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Sample records for aids defining illness

  1. HIV positive patients first presenting with an AIDS defining illness: characteristics and survival.

    PubMed Central

    Poznansky, M. C.; Coker, R.; Skinner, C.; Hill, A.; Bailey, S.; Whitaker, L.; Renton, A.; Weber, J.

    1995-01-01

    OBJECTIVES--To study the presentation and survival of patients who present with their first diagnosis of being HIV positive at the same time as their AIDS defining illness. DESIGN--Retrospective study of patients presenting with AIDS between 1991 and 1993. SETTING--Department of genitourinary medicine, St Mary's Hospital, London. MAIN OUTCOME MEASURES--AIDS defining illness at presentation and survival after diagnosis of AIDS. RESULTS--Between January 1991 and December 1993, 97 out of 436 patients (22%) presented with their first AIDS defining illness coincident with their first positive result of an HIV test (group B). The remaining 339 patients (78%) had tested positive for HIV-1 infection within the previous eight years and had consequently been followed up in clinics before developing their first AIDS defining illness (group A). The two groups of patients did not differ in age and sex distribution, risk factors for HIV-1 infection, nationality, country of origin, or haematological variables determined at the time of the AIDS defining illness. However, the defining illnesses differed between the two groups. Illnesses associated with severe immunodeficiency (the wasting syndrome, cryptosporidiosis, and cytomegalovirus infection) were seen almost exclusively in group A whereas extrapulmonary tuberculosis and Pneumocystis carinii pneumonia were more common in group B. The survival of patients in group B after the onset of AIDS was significantly longer than that of patients in group A as determined by Kaplan-Meier log rank analysis (P = 0.0026). CONCLUSIONS--Subjects who are HIV positive and present late are a challenge to the control of the spread of HIV infection because they progress from asymptomatic HIV infection to AIDS without receiving health care. The finding that presentation with an AIDS defining illness coincident with a positive result in an HIV test did not have a detrimental effect on survival gives insights into the effects of medical intervention on

  2. AIDS-defining opportunistic illnesses in the HAART era in New York City.

    PubMed

    Hanna, D B; Gupta, L S; Jones, L E; Thompson, D M; Kellerman, S E; Sackoff, J E

    2007-02-01

    Despite widespread availability of HAART, opportunistic illnesses (OIs) still occur and result in an increased risk of mortality among persons with AIDS. We estimated the incidence of OIs among all new adult AIDS cases in New York City in 2000 overall and in demographic and clinical subgroups and identified factors associated with occurrence of an AIDS-defining OI versus AIDS diagnosis based on low CD4+ values only. In 2000, 5,451 new AIDS cases were reported to the New York City Department of Health and Mental Hygiene. Of these 27.4% (95% CI: 22.8-32.6) had at least one OI, most frequent being Pneumocystis jiroveci pneumonia (12.2%) and M. tuberculosis (5.3%); 47.1% (41.7-52.5) had a late HIV diagnosis (i.e.< or =6 months before AIDS diagnosis). Persons with a late HIV diagnosis not in recent care had a 3.5-fold increased odds (1.29-9.63) of an OI, compared to non-late testers in care. Other predictors of an OI were injection drug use and older age. We conclude that OIs remain prevalent in the HAART era and late testers not in care are especially likely to develop an OI. Our results support comprehensive HIV programs promoting early HIV testing and linkage to care to prevent OI-related morbidity and mortality.

  3. Unreported AIDS-defining opportunistic illnesses in persons reported with HIV-related severe immunosuppression.

    PubMed

    Lobato, M N; Klevens, R M; Li, J; Slutsker, L; Fleming, P L

    1999-09-01

    To better estimate the distribution of AIDS cases after the 1993 change in the case definition, we assessed the proportion of persons whose AIDS diagnosis was based on laboratory criteria for severe immunosuppression (CD4 count <200 cells/microl or <14%) and who also had an unreported opportunistic illness (OI) at the time of the CD4 report. Five U.S. reporting sites (Arizona; Los Angeles County, California; New Jersey; Oregon; and Washington State) reviewed AIDS cases reported between January 1 and June 30, 1993. From these sites, 3289 immunologic cases were reported; of these cases, 322 (9.8%; range, 1.6%-16.1%) were in persons who had an unreported OI. More of those who had an unreported OI were male, members of racial groups other than white, injection drug users, and had a CD4 count of <50 cells/microl at AIDS diagnosis. Because of recent advances in OI prophylaxis and treatment of HIV infection, studies monitoring HIV-related morbidity should assess the occurrence of OIs in a sample of persons reported with HIV and severe immunosuppression. Such assessment will ensure representative ascertainment of initial AIDS-defining OIs and thus improve the usefulness of the data for public health planning and the allocation of resources for patient care.

  4. A structured approach to recording AIDS-defining illnesses in Kenya: A SNOMED CT based solution

    PubMed Central

    Oluoch, Tom; de Keizer, Nicolette; Langat, Patrick; Alaska, Irene; Ochieng, Kenneth; Okeyo, Nicky; Kwaro, Daniel; Cornet, Ronald

    2016-01-01

    Introduction Several studies conducted in sub-Saharan Africa (SSA) have shown that routine clinical data in HIV clinics often have errors. Lack of structured and coded documentation of diagnosis of AIDS defining illnesses (ADIs) can compromise data quality and decisions made on clinical care. Methods We used a structured framework to derive a reference set of concepts and terms used to describe ADIs. The four sources used were: (i) CDC/Accenture list of opportunistic infections, (ii) SNOMED Clinical Terms (SNOMED CT), (iii) Focus Group Discussion (FGD) among clinicians and nurses attending to patients at a referral provincial hospital in western Kenya, and (iv) chart abstraction from the Maternal Child Health (MCH) and HIV clinics at the same hospital. Using the January 2014 release of SNOMED CT, concepts were retrieved that matched terms abstracted from approach iii & iv, and the content coverage assessed. Post-coordination matching was applied when needed. Results The final reference set had 1054 unique ADI concepts which were described by 1860 unique terms. Content coverage of SNOMED CT was high (99.9% with pre-coordinated concepts; 100% with post-coordination). The resulting reference set for ADIs was implemented as the interface terminology on OpenMRS data entry forms. Conclusion Different sources demonstrate complementarity in the collection of concepts and terms for an interface terminology. SNOMED CT provides a high coverage in the domain of ADIs. Further work is needed to evaluate the effect of the interface terminology on data quality and quality of care. PMID:26184057

  5. Risk factors for AIDS-defining illnesses among a population of poorly adherent people living with HIV/AIDS in Atlanta, Georgia.

    PubMed

    Chow, Jeremy Y; Alsan, Marcella; Armstrong, Wendy; del Rio, Carlos; Marconi, Vincent C

    2015-01-01

    In order to achieve the programmatic goals established in the National HIV/AIDS Strategy, virologic suppression remains the most important outcome within the HIV care continuum for individuals receiving antiretroviral therapy (ART). Therefore, clinicians have dedicated substantial resources to improve adherence and clinic retention for individuals on ART; however, these efforts should be focused first on those most at risk of morbidity and mortality related to AIDS. Our study aimed to characterize the factors that are associated with AIDS-defining illnesses (ADIs) amongst people living with HIV (PLHIV) who are poorly adherent or retained in care in order to identify those at highest risk of poor clinical outcomes. We recruited 99 adult PLHIV with a history of poor adherence to ART, poor clinic attendance, or unsuppressed viral load (VL) from the Infectious Disease Program (IDP) of the Grady Health System in Atlanta, Georgia between January and May 2011 to participate in a survey investigating the acceptability of a financial incentive for improving adherence. Clinical outcomes including the number of ADI episodes in the last five years, VLs, and CD4 counts were abstracted from medical records. Associations between survey items and number of ADIs were performed using chi-square analysis. In our study, 36.4% of participants had ≥1 ADI in the last five years. The most common ADIs were Pneumocystis jirovecii pneumonia, recurrent bacterial pneumonia, and esophageal candidiasis. Age <42.5 years (OR 2.52, 95% CI = 1.08-5.86), male gender (OR 3.51, 95% CI = 1.08-11.34), CD4 nadir <200 cells/µL (OR 11.92, 95% CI = 1.51-94.15), unemployment (OR 3.54, 95% CI = 1.20-10.40), and travel time to clinic <30 minutes (OR 2.80, 95% CI = 1.20-6.52) were all significantly associated with a history of ≥1 ADI in the last five years. Awareness of factors associated with ADIs may help clinicians identify which poorly adherent PLHIV are at highest risk of HIV-related morbidity.

  6. When to Initiate Combined Antiretroviral Therapy to Reduce Mortality and AIDS-Defining Illness in HIV-Infected Persons in Developed Countries

    PubMed Central

    2012-01-01

    Background Most clinical guidelines recommend that AIDS-free, HIV-infected persons with CD4 cell counts below 0.350 × 109 cells/L initiate combined antiretroviral therapy (cART), but the optimal CD4 cell count at which cART should be initiated remains a matter of debate. Objective To identify the optimal CD4 cell count at which cART should be initiated. Design Prospective observational data from the HIV-CAUSAL Collaboration and dynamic marginal structural models were used to compare cART initiation strategies for CD4 thresholds between 0.200 and 0.500 × 109 cells/L. Setting HIV clinics in Europe and the Veterans Health Administration system in the United States. Patients 20 971 HIV-infected, therapy-naive persons with baseline CD4 cell counts at or above 0.500 × 109 cells/L and no previous AIDS-defining illnesses, of whom 8392 had a CD4 cell count that decreased into the range of 0.200 to 0.499 × 109 cells/L and were included in the analysis. Measurements Hazard ratios and survival proportions for all-cause mortality and a combined end point of AIDS-defining illness or death. Results Compared with initiating cART at the CD4 cell count threshold of 0.500 × 109 cells/L, the mortality hazard ratio was 1.01 (95% CI, 0.84 to 1.22) for the 0.350 threshold and 1.20 (CI, 0.97 to 1.48) for the 0.200 threshold. The corresponding hazard ratios were 1.38 (CI, 1.23 to 1.56) and 1.90 (CI, 1.67 to 2.15), respectively, for the combined end point of AIDS-defining illness or death. Limitations CD4 cell count at cART initiation was not randomized. Residual confounding may exist. Conclusion Initiation of cART at a threshold CD4 count of 0.500 × 109 cells/L increases AIDS-free survival. However, mortality did not vary substantially with the use of CD4 thresholds between 0.300 and 0.500 ×109 cells/L. Primary Funding Source National Institutes of Health. PMID:21502648

  7. Clinical Deterioration during Antitubercular Treatment at a District Hospital in South Africa: The Importance of Drug Resistance and AIDS Defining Illnesses

    PubMed Central

    Pepper, Dominique J.; Rebe, Kevin; Morroni, Chelsea; Wilkinson, Robert J.; Meintjes, Graeme

    2009-01-01

    Background Clinical deterioration on drug therapy for tuberculosis is a common cause of hospital admission in Africa. Potential causes for clinical deterioration in settings of high HIV-1 prevalence include drug resistant Mycobacterium tuberculosis (M.tb), co-morbid illnesses, poor adherence to therapy, tuberculosis associated-immune reconstitution inflammatory syndrome (TB-IRIS) and subtherapeutic antitubercular drug levels. It is important to derive a rapid diagnostic work-up to determine the cause of clinical deterioration as well as specific management to prevent further clinical deterioration and death. We undertook this study among tuberculosis (TB) patients referred to an adult district level hospital situated in a high HIV-1 prevalence setting to determine the frequency, reasons and outcome for such clinical deterioration. Method A prospective observational study conducted during the first quarter of 2007. We defined clinical deterioration as clinical worsening or failure to stabilise after 14 or more days of antitubercular treatment, resulting in hospital referral. We collected data on tuberculosis diagnosis and treatment, HIV-1 status and antiretroviral treatment, and investigated reasons for clinical deterioration as well as outcome. Results During this period, 352 TB patients met inclusion criteria; 296 were admitted to hospital accounting for 17% of total medical admissions (n = 1755). Eighty three percent of TB patients (291/352) were known to be HIV-1 co-infected with a median CD4 count of 89cells/mm3 (IQR 38–157). Mortality among TB patients admitted to hospital was 16% (n = 48). The median duration of hospital admission was 9.5 days (IQR 4–18), longer than routine in this setting (4 days). Among patients in whom HIV-1 status was known (n = 324), 72% of TB patients (n = 232) had an additional illness to tuberculosis; new AIDS defining illnesses (n = 80) were the most frequent additional illnesses (n = 208) in HIV-1 co

  8. Defining Occupational Illnesses and Injuries

    DTIC Science & Technology

    1990-11-01

    This technical report will discuss the definitions of occupational illnesses and injuries as established by the Occupational Safety and Health...Administration (OSHA). A systematic method for classifying an occupational event as either an illness or an injury will be presented. The Air Force is...required to collect occupational injury and illness data, to analyze collected data, and to establish preventive programs based upon any identified unsafe

  9. Illness Cognition and Responses to AIDS.

    ERIC Educational Resources Information Center

    Bishop, George D.

    Along with the current epidemic of Acquired Immune Deficiency Syndrome (AIDS) has come what some have called an epidemic of fear. Two studies were conducted to explore lay responses to AIDS from the perspective of recent research on how lay people process illness information. The research examines the cognitive organization of disease information…

  10. When to Monitor CD4 Cell Count and HIV RNA to Reduce Mortality and AIDS-Defining Illness in Virologically Suppressed HIV-Positive Persons on Antiretroviral Therapy in High-Income Countries: A Prospective Observational Study

    PubMed Central

    Caniglia, Ellen C.; Sabin, Caroline; Robins, James M.; Logan, Roger; Cain, Lauren E.; Abgrall, Sophie; Mugavero, Michael J.; Hernandez-Diaz, Sonia; Meyer, Laurence; Seng, Remonie; Drozd, Daniel R.; Seage, George R.; Bonnet, Fabrice; Dabis, Francois; Moore, Richard R.; Reiss, Peter; van Sighem, Ard; Mathews, William C.; del Amo, Julia; Moreno, Santiago; Deeks, Steven G.; Muga, Roberto; Boswell, Stephen L.; Ferrer, Elena; Eron, Joseph J.; Napravnik, Sonia; Jose, Sophie; Phillips, Andrew; Olson, Ashley; Justice, Amy C.; Tate, Janet P.; Bucher, Heiner C.; Egger, Matthias; Touloumi, Giota; Sterne, Jonathan A.; Costagliola, Dominique; Saag, Michael; Hernán, Miguel A.

    2016-01-01

    Objective: To illustrate an approach to compare CD4 cell count and HIV-RNA monitoring strategies in HIV-positive individuals on antiretroviral therapy (ART). Design: Prospective studies of HIV-positive individuals in Europe and the USA in the HIV-CAUSAL Collaboration and The Center for AIDS Research Network of Integrated Clinical Systems. Methods: Antiretroviral-naive individuals who initiated ART and became virologically suppressed within 12 months were followed from the date of suppression. We compared 3 CD4 cell count and HIV-RNA monitoring strategies: once every (1) 3 ± 1 months, (2) 6 ± 1 months, and (3) 9–12 ± 1 months. We used inverse-probability weighted models to compare these strategies with respect to clinical, immunologic, and virologic outcomes. Results: In 39,029 eligible individuals, there were 265 deaths and 690 AIDS-defining illnesses or deaths. Compared with the 3-month strategy, the mortality hazard ratios (95% CIs) were 0.86 (0.42 to 1.78) for the 6 months and 0.82 (0.46 to 1.47) for the 9–12 month strategy. The respective 18-month risk ratios (95% CIs) of virologic failure (RNA >200) were 0.74 (0.46 to 1.19) and 2.35 (1.56 to 3.54) and 18-month mean CD4 differences (95% CIs) were −5.3 (−18.6 to 7.9) and −31.7 (−52.0 to −11.3). The estimates for the 2-year risk of AIDS-defining illness or death were similar across strategies. Conclusions: Our findings suggest that monitoring frequency of virologically suppressed individuals can be decreased from every 3 months to every 6, 9, or 12 months with respect to clinical outcomes. Because effects of different monitoring strategies could take years to materialize, longer follow-up is needed to fully evaluate this question. PMID:26895294

  11. The Creative Use of Psychotherapy with Terminally Ill AIDS Patients.

    ERIC Educational Resources Information Center

    Fraenkel, William A.

    One clinical psychologist who worked with terminally ill, end-stage Acquired Immune Deficiency Syndrome (AIDS) patients in a hospice type setting experienced more than 150 deaths over an 18-month time period. Many of the patients denied that they had AIDS; some distinguished between having AIDS and testing positive for Human Immunodeficiency Virus…

  12. Defining the illness trajectory of metastatic breast cancer

    PubMed Central

    Reed, Elizabeth; Corner, Jessica

    2015-01-01

    Background With significant developments in the management of metastatic breast cancer, the trajectory of progressive breast cancer is becoming increasingly complex with little understanding of the illness course experienced by women, or their ongoing problems and needs. Aim This study set out to systematically explore the illness trajectory of metastatic breast cancer using models from chronic illness as a framework. Design Longitudinal mixed methods studies detailing each woman's illness trajectory were developed by triangulating of narrative interviews, medical and nursing documentation and an assessment of functional ability using the Karnofsky Scale. The Corbin and Strauss Chronic Illness Trajectory Framework was used as a theoretical framework for the study. Participants Ten women aged between 40 and 78 years, with metastatic breast cancer. Results Women’s illness trajectories from diagnosis of metastatic disease ranged from 13 months to 5 years and 9 months. Eight of the 10 women died during the study. Chronic illness trajectory phases identified by Corbin and Strauss (pretrajectory, trajectory onset, living with progressive disease, downward phase and dying phase) were experienced by women with metastatic breast cancer. Three typical trajectories of different duration and intensity were identified. Women's lives were dominated by the physical burden of disease and treatment with little evidence of symptom control or support. Conclusions This is the first study to systematically explore the experience of women over time to define the metastatic breast cancer illness trajectory and provides evidence that current care provision is inadequate. Alternative models of care which address women's increasingly complex problems are needed. PMID:24644176

  13. Workers' Reactions to AIDS and Other Illnesses.

    ERIC Educational Resources Information Center

    Sheehan, Eugene P.; And Others

    Previous research on the public's response to Acquired Immune Deficiency Syndrome (AIDS) has been concerned with attitudes and knowledge in relation to the disease itself. This study investigated people's willingness to interact with individuals with AIDS in the workplace. Participants (N=358) were college students with an average age of 25.…

  14. Disseminated varicella zoster virus in an immunized child as the acquired immunodeficiency syndrome-defining illness.

    PubMed

    Chilek, Katherine; Routhouska, Shannon; Tamburro, Joan

    2010-01-01

    Varicella zoster virus (VZV) immunization aids in the prevention of future VZV infections in immunocompetent patients; however, severely immunocompromised patients remain at increased risk of VZV infection. We report a case of a 10-year-old boy previously immunized to Varicella who presented with herpes zoster with hematogenous dissemination as the Acquired Immunodeficiency Syndrome-defining illness. Disseminated VZV is more commonly seen in human immunodeficiency virus (HIV)-infected individuals with more advanced disease, as was the case with our patient. Disseminated VZV infection in a previously immunized child should raise suspicion for underlying immunosuppression.

  15. Sense Making Process in Defining Health for People with Chronic Illness and Disabilities.

    ERIC Educational Resources Information Center

    Lee, Youngkhill; McCormick, Bryan P.

    2002-01-01

    Presents a sense-making process in defining health, particularly as related to people with chronic illness and disabilities, reviewing existing concepts of health, examining how people make sense of their disability and illness from an existential perspective, offering two concepts (life story and sense of coherence) relevant to this existential…

  16. Atomic Charges and the Electrostatic Potential Are Ill-Defined in Degenerate Ground States.

    PubMed

    Bultinck, Patrick; Cardenas, Carlos; Fuentealba, Patricio; Johnson, Paul A; Ayers, Paul W

    2013-11-12

    A system in a spatially degenerate ground state responds in a qualitatively different way to positive and negative point charges. This means that the molecular electrostatic potential is ill-defined for degenerate ground states due to the ill-defined nature of the electron density. It also means that it is impossible, in practice, to define fixed atomic charges for molecular mechanics simulations of molecules with (quasi-)degenerate ground states. Atomic-polarizability-based models and electronegativity-equalization-type models for molecular polarization also fail to capture this effect. We demonstrate the ambiguity in the electrostatic potential using several molecules of different degree of degeneracy, quasi-degeneracy, and symmetry.

  17. Assessing the impact of HAART on the incidence of defining and non-defining AIDS cancers among patients with HIV/AIDS: a systematic review.

    PubMed

    Cobucci, Ricardo Ney Oliveira; Lima, Paulo Henrique; de Souza, Pollyana Carvalho; Costa, Vanessa Viana; Cornetta, Maria da Conceição de Mesquita; Fernandes, José Veríssimo; Gonçalves, Ana Katherine

    2015-01-01

    After highly active antiretroviral therapy (HAART) became widespread, several studies demonstrated changes in the incidence of defining and non-defining AIDS cancers among HIV/AIDS patients. We conducted a systematic review of observational studies evaluating the incidence of malignancies before and after the introduction of HAART in people with HIV/AIDS. Eligible studies were searched up to December 2012 in the following databases: Pubmed, Embase, Scielo, Cancerlit and Google Scholar. In this study, we determined the cancer risk ratio by comparing the pre- and post-HAART eras. Twenty-one relevant articles were found, involving more than 600,000 people with HIV/AIDS and 10,891 new cases of cancers. The risk for the development of an AIDS-defining cancer decreased after the introduction of HAART: Kaposi's sarcoma (RR=0.30, 95% CI: 0.28-0.33) and non-Hodgkin's lymphoma (RR=0.52, 95% CI: 0.48-0.56), in contrast to invasive cervical cancer (RR=1.46, 95% CI: 1.09-1.94). Among the non-AIDS-defining cancers, the overall risk increased after the introduction of HAART (RR=2.00, 95% CI: 1.79-2.23). The incidence of AIDS-defining cancers decreased and the incidence of non-AIDS-defining cancers increased after the early use of HAART, probably due to better control of viral replication, increased immunity and increased survival provided by new drugs.

  18. Defining Pediatric Chronic Critical Illness for Clinical Care, Research, and Policy.

    PubMed

    Shapiro, Miriam C; Henderson, Carrie M; Hutton, Nancy; Boss, Renee D

    2017-04-01

    Chronically critically ill pediatric patients represent an emerging population in NICUs and PICUs. Chronic critical illness has been recognized and defined in the adult population, but the same attention has not been systematically applied to pediatrics. This article reviews what is currently known about pediatric chronic critical illness, highlighting the unique aspects of chronic critical illness in infants and children, including specific considerations of prognosis, outcomes, and decision-making. We propose a definition that incorporates NICU versus PICU stays, recurrent ICU admissions, dependence on life-sustaining technology, multiorgan dysfunction, underlying medical complexity, and the developmental implications of congenital versus acquired conditions. We propose a research agenda, highlighting existing knowledge gaps and targeting areas of improvement in clinical care, research, and policy.

  19. A new approach to defining and diagnosing malnutrition in adult critical illness

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This review will highlight a new approach to defining malnutrition syndromes for critically ill adults that incorporates a modern understanding of the contributions of inflammatory response. A systematic approach to nutrition assessment is described to help support diagnosis. Recent findings sugges...

  20. Costs and benefits of automatization in category learning of ill-defined rules.

    PubMed

    Raijmakers, Maartje E J; Schmittmann, Verena D; Visser, Ingmar

    2014-03-01

    Learning ill-defined categories (such as the structure of Medin & Schaffer, 1978) involves multiple learning systems and different corresponding category representations, which are difficult to detect. Application of latent Markov analysis allows detection and investigation of such multiple latent category representations in a statistically robust way, isolating low performers and quantifying shifts between latent strategies. We reanalyzed data from three experiments presented in Johansen and Palmeri (2002), which comprised prolonged training of ill-defined categories, with the aim of studying the changing interactions between underlying learning systems. Our results broadly confirm the original conclusion that, in most participants, learning involved a shift from a rule-based to an exemplar-based strategy. Separate analyses of latent strategies revealed that (a) shifts from a rule-based to an exemplar-based strategy resulted in an initial decrease of speed and an increase of accuracy; (b) exemplar-based strategies followed a power law of learning, indicating automatization once an exemplar-based strategy was used; (c) rule-based strategies changed from using pure rules to rules-plus-exceptions, which appeared as a dual processes as indicated by the accuracy and response-time profiles. Results suggest an additional pathway of learning ill-defined categories, namely involving a shift from a simple rule to a complex rule after which this complex rule is automatized as an exemplar-based strategy.

  1. Uptake of smoking cessation aids by smokers with a mental illness.

    PubMed

    Metse, Alexandra P; Wiggers, John; Wye, Paula; Clancy, Richard; Moore, Lyndell; Adams, Maree; Robinson, Maryanne; Bowman, Jenny A

    2016-10-01

    Psychiatric inpatient settings represent an opportunity to initiate the provision of tobacco cessation care to smokers with a mental illness. This study describes the use of evidence-based smoking cessation aids proactively and universally offered to a population of psychiatric inpatients upon discharge, and explores factors associated with their uptake. Data derived from the conduct of a randomised controlled trial were analysed in terms of the proportion of participants (N = 378) that utilised cessation aids including project delivered telephone smoking cessation counselling and nicotine replacement therapy (NRT), and Quitline support. Factors associated with uptake of cessation aids were explored using multivariable logistic regression analyses. A large proportion of smokers utilised project delivered cessation counselling calls (89 %) and NRT (79 %), while 11 % used the Quitline. The majority accepted more than seven project delivered telephone cessation counselling calls (52 %), and reported NRT use during more than half of their accepted calls (70 %). Older age, higher nicotine dependence, irregular smoking and seeing oneself as a non-smoker were associated with uptake of behavioural cessation aids. Higher nicotine dependence was similarly associated with use of pharmacological aids, as was NRT use whilst an inpatient. Most smokers with a mental illness took up a proactive offer of aids to support their stopping smoking. Consideration by service providers of factors associated with uptake may increase further the proportion of such smokers who use evidence-based cessation aids and consequently quit smoking successfully.

  2. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes.

    PubMed

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; Morais Neto, Otaliba Libânio de; Szwarcwald, Célia Landman

    2014-08-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore

  3. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

    PubMed Central

    França, Elisabeth; Teixeira, Renato; Ishitani, Lenice; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; de Morais, Otaliba Libânio; Szwarcwald, Célia Landman

    2014-01-01

    OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore

  4. AIDS-related illness trajectories in Mexico: findings from a qualitative study in two marginalized communities.

    PubMed

    Castro, R; Orozco, E; Eroza, E; Manca, M C; Hernández, J J; Aggleton, P

    1998-10-01

    This paper describes findings from a recent study examining how people affected directly and indirectly by the HIV/AIDS epidemic cope with HIV-related illness in Mexico. One-hundred-and-thirteen in-depth interviews were conducted with key informants in two contrasting communities: Ciudad Netzahualcóyotl (an economically marginalized community) and the gay community in Mexico City (a sexually marginalized community). This paper describes the AIDS-related wellness/illness careers or trajectories followed by individuals in both communities, and identifies critical points for material and emotional intervention. This career comprises four stages: (1) life before infection; (2) life surrounding the discovery of seropositivity; (3) living as an HIV-positive person; and (4) facing death. Comparisons are drawn between the processes of adjustment and coping found in both communities. In Ciudad Netzahualcóyotl, wellness/illness careers are closely linked to prevailing poverty and oppression, as well as the sense of urgency in which local people live their lives. In the case of the gay community, wellness/illness careers are associated with the intolerance and social repression faced by homosexual men. The paper concludes by suggesting possible interventions to improve the lives of people with HIV/AIDS in Mexico today.

  5. Multilevel learning-based segmentation of ill-defined and spiculated masses in mammograms

    SciTech Connect

    Tao, Yimo; Lo, Shih-Chung B.; Freedman, Matthew T.; Makariou, Erini; Xuan, Jianhua

    2010-11-15

    Purpose: A learning-based approach integrating the use of pixel-level statistical modeling and spiculation detection is presented for the segmentation of mammographic masses with ill-defined margins and spiculations. Methods: The algorithm involves a multiphase pixel-level classification, using a comprehensive group of features computed from regional intensity, shape, and textures, to generate a mass-conditional probability map (PM). Then, the mass candidate, along with the background clutters consisting of breast fibroglandular and other nonmass tissues, is extracted from the PM by integrating the prior knowledge of shape and location of masses. A multiscale steerable ridge detection algorithm is employed to detect spiculations. Finally, all the object-level findings, including mass candidate, detected spiculations, and clutters, along with the PM, are integrated by graph cuts to generate the final segmentation mask. Results: The method was tested on 54 masses (51 malignant and 3 benign), all with ill-defined margins and irregular shape or spiculations. The ground truth delineations were provided by five experienced radiologists. Area overlapping ratio of 0.689 ({+-}0.160) and 0.540 ({+-}0.164) were obtained for segmenting entire mass and margin portion only, respectively. Williams index of area and contour based measurements indicated that the segmentation results of the algorithm agreed well with the radiologists' delineation. Conclusions: The proposed approach could closely delineate the mass body. Most importantly, it is capable of including mass margin and its spicule extensions which are considered as key features for breast lesion analyses.

  6. Defining Older Adults' Perceived Causes of Hypertension in the Brief Illness Perception Questionnaire

    ERIC Educational Resources Information Center

    Duwe, Elise A. G.; Koerner, Kari M.; Madison, Anna M.; Falk, Nikki A.; Insel, Kathleen C.; Morrow, Daniel G.

    2014-01-01

    Objectives: This study sought to make the Brief Illness Perception Questionnaire (BIPQ) to be more informative about illness representation among older adults with hypertension. The authors developed categories for coding the open-ended question regarding cause of illness in the BIPQ--a pervasive quantitative measure for illness representation.…

  7. Distress syndromes, illness behavior, access to care and medical utilization in a defined population.

    PubMed

    Mechanic, D; Cleary, P D; Greenley, J R

    1982-04-01

    This article examines the use of general medical services in a representative sample from a defined geographic area and in a sample of persons seeking psychiatric care from the same area. Psychiatric patients made 100 per cent more general medical care visits in the retrospective period and 83 per cent more in the prospective period than persons who did not seek mental health care. The analysis focuses on the determinants in general medical care use between those who sought mental health care and those who did not. The first hypothesis is that physical symptoms and dysfunction concomitant with psychologic disorder explain the difference. The second argues that the association is a product of help-seeking orientations and illness behavior. The third focuses on variations due to differences in access. The first two types of factors are the most important. Using sex, physical symptoms and illness behavior measures, we explain 50 per cent of the differences in retrospective utilization and 40 per cent of the differences in prospective data.

  8. Expertise in ill-defined problem-solving domains as effective strategy use.

    PubMed

    Schunn, Christian D; McGregor, Mark U; Saner, Lelyn D

    2005-12-01

    Expertise consists of many different cognitive structures. Lemaire and Siegler (1995) have proposed a four-layered account of expertise from a strategies perspective: Experts have better strategies, tend to use strategies that are better overall more often, are better able to select the circumstances to which a strategy best applies, and are better able to execute a given strategy. Originally, this account came from work in simple, well-defined domains. We explored this account in the complex, ill-defined domain of platoon leadership. In Experiment 1A, we elicited free-text responses to leadership scenarios from novices, intermediates, and experts, finding expertise effects for strategy base rates and choice, but not for strategy existence or the number of strategies used. In Experiment 1B, we used a new group of experts to gather ratings of the execution accuracy of the responses in Experiment 1A and found expertise differences in the ability to execute the same strategies. We propose several elaborations to the original four-layered strategies account of expertise on the basis of these results.

  9. Themes in managing culturally defined illness in the Cambodian refugee family.

    PubMed

    Frye, B A; D'Avanzo, C

    1994-01-01

    The Cambodian (Khmer) refugee population in America is considered to be the Indochinese refugee population at highest risk for stress-related health problems resulting from traumatic physical and emotional experiences during the Khmer Rouge holocaust in this Southeast Asian country. In this study, koucharang, described as "thinking too much," was identified by informants as a culture-bound syndrome in response to the violence experienced in Cambodia. It is characterized by behavioral changes and somatic complaints. This study identified two cultural themes used by Cambodian families in the management of this disabling condition. The research is a follow-up from a prior study that examined cultural themes in health care decision making among Khmer women. This study of themes in family management of culturally defined illness was conducted with 120 Cambodian refugee women in Long Beach, California and Lowell, Massachusetts. These geographical areas were selected because the Khmer refugee population in America has relocated primarily to the low-income inner-city areas of southern California and Massachusetts. Nursing strategies for utilizing the identified cultural themes in intervening with the Cambodian family are identified. The community health nurse can build upon the strength of these themes and the resulting culturally dictated practices as he or she provides supportive counseling and health promotion to this highly traumatized population. The emotional risks to the community health nurse in working with the Cambodian refugee family are discussed in the context of maintaining self-integrity in the face of overwhelming tragedy.

  10. Trends in the incidence of AIDS-defining and non-AIDS-defining cancers in people living with AIDS: a population-based study from São Paulo, Brazil.

    PubMed

    Tanaka, Luana F; Latorre, Maria do Rosário DO; Gutierrez, Eliana B; Heumann, Christian; Herbinger, Karl-Heinz; Froeschl, Guenter

    2017-01-01

    People living with AIDS are at increased risk of developing certain cancers. Since the introduction of the highly active antiretroviral therapy (HAART), the incidence of AIDS-defining cancers (ADCs) has decreased in high-income countries. The objective of this study was to analyse trends in ADCs and non-AIDS-defining cancers (NADCs) in HIV-positive people with a diagnosis of AIDS, in comparison to the general population, in São Paulo, Brazil. A probabilistic record linkage between the 'Population-based Cancer Registry of São Paulo' and the AIDS notification database (SINAN) was conducted. Cancer trends were assessed by annual per cent change (APC). In people with AIDS, 2074 cancers were diagnosed. Among men with AIDS, the most frequent cancer was Kaposi's sarcoma (469; 31.1%), followed by non-Hodgkin lymphoma (NHL; 304; 20.1%). A decline was seen for ADCs (APC = -14.1%). All NADCs have increased (APC = 7.4%/year) significantly since the mid-2000s driven by the significant upward trends of anal (APC = 24.6%/year) and lung cancers (APC = 15.9%/year). In contrast, in men from the general population, decreasing trends were observed for these cancers. For women with AIDS, the most frequent cancer was cervical (114; 20.2%), followed by NHL (96; 17.0%). Significant declining trends were seen for both ADCs (APC = -15.6%/year) and all NADCs (APC = -15.8%/year), a comparable pattern to that found for the general female population. Trends in cancers among people with AIDS in São Paulo showed similar patterns to those found in developed countries. Although ADCs have significantly decreased, probably due to the introduction of HAART, NADCs in men have shown an opposite upward trend.

  11. Sensitivity analysis as an aid in modelling and control of (poorly-defined) ecological systems. [closed ecological systems

    NASA Technical Reports Server (NTRS)

    Hornberger, G. M.; Rastetter, E. B.

    1982-01-01

    A literature review of the use of sensitivity analyses in modelling nonlinear, ill-defined systems, such as ecological interactions is presented. Discussions of previous work, and a proposed scheme for generalized sensitivity analysis applicable to ill-defined systems are included. This scheme considers classes of mathematical models, problem-defining behavior, analysis procedures (especially the use of Monte-Carlo methods), sensitivity ranking of parameters, and extension to control system design.

  12. Factors Associated With Tuberculosis as an AIDS-Defining Disease in an Immigration Setting

    PubMed Central

    Martín, Vicente; García de Olalla, Patricia; Orcau, Angels; Caylà, Joan A

    2011-01-01

    Background Immigration can affect the evolution of TB as an AIDS-defining disease (AIDS–TB). Methods The Barcelona AIDS register for 1994–2005 was analyzed, and the global characteristics of AIDS–TB and AIDS–non-TB cases were compared. The Mantel-Haenszel test was used in the trend analysis, and logistic regression was used in the multivariate analysis. Results Of the 3600 cases studied, 1130 had both AIDS and TB. A declining trend in AIDS–TB rates was observed in both sexes among both immigrants and native residents. The percentage of AIDS–TB was significantly higher among immigrants (P = 0.02). The number of cases among immigrants remained constant over the period of study, but decreased among native residents. The sociodemographic and immunological characteristics associated with TB were male sex, age younger than 36 years, inner city residence, a record of incarceration, greater than 200 CD4+ T-cells/mm3, injecting drug use, heterosexual sex, and immigration from Latin America, the Caribbean, or sub-Saharan Africa. Conclusions The incidence of TB as an AIDS-defining disease decreased in Barcelona during a recent 10-year period in both native and immigrant populations. However, immigrants remain a high-risk group for AIDS–TB and should be targeted for surveillance and control of both diseases. PMID:21325728

  13. Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients.

    PubMed

    Voltzenlogel, Virginie; Ernst, Alexandra; de Sèze, Jérôme; Brassat, David; Manning, Liliann; Berna, Fabrice

    2016-10-01

    Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients' SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients' self-representations.

  14. Variable Impact on Mortality of AIDS-Defining Events Diagnosed during Combination Antiretroviral Therapy: Not All AIDS-Defining Conditions Are Created Equal

    PubMed Central

    2011-01-01

    Background The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)–defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. Methods We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of anti-retroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a “rare ADEs” category. Results During a median follow-up period of 43 months (interquartile range, 19–70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin’s lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84–22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70–14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin’s lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55–9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76–3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08–2.00]). Conclusions In the combination antiretroviral therapy era, mortality rates

  15. Proposal for Development of EBM-CDSS (Evidence-based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients

    DTIC Science & Technology

    2014-10-01

    TITLE: Proposal for Development of EBM-CDSS (Evidence-based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients...SUBTITLE Proposal for development of EBM-CDSS (Evidence-based Clinical Decision Support System) to aid prognostication in terminally ill patients 5a...to improve prognostication of the life expectancy of terminally ill patients to improve referral of patients to hospice. In addition, the EBM-CDSS

  16. Intelligent Tutoring for Ill-Defined Domains in Military Simulation-Based Training

    ERIC Educational Resources Information Center

    Bratt, Elizabeth Owen

    2009-01-01

    This paper describes the role of simulation-based training in the military. Interviews and observations of military instructors in the damage control and shiphandling domains provide examples of how the instructors extend the student's training beyond the well-defined simulated world with qualitative reasoning about context, hypothetical variants,…

  17. Bayesian population structure analysis reveals presence of phylogeographically specific sublineages within previously ill-defined T group of Mycobacterium tuberculosis.

    PubMed

    Reynaud, Yann; Zheng, Chao; Wu, Guihui; Sun, Qun; Rastogi, Nalin

    2017-01-01

    Mycobacterium tuberculosis genetic structure, and evolutionary history have been studied for years by several genotyping approaches, but delineation of a few sublineages remains controversial and needs better characterization. This is particularly the case of T group within lineage 4 (L4) which was first described using spoligotyping to pool together a number of strains with ill-defined signatures. Although T strains were not traditionally considered as a real phylogenetic group, they did contain a few phylogenetically meaningful sublineages as shown using SNPs. We therefore decided to investigate if this observation could be corroborated using other robust genetic markers. We consequently made a first assessment of genetic structure using 24-loci MIRU-VNTRs data extracted from the SITVIT2 database (n = 607 clinical isolates collected in Russia, Albania, Turkey, Iraq, Brazil and China). Combining Minimum Spanning Trees and Bayesian population structure analyses (using STRUCTURE and TESS softwares), we distinctly identified eight tentative phylogenetic groups (T1-T8) with a remarkable correlation with geographical origin. We further compared the present structure observed with other L4 sublineages (n = 416 clinical isolates belonging to LAM, Haarlem, X, S sublineages), and showed that 5 out of 8 T groups seemed phylogeographically well-defined as opposed to the remaining 3 groups that partially mixed with other L4 isolates. These results provide with novel evidence about phylogeographically specificity of a proportion of ill-defined T group of M. tuberculosis. The genetic structure observed will now be further validated on an enlarged worldwide dataset using Whole Genome Sequencing (WGS).

  18. Bayesian population structure analysis reveals presence of phylogeographically specific sublineages within previously ill-defined T group of Mycobacterium tuberculosis

    PubMed Central

    Reynaud, Yann; Zheng, Chao; Wu, Guihui; Sun, Qun; Rastogi, Nalin

    2017-01-01

    Mycobacterium tuberculosis genetic structure, and evolutionary history have been studied for years by several genotyping approaches, but delineation of a few sublineages remains controversial and needs better characterization. This is particularly the case of T group within lineage 4 (L4) which was first described using spoligotyping to pool together a number of strains with ill-defined signatures. Although T strains were not traditionally considered as a real phylogenetic group, they did contain a few phylogenetically meaningful sublineages as shown using SNPs. We therefore decided to investigate if this observation could be corroborated using other robust genetic markers. We consequently made a first assessment of genetic structure using 24-loci MIRU-VNTRs data extracted from the SITVIT2 database (n = 607 clinical isolates collected in Russia, Albania, Turkey, Iraq, Brazil and China). Combining Minimum Spanning Trees and Bayesian population structure analyses (using STRUCTURE and TESS softwares), we distinctly identified eight tentative phylogenetic groups (T1-T8) with a remarkable correlation with geographical origin. We further compared the present structure observed with other L4 sublineages (n = 416 clinical isolates belonging to LAM, Haarlem, X, S sublineages), and showed that 5 out of 8 T groups seemed phylogeographically well-defined as opposed to the remaining 3 groups that partially mixed with other L4 isolates. These results provide with novel evidence about phylogeographically specificity of a proportion of ill-defined T group of M. tuberculosis. The genetic structure observed will now be further validated on an enlarged worldwide dataset using Whole Genome Sequencing (WGS). PMID:28166309

  19. Coding ill-defined and unknown cause of death is 13 times more frequent in Denmark than in Finland.

    PubMed

    Ylijoki-Sørensen, Seija; Sajantila, Antti; Lalu, Kaisa; Bøggild, Henrik; Boldsen, Jesper Lier; Boel, Lene Warner Thorup

    2014-11-01

    Exact cause and manner of death determination improves legislative safety for the individual and for society and guides aspects of national public health. In the International Classification of Diseases, codes R00-R99 are used for "symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified" designated as "ill-defined" or "with unknown etiology". The World Health Organisation recommends avoiding the use of ill-defined and unknown causes of death in the death certificate as this terminology does not give any information concerning the possible conditions that led to the death. Thus, the aim of the study was, firstly, to analyse the frequencies of R00-R99-coded deaths in mortality statistics in Finland and in Denmark and, secondly, to compare these and the methods used to investigate the cause of death. To do so, we extracted a random 90% sample of the Finnish death certificates and 100% of the Danish certificates from the national mortality registries for 2000, 2005 and 2010. Subsequently, we analysed the frequencies of forensic and medical autopsies and external clinical examinations of the bodies in R00-R99-coded deaths. The use of R00-R99 codes was significantly higher in Denmark than in Finland; OR 18.6 (95% CI 15.3-22.4; p<0.001) for 2000, OR 9.5 (95% CI 8.0-11.3; p<0.001) for 2005 and OR 13.2 (95% CI 11.1-15.7; p<0.001) for 2010. More than 80% of Danish deaths with R00-R99 codes were over 70 years of age at the time of death. Forensic autopsy was performed in 88.3% of Finnish R00-R99-coded deaths, whereas only 3.5% of Danish R00-R99-coded deaths were investigated with forensic or medical autopsy. The codes that were most used in both countries were R96-R99, meaning "unknown cause of death". In Finland, all of these deaths were investigated with a forensic autopsy. Our study suggests that if all deaths in all age groups with unclear cause of death were systematically investigated with a forensic autopsy, only 2-3/1000 deaths per year

  20. Onset polarity and illness course in bipolar I and II disorders: The predictive role of broadly defined mixed states.

    PubMed

    Tundo, Antonio; Musetti, Laura; Benedetti, Alessandra; Berti, Benedetta; Massimetti, Gabriele; Dell'Osso, Liliana

    2015-11-01

    Several studies investigating bipolar disorders have shown that polarity of onset can predict differences in symptomatology, course, and prognosis. Frequently, however, research on the topic has examined only bipolar I inpatients and has not included patients with mixed onset. The aim of the present naturalistic study was to evaluate the clinical characteristics and illness course of a consecutive sample (407 outpatients, 58.7% with bipolar I (BD-I) and 41.3% with bipolar II (BD-II) disorder) according to polarity of onset: depressive (DP-o); manic/hypomanic (HM-o); or mixed--broadly defined to include agitated depression for BD-II--onset (MX-o). As compared with patients in the other two groups: a) DP-o patients (67.3%) were more frequently affected by BD-II and had lower ratings for psychotic symptoms; b) HM-o patients (17%) had a higher rate of family history for psychosis and a lower rate of suicide attempts; and c) patients in the MX-o group (15.7%) more frequently showed substance abuse and had a higher number of mixed recurrences per year. In the BD-II group, MX-o patients more frequently attempted suicide. The present study's main limitations are those of retrospective assessment of onset polarity and lack of treatment-impact evaluations over illness course. In conclusion, we confirm clinical expression differences in bipolar disorder in function of polarity of onset and underscore the importance of carefully considering broadly defined mixed state when examining polarity of onset. Further investigations are required to confirm the present study's results.

