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Sample records for adverse selection problem

  1. An Ss Model with Adverse Selection.

    ERIC Educational Resources Information Center

    House, Christopher L.; Leahy, John V.

    2004-01-01

    We present a model of the market for a used durable in which agents face fixed costs of adjustment, the magnitude of which depends on the degree of adverse selection in the secondary market. We find that, unlike typical models, the sS bands in our model contract as the variance of the shock increases. We also analyze a dynamic version of the model…

  2. Combating adverse selection in secondary PC markets.

    PubMed

    Hickey, Stewart W; Fitzpatrick, Colin

    2008-04-15

    Adverse selection is a significant contributor to market failure in secondary personal computer (PC) markets. Signaling can act as a potential solution to adverse selection and facilitate superior remarketing of second-hand PCs. Signaling is a means whereby usage information can be utilized to enhance consumer perception of both value and utility of used PCs and, therefore, promote lifetime extension for these systems. This can help mitigate a large portion of the environmental impact associated with PC system manufacture. In this paper, the computer buying and selling behavior of consumers is characterized via a survey of 270 Irish residential users. Results confirm the existence of adverse selection in the Irish market with 76% of potential buyers being unwilling to purchase and 45% of potential vendors being unwilling to sell a used PC. The so-called "closet affect" is also apparent with 78% of users storing their PC after use has ceased. Results also indicate that consumers place a higher emphasis on specifications when considering a second-hand purchase. This contradicts their application needs which are predominantly Internet and word-processing/spreadsheet/presentation applications, 88% and 60% respectively. Finally, a market solution utilizing self monitoring and reporting technology (SMART) sensors for the purpose of real time usage monitoring is proposed, that can change consumer attitudes with regard to second-hand computer equipment.

  3. The Algorithm Selection Problem

    NASA Technical Reports Server (NTRS)

    Minton, Steve; Allen, John; Deiss, Ron (Technical Monitor)

    1994-01-01

    Work on NP-hard problems has shown that many instances of these theoretically computationally difficult problems are quite easy. The field has also shown that choosing the right algorithm for the problem can have a profound effect on the time needed to find a solution. However, to date there has been little work showing how to select the right algorithm for solving any particular problem. The paper refers to this as the algorithm selection problem. It describes some of the aspects that make this problem difficult, as well as proposes a technique for addressing it.

  4. Adverse Selection in Health Insurance Markets: A Classroom Experiment

    ERIC Educational Resources Information Center

    Hodgson, Ashley

    2014-01-01

    Adverse selection as it relates to health care policy will be a key economic issue in many upcoming elections. In this article, the author lays out a 30-minute classroom experiment designed for students to experience the kind of elevated prices and market collapse that can result from adverse selection in health insurance markets. The students…

  5. Adverse childhood experiences and behavioral problems in middle childhood.

    PubMed

    Hunt, Tenah K A; Slack, Kristen S; Berger, Lawrence M

    2016-11-21

    Children who have been exposed to maltreatment and other adverse childhood experiences (ACEs) are at increased risk for various negative adult health outcomes, including cancer, liver disease, substance abuse, and depression. However, the proximal associations between ACEs and behavioral outcomes during the middle childhood years have been understudied. In addition, many of the ACE studies contain methodological limitations such as reliance on retrospective reports and limited generalizability to populations of lower socioeconomic advantage. The current study uses data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort, to prospectively assess the adverse experiences and subsequent behavior problems of over 3000 children. Eight ACE categories to which a child was exposed by age 5 were investigated: childhood abuse (emotional and physical), neglect (emotional and physical), and parental domestic violence, anxiety or depression, substance abuse, or incarceration. Results from bivariate analyses indicated that Black children and children with mothers of low education were particularly likely to have been exposed to multiple ACE categories. Regression analyses showed that exposure to ACEs is strongly associated with externalizing and internalizing behaviors and likelihood of ADHD diagnosis in middle childhood. Variation in these associations by racial/ethnic, gender, and maternal education subgroups are examined. This study provides evidence that children as young as 9 begin to show behavioral problems after exposure to early childhood adversities.

  6. GREECE--SELECTED PROBLEMS.

    ERIC Educational Resources Information Center

    MARTONFFY, ANDREA PONTECORVO; AND OTHERS

    A CURRICULUM GUIDE IS PRESENTED FOR A 10-WEEK STUDY OF ANCIENT GREEK CIVILIZATION AT THE 10TH-GRADE LEVEL. TEACHING MATERIALS FOR THE UNIT INCLUDE (1) PRIMARY AND SECONDARY SOURCES DEALING WITH THE PERIOD FROM THE BRONZE AGE THROUGH THE HELLENISTIC PERIOD, (2) GEOGRAPHY PROBLEMS, AND (3) CULTURAL MODEL PROBLEM EXERCISES. THOSE CONCEPTS WITH WHICH…

  7. [The association between adverse events and nursing care: measurement problems].

    PubMed

    Palese, Alvisa

    2011-01-01

    The association between adverse events and nursing care: measurement problems. Staffing of RNs below target levels has been associated with increased adverse events, included mortality. Some events may be directly associated to lack of surveillance or care, others occur as a result of neglected care and cannot be associated to the shift with levels of nurses below the target. However, a close look to negative events, neglecting positive events provides an incomplete view. Such studies have been criticized because they have not shown a direct link between the level of staffing and individual patient experiences, often did not control for sill mix and did not explore in depth what nurses do and what are their priorities when there is an higher workload. Often these studies present data with mean values ignoring that nurse staffing is not the same across an entire hospital and nursing care is delivered in geographically-based units, with wide variation in staffing levels. A future challenge of research is to combine a descriptive-quantitative approach with the collection of more qualitative data and prospective designs.

  8. Adverse Selection and an Individual Mandate: When Theory Meets Practice*

    PubMed Central

    Hackmann, Martin B.; Kolstad, Jonathan T.; Kowalski, Amanda E.

    2014-01-01

    We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. Using data from Massachusetts, we estimate the parameters of the model. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate. We find an annual welfare gain of 4.1% per person or $51.1 million annually in Massachusetts as a result of the reduction in adverse selection. We also find smaller post-reform markups. PMID:25914412

  9. Postmarketing surveillance of adverse drug reactions: problems and solutions.

    PubMed Central

    Lortie, F M

    1986-01-01

    The surveillance of adverse drug reactions (ADRs) is an unqualified must. However, the optimal means of surveillance is still unclear. Although anecdotal reports are the backbone of an ADR surveillance system, they are not enough. The pharmaceutical industry, academics and regulatory agencies need to expand their efforts in monitoring ADRs. The author discusses the various techniques for counting and evaluating adverse reactions and suggests ways in which the system could be improved. PMID:3719483

  10. Family Adversity in DSM-IV ADHD Combined and Inattentive Subtypes and Associated Disruptive Behavior Problems

    ERIC Educational Resources Information Center

    Counts, Carla A.; Nigg, Joel T.; Stawicki, Julie Ann; Rappley, Marsha D.; von Eye, Alexander

    2005-01-01

    Objective: This study evaluated the relationship between a family adversity index and DSM-IV attention-deficit/hyperactivity disorder (ADHD) subtypes and associated behavior problems. The relationship of family adversity to symptoms and subtypes of ADHD was examined. Method: Parents and 206 children aged 7-13 completed diagnostic interviews and…

  11. SSAIS: A Program to Assess Adverse Impact in Multistage Selection Decisions

    ERIC Educational Resources Information Center

    De Corte, Wilfried

    2004-01-01

    The article describes a Windows program to estimate the expected value and sampling distribution function of the adverse impact ratio for general multistage selections. The results of the program can also be used to predict the risk that a future selection decision will result in an outcome that reflects the presence of adverse impact. The method…

  12. Adverse selection with a multiple choice among health insurance plans: a simulation analysis.

    PubMed

    Marquis, M S

    1992-08-01

    This study uses simulation methods to quantify the effects of adverse selection. The data used to develop the model provide information about whether families can accurately forecast their risk and whether this forecast affects the purchase of insurance coverage--key conditions for adverse selection to matter. The results suggest that adverse selection is sufficient to eliminate high-option benefit plans in multiple choice markets if insurers charge a single, experience-rated premium. Adverse selection is substantially reduced if premiums are varied according to demographic factors. Adverse selection is also restricted in supplementary insurance markets. In this market, supplementary policies are underpriced because a part of the additional benefits that purchasers can expect is a cost to the base plan and is not reflected in the supplementary premium. As a result, full supplementary coverage is attractive to both low and high risks.

  13. Cumulative adversity in early childhood is associated with increased BMI and behavioural problems.

    PubMed

    Crowell, Judith A

    2015-04-01

    Implications for practice and research: Mental health problems and obesity are significant outcomes for children experiencing adversity in early life. Behavioural outcomes and body mass index (BMI) are more consistently reported for children experiencing adversity in early life compared with blood pressure (BP). Incomplete data due to drop out over time and a reliance on parental reporting are challenges for large longitudinal studies; future research directions include balancing and testing such investigations with smaller in-depth studies.

  14. Asymmetric Information in Iranian’s Health Insurance Market: Testing of Adverse Selection and Moral Hazard

    PubMed Central

    Lotfi, Farhad; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Hadian, Mohammad

    2015-01-01

    Background: Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. Objective: This study was aimed to evaluate the status of asymmetric information in Iran’s health insurance market with respect to the demand for outpatient services. Materials/sPatients and Methods: This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household’s budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. Results: The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. Conclusions: Due to the existence of the phenomena of adverse selection and moral hazard

  15. Adverse School Context Moderates the Outcomes of Selective Interventions for Aggressive Children

    ERIC Educational Resources Information Center

    Hughes, Jan N.; Cavell, Timothy A.; Meehan, Barbara T.; Zhang, Duan; Collie, Claire

    2005-01-01

    Drawing on social ecological theory and empirical studies on the role of school context in aggression, the authors argue that school adversity is an important consideration in choosing selective interventions for aggressive children. The moderating role of school adversity on intervention effectiveness is illustrated with data from a randomized…

  16. Selected Problems in Sports Safety.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, and Recreation, Washington, DC.

    This publication, covering a broad spectrum of sports safety problems, is designed as a source of information for those who plan, organize, administer, or evaluate various physical education and recreational activities, athletics, or sports. In the first section, the prevention of sports injury is stressed with attention to different age groups…

  17. Early Adversity, Hypocortisolism, and Behavior Problems at School Entry: A Study of Internationally Adopted Children

    PubMed Central

    Mliner, Shanna B.; Donzella, Bonny; Gunnar, Megan R.

    2016-01-01

    The hypothalamic-pituitary-adrenal (HPA) axis is influenced by early life adversity; however, less is known about the potential for recovery following marked improvements in care. The present study examined longitudinal changes in children’s cortisol reactivity in the laboratory (4 assessments over 2 years) after adoption. Post-institutionalized (N=65) and post-foster care children (N=49) demonstrated blunted reactivity relative to non-adopted peers (N=53). Furthermore, post-institutionalized children exhibited no evidence of expected adaptation to repeated sessions in the 2 years following adoption. As evidenced by blunted cortisol reactivity, flatter diurnal slope, and lower home morning cortisol, we found support for hypocortisolism among children experiencing adverse early care. Hypocortisolism served as a mediator between adversity and teacher-reported attention and externalizing problems during kindergarten. Early adversity appears to contribute to the down-regulation of the HPA axis under both basal and stress conditions. PMID:26773398

  18. Selected Problems in Stellar Evolution

    NASA Astrophysics Data System (ADS)

    Swenson, Fritz James

    Three long standing "problems" for stellar evolution are addressed either directly or indirectly. Weakly interacting massive particles (WIMPs) have been proposed as a solution to the "solar neutrino problem" but numerical instabilities have hampered the analysis of their impact on solar and stellar models. These instabilities are analyzed and resolved. If WIMPs exist and they solve the solar neutrino problem, then they will affect the deduced ages of globular clusters. It is shown that WIMPs can reduce globular cluster age estimates, which are an important factor in constraining cosmological models. The lithium depletion observed in the Sun and stars (particularly in the Hyades cluster) has resisted a satisfactory explanation for roughly 25 years. Two mechanisms for depleting lithium are investigated: lithium dilution through main-sequence mass-loss and lithium burning occurring during PMS evolution. A thorough investigation of the mass-loss mechanism shows that it cannot be responsible for the pattern of lithium depletion seen in the Hyades G- and K-dwarfs, but that it could potentially explain (though in an ad hoc fashion) the depletion seen in open cluster F-dwarfs and in the Sun. It is shown that the PMS lithium burning mechanism does appear to be the explanation of the lithium depletion seen in Hyades G- and K-dwarfs (the very recent OPAL opacities are fundamental to this conclusion), but it apparently cannot completely explain the depletion seen in the Sun (although it is a significant contributor). Extensively investigated is the impact of opacity changes (including OPAL opacities) on solar PMS lithium burning and on the structure of solar models, particularly with regard to the discrepancy between the depth of the convective zone as determined from solar oscillations and that deduced from models. Also included in the thesis is a discussion outlining why observations of lithium depletion in the G- and K-stars of young clusters (ages less than {~}5 times 10

  19. Research Mathematicians' Practices in Selecting Mathematical Problems

    ERIC Educational Resources Information Center

    Misfeldt, Morten; Johansen, Mikkel Willum

    2015-01-01

    Developing abilities to create, inquire into, qualify, and choose among mathematical problems is an important educational goal. In this paper, we elucidate how mathematicians work with mathematical problems in order to understand this mathematical process. More specifically, we investigate how mathematicians select and pose problems and discuss to…

  20. Adversity and Internalizing Problems among Rural Chinese Adolescents: The Roles of Parents and Teachers

    ERIC Educational Resources Information Center

    Davidson, Shannon; Adams, Jennifer

    2013-01-01

    Throughout the developing world, adolescents living in rural poverty face multiple and inter-related adaptive challenges. Using longitudinal data from the Gansu Survey of Children and Families, we adopt an approach grounded in resilience theory to investigate the relationship between cumulative adversity and internalizing problems among 1,659…

  1. Early Childhood Adversities and Trajectories of Psychiatric Problems in Adoptees: Evidence for Long Lasting Effects

    ERIC Educational Resources Information Center

    van der Vegt, Esther J. M.; van der Ende, Jan; Ferdinand, Robert F.; Verhulst, Frank C.; Tiemeier, Henning

    2009-01-01

    The aim of the present study is to investigate whether early childhood adversities determine the longitudinal course of psychiatric problems from childhood to adulthood; in particular if the impact of early maltreatment on psychopathology decreases as time passes. A sample of 1,984 international adoptees was followed (955 males and 1029 females;…

  2. Environmental adversity and children's early trajectories of problem behavior: The role of harsh parental discipline.

    PubMed

    Flouri, Eirini; Midouhas, Emily

    2017-03-01

    This study was performed to examine the role of harsh parental discipline in mediating and moderating the effects of environmental adversity (family socioeconomic disadvantage and adverse life events) on emotional and behavioral problems across early-to-middle childhood. The sample included 16,916 children (48% female; 24% non-White) from the U.K.'s Millennium Cohort Study. We analyzed trajectories of conduct, hyperactivity, and emotional problems, measured at ages 3, 5, and 7 years, using growth curve models. Harsh parental discipline was measured at these ages with parent-reported items on the frequency of using the physical and verbal discipline tactics of smacking, shouting at, and "telling off" the child. As expected, family socioeconomic disadvantage and adverse life events were significantly associated with emotional and behavioral problems. Harsh parental discipline was related to children's trajectories of problems, and it moderated, but did not explain, the effect of environmental risk on these trajectories. High-risk children experiencing harsh parental discipline had the highest levels of conduct problems and hyperactivity across the study period. In addition, harsh parental discipline predicted an increase in emotional symptoms over time in high-risk children, unseen in their counterparts experiencing low levels of harsh parental discipline. However, children in low-risk families were also negatively affected by harsh parental discipline concurrently and over time. In conclusion, harsh parental discipline predicted emotional and behavioral problems in high- and low-risk children and moderated the effects of family poverty and adversity on these problems. (PsycINFO Database Record

  3. An evaluation and selection problems of OSS-LMS packages.

    PubMed

    Abdullateef, Belal Najeh; Elias, Nur Fazidah; Mohamed, Hazura; Zaidan, A A; Zaidan, B B

    2016-01-01

    The evaluation and selection of inappropriate open source software in learning management system (OSS-LMS) packages adversely affect the business processes and functions of an organization. Thus, comprehensive insights into the evaluation and selection of OSS-LMS packages are presented in this paper on the basis of three directions. First, available OSS-LMSs are ascertained from published papers. Second, the criteria for evaluating OSS-LMS packages are specified.according to two aspects: the criteria are identified and established, followed by a crossover between them to highlight the gaps between the evaluation criteria for OSS-LMS packages and the selection problems. Third, the abilities of selection methods that appear fit to solve the problems of OSS-LMS packages based on the multi-criteria evaluation and selection problem are discussed to select the best OSS-LMS packages. Results indicate the following: (1) a list of active OSS-LMS packages; (2) the gaps on the evaluation criteria used for LMS and other problems (consisting of main groups with sub-criteria); (3) use of multi-attribute or multi-criteria decision-making (MADM/MCDM) techniques in the framework of the evaluation and selection of the OSS in education as recommended solutions.

  4. The Risk of Adverse Impact in Selections Based on a Test with Known Effect Size

    ERIC Educational Resources Information Center

    De Corte, Wilfried; Lievens, Filip

    2005-01-01

    The authors derive the exact sampling distribution function of the adverse impact (AI) ratio for single-stage, top-down selections using tests with known effect sizes. Subsequently, it is shown how this distribution function can be used to determine the risk that a future selection decision on the basis of such tests will result in an outcome that…

  5. Fuzzy approaches to supplier selection problem

    NASA Astrophysics Data System (ADS)

    Ozkok, Beyza Ahlatcioglu; Kocken, Hale Gonce

    2013-09-01

    Supplier selection problem is a multi-criteria decision making problem which includes both qualitative and quantitative factors. In the selection process many criteria may conflict with each other, therefore decision-making process becomes complicated. In this study, we handled the supplier selection problem under uncertainty. In this context; we used minimum criterion, arithmetic mean criterion, regret criterion, optimistic criterion, geometric mean and harmonic mean. The membership functions created with the help of the characteristics of used criteria, and we tried to provide consistent supplier selection decisions by using these memberships for evaluating alternative suppliers. During the analysis, no need to use expert opinion is a strong aspect of the methodology used in the decision-making.

  6. Adverse Life Events and Emotional and Behavioral Problems in Adolescence: The Role of Non-Verbal Cognitive Ability and Negative Cognitive Errors

    ERIC Educational Resources Information Center

    Flouri, Eirini; Panourgia, Constantina

    2011-01-01

    The aim of this study was to test whether negative cognitive errors (overgeneralizing, catastrophizing, selective abstraction, and personalizing) mediate the moderator effect of non-verbal cognitive ability on the association between adverse life events (life stress) and emotional and behavioral problems in adolescence. The sample consisted of 430…

  7. A Study for Sensor Selection LQ Problem

    NASA Astrophysics Data System (ADS)

    Kuwahara, Masanori; Kawaji, Shigeyasu

    Although it is recognized that linear control theory has been established mostly, but depending on realistic conditions there remain unsolved control problems. As an example we will discuss the sensor selection LQ problem in this paper. Recent sensor technology makes a process to arrange many low-priced sensors possible. In such case we can expect more effective real-time control by changing sensors properly. This problem will be an essential control problem, but it has not been discussed in the literature. This is because of the combinatorial property of the problem solution. In this paper, we first propose the concept of “the comparability of sensors” and yield a result for the uniqueness of optimal solution. Next, we extend the problem in the case of use of observer and yield a sufficient condition for existence of the unique solution.

  8. Adverse life events and emotional and behavioral problems in adolescence: the role of non-verbal cognitive ability and negative cognitive errors.

    PubMed

    Flouri, Eirini; Panourgia, Constantina

    2011-07-01

    The aim of this study was to test whether negative cognitive errors (overgeneralizing, catastrophizing, selective abstraction, and personalizing) mediate the moderator effect of non-verbal cognitive ability on the association between adverse life events (life stress) and emotional and behavioral problems in adolescence. The sample consisted of 430 children (aged 11-15 years) from three state secondary schools in disadvantaged areas in one county in the South East of England. Total difficulties (i.e., emotional symptoms, peer problems, hyperactivity, and conduct problems) were assessed with the Strengths and Difficulties Questionnaire. Adjustment was made for gender, age, ethnicity, special educational needs, exclusion history, family structure, and family socio-economic disadvantage. Adverse life events were measured with Tiet et al.'s (Journal of the American Academy of Child & Adolescent Psychiatry, 37, 1191-1200, 1998) Adverse Life Events Scale. Non-verbal cognitive ability was measured with Raven's Standard Progressive Matrices Plus. Non-verbal cognitive ability moderated the effect of adverse life events both on total difficulties and on emotional symptoms. Overgeneralizing mediated the moderator effect of non-verbal cognitive ability on the association between adverse life events and total difficulties. Adverse life events were related to a tendency to overgeneralize which was associated with emotional and behavioral problems, but particularly among those adolescents with lower non-verbal cognitive ability.

  9. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis

    PubMed Central

    Trindade, E; Menon, D; Topfer, L A; Coloma, C

    1998-01-01

    BACKGROUND: The use of antidepressant medications and the resulting costs have increased dramatically in recent years, partly because of the introduction of selective serotonin reuptake inhibitors (SSRIs). An assessment of the clinical and economic aspects of SSRIs compared with the older tricyclic antidepressants (TCAs) was initiated to generate information for purchasers of these drugs as well as clinicians. One component of this study was an examination of the adverse effects associated with the use of these drugs. METHODS: Searches of bibliographic databases (for January 1980 through May 1996) and manual scanning of both peer-reviewed publications and other documents were used to identify double-blind, randomized controlled trials involving at least one SSRI and one TCA. For the study of adverse effects, only trials that had at least 20 patients in each trial arm and that reported rates of adverse effects in both arms were retained. In total 84 trials reporting on 18 adverse effects were available. Meta-analyses were undertaken to calculate pooled differences in rates of adverse effects. The question of whether the method of eliciting information from patients about adverse effects made a difference in the findings was also examined. Finally, differences in drop-out rates due to adverse effects were calculated. RESULTS: The crude rates of occurrence of adverse effects ranged from 4% (palpitations) to 26% (nausea) for SSRIs and from 4% (diarrhea) to 27% (dry mouth) for TCAs. The differences in the rates of adverse effects between the 2 types of drugs ranged from 14% more with SSRIs (for nausea) to 11% more with TCAs (for constipation). The results did not depend on the method of eliciting information from patients. There were no statistically significant differences between drug classes in terms of drop-outs due to adverse effects. INTERPRETATION: SSRIs and TCAs are both associated with adverse effects, although the key effects differ between the drug classes

  10. Economic Adversity and Children’s Sleep Problems: Multiple Indicators and Moderation of Effects

    PubMed Central

    El-Sheikh, Mona; Bagley, Erika J.; Keiley, Margaret; Elmore-Staton, Lori; Chen, Edith; Buckhalt, Joseph A.

    2014-01-01

    Objective Toward explicating relations between economic adversity and children’s sleep, we examined associations between multiple indicators of socioeconomic status (SES)/adversity and children’s objectively and subjectively derived sleep parameters; ethnicity was examined as potential moderator. Methods Participants were 276 third- and fourth-grade children and their families (133 girls; M age = 9.44 years; SD = .71): 66% European American (EA) and 34% African American (AA). Four SES indicators were used: income-to-needs ratio, perceived economic well-being, maternal education, and community poverty. Children wore actigraphs for 7 nights and completed a self-report measure to assess sleep problems. Results Objectively and subjectively assessed sleep parameters were related to different SES indicators, and overall worse sleep was evident for children from lower SES homes. Specifically, children from homes with lower income-to-needs ratios had higher levels of reported sleep/wake problems. Parental perceived economic well-being was associated with shorter sleep minutes and greater variability in sleep onset for children. Lower mother’s education was associated with lower sleep efficiency. Children who attended Title 1 schools had shorter sleep minutes. Ethnicity was a significant moderator of effects in the link between some SES indicators and children’s sleep. AA children’s sleep was more negatively affected by income-to-needs ratio and mother’s education than was the sleep of EA children. Conclusions The results advocate for the importance of specifying particular SES and sleep variables used because they may affect the ability to detect associations between sleep and economic adversity. PMID:23148451

  11. Growing up with adversity: From juvenile justice involvement to criminal persistence and psychosocial problems in young adulthood.

    PubMed

    Basto-Pereira, Miguel; Miranda, Ana; Ribeiro, Sofia; Maia, Ângela

    2016-12-01

    Several studies have been carried out to investigate the effect of child maltreatment on juvenile justice involvement and future criminal life. However, little is known about the impact of other forms of adversity, beyond abuse and neglect, on juvenile delinquency and criminal persistence. The effect of early adversity on psychosocial problems is underexplored, particularly in juvenile delinquents. This study, using the Childhood Adverse Experiences (ACE) questionnaire, a tool accessing the exposure to different types of abuse, neglect and serious household dysfunction, explored the role of each adverse experience on juvenile justice involvement, persistence in crime and psychosocial problems during young adulthood. A Portuguese sample of 75 young adults with official records of juvenile delinquency in 2010/2011, and 240 young adults from a community sample completed ACE questionnaire and measures of psychosocial adjustment. Seven out of ten adverse experiences were significantly more prevalent in young adults with juvenile justice involvement than in the community sample, after matching the main demographic variables. The strongest predictor of juvenile justice involvement and criminal persistence during early adulthood was sexual abuse. Dimensions of child/adolescent emotional maltreatment and a mental illness in the household predicted a set of psychosocial problems in young adulthood. This study indicates that early adversity is significantly related to juvenile justice involvement, criminal persistence and psychosocial problems. This study also suggests that each experience has a different role in this process. There is an urgent need to screen, prevent and stop serious adversity. Future scientific directions and recommendations for policies are provided.

  12. Sexually Dimorphic Responses to Early Adversity: Implications for Affective Problems and Autism Spectrum Disorder

    PubMed Central

    Davis, Elysia Poggi; Pfaff, Donald

    2014-01-01

    During gestation, development proceeds at a pace that is unmatched by any other stage of the lifecycle. For these reason the human fetus is particularly susceptible not only to organizing influences, but also to pathogenic disorganizing influences. Growing evidence suggests that exposure to prenatal adversity leads to neurological changes that underlie lifetime risks for mental illness. Beginning early in gestation, males and females show differential developmental trajectories and responses to stress. It is likely that sex-dependent organization of neural circuits during the fetal period influences differential vulnerability to mental health problems. We consider in this review evidence that sexually dimorphic responses to early life stress are linked to two developmental disorders: affective problems (greater female prevalence) and autism spectrum disorder (greater male prevalence). Recent prospective studies illustrating the neurodevelopmental consequences of fetal exposure to stress and stress hormones for males and females are considered here. Plausible biological mechanisms including the role of the sexually differentiated placenta are discussed. We consider in this review evidence that sexually dimorphic responses to early life stress are linked to two sets of developmental disorders: affective problems (greater female prevalence) and autism spectrum disorders (greater male prevalence). PMID:25038479

  13. Solving the Swath Segment Selection Problem

    NASA Technical Reports Server (NTRS)

    Knight, Russell; Smith, Benjamin

    2006-01-01

    Several artificial-intelligence search techniques have been tested as means of solving the swath segment selection problem (SSSP) -- a real-world problem that is not only of interest in its own right, but is also useful as a test bed for search techniques in general. In simplest terms, the SSSP is the problem of scheduling the observation times of an airborne or spaceborne synthetic-aperture radar (SAR) system to effect the maximum coverage of a specified area (denoted the target), given a schedule of downlinks (opportunities for radio transmission of SAR scan data to a ground station), given the limit on the quantity of SAR scan data that can be stored in an onboard memory between downlink opportunities, and given the limit on the achievable downlink data rate. The SSSP is NP complete (short for "nondeterministic polynomial time complete" -- characteristic of a class of intractable problems that can be solved only by use of computers capable of making guesses and then checking the guesses in polynomial time).

  14. In Silico Elucidation of the Molecular Mechanism Defining the Adverse Effect of Selective Estrogen Receptor Modulators

    PubMed Central

    Xie, Lei; Wang, Jian; Bourne, Philip E

    2007-01-01

    Early identification of adverse effect of preclinical and commercial drugs is crucial in developing highly efficient therapeutics, since unexpected adverse drug effects account for one-third of all drug failures in drug development. To correlate protein–drug interactions at the molecule level with their clinical outcomes at the organism level, we have developed an integrated approach to studying protein–ligand interactions on a structural proteome-wide scale by combining protein functional site similarity search, small molecule screening, and protein–ligand binding affinity profile analysis. By applying this methodology, we have elucidated a possible molecular mechanism for the previously observed, but molecularly uncharacterized, side effect of selective estrogen receptor modulators (SERMs). The side effect involves the inhibition of the Sacroplasmic Reticulum Ca2+ ion channel ATPase protein (SERCA) transmembrane domain. The prediction provides molecular insight into reducing the adverse effect of SERMs and is supported by clinical and in vitro observations. The strategy used in this case study is being applied to discover off-targets for other commercially available pharmaceuticals. The process can be included in a drug discovery pipeline in an effort to optimize drug leads and reduce unwanted side effects. PMID:18052534

  15. Do cognitive distortions explain the longitudinal relationship between life adversity and emotional and behavioural problems in secondary school children?

    PubMed

    Panourgia, Constantina; Comoretto, Amanda

    2017-02-15

    Research has shown that children exposed to life adversity are at higher risk of negative developmental outcomes than those enduring lower stress levels. Life adversity can lead, among other things, to emotional and behavioural problems. Several factors have been studied to explain this relationship, with several investigators underlining the role of thought structures such as cognitive distortions, which refer to negatively biased information-processing of external events. This can help explain why some individuals characterised by adverse personal life stories interpret ambiguous events in a negatively biased way. This study was aimed at assessing the mediating role of cognitive distortions in the longitudinal relationship between life adversity and two dimensions of psychopathology, namely, emotional and behavioural problems in 247 secondary school children attending three state secondary schools in one county in the South East of England. An increase in life adversity was associated with an increase in cognitive distortions, which was in turn related to a higher number of symptoms reflecting behavioural issues. In terms of practical applications, an effort to protect children from further exposure to adverse life events could represent a step forward to prevent the development of future behavioural problems in at-risk children.

  16. Characterizing the combinatorial beam angle selection problem

    NASA Astrophysics Data System (ADS)

    Bangert, Mark; Ziegenhein, Peter; Oelfke, Uwe

    2012-10-01

    The beam angle selection (BAS) problem in intensity-modulated radiation therapy is often interpreted as a combinatorial optimization problem, i.e. finding the best combination of η beams in a discrete set of candidate beams. It is well established that the combinatorial BAS problem may be solved efficiently with metaheuristics such as simulated annealing or genetic algorithms. However, the underlying parameters of the optimization process, such as the inclusion of non-coplanar candidate beams, the angular resolution in the space of candidate beams, and the number of evaluated beam ensembles as well as the relative performance of different metaheuristics have not yet been systematically investigated. We study these open questions in a meta-analysis of four strategies for combinatorial optimization in order to provide a reference for future research related to the BAS problem in intensity-modulated radiation therapy treatment planning. We introduce a high-performance inverse planning engine for BAS. It performs a full fluence optimization for ≈3600 treatment plans per hour while handling up to 50 GB of dose influence data (≈1400 candidate beams). For three head and neck patients, we compare the relative performance of a genetic, a cross-entropy, a simulated annealing and a naive iterative algorithm. The selection of ensembles with 5, 7, 9 and 11 beams considering either only coplanar or all feasible candidate beams is studied for an angular resolution of 5°, 10°, 15° and 20° in the space of candidate beams. The impact of different convergence criteria is investigated in comparison to a fixed termination after the evaluation of 10 000 beam ensembles. In total, our simulations comprise a full fluence optimization for about 3000 000 treatment plans. All four combinatorial BAS strategies yield significant improvements of the objective function value and of the corresponding dose distributions compared to standard beam configurations with equi

  17. Cost-sharing, physician utilization, and adverse selection among Medicare beneficiaries with chronic health conditions.

    PubMed

    Hoffman, Geoffrey

    2015-02-01

    Pooled data from the 2007, 2009, and 2011/2012 California Health Interview Surveys were used to compare the number of self-reported annual physician visits among 36,808 Medicare beneficiaries ≥65 in insurance groups with differential cost-sharing. Adjusted for adverse selection and a set of health covariates, Medicare fee-for-service (FFS) only beneficiaries had similar physician utilization compared with HMO enrollees but fewer visits compared with those with supplemental (1.04, p = .001) and Medicaid (1.55, p = .003) coverage. FFS only beneficiaries in very good or excellent health had fewer visits compared with those of similar health status with supplemental (1.30, p = .001) or Medicaid coverage (2.15, p = .002). For subpopulations with several chronic conditions, FFS only beneficiaries also had fewer visits compared with beneficiaries with supplemental or Medicaid coverage. Observed differences in utilization may reflect efficient and necessary physician utilization among those with chronic health needs.

  18. Text mining for the Vaccine Adverse Event Reporting System: medical text classification using informative feature selection

    PubMed Central

    Nguyen, Michael D; Woo, Emily Jane; Markatou, Marianthi; Ball, Robert

    2011-01-01

    Objective The US Vaccine Adverse Event Reporting System (VAERS) collects spontaneous reports of adverse events following vaccination. Medical officers review the reports and often apply standardized case definitions, such as those developed by the Brighton Collaboration. Our objective was to demonstrate a multi-level text mining approach for automated text classification of VAERS reports that could potentially reduce human workload. Design We selected 6034 VAERS reports for H1N1 vaccine that were classified by medical officers as potentially positive (Npos=237) or negative for anaphylaxis. We created a categorized corpus of text files that included the class label and the symptom text field of each report. A validation set of 1100 labeled text files was also used. Text mining techniques were applied to extract three feature sets for important keywords, low- and high-level patterns. A rule-based classifier processed the high-level feature representation, while several machine learning classifiers were trained for the remaining two feature representations. Measurements Classifiers' performance was evaluated by macro-averaging recall, precision, and F-measure, and Friedman's test; misclassification error rate analysis was also performed. Results Rule-based classifier, boosted trees, and weighted support vector machines performed well in terms of macro-recall, however at the expense of a higher mean misclassification error rate. The rule-based classifier performed very well in terms of average sensitivity and specificity (79.05% and 94.80%, respectively). Conclusion Our validated results showed the possibility of developing effective medical text classifiers for VAERS reports by combining text mining with informative feature selection; this strategy has the potential to reduce reviewer workload considerably. PMID:21709163

  19. Environmental Adversity and Children’s Early Trajectories of Problem Behavior: The Role of Harsh Parental Discipline

    PubMed Central

    2016-01-01

    This study was performed to examine the role of harsh parental discipline in mediating and moderating the effects of environmental adversity (family socioeconomic disadvantage and adverse life events) on emotional and behavioral problems across early-to-middle childhood. The sample included 16,916 children (48% female; 24% non-White) from the U.K.’s Millennium Cohort Study. We analyzed trajectories of conduct, hyperactivity, and emotional problems, measured at ages 3, 5, and 7 years, using growth curve models. Harsh parental discipline was measured at these ages with parent-reported items on the frequency of using the physical and verbal discipline tactics of smacking, shouting at, and “telling off” the child. As expected, family socioeconomic disadvantage and adverse life events were significantly associated with emotional and behavioral problems. Harsh parental discipline was related to children’s trajectories of problems, and it moderated, but did not explain, the effect of environmental risk on these trajectories. High-risk children experiencing harsh parental discipline had the highest levels of conduct problems and hyperactivity across the study period. In addition, harsh parental discipline predicted an increase in emotional symptoms over time in high-risk children, unseen in their counterparts experiencing low levels of harsh parental discipline. However, children in low-risk families were also negatively affected by harsh parental discipline concurrently and over time. In conclusion, harsh parental discipline predicted emotional and behavioral problems in high- and low-risk children and moderated the effects of family poverty and adversity on these problems. PMID:27977229

  20. Low concentrations of metal mixture exposures have adverse effects on selected biomarkers of Xenopus laevis tadpoles.

    PubMed

    Yologlu, Ertan; Ozmen, Murat

    2015-11-01

    Polluted ecosystems may contain mixtures of metals, such that the combinations of metals, even in low concentrations, may cause adverse effects. In the present study, we focused on toxic effects of mixtures of selected metals, the LC50 values, and also their safety limit in aquatic systems imposed by the European legislation using a model organism. Xenopus laevis tadpoles were used as test organisms. They were exposed to metals or their combinations due to 96-h LC50 values. Glutathione S-transferase (GST), glutathione reductase (GR), acetylcholinesterase (AChE), carboxylesterase (CaE), glutathione peroxidase (GPx), and catalase (CAT) levels were evaluated. Metallothionein concentrations were also determined. The LC50s for Cd, Pb, and Cu were calculated as 5.81mg AI/L, 123.05mg AI/L, and 0.85mg AI/L, respectively. Low lethality ratios were observed with unary exposure of each metal in lower concentrations. Double or triple combinations of LC50 and LC50/2 concentrations caused 100% lethality with Cd+Cu and Pb+Cd+Cu mixtures, while the Pb+Cu mixture also caused high lethal ratios. The selected enzyme activities were significantly affected by metals or mixtures, and dose-related effects were determined. The metallothionein levels generally increased as related to concentration in unary metals and mixtures. Acceptable limit values of unary metals and mixtures did not significantly change metallothionein levels. The results suggest that oxidative stress-related mechanisms are involved in the toxicity induced by selected metals with combinations of very low concentrations.

  1. Velocity selection problem in the presence of the triple junction.

    PubMed

    Brener, E A; Hüter, C; Pilipenko, D; Temkin, D E

    2007-09-07

    Melting of a bicrystal along the grain boundary is discussed. A triple junction plays a crucial role in the velocity selection problem in this case. In some range of the parameters an entirely analytical solution of this problem is given. This allows us to present a transparent picture of the structure of the selection theory. We also discuss the selection problem in the case of the growth of a "eutectoid dendrite."

  2. Pre-Adoption Adversity, Maternal Stress, and Behavior Problems at School-Age in International Adoptees

    ERIC Educational Resources Information Center

    Gagnon-Oosterwaal, Noemi; Cossette, Louise; Smolla, Nicole; Pomerleau, Andree; Malcuit, Gerard; Chicoine, Jean-Francois; Belhumeur, Celine; Jeliu, Gloria; Begin, Jean; Seguin, Renee

    2012-01-01

    Internationally adopted children present more behavior problems than non-adopted children and are overrepresented in mental health services. These problems are related to children's pre-adoption environment, but adoptive families' functioning and characteristics may also affect the development of behavior problems in adopted children. The aim of…

  3. Juvenile Delinquency. Selected Studies in Social Problems.

    ERIC Educational Resources Information Center

    Korn, Richard R., Ed.

    Excerpts from eight books present material on juvenile delinquency. Included are selections from the following: "Wayward Youth" by August Aichhorn, "The Gang" by Frederic M. Thrasher, "The Jack-Roller" by Clifford R. Shaw, "Street Corner Society" by William Foote Whyte, "Children Who Hate" by Fritz Redl and David Wineman, "The Addict in the…

  4. Poverty-Related Adversity and Emotion Regulation Predict Internalizing Behavior Problems among Low-Income Children Ages 8–11

    PubMed Central

    Raver, C. Cybele; Roy, Amanda L.; Pressler, Emily; Ursache, Alexandra M.; Charles McCoy, Dana

    2016-01-01

    The current study examines the additive and joint roles of chronic poverty-related adversity and three candidate neurocognitive processes of emotion regulation (ER)—including: (i) attention bias to threat (ABT); (ii) accuracy of facial emotion appraisal (FEA); and (iii) negative affect (NA)—for low-income, ethnic minority children’s internalizing problems (N = 338). Children were enrolled in the current study from publicly funded preschools, with poverty-related adversity assessed at multiple time points from early to middle childhood. Field-based administration of neurocognitively-informed assessments of ABT, FEA and NA as well as parental report of internalizing symptoms were collected when children were ages 8–11, 6 years after baseline. Results suggest that chronic exposure to poverty-related adversity from early to middle childhood predicted higher levels of internalizing symptomatology when children are ages 8–11, even after controlling for initial poverty status and early internalizing symptoms in preschool. Moreover, each of the 3 hypothesized components of ER played an independent and statistically significant role in predicting children’s parent-reported internalizing symptoms at the 6-year follow-up, even after controlling for early and chronic poverty-related adversity. PMID:28036091

  5. Poverty-Related Adversity and Emotion Regulation Predict Internalizing Behavior Problems among Low-Income Children Ages 8-11.

    PubMed

    Raver, C Cybele; Roy, Amanda L; Pressler, Emily; Ursache, Alexandra M; Charles McCoy, Dana

    2016-12-29

    The current study examines the additive and joint roles of chronic poverty-related adversity and three candidate neurocognitive processes of emotion regulation (ER)-including: (i) attention bias to threat (ABT); (ii) accuracy of facial emotion appraisal (FEA); and (iii) negative affect (NA)-for low-income, ethnic minority children's internalizing problems (N = 338). Children were enrolled in the current study from publicly funded preschools, with poverty-related adversity assessed at multiple time points from early to middle childhood. Field-based administration of neurocognitively-informed assessments of ABT, FEA and NA as well as parental report of internalizing symptoms were collected when children were ages 8-11, 6 years after baseline. Results suggest that chronic exposure to poverty-related adversity from early to middle childhood predicted higher levels of internalizing symptomatology when children are ages 8-11, even after controlling for initial poverty status and early internalizing symptoms in preschool. Moreover, each of the 3 hypothesized components of ER played an independent and statistically significant role in predicting children's parent-reported internalizing symptoms at the 6-year follow-up, even after controlling for early and chronic poverty-related adversity.

  6. Adverse endocrine and metabolic effects of psychotropic drugs: selective clinical review.

    PubMed

    Bhuvaneswar, Chaya G; Baldessarini, Ross J; Harsh, Veronica L; Alpert, Jonathan E

    2009-12-01

    The article critically reviews selected, clinically significant, adverse endocrine and metabolic effects associated with psychotropic drug treatments, including hyperprolactinaemia, hyponatraemia, diabetes insipidus, hypothyroidism, hyperparathyroidism, sexual dysfunction and virilization, weight loss, weight gain and metabolic syndrome (type 2 diabetes mellitus, dyslipidaemia and hypertension). Such effects are prevalent and complex, but can be managed clinically when recognized. They encourage continued critical assessment of benefits versus risks of psychotropic drugs and underscore the importance of close coordination of psychiatric and general medical care to improve long-term health of psychiatric patients. Options for management of hyperprolactinaemia include lowering doses, switching to agents such as aripiprazole, clozapine or quetiapine, managing associated osteoporosis, carefully considering the use of dopamine receptor agonists and ruling out stress, oral contraceptive use and hypothyroidism as contributing factors. Disorders of water homeostasis may include syndrome of inappropriate antidiuretic hormone (SIADH), managed by water restriction or slow replacement by hypertonic saline along with drug discontinuation. Safe management of diabetes insipidus, commonly associated with lithium, involves switching mood stabilizer and consideration of potassium-sparing diuretics. Clinical hypothyroidism may be a more useful marker than absolute cut-offs of hormone values, and may be associated with quetiapine, antidepressant and lithium use, and managed by thyroxine replacement. Hyper-parathyroidism requires comprehensive medical evaluation for occult tumours. Hypocalcaemia, along with multiple other psychiatric and medical causes, may result in decreased bone density and require evaluation and management. Strategies for reducing sexual dysfunction with psychotropics remain largely unsatisfactory. Finally, management strategies for obesity and metabolic syndrome

  7. [Problems in nursing homes: selected case law].

    PubMed

    Diezel, Eva Frida

    2008-01-01

    Problems in nursing homes, which have become the focus of public attention in recent years, increasingly require German courts to deal with nursing home-specific circumstances. Frequently these cases concern liability for falls or inadequate measures to prevent falls or decubitus ulcers (bedsore), the permissibility of restraints such as bed rails, belts and so forth, as well as the refusal to terminate life-extending treatment by the nursing home operator. Issues relating to the extent of the nursing home operator's duties of protection and the duty of care owed by him--taking account of the basic rights of the nursing home resident--as well as issues relating to the burden of proof play a central role in liability cases. In cases relating to the termination of treatment, the nursing home operator generally refuses to stop treatment providing a series of "standard arguments". The present paper presents the state-of-the-art of the still developing pertinent case law.

  8. The swath segment selection problem: extending AI search techniques to a novel real-world problem

    NASA Technical Reports Server (NTRS)

    Knight, R.; Smith, B.

    2003-01-01

    We introduce the Swath Segment Selection problem (SSSP). The SSSP consists of a constrained geometric covering problem and a capacitated resource problem. It comes from the real-life problem of scheduling on- and off-times for air or space-borne instruments that image a target by flying over and collecting a swath of information.

  9. [Adverse effects of selective serotonin reuptake inhibitors use during the third trimester of pregnancy and prevention guidelines].

    PubMed

    Mejías, Consuelo; Rodríguez-Pinilla, Elvira; Fernández Martín, Paloma; Martínez-Frías, María Luisa

    2007-04-21

    Selective Serotonin Reuptake Inhibitors (SSRIs) have become the drug of choice for the treatment of depression and have shown to be effective in the treatment for other mental disorders. Recently, several articles have reported about the adverse effects observed in newborns after maternal exposure to these drugs during the last trimester of pregnancy. In this work, a review of literature is presented, regarding the above mentioned adverse effects. Moreover, some guidelines for the rational use of these drugs during the last trimester of pregnancy and for the management of prenatally exposed newborns are provided.

  10. [Active surveillance of adverse drug reaction in the era of big data: challenge and opportunity for control selection].

    PubMed

    Wang, S F; Zhan, S Y

    2016-07-01

    Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China.

  11. Potassium fertilization mitigates the adverse effects of drought on selected Zea mays cultivars

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the present study, the role of potassium (K) in mitigating the adverse effects of drought stress (DS) on 2 maize (Zea mays L.) cultivars, ‘Shaandan 9’ (S9; drought-tolerant) and ‘Shaandan 911’ (S911; drought-sensitive), was assessed. K application increased dry matter (DM) across all growth stage...

  12. Psychosocial problems of donor heart recipients adversely affecting quality of life.

    PubMed

    Bunzel, B; Wollenek, G; Grundböck, A

    1992-10-01

    Heart transplantation has become an accepted therapy for patients suffering from terminal heart disease for whom neither standard forms of medication nor the usual surgery are of any benefit. Although results regarding postoperative quantity and quality of life are encouraging, it must not be overlooked that the patient and his family face, and have to overcome, profound psychosocial problems. The main stressors were identified in interviews with 47 heart transplant patients. The main preoperative problems were: the way of being informed about the diagnosis, the waiting period for transplantation, anguishing doubts about the decision to have a transplant, being a body without heart ('zombie'), guilt and shame regarding the donor, the reactions of others. Postoperatively the patients have to cope with: re-entering social systems, reactions of friends, neighbours and colleagues, rejection episodes, death of a fellow patient, the need to redesign family life. All the problems reported by the patients interviewed are discussed regarding their psychosocial implications, and hints are given on how to minimize them.

  13. Changes in occupational health problems and adverse patient reactions in orthodontics from 1987 to 2000.

    PubMed

    Jacobsen, Nils; Hensten-Pettersen, Arne

    2003-12-01

    The purpose of the present investigation was to assess the reasons for changes in occupational health problems and patient reactions to orthodontic treatment after a survey carried out in 1987. Questionnaire data on occupation-related health complaints and patient reactions over the preceding 2 years were obtained from 121 of 170 Norwegian orthodontists (71 per cent). Most health complaints were dermatoses of the hands and fingers related to the processing of acrylic removable appliances, to composite bonding materials, or gloves. A few reactions were of a respiratory or systemic nature. In total, occupation-related dermatoses were reported by 17.4 per cent (21/121) compared with 40 per cent previously. Non-dermal complaints comprised 9 per cent compared with 18.2 per cent in 1987. Patient reactions were distributed equally between intra-oral reactions affecting lips, gingiva, oral mucosa, and tongue, and dermal reactions affecting the corner of the mouth, the dorsal part of the neck, the peri-oral area, cheeks, chin or skin elsewhere. A few patients had systemic reactions. The assumed eliciting agents of intra-oral reactions were fixed metallic appliances, acrylic removable appliances, polymer brackets or composite bonding materials, or were related to elastics. Extra-oral (dermal) reactions were attributed to metallic, elastic or textile parts of the extra-oral appliances. Some reactions were verified as allergies. The percentage of patient reactions in total was estimated to be 0.3-0.4 per cent compared with 0.8-0.9 per cent in 1987. The reduction in occupation-related health complaints among orthodontists was explained by changes in previously important hygiene factors such as soaps, detergents, etc., whereas the biomaterials-related reactions persisted. The reduction in the 2 year incidence of patient reactions was associated with a marked reduction in extra-oral reactions following preventive measures such as coating metallic devices, whereas the intra

  14. UM206, a selective Frizzled antagonist, attenuates adverse remodeling after myocardial infarction in swine.

    PubMed

    Uitterdijk, André; Hermans, Kevin C M; de Wijs-Meijler, Daphne P M; Daskalopoulos, Evangelos P; Reiss, Irwin K; Duncker, Dirk J; Matthijs Blankesteijn, W; Merkus, Daphne

    2016-02-01

    Modulation of Wnt/Frizzled signaling with UM206 reduced infarct expansion and prevented heart failure development in mice, an effect that was accompanied by increased myofibroblast presence in the infarct, suggesting that Wnt/Frizzled signaling has a key role in cardiac remodeling following myocardial infarction (MI). This study investigated the effects of modulation of Wnt/Frizzled signaling with UM206 in a swine model of reperfused MI. For this purpose, seven swine with MI were treated with continuous infusion of UM206 for 5 weeks. Six control swine were treated with vehicle. Another eight swine were sham-operated. Cardiac function was determined by echo in awake swine. Infarct mass was estimated at baseline by heart-specific fatty acid-binding protein ELISA and at follow-up using planimetry. Components of Wnt/Frizzled signaling, myofibroblast presence, and extracellular matrix were measured at follow-up with qPCR and/or histology. Results show that UM206 treatment resulted in a significant decrease in infarct mass compared with baseline (-41±10%), whereas infarct mass remained stable in the Control-MI group (+3±17%). Progressive dilation of the left ventricle occurred in the Control-MI group between 3 and 5 weeks after MI, while adverse remodeling was halted in the UM206-treated group. mRNA expression for Frizzled-4 and the Frizzled co-receptor LRP5 was increased in UM206-treated swine as compared with Control-MI swine. Myofibroblast presence was significantly lower in infarcted tissue of the UM206-treated animals (1.53±0.43% vs 3.38±0.61%) at 5 weeks follow-up. This study demonstrates that UM206 treatment attenuates adverse remodeling in a swine model of reperfused MI, indicating that Wnt/Frizzled signaling is a promising target to improve infarct healing and limit post-MI remodeling.

  15. Model selection in cognitive science as an inverse problem

    NASA Astrophysics Data System (ADS)

    Myung, Jay I.; Pitt, Mark A.; Navarro, Daniel J.

    2005-03-01

    How should we decide among competing explanations (models) of a cognitive phenomenon? This problem of model selection is at the heart of the scientific enterprise. Ideally, we would like to identify the model that actually generated the data at hand. However, this is an un-achievable goal as it is fundamentally ill-posed. Information in a finite data sample is seldom sufficient to point to a single model. Multiple models may provide equally good descriptions of the data, a problem that is exacerbated by the presence of random error in the data. In fact, model selection bears a striking similarity to perception, in that both require solving an inverse problem. Just as perceptual ambiguity can be addressed only by introducing external constraints on the interpretation of visual images, the ill-posedness of the model selection problem requires us to introduce external constraints on the choice of the most appropriate model. Model selection methods differ in how these external constraints are conceptualized and formalized. In this review we discuss the development of the various approaches, the differences between them, and why the methods perform as they do. An application example of selection methods in cognitive modeling is also discussed.

  16. Polyandrous, sperm-storing females: carriers of male genotypes through episodes of adverse selection

    PubMed Central

    Zeh, D. W.; Zeh, J. A.; Bermingham, E.

    1997-01-01

    In the pseudoscorpion, Cordylochernes scorpioides, males experience sexual selection in two disparate and well-defined habitats. Populations inhabit decaying trees for several generations before dispersing under the elytra of the harlequin beetle, Acrocinus longimanus. Males compete to monopolize beetle abdomens as strategic sites for inseminating dispersing females. Using single-locus minisatellite DNA profiling to assign paternity for the offspring of dispersing females, we found a strong, positive correlation between male size and reproductive success in the beetle environment. However, this intense selection is undermined by polyandry and the ability of females to store sperm and produce mixed-paternity broods. Although beetle-riding males achieved fertilizations with 70 per cent of the females, paternity could not be assigned for 57 per cent of the offspring. It is likely that many of these offspring were the products of within-tree inseminations since, in a sample of females intercepted in the act of boarding beetles, most (86 per cent) carried sperm from pre-dispersal matings within trees. Polyandry and sperm storage may therefore enable smaller males, unable to monopolize beetle mating territories, to circumvent the bottleneck of dispersal-generated sexual selection and thereby transmit their genes to future tree populations. Sperm stored within females can thus provide the kind of resistant life-history stage shown by recent modelling to be critical for the maintenance of genetic variation by temporally fluctuating selection.

  17. More than g: selection quality and adverse impact implications of considering second-stratum cognitive abilities.

    PubMed

    Wee, Serena; Newman, Daniel A; Joseph, Dana L

    2014-07-01

    When using cognitive tests, personnel selection practitioners typically face a trade-off between the expected job performance and diversity of new hires. We review the increasingly mainstream evidence that cognitive ability is a multidimensional and hierarchically ordered set of concepts, and examine the implications for both composite test validity and subgroup differences. Ultimately, we recommend a strategy for differentially weighting cognitive subtests (i.e., second-stratum abilities) in a way that minimizes overall subgroup differences without compromising composite test validity. Using data from 2 large validation studies that included a total of 15 job families, we demonstrate that this strategy could lead to substantial improvement in diversity hiring (e.g., doubling the number of job offers extended to minority applicants) and to at least 8% improvement in job offers made to minority applicants, without decrements in expected selection quality compared to a unit-weighted cognitive test composite. Finally, we conduct a sensitivity analysis to examine whether the technique continues to perform well when applied to applicant pools of smaller size. We discuss prerequisites for the application of this strategy, potential limitations, and extensions.

  18. The effect of sire selection on cow mortality and early lactation culling in adverse and favorable cow survival environments.

    PubMed

    Dechow, C D; Goodling, R C; Rhode, S P

    2012-02-01

    The objective of this study was to determine the extent that genetic selection can help reduce dairy cow mortality and early lactation culling in adverse cow survival environments. Two datasets were constructed. The first contained 100,911 mortality records and 171,178 sixty-day culling records from 1467 herds. Cows that left the herd (culled or died) from 21 days prior to a due date through 60 days in milk were considered a 60-day cull. Cows were classified as belonging to herds with adverse cow survival environments (≥ 4.4% mortality rate and ≥ 7.1% 60-day cull rate) or favorable cow survival environments (<4.4% mortality rate and <7.1% 60-day cull rate). The second dataset included 20,438 mortality records and 34,942 sixty-day culling records from 314 herds with a known herd management system. Cows from both datasets were stratified into quartiles based on their sire's predicted transmitting ability (PTA) for productive life and other traits. Cows in the first dataset were also stratified into high (>50th percentile) and low (≤ 50th percentile) groups based on their sire's PTA for daughter calving ease and daughter stillbirth rates. Mortality and 60-day culling in the first dataset were evaluated with logistic regression models with the independent effects of sire PTA quartile, cow survival environment (adverse or favorable), the interaction of sire PTA quartile with cow survival environment, lactation number, age within lactation number, and herd-calving-cluster. The second dataset was analyzed in the same manner, but with cow survival environment replaced by herd management system. The estimated proportion of lactations that ended in death declined from 9.0% to 6.8% and 60-day culling incidence from 7.6% to 4.9% as sire productive life PTA went from the lowest to highest quartile in adverse cow survival environments. The corresponding reduction in mortality (0.7%) and 60-day culling (0.9%) were also significant in favorable cow survival environments

  19. Single-phase Stefan problem in selectively absorbing medium

    NASA Astrophysics Data System (ADS)

    Sleptsov, S. D.; Rubtsov, N. A.; Savvinova, N. A.

