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Sample records for aids defining illnesses

  1. The incidence and spectrum of AIDS-defining illnesses in persons treated with antiretroviral drugs.

    PubMed

    Forrest, D M; Seminari, E; Hogg, R S; Yip, B; Raboud, J; Lawson, L; Phillips, P; Schechter, M T; O'Shaughnessy, M V; Montaner, J S

    1998-12-01

    The incidence and spectrum of primary AIDS-defining illnesses in human immunodeficiency virus-positive patients receiving antiretroviral drugs may have changed since the introduction of newer antiretroviral agents. We performed a retrospective analysis of patients enrolled in the British Columbia Drug Treatment Program who were ever prescribed antiretroviral drugs between 1 January 1994 and 31 December 1996. Rates were calculated on a 6-month basis. There were 344 AIDS cases diagnosed among 2,533 participants between 1994 and 1996. The incidence of primary AIDS diseases decreased from 1994 to 1996, with a sharp decline in 1995 and 1996. There was no statistically significant change in the incidence of primary AIDS diagnoses relative to one another, and Pneumocystis carinii pneumonia and Kaposi's sarcoma remain the most common AIDS index diagnoses. In patients receiving antiretroviral therapy in the modern era, the incidence of AIDS-defining illnesses has decreased substantially, but the spectrum of AIDS-defining illnesses remains unchanged.

  2. Apical Pneumocystis jiroveci as an AIDS defining illness: A case report illustrating a change in the paradigm.

    PubMed

    Pfeifer, Kyle; Kalra, Vivek; Adebowale, Adeniran; Juthani-Mehta, Manisha; Soo-Shin, Myung

    2014-11-01

    Pneumocystis jiroveci pneumonia is a common acquired immune deficiency syndrome defining illness. Pneumocystis jiroveci pneumonia is classically described as having symmetrical bilateral perihilar ground-glass opacities on chest radiographs. We present an "atypical" case of Pneumocystis jiroveci pneumonia presenting as symmetric biapical cystic spaces with relative sparing of the remainder of the lungs in a 22 year-old male, previously undiagnosed with acquired immune deficiency syndrome. Our case illustrates that formerly unusual presentations of Pneumocystis jiroveci pneumonia are becoming more common as acquired immune deficiency syndrome defining illnesses as more patients are being imaged with further imaging such as high resolution computed tomography. PMID:25926907

  3. 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.

  4. 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

  5. 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…

  6. 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

  7. Towards Individualized Dialogue Support for Ill-Defined Domains

    ERIC Educational Resources Information Center

    Weerasinghe, Amali; Mitrovic, Antonija; Martin, Brent

    2009-01-01

    One of the critical factors contributing to the effectiveness of human tutoring is the conversational aspect of the instruction. Our goal is to develop a general model for supporting dialogues with menu-based input that could be used in both well- and ill-defined instructional tasks. We have previously studied how human tutors provide additional…

  8. 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.…

  9. HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies

    PubMed Central

    2009-01-01

    Objective To evaluate deaths from AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) in the D:A:D Study and to investigate the relationship between these deaths and immunodeficiency. Design Observational cohort study. Methods Patients (23 437) were followed prospectively for 104 921 person-years. We used Poisson regression models to identify factors independently associated with deaths from ADM and nADM. Analyses of factors associated with mortality due to nADM were repeated after excluding nADM known to be associated with a specific risk factor. Results Three hundred five patients died due to a malignancy, 298 prior to the cutoff for this analysis (ADM: n=110; nADM: n=188). The mortality rate due to ADM decreased from 20.1/1000 person-years of follow-up [95% confidence interval (CI) 14.4, 25.9] when the most recent CD4 cell count was <50 cells/μl to 0.1 (0.03, 0.3)/1000 person-years of follow-up when the CD4 cell count was more than 500 cells/μl; the mortality rate from nADM decreased from 6.0 (95% CI 3.3, 10.1) to 0.6 (0.4, 0.8) per 1000 person-years of follow-up between these two CD4 cell count strata. In multivariable regression analyses, a two-fold higher latest CD4 cell count was associated with a halving of the risk of ADM mortality. Other predictors of an increased risk of ADM mortality were homosexual risk group, older age, a previous (non-malignancy) AIDS diagnosis and earlier calendar years. Predictors of an increased risk of nADM mortality included lower CD4 cell count, older age, current/ex-smoking status, longer cumulative exposure to combination antiretroviral therapy, active hepatitis B infection and earlier calendar year. Conclusion The severity of immunosuppression is predictive of death from both ADM and nADM in HIV-infected populations. PMID:18832878

  10. The Creative Use of Psychotherapy with Terminally Ill with AIDS.

    ERIC Educational Resources Information Center

    Fraenkel, William A.

    One clinical psychologist worked with terminally ill, end-stage Acquired Immune Deficiency Syndrome (AIDS) patients in a hospice type setting for an 18-month time period. Interventions included individual psychotherapy, mental status assessments, staff group sessions, and supportive services for families and significant others. During that time,…

  11. Financial Aid for Self-Supporting Students: Defining Independence.

    ERIC Educational Resources Information Center

    Wagner, Alan P.; Carlson, Nancy

    Current federal definitions and proposed alternative definitions of financially independent students, and the effect of the definitions on the numbers and attributes of independent students, are reviewed. Current federal law defines financial aid applicants as financially independent of their parents if they meet three criteria (the "tri-form"…

  12. Financial issues in defining levels for HIV/AIDS research.

    PubMed

    Eastaugh, S R

    1998-01-01

    This article outlines the issues in cost identification and fair payment for acquired immune deficiency syndrome (AIDS) research. Costs need to be better identified using activity-based costing methods to reveal the structural pattern of care. Patterns of care can be too expensive if they: (1) overutilize the hospital as the locus of care, or (2) underutilize prevention and education. Managers need to learn more about the cost identification issues payers face in designing a fair payment system. In the long run, more health care professionals would serve the cause of innovation and biomedical research if they all work together to define a stable fair funding mechanism. Payers need to learn that fair payment of indirect costs is not a bonus or a windfall profit. PMID:9718508

  13. Correlates of spiritual well-being in terminally ill persons with AIDS and terminally ill persons with cancer.

    PubMed

    Pace, J C; Stables, J L

    1997-01-01

    In an effort to determine if terminally ill patients with AIDS had greater religious and spiritual care needs than other terminally ill patient populations, particularly those with cancer, a study was conducted in a community-based hospice in the southeast. The purpose of the study was to compare the perceptions of spiritual well-being, loneliness, social support, health hardiness, pain, and functional status among terminally ill clients with cancer and terminally ill clients with AIDS in a hospice setting and to examine predictors of spiritual well-being in a hospice population. A sample of 55 hospice patients completed the Correlates of Spiritual Well-Being Scale (COSWEB), which includes a demographic data sheet and instruments to measure spiritual well-being, loneliness, health hardiness, social support, functional status, and pain. Patients with AIDS reported significantly lower spiritual well-being than did patients with cancer and other chronic, terminal illnesses. Patients with AIDS also reported significantly greater loneliness than other patient populations. The number of social supports for patients with AIDS was significantly lower than for cancer patients and other groups; moreover, patients with AIDS were significantly more dissatisfied with their supports than other patient groups. The best predictors of spiritual well-being in this study were social support and loneliness, which explained 47% of the variance in spiritual well-being. The results of this study suggest differences between specific groups of hospice patients. Patients with AIDS may be less spiritually well than other terminally ill patient populations due to decreased support systems, dissatisfaction with supports, greater feelings of loneliness, younger ages on entry to hospice, fewer family supports, lack of recognized long-term relationships, and related issues such as homophobia, perceived rejection by religious denominations, unstable living environments, economic disadvantages, and

  14. Mental Illness and Length of Inpatient Stay for Medicaid Recipients with AIDS

    PubMed Central

    Hoover, Donald R; Sambamoorthi, Usha; Walkup, James T; Crystal, Stephen

    2004-01-01

    Objective To examine the associations between comorbid mental illness and length of hospital stays (LOS) among Medicaid beneficiaries with AIDS. Data Source and Collection/Study Setting Merged 1992–1998 Medicaid claims and AIDS surveillance data obtained from the State of New Jersey for adults with ≥1 inpatient stay after an AIDS diagnosis from 1992 to 1996. Study Design Observational study of 6,247 AIDS patients with 24,975 inpatient visits. Severe mental illness (SMI) and other less severe mental illness (OMI) diagnoses at visits were ascertained from ICD–9 Codes. About 4 percent of visits had an SMI diagnosis; 5 percent had an OMI diagnosis; 43 percent did not have a mental illness diagnosis, but were patients who had been identified as having an SMI or OMI history; and 48 percent were from patients with no identified history of mental illness. Principal Findings The overall mean hospital LOS was 12.7 days. After adjusting for measures of HIV disease severity and health care access in multivariate models, patients presenting with primary and secondary severe mental illness (SMI) diagnoses had ∼32 percent and ∼11 percent longer LOS, respectively, than did similar patients without a mental illness history (p<0.001 for each). But in these adjusted models of length of stay: (1) diagnosis of OMI was not related to LOS, and (2) in the absence of a mental illness diagnosed at the visit, an identified history of either SMI or OMI was also not related to LOS. In adjusted models of time to readmission for a new visit, current diagnosis of SMI or OMI and in the absences of a current diagnosis, history of SMI or OMI all tended to be associated with quicker readmission. Conclusions This study finds greater (adjusted) LOS for AIDS patients diagnosed with severe mental illness (but not for those diagnosed with less severe mental comorbidity) at a visit. The effect of acute severe mental illness on hospitalization time may be comparable to that of an acute AIDS

  15. Homosexuals and AIDS: a new approach to the illness.

    PubMed

    Vandevyer, C

    1993-01-01

    AIDS, historically connected with homosexuals, has provoked a number of social, psychological, and moral reactions within the homosexual community itself as well as elsewhere. Among questions raised, there are all those concerning the meaning and place of human sexuality. Between strict moral condemnation and publicity for "Safer Sex," there is room for a personal ethic, reflection, and a more responsible behavior.

  16. AIDS and family planning counseling of psychiatrically ill women in community mental health clinics.

    PubMed

    Coverdale, J H; Aruffo, J F

    1992-02-01

    Eighty-two of 83 mental health professionals, including psychiatrists, were surveyed to determine their attitudes and behaviors toward AIDS prevention and family planning counseling with psychiatrically ill female outpatients. Nearly all reported that information should be provided on AIDS and family planning. However, they reported that they had raised topics of AIDS with only 19% of patients and family planning with only 25% of patients. This lack of communication was confirmed by patients' own reports. Factors which might relate to this lack of communication are explored.

  17. 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

  18. 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.

  19. Ill-defined problem solving in amnestic mild cognitive impairment: linking episodic memory to effective solution generation.

    PubMed

    Sheldon, S; Vandermorris, S; Al-Haj, M; Cohen, S; Winocur, G; Moscovitch, M

    2015-02-01

    It is well accepted that the medial temporal lobes (MTL), and the hippocampus specifically, support episodic memory processes. Emerging evidence suggests that these processes also support the ability to effectively solve ill-defined problems which are those that do not have a set routine or solution. To test the relation between episodic memory and problem solving, we examined the ability of individuals with single domain amnestic mild cognitive impairment (aMCI), a condition characterized by episodic memory impairment, to solve ill-defined social problems. Participants with aMCI and age and education matched controls were given a battery of tests that included standardized neuropsychological measures, the Autobiographical Interview (Levine et al., 2002) that scored for episodic content in descriptions of past personal events, and a measure of ill-defined social problem solving. Corroborating previous findings, the aMCI group generated less episodically rich narratives when describing past events. Individuals with aMCI also generated less effective solutions when solving ill-defined problems compared to the control participants. Correlation analyses demonstrated that the ability to recall episodic elements from autobiographical memories was positively related to the ability to effectively solve ill-defined problems. The ability to solve these ill-defined problems was related to measures of activities of daily living. In conjunction with previous reports, the results of the present study point to a new functional role of episodic memory in ill-defined goal-directed behavior and other non-memory tasks that require flexible thinking. Our findings also have implications for the cognitive and behavioural profile of aMCI by suggesting that the ability to effectively solve ill-defined problems is related to sustained functional independence.

  20. 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.…

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

    PubMed Central

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

    2010-01-01

    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. PMID:21158311

  2. Risk of Deaths, AIDS-Defining and Non-AIDS Defining Events among Ghanaians on Long-Term Combination Antiretroviral Therapy

    PubMed Central

    Sarfo, Fred Stephen; Sarfo, Maame Anima; Norman, Betty; Phillips, Richard; Bedu-Addo, George; Chadwick, David

    2014-01-01

    Combination antiretroviral therapy (cART) has been widely available in Ghana since 2004. The aim of this cohort study was to assess the incidences of death, AIDS-defining events and non-AIDS defining events and associated risk factors amongst patients initiating cART in a large treatment centre. Clinical and laboratory data were extracted from clinic and hospital case notes for patients initiating cART between 2004 and 2010 and clinical events graded according to recognised definitions for AIDS, non-AIDS events (NADE) and death, with additional events not included in such definitions such as malaria also included. The cumulative incidence of events was calculated using Kaplan Meier analysis, and association of risk factors with events by Cox proportional hazards regression. Data were closed for analysis on 31st December, 2011 after a median follow-up of 30 months (range, 0–90 months). Amongst 4,039 patients starting cART at a median CD4 count of 133 cells/mm3, there were 324 (8%) confirmed deaths, with an event rate of 28.83 (95% CI 25.78–32.15) deaths per 1000-person follow-up years; the commonest established causes were pulmonary TB and gastroenteritis. There were 681 AIDS-defining events (60.60 [56.14–65.33] per 1000 person years) with pulmonary TB and chronic diarrhoea being the most frequent causes. Forty-one NADEs were recorded (3.64 [2.61–4.95] per 1000 person years), of which hepatic and cardiovascular events were most common. Other common events recorded outside these definitions included malaria (746 events) and respiratory tract infections (666 events). Overall 24% of patients were lost-to-follow-up. Alongside expected risk factors, stavudine use was associated with AIDS [adjusted HR of 1.08 (0.90–1.30)] and death (adjusted HR of 1.60 [1.21–2.11]). Whilst frequency of AIDS and deaths in this cohort were similar to those described in other sub-Saharan African cohorts, rates of NADEs were lower and far exceeded by events such as malaria and

  3. Risk of deaths, AIDS-defining and non-AIDS defining events among Ghanaians on long-term combination antiretroviral therapy.

    PubMed

    Sarfo, Fred Stephen; Sarfo, Maame Anima; Norman, Betty; Phillips, Richard; Bedu-Addo, George; Chadwick, David

    2014-01-01

    Combination antiretroviral therapy (cART) has been widely available in Ghana since 2004. The aim of this cohort study was to assess the incidences of death, AIDS-defining events and non-AIDS defining events and associated risk factors amongst patients initiating cART in a large treatment centre. Clinical and laboratory data were extracted from clinic and hospital case notes for patients initiating cART between 2004 and 2010 and clinical events graded according to recognised definitions for AIDS, non-AIDS events (NADE) and death, with additional events not included in such definitions such as malaria also included. The cumulative incidence of events was calculated using Kaplan Meier analysis, and association of risk factors with events by Cox proportional hazards regression. Data were closed for analysis on 31st December, 2011 after a median follow-up of 30 months (range, 0-90 months). Amongst 4,039 patients starting cART at a median CD4 count of 133 cells/mm3, there were 324 (8%) confirmed deaths, with an event rate of 28.83 (95% CI 25.78-32.15) deaths per 1000-person follow-up years; the commonest established causes were pulmonary TB and gastroenteritis. There were 681 AIDS-defining events (60.60 [56.14-65.33] per 1000 person years) with pulmonary TB and chronic diarrhoea being the most frequent causes. Forty-one NADEs were recorded (3.64 [2.61-4.95] per 1000 person years), of which hepatic and cardiovascular events were most common. Other common events recorded outside these definitions included malaria (746 events) and respiratory tract infections (666 events). Overall 24% of patients were lost-to-follow-up. Alongside expected risk factors, stavudine use was associated with AIDS [adjusted HR of 1.08 (0.90-1.30)] and death (adjusted HR of 1.60 [1.21-2.11]). Whilst frequency of AIDS and deaths in this cohort were similar to those described in other sub-Saharan African cohorts, rates of NADEs were lower and far exceeded by events such as malaria and respiratory

  4. How Can Community Religious Groups Aid Recovery for Individuals with Psychotic Illnesses?

    PubMed

    Griffith, James L; Myers, Neely; Compton, Michael T

    2016-10-01

    Ministries of churches, temples, mosques, and synagogues are a potential resource for individuals with chronic psychoses. Church attendance is highest in states with the least mental health funding, suggesting a role for community religious groups to aid over-extended mental health systems. The American Psychiatric Association has initiated new efforts to foster partnerships between psychiatrists and religious groups. Such partnerships should be informed by research evidence: (1) religious coping can have both beneficial and adverse effects upon psychosis illness severity; (2) psychosocial programs for persons with psychotic disorders should target specific psychobiological vulnerabilities, in addition to providing compassionate emotional support; (3) family psychoeducation is a well-validated model for reducing schizophrenia illness severity that could inform how religious groups provide activities, social gatherings, and social networks for persons with psychotic disorders. Positive impacts from such collaborations may be greatest in low- and middle-income countries where mental health services are largely absent. PMID:26711096

  5. Using Weighted Constraints to Diagnose Errors in Logic Programming--The Case of an Ill-Defined Domain

    ERIC Educational Resources Information Center

    Le, Nguyen-Thinh; Menzel, Wolfgang

    2009-01-01

    In this paper, we introduce logic programming as a domain that exhibits some characteristics of being ill-defined. In order to diagnose student errors in such a domain, we need a means to hypothesise the student's intention, that is the strategy underlying her solution. This is achieved by weighting constraints, so that hypotheses about solution…

  6. 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.

  7. Cystatin C Falsely Underestimated GFR in a Critically Ill Patient with a New Diagnosis of AIDS

    PubMed Central

    Brown, Caitlin S.; Kashani, Kianoush B.; Clain, Jeremy M.

    2016-01-01

    Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR) surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS) because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis. The patient was treated with nephrotoxic agents; therefore cystatin C was assessed to determine if cachexia was resulting in a falsely low serum creatinine. Cystatin C measured 1.50 mg/L which corresponded to an eGFR of 36 mL/min. Given the >60 mL/min discrepancy, serial 8-hour urine samples were collected and a GFR > 120 mL/min was confirmed. It is unclear why cystatin C was falsely elevated, but we hypothesize that it relates to the proinflammatory state with AIDS, opportunistic infections, and corticosteroids. More research is needed before routine use of cystatin C in this setting can be recommended. PMID:27293926

  8. 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

  9. Instructional Effects on Critical Thinking: Performance on Ill-Defined Issues

    ERIC Educational Resources Information Center

    Angeli, Charoula; Valanides, Nicos

    2009-01-01

    Undergraduate students in dyads (N = 72) were randomly and equally assigned to four groups, namely three teaching groups (General, Infusion, and Immersion) and the control group. Students were initially administered the California Critical Thinking Skills Test (CCTST). After instruction, each dyad's critical-thinking performance on an ill-defined…

  10. Information Needs of Special Populations: Serving People with Mental Illnesses Using Computer Aided Instruction in a Multimedia Library for Outpatients.

    ERIC Educational Resources Information Center

    Barsh, Adele L.; Jackson, Meliza

    1996-01-01

    Reports on a use of computer-aided instruction and multimedia technology in an outpatient library to meet the information needs of people who have severe and persistent mental illnesses. Topics include funding, special needs related to schizophrenia, computers in mental health rehabilitation, collection development, and library usage. (Author/LRW)

  11. 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

  12. [How to Define Good Health Care: An Ethical Framework for the Evaluation of Health Care for the Chronically Ill].

    PubMed

    Klingler, C; Marckmann, G

    2015-09-01

    In Germany we face an increase in chronic illnesses and a health care system not adjusted to the specific needs of this patient group. Innovative health care management programmes (for example, disease management programmes) might be able to play an important role in overcoming the existing deficits. By developing and implementing such programmes we are, how-ever, implicitly touching upon normative issues, but only rarely are the ethical aspects of these programmes discussed explicitly and evaluated in a systematic way. Against this backdrop, we have developed an ethical framework as a tool for evaluating general health care and innovative programmes for the chronically ill. The framework comprises on the one hand a list of criteria that define good health care in the context of chronic illness. Based on a coherentist conception of ethical justification, we developed 8 criteria (among others "the autonomy of patients concerning therapy, use of data and other life choices have to be promoted and respected") for the context of chronic illness. On the other hand, the framework provides a methodological approach to apply the criteria in 6 steps in order to evaluate a specific programme. Thereby, we want to give orienta-tion to policy makers and practitioners concerning the normative underpinnings of their work and support them in identifying relevant ethical requirements and potential problems at an early stage. PMID:25314688

  13. [How to Define Good Health Care: An Ethical Framework for the Evaluation of Health Care for the Chronically Ill].

    PubMed

    Klingler, C; Marckmann, G

    2015-09-01

    In Germany we face an increase in chronic illnesses and a health care system not adjusted to the specific needs of this patient group. Innovative health care management programmes (for example, disease management programmes) might be able to play an important role in overcoming the existing deficits. By developing and implementing such programmes we are, how-ever, implicitly touching upon normative issues, but only rarely are the ethical aspects of these programmes discussed explicitly and evaluated in a systematic way. Against this backdrop, we have developed an ethical framework as a tool for evaluating general health care and innovative programmes for the chronically ill. The framework comprises on the one hand a list of criteria that define good health care in the context of chronic illness. Based on a coherentist conception of ethical justification, we developed 8 criteria (among others "the autonomy of patients concerning therapy, use of data and other life choices have to be promoted and respected") for the context of chronic illness. On the other hand, the framework provides a methodological approach to apply the criteria in 6 steps in order to evaluate a specific programme. Thereby, we want to give orienta-tion to policy makers and practitioners concerning the normative underpinnings of their work and support them in identifying relevant ethical requirements and potential problems at an early stage.

  14. 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,…

  15. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study.

    PubMed

    Huang, David B; Zhou, Jing

    2007-05-01

    Patients with AIDS frequently develop diarrhoeal illness. In this randomized, controlled study, 260 patients were screened for those who had not had diarrhoea in the preceding 3 months and who had received a stable highly active antiretroviral therapy regimen for at least 6 weeks prior to the study enrollment. A total of 148 patients met the inclusion criteria and were enrolled: 75 patients were randomly assigned to an intensive handwashing intervention (i.e. handwashing after defecation, after cleaning infants who had defecated, before preparing food, before eating, and before and after sex) and 73 patients were randomly assigned to the control group. Patients in both groups were called weekly by telephone to determine compliance with handwashing and to determine the number of diarrhoeal episodes for the preceding week. Patients were observed for 1 year. Patients assigned to the intensive handwashing intervention group washed their hands more frequently compared with the control group (seven vs four times a day, respectively; P <0.05) and developed fewer episodes of diarrhoeal illness (1.24+/-0.9 vs 2.92+/-0.6 new episodes of diarrhoea, respectively; P <0.001) during the 1 year observation. The most common pathogens identified in both groups in patients who developed diarrhoeal illness were Giardia lamblia, Cryptosporidium, Entamoeba histolytica and Shigella flexneri. These data suggest that intensive handwashing reduces diarrhoeal illness in patients with AIDS.

  16. 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

  17. The association between combination antiretroviral adherence and AIDS-defining conditions at HIV diagnosis.

    PubMed

    Abara, Winston E; Xu, Junjun; Adekeye, Oluwatoyosi A; Rust, George

    2016-08-01

    Combination antiretroviral therapy (cART) has changed the clinical course of HIV. AIDS-defining conditions (ADC) are suggestive of severe or advanced disease and are a leading cause of HIV-related hospitalizations and death among people living with HIV/AIDS (PLWHA) in the USA. Optimal adherence to cART can mitigate the impact of ADC and disease severity on the health and survivability of PLWHA. The objective of this study was to evaluate the association between ADC at HIV diagnosis and optimal adherence among PLWHA. Using data from the 2008 and 2009 Medicaid data from 29 states, we identified individuals, between 18 and 49 years, recently infected with HIV and with a cART prescription. Frequencies and descriptive statistics were conducted to characterize sample. Univariate and multivariable Poisson regression analyses were employed to evaluate the association optimal cART adherence (defined as ≥ 95% study days covered by cART) and ADC at HIV diagnosis (≥1 ADC) were assessed. Approximately 17% of respondents with ADC at HIV diagnosis reported optimal cART adherence. After adjusting for covariates, respondents with an ADC at HIV diagnosis were less likely to report optimal cART adherence (adjusted prevalence ratio (APR) = 0.64, 95% confidence intervals (CI), 0.54-0.75). Among the covariates, males (APR=1.10, 95% CI, 1.02-1.19) compared to females were significantly more likely to report optimal adherence while younger respondents, 18-29 years (APR=0.67, 95% CI, 0.57-0.77), 30-39 years (APR=0.86, 95% CI, 0.79-0.95) compared to older respondents were significantly less likely to report optimal adherence. PLWHA with ADC at HIV diagnosis are at risk of suboptimal cART adherence. Multiple adherence strategies that include healthcare providers, case managers, and peer navigators should be utilized to improve cART adherence and optimize health outcomes among PLWHA with ADC at HIV diagnosis. Targeted adherence programs and services are required to address

  18. 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. PMID:26555487

  19. 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.

  20. 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

  1. Hypermedia Aids for Advanced Learning in Complex and Ill-Structured Knowledge Domains.

    ERIC Educational Resources Information Center

    Ramirez, Alejandro; Rivard, Suzanne

    Using the cognitive fit paradigm as a theoretical framework, this study compared the problem-solving performance of users of a hypertext-based learning aid to the performance of users of a computer-based linear text learning aid. Subjects were 103 undergraduate MIS (Management Information Systems) majors enrolled in an information systems analysis…

  2. 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).

  3. AIDS and haemophilia: morbidity and morality in a well defined population.

    PubMed Central

    Jones, P; Hamilton, P J; Bird, G; Fearns, M; Oxley, A; Tedder, R; Cheingsong-Popov, R; Codd, A

    1985-01-01

    One hundred and forty-three multitransfused patients with hereditary haemostatic disorders were examined for evidence of disease related to the acquired immune deficiency syndrome (AIDS). Ninety-nine patients with severe haemophilia A were tested for anti-HTLV-III and 76 were found to be positive. All except one of these seropositive patients had received commercial factor VIII concentrates at some time. Eighteen patients with haemophilia B were tested and all were anti-HTLV-III negative. Three out of 36 sexual partners of patients with haemophilia A positive for anti-HTLV-III were also seropositive. One, who had recently received blood transfusions, had AIDS with Pneumocystis carinii pneumonia. Three patients with severe haemophilia A died from Aids. A further 30 haemophiliacs had AIDS related complex or lymphadenopathy that could be related to HTLV-III infection. There was a significant correlation between lymphadenopathy and anti-HTLV-III seropositivity. No evidence of casual spread of AIDS was found since all 68 health care staff tested were anti-HTLV-III negative, including three surgeons who regularly worked with patients positive for anti-HTLV-III. The resources devoted to counselling and laboratory support in centres treating people at risk and their families need to be urgently reassessed. PMID:2994801

  4. A multidimensional conceptual framework for understanding HIV/AIDS as a chronic long-term illness.

    PubMed

    Mitchell, Christopher G; Linsk, Nathan L

    2004-07-01

    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 with a discussion of HIV prevention and treatment adherence as key focal points for social workers and their clients.

