Easing East-West Tensions in the Third World,

DTIC Science & Technology

1986-03-01

Garden City, NY: Dial7 Press, Anell, Lars and Birgitta Nygren . The developn cuties and the world economic order. New ork St. Matns Press, 1980. (HF...Central America. Edited by Marlene Dixon and Susanne Jonas . Rev. ed. San Francisco: Synthesis Publications, 1983. (F 1439.5 .R48 1983) Rift and revolution

Moving Forward: U.S. Interest and Facilitating the Probable in Iraq

DTIC Science & Technology

2008-05-01

that will ultimately lead to independence in 1991. The Northern No-Fly Zone and the Green Line restricted Iraqi military movement. The Iraqi...John S. Survival among the Kurds: A History of the Yezidis, rev ed. New York, NY: Kegan Paul International, 1993. Gunter, Michael M. The Kurds and

Association between Severity of Behavioral Phenotype and Comorbid Attention Deficit Hyperactivity Disorder Symptoms in Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Rao, Patricia A.; Landa, Rebecca J.

2014-01-01

Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines ("Diagnostic and Statistical Manual of the American Psychiatric Association," 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity…

The Importance of the Peritraumatic Experience in Defining Traumatic Stress

ERIC Educational Resources Information Center

Bovin, Michelle J.; Marx, Brian P.

2011-01-01

In the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev., "DSM-IV-TR"; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or…

Dimensional and Cross-Cutting Assessment in the "DSM-5"

ERIC Educational Resources Information Center

Jones, K. Dayle

2012-01-01

A significant proposed change to the 5th edition of the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM-5") that will significantly affect the way counselors diagnose mental disorders is the addition of dimensional assessments to the categorical diagnoses. The author reviews the current "DSM"'s (4th ed., text rev.; American…

Attention-Deficit/Hyperactivity Disorder Symptoms in Preschool Children: Examining Psychometric Properties Using Item Response Theory

ERIC Educational Resources Information Center

Purpura, David J.; Wilson, Shauna B.; Lonigan, Christopher J.

2010-01-01

Clear and empirically supported diagnostic symptoms are important for proper diagnosis and treatment of psychological disorders. Unfortunately, the symptoms of many disorders presented in the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) lack sufficient psychometric…

Dose Response Effects of Lisdexamfetamine Dimesylate Treatment in Adults with ADHD: An Exploratory Study

ERIC Educational Resources Information Center

Faraone, Stephen V.; Spencer, Thomas J.; Kollins, Scott H.; Glatt, Stephen J.; Goodman, David

2012-01-01

Objective: To explore dose-response effects of lisdexamfetamine dimesylate (LDX) treatment for ADHD. Method: This was a 4-week, randomized, double-blinded, placebo-controlled, parallel-group, forced-dose titration study in adult participants, aged 18 to 55 years, meeting "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.)…

Trends and Implications of Proposed Changes to the "DSM-5" for Vulnerable Populations

ERIC Educational Resources Information Center

Miller, Raissa; Prosek, Elizabeth A.

2013-01-01

The revision process for the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; American Psychiatric Association, 2000) has increased consciousness for the role of diagnosis in counseling. In this article, the authors discuss 3 trends of the proposed changes: the influence of the medical model, the attention to…

Pole-Zero Modeling of Transient Waveforms: A Comparison of Methods with Application to Acoustic Signals

DTIC Science & Technology

1991-03-01

forecasting and control, rev. ed., Holden Day, San Francisco , 1976. 2. John M. Gottman, Time-series analysis, a comprehensive introduction for social...Vol. ASSP-28. No. 3. pp. 292-:303, .June 1980. .58. Luis Vergara - Dominguez, -New insights into the high-order Yule-Walker equa- tions," IEEE Trans

77 FR 442 - Changes To Implement Miscellaneous Post Patent Provisions of the Leahy-Smith America Invents Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... to Manual of Patent Examining Procedure (MPEP) Sec. 2282 (8th ed. 2001) (Rev. 8, July 2010). MPEP Sec... reexamination based on patents and publications cited in a prior reexamination request under 35 U.S.C. 302, as... prior art directed to patents or printed publications allegedly bearing on the patentability of any...

Test Review: Constantino, J. N., & Gruber, C. P. (2012). "Social Responsiveness Scale-Second Edition" ("SRS-2"). Torrance, CA: Western Psychological Services

ERIC Educational Resources Information Center

Bruni, Teryn P.

2014-01-01

This article reviews the Social Responsiveness Scale-Second Edition (SRS-2), a 65-item rating scale measuring deficits in social behavior associated with Autism Spectrum Disorder (ASD), as outlined by the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association,…

Contrasting Models of Posttraumatic Stress Disorder: Reply to Monroe and Mineka (2008)

ERIC Educational Resources Information Center

Berntsen, Dorthe; Rubin, David C.; Bohni, Malene Klindt

2008-01-01

The authors address the 4 main points in S. M. Monroe and S. Mineka's comment. First, the authors show that the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) posttraumatic stress disorder (PTSD) diagnosis includes an etiology and that it is based on a theoretical model with a…

Application of Nucleic Acid-Based Tools for Monitoring Monitored Natural Attenuation (MNA), Biostimulation and Bioaugmentation at Chlorinated Solvent Sites

DTIC Science & Technology

2010-12-01

K. M. Ritalahti, and J. M. Tiedje. 2003. Diversity of Dechlorinating Bacteria, p. 53-87. In M. M. Häggblom and I. D. Bossert (eds.), Dehalogenation ...Anaerobic Microbial Dehalogenation . Annu. Rev. Microbiol. 58:43-73. Smits, T. H.M., C. Devenoges, K. Szynalski, J. Maillard, and C. Holliger. 2004

Collisional and Dynamical Evolution of Planetary Systems

NASA Technical Reports Server (NTRS)

Weidenschilling, Stuart J.

2004-01-01

Senior Scientst S. J. Weidenschilling presents his final administrative report in the research program entitled "Collisional and Dynamical Evolution of Planetary Systems," on which he was the Principal Investigator. This research program produced the following publications: 1) "Jumping Jupiters" in binary star systems. F. Marzari, S. J. Weidenschilling, M. Barbieri and V. Granata. Astrophys. J., in press, 2005; 2) Formation of the cores of the outer planets. To appear in "The Outer Planets" (R. Kallenbach, ED), ISSI Conference Proceedings (Space Sci. Rev.), in press, 2005; 3) Accretion dynamics and timescales: Relation to chondrites. S. J. Weidenschilling and J. Cuzzi. In Meteorites and the Early Solar System LI (D. Lauretta et al., Eds.), Univ. of Arizona Press, 2005; 4) Asteroidal heating and thermal stratification of the asteroid belt. A. Ghosh, S. J.Weidenschilling, H. Y. McSween, Jr. and A. Rubin. In Meteorites and the Early Solar System I1 (D. Lauretta et al., Eds.), Univ. of Arizona Press, 2005.

Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors.

PubMed

Sukhu, Troy; Ross, Sherry; Coward, R Matthew

2018-01-27

Urological survivorship issues encompass an area that may potentially be overlooked after treatment of childhood cancer in adolescent boys and young men. Side effects of cancer therapy may include subsequent development of erectile dysfunction (ED), hypogonadism, and infertility in adulthood. The purpose of this review is to focus on the etiology and prevalence of the range of sexual and gonadal dysfunction in adolescent boys and young men who are cancer survivors, while discussing current recommendations for evaluation and treatment. We performed a literature review of articles evaluating hypogonadism, sexual dysfunction, ED, and infertility in young men cancer survivors. There is compelling evidence that significant survivorship issues are faced by boys entering adulthood after completing cancer therapy. Overall, young men cancer survivors are much more likely to report symptoms of sexual dysfunction than the general population of men. These patients can develop ED due to physiologic and psychological changes that take place with diagnosis of a malignancy and subsequent treatment. Primary hypogonadism can arise due to pelvic radiation or chemotherapy, and central hypogonadism may arise from pituitary insufficiency after brain radiation or surgery. Infertility develops from direct damage to the Sertoli cells and germinal epithelium from radiotherapy or chemotherapy. Cancer survivors who are men should therefore be screened for these important urological survivorship issues, although exact surveillance strategies remain unclear. Urological survivorship issues including ED, hypogonadism, and infertility are common among cancer survivors and result in significant morbidity. Due to the medical complexity of cancer survivorship, the population of adolescent and young adult survivors would benefit from a network of multidisciplinary survivorship experts to aid the transition into adulthood. Improved research efforts may help to clarify risk factors and to develop enhanced strategies for evaluation and treatment. Sukhu T, Ross S, Coward RM. Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors. Sex Med Rev 2018;XX:XXX-XXX. Published by Elsevier Inc.

A cross-sectional study of emergency care utilization and associated costs of violent-related (assault) injuries in the United States.

PubMed

Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K

2017-08-01

Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.

A cross-sectional study of emergency care utilization and associated costs of violent-related (assault) injuries in the United States.

PubMed

Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K

2017-11-01

Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.

Direct Energy Conversion Literature Abstracts

DTIC Science & Technology

1962-12-01

1961. are reviewed. Various types of solar power systems are discussed and compar- " Methods are discussed for providing ed with respect to weight...electron gas to and relate to thermoelectric methods ; convert heat to electrical energy with no thermionic, photovoltaic and electro- moving mechanical...Europ.Mach.Rev. 11:20-25,1961. appears most practical source. Direct methods of generating electrical 2853 energy without the use of fossil fuels are Power

Tunable Oscillations in Optically Injected Semiconductor Lasers With Reduced Sensitivity to Perturbations - Postprint

DTIC Science & Technology

2014-09-01

Squeezed light from injection- locked quantum well lasers ,” Phys. Rev. Lett., vol. 71, pp. 3951–3954, 1993. [30] A. E. Siegman , Lasers , 1st ed...AFRL-RY-WP-TP-2014-0297 TUNABLE OSCILLATIONS IN OPTICALLY INJECTED SEMICONDUCTOR LASERS WITH REDUCED SENSITIVITY TO PERTURBATIONS -POSTPRINT...OSCILLATIONS IN OPTICALLY INJECTED SEMICONDUCTOR LASERS WITH REDUCED SENSITIVITY TO PERTURBATIONS - POSTPRINT 5a. CONTRACT NUMBER In-House 5b. GRANT NUMBER

Experimental Entanglement of Four Particles

DTIC Science & Technology

2016-09-22

operation25, and we are certainly far from this regime. However, even if such a level of fidelity were to be achieved, applications such as quantum comput ...Popescu, S. & Spiller, T. (eds) Introduction to Quantum Computation and Information (World Scientific, Singapore, 1997). 4. Pan, J.-W., Bouwmeester, D...Hagley, E. et al. Generation of Einstein-Podolsky-Rosen pairs of atoms. Phys. Rev. Lett. 79; 1–5 (1997). 11. Cirac, J. & Zoller, P. Quantum computations

Completing EdTPA: TSOL Candidate Performance and Reflection

ERIC Educational Resources Information Center

Micek, Timothy A.

2017-01-01

edTPA is a pre-service assessment process designed to determine if a new teacher is ready for the job. edTPA is part of a national movement towards the use of performance assessments in teacher education. As of 2014, 41 states (a) require a state-approved performance assessment like edTPA for program completion or for state licensure and/or state…

The Role of Attention in Binocular Rivalry as Revealed through Optokinetic Nystagmus.

DTIC Science & Technology

1995-11-01

break down selectively when parts of the stri- ate and prestriate cortex is damaged. Speci cally, a group of patients su ering fromApperceptive Agnosia ...1981). Visual performance in cases of visual agnosia . In M. van- Ho , & G. Hohn (Eds.), Functional recovery from brain damage (pp. 275{286...macaques. Nature, 373, 609{611. Breese, B. (1899). On inhibition. Psychol.Rev., 3, 1{65. Campion, J., & Latto, R. (1985). Apperceptive agnosia due to

Fundamental Noise Limits in Miniature Acoustic and Vibration Sensors

DTIC Science & Technology

1991-12-31

1982) 86 WV " NADC-91113-50 [121 Anderson, Herbert L.. (ed.), A Physicist’s Desk Rcference, AIP, NY (1989) [13] Sears, Francis W. and Gerhard L...Dover, NY (1956) [16] Callen, Herbert B. and Theodore A. Welton, "Irreversibility and generalized noise," Phys. Rev. 83(1), 34-40 (1951) [17] Kittel...34] Misner, Charles W., Kip S. Thorne, and John Archibald Wheeler, Gravitation, W. H. Freeman, NY (1973) 88 NMADC-91113-50 [35] Marcuse , Dietrich

Scanning Tunneling Microscopy, Atomic Force Microscopy, and Related Techniques

DTIC Science & Technology

1992-02-26

92. (B47) Fujui, T.; Suzuki, MA.; Miyashita, MA.; Yamaguchi, M.; Onuki , T.; Nakamura, H .; Matsubara, T.; Yamada, H .; Nakayamia, K. J. Vac. Sd...and seven deflection detection systems (A 15). (Al) Binnig, G.; Rohrer, H .; Gerber, Ch.; Weibel, E. Phys. Rev. Lett. 1982, 49, 57. (A2) Ray, M.A...J. J. Vac Sci. Technol. A 1ඣ, 9, 44-50. (AS) Scanning Tunneling Microscopy and Related Methods; Behm, RJ., Garcia, N., Rohrer, H ., Eds.; NATO ASI

Role of codeposited impurities during growth. I. Explaining distinctive experimental morphology on Cu(0 0 1)

NASA Astrophysics Data System (ADS)

Hamouda, Ajmi Bh.; Sathiyanarayanan, Rajesh; Pimpinelli, Alberto; Einstein, T. L.

2011-01-01

A unified explanation of the physics underlying all the distinctive features of the growth instabilities observed on Cu vicinals has long eluded theorists. Recently, kinetic Monte Carlo studies showed that codeposition of impurities during growth could account for the key distinctive experimental observations [Hamouda , Phys. Rev. BPLRBAQ0556-280510.1103/PhysRevB.77.245430 77, 245430 (2008)]. To identify the responsible impurity atom, we compute the nearest-neighbor binding energies (ENN) and terrace diffusion barriers (Ed) for several candidate impurity atoms on Cu(0 0 1) using DFT-based VASP. Our calculations show that codeposition (with Cu) of midtransition elements, such as Fe, Mn, and W, could—in conjunction with substantial Ehrlich-Schwoebel barriers—cause the observed instabilities; when the experimental setup is considered, W emerges to be the most likely candidate. We discuss the role of impurities in nanostructuring of surfaces.

Cryogenic Optical Refrigeration

DTIC Science & Technology

2012-03-22

Applications of Laser Cooling of Solids, 1st ed. (Wiley-VCH, 2009). 12. M. Sheik- Bahae and R. I . Epstein, “Optical refrigeration,” Nat. Photonics 1(12), 693–699...2007). Advances in Optics and Photonics 4, 78–107 (2012) doi:10.1364/AOP.4.000078 99 13. M. Sheik- Bahae and R. I . Epstein, “Laser cooling of solids...Sheik- Bahae and R. I . Epstein, “Can laser light cool semiconductors,” Phys. Rev. Lett. 92(24), 247403 (2004). 18. P. Asbeck, “Self-absorption effects

Identification of Aerodynamic Coefficients Using Computational Neural Networks

DTIC Science & Technology

1992-01-09

the Am-. icar , Institete ur Aeronautics and mation model, excellent matches of aerodynamic coef- Astronautics, Inc. All rights reserved. ficient...UL NSN 7540-01-2EO-SSO0 Standard Form 296 (Rev. 2-89) ft"""~e by Ar t4ed. Z39-1 SAIA A_ AIAA 92-0172 Identification of Aerodynamic Coefficients Using...state and control space. While the partitions span the space, these global models are, in general, not contin- Precise, smooth aerodynamic models are

The Potential for Restructuring MOS (Military Occupational Specialties) Tasks to Reduce Physical Demand Requirements of Critical MOS

DTIC Science & Technology

1984-09-01

fitness training in the US Army (ARIEM T-5/79). Natick, MS: US Army Research Institute for Environental Medicine, August 1979, p 31. 6Vogel, Wright...Human engineering guide to equipment d (rev. ed.). Washington, DC: US Government Printing Office, 1972, pp 497, 512, 527., 2 2Vogel, Wright, & Patton...physical demands they make. Three of the interview questions addressed this issue . The questions were: "Are you tired after doing this task?" "Have

Diurnal Patterns of Photosynthesis, Chlorophyll Fluorescence, and PRI to Evaluate Water Stress in the Invasive Species, Elaeagnus umbellata Thunb

DTIC Science & Technology

2010-01-01

produced reactive molecules and the water–water cycle (Demmig- Adams and Adams 1992; Flexas and Medrano 2002; Apel and Hirt 2004). Despite the many pathways...509–521 Apel K, Hirt H (2004) Reactive oxygen species: metabolism, oxidative stress and signal transduction. Annu Rev Plant Biol 55:373–399 Baruch Z...with ontogenic changes in water limited Chenopodium quinoa leaves. Photosynthetica 40:227–232 Yates ED, Levia DP Jr, Williams CL (2004) Recruitment of

Naval War College Review. Volume 66, Number 4, Autumn 2013

DTIC Science & Technology

2013-01-01

comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 2013 2. REPORT TYPE 3. DATES...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Naval War College Press advIsory b oard adam bellow Jeffrey Kline gale a ...Mattox robert a . silano Marin strmecki dov s. Zakheim naval war college review edItorIal b oard donald Chisholm audrey Kurth Cronin Peter dombrowski

Impact of Backbone Rigidity on the Photomechanical Response of Glassy, Azobenzene-Functionalized Polyimides (Postprint)

DTIC Science & Technology

2014-01-13

Y .; Choi, H . H .; Hwang , H . K.; Kim, Y .; Lee , S .; Jang, S . H .; Kakimoto, M.; Takezoe, H . Jpn. J. Appl. Phys., Part 1: Regul. Pap. Short Notes Rev... H .; Vaia, R. A.; Tan, L. S .; White, T. J. Angew. Chem., Int. Ed. 2012, 51 (17), 4117−4121. (6) Wang, D. H .; Lee , K. M.; Yu, Z. N .; Koerner, H .; Vaia...J. Macromol. Chem. Phys. 2013, 214 (11), 1189−1194. (8) Wang, D. H .; Lee , K. M.;

Generating GraphML XML Files for Graph Visualization of Architectures and Event Traces for the Monterey Phoenix Program

DTIC Science & Technology

2012-09-01

Thesis Advisor: Mikhail Auguston Second Reader: Terry Norbraten THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved...Language (GraphML). MPGrapher compiles well- formed XML files that conform to the yEd GraphML schema. These files will be opened and analyzed using...ABSTRACT UU NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Prescribed by ANSI Std. 239-18 ii THIS PAGE INTENTIONALLY LEFT BLANK iii Approved

Effects of Using a Neuroeducational Intervention to Enhance Perseverance for Online EdD and EdS Students

ERIC Educational Resources Information Center

Cadle, Charles R.

2013-01-01

Developing and maintaining a "completion mindset" is a necessary mental condition for online educational doctorate (EdD) and educational specialist (EdS) students to obtain their advanced degrees. The purpose of this research study was to examine the effect of a neuroeducational intervention on a volunteer convenience sample of EdD and…

Parent- and Teacher-Reported Symptoms of ADHD in School-Aged Children With Active Epilepsy: A Population-Based Study.

PubMed

Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Chin, Richard F M; Aylett, Sarah E; Burch, Victoria; Gillberg, Christopher; Scott, Rod C; Neville, Brian G R

2017-09-01

Provide data on the distribution of parent- and teacher-reported symptoms of ADHD in childhood epilepsy and describe coexisting cognitive and behavioral disorders in children with both epilepsy and ADHD. Eighty-five (74% of those eligible) children (5-15 years) in a population-based sample with active epilepsy underwent psychological assessment. The ADHD Rating Scale-IV (ADHD-RS-IV) scale was completed by parents ( n = 69) and teachers ( n = 67) of participating children with an IQ > 34. ADHD was diagnosed with respect to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Parents reported significantly more symptoms of ADHD than teachers ( p < .001). Symptoms of inattention were more commonly reported than symptoms of hyperactivity-impulsivity ( p < .001). Neurobehavioral comorbidity was similar in those with ADHD and non-ADHD with the exception of oppositional defiant disorder (ODD) and developmental coordination disorder (DCD), which were more common in those with both epilepsy and ADHD. Symptoms of ADHD are very common in childhood epilepsy but prevalence is influenced by informant.

Roles of Rev1, Pol ζ, Pol32 and Pol η in the bypass of chromosomal abasic sites in Saccharomyces cerevisiae

PubMed Central

Auerbach, Paul A.; Demple, Bruce

2010-01-01

Translesion synthesis (TLS) on DNA is a process by which potentially cytotoxic replication-blocking lesions are bypassed, but at the risk of increased mutagenesis. The exact in vivo role of the individual TLS enzymes in Saccharomyces cerevisiae has been difficult to determine from previous studies due to differing results from the variety of systems used. We have generated a series of S.cerevisiae strains in which each of the TLS-related genes REV1, REV3, REV7, RAD30 and POL32 was deleted, and in which chromosomal apyrimidinic sites were generated during normal cell growth by the activity of altered forms of human uracil-DNA glycosylase that remove undamaged cytosines or thymines. Deletion of REV1, REV3 or REV7 resulted in slower growth dependent on (rev3Δ and rev7Δ) or enhanced by (rev1Δ) expression of the mutator glycosylases and a nearly complete abolition of glycosylase-induced mutagenesis. Deletion of POL32 resulted in cell death when the mutator glycosylases were expressed and, in their absence, diminished spontaneous mutagenesis. RAD30 appeared to be unnecessary for mutagenesis in response to abasic sites, as deleting this gene caused no significant change in either the mutation rates or the mutational spectra due to glycosylase expression. PMID:19901007

Complete set of essential parameters of an effective theory

NASA Astrophysics Data System (ADS)

Ioffe, M. V.; Vereshagin, V. V.

2018-04-01

The present paper continues the series [V. V. Vereshagin, True self-energy function and reducibility in effective scalar theories, Phys. Rev. D 89, 125022 (2014); , 10.1103/PhysRevD.89.125022A. Vereshagin and V. Vereshagin, Resultant parameters of effective theory, Phys. Rev. D 69, 025002 (2004); , 10.1103/PhysRevD.69.025002K. Semenov-Tian-Shansky, A. Vereshagin, and V. Vereshagin, S-matrix renormalization in effective theories, Phys. Rev. D 73, 025020 (2006), 10.1103/PhysRevD.73.025020] devoted to the systematic study of effective scattering theories. We consider matrix elements of the effective Lagrangian monomials (in the interaction picture) of arbitrary high dimension D and show that the full set of corresponding coupling constants contains parameters of both kinds: essential and redundant. Since it would be pointless to formulate renormalization prescriptions for redundant parameters, it is necessary to select the full set of the essential ones. This is done in the present paper for the case of the single scalar field.

Implementation of the infinite-range exterior complex scaling to the time-dependent complete-active-space self-consistent-field method

NASA Astrophysics Data System (ADS)

Orimo, Yuki; Sato, Takeshi; Scrinzi, Armin; Ishikawa, Kenichi L.

2018-02-01

We present a numerical implementation of the infinite-range exterior complex scaling [Scrinzi, Phys. Rev. A 81, 053845 (2010), 10.1103/PhysRevA.81.053845] as an efficient absorbing boundary to the time-dependent complete-active-space self-consistent field method [Sato, Ishikawa, Březinová, Lackner, Nagele, and Burgdörfer, Phys. Rev. A 94, 023405 (2016), 10.1103/PhysRevA.94.023405] for multielectron atoms subject to an intense laser pulse. We introduce Gauss-Laguerre-Radau quadrature points to construct discrete variable representation basis functions in the last radial finite element extending to infinity. This implementation is applied to strong-field ionization and high-harmonic generation in He, Be, and Ne atoms. It efficiently prevents unphysical reflection of photoelectron wave packets at the simulation boundary, enabling accurate simulations with substantially reduced computational cost, even under significant (≈50 % ) double ionization. For the case of a simulation of high-harmonic generation from Ne, for example, 80% cost reduction is achieved, compared to a mask-function absorption boundary.

Mentoring from Different Social Spheres: How Can Multiple Mentors Help in Doctoral Student Success in Ed.D Programs?

ERIC Educational Resources Information Center

Terry, Tarae; Ghosh, Rajashi

2015-01-01

Doctoral students leave their programs early due to lack of mentoring relationships needed to support degree completion and success. However, how mentoring contributes to Ed.D degree completion is not widely studied. In this qualitative narrative study, we sought to explore how multiple mentoring relationships reduced attrition in an Ed.D program.…

Child and Adolescent Adherence With Cognitive Behavioral Therapy for Anxiety: Predictors and Associations With Outcomes.

PubMed

Lee, Phyllis; Zehgeer, Asima; Ginsburg, Golda S; McCracken, James; Keeton, Courtney; Kendall, Philip C; Birmaher, Boris; Sakolsky, Dara; Walkup, John; Peris, Tara; Albano, Anne Marie; Compton, Scott

2017-04-27

Cognitive behavioral therapy (CBT) for anxiety disorders is effective, but nonadherence with treatment may reduce the benefits of CBT. This study examined (a) four baseline domains (i.e., demographic, youth clinical characteristics, therapy related, family/parent factors) as predictors of youth adherence with treatment and (b) the associations between youth adherence and treatment outcomes. Data were from 279 youth (7-17 years of age, 51.6% female; 79.6% White, 9% African American), with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, who participated in CBT in the Child/Adolescent Anxiety Multimodal Study. Adherence was defined in three ways (session attendance, therapist-rated compliance, and homework completion). Multiple regressions revealed several significant predictors of youth adherence with CBT, but predictors varied according to the definition of adherence. The most robust predictors of greater adherence were living with both parents and fewer youth comorbid externalizing disorders. With respect to outcomes, therapist ratings of higher youth compliance with CBT predicted several indices of favorable outcome: lower anxiety severity, higher global functioning, and treatment responder status after 12 weeks of CBT. Number of sessions attended and homework completion did not predict treatment outcomes. Findings provide information about risks for youth nonadherence, which can inform treatment and highlight the importance of youth compliance with participating in therapy activities, rather than just attending sessions or completing homework assignments.

Development of a Polymerase Chain Reaction Assay for the Specific Identification of Burkholderia mallei and Differentiation from Burkholderia pseudomallei and Other Closely Related Burkholderiaceae

DTIC Science & Technology

2005-11-29

used in this work were grown in LB broth. C . violaceum and Y. pestis were propagated at 25 8C, whereas the remaining bacterial isolates were cultured...reference panel, which includ- ed B. cepacia, B. cenocepacia, B. stabilis, B. multivorans, B. vietnamiensis, E. coli, C . violaceum , Y. pestis, and P...19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified Standard Form 298 (Rev. 8-98

Synthetic Lectins: New Tools for Detection and Management of Prostate Cancer

DTIC Science & Technology

2013-08-01

providing a new paradigm for the development of a prostate cancer diagnostic. AIM 1 describes a library based approach for the discovery of SLs...This work was supported by funds provided from NIH COBRE grant P20RR17698.Notes and references 1 D. H. Dube and C. R. Bertozzi, Nat. Rev. Drug... Discovery , 2005, 4, 477–488. 2 V. Harmat and G. Naray-Szabo, Croat. Chim. Acta, 2009, 82, 277– 282. 3 J. J. Lavigne and E. V. Anslyn, Angew. Chem., Int. Ed

Group 12 Thiolates: Syntheses, Characterization and Decomposition Pathways

DTIC Science & Technology

1994-03-08

Stadard Form 298 (Rev 2-89) P ,e~cnwd by ANSI Std 1319. 1 94 3 1 1 180 92_1_ OFFICE OF NAVAL RESEARCH GRANT N00014-92-J-1820 R&T Code 4135035---01...Malik, M. Motevalli. P . O’Brian, Organometallics 10, 730 (1991). 3. M. Bochmann, K. J. Webb. M. Harman. M. B. Hursthouse, Angew. Chem. Int. Engl. Ed...29, 100 (1990). 4. M. Bochmann. K. J. Webb. M. B. Hursthouse, M. Mazid, J. Chem. Soc., Dalton Trans. 1991, 2317. 5. J. G. Brennan. T. Siegrist, P . J

Crosstalk: The Journal of Defense Software Engineering. Volume 18, Number 1

DTIC Science & Technology

2005-01-01

d o t . o r g / a s k slashdot/04/04/12/1757244.shtml>. 5. Dibona , C., et al. Open Sources: Voices From the Open Source Rev- olution. 1st ed. O’Reilly...Volume 18, Number 1, January 2005 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER...5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) OO-ALC/MASE,6022 Fir Ave,Hill AFB,UT,84056-5820 8. PERFORMING

Human Pol ζ purified with accessory subunits is active in translesion DNA synthesis and complements Pol η in cisplatin bypass

PubMed Central

Lee, Young-Sam; Gregory, Mark T.; Yang, Wei

2014-01-01

DNA polymerase ζ (Pol ζ) is a eukaryotic B-family DNA polymerase that specializes in translesion synthesis and is essential for normal embryogenesis. At a minimum, Pol ζ consists of a catalytic subunit Rev3 and an accessory subunit Rev7. Mammalian Rev3 contains >3,000 residues and is twice as large as the yeast homolog. To date, no vertebrate Pol ζ has been purified for biochemical characterization. Here we report purification of a series of human Rev3 deletion constructs expressed in HEK293 cells and identification of a minimally catalytically active human Pol ζ variant. With a tagged form of an active Pol ζ variant, we isolated two additional accessory subunits of human Pol ζ, PolD2 and PolD3. The purified four-subunit Pol ζ4 (Rev3–Rev7–PolD2–PolD3) is much more efficient and more processive at bypassing a 1,2-intrastrand d(GpG)-cisplatin cross-link than the two-subunit Pol ζ2 (Rev3–Rev7). We show that complete bypass of cisplatin lesions requires Pol η to insert dCTP opposite the 3′ guanine and Pol ζ4 to extend the primers. PMID:24449906

Human Pol ζ purified with accessory subunits is active in translesion DNA synthesis and complements Pol η in cisplatin bypass.

PubMed

Lee, Young-Sam; Gregory, Mark T; Yang, Wei

2014-02-25

DNA polymerase ζ (Pol ζ) is a eukaryotic B-family DNA polymerase that specializes in translesion synthesis and is essential for normal embryogenesis. At a minimum, Pol ζ consists of a catalytic subunit Rev3 and an accessory subunit Rev7. Mammalian Rev3 contains >3,000 residues and is twice as large as the yeast homolog. To date, no vertebrate Pol ζ has been purified for biochemical characterization. Here we report purification of a series of human Rev3 deletion constructs expressed in HEK293 cells and identification of a minimally catalytically active human Pol ζ variant. With a tagged form of an active Pol ζ variant, we isolated two additional accessory subunits of human Pol ζ, PolD2 and PolD3. The purified four-subunit Pol ζ4 (Rev3-Rev7-PolD2-PolD3) is much more efficient and more processive at bypassing a 1,2-intrastrand d(GpG)-cisplatin cross-link than the two-subunit Pol ζ2 (Rev3-Rev7). We show that complete bypass of cisplatin lesions requires Pol η to insert dCTP opposite the 3' guanine and Pol ζ4 to extend the primers.

Analytical approximation for the Einstein-dilaton-Gauss-Bonnet black hole metric

NASA Astrophysics Data System (ADS)

Kokkotas, K. D.; Konoplya, R. A.; Zhidenko, A.

2017-09-01

We construct an analytical approximation for the numerical black hole metric of P. Kanti et al. [Phys. Rev. D 54, 5049 (1996), 10.1103/PhysRevD.54.5049] in the four-dimensional Einstein-dilaton-Gauss-Bonnet (EdGB) theory. The continued fraction expansion in terms of a compactified radial coordinate, used here, converges slowly when the dilaton coupling approaches its extremal values, but for a black hole far from the extremal state, the analytical formula has a maximal relative error of a fraction of one percent already within the third order of the continued fraction expansion. The suggested analytical representation of the numerical black hole metric is relatively compact and a good approximation in the whole space outside the black hole event horizon. Therefore, it can serve in the same way as an exact solution when analyzing particles' motion, perturbations, quasinormal modes, Hawking radiation, accreting disks, and many other problems in the vicinity of a black hole. In addition, we construct the approximate analytical expression for the dilaton field.

Threshold krypton charge-state distributions coincident with K-shell fluorescence.

NASA Astrophysics Data System (ADS)

Armen, Brad; Levin, Jon; Kanter, Elliot; Krässig, Bertold; Southworth, Steve; Young, Linda

2001-05-01

The distribution of Kr^q+ ionic charge states has been measured in coincidence with K-shell photon emission as a function of incident-photon energy across the krypton 1s threshold. With this scheme, we observe changes resulting from the contrast between resonant Raman and fluorescence effects. By selecting the radiative(U. Arp, T. LeBrun, S. H. Southworth, M. A. MacDonald, and M. Jung, Phys. Rev.) A 51 3598 (1995), as opposed to the non-radiative(G. B. Armen, J. C. Levin, and I. A. Sellin, Phys. Rev.) A 53 772 (1996) channel, excitation PCI effects are suppressed. In general, the higher charge states are seen to increase in importance as the edge is traversed. We present the experimental results in detail and an interpretation of the observed trends, based on a simple model of the excitation processfootnoteÅberg and Tulkki, in Atomic Inner-Shell Physics ed. B. Crasemann, Plenum 1985 and the ensuing cascade decay.

Reminiscing about thesis work with E T Jaynes at Stanford in the 1950s

NASA Astrophysics Data System (ADS)

Cummings, Frederick W.

2013-11-01

Abstract A short personal and historical account of the field of radiation interacting with (two-level) atoms is given. Subsequent to 1963, developments and extensions have been extensive and fruitful. One of the most fortunate changes in my life came in late 1957. I was looking for a thesis advisor, after two years of graduate course-work at Stanford. I chanced to see a notice of an upcoming lecture by a professor named Edwin T Jaynes. I could not understand from the announcement what he intended to talk about, but I was searching; I went to find out. That decision was a very lucky one. Ed was talking about a subject that inspired him then, and had been for many years, namely his concept of 'Max-Ent'. 'Maximum-Entropy' is a subject now close to my heart also. Ed's very-clear, well-thought-out papers, spread over many subsequent years, are transforming the field of probability (albeit too gradually) to the 'subjective' outlook of Bayes. (A recent book 'Maximum Entropy and Ecology' [1] will probably convert many nay-sayers to 'Max-Ent'.) I went into Ed's office (late 1957) and asked if I could work with him on a thesis. Did he have a problem for me? Yes, he did. Somewhat to my surprise, he asked me to look into the 'maser problem', involving a comparison of the semi-classical theory of radiation to a proper quantum treatment. To make a two-year story short, Ed's guidance was expert. (I imagine that if another of Ed's students (e.g. Joe Eberly) had come into his office fifteen minutes before me, the 'Jaynes-Cummings' (J-C) model would now perhaps be called otherwise, e.g., the 'J-E' model). In the two-year time frame (~1958-60), Ed had a number of other PhD dissertation students whom I knew; these included Joe Eberly, Doug Scalapino, Baldwin Robertson, Larry Davis and Mike Duggan. My thesis work under Ed reminds me of a story about Michelangelo and his famous 'Pieta'. Michelangelo was an old man about then, so he hired a young craftsman to do much of the physical work: 'chip here, carve there, cut off here, eliminate this, etc'. When the beautiful Pieta was finished, the young man was heard to say, 'I didn't realize before this that I was so talented'. Experiments by Clauser in 1972 on Bell's inequalities (e.g. [2]) showed them to be correct, and indicated that semi-classical alternatives to quantum electrodynamics were not viable. Working with Stuart Freedman, these were the first experimental tests of the predictions of Bell's theorem, the first observation of quantum entanglement, as well as the first experimental observation of a violation of a Bell inequality. The perturbation formulation of quantum radiation theory has long been rife with vexing infinities. Ed always insisted that only experiment can end an argument, so he and his students had been sensibly exploring semi-classical theory. This was not only because of the serious failings of standard QED, but more importantly because of the fact that (an improved) semi-classical theory was able to predict both spontaneous emission, with the correct Einstein coefficients, and the Lamb shift. These two effects have long been thought only possible in the quantum radiation domain (cf [3]). Ed readily accepted losing his bet with Franken about what experiment had to say about the Lamb shift. What is clear is that this bet of 50 with Peter Franken stimulated so much subsequent research that this bet played an important role in generally furthering the field of quantum optics. How did 'J-C' come to be published as it did in the IEEE [4]? Ed was not well known for the extravagant use of words, rather for paucity, clarity and economy. After about two years of working with Ed, he said to me one day, 'You have enough, write it up'. He also said 'We should publish'. (This was around early 1960). About this same time, I was contacted by someone from a new research lab just starting in Newport Beach, California (called 'Aeroneutronic', a division of Ford), asking if I would come to work there. I thought it sounded about right as an approximately two-three year position: repay some debts and look around at other possibilities (especially academe?). I left around June 1960 to take up this position in the research lab in Newport Beach. At about this same time (~late 1959), Ed was moving to his new 'chair' at Washington University in St Louis. I proceeded as quickly as I could to put together a thesis after arriving in Newport Beach; I wrote about what I had done, as best as I could in my naiveté about such undertakings. I wrote of the work I had done under Ed's kind and patient guidance for the two years in Palo Alto. I soon remembered that Ed had done a recent Stanford Microwave Lab report on our project; his writing was so much better than mine that I thought it witless to put out something as 'uneven' as I had written by then. At just this time that I was cobbling together a thesis, a consultant at Aeroneutronic, Jay Singer of UC Berkeley EE department, approached me in the hall, (no tele-commuting then!) asking if I might have something to contribute to a special issue of a journal of the IEEE he was editing, on the subject of 'Quantum Electronics'. (Comment: One of the earliest predecessors to the MRI, Jay Singer was then measuring the blood flow in rat tails and human arms; he holds two key MRI patents). I said I thought I did have something. The journal sounded appropriate, so I soon handed my 'thesis' to Jay, put Ed's name first (of course, since it consisted so largely of his words from the Microwave Lab report, but also since Ed was my 'guru'), ...and that was that...done [4]. From my perspective, it seemed to subsequently sink to the bottom of the sea, not to be seen by me again for many years until the elegant Walther-Rempe-Klein (WRK) experiments of 1987 on long-time coherent radiative behavior appeared [5]. They confirmed the long-time quantum-theoretical results of Eberly, Narozhny and Sanchez-Mondragon [6]. Bob Buley and I, while at Aeroneutronic, had published in the field of lasers [7], based on the J-C model. We found very strange, puzzling 'chaotic' output of a 'Q-switched' laser. When computer time-steps were changed, the chaos didn't disappear. It was about then (~June 1963) that both Bob and I headed elsewhere: I to the early-forming UC Riverside Physics Department as Assistant Professor, and Bob to a company in Santa Barbara. Our work on the mysterious 'chaotic' laser effect then ended (the term 'chaos' was not yet in the physics lexicon); Bob was the computer expert, our non-linear laser problem demanded rigorous numerical computations, and I was not savvy with the (then) 'refrigerator-sized' computers at UCR. P W Milonni has greatly extended this work (cf [8]). Mike Tavis, my graduate student at UCR around 1965, extended the J-C model to N atoms [9]. (We have more recently collaborated in a further study of this and other extensions of J-C.) The silence and zero feedback from the 'J-C', Buley and 'T-C' papers for so many years following 1965 was a bit deafening, so I thought it would be best that I go mostly onto other topics. One day in about 1989, I got a tap on the shoulder from a colleague at UCR: 'I saw your name in the title of a paper'. ('Huh?'). An astonishing number of exciting and important new topics have emerged since the 1987 WRK experiment, providing an ever-branching tree of both new theory and experiment. It is tempting to entitle this piece as 'Get your name in print: Diagonalize a 2 × 2'. References [1] Harte J 2011 Maximum Entropy and Ecology: A Theory of Abundance, Distribution, and Energetics (Oxford Series in Ecology and Evolution) (Oxford: Oxford University Press) [2] Freedman S J and Clauser J F 1972 Experimental test of local hidden-variable theories Phys. Rev. Lett. 28 938 [3] Stroud C R Jr and Jaynes E T 1970 Long-term solutions in semiclassical radiation theory Phys. Rev. A 1 106 [4] Jaynes E T and Cummings F W 1963 Comparison of quantum and semiclassical radiation theories with application to the beam maser Proc. IEEE 51 89 [5] Rempe G, Walther H and Klein N 1987 Observation of quantum collapse and revival in a one-atom maser Phys. Rev. Lett. 58 353 [6] Eberly J H, Narozhny N B and Sanchez-Mondragon J J 1980 Periodic spontaneous collapse and revival in a simple quantum Phys. Rev. Lett. 44 1323 [7] Buley E R and Cummings F W 1964 Dynamics of a system of N atoms interacting with a radiation field Phys. Rev. 134 A1454 [8] Milonni P W, Shin M-L and Ackerhalt J R 1987 Chaos in Laser-Matter Interactions (Singapore: World Scientific) [9] Tavis M and Cummings F W 1968 Exact solution for an N -molecule—radiation-field Hamiltonian Phys. Rev. 170 379

Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study.

PubMed

Mehta, Rajnikant L; Baxendale, Bryn; Roth, Katie; Caswell, Victoria; Le Jeune, Ivan; Hawkins, Jack; Zedan, Haya; Avery, Anthony J

2017-09-05

Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0% to 93.0% (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication.

Theory of Charge Transport in Organic Crystals: Lessons from the Past and Prospects for the Future

NASA Astrophysics Data System (ADS)

Kenkre, V. M.

2002-03-01

Interest in fundamental issues regarding charge transport in organic materials shifted in the early 80's from the field of crystals to the field of disordered systems after polaron theories[1,2] were successfully applied[2] to what was suspected to be a mobility transition in naphthalene[3]. Recent experiments on pentacene[4] have been responsible for a reversal of the shift: there is now a revival of interest in crystals particularly in basic questions regarding electron-phonon interactions, polaron formation, the nature of charge carriers, and the issue of band versus hopping transport. High magnitudes of the new mobilities appear to imply large free carrier bandwidths which have led some to conjecture that band (rather than hopping) transport is characteristic of pentacene[5]. And yet, pentacene experiments show an unmistakable rise in the mobility at higher temperature, a rise that seems to signal polaronic behavior. Added to this fascinating mélange of facts are clear velocity saturation effects[6] observed in pentacene[4] along with some cavalier interpretation attempts of those non-Ohmic effects. The purpose of the talk is to attempt to address basic issues raised by these observations. 1. R. Silbey and R. W. Munn, J. Chem. Phys. 72, 2763 (1980). 2. V. M. Kenkre, John D. Andersen, D.H. Dunlap, and C.B. Duke, Phys. Rev. Lett. 62, 1165 (1989); see also M. Pope and C. E. Swenberg, Electronic Processes in Organic Crystals and Polymers, 2nd ed. (Oxford Univ Press, New Yourk 1999), p. 968. 3. L. B. Schein, C. B. Duke, and A.R. McGhie, Phys. Rev. Lett. 40, 197 (1978); C. B. Duke and L. B. Schein, Physics Today 33, 42 (1980). 4. J. H. Schoen, C. Kloc, and B. Batlogg, Phys. Rev. Lett. 86, 3843 (2001); Phys. Rev. B63, 245201 (2001). 5. Note, however, a recent demonstration against bare band descriptions in pentacene provided by J. D. Andersen, L. Giuggioli, and V. M. Kenkre, Phys. Rev. B, submitted. 6. V. M. Kenkre and P. E. Parris, Phys. Rev. B, submitted; P. E. Parris, M. Kús and V. M. Kenkre, Phys. Lett. A 289, 188 (2001).

Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy.

PubMed

Wolitzky-Taylor, Kate B; Arch, Joanna J; Rosenfield, David; Craske, Michelle G

2012-10-01

Understanding for whom, and under what conditions, treatments exert their greatest effects is essential for developing personalized medicine. Research investigating moderators of outcome among evidence-based treatments for anxiety disorders is lacking. The current study examined several theory-driven and atheoretical putative moderators of outcome in cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Eighty-seven patients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) anxiety disorder completed 12 sessions of ACT or CBT and were assessed with a self-report measure of anxiety at baseline, post-treatment, and 6- and 12-month follow-up assessments. CBT outperformed ACT among those at moderate levels of baseline anxiety sensitivity, and among those with no comorbid mood disorder. ACT outperformed CBT among those with comorbid mood disorders. Higher baseline neuroticism was associated with poorer outcome across treatment conditions. Neither moderation nor general prediction was observed for baseline anxiety disorder comorbidity, race/ethnicity, gender, age, or baseline severity of the principal anxiety disorder. When including all randomized participants who completed the pre-treatment assessment (N = 121), a similar pattern was observed. Prescriptive recommendations for clinical practice and directions for future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Dissociative disorders among Chinese inpatients diagnosed with schizophrenia.

PubMed

Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Li, Ying; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Fan, Qing; Xiao, Zeping

2010-01-01

The purpose of this study was to assess the prevalence of dissociative disorders in a sample of Chinese psychiatric inpatients. Participants in the study were 569 consecutively admitted inpatients at Shanghai Mental Health Center, China, of whom 84.9% had a clinical diagnosis of schizophrenia based on the Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3. All participants completed a self-report measure of dissociation (the Dissociative Experiences Scale), and none had a prior diagnosis of a dissociative disorder. A total of 96 randomly selected participants were interviewed with a structured interview (the Dissociative Disorders Interview Schedule) and a clinical interview. These 96 patients did not differ significantly from the 473 patients who were not interviewed on any demographic measures or who did not complete the self-report dissociation measure. A total of 28 patients (15.3%, after weighting of the data) received a clinical diagnosis of a dissociative disorder based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria. Dissociative identity disorder was diagnosed in 2 patients (0.53%, after weighting). Compared to the patients without a dissociative disorder, patients with dissociative disorders were significantly more likely to report childhood abuse (57.1% vs. 22.1%), but the 2 groups did not differ significantly on any demographic measures. Dissociative disorders were readily identified in an inpatient psychiatric population in China.

Development of Guidelines and Resource Materials on Latin America for Use in Grades 1-12. Final Report.

ERIC Educational Resources Information Center

Gill, Clark C.; Conroy, William B.

The Latin America Project (1966-69) consisted of two phases: (1) completion of background studies and (2) preparation, field testing, and evaluation of instructional materials. Five background bulletins were prepared and distributed (See ED 012 832, ED 012 833, ED 012 365, ED 013 342, ED 022 781) and instructional materials organized around…

Balanced nuclear and cytoplasmic activities of EDS1 are required for a complete plant innate immune response.

PubMed

García, Ana V; Blanvillain-Baufumé, Servane; Huibers, Robin P; Wiermer, Marcel; Li, Guangyong; Gobbato, Enrico; Rietz, Steffen; Parker, Jane E

2010-07-01

An important layer of plant innate immunity to host-adapted pathogens is conferred by intracellular nucleotide-binding/oligomerization domain-leucine rich repeat (NB-LRR) receptors recognizing specific microbial effectors. Signaling from activated receptors of the TIR (Toll/Interleukin-1 Receptor)-NB-LRR class converges on the nucleo-cytoplasmic immune regulator EDS1 (Enhanced Disease Susceptibility1). In this report we show that a receptor-stimulated increase in accumulation of nuclear EDS1 precedes or coincides with the EDS1-dependent induction and repression of defense-related genes. EDS1 is capable of nuclear transport receptor-mediated shuttling between the cytoplasm and nucleus. By enhancing EDS1 export from inside nuclei (through attachment of an additional nuclear export sequence (NES)) or conditionally releasing EDS1 to the nucleus (by fusion to a glucocorticoid receptor (GR)) in transgenic Arabidopsis we establish that the EDS1 nuclear pool is essential for resistance to biotrophic and hemi-biotrophic pathogens and for transcriptional reprogramming. Evidence points to post-transcriptional processes regulating receptor-triggered accumulation of EDS1 in nuclei. Changes in nuclear EDS1 levels become equilibrated with the cytoplasmic EDS1 pool and cytoplasmic EDS1 is needed for complete resistance and restriction of host cell death at infection sites. We propose that coordinated nuclear and cytoplasmic activities of EDS1 enable the plant to mount an appropriately balanced immune response to pathogen attack.

Measurement of Ecological Dissonance with Bases of Power.

ERIC Educational Resources Information Center

Lin, Shang-Ping

This study examined a new measure of ecological dissonance (ED), whether different degrees of ED existed within levels of a university's power hierarchy, the relationship between ED and worker morale as a function of administrative power levels, and ED theory. Ninety-four faculty members at Mississippi State University completed the Index of Power…

Outcomes of Fundamentals of Laparoscopic Surgery (FLS) mastery training standards applied to an ergonomically different, lower cost platform.

PubMed

Placek, Sarah B; Franklin, Brenton R; Haviland, Sarah M; Wagner, Mercy D; O'Donnell, Mary T; Cryer, Chad T; Trinca, Kristen D; Silverman, Elliott; Matthew Ritter, E

2017-06-01

Using previously established mastery learning standards, this study compares outcomes of training on standard FLS (FLS) equipment with training on an ergonomically different (ED-FLS), but more portable, lower cost platform. Subjects completed a pre-training FLS skills test on the standard platform and were then randomized to train on the FLS training platform (n = 20) or the ED-FLS platform (n = 19). A post-training FLS skills test was administered to both groups on the standard FLS platform. Group performance on the pretest was similar. Fifty percent of FLS and 32 % of ED-FLS subjects completed the entire curriculum. 100 % of subjects completing the curriculum achieved passing scores on the post-training test. There was no statistically discernible difference in scores on the final FLS exam (FLS 93.4, ED-FLS 93.3, p = 0.98) or training sessions required to complete the curriculum (FLS 7.4, ED-FLS 9.8, p = 0.13). These results show that when applying mastery learning theory to an ergonomically different platform, skill transfer occurs at a high level and prepares subjects to pass the standard FLS skills test.

Reticuloendotheliosis virus: detection of immunological relationship to mammalian type C retroviruses.

PubMed Central

Charman, H P; Gilden, R V; Oroszlan, S

1979-01-01

Reticuloendotheliosis virus (REV) p30 shares cross-reactive determinants and a common NH2-terminal tripeptide with mammalian type C viral p30's. An interspecies competition radioimmunoassay was developed, using iodinated REV p30 and a broadly reactive antiserum to mammalian virus p30's. The avian leukosis-sarcoma viruses and mammalian non-type C retroviruses did not compete in this assay. Previous data indicating that the REV group is not represented completely in normal avian cell DNA lead us to speculate that this may be the first example of interclass transmission, albeit in the remote past, among the Retroviridae. PMID:87519

The etiology of associations between negative emotionality and childhood externalizing disorders.

PubMed

Singh, Amber L; Waldman, Irwin D

2010-05-01

Despite consistent documentation of associations between childhood negative emotionality and externalizing psychopathology, few genetically informative studies have investigated the etiology of that association. The goal of the current study was to delineate the etiology of the covariation of negative emotionality and childhood externalizing problems (e.g., oppositional defiant disorder, conduct disorder, inattention, and hyperactivity/impulsivity). Twin families were recruited from Georgia state birth records and completed parental report questionnaires of negative emotionality and common Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) child psychiatric disorders. Results suggest both genetic and environmental influences underlying negative emotionality and each externalizing symptom dimension, with additional evidence for sibling competition/rater contrast effects for inattention and hyperactivity/impulsivity. Bivariate model-fitting analyses indicated that a portion of the additive (43%-75%) and nonadditive (26%-100%) genetic influences underlying each symptom dimension was accounted for by the genetic influences underlying negative emotionality. Finally, an independent pathways model examining the etiology of the association between negative emotionality and the externalizing dimensions indicated that a substantial portion of the additive genetic, nonadditive genetic, and nonshared environmental influences underlying externalizing behavior is shared with negative emotionality.

Isolation and characterization of a virus-specific ribonucleoprotein complex from reticuloendotheliosis virus-transformed chicken bone marrow cells.

PubMed Central

Wong, T C; Kang, C Y

1978-01-01

Chicken bone marrow cells transformed by reticuloendotheliosis virus (REV) produce in the cytoplasm a ribonucleoprotein (RNP) complex which has a sedimentation value of approximately 80 to 100S and a density of 1.23 g/cm3. This RNP complex is not derived from the mature virion. An endogenous RNA-directed DNA polymerase activity is associated with the RNP complex. The enzyme activity was completely neutralized by anti-REV DNA polymerase antibody but not by anti-avian myeloblastosis virus DNA polymerase antibody. The DNA product from the endogenous RNA-directed DNA polymerase reaction of the RNP complex hybridized to REV RNA but not to avian leukosis virus RNA. The RNA extracted from the RNP hybridized only to REV-specific complementary DNA synthesized from an endogenous DNA polymerase reaction of purified REV. The size of the RNA in the RNP is 30 to 35S, which represents the subunit size of the genomic RNA. No 60S mature genomic RNA was found within the RNP complex. The significance of finding the endogenous DNA polymerase activity in the viral RNP in infected cells and the maturation process of 60S virion RNA of REV are discussed. PMID:81319

Delusional versus nondelusional body dysmorphic disorder: recommendations for DSM-5

PubMed Central

Phillips, Katharine A.; Hart, Ashley S.; Simpson, Helen Blair; Stein, Dan J.

2016-01-01

The core feature of body dysmorphic disorder (BDD) is distressing or impairing preoccupation with nonexistent or slight defects in one’s physical appearance. BDD beliefs are characterized by varying degrees of insight, ranging from good (ie, recognition that one’s BDD beliefs are not true) through “absent insight/delusional” beliefs (ie, complete conviction that one’s BDD beliefs are true). The Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. (DSM-III-R) and The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) classified BDD’s nondelusional form in the somatoform section of the manual and its delusional form in the psychosis section, as a type of delusional disorder, somatic type (although DSM-IV allowed double-coding of delusional BDD as both a psychotic disorder and BDD). However, little or no evidence on this issue was available when these editions were published. In this article, we review the classification of BDD’s delusional and nondelusional variants in earlier editions of DSM and the limitations of their approaches. We then review empirical evidence on this topic, which has become available since DSM-IV was developed. Available evidence indicates that across a range of validators, BDD’s delusional and nondelusional variants have many more similarities than differences, including response to pharmacotherapy. Based on these data, we propose that BDD’s delusional and nondelusional forms be classified as the same disorder and that BDD’s diagnostic criteria include an insight specifier that spans a range of insight, including absent insight/delusional BDD beliefs. We hope that this recommendation will improve care for patients with this common and often-severe disorder. This increased understanding of BDD may also have implications for other disorders that have an “absent insight/delusional” form. PMID:23659348

Measurement of complete and continuous Wigner functions for discrete atomic systems

NASA Astrophysics Data System (ADS)

Tian, Yali; Wang, Zhihui; Zhang, Pengfei; Li, Gang; Li, Jie; Zhang, Tiancai

2018-01-01

We measure complete and continuous Wigner functions of a two-level cesium atom in both a nearly pure state and highly mixed states. We apply the method [T. Tilma et al., Phys. Rev. Lett. 117, 180401 (2016), 10.1103/PhysRevLett.117.180401] of strictly constructing continuous Wigner functions for qubit or spin systems. We find that the Wigner function of all pure states of a qubit has negative regions and the negativity completely vanishes when the purity of an arbitrary mixed state is less than 2/3 . We experimentally demonstrate these findings using a single cesium atom confined in an optical dipole trap, which undergoes a nearly pure dephasing process. Our method can be applied straightforwardly to multi-atom systems for measuring the Wigner function of their collective spin state.

Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome

PubMed Central

Kim, Jeong Gyun; Cho, Won-Sang; Kim, Jeong Eun

2014-01-01

Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure. PMID:24653803

Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome.

PubMed

Kim, Jeong Gyun; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

2014-02-01

Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.

One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice.

PubMed

Capogrosso, Paolo; Colicchia, Michele; Ventimiglia, Eugenio; Castagna, Giulia; Clementi, Maria Chiara; Suardi, Nazareno; Castiglione, Fabio; Briganti, Alberto; Cantiello, Francesco; Damiano, Rocco; Montorsi, Francesco; Salonia, Andrea

2013-07-01

Erectile dysfunction (ED) is a common complaint in men over 40 years of age, and prevalence rates increase throughout the aging period. Prevalence and risk factors of ED among young men have been scantly analyzed. Assessing sociodemographic and clinical characteristics of young men (defined as ≤ 40 years) seeking first medical help for new onset ED as their primary sexual disorder. Complete sociodemographic and clinical data from 439 consecutive patients were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF). Descriptive statistics tested sociodemographic and clinical differences between ED patients ≤ 40 years and >40 years. New onset ED as the primary disorder was found in 114 (26%) men ≤ 40 years (mean [standard deviation [SD

Antecedents of eating disorders and muscle dysmorphia in a non-clinical sample.

PubMed

Lamanna, J; Grieve, F G; Derryberry, W Pitt; Hakman, M; McClure, A

2010-01-01

Muscle Dysmorphia (MD) has recently been conceptualized as the male form of Eating Disorders (ED); although, it is not currently classified as an ED. The current study compares etiological models of MD symptomatology and ED symptomatology. It was hypothesized that sociocultural influences on appearance (SIA) would predict body dissatisfaction (BD), and that this relationship would be mediated by self-esteem (SE) and perfectionism (P); that BD would predict negative affect (NA); and that NA would predict MD and ED symptomatology. Two-hundred-forty-seven female and 101 male college students at a midsouth university completed the study. All participants completed measures assessing each of the constructs, and multiple regression analyses were conducted to test each model's fit. In both models, most predictor paths were significant. These results suggest similarity in symptomatology and etiological models between ED and MD.

Association between body size and composition and erectile dysfunction in older men: Osteoporotic Fractures in Men Study.

PubMed

Garimella, Pranav S; Paudel, Misti L; Ensrud, Kristine E; Marshall, Lynn M; Taylor, Brent C; Fink, Howard A

2013-01-01

To examine the association between body size and composition and erectile dysfunction (ED) in older men. Cross-sectional analysis of the Osteoporotic Fractures in Men study. Six U.S. clinical sites. Community-dwelling men aged 65 and older. Body composition measures using anthropometry (body weight, body mass index (BMI)) and dual X-ray absorptiometry (total body fat percentage, trunk fat percentage, ratio of trunk and total body fat). ED was assessed using the single-item Massachusetts Male Aging Study (MMAS) scale and the five-item International Index of Erectile Function questionnaire (IIEF-5). In men completing the MMAS scale (n = 4,108), prevalence of complete ED was 42%. In sexually active men completing the IIEF-5 questionnaire (n = 1,659), prevalence of moderate to severe ED was 56%. In multivariate-adjusted analyses reporting prevalence ratios (PRs) and 95% confidence intervals (CIs), the prevalence of MMAS-defined complete ED was significantly greater in men in the highest quartile of body weight (PR = 1.24, 95% CI = 1.16-1.34), total body fat percentage (PR = 1.25, 95% CI = 1.13-1.40), and trunk fat percentage (PR = 1.24, 95% CI = 1.15-1.38), and was greater in men with a BMI greater than 30.0 kg/m(2) than in those with BMI of 22.0 to 24.9 kg/m(2) (PR = 1.17, 95% CI = 1.05-1.31). Associations appeared similar for IIEF-5-defined moderate to severe ED in analyses adjusted for age and study site. In a cohort of older men, high body weight, BMI, and total body fat percentage were independently associated with greater prevalence of moderate to severe and complete ED. Future studies should investigate whether interventions to promote weight loss and fat loss will improve erectile function in older men. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

What Parents Want: Does Provider Knowledge of Written Parental Expectations Improve Satisfaction in the Emergency Department?

PubMed

Zoltowski, Kathleen S W; Mistry, Rakesh D; Brousseau, David C; Whitfill, Travis; Aronson, Paul L

2016-01-01

Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey. At ED disposition, all groups completed a 3-item satisfaction survey, scored using 5-point Likert scales (1 = very poor, 5 = very good). The primary outcome was rating of "overall care." Secondary outcomes included likelihood of recommending the ED and staff sensitivity to concerns. Proportions were compared by chi-square test. A total of 304 subjects were enrolled. The proportion of parents rating 5 of 5 for overall care did not differ among the baseline, control, and intervention groups (74.8% vs 73.2% vs 69.2%, P = .56). The proportion of parents rating 5 of 5 also did not differ for likelihood of recommending the ED (77.7% vs 72.2% vs 70.2%, P = .45) or staff sensitivity to concerns (78.6% vs 78.4% vs 78.8%, P = .71). For nonurgent pediatric ED visits, clinician knowledge of written parental expectations does not improve parental satisfaction. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Recent results from the ILL NSEs

NASA Astrophysics Data System (ADS)

Farago, Bela

2007-07-01

In this paper I will try to present some recent results on less usual subjects, which I believe are forward pointing to fields which might develop faster as new sources/instruments become available. The first deals with an assembly of spherical microemulsions which under certain conditions self-organize themselves into a cubic phase. Applying contrast variation and covering the large dynamical range of NSE we just start to be able to identify the different kind of relaxations present [B. Molle, et al., Phys. Rev. Lett. 90 (2003) 068305]. The second shows a nice example of diffusion of alkane chains in porous material (zeolite). Here high resolution and high intensity were needed to pinpoint the predicted “window” effect [H. Jobic, et al., Angew. Chem. Int. Ed. 43(3) (2004) 364]. Finally some results on PMMA/PEO polymer blend will be shown, where the high count rate and simultaneous multi-Q measurement on IN11C made the experiment possible. Still improved resolution would be very welcome to fully extract all possible information [B. Farago, et al., Phys. Rev. E 72 (2005) 031809].

Modified Maxium Likelihood Estimation Method for Completely Separated and Quasi-Completely Separated Data for a Dose-Response Model

DTIC Science & Technology

2015-08-01

McCullagh, P.; Nelder, J.A. Generalized Linear Model , 2nd ed.; Chapman and Hall: London, 1989. 7. Johnston, J. Econometric Methods, 3rd ed.; McGraw...FOR A DOSE-RESPONSE MODEL ECBC-TN-068 Kyong H. Park Steven J. Lagan RESEARCH AND TECHNOLOGY DIRECTORATE August 2015 Approved for public release...Likelihood Estimation Method for Completely Separated and Quasi-Completely Separated Data for a Dose-Response Model 5a. CONTRACT NUMBER 5b. GRANT

Involvement of the Clock Gene Rev-erb alpha in the Regulation of Glucagon Secretion in Pancreatic Alpha-Cells

PubMed Central

Vieira, Elaine; Marroquí, Laura; Figueroa, Ana Lucia C.; Merino, Beatriz; Fernandez-Ruiz, Rebeca; Nadal, Angel; Burris, Thomas P.; Gomis, Ramon; Quesada, Ivan

2013-01-01

Disruption of pancreatic clock genes impairs pancreatic beta-cell function, leading to the onset of diabetes. Despite the importance of pancreatic alpha-cells in the regulation of glucose homeostasis and in diabetes pathophysiology, nothing is known about the role of clock genes in these cells. Here, we identify the clock gene Rev-erb alpha as a new intracellular regulator of glucagon secretion. Rev-erb alpha down-regulation by siRNA (60–70% inhibition) in alphaTC1-9 cells inhibited low-glucose induced glucagon secretion (p<0.05) and led to a decrease in key genes of the exocytotic machinery. The Rev-erb alpha agonist GSK4112 increased glucagon secretion (1.6 fold) and intracellular calcium signals in alphaTC1-9 cells and mouse primary alpha-cells, whereas the Rev-erb alpha antagonist SR8278 produced the opposite effect. At 0.5 mM glucose, alphaTC1-9 cells exhibited intrinsic circadian Rev-erb alpha expression oscillations that were inhibited by 11 mM glucose. In mouse primary alpha-cells, glucose induced similar effects (p<0.001). High glucose inhibited key genes controlled by AMPK such as Nampt, Sirt1 and PGC-1 alpha in alphaTC1-9 cells (p<0.05). AMPK activation by metformin completely reversed the inhibitory effect of glucose on Nampt-Sirt1-PGC-1 alpha and Rev-erb alpha. Nampt inhibition decreased Sirt1, PGC-1 alpha and Rev-erb alpha mRNA expression (p<0.01) and glucagon release (p<0.05). These findings identify Rev-erb alpha as a new intracellular regulator of glucagon secretion via AMPK/Nampt/Sirt1 pathway. PMID:23936124

The Trail-making Test B and driver screening in the emergency department.

PubMed

Betz, Marian E; Fisher, Jonathan

2009-10-01

Emergency departments (EDs) rarely screen for older driving safety. The Trail-Making Test B (TMT-B) is a neuropsychological test that may predict ability to drive. We sought to examine the driving patterns of older ED patients and the feasibility of screening patients in the ED using the TMT-B. At a single ED at a tertiary care center, we administered the TMT-B and a survey of health status and driving habits to a convenience sample of adult (age 18 and older) ED patients. We excluded those with altered mentation, critical illness, or language barriers. The TMT-B, scored by the time of first attempt, requires connection of letters and numbers in sequence on paper, and a time > or = 180 s may suggest elevated driving risk. We compared time to complete the TMT-B among ED patients to published norms. Of 144 patients ages 18 to 95, 95 (72.2%) were current drivers, and 91.4 percent of drivers were able to complete the TMT-B; 47.1 percent of drivers were older (65+), and 88.8 percent of older drivers rated their ability as good or excellent. In multivariate logistic regression, neither TMT-B performance nor being older predicted a recent collision. The mean TMT-B completion time was 66.1 (SD = 36.3, median = 56) s among drivers under age 65 and 117.5 (SD = 79.2, median = 95) s among those 65 or older. Approximately 1.9 percent (95% CI: 0.04-10.2) of drivers under 65 and 14.0 percent (95% CI: 5.3-27.9%) of drivers 65 or older required 180 s or more for the TMT-B. Using unpaired T-tests, study TMT-B times were not significantly different from previously published norms except among 25- to 34-year-olds (79.2 versus 50.7 s; p < 0.05) and 80- to 84-year-olds (223.9 versus 146.8 s; p < 0.01). Many older ED patients drive, and relatively healthy ED patients are able to complete the TMT-B with results similar to standard nomograms. The TMT-B may prove useful as part of targeted driver screening programs in EDs.

B80 and B101-103 clusters: Remarkable stability of the core-shell structures established by validated density functionalsa)

NASA Astrophysics Data System (ADS)

Li, Fengyu; Jin, Peng; Jiang, De-en; Wang, Lu; Zhang, Shengbai B.; Zhao, Jijun; Chen, Zhongfang

2012-02-01

Prompted by the very recent claim that the volleyball-shaped B80 fullerene [X. Wang, Phys. Rev. B 82, 153409 (2010), 10.1103/PhysRevB.82.153409] is lower in energy than the B80 buckyball [N. G. Szwacki, A. Sadrzadeh, and B. I. Yakobson, Phys. Rev. Lett. 98, 166804 (2007), 10.1103/PhysRevLett.98.166804] and core-shell structure [J. Zhao, L. Wang, F. Li, and Z. Chen, J. Phys. Chem. A 114, 9969 (2010), 10.1021/jp1018873], and inspired by the most recent finding of another core-shell isomer as the lowest energy B80 isomer [S. De, A. Willand, M. Amsler, P. Pochet, L. Genovese, and S. Goedecher, Phys. Rev. Lett. 106, 225502 (2011), 10.1103/PhysRevLett.106.225502], we carefully evaluated the performance of the density functional methods in the energetics of boron clusters and confirmed that the core-shell construction (stuffed fullerene) is thermodynamically the most favorable structural pattern for B80. Our global minimum search showed that both B101 and B103 also prefer a core-shell structure and that B103 can reach the complete core-shell configuration. We called for great attention to the theoretical community when using density functionals to investigate boron-related nanomaterials.

Comparative symptomatology of burnout and depression.

PubMed

Bianchi, Renzo; Boffy, Claire; Hingray, Coraline; Truchot, Didier; Laurent, Eric

2013-06-01

The link between burnout and depression remains unclear. In this study, we compared depressive symptoms in 46 burned-out workers, 46 outpatients experiencing a major depressive episode, and 453 burnout-free workers to test the distinctiveness of burnout as a clinical entity. Participants with burnout and major depressive episode reported similar, severe levels of overall depressive symptoms. The between-syndrome overlap was further verified for eight of the nine major depressive episode diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Our findings do not support the view hypothesizing that burnout and depression are separate entities and question the nosological added value of the burnout construct.

Vibration-rotation-translation spectrum of molecular hydrogen in fullerite lattices around 80 K

NASA Astrophysics Data System (ADS)

Herman, Roger M.; Lewis, John Courtenay

2009-05-01

Calculations are presented for the fundamental vibration-rotation spectrum of H2 in fcc C60 (fullerite) lattices near 80 K using the approach and the parameters used by Herman and Lewis [Phys. Rev. B 73 (2006) 155408; in: E. Oks, M. Pindzola (Eds.) Spectral Line Shapes, AIP Conference Proceedings, No. 874, American Institute of Physics, 2006, pp. 162-176 (Proceedings of the 18th ICSLS)] at 293 K. Good agreement is found with recent DRIFT spectra of FitzGerald et al. [Personal communication, 2006]. It is argued that our approach cannot be extended to the 10 K spectrum without significant modification.

Patient satisfaction in the emergency department and the use of business cards by physicians.

PubMed

Olsen, Jon C; Olsen, Eric C

2012-03-01

Emergency departments (EDs) across the country become increasingly crowded. Methods to improve patient satisfaction are becoming increasingly important. To determine if the use of business cards by emergency physicians improves patient satisfaction. A prospective, convenience sample of ED patients were surveyed in a tertiary care, suburban teaching hospital. Inclusion criteria were limited to an understanding of written and spoken English. Excluded patients included those with altered mental status or too ill to complete a survey. Patients were assigned to receive a business card on alternate days in the ED from the treating physician(s) during their patient introductions. The business cards listed the physician's name and position (resident or attending physician) and the institution name and phone number. Before hospital admission or discharge, a research assistant asked patients to complete a questionnaire regarding their ED visit to determine patient satisfaction. Three hundred-twenty patients were approached to complete the questionnaire and 259 patients (81%) completed it. Patient demographics were similar in both the business card and non-business-card groups. There were no statistically significant differences for patient responses to any of the study questions whether or not they received a business card during the physician introduction. The use of business cards during physician introduction in the ED does not improve patient satisfaction. Copyright © 2012 Elsevier Inc. All rights reserved.

Eating disorder-specific health-related quality of life and exercise in college females.

PubMed

Cook, Brian J; Hausenblas, Heather A

2011-11-01

Although eating disorder (ED) symptoms result in reduced quality of life (QOL), research is needed to examine variables that influence this relationship. The purpose of our study was to conceptually examine the relationship among ED-specific QOL, ED symptoms, and exercise behavior. Female university students (N = 387) completed ED-specific QOL, exercise behavior, ED symptoms, and exercise dependence symptoms measures. We found support for the beneficial association of psychological QOL on ED symptoms as well as the detrimental association of exercise dependence on ED symptoms. Our results suggest that improvements in psychological aspects of QOL resulting from exercise may mediate ED symptoms when exercise motivations are not pathological. We discuss further research and intervention implications of our findings.

DOD Hotline Allegations on Army Use of A Computer Contract

DTIC Science & Technology

1993-10-29

Army, the Navy, and the Defense Logistics Agency central order processing offices and reviewed delivery orders issued on the EDS contract. A...o The contracting officers used the EDS contract line item number and the description when completing a delivery order. o The central order ... processing offices used an automated data base system to match contract line item numbers from the delivery orders to the EDS contract. o EDS verified that

Effects of Reticuloendotheliosis Virus Infection on Cytokine Production in SPF Chickens

PubMed Central

Xue, Mei; Shi, Xingming; Zhao, Yan; Cui, Hongyu; Hu, Shunlei; Cui, Xianlan; Wang, Yunfeng

2013-01-01

Infection with reticuloendotheliosis virus (REV), a gammaretrovirus in the Retroviridae family, can result in immunosuppression and subsequent increased susceptibility to secondary infections. The effects of REV infection on expression of mRNA for cytokine genes in chickens have not been completely elucidated. In this study, using multiplex branched DNA (bDNA) technology, we identified molecular mediators that participated in the regulation of the immune response during REV infection in chickens. Cytokine and chemokine mRNA expression levels were evaluated in the peripheral blood mononuclear cells (PBMCs). Expression levels of interleukin (IL)-4, IL-10, IL-13 and tumor necrosis factor (TNF)-α were significantly up-regulated while interferon (IFN)-α, IFN-β, IFN-γ, IL-1β，IL-2, IL-3, IL-15, IL-17F, IL-18 and colony-stimulating factor (CSF)-1 were markedly decreased in PBMCs at all stages of infection. Compared with controls, REV infected chickens showed greater expression levels of IL-8 in PBMCs 21 and 28 days post infection. In addition, REV regulates host immunity as a suppressor of T cell proliferative responses. The results in this study will help us to understand the host immune response to virus pathogens. PMID:24358317

Comment on "Particle path through a nested Mach-Zehnder interferometer"

NASA Astrophysics Data System (ADS)

Salih, Hatim

2018-02-01

In a recent paper [Phys. Rev. A 94, 032115 (2016), 10.1103/PhysRevA.94.032115], Griffiths questioned—based on an interesting consistent-histories (CH) argument—the counterfactuality, for one of the bit choices, of the protocol of Salih et al. for communicating without sending physical particles [Phys. Rev. Lett. 110, 170502 (2013), 10.1103/PhysRevLett.110.170502]. Here, we first show that for the Mach-Zehnder version used to explain our protocol, contrary to Griffiths's claim, no family of consistent histories exists where any history has the photon traveling through the communication channel, thus rendering the question of whether the photon was in the communication channel meaningless from a CH viewpoint. We then show that for the actual Michelson-type protocol, there is a consistent-histories family for each cycle that includes histories where the photon travels through the communication channel. We show that the probability of finding the photon in the communication channel at any time is zero—proving complete counterfactuality.

A novel briefing checklist at shift handoff in an emergency department improves situational awareness and safety event identification.

PubMed

Mullan, Paul C; Macias, Charles G; Hsu, Deborah; Alam, Sartaj; Patel, Binita

2015-04-01

Emergency department (ED) shift handoffs are sources of potential medical error, delays in care, and medicolegal liabilities. Few handoff studies exist in the ED literature. We aimed to describe the implementation of a standardized checklist for improving situational awareness during physician handoffs in a pediatric ED. This is a descriptive observational study in a large academic pediatric ED. Checklists were evaluated for rates of use, completion, and identification of potential safety events. We defined a complete checklist as 80% or more of items checked.  A user perception survey was used. After 1 year, all checklist users (residents, fellows, faculty, and charge nurses with ED experience before and after checklist implementation) were anonymously surveyed to assess the checklist's usability, perceived contributions to Institute of Medicine quality domains, and situational awareness. The electronically administered survey used Likert frequency scales. Of 732 handoffs, 98% used the checklist, and 89% were complete. A mean of 1.7 potential safety events were identified per handoff. The most frequent potential safety events were identification of intensive care unit-level patients in the ED (48%), equipment problems (46%), staffing issues (21%), and intensive care unit-level patients in transport (16%). Eighty-one subjects (88%) responded to the survey. The users agreed that the checklist promoted better communication, safety, efficiency, effective care, and situational awareness. The Physician Active Shift Signout in the Emergency Department briefing checklist was used often and at a high completion rate, frequently identifying potential safety events. The users found that it improved the quality of care and team communication. Future studies on outcomes and processes are needed.

