was measured in 579 healthy adults at enrollment (fall 2009) and after surveillance for illness (spring 2010). Subjects reporting with moderate to severe acute respiratory illness had illness and virus quantitation for 1 week; evaluations for missed illnesses were conducted over holiday periods and at the spring 2010 visit. Results. After excluding 66 subjects who received pH1N1 vaccine, 513 remained. Seventy-seven had reported with moderate to severe illnesses; 31 were infected with pH1N1 virus, and 30 with a rhinovirus. Determining etiology from clinical findings was not possible, but fever and prominent myalgias favored influenza and prominent rhinorrhea favored rhinovirus. Tests of fall and spring antibody indicated pH1N1 infection of 23% had occurred, with the rate decreasing with increasing anti-pH1N1 antibody; a similar pattern was seen for influenza-associated illness. A reducing frequency of pH1N1 infections was also seen with increasing antibody to the recent seasonal A/H1N1 virus (A/Brisbane/59/07). Preexisting antibody to pH1N1 virus, responses to a single vaccine dose, a low infection-to-illness ratio, and a short duration of illness and virus shedding among those with influenza indicated presence of considerable preexisting immunity to pH1N1 in the population. Conclusions. The 2009 A/H1N1 epidemic among healthy adults was relatively mild, most likely because of immunity from prior infections with A/H1N1 viruses. PMID:22075792

  4. Prevalence and determinants of metabolic syndrome: a cross-sectional survey of general medical outpatient clinics using National Cholesterol Education Program-Adult Treatment Panel III criteria in Botswana

    PubMed Central

    Omech, Bernard; Tshikuka, Jose-Gaby; Mwita, Julius C; Tsima, Billy; Nkomazana, Oathokwa; Amone-P’Olak, Kennedy

    2016-01-01

    Background Low- and middle-income countries, including Botswana, are facing rising prevalence of obesity and obesity-related cardiometabolic complications. Very little information is known about clustering of cardiovascular risk factors in the outpatient setting during routine visits. We aimed to assess the prevalence and identify the determinants of metabolic syndrome among the general outpatients’ attendances in Botswana. Methods A cross-sectional study was conducted from August to October 2014 involving outpatients aged ≥20 years without diagnosis of diabetes mellitus. A precoded questionnaire was used to collect data on participants’ sociodemographics, risk factors, and anthropometric indices. Fasting blood samples were drawn and analyzed for glucose and lipid profile. Metabolic syndrome was assessed using National Cholesterol Education Program-Adult Treatment Panel III criteria. Results In total, 291 participants were analyzed, of whom 216 (74.2%) were females. The mean age of the total population was 50.1 (±11) years. The overall prevalence of metabolic syndrome was 27.1% (n=79), with no significant difference between the sexes (female =29.6%, males =20%, P=0.11). A triad of central obesity, low high-density lipoprotein-cholesterol, and elevated blood pressure constituted the largest proportion (38 [13.1%]) of cases of metabolic syndrome, followed by a combination of low high-density lipoprotein, elevated triglycerides, central obesity, and elevated blood pressure, with 17 (5.8%) cases. Independent determinants of metabolic syndrome were antihypertensive use and increased waist circumference. Conclusion Metabolic syndrome is highly prevalent in the general medical outpatients clinics. Proactive approaches are needed to screen and manage cases targeting its most important predictors.

  5. Prevalence and determinants of metabolic syndrome: a cross-sectional survey of general medical outpatient clinics using National Cholesterol Education Program-Adult Treatment Panel III criteria in Botswana

    PubMed Central

    Omech, Bernard; Tshikuka, Jose-Gaby; Mwita, Julius C; Tsima, Billy; Nkomazana, Oathokwa; Amone-P’Olak, Kennedy

    2016-01-01

    Background Low- and middle-income countries, including Botswana, are facing rising prevalence of obesity and obesity-related cardiometabolic complications. Very little information is known about clustering of cardiovascular risk factors in the outpatient setting during routine visits. We aimed to assess the prevalence and identify the determinants of metabolic syndrome among the general outpatients’ attendances in Botswana. Methods A cross-sectional study was conducted from August to October 2014 involving outpatients aged ≥20 years without diagnosis of diabetes mellitus. A precoded questionnaire was used to collect data on participants’ sociodemographics, risk factors, and anthropometric indices. Fasting blood samples were drawn and analyzed for glucose and lipid profile. Metabolic syndrome was assessed using National Cholesterol Education Program-Adult Treatment Panel III criteria. Results In total, 291 participants were analyzed, of whom 216 (74.2%) were females. The mean age of the total population was 50.1 (±11) years. The overall prevalence of metabolic syndrome was 27.1% (n=79), with no significant difference between the sexes (female =29.6%, males =20%, P=0.11). A triad of central obesity, low high-density lipoprotein-cholesterol, and elevated blood pressure constituted the largest proportion (38 [13.1%]) of cases of metabolic syndrome, followed by a combination of low high-density lipoprotein, elevated triglycerides, central obesity, and elevated blood pressure, with 17 (5.8%) cases. Independent determinants of metabolic syndrome were antihypertensive use and increased waist circumference. Conclusion Metabolic syndrome is highly prevalent in the general medical outpatients clinics. Proactive approaches are needed to screen and manage cases targeting its most important predictors. PMID:27616893

  6. [Summary of the Consensus for management of community acquired pneumonia in adults].

    PubMed

    2005-08-01

    This is an update of the Consensus for treatment of community acquired pneumonia in adults, prepared by the Chilean Society of Respiratory Diseases and the Chilean Society of Infectious Diseases. These norms were prepared by thirty specialists in respiratory diseases, internal medicine, infectious diseases, microbiology, intensive medicine and radiology. The purpose of the document is to norm the management of immunocompetent adults with community acquired pneumonia, by the public and private health systems of our country. The complete document will be published in June, in the respective journals of the Societies of Respiratory and Infectious Diseases. This is a summary to obtain a better diffusion of these norms among internists and general practitioners.

  7. Hazards from High Intensity Lamps and Arcs

    NASA Technical Reports Server (NTRS)

    Sliney, D. H.

    1970-01-01

    The principal occupational health problem generally associated with high intensity arc lamps results from exposure of the eye and skin to ultraviolet radiation. Occasionally, the chorioretinal burns are of concern. The eye is generally more susceptible than the skin to injury from high intensity optical radiation sources whether ultraviolet, visible or infrared. Recent developments in technology have shown that some high intensity optical radiation sources which have output parameters greatly different from those encountered in the natural environment present a serious chorioretinal burn hazard.

  8. Survey of intensive care of severely head injured patients in the United Kingdom.

    PubMed Central

    Jeevaratnam, D. R.; Menon, D. K.

    1996-01-01

    OBJECTIVES--To study practice in intensive care of patients with severe head injury in neurosurgical referral centres in United Kingdom. DESIGN--Structured telephone interview of senior nursing staff in intensive care unit of adult neurosurgical referral centre. SETTING--39 intensive care units in hospitals that accepted acute head injuries for specialist neurosurgical management, identified from Medical Directory and information from professional bodies. MAIN OUTCOME MEASURES--Details of organisation and administration of intensive care and patterns of monitoring and treatment for patients admitted with severe head injury. RESULTS--Patients were managed in specialist neurosurgical intensive care units in 21 of the centres and in general intensive care units in 18. Their intensive care was coordinated by an anaesthetist in 25 units and by a neurosurgeon in 12. Annual case-load varied between units: 20 received > 100 patients, 12 received 50-100, and seven received 25-49. Monitoring and treatment varied considerably between centres. Invasive arterial pressure monitoring was used routinely in 36 units, but central venous pressure monitoring was routinely used in 24 and intracranial pressure was routinely monitored in only 19. Corticosteroids were used to treat intracranial hypertension in 19 units. Seventeen units routinely aimed for arterial carbon dioxide pressure of 3.3-4.0 kPa, and one unit still used severe hyperventilation to a pressure of < 3.3 kPa. CONCLUSION--The intensive care of patients with acute head injuries varied widely between the centres surveyed. Rationalisation of the intensive care of severe head injury with the production of widely accepted guidelines ought to improve the quality of care. PMID:8616307

  9. Placing Advocacy at the Heart of Adult Education

    ERIC Educational Resources Information Center

    Taylor, Jackie

    2016-01-01

    Adult educators know that adults and families change their lives through adult education. Adult education also positively impacts a host of social and economic issues. Yet this fact is largely unknown or misunderstood by the general public. Resources have become increasingly scarce, while at the same time adult educators are asked to do more with…

  10. The visual discrimination of negative facial expressions by younger and older adults.

    PubMed

    Mienaltowski, Andrew; Johnson, Ellen R; Wittman, Rebecca; Wilson, Anne-Taylor; Sturycz, Cassandra; Norman, J Farley

    2013-04-01

    Previous research has demonstrated that older adults are not as accurate as younger adults at perceiving negative emotions in facial expressions. These studies rely on emotion recognition tasks that involve choosing between many alternatives, creating the possibility that age differences emerge for cognitive rather than perceptual reasons. In the present study, an emotion discrimination task was used to investigate younger and older adults' ability to visually discriminate between negative emotional facial expressions (anger, sadness, fear, and disgust) at low (40%) and high (80%) expressive intensity. Participants completed trials blocked by pairs of emotions. Discrimination ability was quantified from the participants' responses using signal detection measures. In general, the results indicated that older adults had more difficulty discriminating between low intensity expressions of negative emotions than did younger adults. However, younger and older adults did not differ when discriminating between anger and sadness. These findings demonstrate that age differences in visual emotion discrimination emerge when signal detection measures are used but that these differences are not uniform and occur only in specific contexts.