  5. Echocardiographic findings and their impact on outcomes of critically ill patients with AIDS in the era of HAART.

    PubMed

    Bajwa, Abubakr A; Cury, James D; Jones, Lisa; Shujaat, Adil; Usman, Faisal

    2012-01-01

    Objective. To describe the echocardiographic findings in critically ill patients with AIDS and their impact on clinical outcome. Design. A retrospective chart review of consecutive AIDS patients over 18 years of age, who had a trans-thoracic echocardiogram performed during the course of intensive care unit stay over the course of 2 years at a tertiary care hospital. Main outcome measures. The prevalence of echocardiogram abnormalities in this population and its impact on ICU mortality, ICU length of stay, hospital mortality, hospital length of stay and 60 day survival. Results. Among 107 patients who met the inclusion criteria, an admission echocardiogram was performed in 62 (58%). The prevalence of cardiac abnormalities was 60%. The most common admission diagnosis was respiratory failure n = 27 (43%). The most common finding on echocardiogram was left ventricular (LV) dysfunction n = 31 (50%) followed by pulmonary hypertension n = 25 (40%). None of these findings had a significant impact on clinical outcomes. There was trend toward reduced 60 day survival among patients with depressed LV function. Conclusions. Although echocardiogram abnormalities were prevalent among this population none of these findings had a significant impact on ICU mortality or hospital mortality and ICU length of stay or hospital length of stay.

  6. Self-help/mutual aid as active citizenship associations: a case-study of the chronically ill in Italy.

    PubMed

    Giarelli, Guido; Spina, Elena

    2014-12-01

    Contrary to the most widespread conception that considers self-help/mutual aid as a component of the 'third sector', an approach is proposed which assumes, on the basis of the specific nature of the social bond and of the social action that characterizes it, it can be more properly considered as part of the 'new civil society' as it has been configured during the time in Western societies. This implies its location in the public non-state and non-systemic space that it has been created in the specific form of associations of citizenship. An interuniversity research project is then presented which, using this approach, studied the case of self-help/mutual aid associations for the chronically ill in Italy, offering some of the findings regarding the origin, structural characteristics, geographical distribution and activities of these associations in order to at least partially verify the heuristic value of this approach and its implications for the processes of reform of the health systems.

  7. Outcomes among HIV-1 Infected Individuals First Starting Antiretroviral Therapy with Concurrent Active TB or Other AIDS-Defining Disease

    PubMed Central

    Périssé, André R. S.; Smeaton, Laura; Chen, Yun; La Rosa, Alberto; Walawander, Ann; Nair, Apsara; Grinsztejn, Beatriz; Santos, Breno; Kanyama, Cecilia; Hakim, James; Nyirenda, Mulinda; Kumarasamy, Nagalingeswaran; Lalloo, Umesh G.; Flanigan, Timothy; Campbell, Thomas B.; Hughes, Michael D.

    2013-01-01

    Background Tuberculosis (TB) is common among HIV-infected individuals in many resource-limited countries and has been associated with poor survival. We evaluated morbidity and mortality among individuals first starting antiretroviral therapy (ART) with concurrent active TB or other AIDS-defining disease using data from the “Prospective Evaluation of Antiretrovirals in Resource-Limited Settings” (PEARLS) study. Methods Participants were categorized retrospectively into three groups according to presence of active confirmed or presumptive disease at ART initiation: those with pulmonary and/or extrapulmonary TB (“TB” group), those with other non-TB AIDS-defining disease (“other disease”), or those without concurrent TB or other AIDS-defining disease (“no disease”). Primary outcome was time to the first of virologic failure, HIV disease progression or death. Since the groups differed in characteristics, proportional hazard models were used to compare the hazard of the primary outcome among study groups, adjusting for age, sex, country, screening CD4 count, baseline viral load and ART regimen. Results 31 of 102 participants (30%) in the “TB” group, 11 of 56 (20%) in the “other disease” group, and 287 of 1413 (20%) in the “no disease” group experienced a primary outcome event (p = 0.042). This difference reflected higher mortality in the TB group: 15 (15%), 0 (0%) and 41 (3%) participants died, respectively (p<0.001). The adjusted hazard ratio comparing the “TB” and “no disease” groups was 1.39 (95% confidence interval: 0.93–2.10; p = 0.11) for the primary outcome and 3.41 (1.72–6.75; p<0.001) for death. Conclusions Active TB at ART initiation was associated with increased risk of mortality in HIV-1 infected patients. PMID:24391801

  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

    Goldberg, Rachel E; Short, Susan E

    2016-03-01

    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. 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

  10. 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

  11. Assessment of the efficacy of total lymphocyte counts as predictors of AIDS defining infections in HIV-1 infected people

    PubMed Central

    Stebbing, J; Sawleshwarkar, S; Michailidis, C; Jones, R; Bower, M; Mandalia, S; Nelson, M; Gazzard, B

    2005-01-01

    Background: The CD4 count is a dominant prognostic and predictive factor in HIV infection. This study assessed the utility of the total lymphocyte count (TLC) in place of the CD4 count to predict the development of AIDS defining opportunistic infections (ADOI). Methods: The Chelsea and Westminster cohort was used to identify those people with a first episode of an ADOI. Corresponding CD4 and TLCs were recorded before diagnosis or at the time of first prescribing prophylaxis; patients without an AIDS defining opportunistic infection were defined as being at "risk" and receiver operating characteristic (ROC) curves were used to display the results of sensitivity and the false positive error rate of total lymphocyte and CD4 count groups. Results: A significant linear correlation was seen between the log10 CD4 count and log10 TLC (Pearson's correlation coefficient = 0.70, p<0.001). The finer cut off value for TLC where false positive error rate is minimum and sensitivity maximum was 1500–2000 cells/mm3. Patients with TLC 1000–1500 cells/mm3 were estimated to be at 40% increased risk of developing an ADOI. The cut off value for CD4 counts measured 200 cells/mm3 above which the risk developing an ADOI decreased. Patients with a CD4 count of 150–200 cells/mm3 were at a 34% increased risk of developing an ADOI. The area under the ROC curve for TLC was 10% lower than that for CD4 count. Conclusions: The TLC is minimally less reliable than the CD4 count as a predictor of ADOIs. In the absence of expensive equipment for CD4 measurement, the TLC is a useful test. PMID:16143689

  12. 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

  13. 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. ...

  14. Incidence of AIDS-Defining Opportunistic Infections and Mortality during Antiretroviral Therapy in a Cohort of Adult HIV-Infected Individuals in Hanoi, 2007-2014

    PubMed Central

    Tanuma, Junko; Lee, Kyu Ha; Haneuse, Sebastien; Matsumoto, Shoko; Nguyen, Dung Thi; Nguyen, Dung Thi Hoai; Do, Cuong Duy; Pham, Thuy Thanh; Nguyen, Kinh Van; Oka, Shinichi

    2016-01-01

    Background Although the prognosis for HIV-infected individuals has improved after antiretroviral therapy (ART) scale-up, limited data exist on the incidence of AIDS-defining opportunistic infections (ADIs) and mortality during ART in resource-limited settings. Methods HIV-infected adults in two large hospitals in urban Hanoi were enrolled to the prospective cohort, from October 2007 through December 2013. Those who started ART less than one year before enrollment were assigned to the survival analysis. Data on ART history and ADIs were collected retrospectively at enrollment and followed-up prospectively until April 2014. Results Of 2,070 cohort participants, 1,197 were eligible for analysis and provided 3,446 person-years (PYs) of being on ART. Overall, 161 ADIs episodes were noted at a median of 3.20 months after ART initiation (range 0.03–75.8) with an incidence 46.7/1,000 PYs (95% confidence interval [CI] 39.8–54.5). The most common ADI was tuberculosis with an incidence of 29.9/1,000 PYs. Mortality after ART initiation was 8.68/1,000 PYs and 45% (19/45) died of AIDS-related illnesses. Age over 50 years at ART initiation was significantly associated with shorter survival after controlling for baseline CD4 count, but neither having injection drug use (IDU) history nor previous ADIs were associated with poor survival. Semi-competing risks analysis in 951 patients without ADIs history prior to ART showed those who developed ADIs after starting ART were at higher risk of death in the first six months than after six months. Conclusion ADIs were not rare in spite of being on effective ART. Age over 50 years, but not IDU history, was associated with shorter survival in the cohort. This study provides in-depth data on the prognosis of patients on ART in Vietnam during the first decade of ART scale-up. PMID:26939050

  15. Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya.

    PubMed

    Chepngeno-Langat, Gloria; Madise, Nyovani; Evandrou, Maria; Falkingham, Jane

    2011-12-01

    Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health. Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment (WHODAS) score and the presence of a severe health problem. Women AIDS-caregivers reported higher disability scores for mobility and the lowest scores in self-care and life activities domains while men AIDS-caregivers reported higher scores in all domains (except interpersonal interaction) compared with other caregivers and non-caregivers. Multiple regression analysis is used to examine the association of providing care with health outcomes while controlling for other confounders. Consistently across all the health measures, no significant differences were observed between female AIDS-caregivers and female non-caregivers. Male AIDS-caregivers were however significantly more likely to report disability and having a severe health problem compared with male non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in care-giving gender-role expectations and coping strategies. This study highlights the relatively neglected role of older men as caregivers and recommends comprehensive interventions to mitigate the impact of HIV and AIDS on caregivers that embrace men as well as women.

  16. Cumulative effects of HIV illness and caring for children orphaned by AIDS on anxiety symptoms among adults caring for children in HIV-endemic South Africa.

    PubMed

    Kuo, Caroline; Cluver, Lucie; Casale, Marisa; Lane, Tyler

    2014-06-01

    Adults caring for children in HIV-endemic communities are at risk for poor psychological outcomes. However, we still have a limited understanding of how various HIV impacts--including caregiver's own HIV illness, responsibilities of caring for a child orphaned by AIDS, or both--affect psychological outcomes among caregivers. Furthermore, few studies have explored the relationship between stigma, HIV, and psychological outcomes among caregivers of children in HIV-endemic communities. A cross-sectional survey conducted from 2009 to 2010 assessed anxiety among 2477 caregivers of children in HIV-endemic South Africa. Chi-square tested differences in anxiety among caregivers living with HIV, caregivers of a child orphaned by AIDS, and caregivers affected with both conditions. Multivariate logistic regressions identified whether the relationship between HIV impacts and anxiety remained after controlling for socio-demographic co-factors. Mediation analysis tested the relationship between stigma, HIV, and anxiety. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were two and a half times greater among caregivers living with HIV compared to nonaffected caregivers. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were greatest among caregivers living with HIV and caring for a child orphaned by AIDS. Exposure to AIDS-related stigma partially mediated the relationship between HIV and anxiety. Interventions are needed to address caregiver psychological health, particularly among caregivers affected with both conditions of living with HIV and caring for a child orphaned by AIDS.

  17. Defining Falciparum-Malaria-Attributable Severe Febrile Illness in Moderate-to-High Transmission Settings on the Basis of Plasma PfHRP2 Concentration

    PubMed Central

    Hendriksen, Ilse C. E.; White, Lisa J.; Veenemans, Jacobien; Mtove, George; Woodrow, Charles; Amos, Ben; Saiwaew, Somporn; Gesase, Samwel; Nadjm, Behzad; Silamut, Kamolrat; Joseph, Sarah; Chotivanich, Kesinee; Day, Nicholas P. J.; von Seidlein, Lorenz; Verhoef, Hans; Reyburn, Hugh; White, Nicholas J.; Dondorp, Arjen M.

    2013-01-01

    Background. In malaria-endemic settings, asymptomatic parasitemia complicates the diagnosis of malaria. Histidine-rich protein 2 (HRP2) is produced by Plasmodium falciparum, and its plasma concentration reflects the total body parasite burden. We aimed to define the malaria-attributable fraction of severe febrile illness, using the distributions of plasma P. falciparum HRP2 (PfHRP2) concentrations from parasitemic children with different clinical presentations. Methods. Plasma samples were collected from and peripheral blood slides prepared for 1435 children aged 6−60 months in communities and a nearby hospital in northeastern Tanzania. The study population included children with severe or uncomplicated malaria, asymptomatic carriers, and healthy control subjects who had negative results of rapid diagnostic tests. The distributions of plasma PfHRP2 concentrations among the different groups were used to model severe malaria-attributable disease. Results. The plasma PfHRP2 concentration showed a close correlation with the severity of infection. PfHRP2 concentrations of >1000 ng/mL denoted a malaria-attributable fraction of severe disease of 99% (95% credible interval [CI], 96%–100%), with a sensitivity of 74% (95% CI, 72%–77%), whereas a concentration of <200 ng/mL denoted severe febrile illness of an alternative diagnosis in >10% (95% CI, 3%–27%) of patients. Bacteremia was more common among patients in the lowest and highest PfHRP2 concentration quintiles. Conclusions. The plasma PfHRP2 concentration defines malaria-attributable disease and distinguishes severe malaria from coincidental parasitemia in African children in a moderate-to-high transmission setting. PMID:23136222

  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. Conservation Priorities for Prunus africana Defined with the Aid of Spatial Analysis of Genetic Data and Climatic Variables

    PubMed Central

    Vinceti, Barbara; Loo, Judy; Gaisberger, Hannes; van Zonneveld, Maarten J.; Schueler, Silvio; Konrad, Heino; Kadu, Caroline A. C.; Geburek, Thomas

    2013-01-01

    Conservation priorities for Prunus africana, a tree species found across Afromontane regions, which is of great commercial interest internationally and of local value for rural communities, were defined with the aid of spatial analyses applied to a set of georeferenced molecular marker data (chloroplast and nuclear microsatellites) from 32 populations in 9 African countries. Two approaches for the selection of priority populations for conservation were used, differing in the way they optimize representation of intra-specific diversity of P. africana across a minimum number of populations. The first method (S1) was aimed at maximizing genetic diversity of the conservation units and their distinctiveness with regard to climatic conditions, the second method (S2) at optimizing representativeness of the genetic diversity found throughout the species’ range. Populations in East African countries (especially Kenya and Tanzania) were found to be of great conservation value, as suggested by previous findings. These populations are complemented by those in Madagascar and Cameroon. The combination of the two methods for prioritization led to the identification of a set of 6 priority populations. The potential distribution of P. africana was then modeled based on a dataset of 1,500 georeferenced observations. This enabled an assessment of whether the priority populations identified are exposed to threats from agricultural expansion and climate change, and whether they are located within the boundaries of protected areas. The range of the species has been affected by past climate change and the modeled distribution of P. africana indicates that the species is likely to be negatively affected in future, with an expected decrease in distribution by 2050. Based on these insights, further research at the regional and national scale is recommended, in order to strengthen P. africana conservation efforts. PMID:23544118

  20. Conservation priorities for Prunus africana defined with the aid of spatial analysis of genetic data and climatic variables.

    PubMed

    Vinceti, Barbara; Loo, Judy; Gaisberger, Hannes; van Zonneveld, Maarten J; Schueler, Silvio; Konrad, Heino; Kadu, Caroline A C; Geburek, Thomas

    2013-01-01

    Conservation priorities for Prunus africana, a tree species found across Afromontane regions, which is of great commercial interest internationally and of local value for rural communities, were defined with the aid of spatial analyses applied to a set of georeferenced molecular marker data (chloroplast and nuclear microsatellites) from 32 populations in 9 African countries. Two approaches for the selection of priority populations for conservation were used, differing in the way they optimize representation of intra-specific diversity of P. africana across a minimum number of populations. The first method (S1) was aimed at maximizing genetic diversity of the conservation units and their distinctiveness with regard to climatic conditions, the second method (S2) at optimizing representativeness of the genetic diversity found throughout the species' range. Populations in East African countries (especially Kenya and Tanzania) were found to be of great conservation value, as suggested by previous findings. These populations are complemented by those in Madagascar and Cameroon. The combination of the two methods for prioritization led to the identification of a set of 6 priority populations. The potential distribution of P. africana was then modeled based on a dataset of 1,500 georeferenced observations. This enabled an assessment of whether the priority populations identified are exposed to threats from agricultural expansion and climate change, and whether they are located within the boundaries of protected areas. The range of the species has been affected by past climate change and the modeled distribution of P. africana indicates that the species is likely to be negatively affected in future, with an expected decrease in distribution by 2050. Based on these insights, further research at the regional and national scale is recommended, in order to strengthen P. africana conservation efforts.

  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. Mental health first aid training for the Chinese community in Melbourne, Australia: effects on knowledge about and attitudes toward people with mental illness

    PubMed Central

    2010-01-01

    Background The aim of this study was to investigate in members of the Chinese community in Melbourne the impact of Mental Health First Aid (MHFA) training on knowledge about mental disorders and on attitudes to people with mental illness. The hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and related treatments, and decreased negative attitudes towards people with mental disorders. Methods Respondents were 108 participants of three MHFA training workshops for the Chinese community in Melbourne conducted by a qualified MHFA trainer. Participants completed the research questionnaire prior to the commencement of the training (pre-test) and at its completion (post-test). The questionnaires assessed participants' ability to recognize a mental disorder (depression and schizophrenia) described in the vignettes, knowledge about the professional help and treatment, and negative attitudes towards people with mental illness. Results Between pre- and post-test there was significant improvement in the recognition of mental disorders, beliefs about treatment became more concordant with health professionals, and negative attitudes reduced. Conclusion The MHFA training course for general members of the Chinese community in Melbourne produced significant positive change in the level of mental health literacy and reductions in stigmatizing attitudes. The evidence from this study, together with the accumulated evidence of the benefits of MHFA training in the general Australian community, suggests that this approach should be scaled up to a level where it can have an impact on the whole of the Chinese community in Australia. PMID:20576137

  3. 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

  4. 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

  5. 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. PMID:26287395

  6. First Aid: Dehydration

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Dehydration KidsHealth > For Parents > First Aid: Dehydration Print A A A Text Size Dehydration ... MORE ON THIS TOPIC Summer Safety Heat Illness First Aid: Heat Illness Sun Safety Dehydration Diarrhea Vomiting Word! ...

  7. 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…

  8. 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…

  9. 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.…

  10. Heat Exhaustion, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Exhaustion, First Aid A A A Heat exhaustion signs and symptoms ... specific to the other stages of heat illness. First Aid Guide Use a combination of the following measures ...

  11. Heat Cramps, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Cramps, First Aid A A A Heat cramp signs and symptoms ... if later stages of heat illness are suspected. First Aid Guide Use a combination of the following measures, ...

  12. Heatstroke, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Heatstroke, First Aid A A A Heatstroke signs and symptoms can ... specific to the earlier stages of heat illness. First Aid Guide When heatstroke is suspected, seek emergency medical ...

  13. Effects of etiologically defined respiratory infections on lung function and its growth in an area of low air pollution - spirometry in young children when illness-free

    SciTech Connect

    Collier, A.M.; Strope, G.L.; Helms, R.W.; LaVange, L.M.; Clyde, W.A. Jr.

    1981-03-01

    This longitudinal study was performed in a group of 3-12 year old children to document normal lung growth patterns as measured by spirometry. By clinical and laboratory parameters, these children were free of illness at the time of study and had been for the preceding 21 days. Spirometry was performed prospectively over a period of six years in 69 children (27 black females, 23 black males, 10 white females, and 9 white males) all from a day care center. Eight hundred fifteen spirometric tests were made on these children. Six spirometric parameters were measured: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow during the middle half of the FVC (FEF25-75%), and maximum expiratory flows after 50% and 75% of the FVC have been exhaled (Vmax50% and Vmax75%, respectively). There were significant differences between the regression lines (considering slope and intercept) for all six parameters when black females were compared to black males, white females to white males, black females to white females and black males to white males, except for Vmax75% for the comparison of black females to black males and white females to white males. These slopes and intercepts were similar to those reported by others for children of similar age and height. This study demonstrates that spirometry can be performed reliabley at an early age in a day care center population, that there are significant racial and sexual differences in spirometric volume and flow parameters and that the variability of these measurements is proportional to height rather than being a constant.

  14. 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

  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. Financial Aid.

    ERIC Educational Resources Information Center

    Graves, Mary A.

    This workbook assists college and vocational school bound American Indian students in determining their financial needs and in locating sources of financial aid. A checklist helps students assess the state of their knowledge of financial programs; a glossary defines terms pertinent to the realm of financial aid (i.e., graduate study programs,…

  17. 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

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

    PubMed

    Valera, Pamela; Kratz, Molly

    2014-11-01

    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.

  19. 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

  20. 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

  1. ''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…

  2. ["Knowing about AIDS" and sexual precautions among low-income women from the southern area of Buenos Aires. Notes for defining prevention policies].

    PubMed

    Grimberg, M

    2001-01-01

    This study is part of a line of research on gender and prevention in a research program on the social construction of HIV/AIDS. We present the results of an ethnographic study among low-income women 15-35 years old in the southern area of Buenos Aires. The area has the highest number of HIV/AIDS cases and high poverty levels, extensive social degradation, and urban violence. According to our results, in the interface between "knowing about" and "behaving" there are complex processes involving stigmatized and gender-biased representations of HIV/AIDS as "other people's problem" and social and sexual relations permeated by gender stereotypes and roles. We believe that planning of prevention should be based on the consideration of overall social practices and specifically the characteristics of gender relations, prioritizing relational strategies between women and men and promoting critical reflection on the main nodes organizing daily life and active participation in the production of social relations and practices of reciprocity and equity. The increasingly precarious conditions in social life intensifies poor women's vulnerability and social interaction contexts that relate to the socioeconomic and symbolic role played by women.

  3. ELT in Development Aid: Defining Aims and Measuring Results. Dunford House Seminar Report (England, United Kingdom, July 18-29, 1988).

    ERIC Educational Resources Information Center

    British Council, London (England).

    Proceedings of a seminar on the role of English second language (ELT) training in British technical assistance projects for economic development are presented in the form of a brief analysis of current issues and concerns to participants, a summary of the conference, and related appended materials. This conference focused on defining project…

  4. "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.

  5. "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. PMID:26642922

  6. 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.

  7. 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. PMID:25614537

  8. Foodborne Illnesses

    MedlinePlus

    ... Some parasites and chemicals also cause foodborne illnesses. Bacteria Bacteria are tiny organisms that can cause infections of the GI tract. Not all bacteria are harmful to humans. Some harmful bacteria may ...

  9. Foodborne Illness

    MedlinePlus

    ... get sick from contaminated food. Common culprits include bacteria, parasites and viruses. Symptoms range from mild to ... cramps Nausea and vomiting Diarrhea Fever Dehydration Harmful bacteria are the most common cause of foodborne illness. ...

  10. 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

  11. 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.

  12. 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.

  13. AIDS: Psychosocial Dimensions

    PubMed Central

    Stapleton, Dan

    1986-01-01

    In order to provide comprehensive care to patients who have AIDS, it is important for the family physician to understand the psychosocial elements of the disease. Homosexual men who have AIDS face particular problems, such as the disclosure of sexual orientation to family and friends. Issues discussed in this article include the reactions of the patient, family and friends to the diagnosis, the stigma of AIDS, the patient's support network, and preparations for disability and death. The facts about AIDS are discussed briefly, and the psychosocial implications of the illness for patients and their “significant others” are examined. The role of the family physician is highlighted. PMID:21267233

  14. 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…

  15. First Aid: Chickenpox

    MedlinePlus

    ... Palsy: Shannon's Story" 5 Things to Know About Zika & Pregnancy First Aid: Chickenpox ... Chickenpox (varicella) is an illness that has become much less common in the U.S. due to the chickenpox vaccine . The infection and rash will go away without ...

  16. Identifying and quantifying misclassified and under-reported AIDS deaths in Brazil: a retrospective analysis from 1985 to 2009

    PubMed Central

    Fazito, Erika; Cuchi, Paloma; Ma Fat, Doris; Ghys, Peter Denis; Pereira, Mauricio G; Vasconcelos, Ana Maria Nogales; Pascom, Ana Roberta Pati

    2012-01-01

    Background A retrospective analysis of deaths registered in the Brazilian Mortality System was conducted to quantify the under-reporting of HIV/AIDS deaths and those misclassified to AIDS-related conditions in the 15–49 years old population in Brazil. Methods Death rates for AIDS-related diseases were calculated by age and sex for 1985–2009. Changes in the age-sex-specific death rates over time were used to identify conditions likely to be misclassified AIDS deaths and to quantify the corresponding number of misclassified deaths. Deaths due to ill-defined causes were redistributed across all other natural causes of death. The resulting total number of AIDS deaths was further adjusted for incompleteness of the mortality reporting system. Results Out of the 28 potential causes of death investigated, five increased in the same distinct age pattern as AIDS: pneumonia, Kaposi's sarcoma, other immunodeficiencies, other septicaemia and toxoplasmosis. 18 490 deaths due to these five causes were recoded to HIV/AIDS from 1985 to 2009. 38 145 deaths due to ill-defined causes were redistributed to AIDS and 15 485 were added to the number of AIDS deaths to correct for completeness of the mortality system in Brazil. Altogether, 72 120 deaths were recoded to AIDS between 1985 and 2009 and added to the reported 194 445 AIDS related deaths in the country, representing 27% misclassification of AIDS deaths in Brazil. Conclusions This study demonstrated that AIDS mortality is underestimated by the official mortality information system in Brazil. Efforts need to be made to reduce misclassification of causes of death in the future and identify ways in which the confidentiality of information regarding cause of death can be maintained. PMID:23172349

  17. Defining "Development".

    PubMed

    Pradeu, Thomas; Laplane, Lucie; Prévot, Karine; Hoquet, Thierry; Reynaud, Valentine; Fusco, Giuseppe; Minelli, Alessandro; Orgogozo, Virginie; Vervoort, Michel

    2016-01-01

    Is it possible, and in the first place is it even desirable, to define what "development" means and to determine the scope of the field called "developmental biology"? Though these questions appeared crucial for the founders of "developmental biology" in the 1950s, there seems to be no consensus today about the need to address them. Here, in a combined biological, philosophical, and historical approach, we ask whether it is possible and useful to define biological development, and, if such a definition is indeed possible and useful, which definition(s) can be considered as the most satisfactory.

  18. Defining Infertility

    MedlinePlus

    ... of the American Society for Reproductive Medicine Defining infertility What is infertility? Infertility is “the inability to conceive after 12 months ... to conceive after 6 months is generally considered infertility. How common is it? Infertility affects 10%-15% ...

