Epidemiological characterization of Plasmodium falciparum in the Republic of Cabo Verde: implications for potential large-scale re-emergence of malaria

PubMed Central

Alves, Joana; Roque, Ana Luísa; Cravo, Pedro; Valdez, Tomás; Jelinek, Tomas; do Rosário, Virgílio E; Arez, Ana Paula

2006-01-01

Background Malaria has come near eradication at archipelago of Cabo Verde in 1970. Infections are now only observed in Santiago, where outbreaks occur. In these islands, malaria is considered by the international community as being of limited risk and, therefore, no prophylaxis is recommended. Since the understanding of factors that determine malaria outbreaks are crucial for controlling the disease, the present study aimed to investigate if the malaria infections observed in Santiago Island are maintained in isolated foci and in asymptomatic individuals. Methods The occurrence of asymptomatic carriers in villages with history of malaria as well as the level of exposure of these populations were investigated using PCR and serological analyses. Results Results indicate that malaria is maintained as asymptomatic and sub-patent infections and that the majority of the circulating parasite populations harbour chloroquine-resistant mutations. Conclusion These observations highlight the alarming prospect of malaria to become a serious public health problem and underscore the need for a tighter surveillance. PMID:16630349

Impact of Fetal Versus Perinatal Hypoxia on Sex Differences in Childhood Outcomes: Developmental Timing Matters

PubMed Central

Anastario, Michael; Salafia, Carolyn M.; Fitzmaurice, Garrett; Goldstein, Jill M.

2013-01-01

Purpose To examine how the timing of hypoxic exposure results in specific childhood outcomes and whether there is a differential effect by sex. Methods A sample of 10,879 prospectively followed pregnancies was drawn from the Boston and Providence sites (New England-NE) of the National Collaborative Perinatal Project. Based on placental pathology, we developed and validated a measure of probable chronic fetal hypoxia (CHP) and contrasted the effects of acute perinatal hypoxia on age 7 emotional, behavioral, and cognitive outcomes. Results Perinatal hypoxia had a significant impact on multiple behavioral and cognitive outcomes in boys and girls by age 7, in contrast to probable CHP which had a differential effect on girls and boys such that there was decreased verbal IQ and increased inhibition in females alone. Conclusions Findings underscore the importance of considering the timing of obstetric complications and offspring sex in investigations of the impact of fetal and perinatal hypoxia on offspring’s outcomes throughout the life course. PMID:21327969

Workflow Optimization in Vertebrobasilar Occlusion

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

Kamper, Lars, E-mail: lars.kamper@helios-kliniken.de; Meyn, Hannes; Rybacki, Konrad

2012-06-15

Objective: In vertebrobasilar occlusion, rapid recanalization is the only substantial means to improve the prognosis. We introduced a standard operating procedure (SOP) for interventional therapy to analyze the effects on interdisciplinary time management. Methods: Intrahospital time periods between hospital admission and neuroradiological intervention were retrospectively analyzed, together with the patients' outcome, before (n = 18) and after (n = 20) implementation of the SOP. Results: After implementation of the SOP, we observed statistically significant improvement of postinterventional patient neurological status (p = 0.017). In addition, we found a decrease of 5:33 h for the mean time period from hospital admissionmore » until neuroradiological intervention. The recanalization rate increased from 72.2% to 80% after implementation of the SOP. Conclusion: Our results underscore the relevance of SOP implementation and analysis of time management for clinical workflow optimization. Both may trigger awareness for the need of efficient interdisciplinary time management. This could be an explanation for the decreased time periods and improved postinterventional patient status after SOP implementation.« less

Smoking patterns, quit behaviors, and smoking environment of workers in small manufacturing companies

PubMed Central

Pinsker, Erika A.; Hennrikus, Deborah J.; Hannan, Peter J.; Lando, Harry A; Brosseau, Lisa M.

2016-01-01

Background This study describes smokers employed at 47 small manufacturing companies in Minnesota, USA. Methods Smokers (n=713) participating in a group-randomized trial completed a baseline survey on their smoking patterns, quit behaviors, smoking environment, workplace attitudes about smoking, and correlates of smoking. These characteristics were examined by job type and a latent class analysis (LCA) was performed to group workers with similar characteristics. Results Production workers had the highest prevalence of daily smoking (88% vs. 68% among managers), and addiction (61% vs. 26% among managers), and the highest mean level of perceived stress (6.4 vs. 4.9 among managers). The LCA identified 3 subgroups of smokers that differed in levels of barriers to cessation. Production workers were most likely to be in the group with greater barriers (p=.01). Conclusions These results underscore the importance of targeting interventions to production workers and those who exhibit the greatest barriers to cessation. PMID:26179203

“Love Hurts”: Romantic Attachment and Depressive Symptoms in Pregnant Adolescent and Young Adult Couples

PubMed Central

Desrosiers, Alethea; Sipsma, Heather; Callands, Tamora; Hansen, Nathan; Divney, Anna; Magriples, Urania; Kershaw, Trace

2014-01-01

Objective The current study investigates the relationship between romantic attachment style and depressive symptoms between both members of pregnant adolescent and young adult couples. Method Participants were 296 pregnant young females (mean age = 18.7) and their male partners (mean age = 21.3; 592 total participants) who were recruited from obstetrics and gynecology clinics in Connecticut. The dimensions of avoidant and anxious romantic attachment were assessed using the Experiences in Close Relationships Inventory. Depressive symptoms were measured using the Center for Epidemiological Studies-Depression Scale. Results Results showed that avoidant attachment and anxious attachment were significantly positively related to depressive symptoms. Multilevel modeling for partner effects revealed that anxious attachment and depressive symptoms in partners were significantly positively associated with depressive symptoms Conclusion Findings underscore the importance of considering couples-based approaches to supporting the transition to parenthood and developing the necessary self and relationship skills to manage attachment needs and relationship challenges. PMID:23794358

The Prevalence of Depression Among Men Living With HIV Infection in Vietnam

PubMed Central

Esposito, Catherine Anne; Gioi, Tran Minh; Huyen, Tran Trieu Ngoa; Tarantola, Daniel

2009-01-01

Objectives. We assessed the prevalence of depression among men living with HIV infection in Vietnam and compared the findings with those from a general population survey of Vietnamese men. Methods. Between November 2007 and April 2008, 584 participants completed a structured questionnaire in Vietnamese that measured self-reported depression. We used the χ2 test to detect differences in prevalence rates within HIV populations and between our respondents and a general Vietnamese male population. Results. Respondents had a depression rate of 18.7% over a 1-month period, which was substantially higher than that reported in the Vietnamese male population (0.9%). Rates were highest among men reporting higher levels of stress and more HIV symptoms. Men diagnosed with depression experienced significantly more difficulty than others in accessing medical care. Conclusions. Our results provide the first empirical evidence of depression among men living with HIV in Vietnam and underscore the need to include mental health services in the response to HIV. PMID:19797756