  11. General Information about Pancreatic Cancer

    MedlinePlus

    ... Research Pancreatic Cancer Treatment (PDQ®)–Patient Version General Information About Pancreatic Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  12. General Information about Vaginal Cancer

    MedlinePlus

    ... Research Vaginal Cancer Treatment (PDQ®)–Patient Version General Information About Vaginal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  13. General Information about Gallbladder Cancer

    MedlinePlus

    ... Treatment Gallbladder Cancer Treatment (PDQ®)–Patient Version General Information About Gallbladder Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  14. General Information about Laryngeal Cancer

    MedlinePlus

    ... Research Laryngeal Cancer Treatment (PDQ®)–Patient Version General Information About Laryngeal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  15. General Information about Kaposi Sarcoma

    MedlinePlus

    ... Research Kaposi Sarcoma Treatment (PDQ®)–Patient Version General Information About Kaposi Sarcoma Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  16. General Information about Bladder Cancer

    MedlinePlus

    ... Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  17. General Information About Endometrial Cancer

    MedlinePlus

    ... Research Endometrial Cancer Treatment (PDQ®)–Patient Version General Information About Endometrial Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  18. General Information about Vulvar Cancer

    MedlinePlus

    ... Research Vulvar Cancer Treatment (PDQ®)–Patient Version General Information About Vulvar Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  19. General Information about Thyroid Cancer

    MedlinePlus

    ... Research Thyroid Cancer Treatment (PDQ®)–Patient Version General Information About Thyroid Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  20. General Information about Gastric Cancer

    MedlinePlus

    ... Research Gastric Cancer Treatment (PDQ®)–Patient Version General Information About Gastric Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  1. General Information about Esophageal Cancer

    MedlinePlus

    ... Research Esophageal Cancer Treatment (PDQ®)–Patient Version General Information About Esophageal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  2. General Information About Uterine Sarcoma

    MedlinePlus

    ... Research Uterine Sarcoma Treatment (PDQ®)–Patient Version General Information About Uterine Sarcoma Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  3. General Information about Rectal Cancer

    MedlinePlus

    ... Research Rectal Cancer Treatment (PDQ®)–Patient Version General Information About Rectal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  4. General Information about Penile Cancer

    MedlinePlus

    ... Treatment Penile Cancer Treatment (PDQ®)–Patient Version General Information About Penile Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  5. General Information about Hypopharyngeal Cancer

    MedlinePlus

    ... Research Hypopharyngeal Cancer Treatment (PDQ®)–Patient Version General Information About Hypopharyngeal Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  6. Insulin therapy in the pediatric intensive care unit

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Hyperglycemia is a major risk factor for increased morbidity and mortality in the intensive care unit. Insulin therapy has emerged in adult intensive care units, and several pediatric studies are currently being conducted. This review discusses hyperglycemia and the effects of insulin on metabolic a...

  7. Intensive Versus Non-Intensive Arabic.

    ERIC Educational Resources Information Center

    Hanna, Sami A.

    This paper investigates the difference in achievement among 20 University of Utah students of modern standard Arabic. One group of 11 students followed an intensive eight-week summer course, and a second group of nine students studied the same course during a regular academic year. Also reported on is the correlation between achievement and…

  8. General Dentist

    MedlinePlus

    ... to your desktop! more... What Is a General Dentist? Article Chapters What Is a General Dentist? General ... Reviewed: January 2012 ?xml:namespace> Related Articles: General Dentists FAGD and MAGD: What Do These Awards Mean? ...

  9. Generalized Fibonacci photon sieves

    NASA Astrophysics Data System (ADS)

    Ke, Jie; Zhang, Junyong

    2015-08-01

    We propose a family of zone plates which are produced by the generalized Fibonacci sequences and their axial focusing properties are analyzed in detail. Compared with traditional Fresnel zone plates, the generalized Fibonacci zone plates present two axial foci with equal intensity. Besides, we propose an approach to adjust the axial locations of the two foci by means of different optical path difference, and further give the deterministic ratio of the two focal distances which attributes to their own generalized Fibonacci sequences. The generalized Fibonacci zone plates may allow for new applications in micro and nanophotonics.

  10. Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults.

    PubMed

    Davis, William; Rockway, Susie; Kwasny, Mary

    2009-01-01

    The impact of intensive lipid management, omega-3 fatty acid, and vitamin D3 supplementation on atherosclerotic plaque was assessed through serial computed tomography coronary calcium scoring (CCS). Low-density lipoprotein cholesterol reduction with statin therapy has not been shown to reduce or slow progression of serial CCS in several recent studies, casting doubt on the usefulness of this approach for tracking atherosclerotic progression. In an open-label study, 45 male and female subjects with CCS of > or = 50 without symptoms of heart disease were treated with statin therapy, niacin, and omega-3 fatty acid supplementation to achieve low-density lipoprotein cholesterol and triglycerides < or = 60 mg/dL; high-density lipoprotein > or = 60 mg/dL; and vitamin D3 supplementation to achieve serum levels of > or = 50 ng/mL 25(OH) vitamin D, in addition to diet advice. Lipid profiles of subjects were significantly changed as follows: total cholesterol -24%, low-density lipoprotein -41%; triglycerides -42%, high-density lipoprotein +19%, and mean serum 25(OH) vitamin D levels +83%. After a mean of 18 months, 20 subjects experienced decrease in CCS with mean change of -14.5% (range 0% to -64%); 22 subjects experienced no change or slow annual rate of CCS increase of +12% (range 1%-29%). Only 3 subjects experienced annual CCS progression exceeding 29% (44%-71%). Despite wide variation in response, substantial reduction of CCS was achieved in 44% of subjects and slowed plaque growth in 49% of the subjects applying a broad treatment program. PMID:19092644

  11. Adult outcomes of preterm children.

    PubMed

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

  12. Urinary tract infection - adults

    MedlinePlus

    Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults ... to the hospital if you: Are an older adult Have kidney stones or changes in the anatomy ...

  13. Intensive Care, Intense Conflict: A Balanced Approach.

    PubMed

    Paquette, Erin Talati; Kolaitis, Irini N

    2015-01-01

    Caring for a child in a pediatric intensive care unit is emotionally and physically challenging and often leads to conflict. Skilled mediators may not always be available to aid in conflict resolution. Careproviders at all levels of training are responsible for managing difficult conversations with families and can often prevent escalation of conflict. Bioethics mediators have acknowledged the important contribution of mediation training in improving clinicians' skills in conflict management. Familiarizing careproviders with basic mediation techniques is an important step towards preventing escalation of conflict. While training in effective communication is crucial, a sense of fairness and justice that may only come with the introduction of a skilled, neutral third party is equally important. For intense conflict, we advocate for early recognition, comfort, and preparedness through training of clinicians in de-escalation and optimal communication, along with the use of more formally trained third-party mediators, as required.

  14. Adult Basic Education. State Plan for Fiscal Year 1979.

    ERIC Educational Resources Information Center

    Kansas State Dept. of Education, Topeka.

    This plan seeks generally to improve literacy skills and specifically to aid adults in progressing through three adult performance levels to obtain the general educational development (GED) diploma. The introduction discusses the general growth of adult basic education; a chart depicts that growth in Kansas. The document is then divided into five…

  15. Light intensity compressor

    DOEpatents

    Rushford, Michael C.

    1990-01-01

    In a system for recording images having vastly differing light intensities over the face of the image, a light intensity compressor is provided that utilizes the properties of twisted nematic liquid crystals to compress the image intensity. A photoconductor or photodiode material that is responsive to the wavelength of radiation being recorded is placed adjacent a layer of twisted nematic liquid crystal material. An electric potential applied to a pair of electrodes that are disposed outside of the liquid crystal/photoconductor arrangement to provide an electric field in the vicinity of the liquid crystal material. The electrodes are substantially transparent to the form of radiation being recorded. A pair of crossed polarizers are provided on opposite sides of the liquid crystal. The front polarizer linearly polarizes the light, while the back polarizer cooperates with the front polarizer and the liquid crystal material to compress the intensity of a viewed scene. Light incident upon the intensity compressor activates the photoconductor in proportion to the intensity of the light, thereby varying the field applied to the liquid crystal. The increased field causes the liquid crystal to have less of a twisting effect on the incident linearly polarized light, which will cause an increased percentage of the light to be absorbed by the back polarizer. The intensity of an image may be compressed by forming an image on the light intensity compressor.