  19. Defining cure.

    PubMed

    Hilton, Paul; Robinson, Dudley

    2011-06-01

    This paper is a summary of the presentations made as Proposal 2-"Defining cure" to the 2nd Annual meeting of the ICI-Research Society, in Bristol, 16th June 2010. It reviews definitions of 'cure' and 'outcome', and considers the impact that varying definition may have on prevalence studies and cure rates. The difference between subjective and objective outcomes is considered, and the significance that these different outcomes may have for different stakeholders (e.g. clinicians, patients, carers, industry etc.) is discussed. The development of patient reported outcome measures and patient defined goals is reviewed, and consideration given to the use of composite end-points. A series of proposals are made by authors and discussants as to how currently validated outcomes should be applied, and where our future research activity in this area might be directed.

  20. 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…

  1. Self and other through the prism of AIDS: a literary examination of relationships with patients.

    PubMed

    Shapiro, Johanna

    2002-01-01

    This article examines how the "non-ill," often formal or informal caregivers, structure their relationships with "the ill," using as a specific example the disease of AIDS; and as a specific analytic tool selections of fictional writing. An introductory rationale explores why literature may be well-suited to helping us understand value-laden issues such as relationship. Discussion then focuses on how the professional and personal Self is identified and defined in relation to the suffering Other, through the development of concepts such as threat and boundary work. The concluding section suggests alternative relational models derived from more fluid and permeable definitions of Self and Other.

  2. 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.

  3. HIV / AIDS

    MedlinePlus

    ... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...

  4. The Impact of Illness Identity on Recovery from Severe Mental Illness.

    PubMed

    Yanos, Philip T; Roe, David; Lysaker, Paul H

    2010-04-01

    The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

  5. How to build an "active" patient? The work of AIDS associations in France.

    PubMed

    Barbot, Janine

    2006-02-01

    "What is an "active" patient?" is a question that arises in most medicine and illness-related social science research. This article examines the normative work carried out by AIDS associations in France to define an "active" patient in healthcare and research. While the fight against AIDS is often presented as being homogenous, we look at the diversity of opinion between different associations (Aides, Act Up-Paris, Actions Traitements and Positifs). We find four different cases: the patient as manager of his illness, the empowerment of patients, the science-wise patient and the experimenter. Systematic comparison of these cases shows that these perceptions of the "active" patient, in terms of the same pathology, are based upon different ways of seeing: the nature of the relationships between the different types of knowledge of the illness (scientific knowledge, clinical knowledge, experience of the illness) and the distribution of roles and powers among the various actors in the healthcare system (the government, pharmaceutical companies, the medical profession, the patients). This article highlights the historical dynamics which allow us to have a better understanding of these differences, especially the major distinction between two generations of associations, which adopted different positions with regard to their public identity.

  6. Illness beliefs in schizophrenia.

    PubMed

    Kinderman, Peter; Setzu, Erika; Lobban, Fiona; Salmon, Peter

    2006-10-01

    Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable 'illnesses' and did not have 'illness beliefs'. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional 'health belief' models. Patients' ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients' beliefs about mental illness. PMID:16777306

  7. 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.

  8. Defining mental illnesses: can values and objectivity get along?

    PubMed Central

    2013-01-01

    Background The creation of each edition of the Diagnostic and Statistical Manual (DSM) of psychiatry has proven enormously controversial. The current effort to revise the ‘bible’ of disorder definitions for the field of mental health is no exception. The controversy around DSM-5 reached a crescendo with the announcement from National Institute of Mental Health (NIMH) that the institute would focus efforts on the development of their own psychiatric nosology, the Research Domain Criteria (RDoC) (NIMH, 2013). Discussion The RDoC seem to be structured around the concern that the only way to find objectivity in the classification of diseases or disorders in psychiatry is to begin with biology and work back to symptoms. Values infuse medical categories in various ways and drive practical considerations about where and how to divide up constellations of already agreed upon symptoms. Summary We briefly argue that all nosologies are infused with values and, while we should continue to sharpen the psychiatric nosology, normativity will permeate even the strictest biologically based taxonomy; this need not be a bad thing. PMID:24365131

  9. Suicide in Relation to AIDS.

    ERIC Educational Resources Information Center

    Beckerman, Nancy L.

    1995-01-01

    Explores many dimensions of suicide among the terminally ill, including preemptive, surcease, and rational suicide. The critical issues addressed are the incidence of suicide in HIV-positive individuals, contributing factors associated with the risk of suicide among people with HIV/AIDS, and the clinical and ethical implications of this issue for…

  10. Cognitive representations of AIDS: a phenomenological study.

    PubMed

    Anderson, Elizabeth H; Spencer, Margaret Hull

    2002-12-01

    Cognitive representations of illness determine behavior. How persons living with AIDS image their disease might be key to understanding medication adherence and other health behaviors. The authors' purpose was to describe AIDS patients' cognitive representations of their illness. A purposive sample of 58 men and women with AIDS were interviewed. Using Colaizzi's (1978) phenomenological method, rigor was established through application of verification, validation, and validity. From 175 significant statements, 11 themes emerged. Cognitive representations included imaging AIDS as death, bodily destruction, and just a disease. Coping focused on wiping AIDS out of the mind, hoping for the right drug, and caring for oneself. Inquiring about a patient's image of AIDS might help nurses assess coping processes and enhance nurse-patient relationships.

  11. 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 ...

  12. Hearing Aids

    MedlinePlus

    ... type and degree of loss. Are there different styles of hearing aids? Styles of hearing aids Source: NIH/NIDCD Behind-the- ... the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is ...

  13. Health care and AIDS.

    PubMed

    Peck, J; Bezold, C

    1992-07-01

    The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values. PMID:10119289

  14. 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…

  15. AIDS Resource Manual. A Guide for Teaching about AIDS in Thailand.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    This resource manual discusses Acquired Immune Deficiency Syndrome (AIDS) and offers suggestions on activities and games that can be used to enhance education. The manual begins with question-and-answer sections that address basic facts about AIDS, such as its transmission, prevention, cure, infection in the workplace, loss of income from illness,…

  16. 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.

  17. 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. PMID:27256943

  18. MRI in decompression illness.

    PubMed

    Hierholzer, J; Tempka, A; Stroszczynski, C; Amodio, F; Hosten, N; Haas, J; Felix, R

    2000-05-01

    We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.

  19. Illness causal beliefs in Turkish immigrants

    PubMed Central

    Minas, Harry; Klimidis, Steven; Tuncer, Can

    2007-01-01

    Background People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia. Methods Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness. Results Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness. Conclusion Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and

  20. [AIDS. The trend of HIV/AIDS and the nurse's role in AIDS care].

    PubMed

    Chang, S B

    1993-01-01

    Since the first case of AIDS was found among male homosexuals, the AIDS related problem has been in the male homosexual population, but the AIDS trend is changing from homosexuals to heterosexuals, with the majority of cases in the general population. Even though currently the reported HIV/AIDS cases in Korea are only 324 in Korea, the number of people infected with HIV/AIDS is projected to increase greatly over the next few years. As the number of these cases increases, there will be a major strain on nursing care resources. Since there is no known cure, the only way of halting this epidemic is through the prevention of further infection. In various stages of HIV infection, different problems occur, calling for various specific services and nursing skills. Nurses must develop a strategy to alleviate the negative attitudes related to care of AIDS patients and anxiety and dislike for care of terminally ill patients. Also, nurses must be prepared for teaching the general population about prevention of AIDS, counseling individuals in risk of HIV infection, HIV testing, and transmission risks, and caring for AIDS patients using Hospice concepts in various settings.

  1. Teaching AIDS.

    ERIC Educational Resources Information Center

    Tonks, Douglas

    This book presents a curriculum to educate students about the risk of AIDS and HIV infection. The opening chapters of the book presents a discussion of: how teachers can create an environment of support for an AIDS education program; the political and educational implications of winning principal, district, and parental support for an AIDS…

  2. 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…

  3. Stress in Adolescents with a Chronically Ill Parent: Inspiration from Rolland's Family Systems-Illness Model.

    PubMed

    Sieh, D S; Dikkers, A L C; Visser-Meily, J M A; Meijer, A M

    2012-12-01

    This article was inspired by Rolland's Family Systems-Illness (FSI) model, aiming to predict adolescent stress as a function of parental illness type. Ninety-nine parents with a chronic medical condition, 82 partners, and 158 adolescent children (51 % girls; mean age = 15.1 years) participated in this Dutch study. The Dutch Stress Questionnaire for Children was used to measure child report of stress. Ill parents completed the Beck Depression Inventory. Children filled in a scale of the Inventory of Parent and Peer Attachment measuring the quality of parent attachment. Both parents filled in the Parent-Child-Interaction Questionnaire-Revised. We conducted multilevel regression analyses including illness type, the ill parent's depressive symptoms, family functioning (quality of marital relationship, parent-child interaction, and parent attachment), and adolescents' gender and age. Four regression analyses were performed separately for each illness type as defined by disability (Model 1), and onset (Model 2), course (Model 3), and outcome of illness (Model 4). In all models, higher adolescent stress scores were linked to lower quality of parent-child interaction and parent attachment, and adolescents' female gender. The four models explained approximately 37 % of the variance in adolescent stress between individuals and 43-44 % of the variance in adolescent stress between families. Adolescent stress was not related to parental illness type. Our results partially supported the FSI model stating that family functioning is essential in point of child adjustment to parental illness. In the chronic stage of parental illness, adolescent stress does not seem to vary depending on illness type.

  4. 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.

  5. [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.

  6. High-Altitude Illness

    MedlinePlus

    ... altitude illness: Acute mountain sickness High-altitude pulmonary edema (also called HAPE), which affects the lungs High-altitude cerebral edema (also called HACE), which affects the brain These ...

  7. Symptoms of Tickborne Illness

    MedlinePlus

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

  8. Waterborne Diseases & Illnesses

    MedlinePlus

    ... Gases Impact on Weather Health Effects Take Action Water Pollution Water Pollution Home Chemicals and Pollutants Natural Disasters Drinking Water ... Water Treatment Videos Games Experiments For Teachers Home Water Pollution Waterborne Diseases & Illnesses Print this Page Air Pollution ...

  9. Help for Mental Illnesses

    MedlinePlus

    ... Mental Health America National Alliance on Mental Illness University or medical school-affiliated programs may offer treatment options. Search on the website of local university health centers for their psychiatry or psychology departments. ...

  10. 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 ...

  11. Hearing Aid

    MedlinePlus

    ... and Food and Drug Administration Staff FDA permits marketing of new laser-based hearing aid with potential ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  12. Redirecting British foreign aid.

    PubMed

    Dean, M

    1994-01-01

    Britain has longed followed a disease-control strategy for providing aid in the health sector to developing, low-income countries. Given, however, the high level of waste upon tertiary care and specialized medicine in current health programs of low-income countries as documented by the World Bank; the poor performance of existing general government hospitals and clinics; and the poor image of Third World health systems in the eyes of Western officials and government ministers, the chief health advisor of the Overseas Development Administration has called for a drastic redirection of policy toward development aid. Specifically, a shift away from a specific-disease control approach toward an overall, sweeping reform of the health sector in developing countries is urged. The level of waste needs to be reduced and more attention given to the poor. Unless such changes result, government ministers will grow increasingly reluctant to provide tangible aid to the health sectors of countries in need. The availability of such funds invested in effective, well-managed health programs will grow more critical to health in the Third World as populations shift away from communicable disease morbidity and mortality toward illnesses which are of a more noncommunicable nature such as stroke and cancer.

  13. Tools to Promote Shared Decision Making in Serious Illness

    PubMed Central

    Austin, C. Adrian; Mohottige, Dinushika; Sudore, Rebecca L.; Smith, Alexander K.; Hanson, Laura C.

    2016-01-01

    IMPORTANCE Serious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population. OBJECTIVE To perform a systematic review of evidence about decision aids and other exportable tools that promote shared decision making in serious illness, thereby (1) identifying tools relevant to the treatment decisions of seriously ill patients and their caregivers, (2) evaluating the quality of evidence for these tools, and (3) summarizing their effect on outcomes and accessibility for clinicians. EVIDENCE REVIEW We searched PubMed, CINAHL, and PsychInfo from January 1, 1995, through October 31, 2014, and identified additional studies from reference lists and other systematic reviews. Clinical trials with random or nonrandom controls were included if they tested print, video, or web-based tools for advance care planning (ACP) or decision aids for serious illness. We extracted data on the study population, design, results, and risk for bias using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Each tool was evaluated for its effect on patient outcomes and accessibility. FINDINGS Seventeen randomized clinical trials tested decision tools in serious illness. Nearly all the trials were of moderate or high quality and showed that decision tools improve patient knowledge and awareness of treatment choices. The available tools address ACP, palliative care and goals of care communication, feeding options in dementia, lung transplant in cystic fibrosis, and truth telling in terminal cancer. Five randomized clinical trials provided further evidence that decision tools improve ACP documentation, clinical decisions, and treatment received. CONCLUSIONS AND RELEVANCE Clinicians can access and use evidence-based tools to engage seriously ill patients in shared decision making. This field of research is in an early stage; future research is needed to

  14. [Definition of mental illness and discoursive strategies in psychiatry].

    PubMed

    Hartman, J

    1998-01-01

    Defining mental illness was presented in the article both as a matter of medical knowledge and a political issue. This latter aspect cannot be successfully dealt with by psychiatry itself, since it is a branch of medicine, nevertheless bioethics offers here its competences and possibilities. The presentation of some elements of traditional strategies in defining mental illness introduces a draft of such a project of the definition procedure, which reinforces the constantly threatened (by the decrease of sovereignity) social and legal status of psychiatry, and--on the other hand--enables us to support the evidently handicapped status of psychiatric patients. This solitary definition strategy, which support both psychiatric circles and patients, assumes that a popular modern tendency to deny the very reality of the mental illness is to be avoided. The definition of mental illness proposed in the article is pragmatic in character and is based on a definition of mental illness as a kind of spiritual disorder. PMID:10816967

  15. AIDS lymphomas.

    PubMed

    Middleton, G W; Lau, R K

    1992-01-01

    Chronically immunosuppressed individuals are susceptible to lymphoreticular tumors. Up to 15% of patients with congenital deficiencies such as ataxia=telangiectasia may develop malignancies, mainly high-grade B cell non=Hodgkin's lymphomas (NHLs). AIDS lymphomas are comprised of NHLs including Burkitt's lymphoma (BL) and primary cerebral lymphomas (PCLs). Almost 3% of all AIDS patients (2824 of 97,258 cases) developed NHL. Epstein-Barr virus (EBV) as a co-factor in AIDS lymphomagenesis has been studied: in 12 cases of 24 AIDS lymphomas EBV by DNA in situ hybridization was found. In an analysis of 6 primary cerebral lymphomas, .5 were positive for EBV DNA by Southern blotting. In Burkitt's lymphoma the characteristic genetic alteration affects the c-myc oncogene. In 1/3 of BL p53 mutations were found but none in the 43 NHLs suggesting that p53 mutations and c-myc activation act synergistically in the pathogenesis of these tumors. Cytotoxic agents dideoxyinosine, dideoxycytosine, and zidovudine may cause secondary neoplasia. 8 of 55 AIDS patients under zidovudine treatment developed high-grade lymphoma 23.8 months subsequently; recently doses were reduced. PCL was found in 21 of 90 patients. A 5.2 months survival was associated with combined treatment with cyclophosphamide, Oncovin (vincristine), methotrexate, etoposide, and cytosine arabinoside compared with 11.3 months with chemotherapy. Colony-stimulating factors (CSFs) alleviate drug-induced myelotoxicity and zidovudine-induced neutropenia, however, l8 of 11 patients receiving granulocyte-macrophage CSF developed hematological toxicity. Interleukine-2 produced by T-helper cells enhancing tumor cells cytotoxicity has been used in AIDS-associated cryptosporidial diarrhea and in 4 patients with AIDS lymphoma with modest response, but its stimulation of the HIV-infected substrate may increase viral proliferation.

  16. Complications in Working with AIDS Patients in Group Psychotherapy.

    ERIC Educational Resources Information Center

    Tunnell, Gil

    Numerous research studies have documented that for patients coping with chronic illness, social support is extremely important in facilitating adjustment to the illness. The support may come from organized therapy and self-help groups or from interpersonal relationships outside a group. However, Acquired Immune Deficiency Syndrome (AIDS) is a…

  17. Confronting AIDS.

    PubMed

    Squire, L

    1998-03-01

    By 2020, HIV/AIDS will be the leading infectious killer of young and middle-aged adults in the developing world. Past gains in life expectancy are already being eroded in some countries. Millions of lives can, however, be saved if developing country governments, the international community, and nongovernmental organizations act now. Although more than 11 million people have already died of AIDS, 2.3 billion people live in developing countries in which the disease has not yet spread beyond certain risk groups. If the spread of HIV is checked, the quality of care available to people who are infected with HIV will probably be better than it would be in the context of a full-blown AIDS epidemic. However, while governments need to respond urgently to HIV/AIDS, using resources to help people with AIDS will reduce the resources available for other investments, such as child education, providing safe drinking water, and building roads. Economics can help governments set priorities as they decide how best to allocate their available resources. Externalities, public goods, and redistribution are discussed. All countries will need to use some combination of preventive and coping measures. PMID:12293445

  18. 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.…

  19. 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)

  20. 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.

  1. [Mental illness and media].

    PubMed

    Magli, Erica; Buizza, Chiara; Pioli, Rosaria

    2004-06-01

    Many knowledges on the mental disease that the community possesses are turning out of information disclosed from the media. It's common in the press to connect actions of violence and murders to the mental diseases. For this reason, the reader is induced to infer that murders and other violent actions are more frequent in people who have suffered from mentally ill, than in the general population. The mystifying impression provided by media accrues from the fact that these reports are rarely compensated from positive reports. Objective of the present study is to characterize the type of information concerning mental illness diffused from the local daily paper "Giornale di Brescia" in the year 2001. The results show that many articles connote negatively the mental disease. The journalistic sensationalism, denounced facing the speech of the prejudgment in the comparisons of the mentally ill people, seems to still remain, in the considered year of publication, one unchanging tendency. PMID:15248412

  2. Abraham Lincoln's Gettysburg illness.

    PubMed

    Goldman, Armond S; Schmalstieg, Frank C

    2007-05-01

    When Abraham Lincoln delivered the Gettysburg Address, he was weak and dizzy; his face had a ghastly colour. That evening on the train to Washington, DC, he was febrile and weak, and suffered severe headaches. The symptoms continued; back pains developed. On the fourth day of the illness, a widespread scarlet rash appeared that soon became vesicular. By the tenth day, the lesions itched and peeled. The illness lasted three weeks. The final diagnosis, a touch of varioloid, was an old name for smallpox that was later used in the 20th century to denote mild smallpox in a partially immune individual. It was unclear whether Lincoln had been immunized against smallpox. Indeed, this review suggests that Lincoln had unmodified smallpox and that Lincoln's physicians tried to reassure the public that Lincoln was not seriously ill. Indeed, the successful conclusion of the Civil War and reunification of the country were dependent upon Lincoln's presidency.

  3. [Prophecy and mental illness].

    PubMed

    Vishne, Tali; Harary, Eran

    2005-09-01

    It is a well known platitude that a mentally ill person may "think that he is God" or "believes that he is the Messiah". Despite the generalization and shallowness of this attitude, sometimes psychotic patients indeed have delusions with contents of divine revelation, messianic assignments or prophetic power. In this current article we examine the different connections between prophecy and mental condition, especially psychotic. We present sources that combine prophecy and insanity, and also possible psychiatric interpretation of these situations. Finally, we present the attitude of the Rambam to prophecy and the personality characteristics of the prophet, limiting the possibility of the mentally ill patient who pretends to be a prophet.

  4. Vitamin D Deficiency in Pediatric Critical Illness

    PubMed Central

    Hebbar, Kiran B.; Wittkamp, Michael; Alvarez, Jessica A.; McCracken, Courtney E.; Tangpricha, Vin

    2014-01-01

    Introduction The potential role for vitamin D in infection has been well described in adults. The objective of our study was to determine the prevalence of vitamin D insufficiency and to evaluate the relationship between vitamin D status and markers of innate immunity and infection in critically ill children. Hypothesis Vitamin D deficiency was highly prevalent in children with critical illness and correlated with the severity of illness and dysfunction in innate immunity. Methods We performed a prospective clinical observational study with both case and control groups in the pediatric intensive care unit (PICU). Vitamin D status was defined as vitamin D sufficient (25-hydroxyvitamin D (25(OH)D≥ 20 ng/mL), vitamin D insufficient (25(OH)D 10 to 20 ng/mL), and vitamin D deficient (25(OH)D <10 ng/mL). Vitamin D status, severity of illness scores, and cathelicidin, and other clinical data were collected. Results Sixty-one PICU patients and 46 control patients were enrolled. Over 60% of the PICU cases were found to be vitamin D insufficient while less than 1/3 of the controls were insufficient (p < 0.0001). No significant correlation was seen between plasma 25(OH)D and any severity of illness scores. Cases with asthma had a significantly lower median level 25(OH)D (16.9 ng/mL) than cases without asthma (18.7 ng/mL). Over 50% of patients hospitalized during the fall and winter were considered vitamin D deficient or insufficient whereas in the sunnier seasons (spring and summer) the prevalence of vitamin D deficiency/insufficiency decreased to about 30% (p = 0.003). Conclusions The overall finding of profound vitamin D deficiency in the pediatric critical care population is an important finding. Significant seasonal differences were noted even in the critically ill. Certain diseases like asthma in critically ill children merit further study. PMID:25580380

  5. Neurologic presentations of AIDS.

    PubMed

    Singer, Elyse J; Valdes-Sueiras, Miguel; Commins, Deborah; Levine, Andrew

    2010-02-01

    The human immunodeficiency virus (HIV), the cause of AIDS, has infected an estimated 33 million individuals worldwide. HIV is associated with immunodeficiency, neoplasia, and neurologic disease. The continuing evolution of the HIV epidemic has spurred an intense interest in a hitherto neglected area of medicine, neuroinfectious diseases and their consequences. This work has broad applications for the study of central nervous system (CNS) tumors, dementias, neuropathies, and CNS disease in other immunosuppressed individuals. HIV is neuroinvasive (can enter the CNS), neurotrophic (can live in neural tissues), and neurovirulent (causes disease of the nervous system). This article reviews the HIV-associated neurologic syndromes, which can be classified as primary HIV neurologic disease (in which HIV is both necessary and sufficient to cause the illness), secondary or opportunistic neurologic disease (in which HIV interacts with other pathogens, resulting in opportunistic infections and tumors), and treatment-related neurologic disease (such as immune reconstitution inflammatory syndrome). PMID:19932385

  6. 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…

  7. 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

  8. 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…

  9. Dietitian Aide.

    ERIC Educational Resources Information Center

    Texas Tech. Univ., Lubbock. School of Home Economics.

    This course of study for the dietitian aide is one of a series available for use by teacher-coordinators and students in Grade 11 and 12 home economics cooperative education programs. Based on job analysis interviews with health care facilities personnel, this course was prepared by teachers and Instructional Materials Center staff, field-tested,…

  10. 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;…

  11. The nonthyroidal illness syndrome.

    PubMed

    Adler, Suzanne Myers; Wartofsky, Leonard

    2007-09-01

    This article briefly summarizes thyroid function alterations generally seen in the euthyroid sick syndrome, provides an overview of specific thyroidal adaptations during several clinical conditions and secondary to specific pharmacologic agents, and discusses the current controversy in thyroid hormone treatment of nonthyroidal illness.

  12. Coping with Chronic Illness

    MedlinePlus

    ... and independence. You may not be able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not understand why this is happening to them. These changes can cause stress, anxiety and anger. If they do, it is ...

  13. 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…

  14. 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

  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. Insulin infusion therapy in critically ill patients.

    PubMed

    Boutin, Jean-Marie; Gauthier, Lyne

    2014-04-01

    While dysglycemia (hyperglycemia, hypoglycemia and glucose variability) is clearly associated with increased mortality in critically ill patients, target range of blood glucose control remains controversial. Standardized insulin infusion protocols constitute the basis of treatment of these patients. The choice of protocol and its implementation is a great challenge. In this article, we review the published data to help define the essential elements that compose a good protocol and apply the right conditions to make it safe and effective. PMID:24690510

  17. 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…

  18. 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 .

  19. 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

  20. 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 . PMID:26758166

  1. 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

  2. Mental illness: psychiatry's phlogiston.

    PubMed

    Szasz, T

    2001-10-01

    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.

  3. 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

  4. Darwin's illness revealed.

    PubMed

    Campbell, Anthony K; Matthews, Stephanie B

    2005-04-01

    After returning from the Beagle in 1836, Charles Darwin suffered for over 40 years from long bouts of vomiting, gut pain, headaches, severe tiredness, skin problems, and depression. Twenty doctors failed to treat him. Many books and papers have explained Darwin's mystery illness as organic or psychosomatic, including arsenic poisoning, Chagas' disease, multiple allergy, hypochondria, or bereavement syndrome. None stand up to full scrutiny. His medical history shows he had an organic problem, exacerbated by depression. Here we show that all Darwin's symptoms match systemic lactose intolerance. Vomiting and gut problems showed up two to three hours after a meal, the time it takes for lactose to reach the large intestine. His family history shows a major inherited component, as with genetically predisposed hypolactasia. Darwin only got better when, by chance, he stopped taking milk and cream. Darwin's illness highlights something else he missed--the importance of lactose in mammalian and human evolution. PMID:15811889

  5. Darwin's illness revealed.

    PubMed

    Campbell, Anthony K; Matthews, Stephanie B

    2005-04-01

    After returning from the Beagle in 1836, Charles Darwin suffered for over 40 years from long bouts of vomiting, gut pain, headaches, severe tiredness, skin problems, and depression. Twenty doctors failed to treat him. Many books and papers have explained Darwin's mystery illness as organic or psychosomatic, including arsenic poisoning, Chagas' disease, multiple allergy, hypochondria, or bereavement syndrome. None stand up to full scrutiny. His medical history shows he had an organic problem, exacerbated by depression. Here we show that all Darwin's symptoms match systemic lactose intolerance. Vomiting and gut problems showed up two to three hours after a meal, the time it takes for lactose to reach the large intestine. His family history shows a major inherited component, as with genetically predisposed hypolactasia. Darwin only got better when, by chance, he stopped taking milk and cream. Darwin's illness highlights something else he missed--the importance of lactose in mammalian and human evolution.

  6. Mental illness: psychiatry's phlogiston.

    PubMed

    Szasz, T

    2001-10-01

    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. PMID:11579183

  7. 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

  8. Clinical Criteria for Physician Aid in Dying.

    PubMed

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    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.

  9. 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/ ...

  10. Advances in understanding illness anxiety.

    PubMed

    Harding, Kelli J; Skritskaya, Natalia; Doherty, Emily; Fallon, Brian A

    2008-08-01

    Illness anxiety, also known in its more severe form as hypochondriasis, is a debilitating and chronic condition in which normal bodily symptoms are misinterpreted as signs of serious medical illness. Patients suffer with the fear that they are ill despite reassurance to the contrary and often overuse medical services in the process. This article critically evaluates the recent literature on illness anxiety and related, medically unexplained symptoms, highlighting new and interesting findings in the areas of prevalence, classification/diagnosis, management, and evidence-based treatment and new frontiers in understanding illness anxiety, such as brain imaging, neuroimmunology, and cyberchondria. PMID:18627669

  11. Assessment and management of gastrointestinal symptoms in advanced illness.

    PubMed

    McHugh, Marlene E; Miller-Saultz, Debbie

    2011-06-01

    Primary care clinicians increasingly encounter patients with advanced illness, many suffering from symptoms other than pain. Key principles that guide palliative care must be incorporated into a plan of care for each patient and family. Although medical management continues to be the mainstay of treatment, the generalist in palliative care needs to be familiar with the patient's preferences and goals of care. This article provides an overview of gastrointestinal symptoms including anorexia, cachexia, nausea, vomiting, and constipation. Advanced progressive illnesses are defined here as incurable conditions that have significant morbidity in the later stages of illness.