The Association of Body Size and Composition with Erectile Dysfunction in Older Men: Osteoporotic Fractures in Men (MrOS) Study

PubMed Central

Garimella, Pranav S.; Paudel, Misti L.; Ensrud, Kristine E.; Marshall, Lynn M.; Taylor, Brent C.; Fink, Howard A.

2012-01-01

Objectives To examine the association of body size and composition with erectile dysfunction (ED) in older men. Design Cross-sectional analysis of the Osteoporotic Fractures in Men study. Setting Six U.S. clinical sites. Participants Community-dwelling men aged 65 years and older. Measurements Body composition measures using anthropometry (body weight, body mass index [BMI]) and dual x-ray absorptiometry (total body fat percent, trunk fat percent, ratio of trunk and total body fat). Erectile dysfunction was assessed using the single item Massachusetts Male Aging Study (MMAS) scale and the International Index of Erectile Function questionnaire (IIEF-5). Results Among men completing the MMAS scale (n=4108), prevalence of complete ED was 42%. Among sexually active men completing the IIEF-5 questionnaire (n=1659), prevalence of moderate to severe ED was 56%. In multivariate-adjusted analyses reporting prevalence ratios (PR) and 95% confidence intervals (CI), the prevalence of MMAS-defined complete ED was significantly increased in men in the highest quartile of increased body weight PR = 1.24, 95% CI = 1.16-1.34), total body fat percentage (PR = 1.25, 95% CI = 1.13-1.40), and trunk fat percentage (PR = 1.24, 95% CI = 1.15-1.38), and in men with BMI >30.0 kg/m2 compared to those with BMI 22.0-24.9 kg/m2 (PR = 1.17, 95% CI = 1.05-1.31). Associations appeared similar for IIEF-5 defined moderate to severe ED in analyses adjusted for age and study site. Conclusion In a cohort of older men, increased body weight, BMI, and total body fat percent were independently associated with increased prevalence of moderate to severe and complete ED. Future studies should investigate whether interventions to promote weight loss and fat loss will improve erectile function in older men. PMID:23311552

Reply to "Comment on "Benefits of completing homework for students with different aptitudes in an introductory electricity and magnetism course""

NASA Astrophysics Data System (ADS)

Kontur, F. J.; de La Harpe, K.; Terry, N. B.

2016-12-01

We reply to Rieger, Reinsberg, and Wieman's forgoing Comment [Phys. Rev. Phys. Educ. Res., Comment on "Benefits of completing homework for students with different aptitudes in an introductory electricity and magnetism course" 12, 028001 (2016)].

Reply to "Comment on "Benefits of Completing Homework for Students with Different Aptitudes in an Introductory Electricity and Magnetism Course""

ERIC Educational Resources Information Center

Kontur, F. J.; de La Harpe, K.; Terry, N. B.

2016-01-01

We reply to Rieger, Reinsberg, and Wieman's forgoing Comment [Phys. Rev. Phys. Educ. Res., Comment on "Benefits of completing homework for students with different aptitudes in an introductory electricity and magnetism course" 12, 028001 (2016)].

Exploring the Relationship Among Moral Distress, Coping, and the Practice Environment in Emergency Department Nurses.

PubMed

Zavotsky, Kathleen Evanovich; Chan, Garrett K

2016-01-01

Emergency department (ED) nurses practice in environments that are highly charged and unpredictable in nature and can precipitate conflict between the necessary prescribed actions and the individual's sense of what is morally the right thing to do. As a consequence of multiple moral dilemmas, ED staff nurses are at risk for experiencing distress and how they cope with these challenges may impact their practice. To examine moral distress in ED nurses and its relationship to coping in that specialty group. Using survey methods approach. One hundred ninety-eight ED nurses completed a moral distress, coping, and demographic collection instruments. Advanced statistical analysis was completed to look at relationships between the variables. Data analysis did show that moral distress is present in ED nurses (M = 80.19, SD = 53.27), and when separated into age groups, the greater the age, the less the experience of moral distress. A positive relationship between moral distress and some coping mechanisms and the ED environment was also noted. This study's findings suggest that ED nurses experience moral distress and could receive some benefit from utilization of appropriate coping skills. This study also suggests that the environment in which ED nurses practice has a significant impact on the experience of moral distress. Because health care is continuing to evolve, it is critical that issues such as moral distress and coping be studied in ED nurses to help eliminate human suffering.

Energy drink use frequency among an international sample of people who use drugs: Associations with other substance use and well-being.

PubMed

Peacock, Amy; Bruno, Raimondo; Ferris, Jason; Winstock, Adam

2017-05-01

The study aims were to identify: i.) energy drink (ED), caffeine tablet, and caffeine intranasal spray use amongst a sample who report drug use, and ii.) the association between ED use frequency and demographic profile, drug use, hazardous drinking, and wellbeing. Participants (n=74,864) who reported drug use completed the online 2014 Global Drug Survey. They provided data on demographics, ED use, and alcohol and drug use, completed the Alcohol Use Disorders Identification Test (AUDIT) and Personal Wellbeing Index (PWI), and reported whether they wished to reduce alcohol use. Lifetime ED, caffeine tablet and intranasal caffeine spray use were reported by 69.2%, 24.5% and 4.9%. Median age of ED initiation was 16 years. For those aged 16-37, median years using EDs increased from 4 to 17 years of consumption, where it declined thereafter. Greater ED use frequency was associated with: being male; under 21 years of age; studying; and past year caffeine tablet/intranasal spray, tobacco, cannabis, amphetamine, MDMA, and cocaine use. Past year, infrequent (1-4days) and frequent (≥5days) past month ED consumers reported higher AUDIT scores and lower PWI scores than lifetime abstainers; past month consumers were less likely to report a desire to reduce alcohol use. ED use is part of a complex interplay of drug use, alcohol problems, and poorer personal wellbeing, and ED use frequency may be a flag for current/future problems. Prospective research is required exploring where ED use fits within the trajectory of other alcohol and drug use. Copyright © 2017 Elsevier B.V. All rights reserved.

Agricultural Education Teacher Candidates' Perceptions of the edTPA

ERIC Educational Resources Information Center

Lunsford, Amanda; Warner, Wendy J.; Park, Travis D.; Morgan, Joy E.

2016-01-01

The edTPA has recently emerged within the past few years as an innovative Teacher Performance Assessment and is currently adopted to some extent in 34 states. Researchers conducted four focus groups with 16 teacher candidates during and immediately after completion of the edTPA at North Carolina State University. When asked to articulate about…

Results of the implementation of a new screening protocol for child maltreatment at the Emergency Department of the Academic Medical Center in Amsterdam.

PubMed

Teeuw, Arianne H; Sieswerda-Hoogendoorn, Tessa; Sangers, Esmée J; Heymans, Hugo S A; van Rijn, Rick R

2016-01-01

This study examines the results of the implementation of a new screening protocol for child maltreatment (CM) at the Emergency Department (ED) of the Academic Medical Center in Amsterdam, The Netherlands. This protocol consists of adding a so called 'top-toe' inspection (TTI), an inspection of the fully undressed child, to the screening checklist for child maltreatment, the SPUTOVAMO. We collected data from all patients 0-18 years old directly after introduction (February 2010) and 9 months later. Outcome measures were: completion of the screening and reasons for non-adherence. Data were collected on age, gender, reason for visiting the ED (defined by International Classification of Disease, ICD), presence of a chronic illness, type of professional performing the TTI and admission during week or weekend days. In February 560 and in November 529 paediatric patients were admitted. In February the complete screening protocol was performed in 42% of all children, in November in 17%. A correlation between completion of the SPUTOVAMO and having a TTI performed was found. Older age and presence of a chronic illness influenced the chance of having both SPUTOVAMO and TTI performed negatively. The completion rate of SPUTOVAMO was influenced by ICD code. Completion of TTI was influenced by type of investigator. The best performing professional was the ED physician followed by the paediatrician followed by the ED nurse. The reasons for not performing a TTI were not documented. Refusal of the TTI by a patient or parent was reported three times. Implementation of this new screening protocol for CM was only mildly successful and declined in time. A negative correlation between older child age and having a chronic illness and completion of the screening was found. A practical recommendation resulting from this study could be that, if CM screening protocols prove to be effective in detecting CM, regular training sessions have to be held. Filling out the checklist is something that could be performed by ED nurses. Performing a TTI is perhaps easier for the ED physicians to make part of their daily routine. Copyright © 2015 Elsevier Ltd. All rights reserved.

Delirium in the Emergency Department and Its Extension into Hospitalization (DELINEATE) Study: Effect on 6-month Function and Cognition.

PubMed

Han, Jin H; Vasilevskis, Eduard E; Chandrasekhar, Rameela; Liu, Xulei; Schnelle, John F; Dittus, Robert S; Ely, E Wesley

2017-06-01

The natural course and clinical significance of delirium in the emergency department (ED) is unclear. We sought to (1) describe the extent to which delirium in the ED persists into hospitalization (ED delirium duration) and (2) determine how ED delirium duration is associated with 6-month functional status and cognition. Prospective cohort study. Tertiary care, academic medical center. ED patients ≥65 years old who were admitted to the hospital. The modified Brief Confusion Assessment Method was used to ascertain delirium in the ED and hospital. Premorbid and 6-month function were determined using the Older American Resources and Services Activities of Daily Living (OARS ADL) questionnaire which ranged from 0 (completely dependent) to 28 (completely dependent). Premorbid and 6-month cognition were determined using the short form Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) which ranged from 1 to 5 (severe dementia). Multiple linear regression was performed to determine if ED delirium duration was associated with 6-month function and cognition adjusted for baseline OARS ADL and IQCODE, and other confounders. A total of 228 older ED patients were enrolled. Of the 105 patients who were delirious in the ED, 81 (77.1%) patients' delirium persisted into hospitalization. For every ED delirium duration day, the 6-month OARS ADL decreased by 0.63 points (95% CI: -1.01 to -0.24), indicating poorer function. For every ED delirium duration day, the 6-month IQCODE increased 0.06 points (95% CI: 0.01-0.10) indicating poorer cognition. Delirium in the ED is not a transient event and frequently persists into hospitalization. Longer ED delirium duration is associated with an incremental worsening of 6-month functional and cognitive outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Affective predictors of the severity and change in eating psychopathology in residential eating disorder treatment: The role of social anxiety.

PubMed

Smith, Kathryn E; Mason, Tyler B; Leonard, Rachel C; Wetterneck, Chad T; Smith, Brad E R; Farrell, Nicholas R; Riemann, Brad C

2018-01-01

Despite evidence documenting relationships between eating disorder (ED) psychopathology, depression, and anxiety, little is known regarding how social anxiety is related to ED symptoms in treatment. Therefore this study examined associations between depression, general anxiety, social anxiety, and ED psychopathology at the beginning and end of treatment (EOT) among patients (N = 380) treated in a residential ED program. Participants completed measures of ED psychopathology and affective variables. Higher depression and general anxiety, but not social anxiety, were related to higher ED psychopathology at baseline. However, social anxiety emerged as a unique predictor of ED psychopathology at EOT such that participants with higher social anxiety evidenced less improvement in ED psychopathology. Findings suggest that social anxiety has specific relevance to treatment in EDs, which may reflect shared mechanisms and underlying deficits in emotion regulation.

Does familiarity or conflict account for performance in the word-stem completion task? Evidence from behavioural and event-related-potential data.

PubMed

Klonek, Florian; Tamm, Sascha; Hofmann, Markus J; Jacobs, Arthur M

2009-11-01

The conflict monitoring theory (CMT) assumes that word-stems associated with several completions should lead to crosstalk and conflict due to underdetermined responding situation (Botvinick et al. in Psychol Rev 108(3):624-652, 2001). In contrast, the Multiple-Read-Out-Model (MROM) of Jacobs and Grainger (J Exp Psychol 20(6): 1311-1334, 1994) predicts a high level of general lexical activity (GLA) for word-stems with many completions, indicating a higher stimulus familiarity because these stems are more probable to be read. We compared word-stems with several completions against word-stems with one possible completion while measuring response times and electrophysiological recordings. Slowest response times and a distinct FN400 component, which has previously been related to the concept of familiarity (Curran in Memory Cogn 28(6):923-938, 2000), were apparent for word-stems that could only be associated with a single response. These findings support the claims of the MROM. Furthermore, the lack of the N2-component for word-stems with several completions continues to challenge the EEG-extension of the CMT (Yeung et al. in Psychol Rev 111(4):2004).

Community-based study of erectile dysfunction and sildenafil use: the Rancho Bernardo study.

PubMed

Monga, Manoj; Bettencourt, Ricki; Barrett-Connor, Elizabeth

2002-05-01

To evaluate erectile dysfunction (ED) using a validated self-administered 5-item questionnaire (5-item version of the International Index of Erectile Function [IIEF-5]) and the use of sildenafil in community-dwelling older men. In October 1998, the IIEF-5 was mailed to all surviving members of an established community-based cohort of older men. The degree of ED was stratified by the erectile function domain score as complete (4 or less), severe (5 to 10), moderate (11 to 14), mild (15 to 18), or none (19 to 20). Men were also asked about sildenafil use and its effectiveness. A total of 976 men (64%) responded to the questionnaire. The internal consistency of the questionnaire construct was confirmed, with a Cronbach's alpha coefficient of 0.96 for all 5 questions. Eighty-nine percent of men younger than 50 years were sexually active compared with 37% of men older than age 80. Twenty-six percent of sexually active men reported complete (3%), severe (10.5%), or moderate (12.6%) ED. The prevalence of moderate or complete ED increased with age and was reported by 58% of men aged 75 to 79 years. Eleven percent of sexually active men had used sildenafil one or more times, with 63% reporting good or "terrific" effects and 11% reporting no benefit. The response to sildenafil deteriorated with age and increasing degree of ED. The results of this community-based study confirm the strong correlation between advancing age and the prevalence and degree of ED, with 33% of men aged 75 and older reporting at least moderate ED. Nevertheless, more than 33% of men older than 75 years remained sexually active. Of the 660 sexually active men, 81% reported satisfaction with sexual intercourse; only 11% had tried sildenafil.

Low-acuity presentations to the emergency department in Canada: exploring the alternative attempts to avoid presentation.

PubMed

Krebs, Lynette D; Kirkland, Scott W; Chetram, Rajiv; Nikel, Taylor; Voaklander, Britt; Davidson, Alan; Holroyd, Bryn; Villa-Roel, Cristina; Crick, Katelynn; Couperthwaite, Stephanie; Alexiu, Chris; Cummings, Garnet; Rowe, Brian H

2017-04-01

ED visits have been rising year on year worldwide. It has been suggested that some of these visits could be avoided if low-acuity patients had better primary care access. This study explored patients' efforts to avoid ED presentation and alternative care sought prior to presentation. Consecutive adult patients presenting to three urban EDs in Edmonton, Canada, completed a questionnaire collecting demographics, actions attempted to avoid presentation and reasons for presentation. Survey data were cross-referenced to a minimal patient dataset containing ED and demographic information. A total of 1402 patients (66.5%) completed the survey. Although 89.3% of the patients felt that the ED was their best care option, the majority of patients (60.1%) sought alternative care or advice prior to presentation. Men, individuals who presented with injury only, and individuals with less than a high school education were all less likely to seek alternative care. Alternative care actions included visiting a physician (54.1%) or an alternative healthcare professional (eg, chiropractor, physiotherapist, etc; 21.2%), calling physician offices (47%) or the regional health information line (13%). Of those who called their physicians, the majority received advice to present to the ED (67.5%). Most low-acuity patients attempt to avoid ED presentation by seeking alternative care. This analysis identifies groups of individuals in the study region who are less likely to seek alternative care first and may benefit from targeted interventions/education. Other regions may wish to complete a similar profile to determine which patients are less likely to seek alternative care first. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Redefining the EdD: Seeking a Separate Identity

ERIC Educational Resources Information Center

Boyce, Barbara Ann

2012-01-01

The purpose of this manuscript was to discuss the recommendations and guidelines of the Carnegie Group's 2007 effort to "Reclaim the EdD" as well as to outline the work completed at the University of Virginia related to their re-design of the Doctor of Education (EdD) degree. In order to address the re-envision and re-formulation of the…

Exercise dependence as a mediator of the exercise and eating disorders relationship: a pilot study.

PubMed

Cook, Brian; Hausenblas, Heather; Crosby, Ross D; Cao, Li; Wonderlich, Stephen A

2015-01-01

Excessive exercise is a common feature of eating disorders (ED) and is associated with earlier ED onset, more ED symptoms, and higher persistence of ED behavior. Research indicates that exercise amount alone is not associated with ED. The purpose of this study was to investigate pathological attitudes and behaviors related to exercise (e.g., exercise dependence) as a mediator of the exercise and ED relationship. Participants were 43 women with an ED who completed measures of ED symptoms, exercise behavior, and exercise dependence. Analyses were conducted using the indirect bootstrapping method for examining mediation. Exercise dependence mediated the relationship between exercise and ED. This mediation model accounted for 14.34% of the variance in the relationship. Our results extend the literature by offering preliminary evidence of a psychological variable that may be a candidate for future interventions on the exercise and ED relationship. Implications and suggestions for future research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Characteristics of Youth Seeking Emergency Care for Assault Injuries

PubMed Central

Ranney, Megan; Newton, Manya; Woodhull, Whitney; Zimmerman, Marc; Walton, Maureen A.

2014-01-01

OBJECTIVE: To characterize youth seeking care for assault injuries, the context of violence, and previous emergency department (ED) service utilization to inform ED-based injury prevention. METHODS: A consecutive sample of youth (14–24) presenting to an urban ED with an assault injury completed a survey of partner violence, gun/knife victimization, gang membership, and context of the fight. RESULTS: A total of 925 youth entered the ED with an assault injury; 718 completed the survey (15.4% refused); 730 comparison youth were sampled. The fights leading to the ED visit occurred at home (37.6%) or on streets (30.4%), and were commonly with a known person (68.3%). Fights were caused by issues of territory (23.3%) and retaliation (8.9%); 20.8% of youth reported substance use before the fight. The assault-injured group reported more peer/partner violence and more gun experiences. Assault-injured youth reported higher past ED utilization for assault (odds ratio [OR]: 2.16) or mental health reasons (OR: 7.98). Regression analysis found the assault-injured youth had more frequent weapon use (OR: 1.25) and substance misuse (OR: 1.41). CONCLUSIONS: Assault-injured youth seeking ED care report higher levels of previous violence, weapon experience, and substance use compared with a comparison group seeking care for other complaints. Almost 10% of assault-injured youth had another fight-related ED visit in the previous year, and ∼5% had an ED visit for mental health. Most fights were with people known to them and for well-defined reasons, and were therefore likely preventable. The ED is a critical time to interact with youth to prevent future morbidity. PMID:24323994

Brain regions implicated in inhibitory control and appetite regulation are activated in response to food portion size and energy density in children.

PubMed

English, L K; Fearnbach, S N; Lasschuijt, M; Schlegel, A; Anderson, K; Harris, S; Wilson, S J; Fisher, J O; Savage, J S; Rolls, B J; Keller, K L

2016-10-01

Large portions of energy-dense foods drive energy intake but the brain mechanisms underlying this effect are not clear. Our main objective was to investigate brain function in response to food images varied by portion size (PS) and energy density (ED) in children using functional magnetic resonance imaging (fMRI). Blood-oxygen-level-dependent (BOLD) fMRI was completed in 36 children (ages 7-10 years) after a 2-h fast while viewing food images at two levels of PS (Large PS, Small PS) and two levels of ED (High ED, Low ED). Children rated perceived fullness pre- and post-fMRI, as well as liking of images on visual analog scales post-fMRI. Anthropometrics were completed 4 weeks before the fMRI. Large PS vs Small PS and High ED vs Low ED were compared with region-of-interest analyses using Brain Voyager v 2.8. Region-of-interest analyses revealed that activation in the right inferior frontal gyrus (P=0.03) was greater for Large PS vs Small PS. Activation was reduced for High ED vs Low ED in the left hypothalamus (P=0.03). Main effects were no longer significant after adjustment for pre-fMRI fullness and liking ratings (PS, P=0.92; ED, P=0.58). This is the first fMRI study to report increased activation to large portions in a brain region that is involved in inhibitory control. These findings may contribute to understanding why some children overeat when presented with large portions of palatable food.

Adolescent and Parent Attitudes Toward Screening for Suicide Risk and Mental Health Problems in the Pediatric Emergency Department

PubMed Central

O’Mara, Roisin M.; Hill, Ryan M.; Cunningham, Rebecca M.; King, Cheryl A.

2016-01-01

Objective The objective of this study was to investigate adolescent and parent attitudes toward screening adolescents for suicide risk and other mental health problems in the emergency department (ED). Methods Two hundred ninety-four adolescents and 300 parents completed questionnaires about the importance of screening for suicide risk and other mental health problems in the ED, what would be helpful if the screen was positive, their concerns about screening in the ED, whether they believe screening should be a routine part of an ED visit, and whether they would complete a screening during the current visit if offered the opportunity. Results Overall, parents and adolescents reported positive attitudes toward screening for suicide risk and other mental health problems in the ED, with the majority responding that it should be a routine part of ED care. Suicide risk and drug and alcohol misuse were rated as more important to screen for than any of the other mental health problems by both parents and adolescents. Adolescent females and mothers were more supportive of screening for suicide risk and mental health problems in the ED than male adolescents and fathers. Descriptive data regarding screening concerns and follow-up preferences are reported. Conclusions Study results suggest overall positive support for screening for suicide risk and other mental health problems in the ED, with some important preferences, concerns, and parent versus adolescent and male versus female differences. PMID:22743751

The Expression of Checkpoint and DNA Repair Genes in Head and Neck Cancer as Possible Predictive Factors.

PubMed

Rusz, Orsolya; Pál, Margit; Szilágyi, Éva; Rovó, László; Varga, Zoltán; Tomisa, Bernadett; Fábián, Gabriella; Kovács, Levente; Nagy, Olga; Mózes, Petra; Reisz, Zita; Tiszlavicz, László; Deák, Péter; Kahán, Zsuzsanna

2017-04-01

DNA damage response failure may influence the efficacy of DNA-damaging treatments. We determined the expression of 16 genes involved in distinct DNA damage response pathways, in association with the response to standard therapy. Twenty patients with locoregionally advanced, squamous cell head and neck carcinoma were enrolled. The treatment included induction chemotherapy (iChT) with docetaxel, cisplatin and 5-fluorouracil followed by concomitant chemoradiotherapy (ChRT) or radiotherapy (RT) alone. The volumetric metabolic therapeutic response was determined by [18F]FDG-PET/CT. In the tumor and matched normal tissues collected before treatment, the gene expressions were examined via the quantitative real-time polymerase chain reaction (qRT-PCR). The down-regulation of TP53 was apparently associated with a poor response to iChT, its up-regulation with complete regression in 2 cases. 7 cases with down-regulated REV1 expression showed complete regression after ChRT/RT, while 1 case with REV1 overexpression was resistant to RT. The overexpression of WRN was an independent predictor of tumor relapse. Our results suggest that an altered expression of REV1 predicts sensitivity to RT, while WRN overexpression is an unfavorable prognostic factor.

Identification of seniors at risk (ISAR) screening tool in the emergency department: implementation using the plan-do-study-act model and validation results.

PubMed

Asomaning, Nana; Loftus, Carla

2014-07-01

To better meet the needs of older adults in the emergency department, Senior Friendly care processes, such as high-risk screening are recommended. The identification of Seniors at Risk (ISAR) tool is a 6-item validated screening tool for identifying elderly patients at risk of the adverse outcomes post-ED visit. This paper describes the implementation of the tool in the Mount Sinai Hospital emergency department using a Plan-Do-Study-Act model; and demonstrates whether the tool predicts adverse outcomes. An observational study tracked tool implementation. A retrospective chart audit was completed to collect data about elderly ED patients during 2 time periods in 2010 and 2011. Data analysis compared the characteristics of patients with positive and negative screening tool results. The identification of Seniors at Risk tool was completed for 51.6% of eligible patients, with 61.2% of patients having a positive result. Patients with positive screening results were more likely to be over age 79 (P = .003); be admitted to hospital (P < .001); have a longer mean ED length of stay (P < .001). For patients admitted to hospital, those with positive screening results had a longer mean inpatient stay (P = .012). Implementing the Idenfitication of Seniors at Risk tool was challenged by problematic compliance with tool completion. Strategies to address this included tool adaptation; and providing staff with knowledge of ED and inpatient geriatric resources and feedback on completion rates. Positive screening results predicted adverse outcomes in elderly Mount Sinai Hospital ED patients. © 2014. Published by Elsevier Inc. All rights reserved.

On the possibility of complete revivals after quantum quenches to a critical point

NASA Astrophysics Data System (ADS)

Najafi, K.; Rajabpour, M. A.

2017-07-01

In a recent letter [J. Cardy, Phys. Rev. Lett. 112, 220401 (2014), 10.1103/PhysRevLett.112.220401], the author made a very interesting observation that complete revivals of quantum states after quantum quench can happen in a period that is a fraction of the system size. This is possible for critical systems that can be described by minimal conformal field theories with central charge c <1 . In this paper, we show that these complete revivals are impossible in microscopic realizations of those minimal models. We will prove the absence of the mentioned complete revivals for the critical transverse field Ising chain analytically, and present numerical results for the critical line of the XY chain. In particular, for the considered initial states, we will show that criticality has no significant effect in partial revivals. We also comment on the applicability of quasiparticle picture to determine the period of the partial revivals qualitatively. In particular, we detect a regime in the phase diagram of the XY chain in which one can not determine the period of the partial revivals using the quasiparticle picture.

Adolescent energy drink consumption: An Australian perspective.

PubMed

Costa, Beth M; Hayley, Alexa; Miller, Peter

2016-10-01

Caffeinated Energy Drinks (EDs) are not recommended for consumption by children, yet there is a lack of age-specific recommendations and restrictions on the marketing and sale of EDs. EDs are increasingly popular among adolescents despite growing evidence of their negative health effects. In the current study we examined ED consumption patterns among 399 Australian adolescents aged 12-18 years. Participants completed a self-report survey of consumption patterns, physiological symptoms, and awareness of current ED consumption guidelines. Results indicated that ED consumption was common among the sample; 56% reported lifetime ED consumption, with initial consumption at mean age 10 (SD = 2.97). Twenty-eight percent of the sample consumed EDs at least monthly, 36% had exceeded the recommended two standard EDs/day, and 56% of consumers had experienced negative physiological health effects following ED consumption. The maximum number of EDs/day considered appropriate for children, adolescents, and adults varied, indicating a lack of awareness of current consumption recommendations. These findings add to the growing body of international evidence of adolescent ED consumption, and the detrimental impact of EDs to adolescent health. Enforced regulation and restriction of EDs for children's and adolescents' consumption is urgently needed in addition to greater visibility of ED consumption recommendations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Molecular Structure and Chirality Determination from Pulsed-Jet Fourier Transform Microwave Spectroscopy

NASA Astrophysics Data System (ADS)

Lobsiger, Simon; Perez, Cristobal; Evangelisti, Luca; Seifert, Nathan A.; Pate, Brooks; Lehmann, Kevin

2014-06-01

Fourier transform microwave (FTMW) spectroscopy has been used for many years as one of the most accurate methods to determine gas-phase structures of molecules and small molecular clusters. In the last years two pioneering works ushered in a new era applications. First, by exploiting the reduced measurement time and the high sensitivity, the development of chirped-pulse CP-FTMW spectrometers enabled the full structural determination of molecules of increasing size as well as molecular clusters. Second, and more recently, Patterson et al. showed that rotational spectroscopy can also be used for enantiomer-specific detection. Here we present an experimental approach that combines both in a single spectrometer. This set-up is capable to rapidly obtain the full heavy-atom substitution structure using the CP-FTMW features. The inclusion of an extra set of broadband horns allows for a chirality-sensitive measurement of the sample. The measurement we implement is a three-wave mixing experiment that uses time-separated pulses to optimally create the chiral coherence - an approach that was proposed recently. Using samples of R-, S- and racemic Solketal, the physical properties of the three-wave mixing experiment were studied. This involved the measurement of the corresponding nutation curves (molecular signal intensity vs excitation pulse duration) to demonstrate the optimal pulse sequence. The phase stability of the chiral signal, required to assign the absolute stereochemistry, has been studied as a function of the measurement signal-to-noise ratio using a "phasogram" method. G. G. Brown, B. C. Dian, K. O. Douglass, S. M. Geyer, S. T. Shipman, B. H. Pate, Rev. Sci. Instrum. 2008, 79, 053103. D. Patterson, M. Schnell, J. M. Doyle, Nature 2013, 497, 475-477. D. Patterson, J. M. Doyle, Phys. Rev. Lett. 2013, 111, 023008. V. A. Shubert, D. Schmitz, D. Patterson, J. M. Doyle, M. Schnell, Angew. Chem. Int. Ed. 2014, 53, 1152-1155. J.-U. Grabow, Angew. Chem. 2013, 125, 11914 - 11916; Angew. Chem. Int. Ed. 2013, 52, 11698 -11700.

Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

PubMed

Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

2017-01-01

Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

High energy neutrinos from astrophysical accelerators of cosmic ray nuclei

NASA Astrophysics Data System (ADS)

Anchordoqui, Luis A.; Hooper, Dan; Sarkar, Subir; Taylor, Andrew M.

2008-02-01

Ongoing experimental efforts to detect cosmic sources of high energy neutrinos are guided by the expectation that astrophysical accelerators of cosmic ray protons would also generate neutrinos through interactions with ambient matter and/or photons. However, there will be a reduction in the predicted neutrino flux if cosmic ray sources accelerate not only protons but also significant numbers of heavier nuclei, as is indicated by recent air shower data. We consider plausible extragalactic sources such as active galactic nuclei, gamma ray bursts and starburst galaxies and demand consistency with the observed cosmic ray composition and energy spectrum at Earth after allowing for propagation through intergalactic radiation fields. This allows us to calculate the expected neutrino fluxes from the sources, normalized to the observed cosmic ray spectrum. We find that the likely signals are still within reach of next generation neutrino telescopes such as IceCube.PACS95.85.Ry98.70.Rz98.54.Cm98.54.EpReferencesFor a review, see:F.HalzenD.HooperRep. Prog. Phys.6520021025A.AchterbergIceCube CollaborationPhys. Rev. Lett.972006221101A.AchterbergIceCube CollaborationAstropart. Phys.262006282arXiv:astro-ph/0611063arXiv:astro-ph/0702265V.NiessANTARES CollaborationAIP Conf. Proc.8672006217I.KravchenkoPhys. Rev. D732006082002S.W.BarwickANITA CollaborationPhys. Rev. Lett.962006171101V.Van ElewyckPierre Auger CollaborationAIP Conf. Proc.8092006187For a survey of possible sources and event rates in km3 detectors see e.g.,W.BednarekG.F.BurgioT.MontaruliNew Astron. Rev.4920051M.D.KistlerJ.F.BeacomPhys. Rev. D742006063007A. Kappes, J. Hinton, C. Stegmann, F.A. Aharonian, arXiv:astro-ph/0607286.A.LevinsonE.WaxmanPhys. Rev. Lett.872001171101C.DistefanoD.GuettaE.WaxmanA.LevinsonAstrophys. J.5752002378F.A.AharonianL.A.AnchordoquiD.KhangulyanT.MontaruliJ. Phys. Conf. Ser.392006408J.Alvarez-MunizF.HalzenAstrophys. J.5762002L33F.VissaniAstropart. Phys.262006310F.W.SteckerC.DoneM.H.SalamonP.SommersPhys. Rev. Lett.6619912697(Erratum-ibid. 69 (1992) 2738)F.W.SteckerPhys. Rev. D722005107301A.AtoyanC.D.DermerPhys. Rev. Lett.872001221102L.A.AnchordoquiH.GoldbergF.HalzenT.J.WeilerPhys. Lett. B6002004202E.WaxmanJ.N.BahcallPhys. Rev. Lett.7819972292C.D.DermerA.AtoyanPhys. Rev. Lett.912003071102D.GuettaD.HooperJ.Alvarez-MunizF.HalzenE.ReuveniAstropart. Phys.202004429J.Alvarez-MunizF.HalzenD.W.HooperPhys. Rev. D622000093015A.LoebE.WaxmanJCAP06052006003S. Inoue, G. Sigl, F. Miniati, E. Armengaud, arXiv:astro-ph/0701167.E.WaxmanJ.N.BahcallPhys. Rev. D591999023002Phys. Rev. D642001023002K.MannheimR.J.ProtheroeJ.P.RachenPhys. Rev. D632001023003arXiv:astro-ph/9908031M.AhlersL.A.AnchordoquiH.GoldbergF.HalzenA.RingwaldT.J.WeilerPhys. Rev. D722005023001E.WaxmanAstrophys. J.4521995L1Note that the neutrino spectral shape can deviate from that for protons if the Feynman plateau is not flat in pseudo-rapidity space;L.AnchordoquiH.GoldbergC.NunezPhys. Rev. D712005065014This is in fact suggested by Tevatron data;F.AbeCDF CollaborationPhys. Rev. D4119902330J.G.LearnedS.PakvasaAstropart. Phys.31995267F.HalzenD.SaltzbergPhys. Rev. Lett.8119984305J.F.BeacomN.F.BellD.HooperS.PakvasaT.J.WeilerPhys. Rev. D682003093005(Erratum-ibid. D 72 (2005) 019901)L.A.AnchordoquiH.GoldbergF.HalzenT.J.WeilerPhys. Lett. B593200442L.A.AnchordoquiH.GoldbergF.HalzenT.J.WeilerPhys. Lett. B621200518A.M.HillasAnn. Rev. Astron. Astrophys.221984425For a general discussion on the acceleration time-scale in these sources see, e.g.,D.F.TorresL.A.AnchordoquiRep. Prog. Phys.6720041663M.C.BegelmanB.RudakM.SikoraAstrophys. J.362199038M.J.ChodorowskiA.A.ZdziarskiM.SikoraAstrophys. J.4001992181S.MichalowskiD.AndrewsJ.EickmeyerT.GentileN.MistryR.TalmanK.UenoPhys. Rev. Lett.391977737J.L.PugetF.W.SteckerJ.H.BredekampAstrophys. J.2051976638D.HooperS.SarkarA.M.TaylorAstropart. Phys.272007199The non-thermal energy release in GRBs is much smaller than that output by AGN.P.L.BiermannP.A.StrittmatterAstrophys. J.3221987643R.J.ProtheroeA.P.SzaboPhys. Rev. Lett.6919922885J.P.RachenP.L.BiermannAstron. Astrophys.2721993161J.P.RachenT.StanevP.L.BiermannAstron. Astrophys.2731993377R.C.HartmanEGRET CollaborationAstrophys. J. Suppl.123199979See e.g.,M.PunchNature3581992477D.PetryHEGRA CollaborationAstron. Astrophys.3111996L13P.M.ChadwickAstrophys. J.5131999161C.D.DermerR.SchlickeiserA.MastichiadisAstron. Astrophys.2561992L27S.D.BloomA.P.MarscherAstrophys. J.4611996657K.MannheimAstron. Astrophys.269199367K.MannheimScience2791998684A.DarA.LaorAstrophys. J.4781997L5F.A.AharonianNew Astron.52000377M.BoettcherAstrophys. J.5151999L21C.D.DermerR.SchlickeiserAstrophys. J.4161993458F.W.SteckerPhys. Rev. Lett.2119681016G.J.FishmanC.A.MeeganAnn. Rev. Astron. Astrophys.331995415For a list of papers related to SWIFT, see: http://swift.gsfc.nasa.gov/docs/swift/results/publist/.B.LinkR.I.EpsteinAstrophys. J.4661996764C.A.MeeganNature3551992143M.R.MetzgerNature3871997878See e.g.,T.PiranPhys. Rep.3141999575T.PiranPhys. Rep.3332000529For a recent review of GRB phenomenology, see:P.MeszarosRep. Prog. Phys.6920062259E.WaxmanLect. Notes Phys.5762001122M.MilgromV.UsovAstrophys. J.4491995L37E.WaxmanPhys. Rev. Lett.751995386M.VietriPhys. Rev. Lett.7819974328D.BandAstrophys. J.4131993281F. Halzen, in: K. Oliver (Ed.), Proceedings of the TASI’98, Boulder, 1998, p. 524.J.W.ElbertP.SommersAstrophys. J.4411995151L.A.AnchordoquiG.E.RomeroJ.A.CombiPhys. Rev. D601999103001L.A. Anchordoqui, J.F. Beacom, H. Goldberg, S. Palomares-Ruiz, T.J. Weiler, arXiv:astro-ph/0611580; arXiv:astro-ph/0611581.The factor 9/(4R) results from calculating ∫dr∫dr|r-r|(4πR/3), where r is the position of a star and r is the position of an observer (the position of the reaction), in a region of radius R uniformly filled with sources.D.A.ForbesM.J.WardV.RotaciucM.BlietzR.GenzelS.DrapatzP.P.van der WerfA.KrabbeAstrophys. J.4061993L11P. Chanial, H. Flores, B. Guiderdoni, D. Elbaz, F. Hammer, L. Vigroux, arXiv:astro-ph/0610900.P.O.LagageC.J.CesarskyAstron. Astrophys.1181983223S.P.LaiJ.M.GirartR.CrutcherAstrophys. J.5982003392W.BednarekMon. Not. R. Astron. Soc.3452003847W.BednarekR.J.ProtheroeAstropart. Phys.162002397P.BlasiA.V.OlintoPhys. Rev. D591999023001F.W.SteckerAstropart. Phys.262007398F.W. Stecker, arXiv:astro-ph/0610208.A γ-ray signal from the nearby starburst galaxy NGC253 was reported by the CANGAROO-II Collaboration but their subsequent re-analysis of the data is consistent with the expectation from backgrounds:C.ItohCANGAROO-II CollaborationAstron. Astrophys.3962002L1(Erratum-ibid. 462 (2007) 67)T.A. Thompson, E. Quataert, E. Waxman, A. Loeb, arXiv:astro-ph/0608699.D.J.BirdFly’s Eye CollaborationPhys. Rev. Lett.7119933401D.R.BergmanHiRes CollaborationNucl. Phys. Proc. Suppl.136200440T.Abu-ZayyadHiRes-MIA CollaborationAstrophys. J.5572001686M.NaganoJ. Phys. G181992423V.BerezinskyA.Z.GazizovS.I.GrigorievaPhys. Rev. D742006043005R.U.AbbasiHiRes CollaborationPhys. Rev. Lett.922004151101V.BerezinskyA.Z.GazizovS.I.GrigorievaPhys. Lett. B6122005147V.S.BerezinskyS.I.GrigorievaB.I.HnatykAstropart. Phys.212004617See Fig. 21 in:L.AnchordoquiM.T.DovaA.MariazziT.McCauleyT.PaulS.ReucroftJ.SwainAnn. Phys.3142004145D.AllardE.ParizotE.KhanS.GorielyA.V.OlintoAstron. Astrophys.4432005L29D.AllardE.ParizotA.V.OlintoAstropart. Phys.27200761T.Abu-ZayyadHigh Resolution Fly’s Eye CollaborationAstropart. Phys.232005157P. Sommers, et al., Pierre Auger Collaboration, arXiv:astro-ph/0507150.R.U.AbbasiHiRes CollaborationAstrophys. J.6222005910B.N. Afanasiev, et al., Yakutsk Collaboration, in: M. Nagano (Ed.), Proceedings of the Tokyo Workshop on Techniques for the Study of the Extremely High Energy Cosmic Rays, 1993.J. Knapp, private communication.J.RanftPhys. Rev. D51199564R.S.FletcherT.K.GaisserP.LipariT.StanevPhys. Rev. D5019945710J.EngelT.K.GaisserT.StanevP.LipariPhys. Rev. D4619925013N.N.KalmykovS.S.OstapchenkoA.I.PavlovNucl. Phys. Proc. Suppl.52B19977It is important to stress that the Auger data are still at a preliminary stage and the reconstruction procedures are still to be finalised. However, even allowing for the systematic uncertainties still present, it does appear that at the highest energies fewer events are seen than expected from the AGASA analysis.V.S.BerezinskyG.T.ZatsepinPhys. Lett. B281969423F.W.SteckerAstrophys. J.2281979919R.EngelD.SeckelT.StanevPhys. Rev. D642001093010Z.FodorS.D.KatzA.RingwaldH.TuJCAP03112003015D.De MarcoT.StanevF.W.SteckerPhys. Rev. D732006043003D.HooperA.TaylorS.SarkarAstropart. Phys.23200511M.AveN.BuscaA.V.OlintoA.A.WatsonT.YamamotoAstropart. Phys.23200519A point worth noting at this juncture: If iron nuclei are accelerated to very high energies (much higher than the energy spectrum has been measured), then disintegration can lead to large numbers of protons above the spectrum cutoff. In this case, the resulting cosmogenic neutrino flux is not dramatically suppressed. On the other hand, if iron nuclei are only largely accelerated to around 10eV or less, then the liberated protons will only rarely interact with the CMB to produce pions, hence the cosmogenic neutrino flux will be significantly reduced.

Identifying Neurocognitive Deficits in Adolescents Following Concussion

PubMed Central

Thomas, Danny G.; Collins, Michael W.; Saladino, Richard A.; Frank, Virginia; Raab, Jenny; Zuckerbraun, Noel S.

2011-01-01

Objectives This study of concussed adolescents sought to determine if a computer-based neurocognitive assessment (ImPACT) performed on patients who present to the emergency department (ED) immediately following head injury would correlate with assessments performed three to ten days post-injury, and if ED neurocognitive testing would detect differences in concussion severity that clinical grading scales could not. Methods A prospective cohort sample of patients 11 to 17 years of age presenting to the ED within 12 hours of a head injury were evaluated using two traditional concussion grading scales and neurocognitive testing. ED neurocognitive scores were compared to follow-up scores obtained at least three days post-injury. Post-concussive symptoms, outcomes, and complications were assessed via telephone follow-up for all subjects. Results Sixty patients completed phone follow-up. Thirty-six patients (60%) completed follow-up testing a median of six days post-injury. Traditional concussion grading did not correlate with neurocognitive deficits detected in the ED or at follow-up. For the neurocognitive domains of verbal memory, processing speed, and reaction time, there was a significant correlation between ED and follow-up scores trending toward clinical improvement. By two weeks post-injury, 23 patients (41%) had not returned to normal activity. At six weeks, six patients (10%) still had not returned to normal activity. Conclusions Immediate assessment in the ED can predict neurocognitive deficits seen in follow-up, and may be potentially useful to individualize management or test therapeutic interventions. Neurocognitive assessment in the ED detected deficits that clinical grading could not, and correlated with deficits at follow-up. PMID:21401786

Development of UK recommendations on treatment for post-surgical erectile dysfunction

PubMed Central

Kirby, M G; White, I D; Butcher, J; Challacombe, B; Coe, J; Grover, L; Hegarty, P; Jackson, G; Lowndes, A; Payne, H; Rees, J; Sangar, V; Thompson, A

2014-01-01

Aim To develop a management strategy (rehabilitation programme) for postsurgical erectile dysfunction (ED) among men experiencing ED associated with treatment of prostate, bladder or rectal cancer that is suitable for use in a UK NHS healthcare context. Methods PubMed literature searches of ED management together with a survey of 13 experts in the management of ED from across the UK were conducted. Results Data from 37 articles and completed questionnaires were collated. The results discussed in this study demonstrate improved objective and subjective clinical outcomes for physical parameters, sexual satisfaction, and rates of both spontaneous erections and those associated with ED treatment strategies. Conclusion Based on the literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for postsurgical ED. PMID:24188207

Who uses alcohol mixed with energy drinks? Characteristics of college student users.

PubMed

Patrick, Megan E; Macuada, Carlos; Maggs, Jennifer L

2016-01-01

To examine characteristics associated with alcohol mixed with energy drink (AmED) use in a sample of college students. College students (N = 614, 53% female) in their second year of college participated during the fall of 2008. Students completed a cross-sectional survey with questions regarding AmED use. AmED use in the last 30 days was reported by 27% of participants. Logistic regression analyses found that risk factors for AmED included participating in a fraternity/sorority; participating in athletics; living off-campus; having greater fun/social, relax, and image motives for alcohol consumption; and binge drinking. Protective factors included early morning classes, honors program participation, and greater physical/behavioral motives for not drinking. Risk factors for AmED use can identify college students most likely to consume AmEDs and thereby inform screening and intervention efforts to reduce negative AmED-related consequences.

Three-electron spin qubits

NASA Astrophysics Data System (ADS)

Russ, Maximilian; Burkard, Guido

2017-10-01

The goal of this article is to review the progress of three-electron spin qubits from their inception to the state of the art. We direct the main focus towards the exchange-only qubit (Bacon et al 2000 Phys. Rev. Lett. 85 1758-61, DiVincenzo et al 2000 Nature 408 339) and its derived versions, e.g. the resonant exchange (RX) qubit, but we also discuss other qubit implementations using three electron spins. For each three-spin qubit we describe the qubit model, the envisioned physical realization, the implementations of single-qubit operations, as well as the read-out and initialization schemes. Two-qubit gates and decoherence properties are discussed for the RX qubit and the exchange-only qubit, thereby completing the list of requirements for quantum computation for a viable candidate qubit implementation. We start by describing the full system of three electrons in a triple quantum dot, then discuss the charge-stability diagram, restricting ourselves to the relevant subsystem, introduce the qubit states, and discuss important transitions to other charge states (Russ et al 2016 Phys. Rev. B 94 165411). Introducing the various qubit implementations, we begin with the exchange-only qubit (DiVincenzo et al 2000 Nature 408 339, Laird et al 2010 Phys. Rev. B 82 075403), followed by the RX qubit (Medford et al 2013 Phys. Rev. Lett. 111 050501, Taylor et al 2013 Phys. Rev. Lett. 111 050502), the spin-charge qubit (Kyriakidis and Burkard 2007 Phys. Rev. B 75 115324), and the hybrid qubit (Shi et al 2012 Phys. Rev. Lett. 108 140503, Koh et al 2012 Phys. Rev. Lett. 109 250503, Cao et al 2016 Phys. Rev. Lett. 116 086801, Thorgrimsson et al 2016 arXiv:1611.04945). The main focus will be on the exchange-only qubit and its modification, the RX qubit, whose single-qubit operations are realized by driving the qubit at its resonant frequency in the microwave range similar to electron spin resonance. Two different types of two-qubit operations are presented for the exchange-only qubits which can be divided into short-ranged and long-ranged interactions. Both of these interaction types are expected to be necessary in a large-scale quantum computer. The short-ranged interactions use the exchange coupling by placing qubits next to each other and applying exchange-pulses (DiVincenzo et al 2000 Nature 408 339, Fong and Wandzura 2011 Quantum Inf. Comput. 11 1003, Setiawan et al 2014 Phys. Rev. B 89 085314, Zeuch et al 2014 Phys. Rev. B 90 045306, Doherty and Wardrop 2013 Phys. Rev. Lett. 111 050503, Shim and Tahan 2016 Phys. Rev. B 93 121410), while the long-ranged interactions use the photons of a superconducting microwave cavity as a mediator in order to couple two qubits over long distances (Russ and Burkard 2015 Phys. Rev. B 92 205412, Srinivasa et al 2016 Phys. Rev. B 94 205421). The nature of the three-electron qubit states each having the same total spin and total spin in z-direction (same Zeeman energy) provides a natural protection against several sources of noise (DiVincenzo et al 2000 Nature 408 339, Taylor et al 2013 Phys. Rev. Lett. 111 050502, Kempe et al 2001 Phys. Rev. A 63 042307, Russ and Burkard 2015 Phys. Rev. B 91 235411). The price to pay for this advantage is an increase in gate complexity. We also take into account the decoherence of the qubit through the influence of magnetic noise (Ladd 2012 Phys. Rev. B 86 125408, Mehl and DiVincenzo 2013 Phys. Rev. B 87 195309, Hung et al 2014 Phys. Rev. B 90 045308), in particular dephasing due to the presence of nuclear spins, as well as dephasing due to charge noise (Medford et al 2013 Phys. Rev. Lett. 111 050501, Taylor et al 2013 Phys. Rev. Lett. 111 050502, Shim and Tahan 2016 Phys. Rev. B 93 121410, Russ and Burkard 2015 Phys. Rev. B 91 235411, Fei et al 2015 Phys. Rev. B 91 205434), fluctuations of the energy levels on each dot due to noisy gate voltages or the environment. Several techniques are discussed which partly decouple the qubit from magnetic noise (Setiawan et al 2014 Phys. Rev. B 89 085314, West and Fong 2012 New J. Phys. 14 083002, Rohling and Burkard 2016 Phys. Rev. B 93 205434) while for charge noise it is shown that it is favorable to operate the qubit on the so-called ‘(double) sweet spots’ (Taylor et al 2013 Phys. Rev. Lett. 111 050502, Shim and Tahan 2016 Phys. Rev. B 93 121410, Russ and Burkard 2015 Phys. Rev. B 91 235411, Fei et al 2015 Phys. Rev. B 91 205434, Malinowski et al 2017 arXiv: 1704.01298), which are least susceptible to noise, thus providing a longer lifetime of the qubit.

Two sides of the same coin? A new instrument to assess body checking and avoidance behaviors in eating disorders.

PubMed

Legenbauer, Tanja; Martin, Franziska; Blaschke, Ariane; Schwenzfeier, Anne; Blechert, Jens; Schnicker, Katja

2017-06-01

Body checking (BC) and avoidance behaviors (BA) are the dominant behavioral features of body image disturbances (BID) that characterize most individuals with eating disorders (EDs). Whereas BC can be reliably assessed, a valid assessment tool for BA is lacking, preventing an adequate assessment of BID differences across different EDs (anorexia nervosa, AN; bulimia nervosa, BN; binge eating disorder, BED). A total of 310 women with EDs and 112 nonclinical controls completed measures of BC-, BA- and ED-related symptoms. BA did not differentiate between EDs, whereas BC did: it was highest in AN and BN, and lowest in BED. Multivariate analyses also discriminated AN from BN based on BC. Given that results are of preliminary nature, evidence is promising that EDs can be discriminated from healthy controls and that differential BID profiles for the behavioral component among ED subgroups exist. However, replication of the factor structure remains open within ED subsamples. Copyright © 2017 Elsevier Ltd. All rights reserved.

Are we there yet? A Practitioner's View of DO-178C/ED-12C

NASA Astrophysics Data System (ADS)

Daniels, Dewi

RTCA DO-178B/EUROCAE ED-12B is the industry-accepted guidance for determining that the software aspects of airborne systems and equipment comply with airworthiness requirements. DO-178B/ED-12B, published in 1992, is being updated to DO-178C/ED-12C. Nearly six years in the making, DO- 178C/ED-12C is expected to be completed in December 2010. It will be accompanied by a new set of supplements providing additional and much-needed guidance on tool qualification, model based development and verification, objectoriented technologies, and formal methods. Written by a member of the DO-178C/ED-12C editorial team who is also a practising software developer and verifier, this paper provides a practitioner's view of the new standard and its supplements. It explains how they will affect your organisation, focusing on the practical implications of the many changes between DO-178B/ED-12B and DO-178C/ED-12C.

Sleep disorders in patients with erectile dysfunction.

PubMed

Kalejaiye, Odunayo; Raheem, Amr Abdel; Moubasher, Amr; Capece, Marco; McNeillis, Sara; Muneer, Asif; Christopher, Andrew N; Garaffa, Giulio; Ralph, David J

2017-12-01

To assess the prevalence of obstructive sleep apnoea (OSA) in men presenting with erectile dysfunction (ED) at a single centre. All men attending a specialised andrology outpatient department with a new diagnosis of ED were included in this prospective study. All patients completed three questionnaires: the International Index of Erectile Function (IIEF) and two sleep questionnaires [the Obstructive Sleep Apnoea Screening questionnaire and the Insomnia Severity Index (ISI)]. Their ED management was subsequently undertaken in accordance with local and European guidelines. An OSA diagnosis was made based on a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire and those patients were referred for specialist management. Between February and September 2016, 129 patients with ED completed the study questionnaires. In all, 71 patients (55%) had a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire, indicating a need for specialist sleep referral. Men who scored ≥3 on the Obstructive Sleep Apnoea Screening questionnaire were significantly older (61.4 vs 46.5 years; P < 0.001) and had a significantly higher body mass index (29.4 vs 26.7 kg/m 2 ; P < 0.001) when compared to the control group (OSA score of <3). The sleep apnoea group (OSA score of ≥3) had significantly worse IIEF-ED scores (6.2 vs 9.1; P = 0.018) and ISI scores (7.9 vs 5.5; P = 0.061). Men presenting to the andrology clinic with ED are at significant risk of having undiagnosed sleep disorders. This has serious adverse health consequences, as well as being associated with potential dangers at work and travel. The patient compliance was high with 78% completing all three questionnaires. It is feasible to screen this population for sleep disturbance and this should be part of the ED assessment. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Solving the Tautomeric Equilibrium of Purine Through the Analysis of the Complex Hyperfine Structure of the Four 14N Nuclei

NASA Astrophysics Data System (ADS)

Cocinero, Emilio J.; Uriarte, Iciar; Ecija, Patricia; Favero, Laura B.; Spada, Lorenzo; Calabrese, Camilla; Caminati, Walther

2016-06-01

Microwave spectroscopy has been restricted to the investigation of small molecules in the last years. However, with the advent of FTMW and CP-FTMW spectroscopies coupled with laser vaporization techniques it has turned into a very competitive methodology in the studies of moderate-size biomolecules. Here, we present the study of purine, characterized by two aromatic rings, one six- and one five-membered, fused together to give a planar aromatic bicycle. Biologically, it is the mainframe of two of the five nucleobases of DNA and RNA. Two tautomers were observed by FTMW spectroscopy coupled to UV ultrafast laser vaporization system. The population ratio of the two main tautomers [N(7)H]/[N(9)H] is about 1/40 in the gas phase. It contrasts with the solid state where only the N(7)H species is present, or in solution where a mixture of both tautomers is observed. For both species, a full quadrupolar hyperfine analysis has been performed. This has led to the determination of the full sets of diagonal quadrupole coupling constants of the four 14N atoms, which have provided crucial information for the unambiguous identification of both species. T. J. Balle and W. H. Flygare Rev. Sci. Instrum. 52, 33-45, 1981 J.-U. Grabow, W. Stahl and H. Dreizler Rev. Sci. Instrum. 67, 4072-4084, 1996 G. G. Brown, B. D. Dian, K. O. Douglass, S. M. Geyer, S. T. Shipman and B. H. Pate Rev. Sci. Instrum. 79, 0531031/1-053103/13, 2008 E. J. Cocinero, A. Lesarri, P. écija, F. J. Basterretxea, J. U. Grabow, J. A. Fernández and F. Castaño Angew. Chem. Int. Ed. 51, 3119-3124, 2012

Immunization with viable Brucella organisms*

PubMed Central

Spink, Wesley W.; Hall, James W.; Finstad, Joanne; Mallet, Edmund

1962-01-01

In many parts of the world contact with infected livestock may involve a serious risk of the spread of human brucellosis. Partial control of bovine brucellosis has been achieved by slaughter of infected herds and immunization of cattle with Brucella abortus strain 19 living vaccine. However, in areas where such measures are unpractical there remains a need for protection of humans. This study compares the safety of two living Brucella vaccine preparations in human volunteers. Some 32 healthy male volunteers with no evidence of past exposure to brucellosis were divided into two comparable groups; one group received 19-BA vaccine derived from Br. abortus and the other received Rev 1 vaccine derived from Br. melitensis. Detailed studies over a six-month period of the clinical effects, bacteraemia, Brucella agglutinin response and dermal hypersensitivity revealed striking differences between the two groups. Two of the 16 men in the 19-BA group developed acute brucellosis, and another had a positive blood culture. In the Rev 1 group, 11 of 16 developed acute brucellosis, and brucellae were recovered from 12. All 32 men developed Brucella agglutinins, the Rev 1 group having higher titres. Dermal hypersensitivity occurred in all of the Rev. 1 group but in only nine of the 19-BA group. Tetracycline treatment in all the Rev 1 group and in the two brucellosis cases in the 19-BA group resulted in complete recovery. The authors conclude from this study that neither the Rev 1 vaccine nor the 19-BA vaccine inoculated subcutaneously is sufficiently safe in the dosage used to warrant being used for vaccination of humans for prophylactic purposes. PMID:13915813

The Impact of DSM-5 A-Criteria Changes on Parent Ratings of ADHD in Adolescents.

PubMed

Sibley, Margaret H; Yeguez, Carlos E

2018-01-01

Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) A-criteria for ADHD were expanded to include new descriptors referencing adolescent and adult symptom manifestations. This study examines the effect of these changes on symptom endorsement in a sample of adolescents with ADHD (N = 259; age range = 10.72-16.70). Parent ratings were collected and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) and DSM-5 endorsement of ADHD symptoms were compared. Under the DSM-5, there were significant increases in reported inattention, but not hyperactivity/impulsivity (H/I) symptoms, with specific elevations for certain symptoms. The average adolescent met criteria for less than one additional symptom under the DSM-5, but the correlation between ADHD symptoms and impairment was attenuated when using the DSM-5 items. Impulsivity items appeared to represent adolescent deficits better than hyperactivity items. Results were not moderated by demographic factors. In a sample of adolescents with well-diagnosed DSM-IV-TR ADHD, developmental symptom descriptors led parents to endorse slightly more symptoms of inattention, but this elevation is unlikely to be clinically meaningful.

Tables of X-ray absorption corrections and dispersion corrections: the new versus the old

NASA Astrophysics Data System (ADS)

Creagh, Dudley

1990-11-01

This paper compares the data on X-ray absorption coefficients calculated by Creagh and Hubbell and tabulated in International Tables for Crystallography, vol. C, ed. A.J.C. Wilson (1990) section 4.2.4 [1] with empirical (Saloman, Hubbell and Scofield, At. Data and Nucl. Data Tables 38 (1988) 1, [6]) and semi-empirical (Hubbell, McMaster, Kerr Del Grande and Mallett, in: International Tables for Crystallography, vol. IV, eds. Ibers and Hamilton (Kynoch, Birmingham, 1974) [2]) tabulations as well as the renormalized relativistic Dirac-Hartree-Fock calculations of Scofield [6]. It also makes comparisons of the real part of the dispersion correction ƒ‧(ω, 0) and tabulated in ref. [1], with theoretical data sets (Cromer and Liberman, J. Chem. Phys. 53 (1970) 1891, and Acta Crystallogr. A37 (1981) 267 [4,5]; Wang, Phys. Rev. A34 (1986) 636 [85]; Kissel, in: Workshop Report on New Dimensions in X-ray Scattering, CONF-870459 (Livermore, 1987) p. 9 [86]) and data collected using a variety of experimental techniques. In both cases the data tabulated in ref. [1] is shown to give improved self-consistency and agreement with experiment.

Wigner tomography of multispin quantum states

NASA Astrophysics Data System (ADS)

Leiner, David; Zeier, Robert; Glaser, Steffen J.

2017-12-01

We study the tomography of multispin quantum states in the context of finite-dimensional Wigner representations. An arbitrary operator can be completely characterized and visualized using multiple shapes assembled from linear combinations of spherical harmonics [A. Garon, R. Zeier, and S. J. Glaser, Phys. Rev. A 91, 042122 (2015), 10.1103/PhysRevA.91.042122]. We develop a general methodology to experimentally recover these shapes by measuring expectation values of rotated axial spherical tensor operators and provide an interpretation in terms of fictitious multipole potentials. Our approach is experimentally demonstrated for quantum systems consisting of up to three spins using nuclear magnetic resonance spectroscopy.

Isotropic quantum walks on lattices and the Weyl equation

NASA Astrophysics Data System (ADS)

D'Ariano, Giacomo Mauro; Erba, Marco; Perinotti, Paolo

2017-12-01

We present a thorough classification of the isotropic quantum walks on lattices of dimension d =1 ,2 ,3 with a coin system of dimension s =2 . For d =3 there exist two isotropic walks, namely, the Weyl quantum walks presented in the work of D'Ariano and Perinotti [G. M. D'Ariano and P. Perinotti, Phys. Rev. A 90, 062106 (2014), 10.1103/PhysRevA.90.062106], resulting in the derivation of the Weyl equation from informational principles. The present analysis, via a crucial use of isotropy, is significantly shorter and avoids a superfluous technical assumption, making the result completely general.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Geoffrey Wayne; Leonard, Philip; Hartline, Ernest Leon

High Explosives and Technology (M-7) completed the second round of formulation and testing of Remediated Nitrate Salt (RNS) surrogates on March 17, 2016. This report summarizes the results of the work and also includes additional documentation required under test plan PLAN-TA9-2443 Rev B, "Remediated Nitrate Salt (RNS) Surrogate Formulation and Testing Standard Procedure", released February 16, 2016. All formulation and testing was carried out according to PLAN-TA9-2443 Rev B. Results from the first round of formulation and testing were documented in memorandum M7-16-6042, "Results from First Round of Remediated Nitrate Salt Surrogate Formulation and Testing."

French mental health first aid guidelines for eating disorders: an exploration of user characteristics and usefulness among college students.

PubMed

Melioli, Tiffany; Rispal, Magali; Hart, Laura M; Chabrol, Henri; Rodgers, Rachel F

2018-04-01

The literature has highlighted that strategies to increase appropriate and timely treatment seeking for eating disorders (EDs) are needed. The aim of this study was to use the Internet to disseminate guidelines for providing first aid to individuals suffering from ED among college students. Users were invited to complete two surveys: an initial one assessing user characteristics and, 28 days later, a questionnaire assessing the perceived usefulness of the guidelines. A sample of 651 college students (M age  = 22, standard deviation (SD) = 3.9) responded to the first questionnaire and 50 completed the second questionnaire (M age  = 22.2, SD = 2.6). The guidelines were downloaded 1174 times and 56% of users reported finding them useful. College students might be particularly interested in learning more about ED and the guidelines could be valuable to address the gap in available resources for ED-related mental health literacy. © 2016 John Wiley & Sons Australia, Ltd.

Variable Access to Immediate Bedside Ultrasound in the Emergency Department

PubMed Central

Talley, Brad E.; Ginde, Adit A.; Raja, Ali S.; Sullivan, Ashley F.; Espinola, Janice A.; Camargo, Carlos A.

2011-01-01

Objective: Use of bedside emergency department (ED) ultrasound has become increasingly important for the clinical practice of emergency medicine (EM). We sought to evaluate differences in the availability of immediate bedside ultrasound based on basic ED characteristics and physician staffing. Methods: We surveyed ED directors in all 351 EDs in Colorado, Georgia, Massachusetts, and Oregon between January and April 2009. We assessed access to bedside ED ultrasound by the question: “Is bedside ultrasound available immediately in the ED?” ED characteristics included location, visit volume, admission rate, percent uninsured, total emergency physician full-time equivalents and proportion of EM board-certified (BC) or EM board-eligible (BE) physicians. Data analysis used chi-square tests and multivariable logistical regression to compare differences in access to bedside ED ultrasound by ED characteristics and staffing. Results: We received complete responses from 298 (85%) EDs. Immediate access to bedside ultrasound was available in 175 (59%) EDs. ED characteristics associated with access to bedside ultrasound were: location (39% for rural vs. 71% for urban, P<0.001); visit volume (34% for EDs with low volume [<1 patient/hour] vs. 79% for EDs with high volume [≥3 patients/hour], P<0.001); admission rate (39% for EDs with low [0–10%] admission rates vs. 84% for EDs with high [>20%] rates, P<0.001); and EM BC/BE physicians (26% for EDs with a low percentage [0–20%] vs.74% for EDs with a high percentage [≥80%], P<0.001). Conclusion: U.S. EDs differ significantly in their access to immediate bedside ultrasound. Smaller, rural EDs and those staffed by fewer EM BC/BE physicians more frequently lacked access to immediate bedside ultrasound in the ED. PMID:21691479

Biological responses of beef steers to steroidal implants and zilpaterol hydrochloride.

PubMed

Parr, S L; Brown, T R; Ribeiro, F R B; Chung, K Y; Hutcheson, J P; Blackwell, B R; Smith, P N; Johnson, B J

2014-08-01

British × Continental steers (n = 168; 7 pens/treatment; initial BW = 362 kg) were used to evaluate the effect of dose/payout pattern of trenbolone acetate (TBA) and estradiol-17β (E2) and feeding of zilpaterol hydrochloride (ZH) on serum urea-N (SUN), NEFA, IGF-I, and E2 concentrations and LM mRNA expression of the estrogen (ER), androgen (ANR), IGF-I (IGF-IR), β1-adrenergic (β1-AR), and β2-adrenergic (β2-AR) receptors and IGF-I. A randomized complete block design was used with a 3 × 2 factorial arrangement of treatments. Main effects were implant (no implant [NI], Revalor-S [REV-S; 120 mg TBA + 24 mg E2], and Revalor-XS [REV-X; 200 mg TBA + 40 mg E2]) and ZH (0 or 8.3 mg/kg of DM for 20 d with a 3-d withdrawal). Steers were fed for 153 or 174 d. Blood was collected (2 steers/pen) at d -1, 2, 6, 13, 27, 55, 83, 111, and 131 relative to implanting; LM biopsies (1 steer/pen) were collected at d -1, 27, 55, and 111. Blood and LM samples were collected at d -1, 11, and 19 relative to ZH feeding. A greater dose of TBA + E2 in combination with ZH increased ADG and HCW in an additive manner, suggesting a different mechanism of action for ZH and steroidal implants. Implanting decreased (P < 0.05) SUN from d 2 through 131. Feeding ZH decreased (P < 0.05) SUN. Serum NEFA concentrations were not affected by implants (P = 0.44). There was a day × ZH interaction (P = 0.06) for NEFA; ZH steers had increased (P < 0.01) NEFA concentrations at d 11 of ZH feeding. Serum E2 was greater (P < 0.05) for implanted steers by d 27. Serum trenbolone-17β was greater (P < 0.05) for implanted steers by d 2 followed by a typical biphasic release rate, with a secondary peak at d 111 for REV-X (P < 0.05) implanted steers. Implanting did not affect mRNA expression of the ANR or ER, but the IGF-IR and the β1-AR and β2-AR were less (P < 0.05) for REV-S than NI at d 55 and β2-AR mRNA was less (P < 0.05) for REV-S than for REV-X. Expression of the IGF-IR and the β1-AR at d 111 was greater (P< 0.05) for REV-X than for REV-S and NI at d 111, and the β2-AR was less (P< 0.05) for REV-S than for REV-X. Feeding ZH did not affect mRNA expression of the β1-AR and β2-AR. Both implanting and feeding ZH decreased SUN, but a greater dose of TBA + E2 did not result in further decreases. In addition, feeding ZH increased serum NEFA concentrations. Metabolic changes resulting from implanting and feeding ZH may aid in explaining steer performance and carcass responses to these growth promotants.

Quantum Corral Wave-function Engineering

NASA Astrophysics Data System (ADS)

Correa, Alfredo; Reboredo, Fernando; Balseiro, Carlos

2005-03-01

We present a theoretical method for the design and optimization of quantum corrals[1] with specific electronic properties. Taking advantage that spins are subject to a RKKY interaction that is directly controlled by the scattering of the quantum corral, we design corral structures that reproduce spin Hamiltonians with coupling constants determined a priori[2]. We solve exactly the bi-dimensional scattering problem for each corral configuration within the s-wave approximation[3] and subsequently the geometry of the quantum corral is optimized by means of simulated annealing[4] and genetic algorithms[5]. We demonstrate the possibility of automatic design of structures with complicated target electronic properties[6]. This work was performed under the auspices of the US Department of Energy by the University of California at the LLNL under contract no W-7405-Eng-48. [1] M. F. Crommie, C. P. Lutz and D. M. Eigler, Nature 403, 512 (2000) [2] D. P. DiVincenzo et al., Nature 408, 339 (2000) [3] G. A. Fiete and E. J. Heller, Rev. Mod. Phys. 75, 933 (2003) [4] M. R. A. T. N. Metropolis et al., J. Chem. Phys. 1087 (1953) [5] E. Aarts and J. K. Lenstra, eds. Local search in combinatorial problems (Princeton University Press, 1997) [6] A. A. Correa, F. Reboredo and C. Balseiro, Phys. Rev. B (in press).

How Kondo-holes create intense nanoscale heavy-fermion hybridization disorder

PubMed Central

Hamidian, Mohammad H.; Schmidt, Andrew R.; Firmo, Inês A.; Allan, Milan P.; Bradley, Phelim; Garrett, Jim D.; Williams, Travis J.; Luke, Graeme M.; Dubi, Yonatan; Balatsky, Alexander V.; Davis, J. C.

2011-01-01

Replacing a magnetic atom by a spinless atom in a heavy-fermion compound generates a quantum state often referred to as a “Kondo-hole”. No experimental imaging has been achieved of the atomic-scale electronic structure of a Kondo-hole, or of their destructive impact [Lawrence JM, et al. (1996) Phys Rev B 53:12559–12562] [Bauer ED, et al. (2011) Proc Natl Acad Sci. 108:6857–6861] on the hybridization process between conduction and localized electrons which generates the heavy-fermion state. Here we report visualization of the electronic structure at Kondo-holes created by substituting spinless thorium atoms for magnetic uranium atoms in the heavy-fermion system URu2Si2. At each thorium atom, an electronic bound state is observed. Moreover, surrounding each thorium atom we find the unusual modulations of hybridization strength recently predicted to occur at Kondo-holes [Figgins J, Morr DK (2011) Phys Rev Lett 107:066401]. Then, by introducing the “hybridization gapmap” technique to heavy-fermion studies, we discover intense nanoscale heterogeneity of hybridization due to a combination of the randomness of Kondo-hole sites and the long-range nature of the hybridization oscillations. These observations provide direct insight into both the microscopic processes of heavy-fermion forming hybridization and the macroscopic effects of Kondo-hole doping. PMID:22006302

Assessing rumination in eating disorders: principal component analysis of a minimally modified ruminative response scale.

PubMed

Cowdrey, Felicity A; Park, Rebecca J

2011-12-01

A process account of eating disorders (EDs) (Park et al., in press-a) proposes that preoccupation with ruminative themes of eating, weight and shape may be important in ED maintenance. No self-report measure exists to capture disorder-specific rumination in EDs. 275 healthy participants rated rumination items and completed self-report measures of ED symptoms, depression and anxiety. Principal component analysis revealed two factors, reflection and brooding. The final nine-item Ruminative Response Scale for Eating Disorders (RRS-ED) demonstrated good convergent and discriminant validity and test-retest reliability. The psychometric properties were replicated in an anorexia nervosa sample. The findings support the notion that rumination in EDs is distinct from rumination in depression and is not adequately captured by existing measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Low social interactions in eating disorder patients in childhood and adulthood: a multi-centre European case control study.

PubMed

Krug, Isabel; Penelo, Eva; Fernandez-Aranda, Fernando; Anderluh, Marija; Bellodi, Laura; Cellini, Elena; di Bernardo, Milena; Granero, Roser; Karwautz, Andreas; Nacmias, Benedetta; Ricca, Valdo; Sorbi, Sandro; Tchanturia, Kate; Wagner, Gudrun; Collier, David; Treasure, Janet

2013-01-01

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [p<0.001] and watching TV [p<0.05] and less socializing with friends [p<0.05]) than the healthy control group and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.

Coulomb crystallization in classical and quantum systems

NASA Astrophysics Data System (ADS)

Bonitz, Michael

2007-11-01

Coulomb crystallization occurs in one-component plasmas when the average interaction energy exceeds the kinetic energy by about two orders of magnitude. A simple road to reach such strong coupling consists in using external confinement potentials the strength of which controls the density. This has been succsessfully realized with ions in traps and storage rings and also in dusty plasma. Recently a three-dimensional spherical confinement could be created [1] which allows to produce spherical dust crystals containing concentric shells. I will give an overview on our recent results for these ``Yukawa balls'' and compare them to experiments. The shell structure of these systems can be very well explained by using an isotropic statically screened pair interaction. Further, the thermodynamic properties of these systems, such as the radial density distribution are discussed based on an analytical theory [3]. I then will discuss Coulomb crystallization in trapped quantum systems, such as mesoscopic electron and electron hole plasmas in coupled layers [4,5]. These systems show a very rich correlation behavior, including liquid and solid like states and bound states (excitons, biexcitons) and their crystals. On the other hand, also collective quantum and spin effects are observed, including Bose-Einstein condensation and superfluidity of bound electron-hole pairs [4]. Finally, I consider Coulomb crystallization in two-component neutral plasmas in three dimensions. I discuss the necessary conditions for crystals of heavy charges to exist in the presence of a light component which typically is in the Fermi gas or liquid state. It can be shown that their exists a critical ratio of the masses of the species of the order of 80 [5] which is confirmed by Quantum Monte Carlo simulations [6]. Familiar examples are crystals of nuclei in the core of White dwarf stars, but the results also suggest the existence of other crystals, including proton or α-particle crystals in dense matter and of hole crystals in semiconductors. [1] O. Arp, D. Block, A. Piel, and A. Melzer, Phys. Rev. Lett. 93, 165004 (2004). [2] M. Bonitz, D. Block, O. Arp, V. Golubnychiy, H. Baumgartner, P. Ludwig, A. Piel, and A. Filinov, Phys. Rev. Lett. 96, 075001 (2006). [3] C. Henning, H. Baumgartner, A. Piel, P. Ludwig, V. Golubnychiy, M. Bonitz, and D. Block, Phys. Rev. E 74, 056403 (2006) and Phys. Rev. E (2007). [4] A. Filinov, M. Bonitz, and Yu. Lozovik, Phys. Rev. Lett. 86, 3851 (2001). [5] M. Bonitz, V. Filinov, P. Levashov, V. Fortov, and H. Fehske, Phys. Rev. Lett. 95, 235006 (2005) and J. Phys. A: Math. Gen. 39, 4717 (2006). [6] Introduction to Computational Methods for Many-Body Systems, M. Bonitz and D. Semkat (eds.), Rinton Press, Princeton (2006)

Pseudogap in normal underdoped phase of Bi2212: LDA + DMFT + Σk

NASA Astrophysics Data System (ADS)

Nekrasov, I. A.; Kuchinskii, E. Z.; Pchelkina, Z. V.; Sadovskii, M. V.