Psychological morbidity as a moderator of intention to quit smoking: a study of smokers and former smokers*

PubMed Central

Afonso, Maria Fernanda Besteiro; Alves, Maria Graça Pereira

2013-01-01

OBJECTIVE: To analyze psychological morbidity as a moderator of the relationship between smoking representations and quality of life in smokers and former smokers, as well as to determine which psychological variables discriminate between smokers with and without the intention to quit smoking. METHODS: This was a quantitative, correlational cross-sectional study involving a convenience sample of 224 smokers and 169 former smokers. RESULTS: In smokers and former smokers, psychological morbidity had a moderating effect on the relationship between mental/physical quality of life and smoking representations (cognitive representations, emotional representations, and comprehensibility). Smokers with the intention to quit smoking more often presented with low comprehensibility, threatening emotional representations, behavioral beliefs, and perceived behavioral control, as well as with normative/control beliefs, than did those without the intention to quit. CONCLUSIONS: The results of this study underscore the importance of the moderating effect exerted by psychological morbidity, as well as that of sociocognitive variables, among smokers who have the intention to quit smoking. PMID:24068268

Autosomal Dominant Cataract: Intrafamilial Phenotypic Variability, Interocular Asymmetry, and Variable Progression in Four Chilean Families

PubMed Central

Shafie, Suraiya M.; Barria von-Bischhoffshausen, Fernando R.; Bateman, J. Bronwyn

2006-01-01

PURPOSE To document intrafamilial and interocular phenotypic variability of autosomal dominant cataract (ADC). DESIGN Prospective observational case series. METHODS We performed ophthalmologic examination in four Chilean ADC families. RESULTS The families exhibited variability with respect to morphology, location with the lens, color and density of cataracts among affected members. We documented asymmetry between eyes in the morphology, location within the lens, color and density of cataracts, and a variable rate of progression. CONCLUSIONS The cataracts in these families exhibit wide intrafamilial and interocular phenotypic variability, supporting the premise that the mutated genes are expressed differentially in individuals and between eyes; other genes or environmental factors may be the bases for this variability. Marked progression among some family members underscores the variable clinical course of a common mutation within a family. Like retinitis pigmentosa, classification of ADC will be most useful if based on the gene and specific mutation. PMID:16564818

Maternal ADHD, parenting, and psychopathology among mothers of adolescents with ADHD

PubMed Central

Babinski, Dara E.; Pelham, William E.; Molina, Brooke S.G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Wymbs, Brian T.; Sibley, Margaret H.; Derefinko, Karen J.; Kuriyan, Aparajita B.

2012-01-01

Objective This study describes the parenting and psychopathology of mothers with ADHD of adolescents with ADHD (MCA), non-ADHD mothers of adolescents with ADHD (CA), and non-ADHD mothers of adolescents without ADHD (COMP). Method Two sets of pairwise comparisons: 1) COMP vs. CA and 2) CA vs. MCA were conducted. We hypothesized that CA would experience greater distress in parenting and psychopathology compared to COMP, and that MCA would experience even more impairment compared to CA. Results Few differences emerged in comparisons of CA and COMP, with the exception of CA reporting greater parent-adolescent conflict and internalizing problems. In contrast, differences consistently emerged in comparisons of MCA and CA showing more difficulty for MCA in parenting and psychopathology. Conclusion These findings underscore the need for treatments that address parental ADHD when adolescent ADHD is the intended target. PMID:23160485

Traumatic brain injury in children and adolescents: Surveillance for Pituitary Dysfunction

PubMed Central

Norwood, Kenneth W.; DeBoer, Mark D.; Gurka, Matthew J.; Kuperminc, Michelle N.; Rogol, Alan D.; Blackman, James A.; Wamstad, Julia B.; Buck, Marcia L.; Patrick, Peter D.

2017-01-01

Background Children who sustain traumatic brain injury (TBI) are at risk for developing hypopituitarism, of which growth hormone deficiency (GHD) is the most common manifestation. Objective Determine the prevalence of GHD and associated features following TBI among children and adolescents. Study design 32 children and adolescents were recruited from a pediatric TBI clinic. Subjects were diagnosed with GHD based on insufficient growth hormone release during both spontaneous overnight testing and following arginine/glucagon administration. Results GHD was diagnosed in 5/32 subjects(16%). Subjects with GHD exhibited more rapid weight gain following injury than non-GHD subjects, and had lower levels of free thyroxine and FSH. Males with GHD had lower testosterone levels. Conclusions GHD following TBI is common in children and adolescents, underscoring the importance of assessing for GHD, including evaluating height and weight velocities after TBI. Children and adolescents with GHD may further exhibit absence or intermediate function for other pituitary hormones. PMID:20724335

The Prevalence and Correlates of Mental and Emotional Health Among American Indian Adults With Type 2 Diabetes

PubMed Central

Walls, Melissa L.; Aronson, Benjamin D.; Soper, Garrett V.; Johnson-Jennings, Michelle D.

2014-01-01

Aims The purpose of this study was to examine the prevalence and correlates of mental and emotional health factors among a sample of American Indian (Indigenous) adults diagnosed with type 2 diabetes. Methods Data are from a community-based participatory research project involving two Indigenous reservation communities. Data were collected from 218 Indigenous adults diagnosed with type 2 diabetes via in-person paper-and-pencil survey interviews. Results Reports of greater numbers of mental/emotional health problems were associated with increases in self-reported hyperglycemia, comorbid health problems, and health-impaired physical activities. Conclusions This study addresses a gap in the literature by demonstrating the associations between various mental/emotional health factors and diabetes-related health problems for Indigenous Americans. Findings underscore the importance of holistic, integrated primary care models for more effective diabetes care. PMID:24562607

Health insurance trends are contributing to growing health care inequality.

PubMed

Book, Eric L

2005-01-01

A health plan chief medical officer comments on several trends underscoring the conclusion reached by Robert Hurley and colleagues that disparities in health care are widening. Growing use of new technology is driving up premiums, increasing the ranks of the uninsured and underinsured. Cost shifting by hospitals because of inadequate public program reimbursements drives premiums even higher. Although disparities in health care can never be eliminated, access to essential services can-and must-be made universal. That goal can be accomplished if insurance coverage is mandated and responsibility for its cost is spread broadly.

Dissociations and dissociation theory in hypnosis: comment on Kirsch and Lynn (1998)

PubMed

Kihlstrom, J F

1998-03-01

I. Kirsch and S. J. Lynn's (1998) critique of the neodissociation theory of divided consciousness fails to consider evidence of dissociations between explicit and implicit memory and perception in hypnosis. Contrary to their conclusions, evidence that the rate of hidden observer response (like other hypnotic responses) varies with the wording of instructions does not contradict neodissociation theory; rather, it underscores the fact that hypnosis entails social interaction as well as alterations in conscious awareness. Neodissociation and sociocognitive theories of hypnosis complement each other. Each draws attention to aspects of the experience of hypnosis that the other neglects.