  12. 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…

  13. 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

  14. 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

  15. AIDS epidemic sparks campaign to encourage condom use.

    PubMed

    1985-12-01

    The acquired immune deficiency syndrome (AIDS) is fueling a campaign that encourages use of the condom to combat the spread of sexually transmitted diseases. Condom use is being advocated even when one partner is practicing another form of contraception. The threat of AIDS has spread beyond the original risk groups -- homosexual and bisexual men, intravenous drug users, and transfusion recipients -- to include heterosexual men and women. Researchers from the Centers for Disease Control said at the recent conference, Current Issues in Reproductive Health, that clinicians should take the following steps to control the disease: encourage using condoms to protect against sexually transmitted diseases, even if the patient uses another form of contraception; take steps to prevent perinatal transmission of the AIDS virus, human T-lymphotropic virus type III (HTLV-III); develop ways to use serologic tests for identifying AIDS-infected women of childbearing age; if infection is identified in non-pregnant women, counsel them on the most effective birth control methods; and if infection is identified after a woman is pregnant, discuss the indications for abortion. Dr. Mary E. Guinan, associate director of the CDC's Division of Sexually Transmitted Diseases, said women are most likely at greater risk of heterosexual transmission of the AIDS virus than men. She says that she believes "this is because of semen deposition in women." The virus believed to cause AIDS, HTLV-III, is present in the semen of men with AIDS or HTLV-III infection. Homosexuals are already being advised to use condoms. Intensive education is required to convince patients to accept using condoms in addition to other contraceptive methods. They need to be made aware of the condoms' role in preventing disease transmission. Dr. Harold Jaffe, chief of the epidemiology section of the CDC's AIDS task force, reports that the CDC defines AIDS as an illness at least moderately indicative of an underlying cellular

  16. Using Expert System Job Aids: A Primer.

    ERIC Educational Resources Information Center

    Carr, Clay

    1989-01-01

    Explains how current commercial expert system technology can be used to create useful job aids. Expert systems are defined, situations in which an expert system job aid will be most effective are described, expert system shells are discussed, and three commercial expert system products are described. (LRW)

  17. A Navajo Teacher Teacher-Aide Guide.

    ERIC Educational Resources Information Center

    Ammons, Madeline, Comp.; And Others

    This guide for teachers and teacher aides working with Navajo children is the product of a 3-week workshop for teachers and teacher aides given by the Bureau of Indian Affairs and Arizona Western College in June 1969. It outlines some of the basic differences between Navajo and Anglo culture and defines the liaison role that the bilingual teacher…

  18. Defining Early Adolescent Childbearing.

    ERIC Educational Resources Information Center

    Phipps, Maureen G.; Sowers, MaryFran

    2002-01-01

    Determined the age group for defining early adolescent childbearing based on rates of adverse clinical outcomes. Data on infant mortality, very low birth weight, and very pre-term delivery per 1,000 live births for women age 12-23 years in the 1995 U.S. birth cohort indicate that early adolescent childbearing is best defined as giving birth at age…

  19. Fatherhood and emotional illness.

    PubMed

    Cavenar, J O; Butts, N T

    1977-04-01

    The authors describe four cases in which men developed emotional illnesses related to their wives' pregnancies. In all of the cases, the patients had experienced sibling rivalry at a significant time in their lives. This factor seemed to be more important dynamically in understanding their feelings about fatherhood than previously proposed factors, such as envy of the wife's childbearing capacity, dependence on the wife, and neurotic conflict with the oedipal father. The authors suggest that in men with neuroses, the issue of sibling rivalry is an important determinant of reactions to fatherhood.

  20. The power of AIDS: kinship, mobility and the valuing of social and ritual relationships in Tanzania.

    PubMed

    Dilger, Hansjörg

    2006-09-01

    The HIV/AIDS epidemic in Africa has become a test case of the effects of globalisation, in that it demonstrates how international processes may affect regional life situations and how 'the local' can simultaneously develop in its own way, through the processes of appropriating, modifying, and resisting global influences. Drawing on fieldwork in Tanzania, I show how the Luo in the Mara region define HIV/AIDS as an outcome of modernity and globalisation, which to them have become embodied in processes of migration, the collapse of generational and gender hierarchies, and an increased immorality in contemporary society. While social and moral ruptures in Mara become further condensed in tensions between lineages and AIDS-sick relatives, mourning and burial rituals (including widow cleansing), disputes over inheritance rights, and the attribution of illness to the breaking of a taboo (chira) have become essential for negotiating and maintaining social and cultural relationships in an era of AIDS. In conclusion I argue that the concepts of vitality and moral practice may assist an understanding of how different social actors in sub-Saharan Africa have responded to the breakdowns associated with increased suffering and death, and to describe some social and moral developments observable in the context of internationally driven public health campaigns in the region.

  1. 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. PMID:21661715

  2. Locating legacy in illness.

    PubMed

    Froude, Cameron Kiely

    2016-06-01

    The author, a licensed marriage and family therapist, describes her work with Sofia, an eight-year-old Puerto Rican female with chronic and persistent abdominal pain and leg paralysis with no known organic cause. Sofia's mother, Ana, was also seen by the author. Over the course of several weeks, the family shared stories of painful medical procedures and extreme dietary plans prescribed to them by doctors to identify the etiology of Sofia's illness. Ana described her simultaneous relief and frustration when each test result indicated that there was no organic cause for Sofia's debilitating pain. They talked about the push and pull Ana's family experienced as they prayed simultaneously for abnormal and normal test results. The author told Sofia's pediatrician that she would begin to create a community genogram with the family in their next meeting. She explained that the purpose of the community genogram was to illustrate the social and historical contexts of families' lives. They learned that a seminal narrative in Sofia's family legacy connected deep understanding of others with embodiment of their immediate experience. Sofia's illness became one part of her and her family's legacy and cultural tapestry. Ana described the renewed connections that she and Sofia shared with their family members. As Sofia and Ana spoke with their family members more often, Sofia's leg paralysis and stomach pains decreased. Sofia began attending school regularly and visiting less with her pediatrician. (PsycINFO Database Record PMID:27270250

  3. 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…

  4. Manufacturing Aids

    NASA Technical Reports Server (NTRS)

    1989-01-01

    During a research program, MMTC/Textron invented a computer-aided automatic robotic system for spraying hot plasma onto a turbine blade. The need to control the thickness of the plasma deposit led to the development of advanced optical gaging techniques to monitor and control plasma spray build-up on blade surfaces. The techniques led to computerized optical gages for inspecting aircraft, industrial turbine blades, etc. MMTC offers 10 standard commercial robotic gages. The system also generates two dimensional profiles for assessing status and specifying repairs to the electromechanical cathodes used to make the parts. It is capable of accuracies to a ten-thousandth of an inch. An expanded product line is currently marketed. The gages offer multiple improvements in quality control and significant savings.

  5. Defining Overweight and Obesity

    MedlinePlus

    ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Defining Adult Overweight and ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs File Formats Help: How ...

  6. 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

  7. 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

  8. Between health and illness.

    PubMed

    Davies, Peter G

    2007-01-01

    This essay explores the connections between health and illness, and the processes of salutogenesis, pathogenesis, and homeostasis. Written from an understanding of human embodiment and the consequences this has for our experiences of health and disease, this essay moves towards a positive definition of health, as an on-going outcome from the processes of a life lived well. "Well" here is measured in terms of wealth, relationships, coherence, fitness, and adaptability. Mencken's criticism that "Hygiene is the corruption of medicine by morality" is answered; the search for health is, in part, a moral as well as a biological enterprise. Both generative processes and remedial measures contribute to health. The patients in my consulting room usually need remedial medicine, but they would also like to flourish as human beings. Doctors should be able to provide a balance of measures towards this end.

  9. AIDS in America's Schoolhouses: Learning the Hard Lessons.

    ERIC Educational Resources Information Center

    Kirp, David L.; Epstein, Steven

    1989-01-01

    Contrasts two communities' solutions to the AIDS crisis. Ocilla, Georgia, self-defined as a community of isolation, tries to avoid AIDS and segregate virus-carriers (Blacks only so far) from everyone else. Pilsen Academy (Chicago) is a model of openness, approaching AIDS through education, individual empowerment, collective decision-making, and…

  10. 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.

  11. The ratio of AIDS to non-AIDS Medicaid medical costs from 1992 to 2000.

    PubMed

    Kotzan, J A; McMillan, C A

    1995-01-01

    Our research objective was to calculate and forecast the monthly increase in medical and prescription costs for Medicaid patients with acquired immunodeficiency syndrome (AIDS) and compare these values with costs for non-AIDS patients. A retrospective analysis of AIDS patients and a control group of Georgia Medicaid beneficiaries was conducted between January 1, 1988, and December 31, 1991. AIDS patients were defined using the Keyes algorithm of combinations of International Classification of Diseases, 9th Revision, Clinical Modification codes. The AIDS patient group was matched demographically to a group of non-AIDS patients. Data were adjusted to account for eligibility status, and the ratio of AIDS costs to non-AIDS costs was modeled with an econometric time series procedure. A total of 1966 AIDS patients were identified from 900,000 Medicaid recipients in the study period; 58.0% were male and 59.8% were black. Age was bimodal at < or = 1 year and 33 years. The best fit for the medical cost ratios produced a significant regression coefficient of .37. The initial ratio of AIDS to non-AIDS forecast was 4.25 in January 1992. The January 2000 forecast of this ratio increased to 42.56. This increase equates to an additional $8510.19 per AIDS patient-month for January 2000 in 1991 dollars. The outpatient prescription ratio for AIDS versus non-AIDS patients was not predictable. However, the greatest observed discrepancies were attributed to the expense for antihemophilia products. Overall, the most important finding was the accelerating medical costs for treating AIDS patients compared with costs for treating non-AIDS patients. These results may, in part, reflect additional costs for treating intravenous drug users and pediatric AIDS patients.

  12. Complications in group psychotherapy with AIDS patients.

    PubMed

    Tunnell, G

    1991-10-01

    AIDS has a unique set of characteristics that makes group psychotherapy more complex than with other populations: (1) the threat of an early death, (2) a highly variable course of illness, and (3) stigma related to the illness and to the preexisting lifestyles of most patients. The specific ways in which the three factors seriously interfere with establishing and maintaining group cohesion are discussed, and clinical guidelines are suggested. In addition, a model for understanding and working with these and other issues in group psychotherapy, based on Erik Erikson's interpersonal theory of development, is presented. Finally, particular countertransferential difficulties are discussed in relation to the heightened emotionality common to AIDS psychotherapy groups. PMID:1938017

  13. Defining departmental mission.

    PubMed

    Hartman, M D; Barrow, J A; Sawyer, W R

    1990-02-01

    Mission statements have long been recognized by corporate America as a way to define an enterprise. The necessary business orientation of the health care industry requires that hospitals and hospital departments define their scope of services and reason for existence. The accelerating reprofessionalization affecting departments of pharmacy requires the same. "Improving the quality of patient care" can no longer represent a euphemism for simply reacting to external factors or acting on a whim without clear meaningful intent. Professional departments and hospitals must demonstrate a sense of direction and purpose and be able to justify costs to a budget-conscious management and skeptical public. Mission statements are not substitutes for a clearly defined sense of professional mission. However, well-constructed mission statements contribute to clarity of departmental and professional purpose and effective achievement of goals. PMID:10128549

  14. Defining Risk Drinking

    PubMed Central

    Dawson, Deborah A.

    2011-01-01

    Many efforts to prevent alcohol-related harm are aimed at reducing risk drinking. This article outlines the many conceptual and methodological challenges to defining risk drinking. It summarizes recent evidence regarding associations of various aspects of alcohol consumption with chronic and acute alcohol-related harms, including mortality, morbidity, injury, and alcohol use disorders, and summarizes the study designs most appropriate to defining risk thresholds for these types of harm. In addition, it presents an international overview of low-risk drinking guidelines from more than 20 countries, illustrating the wide range of interpretations of the scientific evidence related to risk drinking. This article also explores the impact of drink size on defining risk drinking and describes variation in what is considered to be a standard drink across populations. Actual and standard drink sizes differ in the United States, and this discrepancy affects definitions of risk drinking and prevention efforts. PMID:22330212

  15. [Influenza, influenza-like illness: from theory to practice].

    PubMed

    Carrat, Fabrice; Avouac, Bernard; Cedraschi, Christine; Duru, Gérard; Greppo, Gwenaël; Libourel, Vincent; Vancells, Jacques; Vétel, Jean-Marie

    2014-03-01

    In France, there are large discrepancies regarding flu between the severe disease described by Health Authorities and the disease that people face, considered as usual and benign. Flu prevention is useful, mainly through vaccination. For a well-established influenza-like illness, both individual measures dedicated to the limitation of the disease propagation and symptomatic treatment are to be initiated. Few clinical data are available regarding the most often used treatments for influenza-like illness (paracetamol, homeopathic and symptomatic treatments). The analysis did not show any decrease in the chances of success for patients with more often used drugs, either being under medical prescription, pharmacist advice or self-medication. In front of an influenza-like illness, the recommendations for daily practice can be based on 2 well-defined clinical situations: a specific management for patients at risk, and the influenza-like illness symptoms relief for the others, using a treatment specific for each patient.

  16. HIV-AIDS Connection

    MedlinePlus

    ... Marketing Share this: Main Content Area The HIV-AIDS Connection AIDS was first recognized in 1981 and ... is there overwhelming scientific consensus that HIV causes AIDS? Before HIV infection became widespread in the human ...

  17. 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 ...

  18. Splinter, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Splinter, First Aid A A A First Aid for Splinter: View ... wet, it makes the area prone to infection. First Aid Guide Self-care measures to remove a splinter ...

  19. 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

  20. Responding to Students' Chronic Illnesses

    ERIC Educational Resources Information Center

    Shaw, Steven R.; Glaser, Sarah E.; Stern, Melissa; Sferdenschi, Corina; McCabe, Paul C.

    2010-01-01

    Chronic illnesses are long-term or permanent medical conditions that have recurring effects on everyday life. Large and growing number of students have chronic illnesses that affect their emotional development, physical development, academic performance, and family interactions. The primary error in educating those students is assuming that the…

  1. 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…

  2. 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. PMID:6100848

  3. Chronic illness and Hmong shamans.

    PubMed

    Helsel, Deborah; Mochel, Marilyn; Bauer, Robert

    2005-04-01

    Among the challenges health care personnel in California's central valley face has been finding ways to help Hmong Americans manage chronic illness. Interviews were conducted with 11 Hmong shamans diagnosed with diabetes or hypertension and were qualitatively analyzed to ascertain respondents' understanding and management of their illnesses. Hmong shamans are influential individuals within their communities and are often the resource persons to whom patients turn for information on health. Understanding the shamans' perspective on chronic illness was seen as a gateway to understanding how the broader Hmong American community perceived these conditions. The concept of chronic illness was not well understood, resulting in sporadic medication and dietary regimens, limited awareness of potential complications, and a persistent impression that these illnesses could be cured rather than managed. Suggestions for patient educators include family and community involvement in care regimens and the use of descriptive terminology to identify the disease.

  4. 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.

  5. 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. PMID:26668226

  6. Defining Faculty Work.

    ERIC Educational Resources Information Center

    Gray, Peter J.; Diamond, Robert M.

    1994-01-01

    A process of planned change is proposed for redefining college faculty work. Legitimate faculty work is defined in broad terms, and information sources and methods for collecting information to support redefinition are identified. The final step in the redefinition process is the development of new mission statements for the institution and its…

  7. Defining Child Abuse.

    ERIC Educational Resources Information Center

    Giovannoni, Jeanne M.; Becerra, Rosina M.

    In seeking to clarify the meaning of the terms "child abuse" and "child neglect" it has been assumed that, like other forms of social deviance, they are socially defined phenomena. Interviews were conducted with those professionals (lawyers, pediatricians, police officers, and social workers) who daily handle the problems of abuse and neglect for…

  8. 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…

  9. Defining Effective Teaching

    ERIC Educational Resources Information Center

    Layne, L.

    2012-01-01

    The author looks at the meaning of specific terminology commonly used in student surveys: "effective teaching." The research seeks to determine if there is a difference in how "effective teaching" is defined by those taking student surveys and those interpreting the results. To investigate this difference, a sample group of professors and students…

  10. Defining and Assessing Quality.

    ERIC Educational Resources Information Center

    Fincher, Cameron, Ed.

    The seven papers in this monograph focus on defining and assessing quality. The paper are: (1) "Reflections on Design Ideals" (E. Grady Bogue), which addresses some "governing ideals" of collegiate quality; (2) "Between a Rock and a Hard Place: Investment and Quality in Higher Education" (Sven Groennings), which sees the competitive quality of…

  11. On Defining Literacy.

    ERIC Educational Resources Information Center

    Sherritt, Caroline A.

    Defining literacy is a compelling challenge to educators. They generally use three models: instrumental, functional, and empowerment. The latter two approaches, which were increasingly evident in the 1980s, identify literacy by the social functions required in a given context or by the qualities needed for illiterate people to take control of…

  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. Defining Equality in Education

    ERIC Educational Resources Information Center

    Benson, Ronald E.

    1977-01-01

    Defines equality of education in three areas: 1) by the degree of integration of school systems; 2) by a comparison of material resources and assets in education; and 3) by the effects of schooling as measured by the mean scores of groups on standardized tests. Available from: College of Education, 107 Quadrangle, Iowa State University, Ames, Iowa…

  14. Contestations over "tradition" and "culture" in a time of AIDS.

    PubMed

    Peters, Pauline E; Kambewa, Daimon; Walker, Peter A

    2010-07-01

    In Malawi, the distress and unease caused by rising numbers of deaths and chronic illness due to HIV infection have led people to search for explanations. Here, we describe two particular "turns to culture." Zomba villagers over two decades have come to link AIDS with kanyera, an indigenous illness syndrome. In contrast, the public media, government, and donors blame "promiscuity" and "cultural practices" for HIV infection. The resulting stigmatization causes people to avoid naming AIDS, and both turns to culture tend to link blame and stigma to women.

  15. Nutritional assessment in the critically ill.

    PubMed

    Manning, E M; Shenkin, A

    1995-07-01

    Although many of the measurements and techniques outlined in this article may be epidemiologically useful and correlate with morbidity and mortality, no single indicator is of consistent value in the nutritional assessment of critically ill patients. Measurements such as anthropometrics, total body fat estimation, or delayed hypersensitivity skin testing either are liable to non-nutritional influences or lack accuracy and precision in individual patients. Plasma concentrations of hepatic proteins are affected significantly by the patient's underlying disease state and therapeutic interventions and therefore lack specificity. Although the measurement of these proteins is of little value in the initial nutritional assessment of the critically ill, serial measurement, particularly of plasma pre-albumin, may be useful in monitoring the response to nutritional support. Nitrogen balance is a widely used and valuable nutritional indicator in the critically ill. Direct measurement of urine nitrogen is the preferred test, although nitrogen excretion often is derived from 24-hour urine urea measurement, an inexpensive and easy procedure, but one that is less accurate. More accurate techniques of assessing change in nutritional status, such as IVNAA of total body nitrogen or isotopic measurement of exchangeable potassium or sodium, are more expensive, less available, unsuitable for repeated analyses, and less feasible in severely ill patients. Total body nitrogen measured using IVNAA and total-body potassium, however, are the most accurate ways of measuring body composition in the presence of large amounts of edema fluid. The application of body composition measurements to patient care remains poorly defined because of the many problems encountered with the various techniques, including cost, availability, and radiation exposure. Improved, more sensitive and, preferably, bedside methods for the measurement of body composition are needed. It is of paramount importance that

  16. 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.

  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. 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) ...

  19. [Emotional-psychiatric disorder and the illness concept].

    PubMed

    Bresser, P H

    1992-08-01

    Who is abnormal--who is sick? Illness is an abnormal state. Abnormal psychological states are manyfold and rich in variations. Therefore it is necessary to define what is insanity and what is personal problem, personal disorder, personal decompensation or only any form of suffering. The problem is important with regard to therapeutical and legal decisions.

  20. The range scheduling aid

    NASA Technical Reports Server (NTRS)

    Halbfinger, Eliezer M.; Smith, Barry D.

    1991-01-01

    The Air Force Space Command schedules telemetry, tracking and control activities across the Air Force Satellite Control network. The Range Scheduling Aid (RSA) is a rapid prototype combining a user-friendly, portable, graphical interface with a sophisticated object-oriented database. The RSA has been a rapid prototyping effort whose purpose is to elucidate and define suitable technology for enhancing the performance of the range schedulers. Designing a system to assist schedulers in their task and using their current techniques as well as enhancements enabled by an electronic environment, has created a continuously developing model that will serve as a standard for future range scheduling systems. The RSA system is easy to use, easily ported between platforms, fast, and provides a set of tools for the scheduler that substantially increases his productivity.

  1. 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.

  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. PMID:26671292

  3. Treatment of suspected heat illness.

    PubMed

    Eichner, E R

    1998-06-01

    1. Despite advances in the art and science of fluid balance, exertional heat illness -- even life-threatening heat stroke -- remains a threat for some athletes today. 2. Risk factors for heat illness include: being unacclimatized, unfit, or hypohydrated; certain illnesses or drugs; not drinking in long events; and a fast finishing pace. 3. Heat cramps typically occur in conditioned athletes who compete for hours in the sun. They can be prevented by increasing dietary salt and staying hydrated. 4. Early diagnosis of heat exhaustion can be vital. Early warning signs include: flushed face, hyperventilation, headache, dizziness, nausea, tingling arms, piloerection, chilliness, incoordination, and confusion. 5. Pitfalls in the diagnosis of heat illness include: confusion preventing self-diagnosis; the lack of trained spotters; rectal temperature not taken promptly; the problem of "seek not, find not;" and the mimicry of heat illness. 6. Heat stroke is a medical emergency. Mainstays of therapy include: emergency on-site cooling; intravenous fluids; treating hypoglycemia as needed; intravenous diazepam for seizures or severe cramping or shivering; and hospitalizing if response is slow or atypical. 7. The best treatment is prevention. Tips to avoiding heat illness include: rely not on thirst; drink on schedule; favor sports drinks; monitor weight; watch urine; shun caffeine and alcohol; key on meals for fluids and salt; stay cool when you can; and know the early warning signs of heat illness.

  4. 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)…

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

    PubMed

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

    2015-08-01

    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.

  6. [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.

  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. Recognising and managing decompression illness.

    PubMed

    Caton-Richards, Michelle

    2013-11-01

    Seen primarily in scuba divers who have breathed compressed air, decompression illness is a rare but potentially fatal condition. Prompt recognition and treatment of the illness, and urgent referral of patients to hyperbaric chambers, can mean the difference between full recovery and paralysis or death. This article describes decompression illness and how to recognise it, and discusses the treatment that patients require for the best chance of recovery with no adverse effects. It also includes a case study of a patient who developed this condition after a dive. PMID:24219686

  9. Recognising and managing decompression illness.

    PubMed

    Caton-Richards, Michelle

    2013-11-01

    Seen primarily in scuba divers who have breathed compressed air, decompression illness is a rare but potentially fatal condition. Prompt recognition and treatment of the illness, and urgent referral of patients to hyperbaric chambers, can mean the difference between full recovery and paralysis or death. This article describes decompression illness and how to recognise it, and discusses the treatment that patients require for the best chance of recovery with no adverse effects. It also includes a case study of a patient who developed this condition after a dive.

  10. An Anthropological View of the Change in Attitudes toward Mental Illnesses and Physical Handicaps.

    ERIC Educational Resources Information Center

    Ross, John Alan

    1983-01-01

    Anthropologists contend that throughout man's history mental illness has been part of all cultures, and, universally, peoples had taxonomies that classified such maladies. Primitive peoples were better able to treat culturally-defined mental illnesses and could, consequently, accommodate behaviors which in Western cultures would require…

  11. 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…

  12. Dimensions, content and validation of the fear of AIDS schedule in health professionals.

    PubMed

    Ross, M W; Hunter, C E

    1991-01-01

    We examined the structure of the Fear of AIDS Schedule (FAIDSS) in a sample of 134 health care workers. Factor analysis indicated that there were five discrete dimension of fear of AIDS: fears of loss of control, of sex, of HIV infection through blood and illness, of death and medical interventions, and of contact with outsiders. These dimensions had low to moderate intercorrelations. The dimensions of fear of HIV infection through blood or illness, was significantly correlated with desired personal social distance from people with AIDS, and this dimension along with fear of death and medical interventions were correlated with desired public social distance. Fear of infection through blood and illness were predictors of both desired personal social distance and public social distance from people with HIV infection. The data suggest greater discrimination of AIDS fears with greater closeness of interaction with people with HIV disease, and that these dimensions of the FAIDSS are both reliable and valid measures of AIDS fears.

  13. 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

  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. 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)

  16. Life Events, Stress, and Illness

    ERIC Educational Resources Information Center

    Rabkin, Judith G.; Struening, Elmer L.

    1976-01-01

    Selectively reviews the research literature on the relation of life events, stress, and the onset of illness; delineates trends in the development of this research, and evaluates the conceptual and methodological approaches employed. (MLH)

  17. Improving Communication About Serious Illness

    ClinicalTrials.gov

    2016-07-12

    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. 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

  19. The Liver in Critical Illness.

    PubMed

    Damm, Tessa W; Kramer, David J

    2016-07-01

    Caring for critically ill patients with acute and/or chronic liver dysfunction poses a unique challenge. Proper resuscitation and early consideration for transfer to liver transplant centers have resulted in improved outcomes. Liver support devices and cellular models have not yet shown mortality benefit, but they hold promise in the critical care of patients with liver disease. This article reviews pertinent anatomic and physiologic considerations of the liver in critical illness, followed by a selective review of associated organ dysfunction. PMID:27339681

  20. Heat Illness - A Practical Primer.

    PubMed

    Raukar, Neha; Lemieux, Renee; Finn, George; Stearns, Rebecca; Casa, Douglas J

    2015-07-01

    Heat stroke is one of the top three causes of death for athletes. Vigilance is required to prevent these illnesses and when faced with an individual who is suffering an exertional heat stroke, the goal is to aggressively cool the patient to 102°F within 30 minutes to optimize survival. The elderly are also at risk for heat illness and physicians caring for these patients should discuss prevention and treatment plans.