2007-09-01

Pseudogap phenomena are observed for normal underdoped phase of different high- Tc cuprates. Among others Bi 2Sr 2CaCu 2O 8- δ (Bi2212) compound is one of the most studied experimentally [A. Damascelli, Z. Hussain, Z.-X. Shen, Rev. Mod. Phys. 75 (2003) 473; J.C. Campuzano, M.R. Norman, M. Randeria, in: K.H. Bennemann, J.B. Ketterson (Eds.), Physics of Superconductors, vol. 2, Springer, Berlin, 2004, p. 167; J. Fink et al., cond-mat/0512307; X.J. Zhou et al., cond-mat/0604284]. To describe pseudogap regime in Bi2212, we employ novel generalized DMFT + Σk approach [E.Z. Kuchinskii, I.A. Nekrasov, M.V. Sadovskii, JETP Lett. 82 (2005) 198; M.V. Sadovskii et al., Phys. Rev. B 72 (2005) 155105, and these proceedings, doi:10.1016/j.physc.2007.03.367]. This approach gives possibility to preserve conventional dynamical mean-field theory (DMFT) equations [A. Georges et al., Rev. Mod. Phys. 68 (1996) 13] and include an additional (momentum dependent) self-energy Σk. In the present case, Σk describes non-local dynamical correlations induced by short-ranged collective Heisenberg-like antiferromagnetic spin fluctuations [M.V. Sadovskii, Physics-Uspekhi 44 (2001) 515, cond-mat/0408489]. The effective single impurity problem in the DMFT + Σk is solved by numerical renormalization group (NRG) [R. Bulla, A.C. Hewson, Th. Pruschke, J. Phys. Cond. Mat. 10 (1998) 8365; R. Bulla, Phys. Rev. Lett. 83 (1999) 136]. To take into account material specific properties of two neighboring CuO 2 layers of Bi2212 we employ local density approximation (LDA) to calculate necessary model parameters, e.g. the values of intra- and interlayer hopping integrals between Cu-sites. Onsite Coulomb interaction U for x2- y2 orbital was calculated in constrained LDA method [O. Gunnarsson et al., Phys. Rev. B 39 (1989) 1708]. The value of pseudogap potential Δ was obtained within DMFT(NRG) [E.Z. Kuchinskii, I.A. Nekrasov, M.V. Sadovskii, JETP Lett. 82 (2005) 198; M.V. Sadovskii et al., Phys. Rev. B 72 (2005) 155105, and these proceedings, doi:10.1016/j.physc.2007.03.367]. Here, we report theoretical LDA + DMFT + Σk quasiparticle bands dispersion, Fermi surface (FS) and angular resolved photoemission (ARPES) spectra accounting for pseudogap and bilayer splitting effects for normal underdoped Bi2212 ( δ = 0.15). We show that LDA-calculated value of bilayer splitting (BS) is too small to describe experimentally observed peak-dip-hump structure. Fermi surface in presence of the pseudogap fluctuations is almost insensitive to the BS value. Results obtained are in good agreement with recent ARPES experiments.

Prevalence of atopic disorders and immunodeficiency in patients with ectodermal dysplasia syndromes

PubMed Central

Mark, Barry J.; Becker, Bradley A.; Halloran, Donna R.; Bree, Alanna F.; Sindwani, Raj; Fete, Mary D.; Motil, Kathleen J.; Srun, Sopheak W.; Fete, Timothy J.

2013-01-01

Background Ectodermal dysplasia (ED) syndromes are a diverse group of disorders that affect multiple ectodermally derived tissues. Small studies and case reports suggest an increase in atopy and primary immunodeficiencies (PIDs) among patients with ED syndromes. Objective To determine the prevalence of clinical symptoms suggestive of atopy or immunodeficiency among a large cohort of children with ED syndromes. Methods A 9-page questionnaire was mailed to families who were members of the National Foundation for Ectodermal Dysplasias. The surveys were completed by parents of children younger than 18 years with a diagnosis of an ED syndrome or carrier state. Portions of the questionnaire were adapted from previously validated questionnaires developed by the International Study of Asthma and Allergies in Childhood (ISAAC). Results We received 347 completed questionnaires (41%). When compared with the 13- to 14-year-old children surveyed by ISAAC, we found both all-aged and age-matched children with ED syndromes, respectively, had significantly higher rates of asthma (32.2% and 37.2% vs 16.4%), rhinitis symptoms (76.1% and 78.3% vs 38.9%), and eczema (58.9% and 48.9% vs 8.2%). The prevalence of physician-diagnosed food allergies (20.7%) and PIDs (6.1%) in these ED patients also exceeded known rates in the general pediatric population. Conclusion This large-scale, retrospective study demonstrates a greater reported prevalence of symptoms suggestive of atopic disorders and PIDs among children with ED syndromes than the general pediatric population. A combination of genetic and environmental factors in ED syndromes may contribute to breaches of skin and mucosal barriers, permitting enhanced transmission and sensitization to irritants, allergens, and pathogens. PMID:22626597

Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions

PubMed Central

Campbell, Ronna L.; Bellolio, M. Fernanda; Motosue, Megan S.; Sunga, Kharmene L.; Lohse, Christine M.; Rudis, Maria I.

2016-01-01

Introduction Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery. Methods This observational study adhered to survey reporting guidelines. It was performed through a Web-based survey completed by healthcare providers at an academic ED. The primary outcomes were assessment of provider perceptions and identification of the preferred IM epinephrine administration method by ED healthcare providers. Results Of 217 ED healthcare providers invited to participate, 172 (79%) completed the survey. Overall, 82% of respondents preferred the autoinjector method of epinephrine administration. Providers rated the autoinjector method more favorably for time required for training, ease of use, convenience, satisfaction with weight-based dosing, risk of dosing errors, and speed of administration (p<0.001 for all comparisons). However, manual injection use was rated more favorably for risk of provider self-injury and patient cost (p<0.001 for both comparisons). Three participants (2%) reported a finger stick injury from an epinephrine autoinjector. Conclusion ED healthcare providers preferred the autoinjector method of IM epinephrine administration for the management of anaphylaxis or allergic reactions. Epinephrine autoinjector use may reduce barriers to epinephrine administration for the management of anaphylaxis in the ED. PMID:27833688

Quantum synchronization in an optomechanical system based on Lyapunov control.

PubMed

Li, Wenlin; Li, Chong; Song, Heshan

2016-06-01

We extend the concepts of quantum complete synchronization and phase synchronization, which were proposed in A. Mari et al., Phys. Rev. Lett. 111, 103605 (2013)PRLTAO0031-900710.1103/PhysRevLett.111.103605, to more widespread quantum generalized synchronization. Generalized synchronization can be considered a necessary condition or a more flexible derivative of complete synchronization, and its criterion and synchronization measure are proposed and analyzed in this paper. As examples, we consider two typical generalized synchronizations in a designed optomechanical system. Unlike the effort to construct a special coupling synchronization system, we purposefully design extra control fields based on Lyapunov control theory. We find that the Lyapunov function can adapt to more flexible control objectives, which is more suitable for generalized synchronization control, and the control fields can be achieved simply with a time-variant voltage. Finally, the existence of quantum entanglement in different generalized synchronizations is also discussed.

Partial coherence with application to the monotonicity problem of coherence involving skew information

NASA Astrophysics Data System (ADS)

Luo, Shunlong; Sun, Yuan

2017-08-01

Quantifications of coherence are intensively studied in the context of completely decoherent operations (i.e., von Neuamnn measurements, or equivalently, orthonormal bases) in recent years. Here we investigate partial coherence (i.e., coherence in the context of partially decoherent operations such as Lüders measurements). A bona fide measure of partial coherence is introduced. As an application, we address the monotonicity problem of K -coherence (a quantifier for coherence in terms of Wigner-Yanase skew information) [Girolami, Phys. Rev. Lett. 113, 170401 (2014), 10.1103/PhysRevLett.113.170401], which is introduced to realize a measure of coherence as axiomatized by Baumgratz, Cramer, and Plenio [Phys. Rev. Lett. 113, 140401 (2014), 10.1103/PhysRevLett.113.140401]. Since K -coherence fails to meet the necessary requirement of monotonicity under incoherent operations, it is desirable to remedy this monotonicity problem. We show that if we modify the original measure by taking skew information with respect to the spectral decomposition of an observable, rather than the observable itself, as a measure of coherence, then the problem disappears, and the resultant coherence measure satisfies the monotonicity. Some concrete examples are discussed and related open issues are indicated.

34 CFR 110.24 - Recipient assessment of age distinctions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FINANCIAL ASSISTANCE Duties of ED Recipients § 110.24 Recipient assessment of age distinctions. (a) As part... recipient employing the equivalent of 15 or more full-time employees to complete a written self-evaluation... Federal financial assistance from ED to assess the recipient's compliance with the Act. (b) Whenever an...

Multimedia Teacher Research

ERIC Educational Resources Information Center

Leaman, Heather; DiLucchio, Connie

2015-01-01

In this qualitative study, two teacher educators and course instructors in a Masters of Education (M.Ed.) program explored beginning teacher researchers' use of multimedia to support action research. Fifty-eight teachers (36 in spring 2010 and 22 in spring 2011) completed teacher research as the capstone in their M.Ed. program. Teachers utilized…

Knowledge of binge eating disorder: a cross-sectional survey of physicians in the United States.

PubMed

Supina, Dylan; Herman, Barry K; Frye, Carla B; Shillington, Alicia C

2016-01-01

Binge eating disorder (BED)--now a designated disorder in the DSM-5--is the most prevalent eating disorder (ED), affecting 2-3% of the US population. This survey of US physicians assesses how BED is diagnosed, treated and referred. Internists, family practitioners, obstetrics/gynecologist (OB/GYNs) and psychiatrists were randomly selected from a nationally-representative panel. Participants completed an online survey and reviewed case vignettes consistent with DSM-5-defined BED, then answered questions to elicit whether they would assess for psychiatric conditions including EDs. Those reporting they would screen and who correctly identified BED in vignettes received additional questions about BED diagnosis, treatment, and referral patterns. Of 278 physicians surveyed, 96% were board-certified and 87% had practiced >10 years. 23% were psychiatrists, 27% family practitioners, 31% internists and 19% OB/GYNs. 92% were 'somewhat likely' to screen for ED after reviewing DSM-5-consistent vignettes. 206 (74%) correctly identified BED. Of these, 33% and 68% reported they proactively screen eating habits for all patients and obese patients, respectively. 10% reported not screening eating habits even in the presence of ED symptoms. Fewer than half reported using DSM criteria in Diagnosing BED, and 56 (27%) did not recognize BED to be a discreet ED. Although ED awareness is improving, understanding BED as a distinct ED is lacking, which may result in low rates of screening and diagnosis. This study illustrates how taking a complete patient history (including probing BED characteristics) may be an effective first-line strategy for clinicians to facilitate optimal care for these patients.

Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

PubMed

Engel, Kirsten G; Heisler, Michele; Smith, Dylan M; Robinson, Claire H; Forman, Jane H; Ubel, Peter A

2009-04-01

To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions and their awareness of deficiencies in their comprehension. We conducted structured interviews of 140 adult English-speaking patients or their primary caregivers after ED discharge in 2 health systems. Participants rated their subjective understanding of 4 domains: (1) diagnosis and cause; (2) ED care; (3) post-ED care, and (4) return instructions. We assessed patient comprehension as the degree of agreement (concordance) between patients' recall of each of these domains and information obtained from chart review. Two authors scored each case independently and discussed discrepancies before providing a final concordance rating (no concordance, minimal concordance, partial concordance, near concordance, complete concordance). Seventy-eight percent of patients demonstrated deficient comprehension (less than complete concordance) in at least 1 domain; 51% of patients, in 2 or more domains. Greater than a third of these deficiencies (34%) involved patients' understanding of post-ED care, whereas only 15% were for diagnosis and cause. The majority of patients with comprehension deficits failed to perceive them. Patients perceived difficulty with comprehension only 20% of the time when they demonstrated deficient comprehension. Many patients do not understand their ED care or their discharge instructions. Moreover, most patients appear to be unaware of their lack of understanding and report inappropriate confidence in their comprehension and recall.

The role of charity care and primary care physician assignment on ED use in homeless patients.

PubMed

Wang, Hao; Nejtek, Vicki A; Zieger, Dawn; Robinson, Richard D; Schrader, Chet D; Phariss, Chase; Ku, Jocelyn; Zenarosa, Nestor R

2015-08-01

Homeless patients are a vulnerable population with a higher incidence of using the emergency department (ED) for noncrisis care. Multiple charity programs target their outreach toward improving the health of homeless patients, but few data are available on the effectiveness of reducing ED recidivism. The aim of this study is to determine whether inappropriate ED use for nonemergency care may be reduced by providing charity insurance and assigning homeless patients to a primary care physician (PCP) in an outpatient clinic setting. A retrospective medical records review of homeless patients presenting to the ED and receiving treatment between July 2013 and June 2014 was completed. Appropriate vs inappropriate use of the ED was determined using the New York University ED Algorithm. The association between patients with charity care coverage, PCP assignment status, and appropriate vs inappropriate ED use was analyzed and compared. Following New York University ED Algorithm standards, 76% of all ED visits were deemed inappropriate with approximately 77% of homeless patients receiving charity care and 74% of patients with no insurance seeking noncrisis health care in the ED (P=.112). About 50% of inappropriate ED visits and 43.84% of appropriate ED visits occurred in patients with a PCP assignment (P=.019). Both charity care homeless patients and those without insurance coverage tend to use the ED for noncrisis care resulting in high rates of inappropriate ED use. Simply providing charity care and/or PCP assignment does not seem to sufficiently reduce inappropriate ED use in homeless patients. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Response to Enhanced Cognitive Behavioural Therapy in an Adolescent with Anorexia Nervosa.

PubMed

Cowdrey, Felicity A; Davis, Jennifer

2016-11-01

Few studies have examined the acceptability and usefulness of enhanced cognitive behavioural therapy (CBT-E) for adolescents with eating disorders (EDs). To investigate whether CBT-E was an acceptable and efficacious treatment for an adolescent presenting to a routine clinical service with an ED. Daily self-monitoring records were completed during a baseline (A) and intervention (B) phase in addition to routine outcome measures. There were reductions in both ED behaviours and "feeling fat", and increases in weight after 11 CBT-E sessions. Progress was only partially maintained at 8-month follow-up. CBT-E may be an acceptable and useful intervention for adolescents with EDs.

Ethics of emergency department triage: SAEM position statement. SAEM Ethics Committee (Society for Academic Emergency Medicine).

PubMed

1995-11-01

Emergency department overcrowding, the growth of managed care, and the high cost of emergency care are creating pressures to triage patients away from U.S. EDs. Paradoxically, this pressure to limit patient access to EDs has increased in spite of federal laws that restrict patient triage and transfer. The latter regulations view EDs as the safety net for the U.S. health care system. The SAEM Ethics Committee evaluated the ethical implications of policies that triage patients out of the ED prior to complete evaluation and treatment. The committee used these implications to develop practical guidelines, which are reported.

Emotional Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder-Validity, Predictability, Severity, and Comorbidity.

PubMed

Corbisiero, Salvatore; Mörstedt, Beatrice; Bitto, Hannes; Stieglitz, Rolf-Dieter

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. However, this triad might not be able to explain the complete spectrum of ADHD symptoms, as emotional dysregulation (ED) frequently seems to accompany the disorder. The aim of this study was to further understand the role of ED in adult ADHD. The sample comprised 393 adults with ADHD without or with comorbidity, and 121 adults without ADHD or any other mental disorder. Additionally, the sample focused on ED. The contribution of core symptoms and the effect of comorbidity on ED were tested and the predictive value of ED for the ADHD diagnosis itself analyzed. Finally, all subjects were categorized into groups-No ADHD, ADHD, and ADHD + ED-to analyze the differences in the severity of ADHD symptomatology in the three groups. ED levels were found to be elevated in patients with ADHD. The core symptoms affected ED, and the ADHD diagnosis was predicted by ED. The addition of ED to a regression model with the core symptoms was shown to improve the predictability of the ADHD diagnosis. The presence of ED proved to be an indicator of the severity of adult ADHD independent of a present comorbidity. ED is a significant symptom in adult patients with ADHD and appears to be associated with ADHD itself. Whilst the presence of other mental disorders intensifies symptoms of ED, ED seems not to manifest solely as a consequence of comorbidity. © 2016 Wiley Periodicals, Inc.

Intrusive thoughts in obsessive-compulsive disorder and eating disorder patients: a differential analysis.

PubMed

García-Soriano, Gemma; Roncero, Maria; Perpiñá, Conxa; Belloch, Amparo

2014-05-01

The present study aims to compare the unwanted intrusions experienced by obsessive-compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy-nine OCD and 177 ED patients completed two equivalent self-reports designed to assess OCD-related and ED-related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control strategies. Intolerance to uncertainty (OCD group) and thought importance (ED group) predicted their respective emotional disturbance and disruption. Additionally, control importance (OCD group) and thought-action fusion moral (OCD and ED groups) predicted their emotional disturbance. OCD and ED share the presence of intrusions; however, different variables explain why they are disruptive and emotionally disturbing. Cognitive intrusions require further investigation as a transdiagnostic variable. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating pathology in East African women: the role of media exposure and globalization.

PubMed

Eddy, Kamryn T; Hennessey, Moira; Thompson-Brenner, Heather

2007-03-01

Eating disorder (ED) pathology and its relation to media exposure and globalization were assessed in a sample of young Tanzanian females (N = 214; 19.4 years +/- 3.8 years). Participants completed Kiswahili versions of a DSM-IV ED symptom clinical interview, the Eating Disorder Inventory (EDI), and a media exposure/globalization questionnaire. One third endorsed cognitive ED symptoms; bingeing (10%) and purging (5%) were less common. Four women (1.9%) met modified criteria for anorexia nervosa, one for bulimia nervosa, and 10 (4.7%) reported clinically significant ED pathology consistent with an ED not otherwise specified diagnosis. Media exposure and Western exposure (e.g., travel abroad) were positively associated with ED symptoms. The intended factor structure of the EDI was not supported. Eating pathology is present in this developing nation and is most common in subpopulations with increased exposure to Western culture. Future research should replicate these findings to clarify the role of Western media in the development of ED pathology.

Depression Prevention for Early Adolescent Girls

PubMed Central

Chaplin, Tara M.; Gillham, Jane E.; Reivich, Karen; Elkon, Andrea G. L.; Samuels, Barbra; Freres, Derek R.; Winder, Breanna; Seligman, Martin E. P.

2015-01-01

Given the dramatic increase in depression that occurs during early adolescence in girls, interventions must address the needs of girls. The authors examined whether a depression prevention program, the Penn Resiliency Program, was more effective for girls in all-girls groups than in co-ed groups. Within co-ed groups, the authors also tested whether there were greater effects for boys than for girls. Participants were 208 11- to 14-year-olds. Girls were randomly assigned to all-girls groups, co-ed groups, or control. Boys were assigned to co-ed groups or control. Students completed questionnaires on depressive symptoms, hopelessness, and explanatory style before and after the intervention. Girls groups were better than co-ed groups in reducing girls’hopelessness and for session attendance rates but were similar to co-ed groups in reducing depressive symptoms. Co-ed groups decreased depressive symptoms, but this did not differ by gender. Findings support prevention programs and suggest additional benefits of girls groups. PMID:26139955

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders

PubMed Central

Espel, Hallie M.; Goldstein, Stephanie P.; Manasse, Stephanie M.; Juarascio, Adrienne S.

2016-01-01

Purpose This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Methods Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Results Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Conclusions Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted. PMID:26511501

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

PubMed

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

Travelling-wave amplitudes as solutions of the phase-field crystal equation

NASA Astrophysics Data System (ADS)

Nizovtseva, I. G.; Galenko, P. K.

2018-01-01

The dynamics of the diffuse interface between liquid and solid states is analysed. The diffuse interface is considered as an envelope of atomic density amplitudes as predicted by the phase-field crystal model (Elder et al. 2004 Phys. Rev. E 70, 051605 (doi:10.1103/PhysRevE.70.051605); Elder et al. 2007 Phys. Rev. B 75, 064107 (doi:10.1103/PhysRevB.75.064107)). The propagation of crystalline amplitudes into metastable liquid is described by the hyperbolic equation of an extended Allen-Cahn type (Galenko & Jou 2005 Phys. Rev. E 71, 046125 (doi:10.1103/PhysRevE.71.046125)) for which the complete set of analytical travelling-wave solutions is obtained by the method (Malfliet & Hereman 1996 Phys. Scr. 15, 563-568 (doi:10.1088/0031-8949/54/6/003); Wazwaz 2004 Appl. Math. Comput. 154, 713-723 (doi:10.1016/S0096-3003(03)00745-8)). The general solution of travelling waves is based on the function of hyperbolic tangent. Together with its set of particular solutions, the general solution is analysed within an example of specific task about the crystal front invading metastable liquid (Galenko et al. 2015 Phys. D 308, 1-10 (doi:10.1016/j.physd.2015.06.002)). The influence of the driving force on the phase-field profile, amplitude velocity and correlation length is investigated for various relaxation times of the gradient flow. This article is part of the theme issue `From atomistic interfaces to dendritic patterns'.

College students' perceptions of individuals with anorexia and bulimia nervosa.

PubMed

Wingfield, Natalie; Kelly, Nichole; Serdar, Kasey; Shivy, Victoria A; Mazzeo, Suzanne E

2011-05-01

Eating disorders (EDs) are highly stigmatized conditions. This study explored factors hypothesized to influence this stigmatization including ethnicity, gender, ED subtype, and proposed etiology. Undergraduates (N = 235) read scenarios depicting fictional characters varying on ethnicity, gender ED subtype, and etiology. Participants reported perceptions of each character, and completed the EAT-26 and the Level-of-Contact scale. Characters with BN were viewed as more responsible for their ED and more self-destructive than those with AN, who were viewed as more self-controlled. Characters with a sociocultural etiology were rated as most likely to recover. Characters with a biological etiology were viewed as more likeable than characters with an ambiguous etiology. Characters in the ambiguous group were viewed as more self-destructive, more responsible for their ED, and less self-controlled. Differences in participants' perceptions of the characters also emerged when examining ethnicity and gender. Finally, participants' own ED symptoms and their level of contact with EDs were associated with viewing characters as more similar and self-controlled. Findings highlight the need for increased education about ED etiology and course. Copyright © 2010 Wiley Periodicals, Inc.

Lessons Learned for Follow-up Phone Booster Counseling Calls with Substance Abusing Emergency Department Patients

PubMed Central

Donovan, Dennis M.; Hatch-Maillette, Mary A.; Phares, Melissa M.; McGarry, Ernest; Peavy, K. Michelle; Taborsky, Julie

2014-01-01

Background Post-visit “booster” sessions have been recommended to augment the impact of brief interventions delivered in the Emergency Department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists’ qualitative perspectives on providing brief interventions over the phone, challenges, “lessons learned”, and recommendations for others attempting to implement adjunctive booster calls. Method Attempts were made to complete two 20-minute telephone “booster” calls within a week following a patient’s ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Results Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls was 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants’ locale and from someone other than ED staff. Conclusions Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. PMID:25534151

Lessons learned for follow-up phone booster counseling calls with substance abusing emergency department patients.

PubMed

Donovan, Dennis M; Hatch-Maillette, Mary A; Phares, Melissa M; McGarry, Ernest; Peavy, K Michelle; Taborsky, Julie

2015-03-01

Post-visit "booster" sessions have been recommended to augment the impact of brief interventions delivered in the emergency department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists' qualitative perspectives on providing brief interventions over the phone, challenges, "lessons learned", and recommendations for others attempting to implement adjunctive booster calls. Attempts were made to complete two 20-minute telephone "booster" calls within a week following a patient's ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls were 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants' locale and from someone other than ED staff. Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits

PubMed Central

Chandra, Anupam; Crane, Sarah J; Tung, Ericka E; Hanson, Gregory J; North, Frederick; Cha, Stephen S; Takahashi, Paul Y

2015-01-01

There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year. PMID:26029477

Motivational and Skills Training HIV/STI Sexual Risk Reduction Groups for Men

PubMed Central

Calsyn, Donald A.; Hatch-Maillette, Mary; Tross, Susan; Doyle, Suzanne R.; Crits-Christoph, Paul; Song, Yong S.; Harrer, Judy M.; Lalos, Genise; Berns, Sara B.

2009-01-01

The effectiveness of a motivational and skills training HIV/AIDS group intervention designed for men in substance abuse treatment was evaluated. Men in methadone maintenance (n=288) or outpatient psychosocial treatment (n=302) completed assessments at baseline, 2 weeks, 3- and 6-months post intervention. Participants were randomly assigned to attend either “Real Men Are Safe” (REMAS; five sessions containing information, motivational exercises and skills training), or HIV education (HIV-Ed; one session containing HIV prevention information). REMAS participants engaged in significantly fewer unprotected vaginal and anal sexual intercourse occasions (USO) during the 90 days prior to the 3- and 6-month follow-ups than HIV-Ed participants. Completing REMAS resulted in an even stronger effect: completers reduced their number of USO by 21% from baseline to 6-month follow-up. In contrast, HIV-Ed completers increased the number of USO by 2%. A motivational and skills training HIV prevention intervention designed for men was associated with greater sexual risk reduction over standard HIV education. Substance abuse treatment programs can therefore help reduce sexual risk among their clientele by providing a more intensive intervention than what is traditionally provided. PMID:19150206

Stem Cell Therapy for Erectile Dysfunction.

PubMed

Matz, Ethan L; Terlecki, Ryan; Zhang, Yuanyuan; Jackson, John; Atala, Anthony

2018-04-06

The prevalence of erectile dysfunction (ED) is substantial and continues to rise. Current therapeutics for ED consist of oral medications, intracavernosal injections, vacuum erection devices, and penile implants. While such options may manage the disease state, none of these modalities, however, restore function. Stem cell therapy has been evaluated for erectile restoration in animal models. These cells have been derived from multiple tissues, have varied potential, and may function via local engraftment or paracrine signaling. Bone marrow-derived stem cells (BMSC) and adipose-derived stem cells (ASC) have both been used in these models with noteworthy effects. Herein, we will review the pathophysiology of ED, animal models, current and novel stem-cell based therapeutics, clinical trials and areas for future research. The relevant literature and contemporary data using keywords, "stem cells and erectile dysfunction" was reviewed. Examination of evidence supporting the association between erectile dysfunction and adipose derived stem cells, bone marrow derived stem cells, placental stem cells, urine stem cells and stem cell therapy respectively. Placental-derived stem cells and urine-derived stem cells possess many similar properties as BMSC and ASC, but the methods of acquisition are favorable. Human clinical trials have already demonstrated successful use of stem cells for improvement of erectile function. The future of stem cell research is constantly being evaluated, although, the evidence suggests a place for stem cells in erectile dysfunction therapeutics. Matz EL, Terlecki R, Zhang Y, et al. Stem Cell Therapy for Erectile Dysfunction. Sex Med Rev 2018;XX:XXX-XXX. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes.

PubMed

Nowak, Dariusz; Jasionowski, Artur

2016-07-29

Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs). The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools. EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1-3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover. EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes

PubMed Central

Nowak, Dariusz; Jasionowski, Artur

2016-01-01

Background: Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs). Methods: The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools. Results: EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1–3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover. Conclusions: EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour. PMID:27483299

The relationship between dysfunctional family patterns and symptom severity among adolescent patients with eating disorders: A gender-specific approach.

PubMed

Anastasiadou, Dimitra; Sepulveda, Ana R; Parks, Melissa; Cuellar-Flores, Isabel; Graell, Montserrat

2016-01-01

The objective of the authors in this study was to identify factors related to dysfunctional family functioning that may be associated with the severity of symptoms among adolescent patients with an eating disorder (ED) at first-contact care. A total of forty-eight mothers and forty-five fathers of fifty patients with EDs were recruited from an ED unit in Madrid, Spain, between October 2011 and July 2012. Parents completed self-report assessments related to family functioning and psychological wellbeing. Patients went through clinical interviews and completed a self-report questionnaire assessing symptom severity. Compared to fathers, mothers showed higher levels of anxiety and emotional over-involvement and perceived to a greater degree the positive and negative aspects of their experience as caregivers. Regarding the relationship between family functioning and symptom severity, mothers' perceptions of their family relationships as enmeshed and less adaptive, along with anxiety, accounted for 39% of variance in the severity of ED symptoms. Anxiety and symptom accommodation by the fathers accounted for 27% of variance in the symptom severity. Interventions that help parents to cope with their caregiving role should target behavioral, cognitive, and emotional aspects of their functioning and be gender-specific, to improve the outcome of ED in patients.

Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations.

PubMed

Poulin, Patricia A; Nelli, Jennifer; Tremblay, Steven; Small, Rebecca; Caluyong, Myka B; Freeman, Jeffrey; Romanow, Heather; Stokes, Yehudis; Carpino, Tia; Carson, Amanda; Shergill, Yaadwinder; Stiell, Ian G; Taljaard, Monica; Nathan, Howard; Smyth, Catherine E

2016-01-01

Background . Chronic pain (CP) accounts for 10-16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives . To describe patients with CP attending the ED and identify factors contributing to their visit. Methods . We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem. Results . Fifty-eight patients (66% women; mean age 46.5, SD = 16.9) completed the study. The most frequently cited reason (60%) for ED visits was inability to cope with pain. Mental health problems were common, including depression (61%) and anxiety (45%). Participants had questions about the etiology of their pain, concerns about severe pain-related impairment, and problems with medication renewals or efficacy and sometimes felt invalidated in the ED. Although most participants had a primary care physician, the ED was seen as the only or best option when pain became unmanageable. Conclusions . Patients with CP visiting the ED often present with complex difficulties that cannot be addressed in the ED. Better access to interdisciplinary pain treatment is needed to reduce the burden of CP on the ED.

Mission requirements: Second Skylab mission SL-3

NASA Technical Reports Server (NTRS)

1972-01-01

Complete SL-3 mission objectives and requirements, as revised 1 February 1972 (Rev. 6), are presented. Detailed test objectives are also given on the medical experiments, Apollo Telescope Mount experiments, Earth Resources Experiment Package, and corollary experiments and environmental microbiology experiments.

An Analysis of Professional Practice Ed.D. Dissertations in Educational Technology

ERIC Educational Resources Information Center

Dawson, Kara; Kumar, Swapna

2014-01-01

The University of Florida offers an online professional practice Ed.D. focused on Educational Technology. Twenty-three students have completed professional practice dissertations and graduated since the program's inception in 2008. The purpose of this article is to share what these dissertations have looked like and to begin a dialogue about…

Breakers, Benders, and Obeyers: Inquiring into Teacher Educators' Mediation of edTPA

ERIC Educational Resources Information Center

Ratner, Andrew R.; Kolman, Joni S.

2016-01-01

This article reflects a qualitative exploratory inquiry into the lived experiences of faculty members working within a system of urban schools of education as they supported diverse teacher candidates in completing the Educative Teacher Performance Assessment (edTPA) during its first semesters of high-stakes implementation. Drawing upon…

I Failed the edTPA

ERIC Educational Resources Information Center

Kuranishi, Adam; Oyler, Celia

2017-01-01

In this article, co-written by a teacher and a professor, the authors examine possible explanations for why Adam (first author), a New York City public school special educator, failed the edTPA, a teacher performance assessment required by all candidates for state certification. Adam completed a yearlong teaching residency where he was the special…

Factorial Validity and Psychometric Examination of the Exercise Dependence Scale-Revised

ERIC Educational Resources Information Center

Downs, Danielle Symons; Hausenblas, Heather A.; Nigg, Claudio R.

2004-01-01

The research purposes were to examine the factorial and convergent validity, internal consistency, and test-retest reliability of the Exercise Dependence Scale (EDS). Two separate studies, containing a total of 1,263 college students, were undertaken to accomplish these purposes. Participants completed the EDS and measures of exercise behavior and…

Redesigning a General Education Science Course to Promote Critical Thinking

PubMed Central

Rowe, Matthew P.; Gillespie, B. Marcus; Harris, Kevin R.; Koether, Steven D.; Shannon, Li-Jen Y.; Rose, Lori A.

2015-01-01

Recent studies question the effectiveness of a traditional university curriculum in helping students improve their critical thinking and scientific literacy. We developed an introductory, general education (gen ed) science course to overcome both deficiencies. The course, titled Foundations of Science, differs from most gen ed science offerings in that it is interdisciplinary; emphasizes the nature of science along with, rather than primarily, the findings of science; incorporates case studies, such as the vaccine-autism controversy; teaches the basics of argumentation and logical fallacies; contrasts science with pseudoscience; and addresses psychological factors that might otherwise lead students to reject scientific ideas they find uncomfortable. Using a pretest versus posttest design, we show that students who completed the experimental course significantly improved their critical-thinking skills and were more willing to engage scientific theories the general public finds controversial (e.g., evolution), while students who completed a traditional gen ed science course did not. Our results demonstrate that a gen ed science course emphasizing the process and application of science rather than just scientific facts can lead to improved critical thinking and scientific literacy. PMID:26231561

Emergency department documentation of alleged excessive use of force.

PubMed

Strote, Jared; Verzemnieks, Erik; Walsh, Mimi

2013-12-01

Patients' complaints of excessive use of force (EUOF) by police occur frequently in emergency departments (EDs). Limited, if any, education or guidelines exist for documenting alleged EUOF despite extensive instruction for other forms of potential abuse or assault. Our objective was to examine the documentation by ED staff when patients complained of EUOF. A retrospective cohort design was used, identifying every use of force over a 1-year period by a single law enforcement agency that was followed by an ED visit within 24 hours. Charts were then analyzed for complaints of excessive force. For these cases, documentation was evaluated using standards for other forms of abuse and assault. Of 187 ED visits, 32 (17%) involved patients who were unable to give a history and 20 (11%) had nontrauma evaluations only. Of the remaining 135, there were 13 documented complaints (10%) of EUOF. Of these, 8 complaints (62%) described the mechanism of injury completely and 10 complaints (77%) had a complete description of the injury. No charts discussed whether the examination was consistent with the history. Inappropriate subjective terminology was used in 7 charts (54%), and the police description of events was described as fact in 7 charts (54%). Guilt was assigned in 5 charts (39%). In one ED, EUOF complaints were not documented to the standards for other forms of alleged assault and abuse. There may be a benefit to further education and guidelines on how to deal with ED presentations of EUOF.

Enhancing capacity for intern training in the emergency department: the MoLIE project.

PubMed

Brazil, Victoria A; Greenslade, Jaimi H; Brown, Anthony F

2011-02-21

To evaluate an intern educational project, the More Learning for Interns in Emergency (MoLIE) project, designed to increase intern placements in the emergency department (ED). The study was conducted in the ED of the Royal Brisbane and Women's Hospital, Queensland, in 2008. As well as the usual direct contact with patients, interns had 8 hours per week of "off the floor" structured learning time supervised by consultants. This allowed for an increased number of interns to complete a term in the ED over a 1-year period. The study was evaluated by an intern exit feedback survey and a senior staff survey. Numbers of intern placements in the ED; intern satisfaction with the project; senior medical staff satisfaction with interns' skills and performance assessments. The number of interns completing a term in the ED increased from 65 in 2007 to 90 in 2008. Overall, the 90 interns surveyed were highly satisfied with their training. Most agreed or strongly agreed that the sessions were relevant and covered the right mix of clinical and professional issues. Most of the 12 senior staff surveyed felt that the participating interns performed slightly or much better than interns in previous years, and that their experience as supervisors and overall patient care were improved. The project successfully combined increased intern numbers with educational outcomes that were well perceived by interns and senior staff, without adversely affecting service delivery or supervision workload in the ED.

Expanding The INSPIRED COPD Outreach Program™ to the emergency department: a feasibility assessment

PubMed Central

Gillis, Darcy; Demmons, Jillian; Rocker, Graeme

2017-01-01

Background The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%–80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission. Methods Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency. Results Referral rates were 0.5/week. Among eligible patients (n=174) 33 (19%) were referred of whom 15 (M=4, F=11) enrolled in INSPIRED-ED. Mean (SD) age was 68 (7) years, post-bronchdilator FEV1 44.2 (15.5) % predicted, and Medical Research Council (MRC) dyspnea score 3.8 (0.41). We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD) Care Transition Measure (CTM-3) improved from 8.6 (2.0) to 11.3 (1.3), P=0.0004, and of 14 patients responding 12 (86%) found the program very helpful. An additional 34 patients were enrolled to our regular program from those referred but ineligible for INSPIRED-ED (n=27) or unwilling to participate (n=7). Conclusions INSPIRED-ED outcomes were generally positive, however referral and enrollment rates were lower than anticipated. Despite the potential of early self-management education, the ED may not be the ideal recruitment setting for home-based programs. Our findings underline the importance of conducting preliminary work to ascertain best settings for implementing new self-management education initiatives. PMID:28615932

Expanding The INSPIRED COPD Outreach Program™ to the emergency department: a feasibility assessment.

PubMed

Gillis, Darcy; Demmons, Jillian; Rocker, Graeme

2017-01-01

The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission. Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency. Referral rates were 0.5/week. Among eligible patients (n=174) 33 (19%) were referred of whom 15 (M=4, F=11) enrolled in INSPIRED-ED. Mean (SD) age was 68 (7) years, post-bronchdilator FEV 1 44.2 (15.5) % predicted, and Medical Research Council (MRC) dyspnea score 3.8 (0.41). We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD) Care Transition Measure (CTM-3) improved from 8.6 (2.0) to 11.3 (1.3), P =0.0004, and of 14 patients responding 12 (86%) found the program very helpful. An additional 34 patients were enrolled to our regular program from those referred but ineligible for INSPIRED-ED (n=27) or unwilling to participate (n=7). INSPIRED-ED outcomes were generally positive, however referral and enrollment rates were lower than anticipated. Despite the potential of early self-management education, the ED may not be the ideal recruitment setting for home-based programs. Our findings underline the importance of conducting preliminary work to ascertain best settings for implementing new self-management education initiatives.

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects.

PubMed

Droste, Nicolas; Peacock, Amy; Bruno, Raimondo; Pennay, Amy; Zinkiewicz, Lucy; Lubman, Dan I; Miller, Peter

2017-08-01

Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. A convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits.

PubMed

Morrison, Andrea K; Schapira, Marilyn M; Gorelick, Marc H; Hoffmann, Raymond G; Brousseau, David C

2014-01-01

We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. This year long cross-sectional study utilized the Newest Vital Sign questionnaire to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model 2 outcomes-prior ED visits and ED visit urgency-stratified by chronic illness. Analyses were weighted by triage level. Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (adjusted incidence rate ratio 1.5; 95% confidence interval 1.2, 1.8) and increased odds of a nonurgent index ED visit (adjusted odds ratio 2.4; 95% confidence interval 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of nonurgent index ED visits (48% vs. 22%; adjusted odds ratio 3.2; 1.8, 5.7). Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for nonurgent conditions. In children without a chronic illness, low health literate caregivers had more than 3 times greater odds of presenting for a nonurgent condition than those with adequate health literacy. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Low Caregiver Health Literacy is Associated with Higher Pediatric Emergency Department Use and Non-urgent Visits

PubMed Central

Morrison, Andrea K.; Schapira, Marilyn M.; Gorelick, Marc H.; Hoffmann, Raymond G.; Brousseau, David C.

2014-01-01

Objective We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. Methods This year long cross-sectional study utilized the Newest Vital Sign to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model the outcomes: 1) prior ED visits and 2) ED visit urgency, stratified by chronic illness. Analyses were weighted by triage level. Results Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (aIRR 1.5; 95% C.I.1.2, 1.8) and increased odds of a non-urgent index ED visit (AOR 2.4; 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of non-urgent index ED visits (48% vs 22%; AOR 3.2; 1.8, 5.7). Conclusions Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for non-urgent conditions. In children without a chronic illness, low health literate caregivers had more than three times great odds of presenting for a non-urgent condition than those with adequate health literacy. PMID:24767784

Emergency medicine versus primary care: a case study of three prevalent, costly, and non-emergent diagnoses at a community teaching hospital.

PubMed

Martin, B C

2000-01-01

The high cost of emergency department (ED) care is often viewed as an area for achieving cost savings through reduced utilization for inappropriate conditions. The implementation of outpatient prospective payment for Medicare ED patients heightens scrutiny of costs and utilization in the ED versus primary care settings. Data from hospital clinical records, financial records, and a provider survey was used to develop a costing methodology and complete a comparative analysis of the cost of care for three diagnoses by setting. Total costs were significantly higher in the ED due primarily to differences in ancillary tests and prescription drugs ordered.

The type-material of Arctiinae (Lepidoptera, Erebidae) described by Burmeister and Berg in the collection of the Museo Argentino de Ciencias Naturales Bernardino Rivadavia (Buenos Aires, Argentina).

PubMed

Beccacece, Hernán M; Vincent, Benoit; Navarro, Fernando R

2014-01-01

Carlos G. Burmeister and Carlos Berg were among the most important and influential naturalists and zoologists in Argentina and South America and described 241 species and 34 genera of Lepidoptera. The Museo Argentino de Ciencias Naturales Bernardino Rivadavia (MACN) housed some of the Lepidoptera type specimens of these authors. In this study we present a catalogue with complete information and photographs of 11 Burmeister type specimens and 10 Berg type specimens of Phaegopterina, Arctiina and Pericopina (Lepidoptera, Erebidae, Arctiinae, Arctiini) housed in the MACN. Lectotypes or holotypes were designated where primary type specimens could be recognized; in some cases we were not able to recognize types. The catalogue also proposes nomenclatural changes and new synonymies: Opharus picturata (Burmeister, 1878), comb. n.; Opharus brunnea Gaede, 1923: 7, syn. n.; Hypocrisias jonesi (Schaus, 1894), syn. n.; Leucanopsis infucata (Berg, 1882), stat. rev.; Paracles argentina (Berg, 1877), sp. rev.; Paracles uruguayensis (Berg, 1886), sp. rev.

The type-material of Arctiinae (Lepidoptera, Erebidae) described by Burmeister and Berg in the collection of the Museo Argentino de Ciencias Naturales Bernardino Rivadavia (Buenos Aires, Argentina)

PubMed Central

Beccacece, Hernán M.; Vincent, Benoit; Navarro, Fernando R.

2014-01-01

Abstract Carlos G. Burmeister and Carlos Berg were among the most important and influential naturalists and zoologists in Argentina and South America and described 241 species and 34 genera of Lepidoptera. The Museo Argentino de Ciencias Naturales Bernardino Rivadavia (MACN) housed some of the Lepidoptera type specimens of these authors. In this study we present a catalogue with complete information and photographs of 11 Burmeister type specimens and 10 Berg type specimens of Phaegopterina, Arctiina and Pericopina (Lepidoptera, Erebidae, Arctiinae, Arctiini) housed in the MACN. Lectotypes or holotypes were designated where primary type specimens could be recognized; in some cases we were not able to recognize types. The catalogue also proposes nomenclatural changes and new synonymies: Opharus picturata (Burmeister, 1878), comb. n.; Opharus brunnea Gaede, 1923: 7, syn. n.; Hypocrisias jonesi (Schaus, 1894), syn. n.; Leucanopsis infucata (Berg, 1882), stat. rev.; Paracles argentina (Berg, 1877), sp. rev.; Paracles uruguayensis (Berg, 1886), sp. rev. PMID:25061380

Temporal variability of the surface and atmosphere of Mars: Viking Orbiter color observations

NASA Technical Reports Server (NTRS)

Mcewen, A. S.

1992-01-01

We are near the final stages in the processing of a large Viking Orbiter global color dataset. Mosaics from 57 spacecraft revolutions (or 'revs' hereafter) were produced, most in both red and violet or red, green, and violet filters. Phase angles range from 13 deg to 85 deg. A total of approximately 2000 frames were processed through radiometric calibration, cosmetic cleanup, geometric control, reprojection, and mosaicking into single-rev mosaics at a scale of 1 km/pixel. All of the mosaics are geometrically tied to the 1/256 deg/pixel Mars Digital Image Mosaic (MDIM). Photometric normalization is in progress, to be followed by production of a 'best coverage' global mosaic at a scale of 1/64 deg/pixel (0.923 km/pixel). Global coverage is near 100 percent in red-filter mosaics and 98 percent and 60 percent in corresponding violet- and green-filter mosaics, respectively. Soon after completion, all final datasets (including single-rev mosaics) will be distributed to the planetary community on compact disks.

Establishment and baseline characteristics of a nationwide Danish cohort of patients with Ehlers-Danlos syndrome.

PubMed

Kulas Søborg, Marie-Louise; Leganger, Julie; Quitzau Mortensen, Laura; Rosenberg, Jacob; Burcharth, Jakob

2017-05-01

The aim of this study was to investigate national prevalence, general demographic characteristics and survival of Danish patients with Ehlers-Danlos syndrome (EDS). A population-based cohort study was conducted using a database consisting of the entire Danish population alive at any given time between 1 January 2000 and 31 December 2012, based upon longitudinal Danish national registers. All patients with EDS were identified, and the cohort was described by disease prevalence, basic demographic characteristics, mean age at death and mortality for the observational period of 13 years. The cohort held 1427 unique persons with EDS, giving a national prevalence of 0.02%. The EDS population had a mean ( s . d .) age of 34.9 (18.6) years and comprised 73.9% females and 26.1% males. Of the cohort, 95.9% originated from Denmark and 57% were unmarried. We found that 31.6% of the cohort received state-granted subsidies, of which 77% were in the form of early retirement pension. Regarding educational status, 28.1% of the EDS cohort had completed primary education (⩽10th grade) as their highest educational level, while 71.9% had completed a higher level. During the observation period, 42 patients died, with a mean ( s . d .) age at death of 53.6 (21.7) years. This study confirmed a small national prevalence of patients diagnosed with EDS and showed that the majority of patients diagnosed are female. The EDS cohort had a lower educational level, mean age and life expectancy compared with the background population and showed a predisposition for receiving state-granted subsidies. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Evaluation of the Role of Umbilical Cord Serum and Autologous Serum Therapy in Reepithelialization After Keratoplasty: A Randomized Controlled Clinical Trial.

PubMed

Kamble, Neha; Sharma, Namrata; Maharana, Prafulla K; Bandivadekar, Pooja; Nagpal, Ritu; Agarwal, Tushar; Velpandian, Thirumurthy; Mittal, Suneeta; Vajpayee, Rasik B

2017-09-01

To evaluate the role of umbilical cord serum (UCS) and autologous serum (AS) therapy in reepithelialization of corneal graft after keratoplasty in a randomized controlled trial. A total of 105 eyes with epithelial defect (ED) after keratoplasty (penetrating keratoplasty-67 and anterior lamellar keratoplasty-38) on the first postoperative day were included in the study. The eyes were randomized into three groups: UCS (n=35), AS (n=35), and artificial tears (AT) (n=35). All patients received standard postoperative medical therapy. The primary outcome measure was time to epithelialization, and secondary outcome measures were best-corrected visual acuity and graft clarity. The ED healed completely in 103 eyes. The mean time for complete reepithelialization was 2.5±2.1, 3.1±2.2, and 4.5±1.4 days in UCS, AS, and AT groups, respectively. The mean percentage decrease in the size of the ED was significantly better in the UCS and AS groups as compared with the AT group (P=0.001). The rate of reepithelialization was comparable between the AS and UCS groups (P=0.3). On bivariate analysis, significant correlation was found between the mean size of postoperative ED, grade of the donor cornea (P=0.001), and the presence of preoperative ED (P=0.001). No complications were associated with the use of serum therapy. Most of the cases of postkeratoplasty corneal ED can be managed with AT only. The serum therapy (AS/UCS) helps in the faster reepithelialization of postkeratoplasty ED as compared with AT and may be considered as a treatment option for early epithelial healing.

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1982)

EPA Science Inventory

This document is an evaluation and assessment of scientific information relative to determining the health and welfare effects associated with exposure to various concentrations of nitrogen oxides in ambient air. The document is not intended as a complete, detailed literature rev...

Public School Graduates and Dropouts from the Common Core of Data: School Year 2009-10. First Look (Provisional Data). NCES 2013-309rev

ERIC Educational Resources Information Center

Stillwell, Robert; Sable, Jennifer

2013-01-01

This report presents the number of high school completers, the Averaged Freshman Graduation Rate (AFGR), and the dropout data for grades 9-12 for public schools in school year 2009-10. State Education Agencies (SEAs) report annual counts of completers, dropouts, and enrollments to the National Center for Education Statistics' (NCES) Common Core of…

Body-Related Social Comparison and Disordered Eating among Adolescent Females with an Eating Disorder, Depressive Disorder, and Healthy Controls

PubMed Central

Hamel, Andrea E.; Zaitsoff, Shannon L.; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel

2012-01-01

The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC. PMID:23112914

Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls.

PubMed

Hamel, Andrea E; Zaitsoff, Shannon L; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel

2012-09-01

The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12-18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others'. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

Rumination, experiential avoidance, and dysfunctional thinking in eating disorders

PubMed Central

Rawal, Adhip; Park, Rebecca J.; Williams, J. Mark G.

2010-01-01

The majority of research in eating disorders (ED) has investigated the content of disorder-specific thoughts, while few studies have addressed underlying cognitive-affective processes. A better understanding of processes underpinning ED may have important implications for treatment development. Two studies were conducted that investigated levels of rumination, beliefs about rumination, experiential avoidance, and aspects of schematic thinking in individuals with eating pathology. The latter was assessed with a newly designed ED-Sentence Completion Task (ED-SCT). Study 1 (N = 177) examined relations between ED psychopathology and these variables in a student population. Extending this, Study 2 (N = 26) assessed differences between patients with anorexia nervosa and healthy control participants. The results showed that ED psychopathology was related to disorder-specific cognitions, experiential avoidance as well as ruminative brooding but not reflection. A follow-up of anorexia nervosa patients indicated that changes in ED psychopathology were associated with changes in dysfunctional attitudes and maladaptive cognitive-affective processes. These findings highlight cognitive processes that may play an important role in the maintenance of eating pathology. PMID:20598670

Consumption of energy drinks among Québec college students.

PubMed

Picard-Masson, Marianne; Loslier, Julie; Paquin, Pierre; Bertrand, Karine

2017-03-01

Consumption of energy drinks (ED) raises concerns because of adverse health effects possibly linked with high levels of caffeine and sugar intake. The study looks at the scope of ED consumption as well as some of the associated characteristics. Thirty-six public colleges in the Canadian province of Québec agreed to participate in a descriptive cross-sectional study (n = 36). In February 2013, participating colleges invited their students to answer an online questionnaire on consumption of ED, alcoholic ED (AED), and ED in combination with other psychotropic drugs. A descriptive and correlational analysis was carried out. Logistic regressions explored associations between ED consumption and associated characteristics. Of the students who successfully completed the questionnaire and participated in the study (n = 10,283), a low proportion consumed ED (9.1%; n = 935) and/or AED (1.1%; n = 109) at least once a week in the previous month. Although low in proportion, a number of participants reported having used ED with other stimulant psychoactive substances (n = 247) and ≥3 ED/day (n = 193) or ≥3 AED/occasion (n = 167), which can pose a risk for serious adverse effects. Weekly ED consumption was associated with consumption of ≥20 cups of coffee/week, smoking, excessive use of alcohol and past use of cannabis, glues or solvents and amphetamines. A majority of respondents are not heavy users of ED, AED, or ED with drugs. Yet, the profiles of ED consumption potentially harmful to health that characterize some participants indicate that the potential health consequences of such behaviour are of concern.

Lonely Days and Lonely Nights: Completing the Doctoral Dissertation.

ERIC Educational Resources Information Center

Germeroth, Darla

A study examined areas of the doctoral dissertation process that are often problematic for the Ph.D./Ed.D. candidate in the field of communication. Subjects, 250 randomly selected Speech Communication Association members holding a Ph.D. or an Ed.D. were surveyed. Of the 250 surveys mailed, 137 were returned, representing a 54.8% return rate.…

The Ed.D. in Educational Leadership and Administration: The Students' and Alumni's Experiences

ERIC Educational Resources Information Center

Vera, Edith B.

2012-01-01

The doctoral experience unfolds many complexities and challenges for students, faculty, and institutions that contribute toward degree completion. The purpose of this study is to investigate the students' and alumni's experiences afforded by the Ed.D. in Educational Leadership and Administration at the University of Texas at El Paso (UTEP). The…

The interaction between erectile dysfunction complaints and depression in men: a cross-sectional study about sleep, hormones and quality of life.

PubMed

Soterio-Pires, J H; Hirotsu, C; Kim, L J; Bittencourt, L; Tufik, S; Andersen, M L

2017-03-01

Depression (DEP) is one of the main disabling diseases and is considered a contributor factor for erectile dysfunction (ED). Both of these conditions may be associated with hormonal changes and sleep disturbances. We aimed to evaluate the interaction between ED complaints and depression symptoms on sleep parameters, hormone levels and quality of life in men. This was a cross-sectional study of 468 men aged 20-80 years. The participants were classified according to the presence of ED and/or DEP in groups of healthy individuals, ED, DEP and DEP with ED (DEP-ED). All participants completed questionnaires about sleep, clinical history and quality of life, and underwent polysomnography with blood collection the following morning. ED participants showed higher frequency of insomnia symptoms (65.5%), whereas DEP group had more complaints of difficulty in falling asleep and early morning awakening. In the polysomnography, all groups showed similar parameters. No differences were found in cortisol and total testosterone levels; however, free testosterone levels and the physiological domain of quality of life were lower in DEP-ED group. ED and DEP, as independent factors, negatively affected subjective sleep parameters. The interaction between these factors led to a low quality of life and was related to a decrease in free testosterone levels.

PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation

PubMed Central

Mitchell, Karen S.; Wolf, Erika J.

2016-01-01

Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. We examined whether lifetime PTSD symptoms were associated with current food addiction and ED symptoms, and whether emotion regulation (expressive suppression and cognitive reappraisal), which has been associated with both PTSD and EDs, mediated these relations, in a sample of trauma-exposed, male (n = 642) and female (n = 55) veterans. Participants were recruited from the Knowledge Networks-GfK Research Panel and completed an online questionnaire. Structural equation modeling revealed that PTSD was directly associated with ED symptoms, food addiction, expressive suppression, and cognitive reappraisal in the full sample and with all constructs except cognitive reappraisal in the male subsample. Expressive suppression was significantly associated with ED symptoms and mediated the PTSD—ED relation. These results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments. PMID:27344589

PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation.

PubMed

Mitchell, Karen S; Wolf, Erika J

2016-09-30

Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. We examined whether lifetime PTSD symptoms were associated with current food addiction and ED symptoms, and whether emotion regulation (expressive suppression and cognitive reappraisal), which has been associated with both PTSD and EDs, mediated these relations, in a sample of trauma-exposed, male (n=642) and female (n=55) veterans. Participants were recruited from the Knowledge Networks-GfK Research Panel and completed an online questionnaire. Structural equation modeling revealed that PTSD was directly associated with ED symptoms, food addiction, expressive suppression, and cognitive reappraisal in the full sample and with all constructs except cognitive reappraisal in the male subsample. Expressive suppression was significantly associated with ED symptoms and mediated the PTSD-ED relation. These results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments. Published by Elsevier Ireland Ltd.

Bombesin-like peptides and receptors in normal fetal baboon lung: roles in lung growth and maturation.

PubMed

Emanuel, R L; Torday, J S; Mu, Q; Asokananthan, N; Sikorski, K A; Sunday, M E

1999-11-01

Previously, we have shown that bombesin-like peptide (BLP) promotes fetal lung development in rodents and humans but mediates postnatal lung injury in hyperoxic baboons. The present study analyzed the normal ontogeny of BLP and BLP receptors as well as the effects of BLP on cultured normal fetal baboon lungs. Transcripts encoding gastrin-releasing peptide (GRP), a pulmonary BLP, were detectable on gestational day 60 (ED60), peaked on approximately ED90, and then declined before term (ED180). Numbers of BLP-immunopositive neuroendocrine cells peaked from ED80 to ED125 and declined by ED160, preceding GRP-receptor mRNAs detected from ED125 until birth. BLP (0.1-10 nM) stimulated type II cell differentiation in organ cultures as assessed by [(3)H]choline incorporation into surfactant phospholipids, electron microscopy, and increased surfactant protein (SP) A- and/or SP-C-immunopositive cells and SP-A mRNA. BLP also induced neuroendocrine differentiation on ED60. Cell proliferation was induced by GRP, peaking on ED90. Similarly, blocking BLP degradation stimulated lung growth and maturation, which was completely reversed by a BLP-specific antagonist. The dissociation between GRP and GRP-receptor gene expression during ontogeny suggests that novel BLP receptors and/or peptides might be implicated in these responses.

Perceived social support among adults seeking care for acute respiratory tract infections in US EDs.

PubMed

Levin, Sara K; Metlay, Joshua P; Maselli, Judith H; Kersey, Ayanna S; Camargo, Carlos A; Gonzales, Ralph

2009-06-01

Emergency departments (EDs) provide a disproportionate amount of care to disenfranchised and vulnerable populations. We examined social support levels among a diverse population of adults seeking ED care for acute respiratory tract infections. A convenience sample of adults seeking care in 1 of 15 US EDs was telephone interviewed 1 to 6 weeks postvisit. The Multidimensional Scale of Perceived Social Support (7-point Likert) assessed social support across 3 domains: friends, family, and significant others. Higher scores indicate higher support. Of 1104 subjects enrolled, 704 (64%) completed the follow-up interview. Factor analysis yielded 3 factors. Mean social support score was 5.54 (SD 1.04). Female sex, greater household income, and better health status were independently associated with higher levels of social support. Social support levels among adults seeking care in the ED for acute respiratory tract infections are similar to general population cohorts, suggesting that social support is not a strong determinant of health care seeking in EDs.

Substance use disorders, anorexia, bulimia, and concurrent disorders.

PubMed

Courbasson, Christine M A; Smith, Patrick D; Cleland, Patricia A

2005-01-01

While the co-prevalence of eating disorders (ED) has been documented in individuals with substance use disorders (SUD), little is known about the co-occurrence of other disorders in this population. Examining this issue is critical for public health policy and treatment success. To identify and evaluate the co-occurrence of ED and other psychiatric disorders in men and women with SUD. The sample consisted of individuals seeking treatment for substance use. Semi-structured interviews and the CAMH Concurrent Disorders Screener were completed to assess DSM-IV psychopathology. Chi-square analyses suggested that more women scored positive for ED than men, EDs were more prevalent in both genders than in the general population, and the co-occurrence of other disorders was higher for clients with both SUD and ED than with SUD. Individuals with both SUD and ED appear to have multiple needs that may not be readily assessed by existing addiction treatment programs. Assessment issues, treatment, potential prevention and health promotion implications are addressed.

Increase in Mexican and Latin American scientific articles on irritable bowel syndrome.

PubMed

Porras, R; López-Colombo, A; Schmulson, M

2015-01-01

There is an implied perception that little scientific information on irritable bowel syndrome (IBS) comes out of Mexico and Latin America in the international medical literature, but the number and tendencies of articles from the region on IBS are not known. To determine the number and type of Mexican and Latin American articles on IBS published between 1990-2015. A systematic search of Medline was carried out employing the terms « Irritable Bowel Syndrome » or its abbreviation (IBS). Mexico and every other Latin American country were added to specify the search. The articles were selected if they were published in Mexico and/or the rest of Latin America, if they were international papers on IBS in the region, or if they were written by Mexican and/or Latin American authors. In addition, the articles were classified into the following categories: Reviews/Editorials/Letters to the Editor (REV/ED), Epidemiology/Quality of Life/Psychosocial Factors (EPI/QOL), Diagnostic (DX), Treatment (TX), and Translational/Pathophysiologic (TRANS) studies. A total of 66 articles from Mexico and 47 from Latin America were identified, but only 87.7 and 48.9%, respectively, fit the selection criteria. Category distribution was: EPI/QOL: 36.2%, REV/ED: 27.5%, TRANS: 18.8, TX: 10%, and DX: 7.5% and was similar between Mexico and Latin America (p=0.33). The year 2005 saw an increase in the number of articles in Mexico, with a peak in 2010. The figures for Latin American articles remained stable over the years, with a peak in 2012. A noticeable increase has been observed over the last decade in the research conducted on IBS in Mexico and Latin America. Even though the EPI/QOL studies predominate, the sophistication of research is reflected in the TRANS studies that are in third place of frequency. The information referred to herein demonstrates maturity in the field, making it possible to carry out consensuses based on local data. Copyright © 2015 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

Electroclinic effect in the chiral lamellar α phase of a lyotropic liquid crystal

NASA Astrophysics Data System (ADS)

Harjung, Marc D.; Giesselmann, Frank

2018-03-01

In thermotropic chiral Sm -A* phases, an electric field along the smectic layers breaks the D∞ symmetry of the Sm -A* phase and induces a tilt of the liquid crystal director. This so-called electroclinic effect (ECE) was first reported by Garoff and Meyer in 1977 and attracted substantial scientific and technological interest due to its linear and submicrosecond electro-optic response [S. Garoff and R. B. Meyer, Phys. Rev. A 19, 338 (1979), 10.1103/PhysRevA.19.338]. We now report the observation of an ECE in the pretransitional regime from a lyotropic chiral lamellar Lα* phase into a lyo-Sm -C* phase, the lyotropic analog to the thermotropic Sm -C* phase which was recently discovered by Bruckner et al. [Angew. Chem. Int. Ed. 52, 8934 (2013), 10.1002/anie.201303344]. We further show that the observed ECE has all signatures of its thermotropic counterpart, namely (i) the effect is chiral in nature and vanishes in the racemic Lα phase, (ii) the effect is essentially linear in the sign and magnitude of the electric field, and (iii) the magnitude of the effect diverges hyperbolically as the temperature approaches the critical temperature of the second order tilting transition. Specific deviations between the ECEs in chiral lamellar and chiral smectic phases are related to the internal field screening effect of electric double layers formed by inevitable ionic impurities in lyotropic phases.

Resilience Scale-25 Spanish version: validation and assessment in eating disorders.

PubMed

Las Hayas, Carlota; Calvete, Esther; Gómez del Barrio, Andrés; Beato, Luís; Muñoz, Pedro; Padierna, Jesús Ángel

2014-08-01

To validate into Spanish the Wagnild and Young Resilience Scale - 25 (RS-25), assess and compare the scores on the scale among women from the general population, eating disorder (ED) patients and recovered ED patients. This is a cross-sectional study. ED participants were invited to participate by their respective therapists. The sample from the general population was gathered via an open online survey. Participants (N general population=279; N ED patients=124; and N recovered ED patients=45) completed the RS-25, the World Health Organization Quality of Life Scale-BREF and the Hospital Anxiety and Depression Scale. Mean age of participants ranged from 28.87 to 30.42years old. Statistical analysis included a multi-group confirmatory factor analysis and ANOVA. The two-factor model of the RS-25 produced excellent fit indexes. Measurement invariance across samples was generally supported. The ANOVA found statistically significant differences in the RS-25 mean scores between the ED patients (Mean=103.13, SD=31.32) and the recovered ED participants (Mean=138.42, SD=22.26) and between the ED patients and the general population participants (Mean=136.63, SD=19.56). The Spanish version of the RS-25 is a psychometrically sound measurement tool in samples of ED patients. Resilience is lower in people diagnosed with ED than in recovered individuals and the general population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

PubMed

MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

2017-12-01

This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

Physician Impressions of Physical Therapist Practice in the Emergency Department: Descriptive, Comparative Analysis Over Time.

PubMed

Fruth, Stacie J; Wiley, Steve

2016-09-01

Emergency department (ED) use in the United States is expected to rapidly increase. Nearly half of all ED visits are classified as semiurgent or nonurgent, and many fall into the musculoskeletal category. Despite growing international evidence that patients are appropriately and safely managed by ED physical therapists in a time-efficient manner, physical therapist practice in EDs is not widely understood or utilized in the United States. To date, no studies have reported the impressions of ED physicians about this practice. The purposes of this study were: (1) to assess ED physicians' impressions of ED physical therapist practice 2 years after practice was initiated and (2) to determine whether physicians' impressions changed 7 years later. All ED staff physicians and medical residents at a level I trauma hospital were invited to complete a survey in 2004 and 2011. In both years, a majority of physicians reported favorable impressions of ED physical therapist practice. Physical therapists were valued for educating patients about safety and injury prevention, providing appropriate gait training, assisting with disposition planning, and providing interventions as alternatives to pain medication. Many physicians supported standing physical therapist orders for certain musculoskeletal conditions. The most common concern was the additional time that patients spend in the ED for a physical therapist consult. The results of this study may not reflect the impressions of physicians in all EDs that employ physical therapists. Emergency department physicians reported favorable impressions of ED physical therapist practice 2 years and 9 years following its implementation in this hospital. This study showed that ED physicians support standing physical therapist orders for certain musculoskeletal conditions, which suggests that direct triage to ED physical therapists for these conditions could be considered. © 2016 American Physical Therapy Association.

The meaning of (quality of) life in patients with eating disorders: a comparison of generic and disease-specific measures across diagnosis and outcome.

PubMed

Ackard, Diann M; Richter, Sara; Egan, Amber; Engel, Scott; Cronemeyer, Catherine L

2014-04-01

Compare general and disease-specific health-related quality of life (HRQoL) among female patients with an eating disorder (ED). Female patients (n = 221; 95.3% Caucasian; 94.0% never married) completed the Medical Outcome Short Form Health Survey (SF-36) and Eating Disorders Quality of Life (EDQoL) as part of a study of treatment outcomes. Multivariate regression models were used to compare HRQoL differences across initial ED diagnosis (85 AN-R, 19 AN-B/P, 27 BN, 90 EDNOS) and ED diagnostic classification at time of outcome assessment (140 no ED, 38 subthreshold ED, 43 full threshold ED). There were no significant differences across ED diagnosis at initial assessment on either of the SF-36 Component Summary scores. However, patients with AN-B/P scored poorer on the work/school EDQoL subscales than other ED diagnoses, and on the psychological EDQoL subscale compared to AN-R and EDNOS. At outcome assessment, comparisons across full threshold, subthreshold and no ED classification indicated that those with no ED reported better HRQoL than those with full threshold ED on the SF-36 Mental Components Summary and three of four EDQoL subscales. Furthermore, those with no ED reported better psychological HRQoL than those with subthreshold ED. Disease-specific HRQOL measures are important to use when comparing HRQoL in ED patients across treatment and outcome, and may have the sensitivity to detect meaningful differences by diagnosis more so than generic instruments. EDQoL scores from patients remitted from symptoms approach but do not reach scores for unaffected college females; thus, treatment should continue until quality of life is restored. Copyright © 2013 Wiley Periodicals, Inc.

Patient nonadherence to filling discharge medication prescriptions from the emergency department: Barriers and clinical implications.

PubMed

Farris, Brian; Shakowski, Courtney; Mueller, Scott W; Phong, Suzanne; Kiser, Tyree H; Jacknin, Gabrielle

2018-03-01

Barriers to and clinical implications of patient nonadherence to filling discharge medication prescriptions from the emergency department (ED) were evaluated. This was a retrospective, observational analysis of patients discharged from the ED from April 2013 through May 2015 with medication prescriptions. Patients age 18-89 years who were seen in the ED and did not retrieve discharge medication prescriptions from the onsite, 24-hour ED discharge pharmacy were included in this study. Patients who did not pick up prescriptions were called and asked about barriers to prescription filling. These charts were then retrospectively reviewed and categorized. The primary study outcome was the frequency of nonadherence to filling discharge medications prescribed during the ED visit at the ED outpatient pharmacy. Secondary outcomes included identifying barriers to medication adherence, the rate of return ED visits within 30 days of ED discharge, and the rate of 30-day hospital admissions. Associations between patient and medication variables and the rates of return ED visits within 30 days of discharge and 30-day hospital admissions were analyzed. Of the 4,444 patients discharged from the ED with a prescription to be filled at the satellite pharmacy, 510 were nonadherent. Of these patients, 505 had complete chart information available for evaluation. A large proportion of nonadherent patients revisited the ED within 30 days of ED discharge. Multivariate logistic regression found payer class, ethnicity, and sex were independently associated with return ED visits. The majority of patients who received a prescription during an ED visit filled their discharge medications. Sex, ethnicity, and payer class were independently associated with nonadherence. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Second-order topological insulators and superconductors with an order-two crystalline symmetry

NASA Astrophysics Data System (ADS)

Geier, Max; Trifunovic, Luka; Hoskam, Max; Brouwer, Piet W.

2018-05-01

Second-order topological insulators and superconductors have a gapped excitation spectrum in bulk and along boundaries, but protected zero modes at corners of a two-dimensional crystal or protected gapless modes at hinges of a three-dimensional crystal. A second-order topological phase can be induced by the presence of a bulk crystalline symmetry. Building on Shiozaki and Sato's complete classification of bulk crystalline phases with an order-two crystalline symmetry [Phys. Rev. B 90, 165114 (2014), 10.1103/PhysRevB.90.165114], such as mirror reflection, twofold rotation, or inversion symmetry, we classify all corresponding second-order topological insulators and superconductors. The classification also includes antiunitary symmetries and antisymmetries.

Weak limit of the three-state quantum walk on the line

NASA Astrophysics Data System (ADS)

Falkner, Stefan; Boettcher, Stefan

2014-07-01

We revisit the one-dimensional discrete time quantum walk with three states and the Grover coin, the simplest model that exhibits localization in a quantum walk. We derive analytic expressions for the localization and a long-time approximation for the entire probability density function (PDF). We find the possibility for asymmetric localization to the extreme that it vanishes completely on one site of the initial conditions. We also connect the time-averaged approximation of the PDF found by Inui et al. [Phys. Rev. E 72, 056112 (2005), 10.1103/PhysRevE.72.056112] to a spatial average of the walk. We show that this smoothed approximation predicts moments of the real PDF accurately.

Effect of cadence selection on peak power and time of power production in elite BMX riders: A laboratory based study.

PubMed

Rylands, Lee P; Roberts, Simon J; Hurst, Howard T; Bentley, Ian

2017-07-01

The aims of this study were to analyse the optimal cadence for peak power production and time to peak power in bicycle motocross (BMX) riders. Six male elite BMX riders volunteered for the study. Each rider completed 3 maximal sprints at a cadence of 80, 100, 120 and 140 revs · min -1 on a laboratory Schoberer Rad Messtechnik (SRM) cycle ergometer in isokinetic mode. The riders' mean values for peak power and time of power production in all 3 tests were recorded. The BMX riders produced peak power (1105 ± 139 W) at 100 revs · min -1 with lower peak power produced at 80 revs · min -1 (1060 ± 69 W, (F(2,15) = 3.162; P = .266; η 2  = 0.960), 120 revs · min -1 (1077 ± 141 W, (F(2,15) = 4.348; P = .203; η 2  = 0.970) and 140 revs · min -1 (1046 ± 175 W, (F(2,15) = 12.350; P = 0.077; η 2  = 0.989). The shortest time to power production was attained at 120 revs · min -1 in 2.5 ± 1.07 s. Whilst a cadence of 80 revs · min -1 (3.5 ± 0.8 s, (F(2,15) = 2.667; P = .284; η 2  = 0.800) 100 revs · min -1 (3.00 ± 1.13 s, (F(2,15) = 24.832; P = .039; η 2  = 0.974) and 140 revs · min -1 (3.50 ± 0.88 s, (F(2,15) = 44.167; P = .006; η 2  = 0.967)) all recorded a longer time to peak power production. The results indicate that the optimal cadence for producing peak power output and reducing the time to peak power output are attained at comparatively low cadences for sprint cycling events. These findings could potentially inform strength and conditioning training to maximise dynamic force production and enable coaches to select optimal gear ratios.

Clinical Pharmacy Services in Canadian Emergency Departments: A National Survey

PubMed Central

Wanbon, Richard; Lyder, Catherine; Villeneuve, Eric; Shalansky, Stephen; Manuel, Leslie; Harding, Melanie

2015-01-01

Background: Providing clinical pharmacy services in emergency departments (EDs) is important because adverse drug events commonly occur before, during, and after ED encounters. Survey studies in the United States have indicated a relatively low presence of clinical pharmacy services in the ED setting, but a descriptive survey specific to Canada has not yet been performed. Objectives: To describe the current status of pharmacy services in Canadian EDs and potential barriers to implementing pharmacy services in this setting. Methods: All Canadian hospitals with an ED and at least 50 acute care beds were contacted to identify the presence of dedicated ED pharmacy services (defined as at least 0.5 full-time equivalent [FTE] position). Three different electronic surveys were then distributed by e-mail to ED pharmacy team members (if available), pharmacy managers (at hospitals without an ED pharmacy team), and ED managers (all hospitals). The surveys were completed between July and September 2013. Results: Of the 243 hospitals identified, 95 (39%) had at least 0.5 FTE clinical pharmacy services in the ED (based on initial telephone screening). Of the 60 ED pharmacy teams that responded to the survey, 56 had pharmacists (27 of which also had ED pharmacy technicians) and 4 had pharmacy technicians (without pharmacists). Forty-four (79%) of the 56 ED pharmacist services had been established within the preceding 10 years. Order clarification, troubleshooting, medication reconciliation, and assessment of renal dosing were the services most commonly provided. The large majority of pharmacy managers and ED managers identified the need for ED pharmacy services where such services do not yet exist. Inadequate funding, competing priorities, and lack of training were the most commonly reported barriers to providing this service. Conclusions: Although the establishment of ward-based pharmacy services in Canadian EDs has increased over the past 10 years, lack of funding and a lack of ED training for pharmacists were reported as significant barriers to the expansion of this role in most hospitals. PMID:26157180

Are eating disorders "all about control?" The elusive psychopathology of nonfat phobic presentations.

PubMed

Murray, Helen B; Coniglio, Kathryn; Hartmann, Andrea S; Becker, Anne E; Eddy, Kamryn T; Thomas, Jennifer J

2017-11-01

There are a subset of individuals with eating disorders (EDs) who do not overevaluate body shape/weight (i.e., nonfat phobic ED; NFP-ED). According to the transdiagnostic cognitive-behavioral conceptualization of EDs, a need for control, in general, is hypothesized as the core psychopathology of NFP-EDs, with shape- and weight-related motivations for ED behavior merely superimposed in FP-ED presentations. This study tested the need for control as motivation for restriction in NFP-ED, using items aimed at assessing control from the Eating Disorder Examination (EDE) Restraint scale. Females ages 13-27 years consecutively admitted to residential treatment completed the EDE, Eating Disorder Inventory-3 Drive for Thinness subscale (EDI-DFT), and other self-report measures of psychopathology. We included patients with DSM-5 EDs, but excluded patients with avoidant/restrictive food intake disorder. Twenty participants had NFP-ED (≤14 on EDI-DFT) and 124 had fatphobic ED (FP-ED; >14 on EDI-DFT). NFP-ED scored significantly lower than FP-ED on EDE Restraint scale shape/weight [χ 2 (1) = 10.73-35.62, p's < .01] and on control items [χ 2 (1) = 10.72-20.62, p's < .01], in addition to scoring lower on measures of general psychopathology and impairment. Findings suggest those with NFP-ED report lower psychopathology overall and the new EDE Restraint scale control items do not capture additional motivation for restriction beyond that captured in the original Restraint scale shape/weight items. Future research should examine whether this latter finding is due to a minimizing response style in NFP-ED, an incomplete capture of desire for control by the EDE assessment method, or indeed reflects that need for control does not motivate restriction in NFP-EDs. © 2017 Wiley Periodicals, Inc.

Contrasting gender differences on two measures of exercise dependence.

PubMed

Weik, M; Hale, B D

2009-03-01

Recent studies using multidimensional measures have shown that men (Exercise Dependence Scale; EDS-R) are more exercise-dependent than women, whereas others have found that women (Exercise Dependence Questionnaire; EDQ) are more exercise-dependent than men. This study investigated whether there may be sex differences in exercise dependence or whether the questionnaires may be measuring different dimensions of exercise dependence. Regular exercisers voluntarily completed the EDS-R, EDQ and Drive for Thinness (DFT) subscale before or after a workout. A local health club in the eastern USA. Male (n = 102) and female (n = 102) exercisers completed the three questionnaires, but 11 participants (1 man, 10 women) were excluded from further analysis because scores indicated possible secondary exercise dependence (eating disorder). Eight subscales of the EDQ, seven subscales of the EDS, the DFT subscale, and several demographic variables served as dependent measures. A multivariate analysis of variance (MANOVA) on the EDS-R showed that men were significantly higher than women on the Withdrawal, Continuance, Tolerance, Lack of Control, Time, and Intention Effect subscales. Another MANOVA on the EDQ indicated that women scored significantly higher than did men on the Interference, Positive Rewards, Withdrawal, and Social Reasons subscales. Statistical analysis using t tests revealed that men had significantly higher total EDS-R scores than women, but women had significantly higher EDQ and DFT scores. These results suggest that both questionnaires measure different aspects of exercise dependence that favour either gender. It remains for further research to determine whether these instruments are equally viable for measurement of ED in both men and women.