  1. Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID).

    PubMed

    Lipman, Grant S; Kanaan, Nicholas C; Phillips, Caleb; Pomeranz, Dave; Cain, Patrick; Fontes, Kristin; Higbee, Becky; Meyer, Carolyn; Shaheen, Michael; Wentworth, Sean; Walsh, Diane

    2015-06-01

    Lipman, Grant S., Nicholas C. Kanaan, Caleb Phillips, Dave Pomeranz, Patrick Cain, Kristin Fontes, Becky Higbee, Carolyn Meyer, Michael Shaheen, Sean Wentworth, and Diane Walsh. Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID). High Alt Med Biol 16:154-161, 2015.--Acute mountain sickness (AMS) affects 25%-70% of the tens of millions of high altitude travelers annually, with hypoxia and nocturnal desaturations as major contributing factors. This is the first double blind randomized placebo controlled trial to assess expiratory positive airway pressure (EPAP) for AMS prevention and nocturnal hypoxic events. Healthy adult participants trekking in the Khumbu region of the Himalayas were randomized to a single-use EPAP nasal strip, or a visually identical sham device (placebo) prior to first night sleeping between 4371-4530 m (14,340-14,800 ft). The primary outcome was AMS incidence, measured by Lake Louise Questionnaire (LLQ), with secondary outcomes of AMS severity (by LLQ) and physiologic sleep indices measured by continuous sleep monitor. Intent-to-treat analysis included 219 participants with comparable demographic characteristics, of which 115 received EPAP and 104 placebo. There was no decrease in AMS with EPAP intervention (14% EPAP vs. 17% placebo; p=0.65; risk difference (-)3.15%, 95% CI (-)12.85%-6.56%). While overall AMS severity was not different between groups, EPAP reported decreased incidence of headache (64% vs. 76%; p<0.05, OR 0.51, 95% CI 0.27-0.95) and dizziness (81% vs. 98%; p<0.03, OR 0.29, 95% CI 0.09-0.78). During sleep, EPAP resulted in significant improvements in average peripheral oxygenation (Spo(2)) (80% versus 78%; p<0.01, mean difference=2, 95% CI 0.58-3.63) and a reduced percentage of time below 80% Spo(2) (31% vs. 46%; p<0.03, median difference=16, 95% CI 2.22-28.18). This lightweight and inexpensive EPAP device did not prevent acute mountain sickness, but did reduce the subgroup incidence of

  2. Effect of Statin Therapy in Reducing the Risk of Serious Non-AIDS-Defining Events and Nonaccidental Death

    PubMed Central

    Overton, E. T.; Kitch, D.; Benson, C. A.; Hunt, P. W.; Stein, J. H.; Smurzynski, M.; Ribaudo, H. J.; Tebas, P.

    2013-01-01

    Background. Excessive inflammation persists despite antiretroviral treatment. Statins decrease cardiovascular (CV) disease risk by reducing low-density lipoprotein cholesterol and inflammation. We performed an exploratory analysis to evaluate whether statin therapy decreased risk of non-AIDS-defining events and nonaccidental death. Methods. A total of 3601 subjects not on a statin from the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials cohort were included. Outcome was time to first clinical event (CV event, renal or hepatic disease, incident diabetes, thrombotic/embolic event, nontraumatic fracture, non-AIDS-defining malignancy, serious bacterial infection, or nonaccidental death); event categories were also analyzed separately. Inverse probability of treatment and censoring weighted Cox proportional hazard models were used to assess the causal statin effect. Differential statin effects by baseline covariates were evaluated. Results. Over 15 135 person-years (PY) of follow-up, 484 subjects initiated statins; 616 experienced an event (crude event rate, 4.4/100 PY on a statin and 4.1/100 PY not on a statin); the unadjusted hazard ratio (HR) was 1.17 (95% confidence interval [CI], .91–1.50). In a final weighted model, the adjusted HR (AHR) was 0.81 (95% CI, .53– 1.24). Results for other clinical events were similar, except for malignancies (AHR, 0.43 [95% CI, .19–.94]) and bacterial infections (AHR, 1.30 [95% CI, .64–2.65]). No differential statin effects by baseline covariates were detected. Conclusions. Although statin therapy was not associated with a reduction in time to all non-AIDS-defining event or nonaccidental death, it was associated with a statistically significant 57% reduction in non-AIDS-defining malignancies. Confirmatory studies are needed to evaluate statin-associated reduction in risk of cancer and non-AIDS-associated morbidities. PMID:23386631

  3. Defining and refining international donor support for combating the AIDS pandemic.

    PubMed

    Attaran, A; Sachs, J

    2001-01-06

    The international aid effort against AIDS is greatly incommensurate with the severity of the epidemic. Drawing on the data that international aid donors self-reported to the Organization for Economic Cooperation and Development (OECD), we find that, between 1996 and 1998, finance from all rich countries to sub-Saharan Africa for projects designated as AIDS control averaged US $69 million annually, and, assuming a safe margin for under-reporting and misreporting, we estimate that total donor spending on HIV/AIDS control was perhaps twice that at most. Since the late 1980s, aid levels have dropped relative to the prevalence of HIV infection, and stood recently at about $3 per HIV-infected person. Lack of finance is now the primary constraint on progress against AIDS, notwithstanding the widespread belief that a lack of interest from the goveements of poor countries is limiting. We argue that to produce a meaningful response to the pandemic, international assistance must be based on grants, not loans, for the poorest countries; be increased within the next 3 years to a minimum of $7.5 billion or more; be directed toward funding projects which are proposed and desired by the affected countries themselves, and which are judged as having epidemiological merit against the pandemic by a panel of independent scientific experts; and fund concurrent needs, including prevention, drug treatment (such as highly active antiretroviral therapy), and blocking mother-to-child HIV transmission. An effort of this scope and scale will both radically alter the prospects for intervention against AIDS in poor countries, and together with comparable efforts to control other infectious diseases, is easily afforded by the OECD donor economies, whose aggregate national income recently surpassed $21 trillion annually.

  4. A Multidimensional Conceptual Framework for Understanding HIV/AIDS as a Chronic Long-Term Illness

    ERIC Educational Resources Information Center

    Mitchell, Christopher G.; Linsk, Nathan L.

    2004-01-01

    New treatment advances have radically altered the course of HIV illness and created new challenges for HIV-affected individuals, families, and communities. This article provides a conceptual framework for understanding HIV in the multiple contexts of the client's culture, strengths, life course, and biomedical progression. The article concludes…

  5. Ethical Guidelines for Counselors when Working with Clients with Terminal Illness Requesting Physician Aid in Dying

    ERIC Educational Resources Information Center

    Kurt, Layla J.; Piazza, Nick J.

    2012-01-01

    In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the "ACA Code of Ethics" (ACA, 2005).

  6. Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS

    PubMed Central

    Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

    2013-01-01

    Introduction The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. Methods A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. Results and discussion The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women “where they are”; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. Conclusions This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately

  7. Relationships between poverty and AIDS Illness in South Africa: an investigation of urban and rural households in KwaZulu-Natal.

    PubMed

    Steinert, Janina Isabel; Cluver, Lucie; Melendez-Torres, G J; Herrero Romero, Rocio

    2016-06-02

    The association between poverty and HIV/AIDS in Sub-Saharan Africa remains contested. A better understanding of the relationship between the prevalence of poverty and the disease is essential for addressing prevention, treatment, and care. The present study interrogates this relationship, using a cross-sectional survey of 2477 households in urban and rural KwaZulu-Natal, South Africa. Structural equation modelling was employed to estimate the correlations between poverty and AIDS illness. The analysis revealed a correlation of rpb = 0.23, denoting that a higher level of household poverty was associated with a higher likelihood of being AIDS-unwell. Post hoc t-test showed that receipt of a disability grant by AIDS-affected households was associated with significantly lower poverty, compared to AIDS-affected households not receiving the grant, t(654) = 3.67, p < .01. Geographic location was found to confound the correlation: the strength of the relationship between poverty and AIDS was decreased to rpb = 0.15 (p < .001) for the urban and rpb = 0.16 (p < .001) for the rural sub-population. Findings suggest the importance of two sets of policies: those that address the potential upstream risk of poverty through economic interventions, and those that alleviate the impoverishing effects of AIDS illness for affected households.

  8. What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature

    PubMed Central

    Goldberg, Rachel E.; Short, Susan E.

    2016-01-01

    ABSTRACT Millions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being. This review confirms that this population of children is substantial in size, and that the vulnerabilities they experience are multi-faceted, spanning physical and emotional health and schooling. Mechanisms were examined empirically in only a small number of studies, but encompass poverty, transmission of opportunistic infections, care for unwell adults, adult distress, AIDS stigma, lack of social support, maternal breastfeeding issues, and vertical HIV transmission. Some evidence is provided that infants, adolescents, children with infected or ill mothers, and children living with severely ill adults are particularly vulnerable. Future research would benefit from more attention to causal inference and further characterization of processes and circumstances related to vulnerability and resilience. It would also benefit from further study of variation in observed associations between adult HIV/AIDS and child well-being based on characteristics such as age, sex, kinship, severity of illness, TB co-infection, disclosure, and serostatus awareness. Almost one-quarter of the studies reviewed did not investigate variation based on any of these factors. More nuanced understanding of the short- and long

  9. Evolution of the deaths registry system in Brazil: associations with changes in the mortality profile, under-registration of death counts, and ill-defined causes of death.

    PubMed

    Lima, Everton Emanuel Campos de; Queiroz, Bernardo Lanza

    2014-08-01

    This paper examines the spatial pattern of ill-defined causes of death across Brazilian regions, and its relationship with the evolution of completeness of the deaths registry and changes in the mortality age profile. We make use of the Brazilian Health Informatics Department mortality database and population censuses from 1980 to 2010. We applied demographic methods to evaluate the quality of mortality data for 137 small areas and correct for under-registration of death counts when necessary. The second part of the analysis uses linear regression models to investigate the relationship between, on the one hand, changes in death counts coverage and age profile of mortality, and on the other, changes in the reporting of ill-defined causes of death. The completeness of death counts coverage increases from about 80% in 1980-1991 to over 95% in 2000-2010 at the same time the percentage of ill-defined causes of deaths reduced about 53% in the country. The analysis suggests that the government's efforts to improve data quality are proving successful, and they will allow for a better understanding of the dynamics of health and the mortality transition.

  10. In vitro growth of the microsporidian Septata intestinalis from an AIDS patient with disseminated illness.

    PubMed Central

    Doultree, J C; Maerz, A L; Ryan, N J; Baird, R W; Wright, E; Crowe, S M; Marshall, J A

    1995-01-01

    A new species of microsporidian, Septata intestinalis, was recently recognized as an opportunistic pathogen of AIDS patients. In this study, it was cultured from the nasopharyngeal aspirate of a human immunodeficiency virus type 1-infected patient with disseminated microsporidiosis. In human embryonic lung cells exposed to S. intestinalis, a cytopathic effect appeared within 28 days as foci of rounded up cells. Thin-section electron microscopy showed a variety of developmental stages of the microsporidium within parasitophorous vacuoles. In monocyte-derived macrophages, evidence of infection and development of the parasite was demonstrated by light and electron microscopy. In both infected human embryonic lung cells and monocyte-derived macrophages, a network of septa separated individual spores. Partial sequencing of the RNA small-subunit gene (16S rDNA gene) confirmed the identity of this parasite as S. intestinalis. This is the first report of the isolation of S. intestinalis in vitro and provides evidence that the parasite can be disseminated by macrophages. PMID:7714208

  11. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model.

    PubMed

    Bee, Penny; Berzins, Kathryn; Calam, Rachel; Pryjmachuk, Steven; Abel, Kathryn M

    2013-01-01

    Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13-18 yrs) with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key 'meta-themes'. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i) the alleviation of parental mental health symptoms, ii) improved problem-based coping skills and iii) increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third sector providers to

  12. Efficacy of Dual Focus Mutual Aid for Persons with Mental Illness and Substance Misuse

    PubMed Central

    Rosenblum, Andrew; Matusow, Harlan; Fong, Chunki; Vogel, Howard; Uttaro, Thomas; Moore, Thomas L.; Magura, Stephen

    2014-01-01

    Background Previous studies have indicated that persons with co-occurring mental health and substance use problems can benefit by attending dual-focus mutual aid groups. However, to date, a trial to test the efficacy of these groups has not been published. Method This study randomly assigned 203 substance misusing clients attending a mental health or dual-diagnosis facility to either a dual-focus 12-step group (Double Trouble in Recovery; DTR) or a waiting list control group. Participants were followed for 3–6 months. The primary outcome was substance use (days used in the past 30 with saliva testing to detect under-reporting); secondary outcomes included psychiatric medication adherence, attendance at traditional (single-focus) 12-step meetings (e.g., AA/NA); and improvement in mental health and substance use problems (quality of life). Multilevel model (MLM) regression was used to analyze the nested effect of participants within 8 facilities (7 in New York City and 1 in Michigan). Regression imputation was used to adjust for drug use under-reporting. Results At follow-up 79% of the subjects were interviewed. In intent to treat analysis, DTR subjects compared with control subjects used alcohol (p=.03) and any substances (p=.02) on fewer days. DTR compared with control subjects were also more likely to rate themselves as experiencing better mental health and fewer substance use problems (p=.001). There were no effects for DTR on drug use only, medication adherence or NA/AA attendance. Conclusion Findings reported in previous studies on the association between exposure to DTR and reductions in substance use were partially supported in this efficacy trial. PMID:24342419

  13. Changes over calendar time in the risk of specific first AIDS-defining events following HIV seroconversion, adjusting for competing risks

    PubMed Central

    Babiker, Abdel; Darbyshire, Janet; Pezzotti, Patrizio; Porter, Kholoud; Rezza, Giovanni; Walker, Sarah A; Beral, Valerie; Coutinho, Roel; Del Amo, Julia; Gill, Noël; Lee, Christine; Meyer, Laurence; Tyrer, Freya; Dabis, François; Thiébaut, Rodolphe; Lawson-Aye, Sylvie; Boufassa, Faroudy; Hamouda, Osamah; Fischer, Klaus; Pezzotti, Patrizio; Touloumi, Giota; Hatzakis, Angelos; Karafoulidou, Anastasia; Katsarou, Olga; Brettle, Ray; Del Romero, Jorge; Prins, Maria; Van Benthem, Birgit; Kirk, Ole; Pederson, Court; Hernández Aguado, Idelfonso; Pérez-Hoyos, Santiago; Eskild, Anne; Bruun, Johan N; Sannes, Mette; Sabin, Caroline; Johnson, Anne M; Phillips, Andrew N; Francioli, Patrick; Vanhems, Philippe; Egger, Mathias; Rickenbach, Martin; Cooper, David; Kaldor, John; Ashton, Lesley; Vizzard, Jeanette; Muga, Roberto; Day, Nicholas E; De Angelis, Daniela

    2002-01-01

    Background Although studies have reported large reductions in the risks of AIDS and death since the introduction of potent anti-retroviral therapies, few have evaluated whether this has been similar for all AIDS-defining diseases. We wished to evaluate changes over time in the risk of specific AIDS-defining diseases, as first events, using data from individuals with known dates of HIV seroconversion. Methods Using a competing risks proportional hazards model on pooled data from 20 cohorts (CASCADE), we evaluated time from HIV seroconversion to each first AIDS-defining disease (16 groups) and to death without AIDS for four calendar periods, adjusting for exposure category, age, sex, acute infection, and stratifying by cohort. We compared results to those obtained from a cause-specific hazards model. Results Of 6941, 2021 (29%) developed AIDS and 437 (6%) died without AIDS. The risk of AIDS or death remained constant to 1996 then reduced; relative hazard = 0.89 (95% CI: 0.77–1.03); 0.90 (95% CI: 0.81–1.01); and 0.32 (95% CI: 0.28–0.37) for 1979–1990, 1991–1993, and 1997–2001, respectively, compared to 1994–1996. Significant risk reductions in 1997–2001 were observed in all but two AIDS-defining groups and death without AIDS in a competing risks model (with similar results from a cause-specific model). There was significant heterogeneity in the risk reduction across events; from 96% for cryptosporidiosis, to 17% for death without AIDS (P < 0.0001). Conclusion These findings suggest that studies reporting a stable trend for particular AIDS diseases over the period 1979–2001 may not have accounted for the competing risks among other events or lack the power to detect smaller trends. PMID:12435766

  14. AIDS

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  15. Defining Democracy and the Terms of Engagement with the Postsocialist Polish State: Insights from HIV/AIDS.

    PubMed

    2009-08-01

    This article explores the history of HIV activism in Poland from the socialist period through the early 1990s transformation as a means of examining the reconfiguration of rights, obligations, and responsibility as Poland redefined itself as a market democracy. Drawing on archival materials, in-depth qualitative interviews with current and former HIV activists, and participant observation at HIV prevention organizations in Warsaw, Poland, I sketch the ways in the socialist system's failures to protect the health of its subjects led to the terms through which state-citizen engagement were defined in the postsocialist period. Uncertainties and anxieties surrounding who was responsible for protecting the health and well-being of citizens in the newly democratic Poland gave rise to a series of violent protests centered on HIV prevention and care for people living with HIV/AIDS. Resolution of these political and social crises involved defining democracy in postsocialist Poland through claims to moral authority, in alliance with the Catholic Church, and an obligation by multiple stakeholders to disseminate technical/scientific knowledge. By comparing the responses to the epidemic by diverse institutions, including the government, the Catholic Church, and the fledgling gay rights movement, this analysis reveals the ways in which democracy in postsocialist Poland tightly links science, democratic reform, and moral/religious authority, while at the same time excluding sexual minorities from engaging in political activism centered on rights to health and inclusion in the new democracy.

  16. Defining Democracy and the Terms of Engagement with the Postsocialist Polish State: Insights from HIV/AIDS

    PubMed Central

    2010-01-01

    This article explores the history of HIV activism in Poland from the socialist period through the early 1990s transformation as a means of examining the reconfiguration of rights, obligations, and responsibility as Poland redefined itself as a market democracy. Drawing on archival materials, in-depth qualitative interviews with current and former HIV activists, and participant observation at HIV prevention organizations in Warsaw, Poland, I sketch the ways in the socialist system’s failures to protect the health of its subjects led to the terms through which state-citizen engagement were defined in the postsocialist period. Uncertainties and anxieties surrounding who was responsible for protecting the health and well-being of citizens in the newly democratic Poland gave rise to a series of violent protests centered on HIV prevention and care for people living with HIV/AIDS. Resolution of these political and social crises involved defining democracy in postsocialist Poland through claims to moral authority, in alliance with the Catholic Church, and an obligation by multiple stakeholders to disseminate technical/scientific knowledge. By comparing the responses to the epidemic by diverse institutions, including the government, the Catholic Church, and the fledgling gay rights movement, this analysis reveals the ways in which democracy in postsocialist Poland tightly links science, democratic reform, and moral/religious authority, while at the same time excluding sexual minorities from engaging in political activism centered on rights to health and inclusion in the new democracy. PMID:20190876

  17. AIDS (image)

    MedlinePlus

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  18. Isolation of Novel Afipia septicemium and Identification of Previously Unknown Bacteria Bradyrhizobium sp. OHSU_III from Blood of Patients with Poorly Defined Illnesses

    PubMed Central

    Lo, Shyh-Ching; Hung, Guo-Chiuan; Li, Bingjie; Lei, Haiyan; Li, Tianwei; Nagamine, Kenjiro; Zhang, Jing; Tsai, Shien; Bryant, Richard

    2013-01-01

    Cultures previously set up for isolation of mycoplasmal agents from blood of patients with poorly-defined illnesses, although not yielding positive results, were cryopreserved because of suspicion of having low numbers of unknown microbes living in an inactive state in the broth. We re-initiated a set of 3 cultures for analysis of the "uncultivable" or poorly-grown microbes using NGS technology. Broth of cultures from 3 blood samples, submitted from OHSU between 2000 and 2004, were inoculated into culture flasks containing fresh modified SP4 medium and kept at room temperature (RT), 30°C and 35°C. The cultures showing evidence of microbial growth were expanded and subjected to DNA analysis by genomic sequencing using Illumina MiSeq. Two of the 3 re-initiated blood cultures kept at RT after 7–8 weeks showed evidence of microbial growth that gradually reached into a cell density with detectable turbidity. The microbes in the broth when streaked on SP4 agar plates produced microscopic colonies in ∼ 2 weeks. Genomic studies revealed that the microbes isolated from the 2 blood cultures were a novel Afipia species, tentatively named Afipia septicemium. Microbes in the 3rd culture (OHSU_III) kept at RT had a limited level of growth and could not reach a plateau with high cell density. Genomic sequencing identified the microbe in the culture as a previously unknown species of Bradyrhizobium bacteria. This study reports on the isolation of novel Afipia and Bradyrhizobium species. Isolation of Bradyrhizobium species bacteria has never been reported in humans. The study also reveals a previously unrecognized nature of hematogenous infections by the 2 unique groups of Bradyrhizobiaceae. Our studies show that improvement of culture system plus effective use of NGS technology can facilitate findings of infections by unusual microbes in patients having poorly-defined, sometimes mysterious illnesses. PMID:24155888

  19. If I Didn't Have HIV I'd Be Dead Now: Illness Narratives of Drug Users Living with HIV/AIDS

    PubMed Central

    Mosack, Katie E.; Abbott, Maryann; Singer, Merrill; Weeks, Margaret R.; Lucy, Rohena

    2010-01-01

    The purpose of this study was to illuminate the experiences of poor, urban HIV-positive drug users. Sixty participants were asked about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. A theoretical framework was developed using Frank's (1995; 1998) Illness Narratives and Boss and Couden's (2002) Ambiguous Loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers' understanding of the HIV/AIDS illness experiences among the very marginalized and they have important implications for physical and mental health care professionals working with HIV-positive drug users. PMID:15802537

  20. Stigma and otherness in the Israeli media's mirror representations of illness.

    PubMed

    Soffer, Michal; Ajzenstadt, Mimi

    2010-08-01

    In this study we examined the social construction of stigma toward HIV/AIDS in the Israeli press by comparing newspaper articles on HIV/AIDS, a highly stigmatized illness, and heart disease, a nonstigmatized illness in Israel. We carried out thematic content analysis of 242 newspaper articles published over a 12-month period. Two counter themes emerged from the analysis. HIV/AIDS was portrayed as a "foreign illness" mainly afflicting immigrants from the former Soviet Union and Ethiopia. In addition, HIV/AIDS was constructed as a disease of "the deviant other," particularly gay men, who pose risk to themselves and those around them. By contrast, heart disease was defined as a "local illness" of "ordinary" individuals, and an unpredictable phenomenon. The mirror images of HIV/AIDS and heart disease, which were involved in the stigmatizing process of HIV/AIDS, reflect the wider moral-sociocultural order of Israeli society.

  1. Two Tales about Illness, Ideologies, and Intimate Identities: Sexuality Politics and AIDS in South Africa, 1980–95

    PubMed Central

    Tsampiras, Carla

    2014-01-01

    This article focuses on the micro-narratives of two individuals whose responses to AIDS were mediated by their sexual identity, AIDS activism and the political context of South Africa during a time of transition. Their experiences were also mediated by well-established metanarratives about AIDS and ‘homosexuality’ created in the USA and the UK which were transplanted and reinforced (with local variations) into South Africa by medico-scientific and political leaders.The nascent process of writing South African AIDS histories provides the opportunity to record responses to AIDS at institutional level, reveal the connections between narratives about AIDS and those responses, and draw on the personal stories of those who were at the nexus of impersonal official responses and the personal politics of AIDS. This article records the experiences of Dennis Sifris, a physician who helped establish one of the first AIDS clinics in South Africa and emptied the dance floors, and Pierre Brouard, a clinical psychologist who was involved in early counselling, support and education initiatives for HIV-positive people, and counselled people about dying, and then about living. Their stories show how, even within government-aligned health care spaces hostile to gay men, they were able to provide support and treatment to people; benefited from international connections with other gay communities; and engaged in socially subversive activities. These oral histories thus provide otherwise hidden insights into the experiences of some gay men at the start of an epidemic that was initially almost exclusively constructed on, and about, gay men’s bodies. PMID:24775431

  2. Two tales about illness, ideologies, and intimate identities: sexuality politics and AIDS in South Africa, 1980-95.

    PubMed

    Tsampiras, Carla

    2014-04-01

    This article focuses on the micro-narratives of two individuals whose responses to AIDS were mediated by their sexual identity, AIDS activism and the political context of South Africa during a time of transition. Their experiences were also mediated by well-established metanarratives about AIDS and 'homosexuality' created in the USA and the UK which were transplanted and reinforced (with local variations) into South Africa by medico-scientific and political leaders.The nascent process of writing South African AIDS histories provides the opportunity to record responses to AIDS at institutional level, reveal the connections between narratives about AIDS and those responses, and draw on the personal stories of those who were at the nexus of impersonal official responses and the personal politics of AIDS. This article records the experiences of Dennis Sifris, a physician who helped establish one of the first AIDS clinics in South Africa and emptied the dance floors, and Pierre Brouard, a clinical psychologist who was involved in early counselling, support and education initiatives for HIV-positive people, and counselled people about dying, and then about living. Their stories show how, even within government-aligned health care spaces hostile to gay men, they were able to provide support and treatment to people; benefited from international connections with other gay communities; and engaged in socially subversive activities. These oral histories thus provide otherwise hidden insights into the experiences of some gay men at the start of an epidemic that was initially almost exclusively constructed on, and about, gay men's bodies.

  3. Defining minimum standards of practice for incorporating African traditional medicine into HIV/AIDS prevention, care, and support: a regional initiative in eastern and southern Africa.

    PubMed

    Homsy, Jaco; King, Rachel; Tenywa, Joseph; Kyeyune, Primrose; Opio, Alex; Balaba, Dorothy

    2004-10-01

    In many resource-poor settings of Africa, a majority of people living with HIV/AIDS depend on and choose traditional healers for psychosocial counseling and health care. If the current pan-African prevention and care efforts spurred by the HIV pandemic do not actively engage African Traditional Medicine, they will effectively miss 80%, the vast majority of the African people who, according to the World Health Organization, rely on traditional medicine for their primary health care needs. In 2001, the Ugandan nongovernmental organization, Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases, in Kampala, identified the need for a concerted, systematic, and sustained effort at both local and regional levels to support and validate African Traditional Medicine on several fronts. The Eastern & Southern Africa Regional Initiative on Traditional Medicine and AIDS was borne out of this assessment. It convened a regional consultation in May 2003, which produced a series of proposed standards around six main themes related to traditional medicine and HIV/AIDS: the systematic evaluation of traditional remedies; spiritual aspects of healing; HIV prevention and care; processing and packaging of traditional remedies; protection of indigenous knowledge; and intellectual property rights related to traditional health systems. These standards, summarized in this paper, will be incorporated into programs on traditional medicine and HIV/AIDS by various implementers in the region. A number of strategies to test and implement these recommendations are also defined.

  4. Non-AIDS definings malignancies among human immunodeficiency virus-positive subjects: Epidemiology and outcome after two decades of HAART era

    PubMed Central

    Brugnaro, Pierluigi; Morelli, Erika; Cattelan, Francesca; Petrucci, Andrea; Panese, Sandro; Eseme, Franklyn; Cavinato, Francesca; Barelli, Andrea; Raise, Enzo

    2015-01-01

    Highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection has been widely available in industrialized countries since 1996; its widespread use determined a dramatic decline in acquired immunodeficiency syndrome (AIDS)-related mortality, and consequently, a significant decrease of AIDS-defining cancers. However the increased mean age of HIV-infected patients, prolonged exposure to environmental and lifestyle cancer risk factors, and coinfection with oncogenic viruses contributed to the emergence of other malignancies that are considered non-AIDS-defining cancers (NADCs) as a relevant fraction of morbidity and mortality among HIV-infected people twenty years after HAART introduction. The role of immunosuppression in the pathogenesis of NADCs is not well defined, and future researches should investigate the etiology of NADCs. In the last years there is a growing evidence that intensive chemotherapy regimens and radiotherapy could be safely administrated to HIV-positive patients while continuing HAART. This requires a multidisciplinary approach and a close co-operation of oncologists and HIV-physicians in order to best manage compliance of patients to treatment and to face drug-related side effects. Here we review the main epidemiological features, risk factors and clinical behavior of the more common NADCs, such as lung cancer, hepatocellular carcinoma, colorectal cancer and anal cancer, Hodgkin’s lymphoma and some cutaneous malignancies, focusing also on the current therapeutic approaches and preventive screening strategies. PMID:26279983

  5. Targeted therapies to treat Non-AIDS Defining Cancers in patients with HIV on HAART therapy – treatment considerations and research outlook

    PubMed Central

    Deeken, John F.; Pantanowitz, Liron; Dezube, Bruce J.

    2012-01-01

    Purpose of review Highly active antiretroviral therapy (HAART) has led to a dramatic improvement in the prognosis of patients diagnosed with HIV and AIDS. This includes a significant decline in the rates of AIDS-related cancers, including Kaposi Sarcoma and Non-Hodgkin's Lymphoma. Unfortunately, rates of Non-AIDS Defining Cancers (NADCs) are on the rise, and now exceed the rates of AIDS-related cancers in patients with HIV. Treating NADCs in patients who are on HAART therapy is an open and complicated clinical question. Recent findings Newer targeted therapies are now available to treat cancers which were historically refractory to traditional cytotoxic chemotherapy. HAART agents are notorious for causing drug-drug interactions. The co-administration of targeted chemotherapies with HAART could well impede the efficacy or increase the toxicity of these targeted therapies. Unfortunately little is known about possible drug-drug interactions because HIV patients are typically excluded from clinical trials. Summary We highlight what is known about how and why HAART agents can affect drug metabolism. We then present the clinical and pharmacological data for nine recently approved targeted therapies – imatinib, dasatinib, nilotinib, erlotinib, sunitinib, lapatinib, bortezomib, sorafenib, and temsirolimus. We conclude with considerations on how to use these new agents to treat NADCs, and discuss a future research agenda to better understand and predict potential HAART-targeted therapy interactions. PMID:19606034

  6. Costs of care for people living with combined HIV/AIDS, chronic mental illness, and substance abuse disorders.

    PubMed

    Conover, Christopher J; Weaver, Marcia; Ang, Alfonso; Arno, Peter; Flynn, Patrick M; Ettner, Susan L

    2009-12-01

    To determine healthcare access and costs for triply diagnosed adults, we examined baseline data from the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, a multi-site cohort study of HIV+ adults with co-occurring mental and substance abuse disorders conducted between 2000 and 2004. Baseline interviews were conducted with 1138 triply diagnosed adults in eight predominantly urban sites nationwide. A modified version of Structured Interview for DSM-IV Axis I Disorders (SCID) was used to assign Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses for the preceding year. Utilization of a broad range of inpatient and outpatient services and medications over the preceding three months was patient-reported in face-to-face interviews. We then applied nationally representative unit costs to impute average monthly expenditures. We measured (poor) access to care during the three-month period by whether the patient had: (a) no outpatient medical visits; (b) at least one emergency room visit without an associated hospitalization; and (c) at least one hospitalization. At baseline, mean expenditures were $3880 per patient per month. This is nearly twice as high as expenditures for HIV/AIDS patients in general. Inpatient care (36%), medications (33%), and outpatient services (31%) each accounted for roughly one-third of expenditures. Expenditures varied by a factor of 2:1 among subgroups of patients, with those on Medicare or Medicaid, not in stable residences, or with poor physical health or high viral loads exhibiting the highest costs. Access to care was worse for women and those with low incomes, unstable residences, same-sex exposure, poor physical or mental health, and high viral loads. We conclude that HIV triply diagnosed adults account for roughly one-fifth of medical spending on HIV patients and that there are large variations in utilization/costs across patient subgroups. Realized access is good for many triply diagnosed

  7. Well-defined hollow nanochanneled-silica nanospheres prepared with the aid of sacrificial copolymer nanospheres and surfactant nanocylinders

    NASA Astrophysics Data System (ADS)

    Kim, Young Yong; Hwang, Bora; Song, Sungjin; Ree, Brian J.; Kim, Yongjin; Cho, Seo Yeon; Heo, Kyuyoung; Kwon, Yong Ku; Ree, Moonhor

    2015-08-01

    A new approach for synthesizing well-defined hollow nanochanneled-silica nanosphere particles is demonstrated, and the structural details of these particles are described for the first time. Positively charged styrene copolymer nanospheres with a clean, smooth surface and a very narrow size distribution are synthesized by surfactant-free emulsion copolymerization and used as a thermal sacrificial core template for the production of core-shell nanoparticles. A surfactant/silica composite shell with a uniform thickness is successfully produced and deposited onto the polymeric core template by charge density matching between the polymer nanosphere template surface and the negatively charged silica precursors and then followed by selective thermal decomposition of the polymeric core and the surfactant cylinder domains in the shell, producing the hollow nanochanneled-silica nanospheres. Comprehensive, quantitative structural analyses collectively confirm that the obtained nanoparticles are structurally well defined with a hollow core and a shell composed of cylindrical nanochannels that provide facile accessibility to the hollow interior space. Overall, the hollow nanochanneled-silica nanoparticles have great potential for applications in various fields.A new approach for synthesizing well-defined hollow nanochanneled-silica nanosphere particles is demonstrated, and the structural details of these particles are described for the first time. Positively charged styrene copolymer nanospheres with a clean, smooth surface and a very narrow size distribution are synthesized by surfactant-free emulsion copolymerization and used as a thermal sacrificial core template for the production of core-shell nanoparticles. A surfactant/silica composite shell with a uniform thickness is successfully produced and deposited onto the polymeric core template by charge density matching between the polymer nanosphere template surface and the negatively charged silica precursors and then

  8. Well-defined hollow nanochanneled-silica nanospheres prepared with the aid of sacrificial copolymer nanospheres and surfactant nanocylinders.

    PubMed

    Kim, Young Yong; Hwang, Bora; Song, Sungjin; Ree, Brian J; Kim, Yongjin; Cho, Seo Yeon; Heo, Kyuyoung; Kwon, Yong Ku; Ree, Moonhor

    2015-09-21

    A new approach for synthesizing well-defined hollow nanochanneled-silica nanosphere particles is demonstrated, and the structural details of these particles are described for the first time. Positively charged styrene copolymer nanospheres with a clean, smooth surface and a very narrow size distribution are synthesized by surfactant-free emulsion copolymerization and used as a thermal sacrificial core template for the production of core-shell nanoparticles. A surfactant/silica composite shell with a uniform thickness is successfully produced and deposited onto the polymeric core template by charge density matching between the polymer nanosphere template surface and the negatively charged silica precursors and then followed by selective thermal decomposition of the polymeric core and the surfactant cylinder domains in the shell, producing the hollow nanochanneled-silica nanospheres. Comprehensive, quantitative structural analyses collectively confirm that the obtained nanoparticles are structurally well defined with a hollow core and a shell composed of cylindrical nanochannels that provide facile accessibility to the hollow interior space. Overall, the hollow nanochanneled-silica nanoparticles have great potential for applications in various fields.

  9. Toward an Understanding of Development of Learning to Solve Ill-Defined Problems in an Online Context: A Multi-Year Qualitative Exploratory Study

    ERIC Educational Resources Information Center

    Peddibhotla, Naren

    2016-01-01

    The case study is a classic tool used in several educational programs that emphasizes solving of illdefined problems. Though it has been used in classroom-based teaching and educators have developed a rich repertoire of methods, its use in online courses presents different challenges. To explore factors that develop skills in solving ill-defined…

  10. Suicide in the Medically Ill.

    ERIC Educational Resources Information Center

    Hughes, Douglas; Kleespies, Phillip

    2001-01-01

    The relationship between medical illness and suicide seems to be multi-faceted. While medical illness is not the sole determinant of suicide, certain illnesses, such as HIV/AIDS and brain cancers, do appear to elevate the risk of suicide. Possible effective prevention efforts include education of primary care providers, and improved medication…

  11. Comparative Impact of Two Training Packages on Awareness and Practices of First Aid for Injuries and Common Illnesses among High School Students in India

    ERIC Educational Resources Information Center

    Goel, Sonu; Singh, Amarjeet

    2008-01-01

    Knowledge about various illnesses and their management is not satisfactory among high school students especially in rural areas in India. Various incorrect practices and myths associated with illnesses and injuries still exit. Training and education about correct management of injuries and illnesses for students is a sound and logical investment.…

  12. Chronic kidney disease at presentation is not an independent risk factor for AIDS-defining events or death in HIV-infected persons.

    PubMed

    Alves, Tahira P; Wu, Pingsheng; Ikizler, T Alp; Sterling, Timothy R; Stinnette, Samuel E; Rebeiro, Peter F; Ghosh, Suvro; Hulgan, Todd

    2013-02-01

    Studies have documented an association between chronic kidney disease (CKD) and increased risk of end stage renal disease, death and comorbidities, including cardiovascular disease and metabolic syndrome, in the general population. However, there is little data on the relationship between CKD and ADE (AIDS defining event), and to our knowledge, no studies have analyzed death as a competing risk for ADE among HIV-infected persons. An observational cohort study was performed to determine the incidence and risks for developing an ADE or death among HIV-infected persons with and without CKD from 1998 - 2005. CKD was defined as an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m2 using the CKDEpidemiology Collaboration (CKD-EPI) equation. Log rank test and Cox regression which determined time to development of ADE and/or death as combined and separate outcomes, and competing risk models for ADE versus mortality, were performed. Among the 2,127 persons that contributed to the 5,824 person years of follow-up: 22% were female, 34% African American, 38% on HAART, and 3% had CKD at baseline. ADE occurred in 227 (11%) persons and there were 80 (4%) deaths. CKD was not significantly associated with ADE/death (HR 1.3, 95% CIs: 0.5, 3.2), ADE (HR 1.0, 95% CIs: 0.4, 3.1), or death (HR 1.6, 95% CIs: 0.4, 3.1). Competing risk analyses confirmed no statistically significant associations between CKD and these outcomes. CKD was uncommon in HIV-infected persons presenting for care in this racially diverse cohort, and was not independently associated with risk of developing an ADE or dying during follow-up.

  13. Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study

    PubMed Central

    Hema, Mariam Noelie; Ferry, Tristan; Dupon, Michel; Cuzin, Lise; Verdon, Renaud; Thiébaut, Rodolphe; Protopopescu, Camelia; Leport, Catherine; Raffi, François; Le Moing, Vincent

    2016-01-01

    Objectives To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART). Methods The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm3, CD4 > 500/mm3 and CD4/CD8 ratio < 1, CD4 > 500/mm3 and CD4/CD8 ratio > 1). Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion. Results We included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2–11.4). Median CD4 was 530/mm3 at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2–0.5) at baseline and 0.6 (IQR: 0.4–0.9) after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%), cardiovascular events (14%) and cancers (10%). For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32–3.44). Conclusions CD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening. PMID:27548257

  14. Incidence of Non-AIDS-Defining Malignancies in HIV-Infected Vs. Non-Infected Patients in the HAART Era: Impact of Immunosuppression

    PubMed Central

    Bedimo, Roger J.; McGinnis, Kathleen A.; Dunlap, Melinda; Rodriguez-Barradas, Maria C.; Justice, Amy C.

    2009-01-01

    Background The incidence of non-AIDS-defining malignancies (non-ADM) is reported as unchanged or increasing in the HAART era. Whether incidence of non-ADM is significantly higher in HIV-infected than in HIV-uninfected patients remains unclear. Methods Incidence rates of malignancies were calculated in a cohort of veterans in care for HIV-infected and age, race, and gender-matched uninfected patients from 1997 to 2004. For HIV-infected patients CD4 counts closest to first observation date were compared between those with and without cancer. Results 33,420 HIV-infected and 66,840 HIV-uninfected patients were followed for a median of 5.1 and 6.4 years. The Incidence rate ratio [IRR] of HIV-infected to HIV-uninfected was 1.6 (1260 vs. 841/100,000 person-years; 95% CI: 1.5–1.7). IRR for individual cancers was highest for anal cancer (14.9; CI: 10.1–22.1). Among HIV-infected patients, median CD4 counts were lower for those with non-ADM (249 vs. 270, p=0.02), anal cancer (154 vs. 270; p<0.001), and Hodgkin’s (217 vs. 270; p=0.03). Prostate cancer was associated with a higher CD4 count (310 vs. 270; p<0.001). Conclusions In the HAART era, the incidence of non-ADMs is higher among HIV-infected than HIV-uninfected patients, adjusting for age, race, and gender. Some non-ADMs do not appear to be associated with significantly lower CD4 counts. PMID:19617846

  15. The Stigma of Mental Illness

    ERIC Educational Resources Information Center

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  16. Non-AIDS defining cancers in the D:A:D Study - time trends and predictors of survival: a cohort study

    PubMed Central

    2013-01-01

    Background Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004–2010, and described subsequent mortality and predictors of these. Methods Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient’s last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient’s death, 1st February 2010 or 6 months after the patient’s last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression. Results Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin’s lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004–2010 in this large observational cohort. Conclusions The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved

  17. Survival Outcomes and Effect of Early vs. Deferred cART Among HIV-Infected Patients Diagnosed at the Time of an AIDS-Defining Event: A Cohort Analysis

    PubMed Central

    Mussini, Cristina; Johnson, Margaret; d'Arminio Monforte, Antonella; Antinori, Andrea; Gill, M. John; Sighinolfi, Laura; Uberti-Foppa, Caterina; Borghi, Vanni; Sabin, Caroline

    2011-01-01

    Objectives We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART). Methods Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997–2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death) was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (<30 days after AIDS event) or deferred (30–270 days after AIDS event) cART. Results The median (interquartile range) CD4 count and viral load (VL) at diagnosis of the 584 patients were 42 (16, 119) cells/µL and 5.2 (4.5, 5.7) log10 copies/mL. Clinical progression was observed in 165 (28.3%) patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL) (vs. other AIDS events) were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6%) received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p = 0.20). Conclusions Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting. PMID:22043301

  18. Alanine-scanning mutagenesis defines a conserved energetic hotspot in the CaVα1 AID-CaVβ interaction site that is critical for channel modulation

    PubMed Central

    Van Petegem, Filip; Duderstadt, Karl E.; Clark, Kimberly A.; Wang, Michelle; Minor, Daniel L.

    2011-01-01

    Voltage-gated calcium channels (CaVs) are large, multisubunit complexes that control cellular calcium entry. CaV pore-forming (CaVα1) and cytoplasmic (CaVβ) subunits associate through a high-affinity interaction between the CaVα1 α-interaction domain (AID) and CaVβ α-binding pocket (ABP). Here, we analyze AID-ABP interaction thermodynamics using isothermal titration calorimetry (ITC). We find that commensurate with their strong sequence similarity, all CaV1 and CaV2 AID peptides bind CaVβ with similar nanomolar affinities. Although the AID-ABP interface encompasses twenty-four sidechains, alanine-scanning mutagenesis reveals that the binding energy is focused in two complementary hotspots comprising four deeply-conserved residues. Electrophysiological experiments show that hotspot interaction disruption prevents trafficking and functional modulation of CaV1.2 by CaVβ. Together, the data support the primacy of the AID-ABP interface for CaVα1-CaVβ association, underscore the idea that hotspots dominate protein-protein interaction affinities, and uncover a target for strategies to control cellular excitability by blocking CaVα1-CaVβ complex formation. PMID:18275819

  19. The illness narratives of men involved in the criminal justice system: A study of health behaviors, chronic conditions and HIV/AIDS

    PubMed Central

    Valera, Pamela; Kratz, Molly

    2014-01-01

    Summary Former inmates encounter a variety of challenges when returning to their community, including poor health status and limited access to healthcare services. This qualitative study examined how former male inmates with chronic conditions perceived, understood, managed, and coped with their illnesses. Findings: The participants were Black and Puerto Rican, with a mean age of 47 years, who were interviewed within three years of their release. Participants reported at least one chronic condition, with 21 HIV-negative men using chaos narratives to depict their approach to disease management. Nine HIV-positive men used quest narratives to present their illnesses and were immediately linked to supportive services, enabling them to overcome the barriers to community reintegration. Applications: Health interventions in the area of forensic social work ought to focus on conducting Medicaid outreach and enrollment efforts prior to correctional facility discharge. PMID:25419175

  20. ''Beauty of Wholeness and Beauty of Partiality.'' New Terms Defining the Concept of Beauty in Architecture in Terms of Sustainability and Computer Aided Design

    ERIC Educational Resources Information Center

    Farid, Ayman A.; Zaghloul, Weaam M.; Dewidar, Khaled M.