  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. Healthcare Disparities in Critical Illness

    PubMed Central

    Soto, Graciela J.; Martin, Greg S.; Gong, Michelle Ng

    2013-01-01

    Objective To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. Data Sources MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Study Selection Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Data Extraction Study findings are presented according to their association with the incidence, clinical presentation, management, and outcomes in acute critical illness. Data Synthesis This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data is organized along the course of acute critical illness. Conclusions The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research. PMID:24121467

  3. Nan Goldin reflects: "I'll be your mirror". Interview by Brandon Judell.

    PubMed

    Goldin, N

    1997-03-01

    Nan Goldin, a photographer whose life has been greatly affected by AIDS, speaks out about the backlash against her work, after the opening of her exhibit, I'll Be Your Mirror, at the Whitney Museum of American Art. Much of Goldin's work involves photographs depicting alternative lifestyles, risque materials, or photos taken in places where AIDS has a more subtle presence, if any at all. She plans an exhibit on hospices soon. PMID:11364124

  4. TAPERED DEFINING SLOT

    DOEpatents

    Pressey, F.W.

    1959-09-01

    An improvement is reported in the shape and formation of the slot or opening in the collimating slot member which forms part of an ion source of the type wherein a vapor of the material to be ionized is bombarded by electrons in a magnetic field to strike an arc-producing ionization. The defining slot is formed so as to have a substantial taper away from the cathode, causing the electron bombardment from the cathode to be dispersed over a greater area reducing its temperature and at the same time bringing the principal concentration of heat from the electron bombardment nearer the anode side of the slot, thus reducing deterioration and prolonging the life of the slot member during operation.

  5. Defining the mobilome.

    PubMed

    Siefert, Janet L

    2009-01-01

    This chapter defines the agents that provide for the movement of genetic material which fuels the adaptive potential of life on our planet. The chapter has been structured to be broadly comprehensive, arbitrarily categorizing the mobilome into four classes: (1) transposons, (2) plasmids, (3) bacteriophage, and (4) self-splicing molecular parasites.Our increasing understanding of the mobilome is as dynamic as the mobilome itself. With continuing discovery, it is clear that nature has not confined these genomic agents of change to neat categories, but rather the classification categories overlap and intertwine. Massive sequencing efforts and their published analyses are continuing to refine our understanding of the extent of the mobilome. This chapter provides a framework to describe our current understanding of the mobilome and a foundation on which appreciation of its impact on genome evolution can be understood.

  6. Defining critical thoughts.

    PubMed

    Lovatt, Abbie

    2014-05-01

    Nursing education has long struggled to define critical thinking and explain how the process of critical thinking fits into the context of nursing. Despite this long time struggle, nurses and nurse educators continue to strive to foster critical thinking skills in nursing students as intuitively most nurses believe that critical thinking is necessary to function competently in the workplace. This article explores the most recent work of Dr. Stephen Brookfield and ties the concepts which are explored in Brookfield's work to nursing practice. Brookfield identifies that learners understand the meaning of critical thinking the best when the process is first demonstrated. Role modeling is a method educators can use to demonstrate critical thinking and is a strategy which nurses often use in the clinical area to train and mentor new nursing staff. Although it is not a new strategy in nursing education, it is a valuable strategy to engage learners in critical thinking activities. PMID:24418065

  7. Defining clinical 'workstation'.

    PubMed

    Safran, C

    1994-01-01

    Interest in the physician's workstation has increased, yet often seems to focus on technological issues. At Boston's Beth Israel Hospital, the Center for Clinical Computing includes heavily used clinical workstations. Their evolution over the past 20 years suggests design criteria: the workstation must be patient-centered, the interface must be uniform, and data acquisition must be addressed at a system level. However, it is clinical function that really defines a workstation. The workstation should do the following: display patient information rapidly and flexibly; assist with administrative tasks; facilitate communication; and provide four important types of decision support: access to literature, access to databases, clinical calculation, and 'synthetic vision,' or different views of patient data. The solutions to our healthcare problems are not in 'workboxes' we can buy, but in creative approaches we can imagine. We need a patient-centered infrastructure and a reduced workload for the clinician-perhaps a 'worklesstation'. PMID:8125637

  8. [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

  9. First aid in acute stroke

    PubMed Central

    Reitmayer, Michael; Raschick, Marlitt; Erbguth, Frank; Neundörfer, Bernhard; Babjar, Elisabeth

    2006-01-01

    Objective First aid training is well established to teach the public how to recognize a medical emergency and take appropriate action. Though it is now handled as a high priority emergency stroke is not among the main topics of first aid. We investigated if first aid training may be useful for enhancing stroke awareness. Methods We developed a 15–20 minute teaching session about stroke as an emergency including signs and symptoms and first hands-on measures. The session was integrated in standard first aid training of the St John Ambulance of Germany and participants were asked to fill out a questionnaire regarding their knowledge about stroke. Subjects were questioned before the stroke lesson and again at the end of the training. Results 532 participants of the training responded to the questionnaire (mean age 28.6 years, 53.6% male). There was a significant increase in proportion of subjects correctly defining what stroke is (28.4% vs. 69.9%, p < 0,001) and in the mean number of stroke symptoms listed (1.52 vs. 3.35, p < 0,001) by the participants. The number of participants unable to list at least 1 symptom decreased significantly (12.8 vs. 3.6%, p<0.001). Conclusions In our study a teaching lesson integrated in first aid training was effective in improving stroke knowledge of participants. First aid training should be used for stroke information complementary to other activities like mass media campaigns as it is effective, could reach younger people that are not primarily interested in stroke and provides connections to other health topics. PMID:16896518

  10. 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…

  11. 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…

  12. Answering the AIDS denialists: is AIDS real?

    PubMed

    Mirken, B

    2000-12-01

    This article looks at theories that say AIDS does not exist, or is not a new disease but only a collection of old ones--and explains some of the history behind earlier changes in the official definition of AIDS in the U.S., changes which caused some public confusion. PMID:12171004

  13. Illness behaviour in mental ill-health in Kuwait.

    PubMed

    el-Islam, M F; Abu-Dagga, S I

    1990-09-01

    Two hundred and eight individuals were interviewed in order to study the behaviour they adopt in relation to the most common somatic and emotional symptoms of mental ill-health. Illness behaviour included ignoring, brooding, self-help and consultation of others. Older individuals tended more frequently to resort to meditation, native healers and doctors. Males consulted doctors more than females. Brooding was more frequent in well educated subjects. A group of married expatriates who left their wives in their original countries were the most likely to consult doctors. Education and marital status were the most predictive of brooding and self-help behaviour. Self-help was the most commonly adopted illness behaviour. The results are explained in terms of the social and cultural background of the individuals studied because this influences their methods of expressing distress and their action in relation to symptoms.

  14. 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

  15. My illness, myself: on the secrecy of shame.

    PubMed

    Baider, Lea

    2010-01-01

    Research has shown that the experience of being diagnosed with cancer has a negative psychosocial impact on patients and their families, often resulting in distress, and numerous practical and relationship challenges. Men with prostate cancer and their partners face special challenges. A range of symptoms that result from monitoring patients and side effects of treatment may reverse the quality of life and intimate relations between patient and partner. However, patients often are reluctant to bring up their distress about the symptoms, leading to an underestimation and reduction in optimal symptom control. As a result of their illness, chronically-ill male patients often experience elevated levels of stress, daily activities are often limited, they are frustrated about the unpredictable course of the illness and its symptoms, and are immersed in fears about their present and future social identity. Most of them avoid disclosure about their illness--when and where possible--and place great importance on sustaining a normal life. Factors related to limiting disclosure include men's low perceived need for support, fear of stigmatization, the need to minimize the threat of illness to aid coping, practical necessities in the workplace, and the desire to avoid burdening others. This paper contributes to an understanding of the complex issues of disclosure related to prostate cancer patients and raises issues about how best to be helpful, within their cultural and social framework. It also deals with feelings of shame, guilt and inadequacy as the cause--or consequence--of concealing the illness. The oral presentation will use a clinical example of secrecy and the subsequent conflicts and quandaries of a religious person diagnosed with advanced prostate cancer. Dilemmas of shame, disclosure and guilt will be the focus of the discussion. PMID:20590351

  16. 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…

  17. Psychological reaction to hospitalization and illness in the emergency department.

    PubMed

    Heiskell, L E; Pasnau, R O

    1991-02-01

    Each personality type presents with different methods of coping. Physicians should be aware of the impact on a patient's psychological functioning and ability to cope with illness and hospitalization, to understand and more effectively manage the patient. The physician must try to assess the patient's baseline personality from their past and present behavior. Establishing a good physician-patient relationship is important as a source of information about behavior of patients and how they will respond to their illness. Depending on the specific personality type, each patient will respond differently to the stress of illness. The effort of the emergency physician to identify personality types will aid in medical management of the patient and enable the physician to help each patient cope effectively with the illness and the hospitalization. The specific issues that seem to be threatening to traumatized patients include the following: helplessness, humiliation, blurring of body image, and gaps in memory filled with distortions. The traumatized patient experiences an altered state of consciousness which is either due to a physiologic cause or an emotional cause. Emotional causes are usually based on defensive dissociation. People who have been in an auto accident characteristically report loss of memory of the intense pain that the accident produces initially. Oftentimes, the core experience for the traumatic patient is not somatic, it is unconscious. The interesting feature is that so many patients do not remember the accident. The mind seems to be filled with all kinds of distortions and irrelevant and perhaps totally inconsistent fantasies, such as imprisonment, confinement, or deathlike experiences. Some report that they are being incarcerated, others recall being in a featureless cubicle with no contact with the normal world in which there are no windows, no pictures, no flowers. Others remember only being surrounded by masked, hatted, uniformed wardens who are

  18. 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…

  19. One aid or two?--more visits please!

    PubMed

    Vaughan-Jones, R H; Padgham, N D; Christmas, H E; Irwin, J; Doig, M A

    1993-04-01

    A prospective trial of hearing aid provision was undertaken to define factors which might be used to allow hearing aids to be fitted optimally. Patients referred for the provision of a hearing aid were studied prospectively at each of five visits when they were questioned by means of a proforma. Fifty-six patients completed the trial and gave adequate responses for analysis. No audiometric or symptomatic criteria were found to be of use in predicting the final choice of hearing aid combination. It may be that initial sequential monaural aiding leads to a higher uptake of binaural aids in the long term. Patients valued multiple visits to the clinic and sequential trials of monaural aiding, the majority felt that binaural aids should be tried.

  20. 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.

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

    PubMed Central

    Miller, Mollie E

    2015-01-01

    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. PMID:26391240

  2. How HIV Causes AIDS

    MedlinePlus

    ... Share this: Main Content Area How HIV Causes AIDS HIV destroys CD4 positive (CD4+) T cells, which ... and disease, ultimately resulting in the development of AIDS. Most people who are infected with HIV can ...

  3. AIDS Myths and Misunderstandings

    MedlinePlus

    ... 21, 2014 Select a Language: Fact Sheet 158 AIDS Myths and Misunderstandings WHY ARE THERE SO MANY ... support this belief. Myth: Current medications can cure AIDS. It’s no big deal if you get infected. ...

  4. 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 ...

  5. Students with AIDS.

    ERIC Educational Resources Information Center

    Broadwell, Cathy Allen; Strope, John L., Jr.

    1989-01-01

    Addresses the law as it pertains to Acquired Immune Deficiency Syndrome (AIDS) in public elementary and secondary schools. Section 504 of the Rehabilitation Act of 1973 has been used successfully in the majority of the AIDS cases discussed. (MLF)

  6. 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 ...

  7. Frostbite, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Frostbite, First Aid A A A Severe frostbite can result in ... became frozen). Frostbite is often associated with hypothermia. First Aid Guide In the case of mild frostbite, the ...

  8. Bruises, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Bruises, First Aid A A A Bruises lighten and change color ... Bruises can be a sign of internal bleeding. First Aid Guide If there is external bleeding in addition ...

  9. Tick Bites, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Tick Bites, First Aid A A A It is important to inspect ... temporary paralysis in their host (called tick paralysis). First Aid Guide To remove an embedded tick: Wash your ...

  10. First Aid: Influenza (Flu)

    MedlinePlus

    ... to Know About Zika & Pregnancy First Aid: The Flu KidsHealth > For Parents > First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

  11. Defining an emerging disease.

    PubMed

    Moutou, F; Pastoret, P-P

    2015-04-01

    Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future. PMID:26470448

  12. Defining an emerging disease.

    PubMed

    Moutou, F; Pastoret, P-P

    2015-04-01

    Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future.

  13. 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.

  14. Critical illness polyneuropathy: a case report.

    PubMed

    Celik, Canan; Ucan, Halil; Alemdaroglu, Ebru; Oktay, Fugen

    2011-01-01

    Critical illness polyneuropathy (CIP) is defined as a common complication of critically ilness patients who were admitted to the intensive care unit due to sepsis, multiple trauma and/or multi-organ failure. We aimed to present a patient who was diagnosed as CIP. He was admitted to our outpatient clinic due to weakness and pain in his lower extremities. He had been followed in an intensive care unit due to suicid five months ago. There were symmetrically and predominantly muscle weakness, sensory impairment, absence of deep tendon reflexes in his lower extremities. Electrophysiological evaluation demonstrated motor and sensory axonal distal polyneuropathy predominantly in lower extremities. At follow up, he had high fever, and elevated acute phase responses. Therefore source of infection was investigated and was suspected to a diagnosis of infective endocarditis. He was discharged to be hospitalized in cardiology clinic. With this case, we think that physiatrists should take into consideration a diagnosis of critical illness polyneuropathy in patients with symmetric motor weakness. In CIP, muscle weakness, sensory loss, neuropathic pain, and autonomic problems lengthened the rehabilitation period. Due to a diagnosis of infective endocarditis in our case, we point out that source of infection should be carefully investigated if there is acute phase responses in CIP patients even if during rehabilitation period.

  15. Rehabilitation of mentally ill women.

    PubMed

    Chatterjee, Rajni; Hashim, Uzma

    2015-07-01

    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

  16. 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

  17. Technology, Society, and Mental Illness

    PubMed Central

    SE Keefe, Richard

    2012-01-01

    Technology is rapidly changing society, and many activities now require the ability to use technology. This situation has the potential to lead to problems for several populations, including the elderly, the disadvantaged, and people with severe mental illness. In this column, we review the state of technology as it affects daily activities. We then review previous efforts to use technology positively for both the assessment and treatment of psychiatric conditions, including posttraumatic stress disorder and severe mental illness. We conclude that technology-based interventions and assessment strategies have the potential to deliver benefit to a wide array of older people and those with severe mental illness, including reaching people who would not have had access otherwise. PMID:23346519

  18. 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.

  19. 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…

  20. 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…

  1. "Helpful People in Touch" Consumer Led Self Help Programs for People with Multiple Disorders, Mental Illness, Drug Addiction, and Alcoholism (MIDAA).

    ERIC Educational Resources Information Center

    Sciacca, Kathleen

    This paper describes the consumer program, "Helpful People in Touch," a self-help treatment program for people with the multiple disorders of mental illness, drug addiction, and/or alcoholism. First, the terms, "Mentally Ill Chemical Abusers and Addicted" (MICAA) and "Chemical Abusing Mentally Ill" (CAMI) are defined and differentiated, with…

  2. 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. PMID:12293156

  3. Hearing-aid tester

    NASA Technical Reports Server (NTRS)

    Kessinger, R.; Polhemus, J. T.; Waring, J. G.

    1977-01-01

    Hearing aids are automatically checked by circuit that applies half-second test signal every thirty minutes. If hearing-aid output is distorted, too small, or if battery is too low, a warning lamp is activated. Test circuit is incorporated directly into hearing-aid package.

  4. HIV and AIDS

    MedlinePlus

    ... I Help a Friend Who Cuts? HIV and AIDS KidsHealth > For Teens > HIV and AIDS Print A A A Text Size What's in ... in human history. HIV causes a condition called acquired immunodeficiency syndrome — better known as AIDS . HIV destroys a type ...

  5. 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…

  6. AIDS Education Curriculum Guide.

    ERIC Educational Resources Information Center

    Horry County Board of Education, Conway, SC.

    This curriculum guide was developed, based on sound principles of human growth and development, to present the most recently available information on AIDS (Acquired Immune Deficiency Syndrome). The curriculum presents information on the known facts about AIDS and the AIDS virus infection. It also addresses the potential for adolescents and adults…

  7. First Aid: Rashes

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Rashes KidsHealth > For Parents > First Aid: Rashes Print A A A Text Size Rashes ... For Kids For Parents MORE ON THIS TOPIC First Aid: Skin Infections Poison Ivy Erythema Multiforme Hives (Urticaria) ...

  8. First Aid: Burns

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  9. First Aid: Croup

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Croup KidsHealth > For Parents > First Aid: Croup Print A A A Text Size Croup ... For Kids For Parents MORE ON THIS TOPIC First Aid: Coughing X-Ray Exam: Neck Why Is Hand ...

  10. First Aid: Falls

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A Text Size en ... Floors, Doors & Windows, Furniture, Stairways: Household Safety Checklist First Aid: Broken Bones Head Injuries Preventing Children's Sports Injuries ...

  11. First Aid: Choking

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Choking KidsHealth > For Parents > First Aid: Choking Print A A A Text Size Choking ... usually are taught as part of any basic first-aid course. Reviewed by: Steven Dowshen, MD Date reviewed: ...

  12. First Aid: Animal Bites

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Animal Bites KidsHealth > For Parents > First Aid: Animal Bites Print A A A Text Size ... For Kids For Parents MORE ON THIS TOPIC First Aid & Safety Center Infections That Pets Carry Dealing With ...

  13. 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)

  14. Patients' narratives of chronic illnesses and the notion of biographical disruption.

    PubMed

    Delbene, Roxana

    2011-01-01

    Bury's (1982) argument that the onset of a chronic illness represents a biographical disruption has become paradigmatic in the sociology of illness studies. More recently Bury (1991, 1997) himself Williams (2000) and other medical sociologists have argued that the notion of illness as biographical disruption needs re-examination. Following a phenomenological approach, in this paper the author draws on different narrative models (Labov and Waletzky 1967 and Ricoeur 1980) to analyze how patients orient to the onset of chronic illness as the complicating action. The data comprise eight narratives collected in South America: three correspond to patients with renal failure, and five to patients with HIV/AIDS disease. It is observed that in some cases, patients' complicating actions are rather oriented to experiences of poverty, drug addiction, and criminality that took place prior to their onset of their illnesses. These experiences, instead of the onset of their illnesses, occupy the place of the complicating action in these patients' narratives. The author discusses that in the studies of illness narratives, it is difficult to operate from a different paradigm, but argues that conflating the onset of chronic illness with a biographical disruption may confuse the episodic dimension of narrative with the configurational dimension.

  15. Caring for mentally ill people.

    PubMed Central

    van Os, J.; Neeleman, J.

    1994-01-01

    Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity in psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental illness show definite international differences. Everywhere, though, mental health care for patients with psychotic illnesses is a "cinderella service," and there is a general move towards care falling increasingly on the family and the community. PMID:7987157

  16. 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.

  17. 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.

  18. 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.

  19. Hypocaloric support in the critically ill.

    PubMed

    Patiño, J F; de Pimiento, S E; Vergara, A; Savino, P; Rodríguez, M; Escallón, J

    1999-06-01

    The critically ill patient exhibits a well defined endocrine and metabolic adaptive response to stressor agents, characterized by incremented resting energy expenditure (hypermetabolism, which is believed to signify increased energy requirements), accelerated whole-body proteolysis (hypercatabolism), and lipolysis. These phenomena occur in the acute stage, which is also characterized by hyperglycemia, typically accompanied by a hyperdynamic cardiovascular reaction manifested by high cardiac output, increased oxygen consumption, high body temperature, and decrease peripheral vascular resistance. High provisions of glucose-derived calories tend to accentuate these reactions and increase the degree of hyperglycemia. We have adopted a hypocaloric-hyperproteic regimen which is provided only during the first days of the flow phase of the adaptive response to injury, sepsis, or critical illness. Our regimen includes a daily supply of 100 to 200 g of glucose and 1.5 to 2.0 g of protein (synthetic amino acids) per kilogram of ideal body weight. We have analyzed the data on 107 critically ill patients, 70 men and 37 women, who were admitted to the surgical intensive care unit and who received nutritional support by the TPN hypocaloric modality for a minimum of 3 days. We found that the high caloric loads contained in TPN regimens results in additional metabolic stress, with consequent hyperdynamic cardiorespiratory repercussion, high CO2 production, and frequently hepatic steatosis. In contrast, our hypocaloric-hyperproteic approach has resulted in a more physiologic clinical course and considerable reduction in cost. The infusion of high glucose loads, such as those used in hypercaloric TPN, does not seem to suppress the excessive endogenous production of glucose but instead markedly exacerbates the hyperglycemia of the postinjury and acute stress condition. We believe that the hypocaloric-hyperproteic regimen we utilize during the first few days of the stress situation is

  20. Adjunctive therapy for decompression illness: a review and update.

    PubMed

    Moon, Richard E

    2009-06-01

    Therapeutic interventions may augment the outcome or provide temporizing support pending recompression. Effective measures include first aid (surface) oxygen therapy, fluid resuscitation, non-steroidal anti-inflammatory drugs and avoidance of fever. Lignocaine may also be effective, particularly for cerebral arterial gas embolism (CAGE). For critically ill patients with CAGE, animal studies do not support the use of hyperventilation. There is strong experimental evidence in animals for the efficacy of intravenous perfluorocarbon. When lower limb paralysis occurs, low molecular weight heparin is recommended to reduce the risk of venous thromboembolism.

  1. 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.

  2. 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.

  3. 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…

  4. Marriage, mental illness and law.

    PubMed

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

    2015-07-01

    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

  5. 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)

  6. Chinese Children's Explanations for Illness

    ERIC Educational Resources Information Center

    Zhu, Liqi; Liu, Guangyi; Tardif, Twila

    2009-01-01

    The study explored how Chinese children spontaneously explained the causes of illness. Two groups of 3-, 4-, and 5-year-old children from different socioeconomic status (SES) backgrounds were recruited, with 30 children in each age group. A group of 30 college students were also recruited and their responses compared to those produced by the…

  7. 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

  8. 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.

  9. 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, ...

  10. 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

  11. Life event, stress and illness.

    PubMed

    Salleh, Mohd Razali

    2008-10-01

    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.

  12. Oxidative stress in severe acute illness.

    PubMed

    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.

  13. Computer aided flexible envelope designs

    NASA Technical Reports Server (NTRS)

    Resch, R. D.

    1975-01-01

    Computer aided design methods are presented for the design and construction of strong, lightweight structures which require complex and precise geometric definition. The first, flexible structures, is a unique system of modeling folded plate structures and space frames. It is possible to continuously vary the geometry of a space frame to produce large, clear spans with curvature. The second method deals with developable surfaces, where both folding and bending are explored with the observed constraint of available building materials, and what minimal distortion result in maximum design capability. Alternative inexpensive fabrication techniques are being developed to achieve computer defined enclosures which are extremely lightweight and mathematically highly precise.

  14. '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.

  15. Defining and measuring outcomes in end-stage dementia.

    PubMed

    Teno, J M; Landrum, K; Lynn, J

    1997-01-01

    Dementia is a life-defining illness that impacts both patients and their loved ones. For dying patients with dementia, there are important and meaningful outcomes that reflect the quality of care. The authors propose 13 domains to examine the quality of care and make the argument that for these patients and their families, measures of satisfaction and patient or family reports of specific events may be the most important markers of the quality of care.

  16. AIDS care: why and how should industry respond?

    PubMed

    Smart, R

    2000-01-01

    This article reports the AIDS care response of industries to the rising AIDS epidemic in South Africa. It has been reported that during 1993-99 the rate of hospital bed occupancy doubled to over 8/1000 and that 50% of ill-health retirements in 1998 were due to AIDS. Important issues to be considered by industries are the medical separation due to ill health, poor health care services. The focus of HIV/AIDS care should be on the patient, family, care giver, community, and health services, and must be based on the principles of decentralization and integration of sustainable and cost-effective HIV/AIDS services. The development of a care package must be based on six dimensions; namely, appropriateness, acceptability, accessibility, effectiveness, efficiency, and equity. On the other hand, identification of indicators in relation to the components of the care package must include support groups and networks of people living with HIV; the provision of home-based care; responsiveness of the health system; the existence and application of clinical guidelines; and the effectiveness of referrals. Any organization with a commitment in providing care should establish a Care Task Team to develop a care strategy. It should focus on who can have access to the care, what the care consists of, and who will cover the cost. In addition, a review of the existing HIV/AIDS services must be done to identify shortfalls and highlight priority gaps. PMID:12322484

  17. AIDS care: why and how should industry respond?

    PubMed

    Smart, R

    2000-01-01

    This article reports the AIDS care response of industries to the rising AIDS epidemic in South Africa. It has been reported that during 1993-99 the rate of hospital bed occupancy doubled to over 8/1000 and that 50% of ill-health retirements in 1998 were due to AIDS. Important issues to be considered by industries are the medical separation due to ill health, poor health care services. The focus of HIV/AIDS care should be on the patient, family, care giver, community, and health services, and must be based on the principles of decentralization and integration of sustainable and cost-effective HIV/AIDS services. The development of a care package must be based on six dimensions; namely, appropriateness, acceptability, accessibility, effectiveness, efficiency, and equity. On the other hand, identification of indicators in relation to the components of the care package must include support groups and networks of people living with HIV; the provision of home-based care; responsiveness of the health system; the existence and application of clinical guidelines; and the effectiveness of referrals. Any organization with a commitment in providing care should establish a Care Task Team to develop a care strategy. It should focus on who can have access to the care, what the care consists of, and who will cover the cost. In addition, a review of the existing HIV/AIDS services must be done to identify shortfalls and highlight priority gaps.

  18. Dutch Universities' Joint Aid to Vietnam

    ERIC Educational Resources Information Center

    Higher Education and Research in the Netherlands, 1975

    1975-01-01

    A survey is presented of the joint aid in the reconstruction of North and South Vietnam provided by Dutch universities. The hospital project, solid matter physics project, micro-electronics project, agricultural project and dentistry project are defined. (Author/PG)

  19. 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…

  20. [Mikulicz disease as the beginning of AIDS].

    PubMed

    Guiral, H; Risco, J; Razquin, S; Pellicer, E; Figuerola, E; Mayayo, E; Añó, T

    1994-01-01

    Major salivary lymphoepithelial lesions accounted for less than 3 percent of all benign parotid tumors, prior to AIDS acquaintance. Defined as the presence of enlargement of one or more salivary glands and, in some cases, with diminished salivary function. The paper present the case of an acquired immunodeficiency syndrome starting as a Mikulicz's disease. Reviewed the medical literature and treatment options.

  1. 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.

  2. Health within illness: experiences of chronically ill/disabled people.

    PubMed

    Lindsey, E

    1996-09-01

    The concept of health within illness is beginning to gain recognition in nursing. However, there has been little research to explore and describe this phenomenon. The results of a recent study investigating the meaning of the experience of feeling healthy for people living with a chronic illness and/or disability are presented. An interpretive phenomenological study was undertaken with eight participants living with a variety of different chronic conditions. The results provide a rich mosaic of themes describing the participants' health experiences. These themes include: (a) honouring the self; (b) seeking and connecting with others; (c) creating opportunities; (d) celebrating life; (e) transcending the self; and (f) acquiring a state of grace. The significance of these results is that they provide for a reconceptualization of health and illness. Such a reconceptualization calls for a transformation in nursing care, from a problem focus and a deficit perspective, to one which focuses on the client's capacity and the promotion of health and healing. PMID:8876405

  3. 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.