Symptoms predicting psychosocial impairment in bulimia nervosa.

PubMed

Jenkins, Paul E; Staniford, Jessica; Luck, Amy

2017-05-12

The current study aimed to determine which particular eating disorder (ED) symptoms and related features, such as BMI and psychological distress, uniquely predict impairment in bulimia nervosa (BN). Two hundred and twenty-two adults with BN completed questionnaires assessing ED symptoms, general psychological distress, and psychosocial impairment. Regression analyses were used to determine predictors which account for variance in impairment. Four variables emerged as significant predictors of psychosocial impairment: concerns with eating; concerns with weight and shape; dietary restraint; and general psychological distress. Findings support previous work highlighting the importance of weight and shape concerns in determining ED-related impairment. Other ED symptoms, notably dietary restraint and concerns with eating, were also significant predictors as was psychological distress. Results suggest that cognitive aspects of EDs, in addition to psychological distress, may be more important determinants of impairment than behavioural symptoms, such as binge eating or purging.

Co-occurring eating and psychiatric symptoms in Taiwanese college students: effects of gender and parental factors.

PubMed

Tseng, Mei-Chih Meg; Gau, Susan Shur-Fen; Tseng, Wan-Ling; Hwu, Hai-Gwo; Lee, Ming-Been

2014-03-01

To test whether gender and parental factors moderate the relationships between symptoms of eating disorder (ED) and other psychiatric symptoms. A total of 5,015 new entrants completed several questionnaires and 541 individuals with ED symptoms were identified by the Adult Self-Report Inventory-4 that assessed a wide range of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition psychopathology. The participants also reported on their parents' attitude toward them before their ages of 16. ED symptoms, female gender, less parental care, and more parental protection were associated with more severe co-occurring psychiatric symptoms. Gender and parental factors also demonstrated differential moderating effects on the relationships between ED and co-occurring psychiatric symptoms. Parenting counseling may be individualized to young adults with ED symptoms and different co-occurring psychiatric symptoms. © 2013 Wiley Periodicals, Inc.

Stigmatizing Attitudes and Beliefs About Anorexia and Bulimia Nervosa Among Italian Undergraduates.

PubMed

Caslini, Manuela; Crocamo, Cristina; Dakanalis, Antonios; Tremolada, Martina; Clerici, Massimo; Carrà, Giuseppe

2016-12-01

Stigmatizing attitudes toward eating disorders (EDs) may lead to reduced treatment seeking. We aimed to estimate the prevalence of stigmatizing trends and beliefs related to anorexia nervosa (AN) and bulimia nervosa (BN), and the associations with the experiential knowledge of the problem, in a large sample of Italian undergraduates. A total of 2109 participants completed an online survey including questionnaires related to stigmatizing beliefs toward AN and BN, and personal contacts with people with EDs. Undergraduates reported almost overlapping low levels of stigmatizing trends for AN and BN, apart from personal responsibility and social distance. Those aged 18 to 25 and living with family held higher stigmatizing attitudes. Stigma was lower in underweight participants and in those (12%) reporting a previous ED diagnosis. Although not improving stigmatizing attitudes, 83% of the sample was familiar with people with an ED. Antistigma actions to increase awareness on EDs and to improve treatment-seeking behaviors are needed.

[Erectile dysfunction: results of the Brazilian Sexual Life Study].

PubMed

Abdo, Carmita Helena Najjar; Oliveira, Waldemar Mendes de; Scanavino, Marco de Tubino; Martins, Fernando Gonini

2006-01-01

To estimate the prevalence of ED and related risk factors in a sample of the Brazilian male population. Cross-sectional study was carried out with a convenience sample of 2,862 men, 18 years of age or older, using an anonymous self-administered questionnaire. ED prevalence in the sample was obtained by a general question which was directly derived from the ED definition. Data were submitted to chi-square or Student's t tests. Logistic regression analyses were used for risk factor calculations. The prevalence of ED was 45.1% (31.2% mild, 12.2% moderate and 1.7% complete). Subjects with ED presented lower self-esteem, hindered interpersonal relationships, fewer sexual intercourses per week, more extra-marital relationships, complaints of lack of libido and premature ejaculation. When compared with men aged 18-39 years, men aged 60-69 presented 2.2 higher risk of ED (95% CI; 1.4-3.4; p < 0.01), whereas men aged 70 or older presented 3.0 higher risk of ED (95% CI; 1.4-6.3; p < 0.01). Level of education was inversely proportional to risk of ED. Yellow race, unemployment, religious affiliation, prostate tumor, hypertension and depression were variables that increased ED risk. The prevalence of ED was high and comparable to that found in other studies. Subjects with ED suffer from less sexual activity and poorer quality of life. Age and lower socioeconomic level are directly proportional to ED risk. Therapeutic and preventive measures should be implemented to minimize the negative impact of this condition, especially in developing countries.

Comparison of associated features and drug treatment between co-occurring unipolar and bipolar disorders in depressed eating disorder patients.

PubMed

Tseng, Mei-Chih Meg; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

2017-02-27

To examine the differences of associated characteristics and prescription drug use between co-occurring unipolar and bipolar disorders in patients with eating disorders (EDs). Patients with EDs and major depressive episode (MDE) were recruited from psychiatric outpatient clinics. They were interviewed and completed self-administered measures assessing eating and general psychopathology. The prescribed drugs at the index outpatient visit were recorded. Clinical characteristics and prescription drugs of groups with major depressive disorder (ED-MDD), MDE with lifetime mania (ED-BP I), and MDE with lifetime hypomania (ED-BP II) were compared. Continuous variables between groups were compared using generalized linear regression with adjustments of age, gender, and ED subtype for pair-wise comparisons. Multivariate logistic regression with adjustments of age, gender, and ED subtype was employed to estimate adjusted odds ratios with 95% confidence intervals between groups. Two hundred and twenty-seven patients with EDs had a current MDE. Among them, 17.2% and 24.2% experienced associated manic and hypomanic episodes, respectively. Bipolar I and II patients displayed significantly poorer weight regulation, more severe impulsivity and emotional lability, and higher rates of co-occurring alcohol use disorders than ED-MDD patients. ED-BP I patients were found to have the lowest IQ, poorest working memory, and the most severe depression, suicidality and functional impairment among all patients. Patients with ED-BP II shared affect and behavioral dysregulations with ED-BP I, but had less severe degrees of cognitive and functional impairments than ED-BP I. Patients with ED-BP I were significantly less likely than those in the ED-MDD and ED-BP II groups to be on antidepressant monotherapy, but a great rate (27%) of ED-BP I individuals taking antidepressant monotherapy had potential risk of mood switch during the course of treatment. Our study identified discriminative features of bipolar I and II disorders from MDD among a group of depressed ED patients. We suggest that the associated mania, hypomania, and mood lability are predictors of clinical severity and should be identified from ED patients presented with depressive features. Accurate diagnosis of bipolar disorders may have implications for pharmacotherapy in patients with EDs.

Prevalence and effects of life event exposure among undergraduate and community college students.

PubMed

Anders, Samantha L; Frazier, Patricia A; Shallcross, Sandra L

2012-07-01

The purposes of this study were to assess lifetime and recent exposure to various life events among undergraduate and community college students and to assess the relation between event exposure and a broad range of outcomes (i.e., mental and physical health, life satisfaction, grade point average). Undergraduate students from a midwestern university (N = 842) and a community college (N = 242) completed online measures of lifetime event exposure and outcomes at Time 1 and recent event exposure at Time 2 two months later. Life events assessed included events that did and did not meet the definition of a traumatic event (i.e., posttraumatic stress disorder Criterion A1) in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) as well as directly (e.g., own life-threatening illness) and indirectly (e.g., others' illness) experienced events. Students reported experiencing many lifetime and recent Criterion A1 and non-A1 events, and community college students reported more events than did university students. Generally, individuals who reported more lifetime events also reported poorer outcomes (e.g., poorer health). The number of non-Criterion A1 and directly experienced events tended to be more strongly correlated with negative outcomes than were the number of Criterion A1 and indirectly experienced events reported. These findings suggest that non-A1 events are important to assess and can be significantly related to outcomes for students.

Levels of uric acid in erectile dysfunction of different aetiology.

PubMed

Barassi, Alessandra; Corsi Romanelli, Massimiliano Marco; Pezzilli, Raffaele; Dozio, Elena; Damele, Clara Anna Linda; Vaccalluzzo, Liborio; Di Dario, Marco; Goi, Giancarlo; Papini, Nadia; Massaccesi, Luca; Colpi, Giovanni Maria; Melzi d'Eril, Gian Vico

2018-01-12

Erectile dysfunction is a common disease characterized by endothelial dysfunction. The aetiology of ED is often multifactorial but evidence is being accumulated in favor of the proper function of the vascular endothelium that is essential to achieving and maintaining penile erection. Uric acid itself causes endothelial dysfunction via decreased nitric oxide production. This study aims to evaluate the serum uric acid (SUA) levels in 180 ED patients, diagnosed with the International Index of Erectile Function-5 (IIEF-5) and 30 non-ED control. Serum uric acid was analyzed with a commercially available kit using ModularEVO (Roche, Monza, Italy). Within-assay and between-assay variations were 3.0% and 6.0%, respectively. Out of the ED patients, 85 were classified as arteriogenic (A-ED) and 95 as non-arteriogenic (NA-ED) with penile-echo-color-Doppler. Uric acid levels (median and range in mg/dL) in A-ED patients (5.8, 4.3-7.5) were significantly higher (p < .001) than in NA-ED patients (4.4, 2.6-5.9) and in control group (4.6, 3.1-7.2). There was a significant difference (p < .001) between uric acid levels in patients with mild A-ED (IIEF-5 16-20) and severe/complete A-ED (IIEF-5 ≤ 10) that were 5.4 (range 4.3-6.5) mg/dL and 6.8 (range 6.4-7.2) mg/dL, respectively. There was no difference between the levels of uric acid in patients with different degree of NA-ED. Our findings reveal that SUA is a marker of ED but only of ED of arteriogenic aetiology.

An automated integration-free path-integral method based on Kleinert's variational perturbation theory

NASA Astrophysics Data System (ADS)

Wong, Kin-Yiu; Gao, Jiali

2007-12-01

Based on Kleinert's variational perturbation (KP) theory [Path Integrals in Quantum Mechanics, Statistics, Polymer Physics, and Financial Markets, 3rd ed. (World Scientific, Singapore, 2004)], we present an analytic path-integral approach for computing the effective centroid potential. The approach enables the KP theory to be applied to any realistic systems beyond the first-order perturbation (i.e., the original Feynman-Kleinert [Phys. Rev. A 34, 5080 (1986)] variational method). Accurate values are obtained for several systems in which exact quantum results are known. Furthermore, the computed kinetic isotope effects for a series of proton transfer reactions, in which the potential energy surfaces are evaluated by density-functional theory, are in good accordance with experiments. We hope that our method could be used by non-path-integral experts or experimentalists as a "black box" for any given system.

Who is dropping your course?

NASA Astrophysics Data System (ADS)

Storrs, Alex; Ghent, C.; Labattaglia, R.

2011-01-01

We present an analysis of pre and post instruction instruments in a basic astronomy course. This analysis is built on the Light and Spectroscopy Concept Inventory (LSCI, Bardar et al. 2007). In addition to assessing our student's gain in knowledge of this fundamental topic, we have added some demographic questions. While the primary purpose is to compare the gain in knowledge during a semester of instruction to changes in instruction, we also look at the demographics of students who take the pretest but not the posttest. These students are usually excluded from this type of analysis. We look for trends in the demographic information among students who drop the course, and suggest ways to make the course more palatable. References: Bardar et al., 2007: "Development and Validation of the Light and Spectroscopy Concept Inventory", Astr. Ed. Rev. 5(2), 103-113

Feasibility of a computer-delivered driver safety behavior screening and intervention program initiated during an emergency department visit.

PubMed

Murphy, Mary; Smith, Lucia; Palma, Anton; Lounsbury, David; Bijur, Polly; Chambers, Paul; Gallagher, E John

2013-01-01

Injuries from motor vehicle crashes are a significant public health problem. The emergency department (ED) provides a setting that may be used to screen for behaviors that increase risk for motor vehicle crashes and provide brief interventions to people who might otherwise not have access to screening and intervention. The purpose of the present study was to (1) assess the feasibility of using a computer-assisted screening program to educate ED patients about risky driving behaviors, (2) evaluate patient acceptance of the computer-based traffic safety educational intervention during an ED visit, and (3) assess postintervention changes in risky driving behaviors. Pre/posteducational intervention involving medically stable adult ED patients in a large urban academic ED serving over 100,000 patients annually. Patients completed a self-administered, computer-based program that queried patients on risky driving behaviors (texting, talking, and other forms of distracted driving) and alcohol use. The computer provided patients with educational information on the dangers of these behaviors and data were collected on patient satisfaction with the program. Staff called patients 1 month post-ED visit for a repeat query. One hundred forty-nine patients participated, and 111 completed 1-month follow up (75%); the mean age was 39 (range: 21-70), 59 percent were Hispanic, and 52 percent were male. Ninety-seven percent of patients reported that the program was easy to use and that they were comfortable receiving this education via computer during their ED visit. All driving behaviors significantly decreased in comparison to baseline with the following reductions reported: talking on the phone, 30 percent; aggressive driving, 30 percent; texting while driving, 19 percent; drowsy driving, 16 percent; driving while multitasking, 12 percent; and drinking and driving, 9 percent. Overall, patients were very satisfied receiving educational information about these behaviors via computer during their ED visits and found the program easy to use. We found a high prevalence of self-reported risky driving behaviors in our ED population. At 1-month follow-up, patients reported a significant decrease in these behaviors. This study indicates that a low-intensity, computer-based educational intervention during an ED visit may be a useful approach to educate patients about safe driving behaviors and safe drinking limits and help promote behavior change.

Elemental analysis using ED-XRF and 14C dating of Cuman wall paintings samples

NASA Astrophysics Data System (ADS)

Brocchieri, J.; Sabbarese, C.; Marzaioli, F.; Passariello, I.; Terrasi, F.; De Maio, C.; Ferrara, L.

2018-04-01

The aim of the present research was to analyse pigments and mortars of fresco fragments located at Cuma (Naples, Italy). The ED-XRF technique and 14C dating were used to establish the nature of the pigments and the age of mortars, respectively. ED-XRF results allowed to determine the elemental composition of the pigments that identified the colours and, hence, the historical period of completion. The 14C dating, applied to mortars using a particular preparation, provided results that are in accordance with the archaeological information within the 2σ interval range.

Emergency department patient compliance with follow-up for outpatient exercise stress testing: a randomized controlled trial.

PubMed

Richards, Doug; Meshkat, Nazanin; Chu, Jaqueline; Eva, Kevin; Worster, Andrew

2007-11-01

Numerous patients are assessed in the emergency department (ED) for chest pain suggestive of acute coronary syndrome (ACS) and subsequently discharged if found to be at low risk. Exercise stress testing is frequently advised as a follow-up investigation for low-risk patients; however, compliance with such recommendations is poorly understood. We sought to determine if compliance with follow-up for exercise stress testing is higher in patients for whom the investigation is ordered at the time of ED discharge, compared with patients who are advised to arrange testing through their family physician (FP). Low-risk chest pain patients being discharged from the ED for outpatient exercise stress test and FP follow-up were randomized into 2 groups. ED staff ordered an exercise stress test for the intervention group, and the control group was advised to contact their FP to arrange testing. The primary outcome was completion of an exercise stress test at 30 days, confirmed through both patient contact and stress test results. Patients were unaware that our primary interest was their compliance with the exercise stress testing recommendations. Two-hundred and thirty-one patients were enrolled and baseline characteristics were similar between the 2 groups. Completion of an exercise stress test at 30 days occurred in 87 out of 120 (72.5%) patients in the intervention group and 60 out of 107 (56.1%) patients in the control group. The difference in compliance rates (16.4%) between the 2 groups was statistically significant (Chi(2) = 6.69, p < 0.001) with a relative risk of 1.29 (95% confidence interval 1.18-1.40), and the results remained significant after a "worst case" sensitivity analysis involving 4 control group cases lost to follow-up. When subjects were contacted by telephone 30 days after the ED visit, 60% of those who were noncompliant patients felt they did not have a heart problem and that further testing was unnecessary. When ED staff order an outpatient exercise stress test following investigation for potential ACS, patients are more likely to complete the test if it is booked for them before ED discharge. After discharge, many low-risk chest pain patients feel they are not at risk and do not return to their FP for further testing in a timely manner as advised. Changing to a strategy of ED booking of exercise stress testing may help earlier identification of patients with coronary heart disease.

Utility of brief questionnaires of health-related quality of life (Airways Questionnaire 20 and Clinical COPD Questionnaire) to predict exacerbations in patients with asthma and COPD

PubMed Central

2013-01-01

Background There is some evidence that quality of life measured by long disease-specific questionnaires may predict exacerbations in asthma and COPD, however brief quality of life tools, such as the Airways Questionnaire 20 (AQ20) or the Clinical COPD Questionnaire (CCQ), have not yet been evaluated as predictors of hospital exacerbations. Objectives To determine the ability of brief specific health-related quality of life (HRQoL) questionnaires (AQ20 and CCQ) to predict emergency department visits (ED) and hospitalizations in patients with asthma and COPD, and to compare them to longer disease-specific questionnaires, such as the St George´s Respiratory Questionnaire (SGRQ), the Chronic Respiratory Disease Questionnaire (CRQ) and the Asthma Quality of Life Questionnaire (AQLQ). Methods We conducted a two-year prospective cohort study of 208 adult patients (108 asthma, 100 COPD). Baseline sociodemographic, clinical, functional and psychological variables were assessed. All patients completed the AQ20 and the SGRQ. COPD patients also completed the CCQ and the CRQ, while asthmatic patients completed the AQLQ. We registered all exacerbations that required ED or hospitalizations in the follow-up period. Differences between groups (zero ED visits or hospitalizations versus ≥ 1 ED visits or hospitalizations) were tested with Pearson´s X2 or Fisher´s exact test for categorical variables, ANOVA for normally distributed continuous variables, and Mann–Whitney U test for non-normally distributed variables. Logistic regression analyses were performed to estimate the predictive ability of each HRQoL questionnaire. Results In the first year of follow-up, the AQ20 scores predicted both ED visits (OR: 1.19; p = .004; AUC 0.723) and hospitalizations (OR: 1.21; p = .04; AUC 0.759) for asthma patients, and the CCQ emerged as independent predictor of ED visits in COPD patients (OR: 1.06; p = .036; AUC 0.651), after adjusting for sociodemographic, clinical, and psychological variables. Among the longer disease-specific questionnaires, only the AQLQ emerged as predictor of ED visits in asthma patients (OR: 0.9; p = .002; AUC 0.727). In the second year of follow-up, none of HRQoL questionnaires predicted exacerbations. Conclusions AQ20 predicts exacerbations in asthma and CCQ predicts ED visits in COPD in the first year of follow-up. Their predictive ability is similar to or even higher than that of longer disease-specific questionnaires. PMID:23706146

Which role does multiphoton interference play in small phase estimation in quantum Fourier transform interferometers?

NASA Astrophysics Data System (ADS)

Zimmermann, Olaf; Tamma, Vincenzo

Recently, quantum Fourier transform interferometers have been demonstrated to allow a quantum metrological enhancement in phase sensitivity for a small number n of identical input single photons [J. P. Olson, K. R. Motes, P. M. Birchall, N. M. Studer, M. LaBorde, T. Moulder, P. P. Rohde and J. P. Dowling, Phys. Rev. A 96 (2017) 013810; K. R. Motes, J. P. Olson, E. J. Rabeaux, J. P. Dowling, S. J. Olson and P. P. Rohde, Phys. Rev. Lett. 114 (2015) 170802; O. Zimmermann, Bachelor Thesis (Ulm University, 2015) arXiv: 1710.03805.]. However, multiphoton distinguishability at the detectors can play an important role from an experimental point of view [V. Tamma and S. Laibacher, Phys. Rev. Lett. 114 (2015) 243601.]. This raises a fundamental question: How is the phase sensitivity affected when the photons are completely distinguishable at the detectors and therefore do not interfere? In other words, which role does multiphoton interference play in these schemes? Here, we show that for small phase values, the phase sensitivity achievable in the proposed schemes with indistinguishable photons is enhanced only by a constant factor with respect to the case of completely distinguishable photons at the detectors. Interestingly, this enhancement arises from the interference of only a polynomial number (in n) of the total n! multiphoton path amplitudes in the n-port interferometer. These results are independent of the number n of single photons and of the phase weight factors employed at each interferometer channel.

Composite cements benefit from light-curing.

PubMed

Lührs, Anne-Katrin; De Munck, Jan; Geurtsen, Werner; Van Meerbeek, Bart

2014-03-01

To investigate the effect of curing of composite cements and a new ceramic silanization pre-treatment on the micro-tensile bond strength (μTBS). Feldspathic ceramic blocks were luted onto dentin using either Optibond XTR/Nexus 3 (XTR/NX3; Kerr), the silane-incorporated 'universal' adhesive Scotchbond Universal/RelyX Ultimate (SBU/RXU; 3M ESPE), or ED Primer II/Panavia F2.0 (ED/PAF; Kuraray Noritake). Besides 'composite cement', experimental variables were 'curing mode' ('AA': complete auto-cure at 21°C; 'AA*': complete auto-cure at 37°C; 'LA': light-curing of adhesive and auto-cure of cement; 'LL': complete light-curing) and 'ceramic surface pre-treatment' ('HF/S/HB': hydrofluoric acid ('HF': IPS Ceramic Etching Gel, Ivoclar-Vivadent), silanization ('S': Monobond Plus, Ivoclar-Vivadent) and application of an adhesive resin ('HB': Heliobond, Ivoclar-Vivadent); 'HF/SBU': 'HF' and application of the 'universal' adhesive Scotchbond Universal ('SBU'; 3M ESPE, only for SBU/RXU)). After water storage (7 days at 37°C), ceramic-dentin sticks were subjected to μTBS testing. Regarding the 'composite cement', the significantly lowest μTBSs were measured for ED/PAF. Regarding 'curing mode', the significantly highest μTBS was recorded when at least the adhesive was light-cured ('LA' and 'LL'). Complete auto-cure ('AA') revealed the significantly lowest μTBS. The higher auto-curing temperature ('AA*') increased the μTBS only for ED/PAF. Regarding 'ceramic surface pre-treatment', only for 'LA' the μTBS was significantly higher for 'HF/S/HB' than for 'HF/SBU'. Complete auto-cure led to inferior μTBS than when either the adhesive (on dentin) or both adhesive and composite cement were light-cured. The use of a silane-incorporated adhesive did not decrease luting effectiveness when also the composite cement was light-cured. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

High-risk cocktails and high-risk sex: examining the relation between alcohol mixed with energy drink consumption, sexual behavior, and drug use in college students.

PubMed

Snipes, Daniel J; Benotsch, Eric G

2013-01-01

Alcohol mixed with energy drink (AmED) consumption has garnered considerable attention in the literature in recent years. Drinking AmED beverages has been associated with a host of negative outcomes. The present study sought to examine associations between AmED consumption and high-risk sexual behaviors in a sample of young adults. Participants (N=704; 59.9% female) completed an online survey assessing AmED consumption, other drug use, and sexual behavior. A total of 19.4% of the entire sample (and 28.8% of those who reported using alcohol) reported consuming AmED. Participants who reported consuming AmED were significantly more likely to report marijuana, cocaine, and ecstasy use. Those who reported consuming AmED also had increased odds of engaging in high-risk sexual behaviors, including unprotected sex, sex while under the influence of drugs, and sex after having too much to drink. Relationships between AmED consumption and sexual behavior remained significant after accounting for the influence of demographic factors and other substance use. Results add to the literature documenting negative consequences for AmED consumers, which may include alcohol dependence, binge drinking, and the potential for sexually transmitted infections via high-risk sexual behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.

Aging and pathogenesis of erectile dysfunction.

PubMed

Corona, G; Mannucci, E; Mansani, R; Petrone, L; Bartolini, M; Giommi, R; Mancini, M; Forti, G; Maggi, M

2004-10-01

The prevalence and the severity of erectile dysfunction (ED) increase with advancing age; different pathogenetic factors could contribute to age-related ED. We studied organic, relational and intrapsychic components of ED as a function of patients' age in a consecutive series of 977 patients with ED, using the specifically designed structured interview SIEDY. A complete physical examination and a series of biochemical, hormonal, psychometric and penile vascular tests were also performed. Relational factors seems to be more relevant in patients aged over 60 y, while intrapsychic disturbances play a major role in younger subjects. Organic factors are the most important determinant of ED in all age groups, but their contribution is more important in older patients. In fact, basal and dynamic peak cavernosal velocity at Doppler ultrasound penile examination was reduced in older patients. Among hormonal factors, the body mass index-dependent reduction of testosterone in older patients does not seem to play a crucial role in the pathogenesis of ED. No significant correlation was observed between testosterone level and the severity of ED, although patients reporting hypoactive sexual desire showed significantly lower testosterone levels when compared with the rest of the sample. A better understanding of the relative contribution of age-related pathogenetic factors of ED could be of help in the design of appropriate therapeutic approaches.

Dose and release pattern of anabolic implants affects growth of finishing beef steers across days on feed.

PubMed

Parr, S L; Chung, K Y; Hutcheson, J P; Nichols, W T; Yates, D A; Streeter, M N; Swingle, R S; Galyean, M L; Johnson, B J

2011-03-01

Four experiments evaluated the effect of implant dose and release pattern on performance and carcass traits of crossbred beef steers. In Exp. 1, steers (4 to 7 pens/treatment; initial BW = 315 kg) were fed an average of 174 d. Treatments were 1) no implant (NI); 2) Revalor-S [120 mg of trenbolone acetate (TBA) and 24 mg of estradiol 17β (E(2)); REV-S]; 3) Revalor-IS followed by REV-S (cumulatively 200 mg of TBA and 40 mg of E(2); reimplanted at 68 to 74 d; REV-IS/S); and 4) Revalor-XS (200 mg of TBA and 40 mg of E(2); REV-X). Carcass-adjusted final BW was greater (P < 0.05) for REV-X and REV-IS/S than for REV-S (610, 609, and 598 kg, respectively). Daily DMI did not differ (P > 0.10) among the 3 implants, but carcass-adjusted G:F was greater (P < 0.05) for REV-X and REV-IS/S than for REV-S (0.197 and 0.195 vs. 0.188). Both HCW and LM area were greater (P < 0.05) for REV-X and REV-IS/S than for REV-S. Marbling scores were greatest (P < 0.05) for REV-S and least (P < 0.05) for REV-IS/S; REV-X was intermediate to NI and REV-IS/S. In Exp. 2, steers (10 pens/treatment; initial BW = 391 kg) were fed 131 d, with treatments of REV-S, REV-IS/S (reimplanted at 44 to 47 d), and REV-X. Carcass-adjusted final BW (598 kg), ADG (1.6 kg), DMI (9.4 kg), G:F (0.17), and HCW did not differ (P > 0.10) among treatments. The percentage of Choice was less (P < 0.05) and percentage of Select greater (P < 0.05) for REV-IS/S than for REV-S and REV-X. In Exp. 3, steers (10 pens/treatment; initial BW = 277 kg) were fed 197 d and received either REV-IS/S (reimplanted at 90 to 103 d) or REV-X. Carcass-adjusted final BW (625 vs. 633 kg) and ADG (1.81 vs. 1.76 kg) were greater (P < 0.05) for REV-X-implanted steers. Daily DMI did not differ, but G:F tended (P < 0.10) to be increased and HCW was greater (P < 0.05) for REV-X than for REV-IS/S. In Exp. 4, steers (8 pens/treatment; initial BW = 238 kg) were fed 243 d and received either REV-IS/S (reimplanted at 68 to 71 d) or REV-X. Carcass-adjusted final BW (612 kg), ADG (1.54 kg), DMI (7.55), and G:F (0.21) did not differ (P > 0.10) for REV-IS/S and REV-X-implanted steers. Carcass traits did not differ among implants, but the percentage of Choice carcasses was greater (P < 0.05) and percentage of Select was less (P < 0.05) for REV-X than for REV-IS/S. These data indicate that when TBA/E(2) dose is equal, the altered release rate of REV-X can improve performance and quality grade, but these effects depend on duration of the feeding period and timing of initial and terminal implants.

Coordination Program Reduced Acute Care Use And Increased Primary Care Visits Among Frequent Emergency Care Users.

PubMed

Capp, Roberta; Misky, Gregory J; Lindrooth, Richard C; Honigman, Benjamin; Logan, Heather; Hardy, Rose; Nguyen, Dong Q; Wiler, Jennifer L

2017-10-01

Many high utilizers of the emergency department (ED) have public insurance, especially through Medicaid. We evaluated how participation in Bridges to Care (B2C)-an ED-initiated, multidisciplinary, community-based program-affected subsequent ED use, hospital admissions, and primary care use among publicly insured or Medicaid-eligible high ED utilizers. During the six months after the B2C intervention was completed, participants had significantly fewer ED visits (a reduction of 27.9 percent) and significantly more primary care visits (an increase of 114.0 percent), compared to patients in the control group. In a subanalysis of patients with mental health comorbidities, we found that recipients of B2C services had significantly fewer ED visits (a reduction of 29.7 percent) and hospitalizations (30.0 percent), and significantly more primary care visits (an increase of 123.2 percent), again compared to patients in the control group. The B2C program reduced acute care use and increased the number of primary care visits among high ED utilizers, including those with mental health comorbidities. Project HOPE—The People-to-People Health Foundation, Inc.

Lower self-reported depression in patients with erectile dysfunction after treatment with sildenafil.

PubMed

Müller, M J; Benkert, O

2001-10-01

Depressive symptoms in men with erectile dysfunction (ED) may improve under successful ED treatment. Self-reported depressive symptoms were compared in men with ED after sildenafil treatment to a group of untreated patients. In an open study, self-reported depressive symptoms of 54 men after successful treatment with sildenafil (>4 weeks) and 51 men awaiting ED treatment were investigated with the Center of Epidemiologic Studies-Depression Scale (CES-D). CES-D items were subjected to an exploratory factor analysis and group differences in CES-D items and factors were analyzed. Groups were comparable with respect to demographic characteristics and illness duration. CES-D total scores were lower in the group treated with sildenafil. Substantial differences were found in favor of the group treated with sildenafil, particularly in scores on a "positive affect" factor. The findings emphasize the relevance of depression associated with ED and the importance of effective ED treatment. Although depression was generally low in this sample, hedonistic aspects were substantially enhanced in the group of ED patients after sildenafil treatment. The open and cross-sectional study design does not permit causal inference. Selection bias and motivational aspects to participate in the study can not completely be ruled out.

Borrowing yet another technique from manufacturing, investigators find that 'operational flexibility' can offer dividends to ED operations.

PubMed

2015-03-01

Through the use of a sophisticated modeling technique, investigators at the University of Cincinnati have found that the creation of a so-called "flex track" that includes beds that can be assigned to either high-acuity or Iow-acuity- patients has the potential to lower mean wait times for patients when it is i added to the traditional fast-track and high-acuity areas of a 50-bed ED that sees 85,000 patients per year. Investigators used discrete-event simulation to model the patient flow and characteristics of the ED at the University of Cincinnati Medical Center, and to test out various operational scenarios without disrupting real-world operations. The investigators concluded that patient wait times were lowest when three flex beds were appropriated from the 10-bed fast track area of the EDs. In light of the results, three flex rooms are being incorporated into a newly remodeled ED scheduled for completion laterthis spring. Investigators suggest the modeling technique could be useful to other EDs interested in optimizing their operational plans. Further, they suggest that ED administrators consider ways to introduce flexibility into departments that are now more rigidly divided between high- and low-acuity areas.

FACTORIAL VALIDITY OF THE KOREAN VERSION OF THE EXERCISE DEPENDENCE SCALE-REVISED.

PubMed

Shin, Kyulee; You, Sukkyung

2015-12-01

This study evaluated the psychometric properties of the Korean version of the 21-item Exercise Dependence Scale-Revised (EDS-R). The EDS-R was designed to measure the multidimensional aspects of exercise dependence symptoms such as withdrawal, continuance, tolerance, lack of control, reductions, time, and intention. Although the EDS-R has demonstrated sound psychometric properties, it has only been validated in Western samples. Cross-cultural validations of the instrument may increase the knowledge of exercise dependence. Therefore, this study aimed to contribute to the file by investigating the validity and utility of the construct of the EDS-R, using a non-Western sample. 402 adult participants who were over 18 years of age and who reported exercising at least once a week were asked to complete the EDS-R. The results from factor analyses supported that the seven-factor model of exercise dependence symptoms showed an adequate fit for both men and women. The EDS-R scores differentiated between samples, with varying amounts of exercise; 15.4% of the sample was classified as being at risk for exercise dependence. In sum, the results indicated that the EDS-R is a psychometrically reliable assessment tool for exercise dependence symptoms in Korea.

A missed primary care appointment correlates with a subsequent emergency department visit among children with asthma.

PubMed

McGovern, Colleen Marie; Redmond, Margaret; Arcoleo, Kimberly; Stukus, David R

2017-11-01

Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits. Longitudinal, retrospective review at a children's hospital was conducted for children with diagnosed asthma (ICD-9 493.xx), ages 2-18 years, scheduled for a PC visit between January 1, 2010, and June 30, 2012 (N = 3895). Records were cross-referenced with all asthma-related ED visits from January 1, 2010 to December 31, 2012. Logistic regression with maximum likelihood estimation was conducted. None of the children who completed a PC appointment experienced an ED visit in the subsequent 6 months whereas 2.7% of those with missed PC appointments had an ED visit (χ 2 = 64.28, p <.0001). Males were significantly more likely to have an ED visit following a missed PC appointment than females (χ 2 = 34.37, p <.0001). There was a statistically significant interaction of sex × age. Younger children (<12 years) made more visits than older children. The importance of adherence to PC appointments for children with asthma as one mechanism for preventing ED visits was demonstrated. Interventions targeting missed visits could decrease asthma-related morbidity, preventable ED visits, and healthcare costs.

Risk and maintenance factors for young women's DSM-5 eating disorders.

PubMed

Dakanalis, Antonios; Clerici, Massimo; Bartoli, Francesco; Caslini, Manuela; Crocamo, Cristina; Riva, Giuseppe; Carrà, Giuseppe

2017-12-01

Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body's appearance from an external observer's perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women's (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.

Prevalence and correlates of bipolar disorders in patients with eating disorders.

PubMed

Tseng, Mei-Chih Meg; Chang, Chin-Hao; Chen, Kuan-Yu; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-01-15

To investigate the prevalence and correlates of bipolar disorders in patients with eating disorders (EDs), and to examine differences in effects between major depressive disorder and bipolar disorder on these patients. Sequential attendees were invited to participate in a two-phase survey for EDs at the general psychiatric outpatient clinics. Patients diagnosed with EDs (n=288) and controls of comparable age, sex, and educational level (n=81) were invited to receive structured interviews for psychiatric co-morbidities, suicide risks, and functional level. All participants also completed several self-administered questionnaires assessing general and eating-related pathology and impulsivity. Characteristics were compared between the control, ED-only, ED with major depressive disorder, and ED with bipolar disorder groups. Patients with all ED subtypes had significantly higher rates of major depressive disorder (range, 41.3-66.7%) and bipolar disorder (range, 16.7-49.3%) than controls did. Compared to patients with only EDs, patients with comorbid bipolar disorder and those with comorbid major depressive disorder had significantly increased suicidality and functional impairments. Moreover, the group with comorbid bipolar disorder had increased risks of weight dysregulation, more impulsive behaviors, and higher rates of psychiatric comorbidities. Participants were selected in a tertiary center of a non-Western country and the sample size of individuals with bipolar disorder in some ED subtypes was small. Bipolar disorders were common in patients with EDs. Careful differentiation between bipolar disorder and major depressive disorder in patients with EDs may help predict associated psychopathology and provide accurate treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of pedal rate and power output on rating of perceived exertion during cycle ergometry exercise.

PubMed

Hamer, Mark; Boutcher, Yati N; Boutcher, Stephen H

2005-12-01

This study examined differentiated rating of perceived exertion (RPE), heart rate, and heart-rate variability during light cycle ergometry exercise at two different pedal rates. 30 healthy men (22.6 +/- 0.9 yr.) were recruited from a student population and completed a continuous 20-min. cycle ergometry exercise protocol, consisting of a 4-min. warm-up (60 rev./min., 30 Watts), followed by four bouts of 4 min. at different combinations of pedal rate (40 or 80 rev./min.) and power output (40 or 80 Watts). The order of the four combinations was counterbalanced across participants. Heart rate was measured using a polar heart-rate monitor, and parasympathetic balance was assessed through time series analysis of heart-rate variability. Measures were compared using a 2 (pedal rate) x 2 (power output) repeated-measures analysis of variance. RPE was significantly greater (p<.05) at 80 versus 40 rev./min. at 40 W. For both power outputs heart rate was significantly increased, and the high frequency component of heart-rate variability was significantly reduced at 80 compared with 40 rev./min. These findings indicate the RPE was greater at higher than at lower pedalling rates for a light absolute power output which contrasts with previous findings based on use of higher power output. Also, pedal rate had a significant effect on heart rate and heart-rate variability at constant power output.

A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood

PubMed Central

Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.

2015-01-01

Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p < 0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p = 0.11), and significantly higher adiposity (p = 0.04) and disordered eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p < 0.001) and BMIz (p = 0.03) but did not differ in adiposity (p = 0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood.

PubMed

Matherne, Camden E; Tanofsky-Kraff, Marian; Altschul, Anne M; Shank, Lisa M; Schvey, Natasha A; Brady, Sheila M; Galescu, Ovidiu; Demidowich, Andrew P; Yanovski, Susan Z; Yanovski, Jack A

2015-08-01

Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (p<0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p=0.11), and significantly higher adiposity (p=0.04) and disordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (p<0.001) and BMIz (p=0.03) but did not differ in adiposity (p=0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. Published by Elsevier Ltd.

Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction.

PubMed

Williams, Nancy I; Leidy, Heather J; Hill, Brenna R; Lieberman, Jay L; Legro, Richard S; De Souza, Mary Jane

2015-01-01

We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18-30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e., mild (ED1; -8 ± 2%), moderate (ED2; -22 ± 3%), or severe (ED3; -42 ± 3%). Menstrual cycle length and changes in urinary concentrations of estrone-1-glucuronide, pregnanediol glucuronide, and midcycle luteinizing hormone were assessed. Thirty-four subjects completed the study. Weight loss occurred in ED1 (-3.8 ± 0.2 kg), ED2 (-2.8 ± 0.6 kg), and ED3 (-2.6 ± 1.1 kg) but was minimal in EXCON (-0.9 ± 0.7 kg). The overall sum of disturbances (luteal phase defects, anovulation, and oligomenorrhea) was greater in ED2 compared with EXCON and greater in ED3 compared with EXCON AND ED1. The average percent energy deficit was the main predictor of the frequency of menstrual disturbances (f = 10.1, β = -0.48, r(2) = 0.23, P = 0.003) even when weight loss was included in the model. The estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from -22 (ED2) to -42% (ED3), reflecting an energy deficit of -470 to -810 kcal/day, respectively. This is the first study to demonstrate a dose-response relationship between the magnitude of energy deficiency and the frequency of exercise-related menstrual disturbances; however, the severity of menstrual disturbances was not dependent on the magnitude of energy deficiency. Copyright © 2015 the American Physiological Society.

First Year Master of Education (M.Ed.) Students' Experiences of Part-Time Study: A South African Case Study

ERIC Educational Resources Information Center

Chikoko, V.

2010-01-01

This article reports on a study of how a group of first year M.Ed. students in the Faculty of Education of the University of KwaZulu-Natal experienced part-time study. Literature suggests that each year, South Africa suffers significant student departures from universities without completing their studies. Apart from the cost and manpower…

Teacher Performance Assessment (edTPA): An Instructor's Development and Evaluation of an Embedded Signature Assessment in an Early Childhood Literacy Course

ERIC Educational Resources Information Center

Noel, Andrea M.

2014-01-01

As of May 2014, all candidates for teacher certification in New York State must successfully complete the teacher performance assessment (edTPA). This article describes an assignment piloted in an early childhood literacy class as an embedded signature assessment and has three goals: to explain the context that led to the development of the…

Postsecondary Institutions in the United States: Fall 2004 and Degrees and Other Awards Conferred: 2003-04. E.D. TAB. NCES 2005-182

ERIC Educational Resources Information Center

Knapp, Laura G.; Kelly-Reid, Janice E.; Whitmore, Roy W.; Cong, June; Levine, Burton; Berzofsky, Marcus; Broyles, Susan G.

2005-01-01

This E.D. TAB presents findings from the Integrated Postsecondary Education Data System (IPEDS) fall 2004 data collection, which included two survey components: Institutional Characteristics for the 2004-05 academic year, and Completions covering the period July 1, 2003, through June 30, 2004. These data were collected through the IPEDS web-based…

Controlling Decoherence in Superconducting Qubits: Phenomenological Model and Microscopic Origin of 1/f Noise

DTIC Science & Technology

2011-04-28

quasiparticle poisoning which include a completely novel physical origin of these noises. We also proposed a model for excess low frequency flux noise which...and quasiparticle poisoning which include a completely novel physical origin of these noises. We also proposed a model for excess low frequency flux...metallic nanomechanical resonators, Phys. Rev. B 81, 184112 (2010). 3) L. Faoro, A. Kitaev and L. B. Ioffe, Quasiparticle poisoning and Josephson current

Comorbid psychiatric diagnosis and psychological correlates of eating disorders in dance students.

PubMed

Liu, Chao-Yu; Tseng, Mei-Chih Meg; Chang, Chin-Hao; Fang, David; Lee, Ming-Been

2016-02-01

Although dancers are at risk for eating disorders (EDs), little is known about the features of EDs among the dance population. This study explores the prevalence of EDs, and their psychiatric comorbidities and correlates in dance students. In total, 442 female high-school dance students participated in a two-phase survey. All participants completed screening questionnaires as well as measures assessing teasing, self-esteem, perfectionism, body dissatisfaction, and personality. Of the participating students, 311 underwent the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Sixty-eight individuals (15.4%) had an ED by DSM-IV diagnosis. The prevalence of any co-occurring mood (47.1%) and anxiety disorders (30.9%) was high. Although low self-esteem, high neuroticism, and high psychological distress were associated with EDs in univariate analysis, only teasing for overweight and body image dissatisfaction were significantly associated with EDs by multivariate analysis. Prevention and intervention programs for dance students should include recognition and management of emotional disorders and strategies promoting positive body image and reducing the incidence of negative weight-related comments. Copyright © 2015. Published by Elsevier B.V.

Self-Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups.

PubMed

Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Strauman, Timothy J; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Klein, Marjorie H; Smith, Tracey L; Peterson, Carol B

2016-11-01

This study examined self-discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi-structured interviews assessing specific types of self-discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self-discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self-discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

PubMed

Raup, Glenn H

2008-10-01

Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

A novel early intervention for preschool depression: findings from a pilot randomized controlled trial.

PubMed

Luby, Joan; Lenze, Shannon; Tillman, Rebecca

2012-03-01

Validation for depression in preschool children has been established; however, to date no empirical investigations of interventions for the early onset disorder have been conducted. Based on this and the modest efficacy of available treatments for childhood depression, the need for novel early interventions has been emphasized. Large effect sizes (ES) for preschool psychotherapies for several Axis I disorders suggest that earlier intervention in depression may also be promising. Therefore, a novel form of treatment for preschool depression, Parent-Child Interaction Therapy Emotion Development (PCIT-ED) was developed and tested. A preliminary randomized controlled trial (RCT) was conducted comparing PCIT-ED to psycho-education in depressed 3- to 7-year-olds and their caregivers. A total of 54 patients met symptom criteria for DSM-IV major depressive disorder and were randomized, 19 patients completed the active treatment (n = 8 dropouts) and 10 completed psycho-education (n = 17 dropouts). Both groups showed significant improvement in several domains, with PCIT-ED showing significance in a greater number of domains. An intent-to-treat analysis suggested that PCIT-ED was significantly more effective than psycho-education on executive functioning (p = .011, ES = 0.12) and emotion recognition skills (p = .002, ES = 0.83). The RCT proved feasible and suggests an individual control condition should be used in future trials to minimize differential dropout. These pilot data, although limited by power, suggest that PCIT-ED may be a promising early intervention for depression. Larger scale randomized controlled trials of PCIT-ED for depressed preschoolers are now warranted. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

Critical care medicine training and certification for emergency physicians.

PubMed

Huang, David T; Osborn, Tiffany M; Gunnerson, Kyle J; Gunn, Scott R; Trzeciak, Stephen; Kimball, Edward; Fink, Mitchell P; Angus, Derek C; Dellinger, R Phillip; Rivers, Emanuel P

2005-09-01

Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine (EM) and critical care medicine (CCM). Critical care is a continuum that includes prehospital, emergency department (ED), and intensive care unit (ICU) care teams. Both EM and CCM require expertise in treating life-threatening acute illness, with many critically ill patients often presenting first to the ED. Increased patient volumes and acuity have resulted in longer ED lengths of stay and more critical care delivery in the ED. However, the majority of CCM fellowships do not accept EM residents, and those who successfully complete a fellowship do not have access to a U.S. certification exam in CCM. Despite these barriers, interest in CCM training among EM physicians is increasing. Dual EM/CCM-trained physicians not only will help alleviate the intensivist shortage but also will strengthen critical care delivery in the ED and facilitate coordination at the ED-ICU interface. We therefore propose that all accreditation bodies work cooperatively to create a route to CCM certification for emergency physicians who complete a critical care fellowship.

Who Explicitly Requests the Ordering of Computed Tomography for Emergency Department Patients? A Multicenter Prospective Study

PubMed Central

Broder, Joshua Seth; Bhat, Rahul; Boyd, Joshua P.; Ogloblin, Ivan A.; Limkakeng, Alexander; Hocker, Michael Brian; Drake, Weiying Gao; Miller, Taylor; Harringa, John Brian; Repplinger, Michael Dean

2016-01-01

Background Emergency department (ED) computed tomography (CT) use has increased substantially in recent years, resulting in increased radiation exposure for patients. Few studies have assessed which parties contribute to CT ordering in the ED. Objective To determine the proportion of CT scans ordered due to explicit requests by various stakeholders in ED patient care. Methods Prospective, observational study at three university hospital EDs. CT scans ordered during research assistant hours were eligible for inclusion. Attending emergency physicians (EPs) completed standardized data forms to indicate all parties who had explicitly requested that a specific CT be performed. Forms were completed before the CT results were known in order to minimize bias. Results Data were obtained from 77 EPs regarding 944 CTs. The parties most frequently requesting CTs were attending EPs (82.0%, 95% CI 79.4–84.3), resident physicians (28.6%, 95%CI 25.8–31.6), consulting physicians (24.4%, 95%CI 21.7–27.2), and admitting physicians (3.9%, 95%CI 2.9–5.4). In the 168 instances in which the attending EP did not explicitly request the CT, requests most commonly came from consulting physicians (51.2%, 95%CI 43.7–58.6), resident physicians in the ED (39.9%, 95%CI, 32.8–47.4), and admitting physicians (8.9%, 95%CI, 5.5–14.2). EPs were the sole party requesting CT in 46.2% of cases while multiple parties were involved in 39.0%. Patients, families, and radiologists were uncommon sources of such requests. Conclusions Emergency physicians requested the majority of CTs, though nearly 20% were actually not desired by them. Admitting, consulting, and resident physicians in the ED were important contributors to CT utilization. PMID:26873604

Phase structure of one-dimensional interacting Floquet systems. II. Symmetry-broken phases

NASA Astrophysics Data System (ADS)

von Keyserlingk, C. W.; Sondhi, S. L.

2016-06-01

Recent work suggests that a sharp definition of "phase of matter" can be given for periodically driven "Floquet" quantum systems exhibiting many-body localization. In this work, we propose a classification of the phases of interacting Floquet localized systems with (completely) spontaneously broken symmetries; we focus on the one-dimensional case, but our results appear to generalize to higher dimensions. We find that the different Floquet phases correspond to elements of Z (G ) , the center of the symmetry group in question. In a previous paper [C. W. von Keyserlingk and S. L. Sondhi, preceding paper, Phys. Rev. B 93, 245145 (2016)], 10.1103/PhysRevB.93.245145, we offered a companion classification of unbroken, i.e., paramagnetic phases.

A poverty-related quality of life questionnaire can help to detect health inequalities in emergency departments.

PubMed

Boyer, Laurent; Baumstarck, Karine; Iordanova, Teodora; Fernandez, Jessica; Jean, Philippe; Auquier, Pascal

2014-03-01

This study aimed to develop a self-administered, multidimensional, poverty-related quality of life (PQoL) questionnaire for individuals seeking care in emergency departments (EDs): the PQoL-17. The development of the PQoL was undertaken in three steps: item generation, item reduction, and validation. The content of the PQoL was derived from 80 interviews with patients seeking care in EDs. Using item response and classical test theories, item reduction was performed in 3 EDs on 300 patients and validation was completed in 10 EDs on 619 patients. The PQoL contains 17 items describing seven dimensions (self-esteem/vitality, psychological well-being, relationships with family, relationships with friends, autonomy, physical well-being/access to care, and future perception). The seven-factor structure accounted for 75.1% of the total variance. This model showed a good fit (indices from the LISREL model: root mean square error of approximation, 0.055; comparative fit index, 0.97; general fit index, 0.96; standardized root mean square residual, 0.058). Each item achieved the 0.40 standard for item internal consistency, and Cronbach α coefficients were >0.70. Significant associations with socioeconomic and clinical indicators showed good discriminant and external validity. Infit statistics ranged from 0.82 to 1.16. The PQoL-17 presents satisfactory psychometric properties and can be completed quickly, thereby fulfilling the goal of brevity sought in EDs. Copyright © 2014 Elsevier Inc. All rights reserved.

Analysis of Inappropriate Admissions of Residents of Medicalized Nursing Homes to Emergency Departments: A Prospective Multicenter Study in Burgundy.

PubMed

Manckoundia, Patrick; Menu, Didier; Turcu, Alin; Honnart, Didier; Rossignol, Sylvie; Alixant, Jean-Christophe; Sylvestre, Franck-Henry; Bailly, Vanessa; Dion, Michèle; Putot, Alain

2016-07-01

To determine the rate of inappropriate admissions to emergency departments (EDs) and to identify determinants of these admissions. Prospective multicenter study. Burgundy (France), EDs and medical nursing homes (MNHs). 1000 Burgundy MNH residents admitted to EDs, from April 17 to June 20, 2013. For each subject, a questionnaire was completed. Data included age, gender, type of health professional who referred the resident to the ED (THP), whether or not a medical dispatcher organized the transfer to the ED, transport mode, reason for admission to the ED, level of independence according to the Groupes Iso-Ressource score (GIRS), and diagnosis made in the ED. The French version of the Appropriateness Evaluation Protocol grid was applied to each admission to the ED, and in some situations, the expert committee ruled on the appropriateness of the admission to the ED. MNH characteristics were also recorded. Two groups were constituted according to the appropriateness or not of admission to the ED. Mean age of the 1000 residents was 87. There were 706 women. Two-thirds were referred to the EDs by a physician, mainly a general practitioner. In 91.7%, the transfer to the ED was organized by a medical dispatcher, and 8.8% were transported by medicalized transport. More than 95% had a GIRS ≤4. Among the admissions to EDs, 18.1% were inappropriate. Female gender (P = .017), nonmedicalized transport (P = .002), public MNH (P = .044), and nonaccess to a geriatric opinion in an emergency (P = .043) were determinants of inappropriate admission to EDs. In this first study on admissions to EDs of MNH residents using French data, we found a lower rate of admissions to the ED than that reported in the literature. Female gender, nonmedicalized transport, public MNH, and nonaccess to a geriatric opinion in an emergency were associated with inappropriate admission to EDs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Three-dimensional electron diffraction as a complementary technique to powder X-ray diffraction for phase identification and structure solution of powders.

PubMed

Yun, Yifeng; Zou, Xiaodong; Hovmöller, Sven; Wan, Wei

2015-03-01

Phase identification and structure determination are important and widely used techniques in chemistry, physics and materials science. Recently, two methods for automated three-dimensional electron diffraction (ED) data collection, namely automated diffraction tomography (ADT) and rotation electron diffraction (RED), have been developed. Compared with X-ray diffraction (XRD) and two-dimensional zonal ED, three-dimensional ED methods have many advantages in identifying phases and determining unknown structures. Almost complete three-dimensional ED data can be collected using the ADT and RED methods. Since each ED pattern is usually measured off the zone axes by three-dimensional ED methods, dynamic effects are much reduced compared with zonal ED patterns. Data collection is easy and fast, and can start at any arbitrary orientation of the crystal, which facilitates automation. Three-dimensional ED is a powerful technique for structure identification and structure solution from individual nano- or micron-sized particles, while powder X-ray diffraction (PXRD) provides information from all phases present in a sample. ED suffers from dynamic scattering, while PXRD data are kinematic. Three-dimensional ED methods and PXRD are complementary and their combinations are promising for studying multiphase samples and complicated crystal structures. Here, two three-dimensional ED methods, ADT and RED, are described. Examples are given of combinations of three-dimensional ED methods and PXRD for phase identification and structure determination over a large number of different materials, from Ni-Se-O-Cl crystals, zeolites, germanates, metal-organic frameworks and organic compounds to intermetallics with modulated structures. It is shown that three-dimensional ED is now as feasible as X-ray diffraction for phase identification and structure solution, but still needs further development in order to be as accurate as X-ray diffraction. It is expected that three-dimensional ED methods will become crucially important in the near future.

Effect of a brief emergency medicine education course on emergency department work intensity of family physicians.

PubMed

Vaillancourt, Samuel; Schultz, Susan E; Leaver, Chad; Stukel, Thérèse A; Schull, Michael J

2013-01-01

Recently, many Canadian emergency departments (EDs) have struggled with physician staffing shortages. In 2006, the Ontario Ministry of Health and Long-Term Care funded a brief "emergency medicine primer" (EMP) course for family physicians to upgrade or refresh skills, with the goal of increasing their ED work intensity. We sought to determine the effect of the EMP on the ED work intensity of family physicians. A retrospective longitudinal study was conducted of the ED work of 239 family physicians in the 2 years before and after a minimum of 6 months and up to 2 years from completing an EMP course in 2006 to 2008 compared to non-EMP physicians. ED work intensity was defined as the number of ED shifts per month and the number of ED patients seen per month. We conducted two analyses: a before and after comparison of all EMP physicians and a matched cohort analysis matching each EMP physician to four non-EMP physicians on sex, year of medical school graduation, rurality, and pre-EMP ED work intensity. Postcourse, EMP physicians worked 0.5 more ED shifts per month (13% increase, p  =  0.027). Compared to their matched controls, EMP physicians worked 0.7 more shifts per month (13% increase, p  =  0.0032) and saw 15 more patients per month (17% increase, p  =  0.0008) compared to matched non-EMP physicians. The greatest increases were among EMP physicians who were younger, were urban, had previous ED experience, or worked in a high-volume ED. The effect of the EMP course was negligible for physicians with no previous ED experience or working in rural areas. The EMP course is associated with modest increases in ED work intensity among some family physicians, in particular younger physicians in urban areas. No increase was seen among physicians without previous ED experience or working in rural areas.

Use of the Emergency Department for Severe Headache. A population-based study

PubMed Central

Friedman, Benjamin W.; Serrano, Daniel; Reed, Michael; Diamond, Merle; Lipton, Richard B.

2008-01-01

Background Although headache is a common emergency department (ED) chief complaint, the role of the ED in the management of primary headache disorders has rarely been assessed from a population perspective. We determined frequency of ED use and risk factors for use among patients suffering severe headache. Methods As part of the American Migraine Prevalence and Prevention study, a validated self-administered questionnaire was mailed to 24,000 severe headache sufferers, who were randomly drawn from a larger sample constructed to be socio-demographically representative of the US population. Participants were asked a series of questions on headache management, healthcare system use, socio-demographic features, and number of ED visits for management of headache in the previous 12 months. In keeping with the work of others, “frequent” ED use was defined as a particpants report of four or more visits to the ED for treatment of a headache in the previous 12 months. Headaches were categorized into specific diagnoses using a validated methodology. Results Of 24,000 surveys, 18,514 were returned, and 13,451 (56%) provided complete data on ED use. Socio-demographic characteristics did not differ substantially between responders and non-responders. Among the 13,451 responders, over the course of the previous year, 12,592 (94%) did not visit the ED at all, 415 (3%) visited the ED once, and 444 (3%) visited the ED more than once. Patients with severe episodic tension-type headache were less likely to use the ED than patients with severe episodic migraine (OR 0.4 [95%CI 0.3, 0.6]). Frequent ED use was reported by 1% of the total sample or 19% (95%CI: 17, 22%) of subjects who used the ED in the previous year, though frequent users accounted for 51% (95%CI: 49, 53) of all ED visits. Predictors of ED use included markers of disease severity, elevated depression scores, low socio-economic status, and a predilection for ED use for conditions other than headache. Conclusions Most individuals suffering severe headaches do not use the ED over the course of a single year. The majority of ED visits for severe headache are accounted for by a small subset of all ED users. Increasing disease severity and depression are the most readily addressable factors associated with ED use. PMID:19040677

Neuromodulation of the lumbar spinal locomotor circuit.

PubMed

AuYong, Nicholas; Lu, Daniel C

2014-01-01

The lumbar spinal cord contains the necessary circuitry to independently drive locomotor behaviors. This function is retained following spinal cord injury (SCI) and is amenable to rehabilitation. Although the effectiveness of task-specific training and pharmacologic modulation has been repeatedly demonstrated in animal studies, results from human studies are less striking. Recently, lumbar epidural stimulation (EDS) along with locomotor training was shown to restore weight-bearing function and lower-extremity voluntary control in a chronic, motor-complete human SCI subject. Related animal studies incorporating EDS as part of the therapeutic regiment are also encouraging. EDS is emerging as a promising neuromodulatory tool for SCI. Copyright © 2014 Elsevier Inc. All rights reserved.

Influence of oral rehabilitation on the oral health-related quality of life of a child with ectodermal dysplasia.

PubMed

de Alencar, Nashalie Andrade; Reis, Kátia Rodrigues; Antonio, Andréa Gonçalves; Maia, Lucianne Cople

2015-01-01

Ectodermal dysplasia (ED) is a rare congenital hereditary disorder among a group of syndromes characterized by abnormalities of ectodermic structures. The purpose of this report is to compare the oral health-related quality of life (OHRQoL) before and after complete oral rehabilitation of a five-year-old boy with ED. Delivery of upper and lower dentures resulted in immediate improvement of the child's OHRQoL. Although ED affects patients physically and emotionally, the early oral rehabilitation of young patients is crucial to improve their social interaction and restore their speech and masticatory function.

Examination of staphylococcal stethoscope contamination in the emergency department (pilot) study (EXSSCITED pilot study).

PubMed

Tang, Patrick H P; Worster, Andrew; Srigley, Jocelyn A; Main, Cheryl L

2011-07-01

The objective of this study was to determine the prevalence of Staphylococcus-contaminated stethoscopes belonging to emergency department (ED) staff and to identify the proportion of these that were Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA). We conducted a prospective observational cohort study of bacterial cultures from 100 ED staff members' stethoscopes at three EDs. Study participants were asked to complete a questionnaire. Fifty-four specimens grew coagulase-negative staphylococci and one grew methicillin-susceptible S. aureus. No MRSA was cultured. Only 8% of participants, all of whom were nurses, reported cleaning their stethoscope before or after each patient assessment. Alcohol-based wipes were most commonly used to clean stethoscopes. A lack of time, being too busy, and forgetfulness were the most frequently reported reasons for not cleaning the stethoscope in the ED. This study indicates that although stethoscope contamination rates in these EDs are high, the prevalence of S. aureus or MRSA on stethoscopes is low.

Does the Broad Categories for the Diagnosis of Eating Disorders (BCD-ED) Scheme Reduce the Frequency of Eating Disorder not Otherwise Specified?

PubMed Central

Sysko, Robyn; Walsh, B. Timothy

2010-01-01

Objective This study evaluated whether the Broad Categories for the Diagnosis of Eating Disorders (BCD-ED) proposal (Walsh & Sysko, 2009) reduces the number of individuals who receive a DSM-IV eating disorder not otherwise specified (EDNOS) diagnosis. Method Individuals calling a tertiary care facility completed a brief telephone interview and were classified into a DSM-IV eating disorder category (anorexia nervosa, bulimia nervosa, EDNOS). Subsequently, the proposed DSM-5 criteria for eating disorders and the BCD-ED scheme were also applied. Results A total of 247 individuals with telephone interview data met criteria for an eating disorder, including 97 (39.3%) with an EDNOS. Of patients with an EDNOS diagnosis, 97.6% were re-classified using the BCD-ED scheme. Discussion The BCD-ED scheme has the potential to virtually eliminate the use of DSM-IV EDNOS; however, additional data are needed to document its validity and clinical utility. PMID:21997426

Facebook Usage Amongst Those Who Have Received Treatment for an Eating Disorder in a Group Setting

PubMed Central

Saffran, Kristina; Fitzsimmons-Craft, Ellen E.; Kass, Andrea E.; Wilfley, Denise E.; Taylor, C. Barr; Trockel, Mickey

2017-01-01

Objective This study explored Facebook use among individuals with a history of receiving treatment for an eating disorder (ED) in a group setting (e.g., inpatient, residential, outpatient group), focusing primarily on comparisons individuals make about their bodies, eating, or exercise to those of their peers from treatment on Facebook and the relation between these comparisons and ED pathology. Method Individuals (N = 415; mean age 28.15 years ± 8.41; 98.1% female) who self-reported receipt of ED treatment in a group setting were recruited via email and social media to complete an online survey. Results Participants reported having an average of 10–19 Facebook friends from treatment and spending up to 30 minutes per day interacting on Facebook with individuals from treatment or ED-related organizations. More comparison to treatment peers on Facebook was associated with greater ED psychopathology and ED-related impairment. Conversely, positive interaction with treatment peers on Facebook was associated with lower ED psychopathology and ED-related impairment. Individuals who had been in treatment longer, more times, and more recently had more Facebook friends from treatment and ED-related organizations as well as spent more time in ED groups’ pages on Facebook. Few participants (19.5%) reported that a therapist asked about the impact of Facebook on pathology. Discussion Interactions on Facebook could affect patients’ recovery and potential for relapse. It may be helpful for treatment providers to discuss Facebook use and its potential benefits and drawbacks with patients preparing for discharge from group treatment. PMID:27302908

Private hospital emergency departments in Australia: challenges and opportunities.

PubMed

FitzGerald, Gerry; Toloo, Ghasem; He, Jun; Doig, Gavin; Rosengren, David; Rothwell, Sean; Sultana, Ron; Costello, Steve; Hou, Xiang-Yu

2013-06-01

Public hospital EDs in Australia have become increasingly congested because of increasing demand and access block. Six per cent of ED patients attend private hospital EDs whereas 45% of the population hold private health insurance. This study describes the patients attending a small selection of four private hospital EDs in Queensland and Victoria, and tests the feasibility of a private ED database. De-identified routinely collected patient data were provided by the four participating private hospital and amalgamated into a single data set. The mean age of private ED patients was 52 years. Males outnumbered females in all age groups except > 80 years. Attendance was higher on weekends and Mondays, and between 08.00 and 20.00 h. There were 6.6% of the patients triaged as categories 1 and 2, and 60% were categories 4 or 5. There were 36.4% that required hospital admission. Also, 96% of the patients had some kind of insurance. Furthermore, 72% were self-referred and 12% were referred by private medical practitioners. Approximately 25% arrived by ambulance. There were 69% that completed their ED treatment within 4 h. This study is the first public description of patients attending private EDs in Australia. Private EDs have a significant role to play in acute medical care and in providing access to private hospitals which could alleviate pressure on public EDs. This study demonstrates the need for consolidated data based on a consistent data set and data dictionary to enable system-wide analysis, benchmarking and evaluation. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

An exploratory examination of At-Risk/Problematic Internet Use and disordered eating in adults.

PubMed

Ivezaj, Valentina; Potenza, Marc N; Grilo, Carlos M; White, Marney A

2017-01-01

At-Risk/Problematic Internet Use (ARPIU) has been associated with impairment in multiple domains including psychopathology. The present study examined the relationship between ARPIU and disordered eating in a large community sample. Participants (n=1000) completed an online survey about health behaviors. Two thresholds of ARPIU and disordered eating each were examined. The ARPIU and Sub-ED (subthreshold eating disorders) groups reported greater depressive symptoms and poorer self-control than the Control group; the Sub-ED group reported greater impulsivity than the Control group. The ARPIU and Sub-ED groups significantly differed in key features related to each condition. Finally, the co-occurrence of ARPIU and Sub-ED was associated with greater depression. In the second set of analyses based on more stringent thresholds, the Problematic Internet Use (PIU) and ED groups differed on all measures compared to the Control group. The PIU and ED groups also differed on key features related to each condition, but did not differ on measures of impulsivity or self-control. The co-occurrence of PIU and ED was associated with greater depressive symptoms than either PIU or ED independently. ARPIU and Sub-ED share links to depression and poor self-control and these may represent possible therapeutic targets across Internet-use and disordered-eating behaviors. Co-occurring PIU and ED at either lenient or stringent thresholds is associated with greater depression. Future studies should examine the temporal nature of these associations and the extent to which targeting depression, Internet use, or disordered eating may lead to improvements across domains. Copyright © 2015 Elsevier Ltd. All rights reserved.

The unique effects of angry and depressive rumination on eating-disorder psychopathology and the mediating role of impulsivity.

PubMed

Wang, Shirley B; Borders, Ashley

2018-04-01

Negative affect and maladaptive emotion regulation strategies are associated with eating-disorder (ED) psychopathology. Depressive rumination is a maladaptive cognitive style associated with the onset, maintenance, and severity of ED psychopathology among both clinical and nonclinical samples. However, although anger is also strongly associated with ED behaviors, the associations between angry rumination and ED psychopathology, as well as mechanisms of the relationships between rumination and ED psychopathology, remain largely unknown. The current study sought to examine the unique influences of trait depressive and angry rumination on ED psychopathology and whether trait negative urgency (i.e., responding rashly to negative affect) mediated these relationships. Study 1 sampled undergraduate students (N = 119) cross-sectionally and longitudinally (five months), and Study 2 sampled patients with eating disorders (N = 85). All participants completed questionnaires assessing angry rumination, depressive rumination, ED psychopathology, and negative urgency. Angry rumination had consistent indirect effects on ED psychopathology via negative urgency among both clinical and nonclinical samples. However, there was mixed support for the influence of depressive rumination: whereas depressive rumination showed total and indirect effects on ED psychopathology in Study 1 cross-sectional analyses, no total or indirect effects emerged in Study 1 longitudinal analyses or in Study 2. Associations between depressive rumination and ED psychopathology may reflect the strong overlap between angry and depressive rumination. Interventions targeting angry rumination and negative urgency may enhance prevention and treatment of disordered eating across eating disorder diagnosis and severity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Revisit rates and associated costs after an emergency department encounter: a multistate analysis.

PubMed

Duseja, Reena; Bardach, Naomi S; Lin, Grace A; Yazdany, Jinoos; Dean, Mitzi L; Clay, Theodore H; Boscardin, W John; Dudley, R Adams

2015-06-02

Return visits to the emergency department (ED) or hospital after an index ED visit strain the health system, but information about rates and determinants of revisits is limited. To describe revisit rates, variation in revisit rates by diagnosis and state, and associated costs. Observational study using the Healthcare Cost and Utilization Project databases. 6 U.S. states. Adults with ED visits between 2006 and 2010. Revisit rates and costs. Within 3 days of an index ED visit, 8.2% of patients had a revisit; 32% of those revisits occurred at a different institution. Revisit rates varied by diagnosis, with skin infections having the highest rate (23.1% [95% CI, 22.3% to 23.9%]). Revisit rates also varied by state. For skin infections, Florida had higher risk-adjusted revisit rates (24.8% [CI, 23.5% to 26.2%]) than Nebraska (10.6% [CI, 9.2% to 12.1%]). In Florida, the only state with complete cost data, total revisit costs for the 19.8% of patients with a revisit within 30 days were 118% of total index ED visit costs for all patients (including those with and without a revisit). Whether a revisit reflects inadequate access to primary care, a planned revisit, the patient's nonadherence to ED recommendations, or poor-quality care at the initial ED visit remains unknown. Revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits. Agency for Healthcare Research and Quality.

Physicians in Postgraduate Training Characteristics and Support of Palliative Sedation for Existential Distress.

PubMed

Cripe, Larry D; Perkins, Susan M; Cottingham, Ann; Tong, Yan; Kozak, Mary Ann; Mehta, Rakesh

2017-09-01

Palliative sedation for refractory existential distress (PS-ED) is ethically troubling but potentially critical to quality end-of-life (EOL) care. Physicians' in postgraduate training support toward PS-ED is unknown nor is it known how empathy, hope, optimism, or intrinsic religious motivation (IRM) affect their support. These knowledge gaps hinder efforts to support physicians who struggle with patients' EOL care preferences. One hundred thirty-four postgraduate physicians rated their support of PS for refractory physical pain (PS-PP) or PS-ED, ranked the importance of patient preferences in ethically challenging situations, and completed measures of empathy, hope, optimism, and IRM. Predictors of PS-ED and PS-PP support were examined using binary and multinomial logistic regression. Only 22.7% of residents were very supportive of PS-ED, and 82.0% were very supportive of PS-PP. Support for PS-PP or PS-ED did not correlate with levels of empathy, hope, optimism, or IRM; however, for residents with lower IRM, greater optimism was associated with greater PS-ED support. In contrast, among residents with higher IRM, optimism was not associated with PS-ED support. Comparing current results to published surveys, a similar proportion of residents and practicing physicians support PS-ED and PS-PP. In contrast to practicing physicians, however, IRM does not directly influence residents' supportiveness. The interaction between optimism and IRM suggests residents' beliefs and characteristics are salient to their EOL decisions. End-of-life curricula should provide physicians opportunities to reflect on the personal and ethical factors that influence their support for PS-ED.

The potential lost hospital income from miscoded emergency department boarders in Ireland.

PubMed

Healy, L; Moloney, E; O'Connor, M; Henry, C; Timmons, S

2014-06-01

Emergency department (ED) boarders, namely patients who have been admitted under an in-patient service but remain on a trolley in the ED, have long been a problem in the Irish healthcare system. We conducted a retrospective analysis of all ED boarders in Cork University Hospital (CUH) for a 6-month period from January to July 2011. Data were obtained from the Hospital In-Patient Enquiry Office (HIPE). The income generated by the hospital for a subset of these patients (January and February attendances) was obtained from the Finance Office in the hospital, based on diagnoses as recorded on the HIPE system. A convenience sample of two-thirds of the 39 acute hospitals nationally was surveyed to ascertain whether ED boarders were coded by individual HIPE offices as hospital in-patients or as ED attendees. A total of 806 patients were admitted to an in-patient service from January to July 2011 in CUH and subsequently discharged, having completed their entire stay in the ED. The income generated by a sub-sample of 228 patients (January and February ED boarders) was determined. The hospital was remunerated by 685,111 for these patients, i.e. an average income of 3,098 per patient. Only 8 hospitals of the 27 surveyed hospitals coded overnight ED Boarders as in-patients and were thus able to request income for these patients appropriately. Discrepancies in coding of ED boarders may result in significant revenue losses for certain hospitals.

Identification of fall risk factors in older adult emergency department patients.

PubMed

Carpenter, Christopher R; Scheatzle, Mark D; D'Antonio, Joyce A; Ricci, Paul T; Coben, Jeffrey H

2009-03-01

Falls represent an increasingly frequent source of injury among older adults. Identification of fall risk factors in geriatric patients may permit the effective utilization of scarce preventative resources. The objective of this study was to identify independent risk factors associated with an increased 6-month fall risk in community-dwelling older adults discharged from the emergency department (ED). This was a prospective observational study with a convenience sampling of noninstitutionalized elders presenting to an urban teaching hospital ED who did not require hospital admission. Interviews were conducted to determine the presence of fall risk factors previously described in non-ED populations. Subjects were followed monthly for 6 months through postcard or telephone contact to identify subsequent falls. Univariate and Cox regression analysis were used to determine the association of risk factors with 6-month fall incidence. A total of 263 patients completed the survey, and 161 (61%) completed the entire 6 months of follow-up. Among the 263 enrolled, 39% reported a fall in the preceding year, including 15% with more than one fall and 22% with injurious falls. Among those completing the 6 months of follow-up, 14% reported at least one fall. Cox regression analysis identified four factors associated with falls during the 6-month follow-up: nonhealing foot sores (hazard ratio [HR] = 3.71, 95% confidence interval [CI] = 1.73 to 7.95), a prior fall history (HR = 2.62, 95% CI = 1.32 to 5.18), inability to cut one's own toenails (HR = 2.04, 95% CI = 1.04 to 4.01), and self-reported depression (HR = 1.72, 95% CI = 0.83 to 3.55). Falls, recurrent falls, and injurious falls in community-dwelling elder ED patients being evaluated for non-fall-related complaints occur at least as frequently as in previously described outpatient cohorts. Nonhealing foot sores, self-reported depression, not clipping one's own toenails, and previous falls are all associated with falls after ED discharge.

The multinational Men's Attitudes to Life Events and Sexuality (MALES) Study Phase II: understanding PDE5 inhibitor treatment seeking patterns, among men with erectile dysfunction.

PubMed

Fisher, William A; Rosen, Raymond C; Eardley, Ian; Niederberger, Craig; Nadel, Andrea; Kaufman, Joel; Sand, Michael

2004-09-01

The aim of Phase II of the Men's Attitudes to Life Events and Sexuality (MALES) Study is to explore PDE5 inhibitor treatment seeking among men with erectile dysfunction (ED). Phase II of the MALES study involved 2,912 men, aged 20-75 years, from 8 countries (U.S., U.K., Germany, France, Italy, Spain, Mexico, and Brazil), who reported ED. Participants were recruited from the MALES Phase I sample [1] and via booster methods (e.g., physician referral, street interception), and completed self-report questionnaires concerning the characteristics of their ED, their efforts to seek PDE5 inhibitor treatment for their sexual dysfunction, and attitudinal and referent influences that potentially affect treatment-seeking. Statistical analyses focus on identification of correlates of PDE5 inhibitor treatment seeking. PDE5 inhibitor utilization is strongly associated with ED sufferers' assessment of the severity of their sexual dysfunction, with their belief that medication for ED is dangerous, and with their perceptions of whether physicians, other professionals, and spouses or family members are supportive of their seeking treatment. ED sufferers who evaluate their sexual dysfunction as severe, who believe that medication for ED is not dangerous, and who perceive support for treatment seeking from referent others, are more likely to utilize PDE5 inhibitor treatment. Findings indicate that perceived ED severity, beliefs about ED medication, and referent influences are strongly correlated with utilization of PDE5 inhibitor therapy. These findings aid our understanding of factors that may incline men with ED to seek-or to avoid-PDE5 inhibitor therapy for their sexual dysfunction, and provide a basis for clinical and educational interventions to assist men with ED to seek appropriate treatment.