On the Use of Gene Ontology Annotations to Assess Functional Similarity among Orthologs and Paralogs: A Short Report

PubMed Central

Thomas, Paul D.; Wood, Valerie; Mungall, Christopher J.; Lewis, Suzanna E.; Blake, Judith A.

2012-01-01

A recent paper (Nehrt et al., PLoS Comput. Biol. 7:e1002073, 2011) has proposed a metric for the “functional similarity” between two genes that uses only the Gene Ontology (GO) annotations directly derived from published experimental results. Applying this metric, the authors concluded that paralogous genes within the mouse genome or the human genome are more functionally similar on average than orthologous genes between these genomes, an unexpected result with broad implications if true. We suggest, based on both theoretical and empirical considerations, that this proposed metric should not be interpreted as a functional similarity, and therefore cannot be used to support any conclusions about the “ortholog conjecture” (or, more properly, the “ortholog functional conservation hypothesis”). First, we reexamine the case studies presented by Nehrt et al. as examples of orthologs with divergent functions, and come to a very different conclusion: they actually exemplify how GO annotations for orthologous genes provide complementary information about conserved biological functions. We then show that there is a global ascertainment bias in the experiment-based GO annotations for human and mouse genes: particular types of experiments tend to be performed in different model organisms. We conclude that the reported statistical differences in annotations between pairs of orthologous genes do not reflect differences in biological function, but rather complementarity in experimental approaches. Our results underscore two general considerations for researchers proposing novel types of analysis based on the GO: 1) that GO annotations are often incomplete, potentially in a biased manner, and subject to an “open world assumption” (absence of an annotation does not imply absence of a function), and 2) that conclusions drawn from a novel, large-scale GO analysis should whenever possible be supported by careful, in-depth examination of examples, to help ensure the conclusions have a justifiable biological basis. PMID:22359495

Long-term albendazole effectiveness for hepatic cystic echinococcosis.

PubMed

Salinas, Jorge Luis; Vildozola Gonzales, Herman; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H

2011-12-01

Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease.

p53 inhibits autophagy by interacting with the human ortholog of yeast Atg17, RB1CC1/FIP200.

PubMed

Morselli, Eugenia; Shen, Shensi; Ruckenstuhl, Christoph; Bauer, Maria Anna; Mariño, Guillermo; Galluzzi, Lorenzo; Criollo, Alfredo; Michaud, Mickael; Maiuri, Maria Chiara; Chano, Tokuhiro; Madeo, Frank; Kroemer, Guido

2011-08-15

The tumor suppressor protein p53 tonically suppresses autophagy when it is present in the cytoplasm. This effect is phylogenetically conserved from mammals to nematodes, and human p53 can inhibit autophagy in yeast, as we show here. Bioinformatic investigations of the p53 interactome in relationship to the autophagy-relevant protein network underscored the possible relevance of a direct molecular interaction between p53 and the mammalian ortholog of the essential yeast autophagy protein Atg17, namely RB1-inducible coiled-coil protein 1 (RB1CC1), also called FAK family kinase-interacting protein of 200 KDa (FIP200). Mutational analyses revealed that a single point mutation in p53 (K382R) abolished its capacity to inhibit autophagy upon transfection into p53-deficient human colon cancer or yeast cells. In conditions in which wild-type p53 co-immunoprecipitated with RB1CC1/FIP200, p53 (K382R) failed to do so, underscoring the importance of the physical interaction between these proteins for the control of autophagy. In conclusion, p53 regulates autophagy through a direct molecular interaction with RB1CC1/FIP200, a protein that is essential for the very apical step of autophagy initiation.

Towards integration of GLAS data into a national fuels mapping program

USGS Publications Warehouse

Peterson, Birgit E.; Nelson, Kurtis; Wylie, Bruce

2013-01-01

vegetation structure and therefore enabled a broader wildland fire modeling capability. The results of this work underscore how GLAS data can be incorporated into LANDFIRE canopy structure and fuel mapping.

Correlates of bullying in Quebec high school students: the vulnerability of sexual-minority youth

PubMed Central

Cénat, Jude Mary; Blais, Martin; Hébert, Martine; Lavoie, Francine; Guerrier, Mireille

2015-01-01

Purpose Bullying has become a significant public health issue, particularly among youth. This study documents cyberbullying, homophobic bullying and bullying at school or elsewhere and their correlates among both heterosexual and sexual-minority high school students in Quebec (Canada). Method A representative sample of 8,194 students aged 14–20 years was recruited in Quebec (Canada) high schools. We assessed cyberbullying, homophobic bullying and bullying at school or elsewhere in the past 12 months and their association with current self-esteem and psychological distress as well as suicidal ideations. Results Bullying at school or elsewhere was the most common form of bullying (26.1%), followed by cyberbullying (22.9%) and homophobic bullying (3.6%). Overall, girls and sexual-minority youth were more likely to experienced cyberbullying and other form of bullying as well as psychological distress, low self-esteem and suicidal ideations. The three forms of bullying were significantly and independently associated with all mental health outcomes. Conclusions The results underscore the relevance of taking into account gender and sexual orientation variations in efforts to prevent bullying experience and its consequences. PMID:26047959

Effects of spatial location and household wealth on health insurance subscription among women in Ghana

PubMed Central

2013-01-01

Background This study compares ownership of health insurance among Ghanaian women with respect to wealth status and spatial location. We explore the overarching research question by employing geographic and proxy means targeting through interactive analysis of wealth status and spatial issues. Methods The paper draws on the 2008 Ghana Demographic and Health Survey. Bivariate descriptive analysis coupled with binary logistic regression estimation technique was used to analyse the data. Results By wealth status, the likelihood of purchasing insurance was significantly higher among respondents from the middle, richer and richest households compared to the poorest (reference category) and these differences widened more profoundly in the Northern areas after interacting wealth with zone of residence. Among women at the bottom of household wealth (poorest and poorer), there were no statistically significant differences in insurance subscription in all the areas. Conclusions The results underscore the relevance of geographic and proxy means targeting in identifying populations who may be need of special interventions as part of the efforts to increase enrolment as well as means of social protection against the vulnerable. PMID:23768255

Individuals with Single Versus Multiple Suicide Attempts Over 10 Years of Prospective Follow-Up

PubMed Central

Boisseau, Christina L.; Yen, Shirley; Markowitz, John C.; Grilo, Carlos M.; Sanislow, Charles A.; Shea, M. Tracie; Zanarini, Mary C.; Skodol, Andrew E.; Gunderson, John G.; Morey, Leslie C.; McGlashan, Thomas H.