  4. 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…

  5. [Mental illness and stigma or how to become mentally ill for life.].

    PubMed

    Massé, J C; T-Brault, M M

    1979-01-01

    In this article mental illness is presented in a sociological perspective, giving prominence to social-interaction factors which, in many cases, are responsable for the permanence of this type of illness. Its thereotical base comes !form the psychology of social-interaction developped by G.H. Mead and his disciples. This perspective defines the social human being as derived from successive interactions, beginning, at birth, with maternal contacts and extending progressively to the entirety of the members of the community of which the individual is a part. This interactional network is comprised of messages, of responses, and of expectations which make up the norms and values which in turn from the basis for the distribution of roles and statuses- From these roles and statuses derive the behaviours acceptable to a given collectivity. Among other theoretical developments, interactionist sociology gave birth to formulations on deviance which became known, in american terminology as "labelling theory". In the case of mental illness many sociologists interested in the phenomenon have studied it, using the framework elaborated by the proponents of this approach to deviance. Thus, rather than considering the deviant as abnormal in himself, deviance is viewed as a process; that is, as the result of a series of interactions confronting the individual who is not, or does not behave like the collectivity as a whole and the milieu in which he lives. When the reaction of the entourage is negative, the so-called deviant is subjected to sanctions such as avoidance, rejection, exclusion, confinement, etc... This process terminates generally in stigmatization which wraps the deviant in a label from which he will probably never free himself. The studies cited demonstrate this interactional process at different stages of mental illness, these being; d) at the point of medical diagnosis, b) during hospitalisation, c) on leaving We psychiatric institution, d) and after the return to

  6. 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.

  7. Helping a Child Manage a Chronic Illness

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_160011.html Helping a Child Manage a Chronic Illness Feeling they have control over their ... News) -- Children and teens who feel confident handling a chronic illness on their own appear better able ...

  8. Caring for a Seriously Ill Child

    MedlinePlus

    ... With Serious Illness When Your Child's in the Pediatric Intensive Care Unit Caring for Siblings of Seriously Ill Children Preparing Your Child for Surgery Managing Home Health Care Marriage Advice for Parents of Children ...

  9. 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

  10. Pediatric AIDS: psychosocial impact.

    PubMed

    Mangos, J A; Doran, T; Aranda-Naranjo, B; Rodriguez-Escobar, Y; Scott, A; Setzer, J R

    1990-06-01

    There is no question that the domain of the American family has been invaded by the HIV infection/AIDS epidemic. The disease, and particularly its form affecting children (pediatric AIDS), has had marked psychosocial impact on patients and families (intellectual/cognitive, emotional/behavioral, spiritual, and financial) and on our society in general (adverse or favorable). These impacts of pediatric AIDS are discussed in the present communication. PMID:2371699

  11. 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. PMID:23858262

  12. [Nutrition in the critically ill].

    PubMed

    Weimann, A; Andrä, J; Sablotzki, A

    2011-11-01

    The prognostic impact of inadequate energy and protein supply in malnourished intensive care patients has been recently reemphasized. Consent exists about the beneficial effects of early enteral nutrition in the critically ill. However, gastrointestinal intolerance of the critically ill may be a major problem for the feasibility of enteral nutrition bearing additional risks. In case adequate enteral nutrition cannot be realized, there is controversy about the appropriate time to start total parenteral or combined enteral / parenteral nutrition. Due to potential adverse effects immune-enhancing substrates have to be cautiously administered. For standardization implementation of a guideline based nutritional protocol is recommended. The review refers to the recent guidelines of the European Society for Clinical Nutrition and Metabolism (2009), the American Society for Parenteral and Enteral Nutrition (ASPEN) (2009) and the German Sepsis Society (DSG) (2010).

  13. 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

  14. Exoneration of the mentally ill.

    PubMed

    Fields, L

    1987-12-01

    Mental illness may be manifested in the impairment of understanding or of volitional control. Impairment of understanding may be manifested in delusions. Impairment of volitional control is shown when a person is unable to act in accordance with good reasons that he himself accepts. In order for an impairment of understanding or of self-control to exculpate, the offence must be causally connected with the impairment in question. The rationale of exculpation in general, which applies also to the case of mental illness, is that the offence does not indicate a morally bad attitude in the offender. A consequence of this rationale is that Kenny is wrong to hold that no injustice would result from the elimination of the legal defence of diminished responsibility.

  15. Darwin's illness: a final diagnosis.

    PubMed

    Orrego, Fernando; Quintana, Carlos

    2007-01-22

    We have re-examined many of the abundant publications on the illness that afflicted Charles Darwin during most of his life, including some of the 416 health-related letters in his correspondence, as well as his autobiographical writings. We have concluded that he suffered from Crohn's disease, located mainly in his upper small intestine. This explains his upper abdominal pain, his flatulence and vomiting, as well as his articular and neurological symptoms, his 'extreme fatigue', low fever and especially the chronic, relapsing course of his illness that evolved in bouts, did not affect his life expectancy and decreased with old age, and also the time of life at which it started. It apparently does not explain, however, many of his cutaneous symptoms. We do not support other diagnoses such as Chagas' disease, lactose intolerance or the many psychiatric conditions that have been postulated. PMID:17575947

  16. Darwin's illness: a final diagnosis.

    PubMed

    Orrego, Fernando; Quintana, Carlos

    2007-01-22

    We have re-examined many of the abundant publications on the illness that afflicted Charles Darwin during most of his life, including some of the 416 health-related letters in his correspondence, as well as his autobiographical writings. We have concluded that he suffered from Crohn's disease, located mainly in his upper small intestine. This explains his upper abdominal pain, his flatulence and vomiting, as well as his articular and neurological symptoms, his 'extreme fatigue', low fever and especially the chronic, relapsing course of his illness that evolved in bouts, did not affect his life expectancy and decreased with old age, and also the time of life at which it started. It apparently does not explain, however, many of his cutaneous symptoms. We do not support other diagnoses such as Chagas' disease, lactose intolerance or the many psychiatric conditions that have been postulated.

  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. 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. PMID:27312081

  19. Nutritional interventions in critical illness.

    PubMed

    Powell-Tuck, Jeremy

    2007-02-01

    The metabolism of critical illness is characterised by a combination of starvation and stress. There is increased production of cortisol, catecholamines, glucagon and growth hormone and increased insulin-like growth factor-binding protein-1. Phagocytic, epithelial and endothelial cells elaborate reactive oxygen and nitrogen species, chemokines, pro-inflammatory cytokines and lipid mediators, and antioxidant depletion ensues. There is hyperglycaemia, hyperinsulinaemia, hyperlactataemia, increased gluconeogenesis and decreased glycogen production. Insulin resistance, particularly in relation to the liver, is marked. The purpose of nutritional support is primarily to save life and secondarily to speed recovery by reducing neuropathy and maintaining muscle mass and function. There is debate about the optimal timing of nutritional support for the patient in the intensive care unit. It is generally agreed that the enteral route is preferable if possible, but the dangers of the parenteral route, a route of feeding that remains important in the context of critical illness, may have been over-emphasised. Control of hyperglycaemia is beneficial, and avoidance of overfeeding is emphasised. Growth hormone is harmful. The refeeding syndrome needs to be considered, although it has been little studied in the context of critical illness. Achieving energy balance may not be necessary in the early stages of critical illness, particularly in patients who are overweight or obese. Protein turnover is increased and N balance is often negative in the face of normal nutrient intake; optimal N intakes are the subject of some debate. Supplementation of particular amino acids able to support or regulate the immune response, such as glutamine, may have a role not only for their potential metabolic effect but also for their potential antioxidant role. Doubt remains in relation to arginine supplementation. High-dose mineral and vitamin antioxidant therapy may have a place. PMID:17343768

  20. 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

  1. Probiotics in critically ill children.

    PubMed

    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

  2. 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

  3. HIV / AIDS Network.

    PubMed

    1995-01-01

    The HIV/AIDS Network and the Philippines Department of Health (DOH) collaborated to produce the AIDS Candlelight Memorial at the Philippine International Convention Center (PICC), May 1995, and World AIDS Day activities on December 1, 1995. After the memorial, a fashion show, "Body Shots," provided a channel for information on acquired immunodeficiency syndrome (AIDS). On World AIDS Day, at the request of DOH, the Network provided speakers who lectured on human immunodeficiency virus (HIV) and AIDS in different government offices. Prior to World AIDS Day, the Network focused on strengthening its cohesiveness and building the capabilities of its member organizations through lectures and symposia during November. Network activities were coordinated by the Remedios AIDS Foundation with support from the other members of the Coordinating Council: Health Action Information Network (HAIN); Caritas; Kabalikat, Stop Trafficking of Pilopinos Foundation, Inc. (STOP);and the Library Foundation (TLF). The Coordinating Council elected for 1996 includes the Remedios AIDS Foundation, HAIN, Caritas, TLF, STOP, the Foundation for Adolescent Development (FAD), and the Salvation Army. PMID:12291699

  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. AIDS and civil disobedience.

    PubMed

    Spiers, H R

    1989-01-01

    Members of groups such as ACT UP (AIDS Coalition to Unleash Power) risk arrest and criminal charges to protest laws and policies they view as unjust to persons with AIDS. Spiers, a founding member of ACT UP, discusses the rationale behind the tactics of civil disobedience employed by AIDS activists. He argues that civil disobedience is justified by American political and legal traditions, and by the federal government's lack of response to the needs of its citizens. Spiers warns that while AIDS protests have been nonviolent and characterized by conscientious planning and execution, violence cannot be ruled out as a "political act born of desperation."

  6. Music and hearing aids.

    PubMed

    Madsen, Sara M K; 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

  7. Sperm retrieval during critical illness.

    PubMed

    Powner, David J; Rumohr, Jon A; Lipshultz, Larry I

    2010-06-01

    Objective of this study is to review technical methods to retrieve sperm from critically ill/injured patients after an appropriate family request, possible harmful effects on sperm production/function by ICU medications or concurrent illnesses, and ethical considerations for hospitals and care providers in providing this resource. Design used for this study includes: literature review, PubMed 1998-2009, and authors' files. There are no interventions. In conclusion, although successful and unsuccessful pregnancies following sperm removal from critically-ill patients are reported, no firm probability predictions for either result are known. Acute and chronic diseases that effect the hypothalamic-pituitary-gonadal axis and multiple medications common to the ICU may reduce sperm production or function. Retrieval methods before and after cardio-respiratory death differ and often require intracytoplasmic sperm injection or other in vitro fertilization techniques to achieve a subsequent pregnancy. The proactive development of a collaborative policy/procedure to identify appropriate roles for the hospital, its employees, and affiliated critical care and urology physicians is strongly recommended.

  8. Meditation's impact on chronic illness.

    PubMed

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.

  9. Fluid therapy in critical illness

    PubMed Central

    2014-01-01

    Major surgery and critical illnesses such as sepsis and trauma all disturb normal physiological fluid handling. Intravenous fluid therapy for resuscitation and fluid maintenance is a central part of medical care during these conditions, yet the evidence base supporting practice in this area lacks answers to a number of important questions. Recent research developments include a refinement of our knowledge of the endothelial barrier structure and function and a focus on the potential harm that may be associated with intravenous fluid therapy. Here, we briefly describe the contemporary view of fluid physiology and how this may be disrupted by pathological processes. The important themes in critical illness fluid research are discussed, with a particular focus on two emerging ideas: firstly, that individualising fluid treatment to the patient, their underlying disease state and the phase of that illness may be key to improving clinical outcomes using fluid interventions and, secondly, that fluids should be considered to be drugs, with specific indications and contraindications, dose ranges and potential toxicities. PMID:25276346

  10. Epigenetic Basis of Mental Illness.

    PubMed

    Nestler, Eric J; Peña, Catherine J; Kundakovic, Marija; Mitchell, Amanda; Akbarian, Schahram

    2016-10-01

    Psychiatric disorders are complex multifactorial illnesses involving chronic alterations in neural circuit structure and function as well as likely abnormalities in glial cells. While genetic factors are important in the etiology of most mental disorders, the relatively high rates of discordance among identical twins, particularly for depression and other stress-related syndromes, clearly indicate the importance of additional mechanisms. Environmental factors such as stress are known to play a role in the onset of these illnesses. Exposure to such environmental insults induces stable changes in gene expression, neural circuit function, and ultimately behavior, and these maladaptations appear distinct between developmental versus adult exposures. Increasing evidence indicates that these sustained abnormalities are maintained by epigenetic modifications in specific brain regions. Indeed, transcriptional dysregulation and the aberrant epigenetic regulation that underlies this dysregulation is a unifying theme in psychiatric disorders. Here, we provide a progress report of epigenetic studies of the three major psychiatric syndromes, depression, schizophrenia, and bipolar disorder. We review the literature derived from animal models of these disorders as well as from studies of postmortem brain tissue from human patients. While epigenetic studies of mental illness remain at early stages, understanding how environmental factors recruit the epigenetic machinery within specific brain regions to cause lasting changes in disease susceptibility and pathophysiology is revealing new insight into the etiology and treatment of these conditions. PMID:26450593

  11. 42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data... immediate past use of medications that could mask symptoms or mimic mental illness. (3) A psychosocial... 42 Public Health 5 2010-10-01 2010-10-01 false Evaluating whether an individual with...

  12. 42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data... immediate past use of medications that could mask symptoms or mimic mental illness. (3) A psychosocial... 42 Public Health 5 2011-10-01 2011-10-01 false Evaluating whether an individual with...

  13. 42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data... immediate past use of medications that could mask symptoms or mimic mental illness. (3) A psychosocial... 42 Public Health 5 2012-10-01 2012-10-01 false Evaluating whether an individual with...

  14. 42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data... immediate past use of medications that could mask symptoms or mimic mental illness. (3) A psychosocial... 42 Public Health 5 2014-10-01 2014-10-01 false Evaluating whether an individual with...

  15. 42 CFR 483.134 - Evaluating whether an individual with mental illness requires specialized services (PASARR/MI).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... this part, needs a specialized services program for mental illness as defined in § 483.120. (b) Data... immediate past use of medications that could mask symptoms or mimic mental illness. (3) A psychosocial... 42 Public Health 5 2013-10-01 2013-10-01 false Evaluating whether an individual with...

  16. Illness Behavior and Social Competence in Adolescents.

    ERIC Educational Resources Information Center

    Walker, Lynn S.; Van Slyke, Deborah A.

    This study examined the relationship of illness behavior to perceived competence and gender in adolescents. It was hypothesized that, like adults, adolescents with lower levels of perceived social competence would report more illness behavior. A significant gender difference was expected such that girls would report more illness behavior than…

  17. ILL: Sacred Cow or Vital Service?

    ERIC Educational Resources Information Center

    Amdursky, Saul J.; Hulsey, Richard; Brandau, Christie Pearson

    2003-01-01

    Includes three articles that debate whether interlibrary loan (ILL) is the best way to get public library patrons what they need. Highlights include return on investment; funding; alternatives to ILL, including purchase on demand and online full-text databases; cost effectiveness; and the advantages of patron-initiated ILL through interconnected…

  18. Loan Stars: ILL Comes of Age.

    ERIC Educational Resources Information Center

    Jackson, Mary E.

    1998-01-01

    Assesses the changes in interlibrary loan (ILL) practices, and points the way to an ideal future. Discusses patron-initiated document request systems; library-mediated ordering systems; document delivery suppliers; accessing electronic resources; ILL management software; paying ILL invoices; new electronic delivery options; and results of a…

  19. HIV/AIDS

    MedlinePlus

    HIV infection; Infection - HIV; Human immunodeficiency virus; Acquired immune deficiency syndrome ... Symptoms related to acute HIV infection (when a person is first infected) can be similar to the flu or other viral illnesses. They include: Fever and ...

  20. African women and AIDS: negotiating behavioral change.

    PubMed

    Ulin, P R

    1992-01-01

    Trends in the incidence of HIV/AIDS infection among women in Sub-Saharan Africa suggest this population is increasingly at risk. Many of the same factors that have predisposed rural African women to ill health in the past now increase their vulnerability to AIDS, including poverty and malnutrition, uncontrolled fertility, and complications of childbirth. As men travel out from rural communities to urban centers in search of employment, their sexual contacts multiply; many will acquire the HIV virus and carry it back to infect wives at home. Women, too, are leaving rural areas for the promise of a better life in cities and commercial centers along the way. Their struggle for economic survival and personal autonomy has led many to form relationships with new sexual partners, with a consequent increase in HIV seroprevalence among women once considered at low risk of infection. This paper argues that AIDS prevention campaigns have not yet taken into account the cultural, social, and economic constraints on most African women's ability to comply with advice to limit partners and use condoms. The author proposes a research agenda to explore the meaning of AIDS and AIDS prevention in the sociocultural context of women's lives. A better understanding of how women, themselves, perceive and respond to current attempts to prevent the transmission of AIDS is an increasingly critical factor in the intervention process. Most important, it is a necessary first step toward their effective participation with men in the development of culturally relevant strategies for protecting themselves and their families. PMID:1738858

  1. Defining dignity in terminally ill cancer patients: a factor-analytic approach.

    PubMed

    Hack, Thomas F; Chochinov, Harvey Max; Hassard, Thomas; Kristjanson, Linda J; McClement, Susan; Harlos, Mike

    2004-10-01

    The construct of 'dignity' is frequently raised in discussions about quality end of life care for terminal cancer patients, and is invoked by parties on both sides of the euthanasia debate. Lacking in this general debate has been an empirical explication of 'dignity' from the viewpoint of cancer patients themselves. The purpose of the present study was to use factor-analytic and regression methods to analyze dignity data gathered from 213 cancer patients having less than 6 months to live. Patients rated their sense of dignity, and completed measures of symptom distress and psychological well-being. The results showed that although the majority of patients had an intact sense of dignity, there were 99 (46%) patients who reported at least some, or occasional loss of dignity, and 16 (7.5%) patients who indicated that loss of dignity was a significant problem. The exploratory factor analysis yielded six primary factors: (1) Pain; (2) Intimate Dependency; (3) Hopelessness/Depression; (4) Informal Support Network; (5) Formal Support Network; and (6) Quality of Life. Subsequent regression analyses of modifiable factors produced a final two-factor (Hopelessness/Depression and Intimate Dependency) model of statistical significance. These results provide empirical support for the dignity model, and suggest that the provision of end of life care should include methods for treating depression, fostering hope, and facilitating functional independence.

  2. 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…

  3. 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.

  4. 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…

  5. 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

    2001-05-01

    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.

  6. The effects of indoor environmental factors on respiratory illness in primary school children in Kuala Lumpur.

    PubMed

    Azizi, B H; Henry, R L

    1991-03-01

    The effects of indoor environmental factors on respiratory illness were studied in 15017-12 year old school children in Kuala Lumpur. Exposure to mosquito coil smoke for at least three nights a week was independently associated with asthma and persistent wheeze. Passive smoking, defined as sharing a bedroom with an adult smoker, was independently associated with a chest illness in the past year. No relationships were found between exposure to kerosene stoves, wood stoves, fumigation mat mosquito repellents or aerosol insecticides and respiratory illness. Host factors predictive of at least one respiratory outcome included family history of chest illness, history of allergy, male sex, hospitalization in the neonatal period and low paternal education. With 95% confidence, avoidance of regular exposure to mosquito coil smoke and passive smoking could reduce the prevalences of persistent wheeze, asthma and chest illness by up to 29%. Measurements of lung function confirmed the validity of questions pertaining to wheezing and asthma in the study questionnaire.

  7. 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

  8. 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. PMID:26929669

  9. 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…

  10. 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. PMID:12577655

  11. Global prevention, funding, accountability debated in fight against HIV / AIDS.

    PubMed

    1999-10-18

    World leaders, physicians, economists, governmental health organizations, and pharmaceutical manufacturers attended the Third International Conference on Healthcare Resource Allocation for HIV/AIDS and Other Life-threatening Illnesses in Vienna, Austria. The conference participants discussed the economic, ethical, and human rights issues underlying health care resource allocation. Some highlights of the meeting included: the prevention strategies in fighting AIDS virus; the use of high medical ethical standards; the affordability and accessibility of essential therapies; the economic aspects affecting the medical assistance mechanisms; the need to improve the pharmaceutical industry; the need to improve HIV/AIDS care access in developing countries; promoting the development of HIV/AIDS vaccines; and developing rapid diagnosis of HIV.

  12. 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.

  13. 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,…

  14. [Epidemiology of AIDS].

    PubMed

    1988-02-01

    The World Health Organization (WHO) estimates that some 300,000 AIDS cases will be diagnosed by the end of 1988. As of December 1987, 128 countries had reported a total of 72,000 cases, about half the number of cases that actually occurred. The WHO estimates that some 5-10 million persons are already infected with HIV, so that the number of AIDS cases will increase rapidly for the next 5 years at least. The number of cases reported in Africa increased considerably in 1987, reflecting greater awareness of AIDS and greater efforts at control. By late 1987 WHO was working actively with over 100 countries to combat AIDS. An expert meeting organized by the WHO Special Program to Combat AIDS recommended to governments and prison administrators that condoms be provided to inmates and that treatment programs be provided for intravenous drug addicts. Prison personnel should receive education about HIV infection and AIDS. Incarceration policies, especially for drug addicts, should be reviewed in light of the AIDS epidemic. An estimated average of 10% of the 270,000 prisoners enumerated in 17 European countries are believed to be HIV positive, but the proportion increases to 26% in the highest risk countries. The proportion of seropositive subjects in general exceeds that in the total population. Prison and health officials will be obliged to assign increasing resources to AIDS in prisons in the years to come. PMID:3201571

  15. What about AIDS?

    ERIC Educational Resources Information Center

    Dreyfuss, Katharine R.

    1987-01-01

    Discusses the nature of Acquired Immune Deficiency Syndrome (AIDS). Suggests ways in which camp directors can establish procedures for making appropriate decisions about accepting campers/staff workers with AIDS. Reviews aspects of environmental sanitation, physical health, confidentiality, camper/staff drug use and sexual behavior, medical…

  16. 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)

  17. Teachers with AIDS.

    ERIC Educational Resources Information Center

    Strope, John L., Jr.

    1988-01-01

    Discusses the application of Section 504 of the Rehabilitation Act of 1973 as a legal theory available to an employee of a public school system who faces isolation, transfer, suspension, or termination because of Acquired Immune Deficiency Syndrome (AIDS). Addresses AIDS in the workplace and the law. (MLF)

  18. 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].

  19. 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…

  20. 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…

  1. 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.

  2. AIDS: an economic perspective.

    PubMed

    Squire, L

    1998-08-01

    Each country currently experiencing an AIDS epidemic did not believe that the epidemics would develop, but they did and more than 6 million people have since died. However, if the governments of the approximately 2.3 billion people who live in developing countries where HIV/AIDS has not yet spread to the general population, together with the international community and nongovernmental organizations, act promptly, many lives will be saved. The World Bank publication "Confronting AIDS: Public Priorities in a Global Epidemic" brings, for the first time, an economic perspective to the problem of AIDS. The author considers how developing country governments should respond to the AIDS epidemic when they also face so many other major and pressing problems related to raising more than 1 billion people out of severe poverty. While AIDS is an important problem which must be immediately addressed, using resources to help people with AIDS will come at the expense of other objectives such as sending children to school, providing safe drinking water, and building infrastructure. The serious nature of the HIV/AIDS epidemic and what governments should do are considered. PMID:12294026

  3. 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…

  4. 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,…

  5. Community responses to AIDS.

    PubMed

    Anderson, S

    1994-01-01

    Some examples of care in the community for people with HIV/AIDS are reported from Africa. Members of communities committed to fighting the AIDS epidemic cannot do so alone and should be given every possible help. Inadequate care favours the spread of HIV, as does the stigmatization of people with HIV infection and their families.

  6. 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…

  7. AIDS -- a modern hydra.

    PubMed

    Chen, D W

    1988-10-01

    So far, AIDS has not been a major problem in Taiwan. Only 79 people have tested HIV-seropositive, and only 6 have been stricken by the disease. The government has allocated money for AIDS research; blood screening is mandatory in all hospitals; confidential AIDS testing is widely available; and doctors are advised to administer azidothymidine to anyone who tests positive. Azidothymidine is not a cure, but it can prevent the virus from destroying more cells. Nevertheless, a climate of irrational fear of and ignorance about AIDS pervades Taiwan. Many people believe that AIDS can be transmitted by casual contact, and people who are HIV-seropositive are treated as social outcasts. One student at the University of Taipei, only a few credits from graduation, has been refused readmission to the university because he tested HIV-positive. Sex education in the schools is not a good route for AIDS education because sex and especially homosexuality are simply not mentioned in public in Taiwan. Activists, including gay-rights representative, Chi Chia-Wei, have turned to the mass media, especially television as a vehicle for AIDS education, and several programs on AIDS have been shown since 1986.

  8. Symptomatic Illness and Low CD4 Cell Count at HIV Seroconversion as Markers of Severe Primary HIV Infection

    PubMed Central

    Lodi, Sara; Fisher, Martin; Phillips, Andrew; De Luca, Andrea; Ghosn, Jade; Malyuta, Ruslan; Zangerle, Robert; Moreno, Santiago; Vanhems, Philippe; Boufassa, Faroudy; Guiguet, Marguerite; Porter, Kholoud

    2013-01-01

    Background The risk/benefit of initiating ART in primary HIV infection (PHI) is unclear. The benefits are more likely to outweigh the risks in patients with severe PHI. An accepted definition of severe PHI is, however, lacking. Methods CASCADE patients with HIV test interval <6 months were classified as severe and non-severe PHI based on whether the following traits were recorded in the first 6 months following seroconversion: severe specific pre-defined symptoms, central nervous system-implicated illness, and ≥1, ≥2 CD4<350 (and <500) cells/mm3. For each definition, we used Kaplan-Meier curves and Cox survival models to compare time to AIDS/death, censoring at the earlier of last clinic visit or 1/1/1997, when combination antiretroviral therapy (cART) became available. Results Among 1108 included patients mostly males (85%) infected through sex between men (71%), 366 were diagnosed with AIDS/died. The risk of AIDS/death was significantly higher for individuals with severe symptoms, those with ≥1 CD4<350 cells/mm3 or ≥2 CD4 <500 cells/mm3 in the first 6 months [aHR (95% confidence interval) 2.1 (1.4,3.2), 2.0 (1.5,2.7), and 2.3, (1.5–3.5) respectively]. Median [interquantile range] survival for patients with ≥2, ≥1 and no CD4<350 cells/mm3 within 6 months of seroconversion was 3.9 [2.7,6.5], 5.4 [4.5,8.4] and 8.1 [4.3,10.3] years, respectively. The diagnosis of CNS-implicated symptoms was rare and did not appear to be prognostic. Conclusion One CD4 count <350 or two <500 cells/mm3 within 6 months of seroconversion and/or severe illness in PHI may be useful early indicators of individuals at high risk of disease progression. PMID:24244330

  9. 33 CFR 149.560 - How must buoys used to define traffic lanes be marked and lighted?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false How must buoys used to define... EQUIPMENT Aids to Navigation Lights on Buoys Used to Define Traffic Lanes § 149.560 How must buoys used to define traffic lanes be marked and lighted? (a) Each buoy that is used to define the lateral...