Uric acid level and erectile dysfunction in patients with coronary artery disease.

PubMed

Solak, Yalcin; Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Gaipov, Abduzhappar; Turk, Suleyman; Perez-Pozo, Santos E; Covic, Adrian; McFann, Kim; Johnson, Richard J; Kanbay, Mehmet

2014-01-01

Erectile dysfunction (ED) is a frequent complaint of elderly subjects and is closely associated with endothelial dysfunction and cardiovascular disease (CVD). Uric acid is also associated with endothelial dysfunction, oxidative stress, and CVD, raising the hypothesis that an increased serum uric acid might predict ED in patients who are at risk for coronary artery disease (CAD). This study aims to evaluate the association of serum uric acid levels with presence and severity of ED in patients presenting with chest pain of presumed cardiac origin. This is a cross-sectional study of 312 adult male patients with suspected CAD who underwent exercise stress test (EST) for workup of chest pain and completed a sexual health inventory for men survey form to determine the presence and severity of ED. Routine serum biochemistry (and uric acid levels) were measured. Logistic regression analysis was used to assess risk factors for ED. The short version of the International Index of Erectile Function questionnaire diagnosed ED (cutoff score ≤ 21). Serum uric acid levels were determined. Patients with chest pain of suspected cardiac origin underwent an EST. One hundred forty-nine of 312 (47.7%) male subjects had ED by survey criteria. Patients with ED were older and had more frequent CAD, hypertension, diabetes and impaired renal function, and also had significantly higher levels of uric acid, fibrinogen, glucose, C-reactive protein, triglycerides compared with patients without ED. Uric acid levels were associated with ED by univariate analysis (odds ratio = 1.36, P = 0.002); however, this association was not observed in multivariate analysis adjusted for estimated glomerular filtration rate. Subjects presenting with chest pain of presumed cardiac origin are more likely to have ED if they have elevated uric acid levels. © 2013 International Society for Sexual Medicine.

Two Swedish screening instruments for exhaustion disorder: cross-sectional associations with burnout, work stress, private life stress, and personality traits.

PubMed

Persson, Roger; Österberg, Kai; Viborg, Njördur; Jönsson, Peter; Tenenbaum, Artur

2017-06-01

To examine the relationships of two screening instruments recently developed for assessment of exhaustion disorder (ED) with some other well-known inventories intended to assess ED-related concepts and self-reports of job demands, job control, job support, private life stressors, and personality factors. A cross-sectional population sample ( n = 1355) completed: the Karolinska Exhaustion Disorder Scale (KEDS), Self-reported Exhaustion Disorder Scale (s-ED), Shirom-Melamed Burnout Questionnaire (SMBQ), Utrecht Work Engagement Scale (UWES-9), Job Content Questionnaire (JCQ), Big Five Inventory (BFI), and items concerning family-to-work interference and stress in private life. Compared to participants without any indication of ED, participants classified as having ED on KEDS or s-ED had higher scores on all four SMBQ subscales, lower scores on the UWES-9 subscales vigor and dedication, higher JCQ job demands scores, lower JCQ job support scores, higher degrees of family-to-work interference and stress in private life, and higher BFI neuroticism and openness scores. In addition, participants classified as having ED on KEDS had lower scores on the UWES-9 absorption subscale, the JCQ job control scale, and lower BFI extraversion, agreeableness and conscientiousness scores, compared to the subgroup not classified as having ED. As expected, we observed an overall pattern of associations between the ED screening inventories KEDS and s-ED and measures of burnout, work engagement, job demands-control-support, stress in private life, family-to-work interference, and personality factors. The results suggest that instruments designed to assess burnout, work engagement, and ED share common ground, despite their conceptual differences.

A simulated emergency department for medical students.

PubMed

Johnson, Patricia; Brazil, Victoria; Raymond-Dufresne, Éliane; Nielson, Tracy

2017-08-01

During their training, medical students often undertake a rotation in an emergency department (ED), where they are exposed to a wide variety of patient presentations. Simulation can be an effective teaching strategy to help prepare learners for the realities of the clinical environment. Simulating an ED shift can provide students with the opportunity to perform a range of clinical activities, within their scope of practice, in a supervised and supportive learning environment. Medical students often undertake a rotation in an emergency department CONTEXT: There is limited literature describing the structure, syllabus, feasibility and perceived usefulness of simulating a typical ED for medical student training. We developed a simulated ED (simED) teaching session for medical students at our university. Students were informed of the purpose and learning tasks of the session prior to attendance. At the start of their 2-hour simED shift students were allocated 'patients' by the Triage nurse. At the completion of their shift, students attended a debriefing discussion. Student feedback indicated that they felt that the simED: provided a good opportunity to practise skills and apply theory to practice; was realistic and challenging; highlighted the importance of teamwork; and enabled them to identify skills requiring further practise. Suggestions for improvements included a longer time spent in the simED and the opportunity to see more patients. The simED approach seemed to be well received and perceived by medical students as useful preparation for the ED. An overview of the structure, materials and resources used is provided to assist educators seeking to implement similar ED clinical scenarios in their curriculum. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

EdU induces DNA damage response and cell death in mESC in culture.

PubMed

Kohlmeier, Fanni; Maya-Mendoza, Apolinar; Jackson, Dean A

2013-03-01

Recently, a novel DNA replication precursor analogue called 5-ethynyl-2'-deoxyuridine (EdU) has been widely used to monitor DNA synthesis as an alternative to bromodeoxyuridine. Use of EdU benefits from simplicity and reproducibility and the simple chemical detection systems allows excellent preservation of nuclear structure. However, the alkyne moiety is highly reactive, raising the possibility that incorporation might compromise genome stability. To assess the extent of possible DNA damage, we have analysed the effect of EdU incorporation into DNA during short- and long-term cell culture using a variety of cell lines. We show that EdU incorporation has no measurable impact on the rate of elongation of replication forks during synthesis. However, using different cell lines we find that during long-term cell culture variable responses to EdU incorporation are seen, which range from delayed cell cycle progression to complete cell cycle arrest. The most profound phenotypes were seen in mouse embryonic stem cells, which following incorporation of EdU accumulated in the G2/M-phase of the cell cycle before undergoing apoptosis. In long-term cell culture, EdU incorporation also triggered a DNA damage response in all cell types analysed. Our study shows that while EdU is extremely useful to tag sites of on-going replication, for long-term studies (i.e. beyond the cell cycle in which labelling is performed), a careful analysis of cell cycle perturbations must be performed in order to ensure that any conclusions made after EdU treatment are not a direct consequence of EdU-dependent activation of cell stress responses.

The Role of Maternal Distress in the Report of Behavioral and Emotional Problems among Children with Chronic Disabilities.

PubMed

Silberg, Tamar; Brezner, Amichai; Gal, Gilad; Ahonniska-Assa, Jaana; Levav, Miriam

2016-01-01

Assessments of psychological symptoms in children often rely on caregivers' (usually mothers') reports. However, the reliability may be affected by the caregivers' own emotional distress (ED). The main objectives of this study were to assess the variability in ED of mothers of children with chronic physical disabilities, and its association with the ratings of their children's emotional and behavioral problems. Medical data of children diagnosed with chronic disabilities were analyzed (N = 72). Mothers completed the 12-item General Health Questionnaire (12-GHQ) to measure ED and the Child Behavior Checklist (CBCL) to assess children's emotional and behavioral problems Mothers' ED scores were compared with communitybased counterparts with similar socio-demographic characteristics (N = 657) from the Israel National Health Survey (INHS). Mothers of children with chronic physical disabilities had higher levels of ED compared to mothers in the general population. About 20% of the sample mothers had 12-GHQ scores compatible with DSM- IV depression or anxiety disorders. No differences in ED were found according to the type of child's disability or IQ score. Marked differences in CBCL scores were reported by mothers with high versus low ED, controlling for baseline maternal and child characteristics. High levels of maternal ED were associated with mothers' reports on child's behavioral and emotional problems.This may contaminate the reliability of parental reports on their child's psychological state.

Emergency medicine summary code for reporting CT scan results: implementation and survey results.

PubMed

Lam, Joanne; Coughlin, Ryan; Buhl, Luce; Herbst, Meghan; Herbst, Timothy; Martillotti, Jared; Coughlin, Bret

2018-06-01

The purpose of the study was to assess the emergency department (ED) providers' interest and satisfaction with ED CT result reporting before and after the implementation of a standardized summary code for all CT scan reporting. A summary code was provided at the end of all CTs ordered through the ED from August to October of 2016. A retrospective review was completed on all studies performed during this period. A pre- and post-survey was given to both ED and radiology providers. A total of 3980 CT scans excluding CTAs were ordered with 2240 CTs dedicated to the head and neck, 1685 CTs dedicated to the torso, and 55 CTs dedicated to the extremities. Approximately 74% CT scans were contrast enhanced. Of the 3980 ED CT examination ordered, 69% had a summary code assigned to it. Fifteen percent of the coded CTs had a critical or diagnostic positive result. The introduction of an ED CT summary code did not show a definitive improvement in communication. However, the ED providers are in consensus that radiology reports are crucial their patients' management. There is slightly increased satisfaction with the providers with less than 5 years of experience with the ED CT codes compared to more seasoned providers. The implementation of a user-friendly summary code may allow better analysis of results, practice improvement, and quality measurements in the future.

Emotion Regulation as a Transdiagnostic Feature Among Eating Disorders: Cross-sectional and Longitudinal Approach.

PubMed

Mallorquí-Bagué, Núria; Vintró-Alcaraz, Cristina; Sánchez, Isabel; Riesco, Nadine; Agüera, Zaida; Granero, Roser; Jiménez-Múrcia, Susana; Menchón, José M; Treasure, Janet; Fernández-Aranda, Fernando

2018-01-01

Emotion regulation (ER) difficulties are observed in eating disorders (EDs). However, few studies have explored ER before and after treatment. The aims are as follows: to explore ER difficulties across ED types and a healthy control (HC) group (Study 1) and to assess pretreatment and post-treatment changes among ED types (Study 2). In Study 1, adult women with EDs (n = 438) and HC (n = 126) completed an assessment including Eating Disorders Inventory-2, Difficulties in Emotion Regulation Scale and Symptom Checklist-90-Revised. Patients in Study 2 (n = 69) were also reassessed after treatment. All ED types reported worse ER compared with HC (p < .001); also, ER differences were found between ED types. Prospective analyses show ER improvements after treatment (p < .001; |d| = 0.51), especially in patients with bulimia nervosa (p < .001; |d| = 1.03; Reliable Change Index = 9.79) with greater improvement in those with a better treatment outcome (p = .034). In conclusion, emotion dysregulation is a part of all forms of EDs. Furthermore, emotional dysregulation can be modified. ED treatments for anorexia nervosa and binge eating disorder might be enhanced by targeting ER skills. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Sex-specific issues in eating disorders: a clinical and psychopathological investigation.

PubMed

Valente, Stefano; Di Girolamo, Giulia; Forlani, Martina; Biondini, Anna; Scudellari, Paolo; De Ronchi, Diana; Atti, Anna Rita

2017-12-01

To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities. Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study. The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative-diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males. ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED. Level of Evidence Level V, cross-sectional descriptive study.

Simulation of Dual Firing of Hydrogen and JP-8 in a Swirling Combustor

DTIC Science & Technology

2012-06-14

completed using the Ansys CFX computational fluid dynamics software. The total Lower Heating Value of the fuel mixture is maintained at a constant 6 kW...PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18

The Effect of Colour on Children's Cognitive Performance

ERIC Educational Resources Information Center

Brooker, Alice; Franklin, Anna

2016-01-01

Background: The presence of red appears to hamper adults' cognitive performance relative to other colours (see Elliot & Maier, 2014, "Ann. Rev. Psychol." 65, 95). Aims and sample: Here, we investigate whether colour affects cognitive performance in 8- and 9-year-olds. Method: Children completed a battery of tasks once in the presence…

1999 Leak Detection and Monitoring and Mitigation Strategy Update

DOE Office of Scientific and Technical Information (OSTI.GOV)

OHL, P.C.

This document is a complete revision of WHC-SD-WM-ES-378, Rev 1. This update includes recent developments in Leak Detection, Leak Monitoring, and Leak Mitigation technologies, as well as, recent developments in single-shell tank retrieval technologies. In addition, a single-shell tank retrieval release protection strategy is presented.

Values and assumptions in the development of DSM-III and DSM-III-R: an insider's perspective and a belated response to Sadler, Hulgus, and Agich's "On values in recent American psychiatric classification".

PubMed

Spitzer, R L

2001-06-01

It is widely acknowledged that the approach taken in the development of a classification of mental disorders is guided by various values and assumptions. The author, who played a central role in the development of DSM-III (American Psychiatric Association [1980] Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC:Author) and DSM-III-R (American Psychiatric Association [1987] Diagnostic and statistical manual of mental disorders, 3rd ed, rev. Washington, DC:Author) will explicate the basic values and assumptions that guided the development of these two diagnostic manuals. In so doing, the author will respond to the critique of DSM-III and DSM-III-R made by Sadler et al. in their 1994 paper (Sadler JZ, Hulgus YF, Agich GJ [1994] On values in recent American psychiatric classification. JMed Phil 19:261-277). The author will attempt to demonstrate that the stated goals of DSM-III and DSM-III-R are not inherently in conflict and are easily explicated by appealing to widely held values and assumptions, most of which appeared in the literature during the development of the manuals. Furthermore, we will demonstrate that it is not true that DSM-III places greater emphasis on reliability over validity and is covertly committed to a biological approach to explaining psychiatric disturbance.

Influence of erectile dysfunction course on its progress and efficacy of treatment with phosphodiesterase type 5 inhibitors.

PubMed

Liu, De-Feng; Jiang, Hui; Hong, Kai; Zhao, Lian-Ming; Tang, Wen-Hao; Ma, Lu-Lin

2010-11-01

Erectile dysfunction (ED) is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerous factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this research was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor (PDE5-I) and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-I treatment. From June 2008 to June 2009, 4252 questionnaires (Quality of Erection Questionnaire, QEQ) were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED (age ≥ 20 years) filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-I therapy. ED courses of most patients were less than 5 years (< 5 years, 74.0%; 5 - 10 years 20.8%; > 10 years, 5.2%). As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase (P ≤ 0.01). PDE5-I was effective in improving the quality of sexual activities (P ≤ 0.01). Administration of PDE5-I improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect (< 5 years, 96.1%; 5 - 10 years, 94.9%; > 10 years, 89.0%) (P ≤ 0.01). The ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Administration of PDE5-I effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.

Eating Disorder Psychopathology as a Marker of Psychosocial Distress and Suicide Risk in Female and Male Adolescent Psychiatric Inpatients

PubMed Central

Zaitsoff, Shannon L.; Grilo, Carlos M.

2009-01-01

Objective To examine psychosocial correlates of specific aspects of eating disorder (ED) psychopathology (i.e., dietary restriction, body dissatisfaction, binge eating, and self-induced vomiting) in psychiatrically-hospitalized adolescent girls and boys. Method Four hundred and ninety-two psychiatric inpatients (286 girls and 206 boys), aged 12 to 19 years, completed self-report measures of psychosocial and behavioral functioning including measures of suicide risk and ED psychopathology. Associations between ED psychopathology and psychosocial functioning were examined separately by sex and after controlling for depressive/negative affect using Beck Depression Inventory scores. Results Among boys and girls, after controlling for depressive/negative affect, ED psychopathology was significantly associated with anxiety, low self-esteem, and current distress regarding childhood abuse. Among girls, after controlling for depressive/negative affect, ED psychopathology was significantly related to hopelessness and suicidality. Among boys, after controlling for depressive/negative affect, ED psychopathology was positively related to self-reported history of sexual abuse and various externalizing problems (drug abuse, violence, and impulsivity). Conclusion In psychiatrically hospitalized adolescents, ED psychopathology may be an important marker of broad psychosocial distress and behavioral problems among girls and boys although the nature of the specific associations differs by sex. PMID:20152294

The effect of Transition to Specialty Practice Programs on Australian emergency nurses' professional development, recruitment and retention.

PubMed

Morphet, Julia; Kent, Bridie; Plummer, Virginia; Considine, Julie

2015-11-01

To date, emergency nursing Transition to Specialty Practice Program (TSPP) evaluations have been single-site observational studies. The aim of this paper was to examine the professional development, recruitment and retention outcomes of Australian emergency nursing TSPPs. An explanatory sequential design was used. Data were collected via online surveys and interviews of emergency Nurse Unit Managers and Nurse Educators. Survey data from EDs with TSPPs and EDs without TSPPs were compared. Qualitative data were analysed using content analysis. Data were collected from 118 EDs, and 13 interviews. TSPPs were offered in 72.1% of EDs. EDs with TSPPs had higher proportions of nurses with postgraduate qualifications (Mdn 28.3% vs. 22.1%, p=0.45) and Clinical Specialists (Mdn 16.4% vs. 6.3%, p=0.04). The median proportion of currently rostered nurses with TSPP completion was 34.2% in EDs with TSPPs introduced in 2000-2005 indicating ED high levels of retention. Emergency nursing TSPPs have had a positive effect on nursing professional development, recruitment and retention. To ensure consistency in outcomes and optimise reliability of emergency nursing skills and knowledge, a national emergency nursing TSPP framework is needed. Copyright © 2015 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

PubMed Central

Dinh, Michael; Rodgers, Craig; Muscatello, David J.; McGuire, Rhydwyn; Ryan, Therese; Thackway, Sarah

2016-01-01

Abstract Introduction and Aims Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. Design and Methods We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression. Results The PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%. Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701] PMID:27786390

Laser Spectroscopy of Highly-Charged Ions in an Electron Beam Ion Trap

NASA Astrophysics Data System (ADS)

Hosaka, K.; Crosby, D. N.; Gaarde-Widdowson, K.; Smith, C. J.; Silver, J. D.; Kinugawa, T.; Ohtani, S.; Myers, E. G.

2002-05-01

Using a ^14C^16O2 carbon-dioxide laser the 2s_1/2 - 2p_3/2 (fine structure - Lamb shift) transition has been induced in hydrogen-like nitrogen ions produced and trapped in the Oxford EBIT [1]. The transition was observed using a Si(Li) x-ray detector as a small increase in x-rays at the energy of the 2p - 1s transition as the laser wavelength was line-tuned across the resonance. A corresponding reduction in x-rays near the peak of the two-photon 2s - 1s energy spectrum was also seen. The method will be compared with the fast-beam laser technique [2]. [1] J.D. Silver et al., Rev. Sci. Instrum. 65, 1072 (1994). [2] E.G. Myers and M.R. Tarbutt, in The Hydrogen Atom, Precision Physics of Simple Atomic Systems, ed. S.G. Karshenboim et al., Springer 2001, p 688.

Substance-related disorders among juvenile offenders: what role do psychopathic traits play?

PubMed

Kimonis, Eva R; Tatar, Joseph R; Cauffman, Elizabeth

2012-06-01

Substance use disorders are associated with psychopathy, a personality disorder that is heterogeneous in both adults and youth; secondary variants of psychopathy with comorbid psychopathology and primary variants without comorbidity show distinct correlates and outcomes. In adult criminal populations, secondary variants report greater substance abuse compared with primary variants. The primary aim of this study is to replicate and extend these findings to a juvenile offender population. Compared with primary variants of juvenile psychopathy, secondary variants (a) reported significantly more frequent substance use--particularly alcohol--within the 6 months prior to incarceration (d = .43), (b) were almost twice as likely to abuse substances while incarcerated, and (c) were more likely to be diagnosed with a current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV; American Psychiatric Association, 2000) substance use disorder. Practical implications for working with justice-involved youth are discussed.

Nuclear Export Signal Masking Regulates HIV-1 Rev Trafficking and Viral RNA Nuclear Export.

PubMed

Behrens, Ryan T; Aligeti, Mounavya; Pocock, Ginger M; Higgins, Christina A; Sherer, Nathan M

2017-02-01

HIV-1's Rev protein forms a homo-oligomeric adaptor complex linking viral RNAs to the cellular CRM1/Ran-GTP nuclear export machinery through the activity of Rev's prototypical leucine-rich nuclear export signal (NES). In this study, we used a functional fluorescently tagged Rev fusion protein as a platform to study the effects of modulating Rev NES identity, number, position, or strength on Rev subcellular trafficking, viral RNA nuclear export, and infectious virion production. We found that Rev activity was remarkably tolerant of diverse NES sequences, including supraphysiological NES (SNES) peptides that otherwise arrest CRM1 transport complexes at nuclear pores. Rev's ability to tolerate a SNES was both position and multimerization dependent, an observation consistent with a model wherein Rev self-association acts to transiently mask the NES peptide(s), thereby biasing Rev's trafficking into the nucleus. Combined imaging and functional assays also indicated that NES masking underpins Rev's well-known tendency to accumulate at the nucleolus, as well as Rev's capacity to activate optimal levels of late viral gene expression. We propose that Rev multimerization and NES masking regulates Rev's trafficking to and retention within the nucleus even prior to RNA binding. HIV-1 infects more than 34 million people worldwide causing >1 million deaths per year. Infectious virion production is activated by the essential viral Rev protein that mediates nuclear export of intron-bearing late-stage viral mRNAs. Rev's shuttling into and out of the nucleus is regulated by the antagonistic activities of both a peptide-encoded N-terminal nuclear localization signal and C-terminal nuclear export signal (NES). How Rev and related viral proteins balance strong import and export activities in order to achieve optimal levels of viral gene expression is incompletely understood. We provide evidence that multimerization provides a mechanism by which Rev transiently masks its NES peptide, thereby biasing its trafficking to and retention within the nucleus. Targeted pharmacological disruption of Rev-Rev interactions should perturb multiple Rev activities, both Rev-RNA binding and Rev's trafficking to the nucleus in the first place. Copyright © 2017 American Society for Microbiology.

Nuclear Export Signal Masking Regulates HIV-1 Rev Trafficking and Viral RNA Nuclear Export

PubMed Central

Behrens, Ryan T.; Aligeti, Mounavya; Pocock, Ginger M.; Higgins, Christina A.

2016-01-01

ABSTRACT HIV-1's Rev protein forms a homo-oligomeric adaptor complex linking viral RNAs to the cellular CRM1/Ran-GTP nuclear export machinery through the activity of Rev's prototypical leucine-rich nuclear export signal (NES). In this study, we used a functional fluorescently tagged Rev fusion protein as a platform to study the effects of modulating Rev NES identity, number, position, or strength on Rev subcellular trafficking, viral RNA nuclear export, and infectious virion production. We found that Rev activity was remarkably tolerant of diverse NES sequences, including supraphysiological NES (SNES) peptides that otherwise arrest CRM1 transport complexes at nuclear pores. Rev's ability to tolerate a SNES was both position and multimerization dependent, an observation consistent with a model wherein Rev self-association acts to transiently mask the NES peptide(s), thereby biasing Rev's trafficking into the nucleus. Combined imaging and functional assays also indicated that NES masking underpins Rev's well-known tendency to accumulate at the nucleolus, as well as Rev's capacity to activate optimal levels of late viral gene expression. We propose that Rev multimerization and NES masking regulates Rev's trafficking to and retention within the nucleus even prior to RNA binding. IMPORTANCE HIV-1 infects more than 34 million people worldwide causing >1 million deaths per year. Infectious virion production is activated by the essential viral Rev protein that mediates nuclear export of intron-bearing late-stage viral mRNAs. Rev's shuttling into and out of the nucleus is regulated by the antagonistic activities of both a peptide-encoded N-terminal nuclear localization signal and C-terminal nuclear export signal (NES). How Rev and related viral proteins balance strong import and export activities in order to achieve optimal levels of viral gene expression is incompletely understood. We provide evidence that multimerization provides a mechanism by which Rev transiently masks its NES peptide, thereby biasing its trafficking to and retention within the nucleus. Targeted pharmacological disruption of Rev-Rev interactions should perturb multiple Rev activities, both Rev-RNA binding and Rev's trafficking to the nucleus in the first place. PMID:27852860

Entanglement criterion for tripartite systems based on local sum uncertainty relations

NASA Astrophysics Data System (ADS)

Akbari-Kourbolagh, Y.; Azhdargalam, M.

2018-04-01

We propose a sufficient criterion for the entanglement of tripartite systems based on local sum uncertainty relations for arbitrarily chosen observables of subsystems. This criterion generalizes the tighter criterion for bipartite systems introduced by Zhang et al. [C.-J. Zhang, H. Nha, Y.-S. Zhang, and G.-C. Guo, Phys. Rev. A 81, 012324 (2010), 10.1103/PhysRevA.81.012324] and can be used for both discrete- and continuous-variable systems. It enables us to detect the entanglement of quantum states without having a complete knowledge of them. Its utility is illustrated by some examples of three-qubit, qutrit-qutrit-qubit, and three-mode Gaussian states. It is found that, in comparison with other criteria, this criterion is able to detect some three-qubit bound entangled states more efficiently.

Modeling transport across the running-sandpile cellular automaton by means of fractional transport equations

NASA Astrophysics Data System (ADS)

Sánchez, R.; Newman, D. E.; Mier, J. A.

2018-05-01

Fractional transport equations are used to build an effective model for transport across the running sandpile cellular automaton [Hwa et al., Phys. Rev. A 45, 7002 (1992), 10.1103/PhysRevA.45.7002]. It is shown that both temporal and spatial fractional derivatives must be considered to properly reproduce the sandpile transport features, which are governed by self-organized criticality, at least over sufficiently long or large scales. In contrast to previous applications of fractional transport equations to other systems, the specifics of sand motion require in this case that the spatial fractional derivatives used for the running sandpile must be of the completely asymmetrical Riesz-Feller type. Appropriate values for the fractional exponents that define these derivatives in the case of the running sandpile are obtained numerically.

Multiloop functional renormalization group for general models

NASA Astrophysics Data System (ADS)

Kugler, Fabian B.; von Delft, Jan

2018-02-01

We present multiloop flow equations in the functional renormalization group (fRG) framework for the four-point vertex and self-energy, formulated for a general fermionic many-body problem. This generalizes the previously introduced vertex flow [F. B. Kugler and J. von Delft, Phys. Rev. Lett. 120, 057403 (2018), 10.1103/PhysRevLett.120.057403] and provides the necessary corrections to the self-energy flow in order to complete the derivative of all diagrams involved in the truncated fRG flow. Due to its iterative one-loop structure, the multiloop flow is well suited for numerical algorithms, enabling improvement of many fRG computations. We demonstrate its equivalence to a solution of the (first-order) parquet equations in conjunction with the Schwinger-Dyson equation for the self-energy.

Screening Adolescents in the Emergency Department for Weapon Carriage

PubMed Central

Cunningham, Rebecca M.; Resko, Stella M.; Harrison, Stephanie Roahen; Zimmerman, Marc; Stanley, Rachel; Chermack, Stephen T.; Walton, Maureen A.

2010-01-01

Objective To describe prevalence and correlates of past year weapon involvement among adolescents seeking care in an inner-city ED. Methods This cross-sectional study administered a computerized survey to all eligible adolescents (age 14–18), seven days a week seeking care in the ED over an 18 month period in an inner-city Level 1 ED. Validated measures were administered including measures of demographics, sexual activity, substance use, injury, violent behavior and weapon carriage/use. Results Adolescents (N=2069, 86% response rate) completed the computerized survey. 55% were female; 56.5% were African American. In the past year, 20% of adolescents reported knife/razor carriage, 7% reported gun carriage, and 6% pulled a knife/gun on someone; zero-inflated Poisson (ZIP) regression models were used to identify correlates of the occurrence and past year frequency of these weapon variables. Although gun carriage was more frequent among males, females were as likely to carry a knife or pull a weapon in the past year. Conclusions One fifth of all adolescent’s seeking care in this inner city ED have carried a weapon. Understanding weapon carriage among teens seeking ED care is a critical first step to future ED based injury prevention initiatives. PMID:20370746

Longitudinal associations between resilience and quality of life in eating disorders.

PubMed

Calvete, Esther; Las Hayas, Carlota; Gómez Del Barrio, Andrés

2018-01-01

This study examined the longitudinal reciprocal associations between resilience factors, quality of life (QoL) domains, and symptoms of eating disorders (EDs). Hypotheses included predictive paths from resilience factors of "acceptance of self and life" and "personal competence" to increased QoL and predictive paths from previous levels of QoL to resilience. A total of 184 patients with EDs (mean age = 29.55, SD = 9.17, 94.8% women) completed measures of resilience, QoL, and EDs symptoms over three waves spaced six month apart. Hypotheses were tested by path analysis. Resilience factors predicted improvements in psychological health and social relationship domains of QoL and a reduction of ED symptoms over time. In addition, psychological health increased acceptance of self and life consistently over time, whereas physical health increased the competence component of resilience. The relationships between resilience factors and QoL are reciprocal, with several mediational paths. A spiral of recursive influences between resilience factors and QoL can take place in people with EDs. This possibility offers new perspectives to understanding the process of recovery in patients with ED. Copyright © 2017 Elsevier B.V. All rights reserved.

Violence against nurses and its impact on stress and productivity.

PubMed

Gates, Donna M; Gillespie, Gordon L; Succop, Paul

2011-01-01

The purpose of this study was to examine how violence from patients and visitors is related to emergency department (ED) nurses' work productivity and symptoms of post-traumatic stress disorder (PTSD). Researchers have found ED nurses experience a high prevalence of physical assaults from patients and visitors. Yet, there is little research which examines the effect violent events have on nurses' productivity, particularly their ability to provide safe and compassionate patient care. A cross-sectional design was used to gather data from ED nurses who are members of the Emergency Nurses Association in the United States. Participants were asked to complete the Impact of Events Scale-Revised and Healthcare Productivity Survey in relation to a stressful violent event. Ninety-four percent of nurses experienced at least one posttraumatic stress disorder symptom after a violent event, with 17% having scores high enough to be considered probable for PTSD. In addition, there were significant indirect relationships between stress symptoms and work productivity. Workplace violence is a significant stressor for ED nurses. Results also indicate violence has an impact on the care ED nurses provide. Interventions are needed to prevent the violence and to provide care to the ED nurse after an event.

Reaching new heights: development of the emergency department nurse practitioner fellowship program.

PubMed

Varghese, Jane R; Silvestri, Antonette; Lopez, Patricia

2012-01-01

With nationwide resident shortages and decreasing resident shifts, and legislation decreasing resident work hours, the nurse practitioners (NPs) have been called upon to expand their scope of practice to encompass patients with immediate and critical conditions and to perform quick procedures. Most pediatric NP (PNP) programs do not have formal training for NP students to work in a pediatric emergency department (ED). Senior ED NPs in collaboration with an NP educator developed a comprehensive clinical program to prepare a general PNP student to practice in an ED. The fellowship committee, met with 3 local university PNP program directors. The fellowship program targeted highly motivated individuals with an interest in working in a pediatric ED at the completion of their program as recruits for the position. Based on positive feedback, there has been overwhelming support and acceptance from the ED attending physicians, the NPs in the specialty clinics, as well as the ED staff regarding the new NP fellowship role. The NP fellow experienced less stress transitioning from student to NP. The development of the fellowship program is a step forward in the future training of NPs. The structured fellowship will hopefully facilitate a seamless transition from student to NP.

Food insecurity and eating disorder pathology.

PubMed

Becker, Carolyn Black; Middlemass, Keesha; Taylor, Brigitte; Johnson, Clara; Gomez, Francesca

2017-09-01

The primary aim of this study was to investigate eating disorder (ED) pathology in those living with food insecurity. A secondary aim was to investigate whether any-reason dietary restraint, weight self-stigma, and worry increased as level of food insecurity increased. Participants (N = 503) seeking food from food pantries completed questionnaires assessing level of food insecurity, demographics, ED pathology, dietary restraint, weight self-stigma, and worry. Consistent with hypotheses, participants with the highest level of food insecurity (i.e., adults who reported having hungry children in their household) also endorsed significantly higher levels of binge eating, overall ED pathology, any-reason dietary restraint, weight self-stigma, and worry compared to participants with lower levels of food insecurity. Contrary to hypotheses, compensatory behaviors also increased as level of food insecurity worsened. Overall, 17% of those in the child hunger food insecurity group reported clinically significant ED pathology. This is the first study to assess the full spectrum of ED pathology in a low-income, marginalized population with food insecurity. Given that food insecurity is a global concern, results from this study suggest that greater attention to the association between ED pathology and food insecurity is warranted by researchers around the world. © 2017 Wiley Periodicals, Inc.

Psychometric examination and factorial validity of the Exercise Dependence Scale-Revised in Italian exercisers.

PubMed

Costa, Sebastiano; Cuzzocrea, Francesca; Hausenblas, Heather A; Larcan, Rosalba; Oliva, Patrizia

2012-12-01

Background and aims The purpose of this study was to verify the factorial structure, internal validity, reliability, and criterion validity of the 21-item Exercise Dependence Scale-Revised (EDS-R) in an Italian sample. Methods Italian voluntary (N = 519) users of gyms who had a history of regular exercise for over a year completed the EDS-R and measures of exercise frequency. Results and conclusions Confirmatory factor analyses demonstrated a good fit to the hypothesized 7-factor model, and adequate internal consistency for the scale was evidenced. Criterion validity was evidenced by significant correlations among all the subscale of the EDS and exercise frequency. Finally, individuals at risk for exercise dependence reported more exercise behavior compared to the nondependent-symptomatic and nondependent-asymptomatic groups. These results suggest that the seven subscales of the Italian version of the EDS are measuring the construct of exercise dependence as defined by the DSM-IV criteria for substance dependence and also confirm previous research using the EDS-R in other languages. More research is needed to examine the psychometric properties of the EDS-R in diverse populations with various research designs.

European Science Notes Information Bulletin Reports on Current European/ Middle Eastern Science

DTIC Science & Technology

1991-12-01

Symposium 89, F.-L. Krause , H. Jansen, eds., held in Berlin, NY:ASME. FRG November 1989. Hansmann, W. November. 1985. Interactiver entwurf und Nowacki, H...8217 Smoothing of Multipatch Bzier Surfaces - Curvature Approximation and Knot Removal for Wolfgang Schwarz, EDS GmbH, FRG (A). Handling Scattered Data - Bernd...Physical Oceanography research vessel. The Institute has three CTDs which have been used to obtain a very complete hydrographic series Dr. Wolfgang F

The Process in Completing a Nontraditional Group Dissertation in Practice for the Carnegie Project on the Education Doctorate, the Ed.D. Educational Leadership Program at Lynn University

ERIC Educational Resources Information Center

Vickers, Jerome

2016-01-01

This study focused on how a cohort of scholarly practitioners extended the traditional Doctorate in Education (Ed.D.) model at Lynn University by undertaking a nontraditional group Dissertation in Practice (DiP). The participants were a cohort of 11 scholarly practitioners known as Cohort 5 who became the first Lynn University doctoral students to…

Simulation of Spacecraft Damage Tolerance and Adaptive Controls

DTIC Science & Technology

2013-06-01

completed this without it. I thank him from the bottom of my heart . xviii THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION A. BACKGROUND...resulting point, and [ ]*Q is the conjugate quaternion (MathWorks, 2013). When Equation 19 is expanded, the following DCM can be extracted (Wie...E., (1999). Spacecraft design and sizing. In J. Wertz & W. Larson (Eds.), Space mission analysis and design (3rd ed.) (pp. 301–351). Hawthorne , CA

A general framework for complete positivity

NASA Astrophysics Data System (ADS)

Dominy, Jason M.; Shabani, Alireza; Lidar, Daniel A.

2016-01-01

Complete positivity of quantum dynamics is often viewed as a litmus test for physicality; yet, it is well known that correlated initial states need not give rise to completely positive evolutions. This observation spurred numerous investigations over the past two decades attempting to identify necessary and sufficient conditions for complete positivity. Here, we describe a complete and consistent mathematical framework for the discussion and analysis of complete positivity for correlated initial states of open quantum systems. This formalism is built upon a few simple axioms and is sufficiently general to contain all prior methodologies going back to Pechakas (Phys Rev Lett 73:1060-1062, 1994). The key observation is that initial system-bath states with the same reduced state on the system must evolve under all admissible unitary operators to system-bath states with the same reduced state on the system, in order to ensure that the induced dynamical maps on the system are well defined. Once this consistency condition is imposed, related concepts such as the assignment map and the dynamical maps are uniquely defined. In general, the dynamical maps may not be applied to arbitrary system states, but only to those in an appropriately defined physical domain. We show that the constrained nature of the problem gives rise to not one but three inequivalent types of complete positivity. Using this framework, we elucidate the limitations of recent attempts to provide conditions for complete positivity using quantum discord and the quantum data processing inequality. In particular, we correct the claim made by two of us (Shabani and Lidar in Phys Rev Lett 102:100402-100404, 2009) that vanishing discord is necessary for complete positivity, and explain that it is valid only for a particular class of initial states. The problem remains open, and may require fresh perspectives and new mathematical tools. The formalism presented herein may be one step in that direction.

The presence, predictive utility, and clinical significance of body dysmorphic symptoms in women with eating disorders

PubMed Central

2013-01-01

Background Both eating disorders (EDs) and body dysmorphic disorder (BDD) are disorders of body image. This study aimed to assess the presence, predictive utility, and impact of clinical features commonly associated with BDD in women with EDs. Methods Participants recruited from two non-clinical cohorts of women, symptomatic and asymptomatic of EDs, completed a survey on ED (EDE-Q) and BDD (BDDE-SR) psychopathology, psychological distress (K-10), and quality of life (SF-12). Results A strong correlation was observed between the total BDDE-SR and the global EDE-Q scores (r = 0.79, p < 0.001). Multivariate analyses demonstrated that participants with probable EDs (n = 61) and BDD (n = 23) scored higher on 28 of the 30 BDDE-SR items compared to healthy controls (n = 173; all p < 0.05), indicating greater severity of BDD symptoms. BDD participants also scored higher than ED participants on 15 of the 30 BDDE-SR items (all p < 0.05). The remaining 15 items that ED and BDD participants scored similarly on (all p > 0.05) measured appearance checking, reassurance-seeking, camouflaging, comparison-making, and social avoidance. In addition to these behaviors, inspection of sensitivity (Se) and specificity (Sp) revealed that BDDE-SR items measuring preoccupation and dissatisfaction with appearance were most predictive of ED cases (Se and Sp > 0.60). Higher total BDDE-SR scores were associated with greater distress on the K-10 and poorer quality of life on the SF-12 (all p < 0.01). Conclusions Clinical features central to the model of BDD are common in, predictive of, and associated with impairment in women with EDs. Practice implications are that these features be included in the assessment and treatment of EDs. PMID:24999401

Facebook usage among those who have received treatment for an eating disorder in a group setting.

PubMed

Saffran, Kristina; Fitzsimmons-Craft, Ellen E; Kass, Andrea E; Wilfley, Denise E; Taylor, Craig Barr; Trockel, Mickey

2016-08-01

This study explored Facebook use among individuals with a history of receiving treatment for an eating disorder (ED) in a group setting (e.g., inpatient, residential, outpatient group), focusing primarily on comparisons individuals make about their bodies, eating, or exercise to those of their peers from treatment on Facebook and the relation between these comparisons and ED pathology. Individuals (N = 415; mean age 28.15 years ± 8.41; 98.1% female) who self-reported receipt of ED treatment in a group setting were recruited via e-mail and social media to complete an online survey. Participants reported having an average of 10-19 Facebook friends from treatment and spending up to 30 min per day interacting on Facebook with individuals from treatment or ED-related organizations. More comparison to treatment peers on Facebook was associated with greater ED psychopathology and ED-related impairment. Conversely, positive interaction with treatment peers on Facebook was associated with lower ED psychopathology and ED-related impairment. Individuals who had been in treatment longer, more times, and more recently had more Facebook friends from treatment and ED-related organizations as well as spent more time in ED groups' pages on Facebook. Few participants (19.5%) reported that a therapist asked about the impact of Facebook on pathology. Interactions on Facebook could affect patients' recovery and potential for relapse. It may be helpful for treatment providers to discuss Facebook use and its potential benefits and drawbacks with patients preparing for discharge from group treatment. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:764-777). © 2016 Wiley Periodicals, Inc.

Adolescent Sexual Behavior and Emergency Department Use.

PubMed

Weisman, Julie; Chase, Alyse; Badolato, Gia M; Teach, Stephen J; Trent, Maria E; Chamberlain, James M; Goyal, Monika K

2018-03-28

The objective of this study was to determine whether adolescents in emergency departments (EDs) who report engaging in high-risk sexual behaviors are less likely to identify a primary care provider (PCP) and more likely to access the ED than their sexually inexperienced peers. This was a secondary analysis of adolescents presenting to a pediatric ED with non-sexually transmitted infection (STI)-related complaints who completed surveys to assess sexual behavior risk and health care access. We measured differences in self-reported PCP identification, preferential use of the ED, and number of ED visits over a 12-month period by sexual experience. Secondary outcomes included clinician documented sexual histories and STI testing. Of 758 patients meeting inclusion criteria, 341 (44.9%) were sexually experienced, and of those, 129 (37.8%) reported engaging in high-risk behavior. Participants disclosing high-risk behavior were less likely to identify a PCP (adjusted odds ratio, 0.5; 95% confidence interval [CI], 0.3-0.9), more likely to prefer the ED for acute care issues (adjusted odds ratio, 1.6; 95% CI, 1.0-2.6), and had a higher rate of ED visits (adjusted relative risk, 1.2; 95% CI, 1.0-1.3) compared with sexually inexperienced peers. Among patients disclosing high-risk behavior, 10.9% had clinician-documented sexual histories and 2.6% underwent STI testing. Adolescents who reported engaging in high-risk sexual behaviors were less likely to identify a PCP, as well as more likely to prefer ED-based care and make more ED visits. However, ED clinicians infrequently obtained sexual histories and performed STI testing in asymptomatic youth, thereby missing opportunities to screen high-risk adolescents who may lack access to preventive care.

Emergency Department Management of Hereditary Angioedema Attacks: Patient Perspectives.

PubMed

Otani, Iris M; Christiansen, Sandra C; Busse, Paula; Camargo, Carlos A; Zuraw, Bruce L; Riedl, Marc A; Banerji, Aleena

Emergency department (ED) management of hereditary angioedema (HAE) has been hindered by misdiagnosis and limited treatment options. Food and Drug Administration approval of 4 on-demand HAE therapies starting in 2009 and the publication of ED guidelines for angioedema management in 2014 should facilitate improvement of HAE management in the ED. The objective of this study was to identify patient-reported areas for improvement in ED management of HAE attacks. Patients with self-reported HAE with C1 inhibitor deficiency who attended the 2015 HAE Association Patient Summit were asked to complete an anonymous 30-question survey. Questions addressed patient characteristics and HAE management in the ED. Patients indicated that understanding of HAE in the ED needed improvement (99%, 104 of 105 patients). Recognition of HAE as a diagnosis (48%, 50 of 105 patients), appreciation of HAE as a serious disease (45%, 47 of 105 patients), and medication management (59%, 62 of 105 patients) were identified as areas needing improvement. Among 39 patients who required ED care within the last year, 6 did not receive any HAE-targeted therapy, and treatment with corticosteroids (n = 3), epinephrine (n = 2), and antihistamines (n = 7) was reported. Among 68 patients whose treatment plan was to receive home on-demand therapy, 26 required ED care because of an inability to receive on-demand therapy at home as outlined in their treatment plan. Having a treatment plan was associated with a greater likelihood of receiving HAE therapy in the ED (99% vs 74%, P = .002). HAE management in the ED can be improved with a focus on recognition of HAE attacks and administration of effective HAE therapies. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

How hot is he? A psychophysiological and psychosocial examination of the arousal patterns of sexually functional and dysfunctional men.

PubMed

Sarin, Sabina; Amsel, Rhonda; Binik, Yitzchak M

2014-07-01

Despite much theorizing about the interchangeability of desire and arousal, research has yet to identify whether men with desire vs. arousal disorders can be differentiated based on their psychophysiological patterns of arousal. Additionally, little research has examined the relationship between subjective (SA) and genital arousal (GA) in sexually dysfunctional men. To compare patterns of SA and GA in a community sample of men meeting DSM-IV-TR criteria for hypoactive sexual desire disorder (HSDD), erectile dysfunction (ED), both HSDD and ED (ED/HSDD), and healthy controls. Seventy-one men (19 controls, 13 HSDD, 19 ED, 20 ED/HSDD) completed self-report measures and watched two 15-minute film clips (neutral and erotic), while GA and SA were measured both continuously and discretely. Groups were compared on genital temperature (as an indicator of GA), SA, and psychosocial variables (i.e., body image, emotion regulation, sexual attitudes, sexual inhibition/excitation, mood, and trauma). Genital temperature increased for all groups during the erotic condition, yet men with ED and ED/HSDD showed less GA than men without erectile difficulties. All groups increased in SA during the erotic condition, yet ED/HSDD men reported less SA than controls or ED men. SA and GA were highly correlated for controls, and less strongly correlated for clinical groups; men with ED showed low agreement between SA and GA. Groups also differed on body image, sexual inhibition/excitation, sexual attitudes and alexithymia. Low desire vs. arousal sufferers have unique patterns of response, with those with both difficulties showing greatest impairment. Results have important implications for the diagnosis and treatment of these disorders. © 2014 International Society for Sexual Medicine.

Morale, stress and coping strategies of staff working in the emergency department: A comparison of two different-sized departments.

PubMed

Abraham, Louisa J; Thom, Ogilvie; Greenslade, Jaimi H; Wallis, Marianne; Johnston, Amy Nb; Carlström, Eric; Mills, Donna; Crilly, Julia

2018-06-01

Clinical staff in EDs are subject to a range of stressors. The objective of this study was to describe and compare clinical staff perceptions of their ED's working environment across two different Australian EDs. This was a cross-sectional, descriptive, research design that included distribution of three survey tools to clinical staff in two Australian EDs in 2016. Descriptive statistics were reported to characterise workplace stressors, coping styles and the ED environment. These data were compared by hospital and the employee's clinical role (nurse or physician). In total, 146 ED nurses and doctors completed the survey (response rate: 67%). Despite geographical variation, the staff at the two locations had similar demographic profiles in terms of age, sex and years of experience. Staff reported moderate levels of workload and self-realisation but low levels of conflict or nervousness in the workplace. Nurses and physicians reported similar perceptions of the work environment, although nurses reported slightly higher median levels of workload. Staff rated the death or sexual abuse of a child as most stressful, followed by workplace violence and heavy workload. Staff used a large range of coping strategies, and these were similar across both sites. These findings are the first multi-site and multidisciplinary examinations of Australian ED staff perceptions, improving our understanding of staff stressors and coping strategies and highlighting similarities across different EDs. These data support the development and implementation of strategies to improve ED working environments to help ensure professional longevity of ED staff. © 2018 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Alcohol mixed with energy drink use among u.s. 12th-grade students: prevalence, correlates, and associations with unsafe driving.

PubMed

Martz, Meghan E; Patrick, Megan E; Schulenberg, John E

2015-05-01

The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) after alcohol consumption. Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and white students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors and other substance use. AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction

PubMed Central

Leidy, Heather J.; Hill, Brenna R.; Lieberman, Jay L.; Legro, Richard S.; Souza, Mary Jane De

2014-01-01

We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18–30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e., mild (ED1; −8 ± 2%), moderate (ED2; −22 ± 3%), or severe (ED3; −42 ± 3%). Menstrual cycle length and changes in urinary concentrations of estrone-1-glucuronide, pregnanediol glucuronide, and midcycle luteinizing hormone were assessed. Thirty-four subjects completed the study. Weight loss occurred in ED1 (−3.8 ± 0.2 kg), ED2 (−2.8 ± 0.6 kg), and ED3 (−2.6 ± 1.1 kg) but was minimal in EXCON (−0.9 ± 0.7 kg). The overall sum of disturbances (luteal phase defects, anovulation, and oligomenorrhea) was greater in ED2 compared with EXCON and greater in ED3 compared with EXCON AND ED1. The average percent energy deficit was the main predictor of the frequency of menstrual disturbances (f = 10.1, β = −0.48, r2 = 0.23, P = 0.003) even when weight loss was included in the model. The estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from −22 (ED2) to −42% (ED3), reflecting an energy deficit of −470 to −810 kcal/day, respectively. This is the first study to demonstrate a dose-response relationship between the magnitude of energy deficiency and the frequency of exercise-related menstrual disturbances; however, the severity of menstrual disturbances was not dependent on the magnitude of energy deficiency. PMID:25352438

Association of emergency department and hospital characteristics with elopements and length of stay.

PubMed

Handel, Daniel A; Fu, Rongwei; Vu, Eugene; Augustine, James J; Hsia, Renee Y; Shufflebarger, Charles M; Sun, Benjamin

2014-06-01

As the Centers for Medicare & Medicaid Services (CMS) core measures in 2013 compare Emergency Department (ED) treatment time intervals, it is important to identify ED and hospital characteristics associated with these metrics to facilitate accurate comparisons. The objective of this study is to assess differences in operational metrics by ED and hospital characteristics. ED-level characteristics included annual ED volume, percentage of patients admitted, percentage of patients presenting by ambulance, and percentage of pediatric patients. Hospital-level characteristics included teaching hospital status, trauma center status, hospital ownership (nonprofit or for-profit), inpatient bed capacity, critical access status, inpatient bed occupancy, and rural vs. urban location area. Data from the ED Benchmarking Alliance from 2004 to 2009 were merged with the American Hospital Association's Annual Survey Database to include hospital characteristics that may impact ED throughput. Overall median length of stay (LOS) and left before treatment is complete (LBTC) were the primary outcome variables, and a linear mixed model was used to assess the association between outcome variables and ED and hospital characteristics, while accounting for correlations among multiple observations within each hospital. All data were at the hospital level on a yearly basis. There were 445 EDs included in the analysis, from 2004 to 2009, with 850 observations over 6 years. Higher-volume EDs were associated with higher rates of LBTC and LOS. For-profit hospitals had lower LBTC and LOS. Higher inpatient bed occupancies were associated with a higher LOS. Increasing admission percentages were positively associated with overall LOS for EDs, but not with rates of LBTC. Higher-volume EDs are associated with higher LBTC and LOS, and for-profit hospitals appear more favorably in these metrics compared with their nonprofit counterparts. It is important to appreciate that hospitals have different baselines for performance that may be more tied to volume and capacity, and less to quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical- and cost-effectiveness of a nurse led self-management intervention to reduce emergency visits by people with epilepsy.

PubMed

Noble, Adam J; McCrone, Paul; Seed, Paul T; Goldstein, Laura H; Ridsdale, Leone

2014-01-01

People with chronic epilepsy (PWE) often make costly, and clinically unnecessary emergency department (ED) visits. Some do it frequently. No studies have examined interventions to reduce them. An intervention delivered by an epilepsy nurse specialist (ENS) might reduce visits. The rationale is it may optimize patients' self-management skills and knowledge of appropriate ED use. We examined such an intervention's clinical- and cost-effectiveness. Eighty-five adults with epilepsy were recruited from three London EDs with similar catchment populations. Forty-one PWE recruited from two EDs received treatment-as-usual (TAU) and formed the comparison group. The remaining 44 PWE were recruited from the ED of a hospital that had implemented a new ENS service for PWE attending ED. These participants formed the intervention group. They were offered 2 one-to-one sessions with an ENS, plus TAU. Participants completed questionnaires on health service use and psychosocial well-being at baseline, 6- and 12-month follow-up. Covariates were identified and adjustments made. Sixty-nine (81%) participants were retained at follow-up. No significant effect of the intervention on ED visits at 12 months or on other outcomes was found. However, due to less time as inpatients, the average service cost for intervention participants over follow-up was less than for TAU participants' (adjusted difference £558, 95% CI, -£2409, £648). Covariates most predictive of subsequent ED visits were patients' baseline feelings of stigmatization due to epilepsy and low confidence in managing epilepsy. The intervention did not lead to a reduction in ED use, but did not cost more, partly because those receiving the intervention had shorter hospital admissions. Our findings on long-term ED predictors clarifies what causes ED use, and suggests that future interventions might focus more on patients' perceptions of stigma and on their confidence in managing epilepsy. If addressed, ED visits might be reduced and efficiency-savings generated.

Perceptions of Australasian emergency department staff of the impact of alcohol-related presentations.

PubMed

Egerton-Warburton, Diana; Gosbell, Andrew; Wadsworth, Angela; Moore, Katie; Richardson, Drew B; Fatovich, Daniel M

2016-03-07

To survey emergency department (ED) clinical staff about their perceptions of alcohol-related presentations. A mixed methods online survey of ED clinicians in Australia and New Zealand, conducted from 30 May to 7 July 2014. The frequency of aggression from alcohol-affected patients or their carers experienced by ED staff; the perceived impact of alcohol-related presentations on ED function, waiting times, other patients and staff. In total, 2002 ED clinical staff completed the survey, including 904 ED nurses (45.2%) and 1016 ED doctors (50.7%). Alcohol-related verbal aggression from patients had been experienced in the past 12 months by 97.9% of respondents, and physical aggression by 92.2%. ED nurses were the group most likely to have felt unsafe because of the behaviour of these patients (92% reported such feelings). Alcohol-related presentations were perceived to negatively or very negatively affect waiting times (noted by 85.5% of respondents), other patients in the waiting room (94.4%), and the care of other patients (88.3%). Alcohol-affected patients were perceived to have a negative or very negative impact on staff workload (94.2%), wellbeing (74.1%) and job satisfaction (80.9%). Verbal and physical aggression by alcohol-affected patients is commonly experienced by ED clinical staff. This has a negative impact on the care of other patients, as well as on staff wellbeing. Managers of health services must ensure a safe environment for staff and patients. More importantly, a comprehensive public health approach to changing the prevailing culture that tolerates alcohol-induced unacceptable behaviour is required.

Help-seeking behavior for erectile dysfunction: a clinic-based survey in China.

PubMed

Zhang, Kai; Yu, Wei; He, Zhan-Ju; Jin, Jie

2014-01-01

The behavior of Chinese patients seeking help for erectile dysfunction (ED) has not been described in detail. This was an observational study conducted using an outpatient clinic-based questionnaire survey of ED patients. From 2008 to 2009, physicians in 10 medical centers in China enrolled 2693 men (aged 25-70 years) diagnosed with ED. The diagnosis was based on the International Index of Erectile Function 5 (IIEF-5) Questionnaire. The men completed a survey that asked questions about demographics, marital status, education level and household income as well as help-seeking behavior and awareness of medical therapy. The mean age of the 2693 men was 43.4 ± 5.3 years; 73% were <50-years-old and 49% had a high household income. The mean time between noticing ED and taking the first treatment was 4.3 ± 2.1 months. Of the 2577 respondents, physicians (54%) and the internet (52%) were most frequently consulted sources for information about ED. Young ED patients preferred using the internet and older patients preferred consulting with physicians. Western medicine (19%) and traditional Chinese medicine (16%) were most frequently used for treatment. Young ED patients preferred to first search the internet for information, whereas older patients first asked physicians for help. Side effects of treatment were the greatest concern, especially for older patients. Physicians and the internet are frequently consulted for ED information and therapy. On the basis of these survey results, we believe that physicians in China should enhance health education about ED, especially via the internet.

Differences in reporting of violence and deliberate self harm related injuries to health and police authorities, Rawalpindi, Pakistan.

PubMed

Farooq, Umar; Majeed, Mudassir; Bhatti, Junaid Ahmad; Khan, Jahangir Sarwar; Razzak, Junaid Abdul; Khan, Muhammad Mussadiq

2010-02-23

The aim of study was to assess differences in reporting of violence and deliberate self harm (DSH) related injuries to police and emergency department (ED) in an urban town of Pakistan. Study setting was Rawalpindi city of 1.6 million inhabitants. Incidences of violence and DSH related injuries and deaths were estimated from record linkage of police and ED data. These were then compared to reported figures in both datasets. All persons reporting violence and DSH related injury to the police station, the public hospital's ED, or both in Rawalpindi city from July 1, 2007 to June 30, 2008 were included. In Rawalpindi city, 1016 intentional injury victims reported to police whereas 3012 reported to ED. Comparing violence related fatality estimates (N = 56, 95% CI: 46-64), police reported 75.0% and ED reported 42.8% of them. Comparing violence related injury estimates (N = 7990, 95% CI: 7322-8565), police reported 12.1% and ED reported 33.2% of them. Comparing DSH related fatality estimates (N = 17, 95% CI: 4-30), police reported 17.7% and ED reported 47.1% of them. Comparing DSH related injury estimates (N = 809, 95% CI: 101-1516), police reported 0.5% and ED reported 39.9% of them. In Rawalpindi city, police records were more likely to be complete for violence related deaths as compared to injuries due to same mechanism. As compared to ED, police reported DSH related injuries and deaths far less than those due to other types of violence.

Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep.

PubMed

Calhoun, Susan L; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Mayes, Susan D; Tsaoussoglou, Marina; Basta, Maria; Bixler, Edward O

2011-04-01

We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e.g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent. Cross-sectional Population -based. 508 school-aged children from the general population. N/A. Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS. It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.

[Analysis of core virion polypeptides from the pathogen causing chicken egg-drop syndrome].

PubMed

Iurov, G K; Dadykov, V A; Neugodova, G L; Naroditskiĭ, B S

1998-01-01

The cores of egg-drop syndrome virus (EDS-76) were isolated by the pyridine technique. EDS-76 proved to be much more resistant to pyridine disruption than other adenoviruses and treatment with 10% pyridine did not lead to complete dissociation of capsid and cores; only increase of pyridine concentration to 20% produced satisfactory results. At least three polypeptides (24, 10.5, and 6.5 kDa) were found in the core by SDS-PAGE, whereas the 40 kDa reacting with the core is most probably not a core component. Much more intensive reactions of the core with EDS-76 virion capsid suggest that its virion structure differs from that of other adenoviruses.

ED becomes 'lean' and cuts LBTC, LOS times.

PubMed

2008-04-01

Lean manufacturing techniques, first developed by Toyota, can be successfully adapted to help improve processes in your ED. St. Luke's Episcopal Hospital in Houston, has used Lean to reduce median length of stay, frequency of diversions, and the percentage of patients who left before treatment was complete (LBTC). Here's why "Lean" can help improve the performance of your ED: It enables you and your staff to see things from the patient's point of view. Lean tools enable you to view the status of your department in real-time and to compare that status with your performance goals. Exercises help identify areas where your processes break down and determine the most likely solutions.

The German version of the Anorectic Behavior Observation Scale (ABOS).

PubMed

Salbach-Andrae, Harriet; Klinkowski, Nora; Holzhausen, Martin; Frieler, Katja; Bohnekamp, Inga; Thiels, Cornelia; Bender, Caroline; Vandereycken, Walter

2009-05-01

To assess the performance of the German version of the Anorectic Behavior Observation Scale (ABOS) as a parent-report screening instrument for eating disorders (ED) in their children. Parents of 101 ED female patients (80 with Anorexia Nervosa; 21 with Bulimia Nervosa) and of 121 age- and socioeconomic status (SES)-matched female controls completed the ABOS. Confirmatory factor analysis supported the original three-factor structure model of the ABOS. Cronbach's alpha coefficients indicated good internal consistency for the three factors and the total score in the total sample. The best cut-off point (100% sensitivity and specificity) in the German version was >or=23. The ABOS may be a useful additional instrument for assessing ED.

Reaching extended length-scales with accelerated dynamics

NASA Astrophysics Data System (ADS)

Hubartt, Bradley; Shim, Yunsic; Amar, Jacques

2012-02-01

While temperature-accelerated dynamics (TAD) has been quite successful in extending the time-scales for non-equilibrium simulations of small systems, the computational time increases rapidly with system size. One possible solution to this problem, which we refer to as parTAD^1 is to use spatial decomposition combined with our previously developed semi-rigorous synchronous sublattice algorithm^2. However, while such an approach leads to significantly better scaling as a function of system-size, it also artificially limits the size of activated events and is not completely rigorous. Here we discuss progress we have made in developing an alternative approach in which localized saddle-point searches are combined with parallel GPU-based molecular dynamics in order to improve the scaling behavior. By using this method, along with the use of an adaptive method to determine the optimal high-temperature^3, we have been able to significantly increase the range of time- and length-scales over which accelerated dynamics simulations may be carried out. [1] Y. Shim et al, Phys. Rev. B 76, 205439 (2007); ibid, Phys. Rev. Lett. 101, 116101 (2008). [2] Y. Shim and J.G. Amar, Phys. Rev. B 71, 125432 (2005). [3] Y. Shim and J.G. Amar, J. Chem. Phys. 134, 054127 (2011).

Association of life threat and betrayal with posttraumatic stress disorder symptom severity.

PubMed

Kelley, Lance P; Weathers, Frank W; Mason, Elizabeth A; Pruneau, Genevieve M

2012-08-01

The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) emphasizes life threat as the defining feature of psychological trauma. Recent theoretical and empirical work, however, indicates the need to identify and evaluate other key aspects of trauma. Betrayal has been proposed as a pertinent, distinct, and complementary factor that can explain effects of trauma not accounted for by life threat alone. This study examined the relationship between injury, perceived life threat (PLT), and betrayal with posttraumatic stress disorder (PTSD) symptom severity. Trauma-exposed college students (N = 185) completed self-report measures of trauma exposure and PTSD, as well as items regarding life threat, betrayal, and level of medical care received. In hierarchical regressions incorporating injury, PLT, and betrayal, betrayal was associated with all PTSD symptom clusters and PTSD total severity (f(2) = .08), whereas PLT was associated with hyperarousal (f(2) = .05) and PTSD total (f(2) = .03), and injury had no association with PTSD symptoms. In a revised model with trauma type as an additional variable, betrayal was associated with avoidance (f(2) = .03), numbing (f(2) = .04), and PTSD total (f(2) = .03), whereas PLT was associated with reexperiencing (f(2) = .04), hyperarousal (f(2) = .04), and PTSD total (f(2) = .03), and injury was associated with avoidance (f(2) = .03). These findings support the idea that betrayal is a core dimension of psychological trauma that may play an important role in the etiology of PTSD. Copyright © 2012 International Society for Traumatic Stress Studies.

Oral phenotype and scoring of vascular Ehlers-Danlos syndrome: a case-control study.

PubMed

Ferré, François Côme; Frank, Michael; Gogly, Bruno; Golmard, Lisa; Naveau, Adrien; Chérifi, Hafida; Emmerich, Joseph; Gaultier, Frédérick; Berdal, Ariane; Jeunemaitre, Xavier; Fournier, Benjamin P J

2012-01-01

Vascular Ehlers-Danlos syndrome (vEDS) is a rare genetic condition related to mutations in the COL3A1 gene, responsible of vascular, digestive and uterine accidents. Difficulty of clinical diagnosis has led to the design of diagnostic criteria, summarised in the Villefranche classification. The goal was to assess oral features of vEDS. Gingival recession is the only oral sign recognised as a minor diagnostic criterion. The authors aimed to check this assumption since bibliographical search related to gingival recession in vEDS proved scarce. Prospective case-control study. Dental surgery department in a French tertiary hospital. 17 consecutive patients with genetically proven vEDS, aged 19-55 years, were compared with 46 age- and sex-matched controls. Complete oral examination (clinical and radiological) with standardised assessment of periodontal structure, temporomandibular joint function and dental characteristics were performed. COL3A1 mutations were identified by direct sequencing of genomic or complementary DNA. Prevalence of gingival recession was low among patients with vEDS, as for periodontitis. Conversely, patients showed marked gingival fragility, temporomandibular disorders, dentin formation defects, molar root fusion and increased root length. After logistic regression, three variables remained significantly associated to vEDS. These variables were integrated in a diagnostic oral score with 87.5% and 97% sensitivity and specificity, respectively. Gingival recession is an inappropriate diagnostic criterion for vEDS. Several new specific oral signs of the disease were identified, whose combination may be of greater value in diagnosing vEDS.

A twin study of erectile dysfunction.

PubMed

Fischer, Mary E; Vitek, Mary Ellen; Hedeker, Don; Henderson, William G; Jacobsen, Steven J; Goldberg, Jack

2004-01-26

The extent of genetic influence on erectile dysfunction (ED) is unknown. This study determines the contribution of heredity to ED in a sample of middle-aged men. A classical twin study was conducted in the Vietnam Era Twin Registry, a national sample of male-male pairs (mean birth year, 1949) who served on active duty during the Vietnam era (1965-1975). A 1999 male health survey was completed by 890 monozygotic (MZ) and 619 dizygotic (DZ) pairs. The prevalence and heritability of 2 self-report indicators of ED, difficulty in having an erection and in maintaining an erection, are estimated. The prevalence of difficulty in having an erection is 23.3% and in maintaining an erection is 26.7%. Twin correlations for dysfunction in having an erection are 0.35 (95% confidence interval [CI], 0.28-0.41) in MZ and 0.17 (95% CI, 0.09-0.27) in DZ pairs. For dysfunction in maintaining an erection, the twin correlations in MZ and DZ pairs are 0.39 (95% CI, 0.32-0.45) and 0.18 (95% CI, 0.09-0.27), respectively. The estimated heritability of liability for dysfunction in having an erection is 35% and in maintaining an erection is 42%. The heritable influence on ED remained significant after adjustment for ED risk factors. The present study demonstrates an ED-specific genetic component that is independent of genetic influences from numerous ED risk factors. The results suggest that future molecular genetic studies to identify ED-related polymorphisms are warranted.

Randomized Controlled Trial of Mailed Personalized Feedback for Risky Drinkers in the Emergency Department: The Impact on Alcohol Consumption, Alcohol-Related Injuries, and Repeat Emergency Department Presentations.

PubMed

Havard, Alys; Shakeshaft, Anthony P; Conigrave, Katherine M

2015-07-01

Due to the difficulty encountered in disseminating resource-intensive emergency department (ED)-based brief alcohol interventions into real-world settings, this study evaluated the effect of a mailed personalized feedback intervention for problem drinking ED patients. At 6-week follow-up, this intervention was associated with a statistically significant reduction in alcohol consumption among patients with alcohol-involved ED presentations. This study aimed to evaluate the effects of this intervention over time. A randomized controlled trial was conducted among problem drinking ED patients, defined as those scoring 8 or more on the Alcohol Use Disorders Identification Test. Participants in the intervention group received mailed personalized feedback regarding their alcohol consumption. The control group received no feedback. Follow-up interviews were conducted over the phone, postal survey, or email survey 6 weeks and 6 months after baseline screening, and repeat ED presentations over 12-month follow-up were ascertained via linked ED records. Six-month follow-up interviews were completed with 210 participants (69%), and linked ED records were obtained for 286 participants (94%). The intervention had no effect on alcohol consumption, while findings regarding alcohol-related injuries and repeat ED presentations remain inconclusive. Further research in which the receipt of feedback is improved and a booster intervention is provided is recommended. Copyright © 2015 by the Research Society on Alcoholism.

Adult Training and Education: Results from the National Household Education Surveys Program of 2016. First Look. NCES 2017-103rev

ERIC Educational Resources Information Center

Cronen, Stephanie; McQuiggan, Meghan; Isenberg, Emily

2018-01-01

This First Look report provides selected key findings on adults' attainment of nondegree credentials (licenses, certifications, and postsecondary certificates), and their completion of work experience programs such as apprenticeships and internships. This version of the report corrects an error in three tables in the originally released version…

Assessment of virtual reality robotic simulation performance by urology resident trainees.

PubMed

Ruparel, Raaj K; Taylor, Abby S; Patel, Janil; Patel, Vipul R; Heckman, Michael G; Rawal, Bhupendra; Leveillee, Raymond J; Thiel, David D

2014-01-01

To examine resident performance on the Mimic dV-Trainer (MdVT; Mimic Technologies, Inc., Seattle, WA) for correlation with resident trainee level (postgraduate year [PGY]), console experience (CE), and simulator exposure in their training program to assess for internal bias with the simulator. Residents from programs of the Southeastern Section of the American Urologic Association participated. Each resident was scored on 4 simulator tasks (peg board, camera targeting, energy dissection [ED], and needle targeting) with 3 different outcomes (final score, economy of motion score, and time to complete exercise) measured for each task. These scores were evaluated for association with PGY, CE, and simulator exposure. Robotic skills training laboratory. A total of 27 residents from 14 programs of the Southeastern Section of the American Urologic Association participated. Time to complete the ED exercise was significantly shorter for residents who had logged live robotic console compared with those who had not (p = 0.003). There were no other associations with live robotic console time that approached significance (all p ≥ 0.21). The only measure that was significantly associated with PGY was time to complete ED exercise (p = 0.009). No associations with previous utilization of a robotic simulator in the resident's home training program were statistically significant. The ED exercise on the MdVT is most associated with CE and PGY compared with other exercises. Exposure of trainees to the MdVT in training programs does not appear to alter performance scores compared with trainees who do not have the simulator. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Heated Ultrasound Gel and Patient Satisfaction with Bedside Ultrasound Studies: The HUGS Trial

PubMed Central

Krainin, Benjamin M.; Thaut, Lane C.; April, Michael D.; Curtis, Ryan A.; Kaelin, Andrea L.; Hardy, Garrett B.; Weymouth, Wells L.; Srichandra, Jonathan; Chin, Eric J.; Summers, Shane M.

2017-01-01

Introduction Our goal was to determine if heated gel for emergency department (ED) bedside ultrasonography improves patient satisfaction compared to room-temperature gel. Methods We randomized a convenience sample of ED patients determined by their treating physician to require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel (82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailed investigation into various measures to improve patient satisfaction with ED US examinations but did not inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves while performing the examinations to blind themselves to the gel temperature. After completion of the US, subjects completed a survey including the primary outcome measure of patient satisfaction as measured on a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographer professionalism measured by an ordinal scale (1–5). Results We enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwent randomization to US studies with room-temperature gel and 61 underwent randomization to heated US gel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with room-temperature gel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95% confidence interval −1.3–8.6). There were similarly no differences between the two arms with regard to patient perceptions of sonographer professionalism. Conclusion The use of heated ultrasound gel appears to have no material impact on the satisfaction of ED patients undergoing bedside ultrasound studies. PMID:29085538

Preemptive Anticoagulation in Patients With a High Pretest Probability of Pulmonary Embolism: Are Guidelines Followed?

PubMed

Willoughby, Laura; Adams, Daniel M; Evans, R Scott; Lloyd, James F; Stevens, Scott M; Woller, Scott C; Bledsoe, Joseph R; Aston, Valerie T; Wilson, Emily L; Elliott, C Gregory

2018-05-01

Guidelines suggest anticoagulation of patients with high pretest probability of pulmonary embolism (PE) while awaiting diagnostic test results (preemptive anticoagulation). Data relevant to the practice of preemptive anticoagulation are not available. We reviewed 3,500 consecutive patients who underwent CT pulmonary angiography (CTPA) at two EDs. We classified the pretest probability for PE using the revised Geneva Score (RGS) as low (RGS 0-3), intermediate (RGS 4-10), or high (RGS 11-18). We classified patients with a high pretest probability of PE as receiving preemptive anticoagulation if therapeutic anticoagulation was given before CTPA completion. Patients with a high bleeding risk and those receiving treatment for DVT before CTPA were excluded from the preemptive anticoagulation analysis. We compared the time elapsed between ED registration and CTPA completion for patients with a low, intermediate, and high pretest probability for PE. We excluded three of 3,500 patients because CTPA preceded ED registration. Of the remaining 3,497 patients, 167 (4.8%) had a high pretest probability for PE. After excluding 29 patients for high bleeding risk and 21 patients who were treated for DVT prior to CTPA, only two of 117 patients (1.7%) with a high pretest probability for PE received preemptive anticoagulation. Furthermore, 37 of the remaining 115 patients (32%) with a high pretest probability for PE had a preexisting indication for anticoagulation but did not receive preemptive anticoagulation. The time from ED registration to CTPA completion did not differ based on the pretest probability of PE. Physicians rarely use preemptive anticoagulation in patients with a high pretest probability for PE. Clinicians do not expedite CTPA examinations for patients with a high pretest probability for PE. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

A content analysis of parents' written communication of needs and expectations for emergency care of their children.

PubMed

Hoppa, Eric Christopher; Porter, Stephen C

2011-06-01

We investigated the potential value of information shared by parents on a written form designed to capture needs and expectations for care to an emergency department (ED) system that values patient-centeredness. We conducted a retrospective content analysis of parent-completed written forms collected during an improvement project focused on parent-provider communication in a pediatric ED. The primary outcome was potential value of the completed forms to a patient-centered ED system, defined as a form that was legible, included observations that mapped to medical problems, and included reasonable parental requests. We analyzed variation in potential value and other form attributes across a priori-defined visit type and acuity. Visit type was validated by a separate, blinded medical record review. A random stratified sample of 1008 forms was established from 6937 parent-completed forms collected during the 6-month improvement project; 995 of 1008 forms had matching medical records; 922 (92.7%) of 995 forms demonstrated potential value; 990 (99.5%) of 995 forms were legible; 948 (95.3%) of 995 forms included observations that mapped to a medical problem, and 599 (93.3%) of 642 forms contained reasonable parental requests. There was good agreement between the form and medical record for visit type (κ = 0.62). The potential value of forms did not vary significantly across visit type (88.2%-92.8%) or acuity (88.9%-93.4%). Information shared by parents on written forms designed to capture needs and expectations provides potential value to a patient-centered ED system. The high level of informational value is consistent across patient type and acuity level.

A sex risk reduction text-message program for young adult females discharged from the emergency department.

PubMed

Suffoletto, Brian; Akers, Aletha; McGinnis, Kathleen A; Calabria, Jaclyn; Wiesenfeld, Harold C; Clark, Duncan B

2013-09-01

To pilot test a text message (SMS) sex risk reduction program among at-risk young adult female patients discharged from an emergency department (ED). A convenience sample of 52 female patients with hazardous drinking behavior and recent risky sexual encounters were recruited from an urban ED and randomized to the SMS program (n = 23) or a control group (n = 29). All participants completed a web-based questionnaire in the ED and at 3-month follow-up. For 12 weeks, SMS participants were asked to report whether they had a risky sexual encounter in the past week, received theory-based feedback, and were asked if they were willing set a goal to refrain from having another risky encounter. Thirty-nine percent of SMS participants completed all weeks of SMS reports, and noncompletion increasing from 12% on week 1 to a 33% by week 12. Three-month follow-up was completed in 56% of participants. In the intervention group, there was an increase in the proportion with condom use with last vaginal sex from 20% (95% CI 4%-48%) to 53% (95% CI 27%-79%) and an increase in always condom use over the past 28 days from 0% (95% CI 0%-22%) to 33% (95% CI 12%-62%). These changes were not statistically different from control participants. SMS programs may be useful to reduce risk for sexually transmitted diseases among at-risk young adults being discharged from the ED. Future trials should examine ways to improve adherence to SMS dialog over time and measure objective outcomes in a larger sample. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms.