    2016-01-01

    The thermal state of a translucent selectively absorbing medium was studied by the methods of numerical simulation at different values of the optical properties of boundaries and heat transfer from the left surface in approximation of one-phase Stefan problem. The temperature fields and densities of resultant radiation fluxes as well as the thermal state of the left boundary and dynamics of layer reduction in the melting process were analyzed. The processes of phase transition in a flat layer of selective and gray absorbing media and emitting media were compared, and their fundamental differences were shown.

  20. Living With Limited Time: Socioemotional Selectivity Theory in the Context of Health Adversity

    PubMed Central

    Sullivan-Singh, Sarah J.; Stanton, Annette L.; Low, Carissa A.

    2016-01-01

    The current research was designed to test the applicability of socioemotional selectivity theory (SST; Carstensen, 2006), a life span theory that posits that perceived time remaining in life (time perspective) is a critical determinant of motivation, to individuals who face foreshortened futures (limited time perspective) due to life-limiting medical illness. In Study 1, we investigated whether life goals and biases in attention and memory for valenced emotional stimuli differed between women living with metastatic breast cancer (n = 113; theoretically living under greater limited time perspective than peers without cancer) and similarly aged women without a cancer diagnosis (n = 50; theoretically living under greater expansive time perspective than peers with cancer) in accordance with SST. As hypothesized, metastatic group goals reflected greater emphasis on limited versus expansive time perspective relative to comparison group goals. Hypotheses regarding biases in attention and memory were not supported. Study 2 followed metastatic group participants over 3 months and revealed that, consistent with hypotheses, whereas limited time perspective goals predicted decreased intrusive thoughts about cancer, expansive time perspective goals predicted decreased perceived cancer-related benefits. Together, these studies suggest that SST is a useful lens through which to view some components of motivation and psychological adjustment among individuals confronting medically foreshortened futures. PMID:25984789

  1. Adolescent Family Adversity and Mental Health Problems: The Role of Adaptive Self-Regulation Capacities. The TRAILS Study

    ERIC Educational Resources Information Center

    Bakker, Martin Paul; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.

    2011-01-01

    Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive…

  2. Factors associated with crashes involving taxi owners and non-owners: A case of moral hazard and adverse selection?

    PubMed

    Tay, Richard; Choi, Jaisung

    2016-02-01

    Taxis experience a higher risk of a motor vehicle crash partly because of their much higher levels of exposure on the roads. Although several studies have been conducted to examine the factors associated with the frequency and severity of taxi collisions, little research has been conducted to examine the differences in the factors associated with owner taxis and non-owner taxis. This study finds that collisions involving non-owners are more likely to be associated with poor or risky driving behaviors than collisions involving taxi vehicle owners. This result is consistent with the economic principles of moral hazard and adverse selection. Hence, policy makers responsible for traffic safety, taxi regulation or taxi operations should consider measures to reduce these market inefficiencies and improve the safety of not only taxi drivers but all road users.

  3. Delinquency and Recidivism: A Multicohort, Matched-Control Study of the Role of Early Adverse Experiences, Mental Health Problems, and Disabilities

    ERIC Educational Resources Information Center

    Barrett, David E.; Katsiyannis, Antonis; Zhang, Dalun; Zhang, Dake

    2014-01-01

    The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile…

  4. Solving the Selectivity Problem in MRAMs using Micromagnetics

    NASA Astrophysics Data System (ADS)

    Arrott, Anthony

    2003-03-01

    To select a single bit from an array in MRAM, two orthogonal current carrying lines are used to provide a bias field Hy and a switching field Hx. The metallurgical challenges in producing identical bits are circumvented by the design of the patterned thin film element to make it insensitive to processing problems. Ideally neither Hx nor Hy alone should ever switch any bit while the combination of the two fields in proper sequence should always switch the selected bit. The memory should act like locked doors. No matter how hard the knob is turned, the door does not open until it is unlocked. The switching field is turning the knob. The bias field is the key that unlocks the door. This lock and key principle is achieved theoretically using the C-state configuration in trapezoidally distorted ellipses (flat tires) with Hy applied before Hx. Recent advances in practical MRAM products support these theoretical results.

  5. Adverse Effects of Androgen Deprivation Therapy: Defining the Problem and Promoting Health Among Men with Prostate Cancer

    PubMed Central

    Saylor, Philip J.; Smith, Matthew R.

    2010-01-01

    Androgen deprivation therapy (ADT) plays a central role in the management of men with locally advanced, recurrent, and metastatic prostate cancer. Because most men diagnosed with prostate cancer will die of something other than their cancer, treatment-related adverse effects are highly relevant to their long-term health. Benefits of ADT in each clinical setting must be weighed against ADT-related adverse effects. ADT is detrimental to several metabolic end points and to bone health. ADT has been prospectively shown to cause decreased lean muscle mass, increased fat mass, weight gain, increased cholesterol and triglycerides, insulin resistance, and loss of bone mineral density. In population-based analyses it has been associated with an increased incidence of diabetes, clinical fractures, and cardiovascular disease. Data-driven recommendations for managing these adverse effects are needed. Currently the authors advocate the use of adapted practice guidelines developed to prevent diabetes, fractures, and coronary heart disease in the general population. PMID:20141678

  6. Selecting radiotherapy dose distributions by means of constrained optimization problems.

    PubMed

    Alfonso, J C L; Buttazzo, G; García-Archilla, B; Herrero, M A; Núñez, L

    2014-05-01

    The main steps in planning radiotherapy consist in selecting for any patient diagnosed with a solid tumor (i) a prescribed radiation dose on the tumor, (ii) bounds on the radiation side effects on nearby organs at risk and (iii) a fractionation scheme specifying the number and frequency of therapeutic sessions during treatment. The goal of any radiotherapy treatment is to deliver on the tumor a radiation dose as close as possible to that selected in (i), while at the same time conforming to the constraints prescribed in (ii). To this day, considerable uncertainties remain concerning the best manner in which such issues should be addressed. In particular, the choice of a prescription radiation dose is mostly based on clinical experience accumulated on the particular type of tumor considered, without any direct reference to quantitative radiobiological assessment. Interestingly, mathematical models for the effect of radiation on biological matter have existed for quite some time, and are widely acknowledged by clinicians. However, the difficulty to obtain accurate in vivo measurements of the radiobiological parameters involved has severely restricted their direct application in current clinical practice.In this work, we first propose a mathematical model to select radiation dose distributions as solutions (minimizers) of suitable variational problems, under the assumption that key radiobiological parameters for tumors and organs at risk involved are known. Second, by analyzing the dependence of such solutions on the parameters involved, we then discuss the manner in which the use of those minimizers can improve current decision-making processes to select clinical dosimetries when (as is generally the case) only partial information on model radiosensitivity parameters is available. A comparison of the proposed radiation dose distributions with those actually delivered in a number of clinical cases strongly suggests that solutions of our mathematical model can be

  7. Self-Focused and Other-Focused Resiliency: Plausible Mechanisms Linking Early Family Adversity to Health Problems in College Women

    ERIC Educational Resources Information Center

    Coleman, Sulamunn R. M.; Zawadzki, Matthew J.; Heron, Kristin E.; Vartanian, Lenny R.; Smyth, Joshua M.

    2016-01-01

    Objectives: This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Participants: Female students (N = 795) participated between October 2009 and May 2010. Methods: Participants completed self-report measures…

  8. Pre-Adoption Adversity and Self-Reported Behavior Problems in 7 Year-Old International Adoptees

    ERIC Educational Resources Information Center

    Gagnon-Oosterwaal, Noemi; Cossette, Louise; Smolla, Nicole; Pomerleau, Andree; Malcuit, Gerard; Chicoine, Jean-Francois; Jeliu, Gloria; Belhumeur, Celine; Berthiaume, Claude

    2012-01-01

    To further investigate the long-term impact of pre-adoption adversity on international adoptees, externalizing and internalizing symptoms were assessed using a self-report measure at school-age in addition to mothers' reports. The sample consisted of 95 adopted children and their mothers. Children's health and developmental status were assessed…

  9. Attitude of nurses and pharmacists on adverse drug reactions reporting in selected hospitals in Sokoto, Northwest Nigeria

    PubMed Central

    Umar, Muhammad Tukur; Bello, Shaibu Oricha; Chika, Aminu; Oche, Oche Mansur

    2016-01-01

    Objective: Objective of this study was to assess the attitude of nurses and pharmacists towards adverse drug reactions (ADRs) reporting. Methods: The questionnaire was designed based on extended “Inman seven deadly sins.” Two hundred and seventy-two respondents were selected by stratified sampling technique. The questionnaires were delivered to the respondents at their places of practice. The data generated were analyzed by Sigma XL Software Inc. Findings: There was no statistically significant relationship between demographic profiles and reporting attitude except for qualification. On extended “Inman seven deadly sins” awareness of reporting protocol and nearby center for ADRs reporting were low 27.3 and 7.5%, respectively. However, respondents’ score on components of attitude of ADRs reporting is generally encouraging. On comparative basis, no statistical significance exists between pharmacists and nurses. Conclusion: The study showed that attitude of respondents towards ADRs reporting is good. However, there is a need for targeted health education intervention among these cadres of health-care professionals, especially on aspects of awareness of reporting protocol and reporting center. PMID:27512716

  10. Changes in plasma levels of BDNF and NGF reveal a gender-selective vulnerability to early adversity in rhesus macaques

    PubMed Central

    Cirulli, Francesca; Francia, Nadia; Branchi, Igor; Antonucci, Maria Teresa; Aloe, Luigi; Suomi, Stephen J.; Alleva, Enrico

    2009-01-01

    Summary Early stressful events can increase vulnerability for psychopathology, although knowledge on the effectors is still limited. Here we tested the hypothesis that peripheral levels of Brain-Derived Neurotrophic Factor (BDNF) and Nerve Growth Factor (NGF), which are involved in the response to stress and in the pathophysiology of anxiety and depression, might be affected in a non-human primate model of adverse rearing. Males and females rhesus macaques reared with their mothers (MR) or in peer-only groups (PR) were used as experimental subjects. BDNF, NGF, adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) were determined at baseline on postnatal days (PND) 14, 30 and 60 by means of specific ELISA and RIA procedures. In addition, behavior was assessed on PND 7, 14, 21, 30 (Brazelton test) and 60 (home cage observation). Data indicate gender differences in basal levels of BDNF throughout development. Peer-rearing increased significantly BDNF levels only in females. In addition, while all peer-reared subjects showed high levels of stereotypies and self-directed behaviors, behavioral passivity was selectively increased in females. By contrast, NGF levels were increased in response to peer rearing only in males, and correlated positively with other “classic” endocrine responses to stress, such as cortisol and growth hormone. Our data identify BDNF and NGF as neuroendocrine markers underlying differential responses to maternal deprivation in males and females rhesus macaques. The selective changes in BDNF levels in females could help explain the greater vulnerability to mood disorders of this gender reported in humans. PMID:18849121

  11. A METHOD FOR SELECTING SOFTWARE FOR DYNAMIC EVENT ANALYSIS I: PROBLEM SELECTION

    SciTech Connect

    J. M. Lacy; S. R. Novascone; W. D. Richins; T. K. Larson

    2007-08-01

    New nuclear power reactor designs will require resistance to a variety of possible malevolent attacks, as well as traditional dynamic accident scenarios. The design/analysis team may be faced with a broad range of phenomena including air and ground blasts, high-velocity penetrators or shaped charges, and vehicle or aircraft impacts. With a host of software tools available to address these high-energy events, the analysis team must evaluate and select the software most appropriate for their particular set of problems. The accuracy of the selected software should then be validated with respect to the phenomena governing the interaction of the threat and structure. In this paper, we present a method for systematically comparing current high-energy physics codes for specific applications in new reactor design. Several codes are available for the study of blast, impact, and other shock phenomena. Historically, these packages were developed to study specific phenomena such as explosives performance, penetrator/target interaction, or accidental impacts. As developers generalize the capabilities of their software, legacy biases and assumptions can remain that could affect the applicability of the code to other processes and phenomena. R&D institutions generally adopt one or two software packages and use them almost exclusively, performing benchmarks on a single-problem basis. At the Idaho National Laboratory (INL), new comparative information was desired to permit researchers to select the best code for a particular application by matching its characteristics to the physics, materials, and rate scale (or scales) representing the problem at hand. A study was undertaken to investigate the comparative characteristics of a group of shock and high-strain rate physics codes including ABAQUS, LS-DYNA, CTH, ALEGRA, ALE-3D, and RADIOSS. A series of benchmark problems were identified to exercise the features and capabilities of the subject software. To be useful, benchmark problems

  12. Association between Selective Beta-adrenergic Drugs and Blood Pressure Elevation: Data Mining of the Japanese Adverse Drug Event Report (JADER) Database.

    PubMed

    Ohyama, Katsuhiro; Inoue, Michiko

    2016-01-01

    Selective beta-adrenergic drugs are used clinically to treat various diseases. Because of imperfect receptor selectivity, beta-adrenergic drugs cause some adverse drug events by stimulating other adrenergic receptors. To examine the association between selective beta-adrenergic drugs and blood pressure elevation, we reviewed the Japanese Adverse Drug Event Reports (JADERs) submitted to the Japan Pharmaceuticals and Medical Devices Agency. We used the Medical Dictionary for Regulatory Activities (MedDRA) Preferred Terms extracted from Standardized MedDRA queries for hypertension to identify events related to blood pressure elevation. Spontaneous adverse event reports from April 2004 through May 2015 in JADERs, a data mining algorithm, and the reporting odds ratio (ROR) were used for quantitative signal detection, and assessed by the case/non-case method. Safety signals are considered significant if the ROR estimates and lower bound of the 95% confidence interval (CI) exceed 1. A total of 2021 reports were included in this study. Among the nine drugs examined, significant signals were found, based on the 95%CI for salbutamol (ROR: 9.94, 95%CI: 3.09-31.93) and mirabegron (ROR: 7.52, 95%CI: 4.89-11.55). The results of this study indicate that some selective beta-adrenergic drugs are associated with blood pressure elevation. Considering the frequency of their indications, attention should be paid to their use in elderly patients to avoid adverse events.

  13. Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems.

    PubMed

    Bethell, Christina; Gombojav, Narangerel; Solloway, Michele; Wissow, Lawrence

    2016-04-01

    US children with emotional, mental, or behavioral conditions (EMB) have disproportionate exposure to adverse childhood experiences (ACEs). There are theoretic and empirical explanations for early and lifelong physical, mental, emotional, educational, and social impacts of the resultant trauma and chronic stress. Using mindfulness-based, mind-body approaches (MBMB) may strengthen families and promote child resilience and success. This paper examines associations between EMB, ACEs, and protective factors, such as child resilience, parental coping/stress, and parent-child engagement. Findings encourage family-centered and mindfulness-based approaches to address social and emotional trauma and potentially interrupt cycles of ACEs and prevalence of EMB.

  14. The relationship between childhood adverse experiences and disability due to physical health problems in a community sample of women.

    PubMed

    Tonmyr, Lil; Jamieson, Ellen; Mery, Leslie S; MacMillan, Harriet L

    2005-01-01

    The goal of this study was to examine the association of physical and sexual abuse in childhood, poverty, parental substance abuse problems and parental psychiatric problems with disability due to physical health problems in a community sample of women. We included 4,243 women aged 15-64 years from the Ontario Mental Health Supplement in the analysis. The associations were tested by multiple logistic regression. Ten percent of women had a disability due to physical health problems. Among women with a disability, approximately 40% had been abused while growing up. After controlling for income and age, disability showed the strongest association with childhood physical abuse, parental education less than high school and parental psychiatric disorder. The association with child sexual abuse was not significant. Given the high correlation between abuse and disability due to physical health problems, it is important to investigate approaches to identify women who are at increased risk of subsequent impairment.

  15. Deciphering Selectivity in Organic Reactions: A Multifaceted Problem.

    PubMed

    Balcells, David; Clot, Eric; Eisenstein, Odile; Nova, Ainara; Perrin, Lionel

    2016-05-17

    Computational chemistry has made a sustained contribution to the understanding of chemical reactions. In earlier times, half a century ago, the goal was to distinguish allowed from forbidden reactions (e.g., Woodward-Hoffmann rules), that is, reactions with low or high to very high activation barriers. A great achievement of computational chemistry was also to contribute to the determination of structures with the bonus of proposing a rationalization (e.g., anomeric effect, isolobal analogy, Gillespie valence shell pair electron repulsion rules and counter examples, Wade-Mingos rules for molecular clusters). With the development of new methods and the constant increase in computing power, computational chemists move to more challenging problems, close to the daily concerns of the experimental chemists, in determining the factors that make a reaction both efficient and selective: a key issue in organic synthesis. For this purpose, experimental chemists use advanced synthetic and analytical techniques to which computational chemists added other ways of determining reaction pathways. The transition states and intermediates contributing to the transformation of reactants into the desired and undesired products can now be determined, including their geometries, energies, charges, spin densities, spectroscopy properties, etc. Such studies remain challenging due to the large number of chemical species commonly present in the reactive media whose role may have to be determined. Calculating chemical systems as they are in the experiment is not always possible, bringing its own share of complexity through the large number of atoms and the associated large number of conformers to consider. Modeling the chemical species with smaller systems is an alternative that historically led to artifacts. Another important topic is the choice of the computational method. While DFT is widely used, the vast diversity of functionals available is both an opportunity and a challenge. Though

  16. Surrogate species selection for assessing potential adverse environmental impacts of genetically engineered plants on non-target organisms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Most regulatory authorities require that developers of genetically engineered insect-resistant (GEIR) crops evaluate the potential for these crops to have adverse impacts on valued non-target organisms (NTOs), i.e., organisms not intended to be controlled by the trait. In many cases, impacts to NTOs...

  17. Dyspareunia: a complex problem requiring a selective approach.

    PubMed

    Walid, Mohammad Sami; Heaton, Richard L

    2009-09-01

    Dyspareunia frequently has a multifactorial aetiology. The problem with the term is that it is not specific enough and does not allow for proper discussion of the very important problem of pain with sexual intercourse, a problem that can be very disturbing to a couple's relationship. We present two cases of patients who had multiple potential anatomic reasons for dyspareunia. The clinical picture, treatment strategy and the complex nature of deep penetration pain was discussed. We also proposed a new way of defining dyspareunia to allow a more adequate way of studying and discussing the problem.

  18. Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood.

    PubMed

    Aebi, Marcel; Giger, Joël; Plattner, Belinda; Metzke, Christa Winkler; Steinhausen, Hans-Christoph

    2014-05-01

    The purpose of this study was to test child and adolescent psychosocial and psychopathological risk factors as predictors of adult criminal outcomes in a Swiss community sample. In particular, the role of active and avoidant problem coping in youths was analysed. Prevalence rates of young adult crime convictions based on register data were calculated. Univariate and multivariate logistic regressions were used to analyse the prediction of adult criminal convictions 15 years after assessment in a large Swiss community sample of children and adolescents (n = 1,086). Risk factors assessed in childhood and adolescence included socio-economic status (SES), migration background, perceived parental behaviour, familial and other social stressors, coping styles, externalizing and internalizing problems and drug abuse including problematic alcohol consumption. The rate of any young adult conviction was 10.1 %. Besides externalizing problems and problematic alcohol consumption, the presence of any criminal conviction in young adulthood was predicted by low SES and avoidant coping even after controlling for the effects of externalizing problems and problematic alcohol use. The other predictors were significant only when externalizing behaviours and problematic alcohol use were not controlled. In addition to child and adolescent externalizing behaviour problems and substance use, low SES and inadequate problem-solving skills, in terms of avoidant coping, are major risk factors of young adult criminal outcomes and need to be considered in forensic research and criminal prevention programs.

  19. A Study of Selected Problems in Armor Operations

    DTIC Science & Technology

    1978-11-01

    states: Selection of the MOE is a subjective process based on how the proponent believes force effectiveness may best be assessed. Its selection is...intuitive process . And, all too often, it is feared, in-- tuition is guided more by expedience than by logic. That is, the MOE selected are those which are...under which the task was to be perform- ed, and the standards by which he would be judged. The techniques and procedures for accomplishing these processes

  20. Surrogate species selection for assessing potential adverse environmental impacts of genetically engineered insect-resistant plants on non-target organisms.

    PubMed

    Carstens, Keri; Cayabyab, Bonifacio; De Schrijver, Adinda; Gadaleta, Patricia G; Hellmich, Richard L; Romeis, Jörg; Storer, Nicholas; Valicente, Fernando H; Wach, Michael

    2014-01-01

    Most regulatory authorities require that developers of genetically engineered insect-resistant (GEIR) crops evaluate the potential for these crops to have adverse impacts on valued non-target organisms (NTOs), i.e., organisms not intended to be controlled by the trait. In many cases, impacts to NTOs are assessed using surrogate species, and it is critical that the data derived from surrogates accurately predict any adverse impacts likely to be observed from the use of the crop in the agricultural context. The key is to select surrogate species that best represent the valued NTOs in the location where the crop is going to be introduced, but this selection process poses numerous challenges for the developers of GE crops who will perform the tests, as well as for the ecologists and regulators who will interpret the test results. These issues were the subject of a conference "Surrogate Species Selection for Assessing Potential Adverse Environmental Impacts of Genetically Engineered Plants on Non-Target Organisms" convened by the Center for Environmental Risk Assessment, ILSI Research Foundation. This report summarizes the proceedings of the conference, including the presentations, discussions and the points of consensus agreed to by the participants.

  1. Problem Analysis: Examining the Selection and Evaluation of Data during Problem-Solving Consultation

    ERIC Educational Resources Information Center

    Newell, Markeda L.; Newell, Terrance S.

    2011-01-01

    The purpose of this study was to analyze how school psychologists engaged in problem analysis during problem-solving consultation. Five aspects of the problem analysis process were examined: 1) the types of questions participants asked during problem identification, 2) the types of data participants requested, 3) the frequency of requests for each…

  2. Non-Verbal Reasoning Ability and Academic Achievement as Moderators of the Relation between Adverse Life Events and Emotional and Behavioural Problems in Early Adolescence: The Importance of Moderator and Outcome Specificity

    ERIC Educational Resources Information Center

    Flouri, Eirini; Tzavidis, Nikos

    2011-01-01

    This study was carried out to model the functional form of the effect of contextual risk (number of adverse life events) on emotional and behavioural problems in early adolescence, and to test how intelligence and academic achievement compare as moderators of this effect. The effect of number of adverse life events on emotional and behavioural…

  3. [Selected Readings for the Professional Working with Drug Related Problems.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison.

    A bibliography of selected readings compiled at the University of Wisconsin for the National Drug Education Training Program. These selected readings include information on narcotics, amphetamines, mescaline, psilogybin, hallucinogens, LSD, barbiturates, alcohol, and other stimulants. The intended user of this bibliography is the professional…

  4. The Formulation of Selected Free Boundary Problems as Conservation Laws,

    DTIC Science & Technology

    1979-12-01

    Numerical Solution of a Stefan Problem," SIAM J. Numer. Anal. 16, 563 (1979). 3. Haim Brezis , Alan E. Berger, and Joel C. W. Rogers, "A Numerical Method...for Solving the Problem ut - tf(u) = 0," to appear. 4. Haim Brezis , Alan E. Berger, and Joel C. W. Rogers, "A Numerical Method for Solving the Problem...Suitable function spaces are mentioned. Formal extensions of the algorithms to systems are proposed. Analytic difficulties in the solution of systems in

  5. Reading: Problems and Practices; A Selection of Papers.

    ERIC Educational Resources Information Center

    Reid, Jessie F., Ed.

    This book of readings begins with a section in which reading problems are defined and the most recent evidence as to their scope is surveyed. Two sections on correlates and causes follow: the first of these deals with correlates of social and emotional origin and the second with developmental reading disability. The next section looks at some…

  6. A selection of biomechanical research problems: From modeling to experimentation

    NASA Astrophysics Data System (ADS)

    Abbasi, Cyrus Omid

    The research undertakings within this manuscript illustrate the importance of biomechanics in today's science. Without doubt, biomechanics can be utilized to obtain a better understanding of many unsolved mysteries involved in the field of medicine. Moreover, biomechanics can be used to develop better prosthetic or surgical devices as well. Chapter 2 represents a medical problem, which has not been solved for more than a century. With the use of fundamental principles of biomechanics', a better insight of this problem and its possible causes were obtained. Chapter 3 investigates the mechanical interaction between the human teeth and some processed food products during mastication, which is a routine but crucial daily activity of a human being. Chapter 4 looks at a problem within the field of surgery. In this chapter the stability and reliability of two different Suturing-Techniques are explored. Chapters 5 and 6 represent new patent designs as a result of the investigations made in Chapter 4. Chapter 7 studies the impact and load transfer patterns during the collision between a child's head and the ground. All of the above mentioned chapters show the significance of biomechanics in solving a range of different medical problems that involve physical and or mechanical characters.

  7. Selective Prevention: Addressing Vulnerability to Problem Drug Use in Europe

    ERIC Educational Resources Information Center

    Burkhart, Gregor; Gyarmathy, V. Anna; Bo, Alessandra

    2011-01-01

    Following the 2003 publication of the European Union (EU) Council Recommendations and the 2005-2008 and 2009-2012 EU Drugs Action Plans, increasing attention has been given in EU member states' drug policies to populations that are vulnerable to problem drug use (PDU). Monitoring data reported to the EMCDDA by designated agencies from 30 countries…

  8. Seeding and harvest: a framework for unsupervised feature selection problems.

    PubMed

    Chen, Gang; Cai, Yuanli; Shi, Juan

    2012-12-27

    Feature selection, also known as attribute selection, is the technique of selecting a subset of relevant features for building robust object models. It is becoming more and more important for large-scale sensors applications with AI capabilities. The core idea of this paper is derived from a straightforward and intuitive principle saying that, if a feature subset (pattern) has more representativeness, it should be more self-organized, and as a result it should be more insensitive to artificially seeded noise points. In the light of this heuristic finding, we established the whole set of theoretical principles, based on which we proposed a two-stage framework to evaluate the relative importance of feature subsets, called seeding and harvest (S&H for short). At the first stage, we inject a number of artificial noise points into the original dataset; then at the second stage, we resort to an outlier detector to identify them under various feature patterns. The more precisely the seeded points can be extracted under a particular feature pattern, the more valuable and important the corresponding feature pattern should be. Besides, we compared our method with several state-of-the-art feature selection methods on a number of real-life datasets. The experiment results significantly confirm that our method can accomplish feature reduction tasks with high accuracy as well as low computing complexity.

  9. Seeding and Harvest: A Framework for Unsupervised Feature Selection Problems

    PubMed Central

    Chen, Gang; Cai, Yuanli; Shi, Juan

    2013-01-01

    Feature selection, also known as attribute selection, is the technique of selecting a subset of relevant features for building robust object models. It is becoming more and more important for large-scale sensors applications with AI capabilities. The core idea of this paper is derived from a straightforward and intuitive principle saying that, if a feature subset (pattern) has more representativeness, it should be more self-organized, and as a result it should be more insensitive to artificially seeded noise points. In the light of this heuristic finding, we established the whole set of theoretical principles, based on which we proposed a two-stage framework to evaluate the relative importance of feature subsets, called seeding and harvest (S&H for short). At the first stage, we inject a number of artificial noise points into the original dataset; then at the second stage, we resort to an outlier detector to identify them under various feature patterns. The more precisely the seeded points can be extracted under a particular feature pattern, the more valuable and important the corresponding feature pattern should be. Besides, we compared our method with several state-of-the-art feature selection methods on a number of real-life datasets. The experiment results significantly confirm that our method can accomplish feature reduction tasks with high accuracy as well as low computing complexity. PMID:23271599

  10. Improved Feature-Selection Method Considering the Imbalance Problem in Text Categorization

    PubMed Central

    2014-01-01

    The filtering feature-selection algorithm is a kind of important approach to dimensionality reduction in the field of the text categorization. Most of filtering feature-selection algorithms evaluate the significance of a feature for category based on balanced dataset and do not consider the imbalance factor of dataset. In this paper, a new scheme was proposed, which can weaken the adverse effect caused by the imbalance factor in the corpus. We evaluated the improved versions of nine well-known feature-selection methods (Information Gain, Chi statistic, Document Frequency, Orthogonal Centroid Feature Selection, DIA association factor, Comprehensive Measurement Feature Selection, Deviation from Poisson Feature Selection, improved Gini index, and Mutual Information) using naïve Bayes and support vector machines on three benchmark document collections (20-Newsgroups, Reuters-21578, and WebKB). The experimental results show that the improved scheme can significantly enhance the performance of the feature-selection methods. PMID:24971386

  11. Selective attention neutralizes the adverse effects of low socioeconomic status on memory in 9-month-old infants.

    PubMed

    Markant, Julie; Ackerman, Laura K; Nussenbaum, Kate; Amso, Dima

    2016-04-01

    Socioeconomic status (SES) has a documented impact on brain and cognitive development. We demonstrate that engaging spatial selective attention mechanisms may counteract this negative influence of impoverished environments on early learning. We previously used a spatial cueing task to compare target object encoding in the context of basic orienting ("facilitation") versus a spatial selective attention orienting mechanism that engages distractor suppression ("IOR"). This work showed that object encoding in the context of IOR boosted 9-month-old infants' recognition memory relative to facilitation (Markant and Amso, 2013). Here we asked whether this attention-memory link further interacted with SES in infancy. Results indicated that SES was related to memory but not attention orienting efficacy. However, the correlation between SES and memory performance was moderated by the attention mechanism engaged during encoding. SES predicted memory performance when objects were encoded with basic orienting processes, with infants from low-SES environments showing poorer memory than those from high-SES environments. However, SES did not predict memory performance among infants who engaged selective attention during encoding. Spatial selective attention engagement mitigated the effects of SES on memory and may offer an effective mechanism for promoting learning among infants at risk for poor cognitive outcomes related to SES.

  12. a Genetic Algorithm Based on Sexual Selection for the Multidimensional 0/1 Knapsack Problems

    NASA Astrophysics Data System (ADS)

    Varnamkhasti, Mohammad Jalali; Lee, Lai Soon

    In this study, a new technique is presented for choosing mate chromosomes during sexual selection in a genetic algorithm. The population is divided into groups of males and females. During the sexual selection, the female chromosome is selected by the tournament selection while the male chromosome is selected based on the hamming distance from the selected female chromosome, fitness value or active genes. Computational experiments are conducted on the proposed technique and the results are compared with some selection mechanisms commonly used for solving multidimensional 0/1 knapsack problems published in the literature.

  13. A robust optimisation approach to the problem of supplier selection and allocation in outsourcing

    NASA Astrophysics Data System (ADS)

    Fu, Yelin; Keung Lai, Kin; Liang, Liang

    2016-03-01

    We formulate the supplier selection and allocation problem in outsourcing under an uncertain environment as a stochastic programming problem. Both the decision-maker's attitude towards risk and the penalty parameters for demand deviation are considered in the objective function. A service level agreement, upper bound for each selected supplier's allocation and the number of selected suppliers are considered as constraints. A novel robust optimisation approach is employed to solve this problem under different economic situations. Illustrative examples are presented with managerial implications highlighted to support decision-making.

  14. Community-Based Providers' Selection of Practices for Children and Adolescents With Comorbid Mental Health Problems.

    PubMed

    Park, Alayna L; Moskowitz, Andrew L; Chorpita, Bruce F

    2016-09-09

    The goal of this study is to explore providers' patterns of implementation by investigating how community mental health providers selected therapy practice modules from a flexible, modular evidence-based treatment working with youths with comorbid mental health problems. Data were obtained from 57 youths, 5-15 years old, presenting with anxiety, depressive, and/or conduct problems and their 27 providers during their participation in an effectiveness trial involving a modular evidence-based treatment. Although all youths evidenced clinically elevated symptomatology in at least two problem areas, providers targeted youths' comorbid problems with only about half of their study cases. Practice modules indicated for youths' comorbid problems were typically used less frequently and with less depth relative to practice modules indicated for youths' principal clinical problem and were often transdiagnostic in nature (i.e., designed to target more than one problem area). To determine whether providers' decisions to target youths' comorbid problems were systematic, multilevel, logistic regression analyses were conducted and revealed that youths' pretreatment characteristics and time in therapy influenced providers' patterns of module selection. Providers tend to use, but not exploit, the flexibility allowed by modular EBTs and to focus treatment on youths' principal presenting problem. In addition, providers appear to make these practice choices in a systematic and rational manner, and whether and which choices are associated with improved outcomes is an important area of future study.

  15. Solving the Supreme Problem: 100 years of selection and recruitment at the Journal of Applied Psychology.

    PubMed

    Ployhart, Robert E; Schmitt, Neal; Tippins, Nancy T

    2017-03-01

    This article reviews 100 years of research on recruitment and selection published in the Journal of Applied Psychology. Recruitment and selection research has been present in the Journal from the very first issue, where Hall (1917) suggested that the challenge of recruitment and selection was the Supreme Problem facing the field of applied psychology. As this article shows, the various topics related to recruitment and selection have ebbed and flowed over the years in response to business, legal, and societal changes, but this Supreme Problem has captivated the attention of scientist-practitioners for a century. Our review starts by identifying the practical challenges and macro forces that shaped the sciences of recruitment and selection and helped to define the research questions the field has addressed. We then describe the evolution of recruitment and selection research and the ways the resulting scientific advancements have contributed to staffing practices. We conclude with speculations on how recruitment and selection research may proceed in the future. Supplemental material posted online provides additional depth by including a summary of practice challenges and scientific advancements that affected the direction of selection and recruitment research and an outline of seminal articles published in the Journal and corresponding time line. The 100-year anniversary of the Journal of Applied Psychology is very much the celebration of recruitment and selection research, although predictions about the future suggest there is still much exciting work to be done. (PsycINFO Database Record

  16. Food selectivity and problem behavior in children with developmental disabilities. Analysis and intervention.

    PubMed

    Levin, L; Carr, E G

    2001-07-01

    Excessive food selectivity typifies some children with developmental disabilities. We conducted functional analyses to determine the controlling variables for problem behavior that accompanied food selectivity and analyzed the role of establishing operations in ameliorating food selectivity. Specifically, we studied the differential effects on intervention efficacy of an individual's having or not having access to preferred food items prior to an intervention that involved the presence versus absence of a positive reinforcement contingency applied to food consumption. Participants displayed significantly more problem behavior during the nonpreferred-foods condition. Participants consumed nonpreferred target food items only when prior access to preferred foods was limited and a positive reinforcement contingency was implemented. Functional analysis suggested that problem behavior was maintained by negative reinforcement. Intervention data suggested that establishing operations increased the efficacy of the contingency-based intervention. The implications of applying this intervention in the community were discussed as were the relative merits of stimulus fading versus escape extinction intervention strategies.

  17. A GPU-Based Implementation of the Firefly Algorithm for Variable Selection in Multivariate Calibration Problems

    PubMed Central

    de Paula, Lauro C. M.; Soares, Anderson S.; de Lima, Telma W.; Delbem, Alexandre C. B.; Coelho, Clarimar J.; Filho, Arlindo R. G.

    2014-01-01

    Several variable selection algorithms in multivariate calibration can be accelerated using Graphics Processing Units (GPU). Among these algorithms, the Firefly Algorithm (FA) is a recent proposed metaheuristic that may be used for variable selection. This paper presents a GPU-based FA (FA-MLR) with multiobjective formulation for variable selection in multivariate calibration problems and compares it with some traditional sequential algorithms in the literature. The advantage of the proposed implementation is demonstrated in an example involving a relatively large number of variables. The results showed that the FA-MLR, in comparison with the traditional algorithms is a more suitable choice and a relevant contribution for the variable selection problem. Additionally, the results also demonstrated that the FA-MLR performed in a GPU can be five times faster than its sequential implementation. PMID:25493625

  18. The Application of Imperialist Competitive Algorithm for Fuzzy Random Portfolio Selection Problem

    NASA Astrophysics Data System (ADS)

    EhsanHesamSadati, Mir; Bagherzadeh Mohasefi, Jamshid

    2013-10-01

    This paper presents an implementation of the Imperialist Competitive Algorithm (ICA) for solving the fuzzy random portfolio selection problem where the asset returns are represented by fuzzy random variables. Portfolio Optimization is an important research field in modern finance. By using the necessity-based model, fuzzy random variables reformulate to the linear programming and ICA will be designed to find the optimum solution. To show the efficiency of the proposed method, a numerical example illustrates the whole idea on implementation of ICA for fuzzy random portfolio selection problem.

  19. Leader selection problem for stochastically forced consensus networks based on matrix differentiation

    NASA Astrophysics Data System (ADS)

    Gao, Leitao; Zhao, Guangshe; Li, Guoqi; Yang, Zhaoxu

    2017-03-01

    The leader selection problem refers to determining a predefined number of agents as leaders in order to minimize the mean-square deviation from consensus in stochastically forced networks. The original leader selection problem is formulated as a non-convex optimization problem where matrix variables are involved. By relaxing the constraints, a convex optimization model can be obtained. By introducing a chain rule of matrix differentiation, we can obtain the gradient of the cost function which consists matrix variables. We develop a "revisited projected gradient method" (RPGM) and a "probabilistic projected gradient method" (PPGM) to solve the two formulated convex and non-convex optimization problems, respectively. The convergence property of both methods is established. For convex optimization model, the global optimal solution can be achieved by RPGM, while for the original non-convex optimization model, a suboptimal solution is achieved by PPGM. Simulation results ranging from the synthetic to real-life networks are provided to show the effectiveness of RPGM and PPGM. This works will deepen the understanding of leader selection problems and enable applications in various real-life distributed control problems.

  20. Fuzzy Multi-Objective Vendor Selection Problem with Modified S-CURVE Membership Function

    NASA Astrophysics Data System (ADS)

    Díaz-Madroñero, Manuel; Peidro, David; Vasant, Pandian

    2010-06-01

    In this paper, the S-Curve membership function methodology is used in a vendor selection (VS) problem. An interactive method for solving multi-objective VS problems with fuzzy goals is developed. The proposed method attempts simultaneously to minimize the total order costs, the number of rejected items and the number of late delivered items with reference to several constraints such as meeting buyers' demand, vendors' capacity, vendors' quota flexibility, vendors' allocated budget, etc. We compare in an industrial case the performance of S-curve membership functions, representing uncertainty goals and constraints in VS problems, with linear membership functions.

  1. A modified genetic algorithm with fuzzy roulette wheel selection for job-shop scheduling problems

    NASA Astrophysics Data System (ADS)

    Thammano, Arit; Teekeng, Wannaporn

    2015-05-01

    The job-shop scheduling problem is one of the most difficult production planning problems. Since it is in the NP-hard class, a recent trend in solving the job-shop scheduling problem is shifting towards the use of heuristic and metaheuristic algorithms. This paper proposes a novel metaheuristic algorithm, which is a modification of the genetic algorithm. This proposed algorithm introduces two new concepts to the standard genetic algorithm: (1) fuzzy roulette wheel selection and (2) the mutation operation with tabu list. The proposed algorithm has been evaluated and compared with several state-of-the-art algorithms in the literature. The experimental results on 53 JSSPs show that the proposed algorithm is very effective in solving the combinatorial optimization problems. It outperforms all state-of-the-art algorithms on all benchmark problems in terms of the ability to achieve the optimal solution and the computational time.

  2. Thymic Selection of T-Cell Receptors as an Extreme Value Problem

    NASA Astrophysics Data System (ADS)

    Košmrlj, Andrej; Chakraborty, Arup K.; Kardar, Mehran; Shakhnovich, Eugene I.

    2009-08-01

    T lymphocytes (T cells) orchestrate adaptive immune responses upon activation. T-cell activation requires sufficiently strong binding of T-cell receptors on their surface to short peptides (p) derived from foreign proteins, which are bound to major histocompatibility gene products (displayed on antigen-presenting cells). A diverse and self-tolerant T-cell repertoire is selected in the thymus. We map thymic selection processes to an extreme value problem and provide an analytic expression for the amino acid compositions of selected T-cell receptors (which enable its recognition functions).

  3. Association between Selective Serotonin Reuptake Inhibitor Therapy and Suicidality: Analysis of U.S. Food and Drug Administration Adverse Event Reporting System Data.

    PubMed

    Umetsu, Ryogo; Abe, Junko; Ueda, Natsumi; Kato, Yamato; Matsui, Toshinobu; Nakayama, Yoko; Kinosada, Yasutomi; Nakamura, Mitsuhiro

    2015-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are prescribed for the treatment of depression worldwide. SSRIs are suspected to increase the risk of suicidal ideation and behavior (suicidality) in children, adolescents, and young adults. We examined the association between SSRI therapy and suicidality by applying a logistic regression model to age-stratified data from the Food and Drug Administration (FDA) Adverse Event Reporting System database. We attempted to mitigate the effect of patient-related factors by data subsetting. We selected case reports for SSRIs as referred to in the World Health Organization Anatomical Therapeutic Chemical classification code N06AB. The association between SSRIs and "suicidal events" or "self-harm events" was calculated as a reporting odds ratio (ROR) and adjusted for covariates by logistic regression. For subjects <18 years old (y.o.) the adjusted RORs (95% confidence interval) of SSRI therapy with suicidal events were 9.58 (8.97-10.23) in the whole data analysis and 4.64 (4.15-5.19) in the subset analysis; those with self-harm events were 31.40 (27.71-35.58) and 16.31 (13.12-20.29), respectively. Although the adjusted RORs were lower in the subset analyses than in the whole data analyses, both analyses indicated associations between SSRI treatment and suicidal and self-harm events. In both analyses these associations were stronger in the <18 y.o. group than other age groups. Children and adolescents should be closely monitored for the occurrence of suicidality when they are prescribed SSRIs. In addition, we found that data subsetting might mitigate the effect of an intrinsic risk among patients taking the suspected drug.

  4. Study on MAX-MIN Ant System with Random Selection in Quadratic Assignment Problem

    NASA Astrophysics Data System (ADS)

    Iimura, Ichiro; Yoshida, Kenji; Ishibashi, Ken; Nakayama, Shigeru

    Ant Colony Optimization (ACO), which is a type of swarm intelligence inspired by ants' foraging behavior, has been studied extensively and its effectiveness has been shown by many researchers. The previous studies have reported that MAX-MIN Ant System (MMAS) is one of effective ACO algorithms. The MMAS maintains the balance of intensification and diversification concerning pheromone by limiting the quantity of pheromone to the range of minimum and maximum values. In this paper, we propose MAX-MIN Ant System with Random Selection (MMASRS) for improving the search performance even further. The MMASRS is a new ACO algorithm that is MMAS into which random selection was newly introduced. The random selection is one of the edgechoosing methods by agents (ants). In our experimental evaluation using ten quadratic assignment problems, we have proved that the proposed MMASRS with the random selection is superior to the conventional MMAS without the random selection in the viewpoint of the search performance.

  5. The Treatment of Food Selectivity and Other Feeding Problems in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Fodstad, Jill C.

    2009-01-01

    Food selectivity and other feeding problems are endemic in children with autism spectrum disorders (ASD). Additionally, many of the challenging behaviors which fall into this category are idiosyncratic to ASD. A technology is beginning to emerge regarding methods to lessen and effectively treat these issues which, if unchecked, can result in poor…

  6. Listening Diary in the Digital Age: Students' Material Selection, Listening Problems, and Perceived Usefulness

    ERIC Educational Resources Information Center

    Chen, Cheryl Wei-yu

    2016-01-01

    The current study reports on a group of Taiwanese college students' first-person diary accounts of their private, transactional listening activities outside the classroom. Issues related to students' material selection, listening problems, and perceived usefulness of keeping a listening diary were explored. It was found that most students chose…

  7. Fuzzy Random λ-Mean SAD Portfolio Selection Problem: An Ant Colony Optimization Approach

    NASA Astrophysics Data System (ADS)

    Thakur, Gour Sundar Mitra; Bhattacharyya, Rupak; Mitra, Swapan Kumar

    2010-10-01

    To reach the investment goal, one has to select a combination of securities among different portfolios containing large number of securities. Only the past records of each security do not guarantee the future return. As there are many uncertain factors which directly or indirectly influence the stock market and there are also some newer stock markets which do not have enough historical data, experts' expectation and experience must be combined with the past records to generate an effective portfolio selection model. In this paper the return of security is assumed to be Fuzzy Random Variable Set (FRVS), where returns are set of random numbers which are in turn fuzzy numbers. A new λ-Mean Semi Absolute Deviation (λ-MSAD) portfolio selection model is developed. The subjective opinions of the investors to the rate of returns of each security are taken into consideration by introducing a pessimistic-optimistic parameter vector λ. λ-Mean Semi Absolute Deviation (λ-MSAD) model is preferred as it follows absolute deviation of the rate of returns of a portfolio instead of the variance as the measure of the risk. As this model can be reduced to Linear Programming Problem (LPP) it can be solved much faster than quadratic programming problems. Ant Colony Optimization (ACO) is used for solving the portfolio selection problem. ACO is a paradigm for designing meta-heuristic algorithms for combinatorial optimization problem. Data from BSE is used for illustration.

  8. Attentional Selectivity and the Problems of Replication: A Reply to Forster and Grierson.

    ERIC Educational Resources Information Center

    Hockey, Robert

    1978-01-01

    The author indicates a number of methodological differences between his experiments and the unsuccessful replication by Forster and Grierson. He also suggests that these problems are complicated by an unnecessarily narrow interpretation of the attentional selectivity hypothesis. Forster and Grierson's study and rejoinder appear in this journal…

  9. On the location selection problem using analytic hierarchy process and multi-choice goal programming

    NASA Astrophysics Data System (ADS)

    Ho, Hui-Ping; Chang, Ching-Ter; Ku, Cheng-Yuan

    2013-01-01

    Location selection is a crucial decision in cost/benefit analysis of restaurants, coffee shops and others. However, it is difficult to be solved because there are many conflicting multiple goals in the problem of location selection. In order to solve the problem, this study integrates analytic hierarchy process (AHP) and multi-choice goal programming (MCGP) as a decision aid to obtain an appropriate house from many alternative locations that better suit the preferences of renters under their needs. This study obtains weights from AHP and implements it upon each goal using MCGP for the location selection problem. According to the function of multi-aspiration provided by MCGP, decision makers can set multi-aspiration for each location goal to rank the candidate locations. Compared to the unaided selection processes, the integrated approach of AHP and MCGP is a better scientific and efficient method than traditional methods in finding a suitable location for buying or renting a house for business, especially under multiple qualitative and quantitative criteria within a shorter evaluation time. In addition, a real case is provided to demonstrate the usefulness of the proposed method. The results show that the proposed method is able to provide better quality decision than normal manual methods.

  10. Pattern selection and tip perturbations in the Saffman-Taylor problem

    NASA Technical Reports Server (NTRS)

    Hong, D. C.; Langer, J. S.

    1987-01-01

    An analytic approach to the Saffman-Taylor problem of predicting the width of a viscous finger in a Hele-Shaw cell is presented. The first purpose is to provide a systematic description of the way in which the singular perturbation introduced by capillary forces leads to a solvability mechanism for pattern selection. It is then shown how recent experimental observations by Couder et al. (1986) may be interpreted in terms suggested by this mechanism.

  11. An efficient heuristic method for dynamic portfolio selection problem under transaction costs and uncertain conditions

    NASA Astrophysics Data System (ADS)

    Najafi, Amir Abbas; Pourahmadi, Zahra

    2016-04-01

    Selecting the optimal combination of assets in a portfolio is one of the most important decisions in investment management. As investment is a long term concept, looking into a portfolio optimization problem just in a single period may cause loss of some opportunities that could be exploited in a long term view. Hence, it is tried to extend the problem from single to multi-period model. We include trading costs and uncertain conditions to this model which made it more realistic and complex. Hence, we propose an efficient heuristic method to tackle this problem. The efficiency of the method is examined and compared with the results of the rolling single-period optimization and the buy and hold method which shows the superiority of the proposed method.

  12. Thymic Selection of T-Cell Receptors as an Extreme Value Problem

    NASA Astrophysics Data System (ADS)

    Kosmrlj, Andrej; Chakraborty, Arup K.; Kardar, Mehran; Shakhnovich, Eugene I.

    2010-03-01

    T lymphocytes (T cells) orchestrate adaptive immune responses that clear pathogens from infected hosts. T cells recognize short peptides (p) derived from foreign proteins, which are bound to major histocompatibility complex (MHC) gene products (displayed on antigen- presenting cells). Recognition occurs when T cell receptor (TCR) proteins expressed on T cells bind sufficiently strongly to antigen- derived pMHC complexes on the surface of antigen-presenting cells. A diverse repertoire of self-tolerant TCR sequences is shaped during development of T cells in the thymus by processes called positive and negative selection. We map thymic selection processes to an extreme value problem and provide analytic expression for the amino acid composition of selected TCR sequences (which enable its recognition functions).

  13. Cutaneous adverse reactions to lenalidomide.

    PubMed

    Imbesi, S; Allegra, A; Calapai, G; Musolino, C; Gangemi, S

    2015-01-01

    Lenalidomide is an immunomodulatory drug (IMiD) used principally in the treatment of multiple myeloma (MM), myelodysplastic syndromes (MS) and amyloidosis. Adverse reactions related to lenalidomide include myelosuppression (mainly neutropenia but also thrombocytopenia), gastrointestinal problems, skin eruption, atrial fibrillation and asthenia, decreased peripheral blood stem cell yield during stem cell collection, venous thromboembolism, and secondary malignances. In this review we focused our attention on the cutaneous adverse reactions to lenalidomide.

  14. Behavior problems among children from different family structures: the influence of genetic self-selection.

    PubMed

    Cleveland, H H; Wiebe, R P; van den Oord, E J; Rowe, D C

    2000-01-01

    To examine both genetic and environmental influences on children's behavior problems in households defined by marital status and sibling relatedness, this study applied behavioral genetic methodology to four groups totalling 1524 sibling pairs drawn from 796 households: (1) two-parent full siblings, (2) two-parent half siblings, (3) mother-only full siblings, and (4) mother-only half siblings. Model-fitting procedures found that within-group variation on four subscales from the Behavior Problems Index was best explained by a model including both genetic and shared environmental factors. This model was then fit to the behavior problems means of the four groups. Its successful fit to these mean structures suggested that mean-level differences between groups were explained with the same influences that accounted for within-group variation. Genetic influences accounted for 81% to 94% of the mean-level difference in behavior problems between the two-parent, full sibling and the mother-only, half sibling groups. In contrast, shared environmental influences accounted for 67% to 88% of the mean-level difference in behavior problems between the two-parent, full sibling and mother-only, full sibling groups. The genetic influences are interpreted in terms of genetic self-selection into family structures.

  15. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Curtin, C.; Hubbard, K.; Anderson, S. E.; Mick, E.; Must, A.; Bandini, L. G.

    2015-01-01

    Mealtime behavior problems and family stress occur frequently among families of children with autism spectrum disorder (ASD). However, it is unknown whether food selectivity is an associated factor. The associations of high food selectivity with mealtime behavior problems, spousal stress, and influence on family members were assessed among 53…

  16. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder

    PubMed Central

    Curtin, C.; Hubbard, K.; Anderson, S.E.; Mick, E.; Must, A.; Bandini, L.G.

    2015-01-01

    Mealtime behavior problems and family stress occur frequently among families of children with autism spectrum disorder (ASD). However, it is unknown whether food selectivity is an associated factor. The associations of high food selectivity with mealtime behavior problems, spousal stress, and influence on family members were assessed among 53 children with ASD and 58 typically developing (TD) children ages 3–11 years. Compared to TD children, children with ASD were more likely to have high food selectivity, and their parents reported more mealtime behavior problems, higher spousal stress, and influence on what other family members ate. High food selectivity was associated with mealtime behavior problems in both groups. Interventions to reduce food selectivity may lead to decreases in mealtime behavior problems. PMID:26070276

  17. Solving portfolio selection problems with minimum transaction lots based on conditional-value-at-risk

    NASA Astrophysics Data System (ADS)

    Setiawan, E. P.; Rosadi, D.

    2017-01-01

    Portfolio selection problems conventionally means ‘minimizing the risk, given the certain level of returns’ from some financial assets. This problem is frequently solved with quadratic or linear programming methods, depending on the risk measure that used in the objective function. However, the solutions obtained by these method are in real numbers, which may give some problem in real application because each asset usually has its minimum transaction lots. In the classical approach considering minimum transaction lots were developed based on linear Mean Absolute Deviation (MAD), variance (like Markowitz’s model), and semi-variance as risk measure. In this paper we investigated the portfolio selection methods with minimum transaction lots with conditional value at risk (CVaR) as risk measure. The mean-CVaR methodology only involves the part of the tail of the distribution that contributed to high losses. This approach looks better when we work with non-symmetric return probability distribution. Solution of this method can be found with Genetic Algorithm (GA) methods. We provide real examples using stocks from Indonesia stocks market.

  18. Self-Regulatory Strategies in Daily Life: Selection, Optimization, and Compensation and Everyday Memory Problems

    PubMed Central

    Stephanie, Robinson; Margie, Lachman; Elizabeth, Rickenbach

    2015-01-01

    The effective use of self-regulatory strategies, such as selection, optimization, and compensation (SOC) requires resources. However, it is theorized that SOC use is most advantageous for those experiencing losses and diminishing resources. The present study explored this seeming paradox within the context of limitations or constraints due to aging, low cognitive resources, and daily stress in relation to everyday memory problems. We examined whether SOC usage varied by age and level of constraints, and if the relationship between resources and memory problems was mitigated by SOC usage. A daily diary paradigm was used to explore day-to-day fluctuations in these relationships. Participants (n=145, ages 22 to 94) completed a baseline interview and a daily diary for seven consecutive days. Multilevel models examined between- and within-person relationships between daily SOC use, daily stressors, cognitive resources, and everyday memory problems. Middle-aged adults had the highest SOC usage, although older adults also showed high SOC use if they had high cognitive resources. More SOC strategies were used on high stress compared to low stress days. Moreover, the relationship between daily stress and memory problems was buffered by daily SOC use, such that on high-stress days, those who used more SOC strategies reported fewer memory problems than participants who used fewer SOC strategies. The paradox of resources and SOC use can be qualified by the type of resource-limitation. Deficits in global resources were not tied to SOC usage or benefits. Conversely, under daily constraints tied to stress, the use of SOC increased and led to fewer memory problems. PMID:26997686

  19. Salience: the key to the selection problem in natural language generation

    SciTech Connect

    Conklin, E.J.; McDonald, D.D.

    1982-01-01

    The authors argue that in domains where a strong notion of salience can be defined, it can be used to provide: (1) an elegant solution to the selection problem, i.e. the problem of how to decide whether a given fact should or should not be mentioned in the text; and (2) a simple and direct control framework for the entire deep generation process, coordinating proposing, planning, and realization. (Deep generation involves reasoning about conceptual and rhetorical facts, as opposed to the narrowly linguistic reasoning that takes place during realization.) The authors report on an empirical study of salience in pictures of natural scenes, and its use in a computer program that generates descriptive paragraphs comparable to those produced by people. 13 references.

  20. Selected topics on the active control of helicopter aeromechanical and vibration problems

    NASA Technical Reports Server (NTRS)

    Friedmann, Peretz P.

    1994-01-01

    This paper describes in a concise manner three selected topics on the active control of helicopter aeromechanical and vibration problems. The three topics are as follows: (1) the active control of helicopter air-resonance using an LQG/LTR approach; (2) simulation of higher harmonic control (HHC) applied to a four bladed hingeless helicopter rotor in forward flight; and (3) vibration suppression in forward flight on a hingeless helicopter rotor using an actively controlled, partial span, trailing edge flap, which is mounted on the blade. Only a few selected illustrative results are presented. The results obtained clearly indicate that the partial span, actively controlled flap has considerable potential for vibration reduction in helicopter rotors.