  10. 33 CFR 149.560 - How must buoys used to define traffic lanes be marked and lighted?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false How must buoys used to define... EQUIPMENT Aids to Navigation Lights on Buoys Used to Define Traffic Lanes § 149.560 How must buoys used to define traffic lanes be marked and lighted? (a) Each buoy that is used to define the lateral...

  11. 33 CFR 149.560 - How must buoys used to define traffic lanes be marked and lighted?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false How must buoys used to define... EQUIPMENT Aids to Navigation Lights on Buoys Used to Define Traffic Lanes § 149.560 How must buoys used to define traffic lanes be marked and lighted? (a) Each buoy that is used to define the lateral...

  12. Childhood AIDS nephropathy: a 10-year experience.

    PubMed Central

    Rajpoot, D.; Kaupke, C. J.; Vaziri, N. D.; Rao, T. K.; Pomrantz, A.; Fikrig, S.

    1996-01-01

    The objective of this study was to define the demographic, immunologic, and clinical characteristics of children with acquired immunodeficiency syndrome (AIDS) and AIDS nephropathy, and contrast this with the existing adult data. Data from 62 pediatric patients with AIDS who were treated at SUNY Health Science Center, Brooklyn, New York, between 1983 and 1993 were analyzed. Human immunodeficiency virus (HIV) infection was acquired during the neonatal period by vertical transmission (n = 60) or blood transfusion (n = 2). All children with AIDS who exhibited clinical nephropathy died (n = 16), with mean survival of 55.3 months. In contrast, 32 of 56 AIDS patients (70%) who did not manifest nephropathy were alive at the end of the study period. Patients with nephropathy were noted to have significantly lower CD4+ lymphocyte counts than those without nephropathy. These observations suggest that the predominant renal lesion in pediatric patients who acquired HIV infection during the perinatal period is focal segmental glomerulosclerosis, although a variety of other histological lesions were present. As in adults, the survival in children is dismal following the onset of clinical renal disease. In contrast to the adult population in whom multiple risk factors can potentially contribute to AIDS-associated nephropathy, occurrence of nephropathy in children with vertical HIV transmission provides convincing evidence for the pathogenetic role of HIV infection. PMID:8803430

  13. 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.

  14. Aspects of spirituality concerning illness.

    PubMed

    van Leeuwen, René; Tiesinga, Lucas J; Jochemsen, Henk; Jochemasen, Henk; Post, Doeke

    2007-12-01

    The spiritual dimension of illness, health and care may be seen as a unique aspect in addition to the physical, mental and social dimension. This contribution describes experiences of patients, nurses and hospital chaplains in relation to the spiritual aspects of being ill. Qualitative research was performed with the design of a focus group study, consisting of 13 focus groups with a total of 67 participants. A purposive sample was used comprising patients, nurses and hospital chaplains working in oncology, cardiology and neurology in different institutions and regions in the Netherlands. The qualitative analysis consisted of open coding and the determining of topics, followed by the subsequent attachment of substantial dimensions and characteristic fragments. Data were analysed by using the computer program KWALITAN. Spirituality play various roles in patients lives during their illness. There is a wide range of topics that may have an individual effect on patients. Despite differences in emphasis, the topics play a role in different patient categories. Although the spiritual topics seem to manifest themselves more clearly in long-term care relationships, they may also play a role during brief admittance periods (such as treatment decisions). The spiritual topics that arise from this study offer caregivers a framework for signalling the spiritual needs of patients. The question is not whether spirituality is a relevant focus area in care, but how and to what degree it plays a role with individual patients. Follow up research should aim at further exploration of spiritual aspects in care, the relationship between spirituality and health and at effective training of caregivers.

  15. Defined Syllabuses in Modern Languages

    ERIC Educational Resources Information Center

    Harding, Ann; Honnor, Sylvia

    1974-01-01

    The advantages of a defined syllabus in second language teaching, especially in relation to public examinations, are discussed. The origin and development of the York defined syllabuses are described, and extracts are given from the introductory document and the French and Russian syllabuses. (RM)

  16. 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 F.…

  17. 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

  18. [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.

  19. [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. PMID:20927146

  20. 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

  1. Treatment of Tobacco Use Disorders in Smokers with Serious Mental Illness: Toward Clinical Best Practices

    PubMed Central

    Evins, A. Eden; Cather, Corinne; Laffer, Alexandra

    2015-01-01

    Addiction to tobacco-derived nicotine remains highly prevalent in the US, with 18% using daily, but 53% of those with serious mental illness smoke regularly. While smokers with serious mental illness have been excluded from most large nicotine dependence treatment studies, a growing evidence base is emerging to guide clinicians in how to assist their patients with psychiatric illness to quit smoking. The aim of this review is to present the evidence on safety and efficacy of smoking cessation interventions for those with serious mental illness. Smokers with schizophrenia spectrum disorders should receive varenicline or bupropion with or without nicotine replacement therapy (NRT) in combination with behavioral treatment. Preliminary evidence suggests that varenicline in combination with behavioral support is efficacious and well tolerated for smoking cessation for those with bipolar disorder and major depressive disorder. More work is needed to establish treatment guidelines for smokers with major depressive disorder and bipolar disorder. Controlled trials to date have not found evidence for worsening of psychiatric symptoms or increased rate of psychiatric adverse events in this population with available pharmacotherapeutic cessation aids. Converging evidence indicates that a majority of smokers with serious mental illness want to quit smoking and that available pharmacotherapeutic cessation aids combined with behavioral support are both effective for and well tolerated by these smokers. Most people with serious mental illness see their psychiatrist more regularly than their primary care physician, and many receive care exclusively in a psychiatric treatment setting. Psychiatrists thus have an important role to play in the recognition and treatment of tobacco use disorders in people with serious mental illness. PMID:25747922

  2. Ascertainment and Verification of End-Stage Renal Disease and End-Stage Liver Disease in the North American AIDS Cohort Collaboration on Research and Design

    PubMed Central

    Kitahata, Mari M.; Drozd, Daniel R.; Crane, Heidi M.; Van Rompaey, Stephen E.; Althoff, Keri N.; Gange, Stephen J.; Klein, Marina B.; Lucas, Gregory M.; Abraham, Alison G.; Lo Re, Vincent; McReynolds, Justin; Lober, William B.; Mendes, Adell; Modur, Sharada P.; Jing, Yuezhou; Morton, Elizabeth J.; Griffith, Margaret A.; Freeman, Aimee M.; Moore, Richard D.

    2015-01-01

    The burden of HIV disease has shifted from traditional AIDS-defining illnesses to serious non-AIDS-defining comorbid conditions. Research aimed at improving HIV-related comorbid disease outcomes requires well-defined, verified clinical endpoints. We developed methods to ascertain and verify end-stage renal disease (ESRD) and end-stage liver disease (ESLD) and validated screening algorithms within the largest HIV cohort collaboration in North America (NA-ACCORD). Individuals who screened positive among all participants in twelve cohorts enrolled between January 1996 and December 2009 underwent medical record review to verify incident ESRD or ESLD using standardized protocols. We randomly sampled 6% of contributing cohorts to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ESLD and ESRD screening algorithms in a validation subcohort. Among 43,433 patients screened for ESRD, 822 screened positive of which 620 met clinical criteria for ESRD. The algorithm had 100% sensitivity, 99% specificity, 82% PPV, and 100% NPV for ESRD. Among 41,463 patients screened for ESLD, 2,024 screened positive of which 645 met diagnostic criteria for ESLD. The algorithm had 100% sensitivity, 95% specificity, 27% PPV, and 100% NPV for ESLD. Our methods proved robust for ascertainment of ESRD and ESLD in persons infected with HIV. PMID:25789171

  3. 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. PMID:12349153

  4. 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

  5. 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.

  6. 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.

  7. AIDS Training in the Workplace.

    ERIC Educational Resources Information Center

    Vest, Jusanne M.; And Others

    1991-01-01

    Management training regarding Acquired Immune Deficiency Syndrome (AIDS) begins with three needs assessment tools--instruments measuring fear of AIDS, knowledge of AIDS, and beliefs about the business consequences of the disease. (SK)

  8. 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, ...

  9. 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. ...

  10. 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 ...

  11. AIDS in Malaysia.

    PubMed

    Singh, J; Che'Rus, S; Chong, S; Chong, Y K; Crofts, N

    1994-01-01

    The first people to be infected with HIV in Malaysia were mainly homosexual men with foreign connections. IV drug users, however, rapidly became the population group with the highest prevalence of HIV. Accurate, timely data are needed in order to responsibly describe the pattern of HIV infection and AIDS in any given setting. In Malaysia, however, there has been little systematic surveillance in population groups other than blood donors. This surveillance indicates the existence of a rapidly increasing rate of seropositivity among blood donors. Otherwise, many people are loathe to undergo voluntary HIV testing to determine their serostatus. Moreover, some people with STDs avoid contact with the health system and the potential for HIV testing. The extent to which AIDS cases are underreported or reported late is unknown. On the other hand, an estimated 10% of notified AIDS cases have been wrongly classified as such. The lack of hard data on HIV/AIDS in Malaysia makes it difficult to project the future course of the epidemic in the country. Since Malaysia shares a land border with Thailand and there is much sea-borne traffic between the two countries, it is highly possible that Malaysia will experience a significant epidemic of HIV infection similar to its neighbors. A National AIDS Committee was established April 1985 to develop responses to the HIV epidemic, while the National AIDS Program Manager of the Ministry of Health is responsible for controlling STDs. A national plan of action for the prevention and control of AIDS, drawn up in 1985 and revised in 1988, includes planning for the continued surveillance of HIV infection and AIDS through existing notification systems, and for screening and sentinel programs for IV drug users, prostitutes, and STD patients. Recent nongovernmental organization responses complement government efforts to prevent HIV and AIDS in Malaysia. PMID:7857575

  12. Latina women and AIDS.

    PubMed

    Worth, D; Rodriguez, R

    1987-01-01

    The incidence of AIDS in Latina women is over 11 times that of white women. Women account for 13% of all Latino AIDS deaths since 1980. This examination of the impact of AIDS on Latino women concentrates on Manhattan's Lower East Side. The AIDS deaths among Puerto Rican women in this neighborhood are predominantly intravenous drug abuse related. Latina women accounted for more than 1/2 of all female AIDS deaths on the Lower East Side during the 1980-1985 period. The age range is parallel with that in the rest of New York City, with the exception of a higher number of deaths on the Lower East Side in the age ranges of 15-19 and over 40. Serious obstacles exist to providing AIDS risk reduction information to Puerto Rican women and their partners. Latinos account for 11% of all US AIDS cases among gay and bisexual men. The cultural proscription against these sexual practices in the Puerto Rican community makes AIDS education related to such practices extremely difficult. Many of the female sex partners of these men are unaware of their bisexuality, and, therefore not aware that they are at risk of HIV infection. The Latina women most at risk are young, poor, and have low educational levels. Latina women seriously underutilize ongoing primary health care, family planning, prenatal or pediatric care. Attempts to reach Latina women with AIDS risk reduction education must also contend with issues such as cultural gender roles. Females tend to be dependent on males and defer to male decision making related to sexual practices. In formulating policy regarding services and education, it is essential to involve the leadership of the Latino community. PMID:12268416

  13. 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. PMID:26399492

  14. Does Major Illness Cause Financial Catastrophe?

    PubMed Central

    Cook, Keziah; Dranove, David; Sfekas, Andrew

    2010-01-01

    Objective We examine the financial impact of major illnesses on the near-elderly and how this impact is affected by health insurance. Data Sources We use RAND Corporation extracts from the Health and Retirement Study from 1992 to 2006.1 Study Design Our dependent variable is the change in household assets, excluding the value of the primary home. We use triple difference median regressions on a sample of newly ill/uninsured near elderly (under age 65) matched to newly ill/insured near elderly. We also include a matched control group of households whose members are not ill. Results Controlling for the effects of insurance status and illness, we find that the median household with a newly ill, uninsured individual suffers a statistically significant decline in household assets of between 30 and 50 percent relative to households with matched insured individuals. Newly ill, insured individuals do not experience a decline in wealth. Conclusions Newly ill/uninsured households appear to be one illness away from financial catastrophe. Newly ill insured households who are matched to uninsured households appear to be protected against financial loss, at least in the near term. PMID:19840132

  15. 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.

  16. 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

  17. 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

  18. 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. PMID:27652231

  19. Gulf War Illness: Challenges Persist

    PubMed Central

    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. PMID:26330683

  20. An interpretation and solution of ill-conditioned linear equations

    NASA Technical Reports Server (NTRS)

    Ojalvo, I. U.; Ting, T.

    1989-01-01

    Data insufficiency, poorly conditioned matrices and singularities in equations occur regularly in complex optimization, correlation, and interdisciplinary model studies. This work concerns itself with two methods of obtaining certain physically realistic solutions to ill-conditioned or singular algebraic systems of linear equations arising from such studies. Two efficient computational solution procedures that generally lead to locally unique solutions are presented when there is insufficient data to completely define the model, or a least-squares error formulation of this system results in an ill-conditioned system of equations. If it is assumed that a reasonable estimate of the uncertain data is available in both cases cited above, then we shall show how to obtain realistic solutions efficiently, in spite of the insufficiency of independent data. The proposed methods of solution are more efficient than singular-value decomposition for dealing with such systems, since they do not require solutions for all the non-zero eigenvalues of the coefficient matrix.

  1. 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.

  2. AIDS and public health.

    PubMed

    Moskop, J C

    1988-01-01

    After briefly stating the significance of acquired immunodeficiency syndrome (AIDS) for public health, this paper considers programs or proposals to control the spread of AIDS in the following eight general areas: (a) education; (b) distribution of sterile needles; (c) screening and treatment of blood, blood products, and other tissues; (d) voluntary and mandatory screening of persons for evidence of infection; (e) reporting; (f) contact tracing; (g) isolation and other restrictions on freedom of movement or association; and (h) physical marking of persons with AIDS. Significant moral issues within each of these areas are discussed, and the overall justifiability of various proposals is examined.

  3. 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.

  4. Suicide in the medically and terminally ill: psychological and ethical considerations.

    PubMed

    Kleespies, P M; Hughes, D H; Gallacher, F P

    2000-09-01

    For the clinician who works in a behavioral-medicine or primary-care setting, this article presents the association between medical illness and suicide. Specific illnesses such as HIV/AIDS, cancers of the brain and nervous system, and multiple sclerosis all are associated with an increased risk of suicide. Rates of major depression rise with increasing rates of serious medical illness; however, depression and associated suicidal ideation tend to be undertreated in the medically ill. When medical illness becomes terminal, the clinician's patient may be confronted with difficult end-of-life decisions. Great concern exists in the United States about the ethics of end-of-life decision making and the issue of physician-assisted suicide. The latter part of this article examines the terminally ill patient's right to refuse life-sustaining treatments or to have death hastened according to the principle of the "double effect." It also reviews psychologists' apparent acceptance of the concept of rational suicide, as well as assisted suicide under certain conditions, and offers several caveats. A reexamination of psychology's role, standards, and principles with respect to rational suicide is recommended.

  5. Nutritional demands in acute and chronic illness.

    PubMed

    Richardson, Rosemary A; Davidson, H Isobel M

    2003-11-01

    Common to both acute and chronic disease are disturbances in energy homeostasis, which are evidenced by quantitative and qualitative changes in dietary intake and increased energy expenditure. Negative energy balance results in loss of fat and lean tissue. The management of patients with metabolically-active disease appears to be simple; it would involve the provision of sufficient energy to promote tissue accretion. However, two fundamental issues serve to prevent nutritional demands in disease being met. The determination of appropriate energy requirements relies on predictive formulae. While equations have been developed for critically-ill populations, accurate energy prescribing in the acute setting is uncommon. Only 25-32% of the patients have energy intakes within 10% of their requirements. Clearly, the variation in energy expenditure has led to difficulties in accurately defining the energy needs of the individual. Second, the acute inflammatory response initiated by the host can have profound effects on ingestive behaviour, but this area is poorly understood by practising clinicians. For example, nutritional targets have been set for specific disease states, i.e. pancreatitis 105-147 kJ (25-35 kcal)/kg; chronic liver disease 147-168 kJ (35-40 kcal)/kg, but given the alterations in gut physiology that accompany the acute-phase response, targets are unlikely to be met. In cancer cachexia attenuation of the inflammatory response using eicosapentaenoic acid results in improved nutritional intake and status. This strategy poses an attractive proposition in the quest to define nutritional support as a clinically-effective treatment modality in other disorders. PMID:15018475

  6. 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)

  7. AIDS.gov

    MedlinePlus

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... October 15th observance calls attention to the disproportionate impact of HIV/AIDS on the Latinx community. The ...

  8. Implantable digital hearing aid

    NASA Technical Reports Server (NTRS)

    Kissiah, A. M., Jr.

    1979-01-01

    Hearing aid converts analog output of microphone into digital pulses in about 10 channels of audiofrequencies. Each pulse band could be directly connected to portion of auditory nerve most sensitive to that range.

  9. 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.

  10. 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 ...

  11. Types of Hearing Aids

    MedlinePlus

    ... They also have greater flexibility in hearing aid programming so that the sound they transmit can be ... 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-INFO-FDA (1-888-463-6332) Contact ...

  12. 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 ...

  13. 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)

  14. AIDS: the hidden enemy.

    PubMed

    Tinker, J; Sabatier, R

    1987-01-01

    This article discusses the acquired immunodeficiency syndrome (AIDS) epidemic an its effect on developing countries, with emphasis on Africa. The AIDS death toll will be high in the US: 180,000 by 1991, but it will be in the millions in developing countries. In Africa, AIDS is mainly transmitted heterosexually, is as prevalent among women as among men, and is taking a serious toll among professional classes and young wage earners. The social costs of funerals has increased, and company clinics and sick pay funds have been overwhelmed. In Uganda, the epidemic adds to the state of psychological shock people have sufferred because of the civil war. Medical professionals have been hard-pressed to acquire equipment for testing blood for the virus, although there have been efforts to protect blood supplies through exhaustive testing. Endemic tuberculosis becomes an even more serious problem in developing countries, since AIDS lowers resistance to it. AIDS also effects many developing country children, usually through infected mothers, who can transmit AIDS through breast milk or during pregnancy of birth. This poses a dilemma for promoters of breastfeeding. It is also feared that innoculation of immunosuppressed children may be dangerous. The global picture suggests that Africa is hardest hit: seropositivity prevalence ranges from 0.7% of Congo blood donors to 33% of male donors in Lusaka Zambia. Brazil's cases are mainly homosexual, and in Asia the prevalence is mostly low, although there is a great potential danger in countries where prostitution and heroin addiction are prevalent. The only effective weapon against AIDS is education and blood testing to prevent spread. Despite good education programs in some countries, e.g. Rwanda, there is still widespread ignorance of how AIDS is spread. PMID:12314457

  15. [AIDS and society].

    PubMed

    Koupernik, C

    1988-03-01

    On the basis of information gathered from media the writer delineates the following aspects of the impact of AIDS upon social life: advertising the danger, sex education of the youth, purposeful contamination by AIDS-patients, legal repressive measures, the doctors and the right to test, Anglican Church and acceptance of homosexuality among ministers, antagonistic incentives epidemiologic research and the right to confidentiality. Finally, he endorses the recent declaration of the America Psychiatric Association determined to fight discrimination and refusal of care.

  16. Minor Illnesses, Temperament, and Toddler Social Functioning

    PubMed Central

    Kolak, Amy M.; Frey, Tara J.; Brown, Chloe A.

    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. Mothers of children who are frequently ill report more child behavior problems; however, previous research in this area has yet to simultaneously examine children’s temperament. This investigation examined whether experience with recurrent, minor illnesses and negative emotionality worked together to predict young children’s social functioning. This multi-method study utilized a sample of 110 daycare-attending children. Nurses went to the daycare centers weekly to perform health screens on the participating children. Minor illness experience was represented using a proportion created by dividing the number of illness diagnoses by the total number of health screenings completed from the time the child was enrolled in the study through his or her second birthday. Toddlers’ negative emotionality and social behavior were assessed using mothers’ and fathers’ reports. The two dimensions of negative emotionality and minor illness experience operated in different ways such that anger worked additively with minor illness experience and fearfulness interacted with minor illness experience to predict social behavior. Children who were described as more temperamentally angry displayed less social competence especially when they also experienced high proportions of minor illness. Temperamentally fearful children exhibited more externalizing problems when they experienced a higher frequency of illness whereas fearfulness was not associated to externalizing problems for children who experienced low proportions of illness. Practice or Policy Children’s frequent experience with minor illnesses combined with negative emotionality appears to place toddlers at a heightened risk for exhibiting behavior problems. These findings have implications for child and family well-being as well as

  17. Blasphemy laws and mental illness in Pakistan

    PubMed Central

    Husain, Muzaffar

    2014-01-01

    There is emerging evidence that individuals who are mentally ill are overrepresented in the group of defendants prosecuted under the blasphemy laws of Pakistan. This article discusses the background of blasphemy legislation in Pakistan, and proposes causal interactions between underlying mental illness in the defendant and prosecution for blasphemy. It sketches possible legal safeguards for such blasphemy defendants with mental illness in mental health legislation. PMID:25237489

  18. 47 CFR 68.224 - Notice of non-hearing aid compatibility.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Notice of non-hearing aid compatibility. 68.224... § 68.224 Notice of non-hearing aid compatibility. Every non-hearing aid compatible telephone offered... telephone is not hearing aid compatible, as is defined in §§ 68.4(a)(3) and 68.316, or if offered for...

  19. AIDS in Africa.

    PubMed

    Wilson, D; Armstrong, M; Lavelle, S

    1991-01-01

    Works on epidemiological, and social and behavioral science aspects of AIDS prevention and support in Africa are reviewed from the 7th Conference on AIDS. Participants were especially concerned with why AIDS spreads at disparate rates in different countries and regions of the world. Research on the casual factors of the spread of HIV generally focused upon patterns of sex behavior, the presence of other STDs, and the effect of circumcision. The roles of certain vaginal tightening agents used by Zairian prostitutes, vaginal bruising and bleeding, sex during menses, and oral contraception were also considered. Further, participants explored the possibility of a more coordinated, integrated approach to research and intervention development between the medical and social disciplines, and expressed the overall need for concurrent mass education interventions. In the face of ever increasing rates of HIV infection, including vertical transmission, making condoms ubiquitous, affordable, and highly publicized should garner higher general acceptance and use rates in these populations. Papers and models on the micro- and macro-socioeconomic impact of AIDS were finally discussed, followed by recommendations for a complete reassessment and reworking of policy for AIDS prevention. AIDS activities should, in fact, be integrated into the daily fabric of society, with prevention measures considered an ultimate necessity for social survival.

  20. AIDS and haemophilia.

    PubMed

    Carr, R

    1985-01-01

    Approximately 1% of all AIDS cases are haemophiliacs. LAV/HTLV-III is transmitted by blood and in factor VIII concentrates. Since 1981, increasing numbers of haemophiliacs have been infected, as indicated by detection of antibodies to LAV/HTLV-III. Up to 90% of haemophiliacs in some populations are now seropositive, but to date less than 1% have progressed to clinical AIDS. Immunological abnormalities, in particular reduced T-lymphocyte helper/suppressor ratios, are common in haemophiliacs treated with factor VIII. Such abnormalities do not necessarily indicate past infection by the AIDS virus, but they may predispose to infection following exposure to the virus. Blood Transfusion agencies are introducing screening tests for antibodies to LAV/HTLV-III to help prevent the spread of AIDS by blood products. Heat treated factor VIII concentrate is now available and appears not to transmit AIDS. Factor IX concentrate may also transmit LAV/HTLV-III, but less frequently. A few cases of AIDS have occurred in Haemophilia B (Christmas Disease) patients.

  1. Use of antineoplastic agents in cancer patients with HIV/AIDS

    PubMed Central

    Rudek, Michelle A.; Flexner, Charles; Ambinder, Richard F.

    2011-01-01

    In the era of highly active antiretroviral therapy (HAART), patients with human immunodeficiency virus (HIV) have reduced morbidity and mortality of AIDS-related complications. However, there is an increase in the prevalence of AIDS-defining and non-AIDS-defining cancers. This article provides an up-to-date review of management of HAART pharmacotherapy in the context of cytotoxic chemotherapy or targeted antineoplastic agents. PMID:21570912

  2. 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.

  3. 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

  4. Heat Illness in Hawai‘i

    PubMed Central

    2014-01-01

    Heat illness is a commonly encountered health problem in the Hawaiian Islands. Year round warm temperatures, proximity to the equator, and high humidity combined with a plethora of opportunities for outdoor activities put many individuals at risk. This paper will focus on the physiology, identification, and treatment of varying forms of heat illness. Severe heat illness can be life threatening. All outdoor enthusiasts should have a basic understanding of how to recognize this potentially life-threatening condition and employ preventive measures. We will discuss appropriate management in pre-hospital and hospital settings. Early recognition and cooling are the most crucial aspects of the management of heat illness. PMID:25478301

  5. 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. PMID:27615420

  6. 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

  7. Illness in a redeployed soldier.

    PubMed

    Nguyen, Dana R

    2007-05-01

    Overseas deployments place military personnel at risk for tropical diseases not typically observed on the U.S. mainland. This case describes the first reported case of brucellosis returning from Operation Enduring Freedom and Operation Iraqi Freedom. A 31-year-old infantry soldier complained of a 6-week history of headaches, relapsing fever, and constitutional symptoms since returning from Iraq. This soldier was determined to have the only reported case of brucellosis, but was one of many soldiers at risk from eating unpasteurized cheese on the local economy. Although malaria and leishmaniasis continue to be the most common deployment-related illnesses, brucellosis must also be considered in the differential of any redeployed soldier with headache, fever, and body aches. Public health as well as command elements must reinforce their role in preventing exposure to this pathogen. PMID:17521107

  8. Depression in medically ill patients.

    PubMed

    Rackley, Sandra; Bostwick, J Michael

    2012-03-01

    In medically ill patients, given the many entities the phenotype of depression may represent, clinicians must be prepared to cast their diagnostic nets widely, not settling for the obvious but frequently incorrect choice of major depressive episode and throwing antidepressants at it willy nilly. Having chosen the correct diagnosis from among a broad differential of depression “look-alikes,” clinicians can draw upon a broad swath of treatment modalities including medications, psychotherapy, social supports, and spiritual interventions. Working as a psychiatrist in the medical arena requires the curiosity and analytic skills of a detective and the breadth of knowledge of a polymath adapting therapeutic tools from across the biopsychosociospiritual spectrum to the specific needs of the patient. PMID:22370500

  9. 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.