PubMed

Vyles, David; Adams, Juan; Chiu, Asriani; Simpson, Pippa; Nimmer, Mark; Brousseau, David C

2017-08-01

Penicillin allergy is commonly reported in the pediatric emergency department (ED). True penicillin allergy is rare, yet the diagnosis results from the denial of first-line antibiotics. We hypothesize that all children presenting to the pediatric ED with symptoms deemed to be low-risk for immunoglobulin E-mediated hypersensitivity will return negative results for true penicillin allergy. Parents of children aged 4 to 18 years old presenting to the pediatric ED with a history of parent-reported penicillin allergy completed an allergy questionnaire. A prespecified 100 children categorized as low-risk on the basis of reported symptoms completed penicillin allergy testing by using a standard 3-tier testing process. The percent of children with negative allergy testing results was calculated with a 95% confidence interval. Five hundred ninety-seven parents completed the questionnaire describing their child's reported allergy symptoms. Three hundred two (51%) children had low-risk symptoms and were eligible for testing. Of those, 100 children were tested for penicillin allergy. The median (interquartile range) age at testing was 9 years (5-12). The median (interquartile range) age at allergy diagnosis was 1 year (9 months-3 years). Rash (97 [97%]) and itching (63 [63%]) were the most commonly reported allergy symptoms. Overall, 100 children (100%; 95% confidence interval 96.4%-100%) were found to have negative results for penicillin allergy and had their labeled penicillin allergy removed from their medical record. All children categorized as low-risk by our penicillin allergy questionnaire were found to have negative results for true penicillin allergy. The utilization of this questionnaire in the pediatric ED may facilitate increased use of first-line penicillin antibiotics. Copyright © 2017 by the American Academy of Pediatrics.

Rev-erb beta regulates the Srebp-1c promoter and mRNA expression in skeletal muscle cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramakrishnan, Sathiya N.; Lau, Patrick; Crowther, Lisa M.

2009-10-30

The nuclear hormone receptor, Rev-erb beta operates as a transcriptional silencer. We previously demonstrated that exogenous expression of Rev-erb{beta}{Delta}E in skeletal muscle cells increased Srebp-1c mRNA expression. We validated these in vitro observations by injection of an expression vector driving Rev-erb{beta}{Delta}E expression into mouse tibialis muscle that resulted in increased Srebp-1c mRNA expression. Paradoxically, Rev-erb{beta} siRNA expression in skeletal muscle cells repressed Srebp-1c expression, and indicated that Rev-erb{beta} expression was necessary for Srebp-1c expression. ChIP analysis demonstrated that Rev-erb{beta} was recruited to the Srebp-1c promoter. Moreover, Rev-erb{beta} trans-activated the Srebp-1c promoter, in contrast, Rev-erb{beta} efficiently repressed the Rev-erb{alpha} promoter, amore » previously characterized target gene. Finally, treatment with the Rev-erb agonist (hemin) (i) increased the trans-activation of the Srebp-1c promoter by Rev-erb{beta}; and (ii) increased Rev-erb{beta} and Srebp-1c mRNA expression. These data suggest that Rev-erb{beta} has the potential to activate gene expression, and is a positive regulator of Srebp-1c, a regulator of lipogenesis.« less

Mutational definition of functional domains within the Rev homolog encoded by human endogenous retrovirus K.

PubMed

Bogerd, H P; Wiegand, H L; Yang, J; Cullen, B R

2000-10-01

Nuclear export of the incompletely spliced mRNAs encoded by several complex retroviruses, including human immunodeficiency virus type 1 (HIV-1), is dependent on a virally encoded adapter protein, termed Rev in HIV-1, that directly binds both to a cis-acting viral RNA target site and to the cellular Crm1 export factor. Human endogenous retrovirus K, a family of ancient endogenous retroviruses that is not related to the exogenous retrovirus HIV-1, was recently shown to also encode a Crm1-dependent nuclear RNA export factor, termed K-Rev. Although HIV-1 Rev and K-Rev display little sequence identity, they share the ability not only to bind to Crm1 and to RNA but also to form homomultimers and shuttle between nucleus and cytoplasm. We have used mutational analysis to identify sequences in the 105-amino-acid K-Rev protein required for each of these distinct biological activities. While mutations in K-Rev that inactivate any one of these properties also blocked K-Rev-dependent nuclear RNA export, several K-Rev mutants were comparable to wild type when assayed for any of these individual activities yet nevertheless defective for RNA export. Although several nonfunctional K-Rev mutants acted as dominant negative inhibitors of K-Rev-, but not HIV-1 Rev-, dependent RNA export, these were not defined by their inability to bind to Crm1, as is seen with HIV-1 Rev. In total, this analysis suggests a functional architecture for K-Rev that is similar to, but distinct from, that described for HIV-1 Rev and raises the possibility that viral RNA export mediated by the approximately 25 million-year-old K-Rev protein may require an additional cellular cofactor that is not required for HIV-1 Rev function.

New mutations affecting induced mutagenesis in yeast.

PubMed

Lawrence, C W; Krauss, B R; Christensen, R B

1985-01-01

Previously isolated mutations in baker's yeast, Saccharomyces cerevisiae, that impair induced mutagenesis were all identified with the aid of tests that either exclusively or predominantly detect base-pair substitutions. To avoid this bias, we have screened 11 366 potentially mutant clones for UV-induced reversion of the frameshift allele, his4-38, and have identified 10 mutants that give much reduced yields of revertants. Complementation and recombination tests show that 6 of these carry mutations at the previously known REV1, REV1 and REV3 loci, while the remaining 4 define 3 new genes, REV4 (2 mutations), REV5 and REV6. The rev4 mutations are readily suppressed in many genetic backgrounds and, like the rev5 mutation, impart only a limited deficiency for induced mutagenesis: it is likely, therefore that the REV4+ and REV5+ gene functions are only remotely concerned with this process. The rev6 mutants have a more general deficiency, however, as well as marked sensitivity to UV and an increased spontaneous mutation rate, properties that suggest the REV6 gene is directly involved in mutation induction. The REV5 gene is located about 1 cM proximal to CYC1 on chromosome X.

Transitioning home: A four-stage reintegration hospital discharge program for adolescents hospitalized for eating disorders.

PubMed

Dror, Sima; Kohn, Yoav; Avichezer, Mazal; Sapir, Benjamin; Levy, Sharon; Canetti, Laura; Kianski, Ela; Zisk-Rony, Rachel Yaffa

2015-10-01

Treatment for adolescents with eating disorders (ED) is multidimensional and extends after hospitalization. After participating in a four-step reintegration plan, treatment success including post-discharge community and social reintegration were examined from perspectives of patients, family members, and healthcare providers. Six pairs of patients and parents, and seven parents without their children were interviewed 2 to 30 months following discharge. All but two adolescents were enrolled in, or had completed school. Five worked in addition to school, and three completed army or national service. Twelve were receiving therapeutic care in the community. Adolescents with ED can benefit from a systematic reintegration program, and nurses should incorporate this into care plans. © 2015, Wiley Periodicals, Inc.

The effect of electronic health record implementation on community emergency department operational measures of performance.

PubMed

Ward, Michael J; Landman, Adam B; Case, Karen; Berthelot, Jessica; Pilgrim, Randy L; Pines, Jesse M

2014-06-01

We study the effect of an emergency department (ED) electronic health record implementation on the operational metrics of a diverse group of community EDs. We performed a retrospective before/after analysis of 23 EDs from a single management group that experienced ED electronic health record implementation (with the majority of electronic health records optimized specifically for ED use). We obtained electronic data for 4 length of stay measures (arrival to provider, admitted, discharged, and overall length of stay) and 4 measures of operational characteristics (left before treatment complete, significant returns, overall patient satisfaction, and provider efficiency). We compared the 6-month "baseline" period immediately before implementation with a "steady-state" period commencing 6 months after implementation for all 8 metrics. For the length of stay measures, there were no differences in the arrival-to-provider interval (difference of -0.02 hours; 95% confidence interval [CI] of difference -0.12 to 0.08), admitted length of stay (difference of 0.10 hours; 95% CI of difference -0.17 to 0.37), discharged length of stay (difference of 0.07 hours; 95% CI of difference -0.07 to 0.22), and overall length of stay (difference of 0.11 hours; 95% CI of difference -0.04 to 0.27). For operational characteristics, there were no differences in the percentage who left before treatment was complete (difference of 0.24%; 95% CI of difference -0.47% to 0.95%), significant returns (difference of -0.04%; 95% CI of difference -0.48% to 0.39%), overall percentile patient satisfaction (difference of -0.02%; 95% CI of difference -2.35% to 2.30%), and provider efficiency (difference of -0.05 patients/hour; 95% CI of difference -0.11 to 0.02). There is no meaningful difference in 8 measures of operational performance for community EDs experiencing optimized ED electronic health record implementation between a baseline and steady-state period. Copyright © 2014 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Evaluation of Pharmacist Impact on Culture Review Process for Patients Discharged From the Emergency Department.

PubMed

Santiago, Ruben D; Bazan, Jose A; Brown, Nicole V; Adkins, Eric J; Shirk, Mary Beth

2016-10-01

Background: Accurate and timely review of microbiological test results is a core component of antimicrobial stewardship. There is documented success of these programs in the inpatient setting; however, emergency department (ED) patients are typically not included in these initiatives. Objectives: To assess the impact of an emergency medicine pharmacist (EMP)-facilitated review process of positive microbiological test results from patients discharged from the ED as measured by time to positive result review and number of indicated interventions completed. Methods: This was a retrospective study that compared EMP-facilitated to ED charge nurse (CN)-facilitated physician review of randomly selected positive microbiological test results. Groups were compared concurrently within the time frame of July 1, 2012 through December 31, 2012. Results: One hundred seventy-eight positive microbiological test results were included (EMP, n = 91; CN, n = 87). The median (IQR) time to initial review was 3 (1.0-6.3) hours for the EMP and 2 (0.3-5.5) hours for the CN group ( p = .35). Four percent (1/25) of indicated interventions were not completed in the EMP group versus 47% (14/30) in the CN group ( p = .0004). Conclusion: An EMP was significantly less likely to miss an intervention when indicated with no difference in time to review of positive microbiological results. These findings support the role of the EMP in antimicrobial stewardship in the ED.

Assessing the impact of a radiology information management system in the emergency department

NASA Astrophysics Data System (ADS)

Redfern, Regina O.; Langlotz, Curtis P.; Lowe, Robert A.; Horii, Steven C.; Abbuhl, Stephanie B.; Kundel, Harold L.

1998-07-01

To evaluate a conventional radiology image management system, by investigating information accuracy, and information delivery. To discuss the customization of a picture archival and communication system (PACS), integrated radiology information system (RIS) and hospital information system (HIS) to a high volume emergency department (ED). Materials and Methods: Two data collection periods were completed. After the first data collection period, a change in work rules was implemented to improve the quality of data in the image headers. Data from the RIS, the ED information system, and the HIS as well as observed time motion data were collected for patients admitted to the ED. Data accuracy, patient waiting times, and radiology exam information delivery were compared. Results: The percentage of examinations scheduled in the RIS by the technologists increased from 0% (0 of 213) during the first period to 14% (44 of 317) during the second (p less than 0.001). The percentage of images missing identification numbers decreased from 36% (98 of 272) during the first data collection period to 10% (56 of 562) during the second period (p less than 0.001). Conclusions: Radiologic services in a high-volume ED, requiring rapid service, present important challenges to a PACS system. Strategies can be implemented to improve accuracy and completeness of the data in PACS image headers in such an environment.

Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses.

PubMed

Lin, Blossom Yen-Ju; Wan, Thomas T H; Hsu, Chung-Ping Cliff; Hung, Feng-Ru; Juan, Chi-Wen; Lin, Cheng-Chieh

2012-05-01

Given the limited studies on emergency care management, this study aimed to explore the relationships of emergency department (ED) culture values to certain dimensions of ED physicians' and nurses' work satisfaction and intent to leave. Four hundred and forty-two emergency medical professionals completed the employee satisfaction questionnaire across 119 hospital-based EDs, which had culture value evaluations filed, were used as unit of analysis in this study. Adjusting the personal and employment backgrounds, and the surrounded EDs' unit characteristics and environmental factors, multiple regression analyses revealed that clan and market cultures were related to emergency physicians' work satisfaction and intent to leave. On the other hand, adhocracy, market and hierarchical cultures were related to emergency nurses' work satisfaction. There do exist different patterns among various culture types on various work satisfaction dimensions and intent to leave of emergency physicians and nurses. The findings could offer hospital and ED leaders insights for changes or for building a better atmosphere to enhance the work life of emergency physicians and nurses.

The Role of Interpersonal Personality Traits and Reassurance Seeking in Eating Disorder Symptoms and Depressive Symptoms among Women with Bulimia Nervosa

PubMed Central

Mason, Tyler B.; Lavender, Jason M.; Wonderlich, Stephen A.; Crosby, Ross D.; Joiner, Thomas E.; Mitchell, James E.; Crow, Scott J.; Klein, Marjorie H.; Le Grange, Daniel; Bardone-Cone, Anna M.; Peterson, Carol B.

2017-01-01

Introduction The role of interpersonal factors has been proposed in various models of eating disorder (ED) psychopathology and treatment. We examined the independent and interactive contributions of two interpersonal-focused personality traits (i.e., social avoidance and insecure attachment) and reassurance seeking in relation to global ED psychopathology and depressive symptoms among women with bulimia nervosa (BN). Method Participants were 204 adult women with full or subclinical BN who completed a battery of self-report questionnaires. Hierarchical multiple OLS regressions including main effects and interaction terms were used to analyze the data. Results Main effects were found for social avoidance and insecure attachment in association with global ED psychopathology and depressive symptoms. In addition, two-way interactions between social avoidance and reassurance seeking were observed for both global ED psychopathology and depressive symptoms. In general, reassurance seeking strengthened the association between social avoidance and global ED psychopathology and depressive symptoms. Conclusion These results demonstrate the importance of reassurance seeking in psychopathology among women with BN who display personality features characterized by social avoidance. PMID:27234198

The role of interpersonal personality traits and reassurance seeking in eating disorder symptoms and depressive symptoms among women with bulimia nervosa.

PubMed

Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Joiner, Thomas E; Mitchell, James E; Crow, Scott J; Klein, Marjorie H; Le Grange, Daniel; Bardone-Cone, Anna M; Peterson, Carol B

2016-07-01

The role of interpersonal factors has been proposed in various models of eating disorder (ED) psychopathology and treatment. We examined the independent and interactive contributions of two interpersonal-focused personality traits (i.e., social avoidance and insecure attachment) and reassurance seeking in relation to global ED psychopathology and depressive symptoms among women with bulimia nervosa (BN). Participants were 204 adult women with full or subclinical BN who completed a battery of self-report questionnaires. Hierarchical multiple OLS regressions including main effects and interaction terms were used to analyze the data. Main effects were found for social avoidance and insecure attachment in association with global ED psychopathology and depressive symptoms. In addition, two-way interactions between social avoidance and reassurance seeking were observed for both global ED psychopathology and depressive symptoms. In general, reassurance seeking strengthened the association between social avoidance and global ED psychopathology and depressive symptoms. These results demonstrate the importance of reassurance seeking in psychopathology among women with BN who display personality features characterized by social avoidance. Copyright © 2016. Published by Elsevier Inc.

Normative data for female adolescents with eating disorders on the Children's Depression Inventory.

PubMed

Watson, Hunna J; Egan, Sarah J; Limburg, Karina; Hoiles, Kimberley J

2014-09-01

Given the importance of assessing depressive symptoms and suicidal ideation in adolescents with eating disorders (EDs), the aim was to provide normative data on the Children's Depression Inventory (CDI) for female adolescents presenting for treatment of an ED. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project registry (N = 1000), a prospective, ongoing registry study comprising consecutive pediatric tertiary ED referrals. Females (N = 256; 12-17 years) with DSM-5 EDs completed the CDI at intake. Results on the CDI revealed a pattern of increasing depressive scores with age and higher scores among patients with anorexic spectrum disorders. The prevalence of suicidal ideation was high and had the same pattern as CDI scores. The mean score on the CDI in the sample was higher than community samples and clinical samples of adolescents with post-traumatic stress disorder, obsessive compulsive disorder, and other clinical disorders. Females adolescents with EDs are at high-risk of depression and suicidal ideation. These data provide information about variation in CDI scores to guide clinicians in interpretation of scores. © 2014 Wiley Periodicals, Inc.

The impact of meal consumption on emotion among individuals with eating disorders.

PubMed

Anderson, Lisa M; Crow, Scott J; Peterson, Carol B

2014-01-01

This pilot study sought to determine how meal consumption impacts affective states for treatment-seeking individuals with eating disorders (ED). Participants with heterogeneous ED diagnoses completed the State-Trait Anxiety Inventory, Positive and Negative Affect Schedule, and Profile of Mood States measures before and immediately after meal consumption. Meal consumption was associated with significant decreases in negative affect and total mood disturbance for individuals with binge eating disorder (BED). Decreases in negative affect across meal time for individuals with BED were significantly different from increases in negative affect for participants with anorexia nervosa (AN) and bulimia nervosa (BN). Findings indicate that individuals with BED have significantly different affective responses to eating non-binge meals than individuals with AN or BN. Data suggest changes in negative affect following meal consumption may be specific to certain ED diagnoses. Results provide preliminary evidence consistent with the idea that emotion states may function as maintenance mechanisms for psychopathology among ED diagnoses. Limitations and future directions pertaining to food-mood relationships for individuals with ED are discussed.

Eating disorders: predictors of change in the quality of life of caregivers.

PubMed

Las Hayas, Carlota; Padierna, Jesús Ángel; Bilbao, Amaia; Martín, Josune; Muñoz, Pedro; Quintana, Jose María

2014-03-30

Eating disorders (EDs) have a strong impact on the quality of life (QoL) of caregivers. This study explores the longitudinal changes in the QoL of ED caregivers at 1 (T1; n=109) and 2 years (T2; n=32) follow-up, and identifies predictors of improvement at 1-year follow-up. ED outpatients also completed a battery of tests at T1 (n=69) and T2 (n=11). Multivariate hierarchical linear mixed models were used, in which the caregivers' 1-year changes in QoL, anxiety and depression scores were analysed as the dependent variables. Predictor variables were the caregivers' perception of burden, perception of the severity of the patient's ED, kinship data, and the ED person's scores on QoL, anxiety depression and ED symptoms. Higher scores in mental health and low perception of burden at baseline predicted improved caregiver QoL at 1-year follow-up. The caregivers' QoL improved if the perception of burden decreased over time and if depression of the patient improved. The results suggest that interventions directed to reduce the caregivers' perception of burden and to improve the mental health of the ED patients would lead to improved caregiver QoL. The high attrition rate at T2 made prediction analyses unviable. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Losartan improves erectile dysfunction in diabetic patients: a clinical trial.

PubMed

Chen, Y; Cui, S; Lin, H; Xu, Z; Zhu, W; Shi, L; Yang, R; Wang, R; Dai, Y

2012-01-01

The activation of cavernous local renin-angiotensin system has an important role in pathogenesis of diabetic erectile dysfunction (ED). In our primary study, we found that angiotensin Type 1 receptor blocker improved the erectile function of diabetic rats. Therefore we explored the losartan in clinical treatment for diabetic patients suffering with ED. A total of 124 diabetic patients with ED were included in this study and treated with losartan or tadalafil or losartan plus tadalafil or watch for waiting as control for 12 weeks. Erectile function was assessed by International Index of Erectile Function (IIEF-5) questionnaire, the percentage of positive responses to sexual encounter profile questions 2 (SEP2), 3 (SEP3) and the global assessment question (GAQ). Losartan or tadalafil or losartan plus tadalafil significantly improved the mean IIEF-5 scores, the percentage of successful penetrations (SEP2), the successful intercourse completions (SEP3) and GAQ (P<0.05). The combination of losartan and tadalafil is more effective than the single-use of losartan or tadalafil (P<0.05). The patients with moderate and mild ED had better response rates to losartan than patients with severe ED. This is the first clinical trial in losartan therapy on diabetic patients suffering from ED. Losartan seems to be effective and well-tolerated in diabetic ED patients, especially for mild to moderate ones. The combination therapy of losartan and tadalafil appeared to be more effective than monotherapy.

Allicin Alleviates Reticuloendotheliosis Virus-Induced Immunosuppression via ERK/Mitogen-Activated Protein Kinase Pathway in Specific Pathogen-Free Chickens

PubMed Central

Wang, Liyuan; Jiao, Hongchao; Zhao, Jingpeng; Wang, Xiaojuan; Sun, Shuhong; Lin, Hai

2017-01-01

Reticuloendotheliosis virus (REV), a gammaretrovirus in the Retroviridae family, causes an immunosuppressive, oncogenic, and runting–stunting syndrome in multiple avian hosts. Allicin, the main effective component of garlic, has a broad spectrum of pharmacological properties. The hypothesis that allicin could relieve REV-induced immune dysfunction was investigated in vivo and in vitro in the present study. The results showed that dietary allicin supplementation ameliorated REV-induced dysplasia and immune dysfunction in REV-infected chickens. Compared with the control groups, REV infection promoted the expression of inflammatory cytokines including interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α (TNF-α), whereas, allicin reversed these changes induced by REV infection. The decreased levels of IFN-α, IFN-β, and IL-2 were observed in REV-infected chickens, which were significantly improved by allicin. Allicin suppressed the REV-induced high expression of toll-like receptors (TLRs) as well as melanoma differentiation-associated gene 5 (MDA5) and the activation of mitogen-activated protein kinase (MAPK) and the nuclear factor kappa B p65. REV stimulated the phosphorylation of JNK, ERK, and p38, the downstream key signaling molecules of MAPK pathway, while allicin retarded the augmented phosphorylation level induced by REV infection. The decreased phosphorylation level of ERK was associated with REV replication, suggesting that ERK signaling is involved in REV replication, and allicin can alleviate the REV-induced immune dysfunction by inhibiting the activation of ERK. In addition, REV infection induced oxidative damage in thymus and spleen, whereas allicin treatment significantly decreased the oxidative stress induced by REV infection, suggesting that the antioxidant effect of allicin should be at least partially responsible for the harmful effect of REV infection. In conclusion, the findings suggest that allicin alleviates the inflammation and oxidative damage caused by REV infection and exerts the potential anti-REV effect by blocking the ERK/MAPK pathway. PMID:29312337

Specificity in the immunosuppression induced by avian reticuloendotheliosis virus.

PubMed Central

Walker, M H; Rup, B J; Rubin, A S; Bose, H R

1983-01-01

Several parameters of the cellular and humoral immune responses of chickens infected with reticuloendotheliosis virus (REV-T), an avian defective acute leukemia virus, or with its helper virus, reticuloendotheliosis-associated virus (REV-A), were evaluated. Spleen cells from chickens infected with REV-T (REV-A) or REV-A exhibited depressed mixed lymphocyte and mitogen responses in vitro. Allograft rejection was delayed by 6 to 14 days in birds infected with REV-A. The specific antitumor cell immune response was also studied by a 51Cr-release cytotoxicity assay. Lymphocytes from chickens infected with low numbers of the REV-T-transformed cells exhibited significant levels of cytolytic reactivity against the 51Cr-labeled REV-T tumor cells in vitro. The mitogen response of lymphocytes from these injected birds was similar to that of uninjected chickens. In contrast, lymphocytes from chickens injected with higher numbers of REV-T-transformed cells exhibited suppressed mitogen reactivity and failed to develop detectable levels of cytotoxic activity directed against the REV-T tumor cells. These results suggest that the general depression of cellular immune competence which occurs during REV-T (REV-A) infection could contribute to the development of this acute leukemia by inhibiting the proliferation of cytotoxic cells directed against the tumor cell antigens. The cytotoxic effect observed after the injection of chickens with non-immunosuppressive levels of REV-T-transformed cells appears to be specific for the REV-T tumor cell antigens since cells transformed by Marek's disease virus or avian erythroblastosis virus were not lysed. In marked contrast, birds whose cellular immune responses were suppressed by infection with REV-A were capable of producing a humoral immune response to viral antigens. Detectable levels of viral antibody, however, did not appear until 12 to 15 days after REV-A infection. Since REV-T (REV-A) induced an acute leukemia resulting in death within 7 to 14 days, it appears unlikely that the ability of chickens to make antiviral antibody influences the development of lethal reticuloendotheliosis. Images PMID:6187691

Cigarette Smoking and Erectile Dysfunction: Focus on NO Bioavailability and ROS Generation

PubMed Central

Tostes, Rita C.; Carneiro, Fernando S.; Lee, Anthony J.; Giachini, Fernanda R.C.; Leite, Romulo; Osawa, Yoichi; Webb, R. Clinton

2010-01-01

Introduction Thirty million men in the United States suffer from erectile dysfunction (ED) and this number is expected to double by 2025. Considered a major public health problem, which seriously affects the quality of life of patients and their partners, ED becomes increasingly prevalent with age and chronic smoking is a major risk factor in the development of ED. Aim To review available evidence concerning the effects of cigarette smoking on vascular changes associated with decreased nitric oxide (NO) bioavailability and increased reactive oxygen species (ROS) generation. Methods We examined epidemiological and clinical data linking cigarette smoking and ED, and the effects of smoking on vascular NO bioavailability and ROS generation. Main Outcome Measures There are strong parallels between smoking and ED and considerable evidence supporting the concept that smoking-related ED is associated with reduced bioavailability of NO because of increased ROS. Results Cigarette smoking-induced ED in human and animal models is associated with impaired arterial flow to the penis or acute vasospasm of the penile arteries. Long-term smoking produces detrimental effects on the vascular endothelium and peripheral nerves and also causes ultrastructural damage to the corporal tissue, all considered to play a role in chronic smoking-induced ED. Clinical and basic science studies provide strong indirect evidence that smoking may affect penile erection by the impairment of endothelium-dependent smooth muscle relaxation or more specifically by affecting NO production via increased ROS generation. Whether nicotine or other products of cigarette smoke mediate all effects related to vascular damage is still unknown. Conclusions Smoking prevention represents an important approach for reducing the risk of ED. The characterization of the components of cigarette smoke leading to ED and the mechanisms by which these components alter signaling pathways activated in erectile responses are necessary for a complete comprehension of cigarette smoking-associated ED. PMID:18331273

Alcohol Mixed with Energy Drink Use as an Event-Level Predictor of Physical and Verbal Aggression in Bar Conflicts.

PubMed

Miller, Kathleen E; Quigley, Brian M; Eliseo-Arras, Rebecca K; Ball, Natalie J

2016-01-01

Young adult use of alcohol mixed with caffeinated energy drinks (AmEDs) has been globally linked with increased odds of interpersonal aggression, compared with the use of alcohol alone. However, no prior research has linked these behaviors at the event level in bar drinking situations. The present study assessed whether AmED use is associated with the perpetration of verbal and physical aggression in bar conflicts at the event level. In Fall 2014, a community sample of 175 young adult AmED users (55% female) completed a web survey describing a recent conflict experienced while drinking in a bar. Use of both AmED and non-AmED alcoholic drinks in the incident were assessed, allowing calculation of our main predictor variable, the proportion of AmEDs consumed (AmED/total drinks consumed). To measure perpetration of aggression, participants reported on the occurrence of 6 verbal and 6 physical acts during the bar conflict incident. Linear regression analyses showed that the proportion of AmEDs consumed predicted scores for perpetration of both verbal aggression (β = 0.16, p < 0.05) and physical aggression (β = 0.19, p < 0.01) after controlling for gender, age, sensation-seeking and aggressive personality traits, aggressive alcohol expectancies, aggressogenic physical and social bar environments, and total number of drinks. Results of this study suggest that in alcohol-related bar conflicts, higher levels of young adult AmED use are associated with higher levels of aggression perpetration than alcohol use alone and that the elevated risk is not attributable to individual differences between AmED users and nonusers or to contextual differences in bar drinking settings. While future research is needed to identify motivations, dosages, and sequencing issues associated with AmED use, these beverages should be considered a potential risk factor in the escalation of aggressive bar conflicts. Copyright © 2016 by the Research Society on Alcoholism.

Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.

PubMed

Martins, Fernando Gonini; Abdo, Carmita Helena Najjar

2010-06-01

Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition. Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old. Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student's t-test and logistic regression analyses. The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question. Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men's self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem. Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects' young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young population.

[Construction of Rev-erbβ gene knockout HEK293 cell line with CRISPR/Cas9 system].

PubMed

Chen, Fang; Zhang, Weifeng; Zhao, Junli; Yang, Peiyan; Ma, Rui; Xia, Haibin

2016-11-01

Objective To prepare Rev-erbβ knockout HEK293 cells using clustered regularly interspaced short palindromic repeats/Cas 9 nuclease (CRISPR/Cas9) gene editing technology. Methods The knock-in or knockout of Rev-erbβ gene could be realized by single-guide RNA (sgRNA)-mediated Cas9 cutting of target DNA, and followed by DNA homologous recombination or non-homologous end joining-mediated DNA repair. Firstly, four sgRNAs were designed for Rev-erbβ gene. The sgRNA1 and sgRNA2 with the higher activity were respectively used to construct pCMV-hCas9-U6-Rev-erbβ sgRNA1 and pCMV-hCas9-U6-Rev-erbβ sgRNA2. Then, pCMV-hCas9-U6-Rev-erbβ sgRNA1, pCMV-hCas9-U6-Rev-erbβ sgRNA2 and pAd5-E1/hRev-erbβ donor plasmid vectors were co-transfected into HEK293 cells. Through drug screening, cloning and sequencing, the Rev-erbβ gene-knockout HEK293 (Rev-erbβ -/- ) cell lines were obtained with one chain integrated with exogenous gene fragment and the other chain for deletion mutants. Finally, the HEK293 (Rev-erbβ -/- ) cell lines (C3-6) was detected with real-time quantitative PCR and Western blotting. Results Expression of Rev-erbβ mRNA and protein was undetectable in HEK293 Rev-erbβ -/- cell line. Conclusion Using CRISPR/Cas9 technology, the HEK293 Rev-erbβ -/- cell line has been successfully constructed, which would provide an effective tool for the study on the function of Rev-erbβ.

The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder.

PubMed

Robinson, Paul; Hellier, Jennifer; Barrett, Barbara; Barzdaitiene, Daiva; Bateman, Anthony; Bogaardt, Alexandra; Clare, Ajay; Somers, Nadia; O'Callaghan, Aine; Goldsmith, Kimberley; Kern, Nikola; Schmidt, Ulrike; Morando, Sara; Ouellet-Courtois, Catherine; Roberts, Alice; Skårderud, Finn; Fonagy, Peter

2016-11-17

In this multi-centre randomized controlled trial (RCT) we compared modified mentalisation-based treatment (MBT-ED) to specialist supportive clinical management (SSCM-ED) in patients with eating disorders (EDs) and borderline personality disorder symptoms (BPD). This group of patients presents complex challenges to clinical services, and a treatment which addresses their multiple problems has the potential to improve outcome. MBT has been shown to be effective in improving outcome in patients with BPD, but its use has not been reported in ED. Sixty-eight eligible participants were randomised to MBT-ED or SSCM-ED. The primary outcome measure was the global score on the Eating Disorder Examination. Secondary outcomes included measures of BPD symptoms (the Zanarini Rating Scale for Borderline Personality Disorder), general psychiatric state, quality of life and service utilisation. Participants were assessed at baseline and at 6, 12 and 18 months after randomisation. Analysis was performed using linear mixed models. Only 15 participants (22 %) completed the 18 month follow-up. Early drop-out occurred significantly more in the SSCM-ED group. Drop-out did not vary with treatment model later in therapy and was sometimes attributed to participants moving away. There was higher drop--out amongst smokers and those with higher neuroticism scores. 47.1 % of participants in the MBT-ED arm and 37.1 % in the SSCM-ED arm attended at least 50 % of therapy sessions offered. Amongst those remaining in the trial, at 12 and 18 months MBT-ED was associated with a greater reduction in Shape Concern and Weight Concern in the Eating Disorder Examination compared to SSCM-ED. At 6, 12 and 18 months there was a decline of ED and BPD symptoms in both groups combined. Ten participants were reported as having had adverse events during the trial, mostly self-harm, and there was one death, attributed as 'unexplained' by the coroner. The high drop-out rate made interpretation of the results difficult. Greater involvement of research staff in clinical management might have improved compliance with both therapy and research assessment. MBT-ED may have had an impact on core body image psychopathology. Current Controlled Trials: ISRCTN51304415 . Registered on 19 April 2011.

Integrability of Spinning Particle Motion in Higher-Dimensional Rotating Black Hole Spacetimes

NASA Astrophysics Data System (ADS)

Kubizňák, David; Cariglia, Marco

2012-02-01

We study the motion of a classical spinning particle (with spin degrees of freedom described by a vector of Grassmann variables) in higher-dimensional general rotating black hole spacetimes with a cosmological constant. In all dimensions n we exhibit n bosonic functionally independent integrals of spinning particle motion, corresponding to explicit and hidden symmetries generated from the principal conformal Killing-Yano tensor. Moreover, we demonstrate that in 4-, 5-, 6-, and 7-dimensional black hole spacetimes such integrals are in involution, proving the bosonic part of the motion integrable. We conjecture that the same conclusion remains valid in all higher dimensions. Our result generalizes the result of Page et al. [Phys. Rev. Lett. 98, 061102 (2007)PRLTAO0031-900710.1103/PhysRevLett.98.061102] on complete integrability of geodesic motion in these spacetimes.

Clinician Perceptions of Teamwork in the Emergency Department: Does Nurse and Medical Provider Workspace Placement Make a Difference?

PubMed

Weaver, Amy L; Hernandez, Susan; Olson, Daiwai M

2017-01-01

This study was intended to determine whether positioning emergency department (ED) physicians, physician assistants, and nurse practitioners at the same workstations as registered nurses (RNs) improved communication and teamwork. Historically in this organization, providers and staff had separate physical locations (workstations). Construction of a new ED provided the opportunity to redesign the physical layout and to study whether a new design improved the perception of communication and teamwork among medical providers. A prospective, self-administered presurvey-postsurvey using the TeamSTEPPS Teamwork Perceptions Questionnaire (TPQ) was completed at 2 medical centers with the same staff premove and postmove but different ED designs. The presurvey was conducted while the staff were at the older facility with a more linear floor design and separated nurse and physician stations. The postsurvey was conducted 3 months after employees and physicians were relocated to a new hospital with a pod design and communal workstations in the ED. Forty-six staff members completed both the presurvey and the postsurvey. There was a statistically significant improvement in the total TPQ scores (P = .0009) and 4 of the 5 components of the TPQ: team structure (P = .0283), situation monitoring (P = .0006), mutual support (P < .0001), and communication (P < .0001). There was no change in the leadership component (P = .4519). Adopting a more communal physical layout was associated with improved overall TPQ scores and most of the TPQ components. The lack of change in the leadership component was explained by the lack of change in leadership structure. The physical placement of medical providers and RNs in an ED is important and can increase the perception of communication and teamwork and thereby improve patient outcomes.

A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study.

PubMed

April, Michael D; Schauer, Steven G; Brown Rd, Calvin A; Ng, Patrick C; Fernandez, Jessie; Fantegrossi, Andrea E; Maddry, Joseph K; Summers, Shane; Sessions, Daniel J; Barnwell, Robert M; Antonacci, Mark

2017-01-01

Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

Bullying and Suicide Risk Among Pediatric Emergency Department Patients.

PubMed

Stanley, Ian H; Horowitz, Lisa M; Bridge, Jeffrey A; Wharff, Elizabeth A; Pao, Maryland; Teach, Stephen J

2016-06-01

This study aimed to describe the association between recent bullying victimization and risk of suicide among pediatric emergency department (ED) patients. Patients presenting to 1 of 3 different urban pediatric EDs with either medical/surgical or psychiatric chief complaints completed structured interviews as part of a study to develop a suicide risk screening instrument, the Ask Suicide-Screening Questions. Seventeen candidate items and the criterion reference Suicidal Ideation Questionnaire were administered to patients ages 10 to 21 years. Bullying victimization was assessed by a single candidate item ("In the past few weeks, have you been bullied or picked on so much that you felt like you couldn't stand it anymore?"). A total of 524 patients completed the interview (34.4% psychiatric chief complaints; 56.9% female; 50.4% white, non-Hispanic; mean [SD] age, 15.2 [2.6] years). Sixty patients (11.5%) reported recent bullying victimization, and of these, 33 (55.0%) screened positive for suicide risk on the Ask Suicide-Screening Questions or the previously validated Suicidal Ideation Questionnaire. After controlling for demographic and clinical variables, including a history of depression and drug use, the odds of screening positive for suicide risk were significantly greater in patients who reported recent bullying victimization (adjusted odds ratio, 3.19; 95% confidence interval, 1.66-6.11). After stratification by chief complaint, this association persisted for medical/surgical patients but not for psychiatric patients. Recent bullying victimization was associated with increased odds of screening positive for elevated suicide risk among pediatric ED patients presenting with medical/surgical complaints. Understanding this important correlate of suicide risk in pediatric ED patients may help inform ED-based suicide prevention interventions.

Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise.

PubMed

Cunningham, Hayley E; Pearman, Silas; Brewerton, Timothy D

2016-08-01

There is disagreement about the conceptualization and measurement of pathological exercise (PE). This study seeks to elucidate the nature of this phenomenon as addictive or compulsive in its primary and secondary forms. 1,497 adults (608 men, 885 women, 4 other) completed a set of validated surveys, including the Godin Leisure-Time Exercise Questionnaire, the Exercise Dependence Scale-21, the Exercise Addiction Inventory, the Compulsive Exercise Test (CET), the Obligatory Exercise Questionnaire, the Commitment to Exercise Scale, and an exercise specific adaptation of the Dimensional Obsessive-Compulsive Scale (ESDOCS). Participants completed the Eating Disorders Examination Questionnaire, and DSM-5 eating disorder (ED) diagnoses were determined according to published guidelines. Pearson correlation coefficients, independent samples t-tests, χ(2) tests, 1-way ANOVA's, and ANCOVA's were calculated. All PE measures correlated highly with one another (P < 0.001). Participants with EDs scored higher on all measures than those without (P < 0.001), and those with bulimia nervosa had the highest scores. Participants with PE and an accompanying ED (secondary PE) scored higher than those with PE and no ED symptoms (primary ED) on the CET (P < 0.002) and ESDOCS (P < 0.003). Correlations between EDE-Q and PE scores were stronger among women than men. PE prevalence was 6.4% (1.4% primary PE, 5.0% secondary PE) in our heterogeneous sample. Secondary PE appears to be more compulsive while primary PE is more addictive in nature. Men and women are equally at risk for PE, but in men it is more often primary and addictive and in women it is more often secondary and compulsive. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:778-792). © 2016 Wiley Periodicals, Inc.

Erectile dysfunction and phosphodiesterase type 5 inhibitor use: associations with sexual activities, function and satisfaction in a population sample of older men.

PubMed

Lee, D M; Nazroo, J; Pendleton, N

2015-07-01

The objective of this study was to examine the association between sexual activities, problems and satisfaction, and ED and PDE5 inhibitor (PDE5i) use. A nationally representative sample of men (n=2612) aged 51-87 years from the English Longitudinal Study of Ageing completed an in-depth Sexual Relationships and Activities Questionnaire. Associations between ED and/or PDE5i use and sexual outcomes were explored using logistic regression models adjusted for age, health and lifestyle factors. PDE5i use in the preceding 3 months was reported by a total of 191 (7%) men, whereas 542 (21%) reported ED but no PDE5i use (untreated ED). Compared with men without ED, PDE5i users were more likely to be sexually active and report more frequent sexual intercourse. Men with untreated ED reported the lowest frequency of sexual activities. Compared with men without ED, both PDE5i users and those with untreated ED were more likely to report being concerned about their level of sexual desire, frequency of sexual activities, erectile function, waking erections and orgasmic experience. PDE5i users were also more concerned about and dissatisfied with their overall sex life than men without ED. This population-based study shows that while PDE5i use is associated with improved sexual functioning, this is not equally reflected in decreased levels of concern and dissatisfaction with their overall sexual health. Clinicians should be aware of this disparity between functional gains and continuing sexual concerns and dissatisfaction, and, where appropriate, offer psychosexual counselling as an adjunct to PDE5i medication.

Preliminary program evaluation of emergency department HIV prevention counseling.

PubMed

Sitlinger, Andrea P; Lindsell, Christopher J; Ruffner, Andrew H; Wayne, D Beth; Hart, Kimberly W; Trott, Alexander T; Fichtenbaum, Carl J; Lyons, Michael S

2011-07-01

Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit. Copyright © 2011. Published by Mosby, Inc.

Circadian clock component REV-ERBα controls homeostatic regulation of pulmonary inflammation.

PubMed

Pariollaud, Marie; Gibbs, Julie E; Hopwood, Thomas W; Brown, Sheila; Begley, Nicola; Vonslow, Ryan; Poolman, Toryn; Guo, Baoqiang; Saer, Ben; Jones, D Heulyn; Tellam, James P; Bresciani, Stefano; Tomkinson, Nicholas Co; Wojno-Picon, Justyna; Cooper, Anthony Wj; Daniels, Dion A; Trump, Ryan P; Grant, Daniel; Zuercher, William; Willson, Timothy M; MacDonald, Andrew S; Bolognese, Brian; Podolin, Patricia L; Sanchez, Yolanda; Loudon, Andrew Si; Ray, David W

2018-06-01

Recent studies reveal that airway epithelial cells are critical pulmonary circadian pacemaker cells, mediating rhythmic inflammatory responses. Using mouse models, we now identify the rhythmic circadian repressor REV-ERBα as essential to the mechanism coupling the pulmonary clock to innate immunity, involving both myeloid and bronchial epithelial cells in temporal gating and determining amplitude of response to inhaled endotoxin. Dual mutation of REV-ERBα and its paralog REV-ERBβ in bronchial epithelia further augmented inflammatory responses and chemokine activation, but also initiated a basal inflammatory state, revealing a critical homeostatic role for REV-ERB proteins in the suppression of the endogenous proinflammatory mechanism in unchallenged cells. However, REV-ERBα plays the dominant role, as deletion of REV-ERBβ alone had no impact on inflammatory responses. In turn, inflammatory challenges cause striking changes in stability and degradation of REV-ERBα protein, driven by SUMOylation and ubiquitination. We developed a novel selective oxazole-based inverse agonist of REV-ERB, which protects REV-ERBα protein from degradation, and used this to reveal how proinflammatory cytokines trigger rapid degradation of REV-ERBα in the elaboration of an inflammatory response. Thus, dynamic changes in stability of REV-ERBα protein couple the core clock to innate immunity.

Eldecalcitol improves chair-rising time in postmenopausal osteoporotic women treated with bisphosphonates

PubMed Central

Iwamoto, Jun; Sato, Yoshihiro

2014-01-01

An open-label randomized controlled trial was conducted to clarify the effect of eldecalcitol (ED) on body balance and muscle power in postmenopausal osteoporotic women treated with bisphosphonates. A total of 106 postmenopausal women with osteoporosis (mean age 70.8 years) were randomly divided into two groups (n=53 in each group): a bisphosphonate group (control group) and a bisphosphonate plus ED group (ED group). Biochemical markers, unipedal standing time (body balance), and five-repetition chair-rising time (muscle power) were evaluated. The duration of the study was 6 months. Ninety-six women who completed the trial were included in the subsequent analyses. At baseline, the age, body mass index, bone mass indices, bone turnover markers, unipedal standing time, and chair-rising time did not differ significantly between the two groups. During the 6-month treatment period, bone turnover markers decreased significantly from the baseline values similarly in the two groups. Although no significant improvement in the unipedal standing time was seen in the ED group, compared with the control group, the chair-rising time decreased significantly in the ED group compared with the control group. The present study showed that ED improved the chair-rising time in terms of muscle power in postmenopausal osteoporotic women treated with bisphosphonates. PMID:24476669

Operability test report for the in SITU vapor sampling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Corbett, J.E., Westinghouse Hanford

1996-05-31

This report documents the successful completion of testing for the In Situ Vapor Sampling (ISVS) system. The report includes the test procedure (WHC-SD-WM-OTP-196, Rev OA), data sheets, exception resolutions, and a test report summary. This report conforms to the guidelines established in WHC-IP-1026, `Engineering Practice Guidelines,` Appendix L, `Operability Test Procedures and Reports.`

Human REV3 DNA Polymerase Zeta Localizes to Mitochondria and Protects the Mitochondrial Genome.

PubMed

Singh, Bhupendra; Li, Xiurong; Owens, Kjerstin M; Vanniarajan, Ayyasamy; Liang, Ping; Singh, Keshav K

2015-01-01

To date, mitochondrial DNA polymerase γ (POLG) is the only polymerase known to be present in mammalian mitochondria. A dogma in the mitochondria field is that there is no other polymerase present in the mitochondria of mammalian cells. Here we demonstrate localization of REV3 DNA polymerase in the mammalian mitochondria. We demonstrate localization of REV3 in the mitochondria of mammalian tissue as well as cell lines. REV3 associates with POLG and mitochondrial DNA and protects the mitochondrial genome from DNA damage. Inactivation of Rev3 leads to reduced mitochondrial membrane potential, reduced OXPHOS activity, and increased glucose consumption. Conversely, inhibition of the OXPHOS increases expression of Rev3. Rev3 expression is increased in human primary breast tumors and breast cancer cell lines. Inactivation of Rev3 decreases cell migration and invasion, and localization of Rev3 in mitochondria increases survival and the invasive potential of cancer cells. Taken together, we demonstrate that REV3 functions in mammalian mitochondria and that mitochondrial REV3 is associated with the tumorigenic potential of cells.

Scaling analyses of the spectral dimension in 3-dimensional causal dynamical triangulations

NASA Astrophysics Data System (ADS)

Cooperman, Joshua H.

2018-05-01

The spectral dimension measures the dimensionality of a space as witnessed by a diffusing random walker. Within the causal dynamical triangulations approach to the quantization of gravity (Ambjørn et al 2000 Phys. Rev. Lett. 85 347, 2001 Nucl. Phys. B 610 347, 1998 Nucl. Phys. B 536 407), the spectral dimension exhibits novel scale-dependent dynamics: reducing towards a value near 2 on sufficiently small scales, matching closely the topological dimension on intermediate scales, and decaying in the presence of positive curvature on sufficiently large scales (Ambjørn et al 2005 Phys. Rev. Lett. 95 171301, Ambjørn et al 2005 Phys. Rev. D 72 064014, Benedetti and Henson 2009 Phys. Rev. D 80 124036, Cooperman 2014 Phys. Rev. D 90 124053, Cooperman et al 2017 Class. Quantum Grav. 34 115008, Coumbe and Jurkiewicz 2015 J. High Energy Phys. JHEP03(2015)151, Kommu 2012 Class. Quantum Grav. 29 105003). I report the first comprehensive scaling analysis of the small-to-intermediate scale spectral dimension for the test case of the causal dynamical triangulations of 3-dimensional Einstein gravity. I find that the spectral dimension scales trivially with the diffusion constant. I find that the spectral dimension is completely finite in the infinite volume limit, and I argue that its maximal value is exactly consistent with the topological dimension of 3 in this limit. I find that the spectral dimension reduces further towards a value near 2 as this case’s bare coupling approaches its phase transition, and I present evidence against the conjecture that the bare coupling simply sets the overall scale of the quantum geometry (Ambjørn et al 2001 Phys. Rev. D 64 044011). On the basis of these findings, I advance a tentative physical explanation for the dynamical reduction of the spectral dimension observed within causal dynamical triangulations: branched polymeric quantum geometry on sufficiently small scales. My analyses should facilitate attempts to employ the spectral dimension as a physical observable with which to delineate renormalization group trajectories in the hope of taking a continuum limit of causal dynamical triangulations at a nontrivial ultraviolet fixed point (Ambjørn et al 2016 Phys. Rev. D 93 104032, 2014 Class. Quantum Grav. 31 165003, Cooperman 2016 Gen. Relativ. Gravit. 48 1, Cooperman 2016 arXiv:1604.01798, Coumbe and Jurkiewicz 2015 J. High Energy Phys. JHEP03(2015)151).

Comprehensive Aeroelastic Analysis of Helicopter Rotor with Trailing-Edge Flap for Primary Control and Vibration Control

DTIC Science & Technology

2003-01-01

183 3.34 5/rev fixed system hub normal force with 4/rev open loop trailing-edge flap input...184 3.35 5/rev fixed system hub normal force with 5/rev open loop trailing-edge flap input...185 3.36 5/rev fixed system hub normal force with 6/rev open loop trailing-edge flap

Protocolized treatment is associated with decreased organ dysfunction in pediatric severe sepsis

PubMed Central

Balamuth, Fran; Weiss, Scott L.; Fitzgerald, Julie C.; Hayes, Katie; Centkowski, Sierra; Chilutti, Marianne; Grundmeier, Robert W.; Lavelle, Jane; Alpern, Elizabeth R.

2016-01-01

Objective To determine whether treatment with a protocolized sepsis guideline in the emergency department (ED) was associated with a lower burden of organ dysfunction (OD) by hospital day 2 compared to non-protocolized usual care in pediatric patients with severe sepsis. Design Retrospective cohort study Setting Tertiary care children’s hospital from January 1, 2012–March 31, 2014. Measurements and Main Results Subjects with international consensus defined severe sepsis and pediatric intensive care unit (PICU) admission within 24 hours of ED arrival were included. The exposure was the use of a protocolized ED sepsis guideline. The primary outcome was complete resolution of OD by hospital day 2. One hundred eighty nine subjects were identified during the study period. Of these, 121 (64%) were treated with the protocolized ED guideline and 68 were not. There were no significant differences between the groups in age, sex, race, number of comorbid conditions, ED triage level, or OD on arrival to the ED. Patients treated with protocolized ED care were more likely to be free of OD on hospital day 2 after controlling for sex, comorbid condition, indwelling central venous catheter, PIM-2 score, and timing of antibiotics and intravenous fluids (adjusted OR 4.2, 95% CI 1.7, 10.4). Conclusions Use of a protocolized ED sepsis guideline was independently associated with resolution of OD by hospital day 2 compared to non-protocolized usual care. These data indicate that morbidity outcomes in children can be improved with the use of protocolized care. PMID:27455114

Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway.

PubMed

Young, Victoria Solveig; Eggesbø, Heidi B; Gaarder, Christine; Næss, Pål Aksel; Enden, Tone

2017-07-01

To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. Nine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff. Plain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected. • Minimum acceptable care (MAC) should replace normal routines in mass casualty incidents. • MAC implied reduced use of imaging in the emergency department (ED). • CT in ED was restricted to suspected severe head injuries during MAC. • The radiologist should cancel all non-head CTs in the ED during MAC.

Gender confirming medical interventions and eating disorder symptoms among transgender individuals.

PubMed

Testa, Rylan J; Rider, G Nicole; Haug, Nancy A; Balsam, Kimberly F

2017-10-01

Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person's gender identity (e.g., using incorrect pronouns). Limited research suggests that gender-confirming medical interventions (GCMIs) may prevent or reduce EDS among transgender people. Participants included 154 transfeminine spectrum (TFS) and 288 transmasculine spectrum (TMS) individuals who completed the Trans Health Survey. Serial multiple mediation analyses controlling for age, education, and income were used to examine whether body satisfaction and nonaffirmation mediate any found relationships between various GCMIs (genital surgery, chest surgery, hormone use, hysterectomy, and hair removal) and EDS. For TFS individuals, the nonaffirmation to body satisfaction path mediated relationships between all GCMIs and EDS, although body satisfaction alone accounted for more of the indirect effects than this path for chest surgery. For TMS individuals, relationships between all GCMIs and EDS were mediated by the nonaffirmation to body satisfaction path. Findings support the hypothesis that GCMIs reduce experiences of nonaffirmation, which increases body satisfaction and thus decreases EDS. Among TFS participants, the relationship between chest surgery and lower levels of EDS was mediated most strongly by body satisfaction alone, suggesting that satisfaction with one's body may result in lower EDS even if affirmation from the external world is unchanged. Implications of these findings for intervention, policy, and legal efforts are discussed, and future research recommendations are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Oral phenotype and scoring of vascular Ehlers–Danlos syndrome: a case–control study

PubMed Central

Frank, Michael; Gogly, Bruno; Golmard, Lisa; Naveau, Adrien; Chérifi, Hafida; Emmerich, Joseph; Gaultier, Frédérick; Berdal, Ariane; Jeunemaitre, Xavier; Fournier, Benjamin P J

2012-01-01

Objective Vascular Ehlers–Danlos syndrome (vEDS) is a rare genetic condition related to mutations in the COL3A1 gene, responsible of vascular, digestive and uterine accidents. Difficulty of clinical diagnosis has led to the design of diagnostic criteria, summarised in the Villefranche classification. The goal was to assess oral features of vEDS. Gingival recession is the only oral sign recognised as a minor diagnostic criterion. The authors aimed to check this assumption since bibliographical search related to gingival recession in vEDS proved scarce. Design Prospective case–control study. Setting Dental surgery department in a French tertiary hospital. Participants 17 consecutive patients with genetically proven vEDS, aged 19–55 years, were compared with 46 age- and sex-matched controls. Observations Complete oral examination (clinical and radiological) with standardised assessment of periodontal structure, temporomandibular joint function and dental characteristics were performed. COL3A1 mutations were identified by direct sequencing of genomic or complementary DNA. Results Prevalence of gingival recession was low among patients with vEDS, as for periodontitis. Conversely, patients showed marked gingival fragility, temporomandibular disorders, dentin formation defects, molar root fusion and increased root length. After logistic regression, three variables remained significantly associated to vEDS. These variables were integrated in a diagnostic oral score with 87.5% and 97% sensitivity and specificity, respectively. Conclusions Gingival recession is an inappropriate diagnostic criterion for vEDS. Several new specific oral signs of the disease were identified, whose combination may be of greater value in diagnosing vEDS. PMID:22492385

Exploring the performance of the National Early Warning Score (NEWS) in a European emergency department.

PubMed

Alam, N; Vegting, I L; Houben, E; van Berkel, B; Vaughan, L; Kramer, M H H; Nanayakkara, P W B

2015-05-01

Several triage systems have been developed for use in the emergency department (ED), however they are not designed to detect deterioration in patients. Deteriorating patients may be at risk of going undetected during their ED stay and are therefore vulnerable to develop serious adverse events (SAEs). The national early warning score (NEWS) has a good ability to discriminate ward patients at risk of SAEs. The utility of NEWS had not yet been studied in an ED. To explore the performance of the NEWS in an ED with regard to predicting adverse outcomes. A prospective observational study. Patients Eligible patients were those presenting to the ED during the 6 week study period with an Emergency Severity Index (ESI) of 2 and 3 not triaged to the resuscitation room. NEWS was documented at three time points: on arrival (T0), hour after arrival (T1) and at transfer to the general ward/ICU (T2). The outcomes of interest were: hospital admission, ICU admission, length of stay and 30 day mortality. A total of 300 patients were assessed for eligibility. Complete data was able to be collected for 274 patients on arrival at the ED. NEWS was significantly correlated with patient outcomes, including 30 day mortality, hospital admission, and length of stay at all-time points. The NEWS measured at different time points was a good predictor of patient outcomes and can be of additional value in the ED to longitudinally monitor patients throughout their stay in the ED and in the hospital. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Emergency department provider preferences related to clinical practice guidelines for tobacco cessation: a multicenter survey.

PubMed

Walters, Elizabeth L; Reibling, Ellen T; Wilber, Scott T; Sullivan, Ashley F; Gaeta, Theodore J; Camargo, Carlos A; Boudreaux, Edwin D

2014-07-01

The objective was to assess current emergency department (ED) provider practices and preferences for tobacco cessation interventions. The ED is an opportune place to initiate smoking cessation interventions. However, little is known about ED provider current practices and preferences for cessation counseling in the ED. This was a survey of ED providers conducted in 2008-2009 (including physicians, nurse practitioners, physician assistants, and nurses), working at least half-time at 10 U.S. academic EDs, regarding adherence to clinical practice guidelines ("5 As") and preferences for cessation interventions/styles. Data analysis occurred in 2012-2013. The response rate was 64% (800 out of 1,246 completed surveys). Providers reported strongest adherence to asking about patient smoking status, followed by advising, with significant variance by clinical role. Assessing, assisting, and arranging support for patients was low overall. Most frequently used interventions were to provide patients with a list of telephone numbers for stop-smoking counseling (87%), pamphlets on smoking health risks and the benefits of stopping (85%), and referrals to the National Toll-Free Smoker's Quitline (84%). Most providers (80%) were supportive of personally conducting brief (less than 3 minutes) smoking cessation counseling sessions during the ED visit, emphasizing education and encouragement. The least appealing intervention was writing a prescription for nicotine replacement therapies or medications to stop smoking (35%). Interventions most likely to be used were brief and delivered with a positive tone and included referral to external resources. The logical next step is to design and test interventions that ED providers find acceptable. © 2014 by the Society for Academic Emergency Medicine.

Low-acuity presentations to regional emergency departments: What is the issue?

PubMed

Cheek, Colleen; Allen, Penny; Shires, Lizzi; Parry, Denise; Ruigrok, Marielle

2016-04-01

To explore GP-referrals and self-referrals to EDs and factors associated with patients seeking low-acuity care at ED. Retrospective analysis of all ED presentations to Mersey Community Hospital and North West Regional Hospital (Tasmania) between 1 January 2009 and 31 December 2013. Cross-sectional survey of patients presenting to the EDs for care triaged as low-acuity. There were 255,365 ED presentations in the retrospective data: 11,252 (4.4%) GP-referrals and 218,205 (85.4%) self-referrals. At ED 49% of GP-referrals were triaged ATS 4 or 5 and 35% of self-referrals were triaged ATS 1-3. There were 138 (84.2%) low-acuity patients who completed the survey; predominantly, all attended for acute injury or illness. Single point-of-care convenience was most commonly selected (71%) as a reason for attending ED. Over 85% of patients who seek emergency care in this region self-refer, so understanding health-seeking behaviour is important. Most low-acuity patients are acutely injured or unwell, and the decision to go to ED is based on their perception of accessibility of expertise aligned with their need. The term 'GP-type' is misleading in this context and should not be used. Providing low-acuity care in parallel with providing a specialised emergency service meets the needs of the local community and is likely to be the lowest cost model in a regional and rural area. Funding models must reflect the actual cost of delivering this important service rather than presentation types. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

A Brief Interview to Detect Panic Attacks and Panic Disorder in Emergency Department Patients with Cardiopulmonary Complaints.

PubMed

Sung, Sharon C; Rush, A John; Earnest, Arul; Lim, Leslie E C; Pek, Maeve P P; Choi, Joen M F; Ng, Magdalene P K; Ong, Marcus E H

2018-01-01

Patients with panic-related anxiety often initially present to the emergency department (ED) complaining of respiratory or cardiac symptoms, but rates of detection of panic symptoms by ED physicians remain low. This study was undertaken to evaluate the relevance of panic attacks and panic disorder in ED patients who present with cardiopulmonary symptoms and to determine whether a brief symptom-based tool could be constructed to assist in rapid recognition of panic-related anxiety in the ED setting. English-speaking adult ED patients with a chief complaint of palpitations, chest pain, dizziness, or difficulty breathing were evaluated for the presence of panic attacks and panic disorder with the Structured Clinical Interview for DSM-IV Axis I Disorders. Participants completed self-report measures to assess panic-related symptoms, comorbid psychiatric conditions, health-related disability, and health service use. In this sample (N=200), 23.5% had panic attacks and 23.0% had panic disorder. Both groups reported higher rates of panic attack symptoms, greater psychiatric comorbidity, greater health-related disability, and higher rates of ED and mental health service use compared with those without either condition. A brief 7-item tool consisting of panic symptoms identified patients with panic attacks or panic disorder with 85% accuracy (area under the curve=0.90, sensitivity=82%, specificity=88%). Patients with panic attacks or panic disorder commonly present to the ED, but often go unrecognized. A brief 7-item clinician rating scale accurately identifies these patients among those ED patients presenting with cardiopulmonary complaints.

Shear viscosity of a two-dimensional emulsion of drops using a multiple-relaxation-time-step lattice Boltzmann method

NASA Astrophysics Data System (ADS)

Halliday, I.; Xu, X.; Burgin, K.

2017-02-01

An extended Benzi-Dellar lattice Boltzmann equation scheme [R. Benzi, S. Succi, and M. Vergassola, Europhys. Lett. 13, 727 (1990), 10.1209/0295-5075/13/8/010; R. Benzi, S. Succi, and M. Vergassola, Phys. Rep. 222, 145 (1992), 10.1016/0370-1573(92)90090-M; P. J. Dellar, Phys. Rev. E 65, 036309 (2002), 10.1103/PhysRevE.65.036309] is developed and applied to the problem of confirming, at low Re and drop fluid concentration, c , the variation of effective shear viscosity, ηeff=η1[1 +f (η1,η2) c ] , with respect to c for a sheared, two-dimensional, initially crystalline emulsion [here η1 (η2) is the fluid (drop fluid) shear viscosity]. Data obtained with our enhanced multicomponent lattice Boltzmann method, using average shear stress and hydrodynamic dissipation, agree well once appropriate corrections to Landau's volume average shear stress [L. Landau and E. M. Lifshitz, Fluid Mechanics, 6th ed. (Pergamon, London, 1966)] are applied. Simulation results also confirm the expected form for f (ηi,η2) , and they provide a reasonable estimate of its parameters. Most significantly, perhaps, the generality of our data supports the validity of Taylor's disputed simplification [G. I. Taylor, Proc. R. Soc. London, Ser. A 138, 133 (1932), 10.1098/rspa.1932.0175] to reduce the effect of one hydrodynamic boundary condition (on the continuity of the normal contraction of stress) to an assumption that interfacial tension is sufficiently strong to maintain a spherical drop shape.

Compact pulse forming line using barium titanate ceramic material

NASA Astrophysics Data System (ADS)

Kumar Sharma, Surender; Deb, P.; Shukla, R.; Prabaharan, T.; Shyam, A.

2011-11-01

Ceramic material has very high relative permittivity, so compact pulse forming line can be made using these materials. Barium titanate (BaTiO3) has a relative permittivity of 1200 so it is used for making compact pulse forming line (PFL). Barium titanate also has piezoelectric effects so it cracks during high voltages discharges due to stresses developed in it. Barium titanate is mixed with rubber which absorbs the piezoelectric stresses when the PFL is charged and regain its original shape after the discharge. A composite mixture of barium titanate with the neoprene rubber is prepared. The relative permittivity of the composite mixture is measured to be 85. A coaxial pulse forming line of inner diameter 120 mm, outer diameter 240 mm, and length 350 mm is made and the composite mixture of barium titanate and neoprene rubber is filled between the inner and outer cylinders. The PFL is charged up to 120 kV and discharged into 5 Ω load. The voltage pulse of 70 kV, 21 ns is measured across the load. The conventional PFL is made up of oil or plastics dielectrics with the relative permittivity of 2-10 [D. R. Linde, CRC Handbook of Chemistry and Physics, 90th ed. (CRC, 2009); Xia et al., Rev. Sci. Instrum. 79, 086113 (2008); Yang et al., Rev. Sci. Instrum. 81, 43303 (2010)], which increases the length of PFL. We have reported the compactness in length achieved due to increase in relative permittivity of composite mixture by adding barium titanate in neoprene rubber.

Trends in Community College Enrollment and Completion Data, 2015

ERIC Educational Resources Information Center

Juszkiewicz, Jolanta

2015-01-01

This is the second of a series of reports on trends in national community college enrollments. National community college enrollments continue to decrease, with variations at the state and local levels. The report also examines completion rates published by the U.S. Department of Education (ED) based on institutional level reporting, and those…

A HIV-1 Tat mutant protein disrupts HIV-1 Rev function by targeting the DEAD-box RNA helicase DDX1.

PubMed

Lin, Min-Hsuan; Sivakumaran, Haran; Jones, Alun; Li, Dongsheng; Harper, Callista; Wei, Ting; Jin, Hongping; Rustanti, Lina; Meunier, Frederic A; Spann, Kirsten; Harrich, David

2014-12-14

Previously we described a transdominant negative mutant of the HIV-1 Tat protein, termed Nullbasic, that downregulated the steady state levels of unspliced and singly spliced viral mRNA, an activity caused by inhibition of HIV-1 Rev activity. Nullbasic also altered the subcellular localizations of Rev and other cellular proteins, including CRM1, B23 and C23 in a Rev-dependent manner, suggesting that Nullbasic may disrupt Rev function and trafficking by intervening with an unidentified component of the Rev nucleocytoplasmic transport complex. To seek a possible mechanism that could explain how Nullbasic inhibits Rev activity, we used a proteomics approach to identify host cellular proteins that interact with Nullbasic. Forty-six Nullbasic-binding proteins were identified by mass spectrometry including the DEAD-box RNA helicase, DDX1. To determine the effect of DDX1 on Nullbasic-mediated Rev activity, we performed cell-based immunoprecipitation assays, Rev reporter assays and bio-layer interferometry (BLI) assays. Interaction between DDX1 and Nullbasic was observed by co-immunoprecipitation of Nullbasic with endogenous DDX1 from cell lysates. BLI assays showed a direct interaction between Nullbasic and DDX1. Nullbasic affected DDX1 subcellular distribution in a Rev-independent manner. Interestingly overexpression of DDX1 in cells not only restored Rev-dependent mRNA export and gene expression in a Rev reporter assay but also partly reversed Nullbasic-induced Rev subcellular mislocalization. Moreover, HIV-1 wild type Tat co-immunoprecipitated with DDX1 and overexpression of Tat could rescue the unspliced viral mRNA levels inhibited by Nullbasic in HIV-1 expressing cells. Nullbasic was used to further define the complex mechanisms involved in the Rev-dependent nuclear export of the 9 kb and 4 kb viral RNAs. All together, these data indicate that DDX1 can be sequestered by Nullbasic leading to destabilization of the Rev nucleocytoplasmic transport complex and decreased levels of Rev-dependent viral transcripts. The outcomes support a role for DDX1 in maintenance of a Rev nuclear complex that transports viral RRE-containing mRNA to the cytoplasm. To our knowledge Nullbasic is the first anti-HIV protein that specifically targets the cellular protein DDX1 to block Rev's activity. Furthermore, our research raises the possibility that wild type Tat may play a previously unrecognized but very important role in Rev function.

Circumcision does not have effect on premature ejaculation: A systematic review and meta-analysis.

PubMed

Yang, Y; Wang, X; Bai, Y; Han, P

2018-03-01

We attempted to evaluate whether circumcision has an effect on premature ejaculation. We searched three databases: PubMed, EMBASE and Google scholar on 1 May 2016 for eligible studies that referred to male sexual function after circumcision. No language restrictions were imposed. The Cochrane Collaboration's RevMan 5.2 software was employed for data analysis, and the fixed or the random-effect model was selected depending on the heterogeneity. Twelve studies were included in the meta-analysis, containing a total of 10019 circumcised and 11570 uncircumcised men. All studies were divided into five subgroups by types of study design to evaluate the effect of circumcision on premature ejaculation (PE). Intravaginal ejaculation latency time (IELT), difficulty of orgasm, erectile dysfunction (ED) and pain during intercourse were also assessed because PE was usually discussed along with these subjects. There were no significant differences in PE (odds ratio [OR], 0.90; 95% confidence interval (CI), 0.72-1.13; p = .37) and orgasm (OR, 1.04; 95% CI, 0.89-1.21; p = .65) between circumcised and uncircumcised group. However, IELT (OR, 0.72; 95% CI, 0.60-0.83; p < .00001), ED (OR, 0.42;95% CI, 0.22-0.78; p = .40) and pain during intercourse (OR, 0.36; 95% CI, 0.17-0.76; p = .007) favoured circumcised group. Based on these findings, circumcision does not have effect on PE. © 2017 Blackwell Verlag GmbH.

Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED. A prospective randomized controlled study.

PubMed

Gulacti, Umut; Lok, Ugur

2017-07-19

Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months. Consultations requested in the ED were allocated into two groups: consultations requested via the secure messaging application and consultations requested by telephone as verbal. A total of 439 consultations requested in the ED were assessed for eligibility and 345 were included in the final analysis: 173 consultations were conducted using secure messaging application and 172 consultations were conducted using standard telephone communications. The median ED LOS was 240 minutes (IQR:230-270, 95% CI:240 to 255.2) for patients in the secure messaging application group and 277 minutes (IQR:270-287.8, 95% CI:277 to 279) for patients in the telephone group. The median total ED LOS was significantly lower among consults conducted using Secure messaging application relative to consults conducted by telephone (median dif: -30, 95%CI:-37to-25, p<0.0001). The median consult time was 158 minutes (IQR:133 to 177.25, 95% CI:150 to 169) for patients in the Secure messaging application group and 170 minutes (IQR:165 to 188.5, 95% CI:170-171) for patients in the Telephone group (median dif: -12, 95%CI:-19 to-7,p<0.0001). Consultations completed without ED arrival was 61.8% in the secure messaging group and 33.1% in the Telephone group (dif: 28.7, 95% CI:48.3 to 66, p<0.001). Use of secure messaging application for consultations in the ED reduces the total ED LOS and consultation time. Consultation with secure messaging application eliminated more than half of in-person ED consultation visits.

Pain control methods in use and perceived effectiveness by patients with Ehlers-Danlos syndrome: a descriptive study.

PubMed

Arthur, Karen; Caldwell, Karen; Forehand, Samantha; Davis, Keith

2016-01-01

The purpose of this study was to assess the pain control methods in use by patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders, and their perceived effectiveness. This descriptive study involved 1179 adults diagnosed with EDS who completed an anonymous on-line survey. The survey consisted of demographics information, the Patient Reported Outcomes Measurement Information System (PROMIS) Pain-Behavior, PROMIS Pain-Interference, and Neuro QOL Satisfaction with Social Roles and Activities scales, as well as a modified version of the Pain Management Strategies Survey. Respondents reported having to seek out confirmation of their EDS diagnosis with multiple healthcare providers, which implies the difficulty many people with EDS face when trying to gain access to appropriate treatment. Patients with EDS experience higher levels of pain interference and lower satisfaction with social roles and activities compared to national norms. Among the treatment modalities in this study, those perceived as most helpful for acute pain control were opioids, surgical interventions, splints and braces, avoidance of potentially dangerous activities and heat therapy. Chronic pain treatments rated as most helpful were opioids, splints or braces and surgical interventions. For methods used for both acute and chronic pain, those perceived as most helpful were opioids, massage therapies, splints or braces, heat therapy and avoiding potentially dangerous activities. EDS is a complex, multi-systemic condition that can be difficult to diagnose and poses challenges for healthcare practitioners who engage with EDS patients in holistic care. Improved healthcare provider knowledge of EDS is needed, and additional research on the co-occurring diagnoses with EDS may assist in comprehensive pain management for EDS patients. Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders associated with defective production of collagen, which can dramatically reduce musculoskeletal functioning by symptoms of joint laxity and frequent dislocations eventually leading to disability. Respondents to an on-line survey reported having to seek out confirmation of their EDS diagnosis with multiple physicians, which implies the difficulty many people with EDS face when trying to gain access to appropriate treatment. Participants with EDS reported the most helpful methods for managing acute pain were opioids, surgical interventions, splints and braces, heat therapy, nerve blocks and physical therapy, while chronic pain was treated most effectively with opioids, heat therapy, splints or braces and surgical interventions.

A complete database for the Einstein imaging proportional counter

NASA Technical Reports Server (NTRS)

Helfand, David J.

1991-01-01

A complete database for the Einstein Imaging Proportional Counter (IPC) was completed. The original data that makes up the archive is described as well as the structure of the database, the Op-Ed analysis system, the technical advances achieved relative to the analysis of (IPC) data, the data products produced, and some uses to which the database has been put by scientists outside Columbia University over the past year.

Personal Characteristics and Experience of Primary Care Predicting Frequent Use of Emergency Department: A Prospective Cohort Study.

PubMed

Hudon, Catherine; Sanche, Steven; Haggerty, Jeannie L

2016-01-01

A small number of patients frequently using the emergency department (ED) account for a disproportionate amount of the total ED workload and are considered using this service inappropriately. The aim of this study was to identify prospectively personal characteristics and experience of organizational and relational dimensions of primary care that predict frequent use of ED. This study was conducted among parallel cohorts of the general population and primary care patients (N = 1,769). The measures were at baseline (T1), 12 (T2) and 24 months (T3): self-administered questionnaire on current health, health behaviours and primary care experience in the previous year. Use of medical services was confirmed using administrative databases. Mixed effect logistic regression modeling identified characteristics predicting frequent ED utilization. A higher likelihood of frequent ED utilization was predicted by lower socioeconomic status, higher disease burden, lower perceived organizational accessibility, higher number of reported healthcare coordination problems and not having a complete annual check-up, above and beyond adjustment for all independent variables. Personal characteristics such as low socioeconomic status and high disease burden as well as experience of organizational dimensions of primary care such as low accessibility, high healthcare coordination problems and low comprehensiveness of care are prospectively associated with frequent ED utilization. Interventions developed to prevent inappropriate ED visits, such as case management for example, should tailor low socioeconomic status and patients with high disease burden and should aim to improve experience of primary care regarding accessibility, coordination and comprehensiveness.

Emergency medicine: an operations management view.

PubMed

Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

2011-12-01

Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider. © 2011 by the Society for Academic Emergency Medicine.

Interaction between the Rev1 C-terminal Domain and the PolD3 Subunit of Polζ Suggests a Mechanism of Polymerase Exchange upon Rev1/Polζ-Dependent Translesion Synthesis

PubMed Central

Pustovalova, Yulia; Magalhães, Mariana T. Q.; D’Souza, Sanjay; Rizzo, Alessandro A.; Korza, George; Walker, Graham C.; Korzhnev, Dmitry M.

2016-01-01

Translesion synthesis (TLS) is a mutagenic branch of cellular DNA damage tolerance that enables bypass replication over DNA lesions carried out by specialized low-fidelity DNA polymerases. The replicative bypass of most types of DNA damage is performed in a two-step process of Rev1/Polζ-dependent TLS. In the first step, a Y-family TLS enzyme, typically Polη, Polι or Polκ, inserts a nucleotide across DNA lesion. In the second step, a four-subunit B-family DNA polymerase Polζ (Rev3/Rev7/PolD2/PolD3 complex) extends the distorted DNA primer-template. The coordinated action of error-prone TLS enzymes is regulated through their interactions with the two scaffold proteins, the sliding clamp PCNA and the TLS polymerase Rev1. Rev1 interactions with all other TLS enzymes are mediated by its C-terminal domain (Rev1-CT), which can simultaneously bind the Rev7 subunit of Polζ and Rev1-interacting regions (RIRs) from Polη, Polι or Polκ. In this work, we identified a previously unknown RIR motif in the C-terminal part of PolD3 subunit of Polζ whose interaction with the Rev1-CT is among the tightest mediated by RIR motifs. Three-dimensional structure of the Rev1-CT/PolD3-RIR complex determined by NMR spectroscopy revealed a structural basis for the relatively high affinity of this interaction. The unexpected discovery of PolD3-RIR motif suggests a mechanism of 'inserter' to 'extender' DNA polymerase switch upon Rev1/Polζ-dependent TLS, in which the PolD3-RIR binding to the Rev1-CT (i) helps displace the 'inserter' Polη, Polι or Polκ from its complex with Rev1, and (ii) facilitates assembly of the four-subunit 'extender' Polζ through simultaneous interaction of Rev1-CT with Rev7 and PolD3 subunits. PMID:26982350

Characteristics of Asthmatic Patients with and without Repeat Emergency Department Visits at an Inner City Hospital

PubMed Central

Pai, Sucheta; Mancuso, Carol A.; Loganathan, Raghu; Boutin-Foster, Carla; Basir, Riyad; Kanna, Balavenkatesh

2014-01-01

Objective The objective of this study was to document the frequency and clinical characteristics associated with repeat emergency department (ED) visits for asthma in an inner city population with a high burden of asthma. Methods During an ED visit for asthma in an inner city hospital (‘index visit’), patients completed a valid survey addressing disease and behavioral factors. Hospital records were reviewed for information about ED visits and hospitalizations for asthma during the 12 months before and the 90 days after the index visit. Results 192 patients were enrolled; the mean age was 42 years, 69% were women, 36% were black, 54% were Latino, 69% had Medicaid, and 17% were uninsured. 100 patients (52%) were treated and released from the ED, 88 patients (46%) were hospitalized, and 4 patients (2%) left against medical advice. During the subsequent 90 days, 64 patients (33%) had at least one repeat ED visit for asthma and 27 (14%) were hospitalized for asthma. In a multivariate model, more past ED visits (OR 1.7, 95% CI 1.4, 2.1; p<.0001) and male gender (OR 2.5, 95% CI 1.2, 5.4; p=.02) remained associated with having a repeat ED visit. Most patients had the first repeat ED visit within 30 days and 18 returned within only 7 days. Among all patients with a repeat visit, those who were not hospitalized for the index visit were more likely to have a repeat visit within 7 days (37%) compared to those who were hospitalized (17%) (p=.05 in multivariate analysis). Conclusions Repeat ED visits were prevalent among inner city asthma patients and most occurred shortly after the index visit. The strongest predictors of repeat visits were male gender and more ED visits in the 12 months before the index visit. PMID:24588683

Characteristics of asthmatic patients with and without repeat emergency department visits at an inner city hospital.