2012-01-01

Background The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression. Method Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12 months, then yearly through 10 years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables. Results Twenty-one percent of participants attempted suicide during the 10 years of observation, with 39 (9.0%) reporting a single suicide attempt and 54 (12.5%) reporting multiple suicide attempts. Although no significant differences in were found in baseline Axis I disorders, multiple attempters were significantly more likely to meet criteria for borderline personality disorder and to have higher impulsivity scores than single attempters. Conclusion These results underscore the importance of considering both personality disorders and traits in the assessment of suicidality. PMID:22995448

The impact of sterile neutrinos on CP measurements at long baselines

DOE PAGES

Gandhi, Raj; Kayser, Boris; Masud, Mehedi; ...

2015-09-01

With the Deep Underground Neutrino Experiment (DUNE) as an example, we show that the presence of even one sterile neutrino of mass ~1 eV can significantly impact the measurements of CP violation in long baseline experiments. Using a probability level analysis and neutrino-antineutrino asymmetry calculations, we discuss the large magnitude of these effects, and show how they translate into significant event rate deviations at DUNE. These results demonstrate that measurements which, when interpreted in the context of the standard three family paradigm, indicate CP conservation at long baselines, may, in fact hide large CP violation if there is a sterilemore » state. Similarly, any data indicating the violation of CP cannot be properly interpreted within the standard paradigm unless the presence of sterile states of mass O(1 eV) can be conclusively ruled out. Our work underscores the need for a parallel and linked short baseline oscillation program and a highly capable near detector for DUNE, but in order that its highly anticipated results on CP violation in the lepton sector may be correctly interpreted.« less

The impact of sterile neutrinos on CP measurements at long baselines

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

Gandhi, Raj; Kayser, Boris; Masud, Mehedi

With the Deep Underground Neutrino Experiment (DUNE) as an example, we show that the presence of even one sterile neutrino of mass ~1 eV can significantly impact the measurements of CP violation in long baseline experiments. Using a probability level analysis and neutrino-antineutrino asymmetry calculations, we discuss the large magnitude of these effects, and show how they translate into significant event rate deviations at DUNE. These results demonstrate that measurements which, when interpreted in the context of the standard three family paradigm, indicate CP conservation at long baselines, may, in fact hide large CP violation if there is a sterilemore » state. Similarly, any data indicating the violation of CP cannot be properly interpreted within the standard paradigm unless the presence of sterile states of mass O(1 eV) can be conclusively ruled out. Our work underscores the need for a parallel and linked short baseline oscillation program and a highly capable near detector for DUNE, but in order that its highly anticipated results on CP violation in the lepton sector may be correctly interpreted.« less

The Cross-Cultural Variation of Predictors of Human Papillomavirus Vaccination Intentions

PubMed Central

Swain, Geoffrey R.; Weinhardt, Lance S.

2011-01-01

Abstract Background The influence of health beliefs on human papillomavirus (HPV) vaccine acceptability have been extensively documented in past research. However, studies documenting the generalizability of prior findings to culturally diverse participants are lacking. The importance of generalizability studies is underscored by the immense disparities in cervical cancer rates across ethnicities. Moreover, theory in cultural psychology suggests that beliefs derived from personal expectations may not be the strongest predictors of intentions in individuals socialized in collectivist cultures. The purpose of this research was to investigate the strongest predictors of mothers' intentions to vaccinate their daughters across three cultural groups: Hispanic, non-Hispanic white, and African American. Methods One hundred fifty mothers were recruited from Public Health Department clinics in Milwaukee, Wisconsin. Mothers were asked to answer measures that assessed personal and normative predictors of intentions. Results Results indicated that predictors of vaccination intentions varied cross-culturally. Specifically, culture moderated the influence of norms on intentions. Conclusions Interventions designed for Hispanics may be more effective if norms, rather than attitudes, are targeted. PMID:21314448

Impaired pulmonary function after treatment for tuberculosis: the end of the disease?

PubMed Central

Chushkin, Mikhail Ivanovich; Ots, Oleg Nikolayevich

2017-01-01

ABSTRACT Objective: To evaluate the prevalence of pulmonary function abnormalities and to investigate the factors affecting lung function in patients treated for pulmonary tuberculosis. Methods: A total of 214 consecutive patients (132 men and 82 women; 20-82 years of age), treated for pulmonary tuberculosis and followed at a local dispensary, underwent spirometry and plethysmography at least one year after treatment. Results: Pulmonary impairment was present in 102 (47.7%) of the 214 patients evaluated. The most common functional alteration was obstructive lung disease (seen in 34.6%). Of the 214 patients, 60 (28.0%) showed reduced pulmonary function (FEV1 below the lower limit of normal). Risk factors for reduced pulmonary function were having had culture-positive pulmonary tuberculosis in the past, being over 50 years of age, having recurrent tuberculosis, and having a lower level of education. Conclusions: Nearly half of all tuberculosis patients evolve to impaired pulmonary function. That underscores the need for pulmonary function testing after the end of treatment. PMID:28380187

The Prevalence and Risks for Depression and Anxiety in Hospice Caregivers

PubMed Central

Washington, Karla; Smith, Jamie; Uraizee, Aisha; Demiris, George

2017-01-01

Abstract Background: Depression and anxiety are common concerns for hospice caregivers. Objective: This study looked at the prevalence and variables associated with hospice caregiver depression and anxiety, as well as the relationship between the two conditions. Subjects: We did a secondary analysis of preexisting data. Measurements: Measures included the PHQ-9 and GAD-7. Results: Nearly one-quarter of caregivers were moderately to severely depressed, and nearly one-third reported moderate to severe symptoms of anxiety. Risk factors for both depression and anxiety included younger age and poorer self-rated global health. Depression-specific risk factors included being married and caring for a patient with a diagnosis other than cancer. The sole anxiety-specific risk factor identified was geographic location, as caregivers living in the Southeast were found to have greater anxiety than those in the Midwest. Conclusion: Hospice providers' recognition of family caregivers as both coproviders and corecipients of care underscores the need to more fully assess and respond to depression and anxiety among caregivers. PMID:27912042

Hematopoietic Kit Deficiency, rather than Lack of Mast Cells, Protects Mice from Obesity and Insulin Resistance.

PubMed

Gutierrez, Dario A; Muralidhar, Sathya; Feyerabend, Thorsten B; Herzig, Stephan; Rodewald, Hans-Reimer

2015-05-05

Obesity, insulin resistance, and related pathologies are associated with immune-mediated chronic inflammation. Kit mutant mice are protected from diet-induced obesity and associated co-morbidities, and this phenotype has previously been attributed to their lack of mast cells. We performed a comprehensive metabolic analysis of Kit-dependent Kit(W/Wv) and Kit-independent Cpa3(Cre/+) mast-cell-deficient mouse strains, employing diet-induced or genetic (Lep(Ob/Ob) background) models of obesity. Our results show that mast cell deficiency, in the absence of Kit mutations, plays no role in the regulation of weight gain or insulin resistance. Moreover, we provide evidence that the metabolic phenotype observed in Kit mutant mice, while independent of mast cells, is immune regulated. Our data underscore the value of definitive mast cell deficiency models to conclusively test the involvement of this enigmatic cell in immune-mediated pathologies and identify Kit as a key hematopoietic factor in the pathogenesis of metabolic syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

Validation of Pre-operative Patient Self-Assessment of Cardiac Risk for Non-Cardiac Surgery: Foundations for Decision Support

PubMed Central

Manaktala, Sharad; Rockwood, Todd; Adam, Terrence J.