  16. Light intensity compressor

    DOEpatents

    Rushford, Michael C.

    1990-02-06

    In a system for recording images having vastly differing light intensities over the face of the image, a light intensity compressor is provided that utilizes the properties of twisted nematic liquid crystals to compress the image intensity. A photoconductor or photodiode material that is responsive to the wavelength of radiation being recorded is placed adjacent a layer of twisted nematic liquid crystal material. An electric potential applied to a pair of electrodes that are disposed outside of the liquid crystal/photoconductor arrangement to provide an electric field in the vicinity of the liquid crystal material. The electrodes are substantially transparent to the form of radiation being recorded. A pair of crossed polarizers are provided on opposite sides of the liquid crystal. The front polarizer linearly polarizes the light, while the back polarizer cooperates with the front polarizer and the liquid crystal material to compress the intensity of a viewed scene. Light incident upon the intensity compressor activates the photoconductor in proportion to the intensity of the light, thereby varying the field applied to the liquid crystal. The increased field causes the liquid crystal to have less of a twisting effect on the incident linearly polarized light, which will cause an increased percentage of the light to be absorbed by the back polarizer. The intensity of an image may be compressed by forming an image on the light intensity compressor.

  17. Physical Criteria for Adult Learning Environments.

    ERIC Educational Resources Information Center

    White, Sally

    The development of learning environments especially for adults has been neglected and research in planning such environments is fragmented and minimal. There is general agreement that facilities for adults should have an aura of adulthood to contribute to an adult's feeling of ease, confidence, and capability; that they should be flexible in room…

  18. Museums: Adult Education as Cultural Politics

    ERIC Educational Resources Information Center

    Borg, Carmel; Mayo, Peter

    2010-01-01

    The sites of adult education practice are multiple, and museums feature regularly among these sites (Chadwick and Stannett, 1995, 2000). This chapter explores the potential of museums as sites for critical "public pedagogy." It foregrounds the role of adult educators as co-interrogators with adult learners of what is generally perceived as…

  19. Teaching Adult Learners: An Assessment, A Resource.

    ERIC Educational Resources Information Center

    Gunn, Susan C.; And Others

    A resource for adult educators, this guide was developed as a teacher aid to be used with "Learning Activities for Adults," a curriculum supplement developed by adult education teachers in Florida that is based on Florida's Minimum Student Performance Standards. This assessment and resource is divided into five general knowledge areas: adult…

  20. Kentucky Competency-Based Adult Education Curriculum.

    ERIC Educational Resources Information Center

    Kentucky Univ., Lexington. Coll. of Education.

    This curriculum was developed to assist adult education teachers (especially in Kentucky) to prepare adults to function in today's society and that of the next century. Materials in the guide go beyond preparing adults to pass the General Educational Development (GED) test to preparing them with life skills. The curriculum includes traditional…

  1. Credit Traps Can Hurt Your Adult Learners.

    ERIC Educational Resources Information Center

    Valentine, Tom, Ed.; Sandlin, Jenny, Ed.

    1996-01-01

    This document, which was written for adult educators in Georgia, offers instructional plans and practical strategies for helping students in adult literacy, adult basic education (ABE), General Educational Development, and English-as-a-second-language (ESL) programs understand the credit traps that can hurt them. The document begins with a…

  2. Training of Adult Educators in Tanzania.

    ERIC Educational Resources Information Center

    Albinson, Folke; Kassam, Yusuf

    The Institute of Adult Education (IAE) of the University of Dar es Salaam has, as its first priority, to provide extensive, as well as intensive, training to teachers and administrators of adult education. The training programs are divided into three categories: the Diploma Course, covering five compulsory subjects; training courses conducted in…

  3. Speaking-Related Dyspnea in Healthy Adults

    ERIC Educational Resources Information Center

    Hoit, Jeannette D.; Lansing, Robert W.; Perona, Kristen E.

    2007-01-01

    Purpose: To reveal the qualities and intensity of speaking-related dyspnea in healthy adults under conditions of high ventilatory drive, in which the behavioral and metabolic control of breathing must compete. Method: Eleven adults read aloud while breathing different levels of inspired carbon dioxide (CO[subscript 2]). After the highest level,…

  4. Planning the acoustic environment of a neonatal intensive care unit.

    PubMed

    Philbin, M Kathleen

    2004-06-01

    This article addresses general principles of designing a quiet neonatal intensive care unit (NICU) and describes basic aspects of room acoustics as these apply to the NICU. Recommended acoustical criteria for walls, background noise, vibration, and reverberation are included as appendices. Crowding in open, multiple-bed NICUs is the major factor in designs that inevitably produce noisy nurseries with limited space for parents. Quiet infant spaces with appropriate sound sources rely on isolation of the infant from facility and operational noise sources (eg, adult work spaces, supply delivery, and travel paths) and extended contact with family members.However, crowding has been an important influence on the clinical practice and social context of neonatology. It allows clinicians to rely on wide visual and auditory access to many patients for monitoring their well-being. It also allows immediate social contact with other adults, both staff and families. Giving up this wide access and relying on other forms of communication in order to provide for increased quiet and privacy for staff, infants, and parents is a challenge for some design teams. Studies of the effects of various nursery designs on infants, parents, clinicians, and the delivery of services are proposed as a means of advancing the field of design.

  5. Effective literacy instruction for adults with specific learning disabilities: implications for adult educators.

    PubMed

    Hock, Michael F

    2012-01-01

    Adults with learning disabilities (LD) attending adult basic education, GED programs, or community colleges are among the lowest performers on measures of literacy. For example, on multiple measures of reading comprehension, adults with LD had a mean reading score at the third grade level, whereas adults without LD read at the fifth grade level. In addition, large numbers of adults perform at the lowest skill levels on quantitative tasks. Clearly, significant instructional challenges exist for adults who struggle with literacy issues, and those challenges can be greater for adults with LD. In this article, the literature on adults with LD is reviewed, and evidenced-based instructional practices that significantly narrow the literacy achievement gap for this population are identified. Primary attention is given to instructional factors that have been shown to affect literacy outcomes for adults with LD. These factors include the use of explicit instruction, instructional technology, and intensive tutoring in skills and strategies embedded in authentic contexts.

  6. Impact of Work Environments and Occupational Hazards on Smoking Intensity in Korean Workers.

    PubMed

    Kim, Young-Ju

    2016-03-01

    The purpose of this study was to investigate the influence of work environments and occupational hazards on smoking intensity by occupation type in Korean workers. This study used the data from the Fourth Korea National Health and Nutrition Examination Survey in 2009. The sample of this study included 3,769 adults who were aged 18 years or older and had an occupation of office work, sales, or manufacturing. After controlling for sociodemographic characteristics, the generalized linear models revealed that office workers and the sales force who had smoking co-workers at the workplace were more likely to smoke than those who did not. A dirty workplace and exposure to occupational noise were significant factors increasing the smoking intensity for manufacturers. A smoking cessation program considering physical work environments and co-workers' support should be developed for Korean workers. PMID:26681605

  7. Auditory intensity discrimination in blackbirds and pigeons.

    PubMed

    Hienz, R D; Sinnott, J M; Sachs, M B

    1980-12-01

    Redwing blackbirds, brown-headed cowbirds, and pigeons were trained with operant conditioning techniques to respond to small increases in the intensity of pulsed tone trains at three frequencies: .5, 1.0, and 2.0 kHz. All three species produced similar intensity difference limens (DLs) at the frequencies tested. Intensity DLs decreased as sensation level (intensity level above absolute threshold) increased at all three frequencies, with the slopes of these sensation level functions being greatest at 2.0 kHz . The median intensity DLs at 50 dB sensation level were 3.3, 2.7, and 2.9 dB at .5, 1.0, and 2.0 kHz, respectively, averaged over the three species. Some subjects were also required to detect decreases in intensity. They produced intensity DLs two to three times larger than the DLs obtained when these same subjects were required to detect increases in intensity. Avian intensity DLs generally appear to be 1-2 dB higher than the DLs of those mammals that have been tested (rat, cat, monkey, humans).

  8. Intensity Biased PSP Measurement

    NASA Technical Reports Server (NTRS)

    Subramanian, Chelakara S.; Amer, Tahani R.; Oglesby, Donald M.; Burkett, Cecil G., Jr.