  1. Selected problems associated with the treatment and care for patients with colostomy – part 2

    PubMed Central

    Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

  2. Adaptation Problems of the Post Industrial Heritage on the Example of Selected Objects of Bydgoszcz

    NASA Astrophysics Data System (ADS)

    Pszczółkowski, Michał

    2016-09-01

    Post-industrial architecture was until recently regarded as devoid of value and importance due to obsolescence, but this awareness has been a clear change in recent years. The old factories become full-fledged cultural heritage, as evidenced by the inclusion of buildings and complexes of this type in the register of monuments and protected by their conservator. More and more often, therefore, one undertakes revitalization of degraded brownfield sites, and within these treatments - conversion works. Specific issues and problems related to the adaptation of industrial facilities are discussed in the article on the basis of selected examples, completed in recent years in Bydgoszcz.

  3. How Important Are Student-Selected versus Instructor-Selected Literature Resources for Students' Learning and Motivation in Problem-Based Learning?

    ERIC Educational Resources Information Center

    Wijnia, Lisette; Loyens, Sofie M.; Derous, Eva; Schmidt, Henk G.

    2015-01-01

    In problem-based learning students are responsible for their own learning process, which becomes evident when they must act independently, for example, when selecting literature resources for individual study. It is a matter of debate whether it is better to have students select their own literature resources or to present them with a list of…

  4. Correlation and studies of habitat selection: problem, red herring or opportunity?

    PubMed Central

    Fieberg, John; Matthiopoulos, Jason; Hebblewhite, Mark; Boyce, Mark S.; Frair, Jacqueline L.

    2010-01-01

    With the advent of new technologies, animal locations are being collected at ever finer spatio-temporal scales. We review analytical methods for dealing with correlated data in the context of resource selection, including post hoc variance inflation techniques, ‘two-stage’ approaches based on models fit to each individual, generalized estimating equations and hierarchical mixed-effects models. These methods are applicable to a wide range of correlated data problems, but can be difficult to apply and remain especially challenging for use–availability sampling designs because the correlation structure for combinations of used and available points are not likely to follow common parametric forms. We also review emerging approaches to studying habitat selection that use fine-scale temporal data to arrive at biologically based definitions of available habitat, while naturally accounting for autocorrelation by modelling animal movement between telemetry locations. Sophisticated analyses that explicitly model correlation rather than consider it a nuisance, like mixed effects and state-space models, offer potentially novel insights into the process of resource selection, but additional work is needed to make them more generally applicable to large datasets based on the use–availability designs. Until then, variance inflation techniques and two-stage approaches should offer pragmatic and flexible approaches to modelling correlated data. PMID:20566500

  5. Band selection for nonlinear unmixing of hyperspectral images as a maximal clique problem.

    PubMed

    Imbiriba, Tales; Bermudez, Jose Carlos; Richard, Cedric

    2017-03-01

    Kernel-based nonlinear mixing models have been applied to unmix spectral information of hyperspectral images when the type of mixing occurring in the scene is too complex or unknown. Such methods, however, usually require the inversion of matrices of sizes equal to the number of spectral bands. Reducing the computational load of these methods remains a challenge in large scale applications. This paper proposes a centralized band selection (BS) method for supervised unmixing in the reproducing kernel Hilbert space (RKHS). It is based upon the coherence criterion, which sets the largest value allowed for correlations between the basis kernel functions characterizing the selected bands in the unmixing model. We show that the proposed BS approach is equivalent to solving a maximum clique problem (MCP), i.e., searching for the biggest complete subgraph in a graph. Furthermore, we devise a strategy for selecting the coherence threshold and the Gaussian kernel bandwidth using coherence bounds for linearly independent bases. Simulation results illustrate the efficiency of the proposed method.

  6. Testosterone replacement therapy to improve secondary sexual characteristics and body composition without adverse behavioral problems in adult male patients with Prader-Willi syndrome: an observational study.

    PubMed

    Kido, Yasuhiro; Sakazume, Satoru; Abe, Yoshiko; Oto, Yuji; Itabashi, Hisashi; Shiraishi, Masahisa; Yoshino, Atsunori; Tanaka, Yuriko; Obata, Kazuo; Murakami, Nobuyuki; Nagai, Toshiro

    2013-09-01

    Prader-Willi syndrome (PWS), a complex genetic disorder, arises from suppressed expression of paternally inherited imprinted genes on chromosome 15q11-q13. Characteristics include short stature, intellectual disability, behavioral problems, hypogonadism, obesity, and reduced bone and muscle mass. Testosterone replacement (TR) remains controversial due to concerns regarding behavioral problems. To evaluate the effects of TR on secondary sexual characteristics, body composition, and behavior in adult males with PWS, 22 male PWS patients over the age of 16 with behavioral scores of less than grade 4 on the Modified Overt Aggression Scale (MOAS) underwent monthly intramuscular TR (125 mg). Pubertal change, body composition and behavior were evaluated before and after 24 months of therapy. Serum testosterone, LH, and FSH did not change. Increased pubic hair was observed in 16 of 22 patients (72.7%). Percent body fat decreased from 47.55 ± 2.06% to 39.75 ± 1.60% (n = 18) (P = 0.018). Bone mineral density increased from 0.8505 ± 0.0426 g/cm(2) to 0.9035 ± 0.0465 g/cm(2) (n = 18) (P = 0.036), and lean body mass increased from 18093.4 ± 863.0 g to 20312.1 ± 1027.2 g (n = 18) (P = 0.009). The MOAS was unchanged, from 4.5 ± 2.0 at the beginning of the study to 3.0 ± 1.7 at the end of study indicating no increase in aggression. No behavioral problems were observed. Based on this pilot study, TR with 125 mg monthly is a potentially safe and useful intervention for adult males with PWS.

  7. Model Selection Criteria for Missing-Data Problems Using the EM Algorithm.

    PubMed

    Ibrahim, Joseph G; Zhu, Hongtu; Tang, Niansheng

    2008-12-01

    We consider novel methods for the computation of model selection criteria in missing-data problems based on the output of the EM algorithm. The methodology is very general and can be applied to numerous situations involving incomplete data within an EM framework, from covariates missing at random in arbitrary regression models to nonignorably missing longitudinal responses and/or covariates. Toward this goal, we develop a class of information criteria for missing-data problems, called IC(H) (,) (Q), which yields the Akaike information criterion and the Bayesian information criterion as special cases. The computation of IC(H) (,) (Q) requires an analytic approximation to a complicated function, called the H-function, along with output from the EM algorithm used in obtaining maximum likelihood estimates. The approximation to the H-function leads to a large class of information criteria, called IC(H̃) (() (k) (),) (Q). Theoretical properties of IC(H̃) (() (k) (),) (Q), including consistency, are investigated in detail. To eliminate the analytic approximation to the H-function, a computationally simpler approximation to IC(H) (,) (Q), called IC(Q), is proposed, the computation of which depends solely on the Q-function of the EM algorithm. Advantages and disadvantages of IC(H̃) (() (k) (),) (Q) and IC(Q) are discussed and examined in detail in the context of missing-data problems. Extensive simulations are given to demonstrate the methodology and examine the small-sample and large-sample performance of IC(H̃) (() (k) (),) (Q) and IC(Q) in missing-data problems. An AIDS data set also is presented to illustrate the proposed methodology.

  8. A Hidden Markov Model Approach to the Problem of Heuristic Selection in Hyper-heuristics with a Case Study in High School Timetabling Problems.

    PubMed

    Kheiri, Ahmed; Keedwell, Ed

    2016-06-03

    Operations research is a well established field that uses computational systems to support decisions in business and public life. Good solutions to operations research problems can make a large difference to the efficient running of businesses and organisations and so the field often searches for new methods to improve these solutions. The high school timetabling problem is an example of an operations research problem and is a challenging task which requires assigning events and resources to time slots subject to a set of constraints. In this paper a new sequence-based selection hyper-heuristic is presented that produces excellent results on a suite of high school timetabling problems. In this study, we present an easy-to-implement, easy-to-maintain and effective sequence-based selection hyper-heuristic to solve high school timetabling problems using a benchmark of unified real-world instances collected from different countries. We show that with sequence-based methods, it is possible to discover new best known solutions for a number of the problems in the timetabling domain. Through this investigation, the usefulness of sequence-based selection hyper-heuristics has been demonstrated and the capability of these methods has been shown to exceed the state-of-the-art.

  9. Adverse effects of cannabis.

    PubMed

    2011-01-01

    Cannabis, Cannabis sativa L., is used to produce a resin that contains high levels of cannabinoids, particularly delta9-tetrahydrocannabinol (THC), which are psychoactive substances. Although cannabis use is illegal in France and in many other countries, it is widely used for its relaxing or euphoric effects, especially by adolescents and young adults. What are the adverse effects of cannabis on health? During consumption? And in the long term? Does cannabis predispose users to the development of psychotic disorders? To answer these questions, we reviewed the available evidence using the standard Prescrire methodology. The long-term adverse effects of cannabis are difficult to evaluate. Since and associated substances, with or without the user's knowledge. Tobacco and alcohol consumption, and particular lifestyles and behaviours are often associated with cannabis use. Some traits predispose individuals to the use of psychoactive substances in general. The effects of cannabis are dosedependent.The most frequently report-ed adverse effects are mental slowness, impaired reaction times, and sometimes accentuation of anxiety. Serious psychological disorders have been reported with high levels of intoxication. The relationship between poor school performance and early, regular, and frequent cannabis use seems to be a vicious circle, in which each sustains the other. Many studies have focused on the long-term effects of cannabis on memory, but their results have been inconclusive. There do not * About fifteen longitudinal cohort studies that examined the influence of cannabis on depressive thoughts or suicidal ideation have yielded conflicting results and are inconclusive. Several longitudinal cohort studies have shown a statistical association between psychotic illness and self-reported cannabis use. However, the results are difficult to interpret due to methodological problems, particularly the unknown reliability of self-reported data. It has not been possible to

  10. Assessing age-related patterns in strategy selection on a mathematical problem-solving task.

    PubMed

    Lamson, Nina; Rogers, Wendy A

    2008-05-01

    We examined age-related differences in strategy-choice behavior in 27 younger and 28 older adults. Participants solved 4 two-digit by two-digit multiplication problems. We expected them to initially calculate the answers but eventually switch to a retrieval strategy, recalling answers from memory. Three groups emerged: younger adults who met the criterion (20 consecutive, correct, retrieval trials selected and answered in time), older adults who met the criterion, and older adults who did not meet the criterion. Younger and older adults who met the criterion had similar performance patterns. Some older adults who did not meet the criterion were slower to learn, whereas others seemed to be averse to the retrieval strategy. Thus, older adult patterns in strategy choice are considerably more varied than younger adult patterns, suggesting different explanations for differences in memory performance.

  11. Space pruning monotonic search for the non-unique probe selection problem.

    PubMed

    Pappalardo, Elisa; Ozkok, Beyza Ahlatcioglu; Pardalos, Panos M

    2014-01-01

    Identification of targets, generally viruses or bacteria, in a biological sample is a relevant problem in medicine. Biologists can use hybridisation experiments to determine whether a specific DNA fragment, that represents the virus, is presented in a DNA solution. A probe is a segment of DNA or RNA, labelled with a radioactive isotope, dye or enzyme, used to find a specific target sequence on a DNA molecule by hybridisation. Selecting unique probes through hybridisation experiments is a difficult task, especially when targets have a high degree of similarity, for instance in a case of closely related viruses. After preliminary experiments, performed by a canonical Monte Carlo method with Heuristic Reduction (MCHR), a new combinatorial optimisation approach, the Space Pruning Monotonic Search (SPMS) method, is introduced. The experiments show that SPMS provides high quality solutions and outperforms the current state-of-the-art algorithms.

  12. Is the Process the Problem? Impact of Selection Methods on Reported Job Satisfaction among Academic Department Chairs

    ERIC Educational Resources Information Center

    Fairchild, Julie E.

    2013-01-01

    The problem of low job satisfaction (JS) among academic department chairs (ADC) may result from the selection process. ADC searches seldom comply with best practices for hiring or are predictive of a good fit. Formal searches are seldom used. Some incumbents did not want the job. Research into the history, nature, and problems of the position…

  13. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    NASA Astrophysics Data System (ADS)

    Lurkittikul, N.; Kittithreerapronchai, O.

    2014-06-01

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients.

  14. Vaccine Adverse Events

    MedlinePlus

    ... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Vaccines, Blood & Biologics Home Vaccines, Blood & Biologics Safety & Availability ( ... Center for Biologics Evaluation & Research Vaccine Adverse Events Vaccine Adverse Events Share Tweet Linkedin Pin it More ...

  15. The multi-objective decision making methods based on MULTIMOORA and MOOSRA for the laptop selection problem

    NASA Astrophysics Data System (ADS)

    Aytaç Adalı, Esra; Tuş Işık, Ayşegül

    2016-10-01

    A decision making process requires the values of conflicting objectives for alternatives and the selection of the best alternative according to the needs of decision makers. Multi-objective optimization methods may provide solution for this selection. In this paper it is aimed to present the laptop selection problem based on MOORA plus full multiplicative form (MULTIMOORA) and multi-objective optimization on the basis of simple ratio analysis (MOOSRA) which are relatively new multi-objective optimization methods. The novelty of this paper is solving this problem with the MULTIMOORA and MOOSRA methods for the first time.

  16. Reduced-Size Integer Linear Programming Models for String Selection Problems: Application to the Farthest String Problem.

    PubMed

    Zörnig, Peter

    2015-08-01

    We present integer programming models for some variants of the farthest string problem. The number of variables and constraints is substantially less than that of the integer linear programming models known in the literature. Moreover, the solution of the linear programming-relaxation contains only a small proportion of noninteger values, which considerably simplifies the rounding process. Numerical tests have shown excellent results, especially when a small set of long sequences is given.

  17. Valid inequalities and facets for a hypergraph model of the nonlinear knapsack and the FMS part selection problems

    SciTech Connect

    Crama, Y.; Mazzola, J.

    1994-12-31

    This paper defines the dense subhypergraph problem (DSP), which provides a generalized modelling framework for the nonlinear knapsack problem and other well-known problems arising in areas such as capital budgeting, flexible manufacturing system production planning, repair-kit selection, and compiler construction. We define several families of valid inequalities and state conditions under which these inequalities are facet-defining for DSP. We also explore the polyhedral structure of the cardinality-constrained DSP. Finally, we examine a special case of this problem that arises, for example, within the context of Lagrangian decomposition. For this case, we present a complete description of the convex hull of the feasible region.

  18. Source selection problem of competitive power plants under government intervention: a game theory approach

    NASA Astrophysics Data System (ADS)

    Mahmoudi, Reza; Hafezalkotob, Ashkan; Makui, Ahmad

    2014-06-01

    Pollution and environmental protection in the present century are extremely significant global problems. Power plants as the largest pollution emitting industry have been the cause of a great deal of scientific researches. The fuel or source type used to generate electricity by the power plants plays an important role in the amount of pollution produced. Governments should take visible actions to promote green fuel. These actions are often called the governmental financial interventions that include legislations such as green subsidiaries and taxes. In this paper, by considering the government role in the competition of two power plants, we propose a game theoretical model that will help the government to determine the optimal taxes and subsidies. The numerical examples demonstrate how government could intervene in a competitive market of electricity to achieve the environmental objectives and how power plants maximize their utilities in each energy source. The results also reveal that the government's taxes and subsidiaries effectively influence the selected fuel types of power plants in the competitive market.

  19. Bayesian Factor Analysis as a Variable-Selection Problem: Alternative Priors and Consequences.

    PubMed

    Lu, Zhao-Hua; Chow, Sy-Miin; Loken, Eric

    2016-01-01

    Factor analysis is a popular statistical technique for multivariate data analysis. Developments in the structural equation modeling framework have enabled the use of hybrid confirmatory/exploratory approaches in which factor-loading structures can be explored relatively flexibly within a confirmatory factor analysis (CFA) framework. Recently, Muthén & Asparouhov proposed a Bayesian structural equation modeling (BSEM) approach to explore the presence of cross loadings in CFA models. We show that the issue of determining factor-loading patterns may be formulated as a Bayesian variable selection problem in which Muthén and Asparouhov's approach can be regarded as a BSEM approach with ridge regression prior (BSEM-RP). We propose another Bayesian approach, denoted herein as the Bayesian structural equation modeling with spike-and-slab prior (BSEM-SSP), which serves as a one-stage alternative to the BSEM-RP. We review the theoretical advantages and disadvantages of both approaches and compare their empirical performance relative to two modification indices-based approaches and exploratory factor analysis with target rotation. A teacher stress scale data set is used to demonstrate our approach.

  20. Causal Factors Influencing Adversity Quotient of Twelfth Grade and Third-Year Vocational Students

    ERIC Educational Resources Information Center

    Pangma, Rachapoom; Tayraukham, Sombat; Nuangchalerm, Prasart

    2009-01-01

    Problem statement: The aim of this research was to study the causal factors influencing students' adversity between twelfth grade and third-year vocational students in Sisaket province, Thailand. Six hundred and seventy two of twelfth grade and 376 third-year vocational students were selected by multi-stage random sampling techniques. Approach:…

  1. LETTER TO THE EDITOR: Information complexity-based regularization parameter selection for solution of ill conditioned inverse problems

    NASA Astrophysics Data System (ADS)

    Urmanov, A. M.; Gribok, A. V.; Bozdogan, H.; Hines, J. W.; Uhrig, R. E.

    2002-04-01

    We propose an information complexity-based regularization parameter selection method for solution of ill conditioned inverse problems. The regularization parameter is selected to be the minimizer of the Kullback-Leibler (KL) distance between the unknown data-generating distribution and the fitted distribution. The KL distance is approximated by an information complexity criterion developed by Bozdogan. The method is not limited to the white Gaussian noise case. It can be extended to correlated and non-Gaussian noise. It can also account for possible model misspecification. We demonstrate the performance of the proposed method on a test problem from Hansen's regularization tools.

  2. Social Networks and the Diffusion of Adolescent Problem Behavior: Reliable Estimates of Selection and Influence from Sixth Through Ninth Grades.

    PubMed

    Osgood, D Wayne; Feinberg, Mark E; Ragan, Daniel T

    2015-08-01

    Seeking to reduce problematic peer influence is a prominent theme of programs to prevent adolescent problem behavior. To support the refinement of this aspect of prevention programming, we examined peer influence and selection processes for three problem behaviors (delinquency, alcohol use, and smoking). We assessed not only the overall strengths of these peer processes, but also their consistency versus variability across settings. We used dynamic stochastic actor-based models to analyze five waves of friendship network data across sixth through ninth grades for a large sample of U.S. adolescents. Our sample included two successive grade cohorts of youth in 26 school districts participating in the PROSPER study, yielding 51 longitudinal social networks based on respondents' friendship nominations. For all three self-reported antisocial behaviors, we found evidence of both peer influence and selection processes tied to antisocial behavior. There was little reliable variance in these processes across the networks, suggesting that the statistical imprecision of the peer influence and selection estimates in previous studies likely accounts for inconsistencies in results. Adolescent friendship networks play a strong role in shaping problem behavior, but problem behaviors also inform friendship choices. In addition to preferring friends with similar levels of problem behavior, adolescents tend to choose friends who engage in problem behaviors, thus creating broader diffusion.

  3. An Examination of Selected Aspects of Pitch-Matching Problems among Children.

    ERIC Educational Resources Information Center

    Howle, Mary Jeanette

    1992-01-01

    This article presents findings from the literature and professionals of music education concerning the characteristics of problem singers, the manifestations of the problem, suggested causes of poor singing, and possible procedures for correcting the problem. It also attempts to determine any parallels between existing research findings and…

  4. Instructional Designers' Media Selection Practices for Distributed Problem-Based Learning Environments

    ERIC Educational Resources Information Center

    Fells, Stephanie

    2012-01-01

    The design of online or distributed problem-based learning (dPBL) is a nascent, complex design problem. Instructional designers are challenged to effectively unite the constructivist principles of problem-based learning (PBL) with appropriate media in order to create quality dPBL environments. While computer-mediated communication (CMC) tools and…

  5. Analysis of an Interactive Technology Supported Problem-Based Learning STEM Project Using Selected Learning Sciences Interest Areas (SLSIA)

    ERIC Educational Resources Information Center

    Kumar, David Devraj

    2017-01-01

    This paper reports an analysis of an interactive technology-supported, problem-based learning (PBL) project in science, technology, engineering and mathematics (STEM) from a Learning Sciences perspective using the Selected Learning Sciences Interest Areas (SLSIA). The SLSIA was adapted from the "What kinds of topics do ISLS [International…

  6. Estimating the "Impact" of Out-of-Home Placement on Child Well-Being: Approaching the Problem of Selection Bias

    ERIC Educational Resources Information Center

    Berger, Lawrence M.; Bruch, Sarah K.; Johnson, Elizabeth I.; James, Sigrid; Rubin, David

    2009-01-01

    This study used data on 2,453 children aged 4-17 from the National Survey of Child and Adolescent Well-Being and 5 analytic methods that adjust for selection factors to estimate the impact of out-of-home placement on children's cognitive skills and behavior problems. Methods included ordinary least squares (OLS) regressions and residualized…

  7. Effects on Learners' Performance of Using Selected and Open Network Resources in a Problem-Based Learning Activity

    ERIC Educational Resources Information Center

    Hsu, Ching-Kun; Hwang, Gwo-Jen; Chuang, Chien-Wen; Chang, Chih-Kai

    2012-01-01

    Owing to the popularity of computers and computer networks, fostering the web-based problem-solving ability of students has become an important educational objective in recent years. This study attempted to compare the effects of using selected and open network resources on students' intentions with regard to their information system usage by…

  8. Problems with Federal Equal Employment Opportunity Guidelines on Employee Selection Procedures Need to Be Resolved. Report to the Congress.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    This report for Congress discusses the problems involved in developing, putting into practice, and complying with federal equal employment opportunity (EEO) guidelines on employee selection and makes some recommendations. It also discusses other factors which influence the concept of equal employment opportunity and how the concept can be realized…

  9. Estimating the "impact" of out-of-home placement on child well-being: approaching the problem of selection bias.

    PubMed

    Berger, Lawrence M; Bruch, Sarah K; Johnson, Elizabeth I; James, Sigrid; Rubin, David

    2009-01-01

    This study used data on 2,453 children aged 4-17 from the National Survey of Child and Adolescent Well-Being and 5 analytic methods that adjust for selection factors to estimate the impact of out-of-home placement on children's cognitive skills and behavior problems. Methods included ordinary least squares (OLS) regressions and residualized change, simple change, difference-in-difference, and fixed effects models. Models were estimated using the full sample and a matched sample generated by propensity scoring. Although results from the unmatched OLS and residualized change models suggested that out-of-home placement is associated with increased child behavior problems, estimates from models that more rigorously adjust for selection bias indicated that placement has little effect on children's cognitive skills or behavior problems.

  10. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    SciTech Connect

    Daniels, J.I.

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of [sup 239,24O]Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual [sup 239]Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with [sup 239,24O]Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10[sup [minus]6], 6 x 10[sup [minus]5], and 5 x 10[sup [minus]4], respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  11. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    SciTech Connect

    Daniels, J.I.; Anspaugh, L.R.; Bogen, K.T.; Daniels, J.I.; Layton, D.W.; Straume, T.; Andricevic, R.; Jacobson, R.L.; Meinhold, A.F.; Holtzman, S.; Morris, S.C.; Hamilton, L.D.

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of {sup 239,24O}Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual {sup 239}Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with {sup 239,24O}Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10{sup {minus}6}, 6 x 10{sup {minus}5}, and 5 x 10{sup {minus}4}, respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  12. Assessing Student Problem-Solving Success on Selected Topics in Introductory Chemistry.

    ERIC Educational Resources Information Center

    Mason, Diana

    Incident identification graphs can be used to diagnose areas of difficulty in a subject's problem-solving schema at the episodic level. In this study, 22 subjects (2 experts and 20 novices) categorized into five problem-solving groups (expert, high algorithmic/high conceptual, low algorithmic/high conceptual, high algorithmic/low conceptual, and…

  13. A Study of Selected Adolescent Problems as Presented in Contemporary Realistic Fiction for Middle School Students.

    ERIC Educational Resources Information Center

    Compton, Mary F.; Skelton, Juanita

    1982-01-01

    Analyzed 15 popular fiction books in terms of problem-concerns of young adolescents. Five were by author Judy Blume. The books reflected personal, family, and interpersonal problems and a trend toward realism. Fiction can be helpful in counseling and in developmental programs. (JAC)

  14. Rigging the deck: Selecting good problems for expert-novice card-sorting experiments

    NASA Astrophysics Data System (ADS)

    Wolf, Steven F.; Dougherty, Daniel P.; Kortemeyer, Gerd

    2012-12-01

    A seminal study by Chi et al. firmly established the paradigm that novices categorize physics problems by “surface features” (e.g., “incline,” “pendulum,” “projectile motion,” etc.), while experts use “deep structure” (e.g., “energy conservation,” “Newton 2,” etc.). Yet, efforts to replicate the study frequently fail, since the ability to distinguish experts from novices turns out to be highly sensitive to the problem set being used. Exactly what properties of problems are most important in problem sets that discriminate experts from novices in a measurable way? To answer this question, we studied the categorizations by known physics experts and novices using a large, diverse set of problems. This set needed to be large so that we could determine how well experts and novices could be discriminated by considering both small subsets using an exhaustive Monte Carlo approach and larger subsets using simulated annealing. We found that the number of questions required to accurately classify experts and novices can be surprisingly small so long as the problem set is carefully crafted to be composed of problems with particular pedagogical and contextual features. Finally, we found that not only was what you ask (deep structure) important, but also how you ask it (problem context).

  15. A Comparative Analysis of Word Problems in Selected United States and Russian First Grade Textbooks

    ERIC Educational Resources Information Center

    Grishchenko, Svetlana

    2009-01-01

    The purpose of this study was to explore word problems as a subject matter in mathematics textbook curricula. The motivation for the study derived from the following evidence: (a) American students find some word problems are more difficult than others (Garcia, Jimenez, & Hess, 2006; Riley & Green, 1988; Stern, 2001), and (b) one of the…

  16. Effects of Problem Scope and Creativity Instructions on Idea Generation and Selection

    ERIC Educational Resources Information Center

    Rietzschel, Eric F.; Nijstad, Bernard A.; Stroebe, Wolfgang

    2014-01-01

    The basic assumption of brainstorming is that increased quantity of ideas results in increased generation as well as selection of creative ideas. Although previous research suggests that idea quantity correlates strongly with the number of good ideas generated, quantity has been found to be unrelated to the quality of selected ideas. This article…

  17. Hospital deaths and adverse events in Brazil

    PubMed Central

    2011-01-01

    Background Adverse events are considered a major international problem related to the performance of health systems. Evaluating the occurrence of adverse events involves, as any other outcome measure, determining the extent to which the observed differences can be attributed to the patient's risk factors or to variations in the treatment process, and this in turn highlights the importance of measuring differences in the severity of the cases. The current study aims to evaluate the association between deaths and adverse events, adjusted according to patient risk factors. Methods The study is based on a random sample of 1103 patient charts from hospitalizations in the year 2003 in 3 teaching hospitals in the state of Rio de Janeiro, Brazil. The methodology involved a retrospective review of patient charts in two stages - screening phase and evaluation phase. Logistic regression was used to evaluate the relationship between hospital deaths and adverse events. Results The overall mortality rate was 8.5%, while the rate related to the occurrence of an adverse event was 2.9% (32/1103) and that related to preventable adverse events was 2.3% (25/1103). Among the 94 deaths analyzed, 34% were related to cases involving adverse events, and 26.6% of deaths occurred in cases whose adverse events were considered preventable. The models tested showed good discriminatory capacity. The unadjusted odds ratio (OR 11.43) and the odds ratio adjusted for patient risk factors (OR 8.23) between death and preventable adverse event were high. Conclusions Despite discussions in the literature regarding the limitations of evaluating preventable adverse events based on peer review, the results presented here emphasize that adverse events are not only prevalent, but are associated with serious harm and even death. These results also highlight the importance of risk adjustment and multivariate models in the study of adverse events. PMID:21929810

  18. Selected Problems of Applying the Law in Adaptation and Modernization of Buildings in Poland

    NASA Astrophysics Data System (ADS)

    Korbel, Wojciech

    2016-06-01

    Chosen problems of law implementation in the contemporary process of building's modernization in Poland. One of the major problems in the contemporary process of building's modernization in Poland is the pluralism of different interpretations of chosen legal terms, existing in the contemporary building code. Incorrect interpretation, results in the incorrect application to the authorities for the proper building permit and as the effect, it causes the lost of time and money. The article tries to identify some of these problems and seeks the solution to solve them, through the evolutionary method of building law creation.

  19. Public and private health insurance in Germany: the ignored risk selection problem.

    PubMed

    Grunow, Martina; Nuscheler, Robert

    2014-06-01

    We investigate risk selection between public and private health insurance in Germany. With risk-rated premiums in the private system and community-rated premiums in the public system, advantageous selection in favor of private insurers is expected. Using 2000 to 2007 data from the German Socio-Economic Panel Study (SOEP), we find such selection. While private insurers are unable to select the healthy upon enrollment, they profit from an increase in the probability to switch from private to public health insurance of those individuals who have experienced a negative health shock. To avoid distorted competition between the two branches of health care financing, risk-adjusted transfers from private to public insurers should be instituted.

  20. Mutual Information Analyses of Neuron Selection Techniques in Synchronous Exponential Chaotic Tabu Search for Quadratic Assignment Problems

    NASA Astrophysics Data System (ADS)

    Kawamura, Tetsuo; Horio, Yoshihiko; Hasegawa, Mikio

    The tabu search was implemented on a neural network with chaotic neuro-dynamics. This chaotic exponential tabu search shows great performance in solving quadratic assignment problems (QAPs). To exploit inherent parallel processing abilities of analog hardware systems, a synchronous updating scheme, where all the neurons in the network are updated at the same time, was proposed. However, several neurons may fire simultaneously with the synchronous updating. As a result, we cannot determine only one candidate for the 2-opt exchange from the many fired neurons. To solve this problem, several neuron selection methods, which select one specific neuron among the fired neurons, were proposed. These neuron selection methods improved the performance of the synchronous updating scheme. In this paper, we analyze the dynamics of the chaotic neural network with the neuron selection methods by means of the spatial and temporal mutual information. Through the analyses, the network solution search dynamics of the exponential chaotic tabu search with different neuron selection methods are evaluated.

  1. Unexpected consequences of genetic selection in broilers and turkeys: problems and solutions.

    PubMed

    Hocking, P M

    2014-02-01

    1. Genetic theory leads to the expectation that unexpected consequences of genetic selection for production traits will inevitably occur and that these changes are likely to be undesirable. 2. Both artificial selection for production efficiency and "natural" selection for adaptation to the production environment result in selection sweeps that increase the frequencies of rare recessive alleles that have a negative effect on fitness. 3. Fitness is broadly defined as any trait that affects the ability to survive, reproduce and contribute to the next generation, such as musculoskeletal disease in growing broiler chickens and multiple ovulation in adult broiler parents. 4. Welfare concerns about the negative effects of genetic selection on bird welfare are sometimes exaggerated but are nevertheless real. Breeders have paid increasing attention to these traits over several decades and have demonstrated improvement in pedigree flocks. There is an urgent need to monitor changes in commercial flocks to ensure that genetic change is accompanied by improvements in that target population. 5. New technologies for trait measurement, whole genome selection and targeted genetic modification hold out the promise of efficient and rapid improvement of welfare traits in future breeding of broiler chickens and turkeys. The potential of targeted genetic modification for enhancing welfare traits is considerable, but the goal of achieving public acceptability for the progeny of transgenic poultry will be politically challenging.

  2. Capability of the Maximax&Maximin selection operator in the evolutionary algorithm for a nurse scheduling problem

    NASA Astrophysics Data System (ADS)

    Ramli, Razamin; Tein, Lim Huai

    2016-08-01

    A good work schedule can improve hospital operations by providing better coverage with appropriate staffing levels in managing nurse personnel. Hence, constructing the best nurse work schedule is the appropriate effort. In doing so, an improved selection operator in the Evolutionary Algorithm (EA) strategy for a nurse scheduling problem (NSP) is proposed. The smart and efficient scheduling procedures were considered. Computation of the performance of each potential solution or schedule was done through fitness evaluation. The best so far solution was obtained via special Maximax&Maximin (MM) parent selection operator embedded in the EA, which fulfilled all constraints considered in the NSP.

  3. A Case Study of Controlling Crossover in a Selection Hyper-heuristic Framework Using the Multidimensional Knapsack Problem.

    PubMed

    Drake, John H; Özcan, Ender; Burke, Edmund K

    2016-01-01

    Hyper-heuristics are high-level methodologies for solving complex problems that operate on a search space of heuristics. In a selection hyper-heuristic framework, a heuristic is chosen from an existing set of low-level heuristics and applied to the current solution to produce a new solution at each point in the search. The use of crossover low-level heuristics is possible in an increasing number of general-purpose hyper-heuristic tools such as HyFlex and Hyperion. However, little work has been undertaken to assess how best to utilise it. Since a single-point search hyper-heuristic operates on a single candidate solution, and two candidate solutions are required for crossover, a mechanism is required to control the choice of the other solution. The frameworks we propose maintain a list of potential solutions for use in crossover. We investigate the use of such lists at two conceptual levels. First, crossover is controlled at the hyper-heuristic level where no problem-specific information is required. Second, it is controlled at the problem domain level where problem-specific information is used to produce good-quality solutions to use in crossover. A number of selection hyper-heuristics are compared using these frameworks over three benchmark libraries with varying properties for an NP-hard optimisation problem: the multidimensional 0-1 knapsack problem. It is shown that allowing crossover to be managed at the domain level outperforms managing crossover at the hyper-heuristic level in this problem domain.

  4. AN AZERBAIDZHAN SSR. INSTITUTE OF ADDITIVE CHEMISTRY ADDITIVES TO LUBRICATING OILS. PROBLEMS OF SYNTHESIS, INVESTIGATION AND USE OF OIL ADDITIVES; FUELS AND POLYMER MATERIALS (SELECTED ARTICLES),

    DTIC Science & Technology

    An Azerbaidzhan SSR. Institute of additive chemistry additives to lubricating oils . Problems of synthesis, investigation and use of oil additives; fuels and polymer materials (Selected articles)--Translation.

  5. Selective placement of overburden in surface coal mining - problems and mining planning

    SciTech Connect

    Chang, J.L.; Kelley, J.H.

    1982-12-01

    Selective placement of overburden is one of the measures that can mitigate surface coal mining's impact on environment which is mandatory by the Public Law PL 95-87 of 1977. When the operation of selective placement of overburden is integrated into the mining cycle, its effectiveness is largely dependent on mining planning, pit design, and equipment scheduling and matching. This study is intended to provide a baseline information for the decision making of mining planning with respect to this particular operation. A review of OSM Permanent Regulatory Program as related to the requirement of selective placement of overburden around surface coal mine is presented. Parameters that might influence the mining planning of selective overburden handling are classified. Following the evaluation of the requirement on regulation and equipment feasibility of current operation, proposed mining schemes for both steep slope and area mining are presented. A case simulation and comparison of overburden handling cost of alternative tandem equipment combinations of a typical dragline operation revealed the competitive position of the scraper-loader-trucks and cross-pit conveyor subsystems in this particular mining layout. Finally, an index of selective overburden handling operation is provided which categorized independent and controlling factors of the mining sites and shows the relationship of mining planning considerations in this particular practices.

  6. Person/Situation Selection Research: The Problem of Identifying Salient Situational Dimensions. Research Report No. 13.

    ERIC Educational Resources Information Center

    Schneider, Benjamin

    The study was concerned with the persistent problem in conducting person/situation research--the identification of relevant dimensions or features of the situation. Since the usual strategy for discovering relevant perceptual dimension of organizational life is to ask organizational employees to respond to a set of predetermined questions, this…

  7. Problem-Based Learning: Cognitive Retention and Cohort Traits of Randomly Selected Participants and Decliners.

    ERIC Educational Resources Information Center

    Eisenstaedt, Richard S.; And Others

    1990-01-01

    In this study of students (N=112) invited to participate in a hematology-transfusion medicine tutorial, it was found that students (N=59) receiving problem-based instruction did more poorly than controls on short-term examination but maintained their knowledge after two years better than control groups. (MLW)

  8. Rigging the Deck: Selecting Good Problems for Expert-Novice Card-Sorting Experiments

    ERIC Educational Resources Information Center

    Wolf, Steven F.; Dougherty, Daniel P.; Kortemeyer, Gerd

    2012-01-01

    A seminal study by Chi "et al." firmly established the paradigm that novices categorize physics problems by "surface features" (e.g., "incline," "pendulum," "projectile motion," etc.), while experts use "deep structure" (e.g., "energy conservation," "Newton 2," etc.). Yet, efforts to replicate the study frequently fail, since the ability to…

  9. Learning Problems in Connection with Special Information Media for the Visually Handicapped - A Selected Bibliography.

    ERIC Educational Resources Information Center

    Ostberg, Ann-Mari; Lindqvist, Bengt

    The bibliography was compiled with the intent to cover areas of special interest with regard to a research program at the Teachers College of Uppsala, Sweden dealing with problems in connection with the special information media for the blind which serve as substitutes for ink-print. Entered in the first section - an introduction to blindness -…

  10. Problem Solving Strategies of Selected Pre-Service Secondary School Mathematics Teachers in Malaysia

    ERIC Educational Resources Information Center

    Yew, Wun Theam; Zamri, Sharifah Norul Akmar Syed

    2016-01-01

    Problem solving strategies of eight pre-service secondary school mathematics teachers (PSSMTs) were examined in this study. A case study research design was employed and clinical interview technique was used to collect the data. Materials collected for analysis consisted of audiotapes and videotapes of clinical interviews, subjects' notes and…

  11. The Presence of Environmental Resource Management Themes in Selected Problems-Of-Democracy Textbooks

    ERIC Educational Resources Information Center

    Voelker, Alan M.; Kolb, Christine L.

    1973-01-01

    Six high-school Problems of Democracy textbooks were evaluated for their environmental education coverage. The amount of coverage was small relative to 26 possible themes used as criteria in the evaluation. An argument is given for a science and social science interdisciplinary approach for meaningful environmental education. (JP)

  12. Authentic Education by Providing a Situation for Student-Selected Problem-Based Learning

    ERIC Educational Resources Information Center

    Strimel, Greg

    2014-01-01

    Students are seldom given an authentic experience within school that allows them the opportunity to solve real-life complex engineering design problems that have meaning to their lives and/ or the greater society. They are often confined to learning environments that are limited by the restrictions set by course content for assessment purposes and…

  13. The Role of Selected Health Problems in the Causation of Juvenile Delinquency.

    ERIC Educational Resources Information Center

    Penner, Maurice J.

    1982-01-01

    Considers sociological theories of delinquency causation in order to attempt to integrate research from the fields of optometry, audiology, neurology, and pediatric medicine into the mainstream of sociological theories of delinquency causation. Found strong and consistent relationships between the presence of these health problems and delinquency.…

  14. Experimental Intervention Studies on Word Problem Solving and Math Disabilities: A Selective Analysis of the Literature

    ERIC Educational Resources Information Center

    Zheng, Xinhua; Flynn, Lindsay J.; Swanson, H. Lee

    2013-01-01

    This article provides a quantitative synthesis of the published literature on word problem solving intervention studies for children with math disabilities (MD). Seven group and eight single-subject design studies met inclusion criteria. Mean effect sizes ("ES"s) for solution accuracy for group design studies were 0.95 (SE = 0.19) for…

  15. An Analysis of Selected Biology Textbooks for the Treatment of Controversial Issues and Biosocial Problems.

    ERIC Educational Resources Information Center

    Levin, Florence S.; Lindbeck, Joy S.

    1979-01-01

    Analyzes five biology textbooks in 11 categories identified as current controversial issues and biosocial problems. Quantitative ratings for each category, based on total number of textbook pages, are presented for Darwinian evolution, disease states, drugs, environment, human genetics, human reproduction, man in nature, origin of life, population…

  16. The Impact of Selectivity on Fitness Evolution in the Multi-Generational Matching Problem

    NASA Astrophysics Data System (ADS)

    Dipple, Stephen; Jia, Tao; Korniss, Gyorgy; Szymanski, Boleslaw

    The stochastic matching hypothesis has been found to produce self-similar pairing without explicitly requiring self-similarity in the rules for matching. Here, we introduce an added complexity of selectivity in which the relative probability of being matched are modified. This allows for probing in areas between the currently established matching hypothesis, random matching, and the extreme case of super selectivity, where only the very best fitness matches for nodes are created. A higher selectivity parameter has been found to indirectly increase the number of matches in the system monotonically. A fairly simple model is then implemented to produce offspring who inherit fitness based on the inherited fitness distribution which is a function of the parents' fitness. While the results show that the specific distribution used may limit the inherited quality factors to a too narrow range to be broadly applicable, the model does expose some interesting patterns in fitness evolution across multiple generations in the context of selectivity and network degree distribution. Supported in part by ARL NS-CTA and ONR.

  17. Self-Regulatory Strategies in Daily Life: Selection, Optimization, and Compensation and Everyday Memory Problems

    ERIC Educational Resources Information Center

    Robinson, Stephanie A.; Rickenbach, Elizabeth H.; Lachman, Margie E.

    2016-01-01

    The effective use of self-regulatory strategies, such as selection, optimization, and compensation (SOC) requires resources. However, it is theorized that SOC use is most advantageous for those experiencing losses and diminishing resources. The present study explored this seeming paradox within the context of limitations or constraints due to…

  18. Analyzing risks of adverse pregnancy outcomes.

    PubMed

    Kramer, Michael S; Zhang, Xun; Platt, Robert W

    2014-02-01

    Approaches for analyzing the risks of adverse pregnancy outcomes have been the source of much debate and many publications. Much of the problem, in our view, is the conflation of time at risk with gestational age at birth (or birth weight, a proxy for gestational age). We consider the causal questions underlying such analyses with the help of a generic directed acyclic graph. We discuss competing risks and populations at risk in the context of appropriate numerators and denominators, respectively. We summarize 3 different approaches to quantifying risks with respect to gestational age, each of which addresses a distinct etiological or prognostic question (i.e., cumulative risk, prospective risk, or instantaneous risk (hazard)) and suggest the appropriate denominators for each. We show how the gestational age-specific risk of perinatal death (PND) can be decomposed as the product of the gestational age-specific risk of birth and the risk of PND conditional on birth at a given gestational age. Finally, we demonstrate how failure to consider the first of these 2 risks leads to selection bias. This selection bias creates the well-known crossover paradox, thus obviating the need to posit common causes of early birth and PND other than the study exposure.

  19. Effect of Integrated Yoga Module on Selected Psychological Variables among Women with Anxiety Problem.

    PubMed

    Parthasarathy, S; Jaiganesh, K; Duraisamy

    2014-01-01

    The implementation of yogic practices has proven benefits in both organic and psychological diseases. Forty-five women with anxiety selected by a random sampling method were divided into three groups. Experimental group I was subjected to asanas, relaxation and pranayama while Experimental group II was subjected to an integrated yoga module. The control group did not receive any intervention. Anxiety was measured by Taylor's Manifest Anxiety Scale before and after treatment. Frustration was measured through Reaction to Frustration Scale. All data were spread in an Excel sheet to be analysed with SPSS 16 software using analysis of covariance (ANCOVA). Selected yoga and asanas decreased anxiety and frustration scores but treatment with an integrated yoga module resulted in significant reduction of anxiety and frustration. To conclude, the practice of asanas and yoga decreased anxiety in women, and yoga as an integrated module significantly improved anxiety scores in young women with proven anxiety without any ill effects.

  20. Bayesian evidence computation for model selection in non-linear geoacoustic inference problems.

    PubMed

    Dettmer, Jan; Dosso, Stan E; Osler, John C

    2010-12-01

    This paper applies a general Bayesian inference approach, based on Bayesian evidence computation, to geoacoustic inversion of interface-wave dispersion data. Quantitative model selection is carried out by computing the evidence (normalizing constants) for several model parameterizations using annealed importance sampling. The resulting posterior probability density estimate is compared to estimates obtained from Metropolis-Hastings sampling to ensure consistent results. The approach is applied to invert interface-wave dispersion data collected on the Scotian Shelf, off the east coast of Canada for the sediment shear-wave velocity profile. Results are consistent with previous work on these data but extend the analysis to a rigorous approach including model selection and uncertainty analysis. The results are also consistent with core samples and seismic reflection measurements carried out in the area.

  1. Scientists Trace Adversity's Toll

    ERIC Educational Resources Information Center

    Sparks, Sarah D.

    2012-01-01

    The stress of a spelling bee or a challenging science project can enhance a student's focus and promote learning. But the stress of a dysfunctional or unstable home life can poison a child's cognitive ability for a lifetime, according to new research. Those studies show that stress forms the link between childhood adversity and poor academic…

  2. The application of remote sensing techniques to selected inter and intra urban data acquisition problems

    NASA Technical Reports Server (NTRS)

    Horton, F. E.

    1970-01-01

    The utility of remote sensing techniques to urban data acquisition problems in several distinct areas was identified. This endeavor included a comparison of remote sensing systems for urban data collection, the extraction of housing quality data from aerial photography, utilization of photographic sensors in urban transportation studies, urban change detection, space photography utilization, and an application of remote sensing techniques to the acquisition of data concerning intra-urban commercial centers. The systematic evaluation of variable extraction for urban modeling and planning at several different scales, and the model derivation for identifying and predicting economic growth and change within a regional system of cities are also studied.

  3. Linear and nonlinear pattern selection in Rayleigh-Benard stability problems

    NASA Technical Reports Server (NTRS)

    Davis, Sanford S.

    1993-01-01

    A new algorithm is introduced to compute finite-amplitude states using primitive variables for Rayleigh-Benard convection on relatively coarse meshes. The algorithm is based on a finite-difference matrix-splitting approach that separates all physical and dimensional effects into one-dimensional subsets. The nonlinear pattern selection process for steady convection in an air-filled square cavity with insulated side walls is investigated for Rayleigh numbers up to 20,000. The internalization of disturbances that evolve into coherent patterns is investigated and transient solutions from linear perturbation theory are compared with and contrasted to the full numerical simulations.

  4. Analysis of selected problems of biomass combustion process in batch boilers - experimental and numerical approach

    NASA Astrophysics Data System (ADS)

    Szubel, Mateusz

    2016-03-01

    It is possible to list numerous groups of heating units that are used in households, such as boilers, stoves and units used as supporting heat sources, namely fireplaces. In each case, however, the same operational problems may be evoked [1]. To understand the causes of energy losses in a boiler system, a proper definition of significant elements of the unit's heat balance is necessary. In the group of energy losses, the flue gas loss and the incomplete combustion loss are the most significant factors. The problem with the loss resulting from incomplete combustion, which is related to the presence of combustible substances in the exhaust, is especially significant in case of biomass boilers [2, 3]. The paper presents results of the research and the optimisation of the biomass combustion process in the 180 kW batch boiler. The studies described have been focused on the reduction of the pollutants emission, which was primarily realised by the modifications of the air feeding system. Results of the experiments and the CFD simulations have been compared and discussed. Both in case of the model as well as the experiment, positive influence of the modifications on the emission have been observed.

  5. Application of SEAWAT to select variable-density and viscosity problems

    USGS Publications Warehouse

    Dausman, Alyssa M.; Langevin, Christian D.; Thorne, Danny T.; Sukop, Michael C.

    2010-01-01

    SEAWAT is a combined version of MODFLOW and MT3DMS, designed to simulate three-dimensional, variable-density, saturated groundwater flow. The most recent version of the SEAWAT program, SEAWAT Version 4 (or SEAWAT_V4), supports equations of state for fluid density and viscosity. In SEAWAT_V4, fluid density can be calculated as a function of one or more MT3DMS species, and optionally, fluid pressure. Fluid viscosity is calculated as a function of one or more MT3DMS species, and the program also includes additional functions for representing the dependence of fluid viscosity on temperature. This report documents testing of and experimentation with SEAWAT_V4 with six previously published problems that include various combinations of density-dependent flow due to temperature variations and/or concentration variations of one or more species. Some of the problems also include variations in viscosity that result from temperature differences in water and oil. Comparisons between the results of SEAWAT_V4 and other published results are generally consistent with one another, with minor differences considered acceptable.

  6. Pilot study risk assessment for selected problems at the Fernald Environmental Management Project (FEMP)

    SciTech Connect

    Hamilton, L.D.; Meinhold, A.F.; Baxter, S.L.; Holtzman, S.; Morris, S.C.; Pardi, R.; Rowe, M.D.; Sun, C. ); Anspaugh, L.; Layton, D. )

    1993-03-01

    Two important environmental problems at the USDOE Fernald Environmental Management Project (FEMP) facility in Fernald, Ohio were studied in this human health risk assessment. The problems studied were radon emissions from the K-65 waste silos, and offsite contamination of ground water with uranium. Waste from the processing of pitchblende ore is stored in the K-65 silos at the FEMP. Radium-226 in the waste decays to radon gas which escapes to the outside atmosphere. The concern is for an increase in lung cancer risk for nearby residents associated with radon exposure. Monitoring data and a gaussian plume transport model were used to develop a source term and predict exposure and risk to fenceline residents, residents within 1 and 5 miles of the silos, and residents of Hamilton and Cincinnati, Ohio. Two release scenarios were studied: the routine release of radon from the silos and an accidental loss of one silo dome integrity. Exposure parameters and risk factors were described as distributions. Risks associated with natural background radon concentrations were also estimated.

  7. The packaging problem: bivalve prey selection and prey entry techniques of the octopus Enteroctopus dofleini.

    PubMed

    Anderson, Roland C; Mather, Jennifer A

    2007-08-01

    Many predators face a complex step of prey preparation before consumption. Octopuses faced with bivalve prey use several techniques to penetrate the shells to gain access to the meat inside. When given prey of mussels Mytilus trossulus, Manila clams Venerupis philippinarum, and littleneck clams Protothaca staminea, Enteroctopus dofleini solved the problem differently. They pulled apart V. philippinarum and M. trossulus, which had the thinnest shells and the least pulling resistance. P. staminea were eaten after the shells had been chipped or had been penetrated by drilling, presumably to inject a toxin. Likely because of these differences, octopuses consumed more V. philippinarum and M. trossulus than P. staminea when the mollusks were given to them either 1 species at a time or all together. However, when the shells were separated and the penetration problem removed, the octopuses predominantly chose P. staminea and nearly ignored M. trossulus. When V. philippinarum were wired shut, octopuses switched techniques. These results emphasize that octopuses can learn on the basis of nonvisual information and monitor their body position to carry out feeding actions.

  8. The Problem of Multiple Criteria Selection of the Surface Mining Haul Trucks

    NASA Astrophysics Data System (ADS)

    Bodziony, Przemysław; Kasztelewicz, Zbigniew; Sawicki, Piotr

    2016-06-01

    Vehicle transport is a dominant type of technological processes in rock mines, and its profit ability is strictly dependent on overall cost of its exploitation, especially on diesel oil consumption. Thus, a rational design of transportation system based on haul trucks should result from thorough analysis of technical and economic issues, including both cost of purchase and its further exploitation, having a crucial impact on the cost of minerals extraction. Moreover, off-highway trucks should be selected with respect to all specific exploitation conditions and even the user's preferences and experience. In this paper a development of universal family of evaluation criteria as well as application of evaluation method for haul truck selection process for a specific exploitation conditions in surface mining have been carried out. The methodology presented in the paper is based on the principles of multiple criteria decision aiding (MCDA) using one of the ranking method, i.e. ELECTRE III. The applied methodology has been allowed for ranking of alternative solution (variants), on the considered set of haul trucks. The result of the research is a universal methodology, and it consequently may be applied in other surface mines with similar exploitation parametres.

  9. Geographical distribution and potential for adverse biological effects of selected trace elements and organic compounds in streambed sediment in the Connecticut, Housatonic, and Thames River basins, 1992-94

    USGS Publications Warehouse

    Breault, Robert F.; Harris, Sandra L.

    1997-01-01

    Streambed-sediment samples were collected in 1992-94 at selected sites in the Connecticut, Housatonic, and Thames River Basins to determine the geographical distribution of trace elements and organic compounds and their potential for adverse biological effects on aquatic organisms. Chromium, copper, lead, mercury, nickel, zinc, chlordane, DDT, PAHs, and PCBs were detected in samples from throughout the basins, but concentrations of these constituents generally were lowest in the northern forested drainage basins and highest in the southern urbanized drainage basins of Springfield, Massachusetts, and Hartford, New Haven and Bridgeport, Connecticut. Possible anthropogenic sources of these contaminants include industrial effluent; municipal wastewater; runoff from agricultural, urban and forested areas; and atmospheric deposition. Some organic compounds pose the greatest threat to biological organisms in terms of exceedances of sediment-quality guidelines; those compounds are present at sufficiently high concentrations to potentially cause severe effects at several locations in the basins.Some trace elements represent the most geographically widespread threat to living organisms. These exceed sediment-quality guidelines over a wider geographical area, although usually by lower ratios of contaminant concentration to sediment-quality guideline than the organic compounds.

  10. Applications of density functional theory calculations to selected problems in hydrocarbon processing

    NASA Astrophysics Data System (ADS)

    Nabar, Rahul

    Recent advances in theoretical techniques and computational hardware have made it possible to apply Density Functional Theory (DFT) methods to realistic problems in heterogeneous catalysis. Hydrocarbon processing is economically, and strategically, a very important industrial sector in today's world. In this thesis, we employ DFT methods to examine several important problems in hydrocarbon processing. Fischer Tropsch Synthesis (FTS) is a mature technology to convert synthesis gas derived from coal, natural-gas or biomass into liquid fuels, specifically diesel. Iron is an active FTS catalyst, but the absence of detailed reaction mechanisms make it difficult to maximize activity and optimize product distribution. We evaluate thermochemistry, kinetics and Rate Determining Steps (RDS) for Fischer Tropsch Synthesis on several models of Fe catalysts: Fe(110), Fe(211) and Pt promoted Fe(110). Our studies indicated that CO-dissociation is likely to be the RDS under most reaction conditions, but the DFT-calculated activation energy ( Ea) for direct CO dissociation was too large to explain the observed catalyst activity. Consequently we demonstrate that H-assisted CO-dissociation pathways are competitive with direct CO dissociation on both Co and Fe catalysts and could be responsible for a major fraction of the reaction flux (especially at high CO coverages). We then extend this alternative mechanistic model to closed-packed facets of nine transition metal catalysts (Fe, Co, Ni, Ru, Rh, Pd, Os, Ir and Pt). H-assisted CO dissociation offers a kinetically easier route on each of the metals studied. DFT methods are also applied to another problem from the petroleum industry: discovery of poison-resistant, bimetallic, alloy catalysts (poisons: C, S, CI, P). Our systematic screening studies identify several Near Surface Alloys (NSAs) that are expected to be highly poison-resistant yet stable and avoiding adsorbate induced reconstruction. Adsorption trends are also correlated with

  11. Type curves for selected problems of flow to wells in confined aquifers

    USGS Publications Warehouse

    Reed, J.E.

    1980-01-01

    This report presents type curves and related material for 11 conditions of flow to wells m confined aquifers. These solutions, compiled from hydrologic literature, span an interval of time from Theis (1935) to Papadopulos, Bredehoeft, and Cooper (1973). Solutions are presented for constant discharge, constant drawdown, and variable discharge for pumping wells that fully penetrate leaky and nonleaky aquifers. Solutions for wells that partially penetrate leaky and nonleaky aquifers are included. Also, solutions are included for the effect of finite well radius and the sudden injection of a volume of water for nonleaky aquifers. Each problem includes the partial differential equation, boundary and initial conditions, and solutions. Programs in FORTRAN for calculating additional function values are included for most of the solutions.

  12. [Cardiovascular pharmacotherapy. Risks and adverse effects].