2013-01-01

Objectives: To better characterize patient understanding of their risk of cardiac complications from non-cardiac surgery and to develop a patient driven clinical decision support system for preoperative patient risk management. Methods: A patient-driven preoperative self-assessment decision support tool for perioperative assessment was created. Patient’ self-perception of cardiac risk and self-report data for risk factors were compared with gold standard preoperative physician assessment to evaluate agreement. Results: The patient generated cardiac risk profile was used for risk score generation and had excellent agreement with the expert physician assessment. However, patient subjective self-perception risk of cardiovascular complications had poor agreement with expert assessment. Conclusion: A patient driven cardiac risk assessment tool provides a high degree of agreement with expert provider assessment demonstrating clinical feasibility. The limited agreement between provider risk assessment and patient self-perception underscores a need for further work including focused preoperative patient education on cardiac risk. PMID:24551384

Hookah and Cigarette Smoking Among African American College Students: Implications for Campus Risk Reduction and Health Promotion Efforts

PubMed Central

Jones, Brittni D.; Cunningham-Williams, Renee M.

2016-01-01

Objective To identify individual and institutional risks and protections for hookah and cigarette smoking among African American (AA) college students. Participants AA college students (n=1,402; mean age=20, range=18–24 years; 75% female) who completed the Fall 2012 American College Health Association–National College Health Assessment II. Methods Respondents were stratified into four mutually exclusive groups by last 30-day smoking status: cigarette-only use (5.1%), hookah-only use (5.9%), dual use (2.4%), and non-use (86.6%). Multinomial logistic regression models identified the relative odds of exclusive and dual hookah and cigarette smoking. Results Current hookah and cigarette smoking rates were comparably low. Age, gender identity, current substance use, interest in tobacco use information, and student population prevailed as risks and protections for hookah and cigarette smoking. Conclusions Campus health promotion campaigns may need to tailor messages to AA students, particularly those who use substances, to underscore the health risks of hookah and cigarette smoking. PMID:26829515

Educational Status, Anger, and Inflammation in the MIDUS National Sample: Does Race Matter?

PubMed Central

Boylan, Jennifer Morozink; Lewis, Tené T.; Coe, Christopher L.; Ryff, Carol D.

2015-01-01

Background Racial differences in anger frequency and expression styles have been found. Further, African Americans receive fewer health benefits from higher education than Whites. Purpose To investigate racial differences in how anger moderates the association between education and inflammation. Methods Midlife in the U.S. (MIDUS) participants (N = 1,200; 43.0% male; 18.5% African American) provided education and anger data via survey assessments. Interleukin-6 (IL-6) and fibrinogen were determined from a fasting blood sample following an overnight clinic visit. Results African Americans reported higher anger-out, IL-6, and fibrinogen and lower anger-control than Whites. Anger-out predicted higher IL-6 and fibrinogen among African Americans with higher education, whereas trait anger and anger-out predicted lower fibrinogen among Whites with higher education. Anger-out marginally predicted higher IL-6 in less educated Whites. Conclusions Findings underscore racial differences in the benefits and consequences of educational attainment, and how social inequities and anger are manifest in inflammatory physiology. PMID:25715901

Breastfeeding and Later Psychosocial Development in the Philippines

PubMed Central

Duazo, Paulita; Avila, Josephine; Kuzawa, Christopher W.

2010-01-01

Objectives Evaluate whether breastfeeding duration predicts later psychosocial development in a large low socioeconomic status (SES) sample in the Philippines. Methods The sample consists of 2,752 children aged 5-6 years who were measured in 2004 as part of the Philippine government's Early Childhood Development Project (ECD). Duration of any breastfeeding was the primary independent variable in regression models predicting a cumulative index of psychosocial development that has been shown previously to predict school readiness. Results In this sample, mothers who breastfed their children for longer tended to have lower educational attainment and to come from lower income households. Despite this, breastfeeding duration was a positive predictor of future psychosocial development (PD) measured in late childhood, but only after adjustment for SES and related confounders. Conclusions These findings add to growing evidence that breastfeeding could provide lasting economic and social benefits and underscore the importance of continuing current public health efforts to promote breastfeeding in the Philippines and across the globe. PMID:20721986

Child Adjustment and Parent Functioning: Considering the Role of Child Driven Effects

PubMed Central

Yan, Ni; Ansari, Arya

2016-01-01

Based on 13,694 mother-child dyads from the Early Childhood Longitudinal Kindergarten Cohort (ECLS-K), this study examined the bidirectional relations between parental and child functioning from kindergarten through third grade. Results from the cross-lagged models demonstrated that child-driven effects co-occurred with parental effects and these effects were comparable in size. At the same time, however, results from the latent profile analysis revealed idiosyncratic patterns of parent and child functioning. Compared with children in the least optimal functioning profiles, those in the average and above average profiles elicited greater improvements in parents’ functioning over time. Although children characterized by poor academic performance at kindergarten appeared to precede parents characterized by harsh parenting at third grade, there was a threshold in the evolving strength of the overall child-driven effects. Taken together, the results from this study underscore the importance of considering reciprocal processes in the parent-child dynamic while also underscoring individual differences in these processes across the early to middle childhood years. PMID:26866838

Evidence from the Cochrane Collaboration for Traditional Chinese Medicine Therapies

PubMed Central

Wieland, Susan; Kimbrough, Elizabeth; Cheng, Ker; Berman, Brian M.