    2014-01-01

    The great shift in sustainability and computer aided design in the field of architecture caused a remarkable change in the architecture philosophy, new aspects of beauty and aesthetic values are being introduced, and traditional definitions for beauty cannot fully cover this aspects, which causes a gap between; new architecture works criticism and…

  1. Voodoo illness.

    PubMed

    Campinha-Bacote, J

    1992-01-01

    Healthcare providers must familiarize themselves with specific culture-bound syndromes and their manifestations in order to provide quality care to culturally diverse clients seeking healthcare services. Voodoo illness is one of several culture-bound syndromes that nurses need to be familiar with, for an inability to understand voodoo illness may result in the client's death (voodoo death).

  2. "Requestioning" AIDS: An Ethical Reflection From 1993 to Today. Reflections on Claude Vandevyer's "Homosexuals and AIDS: A New Approach to the Illness" from Journal of Homosexuality 25(3).

    PubMed

    Lau, Travis

    2016-01-01

    This article serves as one of the supplementary pieces of this special issue on "Mapping Queer Bioethics," in which we take a solipsistic turn to "map" the Journal of Homosexuality itself. Here, the author examines the first feature-length article to address the relationship between HIV status and homosexuality. Lingering on both the temporal gap between the dawn of AIDS in American discourse and its inclusion in this journal, the author asks us to consider (in hindsight) such a delay bearing in mind queer theoretical projects of the present such as gay shame, stigma, and queer biopolitics.

  3. Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions

    PubMed Central

    Jibaja‐Weiss, Maria L.; Volk, Robert J.; Friedman, Lois C.; Granchi, Thomas S.; Neff, Nancy E.; Spann, Stephen J.; Robinson, Emily K.; Aoki, Noriaki; Robert Beck, J.

    2006-01-01

    Abstract Objective  To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design  Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample  Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention  A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes  Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results  Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions  A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. PMID:16911136

  4. Validation of the vascular pedicle width as a diagnostic aid in critically ill patients with pulmonary oedema by novice non-radiology physicians-in-training.

    PubMed

    Farshidpanah, S; Klein, W; Matus, M; Sai, A; Nguyen, H B

    2014-05-01

    Assessing intravascular volume status in the critically ill patient remains a challenge for intensivists, and the accuracy of such estimation based on bedside examination alone is reported to be nearly a coin toss. In this retrospective study we sought to validate a previously recommended chest radiographic vascular pedicle width (VPW) ≥70 mm for identifying cardiogenic pulmonary oedema (CPO). We additionally assessed whether novice physicians-in-training can reliably measure the VPW. The study included intensive care patients with an existing pulmonary artery catheter. Three independent raters performed measurements of VPW from chest radiographs obtained within three hours of pulmonary artery occlusion pressure measurements. In 80 patients enrolled, a VPW cut-off of ≥70 mm had a 55% sensitivity, 88% specificity, 81% positive predictive value, 69% negative predictive value and 73% accuracy for identifying patients with CPO. Receiver operating characteristic curve analysis showed an area under the curve of 0.72 (95% confidence interval 0.61 to 0.84) for VPW in discriminating CPO from non-cardiogenic pulmonary oedema. Kappa statistics for inter-rater reliability showed Kappa=0.41, 0.42 and 0.85 for each pair of the three raters. In conclusion, the previously accepted VPW cut-off of ≥70 mm is reasonably accurate in discriminating CPO from non-cardiogenic pulmonary oedema. VPW can be measured by physicians-in-training with a comparable performance to previous studies utilising expert radiologists.

  5. Protecting the health of the @hlete: how online technology may aid our common goal to prevent injury and illness in sport.

    PubMed

    Verhagen, Evert; Bolling, Caroline

    2015-09-01

    Online technology dominates our era and eHealth has become a reality for sports clinicians and researchers. Contemporary online platforms enable self-monitoring and provide tailored feedback to the different stakeholders who play a role in the health and care of athletes. Innovations such as digital monitoring, mobile applications and connected hardware provide the critical tools to solve current enigmas in sports medicine research, and to streamline and facilitate injury prevention, management and rehabilitation. eHealth is not an emerging future of sports medicine-the technology to move our field forward in terms of research and practice is already available. This Analysis is based on Evert Verhagen's keynote presentation at the IOC World Conference on Injury and Illness Prevention in Sport (Monaco, 12 April 2014). It outlines the use of eHealth in research, implementation and practice, and provides an overview of possibilities and opportunities that existing and emerging eHealth solutions provide for sports and exercise medicine and physiotherapy.

  6. Foodborne Illness

    MedlinePlus

    ... people in the U.S. get sick from contaminated food. Common culprits include bacteria, parasites and viruses. Symptoms ... are the most common cause of foodborne illness. Foods may have some bacteria on them when you ...

  7. Genome-wide CTCF distribution in vertebrates defines equivalent sites that can aid in the identification of disease-associated genes

    PubMed Central

    Martin, David; Pantoja, Cristina; Miñán, Ana Fernández; Valdes-Quezada, Christian; Moltó, Eduardo; Matesanz, Fuencisla; Bogdanovic, Ozren; de la Calle-Mustienes, Elisa; Domínguez, Orlando; Taher, Leila; Furlan-Magaril, Mayra; Alcina, Antonio; Cañón, Susana; Fedetz, María; Blasco, María A.; Pereira, Paulo S.; Ovcharenko, Ivan; Recillas-Targa, Félix; Montoliu, Lluís; Manzanares, Miguel; Guigó, Roderic; Serrano, Manuel; Casares, Fernando; Gómez-Skarmeta, José Luis

    2011-01-01

    Many genomic alterations associated to human diseases localize in non-coding regulatory elements located far from the promoters they regulate, making the association of non-coding mutations or risk associated variants to target genes challenging. The range of action of a given set of enhancers is thought to be defined by insulator elements bound by CTCF. Here, we analyzed the genomic distribution of CTCF in various human, mouse and chicken cell types, demonstrating the existence of evolutionarily conserved CTCF-bound sites beyond mammals. These sites preferentially flank transcription factor-encoding genes, often associated to human diseases, and function as enhancer blockers in vivo, suggesting that they act as evolutionary invariant gene boundaries. We then applied this concept to predict and functionally demonstrate that the polymorphic variants associated to multiple sclerosis located within the EVI5 gene are actually impinging on the adjacent gene GFI1. PMID:21602820

  8. Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C.

    PubMed

    Shin, Jenny; Epperson, Katrina; Yanjanin, Nicole M; Albus, Jennifer; Borgenheimer, Laura; Bott, Natalie; Brennan, Erin; Castellanos, Daniel; Cheng, Melissa; Clark, Michael; Devany, Margaret; Ensslin, Courtney; Farivari, Nina; Fernando, Shanik; Gabriel, Lauren; Gallardo, Rani; Castleman, Moriah; Gutierrez, Olimpia; Herschel, Allison; Hodge, Sarah; Horst, Anne; Howard, Mary; James, Evan; Jones, Lindsey; Kearns, Mary; Kelly, Mary; Kim, Christine; Kiser, Kinzie; Klazura, Gregory; Knoedler, Chris; Kolbus, Emily; Lange, Lauren; Lee, Joan; Li, Eileena; Lu, Wei; Luttrell, Andrew; Ly, Emily; McKeough, Katherine; McSorley, Brianna; Miller, Catherine; Mitchell, Sean; Moon, Abbey; Moser, Kevin; O'Brien, Shane; Olivieri, Paula; Patzwahl, Aaron; Pereira, Marie; Pymento, Craig; Ramelb, Erin; Ramos, Bryce; Raya, Teresa; Riney, Stephen; Roberts, Geoff; Robertshaw, Mark; Rudolf, Frannie; Rund, Samuel; Sansone, Stephanie; Schwartz, Lindsay; Shay, Ryan; Siu, Edwin; Spear, Timothy; Tan, Catherine; Truong, Marisa; Uddin, Mairaj; Vantrieste, Jennifer; Veloz, Omar; White, Elizabeth; Porter, Forbes D; Haldar, Kasturi

    2011-01-01

    Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease.

  9. The critically ill immunosuppressed patient

    SciTech Connect

    Parrillo, J.E.; Masur, H. )

    1987-01-01

    This book discusses the papers on the diagnosis and management of immunosuppressed patient. Some of the topics are: life-threatening organ failure in immunosuppressed patients; diagnosis and therapy of respiratory disease in the immunosuppressed patient; CNS complication of immunosuppression; infections; antineoplastic therapy of immunosuppressed patient; radiation therapy-issues in critically ill patient; AIDS; and management of bone marrow transplant patients.

  10. Concepts, Structures, and Goals: Redefining Ill-Definedness

    ERIC Educational Resources Information Center

    Lynch, Collin; Ashley, Kevin D.; Pinkwart, Niels; Aleven, Vincent

    2009-01-01

    In this paper we consider prior definitions of the terms "ill-defined domain" and "ill-defined problem". We then present alternate definitions that better support research at the intersection of Artificial Intelligence and Education. In our view both problems and domains are ill-defined when essential concepts, relations, or criteria are un- or…

  11. Rupioid histoplasmosis: first case reported in an AIDS patient in Argentina.

    PubMed

    Corti, Marcelo; Villafañe, María F; Palmieri, Omar; Negroni, Ricardo

    2010-01-01

    Disseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.

  12. Foodborne Illness

    DTIC Science & Technology

    1983-02-01

    ond time. Britain. A similar investigational drug, 3.4-dia- Therapy is nonspecific in patients poisoned minopyridine, is less toxic and shows dramatic...time of onset as well as in the type of Because neuromuscular paralysis may pro- toxicity . FOODBORNE ILLNESS-Continuod 19 The earliest manifestations of... toxicity result Favism from the peripheral anticholinergic effects of Some persons with an inherited deficiency of muscarine. Symptoms begin 10 to 120

  13. Parametric modelling of survival following HIV and AIDS in the era of highly active antiretroviral therapy: data from Australia.

    PubMed

    Nakhaee, F; Law, M

    2011-03-01

    Parametric survival models have not previously been applied to survival following a diagnosis of HIV/AIDS in Australia. Four different parametric models--exponential, Weibull, log-normal and log-logistic--were applied to data both on HIV-positive cases and on cases diagnosed with AIDS collected through the national HIV/AIDS surveillance system. Using likelihood based goodness-of-fit criteria the Weibull model was found to be the best-fitted model for predicting survival following a diagnosis of HIV infection without and with a diagnosis of AIDS. Several covariates-age, sex, combined HIV exposure category, CD4 cell counts, antiretroviral treatment and AIDS-defining illnesses--were included in the parametric model to predict factors associated with future mortality. Predicted deaths were in agreement with the observed deaths following HIV infection and AIDS. The Weibull model will be applied for future projections of deaths from HIV/AIDS.

  14. AIDS: acquired immunodeficiency syndrome.

    PubMed Central

    Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1983-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of utmost importance. PMID:6342737

  15. AIDS: acquired immunodeficiency syndrome *

    PubMed Central

    Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1992-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049

  16. First Aid: Dehydration

    MedlinePlus

    ... Aid: Heat Illness Sun Safety Dehydration Diarrhea Vomiting Word! Dehydration What's the Big Sweat About Dehydration? How to Be Safe When You're in the Sun What's Sweat? Dehydration Is It Important to Drink a Lot of Water? Contact Us Print Resources Send to a Friend ...

  17. Trends in AIDS incidence and AIDS-related mortality in British Columbia between 1981 and 2013

    PubMed Central

    Lima, Viviane D.; Lourenço, Lillian; Yip, Benita; Hogg, Robert S.; Phillips, Peter; Montaner, Julio S.G.

    2015-01-01

    Background Appropriate use of highly active antiretroviral therapy (HAART) can markedly decrease the risk of progression to acquired immunodeficiency syndrome (AIDS) and of premature mortality. We aimed to characterize the trends between 1981 and 2013 in AIDS-defining illnesses (ADIs) and in the number AIDS-related deaths in British Columbia (BC), Canada. Methods We included data of 3550 HIV-positive individuals, aged 19 years or older, from different administrative databases in BC. We estimated the relative risk of developing an ADI over time using a Negative Binomial model, and we investigated trends in the percentage of all deaths associated with AIDS using generalized additive models. Findings The number of ADIs has decreased dramatically to its lowest level in 2013. The peak of the AIDS epidemic in BC happened in 1994 with 696 ADIs being reported (rate 42 ADIs per 100 person-years). Since 1997, the number of ADIs decreased from 253 (rate 7 per 100 person-years) to 84 cases in 2013 (rate 1 per 100 person-years) (p-value equals to zero for the trend in the number of ADIs). We have also shown that out of 22 ADIs considered, only PCP maintained its prominent ranking (albeit with much reduced overall prevalence). Finally, we observed that over time very few deaths were related to AIDS-related causes, especially in the most recent years. Interpretation We showed that the number of new ADIs and AIDS-related mortality have been decreasing rapidly over time in BC. These results provide further evidence that integrated comprehensive free programs that facilitate testing, and deliver treatment and care to this population can be effective in markedly decreasing AIDS-related morbidity and mortality, thus suggesting that controlling and eventually ending AIDS is possible. Funding The British Columbia Ministry of Health, the US National Institutes of Health, the US National Institute on Drug Abuse, the Canadian Institutes of Health Research, and the Michael Institute for

  18. Hydrocephalus Defined

    MedlinePlus

    ... narrow pathways. CSF is in constant production and absorption; it has a defined pathway from the lateral ... there is an imbalance of production and/or absorption. With most types of hydrocephalus, the fluid gets ...

  19. Medical aid schemes respond to AIDS.

    PubMed

    Taylor, G

    1999-01-01

    The insurance and medical aid industries reacted strongly in the 1980s to alarmist predictions of the likely impact of HIV upon employee benefits. Actuaries and accountants moved quickly to contain the risk, and most medical aid trustees quickly implemented a total exclusion of HIV treatment from their benefits. For more than 1 decade, it was argued that HIV/AIDS is a self-inflicted illness, often categorized with other STDs. In response, healthcare providers simply bypassed insurance restrictions and compensation limits by masking patient diagnoses to reflect pneumonia or other ambiguous, yet fully reimbursable, illnesses. Now, common sense has finally prevailed as a few managed healthcare programs are stepping forward to break the impasse. The largest such program is Aid for AIDS, run by Pharmaceutical Benefit Management Ltd. for schemes within the Medscheme Group. The Group built an entirely new, secure unit off-site from their normal branches to guarantee the confidentiality of patients' records and diagnoses, while treatment guidelines have been issued to every practicing physician in the country.

  20. Hearing Aids

    MedlinePlus

    ... Health Info » Hearing, Ear Infections, and Deafness Hearing Aids On this page: What is a hearing aid? ... the ear through a speaker. How can hearing aids help? Hearing aids are primarily useful in improving ...

  1. The changing face of HIV/AIDS in treated patients.

    PubMed

    Llibre, Josep M; Falco, Vicenç; Tural, Cristina; Negredo, Eugenia; Pineda, Juan A; Muñoz, Jose; Ortega, Enrique; Videla, Sebastia; Sirera, Guillem; Martinez, Esteban; Miralles, Celia; Iribarren, Josean; Galindo, Maria J; Domingo, Pere; d'Arminio-Monforte, Antonella; Miro, Jose M; Clotet, Bonaventura

    2009-07-01

    The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.

  2. AIDS: Children Too.

    ERIC Educational Resources Information Center

    Lejeune, Genevieve, Ed.

    1994-01-01

    This journal issue is devoted to the many problems faced by children with Acquired Immune Deficiency Syndrome (AIDS) who live in both developing and developed countries. Section 1 provides general information on the pandemic, defining AIDS and exploring the social aspects of the disease. It also addresses child health, child mortality, moral and…

  3. AIDS and Chemical Dependency.

    ERIC Educational Resources Information Center

    Pohl, Melvin I.

    After defining HIV and the AIDS disease and outlining symptoms and means of infection, this fact sheet lists the ways alcohol and drugs are involved with the AIDS epidemic, noting that needle-sharing transmits the virus; that alcohol or mood-altering drugs like crack cocaine cause disinhibition, increase sex drive, encourage sex for drugs, and…

  4. Waterborne Diseases & Illnesses

    MedlinePlus

    ... Pollutants Natural Disasters Drinking Water Waterborne Diseases & Illnesses Water Cycle Water Treatment Videos Games Experiments For Teachers Home ... Pollutants Natural Disasters Drinking Water Waterborne Diseases & Illnesses Water Cycle Water Treatment Waterborne Diseases & Illnesses The Basics Would ...

  5. Garrett County Aids AID

    ERIC Educational Resources Information Center

    Appalachia, 1975

    1975-01-01

    Garrett County, Maryland volunteered to act as a pre-overseas learning laboratory for AID (Agency for International Development) interns who practiced data collection and planning techniques with the help of local citizenry. (JC)

  6. Delayed puberty in chronic illness.

    PubMed

    Pozo, Jesús; Argente, Jesús

    2002-03-01

    Delayed puberty can be defined as the lack of pubertal development at an age of 2 SD above the mean, which corresponds to an age of approximately 14 years for males and 13 years for females, taking both sex and ethnic origin into consideration. Its incidence associated with chronic illnesses is unknown; however, its clinical importance is relevant due to the larger percentage of patients with chronic disorders surviving until the age of puberty. Virtually every child with any chronic disease could present with delayed puberty (due to recurrent infections, immunodeficiency, gastrointestinal disease, renal disturbances, respiratory illnesses, chronic anaemia, endocrine disease, eating disorders, exercise and a number of miscellaneous abnormalities). Pubertal delay associated with chronic illness is accompanied by a delay in growth and the pubertal growth spurt. The degree to which growth and pubertal development are affected in chronic illness depends upon the type of disease and individual factors, as well as on the age at illness onset, its duration and severity. The earlier its onset and the longer and more severe the illness, the greater the repercussions on growth and pubertal development. The mechanism that trigger the start of physiological puberty remain unknown. Although malnutrition is probably the most important mechanism responsible for delayed puberty, emotional deprivation, toxic substances, stress and the side effects of chronic therapy, among others, have been implicated in the pathophysiology of delayed puberty. Therefore, early diagnosis is essential and appropriate and specific therapy fundamental.

  7. Defining chaos

    SciTech Connect

    Hunt, Brian R.; Ott, Edward

    2015-09-15

    In this paper, we propose, discuss, and illustrate a computationally feasible definition of chaos which can be applied very generally to situations that are commonly encountered, including attractors, repellers, and non-periodically forced systems. This definition is based on an entropy-like quantity, which we call “expansion entropy,” and we define chaos as occurring when this quantity is positive. We relate and compare expansion entropy to the well-known concept of topological entropy to which it is equivalent under appropriate conditions. We also present example illustrations, discuss computational implementations, and point out issues arising from attempts at giving definitions of chaos that are not entropy-based.

  8. HIV / AIDS

    MedlinePlus

    ... facebook share with twitter share with linkedin HIV/AIDS HIV, or human immunodeficiency virus, is the virus ... HIV/AIDS. Why Is the Study of HIV/AIDS a Priority for NIAID? Nearly 37 million people ...

  9. Hearing Aids

    MedlinePlus

    ... and Consumer Devices Consumer Products Hearing Aids Hearing Aids Share Tweet Linkedin Pin it More sharing options ... to restrict your daily activities. Properly fitted hearing aids and aural rehabilitation (techniques used to identify and ...

  10. Hearing Aids

    MedlinePlus

    ... Surgery? A Week of Healthy Breakfasts Shyness Hearing Aids KidsHealth > For Teens > Hearing Aids Print A A ... with certain types of hearing loss. How Hearing Aids Help So you went to audiologist and found ...

  11. [Nutrition in critical illness].

    PubMed

    Ökrös, Ilona

    2014-12-21

    Critically ill patients are often unable to eat by themselves over a long period of time, sometimes for weeks. In the acute phase, serious protein-energy malnutrition may develop with progressive muscle weakness, which may result in assisted respiration of longer duration as well as longer stay in intensive care unit and hospital. In view of the metabolic processes, energy and protein intake targets should be defined and the performance of metabolism should be monitored. Enteral nutrition is primarily recommended. However, parenteral supplementation is often necessary because of the disrupted tolerance levels of the gastrointestinal system. Apparently, an early parenteral supplementation started within a week would be of no benefit. Some experts believe that muscle loss can be reduced by increased target levels of protein. Further studies are needed on the effect of immune system feeding, fatty acids and micronutrients.

  12. Depression and HIV/AIDS.

    PubMed

    Benton, Tami D

    2008-06-01

    HIV/AIDS continues to be a significant public health problem. Millions of people worldwide are infected with this virus daily, and thousands die yearly of AIDS-related illnesses. Despite rapid advances in our knowledge about HIV and its mode of transmission, we have been unable to find a cure or prevent new infections. Psychiatric comorbidity is associated with HIV/AIDS: as a risk factor for HIV infection, a comorbidity of HIV infection, sequelae of HIV/AIDS, and a potential mediator for progression to AIDS. In this article, we focus on depression, which is prevalent in HIV/AIDS. We review the evidence associating depression with HIV, the challenges in recognizing depression in HIV-positive individuals, and the psychopharmacologic strategies known to be effective in the treatment of HIV-positive individuals with depression.

  13. High-Altitude Illness

    MedlinePlus

    ... high-altitude illness:Acute mountain sicknessHigh-altitude pulmonary edema (also called HAPE), which affects the lungsHigh-altitude cerebral edema (also called HACE), which affects the brainThese illnesses ...

  14. Illness anxiety disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001236.htm Illness anxiety disorder To use the sharing features on this page, please enable JavaScript. Illness anxiety disorder (IAD) is a preoccupation that physical symptoms ...

  15. Clinical characteristics associated with illness perception in psoriasis.

    PubMed

    Wahl, Astrid K; Robinson, Hilde S; Langeland, Eva; Larsen, Marie H; Krogstad, Anne-Lene; Moum, Torbjørn

    2014-05-01

    Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.

  16. Coping with Chronic Illness

    MedlinePlus

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  17. Iron and ferroptosis: A still ill-defined liaison.

    PubMed

    Doll, Sebastian; Conrad, Marcus

    2017-03-09

    Ferroptosis is a recently described form of regulated necrotic cell death, which appears to contribute to a number of diseases, such as tissue ischemia/reperfusion injury, acute renal failure, and neurodegeneration. A hallmark of ferroptosis is iron-dependent lipid peroxidation, which can be inhibited by the key ferroptosis regulator glutathione peroxidase 4(Gpx4), radical trapping antioxidants and ferroptosis-specific inhibitors, such as ferrostatins and liproxstatins, as well as iron chelation. Although great strides have been made towards a better understanding of the proximate signals of distinctive lipid peroxides in ferroptosis, still little is known about the mechanistic implication of iron in the ferroptotic process. Hence, this review aims at summarizing recent advances in our understanding to what is known about enzymatic and nonenzymatic routes of lipid peroxidation, the involvement of iron in this process and the identification of novel players in ferroptotic cell death. Additionally, we review early works carried out long time before the term "ferroptosis" was actually introduced but which were instrumental in a better understanding of the role of ferroptosis in physiological and pathophysiological contexts. © 2017 IUBMB Life, 2017.

  18. ILLNESS IS WORK: Revisiting the concept of illness careers and recognizing the identity work of patients with ME/CFS.

    PubMed

    Grue, Jan

    2016-07-01

    The concept of careers has an extensive history in the sociology of health and illness. Among other things, the notion of a career has been used to describe the changing identities of patients diagnosed with mental illness, to identify distinct stages in the progression of various illnesses, and to recognize the cooperative efforts of hospitalized patients. However, the career concept may be reanalyzed as part of an analytical metaphor that makes salient both the agency of people with illnesses and the social structures in which they are enmeshed. This metaphor, ILLNESS IS WORK, can valorize and aid understanding of the identity work and actions of patients with chronic illnesses, particularly illnesses with a low degree of social recognition and medical prestige such as myalgic encephalopathy and chronic fatigue syndrome.

  19. Hearing Aids

    MedlinePlus

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  20. HIV and AIDS--employers grapple with difficult issues.

    PubMed

    Pranschke, S C; Wright, B M

    1995-01-01

    HIV infection and AIDS pose special challenges to employers. Myriad laws affect how the employer must respond when an applicant or employee is infected with HIV or is ill due to AIDS. An overall compliance strategy should include thorough knowledge of those laws and a policy on HIV and AIDS, put in place before a crisis occurs.

  1. The social sharing of emotions in HIV/AIDS: a comparative study of HIV/AIDS, diabetic and cancer patients.

    PubMed

    Cantisano, Nicole; Rimé, Bernard; Muñoz-Sastre, María T

    2013-10-01

    Studies have shown that chronic illness patients encounter difficulties in the social sharing of emotions. Do HIV/AIDS patients present distinguishing traits in the inhibition of illness and non-illness-related emotions? The differences in the social sharing of emotion between 35 HIV/AIDS, 35 diabetic and 34 cancer outpatients were studied. A questionnaire assessed illness-related emotions, social sharing of emotion and emotional inhibition. The HIV/AIDS group significantly presented superior scoring in shame, guilt and non-sharing of illness-related emotions, lower frequencies of social sharing of emotion and less sharing partners. These findings could lead to future research examining the emotional expression of guilt and shame in HIV/AIDS.

  2. Orientation to Health Aide Careers Mini-Course & Home Health Aide Course.

    ERIC Educational Resources Information Center

    Novak, Kathy; And Others

    Designed for use in a self-paced, open-entry/open-exit vocational training program for home health aides, this program guide is one of six for teachers of adult women offenders from a correctional institution. Module topic outlines are presented on eight topics: your career as a health aide; maintaining health; recognizing illness; positioning and…

  3. Concept Analysis of Illness Engulfment in Schizophrenia.

    PubMed

    Vining, Danny; Robinson, Jennifer C

    2016-06-01

    Schizophrenia has a significant risk of damaging an individual's self-concept. Through the process of illness engulfment an individual's self-concept becomes reorganized entirely around the experience of having schizophrenia. The purpose of this manuscript is to clarify the structure and function of the concept of illness engulfment in schizophrenia using Walker and Avant's (2011) method of concept analysis. Data came from a review of scholarly literature, as well as contemporary and historical art, literature, music, and other media forms. The analysis discussed two defining attributes of experience of illness and impact on self-concept with a total of seven indicators. The article listed antecedents, consequences, and discussed the Modified Engulfment Scale as empirical referents. Fictional cases were developed to illustrate the concept. Finally, the concept of illness engulfment was discussed within the framework of the Roy Adaptation Model.

  4. The Stigma of Families with Mental Illness

    ERIC Educational Resources Information Center

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  5. Blood-Injury-Illness Phobia: A Review.

    ERIC Educational Resources Information Center

    Thyer, Bruce A.; And Others

    1985-01-01

    Surveys empirical literature pertaining to phobias of blood, injury, or illness (BII); defines BII phobia as selectively associated with vasovagal fainting response upon exposure to phobic stimuli. Presents clinical, demographic, and etiological information from 15 BII phobics and suggests that BII phobia warrants diagnostic category separate from…

  6. Telemedicine for AIDS patients accommodations.

    PubMed

    Kulik, J F; de la Tribonnière, X; Bricon-Souf, N; Beuscart, R J; Mouton, Y

    1997-01-01

    People suffering from AIDS are subject to frequent hospitalisations. In some cases, they cannot go back home after hospitalisations, due to severe illness, family or sociologic problems. This is the reason why some therapeutic flats are at their disposal to make easier their medical follow-up after the hospital's discharge. In these Therapy Accommodation, they are treated by trained GP who often suffer from lack of information and lack of expertise in difficult cases. For this purpose we included these flats in the regional Telemedicine AIDS network to give these physicians free access to the computerised multimedia medical record of their patients and to provide them with synchronous co-operation facilities.

  7. The corporate medical department and AIDS.

    PubMed Central

    Schneider, W. J.; Hait, M. R.; Jenkins, J. L.

    1989-01-01

    HIV infection in the workplace reflects the dimensions and distribution of the problem in the community at large. Despite this, accommodation of ill employees has been the general pattern and disruptions of any kind the exception. Corporate medical departments can be important participants in the clinical and social response to AIDS. Recognition of the illness itself, collaboration in the provision of health services, referral when necessary for treatment and counselling, assistance with medical benefits, and arranging for appropriate workplace modifications are among ways in which medical departments can assist concerned or ill employees. Confidentiality is essential in all of these interactions. Education of the workforce about AIDS is especially important from a public health as well as from an administrative standpoint. Providing input on relevant corporate policies and in determination of corporate philanthropy can be other dimensions of corporate medical departments' response to AIDS. PMID:2597819

  8. Epigenetic regulation of HIV, AIDS, and AIDS-related malignancies.

    PubMed

    Verma, Mukesh

    2015-01-01

    Although epigenetics is not a new field, its implications for acquired immunodeficiency syndrome (AIDS) research have not been explored fully. To develop therapeutic and preventive approaches against the human immunodeficiency virus (HIV) and AIDS, it is essential to understand the mechanisms of interaction between the virus and the host, involvement of genetic and epigenetic mechanisms, characterization of viral reservoirs, and factors influencing the latency of the virus. Both methylation of viral genes and histone modifications contribute to initiating and maintaining latency and, depending on the context, triggering viral gene repression or expression. This chapter discusses progress made at the National Institutes of Health (NIH), recommendations from the International AIDS Society Scientific Working Group on HIV Cure, and underlying epigenetic regulation. A number of epigenetic inhibitors have shown potential in treating AIDS-related malignancies. Epigenetic drugs approved by the US Food and Drug Administration and their implications for the eradication of HIV/AIDS and AIDS-related malignancies also are discussed.Past and current progress in developing treatments and understanding the molecular mechanisms of AIDS and HIV infection has greatly improved patient survival. However, increased survival has been coupled with the development of cancer at higher rates than those observed among the HIV/AIDS-negative population. During the early days of the AIDS epidemic, the most frequent AIDS-defining malignancies were Kaposi's sarcoma and non-Hodgkin lymphoma (NHL). Now, with increased survival as the result of widespread use in the developed world of highly active antiretroviral therapy (HAART), non-AIDS defining cancers (i.e., anal, skin, and lung cancers, and Hodgkin disease) are on the increase in HIV-infected populations. The current status of AIDS-related malignancies also is discussed.

  9. Abandoning the mentally ill.

    PubMed

    Barton, R

    1975-12-01

    Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years. Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives. The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.

  10. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  11. [The AIDS patient in anesthesia].

    PubMed

    Jalowy, A; Flesche, C W; Lorenz, C

    1997-02-01

    Treatment of a patient with Acquired Immune Deficiency Syndrome (AIDS) is very challenging, and makes great demands on the anaesthesiologist. Any of an AIDS patient's vital organ systems may be compromised, either by the human immunodeficiency virus (HIV) itself, opportunistic infections, by tumours, or as a result of AIDS-related drug therapies. Infections of the lungs (e.g., Pneumocystis carinii pneumonia) are prevalent, and cardiac impairment can be found in as many as 50% of AIDS patients. In addition, disorders of the central and peripheral nervous system and water and electrolyte imbalances are often seen. Perioperatively, the AIDS patient is especially prone to infections as a result of a compromised immune system. The choice of anaesthetic procedure for the AIDS patient-aside from the type of operation-depends on the severity of the illness and progression of organ impairment. All anaesthesia personnel must be careful to avoid infection, as they frequently come in contact with the blood or body fluids of their patients. However, the risk of being infected by an AIDS patient is very low, provided hygiene regulations are followed strictly. The rate of seroconversion after accidental needle-stick injury is below 1%. If exposure does occur, regular serologic controls should be continued for one year. Prophylactic treatment with azidothymidine after exposition to HIV is recommended.

  12. Help: first aid issues.

    PubMed

    Granitoff, N; Whitaker, I Y; Diccini, S; Goncalves, V C; Marin, H F

    1995-01-01

    First aid is the initial and immediate care given to a victim outside the hospital environment, with the purpose of assuring life and avoiding worsening conditions until he/she receives qualified assistance. Providing immediate aid to someone requires tranquility and, above all, knowledge on what has to be done or not in each situation. In addition to being treated by health professionals, the chances that a victim will receive early treatment by others are large. However, in Brazil, access to information, and the possibility of reviewing it whenever necessary, may contribute greatly to the process of assimilation of this knowledge, in addition to exercises on simulated cases. Informatics has been shown as an extremely useful tool in the development of educational software, considering its multiplicity of resources and providing for the users: motivation for an interactive experience, an individualized teaching that takes into account his/her own rhythm and desired complexity level, besides making possible the user's capacity for solving problems through simulated situations. Considering that, the number of individuals of the population prepared to act as First Aid helpers in situations of life threatening accidents or sudden illness is still very scarce. The ever increasing use of the computer as a mean of spreading information in schools, enterprises, and even households and considering the advantages of an educational software for the users regarding storage and retrieval of information when needed, we proposed the creation of an interactive teaching software. This software is being developed using Storyboard live. The methodology is the following: literature review, selection of images, development of the program, application tests. The initial selected issues are: assessment of the victim, cardiorespiratory arrest and resuscitation, airway obstruction, wounds, and hemorrhages. After utilizing the program, the user should be able to solve hypothetical

  13. Vaccines Stop Illness

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Vaccines Stop Illness Past Issues / Spring 2008 Table of ... meningitis won't infect, cripple, or kill children. Vaccine Safety In light of recent questions about vaccine ...

  14. [Nonthyroidal illness (NTI)].

    PubMed

    Murakami, Masami

    2012-11-01

    Thyroxine (T4), a major secretory product of thyroid gland, needs to be converted to 3,5,3'-triiodothyronine (T3) by iodothyronine deiodinases to exert its biological effect. Nonthyroidal illness, also known as low T3 syndrome, is associated with low serum T3 concentrations, which are inversely correlated to the severity of the illness. The patients with nonthyroidal illness do not show compensatory rise in serum TSH concentrations, and sometimes develop low serum T4 and TSH concentrations. It has been postulated that decreased extrathyroidal conversion of T4 to T3 is a responsible mechanism underlying low T3 syndrome. The roles of three types of iodothyronine deiodinases (D1, D2, D3) in the pathophysiology of nonthyroidal illness are discussed.

  15. Caregivers and Serious Illness

    MedlinePlus

    ... or those we choose to call family. Caregiver Responsibilities When a family member has a serious illness , ... transportation; do housework; handle your loved one’s former responsibilities, such as child care; and provide help with ...

  16. Help for Mental Illnesses

    MedlinePlus

    ... call, or go the website of the National Suicide Prevention Lifeline (1-800-273-8255). Trained crisis ... improving the quality of life for people with chronic illnesses. Learn more about clinical trials on the ...

  17. Chronic Illness & Mental Health

    MedlinePlus

    ... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...

  18. Hearing Aids

    MedlinePlus

    ... hair cells (outer and inner rows). When the vibrations move through this fluid, the tiny outer hair ... ear to the brain. Hearing aids intensify sound vibrations that the damaged outer hair cells have trouble ...

  19. Teaching Aids

    ERIC Educational Resources Information Center

    Barnard, W. Robert, Ed.

    1976-01-01

    Provides evaluations of several aids for teaching chemistry. Included are The Use of Chemical Abstracts, Practical Technical Writing, Infrared Spectroscopy Programs, and a film titled "You Can't Go Back." (RH)

  20. Death Anxiety in Persons with HIV/AIDS: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Miller, Audrey K.; Lee, Brittany L.; Henderson, Craig E.

    2012-01-01

    One of the most commonly cited psychological sequelae of HIV/AIDS is anxiety regarding death due to the illness (i.e., death anxiety; DA). However, extant research is inconclusive on several empirical issues, such as DA's relation to HIV/AIDS diagnostic status, the impact of illness-related symptoms on DA, and factors that may protect against DA.…

  1. Extenuating Circumstances in Perceptions of Suicide: Disease Diagnosis (AIDS, Cancer), Pain Level, and Life Expectancy.

    ERIC Educational Resources Information Center

    Martin, Stephen K.; Range, Lillian M.

    1991-01-01

    Examined whether illness type, pain level, and life expectancy affected reactions of undergraduates (n=160) toward a terminal illness suicide with Acquired Immune Deficiency Syndrome (AIDS) or cancer. AIDS patients were more stigmatized than cancer patients; suicide was more tolerated if victim was suffering greater pain. (Author/ABL)

  2. Witchcraft illness in the Evuzok nosological system.

    PubMed

    Guimera, L M

    1978-12-01

    The Evuzok nosological system is structured with respect to two frames of reference, one designating illness as an empirical reality (descriptive subsystem), the other designating it according to its religious, magical and social significance (etiological subsystem). The articulation of these two subsystems is brought about in the process of diagnosis. Having examined this system as a whole, the author devotes his attention to a particular set of etiological categories, those which associate illness with witchcraft (nocturnal illnesses). He attempts to define their distinctive traits and, from this, to determine their common elemental structure. This study, based on a number of years of fieldwork, is part of an ongoing research program on African folk-medicine pursued by the Laboratoire d'Ethnologie et de Sociologie Comparative of the Université de Paris X.

  3. HIV/AIDS - resources

    MedlinePlus

    Resources - HIV/AIDS ... The following organizations are good resources for information on AIDS : AIDS.gov -- www.aids.gov AIDS Info -- aidsinfo.nih.gov The Henry J. Kaiser Family Foundation -- www. ...

  4. Types of Hearing Aids

    MedlinePlus

    ... Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing options ... some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed to ...

  5. Heat illness. I. Epidemiology.

    PubMed

    Ellis, F P

    1976-01-01

    Reliable information on the epidemiology of heat illness has come, until recently, mainly from the armed forces and, to a lesser extent, from some industries and civil communities. Data from the records of the British Army, Royal Navy, Royal Air Force, Indian Armed Forces, U.S. Army and forces engaged in the Arab-Israeli wars, from the South African gold mining corporations and Persian Gulf oil tankers, and from civilian communities, mainly in the U.S.A., are reviewed and discussed with particular reference to the classification of heat illness and definition of the terms used, and the effects on acclimatized and non-acclimatized personnel and on other sections of the civilian communities most at risk, i.e. the old and very young. This section concludes with an outline of the classification of acute heat illnesses from 1899 to the eighth revision of the WHO International Classification of Diseases in 1967.

  6. Special issues in pain control during terminal illness.

    PubMed Central

    Librach, S. L.

    1995-01-01

    Pain control is still a prime concern in managing patients with terminal illnesses, such as AIDS and cancer. I review some special issues that confront family physicians providing such care. Issues include common blocks to good pain management, understanding different types of pain, and the appropriate use of adjunct analgesic drugs and therapies. PMID:7539651

  7. Parental Involvement of Mothers with Chronic Illness and Children's Academic Achievement

    ERIC Educational Resources Information Center

    Chen, Yung-Chi; Fish, Marian C.

    2013-01-01

    This study examined how maternal chronic illnesses may affect children's academic achievement through parental involvement. A total of 189 mothers diagnosed with chronic illnesses, such as multiple sclerosis, diabetes, cancer, HIV/AIDS, chronic pain, asthma, myelodysplasic syndrome, and fibromyalgia, and with a child in middle school or high…

  8. How to diagnose a foodborne illness.

    PubMed

    Donnenberg, Michael S; Narayanan, Shivakumar

    2013-09-01

    Timely diagnosis of foodborne infection can be critical not only for the patient, but also for the larger community because of the potential to interrupt further spread. This article presents the diagnostic approach to patients with foodborne illness, discussing epidemiologic clues of various foodborne pathogens and their distinguishing clinical features of diagnostic importance. Also discussed are situations whereby stool cultures should be ordered; other helpful stool tests; nonculture methods of identifying organisms and their applicability in clinical settings; the role of pulsed-field gel electrophoresis in typing organisms; and large-scale sharing of data to aid in identification of large outbreaks.

  9. The contribution of reproductive ill-health to the overall burden of perceived illness among women in southern India.

    PubMed Central

    Bhatia, J.; Cleland, J.

    2001-01-01

    OBJECTIVE: To investigate women's perceptions of the overall burden of illness among a sample of women in southern India. METHODS: A community-based sample of 421 young married women in a subdistrict about 70 kilometres from Bangalore, Karnataka State, India, were interviewed monthly for one year. At each visit, information on the symptoms of all forms of illness they had experienced was elicited with the aid of a checklist. Details were obtained on the durations of episodes of illness and on health-seeking behaviour and costs. The symptoms were subsequently coded in accordance with the International Classification of Diseases (ICD-10). FINDINGS: Reproductive ill-health accounted for half of all illness-days and for 31% of total curative health expenditure. The 1990 Global Burden of Disease study estimated that 27.4% of disability-adjusted life years (DALYs) lost in Indian women aged 15-44 years were attributable to reproductive ill-health. CONCLUSIONS: Our study indicates that this dimension of morbidity, when measured in terms of women's subjective experiences, makes a larger contribution to the burden of illness than that suggested by the DALY approach. This lends justification to the high priority attached to reproductive ill-health in India. PMID:11731815

  10. Classroom Aids

    ERIC Educational Resources Information Center

    Science Activities: Classroom Projects and Curriculum Ideas, 2007

    2007-01-01

    This article describes 6 aids for science instruction, including (1) the use of fudge to represent lava; (2) the "Living by Chemistry" program, designed to make high school chemistry more accessible to a diverse pool of students without sacrificing content; (3) NOAA and NSTA's online coral reef teaching tool, a new web-based "science toolbox" for…

  11. Floriculture Aide.

    ERIC Educational Resources Information Center

    Martin, Joyce; Looney, Era

    Designed for use in a self-paced, open-entry/open-exit vocational training program for a floriculture aide, this program guide is one of six for teachers of adult women offenders from a correctional institution. Module topic outlines and sample lesson plans are presented on eleven topics: occupational opportunities in the retail florist industry;…

  12. Counseling in the Era of AIDS.

    ERIC Educational Resources Information Center

    Dworkin, Sari H.; Pincu, Lester

    1993-01-01

    Describes counselor's role in era of Acquired Immune Deficiency Syndrome (AIDS); psychological reactions to chronic, stigmatized, and fatal illness; and specific populations (gay men, their families and friends, gay youth, significant others, people of color, heterosexual women and lesbians, college students, substance abusers, "worried…

  13. Mental Illness And Brain Disease.

    PubMed

    Bedrick, Jeffrey D

    2014-01-01

    It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.

  14. Mentally Ill Children.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    Estimates suggest that about 15% of all children have some form of mental disturbance. Potential causes can be of a physical, psychological, or environmental origin. Symptoms which indicate that a child needs professional help usually involve emotional overreaction to changes. Diagnosis of a child evidencing symptoms of mental illness should take…

  15. Alienation and Illness.

    ERIC Educational Resources Information Center

    Kobasa, Suzanne C.

    Reviews of studies of four groups (business executives, lawyers, Army officers, and working women) which demonstrate the health-damaging effects of alienation in certain life situations show that, when under stress, members of these groups who feel alienated fall ill, medically and/or psychiatrically. Three models are described which may explain…

  16. Symptoms of Tickborne Illness

    MedlinePlus

    ... Lyme disease , southern tick-associated rash illness (STARI) , Rocky Mountain spotted fever (RMSF) , ehrlichiosis , and tularemia can result in distinctive ... arthritic or neurologic symptoms. The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in ...

  17. Platelets in Critical Illness.

    PubMed

    Levi, Marcel

    2016-04-01

    In patients with critical illness, thrombocytopenia is a frequent laboratory abnormality. However frequent this may occur, a low platelet count is not an epiphenomenon, but a marker with further significance. It is always important to assess the proper cause for thrombocytopenia in critically ill patients because different underlying disorders may precipitate different diagnostic and therapeutic management strategies. Platelets are part of the first-line defense of the body against bleeding; hence, thrombocytopenia may increase the risk of hemorrhage. In case of systemic inflammatory syndromes, such as the response to sepsis, disseminated intravascular platelet activation may occur. This will contribute to microvascular failure and thereby play a role in the development of organ dysfunction. Platelets are circulating blood cells that will normally not interact with the intact vessel wall but that may swiftly respond to endothelial disruption (which is often part of the pathogenesis of critical illness) by adhering to subendothelial structures, followed by interaction with each other, thereby forming a platelet aggregate. The activated platelet (phospholipid) membrane may form a suitable surface on which further coagulation activation may occur. A low platelet count is a strong and independent predictor of an adverse outcome in critically ill patients, thereby facilitating a simple and practically risk assessment in these patients and potentially guiding the use of complex or expensive treatment strategies.