    PubMed

    Voigt, N; Heijman, J; Dobrev, D

    2014-03-01

    Adverse side effects of drugs are a significantly underestimated problem in modern medicine. In this review article, we summarize common adverse side effects of cardiovascular drugs. In particular, we highlight the factors promoting these adverse side effects in patients, including reduced hepatic or renal clearance in elderly patients that often requires dosage adjustment. Pharmacodynamic and pharmacokinetic interactions between drugs (e.g. through the cytochrome P450 system or P-glycoproteins) can modify the plasma concentration of many compounds, thereby also increasing the likelihood of unwanted side effects. The most prominent cardiac side effects include arrhythmias, e.g. atrioventricular (AV) block, drug-induced long-QT syndrome and torsade de pointes and altered inotropy. Non-cardiac side effects are subsequently discussed grouped by drug class. A better understanding of the risks and side effects of cardiovascular drugs is expected to reduce the mortality and morbidity associated with adverse side effects.

  13. Changes in Food Selectivity in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Bandini, Linda G.; Curtin, Carol; Phillips, Sarah; Anderson, Sarah E.; Maslin, Melissa; Must, Aviva

    2017-01-01

    Food selectivity is a common problem in children with autism spectrum disorder (ASD) and has an adverse impact on nutrient adequacy and family mealtimes. Despite recent research in this area, few studies have addressed whether food selectivity present in children with ASD persists into adolescence. In this study, we assessed food selectivity in 18…

  14. The cocktail-party problem revisited: early processing and selection of multi-talker speech.

    PubMed

    Bronkhorst, Adelbert W

    2015-07-01

    How do we recognize what one person is saying when others are speaking at the same time? This review summarizes widespread research in psychoacoustics, auditory scene analysis, and attention, all dealing with early processing and selection of speech, which has been stimulated by this question. Important effects occurring at the peripheral and brainstem levels are mutual masking of sounds and "unmasking" resulting from binaural listening. Psychoacoustic models have been developed that can predict these effects accurately, albeit using computational approaches rather than approximations of neural processing. Grouping—the segregation and streaming of sounds—represents a subsequent processing stage that interacts closely with attention. Sounds can be easily grouped—and subsequently selected—using primitive features such as spatial location and fundamental frequency. More complex processing is required when lexical, syntactic, or semantic information is used. Whereas it is now clear that such processing can take place preattentively, there also is evidence that the processing depth depends on the task-relevancy of the sound. This is consistent with the presence of a feedback loop in attentional control, triggering enhancement of to-be-selected input. Despite recent progress, there are still many unresolved issues: there is a need for integrative models that are neurophysiologically plausible, for research into grouping based on other than spatial or voice-related cues, for studies explicitly addressing endogenous and exogenous attention, for an explanation of the remarkable sluggishness of attention focused on dynamically changing sounds, and for research elucidating the distinction between binaural speech perception and sound localization.

  15. Function-Based Treatments for Escape-Maintained Problem Behavior: A Treatment-Selection Model for Practicing Behavior Analysts

    PubMed Central

    Geiger, Kaneen B; Carr, James E; LeBlanc, Linda A

    2010-01-01

    Escape from instructional activities is a common maintaining variable for problem behavior and a number of effective treatments have been developed for this function. Each of these treatments has characteristics that make them optimal for certain environments and clients, but less optimal for others. We summarize the most commonly researched function-based treatments for escape-maintained behavior, describe the contexts for which they are most appropriate, and provide a clinical model for selecting treatments based on client characteristics and the constraints of the therapeutic environment. PMID:22479669

  16. Development of modelling method selection tool for health services management: From problem structuring methods to modelling and simulation methods

    PubMed Central

    2011-01-01

    Background There is an increasing recognition that modelling and simulation can assist in the process of designing health care policies, strategies and operations. However, the current use is limited and answers to questions such as what methods to use and when remain somewhat underdeveloped. Aim The aim of this study is to provide a mechanism for decision makers in health services planning and management to compare a broad range of modelling and simulation methods so that they can better select and use them or better commission relevant modelling and simulation work. Methods This paper proposes a modelling and simulation method comparison and selection tool developed from a comprehensive literature review, the research team's extensive expertise and inputs from potential users. Twenty-eight different methods were identified, characterised by their relevance to different application areas, project life cycle stages, types of output and levels of insight, and four input resources required (time, money, knowledge and data). Results The characterisation is presented in matrix forms to allow quick comparison and selection. This paper also highlights significant knowledge gaps in the existing literature when assessing the applicability of particular approaches to health services management, where modelling and simulation skills are scarce let alone money and time. Conclusions A modelling and simulation method comparison and selection tool is developed to assist with the selection of methods appropriate to supporting specific decision making processes. In particular it addresses the issue of which method is most appropriate to which specific health services management problem, what the user might expect to be obtained from the method, and what is required to use the method. In summary, we believe the tool adds value to the scarce existing literature on methods comparison and selection. PMID:21595946

  17. Adverse drug reactions.

    PubMed

    O'Reilly-Foley, Georgina

    2017-04-05

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article defined the different types of adverse drug reactions (ADRs) and explored when they can occur. It emphasised the importance of being knowledgeable about medications, considering patient safety when patients are taking medications, being alert to the possibility of ADRs, and recognising and responding to suspected ADRs.

  18. International technology transfer: study of selected problems encountered by multinational businesses in lesser-developed countries

    SciTech Connect

    Maddalena, J.B.

    1987-01-01

    This project describes some of the problems encountered in the transfer of technology to Lesser Developed Countries (LDC) by Multinational Corporations. (MNC) In this study, the concept of technology is expanded to include industrial processes as well as the marketing of the goods containing the technical knowledge. The development and use of this technology is created under the values and standards existing in the MNC's country. However, when it is transferred to Third World Nations, the corporation frequently encounters cultural situations that are contrary to its domestic situation. In the Nestle case, baby formula was marketed in the Third World under assumptions that were valid in the Western World but which had tragic consequencesin the LDCs. The assumption of a clean water supply was taken for granted in the advanced nations. In the LDCs, however, impure water supplies were a fact of life. This and other circumstances led to misuse of the formula. The Union Carbide case involved the transfer of an industrial process for the manufacture of pesticides. These products were prohibited in the MNC's country but the lax regulations in India permitted the corporation to produce the toxic materials using less-stringent control. Many thousands of Indians were killed and injured when a deadly gas escaped from the plant. In both situations, the MNC failed to consider the local cultural conditions in its strategic planning.

  19. Application of household production theory to selected natural-resource problems in less-developed countries

    SciTech Connect

    Mercer, D.E.

    1991-01-01

    The objectives are threefold: (1) to perform an analytical survey of household production theory as it relates to natural-resource problems in less-developed countries, (2) to develop a household production model of fuelwood decision making, (3) to derive a theoretical framework for travel-cost demand studies of international nature tourism. The model of household fuelwood decision making provides a rich array of implications and predictions for empirical analysis. For example, it is shown that fuelwood and modern fuels may be either substitutes or complements depending on the interaction of the gross-substitution and income-expansion effects. Therefore, empirical analysis should precede adoption of any inter-fuel substitution policies such as subsidizing kerosene. The fuelwood model also provides a framework for analyzing the conditions and factors determining entry and exit by households into the wood-burning subpopulation, a key for designing optimal household energy policies in the Third World. The international nature tourism travel cost model predicts that the demand for nature tourism is an aggregate of the demand for the individual activities undertaken during the trip.

  20. Dating problems with selected mining lakes and the adjacent groundwater body in Lusatia, Germany.

    PubMed

    Seebach, Anne; von Rohden, Christoph; Ilmberger, Johann; Weise, Stephan M; Knoller, Kay

    2010-09-01

    This study presents selected results, applying environmental tracers to investigate lake water-groundwater interactions at two study sites located in Lusatia, Germany. The focus of the investigations were two meromictic pit lakes and their adjacent aquifers. In order to follow hydrodynamic processes between lake and groundwater, mixing patterns within the lakes as well as ages of lake and groundwater, water samples of ground- and lake water were collected at three occasions, representing summer and winter conditions in the aquatic systems. The water samples were analysed for stable isotopes (deuterium, oxygen-18) and tritium and sulphurhexafluoride (SF(6) concentration). Lake water profiles of conductivity and (18)O could validate the permanent stratification pattern of both the lakes. Groundwater data sets showed a heterogeneous local distribution in stable isotope values between rain and lake water. A two-component mixing model had been adopted only from (18)O data to determine lake water proportions in the surrounding groundwater wells in order to correct measured tritium and SF(6) concentrations in groundwater samples. This procedure had been hampered by upstream-located wells indicating strong (18)O enrichment in groundwater samples. However, rough groundwater ages were estimated. For both study sites, Piston flow ages between 12.9 and 27.7 years were calculated. The investigations showed the good agreement between two different environmental dating tools, considering the marginal data sets.

  1. Adverse health consequences of the Iraq War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2013-03-16

    The adverse health consequences of the Iraq War (2003-11) were profound. We conclude that at least 116,903 Iraqi non-combatants and more than 4800 coalition military personnel died over the 8-year course. Many Iraqi civilians were injured or became ill because of damage to the health-supporting infrastructure of the country, and about 5 million were displaced. More than 31,000 US military personnel were injured and a substantial percentage of those deployed suffered post-traumatic stress disorder, traumatic brain injury, and other neuropsychological disorders and their concomitant psychosocial problems. Many family members of military personnel had psychological problems. Further review of the adverse health consequences of this war could help to minimise the adverse health consequences of, and help to prevent, future wars.

  2. Pilot study risk assessment for selected problems at three US Department of Energy Facilities

    SciTech Connect

    Hamilton, L.D.; Holtzman, S.; Meinhold, A.F.; Morris, S.C.; Pardi, R.; Rowe, M.D.; Sun, C. ); Anspaugh, L.R.; Bogen, K.T.; Daniels, J.I. )

    1994-01-01

    Objective and realistic human health risk assessments were performed for environmental problems at the Savannah River Site (SRS), the Fernald Environmental Management Project (FEMP), and the Nevada Test Site (NTS). At the SRS, cancer mortality risks were analyzed for projected public exposure to [sup 3]H and [sup 137]Cs released into the Savannah River. For annual human exposures to SRS tritium in Savannah River water, calculated incremental individual lifetime risks in two human receptor populations were small (8[times]10[sup [minus]7]; upper 95 percentile point of the distribution). The 95th percentile point of the distribution for incremental individual lifetime risks from one year's exposure to [sup 137]Cs is less than 10[sup [minus]8]. No deaths are expected in either populations as a result of exposures to tritium or cesium released to the Savannah River. Routine releases of radon and radon progeny from the K-65 silos at FEMP resulted in individual lifetime risks greater than 1[times]10[sup [minus]4] only for onsite workers and fenceline residents. Assessment of risks from exposure to uranium in ground water released by the FEMP predicted no toxic effects for human receptors. All estimated cancer risks were small. The largest predicted individual lifetime risk was for a well close to the facility. For various above-ground shot sites at the NTS, highest predicted lifetime cancer risks are for a resident farmer. At 50,000 and 100,000 y in the future, the predicted cancer risks are all below 10[sup [minus]6]. In the assessment of exposure to radionuclides in ground water at the NTS, for an individual onsite near the site boundary, the geometric mean of the maximum potential excess lifetime risk of cancer mortality for an individual is 7[times]10[sup [minus]3]. For an individual using water offsite, the geometric mean of the maximum potential excess lifetime risk of cancer mortality is 7[times]10[sup [minus]7]. 40 refs., 6 figs., 2 tabs.

  3. Educational Leadership: The Uses of Adversity

    ERIC Educational Resources Information Center

    Culbertson, Jack

    1976-01-01

    Skepticism about the power of education challenges the educational administrator to (1) attain a better understanding of the sources of dissatisfaction and their implications for change, (2) learn to cope with adversity and make constructive use of it, and (3) define the leadership requirements needed to address education's problems. (MB)

  4. Adverse reactions to vaccines.

    PubMed

    Martin, Bryan L; Nelson, Michael R; Hershey, Joyce N; Engler, Renata J M

    2003-06-01

    (The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.) Immunization healthcare is becoming increasingly complex as the number and types of vaccines have continued to expand. Like all prescription drugs, vaccines may be associated with adverse events. The majority of these reactions are self-limited and not associated with prolonged disability. The media, Internet and public advocacy groups have focused on potentially serious vaccine-associated adverse events with questions raised about causal linkages to increasing frequencies of diseases such as autism and asthma. Despite a lack of evidence of a causal relationship to a variety of vaccine safety concerns, including extensive reviews by the Institute of Medicine, questions regarding vaccine safety continue to threaten the success of immunization programs. Risk communication arid individual risk assessment is further challenged by the public health success of vaccine programs creating the perception that certain vaccines are no longer necessary or justified because of the rare reaction risk. There is a need for improved understanding of true vaccine contraindications and precautions as well as host factors and disease threat in order to develop a patient specific balanced risk communication intervention. When they occur, vaccine related adverse events must be treated, documented and reported through the VAERS system. The increasing complexity of vaccination health care has led the Center of Disease Control and Prevention (CDC) to identify Vaccine Safety Assessment and Evaluation as a potential new specialty.

  5. Natural Selection, Adaptive Topographies and the Problem of Statistical Inference: The Moraba scurra Controversy Under the Microscope.

    PubMed

    Grodwohl, Jean-Baptiste

    2016-08-01

    This paper gives a detailed narrative of a controversial empirical research in postwar population genetics, the analysis of the cytological polymorphisms of an Australian grasshopper, Moraba scurra. This research intertwined key technical developments in three research areas during the 1950s and 1960s: it involved Dobzhansky's empirical research program on cytological polymorphisms, the mathematical theory of natural selection in two-locus systems, and the building of reliable estimates of natural selection in the wild. In the mid-1950s the cytologist Michael White discovered an interesting case of epistasis in populations of Moraba scurra. These observations received a wide diffusion when theoretical population geneticist Richard Lewontin represented White's data on adaptive topographies. These topographies connected the information on the genetic structure of these grasshopper populations with the formal framework of theoretical population genetics. As such, they appeared at the time as the most successful application of two-locus models of natural selection to an empirical study system. However, this connection generated paradoxical results: in the landscapes, all grasshopper populations were located on a ridge (an unstable equilibrium) while they were expected to reach a peak. This puzzling result fueled years of research and triggered a controversy attracting contributors from Australia, the United States and the United Kingdom. While the original problem seemed, at first, purely empirical, the subsequent controversy affected the main mathematical tools used in the study of two-gene systems under natural selection. Adaptive topographies and their underlying mathematical structure, Wright's mean fitness equations, were submitted to close scrutiny. Suspicion eventually shifted to the statistical machinery used in data analysis, reflecting the crucial role of statistical inference in applied population genetics. In the 1950s and 1960s, population geneticists were

  6. Double-blind evaluation of two commercial hypoallergenic diets in cats with adverse food reactions.

    PubMed

    Leistra, M; Willemse, T

    2002-12-01

    The aim of this study was to evaluate two commercially available selected-protein-source diets as maintenance diets in cats with dermatological manifestations of adverse food reactions. Twenty cats with a confirmed adverse food reaction were tested in a double-blind manner. An adverse food reaction was diagnosed when, after recovery with a home-cooked elimination diet, the signs relapsed after a challenge with their previous dietary components, and re-disappeared on a second elimination diet period. Hereafter the cats were blind and randomly challenged with two commercial hypoallergenic diets. Relapse of the clinical signs was seen in eight cats (40%) on a lamb and rice diet and in 13 cats (65%) on a chicken and rice diet (P>0.05). Neither one of the commercial diets was as effective in controlling the skin problems as the home-cooked elimination diet. The study confirms that commercial hypoallergenic diets are adequate for maintenance.

  7. [Cutaneous adverse drug reactions].

    PubMed

    Lebrun-Vignes, B; Valeyrie-Allanore, L

    2015-04-01

    Cutaneous adverse drug reactions (CADR) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Exanthematous eruptions, urticaria and vasculitis are the most common forms of CADR. Fixed eruption is uncommon in western countries. Serious reactions (fatal outcome, sequelae) represent 2% of CADR: bullous reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), DRESS (drug reaction with eosinophilia and systemic symptoms or drug-induced hypersensitivity syndrome) and acute generalized exanthematous pustulosis (AGEP). These forms must be quickly diagnosed to guide their management. The main risk factors are immunosuppression, autoimmunity and some HLA alleles in bullous reactions and DRESS. Most systemic drugs may induce cutaneous adverse reactions, especially antibiotics, anticonvulsivants, antineoplastic drugs, non-steroidal anti-inflammatory drugs, allopurinol and contrast media. Pathogenesis includes immediate or delayed immunologic mechanism, usually not related to dose, and pharmacologic/toxic mechanism, commonly dose-dependent or time-dependent. In case of immunologic mechanism, allergologic exploration is possible to clarify drug causality, with a variable sensitivity according to the drug and to the CADR type. It includes epicutaneous patch testing, prick test and intradermal test. However, no in vivo or in vitro test can confirm the drug causality. To determine the cause of the eruption, a logical approach based on clinical characteristics, chronologic factors and elimination of differential diagnosis is required, completed with a literature search. A reporting to pharmacovigilance network is essential in case of a serious CADR whatever the suspected drug and in any case if the involved drug is a newly marketed one or unusually related to cutaneous reactions.

  8. [Selection of the information for solving medical diagnostic problems with "diagnostic games" (the example of predicting the time of sinus rhythm maintenance after eliminating atrial fibrillation)].

    PubMed

    Gel'fand, I M; Syrkin, A L; Alekseevskaia, M A; Nedostup, A V; Kliushin, E S

    1983-01-01

    A new method is proposed for data selection with respect to solving medical diagnosis problems. It reduces the scope of information, leaving for further processing only the facts the physician actually needs for problem-solving. The protocols of "diagnostic games" reflect the physician's mental process and can be used in the development of a physician model.

  9. Early Adverse Experiences and the Developing Brain

    PubMed Central

    Bick, Johanna; Nelson, Charles A

    2016-01-01

    Children exposed to various forms of adversity early in life are at increased risk for a broad range of developmental difficulties, affecting both cognitive and emotional adjustment. We review a growing body of evidence suggesting that exposure to adverse circumstances affects the developing brain in ways that increase risk for a myriad of problems. We focus on two forms of adversity, one in which children are exposed to childhood maltreatment in family environments, and another in which children are exposed to extreme psychosocial deprivation in contexts of institutional rearing. We discuss ways in which each of these experiences represent violations of species-expected caregiving conditions, thereby imposing challenges to the developing brain. We also review emerging data pointing to the effectiveness of early intervention in remediating neurodevelopmental consequences associated with maltreatment or institutional rearing. We conclude by discussing implications of this work for public health efforts and highlight important directions for the field. PMID:26334107

  10. Clinical applications of pharmacogenomics to adverse drug reactions.

    PubMed

    Issa, Amalia M

    2008-03-01

    The problem of adverse drug reactions is a well-documented global public health problem. Recent withdrawals of several widely used prescription medications in the USA and other countries have raised concerns among patients, clinicians, scientists and policy makers. The increasing interest and concern regarding withdrawal of previously approved prescription medications and drug safety has prompted renewed research efforts aimed at improving surveillance of approved drugs and reducing adverse drug reactions. Pharmacogenomics research is increasingly directed at developing genomic diagnostics and tests with predictive ability for adverse drug reactions. This paper focuses on the problem of adverse drug reactions and reviews the evidence and the state of the science for the application of pharmacogenomics to adverse drug reactions.

  11. Adverse events related to blood transfusion.

    PubMed

    Sahu, Sandeep; Hemlata; Verma, Anupam

    2014-09-01

    The acute blood transfusion reactions are responsible for causing most serious adverse events. Awareness about various clinical features of acute and delayed transfusion reactions with an ability to assess the serious reactions on time can lead to a better prognosis. Evidence-based medicine has changed today's scenario of clinical practice to decrease adverse transfusion reactions. New evidence-based algorithms of transfusion and improved haemovigilance lead to avoidance of unnecessary transfusions perioperatively. The recognition of adverse events under anaesthesia is always challenging. The unnecessary blood transfusions can be avoided with better blood conservation techniques during surgery and with anaesthesia techniques that reduce blood loss. Better and newer blood screening methods have decreased the infectious complications to almost negligible levels. With universal leukoreduction of red blood cells (RBCs), selection of potential donors such as use of male donors only plasma and restriction of RBC storage, most of the non-infectious complications can be avoided.

  12. Adverse events temporally associated with meningococcal vaccines.

    PubMed Central

    Yergeau, A; Alain, L; Pless, R; Robert, Y

    1996-01-01

    OBJECTIVE: To determine the incidence of severe adverse events temporally associated with meningococcal vaccines administered as part of a mass vaccination program. DESIGN: Retrospective descriptive study of events reported to a passive provincial surveillance system. SETTING: The province of Quebec. PARTICIPANTS: The 1,198,751 individuals aged 6 months to 20 years who were vaccinated against meningococcal disease between Dec. 27, 1992, and Mar. 31, 1993. OUTCOME MEASURES: Total numbers and rates of severe adverse events, including allergic reactions, anaphylactic reactions, neurological events (other than abnormal crying and screaming) and other serious or unusual events. RESULTS: A total of 118 reports of severe adverse events were selected from the surveillance system. The most frequent were allergic reactions (9.2 per 100,000 doses). Few anaphylactic or neurologic reactions were reported (0.1 and 0.5 per 100,000 doses respectively). There were no reports of sequelae or of encephalopathy, meningitis or encephalitis. CONCLUSION: Meningococcal vaccines seem to be associated with fewer adverse events than have previously been reported. Existing surveillance programs are useful for determining the incidence of adverse events temporally associated with vaccines. PMID:8630839

  13. The Complement System and Adverse Pregnancy Outcomes

    PubMed Central

    Regal, Jean F.; Gilbert, Jeffrey S.; Burwick, Richard M.

    2015-01-01

    Adverse pregnancy outcomes significantly contribute to morbidity and mortality for mother and child, with lifelong health consequences for both. The innate and adaptive immune system must be regulated to insure survival of the feta allograft, and the complement system is no exception. An intact complement system optimizes placental development and function and is essential to maintain host defense and fetal survival. Complement regulation is apparent at the placental interface from early pregnancy with some degree of complement activation occurring normally throughout gestation. However, a number of pregnancy complications including early pregnancy loss, fetal growth restriction, hypertensive disorders of pregnancy and preterm birth are associated with excessive or misdirected complement activation, and are more frequent in women with inherited or acquired complement system disorders or complement gene mutations. Clinical studies employing complement biomarkers in plasma and urine implicate dysregulated complement activation in components of each of the adverse pregnancy outcomes. In addition, mechanistic studies in rat and mouse models of adverse pregnancy outcomes address the complement pathways or activation products of importance and allow critical analysis of the pathophysiology. Targeted complement therapeutics are already in use to control adverse pregnancy outcomes in select situations. A clearer understanding of the role of the complement system in both normal pregnancy and complicated or failed pregnancy will allow a rational approach to future therapeutic strategies for manipulating complement with the goal of mitigating adverse pregnancy outcomes, preserving host defense, and improving long term outcomes for both mother and child. PMID:25802092

  14. Adverse cutaneous drug reaction.

    PubMed

    Nayak, Surajit; Acharjya, Basanti

    2008-01-01

    In everyday clinical practice, almost all physicians come across many instances of suspected adverse cutaneous drug reactions (ACDR) in different forms. Although such cutaneous reactions are common, comprehensive information regarding their incidence, severity and ultimate health effects are often not available as many cases go unreported. It is also a fact that in the present world, almost everyday a new drug enters market; therefore, a chance of a new drug reaction manifesting somewhere in some form in any corner of world is unknown or unreported. Although many a times, presentation is too trivial and benign, the early identification of the condition and identifying the culprit drug and omit it at earliest holds the keystone in management and prevention of a more severe drug rash. Therefore, not only the dermatologists, but all practicing physicians should be familiar with these conditions to diagnose them early and to be prepared to handle them adequately. However, we all know it is most challenging and practically difficult when patient is on multiple medicines because of myriad clinical symptoms, poorly understood multiple mechanisms of drug-host interaction, relative paucity of laboratory testing that is available for any definitive and confirmatory drug-specific testing. Therefore, in practice, the diagnosis of ACDR is purely based on clinical judgment. In this discussion, we will be primarily focusing on pathomechanism and approach to reach a diagnosis, which is the vital pillar to manage any case of ACDR.

  15. Association of the dopamine receptor D1 gene, DRD1, with inattention symptoms in families selected for reading problems.

    PubMed

    Luca, P; Laurin, N; Misener, V L; Wigg, K G; Anderson, B; Cate-Carter, T; Tannock, R; Humphries, T; Lovett, M W; Barr, C L

    2007-08-01

    Twin studies have provided evidence for shared genetic influences between attention-deficit/hyperactivity disorder (ADHD) and specific reading disabilities (RD), with this overlap being highest for the inattentive symptom dimension of ADHD. Previously, we found evidence for association of the dopamine receptor D1 gene (DRD1) with ADHD, and with the inattentive symptom dimension in particular. This, combined with evidence for working memory (WM) deficits in individuals with RD or ADHD, and the importance of D1 receptors in attentional processes and WM function, suggests that DRD1 may be a common genetic influence underlying both disorders. Here, in a study of 232 families ascertained through probands with reading problems, we tested for association of the DRD1 gene with RD, as a categorical trait, and with quantitative measures of key reading component skills, WM ability, and inattentive symptoms. Although no associations were found with RD, or with reading component skills or verbal WM, we found evidence for association with inattentive behaviour. Specifically, DRD1 Haplotype 3, the haplotype previously found to be associated with inattentive symptoms in ADHD, is also associated with parent- and teacher-reported symptoms of inattention in this sample selected for reading problems (P=0.023 and 0.004, respectively). Together, the replicated finding of Haplotype 3 association with inattentive symptoms in two independent study samples strongly supports a role for DRD1 in attentional ability. Furthermore, the association of DRD1 with inattention, but not with RD, or the other reading and reading-related phenotypes analysed, suggests that DRD1 contributes uniquely to inattention, without overlap for reading ability.

  16. Prevention of behavior problems in a selected population: Stepping stones triple P for parents of young children with disabilities.

    PubMed

    Shapiro, Cheri J; Kilburn, Janice; Hardin, James W

    2014-11-01

    Because young children with disabilities are at elevated risk for development of challenging behaviors, and caregivers of these children typically lack access to evidence-based parenting interventions, two randomized trials were conducted to examine the impact of an evidence-based parenting intervention, Stepping Stones Triple P (SSTP), as a selective preventive intervention. Both studies targeted parents of children under two with a variety of disabilities who were enrolled in the IDEA Part C Early Intervention (EI) system in one state. SSTP was delivered in family homes. In Study One, 49 families were randomly assigned to EI services as usual, with or without SSTP; a 52% attrition rate from treatment was seen. No significant between-group differences were seen aside from a trend toward reduced symptoms of parental depression at follow-up. Intervention group children demonstrated significant decline in behavior problems from post treatment to follow-up, and there was a trend toward improved parenting style in the intervention group during this same time frame. Study Two incorporated a separate workforce intervention for EI service coordinators; 40 families on their caseloads were then randomly assigned to receive EI services as usual with or without SSTP. Attrition from treatment was limited to 20%. No differential impact was seen on child behavior; a trend was noted post-treatment on parent symptoms of depression and on the observed parent-child relationship. At 12-month follow-up, there was a trend favoring improvement in the intervention group in parenting style; statistically significant impact was also seen on the observed quality of the parent-child relationship. SSTP shows promise as a selective preventive intervention for an early intervention population. Reasons for the differential findings between the two studies are explored and suggestions for future research are provided.

  17. Telithromycin: review of adverse effects.

    PubMed

    2014-11-01

    Telithromycin is a macrolide antibiotic that has been marketed since the early 2000s. It has not been shown to be more effective against any bacteria than other macrolide antibiotics. Its antibacterial activity is in no way remarkable. In early 2014, we reviewed its adverse effect profile using data from periodic safety update reports, drug regulatory agencies, and detailed published case reports. In addition to the adverse effect profile telithromycin shares with the other macrolides, it provokes several specific adverse effects: visual disturbances due to impaired accommodation; taste and smell disorders; severe liver damage; worsening of myasthenia gravis; rhabdomyolysis; and loss of consciousness. Prolongation of the QT interval with standard oral doses is a worrisome adverse effect. In practice, it is better not to use telithromycin as it exposes patients to disproportionate, serious adverse effects. When treatment with a macrolide antibiotic appears necessary, it is prudent to choose a different macrolide, such as spiramycin or azithromycin, which have fewer adverse effects.

  18. Rethinking the Measurement of Adversity.

    PubMed

    Mersky, Joshua P; Janczewski, Colleen E; Topitzes, James

    2017-02-01

    Research on adverse childhood experiences (ACEs) has unified the study of interrelated risks and generated insights into the origins of disorder and disease. Ten indicators of child maltreatment and household dysfunction are widely accepted as ACEs, but further progress requires a more systematic approach to conceptualizing and measuring ACEs. Using data from a diverse, low-income sample of women who received home visiting services in Wisconsin ( N = 1,241), this study assessed the prevalence of and interrelations among 10 conventional ACEs and 7 potential ACEs: family financial problems, food insecurity, homelessness, parental absence, parent/sibling death, bullying, and violent crime. Associations between ACEs and two outcomes, perceived stress and smoking, were examined. The factor structure and test-retest reliability of ACEs was also explored. As expected, prevalence rates were high compared to studies of more representative samples. Except for parent/sibling death, all ACEs were intercorrelated and associated at the bivariate level with perceived stress and smoking. Exploratory factor analysis confirmed that conventional ACEs loaded on two factors, child maltreatment and household dysfunction, though a more complex four-factor solution emerged once new ACEs were introduced. All ACEs demonstrated acceptable test-retest reliability. Implications and future directions toward a second generation of ACE research are discussed.

  19. Adverse Reactions to Hallucinogenic Drugs.

    ERIC Educational Resources Information Center

    Meyer, Roger E. , Ed.

    This reports a conference of psychologists, psychiatrists, geneticists and others concerned with the biological and psychological effects of lysergic acid diethylamide and other hallucinogenic drugs. Clinical data are presented on adverse drug reactions. The difficulty of determining the causes of adverse reactions is discussed, as are different…

  20. Student Behaviour Problems: Context, Initiatives and Programs. Selected Papers from the National Conference on Student Behaviour Problems: Context, Initiatives and Programs (3rd, Brisbane, Queensland, Australia, October 1991).

    ERIC Educational Resources Information Center

    Elkins, John, Ed.; Izard, John, Ed.

    The conference papers in this collection are grouped under the following topics: behavior problems in context; interpersonal relationships; initiatives by systems and schools; and programs in special settings. Papers included are: (1) National Trends in Discipline Policy Development (Roger Slee); (2) Balancing: The Protocols of Discipline (William…

  1. From Poor Performance to Success under Stress: Working Memory, Strategy Selection, and Mathematical Problem Solving under Pressure

    ERIC Educational Resources Information Center

    Beilock, Sian L.; DeCaro, Marci S.

    2007-01-01

    Two experiments demonstrate how individual differences in working memory (WM) impact the strategies used to solve complex math problems and how consequential testing situations alter strategy use. In Experiment 1, individuals performed multistep math problems under low- or high-pressure conditions and reported their problem-solving strategies.…

  2. Site selection in global clinical trials in patients hospitalized for heart failure: perceived problems and potential solutions

    PubMed Central

    Vaduganathan, Muthiah; Greene, Stephen J.; Mentz, Robert J.; Adams, Kirkwood F.; Anker, Stefan D.; Arnold, Malcolm; Baschiera, Fabio; Cleland, John G. F.; Cotter, Gadi; Fonarow, Gregg C.; Giordano, Christopher; Metra, Marco; Misselwitz, Frank; Mühlhofer, Eva; Nodari, Savina; Peacock, W. Frank; Pieske, Burkert M.; Sabbah, Hani N.; Sato, Naoki; Shah, Monica R.; Stockbridge, Norman L.; Teerlink, John R.; van Veldhuisen, Dirk J.; Zalewski, Andrew; Zannad, Faiez; Butler, Javed

    2014-01-01

    There are over 1 million hospitalizations for heart failure (HF) annually in the United States alone, and a similar number has been reported in Europe. Recent clinical trials investigating novel therapies in patients with hospitalized HF (HHF) have been negative, and the post-discharge event rate remains unacceptably high. The lack of success with HHF trials stem from problems with understanding the study drug, matching the drug to the appropriate HF subgroup, and study execution. Related to the concept of study execution is the importance of including appropriate study sites in HHF trials. Often overlooked issues include consideration of the geographic region and the number of patients enrolled at each study center. Marked differences in baseline patient co-morbidities, serum biomarkers, treatment utilization and outcomes have been demonstrated across geographic regions. Furthermore, patients from sites with low recruitment may have worse outcomes compared to sites with higher enrollment patterns. Consequently, sites with poor trial enrollment may influence key patient end points and likely do not justify the costs of site training and maintenance. Accordingly, there is an unmet need to develop strategies to identify the right study sites that have acceptable patient quantity and quality. Potential approaches include, but are not limited to, establishing a pre-trial registry, developing site performance metrics, identifying a local regionally involved leader and bolstering recruitment incentives. This manuscript summarizes the roundtable discussion hosted by the Food and Drug Administration between members of academia, the National Institutes of Health, industry partners, contract research organizations and academic research organizations on the importance of selecting optimal sites for successful trials in HHF. PMID:23099992

  3. [Analysis of Spontaneously Reported Adverse Events].

    PubMed

    Nakamura, Mitsuhiro

    2016-01-01

    Observational study is necessary for the evaluation of drug effectiveness in clinical practice. In recent years, the use of spontaneous reporting systems (SRS) for adverse drug reactions has increased and they have become an important resource for regulatory science. SRS, being the largest and most well-known databases worldwide, are one of the primary tools used for postmarketing surveillance and pharmacovigilance. To analyze SRS, the US Food and Drug Administration Adverse Event Reporting System (FAERS) and the Japanese Adverse Drug Event Report Database (JADER) are reviewed. Authorized pharmacovigilance algorithms were used for signal detection, including the reporting odds ratio. An SRS is a passive reporting database and is therefore subject to numerous sources of selection bias, including overreporting, underreporting, and a lack of a denominator. Despite the inherent limitations of spontaneous reporting, SRS databases are a rich resource and data mining index that provide powerful means of identifying potential associations between drugs and their adverse effects. Our results, which are based on the evaluation of SRS databases, provide essential knowledge that could improve our understanding of clinical issues.

  4. Understanding adverse events: human factors.

    PubMed Central

    Reason, J

    1995-01-01

    (1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with

  5. A Selected Review of the Literature on Factors and Conditions Driving the High Risk and Dropout Problem. Policy Studies in Language and Cross Cultural Education.

    ERIC Educational Resources Information Center

    Zachman, Jill M.

    This report presents the findings of a review of 45 selected references on issues associated with high risk students and dropouts. The literature was analyzed according to: (1) the manner in which high risk students and dropouts are characterized; (2) the suggested causes and conditions driving the problems of high risk and dropping out; (3) the…

  6. Elder Abuse: The Hidden Problem. A Briefing by the Select Committee on Aging, House of Representatives, Ninety-Sixth Congress, First Session (Boston, Massachusetts, June 23, 1979).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This briefing by the Congressional Select Committee on Aging was designed to gather information on the physical and psychological abuse of the elderly. A number of witness reports are included, testifying to the seriousness and extent of the problem of elder abuse. It is pointed out that many victims refuse to admit abuse; public discussions of…

  7. Recent advances in hopanoids analysis: Quantification protocols overview, main research targets and selected problems of complex data exploration.

    PubMed

    Zarzycki, Paweł K; Portka, Joanna K

    2015-09-01

    Pentacyclic triterpenoids, particularly hopanoids, are organism-specific compounds and are generally considered as useful biomarkers that allow fingerprinting and classification of biological, environmental and geological samples. Simultaneous quantification of various hopanoids together with battery of related non-polar and low-molecular mass compounds may provide principal information for geochemical and environmental research focusing on both modern and ancient investigations. Target compounds can be derived from microbial biomass, water columns, sediments, coals, crude fossils or rocks. This create number of analytical problems due to different composition of the analytical matrix and interfering compounds and therefore, proper optimization of quantification protocols for such biomarkers is still the challenge. In this work we summarizing typical analytical protocols that were recently applied for quantification of hopanoids like compounds from different samples. Main steps including components of interest extraction, pre-purification, fractionation, derivatization and quantification involving gas (1D and 2D) as well as liquid separation techniques (liquid-liquid extraction, solid-phase extraction, planar and low resolution column chromatography, high-performance liquid chromatography) are described and discussed from practical point of view, mainly based on the experimental papers that were published within last two years, where significant increase in hopanoids research was noticed. The second aim of this review is to describe the latest research trends concerning determination of hopanoids and related low-molecular mass lipids analyzed in various samples including sediments, rocks, coals, crude oils and plant fossils as well as stromatolites and microbial biomass cultivated under different conditions. It has been found that majority of the most recent papers are based on uni- or bivariate approach for complex data analysis. Data interpretation involves

  8. The Sioux Indian Goes to College. An Analysis of Selected Problems of South Dakota Indian College Students.

    ERIC Educational Resources Information Center

    Artichoker, John, Jr.; Palmer, Neil M.

    Problems of American Indian college students in South Dakota which appeared to be "distinctively Indian" in nature were identified. Two questionnaires were administered to 72 Indian students enrolled in 4-year colleges and universities during the spring of 1957. Data analysis centered on the comparison of the problems of two pair of…

  9. Reverse Engineering Adverse Outcome Pathways

    SciTech Connect

    Perkins, Edward; Chipman, J.K.; Edwards, Stephen; Habib, Tanwir; Falciani, Francesco; Taylor, Ronald C.; Van Aggelen, Graham; Vulpe, Chris; Antczak, Philipp; Loguinov, Alexandre

    2011-01-30

    The toxicological effects of many stressors are mediated through unknown, or poorly characterized, mechanisms of action. We describe the application of reverse engineering complex interaction networks from high dimensional omics data (gene, protein, metabolic, signaling) to characterize adverse outcome pathways (AOPs) for chemicals that disrupt the hypothalamus-pituitary-gonadal endocrine axis in fathead minnows. Gene expression changes in fathead minnow ovaries in response to 7 different chemicals, over different times, doses, and in vivo versus in vitro conditions were captured in a large data set of 868 arrays. We examined potential AOPs of the antiandrogen flutamide using two mutual information theory methods, ARACNE and CLR to infer gene regulatory networks and potential adverse outcome pathways. Representative networks from these studies were used to predict a network path from stressor to adverse outcome as a candidate AOP. The relationship of individual chemicals to an adverse outcome can be determined by following perturbations through the network in response to chemical treatment leading to the nodes associated with the adverse outcome. Identification of candidate pathways allows for formation of testable hypotheses about key biologic processes, biomarkers or alternative endpoints, which could be used to monitor an adverse outcome pathway. Finally, we identify the unique challenges facing the application of this approach in ecotoxicology, and attempt to provide a road map for the utilization of these tools. Key Words: mechanism of action, toxicology, microarray, network inference

  10. Care of patients with selected health problems in fundholding practices in Scotland in 1990 and 1992: needs, process and outcome.

    PubMed Central

    Howie, J G; Heaney, D J; Maxwell, M

    1995-01-01

    BACKGROUND. At the time of the introduction of fundholding, a number of potential benefits and concerns about fundholding were debated. AIM. A study was undertaken to compare process and outcome of care in patients with different levels of physical, social and psychological need in 1990 and 1992 in six fundholding groups in Scotland. METHOD. Patients aged 16 years and over consulting with a range of marker conditions in 1990 and 1992 completed a pre-consultation health status questionnaire asking about physical, social and psychological problems, and a postconsultation satisfaction/enablement questionnaire asking about their ability to cope, and understand their illness. Main outcome measures were consultation length and satisfaction/enablement score. RESULTS. Of patients attending in the study period, 39% consulted for one or more marker condition. The proportion of patients reporting social problems rose between 1990 and 1992 for 11 out of 12 conditions. Overall, consultation lengths remained constant. Patients wanting to discuss social problems had significantly longer consultations than those reporting no social problems or problems they did not wish to discuss. The proportion of patients expressing enablement dropped for eight conditions and rose for four between 1990 and 1992. The decrease in the proportion expressing enablement remained after controlling for the rise in the percentage reporting social problems. Patients who had social problems they did not wish to discuss but a general health questionnaire score of five or more were the group reporting lowest enablement. Significantly more patients with pain, skin problems and digestive problems reported social problems and significantly fewer of them reported enablement in 1992 compared with 1990. Patients with diabetes, angina, chronic bronchitis and problems seeing fared relatively well over the study period. Some patients with psychosocial problems fared poorly (they had relatively short consultations

  11. Single dose oral analgesics for postoperative pain have few adverse events.

    PubMed

    Wong, Yin J

    2016-09-01

    Data sourcesThe Cochrane Database of Systematic Reviews on the Cochrane Library.Study selectionAll Cochrane reviews of RCTs between 1999 to 2015, conducted in adults examining the adverse events associated with single dose oral analgesics used for acute post-operative pain were considered.Data extraction and synthesisStudies were searched, reviewed and assessed independently by two reviewers and standard data items extracted. Methodological quality was assessed using criteria adapted from AMSTAR (Assessing the Methodological Quality of Systematic Reviews).ResultsData from 39 Cochrane reviews of 41 different analgesics or analgesic combinations involving a total of 350 studies involving 35,000 adults were included. Most analgesics were tested in a narrow dose range. For most NSAIDs, paracetamol (acetaminophen), and combinations not containing opioids, the rates of adverse events were similar to that of placebos (NSAID 3% - 44% vs 4 - 46%; paracetamol 7-18% vs 6-16%; combination 11-30% vs 6-48%). However, for higher dosages, like 1000 mg aspirin, 1000 mg diflunisal, and opioids or drug combinations containing opioids, there was a statistically significant difference in the incidence of adverse events reported (NNH 7.7(95%CI; 4.8 - 20) for 1000 mg aspirin; 7.5(95%CI; 4.8-17) for 1000 mg diflunisal; 3.5-8.6 for opioids and combinations). Serious adverse events were rare, occurring at about 1 in 3,200.ConclusionsDespite ongoing problems with the measurement, recording and reporting of adverse events in clinical trials and in systematic reviews, the large amount of information available for single oral doses of analgesics provides evidence that adverse events rates are generally similar with active drug and placebo in these circumstances, except at higher doses of some drugs, and in combinations including opioids.

  12. Learning Lessons from Adverse Drug Reactions in Children

    PubMed Central

    Sammons, Helen M.; Choonara, Imti

    2016-01-01

    Drug toxicity is, unfortunately, a significant problem in children both in the hospital and in the community. Drug toxicity in children is different to that seen in adults. At least one in 500 children will experience an adverse drug reaction each year. For children in hospital, the risk is far greater (one in ten). Additionally, different and sometimes unique adverse drug reactions are seen in the paediatric age groups. Some of the major cases of drug toxicity historically have occurred in neonates. It is important that we understand the mechanism of action of adverse drug reactions. Greater understanding alongside rational prescribing should hopefully reduce drug toxicity in children in the future. PMID:27417239

  13. A study of selected radiation and propagation problems related to antennas and probes in magneto-ionic media

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Research consisted of computations toward the solution of the problem of the current distribution on a cylindrical antenna in a magnetoplasma. The case of an antenna parallel to the applied magnetic field was investigated. A systematic method of asymptotic expansion was found which simplifies the solution in the general case by giving the field of a dipole even at relatively short range. Some useful properties of the dispersion surfaces in a lossy medium have also been found. A laboratory experiment was directed toward evaluating nonlinear effects, such as those due to power level, bias voltage and electron heating. The problem of reflection and transmission of waves in an electron heated plasma was treated theoretically. The profile inversion problem has been pursued. Some results are very encouraging, however, the general question of stability of the solution remains unsolved.

  14. Treatment-seeking for selected reproductive health problems: behaviours of unmarried female adolescents in two low-performing areas of Bangladesh

    PubMed Central

    2014-01-01

    Purpose The reproductive health needs of unmarried adolescents in Bangladesh are largely unmet. This study aimed to explore treatment-seeking behaviour of unmarried female adolescents for selected reproductive health (RH) concerns in two low-performing areas of Bangladesh. Methods As part of a large community based-project, a cross-sectional survey was conducted from November 2006 to March 2007. From each of two select study areas, 800 unmarried female adolescents aged 12–19 years were selected for participation by simple random sampling through household listing and were recruited into the study. Trained interviewers administered a structured questionnaire to participating female adolescents. Descriptive and bivariate analytic methods were used compare RH conditions and healthcare seeking behaviour of adolescents across urban and rural settings. Results Approximately 50% of the sample reported experiencing menstrual problems in the last year. The predominant problems reported by participants included: lower abdominal pain, back pain, irregular menstruation, and excessive bleeding during menstruation. Irrespective of study area, only 40% of the female adolescents with menstrual problems sought treatment from qualified physicians. Otherwise, utilization of healthcare facilities and care providers for reported problems varied significantly by rural and urban areas. Higher proportions of adolescents in the urban setting (15%) also reported recent symptoms of sexually transmitted infections (STIs), compared to those in the rural setting (9%; p < 0.001). Across sites, however, self-treatment was the most commonly reported method of care for those who experienced any symptoms of STI. Conclusions In general, treatment-seeking behaviours by unmarried female adolescents was low for menstrual problems. A vast majority of unmarried female adolescents practiced self-care for symptoms of STIs while only small proportions sought treatment from qualified physicians. These

  15. [Administrative divisions, population, and the social situation in the Russian Federation: selected problems in the development of Russia].

    PubMed

    Gerloff, J U

    1996-04-01

    The author discusses various problems that arose or were exacerbated after the breakup of the Soviet Union. These include changes in the status of various geographical entities, the population decline caused by decreasing fertility and sharply elevated mortality, internal migration, and runaway inflation.

  16. Sleep Problems, Overtiredness and Overanxiety and Frustrating Children: From Birth to Preschool. Unit for Child Studies. Selected Papers Number 24.

    ERIC Educational Resources Information Center

    Harris, Michael J.

    The first of the two discussions presented here, "Sleep Problems, Overtiredness and Overanxiety," describes sleeping behavior of children from birth to 3 years of age and considers situations that affect children's sleep. Topics briefly addressed include the physiology of sleep; developmental aspects of sleep patterns; the effect of lack…

  17. Selective Spatial Working Memory Impairment in a Group of Children with Mathematics Learning Disabilities and Poor Problem-Solving Skills

    ERIC Educational Resources Information Center

    Passolunghi, Maria Chiara; Mammarella, Irene Cristina

    2012-01-01

    This study examines visual and spatial working memory skills in 35 third to fifth graders with both mathematics learning disabilities (MLD) and poor problem-solving skills and 35 of their peers with typical development (TD) on tasks involving both low and high attentional control. Results revealed that children with MLD, relative to TD children,…

  18. Controlling for Selection Effects in the Relationship between Child Behavior Problems and Exposure to Intimate Partner Violence

    ERIC Educational Resources Information Center

    Emery, Clifton R.

    2011-01-01

    This article used the Project on Human Development in Chicago Neighborhoods (PHDCN) data to examine the relationship between exposure to intimate partner violence (IPV) and child behavior problems (externalizing and internalizing), truancy, grade repetition, smoking, drinking, and use of marijuana. Longitudinal data analysis was conducted on 1,816…

  19. The Problem of Literary Language and Dialect in Arab Countries. Preliminary Translations of Selected Works in Sociolinguistics, Number II.

    ERIC Educational Resources Information Center

    Belkin, V.M.

    The author notes the problems arising from the dichotomy between literary Arabic and the spoken varieties. The thousand-year-old system of teaching literary Arabic, the archaic elements of grammar, and the writing system are discussed. The written history of the literary language is presented in three stages--(1) the pre-Islamic classical, (2) the…

  20. Current Research on Relationships between Selected Higher Order Processes and the Communication Skills and Problems of Deaf Persons.

    ERIC Educational Resources Information Center

    Metz, Dale Evan; And Others

    1980-01-01

    The paper presents four research projects in process in the Communication Sciences Laboratory at the National Technical Institute for the Deaf. These projects illustrate four broad areas of research on the relationships between higher order information processing systems and the communication skills and problems exhibited by deaf people. (Author)

  1. Classifying End-of-Chapter Questions and Problems for Selected General Chemistry Textbooks Used in the United States

    ERIC Educational Resources Information Center

    Davila, Kariluz; Talanquer, Vicente

    2010-01-01

    Science textbooks have a major influence on teaching and learning. Teachers and instructors at all educational levels use them regularly not only as a guide for course content and sequence but also in the design of homework assignments and assessment probes. From this perspective, textbook questions and problems can be expected to have a strong…

  2. The Problems and Prospects of Using Selected Cooperative Learning Structures in Educating Teachers of English as a Foreign Language.

    ERIC Educational Resources Information Center

    Ghaith, Ghazi M.

    2003-01-01

    Describes the aim, preparation, and procedures of five cooperative learning activities for educating teachers of English as a foreign language. Reports that the activities integrate content and methodology, motivate student teachers, and maximize communication, reinforcement, and cognitive work. Documents the prospects and problems of…

  3. Rigorously Selected and Well Trained Senior Student Tutors in Problem Based Learning: Student Perceptions and Study Achievements

    ERIC Educational Resources Information Center

    De Rijdt, Catherine; van der Rijt, Janine; Dochy, Filip; van der Vleuten, Cees

    2012-01-01

    We compared effects of tutoring by students and by staff. In four courses in each of two consecutive first years of an undergraduate problem-based law curriculum we examined the achievements and perceptions of tutors of students taught by student and staff tutors. Achievements were measured by the results on the regular end-of-course tests. After…

  4. A Comparison of Traditional Approaches and Item Response Approaches to the Problem of Item Selection for Criterion-Referenced Measurement.

    ERIC Educational Resources Information Center

    Silva, Sharron J.

    Test item selection techniques based on traditional item analysis methods were compared to techniques based on item response theory. The consistency of mastery classifications in criterion referenced reading tests was examined. Pretest and posttest data were available for 945 first and second grade students and for 1796 fourth to sixth grade…

  5. Selective and Sustained Attention as Predictors of Social Problems in Children with Typical and Disordered Attention Abilities

    ERIC Educational Resources Information Center

    Andrade, Brendan F.; Brodeur, Darlene A.; Waschbusch, Daniel A.; Stewart, Sherry H.; McGee, Robin

    2009-01-01

    Objective: Investigated the relationship between selective and sustained attention and social behavior in children with different degrees of attentional disturbance. Method: Participants were 101 6- to 12-year-old children, including 18 who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), 61 who were clinically referred for…

  6. Forward Looking Radar Imaging by Truncated Singular Value Decomposition and Its Application for Adverse Weather Aircraft Landing.

    PubMed

    Huang, Yulin; Zha, Yuebo; Wang, Yue; Yang, Jianyu

    2015-06-18

    The forward looking radar imaging task is a practical and challenging problem for adverse weather aircraft landing industry. Deconvolution method can realize the forward looking imaging but it often leads to the noise amplification in the radar image. In this paper, a forward looking radar imaging based on deconvolution method is presented for adverse weather aircraft landing. We first present the theoretical background of forward looking radar imaging task and its application for aircraft landing. Then, we convert the forward looking radar imaging task into a corresponding deconvolution problem, which is solved in the framework of algebraic theory using truncated singular decomposition method. The key issue regarding the selecting of the truncated parameter is addressed using generalized cross validation approach. Simulation and experimental results demonstrate that the proposed method is effective in achieving angular resolution enhancement with suppressing the noise amplification in forward looking radar imaging.

  7. Forward Looking Radar Imaging by Truncated Singular Value Decomposition and Its Application for Adverse Weather Aircraft Landing

    PubMed Central

    Huang, Yulin; Zha, Yuebo; Wang, Yue; Yang, Jianyu

    2015-01-01

    The forward looking radar imaging task is a practical and challenging problem for adverse weather aircraft landing industry. Deconvolution method can realize the forward looking imaging but it often leads to the noise amplification in the radar image. In this paper, a forward looking radar imaging based on deconvolution method is presented for adverse weather aircraft landing. We first present the theoretical background of forward looking radar imaging task and its application for aircraft landing. Then, we convert the forward looking radar imaging task into a corresponding deconvolution problem, which is solved in the framework of algebraic theory using truncated singular decomposition method. The key issue regarding the selecting of the truncated parameter is addressed using generalized cross validation approach. Simulation and experimental results demonstrate that the proposed method is effective in achieving angular resolution enhancement with suppressing the noise amplification in forward looking radar imaging. PMID:26094627

  8. Adverse Childhood Experiences and Hallucinations

    ERIC Educational Resources Information Center

    Whitfield, C.L.; Dube, S.R.; Felitti, V.J.; Anda, R.F.

    2005-01-01

    Objective:: Little information is available about the contribution of multiple adverse childhood experiences (ACEs) to the likelihood of reporting hallucinations. We used data from the ACE study to assess this relationship. Methods:: We conducted a survey about childhood abuse and household dysfunction while growing up, with questions about health…

  9. Adverse ocular reactions to drugs.

    PubMed Central

    Spiteri, M. A.; James, D. G.

    1983-01-01

    Drugs acting on various parts of the body may also affect the eye insidiously. Increased awareness of such drug toxicity by the prescribing doctor should encourage him to consider effects on the cornea, lens, retina, optic nerve and elsewhere when checking the patient's progress. The following review concerns adverse ocular effects of systemic drug administration. PMID:6356101

  10. Urbanicity, social adversity and psychosis

    PubMed Central

    Heinz, Andreas; Deserno, Lorenz; Reininghaus, Ulrich

    2013-01-01

    In recent years, there has been increasing interest in research on geographical variation in the incidence of schizophrenia and other psychoses. In this paper, we review the evidence on variation in incidence of schizophrenia and other psychoses in terms of place, as well as the individual- and area-level factors that account for this variation. We further review findings on potential mechanisms that link adverse urban environment and psychosis. There is evidence from earlier and more recent studies that urbanicity is associated with an increased incidence of schizophrenia and non-affective psychosis. In addition, considerable variation in incidence across neighbourhoods has been observed for these disorders. Findings suggest it is unlikely that social drift alone can fully account for geographical variation in incidence. Evidence further suggests that the impact of adverse social contexts – indexed by area-level exposures such as population density, social fragmentation and deprivation – on risk of psychosis is explained (confounding) or modified (interaction) by environmental exposures at the individual level (i.e., cannabis use, social adversity, exclusion and discrimination). On a neurobiological level, several studies suggest a close link between social adversity, isolation and stress on the one hand, and monoamine dysfunction on the other, which resembles findings in schizophrenia patients. However, studies directly assessing correlations between urban stress or discrimination and neurobiological alterations in schizophrenia are lacking to date. PMID:24096775

  11. Reverse engineering adverse outcome pathways.

    PubMed

    Perkins, Edward J; Chipman, J Kevin; Edwards, Stephen; Habib, Tanwir; Falciani, Francesco; Taylor, Ronald; Van Aggelen, Graham; Vulpe, Chris; Antczak, Philipp; Loguinov, Alexandre

    2011-01-01

    The toxicological effects of many stressors are mediated through unknown, or incompletely characterized, mechanisms of action. The application of reverse engineering complex interaction networks from high dimensional omics data (gene, protein, metabolic, signaling) can be used to overcome these limitations. This approach was used to characterize adverse outcome pathways (AOPs) for chemicals that disrupt the hypothalamus-pituitary-gonadal endocrine axis in fathead minnows (FHM, Pimephales promelas). Gene expression changes in FHM ovaries in response to seven different chemicals, over different times, doses, and in vivo versus in vitro conditions, were captured in a large data set of 868 arrays. Potential AOPs of the antiandrogen flutamide were examined using two mutual information-based methods to infer gene regulatory networks and potential AOPs. Representative networks from these studies were used to predict network paths from stressor to adverse outcome as candidate AOPs. The relationship of individual chemicals to an adverse outcome can be determined by following perturbations through the network in response to chemical treatment, thus leading to the nodes associated with the adverse outcome. Identification of candidate pathways allows for formation of testable hypotheses about key biological processes, biomarkers, or alternative endpoints that can be used to monitor an AOP. Finally, the unique challenges facing the application of this approach in ecotoxicology were identified and a road map for the utilization of these tools presented.