PubMed

Pai, Sucheta; Mancuso, Carol A; Loganathan, Raghu; Boutin-Foster, Carla; Basir, Riyad; Kanna, Balavenkatesh

2014-08-01

Abstract Objective: The objective of this study was to document the frequency and clinical characteristics associated with repeat emergency department (ED) visits for asthma in an inner city population with a high burden of asthma. During an ED visit for asthma in an inner city hospital ('index visit'), patients completed a valid survey addressing disease and behavioral factors. Hospital records were reviewed for information about ED visits and hospitalizations for asthma during the 12 months before and the 90 days after the index visit. One hundred and ninety-two patients were enrolled; the mean age was 42 years, 69% were women, 36% were black, 54% were Latino, 69% had Medicaid, and 17% were uninsured. 100 patients (52%) were treated and released from the ED, 88 patients (46%) were hospitalized, and 4 patients (2%) left against medical advice. During the subsequent 90 days, 64 patients (33%) had at least one repeat ED visit for asthma and 27 (14%) were hospitalized for asthma. In a multivariate model, more past ED visits (OR 1.7, 95% CI 1.4, 2.1; p < 0.0001) and male gender (OR 2.5, 95% CI 1.2, 5.4; p = 0.02) remained associated with having a repeat ED visit. Most patients had the first repeat ED visit within 30 days and 18 returned within only 7 days. Among all patients with a repeat visit, those who were not hospitalized for the index visit were more likely to have a repeat visit within 7 days (37%) compared to those who were hospitalized (17%) (p = 0.05 in multivariate analysis). Repeat ED visits were prevalent among inner city asthma patients and most occurred shortly after the index visit. The strongest predictors of repeat visits were male gender and more ED visits in the 12 months before the index visit.

Clinical features and subjective/physiological responses to emotional stimuli in the presence of emotion dysregulation in attention-deficit hyperactivity disorder.

PubMed

Taskiran, Candan; Karaismailoglu, Serkan; Cak Esen, Halime Tuna; Tuzun, Zeynep; Erdem, Aysen; Balkanci, Zeynep Dicle; Dolgun, Anil Barak; Cengel Kultur, Sadriye Ebru

2018-05-01

Emotion dysregulation (ED) has long been recognized in clinical descriptions of attention-deficit hyperactivity disorder (ADHD), but a renewed interest in ED has advanced research on the overlap between the two entities. Autonomic reactivity (AR) is a neurobiological correlate of emotion regulation; however, the association between ADHD and AR remains unclear. Our aim was to explore the clinical differences, AR, and subjective emotional responses to visual emotional stimuli in ADHD children with and without ED. School-aged ADHD children with (n = 28) and without (n = 20) ED, according to the definition of deficiency in emotional self-regulation (DESR), and healthy controls (n = 22) were interviewed by using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime version (K-SADS-PL) to screen frequent psychopathologies for these ages. All subjects were evaluated with Child Behavior Checklist 6-18 (CBCL), the Strengths and Difficulties Questionnaire (SDQ), the McMaster Family Assessment Device (FAD), the School-Age Temperament Inventory (SATI), and Conners' Parent Rating Scale (CPRS-48), which were completed by parents. To evaluate emotional responses, the International Affective Picture System (IAPS) and the subjective and physiological responses (electrodermal activity and heart rate reactivity) to selected pictures were examined. Regarding clinically distinctive features, the ADHD+ED group differed from the ADHD-ED and the control groups in terms of having higher temperamental negative reactivity, more oppositional/conduct problems, and lower prosocial behaviors. In the AR measures, children in the ADHD+ED group rated unpleasant stimuli as more negative, but they still had lower heart rate reactivity (HRR) than the ADHD-ED and control groups; moreover, unlike the two other groups, the ADHD+ED group showed no differences in HRR between different emotional stimuli. The presented findings are unique in terms of their ability to clinically and physiologically differentiate between ADHD children with and without ED.

Orthorexia Nervosa and Eating Disorder Symptoms in Registered Dietitian Nutritionists in the United States.

PubMed

Tremelling, Kaylee; Sandon, Lona; Vega, Gloria L; McAdams, Carrie J

2017-10-01

Registered dietitian nutritionists are trained to identify optimal food choices for clients based on medical state and lifestyle. Orthorexia nervosa (ON) is a proposed disorder related to obsessions about eating healthfully. Eating disorders (EDs) are serious mental illnesses with symptoms related to eating, body image, and self-esteem. Both ON and EDs are more common among RDNs than the general population. This study examined the prevalence of ON and EDs in RDNs in the United States and, among this sample, assessed whether the presence of ON symptoms related to symptoms of EDs, including weight, shape, eating, and restraint. A cross-sectional design compared responses for participants after dividing into three groups: those scoring at-risk for ON, those with a current or past ED, and a comparison group. A sample of 2,500 RDNs were invited to complete surveys electronically; 636 responses were received. Scores on the Orthorexia Nervosa Questionnaire (ORTO-15) and Eating Disorder Examination Questionnaire (EDE-Q) determined prevalence of ON and EDs. Differences in these measures, and body mass index were compared among the three groups. Analysis of variance and χ 2 analyses were used to compare the groups. For the entire sample, scores on the ORTO-15 suggested 49.5% were at risk for ON, and scores on the EDE-Q suggested 12.9% were at risk for an ED, with 8.2% of RDNs self-disclosing treatment for an ED. Both the group disclosing ED treatment and the group at risk for ON had a lower mean body mass index, lower scores on the ORTO-15, and higher scores on the EDE-Q and all its subscales than the comparison group. Clarifying the relationship between ON and EDs is warranted because ON symptoms appear to be associated not only with disturbances in eating, but also with elevated shape and weight concerns. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Consumption of energy drinks, alcohol, and alcohol-mixed energy drinks among Italian adolescents.

PubMed

Flotta, Domenico; Micò, Rocco; Nobile, Carmelo G A; Pileggi, Claudia; Bianco, Aida; Pavia, Maria

2014-06-01

It has been argued that the excessive consumption of energy drinks (EDs) may have serious health consequences, and that may serve as an indicator for substance use and other risky behaviors. The present paper offers a perspective on this topic that remains underexplored on the population of adolescents. Data were collected via self-administered anonymous questionnaires from 870 adolescents aged 15 to 19 years who were recruited from a random sample of public secondary schools in the geographic area of the Calabria Region, in the South of Italy. A total of 616 participants completed the survey for a response rate of 70.8%. Nearly 68% of respondents had drunk at least a whole can of ED during their life, and about 55% reported consuming EDs during the 30 days before the survey. Only 13% of interviewed adolescents were aware that drinking EDs is the same as drinking coffee, whereas a sizable percentage believed that drinking EDs is the same as drinking carbonated beverages or rehydrating sport drinks. Forty-six percent of adolescents had drunk alcohol-mixed energy drinks (AmEDs) during their life, and 63% of lifetime users admitted drinking AmEDs during the 30 days before the survey. Overall, 210 (63.3%) had drunk alcohol alone not mixed with EDs during their life, and more than half (56.3%) reported having consumed it at least once during the 30 days before the survey. Multivariate analysis showed that the factors independently associated with the consumption of AmEDs were the increasing number of sexual partners, being a current smoker, being male, riding with a driver who had been drinking alcohol, and having used marijuana. Comprehensive educational programs among youths focusing on potential health effects of EDs, alcohol, and the combination of the two, designed to empower the ability to manage these drinking habits, are strongly advisable. Copyright © 2014 by the Research Society on Alcoholism.

Investigating the Role of Hypothalamic Tumor Involvement in Sleep and Cognitive Outcomes Among Children Treated for Craniopharyngioma

PubMed Central

Conklin, Heather M.; Scoggins, Matthew A.; Ashford, Jason M.; Merchant, Thomas E.; Mandrell, Belinda N.; Ogg, Robert J.; Curtis, Elizabeth; Wise, Merrill S.; Indelicato, Daniel J.; Crabtree, Valerie M.

2016-01-01

Objective: Despite excellent survival prognosis, children treated for craniopharyngioma experience significant morbidity. We examined the role of hypothalamic involvement (HI) in excessive daytime sleepiness (EDS) and attention regulation in children enrolled on a Phase II trial of limited surgery and proton therapy. Methods: Participants completed a sleep evaluation (N = 62) and a continuous performance test (CPT) during functional magnetic resonance imaging (fMRI; n = 29) prior to proton therapy. Results: EDS was identified in 76% of the patients and was significantly related to increased HI extent (p = .04). There was no relationship between CPT performance during fMRI and HI or EDS. Visual examination of group composite fMRI images revealed greater spatial extent of activation in frontal cortical regions in patients with EDS, consistent with a compensatory activation hypothesis. Conclusion: Routine screening for sleep problems during therapy is indicated for children with craniopharyngioma, to optimize the timing of interventions and reduce long-term morbidity. PMID:27189690

Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified

PubMed Central

2013-01-01

Background This study aimed to assess differences in Quality of Life (QoL) across eating disorder (ED) diagnoses, and to examine the relationship of QoL to specific clinical features. Results 199 patients with a diagnosed ED completed the Clinical Impairment Assessment (CIA) [Cognitive Behavior Therapy and Eating Disorders, 315–318, 2008] and the Eating Disorders Examination (EDE) [Int J Eat Disord 6:1–8]. Differences between diagnostic groups were examined, as were differences between restrictive and binge-purge subtypes. CIA scores and EDE scores were positively correlated and higher in groups with binge-purge behaviours. CIA scores were not correlated with BMI, illness duration or frequency of bingeing/purging behaviours, except in the binge-purge AN group, where CIA scores negatively correlated with BMI. Conclusions Patients with EDs have poor QoL and impairment increases with illness severity. Patients with binge/purge diagnoses are particularly impaired. It remains unclear which clinical features best predict the degree of impairment experienced by patients with EDs. PMID:24999421

Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study.

PubMed

Nicolosi, A; Glasser, D B; Moreira, E D; Villa, M

2003-08-01

We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia about medical history, lifestyle habits and sexual behavior. Men were classified as having moderate or complete erectile dysfunction (ED) if they reported to be sometimes or never able to achieve and maintain an erection satisfactory for sexual intercourse, respectively. There were 1335 men with no diagnosis of cardiovascular or prostate diseases, diabetes, ulcer or depression, nor taking hormones. The prevalence of ED was 16.1%. ED was associated with age (the risk increased 8% per y), moderate (odds ratio (OR)=2.2) or severe (OR=4.9) lower urinary tract symptoms and smoking (OR=2.3 for >30 cigarettes/day). It was inversely associated with physical activity (OR=0.5) and higher educational levels. Between the ages of 40 and 70 y, almost one in six 'healthy' men is affected by ED. Further research should look at preclinical disease stages and genetic factors.

Parental language and dosing errors after discharge from the pediatric emergency department.

PubMed

Samuels-Kalow, Margaret E; Stack, Anne M; Porter, Stephen C

2013-09-01

Safe and effective care after discharge requires parental education in the pediatric emergency department (ED). Parent-provider communication may be more difficult with parents who have limited health literacy or English-language fluency. This study examined the relationship between language and discharge comprehension regarding medication dosing. We completed a prospective observational study of the ED discharge process using a convenience sample of English- and Spanish-speaking parents of children 2 to 24 months presenting to a single tertiary care pediatric ED with fever and/or respiratory illness. A bilingual research assistant interviewed parents to ascertain their primary language and health literacy and observed the discharge process. The primary outcome was parental demonstration of an incorrect dose of acetaminophen for the weight of his or her child. A total of 259 parent-child dyads were screened. There were 210 potential discharges, and 145 (69%) of 210 completed the postdischarge interview. Forty-six parents (32%) had an acetaminophen dosing error. Spanish-speaking parents were significantly more likely to have a dosing error (odds ratio, 3.7; 95% confidence interval, 1.6-8.1), even after adjustment for language of discharge, income, and parental health literacy (adjusted odds ratio, 6.7; 95% confidence interval, 1.4-31.7). Current ED discharge communication results in a significant disparity between English- and Spanish-speaking parents' comprehension of a crucial aspect of medication safety. These differences were not explained purely by interpretation, suggesting that interventions to improve comprehension must address factors beyond language alone.

Redesigning a General Education Science Course to Promote Critical Thinking.

PubMed

Rowe, Matthew P; Gillespie, B Marcus; Harris, Kevin R; Koether, Steven D; Shannon, Li-Jen Y; Rose, Lori A

2015-01-01

Recent studies question the effectiveness of a traditional university curriculum in helping students improve their critical thinking and scientific literacy. We developed an introductory, general education (gen ed) science course to overcome both deficiencies. The course, titled Foundations of Science, differs from most gen ed science offerings in that it is interdisciplinary; emphasizes the nature of science along with, rather than primarily, the findings of science; incorporates case studies, such as the vaccine-autism controversy; teaches the basics of argumentation and logical fallacies; contrasts science with pseudoscience; and addresses psychological factors that might otherwise lead students to reject scientific ideas they find uncomfortable. Using a pretest versus posttest design, we show that students who completed the experimental course significantly improved their critical-thinking skills and were more willing to engage scientific theories the general public finds controversial (e.g., evolution), while students who completed a traditional gen ed science course did not. Our results demonstrate that a gen ed science course emphasizing the process and application of science rather than just scientific facts can lead to improved critical thinking and scientific literacy. © 2015 M. P. Rowe, B. M. Gillespie, et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Series of (2+1)-dimensional stable self-dual interacting conformal field theories

NASA Astrophysics Data System (ADS)

Cheng, Meng; Xu, Cenke

2016-12-01

Using the duality between seemingly different (2+1)-dimensional [(2 +1 )d ] conformal field theories (CFT) proposed recently [D. T. Son, Phys. Rev. X 5, 031027 (2015), 10.1103/PhysRevX.5.031027; M. A. Metlitski and A. Vishwanath, Phys. Rev. B 93, 245151 (2016), 10.1103/PhysRevB.93.245151; C. Wang and T. Senthil, Phys. Rev. X 6, 011034 (2015), 10.1103/PhysRevX.6.011034; C. Wang and T. Senthil, Phys. Rev. X 5, 041031 (2015), 10.1103/PhysRevX.5.041031; C. Wang and T. Senthil, Phys. Rev. B 93, 085110 (2016), 10.1103/PhysRevB.93.085110; C. Xu and Y.-Z. You, Phys. Rev. B 92, 220416 (2015), 10.1103/PhysRevB.92.220416; D. F. Mross et al., Phys. Rev. Lett. 117, 016802 (2016), 10.1103/PhysRevLett.117.016802; A. Karch and D. Tong, arXiv:1606.01893; N. Seiberg et al., arXiv:1606.01989; P.-S. Hsin and N. Seiberg, arXiv:1607.07457], we study a series of (2 +1 )d stable self-dual interacting CFTs. These CFTs can be realized (for instance) on the boundary of the 3 d bosonic topological insulator protected by U(1) and time-reversal symmetry (T ), and they remain stable as long as these symmetries are preserved. When realized as a boundary system, these CFTs can be driven into anomalous fractional quantum Hall states once T is broken. We demonstrate that the newly proposed dualities allow us to study these CFTs quantitatively through a controlled calculation, without relying on a large flavor number of matter fields. We also propose a numerical test for our results, which would provide strong evidence for the originally proposed duality between Dirac fermion and QED.

The Responsible Inclusion of Students Receiving Special Education Services for Emotional Disturbance: Unraveling the Practice to Research Gap.

PubMed

McKenna, John William; Solis, Michael; Brigham, Frederick; Adamson, Reesha

2018-03-01

The majority of students receiving special education services for emotional disturbance (ED) receive a significant amount of instruction in general education classrooms, which emphasizes curriculums based on college and career readiness standards. In turn, those teachers who provide instruction to students with ED in inclusive settings are responsible for using evidence-based practices (EBPs) for those teaching situations in which they exist to meet free appropriate public education (FAPE) mandates. However, the identification of EBPs is a necessary pre-condition to eventual school adoption and teacher use of such practices. In this investigation, we completed a synthesis of syntheses to (a) determine the degree to which academic intervention research has focused on students with ED in general education classrooms and (b) identify practices that are effective at improving the academic performance of students with ED in these settings. Overall, few studies were identified. Of those studies identified, half did not disaggregate outcomes for students with ED. A quality indicator coding based on the What Works Clearinghouse (WWC) design standards revealed that no studies with disaggregated outcomes permitted causal inferences. Implications for school practice and areas for future research are discussed.

Using Local Perturbations To Manipulate and Control Pointer States in Quantum Dot Systems

NASA Astrophysics Data System (ADS)

Akis, Richard; Speyer, Gil; Ferry, David; Brunner, Roland

2012-02-01

Recently, scanning gate microscopy (SGM) was used to image scarred wave functions in an open InAs quantum dot[1]. The SGM tip provides a local potential perturbation and imaging is performed by measuring changes in conductance. Scarred wave functions, long associated with quantum chaos, have been shown in open dots to correspond to pointer states[2], eigenstates that survive the decoherence process that occurs via coupling to the environment. Pointer states modulate the conductance, yielding periodic fluctuations and the scars, normally thought unstable, are stabilized by quantum Darwinism [3]. We shall show that, beyond probing, pointer states can be manipulated by local perturbations. Particularly interesting effects occur in coupled quantum dot arrays, where a pointer state localized in one dot can be shifted over into another with a perturbation in a completely different part of the system. These nonlocal effects may perhaps be exploited to give such systems an exotic functionality. [1] A. M. Burke, R. Akis, T. E. Day, Gil Speyer, D. K. Ferry, and B. R. Bennett, Phys. Rev. Lett. 104, 176801 (2010). [2] D. K. Ferry, R. Akis, and J. P. Bird, Phys. Rev. Lett. 104, 176801 (2004). [3] R. Brunner, R. Akis,D. K. Ferry, F. Kuchar,and R. Meisels, Phys. Rev. Lett. 101, 024102 (2008).

Spectroscopic imaging of limiter heat and particle fluxes and the resulting impurity sources during Wendelstein 7-X startup plasmas.

PubMed

Stephey, L; Wurden, G A; Schmitz, O; Frerichs, H; Effenberg, F; Biedermann, C; Harris, J; König, R; Kornejew, P; Krychowiak, M; Unterberg, E A

2016-11-01

A combined IR and visible camera system [G. A. Wurden et al., "A high resolution IR/visible imaging system for the W7-X limiter," Rev. Sci. Instrum. (these proceedings)] and a filterscope system [R. J. Colchin et al., Rev. Sci. Instrum. 74, 2068 (2003)] were implemented together to obtain spectroscopic data of limiter and first wall recycling and impurity sources during Wendelstein 7-X startup plasmas. Both systems together provided excellent temporal and spatial spectroscopic resolution of limiter 3. Narrowband interference filters in front of the camera yielded C-III and H α photon flux, and the filterscope system provided H α , H β , He-I, He-II, C-II, and visible bremsstrahlung data. The filterscopes made additional measurements of several points on the W7-X vacuum vessel to yield wall recycling fluxes. The resulting photon flux from both the visible camera and filterscopes can then be compared to an EMC3-EIRENE synthetic diagnostic [H. Frerichs et al., "Synthetic plasma edge diagnostics for EMC3-EIRENE, highlighted for Wendelstein 7-X," Rev. Sci. Instrum. (these proceedings)] to infer both a limiter particle flux and wall particle flux, both of which will ultimately be used to infer the complete particle balance and particle confinement time τ P .

Sudden unexpected infant death: differentiating natural from abusive causes in the emergency department.

PubMed

Bechtel, Kirsten

2012-10-01

Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have been sometimes mistaken for sudden infant death syndrome. The distinction between these 2 entities can only be made after a thorough investigation of the scene, interview of caregivers, and a complete forensic autopsy. Development of ED guidelines for the reporting and evaluation of SUID, in collaboration with the local medical examiner and child death review teams, will enable ED practitioners to collect important information in a compassionate manner that will be valuable to the investigating personnel.

The Impact of SNAP-ED and EFNEP on Program Graduates 6 Months after Graduation

ERIC Educational Resources Information Center

Koszewski, Wanda; Sehi, Natalie; Behrends, Donnia; Tuttle, Elizabeth

2011-01-01

Research was conducted to determine if graduates from either the Supplemental Nutrition Assistance Program-Education or Expanded Food and Nutrition Education Program maintained behavioral changes 6 months after completing the program. Staff asked graduates to complete a 10- or 15-question behavior checklist that was identical to the entry and exit…

Surface Demixing in a AuSn Liquid Alloy

NASA Astrophysics Data System (ADS)

Balagurusamy, Venkat; Streitel, Reinhard; Shpyrko, Oleg; Pershan, Peter; Ocko, Ben; Deutsch, Moshe

2006-03-01

We present results of X-ray reflectivity studies of the eutectic AuSn alloy liquid-vapor interface. The analysis shows that in common with the BiSn eutectic, there is surface demixing that extends to more than one monolayer. This is in contrast to a common presumption that the Gibbs adsorption predicts complete demixing only in the surface monolayer. The composition profiles can be explained by surface segregation theory for attractive interaction between Sn and Au atoms, similar to BiIn [1] and BiSn [2]. [1] E. DiMasi, H. Tostmann, O. G. Shpyrko, P. Huber, B. M. Ocko, P. S. Pershan, M. Deutsch, and L. E. Berman, Phys. Rev. Lett. 86, 1538 (2001) [2] O. G. Shpyrko, A. Y. Grigoriev, R. Streitel, D. Pontoni, P. S. Pershan, M. Deutsch, and B. M. Ocko, Phys. Rev. Lett. 95, 106103 (2005) *Present address: Center for Nanoscale Materials, ANL

Elephant random walks and their connection to Pólya-type urns

NASA Astrophysics Data System (ADS)

Baur, Erich; Bertoin, Jean

2016-11-01

In this paper, we explain the connection between the elephant random walk (ERW) and an urn model à la Pólya and derive functional limit theorems for the former. The ERW model was introduced in [Phys. Rev. E 70, 045101 (2004), 10.1103/PhysRevE.70.045101] to study memory effects in a highly non-Markovian setting. More specifically, the ERW is a one-dimensional discrete-time random walk with a complete memory of its past. The influence of the memory is measured in terms of a memory parameter p between zero and one. In the past years, a considerable effort has been undertaken to understand the large-scale behavior of the ERW, depending on the choice of p . Here, we use known results on urns to explicitly solve the ERW in all memory regimes. The method works as well for ERWs in higher dimensions and is widely applicable to related models.

Extension of spatiotemporal chaos in glow discharge-semiconductor systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akhmet, Marat, E-mail: marat@metu.edu.tr; Fen, Mehmet Onur; Rafatov, Ismail

2014-12-15

Generation of chaos in response systems is discovered numerically through specially designed unidirectional coupling of two glow discharge-semiconductor systems. By utilizing the auxiliary system approach, [H. D. I. Abarbanel, N. F. Rulkov, and M. M. Sushchik, Phys. Rev. E 53, 4528–4535 (1996)] it is verified that the phenomenon is not a chaos synchronization. Simulations demonstrate various aspects of the chaos appearance in both drive and response systems. Chaotic control is through the external circuit equation and governs the electrical potential on the boundary. The expandability of the theory to collectives of glow discharge systems is discussed, and this increases themore » potential of applications of the results. Moreover, the research completes the previous discussion of the chaos appearance in a glow discharge-semiconductor system [D. D. Šijačić U. Ebert, and I. Rafatov, Phys. Rev. E 70, 056220 (2004).].« less

Extension of spatiotemporal chaos in glow discharge-semiconductor systems.

PubMed

Akhmet, Marat; Rafatov, Ismail; Fen, Mehmet Onur

2014-12-01

Generation of chaos in response systems is discovered numerically through specially designed unidirectional coupling of two glow discharge-semiconductor systems. By utilizing the auxiliary system approach, [H. D. I. Abarbanel, N. F. Rulkov, and M. M. Sushchik, Phys. Rev. E 53, 4528-4535 (1996)] it is verified that the phenomenon is not a chaos synchronization. Simulations demonstrate various aspects of the chaos appearance in both drive and response systems. Chaotic control is through the external circuit equation and governs the electrical potential on the boundary. The expandability of the theory to collectives of glow discharge systems is discussed, and this increases the potential of applications of the results. Moreover, the research completes the previous discussion of the chaos appearance in a glow discharge-semiconductor system [D. D. Šijačić U. Ebert, and I. Rafatov, Phys. Rev. E 70, 056220 (2004).].

Final Report - LAW Envelope C Glass Formulation Testing to Increase Waste Loading, VSL-05R5900-1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kruger, Albert A.; Pegg, I. L.; Matlack, K. S.

2013-12-03

This report describes the results of testing specified by Test Plan VSL-05R5900-1 Rev.0. The work was performed in compliance with the quality assurance requirements specified in the Test Plan. Results required by the Test Plan are reported. The test results and this report have been reviewed for correctness, technical adequacy, completeness, and accuracy.

SWCC Prediction: Seep/W Add-In Functions

DTIC Science & Technology

2017-11-01

acquire this information is to investigate from which soil data set the predictive method was derived. ERDC/GSL SR-17-4 rev. 38 References...Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing...instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information . Send

Interactions of Ultracold Impurity Particles with Bose-Einstein Condensates

DTIC Science & Technology

2015-06-23

Lukin et al ., Phys. Rev. Lett. 87, 037901 (2001). [2] D. Jaksch et al ., Phys. Rev. Lett. 85, 2208 (2000). [3] L. Isenhower et al ., Phys. Rev. Lett...104, 010503 (2010). [4] T. Wilk et al ., Phys. Rev. Lett. 104, 010502 (2010). [5] I. Mourachko et al ., Phys. Rev. Lett. 80, 253 (1998). [6] W. R...Phys. 12, 103044 (2010). [12] R. M. W. van Bijnen et al ., J. Phys. B 44, 184008 (2011). [13] I. Lesanovsky, Phys. Rev. Lett. 106, 025301 (2011). [14] E

Suppression of atherosclerosis by synthetic REV-ERB agonist

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sitaula, Sadichha; Billon, Cyrielle; Kamenecka, Theodore M.

2015-05-08

The nuclear receptors for heme, REV-ERBα and REV-ERBβ, play important roles in the regulation of metabolism and inflammation. Recently it was demonstrated that reduced REV-ERBα expression in hematopoetic cells in LDL receptor null mice led to increased atherosclerosis. We sought to determine if synthetic REV-ERB agonists that we have developed might have the ability to suppress atherosclerosis in this model. A previously characterized synthetic REV-ERB agonist, SR9009, was used to determine if activation of REV-ERB activity would affect atherosclerosis in LDL receptor deficient mice. Atherosclerotic plaque size was significantly reduced (p < 0.05) in mice administered SR9009 (100 mg/kg) for seven weeks comparedmore » to control mice (n = 10 per group). SR9009 treatment of bone marrow-derived mouse macrophages (BMDM) reduced the polarization of BMDMs to proinflammatory M1 macrophage while increasing the polarization of BMDMs to anti-inflammatory M2 macrophages. Our results suggest that pharmacological targeting of REV-ERBs may be a viable therapeutic option for treatment of atherosclerosis. - Highlights: • Synthetic REV-ERB agonist treatment reduced atherosclerosis in a mouse model. • Pharmacological activation of REV-ERB decreased M1 macrophage polarization. • Pharmacological activation of REV-ERB increased M2 macrophage polarization.« less

Confirmatory factor analysis and psychometric properties of the Yale-Brown-Cornell Eating Disorders Scale Self-Report version (SR-YBC-EDS) in Spanish clinical and non-clinical samples.

PubMed

Perpiñá, Conxa; Giraldo-O'Meara, Martha; Roncero, María; Martínez-Gómez, Mónica

2015-04-01

The aim of the study was to adapt and validate the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) transformed into a self-report format in Spanish clinical and non-clinical samples. Eighty-three eating disordered patients and 358 non-clinical participants completed the Self Report-YBC-EDS version (SR-YBC-EDS), the Eating Attitudes Test (EAT), and the Penn State Worry Questionnaire (PSWQ). Confirmatory factor analyses of a two-factor second-order model showed adequate values of goodness-of-fit indices for non-clinical (normed χ(2)=13.4578; df =18; NFI=0.980; GFI=1.00; RMSEA=0.00) and clinical samples (normed χ(2)=26.5913; df =18; NFI=0.944; GFI=0.981; RMSEA=0.076). The factor loadings were high (preoccupations range: 0.69-0.91; rituals range: 0.61-0.94). Cronbach's alpha (range α=0.85-0.90) and test-retest 2weeks later (range: 0.84-0.91) were excellent in both samples. SR-YBC-EDS showed moderate-high indices of convergent validity with PSWQ and EAT. For the total score, a cutoff of 13 showed a sensitivity of 90.4%, a specificity of 91.6%, and a diagnostic accuracy of 91.4%. Positive and negative predictive values were excellent (71.4% and 97.6%, respectively). Findings indicate that the SR-YBC-EDS is a reliable and valid instrument to identify symptoms and assess the severity of ED, and it can be used as a faster and less costly alternative to the YBC-EDS interview. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE): method and design considerations.

PubMed

Boudreaux, Edwin D; Miller, Ivan; Goldstein, Amy B; Sullivan, Ashley F; Allen, Michael H; Manton, Anne P; Arias, Sarah A; Camargo, Carlos A

2013-09-01

Due to the concentration of individuals at-risk for suicide, an emergency department visit represents an opportune time for suicide risk screening and intervention. The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) uses a quasi-experimental, interrupted time series design to evaluate whether (1) a practical approach to universally screening ED patients for suicide risk leads to improved detection of suicide risk and (2) a multi-component intervention delivered during and after the ED visit improves suicide-related outcomes. This paper summarizes the ED-SAFE's study design and methods within the context of considerations relevant to effectiveness research in suicide prevention and pertinent human participants concerns. 1440 suicidal individuals, from 8 general ED's nationally will be enrolled during three sequential phases of data collection (480 individuals/phase): (1) Treatment as Usual; (2) Universal Screening; and (3) Intervention. Data from the three phases will inform two separate evaluations: Screening Outcome (Phases 1 and 2) and Intervention (Phases 2 and 3). Individuals will be followed for 12 months. The primary study outcome is a composite reflecting completed suicide, attempted suicide, aborted or interrupted attempts, and implementation of rescue procedures during an outcome assessment. While 'classic' randomized control trials (RCT) are typically selected over quasi-experimental designs, ethical and methodological issues may make an RCT a poor fit for complex interventions in an applied setting, such as the ED. ED-SAFE represents an innovative approach to examining the complex public health issue of suicide prevention through a multi-phase, quasi-experimental design embedded in 'real world' clinical settings. Copyright © 2013 Elsevier Inc. All rights reserved.

Incorporating teledermatology into emergency medicine.

PubMed

Muir, Jim; Xu, Cathy; Paul, Sanjoy; Staib, Andrew; McNeill, Iain; Singh, Philip; Davidson, Samantha; Soyer, H Peter; Sinnott, Michael

2011-10-01

The aim of the present study was to investigate the feasibility of using a store-and-forward Skin Emergency Telemedicine Service (SETS) to provide rapid specialist diagnostic and management advice for dermatological cases in an ED. This pilot study was conducted at the Princess Alexandra Hospital between August 2008 and August 2009. Study subjects were consenting patients over 18 years of age who presented with a dermatological condition to the ED. The ED doctor sent the patient's history, examination findings and the digital images of the skin conditions to a secure email address, which automatically forwarded this to the teledermatologist. The teledermatologist reviewed the cases and sent advice on diagnosis and management to the referring ED doctor via email and/or telephone. Face-to-face follow-up consultations with the patients were conducted within 2 weeks. The diagnostic and management concordance between ED doctors, teledermatologists and reviewing dermatologists were analysed. A total of 60 patients participated in the present study. SETS provided a rapid response with 56 (93%) of ED consultations receiving a dermatology opinion within 2 h. Face-to-face follow up occurred in 50 patients (83%). Statistical analysis showed significant levels of agreement between tele-diagnosis and ED diagnosis of 71.2% (Kappa 0.42) and tele-diagnosis and final clinical diagnosis of 98% (Kappa: 0.93). The clinical management concordance was 96% in complete agreement and 4% in relative agreement between the teledermatologists and reviewing dermatologists, based on chart review. The present study has shown that SETS can provide rapid and accurate diagnostic and treatment advice from a specialist for dermatological presentations to the ED. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Use of a midstream clean catch mobile application did not lower urine contamination rates in an ED.

PubMed

Jacob, Mary S; Kulie, Paige; Benedict, Cameron; Ordoobadi, Alexander J; Sikka, Neal; Steinmetz, Erika; McCarthy, Melissa L

2018-01-01

Urine microscopy is a common test performed in emergency departments (EDs). Urine specimens can easily become contaminated by different factors, including the collection method. The midstream clean-catch (MSCC) collection technique is commonly used to reduce urine contamination. The urine culture contamination rate from specimens collected in our ED is 30%. We developed an instructional application (app) to show ED patients how to provide a MSCC urine sample. We hypothesized that ED patients who viewed our instructional app would have significantly lower urine contamination rates compared to patients who did not. We prospectively enrolled 257 subjects with a urinalysis and/or urine culture test ordered in the ED and asked them to watch our MSCC instructional app. After prospective enrollment was complete, we retrospectively matched each enrolled subject to an ED patient who did not watch the instructional app. Controls were matched to cases based on gender, type of urine specimen provided, ED visit date and shift. Urinalysis and urine culture contamination results were compared between the matched pairs using McNemar's test. The overall urine culture contamination rate of the 514 subjects was 38%. The majority of the matched pairs had a urinalysis (63%) or urinalysis plus urine culture (35%) test done. There were no significant differences in our urine contamination rates between the matched pairs overall or when stratified by gender, by prior knowledge of the clean catch process or by type of urine specimen. We did not see a lower contamination rate for patients who viewed our instructional app compared to patients who did not. It is possible that MSCC is not effective for decreasing urine specimen contamination. Copyright © 2017 Elsevier Inc. All rights reserved.

The multiplicative effect of combining alcohol with energy drinks on adolescent gambling.

PubMed

Vieno, Alessio; Canale, Natale; Potente, Roberta; Scalese, Marco; Griffiths, Mark D; Molinaro, Sabrina

2018-07-01

There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence. Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495). Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37). The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents. Copyright © 2018 Elsevier Ltd. All rights reserved.

Classifying eating disorders based on "healthy" and "unhealthy" perfectionism and impulsivity.

PubMed

Slof-Op't Landt, Margarita C T; Claes, Laurence; van Furth, Eric F

2016-07-01

Perfectionism and impulsivity are associated with eating disorders (EDs). The current study examines whether clinically relevant subgroups of women with EDs can be identified based on "healthy" and "unhealthy" perfectionism and impulsivity. Latent profile analyses (LPA) were performed on data of 844 patients (DSM-IV diagnosis: 381 anorexia nervosa, 146 bulimia nervosa, 56 binge-eating disorder, 261 ED not otherwise specified). "Healthy" and "unhealthy" forms of perfectionism and impulsivity were assessed by the Frost Multidimensional Perfectionism Scale and the Dickman Impulsivity Inventory, respectively. The Eating Disorder Examination Questionnaire was completed to assess ED psychopathology. Furthermore, in 229 patients additional ED symptoms, depression, self-esteem, obsessive-compulsive symptoms, and personality features were assessed. The LPA revealed four profiles; 1. "Healthy Impulsivity" (HI; n = 191), 2. "Unhealthy Impulsivity" (UI; n = 238), 3. "Healthy and Unhealthy Perfectionism" (HP + UP; n = 153), 4. "Healthy Perfectionism" (HP; n = 262). Patients belonging to the "HP + UP" and the "UI" classes reported higher levels of ED psychopathology. More severe comorbid symptoms (depressive, obsessive-compulsive and self-esteem) were found in the patients belonging to the "HP + UP" class. Patients from the "HP + UP" and "HP" classes had higher scores for the personality features Harm Avoidance, Persistence and Cooperativeness. Women with EDs could be meaningfully grouped according to perfectionism and impulsivity. These findings can be used to improve treatment matching and intervention strategies. The use of dimensional features, like perfectionism and impulsivity, in ED research, may enable the identification of fundamental underlying mechanisms and provide more insight into potential mechanisms that may drive or maintain disordered eating. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:673-680). © 2016 Wiley Periodicals, Inc.

Increased restrictive feeding practices are associated with reduced energy density in 4-6-year-old, multi-ethnic children at ad libitum laboratory test-meals.

PubMed

Sud, Shama; Tamayo, Nina Carmela; Faith, Myles S; Keller, Kathleen L

2010-10-01

Increased reports of restrictive feeding have shown positive relationships to child obesity, however, the mechanism between the two has not been elucidated. This study examined the relationship between reported use of restrictive feeding practices and 4-6-year-old children's self-selected energy density (ED) and total energy intake from an ad libitum, laboratory dinner including macaroni and cheese, string beans, grapes, baby carrots, cheese sticks, pudding, milks, and a variety of sweetened beverages. A second objective explored the relationship between ED and child body mass index (BMI) z-score. Seventy (n=70) healthy children from primarily non-Caucasian and lower socioeconomic status families participated. Mothers completed the Child Feeding Questionnaire (CFQ) to assess restrictive feeding practices. Energy density (kcal/g) values for both foods and drinks (ED(food+drink)) and ED for foods only (ED(foods)) were calculated by dividing the average number of calories consumed by the average weight eaten across 4 meals. Higher maternal restriction was associated with lower ED(food+drink). In overweight and obese children only, higher maternal restriction was associated with lower ED(food). There was a non-significant trend for both ED measures to be negatively associated with child BMI z-score. Overall, restrictive feeding practices were not associated with child BMI z-score. However, when analyzing separate aspects of restriction, parents reported higher use of restricting access to palatable foods but lower use of using palatable foods as rewards with heavier children. Previous reports of positive associations between child obesity and restrictive feeding practices may not apply in predominantly non-Caucasian, lower socioeconomic status cohorts of children.

The effects of alcohol mixed with energy drinks (AmED) on traffic behaviors among Brazilian college students: a national survey.

PubMed

Eckschmidt, Frederico; de Andrade, Arthur Guerra; dos Santos, Bernardo; de Oliveira, Lúcio Garcia

2013-01-01

Drinking alcohol mixed with energy drinks (AmED) may be contributing to hazardous drinking practices and risk-taking behaviors among college students. In this regard, this study aimed to assess the frequency of AmED consumption in a national sample of Brazilian college students and to estimate the risk that energy drinks pose on drinking and traffic behaviors. A sample of 12,711 college students from across the country was asked to complete a research questionnaire on the use of drugs and other behaviors. Students who reported drinking in the previous 12 months (N = 8672) were divided into 2 groups: (a) those who reported drinking only alcohol (N = 4192) and (b) those who reported drinking AmED (N = 1119). The college students who reported the use of at least one illicit drug were excluded from data analysis. Descriptive and inferential analyses were subsequently carried out using the R library survey software 2.15.0. The null hypothesis was rejected at the level of P < .05. AmED users are more likely to be hazardous drinkers. Being male, single, and involved with high-risk drinking behaviors are associated to AmED. After adjusting for demographic and drinking variables, the odds of being involved in high-risk traffic behaviors--for example, driving at high speed (odds ratio [OR] = 2.6; P < .001) and driving after binge drinking (OR = 2.8; P < .001)--were higher among AmED users than alcohol only users (AUs). The current findings are consistent with the results of previous studies. Drinking AmED may make college students more vulnerable to the occurrence of risky drinking and traffic behaviors. Educational campaigns targeted to young people should be developed warning them about the potential risks of mixing alcohol with energy drinks.

Ethnographic analysis on the use of the electronic medical record for clinical handoff.

PubMed

Nelson, Philippa; Bell, Anthony J; Nathanson, Larry; Sanchez, Leon D; Fisher, Jonathan; Anderson, Philip D

2017-12-01

The objective of this study was to understand the social elements of clinical and organizational interactions of the key stakeholders in the specific context of an electronic dashboard used by the emergency department (ED) and inpatient medicine teams at the time of clinical referral and handover. An electronic handover function is utilised at the ED-inpatient interface at this institution and has given clinicians the ability to better communicate, monitor the department and strive to improve patient safety in streamline the delivery of care in the acute phase. This study uses an ethnographic qualitative research design incorporating semistructured interviews, participant observation on the ED floor and fieldwork notes. The setting for this research was in the ED at a tertiary University affiliated hospital. Triangulation was used to combine information obtained from multiple sources and information from fieldwork and interviews refined into useable chunks culminating in a thematic analysis. Thematic analysis yielded five central themes that reflected how the clinical staff utilised this IT system and why it had become embedded in the culture of clinical referral and handover. Efficient time management for improved patient flow was demonstrated, value added communication (at the interpersonal level), the building trust at the ED-inpatient interface, the maintenance of mutual respect across medical cultures and an overall enhancement of the quality of ED communication (in terms of the information available). A robust electronic handover process, resulted in an integrated approach to patient care by removing barriers to admission for medical inpatients, admitted via ED. The value proposition for patients was a more complete information transfer, both within the ED and between departments.

Personality Traits Predict Emergency Department Utilization Over 3 Years in Older Patients

PubMed Central

Chapman, Benjamin P.; Shah, Manish; Friedman, Bruce; Drayer, Rebecca; Duberstein, Paul R.; Lyness, Jeffrey M.

2009-01-01

Background Emergency department (ED) utilization by older patients has major implications for morbidity, mortality, and health costs, yet its behavioral determinants remain poorly understood. Powerfully tied to health in older adults, the “Big Five” personality traits of neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness may predict ED use. Objectives Investigate the role of personality in prospective ED use among older patients. Research Design Prospective cohort. Subjects Adults aged 65 and older. Measures Participants completed the NEO Five Factor Inventory of personality at baseline, and interviewers administered the Cornell Services Index assessing ED use at baseline and 3 yearly follow-ups. Results Controlling for income, education, gender, age, physician-assessed medical burden and physical functioning, and interviewer-assessed impairments in basic activities of daily living and physical self-maintenance, and depression, lower agreeableness and higher extroversion were each associated with increased odds of an ED visit over the follow-up period. A 1 sample deviation (SD) increase in extroversion (i.e., 50th versus 83rd population percentile) increased the odds of ED use by 51% (adjusted odds ratio [AOR] [95% CI] = 1.51 [1.03-2.21], z = 2.12, N = 923, p = 0.034). A 1-SD decrease in agreeableness (i.e., 50th versus 17th population percentile) increased odds of ED use by 54% (AOR [95% CI] = 1.54 [1.05-2.22], z = -2.25, N = 923, p = 0.034). Conclusion The greater assertiveness and social confidence signified by lower agreeableness and higher extroversion may help older adults overcome potential barriers to the ED. Overly introverted and agreeable older adults may require special encouragement to access the ED—particularly for time-sensitive conditions—to reduce morbidity and mortality. PMID:19461261

Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool.

PubMed

Hasemann, Wolfgang; Grossmann, Florian F; Stadler, Rahel; Bingisser, Roland; Breil, Dieter; Hafner, Martina; Kressig, Reto W; Nickel, Christian H

2017-12-30

Delirium is frequent in older Emergency Department (ED) patients, but detection rates for delirium in the ED are low. To aid in identifying delirium, we developed and implemented a two-step systematic delirium screening and assessment tool in our ED: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). Components of the mCAM-ED include: (1) screening for inattention, the main feature of delirium, which was performed with the Months Backwards Test (MBT); (2) delirium assessment based on a structured interview with questions from the Mental Status Questionnaire by Kahn et al. and the Comprehension Test by Hart et al. The aims of our study are (1) to investigate the performance criteria of the mCAM-ED tool in a consecutive sample of older ED patients, (2) to evaluate the performance of the mCAM-ED in patients with and without dementia and (3) to test whether this tool is efficient in keeping evaluation time to a minimum and reducing screening and assessment burden on the patient. For this prospective validation study, we recruited a consecutive sample of ED patients aged 65 and older during an 11-day period in November 2015. Trained nurses assessed patients with the mCAM-ED. Results were compared to the reference standard [i.e. the geriatricians' delirium diagnosis based on the criteria of the Text Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)]. Performance criteria were computed. We included 286 consecutive ED patients aged 65 and older. The median age was 80.02 (Q 1  = 72.15; Q 3  = 86.76), 58.7% of included patients were female, 14.3% had dementia. We found a delirium prevalence of 7.0%. In patients with dementia, specificity and positive likelihood ratio were lower. When compared to the reference standard, delirium assessment with the mCAM-ED has a 0.98 specificity and a 39.9 positive likelihood ratio. In 80.0% of all cases, the first step of the mCAM-ED, i.e. screening for inattention with the MBT, took less than 30 s. On average, the complete mCAM-ED assessment required 3.2 (SD 2.0), 5.6 (SD 3.2), and 6.2 (SD 2.3) minutes in cognitively unimpaired patients, patients with dementia and patients with dementia or delirium, respectively. The mCAM-ED is able to efficiently rule out delirium as well as confirm the diagnosis of delirium in elderly patients with and without dementia and applies minimal screening and assessment burden on the patient.

A case for stocking O D+ red blood cells in emergency room trauma bays.

PubMed

Meyer, Erin; Uhl, Lynne

2015-04-01

AABB Standard 5.27 requires transfusion services to have a process for urgent release of blood before completion of compatibility testing. Our institution endorses a policy for the emergency release of group O, D+ red blood cells (RBC; O+ RBC) to males and females at least 50 years of age. Our emergency department (ED) stocks 4 O- RBC units. To determine if O+ RBCs can replace ED O- RBCs, we performed a retrospective review. Patients admitted to the ED between January 2001 and August 2011 and transfused emergency-release O- RBCs were identified. Data were collected on sex, age, length of stay, clinical status, ABO/Rh, RBC transfusions, and RBC antibody screen results. A total of 498 ED O- RBC units were transfused to 268 patients (168 male, 100 female). A total of 322 units were transfused to males and 114 to females at least 50 years of age. Thirty-nine (14%) were D- with 18 receiving O+ RBCs. A total of 109 had follow-up antibody screens; one D- patient developed alloanti-D. The findings support the placement of O+ RBCs in the ED. The majority of ED O- RBCs (88%) went to patients who qualified for O+ RBCs; a minority (1.5%) of patients were D- females less than 50 years of age. The rate of alloimmunization was low. © 2014 AABB.

Solution to the satisfiability problem using a complete Grover search with trapped ions

NASA Astrophysics Data System (ADS)

Yang, Wan-Li; Wei, Hua; Zhou, Fei; Chang, Weng-Long; Feng, Mang

2009-07-01

The main idea in the original Grover search (1997 Phys. Rev. Lett. 79 325) is to single out a target state containing the solution to a search problem by amplifying the amplitude of the state, following the Oracle's job, i.e., a black box giving us information about the target state. We design quantum circuits to accomplish a complete Grover search involving both the Oracle's job and the amplification of the target state, which are employed to solve satisfiability (SAT) problems. We explore how to carry out the quantum circuits with currently available ion-trap quantum computing technology.

Combination of longitudinal and circumferential three-dimensional esophageal dose distribution predicts acute esophagitis in hypofractionated reirradiation of patients with non-small-cell lung cancer treated in stereotactic body frame.

PubMed

Poltinnikov, Igor M; Fallon, Kevin; Xiao, Yian; Reiff, Jay E; Curran, Walter J; Werner-Wasik, Maria

2005-07-01

To evaluate dosimetric predictors of acute esophagitis (AE) and clinical outcome of patients with non-small-cell lung cancer (NSCLC) receiving reirradiation. Seventeen patients with NSCLC received reirradiation to the lung tumors/mediastinum, while immobilized in stereotactic body frame (SBF). CT simulation and hypofractionated three-dimensional radiotherapy were used. Two axial segments of esophagus contours merged together were defined as esophagus disc (ED). For each ED, the percentage (%) of the volume of esophageal circumference treated to % of prescribed dose (PD) was assessed. Number of EDs with 50% or any % of volume (V) of esophageal circumference receiving more than or equal to (>/=) 50%, 80%, and 100% of PD (50% V >/=50% PD; 50% V >/=80% PD; any % V >/=100% PD) were calculated. These dosimetric variables and the length of the esophagus within the radiation therapy (RT) port were correlated with AE using exact Wilcoxon test. A median RT dose was 32 Gy with a median fraction size of 4 Gy. Eleven of 13 patients presenting with pain and/or shortness of breath had complete or partial resolution of symptoms. Median survival time from the start of reirradiation in SBF until death was 5.5 months. AE was observed in 7 patients and resolved within 3 months of RT completion. No Grade 3 or higher events were noticed. The length of the esophagus within RT port did not predict for AE (p = 0.71). However, an increased number of EDs predicted for AE for the following dosimetric variables: 50% V >/=50% PD (p = 0.023), 50% V >/=80% PD (p = 0.047), and any % V >/=100% PD (p = 0.004). Patients with at least 2 EDs receiving >/=100% PD to any % V of circumference had AE compared to those with zero EDs. Reirradiation using hypofractionated three-dimensional radiotherapy and SBF immobilization is an effective strategy for palliation of symptoms in selected patients with recurrent NSCLC. The length of the esophagus in the RT field does not predict for AE. However, an increasing number of EDs displaying the combination of longitudinal and circumferential three-dimensional dose distribution along the esophagus is a valuable predictor for AE.

TH-CD-202-02: A Preliminary Study Evaluating Beam-Hardening Artifact Reduction On CT Direct Electron-Density Images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, H; Dolly, S; Zhao, T

Purpose: A prototype reconstruction algorithm that can provide direct electron density (ED) images from single energy CT scans is being currently developed by Siemens Healthcare GmbH. This feature can eliminate the need for kV specific calibration curve for radiation treatemnt planning. An added benefit is that beam-hardening artifacts are also reduced on direct-ED images due to the underlying material decomposition. This study is to quantitatively analyze the reduction of beam-hardening artifacts on direct-ED images and suggest additional clinical usages. Methods: HU and direct-ED images were reconstructed on a head phantom scanned on a Siemens Definition AS CT scanner at fivemore » tube potentials of 70kV, 80kV, 100kV, 120kV and 140kV respectively. From these images, mean, standard deviation (SD), and local NPS were calculated for regions of interest (ROI) of same locations and sizes. A complete analysis of beam-hardening artifact reduction and image quality improvement was conducted. Results: Along with the increase of tube potentials, ROI means and SDs decrease on both HU and direct-ED images. The mean value differences between HU and direct-ED images are up to 8% with absolute value of 2.9. Compared to that on HU images, the SDs are lower on direct-ED images, and the differences are up to 26%. Interestingly, the local NPS calculated from direct-ED images shows consistent values in the low spatial frequency domain for images acquired from all tube potential settings, while varied dramatically on HU images. This also confirms the beam -hardening artifact reduction on ED images. Conclusions: The low SDs on direct-ED images and relative consistent NPS values in the low spatial frequency domain indicate a reduction of beam-hardening artifacts. The direct-ED image has the potential to assist in more accurate organ contouring, and is a better fit for the desired purpose of CT simulations for radiotherapy.« less

Erectile dysfunction in COPD patients

PubMed Central

Ure, Iyimser; Turan, Pakize Ayse

2015-01-01

Sexual dysfunction is a common problem in chronic obstructive pulmonary disease (COPD). We aimed to assess the presence of erectile dysfunction (ED) in COPD patients. Ninety-three outpatients who had been diagnosed as COPD and followed in Bolvadin State Hospital, Afyon, Turkey, were included in the study. All patients underwent pulmonary function tests and arterial blood gas analysis. They completed International Physical Activity Questionnaire (IPAQ), Medical Research Council (MRC) Dyspnea Scale, Short Form 36-item Scale (SF-36), and International Index of Erectile Function (IIEF) Questionnaire. The mean age of 10 (10.8%) mild, 46 (49.5%) moderate, 28 (30.1%) severe, and 9 (9.7%) very severe COPD patients was 61.4 ± 9.8 years. Varying degrees of ED were detected in 67.7% of COPD patients. All patients with hypoxemia had ED. IPAQ score and all SF-36 parameters were low in patients with ED, while MRC score was high. Forced expiratory volume in one second, forced vital capacity, partial pressure of oxygen in blood, oxygen (O2) saturation, IPAQ score, and role-physical parameters were statistically low in ED patients (p = 0.04, 0.02, <0.01, <0.01, 0.02, and 0.04, respectively); MRC score was statistically higher in patients with ED (p = 0.02). Patients with moderate and severe ED had statistically lower score of mental health (p < 0.01 and p = 0.02, respectively). There was a positive correlation between IIEF score and IPAQ scores (p < 0.01), MRC scores (p = 0.01), general health (p < 0.01), role-physical (p < 0.01), role-emotional (p < 0.01), physical functioning (p < 0.01), and mental health (p < 0.01) parameters in SF-36. ED is frequently seen in COPD patients. Hypoxemia, smoking, and limitation of physical activity are thought to be associated with ED in COPD as mechanisms. Quality of life and the functional capacity are negatively affected with the presence of ED. It is important for a physician to question the sexual functions in patients with COPD. The presence of ED may be routinely considered in the daily practice of pulmonologists in COPD patients. PMID:26647416

Erectile dysfunction in COPD patients.

PubMed

Turan, Onur; Ure, Iyimser; Turan, Pakize Ayse

2016-02-01

Sexual dysfunction is a common problem in chronic obstructive pulmonary disease (COPD). We aimed to assess the presence of erectile dysfunction (ED) in COPD patients. Ninety-three outpatients who had been diagnosed as COPD and followed in Bolvadin State Hospital, Afyon, Turkey, were included in the study. All patients underwent pulmonary function tests and arterial blood gas analysis. They completed International Physical Activity Questionnaire (IPAQ), Medical Research Council (MRC) Dyspnea Scale, Short Form 36-item Scale (SF-36), and International Index of Erectile Function (IIEF) Questionnaire. The mean age of 10 (10.8%) mild, 46 (49.5%) moderate, 28 (30.1%) severe, and 9 (9.7%) very severe COPD patients was 61.4 ± 9.8 years. Varying degrees of ED were detected in 67.7% of COPD patients. All patients with hypoxemia had ED. IPAQ score and all SF-36 parameters were low in patients with ED, while MRC score was high. Forced expiratory volume in one second, forced vital capacity, partial pressure of oxygen in blood, oxygen (O2) saturation, IPAQ score, and role-physical parameters were statistically low in ED patients (p = 0.04, 0.02, <0.01, <0.01, 0.02, and 0.04, respectively); MRC score was statistically higher in patients with ED (p = 0.02). Patients with moderate and severe ED had statistically lower score of mental health (p < 0.01 and p = 0.02, respectively). There was a positive correlation between IIEF score and IPAQ scores (p < 0.01), MRC scores (p = 0.01), general health (p < 0.01), role-physical (p < 0.01), role-emotional (p < 0.01), physical functioning (p < 0.01), and mental health (p < 0.01) parameters in SF-36. ED is frequently seen in COPD patients. Hypoxemia, smoking, and limitation of physical activity are thought to be associated with ED in COPD as mechanisms. Quality of life and the functional capacity are negatively affected with the presence of ED. It is important for a physician to question the sexual functions in patients with COPD. The presence of ED may be routinely considered in the daily practice of pulmonologists in COPD patients. © The Author(s) 2015.

Diagnostic and Demographic Differences Between Incarcerated and Nonincarcerated Youth (Ages 6-15) With ADHD in South Carolina.

PubMed

Soltis, Samuel L; Probst, Janice; Xirasagar, Sudha; Martin, Amy B; Smith, Bradley H

2017-05-01

Analyze diagnostic and demographic factors to identify predictors of delinquency resulting in incarceration within a group of children/adolescents diagnosed with ADHD. The study followed a cohort of 15,472 Medicaid covered children/adolescents with ADHD, ages 6 to 15 inclusive, between January 1, 2003, and December 31, 2006. The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [ DSM-IV-TR]), 2000 Codes were used for qualifying diagnosis codes. Available demographic characteristics included race, sex, and residence. The outcome was incarceration at the South Carolina Department of Juvenile Justice during 2005-2006. Among youth with ADHD, incarceration was more likely among black, male, and urban youth. Children/adolescents with comorbid ODD and/or CD were at greater risk compared with those with ADHD alone. Within ADHD-diagnosed youth, comorbid conditions and demographic characteristics increase the risk of incarceration. Intervention and treatment strategies that address behavior among youth with these characteristics are needed to reduce incarceration.

Analysis of microstructure and mechanical properties of aluminium-copper joints welded by FSW process

NASA Astrophysics Data System (ADS)

Iordache, M.; Sicoe, G.; Iacomi, D.; Niţu, E.; Ducu, C.

2017-08-01

The research conducted in this article aimed to check the quality of joining some dissimilar materials Al-Cu by determining the mechanical properties and microstructure analysis. For the experimental measurements there were used tin alloy Al - EN-AW-1050A with a thickness of 2 mm and Cu99 sheet with a thickness of 2 mm, joined by FSW weld overlay. The main welding parameters were: rotating speed of the rotating element 1400 rev/min, speed of the rotating element 50 mm/min. The experimental results were determined on samples specially prepared for metallographic analysis. In order to prepare samples for their characterization, there was designed and built a device that allowed simultaneous positioning and fixing for grinding. The characteristics analyzed in the joint welded samples were mictrostructure, microhardness and residual stresses. The techniques used to determine these characteristics were optical microscopy, electron microscopy with fluorescence radioactive elemental analysis (EDS), Vickers microhardness line - HV0.3 and X-ray diffractometry.

Production and Detection of Spin-Entangled Electrons in Mesoscopic Conductors

NASA Astrophysics Data System (ADS)

Burkard, Guido

2006-03-01

Electron spins are an extremely versatile form of quantum bits. When localized in quantum dots, they can form a register for quantum computation. Moreover, being attached to a charge in a mesoscopic conductor allows the electron spin to play the role of a mobile carrier of quantum information similarly to photons in optical quantum communication. Since entanglement is a basic resource in quantum communication, the production and detection of spin-entangled Einstein-Podolsky-Rosen (EPR) pairs of electrons are of great interest. Besides the practical importance, it is of fundamental interest to test quantum non-locality for electrons. I review the theoretical schemes for the entanglement production in superconductor-normal junctions [1] and other systems. The electron spin entanglement can be detected and quantified from measurements of the fluctuations (shot noise) of the charge current after the electrons have passed through an electronic beam splitter [2,3]. This two-particle interference effect is related to the Hanbury-Brown and Twiss experiment and leads to a doubling of the shot noise SI=<δI δI>φ=0 for spin-entangled states, allowing their differentiation from unentangled pairs. I report on the role of spin-orbit coupling (Rashba and Dresselhaus) in a complete characterization of the spin entanglement [4]. Finally, I address the effects of a discrete level spectrum in the mesoscopic leads and of backscattering and decoherence.[1] P. Recher, E. V. Sukhorukov, D. Loss, Phys. Rev. B 63, 165314 (2001)[2] G. Burkard, D. Loss, E. V. Sukhorukov, Phys. Rev. B 61, R16303 (2000)[3] G. Burkard and D. Loss, Phys. Rev. Lett.91, 087903 (2003)[4] J. C. Egues, G. Burkard, D. Saraga, J. Schliemann, D. Loss, cond-mat/0509038, to appear in Phys.Rev.B (2005).

Effects of bright light exposure during daytime on peripheral clock gene expression in humans.

PubMed

Sato, Maki; Wakamura, Tomoko; Morita, Takeshi; Okamoto, Akihiko; Akashi, Makoto; Matsui, Takuya; Sato, Motohiko

2017-06-01

Light is the strongest synchronizer controlling circadian rhythms. The intensity and duration of light change throughout the year, thereby influencing body weight, food preferences, and melatonin secretion in humans and animals. Although the expression of clock genes has been examined using human samples, it currently remains unknown whether bright light during the daytime affects the expression of these genes in humans. Therefore, we herein investigated the effects of bright light exposure during the daytime on clock gene expression in the hair follicular and root cells of the human scalp. Seven healthy men (20.4 ± 2.2 years old; 172.3 ± 5.8 cm; 64.3 ± 8.5 kg; BMI 21.7 ± 3.1 kg/m 2 , mean ± SD) participated in this study. Subjects completed 3-day experimental sessions twice in 1 month during which they were exposed to bright and dim light conditions. The mRNA expression of Per1-3, Cry1-2, Rev-erb-α (Nr1d1), Rev-erb-β (Nr1d2), and Dec1 was analyzed using branched DNA probes. No significant changes were observed in the expression of Per1, Per2, Per3, Cry1, Cry2, Rev-erb-α (Nr1d1), or Dec1 following exposure to bright light conditions. However, the expression of Rev-erb-β (Nr1d2) tended to be stronger under bright light than dim light conditions. These results suggest that the bright light stimulus did not influence the expression of clock genes in humans. Long-lasting bright light exposure during the daytime may be required to change the expression of clock genes in humans.

Determination of Etomidate in Human Postmortem Fluids and Tissues

DTIC Science & Technology

2009-02-01

8-72) Reproduction of completed page authorized CONTENTs IntroductIon...on.Agent ..Pharma- cotherapy,.3:.251-8.(1983) . 2 .. Doencke,.A ..Etomidate, a New Hypnotic Agent for Intravenous Application.,. 1. ed .. (Sprnger

Rev1 Recruits Ung to Switch Regions and Enhances dU Glycosylation for Immunoglobulin Class Switch DNA Recombination

PubMed Central

Zan, Hong; White, Clayton A.; Thomas, Lisa M.; Mai, Thach; Li, Guideng; Xu, Zhenming; Zhang, Jinsong; Casali, Paolo

2012-01-01

SUMMARY By diversifying the biological effector functions of antibodies, class switch DNA recombination (CSR) plays a critical role in the maturation of the immune response. It is initiated by AID-mediated dC deamination, yielding dUs, and dU glycosylation by Ung in antibody switch (S) region DNA. Here we showed that the translesion DNA synthesis polymerase Rev1 directly interacted with Ung and targeted in an AID-dependent and Ung-independent fashion the S regions undergoing CSR. Rev1–/– Ung+/+ B cells reduced Ung recruitment to S regions, DNA-dU glycosylation and CSR. This together with an S region spectrum of mutations similar to that of Rev1+/+ Ung–/– B cells suggested that Rev1 operated in the same pathway as Ung, as emphasized by further decreased CSR in Rev1–/– Msh2–/– B cells. Rescue of CSR in Rev1–/– B cells by a catalytically inactive Rev1 mutant showed that the important role of Rev1 in CSR is mediated by Rev1 scaffold, not enzymatic function. PMID:23140944

[Construction of autocatalytic caspase-3 driven by amplified human telomerase reverse transcriptase promoter and its enhanced efficacy of inducing apoptosis in human ovarian carcinoma].

PubMed

Song, Yue; Shen, Keng; He, Chun-Xia

2007-09-01

To construct recombinant adenoviral vector expressing autocatalysis caspase-3 driven by human telomerase reverse transcriptase promoter amplified by two-step transcription amplification (hTERTp-TSTA), and investigate its antitumor effect in ovarian cancer in vitro and in vivo. Recombinant adenoviruses expressing autocatalytic caspase-3 (rev-caspase-3) driven by hTERTp-TSTA were prepared, which were named as AdHTVP2G5-rev-casp3. AdHT-rev-casp3, Ad-rev-casp3 and AdHTVP2G5-EGEP, which express rev-caspase-3 driven by hTERTp, cytomegalovirus promoter (CMVp) and enhanced green fluorescent protein (EGFP), respectively, were used as controls. Western blot, cell counting kit (CCK-8), flow cytometry (FCM) and TdT-mediated dUTP-biotin nick end labeling (TUNEL) were used to detect the expression of p17, active subunit of caspase-3, and p85, and to measure cell survival rates, apoptotic rates and cell cycle distribution in ovarian cell line AO and normal human umbilical vein endothelial cell line HUVEC, following treatments of AdHTVP2G5-rev-casp3. subcutaneous tumor models and abdominally spread tumor models of human ovarian carcinoma using AO cells in BALB/c nude mice were established. Following treatments of AdHTVP2G5-rev-casp3, western blot was used to detect the expression of active caspase-3 in abdominally spread tumors and liver tissues, respectively, and the mouse survival rates and the volume of tumor nodules were measured, and the serum level of alanine transaminase (ALT) and aspartate transaminase (AST) were analyzed to monitor liver damages and HE staining was used to detect the histopathological changes of various organs. The levels of p17 expression in AdHTVP2G5-rev-casp3-treated AO cells were significantly higher than that in Ad-rev-casp3 or AdHT-rev-casp3 treated AO cells, while no expression was observed in AdHTVP2G5-rev-casp3-treated HUVEC. There was strong cell killing of AdHTVP2G5-rev-casp3 of hTERT positive AO cells, but not of the hTERT-negative HUVEC cells. Cell survival rate and apoptotic rate of AO cells treated with AdHTVP2G5-rev-casp3 were 17.8% and 40.2%, respectively, significantly different from that treated with AdHT-rev-casp3 (75.2% and 16.1%) at the multiplicity of infection (MOI) of 70 (P < 0.01). There was no significant difference in HUVEC cell survival rate and apoptotic rate between AdHTVP2G5-rev-casp3 treatment (97.7% and 2.1%, respectively) and AdHT-rev-casp3 treatment (98.5% and 1.7%, respectively) at the same MOI (P > 0.05). Significant expressions of active caspase-3 were shown in AdHTVP2G5-rev-casp3-treated tumors, whereas no expression was shown in liver. In contrast, both tumors and liver tissues showed active caspase-3 expression following treatments of Ad-rev-casp3. AdHTVP2G5-rev-casp3 and Ad-rev-casp3 prolonged mouse survival [mean survival time of (259 +/- 14) d and (213 +/- 16) d], when compared with treatment with AdHT-rev-casp3 [(177 +/- 12) d] and AdHTVP2G5-EGFP [(109 +/- 7) d; P < 0.01]. The mean volume of AdHTVP2G5-rev-casp3-treated tumor was 406 mm(3), significantly less than those of AdHT-rev-casp3 treatment (990 mm(3)), Ad-rev-casp3 treatment (645 mm(3)) and AdHTVP2G5-EGFP treatment (1728 mm(3); P < 0.01). The serum ALT and AST levels were not significantly elevated in AdHTVP2G5-rev-casp3-treated mice, whereas significantly elevated in Ad-rev-casp3-treated mice. No obvious lesions were found in any organ in AdHTVP2G5-rev-casp-treated group. Recombinant adenovirus AdHTVP2G5-rev-casp3 expressing rev-caspase-3 driven by hTERTp-TSTA can result in marked cell apoptosis with significant tumor targeting, suppressing tumor growth and prolonging the mouse survival, meanwhile, it can prevent against the liver toxicity induced by rev-caspase-3.

'Seizure First Aid Training' for people with epilepsy who attend emergency departments, and their family and friends: study protocol for intervention development and a pilot randomised controlled trial.

PubMed

Noble, A J; Marson, A G; Tudur-Smith, C; Morgan, M; Hughes, D A; Goodacre, S; Ridsdale, L

2015-07-24

People with chronic epilepsy (PWE) often make costly but clinically unnecessary emergency department (ED) visits. Offering them and their carers a self-management intervention that improves confidence and ability to manage seizures may lead to fewer visits. As no such intervention currently exists, we describe a project to develop and pilot one. To develop the intervention, an existing group-based seizure management course that has been offered by the Epilepsy Society within the voluntary sector to a broader audience will be adapted. Feedback from PWE, carers and representatives from the main groups caring for PWE will help refine the course so that it addresses the needs of ED attendees. Its behaviour change potential will also be optimised. A pilot randomised controlled trial will then be completed. 80 PWE aged ≥16 who have visited the ED in the prior 12 months on ≥2 occasions, along with one of their family members or friends, will be recruited from three NHS EDs. Dyads will be randomised to receive the intervention or treatment as usual alone. The proposed primary outcome is ED use in the 12 months following randomisation. For the pilot, this will be measured using routine hospital data. Secondary outcomes will be measured by patients and carers completing questionnaires 3, 6 and 12 months postrandomisation. Rates of recruitment, retention and unblinding will be calculated, along with the ED event rate in the control group and an estimate of the intervention's effect on the outcome measures. Ethical approval: NRES Committee North West-Liverpool East (Reference number 15/NW/0225). The project's findings will provide robust evidence on the acceptability of seizure management training and on the optimal design of a future definitive trial. The findings will be published in peer-reviewed journals and presented at conferences. ISRCTN13 871 327. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Information technology improves Emergency Department patient discharge instructions completeness and performance on a national quality measure: a quasi-experimental study.

PubMed

Bell, E J; Takhar, S S; Beloff, J R; Schuur, J D; Landman, A B

2013-01-01

To compare the completeness of Emergency Department (ED) discharge instructions before and after introduction of an electronic discharge instructions module by scoring compliance with the Centers for Medicare and Medicaid Services (CMS) Outpatient Measure 19 (OP-19). We performed a quasi-experimental study examining the impact of an electronic discharge instructions module in an academic ED. Three hundred patients discharged home from the ED were randomly selected from two time intervals: 150 patients three months before and 150 patients three to five months after implementation of the new electronic module. The discharge instructions for each patient were reviewed, and compliance for each individual OP-19 element as well as overall OP-19 compliance was scored per CMS specifications. Compliance rates as well as risk ratios (RR) and risk differences (RD) with 95% confidence intervals (CI) comparing the overall OP-19 scores and individual OP-19 element scores of the electronic and paper-based discharge instructions were calculated. The electronic discharge instructions had 97.3% (146/150) overall OP-19 compliance, while the paper-based discharge instructions had overall compliance of 46.7% (70/150). Electronic discharge instructions were twice as likely to achieve overall OP-19 compliance compared to the paper-based format (RR: 2.09, 95% CI: 1.75 - 2.48). The largest improvement was in documentation of major procedures and tests performed: only 60% of the paper-based discharge instructions satisfied this criterion, compared to 100% of the electronic discharge instructions (RD: 40.0%, 95% CI: 32.2% - 47.8%). There was a modest difference in medication documentation with 92.7% for paper-based and 100% for electronic formats (RD: 7.3%, 95% CI: 3.2% - 11.5%). There were no statistically significant differences in documentation of patient care instructions and diagnosis between paper-based and electronic formats. With careful design, information technology can improve the completeness of ED patient discharge instructions and performance on the OP-19 quality measure.

Cocaine-dependent adults and recreational cocaine users are more likely than controls to choose immediate unsafe sex over delayed safer sex.

PubMed

Koffarnus, Mikhail N; Johnson, Matthew W; Thompson-Lake, Daisy G Y; Wesley, Michael J; Lohrenz, Terry; Montague, P Read; Bickel, Warren K

2016-08-01

Cocaine users have a higher incidence of risky sexual behavior and HIV infection than nonusers. Our aim was to measure whether safer sex discount rates-a measure of the likelihood of having immediate unprotected sex versus waiting to have safer sex-differed between controls and cocaine users of varying severity. Of the 162 individuals included in the primary data analyses, 69 met the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for cocaine dependence, 29 were recreational cocaine users who did not meet the dependence criteria, and 64 were controls. Participants completed the Sexual Discounting Task, which measures a person's likelihood of using a condom when one is immediately available and how that likelihood decreases as a function of delay to condom availability with regard to 4 images chosen by the participants of hypothetical sexual partners differing in perceived desirability and likelihood of having a sexually transmitted infection. When a condom was immediately available, the stated likelihood of condom use sometimes differed between cocaine users and controls, which depended on the image condition. Even after controlling for rates of condom use when one is immediately available, the cocaine-dependent and recreational users groups were more sensitive to delay to condom availability than controls. Safer sex discount rates were also related to intelligence scores. The Sexual Discounting Task identifies delay as a key variable that impacts the likelihood of using a condom among these groups and suggests that HIV prevention efforts may be differentially effective based on an individual's safer sex discount rate. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Characterization of individuals seeking treatment for caffeine dependence.

PubMed

Juliano, Laura M; Evatt, Daniel P; Richards, Brian D; Griffiths, Roland R

2012-12-01

Previous investigations have identified individuals who meet criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 years, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts), and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment and suggests that there is a need for effective caffeine dependence treatments. 2013 APA, all rights reserved

The Nuclear Receptor Rev-erbα Controls Circadian Thermogenic Plasticity

PubMed Central

Gerhart-Hines, Zachary; Everett, Logan J.; Loro, Emanuele; Briggs, Erika R.; Bugge, Anne; Hou, Catherine; Ferrara, Christine; Seale, Patrick; Pryma, Daniel A.; Khurana, Tejvir S.; Lazar, Mitchell A.

2013-01-01

Circadian oscillation of body temperature is a basic, evolutionary-conserved feature of mammalian biology1. Additionally, homeostatic pathways allow organisms to protect their core temperatures in response to cold exposure2. However, the mechanism responsible for coordinating daily body temperature rhythm and adaptability to environmental challenges is unknown. Here we show that the nuclear receptor Rev-erbα, a powerful transcriptional repressor, links circadian and thermogenic networks through the regulation of brown adipose tissue (BAT) function. Mice exposed to cold fare dramatically better at 5 AM (Zeitgeber time 22) when Rev-erbα is barely expressed than at 5 PM (ZT10) when Rev-erbα is abundant. Deletion of Rev-erbα markedly improves cold tolerance at 5 PM, indicating that overcoming Rev-erbα-dependent repression is a fundamental feature of the thermogenic response to cold. Physiological induction of uncoupling protein 1 (UCP1) by cold temperatures is preceded by rapid down-regulation of Rev-erbα in BAT. Rev-erbα represses UCP1 in a brown adipose cell-autonomous manner and BAT UCP1 levels are high in Rev-erbα-null mice even at thermoneutrality. Genetic loss of Rev-erbα also abolishes normal rhythms of body temperature and BAT activity. Thus, Rev-erbα acts as a thermogenic focal point required for establishing and maintaining body temperature rhythm in a manner that is adaptable to environmental demands. PMID:24162845

Integrating Population Health Data on Violence Into the Emergency Department: A Feasibility and Implementation Study.