  18. Mozart's illnesses and death.

    PubMed Central

    Davies, P J

    1983-01-01

    Throughout his life Mozart suffered frequent attacks of tonsillitis. In 1784 he developed post-streptococcal Schönlein-Henoch syndrome which caused chronic glomerular nephritis and chronic renal failure. His fatal illness was due to Schönlein-Henoch purpura, with death from cerebral haemorrhage and bronchopneumonia. Venesection(s) may have contributed to his death. PMID:6352940

  19. Food Safety for People with HIV/AIDS

    MedlinePlus

    ... Foodborne Illness Food Safety for People with HIV/AIDS Share Tweet Linkedin Pin it More sharing options ... Email Print Food Safety for People with HIV/AIDS (PDF - 2.46MB) - En español (Spanish) (PDF - 2. ...

  20. Drinking Levels Defined

    MedlinePlus

    ... Is A Standard Drink? Drinking Levels Defined Drinking Levels Defined Moderate alcohol consumption: According to the "Dietary ... of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs ...

  1. Constructivist Learning Environments and Defining the Online Learning Community

    ERIC Educational Resources Information Center

    Brown, Loren

    2014-01-01

    The online learning community is frequently referred to, but ill defined. The constructivist philosophy and approach to teaching and learning is both an effective means of constructing an online learning community and it is a tool by which to define key elements of the learning community. In order to build a nurturing, self-sustaining online…

  2. HIV/AIDS and blindness.

    PubMed Central

    Kestelyn, P. G.; Cunningham, E. T.

    2001-01-01

    Nearly 34 million people are currently living with HIV/AIDS: ocular complications are common, affecting 50% to 75% of all such patients at some point during the course of their illness. Cytomegalovirus retinitis is by far the most frequent cause of vision loss in patients with AIDS. Although the prevalence of cytomegalovirus retinitis is decreasing in industrialized countries because of the widespread availability of highly active antiretroviral therapy, between 10% and 20% of HIV-infected patients worldwide can be expected to lose vision in one or both eyes as a result of ocular cytomegalovirus infection. Less frequent but important causes of bilateral vision loss in patients with HIV/AIDS include varicella zoster virus and herpes simplex virus retinitis, HIV-related ischaemic microvasculopathy, ocular syphilis, ocular tuberculosis, cryptococcal meningitis, and ocular toxic or allergic drug reactions. At present, most patients with HIV/AIDS in developing countries who lose their vision have a very limited life expectancy. As antiretroviral therapy makes its way to these countries, however, both life expectancy and the prevalence of blindness related to HIV/AIDS can be expected to increase dramatically. PMID:11285664

  3. How to perform first aid.

    PubMed

    Gloster, Annabella Satu; Johnson, Phillip John

    2016-01-13

    RATIONALE AND KEY POINTS: This article aims to help nurses to perform first aid in a safe, effective and patient-centred manner. First aid comprises a series of simple, potentially life-saving steps that an individual can perform with minimal equipment. Although it is not a legal requirement to respond to an emergency situation outside of work, nurses have a professional duty to respond and provide care within the limits of their competency. First aid is the provision of immediate medical assistance to an ill or injured person until definitive medical treatment can be accessed. First aid can save lives and it is essential that nurses understand the basic principles. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. Your skill in performing first aid and any areas where you may need to extend your knowledge. 2. How reading this article will change your practice. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

  4. HIV infection and AIDS.

    PubMed

    Lloyd, A

    1996-09-01

    Many of the clinical features of HIV/AIDS can be ascribed to the profound immune deficiency which develops in infected patients. The destruction of the immune system by the virus results in opportunistic infection, as well as an increased risk of autoimmune disease and malignancy. In addition, disease manifestations related to the virus itself may occur. For example, during the primary illness which occurs within weeks after first exposure to HIV, clinical symptoms occur in at least 50% of cases, typically as a mononucleosis syndrome. HIV-related complications are rarely encountered in patients with preserved immunity (i.e. CD4 T-cell counts greater than 500 cells/mm3). Recurrent mucocutaneous herpes simplex (HSV), herpes zoster (VZV), oral candidiasis and oral hairy leukoplakia occur with increasing frequency as the CD4 count drops below this level. Immune thrombocytopenia (ITP) occurs in association with HIV and often presents early in the clinical course. The risk of developing opportunistic infections and malignancies typical of AIDS increases progressively as CD4 counts fall below 200 cells/mm3. The clinical manifestations of infections associated with AIDS tend to fall into well-recognized patterns of presentation, including pneumonia, dysphagia/odynophagia, diarrhoea, neurological symptoms, fever, wasting, anaemia and visual loss. The commonest pathogens include Candida albicans, Pneumocystis carinii, Mycobacterium tuberculosis, Toxoplasma gondii, Cryptococcus neoformans, Mycobacterium avium intracellulare and cytomegalovirus. Malignant disease in patients with HIV infection also occurs in a characteristic pattern. Only two tumours are prevalent: Kaposi's sarcoma, a multifocal tumour of vascular endothelium which typically involves skin and mucosal surfaces; and non-Hodgkin's lymphoma, which is typically high grade in phenotype, often arising within the central nervous system. The principles of therapy include reduction of HIV replication by antiretroviral

  5. Violence and Mental Illness

    PubMed Central

    Rueve, Marie E.; Welton, Randon S.

    2008-01-01

    Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients’ lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, including etiology, comorbidity, risk factor management, and treatment. A psychiatrist who is well versed in the recognition and management of violence can contribute to the appropriate management of dangerous behaviors and minimize risk to patients, their families, mental health workers, and the community as a whole. PMID:19727251

  6. An anatomy of illness.

    PubMed

    Biro, David

    2012-03-01

    Because it focuses primarily on the sick body (disease), medicine ignores many of the concerns and needs of sick people. By listening to the stories of patients in the clinic, on the Internet, and in published book form, health care providers could gain a better understanding of the impact of disease on the person (illness), what it means to patients over and above their physical symptoms and what they might require over and above surgery or chemotherapy. Only by familiarizing themselves with the entire emotional landscape of illness, which includes fear, anger, shame, guilt, and above all loneliness, can the healthy--medicine as well as society in general--hope to heal in a comprehensive manner.

  7. Mental illness: psychiatry's phlogiston

    PubMed Central

    Szasz, T

    2001-01-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity PMID:11579183

  8. Mechanisms in Chronic Multisymptom Illnesses

    DTIC Science & Technology

    2009-10-01

    difficulties commonly seen in patients with Chronic Multisymptom Illnesses (CMI) (i.e., fibromyalgia , chronic fatigue syndrome, Gulf War Illnesses, etc.); to...Avera Research Institute, Sioux Falls, SD. 15. SUBJECT TERMS chronic multisymptom illnesses, fibromyalgia , Gulf War Illness, chronic pain 16. SECURITY...16 2.4.6 Internet and Telehealth Enhanced CBT for the Management of  Fibromyalgia

  9. Parasites and Foodborne Illness

    MedlinePlus

    ... Administrative Forms Standard Forms Skip Navigation Z7_0Q0619C0JGR010IFST1G5B10H1 Web Content Viewer (JSR 286) Actions ${title} Loading... / Topics / ... and Disease / Parasites and Foodborne Illness Z7_0Q0619C0JGR010IFST1G5B10H3 Web Content Viewer (JSR 286) Actions ${title} Loading... Z7_ ...

  10. Images of Illness

    PubMed Central

    Longhurst, Mark F.

    1992-01-01

    The images we as physicians retain of our patients have a bearing on the evolution of our clinical behaviour and attributes. These images can enhance our diagnostic and therapeutic skills, increase our capacity to care for people with incurable diseases, and offer insights into our own emotional response. A recollection of five people with Parkinson's disease offers a college of images to give us further insights into the meaning of illness-for the patient and the physician. PMID:20469529

  11. The BLS survey of occupational injuries and illnesses: a primer.

    PubMed

    Wiatrowski, William J

    2014-10-01

    The Survey of Occupational Injuries and Illnesses (SOII) is the nation's primary surveillance vehicle for nonfatal injuries and illnesses that occur in the workplace. Based on recordable injuries and illnesses as defined by the Occupational Safety and Health Administration (OSHA), the SOII provides annual counts and rates by industry and state for workers in private industry and state and local government. In addition, the SOII provides details about the most severe injuries and illnesses, including characteristics of the workers involved and details of the circumstances surrounding the incident. To accompany articles that discuss research into the completeness of SOII data, this commentary provides an overview of the SOII. Included is information about the history of capturing data on workplace injuries and illnesses, current survey processes, annual outputs, and an introduction to the current concerns about underreporting.

  12. Exercise Prevents Mental Illness

    NASA Astrophysics Data System (ADS)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  13. Comorbid mental illness and criminalness implications for housing and treatment.

    PubMed

    Bartholomew, Nicole R; Morgan, Robert D

    2015-06-01

    The relationship between mental illness, violence, and criminal behavior is complex, and involves a multifaceted interaction of biological, psychological, and social processes. In this article, we review the emerging research that examines the neurobiological and psychological factors that distinguish between persons with mental illness who do and who do not engage in crime and violence. Additionally, a novel model for understanding the interaction between mental illness and criminalness is proposed. (As defined by Morgan and colleagues, criminalness is defined as behavior that breaks laws and social conventions and/or violates the rights and wellbeing of others.) Stemming from this model and outlined research, we argue that management and treatment approaches should target the co-occurring domains of mental illness and criminalness to improve criminal and psychiatric outcomes. Specifically, we discuss and propose effective housing (management) and biopsychosocial intervention strategies for improving outcomes.

  14. Clinical Criteria for Physician Aid in Dying

    PubMed Central

    Pope, Thaddeus Mason; Rich, Ben A.

    2016-01-01

    Abstract More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period. PMID:26539979

  15. HIV/AIDS Basics

    MedlinePlus

    ... Enter ZIP code or city Follow Act Against AIDS Act Against AIDS @talkHIV Act Against AIDS Get Email Updates on AAA Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV/ ...

  16. Mass psychogenic illness after vaccination.

    PubMed

    Clements, C John

    2003-01-01

    When vaccines are administered to groups, the physical reactions of the recipients may be similar, causing a form of mass reaction, the mechanism for which is the same as that for mass reactions from other causes. These phenomena have been categorised as mass psychogenic illness (MPI), and have been defined as the collective occurrence of a constellation of symptoms suggestive of organic illness but without an identified cause in a group of people with shared beliefs about the cause of the symptom(s). A review of the literature shows that such outbreaks have been reported in differing cultural and environmental settings including developing and industrialised countries, in the work place, on public transport, in schools, and the military. The perceived threats have been against agents such as food poisoning, fire and toxic gases. Whatever the place or perceived threat, the response seems to be similar. The symptoms generally included headache, dizziness, weakness, and loss of consciousness. Once under way, MPIs are not easy to stop. Incidents reported in the literature show that they can quickly gather momentum and can be amplified by the press who disseminate information rapidly, escalating the events. Management of such mass events can be extremely difficult. Should the public health official in charge continue to try and determine the cause, or should this person call off the entire investigation? It is suggested here that once vaccines are identified as a probable cause of the phenomenon, a dismissive approach may actually be harmful. Unless the spokesperson has already earned a high level of trust, the public are not likely to be convinced easily that nothing was wrong with the vaccine until it has been tested. An increased awareness of MPIs on the part of organisers of future mass vaccination campaigns seems appropriate. Immunisation managers should be aware that mass immunisation campaigns could generate such mass reactions. It is therefore essential that

  17. Living on the Moon: Persona, Identity, and Metaphor in Paul Monette's "Borrowed Time: An AIDS Memoir."

    ERIC Educational Resources Information Center

    Johnson, Deryl B.

    1995-01-01

    Explores the representation of AIDS in culture through narrative structure by focusing on the critically acclaimed autobiography "Borrowed Time: An AIDS Memoir" by Paul Monette. Examines how poesies and healing represent illness and reflects upon the negotiation between identity and dominant cultural images associated with AIDS. (PA)

  18. 3 CFR 8909 - Proclamation 8909 of November 29, 2012. World AIDS Day, 2012

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 3 The President 1 2013-01-01 2013-01-01 false Proclamation 8909 of November 29, 2012. World AIDS..., 2012 Proc. 8909 World AIDS Day, 2012By the President of the United States of America A Proclamation On World AIDS Day, more than 30 years after the first cases of this tragic illness were reported, we...

  19. Parametrically defined differential equations

    NASA Astrophysics Data System (ADS)

    Polyanin, A. D.; Zhurov, A. I.

    2017-01-01

    The paper deals with nonlinear ordinary differential equations defined parametrically by two relations. It proposes techniques to reduce such equations, of the first or second order, to standard systems of ordinary differential equations. It obtains the general solution to some classes of nonlinear parametrically defined ODEs dependent on arbitrary functions. It outlines procedures for the numerical solution of the Cauchy problem for parametrically defined differential equations.

  20. Teaching AIDS.

    PubMed

    Short, R V

    1989-06-01

    This article reviews a peer group Acquired Immunodeficiency Syndrome (AIDS) educational program at a university in Australia. Studies in the US have shown that most adolescents, although sexually active, do not believe they are likely to become infected with the Human Immunodeficiency Virus, and therefore do not attempt to modify their sexual behavior. A 1st step in educating students is to introduce them to condoms and impress upon them the fact that condoms should be used at the beginning of all sexual relationships, whether homosexual or heterosexual. In this program 3rd year medical students were targeted, as they are effective communicators and disseminators of information to the rest of the student body. After class members blow up condoms, giving them a chance to handle various brands and observe the varying degrees of strength, statistical evidence about the contraceptive failure rate of condoms (0.6-14.7 per 100 women-years) is discussed. Spermicides, such as nonoxynol-9 used in conjunction with condoms, are also discussed, as are condoms for women, packaging and marketing of condoms, including those made from latex and from the caecum of sheep, the latter condoms being of questionable effectiveness in preventing transmission of the virus. The care of terminal AIDS cases and current global and national statistics on AIDS are presented. The program also includes cash prizes for the best student essays on condom use, the distribution of condoms, condom key rings and T-shirts, and a student-run safe sex stand during orientation week. All of these activities are intended to involve students and attract the interest of the undergraduate community. Questionnaires administered to students at the end of the course revealed that the lectures were received favorably. Questionnaires administered to new medical and English students attending orientation week revealed that 72% of students thought the stand was a good idea and 81% and 83%, respectively found it

  1. A Hearing Aid Primer 1

    ERIC Educational Resources Information Center

    Yetter, Carol J.

    2009-01-01

    This hearing aid primer is designed to define the differences among the three levels of hearing instrument technology: conventional analog circuit technology (most basic), digitally programmable/analog circuit technology (moderately advanced), and fully digital technology (most advanced). Both moderate and advanced technologies mean that hearing…

  2. Cost-of-illness studies : a review of current methods.

    PubMed

    Akobundu, Ebere; Ju, Jing; Blatt, Lisa; Mullins, C Daniel

    2006-01-01

    The number of cost-of-illness (COI) studies has expanded considerably over time. One outcome of this growth is that the reported COI estimates are inconsistent across studies, thereby raising concerns over the validity of the estimates and methods. Several factors have been identified in the literature as reasons for the observed variation in COI estimates. To date, the variation in the methods used to calculate costs has not been examined in great detail even though the variations in methods are a major driver of variation in COI estimates. The objective of this review was to document the variation in the methodologies employed in COI studies and to highlight the benefits and limitations of these methods. The review of COI studies was implemented following a four-step procedure: (i) a structured literature search of MEDLINE, JSTOR and EconLit; (ii) a review of abstracts using pre-defined inclusion and exclusion criteria; (iii) a full-text review using pre-defined inclusion and exclusion criteria; and (iv) classification of articles according to the methods used to calculate costs. This review identified four COI estimation methods (Sum_All Medical, Sum_Diagnosis Specific, Matched Control and Regression) that were used in categorising articles. Also, six components of direct medical costs and five components of indirect/non-medical costs were identified and used in categorising articles.365 full-length articles were reflected in the current review following the structured literature search. The top five cost components were emergency room/inpatient hospital costs, outpatient physician costs, drug costs, productivity losses and laboratory costs. The dominant method, Sum_Diagnosis Specific, was a total costing approach that restricted the summation of medical expenditures to those related to a diagnosis of the disease of interest. There was considerable variation in the methods used within disease subcategories. In several disease subcategories (e.g. asthma, dementia

  3. Prevention of deterioration in acutely ill patients in hospital.

    PubMed

    Steen, Colin

    The shift towards providing critical care in general wards has changed the way acutely ill patients are identified, treated and managed in hospital. This requires the expertise of knowledgeable, informed and capable staff. Effective education and appropriate knowledge and skills are required to aid identification of the deteriorating patient and provide prompt, timely and appropriate intervention to prevent further deterioration and possibly death. This article provides information about a systematic approach that will enable healthcare professionals to intervene to prevent deterioration in acutely ill patients.

  4. Treating foodborne illness.

    PubMed

    Steiner, Theodore

    2013-09-01

    In healthy adults and children in developed countries, most foodborne and water-borne infections are short-lived and resolve without specific treatment. In developing areas, these infections may produce acute mortality and chronic morbidity caused by developmental impairment. Immune-compromised hosts are at increased risk of life-threatening complications. This article reviews recommendations for the treatment of the most common and important foodborne illnesses, focusing on those caused by infections or toxins of microbial origin. The cornerstone of life-saving treatment remains oral rehydration therapy, although the use of other supportive measures as well as antibiotics for certain infections is also recommended.

  5. Portraits of an illness

    PubMed Central

    Duffy, Thomas P.

    2009-01-01

    Access to patients' inner lives can be expanded and enriched by incorporating the arts and humanities into the clinical encounter. A series of self-portraits created by an artist undergoing induction chemotherapy for leukemia afforded a unique opportunity to concentrate one's gaze upon the patient as a stimulus for reflection on suffering and isolation of patients. Poetry and theater were also invaluable in expanding the physician's awareness of the shared experience of illness. The process highlights the central role of the “New Humanities” in modern medicine, where science informs the arts and the arts inform science and medicine. PMID:19768179

  6. Biotech's defining moments.

    PubMed

    Miller, Henry I

    2007-02-01

    Confusion about terms related to biotechnology--genetic modification, GMOs, genetic engineering, transgenic, and all the rest--has been around for decades. This definitional dysfunction has created myriad opportunities for mischief and given rise to widespread over-regulation, diminished agricultural R&D, ill-advised conferences and risk assessment studies, flawed analyses (including a recent tome from the OECD), fear-mongering by NGOs, and a perplexed public. Greater precision in terminology would improve the lot of scientists, the quality of public policy and, eventually, human and environmental health.

  7. Heat-related illness.

    PubMed

    Becker, Jonathan A; Stewart, Lynsey K

    2011-06-01

    Heat-related illness is a set of preventable conditions ranging from mild forms (e.g., heat exhaustion, heat cramps) to potentially fatal heat stroke. Hot and humid conditions challenge cardiovascular compensatory mechanisms. Once core temperature reaches 104°F (40°C), cellular damage occurs, initiating a cascade of events that may lead to organ failure and death. Early recognition of symptoms and accurate measurement of core temperature are crucial to rapid diagnosis. Milder forms of heat-related illness are manifested by symptoms such as headache, weakness, dizziness, and an inability to continue activity. These are managed by supportive measures including hydration and moving the patient to a cool place. Hyperthermia and central nervous system symptoms should prompt an evaluation for heat stroke. Initial treatments should focus on lowering core temperature through cold water immersion. Applying ice packs to the head, neck, axilla, and groin is an alternative. Additional measures include transporting the patient to a cool environment, removing excess clothing, and intravenous hydration. Delayed access to cooling is the leading cause of morbidity and mortality in persons with heat stroke. Identification of at-risk groups can help physicians and community health agencies provide preventive measures.

  8. Brand Aid

    ERIC Educational Resources Information Center

    Drozdowski, Mark J.

    2007-01-01

    Planning is a critical step to take before launching a capital campaign, if marketing materials are to cater to all potential donors and reinforce the institution's brand--which defines what the institution is and what it does, and is shaped by what people think of it. Here, the author discusses the importance of maintaining and conveying a…

  9. Unbelievable: AIDS reporting in the business press.

    PubMed

    Michael, K

    2000-01-01

    This article reviews some of the key AIDS-related issues highlighted in the business press over the last 2 years. AIDS reporting in the business press has done little to enlighten its audience. Reports on the macroeconomic impact of HIV/AIDS has been limited to repeated citations of 1-2% annual declines in GDP; still others show that it has only a small and statistically insignificant impact on macroeconomic indicators. Business in South Africa is projected to decrease by 2-50% in the productivity levels of its work force in the next 5-10 years. Moreover, 25% of the work force is expected to be infected with AIDS within the next 10 years, and death rates will rise to up to 18%. Illness and death, early retirement, medical assistance and health care, and training and recruitment have all been noted as potential areas of rising costs of AIDS to business. While business reporting tends to concentrate on this side of the epidemic, it has reported a range of issues related to AIDS and has highlighted several well-considered responses to HIV/AIDS. Recommendations to improve business press reporting on HIV/AIDS are given.

  10. Survival after diagnosis of AIDS: a prospective observational study of 2625 patients. Royal Free/Chelsea and Westminster Hospitals Collaborative Group.

    PubMed Central

    Mocroft, A.; Youle, M.; Morcinek, J.; Sabin, C. A.; Gazzard, B.; Johnson, M. A.; Phillips, A. N.

    1997-01-01

    OBJECTIVE: To estimate median survival and changes in survival in patients diagnosed as having AIDS. DESIGN: Prospective observational study. SETTING: Clinics in two large London hospitals. SUBJECTS: 2625 patients with AIDS seen between 1982 and July 1995. MAIN OUTCOME MEASURES: Survival, estimated using lifetable analyses, and factors associated with survival, identified from Cox proportional hazards models. RESULTS: Median survival (20 months) was longer than previous estimates. The CD4 lymphocyte count at or before initial AIDS defining illness decreased significantly over time from 90 x 10(6)/1 during 1987 or earlier to 40 x 10(6)/1 during 1994 and 1995 (P < 0.0001). In the first three months after diagnosis, patients in whom AIDS was diagnosed after 1987 had a much lower risk of death (relative risk 0.44, 95% confidence interval 0.22 to 0.86; P = 0.017) than patients diagnosed before 1987. When the diagnosis was based on oesophageal candidiasis or Kaposi's sarcoma, patients had a lower risk of death than when the diagnosis was based on Pneumocystis carinii pneumonia (0.21 (0.07 to 0.59). P = 0.0030 and 0.37 (0.16 to 0.83), P = 0.016). Three months after AIDS diagnosis, the risk of death was similar in patients whose diagnosis was made after and before 1987 (1.02 (0.79 to 1.31), P = 0.91). There were no differences in survival between patients diagnosed during 1988-90, 1991-3, or 1994-5. CONCLUSIONS: In later years, patients were much more likely to survive their initial illness, but long term survival has remained poor. The decrease in CD4 lymphocyte count at AIDS diagnosis indicates that patients are being diagnosed as having AIDS at ever more advanced stages of immunodeficiency. PMID:9040386

  11. A randomized double-blind study of the effect of distant healing in a population with advanced AIDS. Report of a small scale study.

    PubMed Central

    Sicher, F; Targ, E; Moore, D; Smith, H S

    1998-01-01

    Various forms of distant healing (DH), including prayer and "psychic healing," are widely practiced, but insufficient formal research has been done to indicate whether such efforts actually affect health. We report on a double-blind randomized trial of DH in 40 patients with advanced AIDS. Subjects were pair-matched for age, CD4+ count, and number of AIDS-defining illnesses and randomly selected to either 10 weeks of DH treatment or a control group. DH treatment was performed by self-identified healers representing many different healing and spiritual traditions. Healers were located throughout the United States during the study, and subjects and healers never met. Subjects were assessed by psychometric testing and blood draw at enrollment and followed for 6 months. At 6 months, a blind medical chart review found that treatment subjects acquired significantly fewer new AIDS-defining illnesses (0.1 versus 0.6 per patient, P = 0.04), had lower illness severity (severity score 0.8 versus 2.65, P = 0.03), and required significantly fewer doctor visits (9.2 versus 13.0, P = 0.01), fewer hospitalizations (0.15 versus 0.6, P = 0.04), and fewer days of hospitalization (0.5 versus 3.4, P = 0.04). Treated subjects also showed significantly improved mood compared with controls (Profile of Mood States score -26 versus 14, P = 0.02). There were no significant differences in CD4+ counts. These data support the possibility of a DH effect in AIDS and suggest the value of further research. PMID:9866433

  12. A randomized double-blind study of the effect of distant healing in a population with advanced AIDS. Report of a small scale study.

    PubMed

    Sicher, F; Targ, E; Moore, D; Smith, H S

    1998-12-01

    Various forms of distant healing (DH), including prayer and "psychic healing," are widely practiced, but insufficient formal research has been done to indicate whether such efforts actually affect health. We report on a double-blind randomized trial of DH in 40 patients with advanced AIDS. Subjects were pair-matched for age, CD4+ count, and number of AIDS-defining illnesses and randomly selected to either 10 weeks of DH treatment or a control group. DH treatment was performed by self-identified healers representing many different healing and spiritual traditions. Healers were located throughout the United States during the study, and subjects and healers never met. Subjects were assessed by psychometric testing and blood draw at enrollment and followed for 6 months. At 6 months, a blind medical chart review found that treatment subjects acquired significantly fewer new AIDS-defining illnesses (0.1 versus 0.6 per patient, P = 0.04), had lower illness severity (severity score 0.8 versus 2.65, P = 0.03), and required significantly fewer doctor visits (9.2 versus 13.0, P = 0.01), fewer hospitalizations (0.15 versus 0.6, P = 0.04), and fewer days of hospitalization (0.5 versus 3.4, P = 0.04). Treated subjects also showed significantly improved mood compared with controls (Profile of Mood States score -26 versus 14, P = 0.02). There were no significant differences in CD4+ counts. These data support the possibility of a DH effect in AIDS and suggest the value of further research.

  13. The microbiome and critical illness

    PubMed Central

    Dickson, Robert P

    2016-01-01

    The central role of the microbiome in critical illness is supported by a half century of experimental and clinical study. The physiological effects of critical illness and the clinical interventions of intensive care substantially alter the microbiome. In turn, the microbiome predicts patients’ susceptibility to disease, and manipulation of the microbiome has prevented or modulated critical illness in animal models and clinical trials. This Review surveys the microbial ecology of critically ill patients, presents the facts and unanswered questions surrounding gut-derived sepsis, and explores the radically altered ecosystem of the injured alveolus. The revolution in culture-independent microbiology has provided the tools needed to target the microbiome rationally for the prevention and treatment of critical illness, holding great promise to improve the acute and chronic outcomes of the critically ill. PMID:26700442

  14. Protein requirement in critical illness.

    PubMed

    Hoffer, Leonard John

    2016-05-01

    How much protein do critically ill patients require? For the many decades that nutritional support has been used there was a broad consensus that critically ill patients need much more protein than required for normal health. Now, however, some clinical investigators recommend limiting all macronutrient provision during the early phase of critical illness. How did these conflicting recommendations emerge? Which of them is correct? This review explains the longstanding recommendation for generous protein provision in critical illness, analyzes the clinical trials now being claimed to refute it, and concludes with suggestions for clinical investigation and practice.

  15. Neuroinflammation and psychiatric illness

    PubMed Central

    2013-01-01

    Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence supporting the pathogenic role of neuroinflammation in selected classical psychiatric disorders. Understanding how psychosocial, genetic, immunological and neurotransmitter systems interact can reveal pathogenic clues and help target new preventive and symptomatic therapies. PMID:23547920

  16. AIDS.gov

    MedlinePlus

    ... concerns. Search Services Share This Help National HIV/AIDS Strategy Check out NHAS's latest progress in the ... from AIDS.gov Read more AIDS.gov tweets AIDS.gov HIV/AIDS Basics • Federal Resources • Using New ...

  17. Crawling Aid

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The Institute for the Achievement of Human Potential developed a device known as the Vehicle for Initial Crawling (VIC); the acronym is a tribute to the crawler's inventor, Hubert "Vic" Vykukal; is an effective crawling aid. The VIC is used by brain injured children who are unable to crawl due to the problems of weight-bearing and friction, caused by gravity. It is a rounded plywood frame large enough to support the child's torso, leaving arms and legs free to move. On its underside are three aluminum discs through which air is pumped to create an air-bearing surface that has less friction than a film of oil. Upper side contains the connection to the air supply and a pair of straps which restrain the child and cause the device to move with him. VIC is used with the intent to recreate the normal neurological connection between brain and muscles. Over repetitive use of the device the child develops his arm and leg muscles as well as coordination. Children are given alternating therapy, with and without the VIC until eventually the device is no longer needed.

  18. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 ...

  19. Buying a Hearing Aid

    MedlinePlus

    ... aids typically cannot be custom-fit. What are costs and styles of hearing aids? Hearing aids vary ... and for improvement in hearing tones. Real ear measurements may also be done, which determine how much ...

  20. Neurological Complications of AIDS

    MedlinePlus

    ... Patient & Caregiver Education » Fact Sheets Neurological Complications of AIDS Fact Sheet Table of Contents (click to jump ... Where can I get more information? What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition ...

  1. HIV and AIDS

    MedlinePlus

    ... dientes Video: Getting an X-ray HIV and AIDS KidsHealth > For Kids > HIV and AIDS Print A ... serious infection. continue How Many People Have HIV/AIDS? Since the discovery of the virus in 1983, ...

  2. Defining the Human Microbiome

    PubMed Central

    Ursell, Luke K; Metcalf, Jessica L; Parfrey, Laura Wegener; Knight, Rob

    2012-01-01

    Rapidly developing sequencing methods and analytical techniques are enhancing our ability to understand the human microbiome, and, indeed, how we define the microbiome and its constituents. In this review we highlight recent research that expands our ability to understand the human microbiome on different spatial and temporal scales, including daily timeseries datasets spanning months. Furthermore, we discuss emerging concepts related to defining operational taxonomic units, diversity indices, core versus transient microbiomes and the possibility of enterotypes. Additional advances in sequencing technology and in our understanding of the microbiome will provide exciting prospects for exploiting the microbiota for personalized medicine. PMID:22861806

  3. Recreational water–related illness

    PubMed Central

    Sanborn, Margaret; Takaro, Tim

    2013-01-01

    Abstract Objective To review the risk factors, management, and prevention of recreational water–related illness in family practice. Sources of information Original and review articles from January 1998 to February 2012 were identified using PubMed and the search terms water-related illness, recreational water illness, and swimmer illness. Main message There is a 3% to 8% risk of acute gastrointestinal illness (AGI) after swimming. The high-risk groups for AGI are children younger than 5 years, especially if they have not been vaccinated for rotavirus, and elderly and immunocompromised patients. Children are at higher risk because they swallow more water when swimming, stay in the water longer, and play in the shallow water and sand, which are more contaminated. Participants in sports with a lot of water contact like triathlon and kite surfing are also at high risk, and even activities involving partial water contact like boating and fishing carry a 40% to 50% increase in risk of AGI compared with nonwater recreational activities. Stool cultures should be done when a recreational water illness is suspected, and the clinical dehydration scale is a useful clinical tool for assessing the treatment needs of affected children. Conclusion Recreational water illness is the main attributable cause of AGI during swimming season. Recognition that swimming is a substantial source of illness can help prevent recurrent and secondary cases. Rotavirus vaccine is highly recommended for children who will swim frequently. PMID:23673583

  4. Water Recreation and Illness Severity

    EPA Science Inventory

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  5. Children Coping with Chronic Illness.

    ERIC Educational Resources Information Center

    Perez, Lissette M.

    Children who live with chronic illness are confronted with challenges that frequently force them to cope in myriad ways. The ways in which children face chronic illness are summarized in this literature review. Also covered, are how the effects of family can influence coping strategies and how family members, especially parents, cope with their…

  6. Pathways from parental AIDS to child psychological, educational and sexual risk: developing an empirically-based interactive theoretical model.

    PubMed

    Cluver, Lucie; Orkin, Mark; Boyes, Mark E; Sherr, Lorraine; Makasi, Daphne; Nikelo, Joy

    2013-06-01

    Increasing evidence demonstrates negative psychological, health, and developmental outcomes for children associated with parental HIV/AIDS illness and death. However, little is known about how parental AIDS leads to negative child outcomes. This study used a structural equation modelling approach to develop an empirically-based theoretical model of interactive relationships between parental or primary caregiver AIDS-illness, AIDS-orphanhood and predicted intervening factors associated with children's psychological distress, educational access and sexual health. Cross-sectional data were collected in 2009-2011, from 6002 children aged 10-17 years in three provinces of South Africa using stratified random sampling. Comparison groups included children orphaned by AIDS, orphaned by other causes and non-orphans, and children whose parents or primary caregivers were unwell with AIDS, unwell with other causes or healthy. Participants reported on psychological symptoms, educational access, and sexual health risks, as well as hypothesized sociodemographic and intervening factors. In order to build an interactive theoretical model of multiple child outcomes, multivariate regression and structural equation models were developed for each individual outcome, and then combined into an overall model. Neither AIDS-orphanhood nor parental AIDS-illness were directly associated with psychological distress, educational access, or sexual health. Instead, significant indirect effects of AIDS-orphanhood and parental AIDS-illness were obtained on all measured outcomes. Child psychological, educational and sexual health risks share a common set of intervening variables including parental disability, poverty, community violence, stigma, and child abuse that together comprise chain effects. In all models, parental AIDS-illness had stronger effects and more risk pathways than AIDS-orphanhood, especially via poverty and parental disability. AIDS-orphanhood and parental AIDS-illness impact

  7. Mental Illness and Mental Health Defenses: Perceptions of the Criminal Bar.

    PubMed

    Frierson, Richard L; Boyd, Mary S; Harper, Angela

    2015-12-01

    As the number of state mental hospital beds declines, persons with persistent mental illness are increasingly encountered by those working in the legal system. Attorneys may have little experience in working with this population. This research involved a 32-item written survey of the 492 members of the criminal bar in South Carolina. Demographic variables were surveyed, and attorneys were asked to define two common terms describing mental illnesses (delusion and psychosis) and the legal criteria for verdicts of not guilty by reason of insanity and guilty but mentally ill. They were also asked to identify the most severe mental illness (schizophrenia). Attitudes about these verdicts and about working with defendants who are mentally ill were also surveyed. Results indicate that attorneys are fairly knowledgeable about mental illness, but not verdicts involving mental illness, particularly the verdict of guilty but mentally ill. Most attorneys prefer to work with clients who do not have mental illness. However, as they become more experienced interacting with defendants who are affected by mental illness, they become more knowledgeable and are more willing to defend them. A large majority believe that their law school education about mental illness was inadequate. When comparing attorney occupations, public defenders were the most knowledgeable about mental illness and mental health defenses, followed by prosecutors and private defense attorneys. Judges were the least knowledgeable group.

  8. Ergogenic aids.

    PubMed

    Coyle, E F

    1984-07-01

    The catabolism of bodily fuels provides the energy for muscular work. Work output can be limited by the size of fuel reserves, the rate of their catabolism, the build-up of by-products, or the neurologic activation of muscle. A substance that favorably affects a step that is normally limiting, and thus increases work output, can be considered an ergogenic aid. The maximal amount of muscular force generated during brief contractions can be acutely increased during hypnosis and with the ingestion of a placebo or psychomotor stimulant. This effect is most obvious in subjects under laboratory conditions and is less evident in athletes who are highly motivated prior to competition. Fatigue is associated with acidosis in the working musculature when attempts are made to maximize work output during a 4 to 15-minute period. Sodium bicarbonate ingestion may act to buffer the acid produced, provided that blood flow to the muscle is adequate. Prolonged intense exercise can be maintained for approximately two hours before carbohydrate stores become depleted. Carbohydrate feedings delay fatigue during prolonged exercise, especially in subjects who display a decline in blood glucose during exercise in the fasting state. Caffeine ingestion prior to an endurance bout has been reported to allow an individual to exercise somewhat more intensely than he or she would otherwise. Its effect may be mediated by augmenting fat metabolism or by altering the perception of effort. Amphetamines may act in a similar manner. Water ingestion during prolonged exercise that results in dehydration and hyperthermia can offset fluid losses and allow an individual to better maintain work output while substantially reducing the risk of heat-related injuries.

  9. Defining Mathematical Giftedness

    ERIC Educational Resources Information Center

    Parish, Linda

    2014-01-01

    This theoretical paper outlines the process of defining "mathematical giftedness" for a present study on how primary school teaching shapes the mindsets of children who are mathematically gifted. Mathematical giftedness is not a badge of honour or some special value attributed to a child who has achieved something exceptional.…

  10. Defined by Limitations

    ERIC Educational Resources Information Center

    Arriola, Sonya; Murphy, Katy

    2010-01-01

    Undocumented students are a population defined by limitations. Their lack of legal residency and any supporting paperwork (e.g., Social Security number, government issued identification) renders them essentially invisible to the American and state governments. They cannot legally work. In many states, they cannot legally drive. After the age of…

  11. Defining the Language Arts.

    ERIC Educational Resources Information Center

    Barth, Patte, Ed.

    1994-01-01

    This issue of "Basic Education" presents articles that discuss, respectively, defining the language arts, an agenda for English, the benefits of two languages, a new teacher (presently teaching English in a foreign country) looking ahead, and the Shaker Fellowships awarded by the school district in Shaker Heights, Ohio. Articles in the…

  12. On Defining Mass

    ERIC Educational Resources Information Center

    Hecht, Eugene

    2011-01-01

    Though central to any pedagogical development of physics, the concept of mass is still not well understood. Properly defining mass has proven to be far more daunting than contemporary textbooks would have us believe. And yet today the origin of mass is one of the most aggressively pursued areas of research in all of physics. Much of the excitement…

  13. Transition Coordinators: Define Yourselves.

    ERIC Educational Resources Information Center

    Asselin, Susan B.; Todd-Allen, Mary; deFur, Sharon

    1998-01-01

    Describes a technique that was used successfully to identify the changing roles and responsibilities of special educators as transition coordinators. The Developing a Curriculum (DACUM) model uses people who are currently working in the occupation to define job responsibilities. The duties of a transition coordinator are identified. (CR)

  14. Defining in Classroom Activities.

    ERIC Educational Resources Information Center

    Mariotti, Maria Alessandra; Fischbein, Efraim

    1997-01-01

    Discusses some aspects of the defining process in geometrical context in the reference frame of the theory of "figural concepts." Presents analysis of some examples taken from a teaching experiment at the sixth-grade level. Contains 30 references. (Author/ASK)

  15. Vulnerable to HIV / AIDS. Migration.

    PubMed

    Fernandez, I

    1998-01-01

    This special report discusses the impact of globalization, patterns of migration in Southeast Asia, gender issues in migration, the links between migration and HIV/AIDS, and spatial mobility and social networks. Migrants are particularly marginalized in countries that blame migrants for transmission of infectious and communicable diseases and other social ills. Effective control of HIV/AIDS among migrant and native populations requires a multisectoral approach. Programs should critically review the privatization of health care services and challenge economic models that polarize the rich and the poor, men and women, North and South, and migrant and native. Programs should recognize the equality between locals and migrants in receipt of health services. Countermeasures should have input from migrants in order to reduce the conditions that increase vulnerability to HIV/AIDS. Gender-oriented research is needed to understand women's role in migration. Rapid assessment has obscured the human dimension of migrants' vulnerability to HIV. Condom promotion is not enough. Migration is a major consequence of globalization, which holds the promise, real or imagined, of prosperity for all. Mass migration can be fueled by explosive regional developments. In Southeast Asia, migration has been part of the process of economic development. The potential to emigrate increases with greater per capita income. "Tiger" economies have been labor importers. Safe sex is not practiced in many Asian countries because risk is not taken seriously. Migrants tend to be used as economic tools, without consideration of social adjustment and sex behavior among singles.

  16. COMPARISON OF ILLNESS ENDPOINTS IN SWIMMERS' HEALTH STUDIES

    EPA Science Inventory

    Prospective epidemiological studies on swimmers¿ health that were conducted by the U.S. Environmental Protection Agency (U.S. EPA) between 1973 and 1980 defined highly credible gastrointestinal illness (HCGI) as the occurrence of one or more of the following set of symptoms: (1) ...

  17. COMPARISON OF ILLNESS ENPOINTS IN SWIMMER'S HEALTH STUDIES

    EPA Science Inventory

    Prospective epidemiological studies on swimmers¿ health that were conducted by the U.S. Environmental Protection Agency between 1973 and 1980 defined highly credible gastrointestinal illness (HCGI) as the occurrence of one or more of the following set of symptoms: (1) vomiting, (...

  18. Measuring Illness Behavior in Patients with Systemic Sclerosis

    PubMed Central

    Merz, Erin L.; Malcarne, Vanessa L.; Roesch, Scott C.; Sharif, Roozbeh; Harper, Brock E.; Draeger, Hilda T.; Gonzalez, Emilio B.; Nair, Deepthi K.; McNearney, Terry A.; Assassi, Shervin; Mayes, Maureen D.

    2012-01-01

    Objective Illness behaviors (cognitive, affective, and behavioral reactions) among individuals with systemic sclerosis (SSc) are of clinical concern due to relationships between these behaviors and physical and mental-health quality of life such as pain and symptoms of depression. Self-report measures with good psychometric properties can aid in the accurate assessment of illness behavior. The Illness Behavior Questionnaire (IBQ) was designed to measure abnormal illness behaviors; however, despite its long-standing use, there is disagreement regarding its subscales. The goal of the present study was to evaluate the validity of the IBQ in a cohort of patients with SSc. Methods Patients with SSc (N = 278) completed the IBQ at enrollment to the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). Structural validity of previously derived factor solutions was investigated using confirmatory factor analysis. Exploratory factor analysis was utilized to derive SSc-specific subscales. Results None of the previously derived structural models were supported for SSc patients. Exploratory factor analysis supported a SSc-specific factor structure with 5 subscales. Validity analyses suggested that the subscales were generally independent of disease severity, but were correlated with other health outcomes (i.e., fatigue, pain, disability, social support, mental health). Conclusion The proposed subscales are recommended for use in SSc, and can be utilized to capture illness behavior that may be of clinical concern. PMID:23097280

  19. Defining Dynamic Route Structure

    NASA Technical Reports Server (NTRS)

    Zelinski, Shannon; Jastrzebski, Michael

    2011-01-01

    This poster describes a method for defining route structure from flight tracks. Dynamically generated route structures could be useful in guiding dynamic airspace configuration and helping controllers retain situational awareness under dynamically changing traffic conditions. Individual merge and diverge intersections between pairs of flights are identified, clustered, and grouped into nodes of a route structure network. Links are placed between nodes to represent major traffic flows. A parametric analysis determined the algorithm input parameters producing route structures of current day flight plans that are closest to todays airway structure. These parameters are then used to define and analyze the dynamic route structure over the course of a day for current day flight paths. Route structures are also compared between current day flight paths and more user preferred paths such as great circle and weather avoidance routing.

  20. The Untapped Potential of School Directors to Strengthen School-Based Responses to HIV/AIDS. Discussion Paper No. III

    ERIC Educational Resources Information Center

    Wijngaarden, Jan; Mallik, Arun; Shaeffer, Sheldon

    2005-01-01

    An evaluation is presented on the impact of HIV/AIDS on the education sector in the Asia Pacific region. The spread of HIV/AIDS not only brings illness and death, it also threatens the efforts already made to achieve the goal of Education for All (EFA). Education can combat the negative consequences wrought by HIV/AIDS. Tactics include (1)…

  1. Defining and Diagnosing Sepsis.

    PubMed

    Scott, Michael C

    2017-02-01

    Sepsis is a heterogeneous clinical syndrome that encompasses infections of many different types and severity. Not surprisingly, it has confounded most attempts to apply a single definition, which has also limited the ability to develop a set of reliable diagnostic criteria. It is perhaps best defined as the different clinical syndromes produced by an immune response to infection that causes harm to the body beyond that of the local effects of the infection.

  2. Youth blogging and serious illness.

    PubMed

    Nesby, Linda; Salamonsen, Anita

    2016-03-01

    In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed.