  12. Evaluating the Assumptions of Surface Reflectance and Aerosol Type Selection Within the MODIS Aerosol Retrieval Over Land: The Problem of Dust Type Selection

    NASA Technical Reports Server (NTRS)

    Mielonen, T.; Levy, R. C.; Aaltonen, V.; Komppula, M.; de Leeuw, G.; Huttunen, J.; Lihavainen, H.; Kolmonen, P.; Lehtinen, K. E. J.; Arola, A.

    2011-01-01

    Aerosol Optical Depth (AOD) and Angstrom exponent (AE) values derived with the MODIS retrieval algorithm over land (Collection 5) are compared with ground based sun photometer measurements at eleven sites spanning the globe. Although, in general, total AOD compares well at these sites (R2 values generally over 0.8), there are cases (from 2 to 67% of the measurements depending on the site) where MODIS clearly retrieves the wrong spectral dependence, and hence, an unrealistic AE value. Some of these poor AE retrievals are due to the aerosol signal being too small (total AOD<0.3) but in other cases the AOD should have been high enough to derive accurate AE. However, in these cases, MODIS indicates AE values close to 0.6 and zero fine model weighting (FMW), i.e. dust model provides the best fitting to the MODIS observed reflectance. Yet, according to evidence from the collocated sun photometer measurements and back-trajectory analyses, there should be no dust present. This indicates that the assumptions about aerosol model and surface properties made by the MODIS algorithm may have been incorrect. Here we focus on problems related to parameterization of the land-surface optical properties in the algorithm, in particular the relationship between the surface reflectance at 660 and 2130 nm.

  13. The buffering effect of selection, optimization, and compensation strategy use on the relationship between problem solving demands and occupational well-being: a daily diary study.

    PubMed

    Schmitt, Antje; Zacher, Hannes; Frese, Michael

    2012-04-01

    This study investigated within-person relationships between daily problem solving demands, selection, optimization, and compensation (SOC) strategy use, job satisfaction, and fatigue at work. Based on conservation of resources theory, it was hypothesized that high SOC strategy use boosts the positive relationship between problem solving demands and job satisfaction, and buffers the positive relationship between problem solving demands and fatigue. Using a daily diary study design, data were collected from 64 administrative employees who completed a general questionnaire and two daily online questionnaires over four work days. Multilevel analyses showed that problem solving demands were positively related to fatigue, but unrelated to job satisfaction. SOC strategy use was positively related to job satisfaction, but unrelated to fatigue. A buffering effect of high SOC strategy use on the demands-fatigue relationship was found, but no booster effect on the demands-satisfaction relationship. The results suggest that high SOC strategy use is a resource that protects employees from the negative effects of high problem solving demands.

  14. Factors affecting the development of adverse drug reactions (Review article)

    PubMed Central

    Alomar, Muaed Jamal

    2013-01-01

    Objectives To discuss the effect of certain factors on the occurrence of Adverse Drug Reactions (ADRs). Data Sources A systematic review of the literature in the period between 1991 and 2012 was made based on PubMed, the Cochrane database of systematic reviews, EMBASE and IDIS. Key words used were: medication error, adverse drug reaction, iatrogenic disease factors, ambulatory care, primary health care, side effects and treatment hazards. Summary Many factors play a crucial role in the occurrence of ADRs, some of these are patient related, drug related or socially related factors. Age for instance has a very critical impact on the occurrence of ADRs, both very young and very old patients are more vulnerable to these reactions than other age groups. Alcohol intake also has a crucial impact on ADRs. Other factors are gender, race, pregnancy, breast feeding, kidney problems, liver function, drug dose and frequency and many other factors. The effect of these factors on ADRs is well documented in the medical literature. Taking these factors into consideration during medical evaluation enables medical practitioners to choose the best drug regimen. Conclusion Many factors affect the occurrence of ADRs. Some of these factors can be changed like smoking or alcohol intake others cannot be changed like age, presence of other diseases or genetic factors. Understanding the different effects of these factors on ADRs enables healthcare professionals to choose the most appropriate medication for that particular patient. It also helps the healthcare professionals to give the best advice to patients. Pharmacogenomics is the most recent science which emphasizes the genetic predisposition of ADRs. This innovative science provides a new perspective in dealing with the decision making process of drug selection. PMID:24648818

  15. Adverse Health Problems Among Municipality Workers in Alexandria (Egypt)

    PubMed Central

    Abd El-Wahab, Ekram W.; Eassa, Safaa M.; Lotfi, Sameh E.; El Masry, Sanaa A.; Shatat, Hanan Z.; Kotkat, Amira M.

    2014-01-01

    Background: Solid waste management has emerged as an important human and environmental health issue. Municipal solid waste workers (MSWWs) are potentially exposed to a variety of occupational biohazards and safety risks. The aim of this study was to describe health practices and safety measures adopted by workers in the main municipal company in Alexandria (Egypt) as well as the pattern of the encountered work related ill health. Methods: A cross-sectional study was conducted between January and April 2013. We interviewed and evaluated 346 workers serving in about 15 different solid waste management activities regarding personal hygiene, the practice of security and health care measures and the impact of solid waste management. Results: Poor personal hygiene and self-care, inadequate protective and safety measures for potentially hazardous exposure were described. Impact of solid waste management on health of MSWWs entailed high prevalence of gastrointestinal, respiratory, skin and musculoskeletal morbidities. Occurrence of accidents and needle stick injuries amounted to 46.5% and 32.7% respectively. The risk of work related health disorders was notably higher among workers directly exposed to solid waste when compared by a group of low exposure potential particularly for diarrhea (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2-3.8), vomiting (OR = 2.7, 95% CI = 1.1-6.6), abdominal colic (OR = 1.9, 95% CI = 1.1-3.2), dysentery (OR = 3.6, 95% CI = 1.3-10), dyspepsia (OR = 1.8, 95% CI = 1.1-3), low back/sciatic pain (OR = 3.5, 95% CI = 1.8-7), tinnitus (OR = 6.2, 95% CI = 0.3-122) and needle stick injury (OR = 3.4, 95% CI = 2.1-5.5). Conclusions: Workers exposed to solid waste exhibit significant increase in risk of ill health. Physician role and health education could be the key to assure the MSWWs health safety. PMID:24932385

  16. A systematic review of selected evidence on developing nursing students' critical thinking through problem-based learning.

    PubMed

    Yuan, Haobin; Williams, Beverly A; Fan, Lin

    2008-08-01

    Rapidly changing developments and expanding roles in healthcare environment requires professional nurses to develop critical thinking. Nursing education strives to facilitate students' critical thinking through the appropriate instructional approaches. Problem-based learning (PBL) is a student-centered approach to learning which enables the students to work cooperatively in small groups for seeking solutions to situations/problems. The systematic review was conducted to provide the available evidence on developing nursing students' critical thinking through PBL. The computerized searches from 1990-2006 in CINAHL, Proquest, Cochrane library, Pubmed etc were performed. All studies which addressed the differences in critical thinking among nursing students in PBL were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. As a result, only ten studies were retrieved, they were: one RCT with a Jadad quality score of 3, one nonrandomized control study, two quasi-experimental studies with non-controlled pretest-posttest design, and six descriptive studies. The available evidence in this review did not provide supportive evidence on developing nursing students' critical thinking through PBL. Clearly, there is a need for additional research with larger sample size and high quality to clarify the effects of PBL on critical thinking development within nursing educational context.

  17. Selective spatial working memory impairment in a group of children with mathematics learning disabilities and poor problem-solving skills.

    PubMed

    Passolunghi, Maria Chiara; Mammarella, Irene Cristina

    2012-01-01

    This study examines visual and spatial working memory skills in 35 third to fifth graders with both mathematics learning disabilities (MLD) and poor problem-solving skills and 35 of their peers with typical development (TD) on tasks involving both low and high attentional control. Results revealed that children with MLD, relative to TD children, failed spatial working memory tasks that had either low or high attentional demands but did not fail the visual tasks. In addition, children with MLD made more intrusion errors in the spatial working memory tasks requiring high attentional control than did their TD peers. Finally, as a post hoc analysis the sample of MLD was divided in two: children with severe MLD and children with low mathematical achievement. Results showed that only children with severe MLD failed in spatial working memory (WM) tasks if compared with children with low mathematical achievement and TD. The findings are discussed on the basis of their theoretical and clinical implications, in particular considering that children with MLD can benefit from spatial WM processes to solve arithmetic word problems, which involves the ability to both maintain and manipulate relevant information.

  18. The neurobiological Correlates of Childhood Adversity and Implications for Treatment

    PubMed Central

    Tyrka, Audrey R.; Burgers, Darcy E.; Philip, Noah S.; Price, Lawrence H.; Carpenter, Linda L.

    2013-01-01

    Objective This paper provides an overview of research on the neurobiological correlates of childhood adversity and a selective review of treatment implications. Method Findings from a broad array of human and animal studies of early adversity were reviewed. Results Topics reviewed include neuroendocrine, neurotrophic, neuroimaging, and cognitive effects of adversity, as well as genetic and epigenetic influences. Effects of early life stress on treatment outcome are considered, and development of treatments designed to address the neurobiological abnormalities is discussed. Conclusion Early adversity is associated with abnormalities of several neurobiological systems that are implicated in the development of psychopathology and other medical conditions. Early life stress negatively impacts treatment outcome and individuals may require treatments that are specific to this condition. PMID:23662634

  19. Adverse drug reactions: part II.

    PubMed

    Wooten, James M

    2010-11-01

    Pharmacovigilance is the process of identifying, monitoring, and effectively reducing adverse drug reactions. Adverse drug reactions (ADRs) are an important consideration when assessing a patient's health. The proliferation of new pharmaceuticals means that the incidence of ADRs is increasing. The goal for all health care providers must be to minimize the risk of ADRs as much as possible. Steps to achieve this include understanding the pharmacology for all drugs prescribed and proactively assessing and monitoring those patients at greatest risk for developing an ADR. Groups at greatest risk for developing ADRs include the elderly, children, and pregnant patients, as well as others. Pharmacovigilance must be effectively practiced by all health care providers in order to avoid ADRs.

  20. Adverse drug reactions: Part I.

    PubMed

    Wooten, James M

    2010-10-01

    Pharmacovigilance is the process of identifying, monitoring, and effectively reducing adverse drug reactions. Adverse drug reactions (ADRs) are an important consideration when assessing a patient's health. The proliferation of new pharmaceuticals means that the incidence of ADRs is increasing. The goal for all health care providers must be to minimize the risk of ADRs as much as possible. Steps to achieve this include understanding the pharmacology for all drugs prescribed and proactively assessing and monitoring those patients at greatest risk for developing an ADR. Groups at greatest risk for developing ADRs include the elderly, children, and pregnant patients, as well as others. Pharmacovigilance must effectively be practiced by all health providers in order to avoid ADRs.

  1. [Finasteride adverse effects: An update].

    PubMed

    Carreño-Orellana, Néstor; Moll-Manzur, Catherina; Carrasco-Zuber, Juan Eduardo; Álvarez-Véliz, Sergio; Berroeta-Mauriziano, Daniela; Porras-Kusmanic, Ninoska

    2016-12-01

    Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.

  2. [Pain as adverse drug reaction].

    PubMed

    Böhmdorfer, Birgit; Schaffarzick, Daniel; Nagano, Marietta; Janowitz, Susanne Melitta; Schweitzer, Ekkehard

    2012-09-01

    We present a multidisciplinary (anaesthesiology--clinical pharmacy--bioinformatics) analysis of pain as possible adverse drug reaction taking different manifestations of pain, indication groups, relevance to the Austrian drug market and possible mechanistic influence of drugs on development and apprehension of pain into consideration.We designed an overview that shows how transmitters that play a part in nociception and antinociception can be influenced by drugs. This allows conclusions to the dolorigene potential of therapeutics.

  3. Thiocolchicoside: review of adverse effects.

    PubMed

    2016-02-01

    Thiocolchicoside has long been used as a muscle relaxant, despite a lack of proven efficacy beyond the placebo effect. Its chemical structure consists of colchicine, a sugar (ose) and a sulphur-containing radical (thio), and its adverse effects are therefore likely to be similar to those of colchicine. Using the standard Prescrire methodology, we reviewed the available data on the adverse effects of thiocolchicoside. Liver injury, pancreatitis, seizures, blood cell disorders, severe cutaneous disorders, rhabdomyolysis and reproductive disorders have all been recorded in the French and European pharmacovigilance databases and in the periodic updates that the companies concerned submit to regulatory agencies. These data do not specify the frequency of the disorders nor do they identify the most susceptible patient populations. Thiocolchicoside is teratogenic in experimental animals and also damages chromosomes. Human data are limited to a follow-up of about 30 pregnant women (no major malformations) and reports of altered spermatogenesis, including cases of azoospermia. In practice, there is no justification for exposing patients to the adverse effects of thiocolchicoside. It is better to use an effective, well-known analgesic for patients complaining of muscle pain, starting with paracetamol.

  4. Adverse food-drug interactions.

    PubMed

    de Boer, Alie; van Hunsel, Florence; Bast, Aalt

    2015-12-01

    Food supplements and herbal products are increasingly popular amongst consumers. This leads to increased risks of interactions between prescribed drugs and these products containing bioactive ingredients. From 1991 up to 2014, 55 cases of suspected adverse drug reactions due to concomitant intake of health-enhancing products and drugs were reported to Lareb, the Netherlands Pharmacovigilance Centre. An overview of these suspected interactions is presented and their potential mechanisms of action are described. Mainly during the metabolism of xenobiotics and due to the pharmacodynamics effects interactions seem to occur, which may result in adverse drug reactions. Where legislation is seen to distinct food and medicine, legislation concerning these different bioactive products is less clear-cut. This can only be resolved by increasing the molecular knowledge on bioactive substances and their potential interactions. Thereby potential interactions can be better understood and prevented on an individual level. By considering the dietary pattern and use of bioactive substances with prescribed medication, both health professionals and consumers will be increasingly aware of interactions and these interactive adverse effects can be prevented.

  5. Selected aspects of discrete-time filtering techniques as applied to sensor control and signal processing problems

    NASA Astrophysics Data System (ADS)

    Bjorset, Lars

    The general structure of the discrete-time linear filter and basic rules for paralleling and cascading multiple filters are defined. Rules for feedback and feedforward within complexes of interconnected filters are established. Discrete-time initial and final value theorems are defined, and applications for the analysis of control systems are discussed. Basic filter synthesis techniques are defined. Implications of sampling rate conversions (decimation and interpolation) in discrete-time control systems are analyzed, and applications to sensor systems are considered. The solution of sensor signal processing problems through the application of discrete-time finite impulse response (FIR) filters is treated. Complex signal representations are defined, together with the generalized complex filter, and basic properties are discussed. The feasibility of parallel-shifting the characteristics of FIR filters along the frequency axis is analyzed. The resulting filters are shown to have close similarities to filters banks realized by windowing and subsequent discrete Fourier transform processing.

  6. Preliminary analysis of selected gas dynamic problems. [space shuttle main engine main combustion transients and IUS nozzle flow

    NASA Technical Reports Server (NTRS)

    Prozan, R. J.; Farmer, R. C.

    1985-01-01

    The VAST computer code was used to analyze SSME main combustion chamber start-up transients and the IUS flow field for a damaged nozzle was investigated to better understand the gas dynamic considerations involved in vehicle problems, the effect of start transients on the nozzle flow field for the SSME, and the possibility that a damaged nozzle could account for the acceleration anomaly noted on IUS burn. The results obtained were compared with a method of characteristics prediction. Pressure solutions from both codes were in very good agreement and the Mach number solution on the nozzle centerline deviates substantially for the high expansions for the SSME. Since this deviation was unexpected, the phenomenon is being further examined.

  7. Predicting adverse drug events from personal health messages.

    PubMed

    Chee, Brant W; Berlin, Richard; Schatz, Bruce

    2011-01-01

    Adverse drug events (ADEs) remain a large problem in the United States, being the fourth leading cause of death, despite post market drug surveillance. Much post consumer drug surveillance relies on self-reported "spontaneous" patient data. Previous work has performed datamining over the FDA's Adverse Event Reporting System (AERS) and other spontaneous reporting systems to identify drug interactions and drugs correlated with high rates of serious adverse events. However, safety problems have resulted from the lack of post marketing surveillance information about drugs, with underreporting rates of up to 98% within such systems. We explore the use of online health forums as a source of data to identify drugs for further FDA scrutiny. In this work we aggregate individuals' opinions and review of drugs similar to crowd intelligence3. We use natural language processing to group drugs discussed in similar ways and are able to successfully identify drugs withdrawn from the market based on messages discussing them before their removal.

  8. Association Patterns in Open Data to Explore Ciprofloxacin Adverse Events

    PubMed Central

    2015-01-01

    Summary Background Ciprofloxacin is one of the main drugs to treat bacterial infections. Bacterial infections can lead to high morbidity, mortality, and costs of treatment in the world. In this study, an analysis was conducted using the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database on the adverse events of ciprofloxacin. Objectives The aim of this study was to explore unknown associations among the adverse events of ciprofloxacin, patient demographics and adverse event outcomes. Methods A search of FDA AERS reports was performed and some statistics was highlighted. The most frequent adverse events and event outcomes of ciprofloxacin were listed, age and gender specific distribution of adverse events are reported, then the apriori algorithm was applied to the dataset to obtain some association rules and objective measures were used to select interesting ones. Furthermore, the results were compared against classical data mining algorithms and discussed. Results The search resulted in 6 531 reports. The reports included within the dataset consist of 3 585 (55.8%) female and 2 884 (44.1%) male patients. The mean age of patients is 54.59 years. Preschool child, middle aged and aged groups have most adverse events reports in all groups. Pyrexia has the highest frequency with ciprofloxacin, followed by pain, diarrhoea, and anxiety in this order and the most frequent adverse event outcome is hospitalization. Age and gender based differences in the events in patients were found. In addition, some of the interesting associations obtained from the Apriori algorithm include not only psychiatric disorders but specifically their manifestation in specific gender groups. Conclusions The FDA AERS offers an important data resource to identify new or unknown adverse events of drugs in the biomedical domain. The results that were obtained in this study can provide valuable information for medical researchers and decision makers at the

  9. Doctors and alcohol. The responses of a self-selected group of general practitioners to patients with alcohol-related problems.

    PubMed

    Casswell, S; McPherson, M

    1982-07-14

    A postal survey of New Zealand general practitioners gathered information from a self-selected sample about their response to alcohol problems. Responses to a series of attitude statements measured the extent to which doctors held traditional beliefs about alcoholism as a disease, the management of which requires abstinence; emerging concepts of alcohol dependence and more moralistic attitudes. General practitioners who responded to the survey were found to be largely in sympathy with the disease concept of alcohol problems though some of the more recently emerging concepts were also widely accepted. The majority reported that they felt they did have an active role to play in connection with the alcohol problems of their patients, both in terms of treatment or advice giving, and referral to specialist agencies. Over half of the respondents requested guidelines for treatment and advice giving. Only a small proportion of general practitioners reported pessimism about their personal role in relation to their patients' alcohol problems. The results are discussed in the context of recent research evidence showing the relative efficacy of a structured advice-counseling session of the type in which general practitioners might engage.

  10. Thermal convection in a cylinder and the problem of planform selection in an internally heated fluid layer

    NASA Astrophysics Data System (ADS)

    Kolmychkov, V. V.; Shcheritsa, O. V.; Mazhorova, O. S.

    2016-12-01

    The paper deals with the hexagonal convective flow near the stability threshold in an internally heated fluid layer. In our previous numerical study of convection near the stability threshold in a square box with internal heat generation [Phys. Lett. A 377, 2111 (2013)], 10.1016/j.physleta.2013.06.013 for a region of large horizontal extent, it has been shown that at small values of Prandtl number (Pr), convection sets in as a pattern of hexagonal cells with upward motion in the center (up-hexagons), whereas at large Pr, a stable flow pattern is formed by hexagonal cells with a downward motion in the center (down-hexagons). Here, we study axisymmetric convection in a cylinder as a model of motion in a single hexagonal cell. The radius of the cylinder matches the size of hexagons observed in our three-dimensional simulation. The lateral boundary of the cylinder is free and heat insulated. Horizontal bounding surfaces are rigid. The upper boundary is maintained at a constant temperature; the lower one is insulated. Two stable, steady-state motions with the upward and downward flow at the cylinder axis have been attained in calculations, irrespective of Pr. Cylindrical motion with the same direction of circulation as in the stable hexagons has a maximum temperature drop measured along the radius at the bottom of the cell. We suggest maximization of the temperature drop as a selection criterion, which determines the preferred state of motion in an internally heated fluid layer. This new selection principle is validated by the comparative analysis of the dominant nonlinear effects in low- and high-Prandtl number convection.

  11. Duration of Internet use and adverse psychosocial effects among European adolescents.

    PubMed

    Secades-Villa, Roberto; Calafat, Amador; Fernández-Hermida, José Ramón; Juan, Montse; Duch, Mariangels; Skärstrand, Eva; Becoña, Elisardo; Talic, Sanela

    2014-01-01

    Despite the significant contributions from previous studies about the prevalence of problematic Internet use (PIU) among adolescents in Europe, important questions remain regarding adverse consequences of PIU. This study aims to assess the relation between duration of Internet use and adverse psychosocial effects among adolescents from six European countries. The final sample included 7,351 adolescents (50.8% male and 49.2% female; mean age: 14.6±1.90) recruited from randomly selected schools within the six study sites. Results showed that 12.9% of adolescents used Internet more than 20 hours per week. There was a significant relationship between duration of Internet use and frequency of alcohol, tobacco, cannabis and other illegal drug use. Duration of Internet use is also significantly associated with school problems, with use of slot machines and with other psychosocial problems. These findings highlight the need to strengthen preventive efforts for reducing PIU and related consequences among adolescents. Key Words: Internet, adolescents, psychosocial problems.

  12. Maternal Psychosocial Adversity and the Longitudinal Development of Infant Sleep

    ERIC Educational Resources Information Center

    Cronin, Alison; Halligan, Sarah L.; Murray, Lynne

    2008-01-01

    Research has identified associations between indicators of social disadvantage and the presence of child sleep problems. We examined the longitudinal development of infant sleep in families experiencing high (n = 58) or low (n = 64) levels of psychosocial adversity, and the contributions of neonatal self-regulatory capacities and maternal settling…

  13. An Analytic Network Process approach for the environmental aspect selection problem — A case study for a hand blender

    SciTech Connect

    Bereketli Zafeirakopoulos, Ilke Erol Genevois, Mujde

    2015-09-15

    Life Cycle Assessment is a tool to assess, in a systematic way, the environmental aspects and its potential environmental impacts and resources used throughout a product's life cycle. It is widely accepted and considered as one of the most powerful tools to support decision-making processes used in ecodesign and sustainable production in order to learn about the most problematic parts and life cycle phases of a product and to have a projection for future improvements. However, since Life Cycle Assessment is a cost and time intensive method, companies do not intend to carry out a full version of it, except for large corporate ones. Especially for small and medium sized enterprises, which do not have enough budget for and knowledge on sustainable production and ecodesign approaches, focusing only on the most important possible environmental aspect is unavoidable. In this direction, finding the right environmental aspect to work on is crucial for the companies. In this study, a multi-criteria decision-making methodology, Analytic Network Process is proposed to select the most relevant environmental aspect. The proposed methodology aims at providing a simplified environmental assessment to producers. It is applied for a hand blender, which is a member of the Electrical and Electronic Equipment family. The decision criteria for the environmental aspects and relations of dependence are defined. The evaluation is made by the Analytic Network Process in order to create a realistic approach to inter-dependencies among the criteria. The results are computed via the Super Decisions software. Finally, it is observed that the procedure is completed in less time, with less data, with less cost and in a less subjective way than conventional approaches. - Highlights: • We present a simplified environmental assessment methodology to support LCA. • ANP is proposed to select the most relevant environmental aspect. • ANP deals well with the interdependencies between aspects and

  14. [Infanticide in the light of post-mortem findings and court files from the period 1990-2000 (selected problems)].

    PubMed

    Kołowski, Janusz; Nowak, Klaudia Magdalena

    2005-01-01

    Drawing upon 28 court files of the District Court in Poznań and 30 post-mortem protocols--from the Department of Forensic Medicine at Poznań Medical Academy. This article tackles the issue of infanticide in the period from 1990 to 2000. The aim of this paper was to find answers to the following questions: what was the social background and mental state of female offenders? How was infanticide committed? In order to solve certain research problems, a document examination technique was employed to analyse the contents of the documents available. Female offenders were aged between 17 to 42 years. In the majority of cases (56.7%), perpetrators were occupationally active, single young women with a low level of education and having a working-class background. In the majority of cases (80%), active infanticide was committed. Most frequently, infanticide was committed by shutting a child into a tight space, and tamponade of throat and larynx. Passive infanticide was committed in 20% of cases, with infants left without care at the place of birth. No case of psychosis was determined in the examined material.

  15. Private property rights and selective private forest conservation: could a Nordic hybrid policy address a United States problem?

    PubMed

    Mortimer, Michael J

    2008-05-01

    Political and legal conflicts between the need for targeted private forest conservation and the continued assurance of private property rights in the U.S. presents a seemingly intractable resource management problem. Scandinavian use of habitat protection areas on private forests offers an additional tool that may be suitable for solving the historical and on-going tension found within U.S. efforts to reconcile desires to maintain lands in a forested condition while also respecting private property rights. This article presents a comparative cross-sectional policy analysis of Sweden, Finland, and the U.S., supported with a supplemental case example from the Commonwealth of Virginia. Similarities in all three countries among forest ownership patterns, use of public subsidies, and changing attitudes towards conservation are generally encouraging. Additionally, Virginia's current consideration and development of state-wide forest policies focused on forestland and open space conservation suggests both a need and an opportunity to systematically assess the applicability of the Nordic forest reserve approach to local private forest conservation. Future research at a high-resolution, and specifically at the state level, should focus on the social and political factors that would ultimately determine the viability of a forest reserve program.

  16. Adverse effects of new antiepileptic drugs.

    PubMed

    Onat, Filiz; Ozkara, Cigdem

    2004-04-01

    Starting with phenobarbital in the 1900s, it took almost 70-80 years to introduce old-generation agents for the treatment of epilepsy. Then, in eleven years, nine more new antiepileptic drugs were added to the armamentarium. These drugs produce a nearly 40-50% decrease in seizure incidence in refractory patients, but few patients have been able to achieve complete freedom from seizures. So the search for more effective drugs with minimal adverse effect profiles will continue. Although the new antiepileptic drugs do not demonstrate a superior efficacy compared to the older ones, they do offer some advantages in terms of tolerability, fewer drug interactions and simpler pharmacokinetics. However, our knowledge concerning their safety profiles can not yet be considered adequate due to the relatively short time these drugs have been on the market and to the limited number of patients exposed to them. The fact that the serious side effects of felbamate and vigabatrine appeared late after marketing should be taken as an important lesson because it implies the potential for unknown side effects at any time during treatment. Antiepileptic drug treatment should begin with diagnosis of the seizure and epileptic syndrome, followed by selection of the drug most appropriate for treatment of the individual patient, and continued with monitoring of not only the seizures but the adverse effect profile as well.

  17. [Interhemisphere neurochemical differences in the brain of silver foxes selected for behavior and the problem of directed asymmetry].

    PubMed

    Trut, L N; Pliusnina, I Z; Kolesnikova, L A; Kozlova, O N

    2000-07-01

    The study deals with the mechanisms that bring about a directional asymmetry in the expression of some morphological traits observed in some animals subjected to experimental domestication. The key role in the integration of development is attributed to the genetic systems controlling the activity of brain neurotransmitter systems. Therefore, the investigation of directional asymmetry of morphological traits began with the analysis of interhemispheral differences in neurotransmitter activity in animal lines selected for domestic and aggressive behavior. Experiments on silver foxes reveal interhemispheral differences in the dopaminergic system emerging in the striatum. An increased dopamine level is observed in the right half of the striatum of aggressive foxes and in both right and left halves of the striata of domestic foxes. On the basis of the literature data, it is suggested that the considerable increase in the dopamine level in the right halves of the striata of both aggressive and domestic animals is related to a genetic increase in the manifestation of emotional response in both lines, whereas its increase in the left half of the striatum of domesticated foxes may be related to a correlated deterioration of the function of the pituitary-adrenal system.

  18. Adverse responses to local anaesthetics.

    PubMed

    Fisher, M M; Graham, R

    1984-11-01

    Progressive challenge was used to investigate twenty-seven patients with a history of an adverse response to local anaesthesia. True allergy was detected in only one patient. The method does not exclude reactions to additives and preservatives in local anaesthetics. If preservative-free local anaesthetics are used for subsequent exposure in patients with no response to progressive challenge, subsequent exposure is safe. The possibility that some of these patients may be reacting to preservatives in the solutions cannot be excluded by such testing. Where possible preservative-free local anaesthetic preparations should be used for subsequent anaesthesia.

  19. Adverse Outcomes in Group Psychotherapy

    PubMed Central

    Roback, Howard B.

    2000-01-01

    Group forms of therapy have been growing at a rapid rate, in part because of their documented effectiveness and economic considerations such as managed care. It is therefore becoming increasingly important to assess the psychological risks of these interventions. The author provides an overview of the published literature and conference presentations on negative effects in adult outpatient groups. Although much of the literature on adverse outcomes in group therapy focuses on single risk factors (e.g., negative leader, group process, or patient characteristics), the author argues that an interactional model should be encouraged. Means of reducing casualties are also discussed, as well as methodological issues and research directions. PMID:10896735

  20. Adverse effects of isolation in hospitalised patients: a systematic review.

    PubMed

    Abad, C; Fearday, A; Safdar, N

    2010-10-01

    The use of transmission precautions such as contact isolation in patients known to be colonised or infected with multidrug-resistant organisms is recommended in healthcare institutions. Although essential for infection control, contact isolation has recently been associated with adverse effects in patients. We undertook a systematic review to determine whether contact isolation leads to psychological or physical problems for patients. Studies were included if (1) hospitalised patients were placed under isolation precautions for an underlying medical indication, and (2) any adverse events related to the isolation were evaluated. We found 16 studies that reported data regarding the impact of isolation on patient mental well-being, patient satisfaction, patient safety or time spent by healthcare workers in direct patient care. The majority showed a negative impact on patient mental well-being and behaviour, including higher scores for depression, anxiety and anger among isolated patients. A few studies also found that healthcare workers spent less time with patients in isolation. Patient satisfaction was adversely affected by isolation if patients were kept uninformed of their healthcare. Patient safety was also negatively affected, leading to an eight-fold increase in adverse events related to supportive care failures. We found that contact isolation may negatively impact several dimensions of patient care. Well-validated tools are necessary to investigate these results further. Large studies examining a number of safety indicators to assess the adverse effects of isolation are needed. Patient education may be an important step to mitigate the adverse psychological effects of isolation and is recommended.

  1. Adverse childhood experience and asthma onset: a systematic review.

    PubMed

    Exley, Daniel; Norman, Alyson; Hyland, Michael

    2015-06-01

    Adverse childhood experiences such as abuse and neglect are associated with subsequent immune dysregulation. Some studies show an association between adverse childhood experiences and asthma onset, although significant disparity in results exists in the published literature. We aimed to review available studies employing a prospective design that investigates associations between adverse childhood experience and asthma. A search protocol was developed and studies were drawn from four electronic journal databases. Studies were selected in accordance with pre-set inclusion criteria and relevant data were extracted. 12 studies, assessing data from a total of 31 524 individuals, were identified that investigate the impact of a range of adverse childhood experiences on the likelihood of developing asthma. Evidence suggests that chronic stress exposure and maternal distress in pregnancy operate synergistically with known triggers such as traffic-related air pollution to increase asthma risk. Chronic stress in early life is associated with an increased risk of asthma onset. There is evidence that adverse childhood experience increases the impact of traffic-related air pollution and inconsistent evidence that adverse childhood experience has an independent effect on asthma onset.

  2. Changing friend selection in middle school: A social network analysis of a randomized intervention study designed to prevent adolescent problem behavior

    PubMed Central

    DeLay, Dawn; Ha, Thao; Van Ryzin, Mark; Winter, Charlotte; Dishion, Thomas J.

    2015-01-01

    Adolescent friendships that promote problem behavior are often chosen in middle school. The current study examines the unintended impact of a randomized school based intervention on the selection of friends in middle school, as well as on observations of deviant talk with friends five years later. Participants included 998 middle school students (526 boys and 472 girls) recruited at the onset of middle school (age 11-12 years) from three public middle schools participating in the Family Check-up model intervention. The current study focuses only on the effects of the SHAPe curriculum—one level of the Family Check-up model—on friendship choices. Participants nominated friends and completed measures of deviant peer affiliation. Approximately half of the sample (n=500) was randomly assigned to the intervention and the other half (n=498) comprised the control group within each school. The results indicate that the SHAPe curriculum affected friend selection within School 1, but not within Schools 2 or 3. The effects of friend selection in School 1 translated into reductions in observed deviancy training five years later (age 16-17 years). By coupling longitudinal social network analysis with a randomized intervention study the current findings provide initial evidence that a randomized public middle school intervention can disrupt the formation of deviant peer groups and diminish levels of adolescent deviance five years later. PMID:26377235

  3. Changing Friend Selection in Middle School: A Social Network Analysis of a Randomized Intervention Study Designed to Prevent Adolescent Problem Behavior.

    PubMed

    DeLay, Dawn; Ha, Thao; Van Ryzin, Mark; Winter, Charlotte; Dishion, Thomas J

    2016-04-01

    Adolescent friendships that promote problem behavior are often chosen in middle school. The current study examines the unintended impact of a randomized school-based intervention on the selection of friends in middle school, as well as on observations of deviant talk with friends 5 years later. Participants included 998 middle school students (526 boys and 472 girls) recruited at the onset of middle school (age 11-12 years) from three public middle schools participating in the Family Check-up model intervention. The current study focuses only on the effects of the SHAPe curriculum-one level of the Family Check-up model-on friendship choices. Participants nominated friends and completed measures of deviant peer affiliation. Approximately half of the sample (n = 500) was randomly assigned to the intervention, and the other half (n = 498) comprised the control group within each school. The results indicate that the SHAPe curriculum affected friend selection within school 1 but not within schools 2 or 3. The effects of friend selection in school 1 translated into reductions in observed deviancy training 5 years later (age 16-17 years). By coupling longitudinal social network analysis with a randomized intervention study, the current findings provide initial evidence that a randomized public middle school intervention can disrupt the formation of deviant peer groups and diminish levels of adolescent deviance 5 years later.

  4. "Adversative Conjunction": The Poetics of Linguistic Opposition.

    ERIC Educational Resources Information Center

    Wallerstein, Nicholas

    1992-01-01

    The general use of adversative conjunction in (primarily) English and U.S. poetry is outlined. The contention is that the adversative is not merely a grammatical convenience but sometimes a highly functional tool of rhetorical strategy. (36 references) (LB)

  5. The international serious adverse events consortium.

    PubMed

    Holden, Arthur L; Contreras, Jorge L; John, Sally; Nelson, Matthew R

    2014-11-01

    The International Serious Adverse Events Consortium is generating novel insights into the genetics and biology of drug-induced serious adverse events, and thereby improving pharmaceutical product development and decision-making.

  6. Effects of Timing of Adversity on Adolescent and Young Adult Adjustment.

    PubMed

    Kiff, Cara J; Cortes, Rebecca; Lengua, Lilana; Kosterman, Rick; Hawkins, J David; Mason, W Alex

    2012-06-01

    Effects of Timing of Adversity on Adolescent and Young Adult Adjustment Abstract Exposure to adversity during childhood and adolescence predicts adjustment across development. Further, adolescent adjustment problems persist into young adulthood. This study examined relations of contextual adversity with concurrent adolescent adjustment and prospective mental health and health outcomes in young adulthood. A longitudinal sample (N = 808) was followed from age 10 through 27. Perceptions of neighborhood in childhood predicted depression, alcohol use disorders, and HIV risk in young adulthood. Further, the timing of adversity was important in determining the type of problem experienced in adulthood. Youth adjustment predicted adult outcomes, and in some cases, mediated the relation between adversity and outcomes. These findings support the importance of adversity in predicting adjustment and elucidate factors that affect outcomes into young adulthood.

  7. Adverse reactions to drug additives.

    PubMed

    Simon, R A

    1984-10-01

    There is a long list of additives used by the pharmaceutical industry. Most of the agents used have not been implicated in hypersensitivity reactions. Among those that have, only reactions to parabens and sulfites have been well established. Parabens have been shown to be responsible for rare immunoglobulin E-mediated reactions that occur after the use of local anesthetics. Sulfites, which are present in many drugs, including agents commonly used to treat asthma, have been shown to provoke severe asthmatic attacks in sensitive individuals. Recent studies indicate that additives do not play a significant role in "hyperactivity." The role of additives in urticaria is not well established and therefore the incidence of adverse reactions in this patient population is simply not known. In double-blind, placebo-controlled studies, reactions to tartrazine or additives other than sulfites, if they occur at all, are indeed quite rare for the asthmatic population, even for the aspirin-sensitive subpopulation.

  8. A drug-adverse event extraction algorithm to support pharmacovigilance knowledge mining from PubMed citations.

    PubMed

    Wang, Wei; Haerian, Krystl; Salmasian, Hojjat; Harpaz, Rave; Chase, Herbert; Friedman, Carol

    2011-01-01

    Adverse drug events (ADEs) create a serious problem causing substantial harm to patients. An executable standardized knowledgebase of drug-ADE relations which is publicly available would be valuable so that it could be used for ADE detection. The literature is an important source that could be used to generate a knowledgebase of drug-ADE pairs. In this paper, we report on a method that automatically determines whether a specific adverse event (AE) is caused by a specific drug based on the content of PubMed citations. A drug-ADE classification method was initially developed to detect neutropenia based on a pre-selected set of drugs. This method was then applied to a different set of 76 drugs to determine if they caused neutropenia. For further proof of concept this method was applied to 48 drugs to determine whether they caused another AE, myocardial infarction. Results showed that AUROC was 0.93 and 0.86 respectively.

  9. Adverse events in healthcare: learning from mistakes.

    PubMed

    Rafter, N; Hickey, A; Condell, S; Conroy, R; O'Connor, P; Vaughan, D; Williams, D

    2015-04-01

    Large national reviews of patient charts estimate that approximately 10% of hospital admissions are associated with an adverse event (defined as an injury resulting in prolonged hospitalization, disability or death, caused by healthcare management). Apart from having a significant impact on patient morbidity and mortality, adverse events also result in increased healthcare costs due to longer hospital stays. Furthermore, a substantial proportion of adverse events are preventable. Through identifying the nature and rate of adverse events, initiatives to improve care can be developed. A variety of methods exist to gather adverse event data both retrospectively and prospectively but these do not necessarily capture the same events and there is variability in the definition of an adverse event. For example, hospital incident reporting collects only a very small fraction of the adverse events found in retrospective chart reviews. Until there are systematic methods to identify adverse events, progress in patient safety cannot be reliably measured. This review aims to discuss the need for a safety culture that can learn from adverse events, describe ways to measure adverse events, and comment on why current adverse event monitoring is unable to demonstrate trends in patient safety.

  10. Contribution of patient and hospital characteristics to adverse patient incidents.

    PubMed Central

    Elnicki, R A; Schmitt, J P

    1980-01-01

    The 1974 medical malpractice "crisis" brought about extensive legislation and insurance regulation in the United States. Hospitals in many states are now required to support risk management programs that include investigation and systematic analyses of adverse patient incidents. However, no research supports the hypothesis that systematic analysis of adverse patient incidents can identify contributory factors. In this study, a simple prediction model was used to estimate relationships between adverse incidents and selected patient and environmental characteristics in a large hospital. While some of the incident-characteristic relationships were significant, none of the estimated equations yielded results that could be logically translated into policy recommendations for the hospital. These results point to the need for further research. The benefits that positive research results would have for patients, hospitals, an the bill-paying public are obvious. Additional negative results would suggest that many legislative bodies and regulatory agencies were presumptions in requiring hospitals to conduct analyses of incidents. PMID:7461973

  11. Misuse of topical corticosteroids: A clinical study of adverse effects

    PubMed Central

    Dey, Vivek Kumar

    2014-01-01

    Background: Misuse of topical corticosteroids is a widespread phenomenon among young people in India, especially women. The practice is associated with significant adverse effects and poor awareness of these effects among the general public. Aim: This study was conducted to examine the misuse and adverse effects of topical corticosteroids among the people in Bastar region in Chhattisgarh state of India. Materials and Methods: Data collected from patients presenting with at least one of the adverse effects of topical corticosteroids as the chief complaint, from November 2010 to October 2011. Results: Out of the 6723 new patients, 379 (5.63%) had presented with misuse and adverse effects of topical corticosteroids, of whom 78.89% were females. More than 65% of the patients were in the age group 10-29 years. The main reason for using the topical corticosteroids was to lighten skin colour and treat melasma and suntan. Acne (37.99%) and telangiectasia (18.99%) were the most common adverse effects noted. Conclusions: Misuse of topical corticosteroids has a huge impact on dermatological practice, leading to a significant proportion of visits to the dermatologist. This hydra-headed problem needs multi-dimensional interventions, involving educational, legal and managerial approaches with cooperation from different sectors of society. PMID:25396124

  12. Effects of Timing of Adversity on Adolescent and Young Adult Adjustment

    ERIC Educational Resources Information Center

    Kiff, Cara J.; Cortes, Rebecca C.; Lengua, Liliana J.; Kosterman, Rick; Hawkins, J. David; Mason, W. Alex

    2012-01-01

    Exposure to adversity during childhood and adolescence predicts adjustment across development. Furthermore, adolescent adjustment problems persist into young adulthood. This study examined relations of contextual adversity with concurrent adolescent adjustment and prospective mental health and health outcomes in young adulthood. A longitudinal…

  13. 'Skating on thin ice?' Consultant surgeon's contemporary experience of adverse surgical events.

    PubMed

    Skevington, Suzanne M; Langdon, Joanne E; Giddins, Grey

    2012-01-01

    Concerns about patient safety have prompted studies of adverse surgical events (ASEs), but descriptive classification of errors and malpractice claims have overshadowed qualitative investigations into the processes that lead to expert errors and their solutions. We studied consultant surgeon's perspectives on how and why events occurred through semi-structured interviews about general and specific events. The sample contained heterogeneous cross-section of ages, gender and specialists, with >2 years consultant status and working within a 25-mile radius. Overarching findings included (1) pressures to work harder, faster and beyond capability within a blaming culture; (2) optimism bias from over-confidence and complacency; and (3) multiple pressures to 'finish' an operation or list, resulting in completion bias. Seven high order themes were identified on the healthcare system, adverse event types, contributing factors, emotions, cognitive processes, error detection, and strategies, solutions and barriers. The process of classifying event types guided solution selection, and the decision about whether to formally report it. How serious consequences were for patients and their temporal effects, defined an adversity continuum. Minor events arose routinely i.e. technical discrepancies, side-effects. More problematic were sub-optimal outcomes and avoidable events. Despite their expertise, consultants were vulnerable to unavoidable, uncontrollable events which were major concerns. Most serious were near-misses, errors and mistakes. However, major errors did not inevitably lead to a catastrophe and minor errors could be extremely serious. A 'cascade' of minor events exacerbated by negative emotions can precipitate major events, and interception methods need investigation. Consultants felt powerless and helpless to change environmental, organisational and systemic problems; new communication and action channels are desirable. Confidence building in team leadership would

  14. Citrate anticoagulation and adverse events.

    PubMed

    De Vos, J; Hombrouckx, R

    2003-01-01

    Several patients with heparin intolerance were dialysed with tri-sodium citrate as anticoagulant without acute clinical problems (good tolerance). After some weeks however problems arose. In all patients an alkalosis developed: the pre dialysis bicarbonate level rose progressively from 27 mmol/l to 40 mmol/l. This could be tempered by lowering the dialysis fluid bicarbonate concentration from 37 mmol/l to 25 mmol/l. A second problem was a progressive rise in pre dialysis sodium level from a mean of 136 mmol/l to 150 mmol/l. Adapting the dialysis fluid sodium concentration from 140 mmol/l towards 132 mmol/l could solve this. The third problem was a progressive rise in serum aluminium level in patients from 3 microg/l to 38 microg/l. After excluding water, concentrate, dialysis fluid, drug intake, etc... as possible sources, we controlled the aluminium level in the glass bottle containing tri-sodium citrate. We noted the very high value of 35,300 microg/l. After replacing the glass bottles with polyvinylchloride bags with a negligible aluminium content, the serum aluminium levels returned back to normal. It is known that citrate chelates the aluminium present in the glass of bottles or vials.

  15. Adverse effects of antihypertensive drugs.

    PubMed

    Husserl, F E; Messerli, F H

    1981-09-01

    Early essential hypertension is asymptomatic and should remain so throughout treatment. In view of the increasing number of available antihypertensive agents, clinicians need to become familiar with the potential side effects of these drugs. By placing more emphasis on non-pharmacological treatment (sodium restriction, weight loss, exercise) and thoroughly evaluating each case in particular, the pharmacological regimen can be optimally tailored to the patient's needs. Potential side effects should be predicted and can often be avoided; if they become clinically significant they should be rapidly recognised and corrected. These side effects can be easily remembered in most instances, as they fall into 3 broad categories: (a) those caused by an exaggerated therapeutic effect; (b) those due to a non-therapeutic pharmacological effect; and (c) those caused by a non-therapeutic, non-pharmacological effect probably representing idiosyncratic reactions. This review focuses mainly on adverse effects of the second and third kind. Each group of drugs in general shares the common side effects of the first two categories, while each individual drug has its own idiosyncratic side effects.

  16. Minimizing AED adverse effects: improving quality of life in the interictal state in epilepsy care.

    PubMed

    St Louis, Erik K; Louis, Erik K

    2009-06-01

    The goals of epilepsy therapy are to achieve seizure freedom while minimizing adverse effects of treatment. However, producing seizure-freedom is often overemphasized, at the expense of inducing adverse effects of treatment. All antiepileptic drugs (AEDs) have the potential to cause dose-related, "neurotoxic" adverse effects (i.e., drowsiness, fatigue, dizziness, blurry vision, and incoordination). Such adverse effects are common, especially when initiating AED therapy and with polytherapy. Dose-related adverse effects may be obviated in most patients by dose reduction of monotherapy, reduction or elimination of polytherapy, or substituting for a better tolerated AED. Additionally, all older and several newer AEDs have idiosyncratic adverse effects which usually require withdrawal in an affected patient, including serious rash (i.e., Stevens-Johnson Syndrome, toxic epidermal necrolysis), hematologic dyscrasias, hepatotoxicity, teratogenesis in women of child bearing potential, bone density loss, neuropathy, and severe gingival hyperplasia. Unfortunately, occurrence of idiosyncratic AED adverse effects cannot be predicted or, in most cases, prevented in susceptible patients. This article reviews a practical approach for the definition and identification of adverse effects of epilepsy therapies, and reviews the literature demonstrating that adverse effects result in detrimental quality of life in epilepsy patients. Strategies for minimizing AED adverse effects by reduction or elimination of AED polytherapy, appropriately employing drug-sparing therapies, and optimally administering AEDs are outlined, including tenets of AED selection, titration, therapeutic AED laboratory monitoring, and avoidance of chronic idiosyncratic adverse effects.

  17. OAE: The Ontology of Adverse Events

    PubMed Central

    2014-01-01

    Background A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. Description The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term ‘adverse event’ denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. Conclusion OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of

  18. Endocrine and Metabolic Adverse Effects of Psychotropic Medications in Children and Adolescents

    ERIC Educational Resources Information Center

    Correll, Christoph U.; Carlson, Harold E.

    2006-01-01

    Objective: Despite increasing use of psychotropic medications in children and adolescents, data regarding their efficacy and safety are limited. Endocrine and metabolic adverse effects are among the most concerning adverse effects of commonly used psychotropic medications. Method: Selective review of endocrine and metabolic effects of psychotropic…

  19. Risk factors associated with adverse reactions to antituberculosis drugs.

    PubMed

    Resende, Laíse Soares Oliveira; Santos-Neto, Edson Theodoro Dos

    2015-01-01

    This review sought to identify the available scientific evidence on risk factors associated with adverse reactions to antituberculosis drugs. We performed a systematic review of studies published in the 1965-2012 period and indexed in the MEDLINE and LILACS databases. A total of 1,389 articles were initially selected. After reading their abstracts, we selected 85 studies. Of those 85 studies, 16 were included in the review. Risk factors for adverse reactions to antituberculosis drugs included age > 60 years, treatment regimens, alcoholism, anemia, and HIV co-infection, as well as sodium, iron, and albumin deficiency. Protective factors against hepatic adverse effects of antituberculosis drugs included being male (combined OR = 0.38; 95% CI: 0.20-0.72) and showing a rapid/intermediate N-acetyltransferase 2 acetylator phenotype (combined OR = 0.41; 95% CI: 0.18-0.90). There is evidence to support the need for management of adverse reactions to antituberculosis drugs at public health care facilities.

  20. Risk factors associated with adverse reactions to antituberculosis drugs*

    PubMed Central

    Resende, Laíse Soares Oliveira; dos Santos-Neto, Edson Theodoro

    2015-01-01

    This review sought to identify the available scientific evidence on risk factors associated with adverse reactions to antituberculosis drugs. We performed a systematic review of studies published in the 1965-2012 period and indexed in the MEDLINE and LILACS databases. A total of 1,389 articles were initially selected. After reading their abstracts, we selected 85 studies. Of those 85 studies, 16 were included in the review. Risk factors for adverse reactions to antituberculosis drugs included age > 60 years, treatment regimens, alcoholism, anemia, and HIV co-infection, as well as sodium, iron, and albumin deficiency. Protective factors against hepatic adverse effects of antituberculosis drugs included being male (combined OR = 0.38; 95% CI: 0.20-0.72) and showing a rapid/intermediate N-acetyltransferase 2 acetylator phenotype (combined OR = 0.41; 95% CI: 0.18-0.90). There is evidence to support the need for management of adverse reactions to antituberculosis drugs at public health care facilities. PMID:25750677

  1. Construing benefits from adversity: adaptational significance and dispositional underpinnings.

    PubMed

    Affleck, G; Tennen, H

    1996-12-01

    The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-finding) and the use of such knowledge as a deliberate strategy of coping with the problem (benefit-reminding) is underscored and illustrated by daily process research on coping with chronic pain.

  2. Adverse health consequences of the Vietnam War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace.

  3. Characterizing "Adversity" of Pathology Findings in ...

    EPA Pesticide Factsheets

    The identification of adverse health effects has a central role in the development and risk/safety assessment of chemical entities and pharmaceuticals. There is currently a need for better alignment in the toxicologic pathology community regarding how nonclinical adversity is determined and characterized. The European Society of Toxicologic Pathology (ESTP) therefore coordinated a workshop in June 2015 to review available definitions of adversity, weigh determining and qualifying factors of adversity based on case examples, and recommend a practical approach to define and characterize adversity in toxicology reports. The international group of expert pathologists and toxicologists emphasized that a holistic, weight-of-evidence, case-specific approach should be followed for each adversity assessment. It was recommended that nonclinical adversity should typically be determined at a morphological level (most often the organ) in the pathology report and should refer specifically to the test species. Final adversity calls, integration of target pharmacology/pathway information, and consideration of human translation should generally be made in toxicology overview reports. Differences in interpretation and implications of adversity calls between (agro)chemical and pharmaceutical industries and among world regions were highlighted. The results of this workshop should serve a valuable prerequisite for future organ- or lesion-specific workshops planned by the ESTP. This

  4. Dietary aspects of adverse reactions to foods in adults.

    PubMed Central

    Parker, S L; Sussman, G L; Krondl, M

    1988-01-01

    Dietary considerations play an important role in the diagnosis, treatment and management of immunologic and nonimmunologic reactions to foods. Food diaries and trial elimination diets may prove helpful in identifying the responsible foods. Elimination diets must be monitored carefully for nutritional adequacy and should be used no longer than absolutely necessary; in some instances appropriate vitamin and mineral supplementation may be necessary. Ideally the identification of foods that provoke symptoms should be confirmed by means of double-blind challenge testing. Avoidance of some problem foods is unlikely to cause nutritional problems, but the practical and nutritional implications of allergies to staple foods such as cow's milk, eggs and wheat are far greater. Nonimmunologic adverse reactions that may mimic food allergic reactions include gastrointestinal disorders, sensitivity to food additives and psychologically based adverse reactions. There may be some degree of tolerance in metabolic disorders, which makes dietary management easier. Sensitivity to food additives necessitates careful scrutiny of food labels. In psychologic adverse reactions to foods, several foods are often involved, which increases the risk of nutritional problems. PMID:3048623

  5. Revealing moments: formulating understandings of adverse experiences in a health appraisal interview.

    PubMed

    Beach, W A; Dixson, C N

    2001-01-01

    Analysis of a health appraisal interview reveals how an interviewer employs formulations to organize talk about a patient's medical history. When selected reportings by patient are paraphrased, a three-part formulations cycle is initiated: (1) interviewer's formulated understandings, (2) patient's confirmation, and (3) topic shift by interviewer. The reenactment of this interactional pattern promotes increasing attention to patient's adverse experiences as "root problems" underlying adult health status (e.g. molestation, obesity, depression). Creating an environment for patient's emergent disclosures is facilitated by displaying non-judgmental sensitivity to patient's stated concerns, soliciting alignment to particular reconstructions and avoidance of moving the interview forward prematurely and to issues not grounded in patient's illness circumstances. The identification and utilization of communication techniques for attending to patient's bio-psycho-social history is critical for refining understandings of empathic interviewing, enhancing diagnosis and treatment (e.g. referrals), decreasing patients' utilization of health care systems, and ultimately reducing costs for quality medical care.

  6. A continuous GRASP to determine the relationship between drugs and adverse reactions

    NASA Astrophysics Data System (ADS)

    Hirsch, Michael J.; Meneses, Claudio N.; Pardalos, Panos M.; Ragle, Michelle; Resende, Mauricio G. C.

    2007-11-01

    Adverse drag reactions (ADRs) are estimated to be one of the leading causes of death. Many national and international agencies have set up databases of ADR reports for the express purpose of determining the relationship between drugs and adverse reactions that they cause. We formulate the drug-reaction relationship problem as a continuous optimization problem and utilize C-GRASP, a new continuous global optimization heuristic, to approximately determine the relationship between drugs and adverse reactions. Our approach is compared against others in the literature and is shown to find better solutions.

  7. A continuous GRASP to determine the relationship between drugs and adverse reactions

    SciTech Connect

    Hirsch, Michael J.; Meneses, Claudio N.; Pardalos, Panos M.; Ragle, Michelle; Resende, Mauricio G. C.

    2007-11-05

    Adverse drag reactions (ADRs) are estimated to be one of the leading causes of death. Many national and international agencies have set up databases of ADR reports for the express purpose of determining the relationship between drugs and adverse reactions that they cause. We formulate the drug-reaction relationship problem as a continuous optimization problem and utilize C-GRASP, a new continuous global optimization heuristic, to approximately determine the relationship between drugs and adverse reactions. Our approach is compared against others in the literature and is shown to find better solutions.

  8. Strategic approaches to adverse outcome pathway development

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are conceptual frameworks for organizing biological and toxicological knowledge in a manner that supports extrapolation of data pertaining to the initiation or early progression of toxicity to an apical adverse outcome that occurs at a level of org...