    2000-01-01

    The current pressure sensitive paint (PSP) technique assumes a linear relationship (Stern-Volmer Equation) between intensity ratio (I(sub o)/I) and pressure ratio (P/P(sub o)) over a wide range of pressures (vacuum to ambient or higher). Although this may be valid for some PSPs, in most PSPs the relationship is nonlinear, particularly at low pressures (less than 0.2 psia when the oxygen level is low). This non-linearity can be attributed to variations in the oxygen quenching (de-activation) rates (which otherwise is assumed constant) at these pressures. Other studies suggest that some paints also have non-linear calibrations at high pressures; because of heterogeneous (non-uniform) oxygen diffusion and quenching. Moreover, pressure sensitive paints require correction for the output intensity due to light intensity variation, paint coating variation, model dynamics, wind-off reference pressure variation, and temperature sensitivity. Therefore to minimize the measurement uncertainties due to these causes, an insitu intensity correction method was developed. A non-oxygen quenched paint (which provides a constant intensity at all pressures, called non-pressure sensitive paint, NPSP) was used for the reference intensity (I(sub NPSP) with respect to which all the PSP intensities (I) were measured. The results of this study show that in order to fully reap the benefits of this technique, a totally oxygen impermeable NPSP must be available.

  9. Intensity Biased PSP Measurement

    NASA Technical Reports Server (NTRS)

    Subramanian, Chelakara S.; Amer, Tahani R.; Oglesby, Donald M.; Burkett, Cecil G., Jr.

    2000-01-01

    The current pressure sensitive paint (PSP) technique assumes a linear relationship (Stern-Volmer Equation) between intensity ratio (I(sub 0)/I) and pressure ratio (P/P(sub 0)) over a wide range of pressures (vacuum to ambient or higher). Although this may be valid for some PSPs, in most PSPs the relationship is nonlinear, particularly at low pressures (less than 0.2 psia when the oxygen level is low). This non-linearity can be attributed to variations in the oxygen quenching (de-activation) rates (which otherwise is assumed constant) at these pressures. Other studies suggest that some paints also have non-linear calibrations at high pressures; because of heterogeneous (non-uniform) oxygen diffusion and c quenching. Moreover, pressure sensitive paints require correction for the output intensity due to light intensity variation, paint coating variation, model dynamics, wind-off reference pressure variation, and temperature sensitivity. Therefore to minimize the measurement uncertainties due to these causes, an in- situ intensity correction method was developed. A non-oxygen quenched paint (which provides a constant intensity at all pressures, called non-pressure sensitive paint, NPSP) was used for the reference intensity (I(sub NPSP)) with respect to which all the PSP intensities (I) were measured. The results of this study show that in order to fully reap the benefits of this technique, a totally oxygen impermeable NPSP must be available.

  10. Acute Migraine Treatment in Adults.

    PubMed

    Becker, Werner J

    2015-06-01

    There are many options for acute migraine attack treatment, but none is ideal for all patients. This study aims to review current medical office-based acute migraine therapy in adults and provides readers with an organized approach to this important facet of migraine treatment. A general literature review includes a review of several recent published guidelines. Acetaminophen, 4 nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, acetylsalicylic acid [ASA], naproxen sodium, and diclofenac potassium), and 7 triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan) have good evidence for efficacy and form the core of acute migraine treatment. NSAID-triptan combinations, dihydroergotamine, non-opioid combination analgesics (acetaminophen, ASA, and caffeine), and several anti-emetics (metoclopramide, domperidone, and prochlorperazine) are additional evidence-based options. Opioid containing combination analgesics may be helpful in specific patients, but should not be used routinely. Clinical features to be considered when choosing an acute migraine medication include usual headache intensity, usual rapidity of pain intensity increase, nausea, vomiting, degree of disability, patient response to previously used medications, history of headache recurrence with previous attacks, and the presence of contraindications to specific acute medications. Available acute medications can be organized into 4 treatment strategies, including a strategy for attacks of mild to moderate severity (strategy one: acetaminophen and/or NSAIDs), a triptan strategy for patients with severe attacks and for attacks not responding to strategy one, a refractory attack strategy, and a strategy for patients with contraindications to vasoconstricting drugs. Acute treatment of migraine attacks during pregnancy, lactation, and for patients with chronic migraine is also discussed. In chronic migraine, it is particularly important that medication

  11. Adult Seborrheic Dermatitis

    PubMed Central

    2011-01-01

    Seborrheic dermatitis is a common chronic-recurrent inflammatory disorder that most commonly affects adults; however, a more transient infantile form also occurs. The definitive cause of seborrheic dermatitis is unknown. However, proliferation of Malassezia species has been described as a contributing factor. The adult form of seborrheic dermatitis affects up to approximately five percent of the general population. The disorder commonly affects the scalp, face, and periauricular region, with the central chest, axillae, and genital region also involved in some cases. Pruritus is not always present and is relatively common, especially with scalp disease. A variety of treatments are available including topical corticosteroids, topical antifungal agents, topical calcineurin inhibitors, and more recently, a nonsteroidal “device ”cream. This article reviews the practical topical management of seborrheic dermatitis in the United States, focusing on the adult population. PMID:21607192

  12. High Technology and General Education.

    ERIC Educational Resources Information Center

    Owen, H. James

    1984-01-01

    Considers the general education component of technical programs as a means of helping adults adjust to today's industrial changes in processes, machines, and management and thereby to hold jobs, move into new ones, and change careers. Reviews the literature on the general education needs of students in high technology programs and models for…

  13. High intensity neutrino beams

    SciTech Connect

    Ichikawa, A. K.

    2015-07-15

    High-intensity proton accelerator complex enabled long baseline neutrino oscillation experiments with a precisely controlled neutrino beam. The beam power so far achieved is a few hundred kW with enourmorous efforts of accelerator physicists and engineers. However, to fully understand the lepton mixing structure, MW-class accelerators are desired. We describe the current intensity-frontier high-energy proton accelerators, their plans to go beyond and technical challenges in the neutrino beamline facilities.

  14. Young adult outcomes of very-low-birth-weight children.

    PubMed

    Hack, Maureen

    2006-04-01

    Information on the young adult outcomes of the initial survivors of neonatal intensive care has been reported from the United States, Canada, Australia, Great Britain and other European countries. The studies have varied with regard to whether they were regional or hospital-based, their birth-weight group and gestational age, rates of survival, socio-demographic background, and measures of assessment and types of outcome studied. Despite these differences the overall results reveal that neurodevelopment and growth sequelae persist to young adulthood. Very-low-birth-weight young adults have, with few exceptions, poorer educational achievement than normal-birth-weight controls, and fewer continue with post-high-school study. Rates of employment are, however, similar. There are no major differences in general health status, but the young adults demonstrate poorer physical abilities, higher mean blood pressure and poorer respiratory function. There is no evidence of major psychiatric disorder, although anxiety and depression are reported more often. The young adults report less risk-taking than control populations. They report fairly normal social lives and quality of life. When differences are noted they are usually due to neurosensory disabilities. Longer-term studies are needed to evaluate ultimate educational and occupational achievement. It will also be important to assess the effects of preterm birth, early growth failure and catch-up growth on later metabolic and cardiovascular health.

  15. The System of Adult Education in Yugoslavia. Notes and Essays on Education for Adults, 59.

    ERIC Educational Resources Information Center

    Savicevic, Dusan M.

    Now an integral part of the Yugoslav national educational system, adult education in Yugoslavia is based on the principles of permanence, democracy, decentralization, functional unity, diversity and dynamism, and voluntarism. Adult basic, vocational, general, and other forms of adult education are offered in varying degrees and forms by primary…

  16. Differences in Amounts and Types of Physical Activity by Obesity Status in US Adults

    ERIC Educational Resources Information Center

    Spees, Colleen K.; Scott, Jonathan M.; Taylor, Christopher A.

    2012-01-01

    Objectives: To describe the physical activity patterns across levels of obesity among US adults. Methods: The frequency, intensity, and duration of physical activities were compared across obesity status in 7695 adults from NHANES, 1999-2006. Results: Significantly more normal-weight adults engaged in moderate- and vigorous- intensity activities…

  17. Strongly intensive quantities

    SciTech Connect

    Gorenstein, M. I.; Gazdzicki, M.

    2011-07-15

    Analysis of fluctuations of hadron production properties in collisions of relativistic particles profits from use of measurable intensive quantities which are independent of system size variations. The first family of such quantities was proposed in 1992; another is introduced in this paper. Furthermore we present a proof of independence of volume fluctuations for quantities from both families within the framework of the grand canonical ensemble. These quantities are referred to as strongly intensive ones. Influence of conservation laws and resonance decays is also discussed.

  18. Rainfall intensity-duration-frequency formulas.

    USGS Publications Warehouse

    Chen, C.-L.

    1983-01-01

    A new general rainfall intensity-duration-frequency formula is presented, utilizing a method similar to, but more accurate than one previously developed. The previously developed formula was based on the average depth-duration ratio of about 40% and the mean depth-frequency ratio of 1.48. It is shown that this formula is only a particular form of the writer's more general formulation. -from Author

  19. 7 CFR 226.1 - General purpose and scope.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Child and Adult Care Food Program. Section 17 of the National School Lunch Act, as amended, authorizes... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM General § 226.1 General purpose and... service programs for children or adult participants in nonresidential institutions which provide care....