  3. Families, children, migration and AIDS.

    PubMed

    Haour-Knipe, Mary

    2009-01-01

    Migration is very often a family affair, and often involves children, directly or indirectly. It may give rise to better quality of life for an entire family, or to bitter disappointment, and may also increase vulnerability to HIV and AIDS. This review, carried out for the Joint Learning Initiative on Children and AIDS, links the literature on "migration", on "HIV and AIDS" and on "families". Three themes are sketched: (1) As both HIV prevalence and circular migration increase, former migrant workers affected by AIDS may return to their families for care and support, especially at the end of life, often under crisis conditions. Families thus lose promising members, as well as sources of support. However, very little is known about the children of such migrants. (2) Following patterns of migration established for far different reasons, children may have to relocate to different places, sometimes over long distances, if their AIDS-affected parents can no longer care for them. They face the same adaptation challenges as other children who move, but complicated by loss of parent(s), AIDS stigma, and often poverty. (3) The issue of migrant families living with HIV has been studied to some extent, but mainly in developed countries with a long history of migration, and with little attention paid to the children in such families. Difficulties include involuntary separation from family members, isolation and lack of support, disclosure and planning for children's care should the parent(s) die and differences in treatment access within the same family. Numerous research and policy gaps are defined regarding the three themes, and a call is made for thinking about migration, families and AIDS to go beyond description to include resilience theory, and to go beyond prevention to include care.

  4. Health Outcomes of HIV-Infected People with Mental Illness

    PubMed Central

    Yehia, Baligh R.; Stephens-Shield, Alisa J.; Momplaisir, Florence; Taylor, Lynne; Gross, Robert; Dubé, Benoit; Glanz, Karen; Brady, Kathleen A.

    2015-01-01

    Improving outcomes for people with HIV and mental illness will be critical to meeting the goals of the US National HIV/AIDS Strategy. In a retrospective analysis of the 2008–2010 cycles of the locally representative Philadelphia Medical Monitoring Project, we compared the proportions of HIV-infected adults with and without mental illness: (1) retained in care (≥2 primary HIV visits separated by ≥90 days in a 12-month period); (2) prescribed antiretroviral therapy (ART) at any point in a 12-month period; and (3) virally suppressed (HIV-1 RNA ≤200 copies/mL at the last measure in the 12-month period). Multivariable regression assessed associations between mental illness and the outcomes, adjusting for age, gender, race/ethnicity, insurance, alcohol abuse, injection drug use, CD4 count, and calendar year. Of 730 HIV-infected persons, representative of 9409 persons in care for HIV in Philadelphia, 49.0 % had mental illness. In adjusted analyses, there were no significant differences in retention (91.3 vs. 90.3 %; AOR 1.30, 95 % CI 0.63–2.56) and prescription of ART (83.2 vs. 88.7 %; AOR 0.79, 95 % CI 0.49–1.25) between those with and without mental illness. However, mentally ill patients were less likely to achieve viral suppression than those without mental illness (65.9 vs. 74.4 %; AOR 0.64, 95 % CI 0.46–0.90). These findings argue for the need to optimize ART adherence in this population. PMID:25931243

  5. [Religious beliefs, illness and death: family's perspectives in illness experience].

    PubMed

    Bousso, Regina Szylit; Poles, Kátia; Serafim, Taís de Souza; de Miranda, Mariana Gonçalves

    2011-04-01

    The objectives of this study were to identify predominant themes in religion, illness and death in the life histories of families and examine the relationship between religion creeds, illness and death in the discourse of families that have an ill person. The theoretical framework used in this study was Symbolic Interactionism and the method was Oral History. Participants were seventeen families with nine different religions, who had experienced the death of a relative. Data analysis showed that following a religion is a relevant part of the lives of many families and cannot be neglected in the illness context. Results point to the importance of understanding the meaning that religion has to the families in the health-disease process, so nurses can work on the promotion of health.

  6. Mental Illness, Alcoholism, Substance Abuse, Multiple Disabilities...Whose Patient, Whose Treatment Approach?

    ERIC Educational Resources Information Center

    Sciacca, Kathleen

    This paper reviews issues in the provision of services to individuals who are mentally ill chemical abusers and addicted (MICAA). Introductory material defines this population and notes that these people are frequently ineligible for services aimed at either mental illness or chemical abuse alone. Service provisions within the psychiatric/mental…

  7. [Non thyroidal illnesses (NTIS)].

    PubMed

    Luca, F; Goichot, B; Brue, T

    2010-09-01

    Abnormalities in the circulating levels of thyroid hormones, without evidence of coexisting thyroid or pituitary gland disease can be observed in all general diseases. These nonthyroidal illnesses (NTIS) are the result of complex mechanisms that combine the effect of some drugs, cytokines, nutritional and endocrine factors at all levels of the thyrotropic axis, from the hypothalamus to the cellular transporters and nuclear receptors of thyroid hormones. The patterns of NTIS depend on the underlying disease and its severity. Thirtyfive years after the initial description, the pathophysiological significance of these anomalies remains controversial. One of the dilemma of NTIS is whether the hormone responses represent an adaptive and normal, physiologic response to conserve energy and protect against hypercatabolism in case of aggression, or whether it is a maladaptive response contributing to a worsening of the disease. This debate is not just a theoretical question, because in the first case the process must be respected, in the other case a vigorous treatment to restore circulating thyroid hormone levels is justified. There have been very few clinical studies designed to address whether the substitution with thyroid hormone is advantageous, and there is at current time no permissive evidence for the use of thyroid hormone replacement in patients with NTIS. But the clinical context, the choice of the molecule or of the dose and the way of administration were not necessarily the most relevant. Theoretically, stimulation of thyreotrope axis used a continuous infusion of TRH seems to provide clinical benefit. With the expectation that randomized clinical trials will provide demonstration of NTIS treatment efficiency, the question might remain unanswered for several more years.

  8. Mental illness and criminal violence.

    PubMed

    Tehrani, J A; Brennan, P A; Hodgins, S; Mednick, S A

    1998-12-01

    This article examines the relationship between criminal violence and mental illness. Our data suggest that mentally ill persons tend to have an increased risk for committing violent offenses, and that the violent offending by these individuals tends to be recidivistic. Our findings suggest that parents who have both committed violent offenses and experienced a psychiatric hospitalization increase the risk of violent offending among their offspring. We propose the hypothesis that mentally ill parents transmit a biological characteristic which may genetically predispose their child towards criminal violence. Prenatal disturbances during critical periods of fetal development may provide clues regarding the etiology of criminal violence.

  9. Freud, his illness, and ourselves.

    PubMed

    Haynal, André

    2008-06-01

    The history of Freud's illness shows that he tried to avoid confrontation with it, and to treat it as unimportant. In his personal letters, the ill body remains outside-as another person, "Konrad," not he himself-and it is not taken into account. Particularly in Freud's correspondence with Ferenczi, we realize to what extent certain phenomena, especially depressive ones, he considered somatic, with a tendency to dismiss them, and this despite important occasional insights, such as about the role played by hate in psychosomatic illnesses. In the post-Freudian development, these topics have been more and more integrated in the dialogue, in the discourse between the analyst and the analysand.

  10. The Master Hearing Aid

    PubMed Central

    Curran, James R.

    2013-01-01

    As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids. PMID:23686682

  11. Defining functional dyspepsia.

    PubMed

    Mearin, Fermín; Calleja, José Luis

    2011-12-01

    Dyspepsia and functional dyspepsia represent a highly significant public health issue. A good definition of dyspepsia is key for helping us to better approach symptoms, decision making, and therapy indications.During the last few years many attempts were made at establishing a definition of dyspepsia. Results were little successful on most occasions, and clear discrepancies arose on whether symptoms should be associated with digestion, which types of symptoms were to be included, which anatomic location should symptoms have, etc.The Rome III Committee defined dyspepsia as "a symptom or set of symptoms that most physicians consider to originate from the gastroduodenal area", including the following: postprandial heaviness, early satiety, and epigastric pain or burning. Two new entities were defined: a) food-induced dyspeptic symptoms (postprandial distress syndrome); and b) epigastric pain (epigastric pain syndrome). These and other definitions have shown both strengths and weaknesses. At times they have been much too complex, at times much too simple; furthermore, they have commonly erred on the side of being inaccurate and impractical. On the other hand, some (the most recent ones) are difficult to translate into the Spanish language. In a meeting of gastroenterologists with a special interest in digestive functional disorders, the various aspects of dyspepsia definition were discussed and put to the vote, and the following conclusions were arrived at: dyspepsia is defined as a set of symptoms, either related or unrelated to food ingestion, localized on the upper half of the abdomen. They include: a) epigastric discomfort (as a category of severity) or pain; b) postprandial heaviness; and c) early satiety. Associated complaints include: nausea, belching, bloating, and epigastric burn (heartburn). All these must be scored according to severity and frequency. Furthermore, psychological factors may be involved in the origin of functional dyspepsia. On the other hand

  12. Pulmonary effects of AIDS: nosocomial transmission.

    PubMed

    Garay, S M; Plottel, C S

    1988-09-01

    This review provides an overview of the risk of nosocomial infection in the "AIDS era." Airborne spread of Mycobacterium tuberculosis from affected patients has re-emerged as a hazard to hospital personnel. The risk of acquiring clinical illness due to Pneumocystis carinii or cytomegalovirus is, in contrast, a function of the immunocompetence of the health care worker. Methods of transmission as well as the epidemiology of human immunodeficiency virus-related infection in the health care worker will be discussed. The increase in the number of immunocompromised patients (AIDS and non-AIDS) requires careful attention to infection control methodology with respect to the cleansing of the fiberoptic bronchoscope, the intensive care unit's respiratory equipment (such as mechanical ventilators and nebulizers), and the pulmonary function laboratory.

  13. Is mental illness complex? From behavior to brain.

    PubMed

    Yang, Albert C; Tsai, Shih-Jen

    2013-08-01

    A defining but elusive feature of the human brain is its astonishing complexity. This complexity arises from the interaction of numerous neuronal circuits that operate over a wide range of temporal and spatial scales, enabling the brain to adapt to the constantly changing environment and to perform various amazing mental functions. In mentally ill patients, such adaptability is often impaired, leading to either ordered or random patterns of behavior. Quantification and classification of these abnormal human behaviors exhibited during mental illness is one of the major challenges of contemporary psychiatric medicine. In the past few decades, attempts have been made to apply concepts adopted from complexity science to better understand complex human behavior. Although considerable effort has been devoted to studying the abnormal dynamic processes involved in mental illness, unfortunately, the primary features of complexity science are typically presented in a form suitable for mathematicians, physicists, and engineers; thus, they are difficult for practicing psychiatrists or neuroscientists to comprehend. Therefore, this paper introduces recent applications of methods derived from complexity science for examining mental illness. We propose that mental illness is loss of brain complexity and the complexity of mental illness can be studied under a general framework by quantifying the order and randomness of dynamic macroscopic human behavior and microscopic neuronal activity. Additionally, substantial effort is required to identify the link between macroscopic behaviors and microscopic changes in the neuronal dynamics within the brain.

  14. Antioxidant Vitamins and Trace Elements in Critical Illness.

    PubMed

    Koekkoek, W A C Kristine; van Zanten, Arthur R H

    2016-08-01

    This comprehensive narrative review summarizes relevant antioxidant mechanisms, the antioxidant status, and effects of supplementation in critically ill patients for the most studied antioxidant vitamins A, C, and E and the enzyme cofactor trace elements selenium and zinc. Over the past 15 years, oxidative stress-mediated cell damage has been recognized to be fundamental to the pathophysiology of various critical illnesses such as acute respiratory distress syndrome, ischemia-reperfusion injury, and multiorgan dysfunction in sepsis. Related to these conditions, low plasma levels of antioxidant enzymes, vitamins, and trace elements have been frequently reported, and thus supplementation seems logical. However, low antioxidant plasma levels per se may not indicate low total body stores as critical illness may induce redistribution of antioxidants. Furthermore, low antioxidant levels may even be beneficial as pro-oxidants are essential in bacterial killing. The reviewed studies in critically ill patients show conflicting results. This may be due to different patient populations, study designs, timing, dosing regimens, and duration of the intervention and outcome measures evaluated. Therefore, at present, it remains unclear whether supplementation of antioxidant micronutrients has any clinical benefit in critically ill patients as some studies show clear benefits, whereas others demonstrate neutral outcomes and even harm. Combination therapy of antioxidants seems logical as they work in synergy and function as elements of the human antioxidant network. Further research should focus on defining the normal antioxidant status for critically ill patients and to study optimal supplement combinations either by nutrition enrichment or by enteral or parenteral pharmacological interventions.

  15. How to Get Hearing Aids

    MedlinePlus

    ... Consumer Products Hearing Aids How to get Hearing Aids Share Tweet Linkedin Pin it More sharing options ... my hearing aids? How do I get hearing aids? Before getting a hearing aid, you should consider ...

  16. Student Attitudes Toward Mental Illness

    ERIC Educational Resources Information Center

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  17. Improving Communication About Serious Illness

    ClinicalTrials.gov

    2017-01-07

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  18. The Ubiquity of Chronic Illness.

    PubMed

    Fonseca, Claudia; Fleischer, Soraya; Rui, Taniele

    2016-01-01

    This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

  19. Dissecting the role of dendritic cells in simian immunodeficiency virus infection and AIDS

    PubMed Central

    Wonderlich, Elizabeth R.; Kader, Muhamuda; Wijewardana, Viskam

    2011-01-01

    Human immunodeficiency virus (HIV) infection is associated with the loss of the two principal types of dendritic cell (DC), myeloid DC (mDC) and plasmacytoid DC (pDC), but the mechanism of this loss and its relationship to AIDS pathogenesis remain ill-defined. The nonhuman primate is a powerful model to dissect this response for several reasons. Both DC subsets have been well characterized in nonhuman primates and shown to have strikingly similar phenotypic and functional characteristics to their counterparts in the human. Moreover, decline of mDC and pDC occurs in rhesus macaques with end-stage simian immunodeficiency virus (SIV) infection, the model of HIV infection in humans. In this brief review, we discuss what is known about DC subsets in pathogenic and nonpathogenic nonhuman primate models of HIV infection and highlight the advances and controversies that currently exist in the field. PMID:21717075

  20. Defining periodontal health

    PubMed Central

    2015-01-01

    Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger PMID:26390888

  1. AIDS and the law: opportunities and limitations.

    PubMed

    Kirby, M

    1995-01-01

    Laws can only partially succeed in modifying behavior, especially with regard to sex, drug use, and other human pleasures. Effective and just laws to slow the spread of AIDS must therefore be based upon a thorough knowledge of the issues, not upon ignorance, fear, political expediency, or to meet the emotional demands of an often ignorant general population. Good laws, like good ethics, are founded in good data. The most effective response to the AIDS epidemic is neither prohibition nor punishment of individual behavior, but laws designed to truly affect human behavior and shape a society in which the spread of HIV is minimized. Central to an appropriate legislative response is the imperative of protecting the basic rights of individuals infected with HIV. An example of an enlightened, rational, and nondiscriminatory approach to checking the spread of HIV/AIDS while guaranteeing individual freedoms and rights is found in a report commissioned for the State Government of New South Wales. The following measures are recommended to bring state laws into harmony with the national HIV/AIDS strategy: decriminalize brothels, set regulations and public health standards for sex workers, cover sex workers under the Industrial Relations Act, ensure the privacy of HIV/AIDS patients and improve their redress against discrimination in the workplace, repeal laws which make it illegal to possess and administer drugs to oneself, investigate the therapeutic use of marijuana as a prescribed treatment for HIV/AIDS and other terminal illnesses, abandon compulsory testing for HIV in prisons, make condoms available to prisoners and sexually active children, establish a Natural Death Act to allow terminally ill patients to die with dignity, and give legal status to permanent relationships between homosexual couples.

  2. Chromosomal abnormalities and mental illness.

    PubMed

    MacIntyre, D J; Blackwood, D H R; Porteous, D J; Pickard, B S; Muir, W J

    2003-03-01

    Linkage studies of mental illness have provided suggestive evidence of susceptibility loci over many broad chromosomal regions. Pinpointing causative gene mutations by conventional linkage strategies alone is problematic. The breakpoints of chromosomal abnormalities occurring in patients with mental illness may be more direct pointers to the relevant gene locus. Publications that describe patients where chromosomal abnormalities co-exist with mental illness are reviewed along with supporting evidence that this may amount to an association. Chromosomal abnormalities are considered to be of possible significance if (a) the abnormality is rare and there are independent reports of its coexistence with psychiatric illness, or (b) there is colocalisation of the abnormality with a region of suggestive linkage findings, or (c) there is an apparent cosegregation of the abnormality with psychiatric illness within the individual's family. Breakpoints have been described within many of the loci suggested by linkage studies and these findings support the hypothesis that shared susceptibility factors for schizophrenia and bipolar disorder may exist. If these abnormalities directly disrupt coding regions, then combining molecular genetic breakpoint cloning with bioinformatic sequence analysis may be a method of rapidly identifying candidate genes. Full karyotyping of individuals with psychotic illness especially where this coexists with mild learning disability, dysmorphism or a strong family history of mental disorder is encouraged.

  3. [Simulation of mental illness].

    PubMed

    Mastronardi, Vincenzo; Del Casale, Antonio

    2012-01-01

    The DSM-IV-TR defines the simulation an "intentional production of physical or psychological symptoms false or grossly exaggerated, motivated by external incentives". The first point to consider is that it has a near zero prevalence in the general population, occurring almost exclusively in people imprisoned, treated in Forensic Psychiatric Hospital, in individuals subjected to trial, or in personalities seen as deviated from a criminological point of view. Both the criteria to set diagnoses of simulation, previously examined by Foreal and Kaufman since 1943, and the relative suspicion indicators, not separated by 'reasons of simulated behavior, are taken into account. The work also addresses several other meanings of self injurious actions appointed by Bachler, as well as the associationist/mechanistic theories of the classical dynamic model and the differential diagnosis with other conditions of Psychiatric Interest and concludes with the topic of "Premeditation".

  4. [Gustave Flaubert's illness].

    PubMed

    Gastaut, H; Gastaut, Y

    1982-01-01

    All those interested in Gustave Flaubert's illness, during his lifetime as well as after his death, have agreed that he had epilepsy. The one important exception is Jean-Paul Sartre, who, in the 2800 pages of his "Idiot de la famille" claimed that Flaubert was a hysteric with very moderate intelligence who somatized his neurosis in the form of seizures. These, in Sartre's views, were moreover probably hysterical, but possibly epileptic resulting from the existence of a psychogenic epilepsy bred from the neurosis. The basis for this neurosis could have originated at the time of Gustave's birth, as this occurred between those of two brothers who both died young, and as his mother had wished for a daughter. Further development of the neurosis might have taken place during a temporary phase of learning difficulties, exaggerated and exploited by his father to make his youngest son the idiot of a family in which the eldest son was the dauphin. Destroyed in this way, Gustave would have sought refuge in passivity and could have developed a hatred for his father and for his elder brother, who he would have liked to kill before killing himself. But, unable to carry out his wishes and desiring both to die and to survive, Gustave, adolescent, might have chosen the pathway of "false deaths", as exemplified by the seizures. Modern epileptology data enables not only to confirm the epileptic etiology and to discount the hysterical nature of the fits, but also: 1. to establish precise details of the site and nature of the cerebral lesions responsible for the attacks: neonatal atrophy or vascular malformation of the occipitotemporal cortex of the left hemisphere, the only lesion capable of provoking: a) the phosphenes marking the onset of the seizures; b) the intellectual manifestations (forced thoughts or flight of ideas), affective features (panic terror), and psychosensory (ecmnesic hallucinations) or psychomotor (confusional automatism) symptoms accompanying some attacks; c) the

  5. Who is the vulnerable child? Using survey data to identify children at risk in the era of HIV and AIDS.

    PubMed

    Akwara, Priscilla Atwani; Noubary, Behzad; Lim Ah Ken, Patricia; Johnson, Kiersten; Yates, Rachel; Winfrey, William; Chandan, Upjeet Kaur; Mulenga, Doreen; Kolker, Jimmy; Luo, Chewe

    2010-09-01

    Over the past decade, there has been increasing global attention to mitigating the impacts of the HIV/AIDS epidemic on children's lives. Within this context, developing and tracking global child vulnerability indicators in relation to HIV and AIDS has been critical in terms of assessing need and monitoring progress. Although orphanhood and adult household illness (co-residence with a chronically ill or HIV-positive adult) are frequently used as markers, or definitions, of vulnerability for children affected by HIV and AIDS, evidence supporting their effectiveness has been equivocal. Data from 60 nationally representative household surveys (36 countries) were analyzed using bivariate and multivariate methods to establish if these markers consistently identified children with worse outcomes and also to identify other factors associated with adverse outcomes for children. Outcome measures utilized were wasting among children aged 0-4 years, school attendance among children aged 10-14 years, and early sexual debut among adolescent boys and girls aged 15-17 years. Results indicate that orphanhood and co-residence with a chronically ill or HIV-positive adult are not universally robust measures of child vulnerability across national and epidemic contexts. For wasting, early sexual debut, and to a lesser extent, school attendance, in the majority of surveys analyzed, there were few significant differences between orphans and non-orphans or children living with chronically ill or HIV-positive adults and children not living with chronically ill or HIV-positive adults. Of other factors analyzed, children living in households where the household head or eldest female had a primary education or higher were significantly more likely to be attending school, better household health and sanitation was significantly associated with less wasting, and greater household wealth was significantly associated both with less wasting and better school attendance. Of all marker of child

  6. Revealing the full extent of households' experiences of HIV and AIDS in rural South Africa.

    PubMed

    Hosegood, Victoria; Preston-Whyte, Eleanor; Busza, Joanna; Moitse, Sindile; Timaeus, Ian M

    2007-09-01

    Households experience HIV and AIDS in a complex and changing set of environments. These include health and welfare treatment and support services, HIV-related stigma and discrimination, and individual and household social and economic circumstances. This paper documents the experiences of 12 households directly affected by HIV and AIDS in rural KwaZulu Natal, South Africa, between 2002 and 2004. The households were observed during repeated visits over a period of more than a year by ethnographically trained researchers. Field notes were analysed using thematic content analysis to identify themes and sub-themes. This paper focuses on three dimensions of household experience of HIV and AIDS that have received little attention in HIV and AIDS impact studies. First, that experience of HIV and AIDS is cumulative. In an area where population surveys report HIV prevalence rates of over 20% in adults, many households face multiple episodes of HIV-related illness and AIDS deaths. We describe how these challenges affect perceptions and responses within and outside households. Second, while over 50% of all adult deaths are due to AIDS, households continue to face other causes of illness and death. We show how these other causes compound the impact of AIDS, particularly where the deceased was the main income earner and/or primary carer for young children. Third, HIV-related illness and AIDS deaths of household members are only part of the households' cumulative experience of HIV and AIDS. Illness and death of non-household members, for example, former partners who are parents of children within the households or relatives who provide financial support, also impact negatively on households. We also discuss how measuring multiple episodes of illness and deaths can be recorded in household surveys in order to improve quantitative assessments of the impact of HIV and AIDS.

  7. Medical Students' Perceptions and Proposed Treatment Strategies for AIDS Patients.

    ERIC Educational Resources Information Center

    Ladany, Nicholas; Stern, Marilyn

    Research has consistently found that health care providers report having negative attitudes and perceptions toward Acquired Immune Deficiency Syndrome (AIDS) patients. This study was conducted to examine the independent and joint influences of a patient's mode of acquisition of illness (blood transfusion versus sexual promiscuity), patient blame…

  8. Manual of First Aid Practices for School Bus Drivers.

    ERIC Educational Resources Information Center

    Nesbitt, William R.

    This manual is intended to assist local school authorities in California in providing the required course in instruction in first aid practices for school bus drivers. While it deals with basic principles of handling serious medical emergencies, major emphasis is on minor injuries or illnesses that are most likely to occur while students are…

  9. Illusions of Immortality: The Confrontation of Adolescence and AIDS.

    ERIC Educational Resources Information Center

    New York State Dept. of Health, Albany.

    Acquired Immune Deficiency Syndrome (AIDS) is a potent and a present danger for teenagers, casting a dark shadow over their lives now and in the future. A small, but significant, number of teenagers will develop Human Immune Virus (HIV)-related illness before they turn 20; a far greater number will become infected with the virus during…

  10. Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS

    PubMed Central

    Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

    2012-01-01

    Objective We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. Methods A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10–12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Results Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. Conclusions The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. PMID:21985490

  11. Collective AIDS Activism and Individuals' Perceived Self-Advocacy in Physician-Patient Communication.

    ERIC Educational Resources Information Center

    Brashers, Dale E.; Haas, Stephen M.; Klingle, Renee S.; Neidig, Judith L.

    2000-01-01

    Describes parallel persuasive processes between social or political activism and personal self-advocacy in a study of AIDS activism and communication patterns between people with HIV or AIDS and health care personnel. Encourages greater patient education about the illness and treatment options. Promotes a more assertive stance toward health care,…

  12. Career Issues and Concerns for Persons Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Dahlbeck, David T.; Lease, Suzanne H.

    2010-01-01

    As the perception of HIV/AIDS continues to shift from a terminal illness to a manageable disease, persons living with HIV/AIDS (PLWHAs) are able to re-enter the workforce or remain in their current jobs for a longer period of time. Although this change is positive, it also raises many career concerns for PLWHAs. Using an ecological approach and…

  13. Defining the Anthropocene

    NASA Astrophysics Data System (ADS)

    Lewis, Simon; Maslin, Mark

    2016-04-01

    Time is divided by geologists according to marked shifts in Earth's state. Recent global environmental changes suggest that Earth may have entered a new human-dominated geological epoch, the Anthropocene. Should the Anthropocene - the idea that human activity is a force acting upon the Earth system in ways that mean that Earth will be altered for millions of years - be defined as a geological time-unit at the level of an Epoch? Here we appraise the data to assess such claims, first in terms of changes to the Earth system, with particular focus on very long-lived impacts, as Epochs typically last millions of years. Can Earth really be said to be in transition from one state to another? Secondly, we then consider the formal criteria used to define geological time-units and move forward through time examining whether currently available evidence passes typical geological time-unit evidence thresholds. We suggest two time periods likely fit the criteria (1) the aftermath of the interlinking of the Old and New Worlds, which moved species across continents and ocean basins worldwide, a geologically unprecedented and permanent change, which is also the globally synchronous coolest part of the Little Ice Age (in Earth system terms), and the beginning of global trade and a new socio-economic "world system" (in historical terms), marked as a golden spike by a temporary drop in atmospheric CO2, centred on 1610 CE; and (2) the aftermath of the Second World War, when many global environmental changes accelerated and novel long-lived materials were increasingly manufactured, known as the Great Acceleration (in Earth system terms) and the beginning of the Cold War (in historical terms), marked as a golden spike by the peak in radionuclide fallout in 1964. We finish by noting that the Anthropocene debate is politically loaded, thus transparency in the presentation of evidence is essential if a formal definition of the Anthropocene is to avoid becoming a debate about bias. The

  14. Cognitions and Procedures in Response to Illness.

    ERIC Educational Resources Information Center

    Diefenbach, Michael A.; And Others

    Recent research in illness has stressed the importance of constructive processes as determinants for coping and appraisal with illnesses. The goal of this study was to construct a lexicon of cognitive and behavioral responses people employ to cope with illness. Undergraduate college students (N=105) were given two illness scenarios describing the…

  15. Defining equity in health

    PubMed Central

    Braveman, P; Gruskin, S

    2003-01-01

    Study objective: To propose a definition of health equity to guide operationalisation and measurement, and to discuss the practical importance of clarity in defining this concept. Design: Conceptual discussion. Setting, Patients/Participants, and Main results: not applicable. Conclusions: For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage—that is, wealth, power, or prestige. Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health. PMID:12646539

  16. Defining Neonatal Sepsis

    PubMed Central

    Wynn, James L.

    2016-01-01

    Purpose of the review Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last three decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress towards improving outcomes. Recent findings Pediatric consensus definitions for sepsis are not accurate in term infants and are not appropriate for preterm infants. In contrast to the defined multi-stage criteria for other devastating diseases encountered in the NICU (e.g., bronchopulmonary dysplasia), there is significant variability in the criteria used by investigators to substantiate the diagnosis of neonatal sepsis. Summary The lack of an accepted consensus definition for neonatal sepsis impedes our efforts towards improved diagnostic and prognostic options as well as accurate outcomes information for this vulnerable population. PMID:26766602

  17. Defining hypercalciuria in nephrolithiasis

    PubMed Central

    Pak, Charles Y.C.; Sakhaee, Khashayar; Moe, Orson W.; Poindexter, John; Adams-Huet, Beverley

    2014-01-01

    The classic definition of hypercalciuria, an upper normal limit of 200 mg/day, is based on a constant diet restricted in calcium, sodium, and animal protein; however, random diet data challenge this. Here our retrospective study determined the validity of the classic definition of hypercalciuria by comparing data from 39 publications analyzing urinary calcium excretion on a constant restricted diet and testing whether hypercalciuria could be defined when extraneous dietary influences were controlled. These papers encompassed 300 non-stone-forming patients, 208 patients with absorptive hypercalciuria type I (presumed due to high intestinal calcium absorption), and 234 stone formers without absorptive hypercalciuria; all evaluated on a constant restricted diet. In non-stone formers, the mean urinary calcium was well below 200 mg/day, and the mean for all patients was 127±46 mg/day with an upper limit of 219 mg/day. In absorptive hypercalciuria type I, the mean urinary calcium significantly exceeded 200 mg/day in all studies with a combined mean of 259±55 mg/day. Receiver operating characteristic curve analysis showed the optimal cutoff point for urinary calcium excretion was 172 mg/day on a restricted diet, a value that approximates the traditional limit of 200 mg/day. Thus, on a restricted diet, a clear demarcation was seen between urinary calcium excretion of kidney stone formers with absorptive hypercalciuria type I and normal individuals. When dietary variables are controlled, the classic definition of hypercalciuria of nephrolithiasis appears valid. PMID:21775970

  18. Somali Refugees' Perceptions of Mental Illness.

    PubMed

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  19. Smoking cessation and reduction in people with chronic mental illness.

    PubMed

    Tidey, Jennifer W; Miller, Mollie E

    2015-09-21

    The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness.

  20. Neurological Complications of AIDS

    MedlinePlus

    ... the neurological complications of AIDS. Some disorders require aggressive therapy while others are treated symptomatically. Medicines range ... certain bacterial infections, and penicillin to treat neurosyphilis. Aggressive antiretroviral therapy is used to treat AIDS dementia ...

  1. Unconsciousness - first aid

    MedlinePlus

    Loss of consciousness - first aid; Coma - first aid; Mental status change; Altered mental status ... person is unconscious and: Does not return to consciousness quickly (within a minute) Has fallen down or ...

  2. First Aid Tips

    MedlinePlus

    ... NEI for Kids > First Aid Tips All About Vision About the Eye Ask a Scientist Video Series ... Eye Health and Safety First Aid Tips Healthy Vision Tips Protective Eyewear Sports and Your Eyes Fun ...

  3. Home Health Aides

    MedlinePlus

    ... do the following: Assist clients in their daily personal tasks, such as bathing or dressing Provide basic ... social networks and communities Home health aides, unlike personal care aides , typically work for certified home health ...

  4. AIDS and Athletes.

    ERIC Educational Resources Information Center

    Calabrese, Leonard H.; Kelley, Dennis

    1989-01-01

    This article discusses the onset and progression of AIDS, its importance as a public health issue, and reducing the risk of AIDS transmission among athletes and those who work with them, including team physicians and athletic trainers. (IAH)

  5. HIV/AIDS

    MedlinePlus

    ... at risk for serious infections and certain cancers. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS. HIV most often spreads through unprotected sex with ...

  6. HIV/AIDS

    MedlinePlus

    ... yeast infection (thrush) Shingles (herpes zoster) Progression to AIDS If you receive no treatment for your HIV ... childbirth or breast-feeding. How does HIV become AIDS? HIV destroys CD4 cells — a specific type of ...

  7. HIV/AIDS Coinfection

    MedlinePlus

    ... Laotian Mongolian Spanish Turkish Vietnamese Hindi Subscribe HIV/AIDS Coinfection Approximately 10% of the HIV-infected population ... Control and Prevention website to learn about HIV/AIDS and Viral Hepatitis guidelines and resources. Home About ...

  8. Raised intracranial pressure and visual complications in AIDS patients with cryptococcal meningitis.

    PubMed

    Johnston, S R; Corbett, E L; Foster, O; Ash, S; Cohen, J

    1992-03-01

    The clinical course of cryptococcal meningitis in AIDS shows some important differences from the features of the illness in non-AIDS patients. Complications such as raised intracranial pressure and visual impairment that are recognised in non-AIDS patients may be less frequent in those with AIDS. Persistent intracranial hypertension should be managed actively to prevent visual impairment. In AIDS patients, in whom ventriculo-peritoneal shunts carry additional risks, acetazolamide can be used successfully to lower the CSF pressure and prevent visual loss.

  9. Music as Illness; Music as Healing.

    PubMed

    Pritchard, Maureen

    2015-09-01

    Throughout the Soviet Union, the arts became tied to ethnicity through the project of Socialist Realism. When, in 1991, the Kyrgyz Republic became independent from the Soviet Union, its national narrative continued to be built upon tropes of Kyrgyz ethnicity. Through their engagement with images of the ethno-national self, the arts provide a great source of beauty. Defining beauty as a representation of the self that is pure whole, and stable, Julia Kristeva asserts that beauty and suffering are part of the same phenomena. Arthur Kleinman argues that suffering is best understood as existing within the triangulated relationship of cultural representation, collective experience, and subjectivity. Music too is part of this triangulated relationship, and therefore, a part of suffering. Drawing upon ten months of ethnographic fieldwork in Kyrgyzstan, this article explores the illness experience of a single Kyrgyz musician. In doing so, it illustrates music's role in self-formation and the development of social, economic, and political ties and the shifts that occur in these during illness. In drawing forth the role of music in the construction of racialized ethnicities, this article demonstrates how the experience of transformative beauty can coexist with turmoil, marginalization, and violence.

  10. Polyneuropathy in critically ill patients.

    PubMed Central

    Bolton, C F; Gilbert, J J; Hahn, A F; Sibbald, W J

    1984-01-01

    Five patients developed a severe motor and sensory polyneuropathy at the peak of critical illness (sepsis and multiorgan dysfunction complicating a variety of primary illnesses). Difficulties in weaning from the ventilator as the critical illness subsided and the development of flaccid and areflexic limbs were early clinical signs. However, electrophysiological studies, especially needle electrode examination of skeletal muscle, provided the definite evidence of polyneuropathy. The cause is uncertain, but the electrophysiological and morphological features indicate a primary axonal polyneuropathy with sparing of the central nervous system. Nutritional factors may have played a role, since the polyneuropathy improved in all five patients after total parenteral nutrition had been started, including the three patients who later died of unrelated causes. The features allow diagnosis during life, and encourage continued intensive management since recovery from the polyneuropathy may occur. Images PMID:6094735

  11. Circadian Rhythms and Psychiatric Illness

    PubMed Central

    Asarnow, Lauren D.; Soehner, Adriane M.; Harvey, Allison G.

    2014-01-01

    Purpose of review The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. Recent Findings In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. Summary Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions, address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes. PMID:24060916

  12. Darwin's illness: a biopsychosocial perspective.

    PubMed

    Pasnau, R O

    1990-01-01

    Throughout an illustrious scientific career, Charles Robert Darwin (1809-1882) suffered from a mysterious and disabling malady. The illness, which was characterized by depressed feelings and violent and uncomfortable cardiac palpitations, gastric upsets, and headaches, began shortly after Darwin returned from a five-year voyage to South America as the naturalist of the Beagle. One explanation for Darwin's symptoms is he suffered from Chagas' disease as a result of being bitten by an insect common to South America. More psychodynamically oriented theorists speculate that Darwin's illness was an expression of repressed anger toward his father. Others have noted a familial vulnerability to the symptoms Darwin described. The author examines these theories and suggests that they all may have validity in explaining the mysterious illness of Charles Darwin.

  13. Rehabilitation of mentally ill women

    PubMed Central

    Chatterjee, Rajni; Hashim, Uzma

    2015-01-01

    Women, the fair sex, are principal providers of care and support to families. But, they are considered to be the weaker sex and one of the most powerless and marginalized sections of our society. The provision of Rehabilitation for mentally ill women has been, and still is, one of the major challenges for mental health systems reform in the last decades, for various reasons. The present paper discusses the global and Indian scenario of rehabilitation of mentally ill women and goes on to detail the contribution of the state and voluntary agencies in this regard. It explores the need of recovery, multilayered strategy of Rehabilitation services and the availability of present services. The stigma attached and legal defects which interfere in good quality of life for the mentally ill women are reviewed. Strategies for changes in future are recommended. PMID:26330653

  14. A Bibliography of Children's and Young Adult's Books about Illness Issues.

    ERIC Educational Resources Information Center

    Cothern, Nancy B.

    This bibliography presents a list of approximately 360 works of children's and young adult's literature that deal with illness issues or issues connected with adverse life conditions such as various forms of child abuse, alcoholism, AIDS, blindness, cancer, death, handicaps, suicide, and surgery. The bibliography is divided into 42 sections, each…

  15. Home Care for Children with Chronic Illnesses and Severe Disabilities: A Bibliography and Resource Guide.

    ERIC Educational Resources Information Center

    Wells, Alice; And Others

    The bibliography and resource guide summarizes relevant research and information on home care for children with disabilities and chronic illnesses, including those with such diagnoses as spina bifida, cerebral palsy, severe mental retardation, acquired immune deficiency syndrome (AIDS), hemophilia, sickle cell anemia, autism, or failure-to-thrive…

  16. Serious Illness Conversations in ESRD.

    PubMed

    Mandel, Ernest I; Bernacki, Rachelle E; Block, Susan D

    2016-12-28

    Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less. This high intensity of care is often inconsistent with the wishes of patients on dialysis but persists due to failure to explore or discuss patient goals, values, and preferences in the context of their serious illness. Fewer than 10% of patients on dialysis report having had a conversation about goals, values, and preferences with their nephrologist, although nearly 90% report wanting this conversation. Many nephrologists shy away from these conversations, because they do not wish to upset their patients, feel that there is too much uncertainty in their ability to predict prognosis, are insecure in their skills at broaching the topic, or have difficulty incorporating the conversations into their clinical workflow. In multiple studies, timely discussions about serious illness care goals, however, have been associated with enhanced goal-consistent care, improved quality of life, and positive family outcomes without an increase in patient distress or anxiety. In this special feature article, we will (1) identify the barriers to serious illness conversations in the dialysis population, (2) review best practices in and specific approaches to conducting serious illness conversations, and (3) offer solutions to overcome barriers as well as practical advice, including specific language and tools, to implement serious illness conversations in the dialysis population.

  17. Differing religious views on the AIDS epidemic.

    PubMed

    Naidu, S

    1997-01-01

    Many religions believe AIDS is mainly a homosexual disease. They have differing views upon how the disease should be treated, but they all agree that people with AIDS should be treated with love, respect, and care. The Hindu religion is strongly opposed to extramarital and premarital sex, two behaviors which promote the spread of HIV. Sex is for procreation and should be experienced only within the limits of marriage, and homosexuality does not fit within the Hindu emphasis upon marriage. However, the person with AIDS should be treated with selfless spirit and reminded of the immortality of the soul as explained in the Hindu Scripture. The Catholic Church does not recognize homosexual relationships and does not promote the use of contraception. A Christian would, however, encourage the person with AIDS to make use of his or her remaining days of life and to look forward to a better afterlife. The Islam sect of Soofieism believes AIDS is a self-inflicted disease caused by promiscuity and the breakdown of morals in society. People who are terminally ill should return to their old religious values and beliefs.

  18. AIDS in Rural California.

    ERIC Educational Resources Information Center

    Wooten, Donald B.

    1989-01-01

    Examines the increase in AIDS patients in rural California, which is greater than that in urban areas, including AIDS population projections through 1991. Describes differences between AIDS populations in rural and urban areas and relates these to state expenditure patterns and differential needs. (DHP)

  19. A Teaching Aids Exhibition.

    ERIC Educational Resources Information Center

    Mahanja, Salah

    1985-01-01

    Describes an exhibition for the benefit of teachers of English in Arab Primary Schools, which was prepared by third-year students at the Teachers College for Arab Teachers. The exhibition included games, songs, audiovisual aids, crossword puzzles, vocabulary, spelling booklets, preposition aids, and worksheet and lesson planning aids. (SED)

  20. Difficult Decisions: AIDS.

    ERIC Educational Resources Information Center

    Slesnick, Irwin L.

    1988-01-01

    Focuses on public education about the acquired immune deficiency syndrome (AIDS) epidemic. Discusses the problems of a second epidemic of fear and anxiety. Presents several questions for classroom discussion and analysis of the public fear of AIDS. Gives some statistics highlighting misinformation about AIDS. (CW)

  1. Stroke: First Aid

    MedlinePlus

    First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when normal blood flow to ... next several hours. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...

  2. Creating Motivating Job Aids.

    ERIC Educational Resources Information Center

    Tilaro, Angie; Rossett, Allison

    1993-01-01

    Explains how to create job aids that employees will be motivated to use, based on a review of pertinent literature and interviews with professionals. Topics addressed include linking motivation with job aids; Keller's ARCS (Attention, Relevance, Confidence, Satisfaction) model of motivation; and design strategies for job aids based on Keller's…

  3. HIV and AIDS

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness HIV and AIDS KidsHealth > For Teens > HIV and AIDS Print A A A What's in this article? ... in human history. HIV causes a condition called acquired immunodeficiency syndrome — better known as AIDS . HIV destroys a type ...

  4. Designing State Aid Formulas

    ERIC Educational Resources Information Center

    Zhao, Bo; Bradbury, Katharine

    2009-01-01

    This paper designs a new equalization-aid formula based on fiscal gaps of local communities. When states are in transition to a new local aid formula, the issue of whether and how to hold existing aid harmless poses a challenge. The authors show that some previous studies and the formulas derived from them give differential weights to existing and…

  5. Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena

    PubMed Central

    Liu, Yang; Patel, Anish A.; Shaw, Janet C.; Fillman, Eric P.; Lamb, Paul B.

    2013-01-01

    Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum. H&E staining and Mucicarmine staining showed findings consistent with C. neoformans. Blood culture and cerebrospinal fluid studies also revealed C. neoformans. Cryptococcus neoformans is an AIDS defining illness that most commonly presents as meningoencephalitis and pneumonitis. Key management principles includes: induction of antifungal therapy followed by consolidation and maintenance; management of elevated intracranial pressure and immune reconstitution inflammatory syndrome. Although the organism can infect nearly all organs, gastrointestinal involvement is rarely described. Our case highlights the fact that gastrointestinal C. neoformans infection can be associated with upper gastrointestinal symptoms and may be the initial presentation of disseminated cryptococcosis. PMID:27785222

  6. Space Derived Health Aids (AID, Heart Monitor)

    NASA Technical Reports Server (NTRS)

    1981-01-01

    CPI's spinoff from miniaturized pace circuitry is the new heart-assist device, the AID implantable automatic pulse generator. AID pulse generator monitors the heart continuously, recognizes onset of fibrillation, then administers a corrective electrical shock. A mini- computer, a power source, and two electrodes which sense heart activity are included in the unit. An associated system was also developed. It includes an external recorder to be worn by AID patients and a physician's console to display the data stored by the recorder. System provides a record of fibrillation occurrences and the ensuing defibrillation.

  7. Problematizing health coaching for chronic illness self-management.

    PubMed

    Howard, Lisa M; Ceci, Christine

    2013-09-01

    To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self-management or self-care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self-management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self-management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the 'care' of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self-management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice.

  8. Assessing illness- and non-illness-based motivations for violence in persons with major mental illness.

    PubMed

    Penney, Stephanie R; Morgan, Andrew; Simpson, Alexander I F

    2016-02-01

    Research on violence perpetrated by individuals with major mental illness (MMI) typically focuses on the presence of specific psychotic symptoms near the time of the violent act. This approach does not distinguish whether symptoms actually motivate the violence or were merely present at the material time. It also does not consider the possibility that non-illness-related factors (e.g., anger, substance use), or multiple motivations, may have been operative in driving violence. The failure to make these distinctions clouds our ability to understand the origins of violence in people with MMI, to accurately assess risk and criminal responsibility, and to appropriately target interventions to reduce and manage risk. This study describes the development of a new coding instrument designed to assess motivations for violence and offending among individuals with MMI, and reports on the scheme's interrater reliability. Using 72 psychiatric reports which had been submitted to the court to assist in determining criminal responsibility, we found that independent raters were able to assess different motivational influences for violence with a satisfactory degree of consistency. More than three-quarters (79.2%) of the sample were judged to have committed an act of violence as a primary result of illness, whereas 20.8% were deemed to have offended as a result of illness in conjunction with other non-illness-based motivating influences. Current findings have relevance for clarifying the rate of illness-driven violence among psychiatric patients, as well as legal and clinical issues related to violence risk and criminal responsibility more broadly.