  9. Regular treatment with formoterol for chronic asthma: serious adverse events

    PubMed Central

    Cates, Christopher J; Cates, Matthew J

    2014-01-01

    Background Epidemiological evidence has suggested a link between beta2-agonists and increases in asthma mortality. There has been much debate about possible causal links for this association, and whether regular (daily) long-acting beta2-agonists are safe. Objectives The aim of this review is to assess the risk of fatal and non-fatal serious adverse events in trials that randomised patients with chronic asthma to regular formoterol versus placebo or regular short-acting beta2-agonists. Search methods We identified trials using the Cochrane Airways Group Specialised Register of trials. We checked websites of clinical trial registers for unpublished trial data and Food and Drug Administration (FDA) submissions in relation to formoterol. The date of the most recent search was January 2012. Selection criteria We included controlled, parallel design clinical trials on patients of any age and severity of asthma if they randomised patients to treatment with regular formoterol and were of at least 12 weeks’ duration. Concomitant use of inhaled corticosteroids was allowed, as long as this was not part of the randomised treatment regimen. Data collection and analysis Two authors independently selected trials for inclusion in the review. One author extracted outcome data and the second author checked them. We sought unpublished data on mortality and serious adverse events. Main results The review includes 22 studies (8032 participants) comparing regular formoterol to placebo and salbutamol. Non-fatal serious adverse event data could be obtained for all participants from published studies comparing formoterol and placebo but only 80% of those comparing formoterol with salbutamol or terbutaline. Three deaths occurred on regular formoterol and none on placebo; this difference was not statistically significant. It was not possible to assess disease-specific mortality in view of the small number of deaths. Non-fatal serious adverse events were significantly increased when

  10. Childhood Adversities and Adult Headache in Poland and Germany

    PubMed Central

    Reuchlein, Bettina; Henn, Lea; Brian, Tamara; Schier, Katarzyna; Hardt, Jochen

    2016-01-01

    Objective Various childhood adversities have been found to be associated with chronic pain in adulthood. However, associations were moderate in most studies, i.e. odds ratios (OR) were between one and two. Method An internet survey was performed in 508 Polish and 500 German subjects. A total of 19 childhood adversities were selected and their associations with headaches explored. Age, gender and country were included as potential confounders, as well as their two-way interaction with the risk factors. Results Two strong risk factors were identified. (1) A combined score for physical and emotional neglect showed an odds ratio (OR) of 2.78 (p < .002) to the frequency of headache in adulthood as a main effect. (2) Father having had chronic pain showed an OR of 4.36 (p < .001) with headache in adulthood for women, but not for men (OR = 0.86, p < .556). The majority of the examined childhood adversities were not associated with adult headache, neither when tested individually nor as a sum score. Conclusion This study confirms results from previous ones that childhood adversities may play a role in the development of adult headache, but it is a rather minor one. Contrary to other studies, neglect turned out to be one of the strongest predictors. PMID:26859500

  11. Evaluation of Proper Usage of Glucocorticosteroid Inhalers and Their Adverse Effects in Asthmatic Patients

    PubMed Central

    Hejazi, Mohammad Esmayil; Shafiifar, Afsaneh; Mashayekhi, Siminozar

    2016-01-01

    Background: The frequent use of corticosteroid inhalers (CSIs), especially at higher doses, has been accompanied by concern about both systemic and local adverse reactions. The local adverse reactions of inhaled corticosteroids (ICSs) are considered to constitute infrequent and minor problems. However, while not usually serious, these local adverse reactions are of clinical importance. This study assessed the prevalence of local adverse reactions, their clinical features, role of inhaler devices and current measures that have been suggested to prevent the problem. Materials and Methods: This study was performed in YAS clinic in Tabriz on 500 asthmatic patients. A questionnaire about the patients’ demographic information, methods of using CSIs, local care after using CSIs, using spacer devices, doses of ICSs, and adverse reactions were filled then the patients were clinically examined for local adverse reactions. Results: Only 56% patients were using CSIs properly. In general, the incidence of complications was: oropharyngeal candidiasis 25.6%, laryngeal weakness 8.8%, choking 17.6%, tooth decay 15.2%, speechlessness 36.2%, taste decrease 20.8%, tongue burning 29.8% and tongue abrasion 27.8%. Conclusion: Persistent asthma can be effectively controlled with currently available CSIs. Although not life-threatening, local adverse reactions of ICSs are clinically significant and warrant attention. Use of spacer devices and changes in CSI usage, dosage amount and frequency and rinsing and gargling are the methods that have been used to reduce the incidence of local adverse reactions. PMID:27403173

  12. Synergistic childhood adversities and complex adult psychopathology.

    PubMed

    Putnam, Karen T; Harris, William W; Putnam, Frank W

    2013-08-01

    Numerous studies find a cumulative effect of different types of childhood adversities on increasing risk for serious adult mental and medical outcomes. This study uses the National Comorbidity Survey-Replication sample to investigate the cumulative impact of 8 childhood adversities on complex adult psychopathology as indexed by (a) number of lifetime diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994); (b) number of 4 DSM-IV disorder categories (mood, anxiety, impulse control, and substance abuse disorders); and (c) coexistence of internalizing and externalizing disorders. Seven of the 8 childhood adversities were significantly associated with complex adult psychopathology. Individuals with 4 or more childhood adversities had an odds ratio of 7.3, 95% confidence interval [4.7, 11.7] for 4 disorder categories. Additive and multiplicative synergistic effects increasing adult psychopathology were found for specific pairwise combinations of childhood adversities. Synergistic patterns differed by gender suggesting that women are more impacted by sexual abuse and men by economic hardship. The absence of childhood adversities was protective, in that it significantly decreased an individual's risk for subsequent adult mental illness. The results support the clinical impression that increased childhood adversity is associated with more complex adult psychopathology.

  13. [Reported adverse reactions of veterinary drugs and vaccines in 2005].

    PubMed

    Müntener, C R; Bruckner, L; Gassner, B; Demuth, D C; Althaus, F R; Zwahlen, R

    2007-02-01

    We received 105 reports of suspected adverse events (SARs) following the use of veterinary drugs for the year 2005. This corresponds to a 35% increase compared to 2004. Practicing veterinarians sent most of these declarations. 73% of these concerned drugs used on companion animals. Antiparasitic drugs approved for topical use were the most frequently represented group with 48%, followed by drugs used to treat gastrointestinal disorders (11%) and drugs used off-label (14%; other target species or other indication). For the first time 2 declarations concerning the application of permethrin containing spot-on preparations used by mistake on cats were received. An overview of 20 declarations about adverse reactions following application of different vaccines is also presented with emphasis on the problem of fibrosarcoma in cats. We are pleased by the growing interest shown by practicing veterinarians for the vigilance system and hope to further develop this collaboration in the future.

  14. Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

    PubMed Central

    2013-01-01

    Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts’ views into various optimal solutions to this problem under the support of this pilot system. Methods After the general framework of China’s institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. Results The market-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the doctors’ point of view; the traditional government’s regulation-oriented health care provider approach was the optimal solution to China’s institutional problem of health care provider selection from the pharmacists’ point of view, the hospital administrators’ point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China’s institutional problem of health care provider selection from the nurses’ point of view, the point of view of officials in medical insurance agencies, and the health care researchers’ point

  15. Practical Approaches to Resolving Behaviour Problems. Selected Papers from the National Conference on Practical Approaches to Resolving Behaviour Problems (2nd, Sydney, New South Wales, Australia, July 1990). Programs Implementation and System Initiatives.

    ERIC Educational Resources Information Center

    Richardson, Susanna, Ed.; Izard, John, Ed.

    This collection of papers focuses on practical approaches to resolving behavior problems in the Australian school system. The papers are divided into four general categories: perspectives on behavior problems, focusing on families, schools and system initiatives, and programs in special settings. The papers include: (1) "Beyond…

  16. Adverse-event profile of Crataegus spp.: a systematic review.

    PubMed

    Daniele, Claudia; Mazzanti, Gabriela; Pittler, Max H; Ernst, Edzard

    2006-01-01

    ), gastrointestinal complaints (n = 24), headache (n = 9), migraine (n = 8) and palpitation (n = 11). The WHO spontaneous reporting scheme received 18 case reports. In the identified trials, the most frequent adverse events were dizziness (n = 6), nausea (n = 5), fall (n = 2), gastrointestinal haemorrhage (n = 2), circulation failure (n = 2) and erythematous rash (n = 2). There were no reports of drug interactions. In conclusion, all data reviewed in this article seem to indicate that hawthorn is well tolerated even if some severe adverse events were reported; this suggests that further studies are needed to better assess the safety of hawthorn-containing preparations. Moreover, the unsupervised use of this drug can be associated with problems, especially if given with concomitant medications.

  17. Childhood adversities and psychosis: evidence, challenges, implications

    PubMed Central

    Morgan, Craig; Gayer‐Anderson, Charlotte

    2016-01-01

    There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities – particularly exposure to multiple adversities involving hostility and threat – do, in some people, contribute to the onset of psychotic experiences and psychotic disorders. PMID:27265690

  18. Childhood adversity: a review of measurement instruments.

    PubMed

    Burgermeister, Diane

    2007-01-01

    Measurement instruments are needed to stimulate research on the long-term outcomes of childhood adversity. Therefore, the purpose of this review was to locate, describe, and assess instruments to measure retrospective perceptions of childhood adversity. An electronic search of instruments was conducted using a combination of keywords that included child maltreatment, child trauma, and childhood stressful events. Nine instruments were located and described according to format, definition of childhood adversity as measured by the instrument, characteristics of the sample used in development and testing, reliability and validity evidence, and feasibility for use. Six out of the nine instruments were suitable for investigators who require a comprehensive measure of childhood adversity. Corroboration with independent sources and use of randomized samples are needed to improve upon reports of validity.

  19. RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES

    EPA Science Inventory

    INTRODUCTION. The disparity between black and white women's adverse birth outcomes has been subject to much investigation, yet the factors underlying its persistence remain elusive, which has encouraged research on neighborhood-level influences, including racial residential segr...

  20. Adverse Outcome Pathways: From Definition to Application

    EPA Science Inventory

    A challenge for both human health and ecological toxicologists is the transparent application of mechanistic (e.g., molecular, biochemical, histological) data to risk assessments. The adverse outcome pathway (AOP) is a conceptual framework designed to meet this need. Specifical...

  1. Design of Adverse Drug Events-Scorecards.

    PubMed

    Marcilly, Romaric; Chazard, Emmanuel; Beuscart-Zéphir, Marie-Catherine; Hackl, Werner; Băceanu, Adrian; Kushniruk, Andre; Borycki, Elizabeth M

    2011-01-01

    This paper presents the design of Adverse Drug Event-Scorecards. The scorecards described are innovative and novel, not having previously been reported in the literature. The Scorecards provide organizations (e.g. hospitals) with summary information about Adverse Drug Events (ADEs) using a Web-based platform. The data used in the Scorecards are routinely updated and report on ADEs detected through data mining processes. The development of the ADE Scorecards is ongoing and they are currently undergoing clinical testing.

  2. [Allergies and adverse events associated with fluoroquinolones].

    PubMed

    Muller, Y; Andrey, D; Emonet, S; Harr, T; Spoerl, D

    2015-04-08

    The prescription ot fluoroquinolones has been constantly increasing over the past decade. consequently, an increasing number of hyper-sensitivity reactions and adverse events have been reported. The aim of the review is to discuss the incidence of hypersensitivity reactions either IgE (immediate) or T cells mediated (delayed). We will make an overview ofthe diagnostic tools available to detect such hypersensitivity reactions. Finally, the specific adverse events associated with fluoroquinolones, including tendinopathy, chondrotoxicity, peripheral neuropathy or retinal detachment will be discussed.

  3. Childhood adversity and frequent medical consultations.

    PubMed

    Fiddler, Maggie; Jackson, Judy; Kapur, Navneet; Wells, Adrian; Creed, Francis

    2004-01-01

    We assessed possible psychological mediators of the relationship between childhood adversity and frequent medical consultations among new outpatients at neurology, cardiology, and gastroenterology clinics. We assessed whether these differed in patients with and without organic disease that explained their symptoms. At first clinic visit we recorded Hospital Anxiety and Depression scale (HADS--anxiety and depression subscale scores), Illness Perception Questionnaire (IPQ--four subscales: consequences, cure, identity, timeline), Health Anxiety Questionnaire (total score), and Symptom Amplification Scale (total score). Subjects were divided into two groups according to whether they had experienced any type of childhood adversity using the Childhood Experience of Care and Abuse Schedule. Outcome was the (log) number of medical consultations for 12 months before and 6 months after the index clinic visits. Multiple regression analysis was used to determine mediators; this was performed separately for patients with symptoms explained and not explained by organic disease. One-hundred and twenty-nine patients (61% response) were interviewed. Fifty-two (40.3%) had experienced childhood adversity; they made a median of 16 doctor visits compared with 10 for those without adversity (adjusted P=.026). IPQ identity score (number of symptoms attributed to the illness) and HAD depression scores were significantly associated with both childhood adversity and number of medical consultations and these variables acted as mediators between childhood adversity and frequency of consultation in the multiple regression analyses. This association was limited to patients with medically unexplained symptoms and was mediated by IPQ Identity Score (number of symptoms attributed to the patient's illness) and HAD depression score. Sexual abuse and overt neglect were the adversities most closely associated with frequent consultations. In patients with medically unexplained symptoms the association

  4. Adverse drug reactions in hospitalized Colombian children

    PubMed Central

    Díaz-Agudelo, Daniela; Burgos-Flórez, Francisco Javier; Vaca, Claudia; Serrano-Meriño, Dolores Vanessa

    2016-01-01

    Introduction: The occurrence of adverse drug reactions is an important issue due to the lack of drug safety data in children. Objective: To describe the Adverse Drug Reactions in inpatient children under 6 years of age in two general pediatrics wards located in Barranquilla, Colombia. Methods: A prospective cohort study based on intensive pharmacovigilance was conducted during six months in order to monitor the emergence of Adverse Drug Reactions in inpatients children under 6 years of age with at least one medication prescribed. The study was conducted in two pediatric wards of two hospitals located in Barranquilla, Colombia. Naranjo´s Algorithm was used to evaluate imputability, the modified Hartwig and Siegel assessment scale to establish severity and the Schumock and Thornton criteria to determine preventability. Results: Of a total of 772 monitored patients, 156 Adverse Drug Reactions were detected on 147 children. The cumulative incidence of Adverse Drug Reactions was 19.0% (147/772); the incidence density was 37.6 Adverse Drug Reactions per 1,000 patients-days (147/3,913). The frequency was higher in children under 2 years of age (12.7%). Emergence of Adverse Drug Reactions was higher in male patients (RR= 1.66; 95% CI= 1.22-2.22, p= 0.001) and in those who used systemic antibiotics (RR= 1.82; 95% CI= 1.17-2.82, p= 0.005). Conclusions: Adverse Drug Reactions are common among hospitalized children and represent an additional burden of morbidity and risk, particularly in those who used several medicines, including antibiotics. PMID:27821893

  5. Socioeconomic Adversity and Women's Sleep: Stress and Chaos as Mediators.

    PubMed

    El-Sheikh, Mona; Keiley, Margaret; Bagley, Erika J; Chen, Edith

    2015-01-01

    We examined income-to-needs ratio, perceived economic well-being, and education and their relations with European and African American women's sleep (n = 219). Sleep was examined through actigraphy and self-reports. Income-to-needs ratio was related to sleep minutes. Perceived economic well-being and education were associated with subjective sleep problems. Perceived stress mediated relations between both income-to-needs ratio and economic well-being and subjective sleep problems. Chaos emerged as a mediator linking income-to-needs ratio and subjective sleep problems. African American women had fewer sleep minutes and lower sleep efficiency than European Americans, and more robust relations between economic well-being and stress was observed for European Americans. Findings highlight the importance of economic adversity for women's sleep and explicate some pathways of risk.

  6. Recognizing and reporting adverse drug reactions.

    PubMed Central

    Lucas, L. M.; Colley, C. A.

    1992-01-01

    Although physicians in practice are most likely to see patients with adverse drug reactions, they may fail to recognize an adverse effect or to attribute it to a drug effect and, when recognized, they may fail to report serious reactions to the US Food and Drug Administration (FDA). To recognize and attribute an adverse event to a drug effect, physicians should review the patient's clinical course, looking at patient risk factors, the known adverse reactions to the suspected drug, and the likelihood of a causal relationship between the drug and the adverse event-based on the temporal relationship, response to stopping or restarting the drug, and whether other factors could explain the reaction. Once an adverse drug reaction has been identified, the patient should be informed and appropriate documentation made in the patient's medical record. Serious known reactions and all reactions to newly released drugs or those not previously known to occur (even if the certainty is low) should be reported to the FDA. PMID:1536067

  7. Childhood Adverse Events and Health Outcomes among Methamphetamine-Dependent Men and Women

    ERIC Educational Resources Information Center

    Messina, Nena P.; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Hunter, Jeremy; Rawson, Richard

    2008-01-01

    To describe the prevalence of childhood adverse events (CAEs) among methamphetamine-dependent men and women, and assess the relationship of cumulative CAEs to health problems. Data for 236 men and 351 women were analyzed assessing CAEs. Dependent variables included 14 self-reported health problems or psychiatric symptom domains. Mental health was…

  8. Analysis of Adverse Events in Identifying GPS Human Factors Issues

    NASA Technical Reports Server (NTRS)

    Adams, Catherine A.; Hwoschinsky, Peter V.; Adams, Richard J.

    2004-01-01

    The purpose of this study was to analyze GPS related adverse events such as accidents and incidents (A/I), Aviation Safety Reporting System (ASRS) reports and Pilots Deviations (PDs) to create a framework for developing a human factors risk awareness program. Although the occurrence of directly related GPS accidents is small the frequency of PDs and ASRS reports indicated there is a growing problem with situational awareness in terminal airspace related to different types of GPs operational issues. This paper addresses the findings of the preliminary research and a brief discussion of some of the literature on related GPS and automation issues.

  9. ACCEPT: Introduction of the Adverse Condition and Critical Event Prediction Toolbox

    NASA Technical Reports Server (NTRS)

    Martin, Rodney A.; Santanu, Das; Janakiraman, Vijay Manikandan; Hosein, Stefan

    2015-01-01

    The prediction of anomalies or adverse events is a challenging task, and there are a variety of methods which can be used to address the problem. In this paper, we introduce a generic framework developed in MATLAB (sup registered mark) called ACCEPT (Adverse Condition and Critical Event Prediction Toolbox). ACCEPT is an architectural framework designed to compare and contrast the performance of a variety of machine learning and early warning algorithms, and tests the capability of these algorithms to robustly predict the onset of adverse events in any time-series data generating systems or processes.

  10. Interventions designed to prevent adverse programming outcomes resulting from exposure to maternal obesity during development

    PubMed Central

    Nathanielsz, PW; Ford, SP; Long, NM; Vega, CC; Reyes-Castro, LA; Zambrano, E

    2013-01-01

    Maternal obesity is a global epidemic affecting the developed and developing world. Human and animal studies indicate that maternal obesity programs development predisposing offspring to later-life chronic diseases. Several mechanisms act together to produce these adverse health problems. There is a need for effective interventions that prevent these outcomes and guide management in human pregnancy. We report here dietary and exercise intervention studies in both altricial and precocial species, rats and sheep, designed to prevent adverse offspring outcomes. Both interventions present exciting opportunities to at least in part prevent adverse metabolic and other outcomes in mother and offspring. PMID:24147928

  11. Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders: Evidence Report

    NASA Technical Reports Server (NTRS)

    Slack, Kelley J.; Williams, Thomas J.; Schneiderman, Jason S.; Whitmire, Alexandra M.; Picano, James J.; Leveton, Lauren B.; Schmidt, Lacey L.; Shea, Camille

    2016-01-01

    In April 2010, President Obama declared a space pioneering goal for the United States in general and NASA in particular. "Fifty years after the creation of NASA, our goal is no longer just a destination to reach. Our goal is the capacity for people to work and learn and operate and live safely beyond the Earth for extended periods of time, ultimately in ways that are more sustainable and even indefinite." Thus NASA's Strategic Objective 1.1 emerged as "expand human presence into the solar system and to the surface of Mars to advance exploration, science, innovation, benefits to humanity, and international collaboration" (NASA 2015b). Any space flight, be it of long or short duration, occurs in an extreme environment that has unique stressors. Even with excellent selection methods, the potential for behavioral problems among space flight crews remain a threat to mission success. Assessment of factors that are related to behavioral health can help minimize the chances of distress and, thus, reduce the likelihood of adverse cognitive or behavioral conditions and psychiatric disorders arising within a crew. Similarly, countermeasures that focus on prevention and treatment can mitigate the cognitive or behavioral conditions that, should they arise, would impact mission success. Given the general consensus that longer duration, isolation, and confined missions have a greater risk for behavioral health ensuring crew behavioral health over the long term is essential. Risk, which within the context of this report is assessed with respect to behavioral health and performance, is addressed to deter development of cognitive and behavioral degradations or psychiatric conditions in space flight and analog populations, and to monitor, detect, and treat early risk factors, predictors and other contributing factors. Based on space flight and analog evidence, the average incidence rate of an adverse behavioral health event occurring during a space mission is relatively low for the

  12. Adverse childhood experiences in the lives of female sex offenders.

    PubMed

    Levenson, Jill S; Willis, Gwenda M; Prescott, David S

    2015-06-01

    This study explored the prevalence of early trauma in a sample of U.S. female sexual offenders (N = 47) using the Adverse Childhood Experiences (ACE) scale. Compared with females in the general population, sex offenders had more than three times the odds of child sexual abuse, four times the odds of verbal abuse, and more than three times the odds of emotional neglect and having an incarcerated family member. Half of the female sex offenders had been sexually abused as a child. Only 20% endorsed zero adverse childhood experiences (compared with 35% of the general female population) and 41% endorsed four or more (compared with 15% of the general female population). Higher ACE scores were associated with having younger victims. Multiple maltreatments often co-occurred in households with other types of dysfunction, suggesting that many female sex offenders were raised within a disordered social environment by adults with problems of their own who were ill-equipped to protect their daughters from harm. By enhancing our understanding of the frequency and correlates of early adverse experiences, we can better devise trauma-informed interventions that respond to the clinical needs of female sex offender clients.

  13. Adverse events attributed to traditional Korean medical practices: 1999–2010

    PubMed Central

    Shin, Hyeun-Kyoo; Jeong, Soo-Jin; Ernst, Edzard

    2013-01-01

    Abstract Objective To investigate adverse events attributed to traditional medical treatments in the Republic of Korea. Methods Adverse events recorded in the Republic of Korea between 1999 and 2010 – by the Food and Drug Administration, the Consumer Agency or the Association of Traditional Korean Medicine – were reviewed. Records of adverse events attributed to the use of traditional medical practices, including reports of medicinal accidents and consumers’ complaints, were investigated. Findings Overall, 9624 records of adverse events attributed to traditional medical practices – including 522 linked to herbal treatments – were identified. Liver problems were the most frequently reported adverse events. Only eight of the adverse events were recorded by the pharmacovigilance system run by the Food and Drug Administration. Of the 9624 events, 1389 – mostly infections, cases of pneumothorax and burns – were linked to physical therapy (n = 285) or acupuncture/moxibustion (n = 1104). Conclusion In the Republic of Korea, traditional medical practices often appear to have adverse effects, yet almost all of the adverse events attributed to such practices between 1999 and 2010 were missed by the national pharmacovigilance system. The Consumer Agency and the Association of Traditional Korean Medicine should be included in the national pharmacovigilance system. PMID:23940404

  14. Childhood adversity profiles and adult psychopathology in a representative Northern Ireland study.

    PubMed

    McLafferty, Margaret; Armour, Cherie; McKenna, Aine; O'Neill, Siobhan; Murphy, Sam; Bunting, Brendan

    2015-10-01

    Childhood adversities are key aetiological factors in the onset and persistence of psychopathology. The aims of this study were to identify childhood adversity profiles, and investigate the relationship between the adversity classes and psychopathology in Northern Ireland. The study utilized data from the Northern Ireland Study of Health and Stress, an epidemiological survey (N=1986), which used the CIDI to examine mental health disorders and associated risk factors. Latent Class Analysis revealed 3 distinct typologies; a low risk class (n=1709; 86%), a poly-adversity class (n=122; 6.1%), and an economic adversity class (n=155; 7.8%). Logistic Regression models revealed that individuals in the economic adversity class had a heightened risk of anxiety and substance disorders, with individuals in the poly-adversity class more likely to have a range of mental health problems and suicidality. The findings indicate the importance of considering the impact of co-occurring childhood adversities when planning treatment, prevention, and intervention programmes.

  15. Putative adverse outcome pathways relevant to neurotoxicity

    PubMed Central

    Bal-Price, Anna; Crofton, Kevin M.; Sachana, Magdalini; Shafer, Timothy J.; Behl, Mamta; Forsby, Anna; Hargreaves, Alan; Landesmann, Brigitte; Lein, Pamela J.; Louisse, Jochem; Monnet-Tschudi, Florianne; Paini, Alicia; Rolaki, Alexandra; Schrattenholz, André; Suñol, Cristina; van Thriel, Christoph; Whelan, Maurice; Fritsche, Ellen

    2016-01-01

    The Adverse Outcome Pathway (AOP) framework provides a template that facilitates understanding of complex biological systems and the pathways of toxicity that result in adverse outcomes (AOs). The AOP starts with an molecular initiating event (MIE) in which a chemical interacts with a biological target(s), followed by a sequential series of KEs, which are cellular, anatomical, and/or functional changes in biological processes, that ultimately result in an AO manifest in individual organisms and populations. It has been developed as a tool for a knowledge-based safety assessment that relies on understanding mechanisms of toxicity, rather than simply observing its adverse outcome. A large number of cellular and molecular processes are known to be crucial to proper development and function of the central (CNS) and peripheral nervous systems (PNS). However, there are relatively few examples of well-documented pathways that include causally linked MIEs and KEs that result in adverse outcomes in the CNS or PNS. As a first step in applying the AOP framework to adverse health outcomes associated with exposure to exogenous neurotoxic substances, the EU Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM) organized a workshop (March 2013, Ispra, Italy) to identify potential AOPs relevant to neurotoxic and developmental neurotoxic outcomes. Although the AOPs outlined during the workshop are not fully described, they could serve as a basis for further, more detailed AOP development and evaluation that could be useful to support human health risk assessment in a variety of ways. PMID:25605028

  16. Is It Adverse, Nonadverse, Adaptive, or Artifact?

    PubMed

    Pandiri, Arun R; Kerlin, Roy L; Mann, Peter C; Everds, Nancy E; Sharma, Alok K; Myers, L Peyton; Steinbach, Thomas J

    2017-01-01

    One of the principal challenges facing a toxicologic pathologist is to determine and differentiate a true adverse effect from a nonadverse or an adaptive response. Recent publications from the Society of Toxicologic Pathology (STP) and the European STP provide guidance for determining and communicating adversity in nonclinical toxicology studies. In order to provide a forum to inform and engage in a discussion on this important topic, a continuing education (CE) course was held during the 2016 STP Annual meeting in San Diego, CA. The lectures at this course provided guidance on determining and communicating adversity using case studies involving both clinical pathology and anatomic pathology. In addition, one talk also focused on data quality, study design, and interpretation of artifacts that could hinder the determination of adversity. The CE course ended with a talk on understanding adversity in preclinical studies and engaging the regulatory agencies in the decision-making process. This manuscript is designed to provide brief summaries of all the talks in this well-received CE course.

  17. Environmental adversity and uncertainty favour cooperation

    PubMed Central

    Andras, Peter; Lazarus, John; Roberts, Gilbert

    2007-01-01

    Background A major cornerstone of evolutionary biology theory is the explanation of the emergence of cooperation in communities of selfish individuals. There is an unexplained tendency in the plant and animal world – with examples from alpine plants, worms, fish, mole-rats, monkeys and humans – for cooperation to flourish where the environment is more adverse (harsher) or more unpredictable. Results Using mathematical arguments and computer simulations we show that in more adverse environments individuals perceive their resources to be more unpredictable, and that this unpredictability favours cooperation. First we show analytically that in a more adverse environment the individual experiences greater perceived uncertainty. Second we show through a simulation study that more perceived uncertainty implies higher level of cooperation in communities of selfish individuals. Conclusion This study captures the essential features of the natural examples: the positive impact of resource adversity or uncertainty on cooperation. These newly discovered connections between environmental adversity, uncertainty and cooperation help to explain the emergence and evolution of cooperation in animal and human societies. PMID:18053138

  18. Drug-Related Adverse Events of Osteoporosis Therapy.

    PubMed

    Khan, Moin; Cheung, Angela M; Khan, Aliya A

    2017-03-01

    Postmenopausal osteoporosis is associated with microarchitectural deterioration and increased risk of fracture. Osteoporosis therapy effectively reduces the risk of vertebral, nonvertebral, and hip fracture and has been associated with increased survival. Currently approved treatments for osteoporosis include bisphosphonates, denosumab, selective estrogen receptor modulators, and teriparatide. This article reviews the adverse events of therapy associated with these medical interventions. Hormone replacement therapy is not included, because it is no longer indicated for the treatment of osteoporosis in all countries. Calcitonin and strontium ranelate are also not included, because their indication for osteoporosis has recently been limited or withdrawn.

  19. Managing patients with side effects and adverse events to immunoglobulin therapy.

    PubMed

    Azizi, Gholamreza; Abolhassani, Hassan; Asgardoon, Mohammad Hossein; Shaghaghi, Shiva; Negahdari, Babak; Mohammadi, Javad; Rezaei, Nima; Aghamohammadi, Asghar

    2016-01-01

    Immunoglobulin therapy has not only served as a lifesaving approach for the prevention and treatment of infections in primary and secondary immunodeficiency diseases, but has also been used as an immunomodulatory agent for autoimmune and inflammatory disorders and to provide passive immunity for some infectious diseases. Most of the adverse effects associated with immunoglobulin therapy are mild, transient and self-limiting. However, serious side effects also occur. Therefore, to minimize the adverse events of immunoglobulin therapy, specialist review of patient clinical status and immunoglobulin products, in addition to selection of appropriate treatment strategy for the management of patients with associated side effects and adverse events, are crucial.

  20. Regular treatment with salmeterol for chronic asthma: serious adverse events

    PubMed Central

    Cates, Christopher J; Cates, Matthew J

    2014-01-01

    Background Epidemiological evidence has suggested a link between beta2-agonists and increases in asthma mortality. There has been much debate about possible causal links for this association, and whether regular (daily) long-acting beta2-agonists are safe. Objectives The aim of this review is to assess the risk of fatal and non-fatal serious adverse events in trials that randomised patients with chronic asthma to regular salmeterol versus placebo or regular short-acting beta2-agonists. Search methods We identified trials using the Cochrane Airways Group Specialised Register of trials. We checked websites of clinical trial registers for unpublished trial data and FDA submissions in relation to salmeterol. The date of the most recent search was August 2011. Selection criteria We included controlled parallel design clinical trials on patients of any age and severity of asthma if they randomised patients to treatment with regular salmeterol and were of at least 12 weeks’ duration. Concomitant use of inhaled corticosteroids was allowed, as long as this was not part of the randomised treatment regimen. Data collection and analysis Two authors independently selected trials for inclusion in the review. One author extracted outcome data and the second checked them. We sought unpublished data on mortality and serious adverse events. Main results The review includes 26 trials comparing salmeterol to placebo and eight trials comparing with salbutamol. These included 62,815 participants with asthma (including 2,599 children). In six trials (2,766 patients), no serious adverse event data could be obtained. All-cause mortality was higher with regular salmeterol than placebo but the increase was not significant (Peto odds ratio (OR) 1.33 (95% CI 0.85 to 2.08)). Non-fatal serious adverse events were significantly increased when regular salmeterol was compared with placebo (OR 1.15 95% CI 1.02 to 1.29). One extra serious adverse event occurred over 28 weeks for every 188 people

  1. Standardizing drug adverse event reporting data.

    PubMed

    Wang, Liwei; Jiang, Guoqian; Li, Dingcheng; Liu, Hongfang

    2013-01-01

    Normalizing data in the Adverse Event Reporting System (AERS), an FDA database, would improve the mining capacity of AERS for drug safety signal detection. In this study, we aim to normalize AERS and build a publicly available normalized Adverse drug events (ADE) data source.he drug information in AERS is normalized to RxNorm, a standard terminology source for medication. Drug class information is then obtained from the National Drug File - Reference Terminology (NDF-RT). Adverse drug events (ADE) are aggregated through mapping with the PT (Preferred Term) and SOC (System Organ Class) codes of MedDRA. Our study yields an aggregated knowledge-enhanced AERS data mining set (AERS-DM). The AERS-DM could provide more perspectives to mine AERS database for drug safety signal detection and could be used by research community in the data mining field.

  2. [Adverse reaction to not iodinated contrast].

    PubMed

    Palma-Gómez, Samuel; González-Díaz, Sandra Nora; Arias-Cruz, Alfredo; Macías-Weinmann, Alejandra; Amaro-Vivian, Laura Elizabeth; Pérez-Vanzzini, Rafael; Gutiérrez-Mujica, José Julio; Yong-Rodríguez, Adrián

    2014-01-01

    Adverse reactions to drugs are relatively frequent in clinical practice, and some of them can be life threatening. Reactions to contrast material (CM) represent an important percentage of these adverse reactions. It has been found that 70% of reactions to contrast material happen within the first five minutes of their administration. Despite the fact that hypersensitivity reactions are traditionally classified as non-allergic, in recent years investigators have reported positive skin prick tests in patients with immediate and late reactions to contrast material. This paper reports the case of a female patient with non-Hodgkin lymphoma that has presented on two distinct occasions adverse reactions to contrast material. We discuss on the type of reaction, severity, suggested prophylaxis, prognosis and recommendations, keeping in mind the underlying disease and the need to have further image studies performed.

  3. Adverse perinatal events associated with ART.

    PubMed

    Skora, Daniel; Frankfurter, David

    2012-04-01

    Since the advent of ART, much research has focused on the potential adverse for resultant harm. Prematurity, low birth-weight, PIH, congenital malformations, and CP are closely tied to multiple gestation. With the increase in elective single embryo transfer, there will be a reduction in adversity related to multiple birth. It is understood that underlying causes of infertility, including advanced maternal age, PCOS, thyroid disease, and uterine fibroids, predispose to adverse outcomes. However, imprinting abnormalities do not appear to stem from multiple births, and thus the need to consider the association between fertility treatment and methylation disorders remains essential. These, as well as risks of multi-fetal gestation, must be discussed with patients when considering using assisted reproduction.

  4. Quinolones: review of psychiatric and neurological adverse reactions.

    PubMed

    Tomé, Ana M; Filipe, Augusto

    2011-06-01

    Quinolones are a class of antibacterial agents for the treatment of several infectious diseases (e.g. urinary and respiratory tract infections). They are used worldwide due to their broad spectrum of activity, high bioavailability and good safety profile. The safety profile varies from quinolone to quinolone. The aim of this article was to review the neurological and psychiatric adverse drug reaction (ADR) profile of quinolones, using a literature search strategy designed to identify case reports and case series. A literature search using PubMed/MEDLINE (from inception to 31 October 2010) was performed to identify case reports and case series related to quinolone-associated neurological and psychiatric ADRs. The search was conducted in two phases: the first phase was the literature search and in the second phase relevant articles were identified through review of the references of the selected articles. Relevant articles were defined as articles referring to adverse events/reactions associated with the use of any quinolone. Abstracts referring to animal studies, clinical trials and observational studies were excluded. Identified case reports were analysed by age group, sex, active substances, dosage, concomitant medication, ambulatory or hospital-based event and seriousness, after Medical Dictionary for Regulatory Activities (MedDRA®) coding. From a total of 828 articles, 83 were identified as referring to nervous system and/or psychiatric disorders induced by quinolones. 145 individual case reports were extracted from the 83 articles. 40.7% of the individual case reports belonged to psychiatric disorders only, whereas 46.9% related to neurological disorders only. Eight (5.5%) individual case reports presented both neurological and psychiatric ADRs. Ciprofloxacin, ofloxacin and pefloxacin were the quinolones with more neurological and psychiatric ADRs reported in the literature. Ciprofloxacin has been extensively used worldwide, which may explain the higher number

  5. The Adverse Effects of Le Châtelier's Principle on Teacher Understanding of Chemical Equilibrium

    NASA Astrophysics Data System (ADS)

    Cheung, Derek

    2009-04-01

    Although the scientific inadequacy of Le Châtelier's principle has long been documented in the literature, the principle is still treated as a central concept of chemical equilibrium by textbook writers and teachers in many countries. In the past, researchers' interest has focused on student misconceptions about chemical equilibrium and has neglected teacher misconceptions. This study aimed to determine how Le Châtelier's principle adversely affects teachers' ability to solve chemical equilibrium problems. This area of research is critically important because teachers cannot help their students understand what they themselves do not understand. In this study, a misconception test was developed and administered to a sample of 33 secondary chemistry teachers in Hong Kong. The test consisted of three open-ended chemical equilibrium questions. Analysis of teacher responses revealed that most of the 33 teachers failed the test as they relied on Le Châtelier's principle rather than the equilibrium law to tackle the three chemical equilibrium problems. Teachers' misconceptions about chemical equilibrium were categorized. Implications of these findings for chemistry teacher education and selection of curriculum content for school chemistry are discussed.

  6. Childhood adversity and adult health: Evaluating intervening mechanisms.

    PubMed

    Turner, R Jay; Thomas, Courtney S; Brown, Tyson H

    2016-05-01

    Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience - implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences - a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure.

  7. Exploratory Problems in Mathematics.

    ERIC Educational Resources Information Center

    Stevenson, Frederick W.

    This book attempts to introduce students to the creative aspects of mathematics through exploratory problems. The introduction presents the criteria for the selection of the problems in the book. Criteria indicate that problems should: be immediately attractive, require data to be generated or gathered, appeal to students from junior high school…

  8. Severe Autoimmune Adverse Events Post Herpes Zoster Vaccine: A Case-Control Study of Adverse Events in a National Database.

    PubMed

    Lai, Yi Chun; Yew, Yik Weng

    2015-07-01

    Zoster vaccine is recommended to reduce the incidence of herpes zoster and its complication of postherpetic neuralgia in older adults. However, there have been reports of autoimmune side effects post vaccination. We therefore aim to investigate the possible relationship of severe autoimmune adverse events (arthritis, vasculitis, systemic lupus erythematosus, thrombocytopenia, alopecia, Guillain-Barre syndrome, optic neuritis and multiple sclerosis) post zoster vaccination with a matched case-control study of reported events in the Vaccine Adverse Event Reporting System (VAERS). Our study showed no significantly increased risks of severe autoimmune adverse events, except arthritis and alopecia, after vaccination. Compared to the unexposed, patients with zoster vaccination had 2.2 and 2.7 times the odds of developing arthritis and alopecia, respectively (P<0.001 and P=0.015, respectively). However, almost none of these events was life threatening. Zoster vaccine is, therefore, relatively safe and unlikely to exacerbate or induce autoimmune diseases. Given its benefits and safety but low coverage, dermatologists and primary care physicians should encourage zoster vaccine use in elderly patients, including selected patients with autoimmune diseases.

  9. Problem Solving

    ERIC Educational Resources Information Center

    Kinsella, John J.

    1970-01-01

    Discussed are the nature of a mathematical problem, problem solving in the traditional and modern mathematics programs, problem solving and psychology, research related to problem solving, and teaching problem solving in algebra and geometry. (CT)

  10. Adverse Experiences in Early Childhood and Kindergarten Outcomes

    PubMed Central

    Wade, Roy; Lin, Yong; Morrow, Lesley M.; Reichman, Nancy E.

    2016-01-01

    OBJECTIVE: To examine associations between adverse childhood experiences (ACEs) in early childhood and teacher-reported academic and behavioral problems in kindergarten. METHODS: We conducted a secondary analysis of data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort. Subjects with primary caregiver-reported information on ACE exposures ascertained at 5 years and teacher-reported outcomes at the end of the child’s kindergarten year were included. Outcomes included teacher ratings of academic skills, emergent literacy skills, and behavior. We included 8 ACE exposures on the basis of the original Centers for Disease Control and Prevention Kaiser study and created an ACE score by summing individual adversities. We examined the associations between teacher-reported academic and behavioral outcomes and ACE scores by using logistic regression. RESULTS: In the study sample, 1007 children were included. Fifty-five percent had experienced 1 ACE and 12% had experienced ≥ 3. Adjusting for potential confounders, experiencing ≥ 3 ACEs was associated with below-average language and literacy skills (adjusted odds ratio [AORs]: 1.8; 95% confidence interval [CI]: 1.1–2.9) and math skills (AOR: 1.8, 95% CI: 1.1–2.9), poor emergent literacy skills, attention problems (AOR: 3.5, 95% CI: 1.8–6.5), social problems (AOR: 2.7, 95% CI: 1.4–5.0), and aggression (AOR: 2.3, 95% CI: 1.2–4.6). CONCLUSIONS: In this study of urban children, experiencing ACEs in early childhood was associated with below-average, teacher-reported academic and literacy skills and behavior problems in kindergarten. These findings underscore the importance of integrated approaches that promote optimal development among vulnerable children. PMID:26768347

  11. Enduring psychobiological effects of childhood adversity.

    PubMed

    Ehlert, Ulrike

    2013-09-01

    This mini-review refers to recent findings on psychobiological long-term consequences of childhood trauma and adverse living conditions. The continuum of trauma-provoked aftermath reaches from healthy adaptation with high resilience, to severe maladjustment with co-occurring psychiatric and physical pathologies in children, adolescents and adults. There is increasing evidence of a strong interconnectivity between genetic dispositions, epigenetic processes, stress-related hormonal systems and immune parameters in all forms of (mal)-adjustment to adverse living conditions. Unfavorable constellations of these dispositions and systems, such as low cortisol levels and elevated markers of inflammation in maltreated children, seem to promote the (co)-occurrence of psychiatric and physical pathologies such as posttraumatic stress disorder, obesity, or diabetes. Although findings from prospective study designs support a deepened understanding of causal relations between adverse living conditions, including traumatic experiences, during childhood and its psychobiological effects, so far, little is known about the temporal coincidence of stress-sensitive developmental stages during childhood and adolescence and trauma consequences. Taken together, childhood adversity is a severe risk factor for the onset of psychobiological (mal)-adjustment, which has to be explained under consideration of diverse physiological systems and developmental stages of childhood and adolescence.

  12. Reducing Adverse Impact: One City's Efforts.

    ERIC Educational Resources Information Center

    Prewitt, Jeff

    Following a workshop on "Innovations in Employment Testing that Improve Validity and Reduce Adverse Impact," the City of Louisville (Kentucky) implemented a strategy to develop a comprehensive testing and recruiting program for police recruits. To improve candidate expectations and preparation, the following activities were undertaken:…

  13. The adverse outcome pathway knowledge base

    EPA Science Inventory

    The rapid advancement of the Adverse Outcome Pathway (AOP) framework has been paralleled by the development of tools to store, analyse, and explore AOPs. The AOP Knowledge Base (AOP-KB) project has brought three independently developed platforms (Effectopedia, AOP-Wiki, and AOP-X...

  14. Clinical spectrum of adverse reactions to tartrazine.

    PubMed

    Collins-Williams, C

    1985-01-01

    Tartrazine, a common additive in foods and drugs, often causes adverse reactions such as recurrent urticaria, angioedema, and asthma and is frequently implicated in hyperkinesis. This paper summarizes the recent literature on the subject and outlines a practical approach for the practicing physician to diagnose and treat these patients in an optimal manner.

  15. The Public Health Burden of Early Adversity

    ERIC Educational Resources Information Center

    Schlueter, Lisa J.; Watamura, Sarah Enos

    2017-01-01

    Severe and chronic stress in early childhood has enormous physical and mental health costs across an individual's lifespan. Unfortunately, exposure to early life adversity is common, and costs accrue to individuals and society. This article highlights several promising approaches to buffer children from the negative health consequences associated…

  16. Adverse skin reactions following intravitreal bevacizumab injection

    PubMed Central

    Ameen, S; Entabi, M; Lee, N; Stavrakoglou, A

    2011-01-01

    The authors describe two separate cases of skin eruption following intravitreal bevacizumab injection with evidence to suggest that these were adverse drug reactions to bevacizumab. The authors also discuss how each case was treated and report on the final outcome. PMID:22715260

  17. Due Process in Adverse Personnel Action.

    ERIC Educational Resources Information Center

    Scriven, Michael

    1997-01-01

    A detailed checklist and timeline for ensuring due process are provided for adverse personnel actions, and the need to supplement this with expert, same-jurisdiction legal advice is stressed. This approach emphasizes the importance of treating due process as an ethical as well as a legal requirement. (SLD)

  18. Adverse outcome pathway (AOP) development and evaluation

    EPA Science Inventory

    The Adverse Outcome Pathway provides a construct for assembling mechanistic information at different levels of biological organization in a form designed to support regulatory decision making. In particular, it frames the link between molecular and cellular events that can be mea...

  19. [Laser trabeculoplasty: therapeutic options and adverse effects].

    PubMed

    Wacker, T; Eckert, S

    2010-01-01

    Laser trabeculoplasty is a simple method for treating glaucoma and ocular hypertension and has few adverse effects. There are different laser systems for reducing the intraocular pressure of patients with glaucoma and ocular hypertension. Complications include transient intraocular pressure elevation, iritis, and anterior synechiae.

  20. Resilience in the Face of Adversity.

    ERIC Educational Resources Information Center

    Patterson, Jerry

    2001-01-01

    "Resilience" is the capacity for moving ahead under adverse circumstances. School superintendents are advised to stay upbeat and mindful of "both-and" opportunities; stay focused on what they care about; remain flexible and tolerant of ambiguity; be proactive, not reactive; and apply resilience-conserving strategies during…

  1. Analytic theory of the selection mechanism in the Saffman-Taylor problem. [concerning shape of fingers in Hele-Shaw cell

    NASA Technical Reports Server (NTRS)

    Hong, D. C.; Langer, J. S.

    1986-01-01

    An analytic approach to the problem of predicting the widths of fingers in a Hele-Shaw cell is presented. The analysis is based on the WKB technique developed recently for dealing with the effects of surface tension in the problem of dendritic solidification. It is found that the relation between the dimensionless width lambda and the dimensionless group of parameters containing the surface tension, nu, has the form lambda - 1/2 = nu exp 2/3 in the limit of small nu.

  2. Short-term medical benefits and adverse effects of weight loss.

    PubMed

    Pi-Sunyer, F X

    1993-10-01

    Weight loss reduces many of the health hazards associated with obesity including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, sleep apnea, hypoxemia and hypercarbia, and osteoarthritis. Potential adverse effects of weight loss include a greater risk for gallstone formation and cholecystitis, excessive loss of lean body mass, water and electrolyte problems, mild liver dysfunction, and elevated uric acid levels. Less consequential problems such as diarrhea, constipation, hair loss, and cold intolerance may also occur. The short-term adverse effects are not severe enough to contraindicate weight loss, nor do they outweigh its short-term benefits.

  3. [Efforts to prevent adverse events in the United States--health care risk management and a fresh perspective on adverse events prevention].

    PubMed

    Ayuzawa, J

    2001-03-01

    Not causing adverse events is never-ceasing issue in the health care field. However, the advances and greater specialization of medical technologies and the increasing number of elderly people, are all factors in the occurrence of adverse events. At the same time, greater efficiency is now demanded in the health care field, and the problem of preventing adverse events has become tougher than ever before. Given the situation, a fresh perspective on attempts to prevent adverse events may be important. One hint for such a new perspective is the health care risk management that is widely practiced in the health care field in the United States. This was introduced in the mid-1970s to counter the disputes and lawsuits at the time, but over the years the focus has shifted to the importance of prevention, and is now recognized as a means to work toward the assurance of quality of health care. Hints are also found in the suggestions related to adverse events prevention. In "To Err Is Human," published in November 1999 in the United States, includes proposals to "respect human limits in process design" and "promote effective team functioning," which are just the approaches we should adopt for a new perspective. I would also like to draw attention to the idea that there should be investigations into "developing effective mechanisms for identifying and dealing with unsafe practitioners" and the importance of "protecting voluntary reporting systems" that is mentioned. Adopting American methods unchanged to the health care system in Japan may not be appropriate, but the way of thinking and know-how from health care risk management, as well as the suggestions for adverse events prevention will provide us new perspectives on adverse events prevention, from which we should work toward a system of more efficient, and high-quality adverse events prevention.

  4. Student Behaviour Problems: Positive Initiatives and New Frontiers. Selected Papers from the National Conference (5th, Fremantle, Western Australia, Australia, 1993).

    ERIC Educational Resources Information Center

    Evans, David, Ed.; And Others

    The following papers from a conference on emotional and behavioral problems of children and adolescents are presented: (1) "Eligibility and Need: Is There a Difference Between Being Disturbed and Being Disturbing?" (Howell); (2) "Prevention and Politics: Giving At-Risk Youth a Future" (Constable and Burton); (3) "The World…

  5. Sexual Exploitation of Children--A Problem of Unknown Magnitude. Report to the Chairman, Subcommittee on Select Education, House Committee on Education and Labor.

    ERIC Educational Resources Information Center

    Ahart, Gregory J.

    This report contains the results of an extensive literature search by the General Accounting Office (GAO) on the subject of teenage prostitution and child pornography and federal, state and local efforts to deal with the problem. Also included are results of a survey of police departments and mayors' offices of the 22 largest U.S. cities and all…

  6. Report of In-Service Institute for Selected Professional Personnel of Three School Districts: El Dorado, Smackover and Sparkman Concerning Problems of School Desegregation.

    ERIC Educational Resources Information Center

    Henderson State Coll., ARadelphia, AR.

    The objective of the three phases of this institute was to change the attitudes of the participating school administrators, school board members, community leaders, counselors, and teachers so that they would be willing to accept responsibility for dealing with the problems of school desegregation in their respective school districts. Phase I…

  7. A Hierarchical Preference Voting System for Mining Method Selection Problem / Wykorzystanie Systemu Głosowania Zakładający Hierarchię Preferencji Przy Wyborze Odpowiedniej Metody Wybierania

    NASA Astrophysics Data System (ADS)

    Nourali, Hamidreza; Nourali, Saeid; Ataei, Mohammad; Imanipour, Narges

    2012-12-01

    To apply decision making theory for Mining Method Selection (MMS) problem, researchers have faced two difficulties in recent years: (i) calculation of relative weight for each criterion, (ii) uncertainty in judgment for decision makers. In order to avoid these difficulties, we apply a Hierarchical Preference Voting System (HPVS) for MMS problem that uses a Data Envelopment Analysis (DEA) model to produce weights associated with each ranking place. The presented method solves the problem in two stages. In the first stage, weights of criteria are calculated and at the second stage, alternatives are ranked with respect to all criteria. A simple case study has also been presented to illustrate the competence of this method. The results show that this approach reduces some difficulties of previous methods and could be applied simply in group decision making with too many decision makers and criteria. Also, regarding to application of a mathematical model, subjectivity is reduced and outcomes are more reliable.

  8. Do benzodiazepines contribute to respiratory problems?

    PubMed

    Vozoris, Nicholas T

    2014-12-01

    Non-selective benzodiazepines are a class of sedative and anxiolytic medication that are commonly prescribed. Physiology studies and animal studies suggest that non-selective benzodiazepines may adversely impact respiration through a variety of mechanisms. Several recent, well-designed, population-based observational studies confirm that benzodiazepine-related negative respiratory outcomes are a concern. In this article, the mechanisms and clinical evidence for non-selective benzodiazepine-related adverse respiratory outcomes, as well as the methodological issues relating to the evaluation of adverse drug effects are reviewed.

  9. Crossing Boundaries: Collaborative Solutions to Urban Problems. Selected Proceedings of the National Conference on Urban Issues (1st, Buffalo, New York, November 11-13, 1994).

    ERIC Educational Resources Information Center

    Koritz, Douglas, Ed.; And Others

    Selected papers are presented from a national conference on urban issues. They are: (1) "Collaboration as a Social Process: Inter-Institutional Cooperation and Educational Change" (Charles F. Underwood and Hardy T. Frye); (2) "Mobilizing the Village To Educate the Child" (Valerie Maholmes); (3) "Pathways to Teaching: An Urban Teacher Licensure…

  10. Workshop on Problems of Planning, Recruitment and Selection for Youth-Work Programs, Summary of Proceedings (Sterling Forest, N.Y., November 30-December 2, 1965).

    ERIC Educational Resources Information Center

    Herman, Melvin; Sadofsky, Stanley

    Thirty-five representatives of local, state, and federal youth-work programs attended a workshop which focused on issues related to planning a youth-work program, identifying the target population, designing a comprehensive program, and recruiting, screening, and selecting youth. Its agenda was established following field visits to a dozen…

  11. Gambling and Adverse Life Events Among Urban Adolescents

    PubMed Central

    Lee, Grace P.; Derevensky, Jeffrey L.; Ialongo, Nicholas S.; Martins, Silvia S.

    2011-01-01

    This study explored the cross sectional association between adverse life events and gambling in a sample of 515 urban adolescents (average age 17, 55% male, 88% African American). Approximately half of the sample had gambled in the past year (51%); 78% of the gamblers gambled monthly and 39% had a gambling-related problem. On the other hand, 88% of the sample had experienced at least one life event in the past year, and those experiencing events tended to live in more disadvantaged neighborhoods. The mere acknowledgement of experiencing a stressful life event in the past year (yes/no) was not associated with an increase in odds of being a gambler, with gambling more frequently, or with having a gambling problem. However, when the context of the event was considered, an association was found between directly experiencing threatening and deviant/violent types of events and frequent gambling (OR > 2). Additionally, the probability of being a gambler increased as the number of events experienced increased (aOR = 1.07, 95% CI = 1.01, 1.13, P = 0.013), but problems among gamblers were not associated with the number of events experienced (aOR = 1.01, 95% CI = 0.92, 1.11, P = 0.876). During adolescence, life events appear to be connected more with the frequency of gambling rather than with problems related to gambling. PMID:21614529

  12. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  13. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  14. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. (a) Records shall be maintained of any reports of complaints of adverse reactions... thorough investigation of each reported adverse reaction shall be made. A written report of...

  15. A Literature Review-Problem Definition Studies on Selected Toxic Chemicals. Volume 1. Occupational Health and Safety Aspects of Diesel Fuel and White Smoke Generated from It

    DTIC Science & Technology

    1978-04-01

    protected from breathing the smoke and getting it in eyes , on skin and hair. Medical examinations should be provided to check for lung problems, skin...related hydrocarbons to laboratory animals: blood, lungs, skin, central nervous system, bone marrow, spleen, liver, kidney, eye (cataract...the alkanes is absorbed unaltered. Absorption into lymph is greater than directly into portal blood. After application of hexadecane to the skin of

  16. Social work and adverse childhood experiences research: implications for practice and health policy.

    PubMed

    Larkin, Heather; Felitti, Vincent J; Anda, Robert F

    2014-01-01

    Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

  17. Recurrent adverse pregnancy outcome and antiphospholipid antibodies.

    PubMed

    Reece, E A; Gabrielli, S; Cullen, M T; Zheng, X Z; Hobbins, J C; Harris, E N

    1990-07-01

    Antiphospholipid antibodies, which include lupus-like anticoagulant and anticardiolipin antibody, have been linked to a number of adverse pregnancy outcomes, although their exact pathogenic mechanisms remain poorly defined. The relative risk of complications such as intrauterine growth retardation, spontaneous abortions, and stillbirth in patients with antiphospholipid antibodies also remains undetermined. Heightened attention has been focused on the association, leading to investigations into the pathogenesis. Uncontrolled studies have also explored therapeutic regimens such as aspirin, steroids, and heparin, and clinical trials have used various treatment protocols. Although knowledge into the association of antiphospholipid antibodies and recurrent adverse pregnancy outcome is limited and continues to evolve, this association provides new insights into the disease and offers promise for pharmacologic prophylaxis. In this article, current concepts on pathogenesis, diagnosis, and therapy are reviewed and recommendations are made for clinical care of these patients.

  18. Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

    PubMed Central

    Friedman, Esther M.; Montez, Jennifer Karas; Sheehan, Connor McDevitt; Guenewald, Tara L.; Seeman, Teresa E.