  20. 7 CFR 226.1 - General purpose and scope.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Child and Adult Care Food Program. Section 17 of the National School Lunch Act, as amended, authorizes... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM General § 226.1 General purpose and... service programs for children or adult participants in nonresidential institutions which provide care....

  1. 7 CFR 226.1 - General purpose and scope.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Child and Adult Care Food Program. Section 17 of the National School Lunch Act, as amended, authorizes... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM General § 226.1 General purpose and... service programs for children or adult participants in nonresidential institutions which provide care....

  2. Adult Children.

    ERIC Educational Resources Information Center

    Frazier, Billie H.

    This document contains a brief bibliography of peer-reviewed literature, with abstracts, on adult children. It is one of 12 bibliographies on aging prepared by the National Agricultural Library for its "Pathfinders" series of publications. Topics covered by the other 11 bibliographies include aging parents, dementia and Alzheimer's disease in the…

  3. Adult Psychology.

    ERIC Educational Resources Information Center

    Bischof, Ledford J.

    This volume comprehensively reviews the research on the psychology of the middle aged (ages 40-65). Topics include the concept of maturity and maturation models, the measurement and influences of adult self image; marriage and sexual patterns; intergenerational relationships between and children; vocations and avocations (work, retirement, play,…

  4. Expressive suppression and enhancement during music-elicited emotions in younger and older adults.

    PubMed

    Vieillard, Sandrine; Harm, Jonathan; Bigand, Emmanuel

    2015-01-01

    When presented with emotional visual scenes, older adults have been found to be equally capable to regulate emotion expression as younger adults, corroborating the view that emotion regulation skills are maintained or even improved in later adulthood. However, the possibility that gaze direction might help achieve an emotion control goal has not been taken into account, raising the question whether the effortful processing of expressive regulation is really spared from the general age-related decline. Since it does not allow perceptual attention to be redirected away from the emotional source, music provides a useful way to address this question. In the present study, affective, behavioral, and physiological consequences of free expression of emotion, expressive suppression and expressive enhancement were measured in 31 younger and 30 older adults while they listened to positive and negative musical excerpts. The main results indicated that compared to younger adults, older adults reported experiencing less emotional intensity in response to negative music during the free expression of emotion condition. No age difference was found in the ability to amplify or reduce emotional expressions. However, an age-related decline in the ability to reduce the intensity of emotional state and an age-related increase in physiological reactivity were found when participants were instructed to suppress negative expression. Taken together, the current data support previous findings suggesting an age-related change in response to music. They also corroborate the observation that older adults are as efficient as younger adults at controlling behavioral expression. But most importantly, they suggest that when faced with auditory sources of negative emotion, older age does not always confer a better ability to regulate emotions.

  5. Expressive suppression and enhancement during music-elicited emotions in younger and older adults

    PubMed Central

    Vieillard, Sandrine; Harm, Jonathan; Bigand, Emmanuel

    2015-01-01

    When presented with emotional visual scenes, older adults have been found to be equally capable to regulate emotion expression as younger adults, corroborating the view that emotion regulation skills are maintained or even improved in later adulthood. However, the possibility that gaze direction might help achieve an emotion control goal has not been taken into account, raising the question whether the effortful processing of expressive regulation is really spared from the general age-related decline. Since it does not allow perceptual attention to be redirected away from the emotional source, music provides a useful way to address this question. In the present study, affective, behavioral, and physiological consequences of free expression of emotion, expressive suppression and expressive enhancement were measured in 31 younger and 30 older adults while they listened to positive and negative musical excerpts. The main results indicated that compared to younger adults, older adults reported experiencing less emotional intensity in response to negative music during the free expression of emotion condition. No age difference was found in the ability to amplify or reduce emotional expressions. However, an age-related decline in the ability to reduce the intensity of emotional state and an age-related increase in physiological reactivity were found when participants were instructed to suppress negative expression. Taken together, the current data support previous findings suggesting an age-related change in response to music. They also corroborate the observation that older adults are as efficient as younger adults at controlling behavioral expression. But most importantly, they suggest that when faced with auditory sources of negative emotion, older age does not always confer a better ability to regulate emotions. PMID:25741278

  6. Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment.

    PubMed

    van Uffelen, Jannique G Z; Chinapaw, Marijke J M; Hopman-Rock, Marijke; van Mechelen, Willem

    2009-10-01

    This study examined the feasibility and effect on aerobic fitness of a 1-yr, twice-weekly, group-based moderate-intensity walking program (MI-WP, n = 77) compared with a low-intensity activity program (LI-AP, n = 75) for community-dwelling older adults with mild cognitive impairment (MCI). Thirty participants did not start a program; median attendance in the other 122 participants was 71%. Small but significant associations were observed between attendance and memory in the MI-WP and general cognition in the LI-AP. Associations were no longer significant when both groups were analyzed together. Intensity, assessed using percentage of heart-rate reserve and the Borg scale, equaled intended intensity for both programs. Aerobic fitness improved significantly in participants in the MI-WP. In conclusion, cognition was not clearly associated with attendance in the 62 participants starting the MI-WP, and average attendance was good. The intensity was feasible for participants who continued the MI-WP. The findings support the proposal that regular moderate-intensity walking improves aerobic fitness in adults with MCI.

  7. Rising to the challenge: transforming an adult ICU into an adult and pediatric ICU.

    PubMed

    Comeau, Odette Y; Heffernan, Jamie M; Sheaffer, Jason L; Sayles, Foster M

    2014-01-01

    Published literature on natural disasters describes lessons learned in preparing for disasters, evacuating patients, and caring for patients in the immediate aftermath. Some disasters, however, require longer-term solutions to best meet the health needs of the community during the recovery from the disaster. This article presents an account of one academic medical center's experience in transforming an existing adult burn intensive care unit into an adult and pediatric burn intensive care unit to meet the needs of a community following a hurricane. The process of training 2 groups of specialty nurses and the success of expanding an adult unit are described.

  8. Social Change and Adult Education Research--Adult Education Research in Nordic Countries 1990/91.

    ERIC Educational Resources Information Center

    Linkoping Univ. (Sweden). Dept. of Education and Psychology.

    This yearbook contains papers that provide the reader with a general idea of the aspects and issues that interest Nordic researchers today and how they approach these problems. To provide a more uniform picture of the status of adult education in the different Nordic countries, four brief general surveys begin the book: "Adult Education Research…

  9. ADULT EDUCATION OF MIGRANT ADULTS.

    ERIC Educational Resources Information Center

    BEAL, CATHERINE; AND OTHERS

    UNITS ON MIGRANT ADULT EDUCATION, AND A UNIT ON ORGANIZING INFORMAL GROUPS OF MIGRANT WOMEN TO DISCUSS MAINTAINING AND IMPROVING THEIR TEMPORARY HOMES, ARE PRESENTED. THE GOALS OF THE UNIT ON EDUCATION FOR MIGRANT MEN ARE ECONOMIC INDEPENDENCE, BETTER HEALTH AND WELL-BEING, AND BETTER HANDLING OF RESPONSIBILITIES. THE MAIN DIVISIONS OF THE…

  10. Intense fusion neutron sources

    NASA Astrophysics Data System (ADS)

    Kuteev, B. V.; Goncharov, P. R.; Sergeev, V. Yu.; Khripunov, V. I.

    2010-04-01

    The review describes physical principles underlying efficient production of free neutrons, up-to-date possibilities and prospects of creating fission and fusion neutron sources with intensities of 1015-1021 neutrons/s, and schemes of production and application of neutrons in fusion-fission hybrid systems. The physical processes and parameters of high-temperature plasmas are considered at which optimal conditions for producing the largest number of fusion neutrons in systems with magnetic and inertial plasma confinement are achieved. The proposed plasma methods for neutron production are compared with other methods based on fusion reactions in nonplasma media, fission reactions, spallation, and muon catalysis. At present, intense neutron fluxes are mainly used in nanotechnology, biotechnology, material science, and military and fundamental research. In the near future (10-20 years), it will be possible to apply high-power neutron sources in fusion-fission hybrid systems for producing hydrogen, electric power, and technological heat, as well as for manufacturing synthetic nuclear fuel and closing the nuclear fuel cycle. Neutron sources with intensities approaching 1020 neutrons/s may radically change the structure of power industry and considerably influence the fundamental and applied science and innovation technologies. Along with utilizing the energy produced in fusion reactions, the achievement of such high neutron intensities may stimulate wide application of subcritical fast nuclear reactors controlled by neutron sources. Superpower neutron sources will allow one to solve many problems of neutron diagnostics, monitor nano-and biological objects, and carry out radiation testing and modification of volumetric properties of materials at the industrial level. Such sources will considerably (up to 100 times) improve the accuracy of neutron physics experiments and will provide a better understanding of the structure of matter, including that of the neutron itself.

  11. NEUTRON FLUX INTENSITY DETECTION

    DOEpatents

    Russell, J.T.