2009-01-01

Abstract Background The Cochrane Collaboration, an international not-for-profit organization that prepares and maintains systematic reviews of randomized trials of health care therapies, has produced reviews summarizing much of the evidence on Traditional Chinese Medicine (TCM). Our objective was to review the evidence base according to Cochrane systematic reviews. Methods In order to detect reviews focusing on TCM, we searched the titles and abstracts of all reviews in Issue 4, 2008 of the Cochrane Database of Systematic Reviews. For each review, we extracted data on the number of trials included and the total number of participants. We provided an indication of the strength of the review findings by assessing the reviewers' abstract conclusions statement. We supplemented our assessment of the abstract conclusions statements with a listing of the comparisons and outcomes showing statistically significant meta-analyses results. Results We identified 70 Cochrane systematic reviews of TCM, primarily acupuncture (n = 26) and Chinese herbal medicine (n = 42), and 1 each of moxibustion and t'ai chi. Nineteen (19) of 26 acupuncture reviews and 22/42 herbal medicine reviews concluded that there was not enough good quality trial evidence to make any conclusion about the efficacy of the evaluated treatment, while the remaining 7 acupuncture and 20 herbal medicine reviews and each of the moxibustion and t'ai chi reviews indicated a suggestion of benefit, which was qualified by a caveat about the poor quality and quantity of studies. Most reviews included many distinct interventions, controls, outcomes, and populations, and a large number of different comparisons were made, each with a distinct forest plot. Conclusions Most Cochrane systematic reviews of TCM are inconclusive, due specifically to the poor methodology and heterogeneity of the studies reviewed. Some systematic reviews provide preliminary evidence of Chinese medicine's benefits to certain patient populations, underscoring the importance and appropriateness of further research. These preliminary findings should be considered tentative and need to be confirmed with rigorous randomized controlled trials. PMID:19757977

Effect of electrolytes and temperature on dications and radical cations of carotenoids: Electrochemical, optical absorption, and high-performance liquid chromatography studies

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

He, Z.; Kispert, L.D.

1999-11-25

The effect of supporting electrolytes and temperature on the behavior of dications and radical cations of carotenoids is studied. Cyclic voltammograms (CVs) of canthaxanthin (I) at 23 and {minus}25 C show that Car{sup sm{underscore}bullet+} of I has similar stability during the time of the CV scan, when using tetrabutylammonium perchlorate (TBAPC), tetrabutylammonium tetrafluoroborate (TBATFB), or tetrabutylammonium hexafluorophosphate (TBAHFP) as supporting electrolyte. However, the stability of Car{sup 2+} decreases when using TBAPC or TBATFB; {beta}-carotene (II) shows similar behavior. The CV of I at {minus}25 C shows a strong cathodic wave (wave 6) near {minus}0.15 V (vs Ag) with an intensitymore » about half that of the neutral oxidation wave when TBAPC or TBATFB is the supporting electrolyte. When TBAHFP is used, wave 6 (ca. {minus}0.05 V vs Ag) is ca. 8 times weaker than when TBAPC or TBATFB is used. This wave results from the reduction of a species that may be a decay product of Car{sup 2+} of I. Results show that these electrolytes commonly used in electrochemical studies may affect the studied systems to different extents. In simultaneous bulk electrolysis (BE) and optical absorption spectroscopic measurements, the absorption band of Car{sup 2+} of I in the presence of 0.1 M TBAHFP can be observed by lowering the BE temperature to {minus}20 C. In the presence of 0.1 M TBAPC or TBATFB, this band is not observed, even at {minus}50 C. Isomerization of neutral I (as shown by HPLC and its blue absorption band shift) is observed only when the Car{sup 2+} absorption band is absent during BE. This observation, along with an increase of the neutral absorption band after stopping BE, suggests that the equilibrium Car + Car{sup 2+} {r{underscore}equilibrium} 2Car{sup {sm{underscore}bullet}+} is shifted to the left because Car{sup 2+} decays more quickly than Car{sup {sm{underscore}bullet}+} in the presence of electrolyte and this is a major path for formation of cis neutral species from cis Car{sup {sm{underscore}bullet}+}. The optical absorption of Car{sup 2+} of I at 18 C in the presence of 0.1 M TBAHFP is obtained, which suggests that Car{sup 2+} of I is not as unstable at room temperature in the presence of TBAHFP as was thought before.« less

Prevention of a wrong-location misadministration through the use of an intradepartmental incident learning system

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

Ford, Eric C.; Smith, Koren; Harris, Kendra

2012-11-15

Purpose: A series of examples are presented in which potential errors in the delivery of radiation therapy were prevented through use of incident learning. These examples underscore the value of reporting near miss incidents. Methods: Using a departmental incident learning system, eight incidents were noted over a two-year period in which fields were treated 'out-of-sequence,' that is, fields from a boost phase were treated, while the patient was still in the initial phase of treatment. As a result, an error-prevention policy was instituted in which radiation treatment fields are 'hidden' within the oncology information system (OIS) when they are notmore » in current use. In this way, fields are only available to be treated in the intended sequence and, importantly, old fields cannot be activated at the linear accelerator control console. Results: No out-of-sequence treatments have been reported in more than two years since the policy change. Furthermore, at least three near-miss incidents were detected and corrected as a result of the policy change. In the first two, the policy operated as intended to directly prevent an error in field scheduling. In the third near-miss, the policy operated 'off target' to prevent a type of error scenario that it was not directly intended to prevent. In this incident, an incorrect digitally reconstructed radiograph (DRR) was scheduled in the OIS for a patient receiving lung cancer treatment. The incorrect DRR had an isocenter which was misplaced by approximately two centimeters. The error was a result of a field from an old plan being scheduled instead of the intended new plan. As a result of the policy described above, the DRR field could not be activated for treatment however and the error was discovered and corrected. Other quality control barriers in place would have been unlikely to have detected this error. Conclusions: In these examples, a policy was adopted based on incident learning, which prevented several errors, at least one of which was potentially severe. These examples underscore the need for a rigorous, systematic incident learning process within each clinic. The experiences reported in this technical note demonstrate the value of near-miss incident reporting to improve patient safety.« less

Long-Term Albendazole Effectiveness for Hepatic Cystic Echinococcosis

PubMed Central

Salinas, Jorge Luis; Gonzales, Herman Vildozola; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H.

2011-01-01

Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease. PMID:22144447

Neuropsychiatric Symptom Modeling in Male and Female C57BL/6J Mice after Experimental Traumatic Brain Injury

PubMed Central

Tucker, Laura B.; Burke, John F.; Fu, Amanda H.

2017-01-01

Abstract Psychiatric symptoms such as anxiety and depression are frequent and persistent complaints following traumatic brain injury (TBI). Modeling these symptoms in animal models of TBI affords the opportunity to determine mechanisms underlying behavioral pathologies and to test potential therapeutic agents. However, testing these symptoms in animal models of TBI has yielded inconsistent results. The goal of the current study was to employ a battery of tests to measure multiple anxiety- and depressive-like symptoms following TBI in C57BL/6J mice, and to determine if male and female mice are differentially affected by the injury. Following controlled cortical impact (CCI) at a parietal location, neither male nor female mice showed depressive-like symptoms as measured by the Porsolt forced-swim test and sucrose preference test. Conclusions regarding anxiety-like behaviors were dependent upon the assay employed; CCI-induced thigmotaxis in the open field suggested an anxiogenic effect of the injury; however, results from the elevated zero maze, light-dark box, and marble-burying tests indicated that CCI reduced anxiety-like behaviors. Fewer anxiety-like behaviors were also associated with the female sex. Increased levels of activity were also measured in female mice and injured mice in these tests, and conclusions regarding anxiety should be taken with caution when experimental manipulations induce changes in baseline activity. These results underscore the irreconcilability of results from studies attempting to model TBI-induced neuropsychiatric symptoms. Changes in injury models or better attempts to replicate the clinical syndrome may improve the translational applicability of rodent models of TBI-induced anxiety and depression. PMID:27149139