PubMed

Levas, Michael N; Hernandez-Meier, Jennifer L; Kohlbeck, Sara; Piotrowski, Nancy; Hargarten, Stephen

Geocoded emergency department (ED) data have allowed for the development and evaluation of novel interventions for the prevention of violence in cities outside of the United States. First implemented in Cardiff, United Kingdom, collection of these data provides public health agencies, community organizations, and law enforcement with place-based information on assaults. The purpose of this study was to assess the feasibility of translating this model within the electronic medical record (EMR) in the United States. A new EMR module based on the Cardiff Model was developed and integrated into the existing ED EMR. Data were collected for all patients reporting an assaultive injury upon arrival to the ED. Emergency department nurses were subsequently recruited to participate in 2 surveys and a focus group to evaluate the implementation and to provide qualitative feedback to enhance integration. Nurses completed EMR questions in 98.2% of patients reporting to the ED over the study period. More than 90% of survey respondents were satisfied with their participation, and most felt that the questions were useful for clinical care (79/70%), were integrated well into workflow (89/90%), and were congruent with the ED and hospital goals and mission (93/98%). Focus group themes centered on ED culture, external factors, and internal workflow. It is feasible to implement place-based, assault-related injury-specific questions into the EMR with minimal disruption of workflow and triage times. Nurses, as key members of the ED team, are receptive to participating in the collection of population health data that may inform community violence prevention activities.

Review article: Methodology for the 'rapid review' series on musculoskeletal injuries in the emergency department.

PubMed

Strudwick, Kirsten; McPhee, Megan; Bell, Anthony; Martin-Khan, Melinda; Russell, Trevor

2018-02-01

Musculoskeletal injuries are a common presentation to the ED, with significant costs involved in the management of these injuries, variances in care within the ED and associated morbidity. A series of rapid review papers were completed to guide best practice for the assessment and management of common musculoskeletal injuries presenting to the ED. This paper presents the methodology used across the rapid reviews. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2015. The search was repeated consistently for each topic area (injuries of the foot and ankle, knee, hand and wrist, elbow, shoulder, lumbar spine and cervical spine). English-language primary studies, systematic reviews and guidelines that were published in the last 10 years and addressed acute musculoskeletal injury management were considered for inclusion. Data extraction of each included article was conducted, followed by a quality appraisal. The extracted data from each article was synthesised to group similar evidence together. For each rapid review, the evidence has been organised in a way that a clinician can direct their attention to a specific component of the clinical cycle of care in the ED, such as the assessment, diagnostic tests, management and follow-up considerations from ED. The series of rapid reviews are designed to foster evidence-based practice within the ED, targeting the injuries most commonly presenting. The reviews provide clinicians in EDs with rapid access to the best current evidence, which has been synthesised and organised to assist decision-making. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Implementation of a novel communication tool and its effect on patient comprehension of care and satisfaction.

PubMed

Simmons, Stefanie Anne; Sharp, Brian; Fowler, Jennifer; Singal, Bonita

2013-05-01

Emergency department (ED) communication has been demonstrated as requiring improvement and ED patients have repeatedly demonstrated poor comprehension of the care they receive. Through patient focus groups, the authors developed a novel tool designed to improve communication and patient comprehension. This is a prospective, randomised controlled clinical trial to test the efficacy of a novel, patient-centred communication tool. Patients in a small community hospital ED were randomised to receive the instrument, which was utilised by the entire ED care team and served as a checklist or guide to the patients' ED stay. At the end of the ED stay, patients completed a survey of their comprehension of the care and a communication assessment tool-team survey (a validated instrument to assess satisfaction with communication). Three blinded chart reviewers scored patients' comprehension of their ED care as concordant, partially concordant or discordant with charted care. The authors tested whether there was a difference in satisfaction using a two-sample t test and a difference in comprehension using ordinal logistic regression analysis. 146 patients were enrolled in the study with 72 randomised to receive the communication instrument. There was no significant difference between groups in comprehension (OR=0.65, 95% CI 0.34 to 1.23, p=0.18) or communication assessment tool-team scores (difference=0.2, 95% CI: -3.4 to 3.8, p=0.91). Using their novel communication tool, the authors were not able to show a statistically significant improvement in either comprehension or satisfaction, though a tendency towards improved comprehension was seen.

Active antitumor immunity elicited by vaccine based on recombinant form of epidermal growth factor receptor.

PubMed

Hu, Bing; Wei, Yuquan; Tian, Ling; Zhao, Xia; Lu, You; Wu, Yang; Yao, Bing; Liu, Jiyan; Niu, Ting; Wen, Yanjun; He, Qiuming; Su, Jingmei; Huang, Meijuan; Lou, Yanyan; Luo, Yan; Kan, Bing

2005-01-01

Active immunotherapy targeting epidermal growth factor receptor (EGFR) should be another attractive approach to the treatment of EGFR-positive tumors. To test this concept, the authors evaluated the potential immune responses and antitumor activities elicited by dendritic cells pulsed with recombinant ectodomain of mouse EGFR (DC-edMER). Spleen cells isolated from DC-edMER-vaccinated mice showed a high quantity of EGFR-specific antibody-producing cells. EGFR-reactive antibody in sera isolated from vaccinated mice was identified and shown to be effective against tumors in vitro and in vivo by adoptive transfer. DC-edMER vaccine also elicited cytotoxic T-lymphocyte responses that could mediate antitumor effects in vitro and adoptive transfer in vivo. In addition, EGFR-specific cytokines responses were elicited by DC-edMER vaccine. Immunization with DC-edMER resulted in tumor regression and prolonged survival in mice challenged with Lewis lung carcinomas and mammary cancer models. Depletion of CD4+ T lymphocytes could completely abrogate the antitumor activity and EGFR-specific antibody responses, whereas the depletion of CD8+ T lymphocytes showed partial abrogation of the antitumor activity but antibody was still detected. Furthermore, tumor-induced angiogenesis was suppressed in DC-edMER-vaccinated mice or mice treated with antibody adoptive transfer. Taken together, these findings suggest the antitumor immunity could be induced by DC-edMER, which may involve both humoral and cellular immunity, and may provide insight into the treatment of EGFR-positive tumors through the induction of active immunity against EGFR.

The prevalence of erectile dysfunction among hypertensive and prehypertensive men aged 25-40 years.

PubMed

Heruti, Rafi J; Sharabi, Yehonatan; Arbel, Yaron; Shochat, Tzipi; Swartzon, Michael; Brenner, Galit; Justo, Dan

2007-05-01

Erectile dysfunction (ED) and hypertension (HTN) are common and associated among men aged 40-70 years. Data on the prevalence of ED among younger hypertensive and prehypertensive men are limited. To study the prevalence of ED in a large-scale population of hypertensive and prehypertensive men aged 25-40 years. ED severity, systolic blood pressures (SBPs), diastolic blood pressures (DBPs), and mean arterial blood pressures (MAPs). Israel Defense Force personnel, aged 25 years and older, go through routine health checks at the Staff Periodic Health Examination Center (SPEC) every 3-5 years, including measuring blood pressure and completing the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect HTN and ED, respectively, and assess its severity. Pre-HTN was defined as SBP 120-139 mm Hg or DBP 80-89 mm Hg. HTN was defined as SBP >/or140 mm Hg and/or DBP >or=90 mm Hg. During 2001-2004, an overall of 11,252 men, aged 25-40 years, reported to the SPEC, and 5,860 (52.1%) men filled out the SHIM questionnaire. Among responders to the SHIM questionnaire, 1,278 (21.8%) men had low scores (

Optimizing patient/caregiver satisfaction through quality of communication in the pediatric emergency department.

PubMed

Locke, Robert; Stefano, Mariane; Koster, Alex; Taylor, Beth; Greenspan, Jay

2011-11-01

Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and liability reduction. The variables that contribute to an optimal outcome in the pediatric ED setting have been less well investigated. The specific hypothesis tested was that patient/family caregiver-provider communication and 24-hour postdischarge phone contact would be associated with an increased frequency of highest possible satisfaction scores. A consecutive set of Press Ganey satisfaction survey responses between June and December 2009 in a large tertiary referral pediatric ED was evaluated. Press Ganey responses were subsequently linked to defined components of the electronic medical record associated with each survey respondent's ED visit to ascertain specific objective ED data. Multivariate modeling utilizing generalized linear equations was achieved to obtain a composite model of drivers of patient/caregiver satisfaction. Primary drivers of satisfaction and willingness to return or refer others to the ED were as follows: being informed about delays, ease of the insurance process, overall physician rating, registered nurse attention to needs, control of pain, and successful completion of postdischarge phone call to a family caregiver. Multiple wait time variables that were statistically significant in univariate modeling, including total length of time in the ED, time in waiting room, comfort of waiting room, time in treatment room, and play items, were not statistically significant once controlling for the other variables in the model. Type of insurance, race, patient age, or time of year did not influence the models. Achieving optimal patient/caregiver satisfaction scores in the pediatric ED is highly dependent on the quality of the interpersonal interaction and communication of ED activities. Wait time and other throughput variables are less important than perceived quality of the health interaction and interpersonal communication. Patient satisfaction has advantages greater than market share and should be considered a component of the care-delivery paradigm.

Clinical and psychosocial factors associated with quality of life in alcohol-dependent men with erectile dysfunction.

PubMed

Ponizovsky, Alexander M

2008-10-01

Men with alcohol dependence (AD) commonly suffer from alcohol-induced sexual (erectile) dysfunction (ED) and have poor quality of life (Qol). Knowledge about the factors associated with Qol in such patients is lacking. To identify in men who sought medical help for both AD and ED the variables that best predicted feelings of satisfaction with life and with specific life domains. The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Secondary study measures were the International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI-13), General Health Questionnaire (GHQ-12), Rosenberg's General Self-Esteem Scale (RGSES), and the Multidimensional Scale of Perceived Social Support (MSPSS). Within an open-label sildenafil trial, 101 men aged 18-50 years with an International Classification of Diseases, Tenth Edition diagnosis of AD and concomitant ED were interviewed and completed the questionnaires. Multivariate analyses were applied to establish predictors of life satisfaction and factors mediating the relation between ED and life satisfaction. ED and self-rated depressive symptoms, emotional distress, self-esteem, and perceived social support were found to be significantly associated with Qol and its component domains. Altogether they explained 18-38% of the variance in the Qol ratings. Depressive symptomatology, distress, and self-esteem, individually, demonstrated a mediating effect on the relation between ED and Qol. Finally, self-esteem was shown to be the primary mediator in this relationship. The results of the study show that self-esteem is the primary factor, and depressive symptoms and severe emotional distress are secondary factors mediating the effects of ED on Qol in male patients seeking medical help for both AD and ED. An integrated pharmacopsychosocial approach targeting the underlying ED as well as the mediating emotional conditions could improve Qol of these patients and thus help them to stop using alcohol.

Reported emergency department avoidance, use, and experiences of transgender persons in Ontario, Canada: results from a respondent-driven sampling survey.

PubMed

Bauer, Greta R; Scheim, Ayden I; Deutsch, Madeline B; Massarella, Carys

2014-06-01

Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. The Trans PULSE Project conducted a survey of trans people in Ontario, Canada (n=433) in 2009 to 2010, using respondent-driven sampling, a tracked network-based method for studying hidden populations. Weighted frequencies and bootstrapped 95% confidence intervals (CIs) were estimated for the trans population in Ontario and for the subgroup (n=167) reporting ED use in their felt gender. Four hundred eight participants completed the ED experience items. Trans people were young (34% aged 16 to 24 years and only 10% >55 years); approximately half were female-to-male and half male-to-female. Medically supervised hormones were used by 37% (95% CI 30% to 46%), and 27% (95% CI 20% to 35%) had at least 1 transition-related surgery. Past-year ED need was reported by 33% (95% CI 26% to 40%) of trans Ontarians, though only 71% (95% CI 40% to 91%) of those with self-reported need indicated that they were able to obtain care. An estimated 21% (95% CI 14% to 25%) reported ever avoiding ED care because of a perception that their trans status would negatively affect such an encounter. Trans-specific negative ED experiences were reported by 52% (95% CI 34% to 72%) of users presenting in their felt gender. This first exploratory analysis of ED avoidance, utilization, and experiences by trans persons documented ED avoidance and possible unmet need for emergency care among trans Ontarians. Additional research, including validation of measures, is needed. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Emergency Department Visits Following Elective Total Hip and Knee Replacement Surgery: Identifying Gaps in Continuity of Care.

PubMed

Finnegan, Micaela A; Shaffer, Robyn; Remington, Austin; Kwong, Jereen; Curtin, Catherine; Hernandez-Boussard, Tina

2017-06-21

Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty. Factors associated with increased risk of an ED visit were estimated using hierarchical regression models controlling for patient variables with a fixed hospital effect. The main outcome was an ED visit within 30 days of discharge. Among the 152,783 patients who underwent major joint replacement, 5,229 (3.42%) returned to the inpatient setting and 8,883 (5.81%) presented to the ED for care within 30 days. Among ED visits, 17.94% had a primary diagnosis of pain and 25.75% had both a primary and/or a secondary diagnosis of pain. Patients presenting to the ED for subsequent care had more comorbidities and were more frequently non-white with public insurance relative to those not returning to the ED (p < 0.001). There was a significantly increased risk (p < 0.05) of isolated ED visits with regard to type of insurance when patients with Medicaid (odds ratio [OR], 2.28 [95% confidence interval (CI), 2.04 to 2.55]) and those with Medicare (OR, 1.38 [95% CI, 1.29 to 1.47]) were compared with patients with private insurance and with regard to race when black patients (OR, 1.38 [95% CI, 1.25 to 1.53]) and Hispanic patients (OR, 1.12 [95% CI, 1.03 to 1.22]) were compared with white patients. These increases in risk were stronger for isolated ED visits for patients with a pain diagnosis. ED visits following an elective major joint replacement surgical procedure were numerous and most commonly for pain-related diagnoses. Medicaid patients had almost double the risk of an ED or pain-related ED visit following a surgical procedure. The future of U.S. health-care insurance coverage expansions are uncertain; however, there are ongoing attempts to improve quality across the continuum of care. It is therefore essential to ensure that all patients, particularly vulnerable populations, receive appropriate postoperative care, including pain management. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

[The efficacy of autocatalytic casapse-3 driven by human telomerase reverse transcriptase promoter on human ovarian carcinoma].

PubMed

Song, Yue; Shen, Keng; Yu, Jing-rong

2007-11-06

To construct recombinant adenoviral vector expressing autocatalysis caspase-3 driven by human telomerase reverse transcriptase promoter (hTERTp), and investigate its antitumor effect on ovarian cancer in vitro and in vivo. Recombinant adenovirus expressing autocatalytic caspase-3 (rev-csapase-3) driven by hTERTp, AdHT-rev-casp3, was constructed. Ad-rev-casp3 expressing rev-caspase-3 driven by cytomegalovirus promoter (CMVp) was used as a positive control. hTERT positive human ovarian cancer cells of the line AO and hTERT-negative human umbilical venous endothelial cells (HUVECs) were cultured and transfected with AdHT-rev-casp3, Ad-rev-casp3, or Ad-EGFG expressing enhanced green fluorescent protein as control group. Western blotting, Cell Counting Kit (CCK-8), flow cytometry, and TUNEL were used to detect the expression of p17, active subunit of caspase-3, and p85, a poly ADP-ribose polymerase (PARP) cleavage fragment, and they were also used to measure the cell survival rate and apoptotic rate. Western blotting was used to detect the expression of active caspase-3 and its substrate PARP in the AO cells and HUVECs. Twenty nude BALB/c mice were inoculated subcutaneously with AO cells to establish subcutaneous tumor models, when the tumor grew to the volume of 150 mm3 the rats were divided into 4 equal groups to undergo intra-tumor injection of AdHT-rev-casp3, Ad-rev-casp3, Ad-EGFG, and phosphate-buffered saline (PBS) respectively, the survival rate tumor inhibition rate was observed, 72 days later the mice were killed with their livers and tumors taken out, and Western blotting was used to detect the expression of active caspase-3. Another 40 mice underwent intraperitoneal injection of AO cells to establish intraperitoneal transplanted tumor models, 21 days later the rats were divided into 4 equal groups to be injected intraperitoneally with AdHT-rev-casp3, Ad-rev-casp3, Ad-EGFG, or PBS, the survival rate was observed, and the blood levels of alanine transaminase (ALT) and aspartate transaminase (AST) were detected. Following the administration of AdHT-rev-casp3, active caspase-3 protein was significantly expressed, and the levels of p17 and p85 expressions were significantly elevated in AO cells, while no expressions of p17 and p85 was observed in HUVEC. In contrast, both AO and HUVEC expressed high levels of p17 and p85 protein after administrations of Ad-rev-casp3. AdHT-rev-casp3 dose-dependently killed the hTERT positive AO cells, however, showed no killing effect on the hTERT-negative HUVEC cells; whereas Ad-rev-casp3 was cytotoxic independent of the hTERT status of the cells. The killing effect of Ad-rev-casp3 was stronger than that of AdHT-rev-casp3. Treated with AdHT-rev-cap3 the expression levels of the caspase-3 fragment p17 and PARP cleavage fragment p85 of the AO cells were significantly higher than those before the treatment, however, the expression levels of p17 and p85 were both weaker than those of the AO cells treated with Ad-rev-casp-3. Though treated with AdHT-rev-casp-3, there was still no remarkable expression of p17 and p85 in the HUVECs, however, rather high protein expression levels of p17 and p85 was shown. After treatment with AdHT-rev-casp3 remarkable expression of active caspase-3 was seen in the tumor collected from the mouse body, but not in the liver; however, high caspase-3 expression level was shown in both the liver and tumor after the treatment of Ad-rev-casp-3. 53 days after treatment the tumor suppression rate of the AdHT-rev-casp3 and ad-rev-casp-3 groups were 60% and 70% respectively, both significantly higher than that of the control group. The survival rates of the mice treated with AdHT-rev-casp3 and Ad-rev-casp-3 were both significantly longer than that of the PBS group; however the survival rate of the Ad-rev-casp-3 group was longer than that of the AdHT-rev-casp3 group. The serum ALT and AST levels were not significantly elevated in the AdHT-rev-casp3-treated mice, whereas 7-9-times that before treatment in the Ad-rev-casp3-treated mice. Recombinant adenovirus AdHT-rev-casp3 expressing rev-caspase-3 driven by hTERTp effectively causes cell apoptosis targeting tumor, significantly suppresses tumor growth and prolongs the mouse survival duration, with mild liver toxicity.

Typology of alcohol mixed with energy drink consumers: motivations for use.

PubMed

Peacock, Amy; Droste, Nicolas; Pennay, Amy; Miller, Peter; Lubman, Dan I; Bruno, Raimondo

2015-06-01

Previous research on alcohol mixed with energy drinks (AmED) has shown that use is typically driven by hedonistic, social, functional, and intoxication-related motives, with differential associations with alcohol-related harm across these constructs. There has been no research looking at whether there are subgroups of consumers based on patterns of motivations. Consequently, the aims were to determine the typology of motivations for AmED use among a community sample and to identify correlates of subgroup membership. In addition, we aimed to determine whether this structure of motivations applied to a university student sample. Data were used from an Australian community sample (n = 731) and an Australian university student sample (n = 594) who were identified as AmED consumers when completing an online survey about their alcohol and ED use. Participants reported their level of agreement with 14 motivations for AmED use; latent classes of AmED consumers were identified based on patterns of motivation endorsement using latent class analysis. A 4-class model was selected using data from the community sample: (i) taste consumers (31%): endorsed pleasurable taste; (ii) energy-seeking consumers (24%): endorsed functional and taste motives; (iii) hedonistic consumers (33%): endorse pleasure and sensation-seeking motives, as well as functional and taste motives; and (iv) intoxication-related consumers (12%): endorsed motives related to feeling in control of intoxication, as well as hedonistic, functional, and taste motives. The consumer subgroups typically did not differ on demographics, other drug use, alcohol and ED use, and AmED risk taking. The patterns of motivations for the 4-class model were similar for the university student sample. This study indicated the existence of 4 subgroups of AmED consumers based on their patterns of motivations for AmED use consistently structured across the community and university student sample. These findings lend support to the growing conceptualization of AmED consumers as a heterogeneous group in regard to motivations for use, with a hierarchical and cumulative class order in regard to the number of types of motivation for AmED use. Prospective research may endeavor to link session-specific motives and outcomes, as it is apparent that primary consumption motives may be fluid between sessions. Copyright © 2015 by the Research Society on Alcoholism.

Underweight? Add Pounds Healthfully

MedlinePlus

... weight. In: Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. 5th ed. New York, N.Y.: Houghton Mifflin Harcourt; 2017. Whitney E, et al. Weight management: Overweight, obesity, and underweight. In: Understanding Nutrition. 14th ...

Application of Out-of-Plane Warping to Control Rotor Blade Twist

NASA Technical Reports Server (NTRS)

VanWeddingen, Yannick; Bauchau, Olivier; Kottapalli, Sesi; Ozbay, Serkan; Mehrotra, Yogesh

2012-01-01

The goal of this ongoing study is to develop and demonstrate the feasibility of a blade actuation system to dynamically change the twist, and/or the camber, of an airfoil section and, consequently, alter the in-flight aerodynamic loading on the blade for efficient flight control. The required analytical and finite element tools are under development to enable an accurate and comprehensive aeroelastic assessment of the current Full-Blade Warping and 3D Warping Actuated Trailing Edge Flap concepts. The feasibility of the current concepts for swashplateless rotors and higher harmonic blade control is also being investigated. In particular, the aim is to complete the following objectives, some of which have been completed (as noted below) and others that are currently ongoing: i) Develop a Vlasov finite element model and validate against the ABAQUS shell models (completed). ii) Implement the 3D warping actuation concept within the comprehensive analysis code DYMORE. iii) Perform preliminary aeroelastic simulations of blades using DYMORE with 3D warping actuation: a) Investigate the blade behavior under 1 per/rev actuation. Determine whether sufficient twist can be generated and sustained to achieve primary blade control. b) Investigate the behavior of a trailing edge flap configuration under higher harmonic excitations. Determine how much twist can be obtained at the harmonics 2-5 per/rev. iv) Determine actuator specifications such as the power required, load and displacements, and identify the stress and strain distributions in the actuated blades. In general, the completion of Item ii) above will give an additional research capability in rotorcraft dynamics analyses, i.e., the capability to calculate the rotor blade twist due to warping, something that is not currently available in any of the existing comprehensive rotorcraft analyses.

Final Report - LAW Envelope A and B Glass Formulations Testing in Increase Waste Loading. VSL-06R6900-1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kruger, Albert A.; Joseph, I.; Muller, I. S.

This report describes the results of testing specified by the Test Plan VSL-06R6900-1 Rev 0. The work was performed in compliance with quality assurance requirements specified in the Test Plan. Results required by the Test Plan are reported. The test results and this report have been reviewed for correctness, technical adequacy, completeness, and accuracy.

Identifying Acquisition Patterns of Failure Using Systems Archetypes

DTIC Science & Technology

2008-04-02

OF PAGES 18 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b . ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev...any but the smallest programs, complete path coverage for defect detection is impractical. Adapted from Pressman , R.S., Software Engineering: A...Firefighting” concept from “Past the Tipping Point” Fix S O B Problem Symptom R “Fixes That Fail” – Systems Archetype S Unintended Consequences S

2014 Enhanced LAW Glass Property-Composition Models, Phase 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muller, Isabelle; Pegg, Ian L.; Joseph, Innocent

2015-10-28

This report describes the results of testing specified by the Enhanced LAW Glass Property-Composition Models, VSL-13T3050-1, Rev. 0 Test Plan. The work was performed in compliance with the quality assurance requirements specified in the Test Plan. Results required by the Test Plan are reported. The te4st results and this report have been reviewed for correctness, technical adequacy, completeness, and accuracy.

Link-Prediction Enhanced Consensus Clustering for Complex Networks (Open Access)

DTIC Science & Technology

2016-05-20

92:022816. Available from: http://link.aps.org/doi/10.1103/PhysRevE.92.022816. doi: 10. 1103 /PhysRevE.92.022816 16. Aldecoa R, Marín I. Exploring the...from: http://link.aps.org/doi/10.1103/PhysRevE.80.056117. doi: 10. 1103 /PhysRevE.80.056117 18. Dahlin J, Svenson P. Ensemble approaches for improving...046110. Available from: http://link.aps.org/doi/10.1103/PhysRevE.81.046110. doi: 10. 1103 /PhysRevE.81.046110 28. Gfeller D, Chappelier JC, De Los Rios P

World-wide precision airports for SVS

NASA Astrophysics Data System (ADS)

Schiefele, Jens; Lugsch, Bill; Launer, Marc; Baca, Diana

2004-08-01

Future cockpit and aviation applications require high quality airport databases. Accuracy, resolution, integrity, completeness, traceability, and timeliness [1] are key requirements. For most aviation applications, attributed vector databases are needed. The geometry is based on points, lines, and closed polygons. To document the needs for aviation industry RTCA and EUROCAE developed in a joint committee, the DO-272/ED-99 document. It states industry needs for data features, attributes, coding, and capture rules for Airport Mapping Databases (AMDB). This paper describes the technical approach Jeppesen has taken to generate a world-wide set of three-hundred AMDB airports. All AMDB airports are DO-200A/ED-76 [1] and DO-272/ED-99 [2] compliant. Jeppesen airports have a 5m (CE90) accuracy and an 10-3 integrity. World-wide all AMDB data is delivered in WGS84 coordinates. Jeppesen continually updates the databases.

The Milestones Passport: A Learner-Centered Application of the Milestone Framework to Prompt Real-Time Feedback in the Emergency Department.

PubMed

Yarris, Lalena M; Jones, David; Kornegay, Joshua G; Hansen, Matthew

2014-09-01

In July 2013, emergency medicine residency programs implemented the Milestone assessment as part of the Next Accreditation System. We hypothesized that applying the Milestone framework to real-time feedback in the emergency department (ED) could affect current feedback processes and culture. We describe the development and implementation of a Milestone-based, learner-centered intervention designed to prompt real-time feedback in the ED. We developed and implemented the Milestones Passport, a feedback intervention incorporating subcompetencies, in our residency program in July 2013. Our primary outcomes were feasibility, including faculty and staff time and costs, number of documented feedback encounters in the first 2 months of implementation, and user-reported time required to complete the intervention. We also assessed learner and faculty acceptability. Development and implementation of the Milestones Passport required 10 hours of program coordinator time, 120 hours of software developer time, and 20 hours of faculty time. Twenty-eight residents and 34 faculty members generated 257 Milestones Passport feedback encounters. Most residents and faculty reported that the encounters required fewer than 5 minutes to complete, and 48% (12 of 25) of the residents and 68% (19 of 28) of faculty reported satisfaction with the Milestones Passport intervention. Faculty satisfaction with overall feedback in the ED improved after the intervention (93% versus 54%, P  =  .003), whereas resident satisfaction with feedback did not change significantly. The Milestones Passport feedback intervention was feasible and acceptable to users; however, learner satisfaction with the Milestone assessment in the ED was modest.

RNA helicase MOV10 functions as a co-factor of HIV-1 Rev to facilitate Rev/RRE-dependent nuclear export of viral mRNAs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Feng; Zhang, Junsong; Zhang, Yijun

Human immunodeficiency virus type 1 (HIV-1) exploits multiple host factors during its replication. The REV/RRE-dependent nuclear export of unspliced/partially spliced viral transcripts needs the assistance of host proteins. Recent studies have shown that MOV10 overexpression inhibited HIV-1 replication at various steps. However, the endogenous MOV10 was required in certain step(s) of HIV-1 replication. In this report, we found that MOV10 potently enhances the nuclear export of viral mRNAs and subsequently increases the expression of Gag protein and other late products through affecting the Rev/RRE axis. The co-immunoprecipitation analysis indicated that MOV10 interacts with Rev in an RNA-independent manner. The DEAG-boxmore » of MOV10 was required for the enhancement of Rev/RRE-dependent nuclear export and the DEAG-box mutant showed a dominant-negative activity. Our data propose that HIV-1 utilizes the anti-viral factor MOV10 to function as a co-factor of Rev and demonstrate the complicated effects of MOV10 on HIV-1 life cycle. - Highlights: • MOV10 can function as a co-factor of HIV-1 Rev. • MOV10 facilitates Rev/RRE-dependent transport of viral mRNAs. • MOV10 interacts with Rev in an RNA-independent manner. • The DEAG-box of MOV10 is required for the enhancement of Rev/RRE-dependent export.« less

Original sound compositions reduce anxiety in emergency department patients: a randomised controlled trial.

PubMed

Weiland, Tracey J; Jelinek, George A; Macarow, Keely E; Samartzis, Philip; Brown, David M; Grierson, Elizabeth M; Winter, Craig

2011-12-19

To determine whether emergency department (ED) patients' self-rated levels of anxiety are affected by exposure to purpose-designed music or sound compositions with and without the audio frequencies of embedded binaural beat. Randomised controlled trial in an ED between 1 February 2010 and 14 April 2010 among a convenience sample of adult patients who were rated as category 3 on the Australasian Triage Scale. All interventions involved listening to soundtracks of 20 minutes' duration that were purpose-designed by composers and sound-recording artists. Participants were allocated at random to one of five groups: headphones and iPod only, no soundtrack (control group); reconstructed ambient noise simulating an ED but free of clear verbalisations; electroacoustic musical composition; composed non-musical soundtracks derived from audio field recordings obtained from natural and constructed settings; sound composition of audio field recordings with embedded binaural beat. All soundtracks were presented on an iPod through headphones. Patients and researchers were blinded to allocation until interventions were administered. State-trait anxiety was self-assessed before the intervention and state anxiety was self-assessed again 20 minutes after the provision of the soundtrack. Spielberger State-Trait Anxiety Inventory. Of 291 patients assessed for eligibility, 170 patients completed the pre-intervention anxiety self-assessment and 169 completed the post-intervention assessment. Significant decreases (all P < 0.001) in anxiety level were observed among patients exposed to the electroacoustic musical composition (pre-intervention mean, 39; post-intervention mean, 34), audio field recordings (42; 35) or audio field recordings with embedded bianaural beats (43; 37) when compared with those allocated to receive simulated ED ambient noise (40; 41) or headphones only (44; 44). In moderately anxious ED patients, state anxiety was reduced by 10%-15% following exposure to purpose-designed sound interventions. Australian New Zealand Clinical Trials Registry ACTRN 12608000444381.

Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.

PubMed

Haukoos, Jason S; Campbell, Jonathan D; Conroy, Amy A; Hopkins, Emily; Bucossi, Meggan M; Sasson, Comilla; Al-Tayyib, Alia A; Thrun, Mark W

2013-01-01

The Centers for Disease Control and Prevention recommends nontargeted opt-out HIV screening in healthcare settings. Cost effectiveness is critical when considering potential screening methods. Our goal was to compare programmatic costs of nontargeted opt-out rapid HIV screening with physician-directed diagnostic rapid HIV testing in an urban emergency department (ED) as part of the Denver ED HIV Opt-Out Trial. This was a prospective cohort study nested in a larger quasi-experiment. Over 16 months, nontargeted rapid HIV screening (intervention) and diagnostic rapid HIV testing (control) were alternated in 4-month time blocks. During the intervention phase, patients were offered HIV testing using an opt-out approach during registration; during the control phase, physicians used a diagnostic approach to offer HIV testing to patients. Each method was fully integrated into ED operations. Direct program costs were determined using the perspective of the ED. Time-motion methodology was used to estimate personnel activity costs. Costs per patient newly-diagnosed with HIV infection by intervention phase, and incremental cost effectiveness ratios were calculated. During the intervention phase, 28,043 eligible patients were included, 6,933 (25%) completed testing, and 15 (0.2%, 95% CI: 0.1%-0.4%) were newly-diagnosed with HIV infection. During the control phase, 29,925 eligible patients were included, 243 (0.8%) completed testing, and 4 (1.7%, 95% CI: 0.4%-4.2%) were newly-diagnosed with HIV infection. Total annualized costs for nontargeted screening were $148,997, whereas total annualized costs for diagnostic HIV testing were $31,355. The average costs per HIV diagnosis were $9,932 and $7,839, respectively. Nontargeted HIV screening identified 11 more HIV infections at an incremental cost of $10,693 per additional infection. Compared to diagnostic testing, nontargeted HIV screening was more costly but identified more HIV infections. More effective and less costly testing strategies may be required to improve the identification of patients with undiagnosed HIV infection in the ED.

Dirac quasiparticle tunneling in a NG/ferromagnetic barrier/SG graphene junction

NASA Astrophysics Data System (ADS)

Soodchomshom, Bumned; Tang, I.-Ming; Hoonsawat, Rassmidara

2009-07-01

We study the tunneling conductance in a spin dependent barrier NG/F B/SG graphene junction, where NG, F B and SG are normal graphene, gate ferromagnetic graphene barrier with thickness d and the graphene s-wave superconductor, respectively. In our work, the quasiparticle scattering process at the interfaces is based on quasi particles governed by the Dirac Bogoliubov-de Gennes equation with effective speed of light vF ∼ 10 6 m/s. The conductance of the junction is calculated based on Blonder-Tinkham-Klapwijk (BTK) formalism. The oscillatory conductance under varying gate potential and exchange energy in F B and the conductance induced by specular Andreev reflection are studied. By taking into account both effects of barrier strengths due to the gate potential χ∼Vd/ℏv and the exchange energy χ∼Ed/ℏv in the F B region, we find that the zero bias conductance of junction depends only on the ferromagnetic barrier strength χex in F B, when the Fermi energy in SG is very much larger than that the Fermi energy in NG ( EFS ≫ EFN). The oscillatory conductance peaks can be controlled by either varying χex or χG. In the limiting case, by setting Eex = 0, the conductance in a NG/N B/SG graphene junction, where SG is the s-wave superconductor, is also studied in order to compare with two earlier contradicted data. Our result agrees with what was obtained by Linder and Sudbo [J. Linder, A. Sudbo, Phys. Rev. B 77 (2008) 64507], which confirms the contradiction to what was given by Bhattacharjee and Sengupta [S. Bhattacharjee, K. Sengupta, Phys. Rev. Lett. 97 (2006) 217001].

Identification of Small Molecule Translesion Synthesis Inhibitors That Target the Rev1-CT/RIR Protein-Protein Interaction.

PubMed

Sail, Vibhavari; Rizzo, Alessandro A; Chatterjee, Nimrat; Dash, Radha C; Ozen, Zuleyha; Walker, Graham C; Korzhnev, Dmitry M; Hadden, M Kyle

2017-07-21

Translesion synthesis (TLS) is an important mechanism through which proliferating cells tolerate DNA damage during replication. The mutagenic Rev1/Polζ-dependent branch of TLS helps cancer cells survive first-line genotoxic chemotherapy and introduces mutations that can contribute to the acquired resistance so often observed with standard anticancer regimens. As such, inhibition of Rev1/Polζ-dependent TLS has recently emerged as a strategy to enhance the efficacy of first-line chemotherapy and reduce the acquisition of chemoresistance by decreasing tumor mutation rate. The TLS DNA polymerase Rev1 serves as an integral scaffolding protein that mediates the assembly of the active multiprotein TLS complexes. Protein-protein interactions (PPIs) between the C-terminal domain of Rev1 (Rev1-CT) and the Rev1-interacting region (RIR) of other TLS DNA polymerases play an essential role in regulating TLS activity. To probe whether disrupting the Rev1-CT/RIR PPI is a valid approach for developing a new class of targeted anticancer agents, we designed a fluorescence polarization-based assay that was utilized in a pilot screen for small molecule inhibitors of this PPI. Two small molecule scaffolds that disrupt this interaction were identified, and secondary validation assays confirmed that compound 5 binds to Rev1-CT at the RIR interface. Finally, survival and mutagenesis assays in mouse embryonic fibroblasts and human fibrosarcoma HT1080 cells treated with cisplatin and ultraviolet light indicate that these compounds inhibit mutagenic Rev1/Polζ-dependent TLS in cells, validating the Rev1-CT/RIR PPI for future anticancer drug discovery and identifying the first small molecule inhibitors of TLS that target Rev1-CT.

Screening adolescents in the emergency department for weapon carriage.

PubMed

Cunningham, Rebecca M; Resko, Stella M; Harrison, Stephanie Roahen; Zimmerman, Marc; Stanley, Rachel; Chermack, Stephen T; Walton, Maureen A

2010-02-01

The objective was to describe the prevalence and correlates of past-year weapon involvement among adolescents seeking care in an inner-city emergency department (ED). This cross-sectional study administered a computerized survey to all eligible adolescents (age 14-18 years), 7 days a week, who were seeking care over an 18-month period at an inner-city Level 1 ED. Validated measures were administered, including measures of demographics, sexual activity, substance use, injury, violent behavior, weapon carriage, and/or weapon use. Zero-inflated Poisson (ZIP) regression models were used to identify correlates of the occurrence and past-year frequency of these weapons variables. Adolescents (n = 2069, 86% response rate) completed the computerized survey. Fifty-five percent were female; 56.5% were African American. In the past year, 20% of adolescents reported knife or razor carriage, 7% reported gun carriage, and 6% pulled a knife or gun on someone. Although gun carriage was more frequent among males, females were as likely to carry a knife or pull a weapon in the past year. One-fifth of all adolescents seeking care in this inner-city ED have carried a weapon. Understanding weapon carriage among teens seeking ED care is a critical first step to future ED-based injury prevention initiatives. (c) 2010 by the Society for Academic Emergency Medicine.

Low volume tubes are not effective to reduce the rate of hemolyzed specimens from the emergency department.

PubMed

Lippi, Giuseppe; Bonelli, Patrizia; Graiani, Virna; Caleffi, Catia; Cervellin, Gianfranco

2014-02-01

Spurious hemolysis is the leading source of nonconformities that can be recorded in diagnostic samples, especially those collected in the emergency department (ED). The aim of this study was to assess whether the shift from regular to low volume blood collection tubes may reduce the rate of hemolysis in a large urban ED, where approximately 80% of blood collections are performed through catheters. In a former 5-month period, blood collection in the ED was performed using 5.0mL (13×100mm) plastic serum tubes, which were then completely replaced with 3.5mL (13×75mm) plastic serum tubes for another period of 5months. The rate of hemolyzed specimens (i.e., those containing a cell-free hemoglobin ≥0.5gL) collected in the two periods was compared by Fisher exact test. The rate of hemolyzed specimens received from the ED increased from 3.5% using 5.0mL plastic serum tubes to 5.2% after introduction of 3.5mL plastic serum tubes (p<0.001). The use of low volume tubes was not effective to decrease the hemolysis rate in a large urban ED. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Parental Involvement and Child and Adolescent Eating Disorders: Perspectives from Residents in Psychiatry, Pediatrics, and Family Medicine

PubMed Central

Marcon, Tamara Davidson; Girz, Laura; Stillar, Amanda; Tessier, Carole; Lafrance, Adele

2017-01-01

Objectives Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents’ perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. Method Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey. Questions pertained to assessment and treatment practices for child/adolescent ED. Analyses included ANOVAs, paired t-tests, and, for residents who endorsed family involvement (N = 444), qualitative content analysis. Results Overall, residents reported that they “mostly” agreed with the involvement of family in the assessment and treatment of ED. Residents’ endorsement of family involvement in both domains increased according to the extent of ED training received. Four major themes emerged from the content analysis of family involvement and included recommendations in line with evidence-based models and unspecified, passive involvement in the assessment and recovery process. Conclusions Many residents endorse family involvement in both assessment and treatment; however, understanding of the nature of such involvement is often vague. Training in evidence-based protocols is necessary for residents planning to engage in multi-disciplinary assessment, referral, and/or treatment in their future practice. PMID:28747930

Mapping patient flow in a regional Australian emergency department: a model driven approach.

PubMed

Martin, Mary; Champion, Robert; Kinsman, Leigh; Masman, Kevin

2011-04-01

Unified Modelling Language (UML) models of the patient journey in a regional Australian emergency department (ED) were used to develop an accurate, complete representation of ED processes and drive the collection of comprehensive quantitative and qualitative service delivery and patient treatment data as an evidence base for hospital service planning. The focus was to identify bottle-necks that contribute to over-crowding. Data was collected entirely independently of the routine hospital data collection system. The greatest source of delay in patient flow was the waiting time from a bed request to exit from the ED for hospital admission. It represented 61% of the time that these patients occupied ED cubicles. The physical layout of the triage area was identified as counterproductive to efficient triaging, and the results of investigations were often observed to be available for some time before clinical staff became aware. The use of independent primary data to construct UML models of the patient journey was effective in identifying sources of delay in patient flow, and aspects of ED activity that could be improved. The findings contributed to recent department re-design and informed an initiative to develop a business intelligence system for predicting impending occurrence of access block. Copyright © 2010 Elsevier Ltd. All rights reserved.

An Exploratory Examination of At-Risk/Problematic Internet Use and Disordered Eating in Adults

PubMed Central

Ivezaj, Valentina; Potenza, Marc N.; Grilo, Carlos M.; White, Marney A.

2016-01-01

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Purpose At-risk/problematic Internet use (ARPIU) has been associated with impairment in multiple domains including psychopathology. The present study examined the relationship between ARPIU and disordered eating in a large community sample. Methods Participants (n=1000) completed an online survey about health behaviors. Two thresholds of ARPIU and disordered eating each were examined. Results The ARPIU and Sub-ED (subthreshold eating disorders) groups reported greater depressive symptoms and poorer self-control than the Control group; the Sub-ED group reported greater impulsivity than the Control group. The ARPIU and Sub-ED groups significantly differed in key features related to each condition. Finally, the co-occurrence of ARPIU and Sub-ED was associated with greater depression. In the second set of analyses based on more stringent thresholds, the Problematic Internet Use (PIU) and ED groups differed on all measures compared to the Control group. The PIU and ED groups also differed on key features related to each condition, but did not differ on measures of impulsivity or self-control. The co-occurrence of PIU and ED was associated with greater depressive symptoms than either PIU or ED independently. Conclusions ARPIU and Sub-ED share links to depression and poor self-control and these may represent possible therapeutic targets across Internet-use and disordered-eating behaviors. Co-occurring PIU and ED at either lenient or stringent thresholds is associated with greater depression. Future studies should examine the temporal nature of these associations and the extent to which targeting depression, Internet use, or disordered eating may lead to improvements across domains. PMID:26725439

NMR Structure and Dynamics of the C-terminal Domain from Human Rev1 and its Complex with Rev1 Interacting Region of DNA Polymerase η

PubMed Central

Pozhidaeva, Alexandra; Pustovalova, Yulia; D'Souza, Sanjay; Bezsonova, Irina; Walker, Graham C.; Korzhnev, Dmitry M.

2013-01-01

Rev1 is a translesion synthesis (TLS) DNA polymerase essential for DNA damage tolerance in eukaryotes. In the process of TLS stalled high-fidelity replicative DNA polymerases are temporarily replaced by specialized TLS enzymes that can bypass sites of DNA damage (lesions), thus allowing replication to continue or postreplicational gaps to be filled. Despite its limited catalytic activity, human Rev1 plays a key role in TLS by serving as a scaffold that provides an access of Y-family TLS polymerases polη, ι, and κ to their cognate DNA lesions and facilitates their subsequent exchange to polζ that extends the distorted DNA primer-template. Rev1 interaction with the other major human TLS polymerases, polη, ι, κ and the regulatory subunit Rev7 of polζ, is mediated by Rev1 C-terminal domain (Rev1-CT). We used NMR spectroscopy to determine the spatial structure of the Rev1-CT domain (residues 1157-1251) and its complex with Rev1 interacting region (RIR) from polη (residues 524-539). The domain forms a four-helix bundle with a well-structured N-terminal β-hairpin docking against helices 1 and 2, creating a binding pocket for the two conserved Phe residues of the RIR motif that upon binding folds into an α-helix. NMR spin-relaxation and NMR relaxation dispersion measurements suggest that free Rev1-CT and Rev1-CT/polη-RIR complex exhibit μs-ms conformational dynamics encompassing the RIR binding site, which might facilitate selection of the molecular configuration optimal for binding. These results offer new insights into the control of TLS in human cells by providing a structural basis for understanding the recognition of the Rev1-CT by Y-family DNA polymerases. PMID:22691049

REV-ERBs agonism suppresses osteoclastogenesis and prevents ovariectomy-induced bone loss partially via FABP4 upregulation.

PubMed

Song, Chao; Tan, Peng; Zhang, Zheng; Wu, Wei; Dong, Yonghui; Zhao, Liming; Liu, Huiyong; Guan, Hanfeng; Li, Feng

2018-01-22

REV-ERBs (REV-ERBα and REV-ERBβ) are transcription repressors and circadian regulators. Previous investigations have shown that REV-ERBs repress the expression of target genes, including MMP9 and CX3CR1, in macrophages. Because MMP9 and CX3CR1 reportedly participate in receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis, we inferred that REV-ERBs might play a role in osteoclastogenesis. In the present study, we found that the REV-ERBα level decreased significantly during RANKL-induced osteoclast differentiation from primary bone marrow-derived macrophages (BMMs). REV-ERBα knockdown by small interfering RNA in BMMs resulted in the enhanced formation of osteoclasts, whereas REV-ERBβ knockdown showed no effect on osteoclast differentiation. Moreover, the REV-ERB agonist SR9009 inhibited osteoclast differentiation and bone resorption. Intraperitoneal SR9009 administration prevented ovariectomy-induced bone loss; this effect was accompanied by decreased serum RANKL and C-terminal telopeptide of type I collagen levels and increased osteoprotegerin levels. Further investigation revealed that NF-κB and MAPK activation and nuclear factor of activated T cells, cytoplasmic 1, and c-fos expression were suppressed by SR9009. The level of reactive oxygen species was also decreased by SR9009, with NADPH oxidase subunits also being down-regulated. In addition, an expression microarray showed that FABP4, an intracellular lipid-binding protein, was up-regulated by REV-ERB agonism. BMS309403, an inhibitor of FABP4, partially prevented the suppression of osteoclastogenesis by SR9009 through stabilizing phosphorylation of p65. To summarize, our results proved that the REV-ERB agonism inhibited osteoclastogenesis partially via FABP4 up-regulation.-Song, C., Tan, P., Zhang, Z., Wu, W., Dong, Y., Zhao, L., Liu, H., Guan, H., Li, F. REV-ERBs agonism suppresses osteoclastogenesis and prevents ovariectomy-induced bone loss partially via FABP4 upregulation.

Addressing Unmet Need for HIV Testing in Emergency Care Settings: A Role for Computer-facilitated Rapid HIV Testing?

PubMed Central

Kurth, Ann E.; Severynen, Anneleen; Spielberg, Freya

2014-01-01

HIV testing in emergency departments (EDs) remains underutilized. We evaluated a computer tool to facilitate rapid HIV testing in an urban ED. Randomly assigned non-acute adult ED patients to computer tool (‘CARE’) and rapid HIV testing before standard visit (n=258) or to standard visit (n=259) with chart access. Assessed intervention acceptability and compared noted HIV risks. Participants were 56% non-white, 58% male; median age 37 years. In the CARE arm nearly all (251/258) completed the session and received HIV results; 4 declined test consent. HIV risks were reported by 54% of users and there was one confirmed HIV-positive and 2 false-positives (seroprevalence 0.4%, 95% CI 0.01–2.2%). Half (55%) preferred computerized, over face-to-face, counseling for future HIV testing. In standard arm, one HIV test and 2 referrals for testing occurred. Computer-facilitated HIV testing appears acceptable to ED patients. Future research should assess cost-effectiveness compared with staff-delivered approaches. PMID:23837807

Reward Dependence and Harm Avoidance among Patients with Binge-Purge Type Eating Disorders.

PubMed

Gat-Lazer, Sigal; Geva, Ronny; Gur, Eitan; Stein, Daniel

2017-05-01

The Cloninger's Psychobiological Model of Temperament and Character includes temperamental dimensions such as reward dependence (RD) and harm avoidance (HA). Studies of RD differentiate between sensitivity to reward (SR) versus to punishment (SP). We investigated the interrelationship between HA and RD in acutely ill patients with binge/purge (B/P) type eating disorders (EDs) and following symptomatic stabilization. Fifty patients with B/P EDs were assessed at admission to inpatient treatment, 36 of whom were reassessed at discharge. Thirty-six controls were similarly assessed. Participants completed Tridimensional Personality Questionnaire (TPQ), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), and took the Gambling Task. Patients with B/P EDs had higher TPQ-RD and lower TPQ-HA accompanied by lower SPSRQ-SR and SPSRQ-SP. SPSRQ-SP correlated positively and negatively with TPQ-HA and TPQ-RD, respectively. Combination of lower TPQ-HA, lower SPSRQ-SP, and greater risk-taking inclination may maintain disordered eating in patients with B/P EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

An evaluation of the Kinect-Ed presentation, a motivating nutrition and cooking intervention for young adolescents in grades 6-8.

PubMed

Santarossa, Sara; Ciccone, Jillian; Woodruff, Sarah J

2015-09-01

Recently, public health messaging has included having more family meals and involving young adolescents (YAs) with meal preparation to improve healthful diets and family dinner frequency (FDF). Kinect-Ed, a motivational nutrition education presentation was created to encourage YAs (grades 6-8) to help with meal preparation and ultimately improve FDF. The purpose of this study was to evaluate the Kinect-Ed presentation, with the goals of the presentation being to improve self-efficacy for cooking (SE), food preparation techniques (TECH), food preparation frequency (PREP), family meal attitudes and behaviours, and ultimately increase FDF. A sample of YAs (n = 219) from Southern Ontario, Canada, completed pre- and postpresentation surveys, measuring FDF, PREP, SE, and TECH. Kinect-Ed successfully improved participants' FDF (p < 0.01), PREP (p < 0.01), SE (p < 0.01), and TECH (<0.01). Overall, goals of the presentation were met. Encouraging YAs to help prepare meals and get involved in the kitchen may reduce the time needed from parents to prepare meals, and, in turn, allow more time for frequent family dinners.

A rapid non-radioactive technique for measurement of repair synthesis in primary human fibroblasts by incorporation of ethynyl deoxyuridine (EdU).

PubMed

Limsirichaikul, Siripan; Niimi, Atsuko; Fawcett, Heather; Lehmann, Alan; Yamashita, Shunichi; Ogi, Tomoo

2009-03-01

Xeroderma pigmentosum (XP) is an autosomal recessive genetic disorder. Afflicted patients show extreme sun-sensitivity and skin cancer predisposition. XP is in most cases associated with deficient nucleotide excision repair (NER), which is the process responsible for removing photolesions from DNA. Measuring NER activity by nucleotide incorporation into repair patches, termed 'unscheduled DNA synthesis (UDS)', is one of the most commonly used assays for XP-diagnosis and NER research. We have established a rapid and accurate procedure for measuring UDS by replacement of thymidine with 5-ethynyl-2'-deoxyuridine (EdU). EdU incorporated into repair patches can be directly conjugated to fluorescent azide derivatives, thereby obviating the need for either radiolabeled thymidine or denaturation and antibody detection of incorporated bromodeoxyuridine (BrdU). We demonstrate that the EdU incorporation assay is compatible with conventional techniques such as immunofluorescent staining and labeling of cells with micro-latex beads. Importantly, we can complete the entire UDS assay within half a day from preparation of the assay coverslips; this technique may prove useful as a method for XP diagnosis.

Embodiment Mediates the Relationship between Avoidant Attachment and Eating Disorder Psychopathology.

PubMed

Monteleone, Alessio Maria; Castellini, Giovanni; Ricca, Valdo; Volpe, Umberto; De Riso, Francesco; Nigro, Massimiliano; Zamponi, Francesco; Mancini, Milena; Stanghellini, Giovanni; Monteleone, Palmiero; Treasure, Janet; Maj, Mario

2017-11-01

The overvaluation of body shape and weight of persons with eating disorders (EDs) is putatively explained by a disturbance in the way they experience their own body (embodiment). Moreover, attachment disorders seem to promote the use of body as source for self-definition. Therefore, we assessed the role of embodiment in the connection between attachment styles and ED psychopathology. One-hundred and thirteen ED patients and 117 healthy subjects completed the Identity and Eating Disorders (IDEA) Questionnaire, the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships Scale. Eating disorder patients displayed IDEA, EDI-2 and Experiences in Close Relationships scores significantly higher than controls. IDEA total and subtotal scores mediated entirely the influence of avoidant attachment on EDI-2 interoceptive awareness and impulsivity. These findings demonstrate a relationship between insecure attachment and disorders of identity and embodiment and point to embodiment as a possible mediator between avoidant attachment and specific ED psychopathological traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Ehlers-Danlos syndrome and wound healing: injury in a collagen disorder.

PubMed

Trudgian, Julie; Trotman, Sara

Ehlers-Danlos syndrome (EDS) is a rare familial disorder affecting the production, quality and strength of collagen. It presents in many forms, and many individuals experience hypermobile joints and soft, elastic skin. When injury occurs, EDS can result in severe bruising, the development of wide open wounds and delayed healing (Babak et al, 2003). In the case discussed, Lilly, a 10-year-old girl, presented with a wide trauma injury to her lower leg. Healing was influenced by the poor collagen production associated with EDS, and the presence of a high bacterial burden that resulted in infection. Manuka honey was used to reduce the level of invading bacilli and stimulate production of collagen. Following this intervention, complete healing was achieved in two weeks. The action of manuka honey appears to be beneficial in the management of complex wounds, and further research is needed to determine its value in EDS. Involvement of Lilly and her family in clinical decision-making and in the production of this article resulted in a growth in understanding for all parties and the development of a relationship that optimized the nurse/patient experience.

Suppression of atherosclerosis by synthetic REV-ERB agonist

PubMed Central

Sitaula, Sadichha; Billon, Cyrielle; Kamenecka, Theodore M.; Solt, Laura A.; Burris, Thomas P.

2015-01-01

The nuclear receptors for heme, REV-ERBα and REV-ERBβ, play important roles in the regulation of metabolism and inflammation. Recently it was demonstrated that reduced REV-ERBα expression in hematopoetic cells in LDL receptor null mice led to increased atherosclerosis. We sought to determine if synthetic REV-ERB agonists that we have developed might have the ability to suppress atherosclerosis in this model. A previously characterized synthetic REV-ERB agonist, SR9009, was used to determine if activation of REV-ERB activity would affect atherosclerosis in LDL receptor deficient mice. Atherosclerotic plaque size was significantly reduced (p < 0.05) in mice administered SR9009 (100 mg/kg) for seven weeks compared to control mice (n = 10 per group). SR9009 treatment of bone marrow-derived mouse macrophages (BMDM) reduced the polarization of BMDMs to proinflammatory M1 macrophage while increasing the polarization of BMDMs to anti-inflammatory M2 macrophages. Our results suggest that pharmacological targeting of REV-ERBs may be a viable therapeutic option for treatment of atherosclerosis. PMID:25800870

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study

PubMed Central

Celio, Mark A.; Mastroleo, Nadine R.; DiGuiseppi, Graham; Barnett, Nancy P.; Colby, Suzanne M.; Kahler, Christopher W.; Operario, Don; Suffoletto, Brian; Monti, Peter M.

2016-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; Mage = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings. PMID:28649188

Attendance at a hospital emergency department by drivers involved in automobile accidents in Italy.

PubMed

Pileggi, C; Nicotera, G; Angelillo, I F

2005-04-01

This study investigated the profile of drivers involved in automobile accidents attending a hospital emergency department (ED) in Catanzaro (Italy). Car drivers involved in automobile accidents who were registered for emergency care between May 2003 and February 2004 were included in the study. Demographics and details of the accident were collected immediately after admittance, before examination by the medical staff. For each patient, the medical staff completed a form including diagnostic investigations and medical/surgical examination in the ED. Of a total of 424 drivers included in the study 27.4% had conditions that were definitely non-urgent problems. Multiple logistic regression analysis indicated that the use of the ED as a source of non-urgent care was significantly higher among patients who were driving at a lower speed when the accident occurred, among those who presented to the ED before the implementation of the new Italian traffic code, and among those who underwent fewer diagnostic investigations and medical/surgical examinations in the ED. Most of the automobile related lesions occurred in the neck (43.9%) followed by multiple body regions (12.5%) and the upper extremities (10.4%). According to the nature of the injury a third were contusions (34%), followed by pain without physical signs and symptoms (28.8%), and dislocation, sprains, and strains (22.9%). Development of health promotion and education campaigns is required to prevent the use of the ED as a source of non-urgent care by those involved in automobile accidents.

Why a disaster is not just normal business ramped up: Disaster response among ED nurses.

PubMed

Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison

2017-11-15

The emergency department (ED) is a familiar place for the emergency nurse who spends their working days inside it. A disaster threatens that familiarity and creates changes that make working in the ED during a disaster response different from the everyday experience of working in the ED. This research reports on an aspect of the findings from a larger study about the experience of working as a nurse in the ED during a disaster response. Thirteen nurses from 8 different countries were interviewed about their experience. The findings from this research demonstrate that a disaster event leads to a chain reaction of changes in process, space and practice. Nurses' respond to the news of a disaster event with shock and disbelief. The ED may change as a result of the event requiring nurses to work in an altered environment or a completely different setting. These changes provoke nurses to alter their behaviour and practice and reflect on the experience after the response. Emergency nurses have a high likelihood of participating in disaster response and as such should be adequately prepared. This highlights how disaster response is different and leads to recommendations to enhance training for emergency nurses which will better prepare them Disasterresponse is not normal business ramped up. There are a number of challenges and changes that should be considered when preparing emergency nurses for the realities of disaster response. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study.

PubMed

Celio, Mark A; Mastroleo, Nadine R; DiGuiseppi, Graham; Barnett, Nancy P; Colby, Suzanne M; Kahler, Christopher W; Operario, Don; Suffoletto, Brian; Monti, Peter M

2017-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; M age = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings.

Direct experience while eating: Laboratory outcomes among individuals with eating disorders versus healthy controls.

PubMed

Elices, Matilde; Carmona, Cristina; Narváez, Vanessa; Seto, Victoria; Martin-Blanco, Ana; Pascual, Juan C; Soriano, José; Soler, Joaquim

2017-12-01

To compare individuals with eating disorders (EDs) to healthy controls (HCs) to assess for differences in direct engagement in the eating process. Participants (n=58) were asked to eat an orange slice. To assess the degree of direct engagement with the eating process, participants were asked to write down 10 thoughts about the experience of eating the orange slice. Next, the participants were instructed to classify the main focus of each thought as either experiential ("direct experience") or analytical ("thinking about"). A direct experience index (DEI) was computed by dividing the number of times that participants classified an experience as a "direct experience" (the numerator) by the total number of all observations (i.e., direct experience+thinking about). Participants also completed the Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ) to assess mindfulness facets and decentering, respectively. Compared to controls, participants in the EDs group presented significantly lower levels of direct experience during the eating task (EDs group: mean=43.54, SD=29.64; HCs group: mean=66.17, SD=22.23, p=0.03). Participants in the EDs group also scored significantly lower on other mindfulness-related variables. These findings suggest that engagement with the direct experience of eating is lower in individuals with EDs. Future research should investigate the role of mindfulness-based interventions to address direct experience while eating in individuals with EDs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Thermodynamics of quantum spacetime histories

NASA Astrophysics Data System (ADS)

Smolin, Lee

2017-11-01

We show that the simplicity constraints, which define the dynamics of spin foam models, imply, and are implied by, the first law of thermodynamics, when the latter is applied to causal diamonds in the quantum spacetime. This result reveals an intimate connection between the holographic nature of gravity, as reflected by the Bekenstein entropy, and the fact that general relativity and other gravitational theories can be understood as constrained topological field theories. To state and derive this correspondence we describe causal diamonds in the causal structure of spin foam histories and generalize arguments given for the near horizon region of black holes by Frodden, Gosh and Perez [Phys. Rev. D 87, 121503 (2013); , 10.1103/PhysRevD.87.121503Phys. Rev. D 89, 084069 (2014); , 10.1103/PhysRevD.89.084069Phys. Rev. Lett. 107, 241301 (2011); , 10.1103/PhysRevLett.107.241301Phys. Rev. Lett.108, 169901(E) (2012)., 10.1103/PhysRevLett.108.169901] and Bianchi [arXiv:1204.5122.]. This allows us to apply a recent argument of Jacobson [Phys. Rev. Lett. 116, 201101 (2016).10.1103/PhysRevLett.116.201101] to show that if a spin foam history has a semiclassical limit described in terms of a smooth metric geometry, that geometry satisfies the Einstein equations. These results suggest also a proposal for a quantum equivalence principle.

ANNUAL RADIOACTIVE WASTE TANK INSPECTION PROGRAM - 2011

DOE Office of Scientific and Technical Information (OSTI.GOV)

West, B.; Waltz, R.

2012-06-21

Aqueous radioactive wastes from Savannah River Site (SRS) separations and vitrification processes are contained in large underground carbon steel tanks. Inspections made during 2011 to evaluate these vessels and other waste handling facilities along with evaluations based on data from previous inspections are the subject of this report. The 2011 inspection program revealed that the structural integrity and waste confinement capability of the Savannah River Site waste tanks were maintained. All inspections scheduled per SRR-LWE-2011-00026, HLW Tank Farm Inspection Plan for 2011, were completed. Ultrasonic measurements (UT) performed in 2011 met the requirements of C-ESR-G-00006, In-Service Inspection Program for Highmore » Level Waste Tanks, Rev. 3, and WSRC-TR-2002-00061, Rev.6. UT inspections were performed on Tanks 25, 26 and 34 and the findings are documented in SRNL-STI-2011-00495, Tank Inspection NDE Results for Fiscal Year 2011, Waste Tanks 25, 26, 34 and 41. A total of 5813 photographs were made and 835 visual and video inspections were performed during 2011. A potential leaksite was discovered at Tank 4 during routine annual inspections performed in 2011. The new crack, which is above the allowable fill level, resulted in no release to the environment or tank annulus. The location of the crack is documented in C-ESR-G-00003, SRS High Level Waste Tank Leaksite Information, Rev.6.« less

Spectroscopic imaging of limiter heat and particle fluxes and the resulting impurity sources during Wendelstein 7-X startup plasmas

DOE PAGES

Stephey, L.; Wurden, G. A.; Schmitz, O.; ...

2016-08-08

A combined IR and visible camera system [G. A. Wurden et al., “A high resolution IR/visible imaging system for the W7-X limiter,” Rev. Sci. Instrum. (these proceedings)] and a filterscope system [R. J. Colchin et al., Rev. Sci. Instrum. 74, 2068 (2003)] were implemented together to obtain spectroscopic data of limiter and first wall recycling and impurity sources during Wendelstein 7-X startup plasmas. Both systems together provided excellent temporal and spatial spectroscopic resolution of limiter 3. Narrowband interference filters in front of the camera yielded C-III and Hα photon flux, and the filterscope system provided H α, H β, He-I,more » He-II, C-II, and visible bremsstrahlung data. The filterscopes made additional measurements of several points on the W7-X vacuum vessel to yield wall recycling fluxes. Finally, the resulting photon flux from both the visible camera and filterscopes can then be compared to an EMC3-EIRENE synthetic diagnostic [H. Frerichs et al., “Synthetic plasma edge diagnostics for EMC3-EIRENE, highlighted for Wendelstein 7-X,” Rev. Sci. Instrum. (these proceedings)] to infer both a limiter particle flux and wall particle flux, both of which will ultimately be used to infer the complete particle balance and particle confinement time τ P.« less

Cooperativity among Rev-Associated Nuclear Export Signals Regulates HIV-1 Gene Expression and Is a Determinant of Virus Species Tropism

PubMed Central

Aligeti, Mounavya; Behrens, Ryan T.; Pocock, Ginger M.; Schindelin, Johannes; Dietz, Christian; Eliceiri, Kevin W.; Swanson, Chad M.; Malim, Michael H.; Ahlquist, Paul

2014-01-01

ABSTRACT Murine cells exhibit a profound block to HIV-1 virion production that was recently mapped to a species-specific structural attribute of the murine version of the chromosomal region maintenance 1 (mCRM1) nuclear export receptor and rescued by the expression of human CRM1 (hCRM1). In human cells, the HIV-1 Rev protein recruits hCRM1 to intron-containing viral mRNAs encoding the Rev response element (RRE), thereby facilitating viral late gene expression. Here we exploited murine 3T3 fibroblasts as a gain-of-function system to study hCRM1's species-specific role in regulating Rev's effector functions. We show that Rev is rapidly exported from the nucleus by mCRM1 despite only weak contributions to HIV-1's posttranscriptional stages. Indeed, Rev preferentially accumulates in the cytoplasm of murine 3T3 cells with or without hCRM1 expression, in contrast to human HeLa cells, where Rev exhibits striking en masse transitions between the nuclear and cytoplasmic compartments. Efforts to bias Rev's trafficking either into or out of the nucleus revealed that Rev encoding a second CRM1 binding domain (Rev-2xNES) or Rev-dependent viral gag-pol mRNAs bearing tandem RREs (GP-2xRRE), rescue virus particle production in murine cells even in the absence of hCRM1. Combined, these results suggest a model wherein Rev-associated nuclear export signals cooperate to regulate the number or quality of CRM1's interactions with viral Rev/RRE ribonucleoprotein complexes in the nucleus. This mechanism regulates CRM1-dependent viral gene expression and is a determinant of HIV-1's capacity to produce virions in nonhuman cell types. IMPORTANCE Cells derived from mice and other nonhuman species exhibit profound blocks to HIV-1 replication. Here we elucidate a block to HIV-1 gene expression attributable to the murine version of the CRM1 (mCRM1) nuclear export receptor. In human cells, hCRM1 regulates the nuclear export of viral intron-containing mRNAs through the activity of the viral Rev adapter protein that forms a multimeric complex on these mRNAs prior to recruiting hCRM1. We demonstrate that Rev-dependent gene expression is poor in murine cells despite the finding that, surprisingly, the bulk of Rev interacts efficiently with mCRM1 and is rapidly exported from the nucleus. Instead, we map the mCRM1 defect to the apparent inability of this factor to engage Rev multimers in the context of large viral Rev/RNA ribonucleoprotein complexes. These findings shed new light on HIV-1 gene regulation and could inform the development of novel antiviral strategies that target viral gene expression. PMID:25275125

The orphan receptor Rev-erbα gene is a target of the circadian clock pacemaker

PubMed Central

Triqueneaux, Gérard; Thenot, Sandrine; Kakizawa, Tomoko; Antoch, Marina P; Safi, Rachid; Takahashi, Joseph S; Delaunay, Franck; Laudet, Vincent

2013-01-01

Rev-erbα is a ubiquitously expressed orphan nuclear receptor which functions as a constitutive transcriptional repressor and is expressed in vertebrates according to a robust circadian rhythm. We report here that two Rev-erbα mRNA isoforms, namely Rev-erbα1 and Rev-erbα2, are generated through alternative promoter usage and that both show a circadian expression pattern in an in vitro system using serum-shocked fibroblasts. Both promoter regions P1 (Rev-erbα1) and P2 (Rev-erbα2) contain several E-box DNA sequences, which function as response elements for the core circadian-clock components: CLOCK and BMAL1. The CLOCK–BMAL1 heterodimer stimulates the activity of both P1 and P2 promoters in transient transfection assay by 3–6-fold. This activation was inhibited by the overexpression of CRY1, a component of the negative limb of the circadian transcriptional loop. Critical E-box elements were mapped within both promoters. This regulation is conserved in vertebrates since we found that the CLOCK–BMAL1 heterodimer also regulates the zebrafish Rev-erbα gene. In line with these data Rev-erbα circadian expression was strongly impaired in the livers of Clock mutant mice and in the pineal glands of zebrafish embryos treated with Clock and Bmal1 antisense oligonucleotides. Together these data demonstrate that CLOCK is a critical regulator of Rev-erbα circadian gene expression in evolutionarily distant vertebrates and suggest a role for Rev-erbα in the circadian clock output. PMID:15591021

Effect of Telephone vs Video Interpretation on Parent Comprehension, Communication, and Utilization in the Pediatric Emergency Department: A Randomized Clinical Trial.

PubMed

Lion, K Casey; Brown, Julie C; Ebel, Beth E; Klein, Eileen J; Strelitz, Bonnie; Gutman, Colleen Kays; Hencz, Patty; Fernandez, Juan; Mangione-Smith, Rita

2015-12-01

Consistent professional interpretation improves communication with patients who have limited English proficiency. Remote modalities (telephone and video) have the potential for wide dissemination. To test the effect of telephone vs. video interpretation on communication during pediatric emergency care. Randomized trial of telephone vs. video interpretation at a free-standing, university-affiliated pediatric emergency department (ED). A convenience sample of 290 Spanish-speaking parents of pediatric ED patients with limited English proficiency were approached from February 24 through August 16, 2014, of whom 249 (85.9%) enrolled; of these, 208 (83.5%) completed the follow-up survey (91 parents in the telephone arm and 117 in the video arm). Groups did not differ significantly by consent or survey completion rate, ED factors (eg, ED crowding), child factors (eg, triage level, medical complexity), or parent factors (eg, birth country, income). Investigators were blinded to the interpretation modality during outcome ascertainment. Intention-to-treat data were analyzed August 25 to October 20, 2014. Telephone or video interpretation for the ED visit, randomized by day. Parents were surveyed 1 to 7 days after the ED visit to assess communication and interpretation quality, frequency of lapses in interpreter use, and ability to name the child's diagnosis. Two blinded reviewers compared parent-reported and medical record-abstracted diagnoses and classified parent-reported diagnoses as correct, incorrect, or vague. Among 208 parents who completed the survey, those in the video arm were more likely to name the child's diagnosis correctly than those in the telephone arm (85 of 114 [74.6%] vs. 52 of 87 [59.8%]; P = .03) and less likely to report frequent lapses in interpreter use (2 of 117 [1.7%] vs. 7 of 91 [7.7%]; P = .04). No differences were found between the video and telephone arms in parent-reported quality of communication (101 of 116 [87.1%] vs. 74 of 89 [83.1%]; P = .43) or interpretation (58 of 116 [50.0%] vs. 42 of 89 [47.2%]; P = .69). Video interpretation was more costly (per-patient mean [SD] cost, $61 [$36] vs. $31 [$20]; P < .001). Parent-reported adherence to the assigned modality was higher for the video arm (106 of 114 [93.0%] vs .68 of 86 [79.1%]; P = .004). Families with limited English proficiency who received video interpretation were more likely to correctly name the child's diagnosis and had fewer lapses in interpreter use. Use of video interpretation shows promise for improving communication and patient care in this population. clinicaltrials.gov Identifier: NCT01986179.

Improving ED specimen TAT using Lean Six Sigma.

PubMed

Sanders, Janet H; Karr, Tedd

2015-01-01

Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1,000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment. While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focussed approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.

Physical dating violence among adolescents and young adults with alcohol misuse.

PubMed

Singh, Vijay; Epstein-Ngo, Quyen; Cunningham, Rebecca M; Stoddard, Sarah A; Chermack, Stephen T; Walton, Maureen A

2015-08-01

This study determined prevalence and correlates of physical dating violence (victimization or aggression) among male and female youth with alcohol misuse and seeking emergency department (ED) care. Patients age 14-20 seeking care at a single large university-based ED completed a computerized, self-administered, cross-sectional survey. Measures included demographics, alcohol and substance use, mental health problems, health service use, peer influences, parent support, and community involvement. Bivariate and multivariate regression assessed physical dating violence correlates. Among 842 male and female youth seeking ED care who screened positive for alcohol misuse, 22.3% (n=188) reported dating violence in the past year. Multivariate analyses showed variables associated with dating violence were female gender (AOR 2.17, CI 1.46-3.22), Caucasian race (AOR 0.59, CI 0.37-0.93), receipt of public assistance (AOR 1.82, CI 1.16-2.87), AUDIT Score (AOR 1.06, CI 1.02-1.10), older age of drinking onset (AOR 0.86, CI 0.77-0.96), suicidal ideation or attempt (AOR 1.95, CI 1.13-3.37), frequency of ED visits (AOR 1.22, CI 1.05-1.46), negative peer influences (AOR 1.05, CI 1.01-1.10), and positive peer influences (AOR 0.86, CI 0.80-0.93). Nearly 1 in 4 youth with alcohol misuse seeking ED care report dating violence. Key correlates of dating violence included alcohol use severity, suicidal ideation, ED services, and peer influences. Evidence-based dating violence interventions addressing these correlates are needed for youth with alcohol misuse seeking ED care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Past Year Intentional and Unintentional injury Among Teens Treated In An Inner City Emergency Department

PubMed Central

Cunningham, Rebecca M.; Walton, Maureen A.; Harrison, Stephanie Roahen; Resko, Stella M.; Stanley, Rachel; Zimmerman, Marc; Bingham, C. Raymond; Shope, Jean T.

2010-01-01

An inner-city Emergency Department (ED) visit provides an opportunity for contact with high-risk adolescents for promoting injury prevention. Objectives To identify the prevalence of injuries sustained over the past year by teens presenting to an inner city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. Methods Over one year, seven days a week, from 1:00–11:00 PM, patients ages 14–18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. Results Of the entire group of teens presenting to the ED (n=1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found binge drinking (adjusted odds ratio [AOR]=1.95) and illicit weapon carrying (AOR=2.31) predicted a past-year intentional injury. African American youth (AOR=0.56) and those receiving public assistance (AOR=0.73) were less likely to report past-year unintentional injuries. Conclusions Adolescents seeking care in an inner city ED, regardless of reason for seeking care, report an elevated prevalence of recent injury including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care. PMID:20149570

Risk factors for repeat adverse asthma events in children after visiting an emergency department.

PubMed

To, Teresa; Wang, Chengning; Dell, Sharon; Fleming-Carroll, Bonnie; Parkin, Patricia; Scolnik, Dennis; Ungar, Wendy

2008-01-01

The aim of this study was to identify risk factors for long-term adverse outcomes in children with asthma after visiting the emergency department (ED). A prospective observational study was conducted at the ED of a pediatric tertiary hospital in Ontario, Canada. Patient outcomes (ie, acute asthma episodes and ED visits) were measured at baseline and at 1- and 6-months post-ED discharge. Time trends in outcomes were assessed using the generalized estimating equations method. Multiple conditional logistic regressions were used to model outcomes at 6 months and examine the impact of drug insurance coverage while adjusting for confounders. Of the 269 children recruited, 81.8% completed both follow-ups. ED use significantly reduced from 39.4% at baseline to 26.8% at 6 months (P < .001), whereas the level of acute asthma episodes remained unchanged. Children with drug insurance coverage were less likely to have acute asthma episodes (adjusted odds ratio [AOR] = 0.36; 95% CI, 0.15-0.85; P < .02) or repeat ED visits (AOR = 0.45; 95% CI, 0.20-0.99; P < .05) at 6 months. Other risk factors for adverse outcomes included previous adverse asthma events and certain asthma triggers (eg, cold/sinus infection). Washing bed linens in hot water weekly was protective against subsequent acute asthma episodes. Our study demonstrated significant improvements in long-term outcomes in children seeking acute care for asthma in the ED. Future efforts remain in targeting the sustainability of improved outcomes beyond 6 months. Risk factors identified can help target vulnerable populations for proper interventions, which may include efforts to maximize insurance coverage for asthma medications and strategies to improve asthma self-management through patient and provider education.