    1964-04-21

    A method of measuring the instantaneous intensity of neutron flux in the core of a nuclear reactor is described. A target gas capable of being transmuted by neutron bombardment to a product having a resonance absorption line nt a particular microwave frequency is passed through the core of the reactor. Frequency-modulated microwave energy is passed through the target gas and the attenuation of the energy due to the formation of the transmuted product is measured. (AEC)

  12. Intense ion beam generator

    DOEpatents

    Humphries, Jr., Stanley; Sudan, Ravindra N.

    1977-08-30

    Methods and apparatus for producing intense megavolt ion beams are disclosed. In one embodiment, a reflex triode-type pulsed ion accelerator is described which produces ion pulses of more than 5 kiloamperes current with a peak energy of 3 MeV. In other embodiments, the device is constructed so as to focus the beam of ions for high concentration and ease of extraction, and magnetic insulation is provided to increase the efficiency of operation.

  13. Water intensity of transportation.

    PubMed

    King, Carey W; Webber, Michael E

    2008-11-01

    As the need for alternative transportation fuels increases, it is important to understand the many effects of introducing fuels based upon feedstocks other than petroleum. Water intensity in "gallons of water per mile traveled" is one method to measure these effects on the consumer level. In this paper we investigate the water intensity for light duty vehicle (LDV) travel using selected fuels based upon petroleum, natural gas, unconventional fossil fuels, hydrogen, electricity, and two biofuels (ethanol from corn and biodiesel from soy). Fuels more directly derived from fossil fuels are less water intensive than those derived either indirectly from fossil fuels (e.g., through electricity generation) or directly from biomass. The lowest water consumptive (<0.15 gal H20/mile) and withdrawal (<1 gal H2O/mile) rates are for LDVs using conventional petroleum-based gasoline and diesel, nonirrigated biofuels, hydrogen derived from methane or electrolysis via nonthermal renewable electricity, and electricity derived from nonthermal renewable sources. LDVs running on electricity and hydrogen derived from the aggregate U.S. grid (heavily based upon fossil fuel and nuclear steam-electric power generation) withdraw 5-20 times and consume nearly 2-5 times more water than by using petroleum gasoline. The water intensities (gal H20/mile) of LDVs operating on biofuels derived from crops irrigated in the United States at average rates is 28 and 36 for corn ethanol (E85) for consumption and withdrawal, respectively. For soy-derived biodiesel the average consumption and withdrawal rates are 8 and 10 gal H2O/mile. PMID:19031873

  14. [Adult twins].

    PubMed

    Charlemaine, Christiane

    2006-12-31

    This paper explores the deep roots of closeness that twins share in their youngest age and their effect on their destiny at the adult age. Psychologists believe the bond between twins begins in utero and develops throughout the twins' lives. The four patterns of twinship described show that the twin bond is determined by the quality of parenting that twins receive in their infancy and early childhood. Common problems of adult twins bring about difficulties to adapt in a non-twin world. The nature versus nurture controversy has taken on new life focusing on inter-twin differences and the importance of parent-child interaction as fundamental to the growth and development of personality. PMID:17352324

  15. Adult Stem and Progenitor Cells

    NASA Astrophysics Data System (ADS)

    Geraerts, Martine; Verfaillie, Catherine M.

    The discovery of adult stem cells in most adult tissues is the basis of a number of clinical studies that are carried out, with therapeutic use of hematopoietic stem cells as a prime example. Intense scientific debate is still ongoing as to whether adult stem cells may have a greater plasticity than previously thought. Although cells with some features of embryonic stem cells that, among others, express Oct4, Nanog and SSEA1 are isolated from fresh tissue, it is not clear if the greater differentiation potential is acquired during cell culture. Moreover, adult more pluripotent cells do not have all pluripotent characteristics typical for embryonic stem cells. Recently, some elegant studies were published in which adult cells could be completely reprogrammed to embryonic stem cell-like cells by overexpression of some key transcription factors for pluripotency (Oct4, Sox2, Klf4 and c-Myc). It will be interesting for the future to investigate the exact mechanisms underlying this reprogramming and whether similar transcription factor pathways are present and/or can be activated in adult more pluripotent stem cells.

  16. Obstructive sleep apnea - adults

    MedlinePlus

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  17. Generalization of Fear to Respiratory Sensations.

    PubMed

    Schroijen, Mathias; Pappens, Meike; Schruers, Koen; Van den Bergh, Omer; Vervliet, Bram; Van Diest, Ilse

    2015-09-01

    Interoceptive fear conditioning (IFC), fear generalization and a lack of safety learning have all been hypothesized to play a role in the pathogenesis of panic disorder, but have never been examined in a single paradigm. The present study aims to investigate whether healthy participants (N=43) can learn both fear and safety to an interoceptive sensation, and whether such learning generalizes to other, similar sensations. Two intensities of inspiratory breathing impairment (induced by two pressure threshold loads of 6 and 25 cm H2O) served as interoceptive conditional stimuli (CSs) in a differential conditioning paradigm. An inspiratory occlusion was used as the unconditioned stimulus (US). Generalization was tested 24h after conditioning, using four generalization stimuli with intensities in-between CS+ and CS- (GSs: 8-10.5-14-18.5 cm H2O). Measures included US-expectancy, startle blink EMG responses, electrodermal activity and respiration. Perceptual discrimination of interoceptive CSs and GSs was explored with a discrimination task prior to acquisition and after generalization. Results indicate that differential fear learning was established for US-expectancy ratings. The group with a low intensity CS+ and a high intensity CS- showed the typical pattern of differential fear responding and a similarity-based generalization gradient. In contrast, the high intensity CS+ and low intensity CS- group showed impaired differential learning and complete generalization of fear. Our findings suggest that interoceptive fear learning and generalization are modulated by stimulus intensity and that the occurrence of discriminatory learning is closely related to fear generalization.

  18. Teaching Adults. Third Edition.

    ERIC Educational Resources Information Center

    Rogers, Alan

    The question of how adult educators can make their teaching of adults more effective is explored in the context of recent work on adult lifelong learning. The following are among the topics discussed: (1) modes of adult education and the shift in focus from adult education to lifelong learning; (2) the contract between adult student and adult…

  19. Intensity and directionality of bat echolocation signals.

    PubMed

    Jakobsen, Lasse; Brinkløv, Signe; Surlykke, Annemarie

    2013-01-01

    The paper reviews current knowledge of intensity and directionality of bat echolocation signals. Recent studies have revealed that echolocating bats can be much louder than previously believed. Bats previously dubbed "whispering" can emit calls with source levels up to 110 dB SPL at 10 cm and the louder open space hunting bats have been recorded at above 135 dB SPL. This implies that maximum emitted intensities are generally 30 dB or more above initial estimates. Bats' dynamic control of acoustic features also includes the intensity and directionality of their sonar calls. Aerial hawking bats will increase signal directionality in the field along with intensity thus increasing sonar range. During the last phase of prey pursuit, vespertilionid bats broaden their echolocation beam considerably, probably to counter evasive maneuvers of eared prey. We highlight how multiple call parameters (frequency, duration, intensity, and directionality of echolocation signals) in unison define the search volume probed by bats and in turn how bats perceive their surroundings. Small changes to individual parameters can, in combination, drastically change the bat's perception, facilitating successful navigation and food acquisition across a vast range of ecological niches. To better understand the function of echolocation in the natural habitat it is critical to determine multiple acoustic features of the echolocation calls. The combined (interactive) effects, not only of frequency and time parameters, but also of intensity and directionality, define the bat's view of its acoustic scene.

  20. Intensity and directionality of bat echolocation signals

    PubMed Central

    Jakobsen, Lasse; Brinkløv, Signe; Surlykke, Annemarie

    2013-01-01

    The paper reviews current knowledge of intensity and directionality of bat echolocation signals. Recent studies have revealed that echolocating bats can be much louder than previously believed. Bats previously dubbed “whispering” can emit calls with source levels up to 110 dB SPL at 10 cm and the louder open space hunting bats have been recorded at above 135 dB SPL. This implies that maximum emitted intensities are generally 30 dB or more above initial estimates. Bats' dynamic control of acoustic features also includes the intensity and directionality of their sonar calls. Aerial hawking bats will increase signal directionality in the field along with intensity thus increasing sonar range. During the last phase of prey pursuit, vespertilionid bats broaden their echolocation beam considerably, probably to counter evasive maneuvers of eared prey. We highlight how multiple call parameters (frequency, duration, intensity, and directionality of echolocation signals) in unison define the search volume probed by bats and in turn how bats perceive their surroundings. Small changes to individual parameters can, in combination, drastically change the bat's perception, facilitating successful navigation and food acquisition across a vast range of ecological niches. To better understand the function of echolocation in the natural habitat it is critical to determine multiple acoustic features of the echolocation calls. The combined (interactive) effects, not only of frequency and time parameters, but also of intensity and directionality, define the bat's view of its acoustic scene. PMID:23630501