Asian American Women in California: A Pooled Analysis of Predictors for Breast and Cervical Cancer Screening

PubMed Central

Breen, Nancy; Liu, Benmei; Lee, Richard; Kagawa-Singer, Marjorie

2015-01-01

Objectives. We examined patterns of cervical and breast cancer screening among Asian American women in California and assessed their screening trends over time. Methods. We pooled weighted data from 5 cycles of the California Health Interview Survey (2001, 2003, 2005, 2007, 2009) to examine breast and cervical cancer screening trends and predictors among 6 Asian nationalities. We calculated descriptive statistics, bivariate associations, multivariate logistic regressions, predictive margins, and 95% confidence intervals. Results. Multivariate analyses indicated that Papanicolaou test rates did not significantly change over time (77.9% in 2001 vs 81.2% in 2007), but mammography receipt increased among Asian American women overall (75.6% in 2001 vs 81.8% in 2009). Length of time in the United States was associated with increased breast and cervical cancer screening among all nationalities. Sociodemographic and health care access factors had varied effects, with education and insurance coverage significantly predicting screening for certain groups. Overall, we observed striking variation by nationality. Conclusions. Our results underscore the need for intervention and policy efforts that are targeted to specific Asian nationalities, recent immigrants, and individuals without health care access to increase screening rates among Asian women in California. PMID:25521898

Analysis of Over 10,000 Cases Finds No Association between Previously-Reported Candidate Polymorphisms and Ovarian Cancer Outcome

PubMed Central

White, Kristin L.; Vierkant, Robert A.; Fogarty, Zachary C.; Charbonneau, Bridget; Block, Matthew S.; Pharoah, Paul D.P.; Chenevix-Trench, Georgia; Rossing, Mary Anne; Cramer, Daniel W.; Pearce, C. Leigh; Schildkraut, Joellen M.; Menon, Usha; Kjaer, Susanne Kruger; Levine, Douglas A.; Gronwald, Jacek; Culver, Hoda Anton; Whittemore, Alice S.; Karlan, Beth Y.; Lambrechts, Diether; Wentzensen, Nicolas; Kupryjanczyk, Jolanta; Chang-Claude, Jenny; Bandera, Elisa V.; Hogdall, Estrid; Heitz, Florian; Kaye, Stanley B.; Fasching, Peter A.; Campbell, Ian; Goodman, Marc T.; Pejovic, Tanja; Bean, Yukie; Lurie, Galina; Eccles, Diana; Hein, Alexander; Beckmann, Matthias W.; Ekici, Arif B.; Paul, James; Brown, Robert; Flanagan, James; Harter, Philipp; du Bois, Andreas; Schwaab, Ira; Hogdall, Claus K.; Lundvall, Lene; Olson, Sara H.; Orlow, Irene; Paddock, Lisa E.; Rudolph, Anja; Eilber, Ursula; Dansonka-Mieszkowska, Agnieszka; Rzepecka, Iwona K.; Ziolkowska-Seta, Izabela; Brinton, Louise; Yang, Hannah; Garcia-Closas, Montserrat; Despierre, Evelyn; Lambrechts, Sandrina; Vergote, Ignace; Walsh, Christine; Lester, Jenny; Sieh, Weiva; McGuire, Valerie; Rothstein, Joseph H.; Ziogas, Argyrios; Lubiński, Jan; Cybulski, Cezary; Menkiszak, Janusz; Jensen, Allan; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Aleksandra; Berchuck, Andrew; Wu, Anna H.; Pike, Malcolm C.; Van Den Berg, David; Terry, Kathryn L.; Vitonis, Allison F.; Doherty, Jennifer A.; Johnatty, Sharon; deFazio, Anna; Song, Honglin; Tyrer, Jonathan; Sellers, Thomas A.; Phelan, Catherine M.; Kalli, Kimberly R.; Cunningham, Julie M.; Fridley, Brooke L.; Goode, Ellen L.

2013-01-01

Background Ovarian cancer is a leading cause of cancer-related death among women. In an effort to understand contributors to disease outcome, we evaluated single-nucleotide polymorphisms (SNPs) previously associated with ovarian cancer recurrence or survival, specifically in angiogenesis, inflammation, mitosis, and drug disposition genes. Methods Twenty-seven SNPs in VHL, HGF, IL18, PRKACB, ABCB1, CYP2C8, ERCC2, and ERCC1 previously associated with ovarian cancer outcome were genotyped in 10,084 invasive cases from 28 studies from the Ovarian Cancer Association Consortium with over 37,000 observed person-years and 4,478 deaths. Cox proportional hazards models were used to examine the association between candidate SNPs and ovarian cancer recurrence or survival with and without adjustment for key covariates. Results We observed no association between genotype and ovarian cancer recurrence or survival for any of the SNPs examined. Conclusions These results refute prior associations between these SNPs and ovarian cancer outcome and underscore the importance of maximally powered genetic association studies. Impact These variants should not be used in prognostic models. Alternate approaches to uncovering inherited prognostic factors, if they exist, are needed. PMID:23513043

Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

PubMed Central

Ghosh, Sudip; Niklewski, Paul; Roy, Sanjoy

2017-01-01

Background: Laparoscopic surgery is increasingly replacing the open procedure because of its many patient-related benefits that are well aligned with policies and programs that seek to optimize health system performance. However, widespread adoption of laparoscopic surgery has been slow, in part, because of the complexity of laparoscopic suturing. The objective of this study was to review the clinical and economic impacts of laparoscopic suturing in key procedures and to assess its role as a barrier to the broader adoption of laparoscopic surgery. Database: A medical literature search of MEDLINE, EMBASE, and BIOSIS from January 2010 through June 2016 identified 47 relevant articles. Conclusion: Laparoscopic suturing and intracorporeal knot tying may result in extended surgical time, complications, and surgeon errors, while improving patient quality of life through improved cosmesis, diet toleration, and better bowel movements. Despite advancement in surgical techniques and the availability of newer surgical tools, the complexity of laparoscopic suturing continues to be a barrier to greater adoption of MIS. The results of the study underscore the need for development of proficiency in laparoscopic suturing, which may help improve patient outcomes and reduce healthcare costs. PMID:28694682

Targeting Host Cell Surface Nucleolin for RSV Therapy: Challenges and Opportunities.