  9. What Is HIV/AIDS?

    MedlinePlus

    ... Subscribe Translate Text Size Print What Is HIV/AIDS? Human Immunodeficiency Virus (HIV) HIV stands for human ... use the HIV Testing & Care Services Locator. GO Acquired Immunodeficiency Syndrome (AIDS) AIDS stands for acquired immunodeficiency syndrome. AIDS ...

  10. HIV, AIDS, and the Future

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV, AIDS, and the Future Past Issues / Summer 2009 Table ... and your loved ones from HIV/AIDS. The AIDS Memorial Quilt In 1987, a total of 1, ...

  11. Hearing Aid Assembly

    NASA Technical Reports Server (NTRS)

    Grugel, Richard N. (Inventor)

    2002-01-01

    Progress in hearing aids has come a long way. Yet despite such progress hearing aids are not the perfect answer to many hearing problems. Some adult ears cannot accommodate tightly fitting hearing aids. Mouth movements such as chewing, talking, and athletic or other active endeavors also lead to loosely fitting ear molds. It is well accepted that loosely fitting hearing aids are the cause of feedback noise. Since feedback noise is the most common complaint of hearing aid wearers it has been the subject of various patents. Herein a hearing aid assembly is provided eliminating feedback noise. The assembly includes the combination of a hearing aid with a headset developed to constrict feedback noise.

  12. Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS1234

    PubMed Central

    Young, Sera L; Cohen, Craig R; Kushel, Margot B; Tsai, Alexander C; Tien, Phyllis C; Hatcher, Abigail M; Frongillo, Edward A; Bangsberg, David R

    2011-01-01

    Food insecurity, which affects >1 billion people worldwide, is inextricably linked to the HIV epidemic. We present a conceptual framework of the multiple pathways through which food insecurity and HIV/AIDS may be linked at the community, household, and individual levels. Whereas the mechanisms through which HIV/AIDS can cause food insecurity have been fairly well elucidated, the ways in which food insecurity can lead to HIV are less well understood. We argue that there are nutritional, mental health, and behavioral pathways through which food insecurity leads to HIV acquisition and disease progression. Specifically, food insecurity can lead to macronutrient and micronutrient deficiencies, which can affect both vertical and horizontal transmission of HIV, and can also contribute to immunologic decline and increased morbidity and mortality among those already infected. Food insecurity can have mental health consequences, such as depression and increased drug abuse, which, in turn, contribute to HIV transmission risk and incomplete HIV viral load suppression, increased probability of AIDS-defining illness, and AIDS-related mortality among HIV-infected individuals. As a result of the inability to procure food in socially or personally acceptable ways, food insecurity also contributes to risky sexual practices and enhanced HIV transmission, as well as to antiretroviral therapy nonadherence, treatment interruptions, and missed clinic visits, which are strong determinants of worse HIV health outcomes. More research on the relative importance of each of these pathways is warranted because effective interventions to reduce food insecurity and HIV depend on a rigorous understanding of these multifaceted relationships. PMID:22089434

  13. Family Therapy and Psychosomatic Illness.

    ERIC Educational Resources Information Center

    Waring, Edward M.

    1980-01-01

    Reviews the use of family therapy in dealing with illnesses such as childhood diabetes, asthma, pain, and anorexia nervosa. Marital and family therapy may be effective in treating some psychosomatic problems. Family assessment is helpful in the management of all psychosomatic problems. (Author/JAC)

  14. Foodborne illness and microbial agents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne illnesses result from the consumption of food containing microbial agents such as bacteria, viruses, parasites or food contaminated by poisonous chemicals or bio-toxins. Pathogen proliferation is due to nutrient composition of foods, which are capable of supporting the growth of microorgan...

  15. Program for the Chronically Ill.

    ERIC Educational Resources Information Center

    Schoenherr, Arline; Schnarr, Barbara

    The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

  16. Nonthyroidal illness syndrome in children.

    PubMed

    Marks, Seth D

    2009-12-01

    Neuroendocrine changes in the hypothalamic-pituitary-thyroid axis during critical illness result in nonthyroidal illness syndrome (NTIS) characterized by abnormal thyrotropin (TSH) and thyroid hormone levels. Studies looking at the natural history of neuroendocrine changes during critical illness have revealed the presence of NTIS. NTIS has been described in a variety of patient settings. Many studies have tried to uncover the pathophysiology behind NTIS and several theories are proposed. Whether NTIS requires treatment or intervention is still controversial and the results of the treatment studies are arguably mixed. Whether implicitly stated or not, the underlying purpose of all the natural history, pathophysiology, or treatment studies is to determine whether NTIS is adaptive or maladaptive. Some studies have illustrated a correlation between illness severity and the degree of NTIS but a cause and effect relationship is still elusive. The human studies can be divided between those with either adult or pediatric subjects, with much less data available in the latter. This review examines the available literature on NTIS with an emphasis on the pediatric literature.

  17. Illness, suffering and voluntary euthanasia.

    PubMed

    Varelius, Jukka

    2007-02-01

    It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

  18. Marriage, mental illness and law

    PubMed Central

    Sharma, Indira; Reddy, Karri Rama; Kamath, Rabindra Mukund

    2015-01-01

    The Special Marriage Act (SMA), 1954 and the Hindu Marriage Act (HMA), 1955 have put restrictions on the marriage of persons with mental illness, which are proving to be detrimental to patients and their families. There is an urgent need to address this problem. The deficiencies in the existing legislation have been projected and constructive suggestions have been put forward. PMID:26330652

  19. Teaching the Terminally Ill Child.

    ERIC Educational Resources Information Center

    Ainsa, Trisha

    1981-01-01

    Classroom teachers of terminally ill children face potentially difficult, challenging, rewarding and professionally expanding experiences which require an understanding of the basic needs of the dying. Strategies for teaching such children include literature, writing, role playing, magic circle discussions, play therapy, art therapy, counseling,…

  20. Gulf War Illness Research Program

    DTIC Science & Technology

    2010-01-01

    neurofibromato- sis; autism ; and other areas with military health interests including psychological health, traumatic brain injury, and Gulf War Illness (GWI...the national news headlines, it has not dimmed our hope that treatments and cures for GWI are waiting to be discovered and brought to bear against

  1. A simple method for defining malaria seasonality

    PubMed Central

    2009-01-01

    Background There is currently no standard way of defining malaria seasonality, resulting in a wide range of definitions reported in the literature. Malaria cases show seasonal peaks in most endemic settings, and the choice and timing for optimal malaria control may vary by seasonality. A simple approach is presented to describe the seasonality of malaria, to aid localized policymaking and targeting of interventions. Methods A series of systematic literature reviews were undertaken to identify studies reporting on monthly data for full calendar years on clinical malaria, hospital admission with malaria and entomological inoculation rates (EIR). Sites were defined as having 'marked seasonality' if 75% or more of all episodes occurred in six or less months of the year. A 'concentrated period of malaria' was defined as the six consecutive months with the highest cumulative proportion of cases. A sensitivity analysis was performed based on a variety of cut-offs. Results Monthly data for full calendar years on clinical malaria, all hospital admissions with malaria, and entomological inoculation rates were available for 13, 18, and 11 sites respectively. Most sites showed year-round transmission with seasonal peaks for both clinical malaria and hospital admissions with malaria, with a few sites fitting the definition of 'marked seasonality'. For these sites, consistent results were observed when more than one outcome or more than one calendar year was available from the same site. The use of monthly EIR data was found to be of limited value when looking at seasonal variations of malaria transmission, particularly at low and medium intensity levels. Conclusion The proposed definition discriminated well between studies with 'marked seasonality' and those with less seasonality. However, a poor fit was observed in sites with two seasonal peaks. Further work is needed to explore the applicability of this definition on a wide-scale, using routine health information system data

  2. Mental Illness Disclosure Decision Making.

    PubMed

    Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

    2017-04-10

    Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record

  3. Life Event, Stress and Illness

    PubMed Central

    Salleh, Mohd. Razali

    2008-01-01

    The relationship between stress and illness is complex. The susceptibility to stress varies from person to person. Among the factors that influenced the susceptibility to stress are genetic vulnerability, coping style, type of personality and social support. Not all stress has negative effect. Studies have shown that short-term stress boosted the immune system, but chronic stress has a significant effect on the immune system that ultimately manifest an illness. It raises catecholamine and suppressor T cells levels, which suppress the immune system. This suppression, in turn raises the risk of viral infection. Stress also leads to the release of histamine, which can trigger severe broncho-constriction in asthmatics. Stress increases the risk for diabetes mellitus, especially in overweight individuals, since psychological stress alters insulin needs. Stress also alters the acid concentration in the stomach, which can lead to peptic ulcers, stress ulcers or ulcerative colitis. Chronic stress can also lead to plaque buildup in the arteries (atherosclerosis), especially if combined with a high-fat diet and sedentary living. The correlation between stressful life events and psychiatric illness is stronger than the correlation with medical or physical illness. The relationship of stress with psychiatric illness is strongest in neuroses, which is followed by depression and schizophrenia. There is no scientific evidence of a direct cause-and-effect relationship between the immune system changes and the development of cancer. However, recent studies found a link between stress, tumour development and suppression of natural killer (NK) cells, which is actively involved in preventing metastasis and destroying small metastases. PMID:22589633

  4. Oxidative stress in severe acute illness

    PubMed Central

    Bar-Or, David; Bar-Or, Raphael; Rael, Leonard T.; Brody, Edward N.

    2015-01-01

    The overall redox potential of a cell is primarily determined by oxidizable/reducible chemical pairs, including glutathione–glutathione disulfide, reduced thioredoxin–oxidized thioredoxin, and NAD+–NADH (and NADP–NADPH). Current methods for evaluating oxidative stress rely on detecting levels of individual byproducts of oxidative damage or by determining the total levels or activity of individual antioxidant enzymes. Oxidation–reduction potential (ORP), on the other hand, is an integrated, comprehensive measure of the balance between total (known and unknown) pro-oxidant and antioxidant components in a biological system. Much emphasis has been placed on the role of oxidative stress in chronic diseases, such as Alzheimer's disease and atherosclerosis. The role of oxidative stress in acute diseases often seen in the emergency room and intensive care unit is considerable. New tools for the rapid, inexpensive measurement of both redox potential and total redox capacity should aid in introducing a new body of literature on the role of oxidative stress in acute illness and how to screen and monitor for potentially beneficial pharmacologic agents. PMID:25644686

  5. HIV-1-induced AIDS in monkeys.

    PubMed

    Hatziioannou, Theodora; Del Prete, Gregory Q; Keele, Brandon F; Estes, Jacob D; McNatt, Matthew W; Bitzegeio, Julia; Raymond, Alice; Rodriguez, Anthony; Schmidt, Fabian; Mac Trubey, C; Smedley, Jeremy; Piatak, Michael; KewalRamani, Vineet N; Lifson, Jeffrey D; Bieniasz, Paul D

    2014-06-20

    Primate lentiviruses exhibit narrow host tropism, reducing the occurrence of zoonoses but also impairing the development of optimal animal models of AIDS. To delineate the factors limiting cross-species HIV-1 transmission, we passaged a modified HIV-1 in pigtailed macaques that were transiently depleted of CD8(+) cells during acute infection. During adaptation over four passages in macaques, HIV-1 acquired the ability to antagonize the macaque restriction factor tetherin, replicated at progressively higher levels, and ultimately caused marked CD4(+) T cell depletion and AIDS-defining conditions. Transient treatment with an antibody to CD8 during acute HIV-1 infection caused rapid progression to AIDS, whereas untreated animals exhibited an elite controller phenotype. Thus, an adapted HIV-1 can cause AIDS in macaques, and stark differences in outcome can be determined by immunological perturbations during early infection.

  6. 'Our Families are Killing Us': HIV/AIDS, Witchcraft and Social Tensions in the Caprivi Region, Namibia.

    PubMed

    Thomas, Felicity

    2007-12-01

    The importance of exploring 'indigenous' constructions of illness is vital when explanatory models of ill health differ markedly from dominant biomedical paradigms. In the Caprivi region of Namibia, an upsurge of witchcraft accusations can be seen as a direct reaction to increasing AIDS-related illness and deaths, and to changes in socio-economic attitudes and expectations. The mobilization of witchcraft narratives provides a socially acceptable explanation for illness, and can positively influence decisions regarding the care and identity of the ill person. However, drawing upon data collected at kin and village level, this paper demonstrates that while witchcraft accusations can avert stigma and blame away from the ill person, they can also result in significant disruption to livelihoods, and place considerable tension upon key social capital networks at a time when the household is particularly vulnerable. Such findings have significant implications for the effectiveness of HIV prevention and AIDS mitigation initiatives, and for livelihood security.

  7. Computer-Aided Design in Further Education.

    ERIC Educational Resources Information Center

    Ingham, Peter, Ed.

    This publication updates the 1982 occasional paper that was intended to foster staff awareness and assist colleges in Great Britain considering the use of computer-aided design (CAD) material in engineering courses. The paper begins by defining CAD and its place in the Integrated Business System with a brief discussion of the effect of CAD on the…

  8. Living with diabetes in rural and urban Ghana: a critical social psychological examination of illness action and scope for intervention.

    PubMed

    Aikins, Ama De-Graft

    2003-09-01

    Current chronic illness research in Africa neglects the social psychological dimensions of illness experiences that present more appropriate frameworks for intervention. Informed by social representations theory, links between social knowledge of diabetes, illness experience and illness action were examined through semistructured individual interviews with rural and urban Ghanaians with diabetes. All respondents drew interchangeably from commonsense, scientized, and religious knowledge modalities in defining health, illness and diabetes. Diabetes caused disruption to: body-self, social identity, family/social relationships, economic circumstance and nutrition. Commonsense and scientized notions of health, illness and diabetes framed illness action goals that merged with biomedical goals, specifically drug and diet management. These goals were compromised by the nature, severity and duration of disruption(s) and emotional responses evoked. The paper dicusses implications of the findings and outlines recommendations for interventions that span individual/group, community and structural dimensions.

  9. RASCAL: A Rudimentary Adaptive System for Computer-Aided Learning.

    ERIC Educational Resources Information Center

    Stewart, John Christopher

    Both the background of computer-assisted instruction (CAI) systems in general and the requirements of a computer-aided learning system which would be a reasonable assistant to a teacher are discussed. RASCAL (Rudimentary Adaptive System for Computer-Aided Learning) is a first attempt at defining a CAI system which would individualize the learning…

  10. Software For Computer-Aided Design Of Control Systems

    NASA Technical Reports Server (NTRS)

    Wette, Matthew

    1994-01-01

    Computer Aided Engineering System (CAESY) software developed to provide means to evaluate methods for dealing with users' needs in computer-aided design of control systems. Interpreter program for performing engineering calculations. Incorporates features of both Ada and MATLAB. Designed to be flexible and powerful. Includes internally defined functions, procedures and provides for definition of functions and procedures by user. Written in C language.

  11. Confidentiality Limits with Clients Who Have the AIDS Virus.

    ERIC Educational Resources Information Center

    Gray, Lizbeth A.; Harding, Anna K.

    1988-01-01

    Addresses the issue of defining limits of confidentiality for the life-threatening dilemma of a client who has the acquired immunodeficiency syndrome (AIDS) virus and who continues to be sexually active without informing his or her partners. Reviews the medical background of AIDS, legal limits, and ethical issues of confidentiality. Supports…

  12. Bodily remembering: memory, place, and understanding Latino folk illnesses among the Amuzgos Indians of Oaxaca, Mexico.

    PubMed

    Cartwright, Elizabeth

    2007-12-01

    This paper takes the theoretical construct of popular nosology of Latino folk illnesses and combines it with Edward Casey's concept of bodily remembering in order to more fully describe the role of memory and place in the illness experiences of the Amuzgos Indians of Oaxaca, Mexico. I ethnographically describe, across time, the interrelated links among social events, physical symptoms, and illness narratives of Latino folk illness popular nosologies as they are contextualized in their unique, social topographies. This enlarged theoretical perspective implies a smallest unit of meaning that is ethnographically defined, but that will often encompass more than the individual sufferer and more than one illness. The research objective of this study was to understand Amuzgan illness experiences through the narratives of detailed case histories and ethnographic observations that were gathered during 18 months of qualitative research. The data show that Amuzgos experience Latino folk illnesses as bodily rememberings of illness events combined with negative interpersonal interactions. Healing these Latino folk illnesses implies curing bodies, households, social relationships, and living environments.

  13. HIV/AIDS: impact on healing.

    PubMed

    Burns, J; Pieper, B

    2000-03-01

    Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) are leading chronic illnesses in many major cities worldwide. Frequently, people with HIV infection require surgery or develop chronic wounds. This paper summarizes the impact of HIV infection on body organs and systems and the effect of antiretroviral therapy as a basis for potential complications with wound care and healing. The authors also present research on wound healing in HIV-positive people undergoing operative procedures. Besides the physical effect of HIV infection on the person, clinicians must also realize psychosocial and economic effects of the disease when considering wound care. This paper also addresses care considerations for patients with HIV/AIDS in the inpatient, outpatient, and home care settings.

  14. Defining Support Requirements During Conceptual Design of Reusable Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Morris, W. D.; White, N. H.; Davis, W. T.; Ebeling, C. E.

    1995-01-01

    Current methods for defining the operational support requirements of new systems are data intensive and require significant design information. Methods are being developed to aid in the analysis process of defining support requirements for new launch vehicles during their conceptual design phase that work with the level of information available during this phase. These methods will provide support assessments based on the vehicle design and the operating scenarios. The results can be used both to define expected support requirements for new launch vehicle designs and to help evaluate the benefits of using new technologies. This paper describes the models, their current status, and provides examples of their use.

  15. HIV / AIDS in the workplace: principles, planning, policy, programmes and project participation.

    PubMed

    Smart, R

    1999-01-01

    15 years ago, most business, labor, government, and nongovernment representatives would have had only a small idea of what AIDS was, and let alone why it should concern them. However, companies have since lost top managers, workers have lost colleagues, and considerable time, energy, and emotion have been spent upon issues of illness and loss. Entire families have collapsed, as companies struggle against a background of chronic poverty. The HIV/AIDS pandemic has forced a reconsideration of whether disease prevention and health promotion are business concerns. AIDS causes illness, disability, and death to workers, as well as severe economic and emotional disruptions to their families. It also increases the cost of doing business. As South Africa faces a large epidemic, business must take prompt and incisive action against AIDS. A list of 10 workplace principles is presented and a 3-stage process recommended to ensure optimal workplace HIV/AIDS/STD and tuberculosis policies and programs.

  16. AIDS in South Africa.

    PubMed

    Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H

    1993-01-01

    The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

  17. Hinduism, marriage and mental illness.

    PubMed

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.

  18. Bipolar illness, creativity, and treatment.

    PubMed

    Rothenberg, A

    2001-01-01

    There have been in recent years increasing claims in both popular and professional literature for a connection between bipolar illness and creativity. A review of studies supporting this claim reveals serious flaws in sampling, methodology, presentation of results, and conclusions. Although there is therefore no evidence for etiological or genetic linkages, it is still necessary to explain interrelationships in those creative persons suffering from the illness. Examples of the work in progress of artists with bipolar disorder, Jackson Pollock and Edvard Munch, illustrate the use of healthy and adaptive creative cognition--janusian and homospatial processes--in the former's breakthrough conception during an improvement phase in treatment leading to the development of the Abstract Expressionist Movement and in the latter's transformation of an hallucination into his famous artwork "The Scream." Treatment options that do not produce cognitive effects are important for creative persons with bipolar disorder.

  19. Hinduism, marriage and mental illness

    PubMed Central

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations. PMID:23858262

  20. 'Chronic' identities in mental illness.

    PubMed

    von Peter, Sebastian

    2013-04-01

    The term 'chronicity' is still widely used in psychiatric discourse and practice. A category employed in political, administrative and therapeutic contexts, it guides practitioners' beliefs and actions. This paper attempts a review of the attitudes and procedures that result as a consequence of identifying 'chronically' disturbed identities in clinical practice. An essentially social, relational and materialist understanding of mental illness is used to highlight the kind of thinking underlying the notion of 'chronic' identities in day-to-day psychiatric routines. Problematising the notions of singularity and expressiveness, as well as mind/body- and self/other-distinctions, it claims the category itself is responsible for creating a 'chronic' kind of being. A spatial metaphor is presented in the conclusion, illustrating a mental strategy by which we can re-shape our thinking about 'chronic' identities. It attempts to describe how the shift from an epistemological to a praxeographic approach could build a more complete understanding of mental illness.

  1. Adult Neurogenesis and Mental Illness

    PubMed Central

    Schoenfeld, Timothy J; Cameron, Heather A

    2015-01-01

    Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407

  2. Real Time Free Cortisol Quantification Among Critically Ill Children

    PubMed Central

    Zimmerman, Jerry J.; Donaldson, Amy; Barker, Ruth M.; Meert, Kathleen L.; Harrison, Rick; Carcillo, Joseph A.; Anand, Kanwaljeet J. S.; Newth, Christopher J. L.; Berger, John; Willson, Douglas F.; Jack, Rhona; Nicholson, Carol; Dean, J. Michael

    2013-01-01

    Objectives Ascertainment of adrenal function assessing free (FC) rather that total (TC) cortisol may be beneficial for the diagnosis of critical illness related cortisol insufficiency (CIRCI). We hypothesized that centrifugal ultrafiltration (CUF) would provide timely FC data that highly correlated with the gold standard, but logistically cumbersome, equilibrium dialysis (EQD) technique when the FC fractions were identically quantified by chemiluminescence immunoassay. We also hypothesized that FC would correlate with illness severity in a large cohort of critically ill children. Design Prospective, multi-institutional, observational cohort investigation. Setting Seven pediatric intensive care units (PICUs) within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Patients 165 critically ill children across the spectrum of illness severity. Interventions Blood sampling. Measurements and main results Time to derive plasma FC concentrations following CUF or EQD fractionation with chemiluminescence immunoassay was ~2 versus ~24 hours, respectively. Utilizing CUF, mean plasma FC was 4.1 ± 6.7 ug/dL (median 1.6, range 0.2-43.6), representing an average of 15.2 ± 9.4% of total cortisol. Nearly 60% of subjects exhibited FC < 2 and 30% < 0.8 ug/dL, previously suggested threshold concentrations for defining CIRCI. Plasma FC concentrations comparing CUF versus EQD fractionation demonstrated a strong correlation (R2 = 0.97). For FC < 2 ug/dL Bland-Altman analysis revealed minimal negative bias for the CUF technique. Illness severity assessed by PRISM III correlated moderately with FC and percent TC as FC. Conclusions Determination of CUF fractionated FC was fast and results correlated highly with EQD fractionated FC. Many children exhibited FC < 2 and < 0.8 ug/dL, but did not demonstrate clinical evidence of CIRCI. This study ascertains that real time FC quantification is feasible to

  3. Probiotics in critically ill children

    PubMed Central

    Singhi, Sunit C.; Kumar, Suresh

    2016-01-01

    Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing either Lactobacillus alone or in combination with Bifidobacterium reduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administered Lactobacillus casei subspecies rhamnosus, Lactobacillus reuteri, and Lactobacillus rhamnosus were effective in the prevention of late-onset sepsis and GIT colonization by Candida in preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization by Candida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics, optimum dosage regimens

  4. Music and hearing aids.

    PubMed

    Madsen, Sara M K; Moore, Brian C J

    2014-10-31

    The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems.

  5. Music and Hearing Aids

    PubMed Central

    Moore, Brian C. J.

    2014-01-01

    The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601

  6. AIDS and confidentiality.

    PubMed

    Kirkman, M B; Bell, S K

    1989-01-01

    AIDS has created many challenges for those who provide care for AIDS patients. One major challenge has been the request of many public officials for healthcare professionals to abandon the traditional view of confidentiality and to reveal AIDS patients' names. This ethical dilemma is explored and some ethical theories are presented as possible resolutions. The conclusion presented is that healthcare professionals must recognize that the power of the healthcare system over an AIDS patient is immense. Therefore, healthcare professionals must make a commitment to protect the patient's right to privacy by preventing any unauthorized disclosure at all costs.

  7. Explanatory Models for Psychiatric Illness

    PubMed Central

    Kendler, Kenneth S.

    2009-01-01

    How can we best develop explanatory models for psychiatric disorders? Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable explanatory laws are ill suited for our field. Such models are based on the incorrect assumption that psychiatric illnesses can be understood from a single perspective. A more appropriate scientific model for psychiatry emphasizes the understanding of mechanisms, an approach that fits naturally with a multicausal framework and provides a realistic paradigm for scientific progress, that is, understanding mechanisms through decomposition and reassembly. Simple subunits of complicated mechanisms can be usefully studied in isolation. Reassembling these constituent parts into a functioning whole, which is straightforward for simple additive mechanisms, will be far more challenging in psychiatry where causal networks contain multiple nonlinear interactions and causal loops. Our field has long struggled with the interrelationship between biological and psychological explanatory perspectives. Building from the seminal work of the neuronal modeler and philosopher David Marr, the author suggests that biology will implement but not replace psychology within our explanatory systems. The iterative process of interactions between biology and psychology needed to achieve this implementation will deepen our understanding of both classes of processes. PMID:18483135

  8. Women living with environmental illness.

    PubMed

    Chircop, Andrea; Keddy, Barbara

    2003-01-01

    We used a case study approach to explore the experiences of 4 women who live with environmental illness (EI). From the unstructured interviews we found a variety of themes that pointed to the complexity of EI and its severe impact on the lives of these women, their families, and their significant others. The methodology was guided by an ecofeminist approach, which enabled a critical analysis of the data to move beyond the personal to the broader sociopolitical forces shaping society. We identified the following themes from the women's stories: indirect exposure to incitants through people with whom these women come in close physical contact; the phenomenon of burden of proof, meaning that these women are forced to explain and legitimize their illness on a continuous basis; taking refuge from a hostile environment in social isolation to a more controlled environment, not as a matter of choice, but because of the severity of the illness; and, finally, a change in value system was integral to the entire process of living with EI.

  9. Delirium in critically ill patients.

    PubMed

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models. Treatment of delirium can be improved with frequent monitoring, as early detection and subsequent treatment of the underlying condition can improve outcome. Cautious use or avoidance of benzodiazepines may reduce the likelihood of developing delirium. Nonpharmacologic strategies with early mobilization, reducing causes for sleep deprivation, and reorientation measures may be effective in the prevention of delirium. Antipsychotics are effective in treating hallucinations and agitation, but do not reduce the duration of delirium. Combined pain, agitation, and delirium protocols seem to improve the outcome of critically ill patients and may reduce delirium incidence.

  10. Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS.

    PubMed

    Badowski, Melissa E; Perez, Sarah E

    2016-01-01

    Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol), anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone), or, rarely, cytokine production modulators (thalidomide). The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (-2.0 to 3.2 kg), dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes.

  11. Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS

    PubMed Central

    Badowski, Melissa E; Perez, Sarah E

    2016-01-01

    Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol), anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone), or, rarely, cytokine production modulators (thalidomide). The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (–2.0 to 3.2 kg), dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes. PMID:26929669

  12. The acute care physical therapy HIV/AIDS patient population: a descriptive study.

    PubMed

    Kinirons, Stacy A; Do, Sandy

    2015-01-01

    This study was based on an analysis of an existing database compiled from 475 medical records of people living with HIV/AIDS admitted to an acute-care hospital in New York City in 2004. The characteristics of patients with HIV infection that received physical therapy were determined. Differences between patients with HIV infection that did and did not receive physical therapy, as well as predictors of receipt of physical therapy, were identified. The physical therapy subgroup (n = 69) had a mean age of 48.3 years, consisted of more men than women, and was predominately black, with public health insurance. Admissions were commonly due to non-AIDS-defining illness as the primary diagnoses, accompanied by several comorbidities. Admissions often presented with functional deficits, incurred a prolonged length of stay, and required assistance at discharge. Differences existed between the physical therapy subgroup and the non-physical therapy subgroup (n = 406). Predictors of receipt of physical therapy were functional status on admission and length of stay.

  13. HIV/AIDS

    MedlinePlus

    ... care providers. 3. Testing and counselling, linkages to tuberculosis care Tuberculosis (TB) is the most common presenting illness and ... care; access to condoms; and management of STIs, tuberculosis and viral hepatitis. 7. Elimination of mother-to- ...

  14. Towards Defining Adequate Lithium Trials for Individuals with Mental Retardation and Mental Illness.

    ERIC Educational Resources Information Center

    Pary, Robert J.

    1991-01-01

    Use of lithium with mentally retarded individuals with psychiatric conditions and/or behavior disturbances is discussed. The paper describes components of an adequate clinical trial and reviews case studies and double-blind cases. The paper concludes that aggression is the best indicator for lithium use, and reviews treatment parameters and…

  15. Exploring the intelligibilty of foreign-accented English vowels when ``English'' is ill-defined

    NASA Astrophysics Data System (ADS)

    Bundgaard-Nielsen, Rikke Louise; Bohn, Ocke-Schwen

    2004-05-01

    Many studies of foreign-accented speech have been conducted in second language settings in which learners are assumed to be exposed to a relatively homogeneous non-native sound system. However, foreign language learners, who learn an additional language in a setting where this language is not the primary medium of communication, are frequently exposed to a range of varieties of the target language which may differ considerably with respect to their sound systems. The present study examined and compared the intelligibility of English monophthongs produced by two speaker groups: Native Danes who had learned English as a foreign language (with exposure to different native and non-native varieties) and native English speakers from Australia, the US, and the UK. Ten native Canadian-English listeners, who were familiar with native and non-native accents of English, identified the 11 monophthongs of English produced by the speaker groups in a /bVt/ context. As expected, the listeners' error patterns were specific for each speaker group. However, reduced intelligibility was observed for much the same vowels irrespective of speaker group. Our results suggest that one source of problems in learning the sounds of English is the heterogeneity of English vowel systems in addition to transfer from the native language.

  16. Enhancing Perception in Ethical Decision Making: A Method to Address Ill-Defined Training Domains

    DTIC Science & Technology

    2010-08-01

    The psychology of moral development. New York: Harper & Row. Kohler, W. (1947). Gestalt psychology : An introduction to new concepts in modern...Development Ethical Decision Making Qualitative Methods Applications of Gestalt Theory Decision Making Experiences Mixed-Method...Simon Center for the Professional Military Ethic at the United States Military Academy and have been presented at the Association for Psychological

  17. Thyroid remnant ablation: questionable pursuit of an ill-defined goal

    SciTech Connect

    Snyder, J.; Gorman, C.; Scanlon, P.

    1983-08-01

    Ablative therapy with I-/sup 131/ in 30-mCi doses, directed to postsurgical remnants in patients with differentiated thyroid cancer, reduced visible I-/sup 131/ uptake to zero or nearly zero in 81% of patients but did not protect against tumor recurrence in six of 69 patients who were followed for 2-5 yr. Recurrences developed within 5-37 mo. Effectiveness of 30-mCi doses of I-/sup 131/ in producing ablation did not correlate with I-/sup 131/ uptake by the thyroid remnant, surgeon's estimate of remnant size, or delivered dose to the remnant in rads, calculated using reasonable assumptions. These findings emphasize the difficulty of dosimetric measurements and calculations. The value of postsurgical ablative therapy in diminishing morbidity and mortality in patients with differentiated thyroid cancer has not yet been firmly established, and until this is done we advocate a conservative, economical approach to thyroid ablation with 30-mCi treatment doses of I-/sup 131/ and 1-mCi neck-scanning doses to check on effectiveness of therapy.

  18. Occupational hazards to health care workers: Diverse, ill-defined, and not fully appreciated

    SciTech Connect

    Moore, R.M. Jr.; Kaczmarek, R.G. )

    1990-10-01

    Health care workers are challenged by an imposing group of occupational hazards. These hazards include exposure to ionizing radiation, stress, injury, infectious agents, and chemicals. The magnitude and diversity of these hazards are not fully appreciated. The acquired immunodeficiency syndrome epidemic has created additional occupational hazards and has focused attention on the problem of occupational hazards to health care workers. Concern over the nosocomial transmission of the human immunodeficiency virus has contributed to efforts to implement universal infection control precautions and to decrease needlestick injuries. Health care organizations and providers, who have prompted health and safety campaigns for the general public, should not overlook the dangers associated with the health care setting.

  19. The Efficacy of Cross-Discipline Representations for Ill-Defined IAS Concepts

    ERIC Educational Resources Information Center

    Rigby, Steven

    2009-01-01

    A universal problem to our society is the dramatic increase in the number of security threats, risks, and vulnerabilities to our nation's computer systems, data, and infrastructure. Our future success depends upon the problem-solving and thinking abilities of professionals entering the Information Assurance and Security (IAS) field. These…

  20. A Field Study of Control Systems in Environments with Ill-Defined Technology and Output

    DTIC Science & Technology

    1989-12-01

    Care Center B was a privately owned, client- funded, profit-seeking child care center. It was a certified Montessori school established in 1978. The...third, provide a quality, Montessori education. Of these three goals, only the third was written in the organization’s literature (in the Parent’s...that Child Care Center B generated its own SOPs. The director/owner stated that the state-regulations binder, along with the Montessori manuals

  1. ITV Resources in the Defined Minimum Program. 1989-90 Curriculum Guide.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Instructional Technology.

    This curriculum guide is intended for use by superintendents, district directors of instruction, curriculum writers, principals, and teachers in identifying instructional resources that will aid their schools in meeting specific requirements of the Defined Minimum Program and objectives of the Basic Skills Assessment Program. It also aids in the…

  2. AIDS is your business.

    PubMed

    Rosen, Sydney; Simon, Jonathon; Vincent, Jeffrey R; MacLeod, William; Fox, Matthew; Thea, Donald M

    2003-02-01

    If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense.

  3. Computer aided surface representation

    SciTech Connect

    Barnhill, R.E.

    1989-02-09

    The central research problem of this project is the effective representation and display of surfaces, interpolating to given information, in three or more dimensions. In a typical problem, we wish to create a surface from some discrete information. If this information is itself on another surface, the problem is to determine a surface defined on a surface,'' which is discussed below. Often, properties of an already constructed surface are desired: such geometry processing'' is described below. The Summary of Proposed Research from our original proposal describes the aims of this research project. This Summary and the Table of Contents from the original proposal are enclosed as an Appendix to this Progress Report. The broad sweep from constructive mathematics through algorithms and computer graphics displays is utilized in the research. The wide range of activity, directed in both theory and applications, makes this project unique. Last month in the first Ardent Titan delivered in the State of Arizona came to our group, funded by the DOE and Arizona State University. Although the Titan is a commercial product, its newness requires our close collaboration with Ardent to maximize results. During the past year, four faculty members and several graduate research assistants have worked on this DOE project. The gaining of new professionals is an important aspect of this project. A listing of the students and their topics is given in the Appendix. The most significant publication during the past year is the book, Curves and Surfaces for Computer Aided Geometric Design, by Dr. Gerald Farin. This 300 page volume helps fill a considerable gap in the subject and includes many new results on Bernstein-Bezier curves and surfaces.

  4. AIDS Fact Pack.

    ERIC Educational Resources Information Center

    Center for Population Options, Washington, DC.

    The three fact sheets presented in this document address issues surrounding adolescent sexuality and sexually transmitted diseases (STDs), especially the Acquired Immune Deficiency Syndrome (AIDS). The first fact sheet, "Young Women and AIDS: A Worldwide Perspective," suggests that since open discussions of adolescent sexuality have long been…

  5. Detecting Student Aid Fraud.

    ERIC Educational Resources Information Center

    Sheppard, Jeffrey

    1998-01-01

    Describes the varied kinds of student aid fraud found to be occurring within and outside colleges and universities, and examines implications for public policy on student aid programs. Discusses specific fraud cases and their outcomes, and makes suggestions for institutional action if student fraud is suspected. (MSE)

  6. Computer Aids to Translation.

    ERIC Educational Resources Information Center

    Krollmann, Friedrich

    1981-01-01

    Describes the structure and modes of operation of the Bundessprachenamt's (BSprA: Federal Office of Languages of the Federal Republic of Germany) terminology data bank as an aid to translation. Analyzes advantages and disadvantages of each user mode, and discusses probable developments in the immediate future of machine-aided translation. (MES)

  7. International Aid to Education

    ERIC Educational Resources Information Center

    Benavot, Aaron

    2010-01-01

    Recent evidence highlights several worrisome trends regarding aid pledges and disbursements, which have been exacerbated by the global financial crisis. First, while overall development assistance rose in 2008, after 2 years of decline, the share of all sector aid going to the education sector has remained virtually unchanged at about 12 percent…

  8. AIDS as Metaphor.

    ERIC Educational Resources Information Center

    McMillen, Liz

    1994-01-01

    Scholarly interest in Acquired Immune Deficiency Syndrome (AIDS) has spread throughout the humanities, attracting the attention of historians of medicine, political scientists, sociologists, public health scholars, and anthropologists. Most theorists hope their research will aid in policymaking or change understanding of the epidemic. (MSE)

  9. First Aid: Diaper Rash

    MedlinePlus

    ... Your 1- to 2-Year-Old First Aid: Diaper Rash KidsHealth > For Parents > First Aid: Diaper Rash A A A Diaper rash is a common skin condition in babies. ... rash is due to irritation caused by the diaper, but it can have other causes not related ...

  10. Hospital Nurse Aide. Revised.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Coll. of Education.

    This report presents results of a project to revise the current 120-hour advanced nurse aide course to include all recommended minimum competencies. A three-page description of project objectives, activities, and outcomes is followed by a list of the competencies for the 75-hour nurse aide course for long-term care and for the 120-hour advanced…

  11. Preventing AIDS via Education.

    ERIC Educational Resources Information Center

    House, Reese M.; Walker, Catherine M.

    1993-01-01

    Compares the Acquired Immune Deficiency Syndrome (AIDS) epidemic to past epidemics, including social and political responses. Identifies populations at risk for human immunodeficiency virus (HIV) infection. Discusses current social and economic factors affecting AIDS education programs. Makes recommendations and identifies resources for starting…

  12. THE AIDS MYTH

    PubMed Central

    Poehlmann, Karl Horst

    1996-01-01

    AIDS is now said to threaten humanity as a modern-day scourge. However, there is a group of scientists which maintains that this scare is unwarranted. Some arguments in favour of the re-evaluation of the AIDS hypothesis are presented in this article. PMID:22556763

  13. Aid, Development, and Education

    ERIC Educational Resources Information Center

    Klees, Steven J.

    2010-01-01

    The world faces pervasive poverty and inequality. Hundreds of billions of dollars in international aid have been given or loaned to developing countries though bilateral and multilateral mechanisms, at least, ostensibly, in order to do something about these problems. Has such aid helped? Debates around this question have been ongoing for decades,…

  14. BIBLIOGRAPHY OF TRAINING AIDS.

    ERIC Educational Resources Information Center

    MCKEONE, CHARLES J.

    THIS COMPILATION OF INSTRUCTIONAL AIDS FOR USE IN AIR-CONDITIONING AND REFRIGERATION TRAINING PROGRAMS CONTAINS LISTS OF VISUAL AND AUDIOVISUAL TRAINING AIDS AND GUEST LECTURERS AVAILABLE FROM MEMBER COMPANIES OF THE AIR-CONDITIONING AND REFRIGERATION INSTITUTE AS AN INDUSTRY SERVICE TO SCHOOL OFFICIALS INTERESTED IN CONDUCTING SUCH PROGRAMS. THE…

  15. First Aid: Falls

    MedlinePlus

    ... Your 1- to 2-Year-Old First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A en español Folleto de instructiones: Caídas (Falls) With all the running, climbing, and exploring kids ...

  16. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  17. Inertially Aided Robotics

    DTIC Science & Technology

    1989-12-31

    0031 dis~bti:,1 is uitsnjt( Deczmllcr 31: 1989 92-05530 2:.-: 3o : T >VE?-A ~ : Inertially Aided Robotics FINAL REPORT for Contract No. DAAHO1 -88-D-0057...1 2 Advantages of Inertially Aided Robotics ...86 iii List of Figures Figure 1 - Robot Manipulator having Joint Sensor Based Control ..................... 2

  18. Marketing Financial Aid

    ERIC Educational Resources Information Center

    Huddleston, Thomas, Jr.; Batty, Burt F.

    1978-01-01

    Student financial assistance services are becoming a major part of the institutional marketing plan as traditional college-age students decline in numbers and price competition among institutions increases. The effect of financial aid on enrollment and admissions processes is discussed along with the role of the financial aid officer. (Author/LBH)

  19. Participative AIDS Education Methods.

    ERIC Educational Resources Information Center

    Chambliss, Catherine; And Others

    Since assuring quality health care delivery to patients suffering from Acquired Immunodeficiency Syndrome (AIDS) and those who test positive for Human Immunodeficiency Virus (HIV) is a priority, development of effective staff training methods is imperative. This pilot study assessed the effect on staff attitudes of a participative AIDS/HIV staff…

  20. Innovative Teaching Aids.

    ERIC Educational Resources Information Center

    Christner, Chris

    1988-01-01

    Describes the DACUM (Developing A CurriculUM) process and how it is used at Universal Technical Institute to determine what types of training aids to produce. Indicates that examining the employment needs of industry and educational needs of students enhances programs and promotes development of innovative aids. (JOW)

  1. First Aid: Burns

    MedlinePlus

    ... Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild ...

  2. The New Merit Aid

    ERIC Educational Resources Information Center

    Dynarski, Susan

    2004-01-01

    Merit aid, a discount to college costs contingent upon academic performance, is nothing new. Colleges and private organizations have long rewarded high-achieving, college-bound high school students with scholarships. While merit aid has a long history in the private sector, it has not played a major role in the public sector. At the state level,…

  3. AIDS Epidemiological models

    NASA Astrophysics Data System (ADS)

    Rahmani, Fouad Lazhar

    2010-11-01

    The aim of this paper is to present mathematical modelling of the spread of infection in the context of the transmission of the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS). These models are based in part on the models suggested in the field of th AIDS mathematical modelling as reported by ISHAM [6].

  4. Use of the transgenic mouse in models of AIDS cardiomyopathy.

    PubMed

    Lewis, William

    2003-04-01

    Heart disease in AIDS, particularly cardiomyopathy (CM), is an increasingly recognized clinical problem with as yet undefined pathogenetic mechanisms. Among the potential etiologies of AIDS CM are HIV-1 infection of cardiac myocytes and subsequent cardiac dysfunction, opportunistic infection, inflammatory reactions, cytokine effects, and cardiotoxicity of prescribed or illicit drugs. It seems probable that multiple factors may impact on the development of CM in AIDS. Transgenic mice (TG) are useful biological tools to explore mechanisms of cardiac function and disease. In AIDS models, TG offer novel ways to elucidate mechanisms of AIDS CM through combined in vivo and in vitro studies. With targeted and non-targeted TG, structural and functional effects of specific HIV-1 gene products on heart tissue may be addressed. The impact of environmental agents including therapeutics or cardiotoxins may also be defined. To address the complexity of AIDS CM using TG, an experimental approach has been employed in our laboratories to model the clinical condition. We utilize AIDS TG with generalized expression of HIV-1 gene products in CM models with combined antiretroviral regimens to define the cardiovascular effects of AIDS and its therapy on the structure and function of the murine heart. We are developing a series of cardiac specific TG bearing selected HIV-1 genes. These TG target the selected HIV-1 genes expressed in cardiac ventricular myocytes. Tissue-specific targeting of this type enables us to define structural and functional effects of specific HIV-1 gene products on the cardiac myocyte.

  5. AIDS in the pre-AIDS era.

    PubMed

    Huminer, D; Rosenfeld, J B; Pitlik, S D

    1987-01-01

    A search of the medical literature published since 1950 disclosed 19 cases of probable AIDS reported before the start of the current epidemic. These cases retrospectively met the Centers for Disease Control's surveillance definition of the syndrome and had a clinical course suggestive of AIDS. The reports originated from North America, Western Europe, Africa, and the Middle East. The mean age of patients was 37 years, and the ratio of male to female patients was 1.7:1. Sixteen patients had opportunistic infections(s) without Kaposi's sarcoma. The remainder had disseminated Kaposi's sarcoma. The commonest opportunistic infection was Pneumocystis carinii pneumonia. Two patients were reported to be homosexual. Three others had been living in Africa, and one patient was born in Haiti. In two instances concurrent or subsequent opportunistic infection occurred in family members. All patients died 1 month to 6 years after the initial manifestation of disease. In view of the historical data, unrecognized cases of AIDS appear to have occurred sporadically in the pre-AIDS era.