  1. Evaluation of adult aphasics with the Pediatric Speech Intelligibility test.

    PubMed

    Jerger, S; Oliver, T A; Martin, R C

    1990-04-01

    Results of conventional adult speech audiometry may be compromised by the presence of speech/language disorders, such as aphasia. The purpose of this project was to determine the efficacy of the speech intelligibility materials and techniques developed for young children in evaluating central auditory function in aphasic adults. Eight adult aphasics were evaluated with the Pediatric Speech Intelligibility (PSI) test, a picture-pointing approach that was carefully developed to be relatively insensitive to linguistic-cognitive skills and relatively sensitive to auditory-perceptual function. Results on message-to-competition ratio (MCR) functions or performance-intensity (PI) functions were abnormal in all subjects. Most subjects served as their own controls, showing normal performance on one ear coupled with abnormal performance on the other ear. The patterns of abnormalities were consistent with the patterns seen (1) on conventional speech audiometry in brain-lesioned adults without aphasia and (2) on the PSI test in brain-lesioned children without aphasia. An exception to this general observation was an atypical pattern of abnormality on PI-function testing in the subgroup of nonfluent aphasics. The nonfluent subjects showed substantially poorer word-max scores than sentence-max scores, a pattern seen previously in only one other patient group, namely young children with recurrent otitis media. The unusually depressed word-max abnormality was not meaningfully related to clinical diagnostic data regarding the degree of hearing loss and the location and severity of the lesions or to experimental data regarding the integrity of phonologic processing abilities. The observations of ear-specific and condition-specific abnormalities suggest that the linguistically- and cognitively-simplified PSI test may be useful in the evaluation of auditory-specific deficits in the aphasic adult. PMID:2132591

  2. Responses to Intensity-Shifted Auditory Feedback during Running Speech

    ERIC Educational Resources Information Center

    Patel, Rupal; Reilly, Kevin J.; Archibald, Erin; Cai, Shanqing; Guenther, Frank H.

    2015-01-01

    Purpose: Responses to intensity perturbation during running speech were measured to understand whether prosodic features are controlled in an independent or integrated manner. Method: Nineteen English-speaking healthy adults (age range = 21-41 years) produced 480 sentences in which emphatic stress was placed on either the 1st or 2nd word. One…

  3. The Effect of Vigorous Intensity Acute Exercise on Executive Function

    ERIC Educational Resources Information Center

    Phillips, David Spencer

    2012-01-01

    The effect of physical activity (PA) and consequent influence on cognition within adult seniors has been widely published. However, there is a paucity of causal research relating PA and cognition to schoolchildren within an authentic setting. Also, little is known about the required intensity and dosage of PA to effect executive function (EF)…

  4. Intensity modulated proton therapy.

    PubMed

    Kooy, H M; Grassberger, C

    2015-07-01

    Intensity modulated proton therapy (IMPT) implies the electromagnetic spatial control of well-circumscribed "pencil beams" of protons of variable energy and intensity. Proton pencil beams take advantage of the charged-particle Bragg peak-the characteristic peak of dose at the end of range-combined with the modulation of pencil beam variables to create target-local modulations in dose that achieves the dose objectives. IMPT improves on X-ray intensity modulated beams (intensity modulated radiotherapy or volumetric modulated arc therapy) with dose modulation along the beam axis as well as lateral, in-field, dose modulation. The clinical practice of IMPT further improves the healthy tissue vs target dose differential in comparison with X-rays and thus allows increased target dose with dose reduction elsewhere. In addition, heavy-charged-particle beams allow for the modulation of biological effects, which is of active interest in combination with dose "painting" within a target. The clinical utilization of IMPT is actively pursued but technical, physical and clinical questions remain. Technical questions pertain to control processes for manipulating pencil beams from the creation of the proton beam to delivery within the patient within the accuracy requirement. Physical questions pertain to the interplay between the proton penetration and variations between planned and actual patient anatomical representation and the intrinsic uncertainty in tissue stopping powers (the measure of energy loss per unit distance). Clinical questions remain concerning the impact and management of the technical and physical questions within the context of the daily treatment delivery, the clinical benefit of IMPT and the biological response differential compared with X-rays against which clinical benefit will be judged. It is expected that IMPT will replace other modes of proton field delivery. Proton radiotherapy, since its first practice 50 years ago, always required the highest level of

  5. High intensity ultrasound.

    PubMed

    ter Haar, G

    2001-03-01

    High-intensity focused ultrasound (HIFU) is a technique that was first investigated in the 1940s as a method of destroying selective regions within the brain in neuro-surgical An ultrasound beam can be brought to a tight focus at a distance from its source, and if sufficient energy is concentrated within the focus, the cells lying within this focal volume are killed, whereas those lying elsewhere are spared. This is a noninvasive method of producing selective and trackless tissue destruction in deep seated targets in the body, without damage to overlying tissues. This field, known both as HIFU and focused ultrasound surgery (FUS), is reviewed in this article.

  6. Intensive Care Unit Psychosis

    PubMed Central

    Monks, Richard C.

    1984-01-01

    Patients who become psychotic in intensive care units are usually suffering from delirium. Underlying causes of delirium such as anxiety, sleep deprivation, sensory deprivation and overload, immobilization, an unfamiliar environment and pain, are often preventable or correctable. Early detection, investigation and treatment may prevent significant mortality and morbidity. The patient/physician relationship is one of the keystones of therapy. More severe cases may require psychopharmacological measures. The psychotic episode is quite distressing to the patient and family; an educative and supportive approach by the family physician may be quite helpful in patient rehabilitation. PMID:21279016

  7. Intensity modulated proton therapy

    PubMed Central

    Grassberger, C

    2015-01-01

    Intensity modulated proton therapy (IMPT) implies the electromagnetic spatial control of well-circumscribed “pencil beams” of protons of variable energy and intensity. Proton pencil beams take advantage of the charged-particle Bragg peak—the characteristic peak of dose at the end of range—combined with the modulation of pencil beam variables to create target-local modulations in dose that achieves the dose objectives. IMPT improves on X-ray intensity modulated beams (intensity modulated radiotherapy or volumetric modulated arc therapy) with dose modulation along the beam axis as well as lateral, in-field, dose modulation. The clinical practice of IMPT further improves the healthy tissue vs target dose differential in comparison with X-rays and thus allows increased target dose with dose reduction elsewhere. In addition, heavy-charged-particle beams allow for the modulation of biological effects, which is of active interest in combination with dose “painting” within a target. The clinical utilization of IMPT is actively pursued but technical, physical and clinical questions remain. Technical questions pertain to control processes for manipulating pencil beams from the creation of the proton beam to delivery within the patient within the accuracy requirement. Physical questions pertain to the interplay between the proton penetration and variations between planned and actual patient anatomical representation and the intrinsic uncertainty in tissue stopping powers (the measure of energy loss per unit distance). Clinical questions remain concerning the impact and management of the technical and physical questions within the context of the daily treatment delivery, the clinical benefit of IMPT and the biological response differential compared with X-rays against which clinical benefit will be judged. It is expected that IMPT will replace other modes of proton field delivery. Proton radiotherapy, since its first practice 50 years ago, always required the

  8. Shrub control by browsing: Targeting adult plants

    NASA Astrophysics Data System (ADS)

    da Silveira Pontes, Laíse; Magda, Danièle; Gleizes, Benoît; Agreil, Cyril

    2016-01-01

    Reconciling the well known benefits of shrubs for forage with environmental goals, whilst preventing their dominance, is a major challenge in rangeland management. Browsing may be an economical solution for shrubby rangelands as herbivore browsing has been shown to control juvenile shrub growth. Less convincing results have been obtained for adult plants, and long-term experiments are required to investigate the cumulative effects on adult plants. We therefore assessed the impact of different levels of browsing intensity on key demographic parameters for a major dominant shrub species (broom, Cytisus scoparius), focusing on adult plants. We assigned individual broom plants to one of three age classes: 3-5 years (young adults); 5-7 years (adults); and 7-9 years (mature adults). These plants were then left untouched or had 50% or 90% of their total edible stem biomass removed in simulated low-intensity and high-intensity browsing treatments, respectively. Morphological, survival and fecundity data were collected over a period of four years. Browsing affected the morphology of individual plants, promoting changes in subsequent regrowth, and decreasing seed production. The heavily browsed plants were 17% shorter, 32% narrower, and their twigs were 28% shorter. Light browsing seemed to control the growth of young adult plants more effectively than that of older plants. Reproductive output was considerably lower than for control plants after light browsing, and almost 100% lower after heavy browsing. High-intensity browsing had a major effect on survival causing high levels of plant mortality. We conclude that suitable browsing practices could be used to modify adult shrub demography in the management of shrub dominance and forage value.

  9. [Safety of intensive sweeteners].