    2015-01-01

    Objective Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health. Results The best-fitting specification of quantity of events was a linear measure reflecting a dose–response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women’s risk of heart disease. Discussion Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures. PMID:25903978

  19. Balance Problems

    MedlinePlus

    ... often, it could be a sign of a balance problem. Balance problems can make you feel unsteady or as ... fall-related injuries, such as hip fracture. Some balance problems are due to problems in the inner ...

  20. Adverse Outcome Pathway (AOP) Network Development for ...

    EPA Pesticide Factsheets

    Adverse outcome pathways (AOPs) are descriptive biological sequences that start from a molecular initiating event (MIE) and end with an adverse health outcome. AOPs provide biological context for high throughput chemical testing and further prioritize environmental health risk research. According to the Organization for Economic Co-operation and Development guidelines, AOPs are pathways with one MIE anchored to an adverse outcome (AO) by key events (KEs) and key event relationships (KERs). However, this approach does not always capture the cumulative impacts of multiple MIEs on the AO. For example, hepatic lipid flux due to chemical-induced toxicity initiates from multiple ligand-activated receptors and signaling pathways that cascade across biology to converge upon a common fatty liver (FL, also known as steatosis) outcome. To capture this complexity, a top-down strategy was used to develop a FL AOP network (AOPnet). Literature was queried based on the terms steatosis, fatty liver, cirrhosis, and hepatocellular carcinoma. Search results were analyzed for physiological and pathophysiological organ level, cellular and molecular processes, as well as pathway intermediates, to identify potential KEs and MIEs that are key for hepatic lipid metabolism, maintenance, and dysregulation. The analysis identified four apical KE nodes (hepatic fatty acid uptake, de novo fatty acid and lipid synthesis, fatty acid oxidation, and lipid efflux) juxtaposed to the FL AO. The apic

  1. Serious Adverse Events After Cataract Surgery

    PubMed Central

    Stein, Joshua D.

    2013-01-01

    Purpose Over the past several decades there have been many advances in the equipment, instrumentation and techniques of performing cataract surgery. This review will address the impact of these advances on the safety profile of cataract surgery. Recent Findings Recent studies have demonstrated a decline in the risk of serious postoperative adverse events (endophthalmitis, suprachoroidal hemorrhage, retinal detachment) following cataract surgery. Factors that increase the risk of serious complications from cataract surgery include patient-related factors (male sex, concomitant diabetic retinopathy, same day cataract surgery combined with another intraocular surgery, tamsulosin use) and surgeon-related factors (low surgical volume, limited experience, operating on patients who are most prone to adverse events). Summary Cataract surgery continues to be a very safe surgical procedure with few patients experiencing serious sight-threatening adverse events. Studies in the literature have helped surgeons identify patients who are at high risk for surgical complications and to develop strategies to limit surgical complications when operating on these patients. As multifocal intraocular lenses, femtosecond laser technology, and other surgical innovations continue to gain popularity, it will be interesting in the coming years to determine whether there will be a continued reduction in complications of cataract surgery. PMID:22450221

  2. Statin-Associated Muscle Adverse Events

    PubMed Central

    Al-Mohaissen, Maha A.; Ignaszewski, Martha J.; Frohlich, Jiri; Ignaszewski, Andrew P.

    2016-01-01

    Statins are potent medications which reduce low-density lipoprotein cholesterol (LDL-C) levels. Their efficacy in cardiovascular risk reduction is well established and indications for their use are expanding. While statins are generally well tolerated and safe, adverse events are relatively common, particularly statin-associated muscle adverse events (SaMAEs), which are the most frequently encountered type of adverse event. Recent guidelines and guideline updates on SaMAEs and statin intolerance have included revised definitions of SaMAEs, incorporating new evidence on their pathogenesis and management. As SaMAEs emerge as a therapeutic challenge, it is important for physicians to be aware of updates on management strategies to ensure better patient outcomes. The majority of patients who are considered statin-intolerant can nevertheless tolerate some forms of statin therapy and successfully achieve optimal LDL-C levels. This review article discusses the recent classification of SaMAEs with emphasis on pathogenesis and management strategies. PMID:28003885

  3. Metabolic and adverse effects of diuretics.

    PubMed

    Wilcox, C S

    1999-11-01

    Diuretics are among the most frequently prescribed drugs. They enjoy a very high clinical reputation for safety and efficacy. However, more than 3 decades of clinical investigation have disclosed a number of abnormalities in fluid electrolyte handling, metabolism, and other adverse effects that can complicate therapy with diuretic drugs. Some of these complications are a direct extension of the wanted action of the drug. These include extracellular fluid volume depletion, associated orthostatic hypotension, and prerenal azotemia. Others are not a direct action of the diuretic, but can be explained as an intranephronal compensation to the diuretic action. These include hypokalemia, in part to increased potassium secretion secondary to the enhanced tubular fluid flow and aldosterone secretion induced by diuretic administration. Metabolic abnormalities are usually mild. Hyperglycemia and carbohydrate intolerance have been related to diuretic-induced hypokalemia, which inhibits insulin secretion by the beta cells, and reductions in extracellular fluid volume and cardiac output. This is compounded by increases in catecholamines from sympathetic nerve activity which decrease peripheral glucose utilization. A mild increase in serum cholesterol concentration is seen frequently during initiation of diuretic therapy, but during steady state therapy after 6 to 12 months, values usually return to baseline. Knowledge of the more common adverse effects induced by diuretics helps the physician in predicting patients at risk and taking effective steps to anticipate or treat adverse responses.

  4. Neuropsychiatric Adverse Effects of Amphetamine and Methamphetamine.

    PubMed

    Harro, Jaanus

    2015-01-01

    Administration of amphetamine and methamphetamine can elicit psychiatric adverse effects at acute administration, binge use, withdrawal, and chronic use. Most troublesome of these are psychotic states and aggressive behavior, but a large variety of undesirable changes in cognition and affect can be induced. Adverse effects occur more frequently with higher dosages and long-term use. They can subside over time but some persist long-term. Multiple alterations in the gray and white matter of the brain assessed as changes in tissue volume or metabolism, or at molecular level, have been associated with amphetamine and methamphetamine use and the psychiatric adverse effects, but further studies are required to clarify their causal role, specificity, and relationship with preceding states and traits and comorbidities. The latter include other substance use disorders, mood and anxiety disorders, attention deficit hyperactivity disorder, and antisocial personality disorder. Amphetamine- and methamphetamine-related psychosis is similar to schizophrenia in terms of symptomatology and pathogenesis, and these two disorders share predisposing genetic factors.

  5. Effects of a selective educational system on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan

    PubMed Central

    Chen, Tien-Yu; Chou, Yu-Ching; Tzeng, Nian-Sheng; Chang, Hsin-An; Kuo, Shin-Chang; Pan, Pei-Yin; Yeh, Yi-Wei; Yeh, Chin-Bin; Mao, Wei-Chung

    2015-01-01

    Objective The aim of the study reported here was to clarify the effects of academic pressure on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan. Methods This cross-sectional study enrolled 757 senior high school adolescents who were classified into four groups: Grade 1 (n=261), Grade 2 (n=228), Grade 3T (n=199; Grade 3 students who had another college entrance test to take), and Grade 3S (n=69; Grade 3 students who had succeeded in their college application). Fatigue, sleep quality, daytime sleepiness, and depression were assessed using the Chinese version of the Multidimensional Fatigue Symptom Inventory – Short Form, Pittsburgh Sleep Quality Index-Taiwan Form, the Chinese version of the Epworth Sleepiness Scale, and the Chinese version of the Beck Depression Inventory®-II (BDI-II), respectively. Results Physical, emotional, and mental fatigue scores were all higher in higher-grade groups. The Grade 3T (test) students had the worst fatigue severity, and the Grade 3S (success) students had the least fatigue severity. More than half of the students (60.9%) went to bed after 12 am, and they had on average 6.0 hours of sleep per night. More than 30% of the students in Grade 2 (37.3%) and Grades 3T/S (30.2%/30.4%) possibly had daily sleepiness problems. The students in Grade 3T had the worst BDI-II score (13.27±9.24), and the Grade 3S students had a much lower BDI-II score (7.91±6.13). Conclusion Relatively high proportions of fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents were found in our study. The severities of fatigue, sleep problems, and depression were significantly diminished in the group under less academic stress (Grade 3S). Our findings may increase the understanding of the mental health of senior high school students under academic pressure in Taiwan. Further large sample size and population-based study should be done for better understanding

  6. Adverse effects of antiretroviral therapy for HIV infection.

    PubMed

    Montessori, Valentina; Press, Natasha; Harris, Marianne; Akagi, Linda; Montaner, Julio S G

    2004-01-20

    Long-term remission of HIV-1 disease can be readily achieved by combinations of antiretroviral agents. The suppression of plasma viral loads to less than the limit of quantification of the most sensitive commercially available assays (i.e., less than 50 copies/mL) and the coincident improvement in CD4 T cell counts is associated with resolution of established opportunistic infections and a decrease in the risk of new opportunistic infections. However, prolonged treatment with combination regimens can be difficult to sustain because of problems with adherence and toxic effects. All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists as they try to optimize therapy, but also for other physicians who care for HIV-positive patients.

  7. [Adverse reactions and risks associated with non compliance].

    PubMed

    Russmann, Stefan; Curkovic, Ivanka; Huber, Martin

    2010-06-01

    Non compliance is a frequent and underestimated problem in clinical practice, that is associated with considerable risks, adverse reactions and costs. Next to omitting one or several doses with consequent lack of efficacy, other forms of non compliance can be described. These include administration of a wrong dose or at a wrong time, early termination of therapy or also its unwarranted continuation, and self-administered comedication without consideration of potential interactions. A number of risks and adverse effects can be derived from these different forms of non compliance, for which we present several examples from clinical practice and the literature. Anticipation, recognition and appropriate countermeasures are important elements for the prevention of non compliance, which may target the pharmacotherapy itself, the patient, or the health system providing the therapeutic framework. Furthermore, a climate of trust and good communication between the patient and the health care provider is the cornerstone for all strategies that aim to improve compliance. Computerized physician order entry and clinical decision support systems may have an additional important role for the prevention of non compliance in the future.

  8. The Influence of Perinatal Complications and Environmental Adversity on Boys' Antisocial Behavior

    ERIC Educational Resources Information Center

    Beck, Joy E.; Shaw, Daniel S.

    2005-01-01

    Background: The purpose of the present study was to test components of Raine's (2002) biosocial model, specifically the interactive effects of perinatal complications, rejecting parenting, and family adversity on the development of early-onset antisocial behavior (ASB). Boys' internalizing problems were also tested to investigate the specificity…

  9. Severe Affective and Behavioural Dysregulation Is Associated with Significant Psychosocial Adversity and Impairment

    ERIC Educational Resources Information Center

    Jucksch, Viola; Salbach-Andrae, Harriet; Lenz, Klaus; Goth, Kirstin; Dopfner, Manfred; Poustka, Fritz; Freitag, Christine M.; Lehmkuhl, Gerd; Lehmkuhl, Ulrike; Holtmann, Martin

    2011-01-01

    Background: Recently, a highly heritable behavioral phenotype of simultaneous deviance on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndrome scales has been identified on the Child Behavior Checklist (CBCL-Dysregulation Profile, CBCL-DP). This study aims to investigate psychosocial adversity and impairment of the CBCL-DP.…

  10. Adverse Childhood Experiences of Referred Children Exposed to Intimate Partner Violence: Consequences for their Wellbeing

    ERIC Educational Resources Information Center

    Lamers-Winkelman, Francien; Willemen, Agnes M.; Visser, Margreet

    2012-01-01

    Objective: This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a high risk clinical sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms. Methods: The study population comprised 208 children (M = 7.81 years, SD =…

  11. Adverse Effect of Child Abuse Victimization among Substance-Using Women in Treatment.

    ERIC Educational Resources Information Center

    Kang, Sung-Yeon; Magura, Stephen; Laudet, Alexandre; Whitney, Shirley

    1999-01-01

    Study examined adverse effects of childhood sexual/physical abuse among substance-abusing women with children. Several significant differences between abused and nonabused women were found in service outcomes. Abused women had more problems relating to drug use and psychiatric/psychological adjustment at follow-up. Findings support a need for…

  12. Selective video blanking technique

    NASA Technical Reports Server (NTRS)

    Saboe, M. M.; Treude, R. C.

    1968-01-01

    Adverse viewing effects caused by faulty photosensitive elements are eliminated. A linear maximal /or nonmaximal/ sequence generator gives a pseudorandom pulse train to selectively blank the display monitor during specified mosaic interrogation times. The outputs minimize the length of the required shift register generator.

  13. Shallow Water Turbulent Surface Wave Striking an Adverse Slope

    NASA Astrophysics Data System (ADS)

    Bose, Sujit K.

    2015-08-01

    The problem of a sinusoidal wave crest striking an adverse slope due to gradual elevation of the bed is relevant for coastal sea waves. Turbulence based RANS equations are used here under turbulence closure assumptions. Depth-averaging the equations of continuity and momentum, yield two differential equations for the surface elevation and the average forward velocity. After nondimensionalization, the two equations are converted in terms of elevation over the inclined bed and the discharge, where the latter is a function of the former satisfying a first order differential equation, while the elevation is given by a first order evolution equation which is treated by Lax-Wendroff discretization. Starting initially with a single sinusoidal crest, it is shown that as time progresses, the crest leans forwards, causing a jump in the crest upfront resulting in its roll over as a jet. Three cases show that jump becomes more prominent with increasing bed inclination.

  14. Ofloxacin Induced Angioedema: A Rare Adverse Drug Reaction

    PubMed Central

    Yadav, Sankalp; Kumar, Raj; Wani, Umar Rasool

    2016-01-01

    The Adverse Drug Reaction (ADR) to a commonly prescribed anti-microbial can pose a major public health problem. The authors report a rare case of 24-year-old young lady who presented with angioedema of lips after ingestion of Ofloxacin, prescribed to her for treatment of loose motions. Fluoroquinolones are widely prescribed antibiotics for various disease conditions. The history, clinical examination and normal laboratory parameters led to the diagnosis of ofloxacin induced hypersensitivity reaction and the patient was successfully treated with corticosteroids and antihistamines. The hypersensitivity reactions to fluoroquinolones are rare with an incidence of 0.4% to 2%. The pharmacovigilance program and self-reporting of all the ADR’s by the health care workers can help in ensuring the judicious use of the drug, drug safety and thus decrease the associated morbidity and mortality. PMID:28050397

  15. Frequency-Weighting Filter Selection, for H2 Control of Microgravity Isolation Systems: A Consideration of the "Implicit Frequency Weighting" Problem

    NASA Technical Reports Server (NTRS)

    Hampton, Roy David; Whorton, Mark S.

    1999-01-01

    Many space-science experiments need an active isolation system to provide them with the requisite microgravity environment. The isolation systems planned for use with the International Space Station (ISS) have been appropriately modeled using relative position, relative velocity, and acceleration states. In theory, frequency-weighting design filters can be applied to these state-space models, in order to develop optimal H2 or mixed-norm controllers with desired stability and performance characteristics. In practice, however, since there is a kinematic relationship among the various states, any frequency weighting applied to one state will implicitly weight other states. These implicit frequency-weighting effects must be considered, for intelligent frequency-weighting filter assignment. This paper suggests a rational approach to the assignment of frequency-weighting design filters, in the presence of the kinematic coupling among states that exists in the microgravity vibration isolation problem.

  16. Childhood Adversity as a Predictor of Non-Adherence to Statin Therapy in Adulthood

    PubMed Central

    Korhonen, Maarit Jaana; Halonen, Jaana I.; Brookhart, M. Alan; Kawachi, Ichiro; Pentti, Jaana; Karlsson, Hasse; Kivimäki, Mika; Vahtera, Jussi

    2015-01-01

    Purpose To investigate whether adverse experiences in childhood predict non-adherence to statin therapy in adulthood. Methods A cohort of 1378 women and 538 men who initiated statin therapy during 2008–2010 after responding to a survey on childhood adversities, was followed for non-adherence during the first treatment year. Log-binomial regression was used to estimate predictors of non-adherence, defined as the proportion of days covered by dispensed statin tablets <80%. In fully adjusted models including age, education, marital status, current smoking, heavy alcohol use, physical inactivity, obesity, presence of depression and cardiovascular comorbidity, the number of women ranged from 1172 to 1299 and that of men from 473 to 516, because of missing data on specific adversities and covariates. Results Two in three respondents reported at least one of the following six adversities in the family: divorce/separation of the parents, long-term financial difficulties, severe conflicts, frequent fear, severe illness, or alcohol problem of a family member. 51% of women and 44% of men were non-adherent. In men, the number of childhood adversities predicted an increased risk of non-adherence (risk ratio [RR] per adversity 1.11, 95% confidence interval [CI] 1.01–1.21], P for linear trend 0.013). Compared with those reporting no adversities, men reporting 3–6 adversities had a 1.44-fold risk of non-adherence (95% CI 1.12–1.85). Experiencing severe conflicts in the family (RR 1.27, 95% CI 1.03–1.57]) and frequent fear of a family member (RR 1.27, 95% CI 1.00–1.62]) in particular, predicted an increased risk of non-adherence. In women, neither the number of adversities nor any specific type of adversity predicted non-adherence. Conclusions Exposure to childhood adversity may predict non-adherence to preventive cardiovascular medication in men. Usefulness of information on childhood adversities in identification of adults at high risk of non-adherence deserves

  17. Possible adverse events in children treated by manual therapy: a review

    PubMed Central

    2010-01-01

    therapy, particularly spinal manipulation report that mild to moderate adverse events are common and self limiting. However serious adverse events are rare and much less than for medication commonly prescribed for these problems. More high quality research specifically addressing adverse events and pediatric manual therapy is needed. PMID:20525194

  18. Adverse effects of statins - myths and reality.

    PubMed

    Šimić, Iveta; Reiner, Željko

    2015-01-01

    Statins reduce cardiovascular mortality and morbidity as well as cardiovascular events in patients with a very high risk of cardiovascular disease (CVD) and also in subjects with high or moderate risk by reducing the levels of low-density lipoprotein cholesterol (LDL-C). Although they are considered to be drugs with a very good safety profile, because of their wide use there are many concerns that their adverse effects might compromise their proven beneficial effects. Therefore this article reviews all the data and provides an evidence- based insight what are the proven adverse effects of statins and what are the "myths" about them. The most important side effects include myopathy and rhabdomyolysis. Another side effect is increased activity of liver tests which occurs occasionally and is reversible. However, recent studies even suggest that statin therapy can improve hepatic steatosis. It is beyond any doubt that statins do slightly increase the incidence of type 2 diabetes mellitus in people with two or more components of metabolic syndrome but the cardiovascular benefits of such a treatment by far exceed this risk. Statin therapy has also been associated with some adverse renal effects, eg. acute renal failure, but recent data suggest even a possible protective effect of these drugs on renal dysfunction. Concerns that statins might increase cancer have not been proven. On the contrary, several studies have indicated a possible benefit of these drugs in patients with different types of cancer. Early concerns about cognitive dysfunction and memory loss associated with statins use could not be proven and most recent data even suggest a possible beneficial effect of statins in the prevention of dementia. Systematic reviews and clinical guidelines suggest that the cardiovascular benefits of statins by far out-weight non-cardiovascular harms in patients with cardiovascular risk.

  19. Determinants of Adverse Events in Vascular Surgery

    PubMed Central

    Hernandez-Boussard, Tina; McDonald, Kathryn; Morton, John; Dalman, Ron L; Bech, Fritz R

    2016-01-01

    Background Patient safety is a national priority. Patient Safety Indicators (PSIs) monitor potential adverse events during hospital stays. Surgical specialty PSI benchmarks do not exist, which are needed to account for differences in the range of procedures performed, reasons for the procedure, and differences in patient characteristics. A comprehensive profile of adverse events in vascular surgery was created. Study Design The Nationwide Inpatient Sample was queried for 8 vascular procedures using ICD-9-CM codes from 2005–2009. Factors associated with PSI development were evaluated in univariate and multivariate analyses. Results A total of 1,412,703 patients underwent a vascular procedure and 5.2% developed a PSI. PSIs were more frequent in female, non-white patients with public payers (p<.01). Patients at mid and low volume hospitals had greater odds of developing a PSI (Odds Ratio [OR], 1.17; 95% Confidence Interval [CI], 1.10–1.23 and OR, 1.69; CI, 1.53–1.87). Amputations had highest PSI risk-adjusted rate (RAR) and carotid endarterectomy and endovascular abdominal aortic aneurysm (AAA) repair had lower RAR (p<.0001). PSI RAR increased linearly by severity of patient indication: claudicants (OR, 0.40, CI, 0.35–0.46), rest pain patients (OR, 0.78, CI 0.69–0.90), ulcer (OR: 1.20, CI: 1.07–1.34) and gangrene patients (OR:1.85, CI: 1.66–2.06). Conclusions Patient safety events in vascular surgery were high and varied by procedure, with amputations and open AAA having substantially more potential adverse events. PSIs were associated with black race, public payer, and procedure indication. It is important to note the overall higher rates of PSIs occurring in vascular patients and appropriately adjust benchmarks for this surgical specialty. PMID:22425449

  20. Gambling in the Landscape of Adversity in Youth: Reflections from Men Who Live with Poverty and Homelessness

    PubMed Central

    Hamilton-Wright, Sarah; Woodhall-Melnik, Julia; Guilcher, Sara J. T.; Schuler, Andrée; Wendaferew, Aklilu; Hwang, Stephen W.; Matheson, Flora I.

    2016-01-01

    Most of the research on gambling behaviour among youth has been quantitative and focused on measuring prevalence. As a result, little is known about the contextual experiences of youth gambling, particularly among those most vulnerable. In this paper, we explore the previous experiences of youth gambling in a sample of adult men experiencing housing instability and problem gambling. We present findings from a qualitative study on problem gambling and housing instability conducted in Toronto, Canada. Thirty men with histories of problem or pathological gambling and housing instability or homelessness were interviewed. Two thirds of these men reported that they began gambling in youth. Five representative cases were selected and the main themes discussed. We found that gambling began in early life while the men, as youth, were also experiencing adversity (e.g., physical, emotional and/or sexual abuse, neglect, housing instability, homelessness, substance addiction and poverty). Men reported they had access to gambling activity through their family and wider networks of school, community and the streets. Gambling provided a way to gain acceptance, escape from emotional pain, and/or earn money. For these men problematic gambling behaviour that began in youth, continued into adulthood. PMID:27589784

  1. Adverse testicular effects of Botox® in mature rats

    SciTech Connect

    Breikaa, Randa M.; Mosli, Hisham A.; Nagy, Ayman A.; Abdel-Naim, Ashraf B.

    2014-03-01

    Botox® injections are taking a consistently increasing place in urology. Intracremasteric injections, particularly, have been applied for cryptorchidism and painful testicular spasms. Studies outlining their safety for this use are, however, scanty. Thus, the present study aimed at evaluating possible testicular toxicity of Botox® injections and their effect on male fertility. Mature rats were given intracremasteric Botox® injections (10, 20 and 40 U/kg) three times in a two-week interval. Changes in body and testes weights were examined and gonadosomatic index compared to control group. Semen quality, sperm parameters, fructose, protein, cholesterol and triglycerides contents were assessed. Effects on normal testicular function were investigated by measuring testosterone levels and changes in enzyme activities (lactate dehydrogenase-X and acid phosphatase). To draw a complete picture, changes in oxidative and inflammatory states were examined, in addition to the extent of connective tissue deposition between seminiferous tubules. In an attempt to have more accurate information about possible spermatotoxic effects of Botox®, flowcytometric analysis and histopathological examination were carried out. Botox®-injected rats showed altered testicular physiology and function. Seminiferous tubules were separated by dense fibers, especially with the highest dose. Flowcytometric analysis showed a decrease in mature sperms and histopathology confirmed the findings. The oxidative state was, however, comparable to control group. This study is the first to show that intracremasteric injections of Botox® induce adverse testicular effects evidenced by inhibited spermatogenesis and initiation of histopathological changes. In conclusion, decreased fertility may be a serious problem Botox® injections could cause. - Highlights: • Botox® injections are the trend nowadays, for both medical and non-medical uses. • They were recently suggested for cryptorchidism and

  2. Agomelatine: a review of adverse effects.

    PubMed

    2013-03-01

    More pharmacovigilance data on agomelatine became available in 2012. The main sources of information were surveillance data from the French national monitoring system, EU periodic safety update reports (PSURs), and the European pharmacovigilance database. The principal adverse effects of agomelatine consist of hepatic, pancreatic, neuropsychiatric, muscular and cutaneous disorders. The harms associated with agomelatine, which has no proven efficacy in depression, clearly outweigh the benefits. Until regulatory agencies decide to withdraw agomelatine from the market, it is up to healthcare professionals to protect patients from this unnecessarily dangerous drug.

  3. Joint Commission suspends 'auto' adverse decision.

    PubMed

    2010-08-01

    The Joint Commission's revision of its policy on root cause analysis puts greater attention of something that, quite frankly, some ED managers might not have been aware of. The ED manager plays an important role when events occur in the department, such as: knowing who the main Joint Commission contact is in the hospital, and making them aware of a potential adverse or sentinel event that has occurred; participating in the root cause analysis to identify what ED processes might need improvement; making sure the remedial activities recommended can be measured, so The Joint Commission can see an active attempt is being made to improve.

  4. Environmental Perchlorate Exposure: Potential Adverse Thyroid Effects

    PubMed Central

    Leung, Angela M.; Pearce, Elizabeth N.; Braverman, Lewis E.

    2014-01-01

    Purpose of review This review will present a general overview of the sources, human studies, and proposed regulatory action regarding environmental perchlorate exposure. Recent findings Some recent studies have reported significant associations between urinary perchlorate concentrations, thyroid dysfunction, and decreased infant IQ in groups who would be particularly susceptible to perchlorate effects. An update regarding the recent proposed regulatory actions and potential costs surrounding amelioration of perchlorate contamination is provided. Summary The potential adverse thyroidal effects of environmental perchlorate exposure remain controversial, and further research is needed to further define its relationship to human health among pregnant and lactating women and their infants. PMID:25106002

  5. [Adverse drug effects in the community pharmacy].

    PubMed

    Arnet, Isabelle; Seidling, Hanna M; Hersberger, Kurt E

    2015-12-01

    Community pharmacists represent an important pillar for the identification and the reporting of adverse drug effects (ADE}. Thanks to their broad view on the pharmacotherapy, over-the-counter medication included, they contribute greatly to the improvement of drug safety. In principle, the community pharmacy will face three groups of ADE which require specific attention. This article deals with these specific ADE groups and presents some illustrative examples from daily practice. Furthermore, we suggest some solutions to identify potential relevant interactions - including herbal-drug interactions - and give tips for daily practice, along with some often overseen cutaneous ADE.

  6. Mitigation of adverse environmental and unavoidable impacts

    SciTech Connect

    1995-10-01

    This portion of the Energy Vision 2020 draft report is a broad scope discussion of the mitigation of adverse environmental and unavoidable impacts. TVA will mitigate site specific environmental impacts from the construction and operation of new power facilities through a combination of planning, pollution prevention, and environmental controls. However, one of the most important mitigative measures associated with Energy Vision 2020 is the multi-attribute tradeoff method used for the evaluation. This method allowed proposed strategies to be reformated in order to reduce potential impacts.

  7. Prenatal alcohol and other early childhood adverse exposures: Direct and indirect pathways to adolescent drinking

    PubMed Central

    Cornelius, Marie D.; De Genna, Natacha M.; Goldschmidt, Lidush; Larkby, Cynthia; Day, Nancy L.

    2016-01-01

    We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n = 917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14 years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking. PMID:26994529

  8. Adverse Childhood Experiences, Commitment Offense, and Race/Ethnicity: Are the Effects Crime-, Race-, and Ethnicity-Specific?

    PubMed Central

    DeLisi, Matt; Alcala, Justin; Kusow, Abdi; Hochstetler, Andy; Heirigs, Mark H.; Caudill, Jonathan W.; Trulson, Chad R.; Baglivio, Michael T.

    2017-01-01

    Adverse childhood experiences are associated with an array of health, psychiatric, and behavioral problems including antisocial behavior. Criminologists have recently utilized adverse childhood experiences as an organizing research framework and shown that adverse childhood experiences are associated with delinquency, violence, and more chronic/severe criminal careers. However, much less is known about adverse childhood experiences vis-à-vis specific forms of crime and whether the effects vary across race and ethnicity. Using a sample of 2520 male confined juvenile delinquents, the current study used epidemiological tables of odds (both unadjusted and adjusted for onset, total adjudications, and total out of home placements) to evaluate the significance of the number of adverse childhood experiences on commitment for homicide, sexual assault, and serious persons/property offending. The effects of adverse childhood experiences vary considerably across racial and ethnic groups and across offense types. Adverse childhood experiences are strongly and positively associated with sexual offending, but negatively associated with homicide and serious person/property offending. Differential effects of adverse childhood experiences were also seen among African Americans, Hispanics, and whites. Suggestions for future research to clarify the mechanisms by which adverse childhood experiences manifest in specific forms of criminal behavior are offered. PMID:28327508

  9. Adverse Childhood Experiences, Commitment Offense, and Race/Ethnicity: Are the Effects Crime-, Race-, and Ethnicity-Specific?

    PubMed

    DeLisi, Matt; Alcala, Justin; Kusow, Abdi; Hochstetler, Andy; Heirigs, Mark H; Caudill, Jonathan W; Trulson, Chad R; Baglivio, Michael T

    2017-03-22

    Adverse childhood experiences are associated with an array of health, psychiatric, and behavioral problems including antisocial behavior. Criminologists have recently utilized adverse childhood experiences as an organizing research framework and shown that adverse childhood experiences are associated with delinquency, violence, and more chronic/severe criminal careers. However, much less is known about adverse childhood experiences vis-à-vis specific forms of crime and whether the effects vary across race and ethnicity. Using a sample of 2520 male confined juvenile delinquents, the current study used epidemiological tables of odds (both unadjusted and adjusted for onset, total adjudications, and total out of home placements) to evaluate the significance of the number of adverse childhood experiences on commitment for homicide, sexual assault, and serious persons/property offending. The effects of adverse childhood experiences vary considerably across racial and ethnic groups and across offense types. Adverse childhood experiences are strongly and positively associated with sexual offending, but negatively associated with homicide and serious person/property offending. Differential effects of adverse childhood experiences were also seen among African Americans, Hispanics, and whites. Suggestions for future research to clarify the mechanisms by which adverse childhood experiences manifest in specific forms of criminal behavior are offered.

  10. Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

    ERIC Educational Resources Information Center

    Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

    2010-01-01

    Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

  11. Adverse environments and children's creativity development: transforming the notion of "success in adversity" in China.

    PubMed

    Cheng, Li; Tan, Mei; Liu, Zhengkui

    2015-01-01

    China has been undergoing great social change due to its new focus on urbanization and globalization. Such change has had a tremendous adverse impact on the living conditions of millions of young children, simultaneously generating new interest in children's creativity development. The intersection of these two issues has important implications for China's future as it brings together one of China's core cultural values-"success in adversity"-the importance of creativity, and very real social and economic needs. "Success in adversity" reflects the strongly held belief that individuals who suffer adverse environments can rise to excellence and success through persistence, effort, and creativity. In this article, we briefly explore the historical sources of this belief and how it is closely related to the Chinese conception of creativity. We then present some studies on the creativity of some of China's migrant children. Findings show that while migrant children as a group may not generally exhibit higher creativity than their urban peers as hypothesized, indications of resilience and creative potential suggest that the notion of success in adversity may contribute to the positive development of China's migrant children more substantially when it is informed by research and augmented by research-supported policy.

  12. Adverse Effects of Psychotropic Medications: A Call to Action.

    PubMed

    Mago, Rajnish

    2016-09-01

    Adverse effects are common, bothersome, and a leading cause of discontinuation of treatment. The methodology for evaluating adverse effects of medications has been greatly neglected, however, especially in comparison to the methodology for assessment of efficacy of medications. Existing methods for assessment and reporting of adverse effects have important limitations leading to lack of much-needed data related to adverse effects. Lastly, there is little systematic research into management of most adverse effects. A series of recommendations are made in this article about how to improve identification, assessment, reporting, and management of adverse effects.

  13. The Useage of Opioids and their Adverse Effects in Gastrointestinal Practice: A Review

    PubMed Central

    Khansari, MahmoudReza; Sohrabi, MasourReza; Zamani, Farhad

    2013-01-01

    Opium is one of the oldest herbal medicines currently used as an analgesic, sedative and antidiarrheal treatment. The effects of opium are principally mediated by the μ-, κ- and δ-opioid receptors. Opioid substances consist of all natural and synthetic alkaloids that are derived from opium. Most of their effects on gastrointestinal motility and secretion result from suppression of neural activity. Inhibition of gastric emptying, increase in sphincter tone, changes in motor patterns, and blockage of peristalsis result from opioid use. Common adverse effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, dependency and tolerance, and respiratory depression. The most common adverse effect of opioid use is constipation. Although stool softeners are frequently used to decrease opioid-induced bowel dysfunction, however they are not efficacious. Possibly, the use of specific opioid receptor antagonists is a more suitable approach. Opioid antagonists, both central and peripheral, could affect gastrointestinal function and visceromotor sensitivity, which suggests an important role for endogenous opioid peptides in the control of gastrointestinal physiology. Underlying diseases or medications known to influence the central nervous system (CNS) often accelerate the opioid’s adverse effects. However, changing the opioid and/or route of administration could also decrease their adverse effects. Appropriate patient selection, patient education and discussion regarding potential adverse effects may assist physicians in maximizing the effectiveness of opioids, while reducing the number and severity of adverse effects. PMID:24829664

  14. Close Friends' Psychopathology as a Pathway From Early Adversity to Young Adulthood Depressive Symptoms.

    PubMed

    Raposa, Elizabeth B; Hammen, Constance L; Brennan, Patricia A

    2015-01-01

    Past research has highlighted the negative impact of early adverse experiences on childhood social functioning, including friendship selection, and later mental health. The current study explored the long-term effects of early adversity on young adults' close friends' psychological symptoms and the impact of these close friendships on later depressive symptoms. A prospective longitudinal design was used to examine 816 youth from a large community-based sample, who were followed from birth through age 25. Participants' mothers provided contemporaneous information about adversity exposure up to age 5, and participants completed questionnaires about their own depressive symptoms at age 20 and in their early 20s. Youth also nominated a best friend to complete questionnaires about his or her own psychopathology at age 20. Individuals who experienced more early adversity by age 5 had best friends with higher rates of psychopathology at age 20. Moreover, best friends' psychopathology predicted target youth depressive symptoms 2 to 5 years later. Results indicate that early adversity continues to affect social functioning throughout young adulthood and that best friendships marked by elevated psychopathology in turn negatively affect mental health. Findings have implications for clinical interventions designed to prevent the development of depressive symptoms in youth who have been exposed to early adversity.

  15. Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

    PubMed Central

    Zegers, Marieke; Hesselink, Gijs; Geense, Wytske; Vincent, Charles; Wollersheim, Hub

    2016-01-01

    Objective To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. Design Systematic review of systematic reviews. Data sources PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. Study selection English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included. Two reviewers independently assessed each study's quality and extracted data on the study population, study design, intervention characteristics and adverse patient outcomes. Results Sixty systematic reviews with moderate to high quality were included. Statistically significant pooled effect sizes were found for 14 types of interventions, including: (1) multicomponent interventions to prevent delirium; (2) rapid response teams to reduce cardiopulmonary arrest and mortality rates; (3) pharmacist interventions to reduce adverse drug events; (4) exercises and multicomponent interventions to prevent falls; and (5) care bundle interventions, checklists and reminders to reduce infections. Most (82%) of the significant effect sizes were based on 5 or fewer primary studies with an experimental study design. Conclusions The evidence for patient-safety interventions implemented in hospitals worldwide is weak. The findings address the need to invest in high-quality research standards in order to identify interventions that have a real impact on patient safety. Interventions to prevent delirium, cardiopulmonary arrest and mortality, adverse drug events, infections and falls are most effective and should therefore be prioritised by clinicians. PMID:27687901

  16. Adverse outcome pathway development II: best practices.

    PubMed

    Villeneuve, Daniel L; Crump, Doug; Garcia-Reyero, Natàlia; Hecker, Markus; Hutchinson, Thomas H; LaLone, Carlie A; Landesmann, Brigitte; Lettieri, Teresa; Munn, Sharon; Nepelska, Malgorzata; Ottinger, Mary Ann; Vergauwen, Lucia; Whelan, Maurice

    2014-12-01

    Organization of existing and emerging toxicological knowledge into adverse outcome pathway (AOP) descriptions can facilitate greater application of mechanistic data, including those derived through high-throughput in vitro, high content omics and imaging, and biomarker approaches, in risk-based decision making. The previously ad hoc process of AOP development is being formalized through development of internationally harmonized guidance and principles. The goal of this article was to outline the information content desired for formal AOP description and some rules of thumb and best practices intended to facilitate reuse and connectivity of elements of an AOP description in a knowledgebase and network context. For example, key events (KEs) are measurements of change in biological state that are indicative of progression of a perturbation toward a specified adverse outcome. Best practices for KE description suggest that each KE should be defined as an independent measurement made at a particular level of biological organization. The concept of "functional equivalence" can help guide both decisions about how many KEs to include in an AOP and the specificity with which they are defined. Likewise, in describing both KEs and evidence that supports a causal linkage or statistical association between them (ie, a key event relationship; KER), best practice is to build from and contribute to existing KE or KER descriptions in the AOP knowledgebase rather than creating redundant descriptions. The best practices proposed address many of the challenges and uncertainties related to AOP development and help promote a consistent and reliable, yet flexible approach.

  17. Adverse outcome pathway (AOP) development and evaluation ...

    EPA Pesticide Factsheets

    The Adverse Outcome Pathway provides a construct for assembling mechanistic information at different levels of biological organization in a form designed to support regulatory decision making. In particular, it frames the link between molecular and cellular events that can be measured in high throughput toxicity testing and the organism or population-level events that are commonly relevant in defining risk. Recognizing the importance of this emerging framework, the Organisation for Economic Co-operation and Development (OECD) launched a program to support the development, documentation and consideration of AOPs by the international community in 2012 (http://www.oecd.org/chemicalsafety/testing/adverse-outcome-pathways-molecular-screening-and-toxicogenomics.htm). In 2014, a handbook (https://aopkb.org/common/AOP_Handbook.pdf) was developed to guide users in the documentation and evaluation of AOPs and their entry into an official knowledgebase. The handbook draws on longstanding experience in consideration of mechanistic data (e.g., mode of action analysis) to inform risk assessment. To further assist users, a training program was developed by members of the OECD Extended Advisory Group to teach users the basic principles of AOP development and the best practices as outlined in the OECD AOP handbook. Training sessions began in early 2015, and this course will provide training for interested SOT scientists. Following this course, all participants will be familiar w

  18. [Adverse events of immune checkpoint inhibitors].

    PubMed

    Foller, S; Oppel-Heuchel, H; Fetter, I; Winkler, Y; Grimm, M-O

    2017-04-01

    After immune checkpoint inhibitor therapy was approved for renal cell carcinoma last year, this new immune therapy has spread to urology. Further approvals (atezolizumab, nivolumab, pembrolizumab) are expected in 2017 for metastatic urothelial carcinoma that has progressed following treatment with platinum-based chemotherapy. With expanding use of immune checkpoint inhibitors, experience in diagnosing and managing immune-mediated adverse events increases. Although of low incidence, grade 3/4 toxicities play a central role. Organs most common for immune-mediated adverse events are skin, liver (hepatitis), kidneys (nephritis), gastrointestinal tract (diarrhea and colitis), lungs (pneumonitis), and endocrine organs (hyper-, hypothyroidism and hypophysitis). Diagnostic workup includes routine laboratory tests (including liver function tests) and may be supplemented with hormone values. In cases of pneumonitis or hypophysitis, imaging (high-resolution CT, MRI) can confirm diagnoses. Immune-mediated toxicities are treated with therapy interruption and administration of corticosteroids (and in individual cases additional immunosuppression). Dose modification is not intended!

  19. Immunomodulatory drugs: Oral and systemic adverse effects

    PubMed Central

    Mattila, Riikka; Gomez-Font, Rafael; Meurman, Jukka H.

    2014-01-01

    Objectives: The main objectives are to present the different adverses effects of the immunomodulatory drugs that can impair the quality of life of the immunosupressed patients and study the impact of immunomodualtion on oral diseases. Immunomodulatory drugs have changed the treatment protocols of many diseases where immune functions play a central role, such as rheumatic diseases. Their effect on oral health has not been systematically investigated, however. Study Design: We review current data on the new immunomodulatory drugs from the oral health perspective based on open literature search of the topic. Results: These target specific drugs appear to have less drug interactions than earlier immunomodulating medicines but have nevertheless potential side effects such as activating latent infections. There are some data showing that the new immunomodulatory drugs may also have a role in the treatment of certain oral diseases such as lichen planus or ameliorating symptoms in Sjögren´s syndrome, but the results have not been overly promising. Conclusions: In general, data are sparse of the effect of these new drugs vs. oral diseases and there are no properly powered randomized controlled trials published on this topic. Key words:Immunomodulatory drugs, oral diseases, adverse effects, therapeutic action. PMID:23986016

  20. Hyperinsulinemia adversely affects lung structure and function.

    PubMed

    Singh, Suchita; Bodas, Manish; Bhatraju, Naveen K; Pattnaik, Bijay; Gheware, Atish; Parameswaran, Praveen Kolumam; Thompson, Michael; Freeman, Michelle; Mabalirajan, Ulaganathan; Gosens, Reinoud; Ghosh, Balaram; Pabelick, Christina; Linneberg, Allan; Prakash, Y S; Agrawal, Anurag

    2016-05-01

    There is limited knowledge regarding the consequences of hyperinsulinemia on the lung. Given the increasing prevalence of obesity, insulin resistance, and epidemiological associations with asthma, this is a critical lacuna, more so with inhaled insulin on the horizon. Here, we demonstrate that insulin can adversely affect respiratory health. Insulin treatment (1 μg/ml) significantly (P < 0.05) increased the proliferation of primary human airway smooth muscle (ASM) cells and induced collagen release. Additionally, ASM cells showed a significant increase in calcium response and mitochondrial respiration upon insulin exposure. Mice administered intranasal insulin showed increased collagen deposition in the lungs as well as a significant increase in airway hyperresponsiveness. PI3K/Akt mediated activation of β-catenin, a positive regulator of epithelial-mesenchymal transition and fibrosis, was observed in the lungs of insulin-treated mice and lung cells. Our data suggests that hyperinsulinemia may have adverse effects on airway structure and function. Insulin-induced activation of β-catenin in lung tissue and the contractile effects on ASM cells may be causally related to the development of asthma-like phenotype.

  1. Development of a Pediatric Adverse Events Terminology

    PubMed Central

    Gipson, Debbie S.; Kirkendall, Eric S.; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A.; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M.; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute’s Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute’s Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. PMID:28028203

  2. Development of a Pediatric Adverse Events Terminology.

    PubMed

    Gipson, Debbie S; Kirkendall, Eric S; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute's Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute's Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization.

  3. Diagnosis of potential stressors adversely affecting benthic ...

    EPA Pesticide Factsheets

    Greenwich Bay is an urbanized embayment of Narragansett Bay potentially impacted by multiple stressors. The present study identified the important stressors affecting Greenwich Bay benthic fauna. First, existing data and information were used to confirm that the waterbody was impaired. Second, the presence of source, stressor, and effect were established. Then linkages between source, stressor, and effect were developed. This allows identification of probable stressors adversely affecting the waterbody. Three pollutant categories were assessed: chemicals, nutrients, and suspended sediments. This weight of evidence approach indicated that Greenwich Bay was primarily impacted by eutrophication-related stressors. The sediments of Greenwich Bay were carbon enriched and low dissolved oxygen concentrations were commonly seen, especially in the western portions of Greenwich Bay. The benthic community was depauperate, as would be expected under oxygen stress. Although our analysis indicated that contaminant loads in Greenwich Bay were at concentrations where adverse effects might be expected, no toxicity was observed, as a result of high levels of organic carbon in these sediments reducing contaminant bioavailability. Our analysis also indicated that suspended sediment impacts were likely nonexistent for much of the Bay. This analysis demonstrates that the diagnostic procedure was useful to organize and assess the potential stressors impacting the ecological well-being

  4. Consumer reporting of adverse events following immunization

    PubMed Central

    Clothier, Hazel J; Selvaraj, Gowri; Easton, Mee Lee; Lewis, Georgina; Crawford, Nigel W; Buttery, Jim P

    2014-01-01

    Surveillance of adverse events following immunisation (AEFI) is an essential component of vaccine safety monitoring. The most commonly utilized passive surveillance systems rely predominantly on reporting by health care providers (HCP). We reviewed adverse event reports received in Victoria, Australia since surveillance commencement in July 2007, to June 2013 (6 years) to ascertain the contribution of consumer (vaccinee or their parent/guardian) reporting to vaccine safety monitoring and to inform future surveillance system development directions. Categorical data included were: reporter type; serious and non-serious AEFI category; and, vaccinee age group. Chi-square test and 2-sample test of proportions were used to compare categories; trend changes were assessed using linear regression. Consumer reporting increased over the 6 years, reaching 21% of reports received in 2013 (P <0.001), most commonly for children aged less than 7 years. Consumer reports were 5% more likely to describe serious AEFI than HCP (P = 0.018) and 10% more likely to result in specialist clinic attendance (P <0.001). Although online reporting increased to 32% of all report since its introduction in 2010, 85% of consumers continued to report by phone. Consumer reporting of AEFI is a valuable component of vaccine safety surveillance in addition to HCP reporting. Changes are required to AEFI reporting systems to implement efficient consumer AEFI reporting, but may be justified for their potential impact on signal detection sensitivity. PMID:25483686

  5. Accelerating Adverse Outcome Pathway (AOP) development ...

    EPA Pesticide Factsheets

    The Adverse Outcome Pathway (AOP) framework is increasingly being adopted as a tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse outcomes relevant for ecological and human health outcomes. However, the conventional process for assembly of these AOPs is time and resource intensive, and has been a rate limiting step for AOP use and development. Therefore computational approaches to accelerate the process need to be developed. We previously developed a method for generating computationally predicted AOPs (cpAOPs) by association mining and integration of data from publicly available databases. In this work, a cpAOP network of ~21,000 associations was established between 105 phenotypes from TG-GATEs rat liver data from different time points (including microarray, pathological effects and clinical chemistry data), 994 REACTOME pathways, 688 High-throughput assays from ToxCast and 194 chemicals. A second network of 128,536 associations was generated by connecting 255 biological target genes from ToxCast to 4,980 diseases from CTD using either HT screening activity from ToxCast for 286 chemicals or CTD gene expression changes in response to 2,330 chemicals. Both networks were separately evaluated through manual extraction of disease-specific cpAOPs and comparison with expert curation of the relevant literature. By employing data integration strategies that involve the weighting of n

  6. PUTATIVE ADVERSE OUTCOME PATHWAY FOR INHIBITON ...

    EPA Pesticide Factsheets

    The adverse outcome pathway (AOP) provides a framework for organizing knowledge to define links between a molecular initiating event (MIE) and an adverse outcome (AO) occurring at a higher level of biological organization, such as the individual or population. The AOP framework proceeds from a general (e.g., not chemical specific) molecular mode of action, designated as a MIE, through stepwise changes in biological status, defined as key events (KEs), to a final AO that can be used in risk assessment. Because aromatase-inhibiting pharmaceuticals are widely used to treat breast cancer patients, we explored the unintended consequences that might occur in fish exposed to these chemicals through wastewater discharge into the aquatic environment. Unlike mammals, fish have two isoforms of aromatase, one that predominates in the ovary (cyp19a1a) and a second (cyp19a1b) that prevails in the brain. Aromatase activity in fish brain can be 100 to 1000 times that in mammals and is associated with reproduction. We have developed a putative AOP for inhibition of brain aromatase in fish leading to reproductive dysfunction based on review of relevant literature and reproductive experiments with the marine fish cunner (Tautogolabrus adspersus) exposed to aromatase-inhibiting pharmaceuticals in the laboratory. The first KE in this AOP is a decrease in brain aromatase activity due to exposure to an aromatase inhibitor. KEs then progress through subsequent steps including decreas

  7. Balance Problems

    MedlinePlus

    ... version of this page please turn Javascript on. Balance Problems About Balance Problems Have you ever felt dizzy, lightheaded, or ... dizziness problem during the past year. Why Good Balance is Important Having good balance means being able ...

  8. Detecting adverse drug events in discharge summaries using variations on the simple Bayes model.

    PubMed

    Visweswaran, Shyam; Hanbury, Paul; Saul, Melissa; Cooper, Gregory F

    2003-01-01

    Detection and prevention of adverse events and, in particular, adverse drug events (ADEs), is an important problem in health care today. We describe the implementation and evaluation of four variations on the simple Bayes model for identifying ADE-related discharge summaries. Our results show that these probabilistic techniques achieve an ROC curve area of up to 0.77 in correctly determining which patient cases should be assigned an ADE-related ICD-9-CM code. These results suggest a potential for these techniques to contribute to the development of an automated system that helps identify ADEs, as a step toward further understanding and preventing them.

  9. Selected problems with boron determination in water treatment processes. Part I: comparison of the reference methods for ICP-MS and ICP-OES determinations.

    PubMed

    Kmiecik, Ewa; Tomaszewska, Barbara; Wątor, Katarzyna; Bodzek, Michał

    2016-06-01

    The aim of the study was to compare the two reference methods for the determination of boron in water samples and further assess the impact of the method of preparation of samples for analysis on the results obtained. Samples were collected during different desalination processes, ultrafiltration and the double reverse osmosis system, connected in series. From each point, samples were prepared in four different ways: the first was filtered (through a membrane filter of 0.45 μm) and acidified (using 1 mL ultrapure nitric acid for each 100 mL of samples) (FA), the second was unfiltered and not acidified (UFNA), the third was filtered but not acidified (FNA), and finally, the fourth was unfiltered but acidified (UFA). All samples were analysed using two analytical methods: inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectrometry (ICP-OES). The results obtained were compared and correlated, and the differences between them were studied. The results show that there are statistically significant differences between the concentrations obtained using the ICP-MS and ICP-OES techniques regardless of the methods of sampling preparation (sample filtration and preservation). Finally, both the ICP-MS and ICP-OES methods can be used for determination of the boron concentration in water. The differences in the boron concentrations obtained using these two methods can be caused by several high-level concentrations in selected whole-water digestates and some matrix effects. Higher concentrations of iron (from 1 to 20 mg/L) than chromium (0.02-1 mg/L) in the samples analysed can influence boron determination. When iron concentrations are high, we can observe the emission spectrum as a double joined and overlapping peak.

  10. 19 CFR 181.116 - Petition regarding adverse marking decision.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... for NAFTA Review of Adverse Marking Decision” and shall be signed by the exporter, producer or his... other than the principal. (c) Content. The Petition for NAFTA Review of Adverse Marking Decision...

  11. 19 CFR 181.116 - Petition regarding adverse marking decision.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... for NAFTA Review of Adverse Marking Decision” and shall be signed by the exporter, producer or his... other than the principal. (c) Content. The Petition for NAFTA Review of Adverse Marking Decision...

  12. 19 CFR 181.116 - Petition regarding adverse marking decision.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... for NAFTA Review of Adverse Marking Decision” and shall be signed by the exporter, producer or his... other than the principal. (c) Content. The Petition for NAFTA Review of Adverse Marking Decision...

  13. 19 CFR 181.116 - Petition regarding adverse marking decision.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for NAFTA Review of Adverse Marking Decision” and shall be signed by the exporter, producer or his... other than the principal. (c) Content. The Petition for NAFTA Review of Adverse Marking Decision...

  14. 19 CFR 181.116 - Petition regarding adverse marking decision.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for NAFTA Review of Adverse Marking Decision” and shall be signed by the exporter, producer or his... other than the principal. (c) Content. The Petition for NAFTA Review of Adverse Marking Decision...

  15. Adverse Outcome Pathways – Tailoring Development to Support Use

    EPA Science Inventory

    Adverse Outcome Pathways (AOPs) represent an ideal framework for connecting high-throughput screening (HTS) data and other toxicity testing results to adverse outcomes of regulatory importance. The AOP Knowledgebase (AOP-KB) captures AOP information to facilitate the development,...

  16. Adverse outcome pathway (AOP) development I: Strategies and principles

    EPA Science Inventory

    An adverse outcome pathway (AOP) is a conceptual framework that organizes existing knowledge concerning biologically plausible, and empirically-supported, links between molecular-level perturbation of a biological system and an adverse outcome at a level of biological organizatio...

  17. Adverse Outcome Pathway (AOP) Network Development for Fatty Liver

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are descriptive biological sequences that start from a molecular initiating event (MIE) and end with an adverse health outcome. AOPs provide biological context for high throughput chemical testing and further prioritize environmental health risk re...

  18. Adverse weather impacts on arable cropping systems

    NASA Astrophysics Data System (ADS)

    Gobin, Anne

    2016-04-01

    Damages due to extreme or adverse weather strongly depend on crop type, crop stage, soil conditions and management. The impact is largest during the sensitive periods of the farming calendar, and requires a modelling approach to capture the interactions between the crop, its environment and the occurrence of the meteorological event. The hypothesis is that extreme and adverse weather events can be quantified and subsequently incorporated in current crop models. Since crop development is driven by thermal time and photoperiod, a regional crop model was used to examine the likely frequency, magnitude and impacts of frost, drought, heat stress and waterlogging in relation to the cropping season and crop sensitive stages. Risk profiles and associated return levels were obtained by fitting generalized extreme value distributions to block maxima for air humidity, water balance and temperature variables. The risk profiles were subsequently confronted with yields and yield losses for the major arable crops in Belgium, notably winter wheat, winter barley, winter oilseed rape, sugar beet, potato and maize at the field (farm records) to regional scale (statistics). The average daily vapour pressure deficit (VPD) and reference evapotranspiration (ET0) during the growing season is significantly lower (p < 0.001) and has a higher variability before 1988 than after 1988. Distribution patterns of VPD and ET0 have relevant impacts on crop yields. The response to rising temperatures depends on the crop's capability to condition its microenvironment. Crops short of water close their stomata, lose their evaporative cooling potential and ultimately become susceptible to heat stress. Effects of heat stress therefore have to be combined with moisture availability such as the precipitation deficit or the soil water balance. Risks of combined heat and moisture deficit stress appear during the summer. These risks are subsequently related to crop damage. The methodology of defining

  19. STAGS Example Problems Manual

    NASA Technical Reports Server (NTRS)

    Knight, Norman F., Jr.; Rankin, Charles C.

    2006-01-01

    This document summarizes the STructural Analysis of General Shells (STAGS) development effort, STAGS performance for selected demonstration problems, and STAGS application problems illustrating selected advanced features available in the STAGS Version 5.0. Each problem is discussed including selected background information and reference solutions when available. The modeling and solution approach for each problem is described and illustrated. Numerical results are presented and compared with reference solutions, test data, and/or results obtained from mesh refinement studies. These solutions provide an indication of the overall capabilities of the STAGS nonlinear finite element analysis tool and provide users with representative cases, including input files, to explore these capabilities that may then be tailored to other applications.

  20. Patient stratification and identification of adverse event correlations in the space of 1190 drug related adverse events

    PubMed Central

    Roitmann, Eva; Eriksson, Robert; Brunak, Søren

    2014-01-01

    Purpose: New pharmacovigilance methods are needed as a consequence of the morbidity caused by drugs. We exploit fine-grained drug related adverse event information extracted by text mining from electronic medical records (EMRs) to stratify patients based on their adverse events and to determine adverse event co-occurrences. Methods: We analyzed the similarity of adverse event profiles of 2347 patients extracted from EMRs from a mental health center in Denmark. The patients were clustered based on their adverse event profiles and the similarities were presented as a network. The set of adverse events in each main patient cluster was evaluated. Co-occurrences of adverse events in patients (p-value < 0.01) were identified and presented as well. Results: We found that each cluster of patients typically had a most distinguishing adverse event. Examination of the co-occurrences of adverse events in patients led to the identification of potentially interesting adverse event correlations that may be further investigated as well as provide further patient stratification opportunities. Conclusions: We have demonstrated the feasibility of a novel approach in pharmacovigilance to stratify patients based on fine-grained adverse event profiles, which also makes it possible to identify adverse event correlations. Used on larger data sets, this data-driven method has the potential to reveal unknown patterns concerning adverse event occurrences. PMID:25249979

  1. Adversity and Resilience: A Synthesis of International Research

    ERIC Educational Resources Information Center

    Noltemeyer, Amity L.; Bush, Kevin R.