  6. Epidemic and Identity: A Cross-Cultural Comparison of AIDS Prevention Approaches in France and the United States

    ERIC Educational Resources Information Center

    Stambolis-Ruhstorfer, Michael

    2005-01-01

    The last twenty years have witnessed the explosion of a worldwide epidemic. AIDS is a syndrome that crosses national borders and renders obsolete the distinctions between the public and private spheres. Researchers and historians who try to understand the social nuances of AIDS often classify it as a cultural illness that underlines national…

  7. Health Care and the Social Construction of AIDS: Impact of Disease Definitions on Psychosocial Adaptation and Economic Circumstances.

    ERIC Educational Resources Information Center

    Crystal, Stephen; Jackson, Marguerite

    As with other illnesses, Acquired Immune Deficiency Syndrome (AIDS) is a socially constructed phenomenon, not simply a biological entity. Biologically, Human Immunodeficiency Virus (HIV) infection causes immunosuppression, which in turn causes a spectrum of disease states. The official definition of AIDS by the Centers for Disease Control requires…

  8. Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis.

    PubMed

    Farahani, Mansour; Mulinder, Holly; Farahani, Alexander; Marlink, Richard

    2016-02-10

    The advent of antiretroviral therapy has significantly improved AIDS-related morbidity and mortality. Yet, among people living with HIV, deaths due to non-AIDS-defining illnesses have been on the rise. The objective of this study was to provide information about the global prevalence and distribution of non-AIDS causes of death in the last ten years among people living with HIV receiving antiretroviral therapy, by income levels of countries. We used broad search terms in Google Scholar, PubMed, and EMBASE to identify all studies that investigated the cause of death among people living with HIV receiving antiretroviral therapy, published after January 1, 2005. References were also identified from review articles and reference lists. Inclusion criteria were English language, the study's end date was after 2005, all patients were HIV-positive, at least two-thirds of the patients were receiving antiretroviral therapy, at least one patient died of non-AIDS causes of death. Titles, abstracts, and articles were reviewed by at least two independent readers. Of 2951 titles identified in our original search, 151 articles were selected for further screening. We identified 19 studies meeting our full criteria, with patients from 55 different nations. Pooled non-AIDS causes of death prevalence estimates in high-income countries were 53.0% (95% confidence interval, 43.6-62.3), in developing countries 34.0% (95% confidence interval, 20.3-49.1), and in sub-Saharan countries 18.5% (95% confidence interval, 13.8-23.7). Statistically significant variation was noted within and between categories. Our findings show that a significant number of people living with HIV across the world die from cardiovascular disease, non-AIDS malignancies, and liver disease. There is a global need for further scrutiny in all regions to improve preventive measures and early detection according to distinct causes of death patterns.

  9. Associations between perceived chronic care quality, perceived patient centeredness, and illness representations among persons with diabetes.

    PubMed

    Thomas, Joseph; Iyer, Neeraj N; Collins, William B

    2014-01-01

    Patient beliefs about their illness can motivate behaviors consistent with good disease management. Perceived high-quality chronic care would be expected to increase likelihood of having such beliefs. Associations between perceived quality of chronic care and illness representations, and associations between patient centeredness and illness representations were assessed among persons with diabetes. A mail survey of diabetic patients visiting a multispecialty physician network serving urban and suburban populations in a large midwestern city was conducted. The Patient Assessment of Chronic Illness Care-5A questionnaire was used to assess perceived chronic care quality and patient centeredness. The Brief Illness Perception Questionnaire was used to assess illness representations. Of 500 mailed surveys, 89 completed surveys were returned. The sample consisted mostly of retirees (61%), Whites (81%), and women (60%). Higher perceived chronic care quality was associated with better disease understanding of diabetes (0.24, p = .05). Patients reporting higher patient centeredness (or lower patient-centeredness scores) indicated better disease understanding (-0.26, p = .04) and those reporting higher patient centeredness (or lower patient-centeredness scores) perceived less impact of illness (0.29, p = .02). Chronic care quality as defined in the Chronic Care Model and consistency of chronic care with patient expectations (patient centeredness) was associated with illness representations favorable for good self-care management.

  10. Families suffering with HIV/AIDS: what family nursing interventions are useful to promote healing?

    PubMed

    Wacharasin, Chintana

    2010-08-01

    The purpose of this clinical research project was to examine the usefulness of a family nursing intervention program offered to families experiencing illness suffering related to HIV/AIDS. The interventions were based on the Family Caregiving Model and the Illness Beliefs Model. Sixteen Thai families with one or more family members living with HIV/AIDS were offered three to four family clinical sessions by an advanced practice family nurse. The audiotaped family clinical sessions and field notes were analyzed using thematic analysis. The outcomes reported by families included a competence to manage illness care of family members experiencing HIV/AIDS, new meaning and purpose, improved family interaction, embraced facilitating beliefs and changed constraining beliefs, and a recognition of the family's strengths.

  11. Clarifying and Defining Library Services.

    ERIC Educational Resources Information Center

    Shubert, Joseph F., Ed.; Josey, E. J., Ed.

    1991-01-01

    This issue presents articles which, in some way, help to clarify and define library services. It is hoped that this clarification in library service will serve to secure the resources libraries need to serve the people of New York. The following articles are presented: (1) Introduction: "Clarifying and Defining Library Services" (Joseph…

  12. Ethics and mental illness research.

    PubMed

    Roberts, Laura Weiss

    2002-09-01

    There are many tasks ahead in the area of ethics and mental illness research. We face unknown challenges in psychiatric genetics projects, studies of psychopharmacological interventions in children, controversial scientific designs (e.g., symptom challenge, medication-free interval), and cross-disciplinary research incorporating goals and methods of health services, epidemiology, and social and behavioral science endeavors. Boundaries between innovative clinical practices and research-related experimentation will become increasingly difficult to distinguish, as will the roles between clinicians, clinical researchers, and basic scientists. Moreover, the institutions and systems in which research occurs are being rapidly and radically revised, raising new questions about oversight responsibilities and standards. Our ability to identify and respond to the ethical questions arising in this uncharted territory will depend on our willingness to self-reflect, to integrate the observations and insights of the past century, to think with great clarity, and to anticipate novel ethical problems that keep company with scientific advancements. It will also depend on data. Empirical study of ethical dimensions of human research is essential to anchor and attune the intuitions and theoretical constructs that we develop. Science and ethics have changed over the past 100 years, as they will over the next century. It is ironic that the ethical acceptability of psychiatric research is so much in question at this time, when it holds so much promise for advancing our understanding of mental illness and its treatment. The tension between the duty to protect vulnerable individuals and the duty to perform human science will continue to grow, as long as ethics and science are seen as separable, opposing forces with different aims championed by different heroes. The profession of psychiatry is poised to move toward a new, more coherent research ethics paradigm in which scientific and

  13. [Family and chronic paediatric illness].

    PubMed

    Grau Rubio, Claudia; Fernández Hawrylak, M

    2010-01-01

    Pediatric illnesses are always a family problem. Hospitalization, treatments and their long term consequences constitute a challenge for the family. In this paper, we describe the structural, procedural and emotional alterations that affect the family dynamic. We argue that the child should be treated within the family context and propose a multi-dimensional intervention model centered on the family's singularities and specific needs, the support available in their environment, the development of capacities and resilience, and also the organization of user-centered services that are coordinated with all the services provided by the community.

  14. [Pets for the mentally ill].

    PubMed

    Jonas, C; Feline, A

    1981-07-01

    After studying the historical importance of the domestic animal through the ages and the role of the "pet" animal in the contemporary world, the authors present an analysis of the literature dealing with the function of the animal in child development and the use of animals as therapeutic "tools". The author's then consider, based on a series of observations, the relationship certain mentally ill patients may establish with one or several pet animals and the significance this object relation may have for the patient : animals become invested as counter depressive or delusional objects, auxiliary means for identification and projection, symbiotic relationship, as well as encouraging feeling of security and responsibility.

  15. HIV / AIDS and tourism.

    PubMed

    Forsythe, S

    1999-01-01

    Since it tends to be significantly affected by HIV/AIDS, the tourism sector is a likely target for HIV/AIDS interventions in many countries. The tourist industry is at particular risk from the pandemic because of the mobility of the work force, the presence of sex tourists, and the heavy reliance of many countries upon tourism revenues. Indeed, tourism is one of the largest and fastest growing industries in many countries. Some people have speculated that potential tourists' fear of AIDS could discourage them from visiting certain countries, while others have even suggested that tourism should be discouraged because the industry contributes to the spread of HIV/AIDS. When traveling, tourists often take risks that they would not take at home. They tend to drink more, use drugs more, and be generally more adventurous while on holiday. Such adventures often include taking sexual risks. When tourists have sex with prostitutes, hotel staff, and others in the local population, a bridge can be created for HIV to cross back and forth between the tourist's home country and the tourist destination. The author reviews selected studies on the relationship between HIV/AIDS and tourism. Overall, the existing literature offers no definitive evidence that AIDS has had any lasting impact upon the tourism industry anywhere in the world. Rather, promoting a healthy tourism industry and HIV/AIDS prevention are likely complementary in many ways.

  16. AIDS radio triggers.

    PubMed

    Elias, A M

    1991-07-01

    In April 1991, the Ethnic Communities' Council of NSW was granted funding under the Community AIDS Prevention and Education Program through the Department of Community Services and Health, to produce a series of 6x50 second AIDS radio triggers with a 10-second tag line for further information. The triggers are designed to disseminate culturally-sensitive information about HIV/AIDS in English, Italian, Greek, Spanish, Khmer, Turkish, Macedonian, Serbo-Croatian, Arabic, Cantonese, and Vietnamese, with the goal of increasing awareness and decreasing the degree of misinformation about HIV/AIDS among people of non-English-speaking backgrounds through radio and sound. The 6 triggers cover the denial that AIDS exists in the community, beliefs that words and feelings do not protect one from catching HIV, encouraging friends to be compassionate, compassion within the family, AIDS information for a young audience, and the provision of accurate and honest information on HIV/AIDS. The triggers are slated to be completed by the end of July 1991 and will be broadcast on all possible community, ethnic, and commercial radio networks across Australia. They will be available upon request in composite form with an information kit for use by health care professionals and community workers.

  17. Hearing AIDS and music.

    PubMed

    Chasin, Marshall; Russo, Frank A

    2004-01-01

    Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even though the converse is not necessarily true. Similarities and differences between speech and music as inputs to a hearing aid are described. Many of these lead to the specification of a set of optimal electro-acoustic characteristics. Parameters such as the peak input-limiting level, compression issues-both compression ratio and knee-points-and number of channels all can deleteriously affect music perception through hearing aids. In other cases, it is not clear how to set other parameters such as noise reduction and feedback control mechanisms. Regardless of the existence of a "music program,'' unless the various electro-acoustic parameters are available in a hearing aid, music fidelity will almost always be less than optimal. There are many unanswered questions and hypotheses in this area. Future research by engineers, researchers, clinicians, and musicians will aid in the clarification of these questions and their ultimate solutions.

  18. Solidarity and AIDS: introduction.

    PubMed

    Krieger, N

    1991-01-01

    Perhaps more than any other disease in recent history, AIDS has taught a cruel and crucial lesson: the constraints on our response to this epidemic are as deep as our denial, as entrenched as the inequities that permeate our society, as circumscribed as our knowledge, and as unlimited as our compassion and our commitment to human rights. Elaborating on these themes, the final three articles in this Special Section on AIDS consider three widely divergent yet intimately connected topics: AIDS in Cuba, AIDS in Brazil, and global AIDS prevention in the 1990s. Together, they caution that if we persist in treating AIDS as a problem only of "others," no country will be spared the social and economic devastation that promises to be the cost of our contempt and our folly. Solidarity is not an option; it is a necessity. Without conscious recognition of the worldwide relationship between health, human rights, and social inequalities, our attempts to abate the spread of AIDS--and to ease the suffering that follows in its wake--most surely will fall short of our goals. Finally, as we mourn our dead, we must take to heart the words of Mother Jones, and "fight like hell for living." This is the politics of survival.

  19. Hearing Aids and Music

    PubMed Central

    Chasin, Marshall; Russo, Frank A.

    2004-01-01

    Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even though the converse is not necessarily true. Similarities and differences between speech and music as inputs to a hearing aid are described. Many of these lead to the specification of a set of optimal electro-acoustic characteristics. Parameters such as the peak input-limiting level, compression issues—both compression ratio and knee-points—and number of channels all can deleteriously affect music perception through hearing aids. In other cases, it is not clear how to set other parameters such as noise reduction and feedback control mechanisms. Regardless of the existence of a “music program,” unless the various electro-acoustic parameters are available in a hearing aid, music fidelity will almost always be less than optimal. There are many unanswered questions and hypotheses in this area. Future research by engineers, researchers, clinicians, and musicians will aid in the clarification of these questions and their ultimate solutions. PMID:15497032

  20. Women and HIV/AIDS

    MedlinePlus

    ... AIDS email updates Enter email Submit HIV and AIDS The human immunodeficiency (IH-myoo-noh-di-FISH- ... health Pregnancy and HIV View more HIV and AIDS resources Related information Birth control methods Sexually transmitted ...

  1. HIV / AIDS: An Unequal Burden

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 Table ... Victoria Cargill talks to students about HIV and AIDS at the opening of a National Library of ...

  2. HIV/AIDS and Alcohol

    MedlinePlus

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS HIV/AIDS Human immunodeficiency virus (HIV) targets the body’s immune ... and often leads to acquired immune deficiency syndrome (AIDS). Each year in the United States, between 55, ...

  3. Research Report: HIV/AIDS

    MedlinePlus

    ... Reports » HIV/AIDS » Letter from the Director HIV/AIDS Email Facebook Twitter Letter from the Director Human ... the virus that causes acquired immune deficiency syndrome (AIDS) — has been with us for three decades now. ...

  4. HIV/AIDS and Vaccines

    MedlinePlus

    ... NIAID). /* // ** // */ Prevention Research Vaccines Microbicides Related Topics on AIDS.gov Clinical Trials Immune System 101 HIV Vaccine ... Be the Generation Last revised: 12/09/2016 AIDS.gov HIV/AIDS Basics • Federal Resources • Using New ...

  5. Tight Glycemic Control in Critically Ill Children.

    PubMed

    Agus, Michael S D; Wypij, David; Hirshberg, Eliotte L; Srinivasan, Vijay; Faustino, E Vincent; Luckett, Peter M; Alexander, Jamin L; Asaro, Lisa A; Curley, Martha A Q; Steil, Garry M; Nadkarni, Vinay M

    2017-02-23

    Background In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies involving critically ill children who have not undergone cardiac surgery are lacking. Methods In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4.4 to 6.1 mmol per liter; lower-target group) or 150 to 180 mg per deciliter (8.3 to 10.0 mmol per liter; higher-target group). Clinicians were guided by continuous glucose monitoring and explicit methods for insulin adjustment. The primary outcome was the number of intensive care unit (ICU)-free days to day 28. Results The trial was stopped early, on the recommendation of the data and safety monitoring board, owing to a low likelihood of benefit and evidence of the possibility of harm. Of 713 patients, 360 were randomly assigned to the lower-target group and 353 to the higher-target group. In the intention-to-treat analysis, the median number of ICU-free days did not differ significantly between the lower-target group and the higher-target group (19.4 days [interquartile range {IQR}, 0 to 24.2] and 19.4 days [IQR, 6.7 to 23.9], respectively; P=0.58). In per-protocol analyses, the median time-weighted average glucose level was significantly lower in the lower-target group (109 mg per deciliter [IQR, 102 to 118]; 6.1 mmol per liter [IQR, 5.7 to 6.6]) than in the higher-target group (123 mg per deciliter [IQR, 108 to 142]; 6.8 mmol per liter [IQR, 6.0 to 7.9]; P<0.001). Patients in the lower-target group also had higher rates of health care-associated infections than those in the higher-target group (12 of 349 patients [3.4%] vs. 4 of 349 [1.1%], P=0.04), as well as higher rates of severe hypoglycemia, defined as a blood glucose level below 40 mg per

  6. [Between the fear of HIV contamination and the symbolic representations of AIDS: the specter of contemporary despair].

    PubMed

    Meneghin, P

    1996-12-01

    Lack of knowledge and misinformations on HIV/AIDS are predictors of emotional responses as fear of contagion, homophobia, avoidance and excessive precautions. Fear of contagion is an affective stress response to the neurocognitive activity that leads to a perceived threat of AIDS in connection with the symbolic meanings os illness. Focused interviews were conducted with an opportunistic sample of 31 young people to know the affective responses and behaviors after blood screening for HIV antibody testing. The findings confirm the relationship of symbolic representation of illness as mystery, death, punishment and sexuality to fear of contagion and mitic conception of AIDS.

  7. Political dimensions of AIDS.

    PubMed

    Blewett, N

    1988-01-01

    World political aspects and the example of Australia as a national political response to AIDS are presented. Global policy on AIDS is influenced by the fact that the AIDS epidemic is the 1st to be largely predictable, that long lag times occur between intervention and measurable events, and by the prompt, professional leadership of WHO, lead by Dr. J. Mann. WHO began a Global Programme on AIDS in 1987, modelled on the responses of Canada and Australia. A world summit of Ministers of Health was convened in January 1988. These moves generated a response qualified by openness, cooperation, hope and common sense. The AIDS epidemic calls for unprecedented involvement of politicians: they must coordinate medical knowledge with community action, deal with public fear, exert strong, rational leadership and avoid quick, appealing counterproductive responses. 3 clear directions must be taken to deal with the epidemic: 1) strong research and education campaigns; 2) close contact with political colleagues, interest groups and the community; 3) a national strategy which enjoins diverse interest groups, with courage, rationality and compassion. In Australia, the AIDS response began with the unwitting infection of 3 infants by blood transfusion. A public information campaign emphasizing a penetrating TV ad campaign was instituted in 1987. Policy discussions were held in all parliamentary bodies. The AIDS epidemic demands rapid, creative responses, a break from traditions in health bureaucracy, continual scrutiny of funding procedures and administrative arrangements. In practical terms in Australia, this meant establishing a special AIDS branch within the Health Advancement Division of the Community Health Department. AIDS issues must remain depoliticized to defuse adversary politics and keep leaders in a united front.

  8. Post orgasmic illness syndrome (POIS)

    PubMed Central

    2016-01-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS “attacks” that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man’s seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur—although rarely—in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina. PMID:27652231

  9. Febrile Illness with Skin Rashes

    PubMed Central

    2015-01-01

    Skin rashes that appear during febrile illnesses are in fact caused by various infectious diseases. Since infectious exanthematous diseases range from mild infections that disappear naturally to severe infectious diseases, focus on and basic knowledge of these diseases is very important. But, these include non-infectious diseases, so that comprehensive knowledge of these other diseases is required. Usually, early diagnostic testing for a febrile illness with a rash is inefficient. For clinical diagnosis of diseases accompanied by skin rash and fever, a complete history must be taken, including recent travel, contact with animals, medications, and exposure to forests and other natural environments. In addition, time of onset of symptoms and the characteristics of the rash itself (morphology, location, distribution) could be helpful in the clinical diagnosis. It is also critical to understand the patient's history of specific underlying diseases. However, diagnostic basic tests could be helpful in diagnosis if they are repeated and the clinical course is monitored. Generally, skin rashes are nonspecific and self-limited. Therefore, it could be clinically meaningful as a characteristic diagnostic finding in a very small subset of specific diseases. PMID:26483989

  10. Seizures in the critically ill.

    PubMed

    Ch'ang, J; Claassen, J

    2017-01-01

    Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy. In this population, untreated isolated seizures can quickly escalate to generalized convulsive status epilepticus or, more frequently, nonconvulsive status epileptics, which is associated with a high morbidity and mortality. Status epilepticus (SE) arises from a failure of inhibitory mechanisms and an enhancement of excitatory pathways causing permanent neuronal injury and other systemic sequelae. Carrying a high 30-day mortality rate, SE can be very difficult to treat in this complex setting, and a portion of these patients will become refractory, requiring narcotics and anesthetic medications. The most significant factor in successfully treating status epilepticus is initiating antiepileptic drugs as soon as possible, thus attentiveness and recognition of this disease are critical.

  11. Post orgasmic illness syndrome (POIS).

    PubMed

    Waldinger, Marcel D

    2016-08-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS "attacks" that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man's seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur-although rarely-in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina.

  12. Gulf War Illness: Challenges Persist.

    PubMed

    Nettleman, Mary

    2015-01-01

    It has been more than 20 years since the United States and coalition forces entered Kuwait and Iraq. Actual combat was of remarkably short duration: less than 1 week of sustained ground activity and 6 weeks of air missions. Thus, it was surprising when approximately 200,000 returning US veterans were affected by a chronic multi-symptom illness that came to be known as Gulf War Illness (GWI). There were many challenges in investigating GWI, not least of which was that it took several years before the condition was officially taken seriously. There were multiple exposures to potentially causal agents on and off the battlefield, but these exposures were documented incompletely if at all, leaving epidemiologists to rely on self-report for information. In the past 2 years, significant controversy has arisen over the future directions of the field. Despite these challenges, several studies have implicated exposure to acetylcholinesterase inhibitors such as pyridostigmine bromide in the genesis of the condition. The story of GWI can inform research into other conditions and guide future work on veterans' health.

  13. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

  14. Pulmonary complications of AIDS: radiologic features. [AIDS

    SciTech Connect

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-07-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed.

  15. Associations Between Fluid Balance and Outcomes in Critically Ill Children

    PubMed Central

    Alobaidi, Rashid; Morgan, Catherine; Basu, Rajit K.; Stenson, Erin; Featherstone, Robin; Majumdar, Sumit R.; Bagshaw, Sean M.

    2017-01-01

    Background: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. Objectives: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children. Design: Systematic review and meta-analysis. Measurements: Fluid balance, fluid accumulation, and fluid overload as defined by authors. Methods: We will search Ovid MEDLINE, Ovid EMBASE, Cochrane Library, and ProQuest, Dissertations and Theses. In addition, we will search www.clinicaltrials.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and the proceedings of selected key conferences for ongoing and completed studies. Search strategy will be done in consultation with a research librarian. Clinical trials and observational studies (from database inception to present) in patients (<25 years) admitted to pediatric intensive care units (PICUs) reporting fluid balance, fluid accumulation, or fluid overload, and associated outcomes will be included. Language will not be restricted. Two reviewers will independently screen studies and extract data. Primary outcome is mortality, and secondary outcomes encompass critical care resource utilization. Quality of evidence and risk of bias will be assessed using the Newcastle-Ottawa Scale (NOS). Results will be synthesized qualitatively and pooled for meta-analysis if possible. Limitations: Quality of the included studies; lack of randomized trials; high degrees of expected heterogeneity; and variations in definitions of fluid balance and fluid overload between studies. Conclusion: We will comprehensively appraise and summarize the evidence of the association between

  16. Evolving definitions of mental illness and wellness.

    PubMed

    Manderscheid, Ronald W; Ryff, Carol D; Freeman, Elsie J; McKnight-Eily, Lela R; Dhingra, Satvinder; Strine, Tara W

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  17. Media and mental illness: relevance to India.

    PubMed

    Padhy, S K; Khatana, S; Sarkar, S

    2014-01-01

    Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.

  18. The Problem of Defining Intelligence.

    ERIC Educational Resources Information Center

    Lubar, David

    1981-01-01

    The major philosophical issues surrounding the concept of intelligence are reviewed with respect to the problems surrounding the process of defining and developing artificial intelligence (AI) in computers. Various current definitions and problems with these definitions are presented. (MP)

  19. First Aid and Safety

    MedlinePlus

    ... First-Aid Kit Food Safety for Your Family Gun Safety Halloween Candy Hints Household Safety Checklists Household ... Climbing, and Grabbing Household Safety: Preventing Injuries From Firearms Household Safety: Preventing Injuries in the Crib Household ...

  20. HIV and AIDS

    MedlinePlus

    ... known as AIDS . HIV destroys a type of defense cell in the body called a CD4 helper ... are part of the body's immune system , the defense system that fights infections. When HIV destroys these ...

  1. AIDS: A National Dilemma.

    ERIC Educational Resources Information Center

    Issues in Science and Technology, 1987

    1987-01-01

    Contains excerpts from a special study on the AIDS epidemic by the Institute of Medicine and National Academy of Sciences. Presents an overview of the problem, outlines educational needs and public health measures, and identifies future research needs. (ML)

  2. Convulsions - first aid - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100212.htm Convulsions - first aid - series—Procedure, part 1 To use ... slide 2 out of 2 Overview When a seizure occurs, the main goal is to protect the ...

  3. First Aid: Burns

    MedlinePlus

    ... MORE ON THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns ... Being Safe in the Kitchen Finding Out About Fireworks Safety Playing With Fire? Dealing With Burns Fireworks ...

  4. Hearing Aid Tester

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Hearing aids often develop malfunctions that are not detected by the wearer. This is particularly true when the wearers are school-age children. Studies of selected groups showed that from 30 to more than 50 percent of school children were not getting adequate benefit from their hearing aids because of unrecognized malfunctions, usually low or dead batteries. This can be serious because hearing impairment retards a child's educational progress. NASA technology incorporated in the Hearing Aid Malfunction Detection Unit (HAMDU), the device pictured, is expected to provide an effective countermeasure to the childrens' hearing aid problem. A patent license has been awarded to a minority-owned firm, Hopkins International Company, a subsidiary of H. H. Aerospace Design Co., Inc., Elmford, New York. The company plans early commercial availability of its version of the device.

  5. First Aid: Croup

    MedlinePlus

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... with each breath has a pale or bluish color around the mouth drools or has difficulty swallowing ...

  6. Computer Aided Creativity.

    ERIC Educational Resources Information Center

    Proctor, Tony

    1988-01-01

    Explores the conceptual components of a computer program designed to enhance creative thinking and reviews software that aims to stimulate creative thinking. Discusses BRAIN and ORACLE, programs intended to aid in creative problem solving. (JOW)

  7. HIV/AIDS Treatment

    MedlinePlus

    ... HIV/AIDS Influenza Malaria Respiratory Syncytial Virus (RSV) Tuberculosis Zika Virus Find a Funding Opportunity Opportunities & Announcements ... related co-infections, such as hepatitis, malaria, and tuberculosis. Treatment of HIV Infection In the early 1980s ...

  8. First Aid: Croup

    MedlinePlus

    ... difficulty swallowing becomes tired easily Think Prevention! Frequent hand washing and avoiding contact with people who have respiratory ... Aid: Coughing X-Ray Exam: Neck Why Is Hand Washing So Important? Coughing Croup Contact Us Print Resources ...

  9. HIV and AIDS

    MedlinePlus

    ... that causes the disease AIDS. HIV Hurts the Immune System People who are HIV positive have been tested ... to everyone in the world. When the person's immune system has weakened and more of the blood's T ...

  10. AIDS in Africa

    DTIC Science & Technology

    2006-03-09

    have recommended that Africans infected with HIV be treated with an antibiotic/ sulfa drug combination known as cotrimoxazole in order to prevent...response is the subject of much debate. An estimated 500,000 Africa AIDS patients were being treated with antiretroviral drugs in mid-2005, up from 150,000...whether drugs can be made widely accessible without costly health infrastructure improvements. U.S. concern over AIDS in Africa grew in the 1980s, as the

  11. Naval Tactical Decision Aids

    DTIC Science & Technology

    1989-09-01

    Strike Planning Aid ( ESPA ) . .V-14 5.4. Tactical Environmental Ship Routing (TESR) V-24 5.5. Chaff Prediction and Planning System (CHAPPS).. V-29...chapter four TDAS from TESS: NAVSAR, acAS program for search and rescue (SARjat sea; ESPA , the Environmental Strike Planning Aid; TESR, the Tactical...STATISTICS CURRENT LOCATION AND CHARACTERISTICS SATELLITE DATA CONVERSION CONSTANTS In 5.1, we give a brief history of TESS. The TDAS NAVSAR, ESPA

  12. AIDS and National Security

    DTIC Science & Technology

    2007-11-02

    the body loses its ability to fight off other infections like the flu or pneumonia that it could normally handle with ease.11 These infections are... children orphaned by AIDS in sub-Saharan Africa.32 Failing states are not able to provide care for these orphans so they are lured into crime or...four major program elements funded by USAID are primary prevention, caring for children affected by AIDS, home and community based care and treatment

  13. HIV infection late detection in AIDS patients of an European city with increased immigration since mid 1990s.

    PubMed

    Carnicer-Pont, Dolors; de Olalla, Patricia G; Caylă, Joan A

    2009-03-01

    The study goal is to identify predictors of HIV infection late detection in an European city with increased immigration, and determine the effects of HAART era in HIV infection detection. We used Barcelona city AIDS registry (1987-2006). Late testers were those diagnosed of AIDS defining illness within less than 3 months from time of testing positive for HIV infection. Independent variables were: date of birth, sex, country of origin, HIV transmission category, prison history, city district of residence, AIDS diagnostic disease and HAART era when diagnosed. The statistical methods were based on logistic regression (Odds Ratio, OR and 95% confidence interval, CI). Among the 6186 AIDS patients, 43.9% (n=2741) were late testers. Being a male (OR: 1.57, 95% CI: 1.35-1.83), either < 30 years (OR: 1.21, 95% CI: 1.06-1.38) or > 40 years (OR: 1.20, 95% CI: 1.03-1.40), with heterosexual (OR: 3.07, 95% CI: 2.59-3.63) routes of transmission or men who have sex with men (OR: 2.20, 95% CI: 1.89-2.57) and with Pneumocystis jiroveci pneumoniae (OR: 1.71, 95% CI: 1.47-2.00) or tuberculosis (OR: 1.57, 95% CI: 1.36-1.82) were all independent risk factors for being a late tester. Conversely, injecting drug use (IDU) was associated with early detection (OR: 0.36, 95% CI: 0.33-0.40). Being migrant was associated with late testing only in the univariate analysis. Individuals with the detected factors (male, having any sexual risk behaviour and being > 50 years) should be in the main focus for HIV testing to further ensure continuous decrease in the slope of late detected HIV infections overall.

  14. [Aids, physicians, Catholic Church].

    PubMed

    Pipino, Marica; Boldrini, Elena; Cristani, Alessandro

    2003-01-01

    The latest AIDS' congress (Barcelona) reminded the world this dramatic situation. The shown data are remarkable: 5 million people of new infected in 2001, 68 million people could die in the next 20 years because of AIDS and the biggest part of them is living in the South of the world. There are two different kind of AIDS: the AIDS of rich people (2% of infected ones), who can reach the modern therapies that changed the course of the disease now curable out of hospital, and the AIDS of poor ones, without therapies and future. The political-economic effort of Western governments, of global fund anti-AIDS and of non governmental organizations now is not able to answer to this emergency in the right way. The lacking sensibility of Western doctors and the inflexible position of Catholic Church about contraception make the situation more complicated. It's hopeful the overcoming of this position using a Catholic Church's precious concept: the distinction between "simpliciter" and "secundum quid" to agree the use of condoms in case of absolute need.

  15. Association between Physical Activity Levels and Physical Symptoms or Illness among University Students in Korea

    PubMed Central

    Ahn, Sang-Hyun; Um, Yoo-Jin; Kim, Young-Ju; Kim, Hyun-Joo; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

    2016-01-01

    Background Low levels of physical activity can cause various physical symptoms or illness. However, few studies on this association have been conducted in young adults. The aim of this study was to investigate the association between physical activity levels and physical symptoms or illness in young adults. Methods Subjects were university students who participated in a web-based self-administered questionnaire in a university in Seoul in 2013. We obtained information on physical activities and physical symptoms or illness in the past year. Independent variables were defined as symptoms or illness which were associated with decreased academic performance. Logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of each physical symptom or illness with adjustment for covariables. Results A total of 2,201 participants were included in the study. The main physical symptoms or illness among participants were severe fatigue (64.2%), muscle or joint pain (46.3%), gastrointestinal problems (43.1%), headache or dizziness (38.6%), frequent colds (35.1%), and sleep problems (33.3%). Low physical activity levels were significantly associated with high ORs of physical symptoms or illness. Multivariable-adjusted ORs (95% CIs) in the lowest vs. highest tertile of physical activity were 1.45 (1.14–1.83) for severe fatigue, 1.35 (1.07–1.70) for frequent colds, and 1.29 (1.02–1.63) for headaches or dizziness. We also found that lower levels of physical activity were associated with more physical symptoms or bouts of illness. Conclusion Low physical activity levels were significantly associated with various physical symptoms or illness among university students. Also, individuals in the lower levels of physical activity were more likely to experience more physical symptoms or bouts of illness than those in the highest tertile of physical activity. PMID:27688861

  16. Association of self-reported race with AIDS death in continuous HAART users in a cohort of HIV-infected women in the United States

    PubMed Central

    Murphy, Kerry; Hoover, Donald R.; Shi, Qiuhu; Cohen, Mardge; Gandhi, Monica; Golub, Elizabeth T.; Gustafson, Deborah R.; Pearce, Celeste Leigh; Young, Mary; Anastos, Kathryn

    2013-01-01

    Objective: To assess the association of race with clinical outcomes in HIV-positive women on continuous HAART. Design: Prospective study that enrolled women from 1994 to 1995 and 2001 to 2002. Setting: Women's Interagency HIV Study, a community-based cohort in five US cities. Participants: One thousand, four hundred and seventy-one HIV-positive continuous HAART users. Main outcome measures: Times to AIDS and non-AIDS death and incident AIDS-defining illness (ADI) after HAART initiation. Results: In adjusted analyses, black vs. white women had higher rates of AIDS death [adjusted hazard ratio (aHR) 2.14, 95% confidence interval (CI) 1.30, 3.50; P = 0.003] and incident ADI (aHR 1.58, 95% CI 1.08, 2.32; P = 0.02), but not non-AIDS death (aHR 0.91, 95% CI 0.59, 1.39; P = 0.65). Cumulative AIDS death incidence at 10 years was 17.3 and 8.3% for black and white women, respectively. Other significant independent pre-HAART predictors of AIDS death included peak viral load (aHR 1.70 per log10, 95% CI 1.34, 2.16; P < 0.001), nadir CD4+ cell count (aHR 0.65 per 100 cells/μl, 95% CI 0.56, 0.76; P < 0.001), depressive symptoms by Center for Epidemiology Studies Depression score at least 16 (aHR 2.10, 95% CI 1.51, 2.92; P < 0.001), hepatitis C virus infection (aHR 1.57, 95% CI 1.02, 2.40; P = 0.04), and HIV acquisition via transfusion (aHR 2.33, 95% CI 1.21, 4.49; P = 0.01). In models with time-updated HAART adherence, association of race with AIDS death remained statistically significant (aHR 3.09, 95% CI 1.38, 6.93; P = 0.006). Conclusion: In continuous HAART-using women, black women more rapidly died from AIDS or experienced incident ADI than their white counterparts after adjusting for confounders. Future studies examining behavioral and biologic factors in these women may further the understanding of HAART prognosis. PMID:24037210

  17. Liver Illness and Psychiatric Patients

    PubMed Central

    Carrier, Paul; Debette-Gratien, Marilyne; Girard, Murielle; Jacques, Jérémie; Nubukpo, Philippe; Loustaud-Ratti, Véronique

    2016-01-01

    Patients with psychiatric disorders are usually more exposed to multiple somatic illnesses, including liver diseases. Specific links are established between psychiatric disorders and alcohol hepatitis, hepatitis B, and hepatitis C in the population as a whole, and specifically in drug abusers. Metabolic syndrome criteria, and associated steatosis or non-alcoholic steato-hepatitis (NASH) are frequent in patients with chronic psychiatric disorders under psychotropic drugs, and should be screened. Some psychiatric medications, such as neuroleptics, mood stabilizers, and a few antidepressants, are often associated with drug-induced liver injury (DILI). In patients with advanced chronic liver diseases, the prescription of some specific psychiatric treatments should be avoided. Psychiatric disorders can be a limiting factor in the decision-making and following up for liver transplantation. PMID:28123443

  18. Social networks and neurological illness.

    PubMed

    Dhand, Amar; Luke, Douglas A; Lang, Catherine E; Lee, Jin-Moo

    2016-10-01

    Every patient is embedded in a social network of interpersonal connections that influence health outcomes. Neurologists routinely need to engage with a patient's family and friends due to the nature of the illness and its social sequelae. Social isolation is a potent determinant of poor health and neurobiological changes, and its effects can be comparable to those of traditional risk factors. It would seem reasonable, therefore, to map and follow the personal networks of neurology patients. This approach reveals influential people, their habits, and linkage patterns that could facilitate or limit health behaviours. Personal network information can be particularly valuable to enhance risk factor management, medication adherence, and functional recovery. Here, we propose an agenda for research and clinical practice that includes mapping the networks of patients with diverse neurological disorders, evaluating the impact of the networks on patient outcomes, and testing network interventions.

  19. Mental Illness and Juvenile Offenders

    PubMed Central

    Underwood, Lee A.; Washington, Aryssa

    2016-01-01

    Within the past decade, reliance on the juvenile justice system to meet the needs of juvenile offenders with mental health concerns has increased. Due to this tendency, research has been conducted on the effectiveness of various intervention and treatment programs/approaches with varied success. Recent literature suggests that because of interrelated problems involved for youth in the juvenile justice system with mental health issues, a dynamic system of care that extends beyond mere treatment within the juvenile justice system is the most promising. The authors provide a brief overview of the extent to which delinquency and mental illness co-occur; why treatment for these individuals requires a system of care; intervention models; and the juvenile justice systems role in providing mental health services to delinquent youth. Current and future advancements and implications for practitioners are provided. PMID:26901213

  20. Mental Illness and Juvenile Offenders.

    PubMed

    Underwood, Lee A; Washington, Aryssa

    2016-02-18

    Within the past decade, reliance on the juvenile justice system to meet the needs of juvenile offenders with mental health concerns has increased. Due to this tendency, research has been conducted on the effectiveness of various intervention and treatment programs/approaches with varied success. Recent literature suggests that because of interrelated problems involved for youth in the juvenile justice system with mental health issues, a dynamic system of care that extends beyond mere treatment within the juvenile justice system is the most promising. The authors provide a brief overview of the extent to which delinquency and mental illness co-occur; why treatment for these individuals requires a system of care; intervention models; and the juvenile justice systems role in providing mental health services to delinquent youth. Current and future advancements and implications for practitioners are provided.

  1. Wounded, Ill, and Injured Challenges.

    PubMed

    Jones, Stephen L

    2016-01-01

    The Washington Post articles of February 2007 led to a close examination of the care provided Wounded Warriors at Walter Reed Army Medical Center. Subsequent reports by the President's Commission, Independent Review Group, and Defense Health Board all recommended ways to improve care. Joint Task Force National Capital Region Medical was established to implement the recommended improvements in Warrior care, and the recommendations of the Base Realignment and Closure Commission to close Walter Reed and realign the staff into a new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital. It accomplished these tasks, maintained existing wounded, ill, and injured care, and safely transferred patients during the height of the fighting season in Afghanistan. It successfully accomplished its mission through engaged leadership, establishing an appropriate environment for Warrior care, careful management of casualty flow, and robust communication with all parties affected by the changes. The lessons learned in Warrior care should be considered when planning future military medical operations.

  2. Computer-aided dispatching system design specification

    SciTech Connect

    Briggs, M.G.

    1997-12-16

    This document defines the performance requirements for a graphic display dispatching system to support Hanford Patrol Operations Center. This document reflects the as-built requirements for the system that was delivered by GTE Northwest, Inc. This system provided a commercial off-the-shelf computer-aided dispatching system and alarm monitoring system currently in operations at the Hanford Patrol Operations Center, Building 2721E. This system also provides alarm back-up capability for the Plutonium Finishing Plant (PFP).

  3. A rule based computer aided design system

    NASA Technical Reports Server (NTRS)

    Premack, T.

    1986-01-01

    A Computer Aided Design (CAD) system is presented which supports the iterative process of design, the dimensional continuity between mating parts, and the hierarchical structure of the parts in their assembled configuration. Prolog, an interactive logic programming language, is used to represent and interpret the data base. The solid geometry representing the parts is defined in parameterized form using the swept volume method. The system is demonstrated with a design of a spring piston.

  4. 13 percent remain AIDS-free.

    PubMed

    1995-01-01

    Researchers predict that approximately thirteen percent of homosexual/bisexual men infected with HIV at an early age will be long-term survivors, remaining free of disease for more than twenty years. Researchers with the Multicenter AIDS Cohort Study based their predictions on data from the ongoing study of 1,809 HIV-positive men. Stable immune markers and no use of antiretrovirals were the criteria used to define long-term.

  5. Cross-study analysis of genomic data defines the ciliate multigenic epiplasmin family: strategies for functional analysis in Paramecium tetraurelia

    PubMed Central

    Damaj, Raghida; Pomel, Sébastien; Bricheux, Geneviève; Coffe, Gérard; Viguès, Bernard; Ravet, Viviane; Bouchard, Philippe

    2009-01-01

    Background The sub-membranous skeleton of the ciliate Paramecium, the epiplasm, is composed of hundreds of epiplasmic scales centered on basal bodies, and presents a complex set of proteins, epiplasmins, which belong to a multigenic family. The repeated duplications observed in the P. tetraurelia genome present an interesting model of the organization and evolution of a multigenic family within a single cell. Results To study this multigenic family, we used phylogenetic, structural, and analytical transcriptional approaches. The phylogenetic method defines 5 groups of epiplasmins in the multigenic family. A refined analysis by Hydrophobic Cluster Analysis (HCA) identifies structural characteristics of 51 epiplasmins, defining five separate groups, and three classes. Depending on the sequential arrangement of their structural domains, the epiplasmins are defined as symmetric, asymmetric or atypical. The EST data aid in this classification, in the identification of putative regulating sequences such as TATA or CAAT boxes. When specific RNAi experiments were conducted using sequences from either symmetric or asymmetric classes, phenotypes were drastic. Local effects show either disrupted or ill-shaped epiplasmic scales. In either case, this results in aborted cell division. Using structural features, we show that 4 epiplasmins are also present in another ciliate, Tetrahymena thermophila. Their affiliation with the distinctive structural groups of Paramecium epiplasmins demonstrates an interspecific multigenic family. Conclusion The epiplasmin multigenic family illustrates the history of genomic duplication in Paramecium. This study provides a framework which can guide functional analysis of epiplasmins, the major components of the membrane skeleton in ciliates. We show that this set of proteins handles an important developmental information in Paramecium since maintenance of epiplasm organization is crucial for cell morphogenesis. PMID:19493334

  6. Illness narratives of people who are homeless.

    PubMed

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  7. Illness narratives of people who are homeless

    PubMed Central

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets. PMID:27914194

  8. The Student Guide: Financial Aid.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Student Financial Assistance.

    This publication explains what federal student financial aid is and what types of student aid are available. Two introductory sections present: federal student aid at-a-glance (what it is, who gets it, and how to get it) and finding out about student aid. The first section presents general information on the following subjects: student…

  9. Mommy, Daddy--What's AIDS?

    ERIC Educational Resources Information Center

    National Association of Pediatric Nurse Associates and Practitioners, Cherry Hill, NJ.

    This brochure is designed to help parents answer the questions that their children may ask them about Acquired Immune Deficiency Syndrome (AIDS) and the Human Immuno Deficiency Virus (HIV), the virus that causes AIDS. It provides basic information about AIDS and HIV, as well as sources for further information, such as the National AIDS Hotline. It…

  10. The First Aid Training Picture.

    ERIC Educational Resources Information Center

    Moore, Ian

    2000-01-01

    Discusses the history of first aid training provisions in the United Kingdom with respect to the outdoor industry, what to look for in a first aid training provider, an experiential model of first aid training, and the current National Governing Body requirements for first aid training for various types of coaches and instructors. (TD)

  11. Answering Your Questions about AIDS.

    ERIC Educational Resources Information Center

    Kalichman, Seth C.

    This book focuses on AIDS education and answers 350 commonly asked questions about Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) taken from questions addressed to two major urban AIDS hotlines (Milwaukee, Wisconsin, and Houston, Texas). Chapter 1, "HIV - The Virus That Causes AIDS," discusses: the HIV…

  12. Impact of AIDS on rural livelihoods in Benue State, Nigeria.

    PubMed

    Hilhorst, T; van Liere, M J; Ode, A V; de Koning, K

    2006-05-01

    This study addresses the socio-economic impact of AIDS on rural livelihoods in Benue State, Nigeria, where HIV prevalence is 9.3% but the number of AIDS cases is still relatively low. About 6% of the study households had experienced illness and death classified as AIDS, and reported high costs in terms of expenditures and time spent on care, funerals and mourning. These demands on time affected income and productivity, while the diversion of resources had implications for investments and savings. Coping strategies varied between households, mainly as a reflection of asset levels, which were often related to the gender of the household head. Reported coping strategies also differed between ethnic groups. First-line relatives were the most important source of support for households under pressure. Erosive coping strategies that undermined the sustainability of livelihoods were used by more vulnerable households following multiple cases of illness and death. Mourning practices, rules of inheritance and stigma tended to increase a household's vulnerability. Currently, Benue State is facing growing adult morbidity and mortality because of HIV infections. A context-specific study of its possible impact in a setting with a still relatively low number of AIDS cases is therefore important for informing local policy development and for building advocacy.