    PubMed

    Lugasi, Andrea

    2016-04-01

    Nowadays low calorie or intesive sweeteners are getting more and more popular. These sweeteners can be placed to the market and used as food additives according to the recent EU legislation. In the meantime news are coming out one after the other stating that many of these artificial intensive sweeteners can cause cancer - the highest risk has been attributed to aspartam. Low calorie sweeteners, just like all the other additives can be authorized after strickt risk assessment procedure according to the recent food law. Only after the additive has gone through these procedure can be placed to the list of food additives, which contains not only the range of food these additives can be used, but also the recommended highest amount of daily consumption. European Food Safety Authority considering the latest scientific examination results, evaluates regularly the safety of sweeteners authorized earlier. Until now there is no evidence found to question the safety of the authorized intensive sweeteners. Orv. Hetil., 2016, 157(Suppl. 1), 14-28. PMID:27088715

  10. French intensive truck garden

    SciTech Connect

    Edwards, T D

    1983-01-01

    The French Intensive approach to truck gardening has the potential to provide substantially higher yields and lower per acre costs than do conventional farming techniques. It was the intent of this grant to show that there is the potential to accomplish the gains that the French Intensive method has to offer. It is obvious that locally grown food can greatly reduce transportation energy costs but when there is the consideration of higher efficiencies there will also be energy cost reductions due to lower fertilizer and pesticide useage. As with any farming technique, there is a substantial time interval for complete soil recovery after there have been made substantial soil modifications. There were major crop improvements even though there was such a short time since the soil had been greatly disturbed. It was also the intent of this grant to accomplish two other major objectives: first, the garden was managed under organic techniques which meant that there were no chemical fertilizers or synthetic pesticides to be used. Second, the garden was constructed so that a handicapped person in a wheelchair could manage and have a higher degree of self sufficiency with the garden. As an overall result, I would say that the garden has taken the first step of success and each year should become better.

  11. High intensity proton synchrotrons

    NASA Astrophysics Data System (ADS)

    Craddock, M. K.

    1986-10-01

    Strong initiatives are being pursued in a number of countries for the construction of ``kaon factory'' synchrotrons capable of producing 100 times more intense proton beams than those available now from machines such as the Brookhaven AGS and CERN PS. Such machines would yield equivalent increases in the fluxes of secondary particles (kaons, pions, muons, antiprotons, hyperons and neutrinos of all varieties)—or cleaner beams for a smaller increase in flux—opening new avenues to various fundamental questions in both particle and nuclear physics. Major areas of investigation would be rare decay modes, CP violation, meson and hadron spectroscopy, antinucleon interactions, neutrino scattering and oscillations, and hypernuclear properties. Experience with the pion factories has already shown how high beam intensities make it possible to explore the ``precision frontier'' with results complementary to those achievable at the ``energy frontier''. This paper will describe proposals for upgrading and AGS and for building kaon factories in Canada, Europe, Japan and the United States, emphasizing the novel aspects of accelerator design required to achieve the desired performance (typically 100 μA at 30 GeV).

  12. Rapid onset pressor and sympathetic responses to static handgrip in older hypertensive adults.

    PubMed

    Greaney, J L; Edwards, D G; Fadel, P J; Farquhar, W B

    2015-07-01

    Exaggerated pressor and muscle sympathetic nerve activity (MSNA) responses have been reported during static handgrip in hypertensive (HTN) adults. Recent work suggests that such responses may occur much more rapidly in HTN patients; however, this has not been extensively studied. Thus, we examined the blood pressure (BP) and MSNA responses at the immediate onset of muscle contraction and tested the hypothesis that older HTN adults would exhibit rapid onset pressor and sympathetic responses compared with normotensive (NTN) adults. Heart rate (HR), BP (Finometer) and MSNA (peroneal microneurography) were retrospectively analyzed in 15 HTN (62 ± 1 years; resting BP 153 ± 3/91 ± 5 mm Hg) and 23 age-matched NTN (60 ± 1 years; resting BP 112 ± 1/67 ± 2 mm Hg) subjects during the first 30 s of static handgrip at 30 and 40% of maximal voluntary contraction (MVC). HTN adults demonstrated exaggerated increases in mean BP during the first 10 s of both 30% (NTN: Δ1 ± 1 vs HTN: Δ7 ± 2 mm Hg; P < 0.05) and 40% (NTN: Δ2 ± 1 vs HTN: Δ8 ± 2 mm Hg; P < 0.05) intensity handgrip. Likewise, HTN adults exhibited atypical increases in MSNA within 10 s. Increases in HR were also greater in HTN adults at 10 s of 30% MVC handgrip, although not at 40% MVC. There were no group differences in 10 s pressor or sympathetic responses to a cold pressor test, suggesting no differences in generalized sympathetic responsiveness. Thus, static handgrip evokes rapid onset pressor and sympathetic responses in older HTN adults. These findings suggest that older HTN adults likely have greater cardiovascular risk even during short duration activities of daily living that contain an isometric component. PMID:25471615

  13. Rapid onset pressor and sympathetic responses to static handgrip in older hypertensive adults.

    PubMed

    Greaney, J L; Edwards, D G; Fadel, P J; Farquhar, W B

    2015-07-01

    Exaggerated pressor and muscle sympathetic nerve activity (MSNA) responses have been reported during static handgrip in hypertensive (HTN) adults. Recent work suggests that such responses may occur much more rapidly in HTN patients; however, this has not been extensively studied. Thus, we examined the blood pressure (BP) and MSNA responses at the immediate onset of muscle contraction and tested the hypothesis that older HTN adults would exhibit rapid onset pressor and sympathetic responses compared with normotensive (NTN) adults. Heart rate (HR), BP (Finometer) and MSNA (peroneal microneurography) were retrospectively analyzed in 15 HTN (62 ± 1 years; resting BP 153 ± 3/91 ± 5 mm Hg) and 23 age-matched NTN (60 ± 1 years; resting BP 112 ± 1/67 ± 2 mm Hg) subjects during the first 30 s of static handgrip at 30 and 40% of maximal voluntary contraction (MVC). HTN adults demonstrated exaggerated increases in mean BP during the first 10 s of both 30% (NTN: Δ1 ± 1 vs HTN: Δ7 ± 2 mm Hg; P < 0.05) and 40% (NTN: Δ2 ± 1 vs HTN: Δ8 ± 2 mm Hg; P < 0.05) intensity handgrip. Likewise, HTN adults exhibited atypical increases in MSNA within 10 s. Increases in HR were also greater in HTN adults at 10 s of 30% MVC handgrip, although not at 40% MVC. There were no group differences in 10 s pressor or sympathetic responses to a cold pressor test, suggesting no differences in generalized sympathetic responsiveness. Thus, static handgrip evokes rapid onset pressor and sympathetic responses in older HTN adults. These findings suggest that older HTN adults likely have greater cardiovascular risk even during short duration activities of daily living that contain an isometric component.

  14. Exploring General Education Development Retention

    ERIC Educational Resources Information Center

    Grover, Sharon D.

    2013-01-01

    According to the instructors and administrators at a local adult education (AE) program in Houston, Texas, retaining and graduating general education development (GED) students has been a constant challenge. Locating GED attendance barriers could enable AE programs to develop techniques that increase student retention and graduation rates. The…

  15. Does the Field of EBD Need a Distinct Set of "Intensive" Interventions or More Systemic Intensity within a Continuum of Social/Emotional Supports?

    ERIC Educational Resources Information Center

    Lewis, Timothy J.

    2016-01-01

    The challenges of educating children and youth with intensive social, emotional, and academic needs have been well documented. Students with emotional/ behavioral disorders (EBD) present a range of daily challenges from low intensity, high frequency chronic behaviors such as poor school attendance, disrespect addressed to adults and peers,…

  16. The older adult driver.

    PubMed

    Carr, D B

    2000-01-01

    More adults aged 65 and older will be driving in the next few decades. Many older drivers are safe behind the wheel and do not need intensive testing for license renewal. Others, however, have physiologic or cognitive impairments that can affect their mobility and driving safety. When an older patient's driving competency is questioned, a comprehensive, step-by-step assessment is recommended. Many diseases that impair driving ability can be detected and treated effectively by family physicians. Physicians should take an active role in assessing and reducing the risk for injury in a motor vehicle and, when possible, prevent or delay driving cessation in their patients. Referral to other health care professionals, such as an occupational or physical therapist, may be helpful for evaluation and treatment. When an older patient is no longer permitted or able to drive, the physician should counsel the patient about using alternative methods of transportation. PMID:10643955

  17. 34 CFR 460.1 - What is the purpose of the Adult Education Act?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false What is the purpose of the Adult Education Act? 460.1... VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION-GENERAL PROVISIONS § 460.1 What is the purpose of the Adult Education Act? The purpose of the Adult Education Act (the Act) is to...

  18. 34 CFR 460.1 - What is the purpose of the Adult Education Act?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false What is the purpose of the Adult Education Act? 460.1... VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION-GENERAL PROVISIONS § 460.1 What is the purpose of the Adult Education Act? The purpose of the Adult Education Act (the Act) is to...

  19. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for...

  20. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for...