  10. Illnesses among recently immigrated children.

    PubMed

    Schwarzwald, Heidi

    2005-04-01

    The number of children immigrating to the United States has increased steadily during the last decade. American families are adopting a significant portion of these children, more than 20,000. Recently immigrated children face many different health risks when compared to children born in the United States. They are subject to many infectious diseases no longer seen commonly in the United States such as malaria, tuberculosis, and HIV. They are more likely to have inadequate immunity to vaccine-preventable illnesses. Recent immigrants have a higher likelihood of having malnutrition and developmental delay. Finally, many will have suffered psychological trauma in either institutions or refugee camps. These children require specialized testing, care, and treatment in the pediatric office. PMID:15825138

  11. Mental Illness and Juvenile Offenders.

    PubMed

    Underwood, Lee A; Washington, Aryssa

    2016-02-01

    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

  12. Strategies for Implementing AIDS/HIV Policy Guidelines in Developmental and Mental Health Services: A Background and Checklist for Advocates. AIDS Technical Report, No. 3.

    ERIC Educational Resources Information Center

    Harvey, David C.

    This technical report is part of a series on AIDS/HIV (Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus) and is intended to help link various legal advocacy organizations providing services to persons with mental illness or developmental disabilities. Through a series of case examples, questions, background information, and…

  13. AIDS heterosexual predominance in the Dominican Republic.

    PubMed

    Garris, I; Rodriguez, E M; De Moya, E A; Guerrero, E; Peña, C; Puello, E; Gomez, E; Monterroso, E R; Weissenbacher, M; Vermund, S H

    1991-01-01

    AIDS surveillance data from the Dominican Republic are described for 1983-89. A positive serologic test for HIV was required, and standard clinical criteria were used for defining AIDS. There were 1,202 AIDS cases (820 men, 372 women, 10 of unknown gender) reported to the Ministry of Health, for a cumulative case rate of 17 per 100,000 persons. Rapid growth of the epidemic is noted, with 43% of the total cases reported in 1989. Heterosexual exposure accounts for 53% (593) of all cases, with a male-to-female ratio of 2.2:1, resembling a World Health Organization Pattern I/II country. Prevalence is highest in and surrounding the urbanized tourist areas of Santo Domingo and Puerto Plata and in districts with a high concentration of sugar plantation barracks, where laborers from Haiti and the Dominican Republic work and live. The distribution of AIDS cases is described by transmission exposure category, age, sex, year of diagnosis, and district. The National AIDS Surveillance Program can be improved by validation of exposure transmission categories through selected case investigation and by better reporting through training of health care providers. Surveillance data will assist in targeting future public health efforts to regions and persons at highest risk.

  14. Epidemiology of cryptosporidiosis among European AIDS patients.

    PubMed Central

    Pedersen, C; Danner, S; Lazzarin, A; Glauser, M P; Weber, R; Katlama, C; Barton, S E; Lundgren, J D

    1996-01-01

    OBJECTIVE: To study epidemiology and possible risk factors associated with the development of cryptosporidiosis among European patients with AIDS. METHODS: An inception cohort of 6548 patients with AIDS, consecutively diagnosed from 1979 to 1989, from 52 centres in 17 European countries was studied. Data on all AIDS defining events were collected retrospectively from patients' clinical records. Kaplan-Meier estimates, log rank tests and Cox proportional hazard models were used to examine for possible risk factors associated with cryptosporidiosis. RESULTS: Cryptosporidiosis was diagnosed in 432 (6.6%) patients, 216 at time of the AIDS diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p < 0.001). The probability was also higher for patients from Central Europe compared with patients from South Europe (4.1% versus 2.5%, p = 0.005). The rate of developing cryptosporidiosis after the diagnosis of AIDS was 3 per 100 patient years of follow-up. The rate was significantly lower for intravenous drug users than for homosexual men (relative risk 0.34, 95% confidence limits 0.22-0.54) and for women compared with men (RR 0.43 (0.21-0.87)). The risk was higher in North Europe than in South and Central Europe. In a multivariate analysis only transmission category remained a significant predictor for the development of cryptosporidiosis. CONCLUSION: The development of cryptosporidiosis in AIDS patients may be associated with sexual risk behaviour. PMID:8698361

  15. 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).

  16. 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.

  17. Incidence of opportunistic illness before and after initiation of highly active antiretroviral therapy in children in LEGACY

    PubMed Central

    Nesheim, Steven R.; Hardnett, Felicia; Wheeling, John T.; Siberry, George K.; Paul, Mary E.; Emmanuel, Patricia; Bohannon, Beverly; Dominguez, Kenneth

    2013-01-01

    Background Little is known about immune-reconstitution inflammatory syndrome (IRIS) in children in the United States. Methods LEGACY is a longitudinal cohort study of HIV-infected participants age 0-24 years at enrollment during 2005-2007 from 22 US clinics. For this analysis, we included participants with complete medical record abstraction from birth or time of HIV diagnosis through 2006. Opportunistic illness (OI) included AIDS-defining conditions and selected HIV-related diagnoses. We calculated the incidence (#/100 patient-years) of OI diagnosed in the six months pre- and post-initiation of the first HAART regimen with a virologic response. We defined OI as IRIS if an OI’s incidence increased after HAART initiation. “Responders” were defined as experiencing ≥1 log decline in viral load within six months following HAART initiation. Results Among 575 patients with complete chart abstraction, 524 received HAART. Of these 524 patients, 343 were responders, 181 were non-responders, and 86 experienced OI. Responders accounted for 98/124 (79%) of OI. Pre-HAART and post-HAART OI incidences were 43.7 and 24.4 (P = 0.003), respectively, among responders, and 15.9 and 9.1 (P =0.2), respectively, among non-responders. Overall, OI incidences among responders and non-responders were 33.8 and 12.3, respectively (P = 0.002). Responders were more likely to experience herpes simplex, herpes zoster, and CMV, before HAART initiation (all, P<0.05). Conclusions We detected few OIs and no IRIS among participants initiating HAART. The unexpectedly higher OI prevalence among responders, mostly occurring before HAART initiation, may have motivated higher adherence by responders and subsequent categorization as a responder. PMID:24067552

  18. Therapy may explain recent deficits in AIDS incidence.

    PubMed

    Gail, M H; Rosenberg, P S; Goedert, J J

    1990-01-01

    Since the middle of 1987, fewer consistently defined AIDS cases have been reported than expected among homosexual and bisexual men in the United States. This "AIDS deficit" was greater among homosexual and bisexual men in New York City, San Francisco, and Los Angeles, but was also striking among all homosexual and bisexual men in the United States. Deficits were virtually absent among intravenous drug users (IVDUs) in the United States. Three independent sources of data--placebo-controlled trials, pharmaceutical company reports, and the San Francisco Men's Health Study--were used to demonstrate that the amounts of zidovudine (AZT) given prophylactically to those at highest risk of AIDS since March 1987 have been sufficient to account for most of the observed AIDS deficits. Other advances in the medical care of pre-AIDS patients may have combined with AZT to produce the deficits. Other hypothesized explanations were examined and found insufficient to account for the observed AIDS deficits, including: (a) a sudden halt in new human immunodeficiency virus (HIV) infections during the early or mid-1980s; (b) misspecification of the distribution of AIDS incubation times following HIV infection; (c) increasing delays in the reporting of AIDS cases; (d) changes in the surveillance definition of AIDS in 1987; and (e) evolution of attenuated HIV strains. The hypothesis that therapy is affecting national AIDS rates has important implications. Failure to take the effects of therapy into account can lead to serious underestimates by back-calculation of the cumulative numbers infected with HIV and of AIDS incidence over the longer term. Moreover, it appears that AIDS incidence could be retarded in underserved groups, such as IVDUs, by making AZT and other state-of-the-art treatments readily available to AIDS-free patients with advanced immunodeficiency.

  19. 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

  20. AIDS and racism in America.

    PubMed

    Hutchinson, J

    1992-02-01

    Institutionalized racism affects general health care as well as acquired immunodeficiency syndrome (AIDS) health intervention and services in minority communities. The overrepresentation of minorities in various disease categories, including AIDS, is partially related to racism. The national response to the AIDS epidemic in minority communities has been slow, showing an insensitivity to ethnic diversity in prevention efforts and AIDS health services.

  1. 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)

  2. 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 virus; the…

  3. Sensory Aids for the Blind.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Committee on Prosthetics Research and Development.

    The problems of providing sensory aids for the blind are presented and a report on the present status of aids discusses direct translation and recognition reading machines as well as mobility aids. Aspects of required research considered are the following: assessment of needs; vision, audition, taction, and multimodal communication; reading aids,…

  4. Patients understanding of depression associated with chronic physical illness: a qualitative study

    PubMed Central

    2014-01-01

    Background Detection of depression can be difficult in primary care, particularly when associated with chronic illness. Patient beliefs may affect detection and subsequent engagement with management. We explored patient beliefs about the nature of depression associated with physical illness. Methods A qualitative interview study of patients registered with general practices in Leeds, UK. We invited patients with coronary heart disease or diabetes from primary care to participate in semi-structured interviews exploring their beliefs and experiences. We analysed transcripts using a thematic approach, extended to consider narratives as important contextual elements. Results We interviewed 26 patients, including 17 with personal experience of depression. We developed six themes: recognising a problem, complex causality, the role of the primary care, responsibility, resilience, and the role of their life story. Participants did not consistently talk about depression as an illness-like disorder. They described a change in their sense of self against the background of their life stories. Participants were unsure about seeking help from general practitioners (GPs) and felt a personal responsibility to overcome depression themselves. Chronic illness, as opposed to other life pressures, was seen as a justifiable cause of depression. Conclusions People with chronic illness do not necessarily regard depression as an easily defined illness, especially outside of the context of their life stories. Efforts to engage patients with chronic illness in the detection and management of depression may need further tailoring to accommodate beliefs about how people view themselves, responsibility and negative views of treatment. PMID:24555886

  5. Defining the states of consciousness.

    PubMed

    Tassi, P; Muzet, A

    2001-03-01

    Consciousness remains an elusive concept due to the difficulty to define what has been regarded for many years as a subjective experience, therefore irrelevant for scientific study. Recent development in this field of research has allowed to provide some new insight to a possible way to define consciousness. Going through the extensive literature in this domain, several perspectives are proposed to define this concept. (1) Consciousness and Attention may not reflect the same process. (2) Consciousness during wake and sleep may not involve the same mechanisms. (3) Besides physiological states of consciousness, human beings can experience modified states of consciousness either by self-training (transcendental meditation, hypnosis, etc.) or by drug intake (hallucinogens, anaesthetics, etc.). Altogether, we address the question of a more precise terminology, given the theoretical weight words can convey. To this respect, we propose different definitions for concepts like consciousness, vigilance, arousal and alertness as candidates to separate functional entities.

  6. Quality Nursing Care for Hospitalized Patients with Advanced Illness: Concept Development

    PubMed Central

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

    2011-01-01

    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. PMID:20572095

  7. Rumination and self-defining memories in the context of health concerns.

    PubMed

    Sansom-Daly, Ursula M; Bryant, Richard A; Cohn, Richard J; Wakefield, Claire E

    2016-08-01

    Individuals with health anxiety report experiencing a strong sense of vulnerability to illness. Such beliefs may be driven by the biased recollection of past illness-related events. However, little research has explored the role of memory in health anxiety. In other disorders, rumination has also been identified as a process that leads individuals to recall memories dominated by the content of their concerns. This study examined the proposition that rumination might impact the content of "self-defining" autobiographical memories among 60 college students with varying health anxiety (35% with clinical-level health anxiety). Participants were randomised to experiential/ruminative self-focus conditions, and then they completed the Self-Defining Memory Task. Responses were coded for valence and illness-relatedness. Results indicated that rumination led participants to retrieve more illness-related self-defining memories, while higher health anxiety scores were associated with more negative, but not more illness-focused memories. Ruminative thinking appears to activate health concerns, and may play a role in maintaining ongoing health anxiety.

  8. 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…

  9. 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…

  10. Mental Illness, Work, and Income Support Programs

    PubMed Central

    Danziger, Sheldon; Frank, Richard G.; Meara, Ellen

    2009-01-01

    Improved treatment makes it easier for individuals with mental illness to participate in mainstream society, including the labor force. Nevertheless, a diagnosis of a severe and persistent mental illness or a substance use disorder often coincides with reduced work activity and lower earnings. The Social Security Disability Insurance Program and the Supplemental Security Income program provide income support for increasing numbers of individuals with mental illness. A growing share of a third program, Temporary Assistance for Needy Families, which offers cash support to low-income single caregivers, is composed of individuals with mental illness, as new work requirements result in faster exits of those without mental health conditions. These programs have come under increasing scrutiny as the shares of recipients with mental illness increase. Some question whether these programs serve many individuals capable of working and supporting themselves. However, evidence on whether eligibility criteria for these income support programs are too stringent or too lax regarding individuals with mental illness is mixed. Appropriate income support policy for those with mental illness will differ dramatically depending on the source of the recent rise in individuals with mental illness using income support. PMID:19339364

  11. When a Student Is Mentally Ill.

    ERIC Educational Resources Information Center

    Hover, Margot

    1995-01-01

    Highlights issues facing teachers who have mentally ill students in their classes and ways for teachers to address the issues. Discusses in-school interventions, out-of-school treatment, and the role of the teacher as mediator in helping students relate to other mentally ill students and in offering support to parents. (MAB)

  12. 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. ...

  13. 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…

  14. 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,…

  15. 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…

  16. 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…

  17. Reducing the Stigma of Mental Illness.

    ERIC Educational Resources Information Center

    Brown, Kaylene; Bradley, Loretta J.

    2002-01-01

    Each year, an estimated 50 million Americans will experience a mental disorder while only one fourth of them will seek mental health services. Contends that this disparity results from the stigma attached to mental illness. Proposes that counselors must educate the general public about the misconceptions of mental illness and advocate for parity…

  18. Bill would offer parole to inmates with AIDS.

    PubMed

    1995-09-01

    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.

  19. Time spent on health related activities associated with chronic illness: a scoping literature review

    PubMed Central

    2012-01-01

    Background The management of health care, particularly for people with chronic conditions, combines the activities of health professionals, patients, informal carers and social networks that support them. Understanding the non-professional roles in health management requires information about the health related activities (HRA) that are undertaken by patients and informal carers. This understanding allows management planning that incorporates the capacity of patients and informal carers, as well as identifying the particular skills, knowledge and technical support that are necessary. This review was undertaken to identify how much time people with chronic illness and their informal carers spend on HRA. Methods Literature searches of three electronic databases (CINAHL, Medline, and PubMed) and two journals (Time and Society, Sociology of Health and Illness) were carried out in 2011 using the following search terms (and derivatives): chronic illness AND time AND consumer OR carer. The search was aimed at finding studies of time spent on HRA. A scoping literature review method was utilised. Results Twenty-two peer reviewed articles published between 1990 and 2010 were included for review. The review identified limited but specific studies about time use by people with a chronic illness and/or their carers. While illness work was seen as demanding, few studies combined inquiry about both defined tasks and defined time use. It also identified methodological issues such as consistency of definition and data collection methods, which remain unresolved. Conclusions While HRA are seen as demanding by people doing them, few studies have measured actual time taken to carry out a comprehensive range of HRA. The results of this review suggest that both patients with chronic illness and informal carers may be spending 2 hours a day or more on HRA. Illnesses such as diabetes may be associated with higher time use. More empirical research is needed to understand the time demands

  20. Women and AIDS care: coping with "triple jeopardy".

    PubMed

    Henry, K

    1995-11-01

    Women in developing countries are at "triple jeopardy" in the acquired immunodeficiency syndrome (AIDS) epidemic. As women, a combination of biological, social, and economic risk factors increase their vulnerability to human immunodeficiency virus (HIV) infection. As mothers, they can infect their children with HIV. And, as society's traditional caregivers, women are burdened with the care of sick family members. The most effective AIDS programs deliver counseling and social support to family caregivers as well as clinical management of AIDS-related illnesses and nursing care. In several African countries, the physical, financial, and emotional demands associated with home care of AIDS patients are addressed by mobile teams of health workers and counselors. Government health services and nongovernmental organizations are training village health workers to help people cope with the fear and stigma associated with AIDS. These community AIDS workers conduct formal and informal educational sessions, visit homes to provide counseling, instruct caregivers on precautions to protect themselves from infection, and refer people for HIV testing and medical treatment. A multisectoral approach to providing the mix of services required is the best strategy for maximizing program coverage while maintaining a high quality of services.

  1. The Ryder Cognitive Aid Checklist for Trauma Anesthesia.

    PubMed

    Behrens, Vicente; Dudaryk, Roman; Nedeff, Nicholas; Tobin, Joshua M; Varon, Albert J

    2016-05-01

    Despite mixed results regarding the clinical utility of checklists, the anesthesia community is increasingly interested in advancing research around this important topic. Although several checklists have been developed to address routine perioperative care, few checklists in the anesthesia literature specifically target the management of trauma patients. We adapted a recently published "trauma and emergency checklist" for the initial phase of resuscitation and anesthesia of critically ill trauma patients into an applicable perioperative cognitive aid in the form of a pictogram that can be downloaded by the medical community. The Ryder Cognitive Aid Checklist for Trauma Anesthesia is a letter-sized, full-color document consisting of 2 pages and 5 sections. This cognitive aid describes the essential steps to be performed: before patient arrival to the hospital, on patient arrival to the hospital, during the initial assessment and management, during the resuscitation phase, and for postoperative care. A brief online survey is also presented to obtain feedback for improvement of this tool. The variability in utility of cognitive aids may be because of the specific clinical task being performed, the skill level of the individuals using the cognitive aid, overall quality of the cognitive aid, or organizational challenges. Once optimized, future research should be focused at ensuring successful implementation and customization of this tool.

  2. HIV/AIDS and care provider attributions: who's to blame?

    PubMed

    Cobb, M; De Chabert, J T

    2002-08-01

    The discovery of HIV/AIDS prompted a profusion of research focusing on the disease and its causes. Though the bulk of this research emphasizes behavioural risk factors, treatment and disease progression, researcher efforts are beginning to examine the public's attitude toward individuals who are HIV-positive or have developed AIDS. Utilizing Weiner's Attribution Theory, the current study examines the beliefs of social service providers who work directly with individuals affected by HIV/AIDS. Forty-six (28 female and 18 male) HIV/AIDS social service providers from three community-based organizations were asked to read a hypothetical scenario depicting an individual at-risk for HIV/AIDS because of multiple high-risk behaviours. The gender of the target was manipulated and at the conclusion of the scenario participants completed a questionnaire designed to assess attributions. Results of the study show that social service providers who perceive individuals as more responsible for their illness report increased anger, attribute more blame and express less willingness to help those at-risk for HIV/AIDS. This research suggests that despite growing numbers of media campaigns and national distribution of information regarding the disease and its transmission, in general, people continue to stigmatize and place blame on those at-risk.

  3. Mass Psychogenic Illness: Demography and Symptom Profile of an Episode

    PubMed Central

    Tarafder, Binoy Krishna; Khan, Mohammad Ashik Imran; Islam, Md. Tanvir; Mahmud, Sheikh Abdullah Al; Sarker, Md. Humayun Kabir; Faruq, Imtiaz; Miah, Md. Titu; Arafat, S. M. Yasir

    2016-01-01

    Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls' high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls' high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes. PMID:27294104

  4. Hurricane Andrew-related injuries and illnesses, Louisiana, 1992.

    PubMed

    McNabb, S J; Kelso, K Y; Wilson, S A; McFarland, L; Farley, T A

    1995-06-01

    To determine the extent and types of injuries and illnesses in Louisiana associated with or related to Hurricane Andrew, we gathered data from hospital emergency departments and coroner's offices on demographic variables, institution, nature and cause of the injury or illness, body part affected, location, and date and time of the event. A hurricane-related injury or illness was defined as one that occurred from noon on August 24, 1992, through midnight on September 21, 1992, as a direct or indirect result of the preparation for (preimpact), the impact of, or the clean-up after the hurricane (postimpact). Nineteen parishes in south-central Louisiana that were most affected by Hurricane Andrew provided data from patients seen in emergency departments and reports from coroner's offices. Active, advance surveillance of this type promotes and facilitates the reporting of disaster-related health outcomes. Future planning for hurricanes should take into account the high rate of cuts, lacerations, and puncture wounds, particularly during the postimpact phase.

  5. Mass Psychogenic Illness: Demography and Symptom Profile of an Episode.

    PubMed

    Tarafder, Binoy Krishna; Khan, Mohammad Ashik Imran; Islam, Md Tanvir; Mahmud, Sheikh Abdullah Al; Sarker, Md Humayun Kabir; Faruq, Imtiaz; Miah, Md Titu; Arafat, S M Yasir

    2016-01-01

    Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls' high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls' high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes. PMID:27294104

  6. OMEGA-3 FATTY ACIDS IN CRITICAL ILLNESS

    PubMed Central

    Martin, Julie M.; Stapleton, Renee D.

    2015-01-01

    Supplementation of enteral nutritional formulas and parenteral nutrition lipid emulsions with omega-3 fatty acids is a recent area of research in patients with critical illness. It is hypothesized that omega-3 fatty acids may help reduce inflammation in critically ill patients, particularly those with sepsis and acute lung injury. The objective of this article is to review the data on supplementing omega-3 fatty acids during critical illness; enteral and parenteral supplementation are reviewed separately. The results of the research available to date are contradictory for both enteral and parenteral omega-3 fatty acid administration. Supplementation with omega-3 fatty acids may influence the acute inflammatory response in critically ill patients, but more research is needed before definitive recommendations about the routine use of omega-3 fatty acids in caring for critically ill patients can be made. PMID:20796218

  7. 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),…

  8. 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…

  9. 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

  10. [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.

  11. Gay youth and AIDS.

    PubMed

    Feldman, D A

    1989-01-01

    Gay male teenagers face considerable adversity during their "coming out" process due to the AIDS epidemic. They must decide whether to be tested for HIV-1 infection, whether to postpone sexual activity, how to select a partner, and which kinds of sexual practices to engage in. Gay youth often make such decisions based upon misinformation and faulty premises. This paper reviews what is known about gay youth and AIDS, and assesses their possible risk for HIV-1 infection. It is recommended that school and community-based health education programs be developed to teach gay and bisexual youth about safe sex. Moreover, research is needed into sociocultural variations among gay youth in order to develop appropriate and effective intervention strategies for AIDS risk reduction in this diverse population.

  12. 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.

  13. 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.

  14. 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. PMID:25581195

  15. A constitution for AIDS.

    PubMed

    Koshy, L M

    1996-01-15

    The Indian Health Organization projected the number of deaths per day due to AIDS by the year 2000 at 10,000. An interdisciplinary international conference was held in New Delhi to draft an international law governing the issues related to AIDS. Human freedom and public health policies are the most affected by this disease. In the absence of an international AIDS law, judicial verdicts set precedents and could have serious ramifications. A participant from the John Marshall Law School, Chicago, suggested that instead of making new laws, the existing ones from the colonial past should be repealed. This includes Section 377 of the Indian Penal Code, which provides criminal sanctions against those who indulge in unnatural relations with man, woman, or animal. Penalizing homosexuality will only perpetuate clandestine relations and spread the virus into their families. Another participant seconded this motion stating that even a sex worker must be protected from abuse and indignity. The National AIDS Control Organization responded to the criticism that the government had not utilized all the World Bank funds allocated for anti-AIDS projects. The trends of the epidemic were the most important indicators not just the numbers. In Manipur and Mizoram, infection was almost entirely due to injecting drug use. The Saheli project undertaken in the red-light areas of Bombay encompassed brothel owners and prostitutes, which could be replicated in other areas. Because existing government policies were focusing on prevention, there was no protection of an HIV-infected individual's privacy, one participant from Madras stated. The confidentiality issue was also echoed by a US participant. The New Delhi Declaration and Action Plan on HIV/AIDS was also discussed. It forbids discrimination in employment, education, housing, health care, social security, travel, and marital and reproductive rights. Providing sterile needles and ensuring the safety of the blood supply were other concerns

  16. AIDS--legal issues.

    PubMed

    Kirby, M

    1988-01-01

    Legal issues worldwide prompted by the AIDS epidemic are discussed, in a general way, since legal systems vary widely in different countries and localities. WHO publishes a tabulation of legal instruments dealing with AIDS and HIV infection. Criminal laws intended to protect people from harm from HIV infection have been enacted, such as a penalty for unprotected sexual intercourse by infected persons, in some Australian states. Knowing spread of HIV already amounts to a crime in many systems. The U.S. Supreme Court has already ruled that states do not violate the constitution for punishing homosexuals for consensual sodomy, nor the Army for discharging homosexuals. Quarantine law is a civil matter, but may provide penalties stricter than criminal penalties, without as much protection. No quarantines against AIDS have been enacted, although some countries require screening of immigrants. Legal issues regarding screening, liability of suppliers of blood products, and tracing of sexual partners are much discussed. Stigmatization of minority and alienated groups such as homosexuals, prostitutes, migrants, drug users and prisoners is a tricky legal problem. The apparent failure of the criminalization of drug users and how to contain the spread of AIDS into the drug free population may prompt drastic new solutions. Other legal issues drawing attention include regulation of health insurance, changes in family law, pre-marriage HIV tests, screening for HIV ostensibly to detect HIV-associated dementia, liability protection for developers and testers of vaccines, and euthanasia and the treatment of the deceased. The legal system tends to lag behind medicine. In the case of AIDS, it cannot afford to delay, therefore effective legal strategies will include effective media presentation of AIDS information to the general public; ready and cheap supply of condoms; and a new approach to illegal drugs.

  17. Trajectories of illness perceptions in persons with chronic illness: An explorative longitudinal study.

    PubMed

    Bonsaksen, Tore; Lerdal, Anners; Fagermoen, May Solveig

    2015-07-01

    Accurate illness perceptions are essential to the self-management of chronic illness. This study explored trajectories of illness perceptions in persons with morbid obesity (n = 53) and persons with chronic obstructive pulmonary disease (n = 52) following a patient education course. Participants completed the Brief Illness Perception Questionnaire five times over a 1-year period. Repeated measures analysis of variance was employed. Over time, obese participants perceived shorter illness duration, fewer consequences, less emotional stress, and more personal control. Chronic obstructive pulmonary disease participants had initial increases in personal control and understanding, but these changes were not maintained throughout the follow-up period.

  18. Illness behavior, social adaptation, and the management of illness. A comparison of educational and medical models.

    PubMed

    Mechanic, D

    1977-08-01

    Motivational needs and coping are important aspects of illness response. Clinicians must help guide illness response by suggesting constructive adaptive opportunities and by avoiding reinforcement of maladaptive patterns. This paper examines how the patient's search for meaning, social attributions, and social comparisons shapes adaptation to illness and subsequent disability. It proposes a coping-adaptation model involving the following five resources relevant to rehabilitation: economic assets, abilities and skills, defensive techniques, social supports, and motivational impetus. It is maintained that confusion between illness and illness behavior obfuscates the alternatives available to guide patients through smoother adaptations and resumption of social roles. PMID:328824

  19. Extreme Dysbiosis of the Microbiome in Critical Illness.

    PubMed

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

    2016-01-01

    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. PMID:27602409

  20. 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. PMID:27602409