  13. The use of health care services: is illness the only motivator?

    PubMed

    Gould, S J

    1989-01-01

    Increasingly, consumer researchers and marketers have turned their attention to the marketing of health care services. In that vein, this paper addresses the question of what determines a consumer's use of these services. Through a review of relevant studies, an examination is made of such factors as illness, social and behavioral variables, and changing attitudes toward health, which have been prompted by various social movements. It is concluded that while illness is a critical factor in the use of health care services, other factors are playing an increasingly important role. Strategic marketing implications are offered as to how health care marketers should address the illness factor in the promotion and delivery of care services. Finally, future research directions are suggested which would help to define and gauge the role of illness in the consumption and strategic marketing of health care services.

  14. Ship size as a factor in illness incidence among U.S. Navy vessels.

    PubMed

    Blood, C G; Griffith, D K

    1990-07-01

    Illness incidence was examined aboard U.S. Navy vessels to ascertain whether sick call rates vary with ship size. Outpatient data from ships of three different sizes (destroyers/frigates, cruisers, aircraft carriers) were surveyed, controlling for geographical region of deployment. Overall rates of illness were lower for the largest ships when contrasted with the smallest vessels for all three operational theaters; these rate differences were significant for the East Asia and Indian Ocean regions. Among major categories of disease, significantly higher rates aboard the small vessels were seen in at least two of the geographic regions for respiratory disorders, digestive diseases, and musculoskeletal problems. Infective and parasitic diseases, skin and subcutaneous disorders, as well as symptoms and ill-defined disorders were significantly higher for small ships in one theater. It was concluded that ship size is a factor in illness incidence and should be considered in medical resource planning.

  15. Quality nursing care for hospitalized patients with advanced illness: concept development.

    PubMed

    Izumi, Shigeko; Baggs, Judith G; Knafl, Kathleen A

    2010-08-01

    The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability.

  16. Antibodies to squalene in US Navy Persian Gulf War veterans with chronic multisymptom illness.

    PubMed

    Phillips, Christopher J; Matyas, Gary R; Hansen, Christian J; Alving, Carl R; Smith, Tyler C; Ryan, Margaret A K

    2009-06-12

    Since the end of the 1991 Gulf War, there have been reports of unexplained, multisymptom illnesses afflicting veterans who consistently report more symptoms than do nondeployed veterans. One of the many possible exposures suspected of causing chronic multisymptom illnesses Gulf War veterans is squalene, thought to be present in anthrax vaccine. We examined the relationship between squalene antibodies and chronic symptoms reported by Navy construction workers (Seabees), n=579. 30.2% were deployers, 7.4% were defined as ill, and 43.5% were positive for squalene antibodies. We found no association between squalene antibody status and chronic multisymptom illness (p=0.465). The etiology of Gulf War syndrome remains unknown, but should not include squalene antibody status.

  17. Preventing heat-related illness among agricultural workers.

    PubMed

    Jackson, Larry L; Rosenberg, Howard R

    2010-07-01

    and audience-sensitive education to promote understanding of basic physiology and recognition of hyperthermia symptoms can aid in heat illness prevention. This review was prepared for the Agricultural Safety and Health Council of America/ National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," Dallas/Fort Worth, Texas, January 27-28, 2010.

  18. Random Assignment to Illness: Teaching Illness and Disease in the Introductory Health Communication Course

    ERIC Educational Resources Information Center

    Gray, Jennifer B.; Riley, Sarah

    2011-01-01

    A key concept in health communication is the difference between disease and illness: disease refers to the physical manifestations of a condition, while illness encompasses the physical, emotional, social, communicative, and psychological experience of living with a condition. The individual illness experience takes into account the full story of…

  19. Triple jeopardy for HIV: substance using Severely Mentally Ill Adults.

    PubMed

    Devieux, Jessy G; Malow, Robert; Lerner, Brenda G; Dyer, Janyce G; Baptista, Ligia; Lucenko, Barbara; Kalichman, Seth

    2007-01-01

    Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.

  20. Women and AIDS: introduction.

    PubMed

    Krieger, N; Margo, G

    1991-01-01

    Around the world, more and more women--principally poor women of color--are being diagnosed with and are dying of AIDS, the acquired immune deficiency syndrome. Yet, effective and appropriate prevention programs for women are sorely missing from the global program to control AIDS. To help us understand why this gap exists, and what we must do to close it, the three articles in this issue focus on women and AIDS. Examining the situation in such countries as Zimbabwe and South Africa, as well as in other economically underdeveloped and developed regions, the authors argue that women with the least control over their bodies and their lives are at greatest risk of acquiring AIDS. For example, the high rate of infection among women in Africa cannot be understood apart from the legacy of colonialism (including land expropriation and the forced introduction of a migrant labor system) and the insidious combination of traditional and European patriarchal values. Only by recognizing the socioeconomic and cultural determinants of both disease and sexual behavior, and only by incorporating these insights into our AIDS prevention programs, will we be able to curb the spread of this lethal disease.

  1. AIDS in Africa.

    PubMed

    Mokhobo, D

    1989-03-01

    Numerous cultural practices and attitudes in Africa represent formidable obstacles to the prevention of the further spread of acquired immunodeficiency syndrome (AIDS). Polygamy and concubinage are still widely practiced throughout Africa. In fact, sexual promiscuity on the part of males is traditionally viewed as positive--a reflection of male supremacy and male sexual prowess. The disintegration of the rural African family, brought about by urbanization, the migrant labor system, and poverty, has resulted in widespread premarital promiscuity. Contraceptive practices are perceived by many as a white conspiracy aimed at limiting the growth of the black population and thereby diminishing its political power. Condom use is particularly in disfavor. Thus, AIDS prevention campaigns urging Africans to restrict the number of sexual partners and to use condoms are unlikely to be successful. Another problem is that most Africans cannot believe that AIDS is sexually linked in that the disease does not affect the sex organs as is the case with other sexually transmitted diseases. The degree to which African governments are able to allocate resources to AIDS education will determine whether the epidemic can be controlled. Even with a massive outpouring of resources, it may be difficult to arouse public alarm about AIDS since Africans are so acclimated to living with calamities of every kind.

  2. Bill would offer parole to inmates with AIDS.

    PubMed

    1995-09-08

    The Massachusetts House of Representatives will vote on a bill that would grant medical parole for prisoners with AIDS and other terminal illnesses. Currently, Massachusetts has no policy of early parole solely for medical reasons. The bill has already passed the State senate, and is seen as essential given the rise in incarceration of intravenous drug users, many of whom have HIV. In a related incident, a California judge granted compassionate early release to an inmate with AIDS. The prisoner, [name removed], is a repeat offender sentenced under the State's three-strikes law; she has advanced AIDS and was given three months to live. A California Superior Court judge set precedent by granting compassionate leave to a repeat offender sentenced under this law.

  3. Resilience in the Chronic Illness Experience

    ERIC Educational Resources Information Center

    Kralik, Debbie; van Loon, Antonia; Visentin, Kate

    2006-01-01

    This article advances the consideration of resilience as an important concept in the transitional process of learning to adapt to life with chronic illness, by utilising interactional processes inherent in participatory action research (PAR) that may strengthen a person's capacity to live well with long-term illness. Sharing experiences and…

  4. Minor Illnesses, Temperament, and Toddler Social Functioning

    ERIC Educational Resources Information Center

    Kolak, Amy M.; Frey, Tara J.; Brown, Chloe A.; Vernon-Feagans, Lynne

    2013-01-01

    Research Findings: Minor illnesses, such as upper respiratory infections, stomachaches, and fevers, have been associated with children's decreased activity and increased irritability. This multi-method investigation of 110 day care-attending children examined whether experience with recurrent, minor illnesses and negative emotionality worked…

  5. A Behavioral Response to Illness. N106.

    ERIC Educational Resources Information Center

    Tanner, Judith

    A description is provided of "Behavioral Response to Illness," a required course offered in the second quarter of a two-year college nursing program, which examines physiological and psychosocial changes in patients from the framework of illness as a stressor, and the possible behavioral responses to such stress. The course focuses on behavioral…

  6. Chronic Illness and the Academic Career

    ERIC Educational Resources Information Center

    Goodwin, Stephanie A.; Morgan, Susanne

    2012-01-01

    In this article, the authors discuss the hidden epidemic in higher education. They describe the stigma of chronic illness and argue that the invisibility of chronic illness may elicit particularly problematic responses from others, especially when faculty work in a context where people are expected to be highly productive and have unlimited…

  7. Foodborne Illnesses: What You Need to Know

    MedlinePlus

    Foodborne Illness-Causing Organisms in the U.S. WHAT YOU NEED TO KNOW While the American food supply is among the safest in the ... deaths. The chart below includes foodborne disease-causing organisms that frequently cause illness in the United States. ...

  8. Mental Illness in the Peripartum Period

    ERIC Educational Resources Information Center

    Ostler, Teresa

    2009-01-01

    Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…

  9. Combating the Stigma of Mental Illness. Revised.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHHS), Rockville, MD.

    Many former mental patients see their biggest problem in resuming community life to be their inability to be accepted by other people. The National Institute of Mental Health has worked to remove the stigma associated with mental illness and research has unraveled many of the mysteries about the origins of mental illness. Deinstitutionalization,…

  10. Comorbid medical illness in bipolar disorder

    PubMed Central

    Forty, Liz; Ulanova, Anna; Jones, Lisa; Jones, Ian; Gordon-Smith, Katherine; Fraser, Christine; Farmer, Anne; McGuffin, Peter; Lewis, Cathryn M.; Hosang, Georgina M.; Rivera, Margarita; Craddock, Nick

    2014-01-01

    Background Individuals with a mental health disorder appear to be at increased risk of medical illness. Aims To examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden. Method Participants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria. Results We found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset. Conclusions Bipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role. PMID:25359927

  11. Host gene expression classifiers diagnose acute respiratory illness etiology

    PubMed Central

    Nichols, Marshall; Burke, Thomas; Ko, Emily R.; McClain, Micah T.; Hudson, Lori L.; Mazur, Anna; Freeman, Debra H.; Veldman, Tim; Langley, Raymond J.; Quackenbush, Eugenia B.; Glickman, Seth W.; Cairns, Charles B.; Jaehne, Anja K.; Rivers, Emanuel P.; Otero, Ronny M.; Zaas, Aimee K.; Kingsmore, Stephen F.; Lucas, Joseph; Fowler, Vance G.; Carin, Lawrence; Ginsburg, Geoffrey S.; Woods, Christopher W.

    2016-01-01

    Acute respiratory infections caused by bacterial or viral pathogens are among the most common reasons for seeking medical care. Despite improvements in pathogen-based diagnostics, most patients receive inappropriate antibiotics. Host response biomarkers offer an alternative diagnostic approach to direct antimicrobial use. This observational, cohort study determined whether host gene expression patterns discriminate non-infectious from infectious illness, and bacterial from viral causes of acute respiratory infection in the acute care setting. Peripheral whole blood gene expression from 273 subjects with community-onset acute respiratory infection (ARI) or non-infectious illness as well as 44 healthy controls was measured using microarrays. Sparse logistic regression was used to develop classifiers for bacterial ARI (71 probes), viral ARI (33 probes), or a non-infectious cause of illness (26 probes). Overall accuracy was 87% (238/273 concordant with clinical adjudication), which was more accurate than procalcitonin (78%, p<0.03) and three published classifiers of bacterial vs. viral infection (78-83%). The classifiers developed here externally validated in five publicly available datasets (AUC 0.90-0.99). A sixth publically available dataset included twenty-five patients with co-identification of bacterial and viral pathogens. Applying the ARI classifiers defined four distinct groups: a host response to bacterial ARI; viral ARI; co-infection; and neither a bacterial nor viral response. These findings create an opportunity to develop and utilize host gene expression classifiers as diagnostic platforms to combat inappropriate antibiotic use and emerging antibiotic resistance. PMID:26791949

  12. Heat Illness among North Carolina Latino Farmworkers

    PubMed Central

    Arcury, Thomas A.; Summers, Phillip; Talton, Jennifer W.; Chen, Haiying; Sandberg, Joanne C.; Spears Johnson, Chaya R.; Quandt, Sara A.

    2015-01-01

    Objective Heat exposure is an important hazard for workers in manual occupations, including farmworkers. This analysis delineates the prevalence of heat illness among farmworkers, and the factors associated with heat illness. Methods North Carolina Latino male farmworkers completed interviews in August, 2013. They reported on heat exposure and behaviors over the previous 3 months while working both outdoors and indoors. Results A third (35.6%) of the participants reported heat illness while working outside, and 13.9% while working inside. Factors associated with heat illness while working outside included working in wet clothes and shoes, harvesting and topping tobacco, and spending after-work time in an extremely hot house. Conclusions Policy addressing heat illness is needed, as is more detailed research on occupational heat exposure that uses common measures. PMID:26641825

  13. Empirical Testing of an Algorithm for Defining Somatization in Children

    PubMed Central

    Eisman, Howard D.; Fogel, Joshua; Lazarovich, Regina; Pustilnik, Inna

    2007-01-01

    Introduction A previous article proposed an algorithm for defining somatization in children by classifying them into three categories: well, medically ill, and somatizer; the authors suggested further empirical validation of the algorithm (Postilnik et al., 2006). We use the Child Behavior Checklist (CBCL) to provide this empirical validation. Method Parents of children seen in pediatric clinics completed the CBCL (n=126). The physicians of these children completed specially-designed questionnaires. The sample comprised of 62 boys and 64 girls (age range 2 to 15 years). Classification categories included: well (n=53), medically ill (n=55), and somatizer (n=18). Analysis of variance (ANOVA) was used for statistical comparisons. Discriminant function analysis was conducted with the CBCL subscales. Results There were significant differences between the classification categories for the somatic complaints (p=<0.001), social problems (p=0.004), thought problems (p=0.01), attention problems (0.006), and internalizing (p=0.003) subscales and also total (p=0.001), and total-t (p=0.001) scales of the CBCL. Discriminant function analysis showed that 78% of somatizers and 66% of well were accurately classified, while only 35% of medically ill were accurately classified. Conclusion The somatization classification algorithm proposed by Postilnik et al. (2006) shows promise for classification of children and adolescents with somatic symptoms. PMID:18421368

  14. Defined by Word and Space

    ERIC Educational Resources Information Center

    Brisco, Nicole D.

    2010-01-01

    In the author's art class, she found that many of her students in an intro art class have some technical skill, but lack the ability to think conceptually. Her goal was to create an innovative project that combined design, painting, and sculpture into a compact unit that asked students how they define themselves. In the process of answering this…

  15. Defining and Measuring Psychomotor Performance

    ERIC Educational Resources Information Center

    Autio, Ossi

    2007-01-01

    Psychomotor performance is fundamental to human existence. It is important in many real world activities and nowadays psychomotor tests are used in several fields of industry, army, and medical sciences in employee selection. This article tries to define psychomotor activity by introducing some psychomotor theories. Furthermore the…

  16. Defining "Folklore" in the Classroom.

    ERIC Educational Resources Information Center

    Falke, Anne

    Folklore, a body of traditional beliefs of a people conveyed orally or by means of custom, is very much alive, involves all people, and is not the study of popular culture. In studying folklore, the principal tasks of the folklorist have been defined as determining definition, classification, source (the folk), origin (who composed folklore),…

  17. [PHARMACONUTRITION IN SEVERELY ILL PATIENT].

    PubMed

    Burgos Peláez, Rosa; Escudero Álvarez, Elena; García Almeida, Jose Manuel; García de Lorenzo, Abelardo; García Luna, Pedro Pablo; Gil Hernández, Angel; Matos Adames, Alfredo; Molina Soria, Juan Bautista; Montejo González, Juan Carlos; Sánchez Alvarez, Carmen; Perez de la Cruz, Antonio

    2015-08-01

    "Pharmaconutrient" is a term applicable to those compounds which. in addition to their nutritional function, play a role as aids in the treatment of patients with severe pathologies, including sepsis, trauma, burns and major surgery, In general, enrichment of enteral an parenteral formulas with pharmaconutrients contribute to positively modulate the inflammatory response, infection and controlling the internal milieu, which in turn can be evaluated through lower mortality, hospital and intensive care units stay, days of mechanical ventilation and other parameters allowing to asses their effects. Arginine, glutamine, nucleotides, omega-3 fatty acids and antioxidant micronutrients, make up the nucleus of pharmaconutrients used with that aim, usually as mixtures of them. In the present review current evidence about the effects, indications, limitations, doses, potential adverse risks and even counter-indications is analysed.

  18. AIDS in Colombia.

    PubMed

    Boshell, J; Gacharná, M G; García, M; Jaramillo, L S; Márquez, G; Fergusson, M M; González, S; Prada, E Y; de Rangel, R; de Cabas, R

    1989-01-01

    Between January 1984 and December 1987 a total of 178 AIDS cases were reported to the Colombian Ministry of Health. The location of these cases suggests that the human immunodeficiency virus (HIV) is widely distributed in Colombia. Most of those afflicted (97%) have been adult males. HIV seroprevalence studies of selected population groups revealed the highest antibody prevalence (5.65% in females, 22.5% in males) among individuals involved in high-risk behaviors who participated in a free AIDS testing program. High prevalences (from 0.6% to 3.9% in females, and 14.6% to 15.9% in males) were also found in patients (primarily female prostitutes and male homosexuals) attending clinics for sexually transmitted diseases in several urban areas. The number of AIDS cases in Colombia has doubled or tripled annually since reporting began in 1984, a pattern similar to that observed worldwide.

  19. Recapture training aid.

    SciTech Connect

    Pacheco, James Edward

    2004-08-01

    The breacher's training aid described in this report was designed to simulate features of magazine and steel-plate doors. The training aid enables breachers to practice using their breaching tools on components that they may encounter when attempting to enter a facility. Two types of fixtures were designed and built: (1) a large fixture incorporates simulated hinges, hasps, lock shrouds, and pins, and (2) a small fixture simulates the cross section of magazine and steel-plate doors. The small fixture consists of steel plates on either side of a structural member, such as an I-beam. The report contains detailed descriptions and photographs of the training aids, assembly instructions, and drawings.

  20. Does artificial nutrition improve outcome of critical illness? An alternative viewpoint!

    PubMed

    Heyland, Daren K; Wischmeyer, Paul E

    2013-08-27

    Recent studies challenge the beneficial role of artificial nutrition provided to critically ill patients and point out the limitations of existing studies in this area. We take a differing view of the existing data and refute many of the arguments put forward by previous authors. We review the mechanistic, observational, and experimental data supporting a role for early enteral nutrition in the critically ill patient. We conclude without question that more, high-quality research is needed to better define the role of artificial nutrition in the critical care setting, but until then early and adequate delivery of enteral nutrition is a legitimate, evidence-based treatment recommendation and we see no evidence-based role for restricting enteral nutrition in critically ill patients. The role of early supplemental parenteral nutrition continues to be defined as new data emerge.

  1. Managerial practices regarding workers working while ill.

    PubMed

    Norton, D M; Brown, L G; Frick, R; Carpenter, L R; Green, A L; Tobin-D'Angelo, M; Reimann, D W; Blade, H; Nicholas, D C; Egan, J S; Everstine, K

    2015-01-01

    Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants' policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or "stomach flu," possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non-food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill.

  2. Musicians' illness perceptions of musculoskeletal complaints.

    PubMed

    Kok, Laura M; Vliet Vlieland, Theodora P M; Fiocco, Marta; Kaptein, Ad A; Nelissen, Rob G H H

    2013-04-01

    The purpose of this study is to know the views of people about their illness, i.e., illness perceptions, determine coping strategies, and outcome. Previous research suggests a higher prevalence and a different perception of musculoskeletal complaints between musicians and nonmusicians. The aim of this study is to compare illness perceptions related to musculoskeletal complaints between musicians and nonmusicians. In this cross-sectional study, students from three music academies (n = 345) and one university medical center (n = 2,870) in the Netherlands received an electronic questionnaire concerning questions on sociodemographic characteristics, use of musical instruments, occurrence and characteristics of musculoskeletal complaints in the past year, and the Brief Illness Perception Questionnaire (B-IPQ). Baseline and B-IPQ scores were compared between the samples by means of t tests, chi-square tests, and regression models to adjust for differences in sociodemographic characteristics. Eighty-three music academy students and 494 medical students completed the questionnaire (response rates, 25.5 and 17.6 %, respectively). Seventy-four (89 %) persons in the musician group and 382 (78 %) persons in the nonmusician group reported occurrence of musculoskeletal complaints during the last 12 months. Adjusted for sociodemographic characteristics, the B-IPQ scores of the domains consequences (my illness is a serious condition), concern (I am extremely concerned about my illness), and emotions (my illness makes me scared) were significantly higher among musicians, whereas personal control (there is little I can do to improve my illness), identity (number of symptoms patient sees as part of illness) were not significantly different. Music academy students had a significant more positive score on treatment control. Music academy students report more negative perceptions of their musculoskeletal complaints compared to medical students. Although some selection bias is

  3. What is AIDS in Guadeloupe? A descriptive and comparative study.

    PubMed

    Elenga, Narcisse; Georger-Sow, Marie-Thérèse; Messiaen, Thierry; Lamaury, Isabelle; Favre, Isabelle; Nacher, Mathieu; Beaucaire, Gilles

    2014-03-01

    Since the pathogen ecology differs between Caribbean regions, specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS) may be expected. We therefore conducted the present retrospective cohort study in order to describe the main AIDS-defining events in Guadeloupe and to compare them with those observed in Metropolitan France and in French Guiana. We discuss the local pathogen ecology, the diagnostic limitations of hospitals in overseas territories and the drivers of the epidemic.

  4. Extreme Dysbiosis of the Microbiome in Critical Illness

    PubMed Central

    McDonald, Daniel; Ackermann, Gail; Khailova, Ludmila; Baird, Christine; Heyland, Daren; Kozar, Rosemary; Lemieux, Margot; Derenski, Karrie; King, Judy; Vis-Kampen, Christine; Knight, Rob

    2016-01-01

    normal, “health promoting” bacteria, allowing overgrowth of disease-promoting pathogenic bacteria (dysbiosis), which, in turn, makes patients susceptible to hospital-acquired infections, sepsis, and organ failure. This has significant world health implications, because sepsis is becoming a leading cause of death worldwide, and hospital-acquired infections contribute to significant illness and increased costs. Thus, a trial that monitors the ICU patient microbiome to confirm and characterize this hypothesis is urgently needed. Our study analyzed the microbiomes of 115 critically ill subjects and demonstrated rapid dysbiosis from unexpected environmental sources after ICU admission. These data may provide the first steps toward defining targeted therapies that correct potentially “illness-promoting” dysbiosis with probiotics or with targeted, multimicrobe synthetic “stool pills” that restore a healthy microbiome in the ICU setting to improve patient outcomes. Podcast: A podcast concerning this article is available. PMID:27602409

  5. Attitudes of Canadian psychiatry residents if mentally ill: awareness, barriers to disclosure, and help-seeking preferences

    PubMed Central

    Hassan, Tariq; Tran, Tanya; Doan, Nam; Mazhar, Mir; Bajaj, Neeraj; Munshi, Tariq; Galbraith, Niall; Groll, Dianne

    2016-01-01

    Background The medical culture is defined by mental illness stigma, non-disclosure, and avoidance of professional treatment. Little research has explored attitudes and help-seeking behaviors of psychiatry trainees if they were to become mentally ill. Method Psychiatry residents (n = 106) from training centres across Ontario, Canada completed a postal survey on their attitudes, barriers to disclosure, and help-seeking preferences in the context of hypothetically becoming mentally ill. Results Thirty-three percent of respondents reported personal history of mental illness and the frequency of mental illness by year of training did not significantly differ. The most popular first contact for disclosure of mental illness was family and friends (n = 61, 57.5%). Frequent barriers to disclosure included career implications (n = 39, 36.8%), stigma (n = 11, 10.4%), and professional standing (n = 15, 14.2%). Personal history of mental illness was the only factor associated with in-patient treatment choice, with those with history opting for more formal advice versus informal advice. Conclusions At the level of residency training, psychiatrists are reporting barriers to disclosure and help-seeking if they were to experience mental illness. A majority of psychiatry residents would only disclose to informal supports. Those with a history of mental illness would prefer formal treatment services over informal services. PMID:28344690

  6. AIDS and tuberculosis.

    PubMed

    Morales Suárez-Valera, M M; Llopis González, A; Ballester Calabuig, M L

    1993-03-01

    Between 1985-1989 were diagnosed 376 cases of TBC in "La Fe" hospital in Valencia. 36 of this cases also had AIDS. We have carried out a compared study among the 340 cases of TBC and the 36 cases of AIDS+TBC. In this way we have described the social and work conditions of both groups, the hospitalization, the associated pathologies, the different risk factors, the different characteristics of the disease in each group of TBC, the diagnoses methods and the treatment of each case.

  7. Jacob Aall's illness and death.

    PubMed

    Hem, Erlend; Stubhaug, Arild

    2013-12-10

    Jacob Aall (1773-1844) was one of Norway's most notable nation-builders at the beginning of the 19th century. He owned and operated a large ironworks, participated in political life and was an historian, writer and translator of sagas. In the last 15 years of his life, he suffered greatly from pain attacks. After his death, an autopsy was performed and the doctors found a stone the size of a hen's egg, which weighed more than 90 g. The stone was variously described as a kidney stone and a bladder stone. Aall had travelled to Copenhagen in 1837 and consulted the Danish doctor Ludvig Levin Jacobson (1783-1843), known for his instrument for crushing bladder stones, a new and revolutionary treatment method. But some disagreement appears to have arisen between them about the treatment. A year later Aall consulted Christen Heiberg (1799-1872), a professor of surgery in Christiania (now Oslo). Heiberg also examined Aall's bladder and found «no cause for alarm». Aall adhered to a strict diet, including drinking an Italian «spa water» daily which he obtained in bottles from Trieste. However, he showed no great improvement. To all appearances, it was kidney stones that afflicted him in his last years and which finally ended his life. This article gives a full portrayal of the course of his illness with an authentic description from an age when there were no treatment possibilities for kidney stones.

  8. Molecular genetics in affective illness

    SciTech Connect

    Mendlewicz, J.; Sevy, S.; Mendelbaum, K. )

    1993-01-01

    Genetic transmission in manic depressive illness (MDI) has been explored in twins, adoption, association, and linkage studies. The X-linked transmission hypothesis has been tested by using several markers on chromosome X: Xg blood group, color blindness, glucose-6-phosphate dehydrogenase (G6PD), factor IX (hemophilia B), and DNA probes such as DXS15, DXS52, F8C, ST14. The hypothesis of autosomal transmission has been tested by association studies with the O blood group located on chromosome 9, as well as linkage studies on chromosome 6 with the Human Leucocyte Antigens (HLA) haplotypes and on Chromosome 11 with DNA markers for the following genes: D2 dopamine receptor, tyrosinase, C-Harvey-Ras-A (HRAS) oncogene, insuline (ins), and tyrosine hydroxylase (TH). Although linkage studies support the hypothesis of a major locus for the transmission of MDI in the Xq27-28 region, several factors are limiting the results, and are discussed in the present review. 105 refs., 1 fig., 2 tabs.

  9. Writing about an experience of illness in medical students

    PubMed Central

    Hwang, Kun; Fan, Huan; Hwang, Se Won

    2013-01-01

    Pathography is defined as “historical biography from a medical, psychological, and psychiatric viewpoint.” We thought that writing about an experience of illness might help students understand patients’ experience and in turn grow in terms of self-understanding. Participants included 151 medical students. Students wrote about their own experience of illness and were asked to answer questions from the Likert scale. Most students wrote about themselves (79.2%); however, some students (20.8%) wrote about the illness of others. Among the 149 pathographies, ecopathography was most frequent (30.9%), followed by testimonial pathography (25.5%); angry pathography (13.4%) and alternative pathography (12.1%) were relatively less frequent. Eighty-eight pathographies (59.1%) showed 120 expressions of family relationship. Among the 120 cases, worrying about family members was most frequent (47.5%), followed by reliance on a family member (32.5%). All students wrote about the enlightenment experienced on returning to daily life. The sense of belonging together was most frequent (38.3%), followed by gratitude for living (20.8%), resolution to be a good doctor (18.1%), and a will to live and be healthy (12.1%). Answers on the Likert scale (total 5) for pathography beneficence were very high in understanding desirable doctor image (4.46), attaining morals and personality as a health care professional (4.49), and understanding basic communication skills (4.46). Writing about an experience of illness allows students to better understand patients’ experience and to grow in self-understanding. PMID:24062621

  10. Writing about an experience of illness in medical students.

    PubMed

    Hwang, Kun; Fan, Huan; Hwang, Se Won

    2013-01-01

    Pathography is defined as "historical biography from a medical, psychological, and psychiatric viewpoint." We thought that writing about an experience of illness might help students understand patients' experience and in turn grow in terms of self-understanding. Participants included 151 medical students. Students wrote about their own experience of illness and were asked to answer questions from the Likert scale. Most students wrote about themselves (79.2%); however, some students (20.8%) wrote about the illness of others. Among the 149 pathographies, ecopathography was most frequent (30.9%), followed by testimonial pathography (25.5%); angry pathography (13.4%) and alternative pathography (12.1%) were relatively less frequent. Eighty-eight pathographies (59.1%) showed 120 expressions of family relationship. Among the 120 cases, worrying about family members was most frequent (47.5%), followed by reliance on a family member (32.5%). All students wrote about the enlightenment experienced on returning to daily life. The sense of belonging together was most frequent (38.3%), followed by gratitude for living (20.8%), resolution to be a good doctor (18.1%), and a will to live and be healthy (12.1%). Answers on the Likert scale (total 5) for pathography beneficence were very high in understanding desirable doctor image (4.46), attaining morals and personality as a health care professional (4.49), and understanding basic communication skills (4.46). Writing about an experience of illness allows students to better understand patients' experience and to grow in self-understanding.

  11. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire.

    PubMed

    Nowicka-Sauer, Katarzyna; Banaszkiewicz, Dorota; Staśkiewicz, Izabela; Kopczyński, Piotr; Hajduk, Adam; Czuszyńska, Zenobia; Ejdys, Mariola; Szostakiewicz, Małgorzata; Sablińska, Agnieszka; Kałużna, Anna; Tomaszewska, Magda; Siebert, Janusz

    2016-08-01

    The study evaluates the psychometric properties of a Polish translation of the Brief Illness Perception Questionnaire. A total of 276 patients with chronic conditions (58.7% women) completed the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. The internal consistency of the Polish Brief Illness Perception Questionnaire measured with Cronbach's alpha was satisfactory (α = 0.74). Structural validity was demonstrated by significant inter-correlations between the Brief Illness Perception Questionnaire components. Discriminant validity was supported by the fact that the Brief Illness Perception Questionnaire enables patients with various conditions to be differentiated. Significant correlations were found between Brief Illness Perception Questionnaire and depression and anxiety levels. The Polish Brief Illness Perception Questionnaire thus evaluated is a reliable and valid tool.

  12. Treatment Considerations for HIV-Infected Individuals with Severe Mental Illness

    PubMed Central

    Himelhoch, Seth; Walkup, James; Eisenberg, Marlene M.

    2013-01-01

    There has been a general recognition of a syndemic that includes HIV/AIDS and serve mental illnesses including schizophrenia, major depression, bipolar disorder, post-traumatic stress disorder, and others. The pathophysiology and direction of effects between severe mental illness and HIV infection is less clear however, and relatively little work has been done on prevention and treatment for people with these complex, co-occurring conditions. Here we present the most recent work that has been published on HIV and mental illness. Further, we describe the need for better treatments for “triply diagnosed persons”; those with HIV, mental illness, and substance abuse and dependence. Finally, we describe the potential drug-drug interactions between psychotropic medications and anti-retrovirals, and the need for better treatment guidelines in this area. We describe one example of an individually tailored intervention for persons with serious mental illness and HIV (PATH+) that shows that integrated community-based treatments using advanced practice nurses (APNs) as health navigators can be successful in improving health-related quality of life and reducing the burden of disease in these persons. PMID:24158425

  13. Risk factors for heat illness among British soldiers in the hot Collective Training Environment

    PubMed Central

    Moore, Alice C; Stacey, M J; Bailey, K G H; Bunn, R J; Woods, D R; Haworth, K J; Brett, S J; Folkes, S E F

    2016-01-01

    Background Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops. Objective To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses. Methods An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation). Results The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation. Conclusions Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of ‘marginal gains’ is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE. PMID:26036822

  14. How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data

    PubMed Central

    Etkind, Simon Noah; Bristowe, Katherine; Bailey, Katharine; Selman, Lucy Ellen; Murtagh, Fliss EM

    2016-01-01

    Background: Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes. Aim: We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients’ responses and preferences to inform practice. Design: Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. Analysis used a thematic approach with 10% of coding cross-checked to enhance reliability. Setting/participants: Qualitative interviews from six studies including patients with heart failure, chronic obstructive pulmonary disease, renal disease, cancer and liver failure. Results: A total of 30 transcripts were analysed. Median age was 75 (range, 43–95), 12 patients were women. The impact of uncertainty was frequently discussed: the main related themes were engagement with illness, information needs, patient priorities and the period of time that patients mainly focused their attention on (temporal focus). A typology of patient responses to uncertainty was developed from these themes. Conclusion: Uncertainty influences patient experience in advanced illness through affecting patients’ information needs, preferences and future priorities for care. Our typology aids understanding of how patients with advanced illness respond to uncertainty. Assessment of these three factors may be a useful starting point to guide clinical assessment and shared decision making. PMID:27129679

  15. 20 CFR 30.706 - How are the maximum fees defined?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Fee Schedule § 30.706 How are the maximum fees defined? For professional medical services.... The schedule shall consist of: An assignment of a value to procedures identified by HCPCS/CPT...

  16. 20 CFR 30.706 - How are the maximum fees defined?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Fee Schedule § 30.706 How are the maximum fees defined? For professional medical services.... The schedule shall consist of: An assignment of a value to procedures identified by HCPCS/CPT...

  17. 20 CFR 30.706 - How are the maximum fees defined?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Information for Medical Providers Medical Fee Schedule § 30.706 How are the maximum fees defined? For professional medical services.... The schedule shall consist of: An assignment of a value to procedures identified by HCPCS/CPT...

  18. Indigenous narratives of HIV/AIDS: morality and blame in a time of change.

    PubMed

    Thomas, Felicity

    2008-01-01

    While it is increasingly recognized that contextually relevant HIV prevention and AIDS mitigation interventions are more likely to succeed than enforced generic strategies, relatively little attention has been given to understanding the manner in which affected individuals and communities themselves perceive and subsequently experience the epidemic. Drawing on research undertaken in the Caprivi region of Namibia, this article challenges dominant biomedical HIV/AIDS discourse and demonstrates the important role of alternative illness narratives in shaping local understandings of and responses to HIV/AIDS. Four interlinked illness narratives are examined: the relationship between illness and resource use, gender and pollution, religious ideas about morality, and witchcraft accusations. Links are made between these narratives and threats to the social and moral order brought about by socioeconomic change. While treatment sought can initially be influenced by the illness narrative employed, an overriding concern to cure the ill person combined with a range of coexisting social pressures to be seen to be doing the "right thing" ultimately play a more significant role in determining treatment.

  19. Defining Our National Cyberspace Boundaries

    DTIC Science & Technology

    2010-02-17

    invention of the World Wide Web in 19 1989, the Internet Corporation for Assigned Names and Numbers ( ICANN ) (the international organization that...anonymity in cyberspace could be accomplished through the issuing of IP addresses as the Internet transitions from IPv4 to IPv6. ICANN should issue...agreement (MOA) between the U.S. Department of Commerce and ICANN . This new MOA should define which blocks of IP addresses will be used for entities

  20. New pharmaceuticals reduce cost of illness.

    PubMed

    Hansen, R W

    1986-06-01

    The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.

  1. How to define green adjuvants.

    PubMed

    Beck, Bert; Steurbaut, Walter; Spanoghe, Pieter

    2012-08-01

    The concept 'green adjuvants' is difficult to define. This paper formulates an answer based on two approaches. Starting from the Organisation for Economic Cooperation and Development (OECD) definition for green chemistry, production-based and environmental-impact-based definitions for green adjuvants are proposed. According to the production-based approach, adjuvants are defined as green if they are manufactured using renewable raw materials as much as possible while making efficient use of energy, preferably renewable energy. According to the environmental impact approach, adjuvants are defined as green (1) if they have a low human and environmental impact, (2) if they do not increase active ingredient environmental mobility and/or toxicity to humans and non-target organisms, (3) if they do not increase the exposure to these active substances and (4) if they lower the impact of formulated pesticides by enhancing the performance of active ingredients, thus potentially lowering the required dosage of active ingredients. Based on both approaches, a tentative definition for 'green adjuvants' is given, and future research and legislation directions are set out.

  2. First aid kit

    MedlinePlus

    ... bandages (Band-Aid or similar brand); assorted sizes Aluminum finger splints Elastic (ACE) bandage for wrapping wrist, ... to reduce contamination risk Save-A-Tooth storage device in case a tooth is broken or knocked out; ... equipment, and medical supplies. In: Auerbach PS, ed. Auerbach: Wilderness Medicine . ...

  3. Machine Aids to Translation.

    ERIC Educational Resources Information Center

    Brinkmann, Karl-Heinz

    1981-01-01

    Describes the TEAM Program System of the Siemens Language Services Department, particularly the main features of its terminology data bank. Discusses criteria to which stored terminology must conform and methods of data bank utilization. Concludes by summarizing the consequences that machine-aided translation development has had for the…

  4. Good Teaching Aids.

    ERIC Educational Resources Information Center

    National Audubon Society, New York, NY.

    This set of teaching aids consists of 14 Audubon Nature Bulletins with these titles: Schoolyard Laboratories, How to Lead a Field Trip, Natural Resources in the City, Mysteries of Bird Migration, Rock Stories and How to Read Them, The Ground Water Table, The Terrarium, Some Adventures With Wild Plants Outdoors and Indoors, Plant Propagation in the…

  5. More than First Aid

    ERIC Educational Resources Information Center

    Schoessler, Sally

    2011-01-01

    The school nurse is an important member of the school team since school health services keep students in school, in the classroom, and ready to learn. Although school nurses are often seen as the people who deliver first aid at school, their role is much deeper and has such breadth that only a registered, professional nurse has the skill set to…

  6. Instructional Aide Program.

    ERIC Educational Resources Information Center

    Thomson, Henry

    The Instructional Aide Program (Shoreline Community College, Seattle, Washington) is a flexible curriculum designed to prepare students to meet the paraprofessional manpower needs of several kinds of institution. It was prepared after consultation with representatives of the schools, the YMCA, and the country park system. Other agencies still to…

  7. Management of Student Aid.

    ERIC Educational Resources Information Center

    Nevin, Jeanne, Ed.

    The principles, practices, responsibilities, and controls in student financial aid are described in this manual. It traces the flow of funds, management activities, and legal issues as they occur in the process. The emphasis is on sound management principles of a general and permanent nature rather than on specific government requirements that may…

  8. Computer Aided Manufacturing.

    ERIC Educational Resources Information Center

    Insolia, Gerard

    This document contains course outlines in computer-aided manufacturing developed for a business-industry technology resource center for firms in eastern Pennsylvania by Northampton Community College. The four units of the course cover the following: (1) introduction to computer-assisted design (CAD)/computer-assisted manufacturing (CAM); (2) CAM…

  9. Coil Welding Aid

    NASA Technical Reports Server (NTRS)

    Wiesenbach, W. T.; Clark, M. C.

    1983-01-01

    Positioner holds coil inside cylinder during tack welding. Welding aid spaces turns of coil inside cylinder and applies contact pressure while coil is tack-welded to cylinder. Device facilitates fabrication of heat exchangers and other structures by eliminating hand-positioning and clamping of individual coil turns.

  10. Parent Hearing Aid Experiences

    ERIC Educational Resources Information Center

    Munoz, Karen; Roberts, Mallory; Mullings, Day; Harward, Richard

    2012-01-01

    This study addresses parent experiences in obtaining and managing hearing aids for their young child. The purpose was to identify challenges parents encounter to determine what state agencies can do to improve parent access to amplification. Data were collected July through September of 2010; 40 parents of children ages birth to 3 years old…

  11. AIDS: The Second Decade.

    ERIC Educational Resources Information Center

    Miller, Heather G., Ed.; And Others

    This report reviews the course of the Acquired Immune Deficiency Syndrome (AIDS) epidemic and its current status, examining changing patterns of sexual behavior and intravenous drug use, the distribution of cases of human immunodeficiency virus (HIV) infection, and the results of intervention efforts under way. It also discusses prevention…

  12. Impact Aid Program.

    ERIC Educational Resources Information Center

    Office of Elementary and Secondary Education (ED), Washington, DC.

    Impact Aid is a federal formula grant program designed to assist local school districts that have lost property tax revenue due to the presence of tax-exempt federal property or that have experienced increased expenditures due to the enrollment of federally connected children. Federally connected children are those whose parents pay minimal or no…

  13. AIDS Researcher Gives Retrospective

    ERIC Educational Resources Information Center

    Hawkins, B. Denise

    2011-01-01

    Nearly 30 years ago, renowned immunologist James E.K. Hildreth, M.D., Ph.D., was compelled to start researching the virus that causes AIDS. He marveled at its enigma and was pressed into action by its ability to cut lives short and devastate communities. The disease set him on a course of medical inquiry that has included biomedical breakthroughs…

  14. Newspaper Lesson Aids.

    ERIC Educational Resources Information Center

    Communication: Journalism Education Today (C:JET), 1986

    1986-01-01

    Provides photocopy-ready lesson aids on story ideas, interviewing, inverted pyramid writing style, newswriting, sports/scavenger hunt, finding feature material, identifying feature leads, feature lead selection, evaluating feature leads, compiling survey material, cutlines, headlines, paste-up rules, advertising, final semester project, newspaper…

  15. Computer Aided Art Major.

    ERIC Educational Resources Information Center

    Gibson, Jim

    The Computer Aided Art program offered at Northern State State University (Aberdeen, South Dakota), is coordinated with the traditional art major. The program is designed to familiarize students with a wide range of art-related computer hardware and software and their applications and to prepare students for problem-solving with unfamiliar…

  16. Job Aids and Motivation.

    ERIC Educational Resources Information Center

    Grau, Joseph A.

    1986-01-01

    Suggests job aids have motivational benefits and discusses three ways in which they positively affect motivation: increases worker's confidence of success and amount of effort they are willing to invest in attempting tasks; increases expectancy while decreasing amount of motivation needed; and reinforces task importance. (MBR)

  17. First Aid Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2011-01-01

    This article describes a challenge wherein students will be asked to design a portable first aid kit that is normally carried in a recreational vehicle (RV), but can also be hand-carried or backpacked off road for distances of approximately 1-2 miles. This can be a very practical challenge for the students because it touches everyone. Everybody…

  18. [Post-transfusional AIDS].

    PubMed

    Azzini, M; Maccabruni, A; Marcellini, M; Michelone, G; Dei Cas, A

    1987-01-01

    Two cases of post-transfusional AIDS in two premature babies who received blood of the same seropositive donor, are reported. The risk of the susceptibility to HIV infection of these patients, in relation to the immaturity of immune system and to the transfusional treatment often necessary in premature newborns, is stressed.

  19. Evaluating the Effectiveness of Mental Health First Aid Program for Chinese People in Hong Kong

    ERIC Educational Resources Information Center

    Wong, Daniel F. K.; Lau, Ying; Kwok, Sylvia; Wong, Prudence; Tori, Christopher

    2017-01-01

    Purpose: Chinese people generally lack knowledge of mental illness. Such phenomenon may lead to a delay in seeking psychiatric treatments. This study evaluated the effectiveness of Mental Health First Aid (MHFA) program in improving mental health knowledge of the general public in Hong Kong. Methods: A quasi-experimental design was adopted whereby…

  20. Manual of First-Aid Practices for School Bus Drivers. Revised.

    ERIC Educational Resources Information Center

    Nesbitt, William R.

    This manual is intended to provide California school bus drivers with the required course of instruction in first aid practices. It deals with the basic principles of handling serious medical emergencies, but major emphasis is on the variety of minor injuries or illnesses that may occur while students are riding on school buses. Chapter 1 covers…