    2013-01-01

    Children and adolescents worldwide experience a variety of adversities that have the potential to disrupt typical development. However, some of these individuals exhibit resilience, evidencing normal development in the face of adversity. Here we review research on these constructs of risk, adversity, and resilience; synthesize international…

  2. 36 CFR 800.5 - Assessment of adverse effects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Assessment of adverse effects... PROTECTION OF HISTORIC PROPERTIES The section 106 Process § 800.5 Assessment of adverse effects. (a) Apply criteria of adverse effect. In consultation with the SHPO/THPO and any Indian tribe or Native...

  3. 21 CFR 606.170 - Adverse reaction file.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Adverse reaction file. 606.170 Section 606.170... Adverse reaction file. Link to an amendment published at 77 FR 18, Jan. 3, 2012. (a) Records shall be maintained of any reports of complaints of adverse reactions regarding each unit of blood or blood...

  4. 36 CFR 800.6 - Resolution of adverse effects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Resolution of adverse effects... PROTECTION OF HISTORIC PROPERTIES The section 106 Process § 800.6 Resolution of adverse effects. (a) Continue... the undertaking that could avoid, minimize, or mitigate adverse effects on historic properties....

  5. 7 CFR 1900.55 - Adverse action procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... REGULATIONS GENERAL Adverse Decisions and Administrative Appeals § 1900.55 Adverse action procedures. (a) If an applicant, guaranteed lender, a holder, borrower or grantee is adversely affected by a...

  6. Adverse effects of differential parental attention1

    PubMed Central

    Sajwaj, Thomas E.; Pinkston, Susan; Cordua, Glenn; Jackson, Carolyn; Herbert, Emily W.; Pinkston, Elsie M.; Hayden, M. Loeman

    1973-01-01

    In two independent parent training projects (Kansas and Mississippi), mothers of deviant young children were observed to follow almost all child behaviors with attention. The mothers were then trained to use differential attention procedures to increase their child's appropriate behaviors and to decrease deviant behaviors. Contrary to expectations, the differential attention procedure produced substantial increases in deviant behavior for four of the children. This adverse effect was maintained over many sessions and was replicated in single organism, reversal designs. A fifth child showed no change. A sixth child showed some improvement. However, this effect was not recovered in a second application of differential attention, and the child became worse. The results underline the importance of subject generality in applied behavior analysis and strongly suggest that service programs using operant techniques must carefully evaluate their effects on behavior. PMID:16795386

  7. D-Dimer elevation and adverse outcomes.

    PubMed

    Halaby, Rim; Popma, Christopher J; Cohen, Ander; Chi, Gerald; Zacarkim, Marcelo Rodrigues; Romero, Gonzalo; Goldhaber, Samuel Z; Hull, Russell; Hernandez, Adrian; Mentz, Robert; Harrington, Robert; Lip, Gregory; Peacock, Frank; Welker, James; Martin-Loeches, Ignacio; Daaboul, Yazan; Korjian, Serge; Gibson, C Michael

    2015-01-01

    D-Dimer is a biomarker of fibrin formation and degradation. While a D-dimer within normal limits is used to rule out the diagnosis of deep venous thrombosis and pulmonary embolism among patients with a low clinical probability of venous thromboembolism (VTE), the prognostic association of an elevated D-dimer with adverse outcomes has received far less emphasis. An elevated D-dimer is independently associated with an increased risk for incident VTE, recurrent VTE, and mortality. An elevated D-dimer is an independent correlate of increased mortality and subsequent VTE across a broad variety of disease states. Therefore, medically ill subjects in whom the D-dimer is elevated constitute a high risk subgroup in which the prospective evaluation of the efficacy and safety of antithrombotic therapy is warranted.

  8. Adverse reactions to the sulphite additives

    PubMed Central

    Misso, Neil LA

    2012-01-01

    Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Exposure to sulphites has been reported to induce a range of adverse clinical effects in sensitive individuals, ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. Exposure to the sulphites arises mainly from the consumption of foods and drinks that contain these additives; however exposure may also occur through the use of pharmaceutical products, as well as in occupational settings. Most studies report a prevalence of sulphite sensitivity of 3 to 10% among asthmatic subjects who ingest these additives. However, the severity of these reactions varies, and steroid-dependent asthmatics, those with marked airway hyperresponsiveness, and children with chronic asthma, appear to be at greater risk. Although a number of potential mechanisms have been proposed, the precise mechanisms underlying sulphite sensitivity remain unclear. PMID:24834193

  9. Adverse Risks Associated With Proton Pump Inhibitors

    PubMed Central

    2009-01-01

    Proton pump inhibitors (PPIs) are among the most commonly utilized agents for treatment of symptomatic disorders of the upper gastrointestinal tract, accounting for a significant proportion of sales of both over-the-counter and prescription formulations. A systematic review of the literature was conducted via MEDLINE to evaluate the most rigorous studies linking the potential risk of PPI therapy with adverse events. Emerging data illustrate the potential risks associated with both short-and long-term PPI therapy, including Clostridium difficile–associated diarrhea, community-acquired pneumonia, osteoporotic fracture, vitamin B12 deficiency, and inhibition of antiplatelet therapy. Due to these associations, it is recommended that clinicians assess the continuing need for PPI therapy and use the lowest possible dose to achieve the desired therapeutic goals.

  10. Vaccine adverse events: separating myth from reality.

    PubMed

    Kimmel, Sanford R

    2002-12-01

    Vaccines have turned many childhood diseases into distant memories in industrialized countries. However, questions have been raised about the safety of some vaccines because of rare but serious adverse effects that have been attributed to them. Pain, swelling, and redness at the injection site are common local reactions to vaccines. Fever and irritability may occur after some immunizations. Currently, no substantial evidence links measles-mumps-rubella vaccine to autism, or hepatitis B vaccine to multiple sclerosis. Thimerosal is being eliminated from routine childhood vaccines because of concerns that multiple immunizations with vaccines containing this preservative could exceed recommended mercury exposures. Family physicians should be knowledgeable about vaccines so that they can inform their patients of the benefits of immunization and any proven risks. If immunization rates fall, the incidence of vaccine-preventable illnesses may rise.

  11. Adverse Environments and Children's Creativity Development: Transforming the Notion of "Success in Adversity" in China

    ERIC Educational Resources Information Center

    Cheng, Li; Tan, Mei; Liu, Zhengkui

    2015-01-01

    China has been undergoing great social change due to its new focus on urbanization and globalization. Such change has had a tremendous adverse impact on the living conditions of millions of young children, simultaneously generating new interest in children's creativity development. The intersection of these two issues has important implications…

  12. Signal Detection of Adverse Drug Reaction of Amoxicillin Using the Korea Adverse Event Reporting System Database.

    PubMed

    Soukavong, Mick; Kim, Jungmee; Park, Kyounghoon; Yang, Bo Ram; Lee, Joongyub; Jin, Xue Mei; Park, Byung Joo

    2016-09-01

    We conducted pharmacovigilance data mining for a β-lactam antibiotics, amoxicillin, and compare the adverse events (AEs) with the drug labels of 9 countries including Korea, USA, UK, Japan, Germany, Swiss, Italy, France, and Laos. We used the Korea Adverse Event Reporting System (KAERS) database, a nationwide database of AE reports, between December 1988 and June 2014. Frequentist and Bayesian methods were used to calculate disproportionality distribution of drug-AE pairs. The AE which was detected by all the three indices of proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC) was defined as a signal. The KAERS database contained a total of 807,582 AE reports, among which 1,722 reports were attributed to amoxicillin. Among the 192,510 antibiotics-AE pairs, the number of amoxicillin-AE pairs was 2,913. Among 241 AEs, 52 adverse events were detected as amoxicillin signals. Comparing the drug labels of 9 countries, 12 adverse events including ineffective medicine, bronchitis, rhinitis, sinusitis, dry mouth, gastroesophageal reflux, hypercholesterolemia, gastric carcinoma, abnormal crying, induration, pulmonary carcinoma, and influenza-like symptoms were not listed on any of the labels of nine countries. In conclusion, we detected 12 new signals of amoxicillin which were not listed on the labels of 9 countries. Therefore, it should be followed by signal evaluation including causal association, clinical significance, and preventability.

  13. Signal Detection of Adverse Drug Reaction of Amoxicillin Using the Korea Adverse Event Reporting System Database

    PubMed Central

    2016-01-01

    We conducted pharmacovigilance data mining for a β-lactam antibiotics, amoxicillin, and compare the adverse events (AEs) with the drug labels of 9 countries including Korea, USA, UK, Japan, Germany, Swiss, Italy, France, and Laos. We used the Korea Adverse Event Reporting System (KAERS) database, a nationwide database of AE reports, between December 1988 and June 2014. Frequentist and Bayesian methods were used to calculate disproportionality distribution of drug-AE pairs. The AE which was detected by all the three indices of proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC) was defined as a signal. The KAERS database contained a total of 807,582 AE reports, among which 1,722 reports were attributed to amoxicillin. Among the 192,510 antibiotics-AE pairs, the number of amoxicillin-AE pairs was 2,913. Among 241 AEs, 52 adverse events were detected as amoxicillin signals. Comparing the drug labels of 9 countries, 12 adverse events including ineffective medicine, bronchitis, rhinitis, sinusitis, dry mouth, gastroesophageal reflux, hypercholesterolemia, gastric carcinoma, abnormal crying, induration, pulmonary carcinoma, and influenza-like symptoms were not listed on any of the labels of nine countries. In conclusion, we detected 12 new signals of amoxicillin which were not listed on the labels of 9 countries. Therefore, it should be followed by signal evaluation including causal association, clinical significance, and preventability. PMID:27510377

  14. The NAS Perchlorate Review: Adverse Effects?

    SciTech Connect

    Johnston, Richard B.; Corley, Richard; Cowan, Linda; Utiger, Robert D.

    2005-11-01

    To the editor: Drs. Ginsberg and Rice argue that the reference dose for perchlorate of 0.0007 mg/kg per day recommended by the National Academies’ Committee to Assess the Health Implications of Perchlorate Ingestion is not adequately protective. As members of the committee, we disagree. Ginsberg and Rice base their conclusion on three points. The first involves the designation of the point of departure as a NOEL (no-observed-effect level) versus a LOAEL (lowest-observed-adverse- effect level). The committee chose as its point of departure a dose of perchlorate (0.007 mg/kg per day) that when given for 14 days to 7 normal subjects did not cause a significant decrease in the group mean thyroid iodide uptake (Greer et al. 2002). Accordingly, the committee considered it a NOEL. Ginsberg and Rice focus on the fact that only 7 subjects were given that dose, and they 1seem to say that attention should be paid only to the results in those subjects in whom there was a 1fall in thyroid iodide uptake, and that the results in those in whom there was no fall or an increase should be ignored. They consider the dose to be a LOAEL because of the fall in uptake in those few subjects. It is important to note that a statistically significant decrease of, for example, 5% or even 10%, would not be biologically important and, more important, would not be sustained. For example, in another study (Braverman et al. 2004), administration of 0.04 mg/kg per day to normal subjects for 6 months had no effect on thyroid iodide uptake when measured at 3 and 6 months, and no effect on serum thyroid hormone or thyrotropin concentrations measured monthly (inspection of Figure 5A in the paper by Greer et al. suggests that this dose would inhibit thyroid iodide uptake by about 25% if measured at 2 weeks). The second issue involves database uncertainty. In clinical studies, perchlorate has been administered prospectively to 68 normal subjects for 2 weeks to 6 months. In one study (Brabant et al. 1992

  15. Latex allergies and adverse reactions: a review of the literature.

    PubMed

    Weesner, B W

    1997-04-01

    In the last few years, the allergenic potential of latex has been receiving greater attention. While latex allergies have been widely reported in the literature, the prevalence and severity have rapidly increased in the last few years. The role of rubber in the prevention of HIV infection has played a part in recognizing the allergenic potential, as with increased emphasis on infection control in the dental office has come an increase in complaints of adverse reactions to surgical gloves. A review of the literature reveals latex allergy problems to be not confined to gloves, but to articles of clothing, rubber dam material, and other latex-containing materials. Life-threatening cases have been reported. Little information in the literature concerns the extent of the problem among dental personnel. The dental professional may be faced with not only discomfort for the dental staff, but also compromising reactive possibilities in certain patients. There is a need for development of alternative protective products for the dental office, since elimination of barrier protection is not a viable alternative to infection control.

  16. Adverse drug reactions in older people: detection and prevention.

    PubMed

    Petrovic, Mirko; van der Cammen, Tischa; Onder, Graziano

    2012-06-01

    Adverse drug reactions (ADRs) in older adults are an important healthcare problem since they are frequently a cause of hospitalization, occur commonly during admission, and are an important cause of morbidity and mortality. Older adults are particularly susceptible to ADRs because they are usually on multiple drug regimens and because age is associated with changes in pharmacokinetics and pharmacodynamics. The presentation of an ADR in older adults is often atypical, which further complicates its recognition. One potential strategy for improving recognition of ADRs is to identify those patients who are at risk of an ADR. The recently developed GerontoNet ADR Risk Score is a practical tool for identification of older patients who are at increased risk for an ADR and who may represent a target for interventions aimed at reducing ADRs. Provision of adequate education in the domain of clinical geriatric pharmacology can improve recognition of ADRs. Besides formal surveillance systems, built-in computer programs with electronic prescribing databases and clinical pharmacist involvement in patient care within multidisciplinary geriatric teams might help to minimize the occurrence of ADRs. In addition, a number of actions can be taken in hospitals to stimulate appropriate prescribing and to assure adequate communication between primary and hospital care. In older adults with complex medical problems and needs, a global evaluation obtained through a comprehensive geriatric assessment may be helpful in simplifying drug prescription and prioritizing pharmacological and healthcare needs, resulting in an improvement in quality of prescribing.

  17. Adverse reactions triggered by dental local anesthetics: a clinical survey.

    PubMed Central

    Kaufman, E.; Goharian, S.; Katz, Y.

    2000-01-01

    One hundred and seventy-nine patients completed a questionnaire focusing on adverse reactions to dental local anesthetics as manifested by 16 signs and symptoms. Twenty-six percent of the participants reported having at least 1 adverse reaction. It was found that most of the adverse reactions occurred within the first 2 hours following the injection of local anesthetics. Pallor, palpitations, diaphoresis, and dizziness were the most common adverse reactions reported in the study. The results pointed to a significant relationship between anxiety, gender, injection technique, and procedure with a higher incidence of adverse reactions. PMID:11432179

  18. Physical activity to overcome the adversity of widowhood

    PubMed Central

    Li, Chu-Shiu; Lee, June Han; Chang, Ly-yun; Liu, Chwen-Chi; Chan, Yan-Lan; Wen, Christopher; Chiu, Mu-Lin; Tsai, Min Kuang; Tsai, Shan Pou; Wai, Jackson Pui Man; Tsao, Chwen Keng; Wu, Xifeng; Wen, Chi Pang

    2016-01-01

    Abstract Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows. A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results. The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles. Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life. PMID:27512856

  19. Adverse effects of outdoor pollution in the elderly.

    PubMed

    Simoni, Marzia; Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

    2015-01-01

    With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure

  20. Adverse effects of outdoor pollution in the elderly

    PubMed Central

    Baldacci, Sandra; Maio, Sara; Cerrai, Sonia; Sarno, Giuseppe; Viegi, Giovanni

    2015-01-01

    With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure

  1. A review of the adverse effects and safety of noradrenergic antidepressants.

    PubMed

    Whiskey, Eromona; Taylor, David

    2013-08-01

    There are a variety of noradrenergic antidepressants available, most of which act by inhibiting neuronal noradrenaline re-uptake, although few drugs are specific for this action. Where drugs have numerous actions the adverse effects of noradrenaline reuptake may be difficult to isolate, although in this respect the adverse effects of reboxetine, a specific noradrenaline re-uptake inhibitor, are illuminating. Noradrenergic antidepressants typically cause minor changes in blood and heart rate, sweating and insomnia. Other pharmacological actions shown by non-specific antidepressants may act to worsen or mitigate these adverse effects. Noradrenergic drugs are less likely than selective serotonin reuptake inhibitors (SSRIs) to cause sexual dysfunction but more likely to cause urinary hesitancy. Doubts remain over the relative propensity for antidepressants with different modes of action to cause diabetes and hyponatraemia. Noradrenergic actions do not seem to confer a risk of death in overdose.

  2. Defining risks and predicting adverse events after lower extremity bypass for critical limb ischemia

    PubMed Central

    Siracuse, Jeffrey J; Huang, Zhen S; Gill, Heather L; Parrack, Inkyong; Schneider, Darren B; Connolly, Peter H; Meltzer, Andrew J

    2014-01-01

    Successful treatment of patients with critical limb ischemia (CLI), hinges on the adequacy of revascularization. However, CLI is associated with a severe burden of systemic atherosclerosis, and patients often suffer from multiple cardiovascular comorbidities. Therefore, CLI patients in general represent a cohort at increased risk for procedural complications and adverse events. Although endovascular therapy represents a minimally invasive alternative to open surgical bypass, the durability of surgical reconstruction is superior, and it remains the “gold standard” approach to revascularization in CLI. Therefore, selection of the optimal treatment modality for individual patients requires careful consideration of the procedural risks and likelihood of adverse events associated with surgery. Individualized decision-making with regard to revascularization strategy requires a comprehensive understanding of the likelihood of adverse outcomes after major surgery. Here we review the risks of surgical bypass in patients with CLI, with particular emphasis on the identification of preoperative variables that predict poor outcome. PMID:25018636

  3. Cumulative early life adversity predicts longevity in wild baboons

    PubMed Central

    Tung, Jenny; Archie, Elizabeth A.; Altmann, Jeanne; Alberts, Susan C.

    2016-01-01

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations. PMID:27091302

  4. Cumulative early life adversity predicts longevity in wild baboons.

    PubMed

    Tung, Jenny; Archie, Elizabeth A; Altmann, Jeanne; Alberts, Susan C

    2016-04-19

    In humans and other animals, harsh circumstances in early life predict morbidity and mortality in adulthood. Multiple adverse conditions are thought to be especially toxic, but this hypothesis has rarely been tested in a prospective, longitudinal framework, especially in long-lived mammals. Here we use prospective data on 196 wild female baboons to show that cumulative early adversity predicts natural adult lifespan. Females who experience ≥3 sources of early adversity die a median of 10 years earlier than females who experience ≤1 adverse circumstances (median lifespan is 18.5 years). Females who experience the most adversity are also socially isolated in adulthood, suggesting that social processes partially explain the link between early adversity and adult survival. Our results provide powerful evidence for the developmental origins of health and disease and indicate that close ties between early adversity and survival arise even in the absence of health habit and health care-related explanations.

  5. Systematic Review: Adverse Events of Fecal Microbiota Transplantation

    PubMed Central

    Wang, Weiqiang; Cao, Xiaocang; Piao, Meiyu; Khan, Samiullah; Yan, Fang; Cao, Hailong; Wang, Bangmao

    2016-01-01

    Background Fecal microbiota transplantation (FMT) is a microbiota-based therapy that shows therapeutic potential in recurrent or refractory Clostridium difficile infections and other intestinal or extra-intestinal disorders. Nonetheless, adverse events (AEs) remain a major challenge in the application of FMT. Aim To review the AEs of FMT and to address the concerns of safety during the procedure. Methods Publications were retrieved in the databases of Medline, Embase and Cochrane Library. AEs were classified according to their causality with FMT or their severity. Results A total of 7562 original articles about FMT were identified in this study, 50 of them fulfilled the inclusion criteria. Totally 78 kinds of AEs were revealed enrolled in these 50 selected publications. The total incidence rate of AEs was 28.5%. Among the 42 publications, 5 kinds were definitely and 38 kinds were probably related to FMT. The commonest FMT-attributable AE was abdominal discomfort, which was reported in 19 publications. For upper gastrointestinal routes of FMT, 43.6% (89/204) patients were compromised by FMT-attributable AE, while the incidence dropped to 17.7% (76/430) for lower gastrointestinal routes. In contrast, the incidences of serious adverse events (SAEs) were 2.0% (4/196) and 6.1% (40/659) for upper and lower gastrointestinal routes, respectively. A total of 44 kinds of SAEs occurred in 9.2% patients, including death (3.5%, 38/1089), infection (2.5%, 27/1089), relapse of inflammatory bowel diseases (0.6%, 7/1089) and Clostridium difficile infection (0.9%, 10/1089). Conclusion Consequently, both AEs and SAEs are not rare and should be carefully monitored throughout FMT. However, high quality randomized controlled trials are still needed for the more definite incidence of AEs of FMT. PMID:27529553

  6. Dynamic Restructuring Of Problems In Artificial Intelligence

    NASA Technical Reports Server (NTRS)

    Schwuttke, Ursula M.

    1992-01-01

    "Dynamic tradeoff evaluation" (DTE) denotes proposed method and procedure for restructuring problem-solving strategies in artificial intelligence to satisfy need for timely responses to changing conditions. Detects situations in which optimal problem-solving strategies cannot be pursued because of real-time constraints, and effects tradeoffs among nonoptimal strategies in such way to minimize adverse effects upon performance of system.

  7. Future Directions in Childhood Adversity and Youth Psychopathology.

    PubMed

    McLaughlin, Katie A

    2016-01-01

    Despite long-standing interest in the influence of adverse early experiences on mental health, systematic scientific inquiry into childhood adversity and developmental outcomes has emerged only recently. Existing research has amply demonstrated that exposure to childhood adversity is associated with elevated risk for multiple forms of youth psychopathology. In contrast, knowledge of developmental mechanisms linking childhood adversity to the onset of psychopathology-and whether those mechanisms are general or specific to particular kinds of adversity-remains cursory. Greater understanding of these pathways and identification of protective factors that buffer children from developmental disruptions following exposure to adversity is essential to guide the development of interventions to prevent the onset of psychopathology following adverse childhood experiences. This article provides recommendations for future research in this area. In particular, use of a consistent definition of childhood adversity, integration of studies of typical development with those focused on childhood adversity, and identification of distinct dimensions of environmental experience that differentially influence development are required to uncover mechanisms that explain how childhood adversity is associated with numerous psychopathology outcomes (i.e., multifinality) and identify moderators that shape divergent trajectories following adverse childhood experiences. A transdiagnostic model that highlights disruptions in emotional processing and poor executive functioning as key mechanisms linking childhood adversity with multiple forms of psychopathology is presented as a starting point in this endeavour. Distinguishing between general and specific mechanisms linking childhood adversity with psychopathology is needed to generate empirically informed interventions to prevent the long-term consequences of adverse early environments on children's development.

  8. Long-term antidepressant use: patient perspectives of benefits and adverse effects

    PubMed Central

    Cartwright, Claire; Gibson, Kerry; Read, John; Cowan, Ondria; Dehar, Tamsin

    2016-01-01

    Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment. This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue. PMID:27528803

  9. The worldwide "wildfire" problem.

    PubMed

    Gill, A Malcolm; Stephens, Scott L; Cary, Geoffrey J

    2013-03-01

    The worldwide "wildfire" problem is headlined by the loss of human lives and homes, but it applies generally to any adverse effects of unplanned fires, as events or regimes, on a wide range of environmental, social, and economic assets. The problem is complex and contingent, requiring continual attention to the changing circumstances of stakeholders, landscapes, and ecosystems; it occurs at a variety of temporal and spatial scales. Minimizing adverse outcomes involves controlling fires and fire regimes, increasing the resistance of assets to fires, locating or relocating assets away from the path of fires, and, as a probability of adverse impacts often remains, assisting recovery in the short-term while promoting the adaptation of societies in the long-term. There are short- and long-term aspects to each aspect of minimization. Controlling fires and fire regimes may involve fire suppression and fuel treatments such as prescribed burning or non-fire treatments but also addresses issues associated with unwanted fire starts like arson. Increasing the resistance of assets can mean addressing the design and construction materials of a house or the use of personal protective equipment. Locating or relocating assets can mean leaving an area about to be impacted by fire or choosing a suitable place to live; it can also mean the planning of land use. Assisting recovery and promoting adaptation can involve insuring assets and sharing responsibility for preparedness for an event. There is no single, simple, solution. Perverse outcomes can occur. The number of minimizing techniques used, and the breadth and depth of their application, depends on the geographic mix of asset types. Premises for policy consideration are presented.

  10. Walking Problems

    MedlinePlus

    ... Parkinson's disease Diseases such as arthritis or multiple sclerosis Vision or balance problems Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

  11. Peripartum cocaine use and adverse pregnancy outcome.

    PubMed

    Little, Bertis B.; Snell, Laura M.; Trimmer, Kenneth J.; Ramin, Susan M.; Ghali, Fred; Blakely, Craig A.; Garret, Andrea

    1999-09-01

    The objective of the study was to analyze possible adverse effects of peripartum cocaine use on maternal and fetal outcomes. Informed consent was given by 720 (97%) of 740 women who delivered consecutively at a large urban public hospital to test an umbilical cord blood sample for the presence of non-medically administered drugs of abuse and alcohol and to be interviewed for the study. Samples were tested for the presence of a cocaine metabolite (benzoylecgonine-BZE) by radioimmunoassay. The presence of other substances of abuse (alcohol, methamphetamine, opiates) resulted in exclusion from the sample of 143 subjects. Thus, in this cohort analysis, drug-free controls (N = 469) were compared to those positive for cocaine only (N = 108). Peripartum exposure to cocaine only, and no other substances of abuse, was associated with an increased frequency of abruptio placentae (1.9% vs 0% for control, P < 0.004), thick meconium stained amniotic fluid (3.9% vs 0.7% for controls, P < 0.006), premature rupture of membranes (P < 0.02), genitourinary anomalies (OR = 3.6, P < 0.05), abdominal wall defects (OR = 4.4, P < 0.01) and increased frequency of low birth weight (OR = 2.0, P < 0.02). These are important findings because previous studies have been complicated by the confounding effects of other substances of abuse. Am. J. Hum. Biol. 11:598-602, 1999. Copyright 1999 Wiley-Liss, Inc.

  12. Constructing Adverse Outcome Pathways: a Demonstration of ...

    EPA Pesticide Factsheets

    Adverse outcome pathway (AOP) provides a conceptual framework to evaluate and integrate chemical toxicity and its effects across the levels of biological organization. As such, it is essential to develop a resource-efficient and effective approach to extend molecular initiating events (MIEs) of chemicals to their downstream phenotypes of a greater regulatory relevance. A number of ongoing public phenomics (high throughput phenotyping) efforts have been generating abundant phenotypic data annotated with ontology terms. These phenotypes can be analyzed semantically and linked to MIEs of interest, all in the context of a knowledge base integrated from a variety of ontologies for various species and knowledge domains. In such analyses, two phenotypic profiles (PPs; anchored by genes or diseases) each characterized by multiple ontology terms are compared for their semantic similarities within a common ontology graph, but across boundaries of species and knowledge domains. Taking advantage of publicly available ontologies and software tool kits, we have implemented an OS-Mapping (Ontology-based Semantics Mapping) approach as a Java application, and constructed a network of 19383 PPs as nodes with edges weighed by their pairwise semantic similarity scores. Individual PPs were assembled from public phenomics data. Out of possible 1.87×108 pairwise connections among these nodes, about 71% of them have similarity scores between 0.2 and the maximum possible of 1.0.

  13. Adapting biomarker technologies to adverse outcome ...

    EPA Pesticide Factsheets

    Adverse outcome pathways (AOP) research is a relatively new concept in human systems biology for assessing the molecular level linkage from an initiating (chemical) event that could lead to a disease state. Although most implementations of AOPs are based on liquids analyses, there are now new technologies being considered derived from the broad field of breath research, especially in applications of gas-phase analysis and instrumentation. The ultimate goal is to discover disease progressions in human or animal systems, identify them at the molecular or cellular level, and then choose analytes that can distinctly define the presence of a particular path (Ankley et al. 2010, Villeneuve et al. 2014). Once such in vivo pathways are identified, then in vitro assays can be developed for streamlined testing of chemical effects without additional human or animal based studies (Pleil et al. 2012). Recent work has focused on discovery analysis in breath, or other biological media, wherein as many as possible compounds are cataloged and then linked to their biochemical source as exogenous (external), endogenous (internal) or from the microbiome (Pleil et al. 2013a, de Lacy Costello 2014, Pleil et al. 2013b, Trefz et al. 2013, Pleil et al. 2014). Such research lays the groundwork for identifying compounds from systems biology that might be relevant for developing AOPs for in vitro research. The National Exposure Research Laboratory’s (NERL’s) Human Exposure and Atm

  14. [Management of adverse effects with antituberculosis chemotherapy].

    PubMed

    Tsuyuguchi, Kazunari; Wada, Masako

    2011-02-01

    Tuberculosis has now become a curable disease with chemotherapy. So it is natural that the present issues in tuberculosis management are focused on how to complete standard chemotherapy. In this context, management of adverse effects constitutes an essential part of antituberculosis chemotherapy, as well as directly observed therapy. In this symposium, discussions were held about three major subjects on this issue. First, hepatotoxicity develops frequently and has sometimes fatal outcome, which makes it the most problematic adverse effect. "Management of hepatotoxicity during antituberculosis chemotherapy" was published by the Japanese Society for Tuberculosis (JST) in 2006. Dr. Shinsho Yoshiba evaluated this recommendation and pointed out that the criteria for discontinuation of drug based on AST, ALT and bilirubin levels is too sensitive and the concept of predicting fulminant hepatic failure (FHF) is lacking. He stressed the importance of monitoring serum prothrombin time for predicting FHF. Next, allergic drug reaction such as fever or skin rash often causes distress, although rarely fatal. As isoniazid (INH) and rifampicin (RFP) are key drugs for the cure, readministration of these drugs is often attempted by desensitization therapy. "Recommendation about desensitization therapy of antituberculosis drugs" was also published by JST in 1997. Dr. Yoshihiro Kobashi reported high success rates of 79 percent for INH and 75 percent for RFP according to this recommendation. He also reported correlated factor with the success, such as the longer period from the discontinuation to the desensitization therapy and lower doses of drugs at starting desensitization. Finally, we sometimes experience transient worsening of radiographical findings and general symptoms during antituberculosis chemotherapy. This is presumed to be due to allergic reaction to dead bacilli without requiring discontinuation of the drug. Differential diagnosis includes drug-induced pneumonia requring

  15. Adverse immunologic effects of antithyroid drugs.

    PubMed Central

    Wing, S S; Fantus, I G

    1987-01-01

    Propylthiouracil and methimazole are frequently used in the management of hyperthyroidism. Two patients in whom adverse immunologic effects other than isolated agranulocytosis developed during treatment with propylthiouracil are described. A review of the literature revealed 53 similar cases over a 35-year period. Rash, fever, arthralgias and granulocytopenia were the most common manifestations. Vasculitis, particularly with cutaneous manifestations, occurs and may be fatal. The clinical evidence suggests that an immunologic mechanism is involved. A number of different autoantibodies were reported, but antinuclear antibodies were infrequent, and none of the cases met the criteria for a diagnosis of systemic lupus erythematosus. Thus, the reactions do not represent a true drug-induced lupus syndrome. Current hypotheses and experimental data regarding the cause of the reactions are reviewed. No specific clinical subgroup at high risk can be identified, and manifestations may occur at any dosage and at any time during therapy. Cross-reactivity between the two antithyroid drugs can be expected. Except for minor symptoms (e.g., mild arthralgias or transient rash), such reactions are an indication for withdrawal of the drug and the use of alternative methods to control the hyperthyroidism. In rare cases of severe vasculitis a short course of high-dose glucocorticoid therapy may be helpful. PMID:3539299

  16. Idiosyncratic Adverse Drug Reactions: Current Concepts

    PubMed Central

    Naisbitt, Dean J.

    2013-01-01

    Idiosyncratic drug reactions are a significant cause of morbidity and mortality for patients; they also markedly increase the uncertainty of drug development. The major targets are skin, liver, and bone marrow. Clinical characteristics suggest that IDRs are immune mediated, and there is substantive evidence that most, but not all, IDRs are caused by chemically reactive species. However, rigorous mechanistic studies are very difficult to perform, especially in the absence of valid animal models. Models to explain how drugs or reactive metabolites interact with the MHC/T-cell receptor complex include the hapten and P-I models, and most recently it was found that abacavir can interact reversibly with MHC to alter the endogenous peptides that are presented to T cells. The discovery of HLA molecules as important risk factors for some IDRs has also significantly contributed to our understanding of these adverse reactions, but it is not yet clear what fraction of IDRs have a strong HLA dependence. In addition, with the exception of abacavir, most patients who have the HLA that confers a higher IDR risk with a specific drug will not have an IDR when treated with that drug. Interindividual differences in T-cell receptors and other factors also presumably play a role in determining which patients will have an IDR. The immune response represents a delicate balance, and immune tolerance may be the dominant response to a drug that can cause IDRs. PMID:23476052

  17. Reporting vaccine-associated adverse events.

    PubMed Central

    Duclos, P.; Hockin, J.; Pless, R.; Lawlor, B.

    1997-01-01

    OBJECTIVE: To determine family physicians' awareness of the need to monitor and report vaccine-associated adverse events (VAAE) in Canada and to identify mechanisms that could facilitate reporting. DESIGN: Mailed survey. SETTING: Canadian family practices. PARTICIPANTS: Random sample of 747 family physicians. Overall response rate was 32% (226 of 717 eligible physicians). MAIN OUTCOME MEASURES: Access to education on VAAE; knowledge about VAAE monitoring systems, reporting criteria, and reporting forms; method of reporting VAAEs and reasons for not reporting them; and current experience with VAAEs. RESULTS: Of 226 respondents, 55% reported observing VAAEs, and 42% reported the event. Fewer than 50% were aware of a monitoring system for VAAE, and only 39% had had VAAE-related education during medical training. Only 28% knew the reporting criteria. Reporting was significantly associated with knowledge of VAAE monitoring systems and reporting criteria (P < 0.01). CONCLUSION: Physicians need more feedback and education on VAAE reporting and more information about the importance of reporting and about reporting criteria and methods. PMID:9303234

  18. Systematic Analysis of Adverse Event Reports for Sex Differences in Adverse Drug Events

    PubMed Central

    Yu, Yue; Chen, Jun; Li, Dingcheng; Wang, Liwei; Wang, Wei; Liu, Hongfang

    2016-01-01

    Increasing evidence has shown that sex differences exist in Adverse Drug Events (ADEs). Identifying those sex differences in ADEs could reduce the experience of ADEs for patients and could be conducive to the development of personalized medicine. In this study, we analyzed a normalized US Food and Drug Administration Adverse Event Reporting System (FAERS). Chi-squared test was conducted to discover which treatment regimens or drugs had sex differences in adverse events. Moreover, reporting odds ratio (ROR) and P value were calculated to quantify the signals of sex differences for specific drug-event combinations. Logistic regression was applied to remove the confounding effect from the baseline sex difference of the events. We detected among 668 drugs of the most frequent 20 treatment regimens in the United States, 307 drugs have sex differences in ADEs. In addition, we identified 736 unique drug-event combinations with significant sex differences. After removing the confounding effect from the baseline sex difference of the events, there are 266 combinations remained. Drug labels or previous studies verified some of them while others warrant further investigation. PMID:27102014

  19. Childhood adversity impacts on brain subcortical structures relevant to depression.

    PubMed

    Frodl, Thomas; Janowitz, Deborah; Schmaal, Lianne; Tozzi, Leonardo; Dobrowolny, Henrik; Stein, Dan J; Veltman, Dick J; Wittfeld, Katharina; van Erp, Theo G M; Jahanshad, Neda; Block, Andrea; Hegenscheid, Katrin; Völzke, Henry; Lagopoulos, Jim; Hatton, Sean N; Hickie, Ian B; Frey, Eva Maria; Carballedo, Angela; Brooks, Samantha J; Vuletic, Daniella; Uhlmann, Anne; Veer, Ilya M; Walter, Henrik; Schnell, Knut; Grotegerd, Dominik; Arolt, Volker; Kugel, Harald; Schramm, Elisabeth; Konrad, Carsten; Zurowski, Bartosz; Baune, Bernhard T; van der Wee, Nic J A; van Tol, Marie-Jose; Penninx, Brenda W J H; Thompson, Paul M; Hibar, Derrek P; Dannlowski, Udo; Grabe, Hans J

    2017-03-01

    Childhood adversity plays an important role for development of major depressive disorder (MDD). There are differences in subcortical brain structures between patients with MDD and healthy controls, but the specific impact of childhood adversity on such structures in MDD remains unclear. Thus, aim of the present study was to investigate whether childhood adversity is associated with subcortical volumes and how it interacts with a diagnosis of MDD and sex. Within the ENIGMA-MDD network, nine university partner sites, which assessed childhood adversity and magnetic resonance imaging in patients with MDD and controls, took part in the current joint mega-analysis. In this largest effort world-wide to identify subcortical brain structure differences related to childhood adversity, 3036 participants were analyzed for subcortical brain volumes using FreeSurfer. A significant interaction was evident between childhood adversity, MDD diagnosis, sex, and region. Increased exposure to childhood adversity was associated with smaller caudate volumes in females independent of MDD. All subcategories of childhood adversity were negatively associated with caudate volumes in females - in particular emotional neglect and physical neglect (independently from age, ICV, imaging site and MDD diagnosis). There was no interaction effect between childhood adversity and MDD diagnosis on subcortical brain volumes. Childhood adversity is one of the contributors to brain structural abnormalities. It is associated with subcortical brain abnormalities that are relevant to psychiatric disorders such as depression.

  20. Future Directions in Childhood Adversity and Youth Psychopathology

    PubMed Central

    McLaughlin, Katie A.

    2016-01-01

    Despite long-standing interest in the influence of adverse early experiences on mental health, systematic scientific inquiry into childhood adversity and developmental outcomes has emerged only recently. Existing research has amply demonstrated that exposure to childhood adversity is associated with elevated risk for multiple forms of youth psychopathology. In contrast, knowledge of developmental mechanisms linking childhood adversity to the onset of psychopathology—and whether those mechanisms are general or specific to particular kinds of adversity—remains cursory. Greater understanding of these pathways and identification of protective factors that buffer children from developmental disruptions following exposure to adversity is essential to guide the development of interventions to prevent the onset of psychopathology following adverse childhood experiences. This article provides recommendations for future research in this area. In particular, use of a consistent definition of childhood adversity, integration of studies of typical development with those focused on childhood adversity, and identification of distinct dimensions of environmental experience that differentially influence development are required to uncover mechanisms that explain how childhood adversity is associated with numerous psychopathology outcomes (i.e., multifinality) and identify moderators that shape divergent trajectories following adverse childhood experiences. A transdiagnostic model that highlights disruptions in emotional processing and poor executive functioning as key mechanisms linking childhood adversity with multiple forms of psychopathology is presented as a starting point in this endeavour. Distinguishing between general and specific mechanisms linking childhood adversity with psychopathology is needed to generate empirically informed interventions to prevent the long-term consequences of adverse early environments on children’s development. PMID:26849071

  1. Practitioner Review: Early Adversity and Developmental Disorders

    ERIC Educational Resources Information Center

    Taylor, Eric; Rogers, Jody Warner

    2005-01-01

    Background: Knowledge of genetic influences, on developmental disorders such as autism spectrum, attention deficit/hyperactivity disorder and learning disabilities, has increased the opportunities for understanding the influences of the early environment. Methods: This paper provides a selective, narrative review for clinicians of the effects of…

  2. Safety profile and protocol prevention of adverse reactions to uroangiographic contrast media in diagnostic imaging.

    PubMed

    Rossi, C; Reginelli, A; D'Amora, M; Di Grezia, G; Mandato, Y; D'Andrea, A; Brunese, L; Grassi, R; Rotondi, A

    2014-01-01

    The purpose of the study is to examine the incidence of adverse reactions caused by non-ionic contrast media in selected patients after desensitization treatment and to evaluate the safety profile of organ iodine contrast media (i.c.m.) in a multistep prevention protocol. In a population of 2000 patients that had received a CT scan, 100 patients with moderate/high risk for adverse reactions against iodinated contrast agents followed a premedication protocol and all adverse reactions are reported and classified as mild, moderate or severe. 1.7 percent of the pre-treated patients reported a mild, immediate type reaction to iodine contrast; of these five patients with allergy 0.71 percent had received iomeprol, 0.35 percent received ioversol and 0.71 percent received iopromide. The incidence of adverse reactions was reported to be higher (4 out of 5 patients) among those that referred a history of hypersensitivity against iodinated i.c.m. Although intravenous contrast materials have greatly improved, especially in terms of their safety profile, they should not be administered if there isn't a clear or justified indication. In conclusion, even if we know that the majority of these reactions are idiosyncratic and unpredictable we propose, with the aim of improving our knowledge on this subject, a multicenter study, based on skin allergy tests (prick test, patch test, intradermal reaction) in selected patients that have had previous experiences of hypersensitivity against parenteral organ iodine contrast media.

  3. Parameter Selection Methods in Inverse Problem Formulation

    DTIC Science & Technology

    2010-11-03

    therapy levels, with u(t) = 0 for fully off and u(t) = 1, for fully on. Although HIV treatment is nearly always administered as combination therapy...Davidian, and E.S. Rosenberg, Model fitting and predic- tion with HIV treatment interruption data, CRSC-TR05-40, NCSU, October 2005; Bull. Math

  4. Problems of Technical Electrodynamics (Selected Articles),

    DTIC Science & Technology

    1984-04-11

    the maximum temperature is measured at the depth of 8-10 mm from the end/face of core (axis II). This is explained-by the - screening effect of the...sharply descends in proportion to removal/distance in the direction of back, for the pressure collar, which plays the role of screen . On the basis of...value Ba. almost is three times less than in the zone of crown; in the region of the back, shielded by the pressure/clamping collar, which works as screen

  5. Selected supplies prognosis problems of aviation techniques

    NASA Astrophysics Data System (ADS)

    Żurek, J.; Czapla, R.

    2016-06-01

    Aviation technology, i.e. aircraft, control and airfield infrastructure wear out, become defective and need servicing. It seems indispensible to maintain facilities and spare parts at a level necessary to keep the technology in commission. The paper discusses the factors influencing spare parts supply requirements to secure air operations. Aviation technology has been classified with regard to various criteria, which influence the choice of supply management strategies, along with availability and aircraft exploitation cost. The method of optimization of the stock for a complex system characterized by series reliability structure according to the wear-out and cost criteria assuming Poisson's process of demand has been presented.

  6. Gender Differences in the Physical and Psychological Manifestation of Childhood Trauma and/or Adversity in People with Psychosis

    PubMed Central

    Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Shah, Sonal S.; Galletly, Cherrie

    2015-01-01

    The link between childhood trauma and/or adversity and risk of psychosis is well known. Our aim was to determine the prevalence of childhood trauma and/or adversity in people who have psychotic disorders and to investigate the association between childhood trauma and/or adversity and a range of social and health measures. Participants (n = 391, 42% male) were specifically asked about any experience of childhood trauma and/or adversity. Respondents provided information about education, employment, physical health, and health service utilization. Univariate analyses revealed that childhood trauma and/or adversity was associated with poorer levels of self-reported physical health and social problems. This includes the experience of chronic pain, headaches, arthritis, asthma, and victimization/stigma in men. Participants with a childhood trauma and/or adversity history indicated higher rates of lifetime suicide attempts with women reporting more lifetime depressive symptoms. Multivariate analyses revealed differing profiles in relation to physical and psychological health variable between males and females. Males with the experience of childhood trauma and/or adversity were significantly more likely to report cardiovascular/stroke issues, migraines and anhedonia. Females with the experience of childhood trauma and/or adversity were more likely to report a lifetime history of elevated mood and to be married or in a de facto relationship. There has been very little research into the assessment and treatment of the effects of childhood trauma and/or adversity in adults with psychosis. Childhood trauma and/or adversity may contribute to higher rates of self-reported poor health in men and is associated with increased depression in women. Our findings suggest that interventions to address the effects of past trauma are urgently needed. PMID:26635676

  7. Gender Differences in the Physical and Psychological Manifestation of Childhood Trauma and/or Adversity in People with Psychosis.

    PubMed

    Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Galletly, Cherrie

    2015-01-01

    The link between childhood trauma and/or adversity and risk of psychosis is well known. Our aim was to determine the prevalence of childhood trauma and/or adversity in people who have psychotic disorders and to investigate the association between childhood trauma and/or adversity and a range of social and health measures. Participants (n = 391, 42% male) were specifically asked about any experience of childhood trauma and/or adversity. Respondents provided information about education, employment, physical health, and health service utilization. Univariate analyses revealed that childhood trauma and/or adversity was associated with poorer levels of self-reported physical health and social problems. This includes the experience of chronic pain, headaches, arthritis, asthma, and victimization/stigma in men. Participants with a childhood trauma and/or adversity history indicated higher rates of lifetime suicide attempts with women reporting more lifetime depressive symptoms. Multivariate analyses revealed differing profiles in relation to physical and psychological health variable between males and females. Males with the experience of childhood trauma and/or adversity were significantly more likely to report cardiovascular/stroke issues, migraines and anhedonia. Females with the experience of childhood trauma and/or adversity were more likely to report a lifetime history of elevated mood and to be married or in a de facto relationship. There has been very little research into the assessment and treatment of the effects of childhood trauma and/or adversity in adults with psychosis. Childhood trauma and/or adversity may contribute to higher rates of self-reported poor health in men and is associated with increased depression in women. Our findings suggest that interventions to address the effects of past trauma are urgently needed.

  8. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects.

    PubMed

    Streissguth, Ann P; Bookstein, Fred L; Barr, Helen M; Sampson, Paul D; O'Malley, Kieran; Young, Julia Kogan

    2004-08-01

    Clinical descriptions of patients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) suggest major problems with adaptive behavior. Five operationally defined adverse outcomes and 18 associated risk/protective factors were examined using a Life History Interview with knowledgeable informants of 415 patients with FAS or FAE (median age 14 years, range 6-51; median IQ 86, range 29-126). Eighty percent of these patients were not raised by their biological mothers. For adolescents and adults, the life span prevalence was 61% for Disrupted School Experiences, 60% for Trouble with the Law, 50% for Confinement (in detention, jail, prison, or a psychiatric or alcohol/drug inpatient setting), 49% for Inappropriate Sexual Behaviors on repeated occasions, and 35% for Alcohol/Drug Problems. The odds of escaping these adverse life outcomes are increased 2- to 4-fold by receiving the diagnosis of FAS or FAE at an earlier age and by being reared in good stable environments.

  9. 21 CFR 803.52 - If I am a manufacturer, what information must I submit in my individual adverse event reports?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Patient gender; and (4) Patient weight. (b) Adverse event or product problem (Form 3500A, Block B). You... intervention to prevent permanent impairment of a body structure or function; (3) Date of event; (4) Date...

  10. 21 CFR 803.42 - If I am an importer, what information must I submit in my individual adverse event reports?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of birth; (3) Patient gender; and (4) Patient weight. (b) Adverse event or product problem (Form... that requires intervention to prevent permanent impairment of a body structure or function; (3) Date...

  11. 21 CFR 803.32 - If I am a user facility, what information must I submit in my individual adverse event reports?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Patient gender; and (4) Patient weight. (b) Adverse event or product problem (Form 3500A, Block B). You... intervention to prevent permanent impairment of a body structure or function; (3) Date of event; (4) Date...

  12. The Problems of Problem Solving

    ERIC Educational Resources Information Center

    Watson, Charles E.

    1976-01-01

    Discusses some common pitfalls in problem-solving and outlines three basic approaches to successfully identifying problems and their causes. (Available from Business Horizons, School of Business, Indiana University, Bloomington, Indiana 47401; $2.50, single copy) (Author/JG)

  13. Mechanisms of adverse drug reactions to biologics.

    PubMed

    Clarke, Janet B

    2010-01-01

    Biologics encompass a broad range of therapeutics that include proteins and other products derived from living systems. Although the multiplicity of target organs often seen with new chemical entities is generally not seen with biologics, they can produce significant adverse reactions. Examples include IL-12 and an anti-CD28 antibody that resulted in patient deaths and/or long stays in intensive care units. Mechanisms of toxicities can be categorized as pharmacological or nonpharmacological, with most, excepting hypersensitivity reactions, associated with the interaction of the agent with its planned target. Unexpected toxicities generally arise as a result of previously unknown biology. Manufacturing quality is a significant issue relative to the toxicity of biologics. The development of recombinant technology represented the single biggest advance leading to humanized products with minimal or no contaminants in comparison to products purified from animal tissues. Nevertheless, the type of manufacturing process including choice of cell type, culture medium, and purification method can result in changes to the protein. For example, a change to the closure system for erythropoietin led to an increase in aplastic anemia as a result of changing the immunogenicity characteristics of the protein. Monoclonal antibodies represent a major class of successful biologics. Toxicities associated with these agents include those associated with the binding of the complementary determining region (CDR) with the target. First dose reactions or infusion reactions are generally thought to be mediated via the Fc region of the antibody activating cytokine release, and have been observed with several antibodies. Usually, these effects (flu-like symptoms, etc.) are transient with subsequent dosing. Although biologics can have nonpharmacologic toxicities, these are less common than with small molecule drugs.

  14. Adverse effects of cow's milk in infants.

    PubMed

    Ziegler, Ekhard E

    2007-01-01

    The feeding of cow's milk has adverse effects on iron nutrition in infants and young children. Several different mechanisms have been identified that may act synergistically. Probably most important is the low iron content of cow's milk. It makes it difficult for the infant to obtain the amounts of iron needed for growth. A second mechanism is the occult intestinal blood loss, which occurs in about 40% of normal infants during feeding of cow's milk. Loss of iron in the form of blood diminishes with age and ceases after 1 year of age. A third factor is calcium and casein provided by cow's milk in high amounts. Calcium and casein both inhibit the absorption of dietary nonheme iron. Infants fed cow's milk receive much more protein and minerals than they need. The excess has to be excreted in the urine. The high renal solute load leads to higher urine concentration during the feeding of cow's milk than during the feeding of breast milk or formula. When fluid intakes are low and/or when extrarenal water losses are high, the renal concentrating ability of infants may be insufficient for maintaining water balance in the face of high water use for excretion of the high renal solute. The resulting negative water balance, if prolonged, can lead to serious dehydration. There is strong epidemiological evidence that the feeding of cow's milk or formulas with similarly high potential renal solute load places infants at an increased risk of serious dehydration. The feeding of cow's milk to infants is undesirable because of cow's milk's propensity to lead to iron deficiency and because it unduly increases the risk of severe dehydration.

  15. The Neurobiology of Intervention and Prevention in Early Adversity.

    PubMed

    Fisher, Philip A; Beauchamp, Kate G; Roos, Leslie E; Noll, Laura K; Flannery, Jessica; Delker, Brianna C

    2016-01-01

    Early adverse experiences are well understood to affect development and well-being, placing individuals at risk for negative physical and mental health outcomes. A growing literature documents the effects of adversity on developing neurobiological systems. Fewer studies have examined stress neurobiology to understand how to mitigate the effects of early adversity. This review summarizes the research on three neurobiological systems relevant to interventions for populations experiencing high levels of early adversity: the hypothalamic-adrenal-pituitary axis, the prefrontal cortex regions involved in executive functioning, and the system involved in threat detection and response, particularly the amygdala. Also discussed is the emerging field of epigenetics and related interventions to mitigate early adversity. Further emphasized is the need for intervention research to integrate knowledge about the neurobiological effects of prenatal stressors (e.g., drug use, alcohol exposure) and early adversity. The review concludes with a discussion of the implications of this research topic for clinical psychology practice and public policy.

  16. The adverse health effects of chronic cannabis use.

    PubMed

    Hall, Wayne; Degenhardt, Louisa

    2014-01-01

    This paper summarizes the most probable of the adverse health effects of regular cannabis use sustained over years, as indicated by epidemiological studies that have established an association between cannabis use and adverse outcomes; ruled out reverse causation; and controlled for plausible alternative explanations. We have also focused on adverse outcomes for which there is good evidence of biological plausibility. The focus is on those adverse health effects of greatest potential public health significance--those that are most likely to occur and to affect a substantial proportion of regular cannabis users. These most probable adverse effects of regular use include a dependence syndrome, impaired respiratory function, cardiovascular disease, adverse effects on adolescent psychosocial development and mental health, and residual cognitive impairment.

  17. Reporting hospital adverse events using the Alfred Hospital's morbidity data.

    PubMed

    Carroll, Rhonda; McLean, Jenny; Walsh, Michael

    2003-01-01

    Hospital morbidity data were analysed to determine their usefulness for reporting adverse events. The entire ICD-10-AM classification system was reviewed in conjunction with the Australian Coding Standards to identify external cause codes and code prefixes associated with adverse events. For the 50,712 separations registered at The Alfred from July 2000-June 2001, 4,740 external cause codes were associated with adverse events. Place of occurrence code CY92.22 was considered the best indicator of the number of separations associated with adverse events. Approximately 4% of all separations were associated with adverse events occurring during an episode of care. Results suggest that hospital morbidity data are useful for monitoring adverse events at hospital level. Reliable reporting across the health care industry requires consistent reporting requirements at state and national levels and the adoption of standard code prefixes nationally.

  18. Nature of preventable adverse drug events in hospitals: a literature review.

    PubMed

    Kanjanarat, Penkarn; Winterstein, Almut G; Johns, Thomas E; Hatton, Randy C; Gonzalez-Rothi, Ricardo; Segal, Richard

    2003-09-01

    A literature review was conducted to identify the drug classes, types of errors, and types of adverse outcomes related to preventable adverse drug events (pADEs). Studies were identified by keyword search of MEDLINE and International Pharmaceutical Abstracts and by a manual search. The search was limited to peer-reviewed literature reporting pADEs in hospitalized patients and the frequencies of at least one pADE characteristic. The frequencies of pADEs and their characteristics were summarized using median and range. Ten studies published between 1994 and 2001 were included in the review. The reported median frequency of pADEs was 1.8% (range, 1.3-7.8%), and the median preventability rate of ADEs in the hospitals was 35.2% (range, 18.7-73.2%). Cardiovascular drugs were implicated for 17.9% of pADEs (range, 4.3-28.1%). Most pADEs occurred in the prescribing stage of the medication-use process and were dose related. Inappropriate prescribing decisions and patient monitoring were the most frequently identified causes of pADEs. The most common adverse outcomes were allergic reactions, hepatic or renal problems, cardiovascular problems, hematologic problems and bleeding, and central nervous system problems. Frequently reported examples of pADEs included antihypertensive overdose associated with bradycardia or hypotension, antiinfectives prescribed despite a history of allergy, warfarin overdose and inappropriate monitoring resulting in hemorrhage, and opioid overdose or underdose associated with respiratory depression or poor pain control, respectively. Despite the heterogeneity of pADEs, the results of this literature review suggest that a few types of drugs, errors, and adverse outcomes constitute a substantial proportion of pADEs. Targeting these high-priority areas could significantly reduce the overall frequency of pADEs.

  19. Potential Adverse Effects of Competitive Prototype Validation

    DTIC Science & Technology

    1974-11-01

    dearth of literature on this subject, the best source of information was the persons charged with materiel acquisition responsibilities in the U.S. Army...that the best method of collecting information on this subject was by personal interview with knowledgeable persons . The persons selecte for interview...program experience prior to being asked. Names of persone interviewed are in the bibliography. The objective of interviewing General Miley was twofold

  20. Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impairment in Youth Referred For Trauma-Specific Services.

    PubMed

    Grasso, Damion J; Dierkhising, Carly B; Branson, Christopher E; Ford, Julian D; Lee, Robert

    2016-07-01

    By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.