PubMed

Mastrangelo, Peter; Norris, Michael J; Duan, Wenming; Barrett, Edward G; Moraes, Theo J; Hegele, Richard G

2017-09-19

Nucleolin (NCL) has been reported as a cellular receptor for the human respiratory syncytial virus (RSV). We studied the effects of re-purposing AS1411, an anti-cancer compound that binds cell surface NCL, as a possible novel strategy for RSV therapy in vitro and in vivo. AS1411 was administered to RSV-infected cultures of non-polarized (HEp-2) and polarized (MDCK) epithelial cells and to virus-infected mice and cotton rats. Results of in vitro experiments showed that AS1411, used in micromolar concentrations, was associated with decreases in the number of virus-positive cells. Intranasal administration of AS1411 (50 mg/kg) to RSV-infected mice and cotton rats was associated with partial reductions in lung viral titers, decreased virus-associated airway inflammation, and decreased IL-4/IFN-γ ratios when compared to untreated, infected animals. In conclusion, our findings indicate that therapeutic use of AS1411 has modest effects on RSV replication and host response. While the results underscore the challenges of targeting cell surface NCL as a potential novel strategy for RSV therapy, they also highlight the potential of cell surface NCL as a therapeutic target.

Internalized Homophobia as a Partial Mediator between Homophobic Bullying and Self-Esteem among Sexual Minority Youths in Quebec (Canada)

PubMed Central

Blais, Martin; Gervais, Jesse; Hébert, Martine

2016-01-01

Verbal/psychological homophobic bullying is widespread among sexual minority youths. Homophobic bullying has been associated with both high internalized homophobia and low self-esteem. The objectives were to document verbal/psychological homophobic bullying among sexual minority youths and to model the relationships between homophobic bullying, internalized homophobia and self-esteem. Method: A community sample of 300 sexual minority youths aged 14 to 22 years old was used. A structural equations model was tested using a nonlinear, robust estimator implemented in Mplus. The model postulated that homophobic bullying impacts self-esteem both directly and indirectly, via internalized homophobia. Results: 60.7% of the sample reported at least on form of verbal/psychological homophobic bullying. The model explained 29% of the variance of self-esteem, 19.6% of the variance of internalized homophobia and 5.3% of the verbal/psychological homophobic bullying. The model suggests that the relationship between verbal/psychological homophobic bullying and self-esteem is partially mediated by internalized homophobia. Conclusion: Our results underscore the importance of initiatives to prevent homophobic bullying in order to prevent its negative effects on well-being of sexual minority youths. PMID:24714888

Observability of ionospheric space-time structure with ISR: A simulation study

NASA Astrophysics Data System (ADS)

Swoboda, John; Semeter, Joshua; Zettergren, Matthew; Erickson, Philip J.

2017-02-01

The sources of error from electronically steerable array (ESA) incoherent scatter radar (ISR) systems are investigated both theoretically and with use of an open-source ISR simulator, developed by the authors, called Simulator for ISR (SimISR). The main sources of error incorporated in the simulator include statistical uncertainty, which arises due to nature of the measurement mechanism and the inherent space-time ambiguity from the sensor. SimISR can take a field of plasma parameters, parameterized by time and space, and create simulated ISR data at the scattered electric field (i.e., complex receiver voltage) level, subsequently processing these data to show possible reconstructions of the original parameter field. To demonstrate general utility, we show a number of simulation examples, with two cases using data from a self-consistent multifluid transport model. Results highlight the significant influence of the forward model of the ISR process and the resulting statistical uncertainty on plasma parameter measurements and the core experiment design trade-offs that must be made when planning observations. These conclusions further underscore the utility of this class of measurement simulator as a design tool for more optimal experiment design efforts using flexible ESA class ISR systems.

Work Injury Risk Among Young People With Learning Disabilities and Attention-Deficit/Hyperactivity Disorder in Canada

PubMed Central

Pole, Jason D.

2009-01-01

Objectives. We sought to gain a better understanding of the relationship between learning disabilities, attention-deficit/hyperactivity disorder (ADHD), and risk of occupational injury among young workers. Methods. We assessed 15- to 24-year-old workers (n = 14 379) from cycle 2.1 of the Canadian Community Health Survey (CCHS). We gathered data on demographic characteristics, work-related factors, and presence of learning disabilities or ADHD. We conducted a multivariate logistic regression analysis to assess occurrences of medically attended work injuries. Results. There was an 89% adjusted increase in work injury risk among workers with self-reported dyslexia (a type of learning disability) relative to workers reporting no learning disabilities, although this result did not meet traditional statistical significance criteria. Being out of school, either with or without a high school diploma, was associated with a significantly increased risk of work injury, even after control for a number of demographic and work-related variables. Conclusions. Our findings underscore the notion that individual differences salient in the education system (e.g., learning disabilities, school dropout) need to be integrated into conceptual models of injury risk among young workers. PMID:19542044

Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

PubMed Central

Shi, Leiyu; Hayashi, Arthur Seiji; Sharma, Ravi; Daly, Charles; Ngo-Metzger, Quyen

2013-01-01

Objectives. We examined utilization, unmet need, and satisfaction with oral health services among Federally Qualified Health Center patients. We examined correlates of unmet need to guide efforts to increase access to oral health services among underserved populations. Methods. Using the 2009 Health Center Patient Survey, we performed multivariate logistic regressions to examine factors associated with access to dental care at health centers, unmet need, and patient experience. Results. We found no racial or ethnic disparities in access to timely oral health care among health center patients; however, uninsured patients and those whose insurance does not provide dental coverage experienced restricted access and greater unmet need. Slightly more than half of health center patients had a dental visit in the past year, but 1 in 7 reported that their most recent visit was at least 5 years ago. Among health center patients who accessed dental care at their health center, satisfaction was high. Conclusions. These results underscore the critical role that health centers play in national efforts to improve oral health status and eliminate disparities in access to timely and appropriate dental services. PMID:23327254

Psychological Aspects of Cosmetic Surgery among Females: A Media Literacy Training Intervention

PubMed Central

Khazir, Zahra; Dehdari, Tahereh; Majdabad, Mahmood Mahmoodi; Tehrani, Said Pournaghash

2016-01-01

Introduction: The present study examined the favorable attitude of a sample of female university students regarding elective cosmetic surgery, body dysmorphic disorder, self-esteem and body dissatisfaction following a media literacy training intervention. Methods: This study was a quasi-experimental type. The study sample included 140 female university students who were allocated to either the intervention (n=70) or the control group (n=70). Attitude toward cosmetic surgery, body dysmorphic disorder, self-esteem and, body satisfaction was measured in both groups before the intervention and 4 weeks later. Four media literacy training sessions were conducted over 4 weeks for the intervention group. The data was analyzed through analysis of covariance, student’s paired-samples t test, and Pearson correlation. Results: Our findings showed that favorable attitude, body dysmorphic disorder and body dissatisfaction scores were significantly lower (p<0.05) in the intervention group than the control group. Furthermore, self-esteem score increased significantly in the intervention group. Conclusions: Our results underscores the importance of media literacy intervention in decreasing female’s favorable attitude towards elective cosmetic surgery, body dysmorphic disorder and body dissatisfaction as well as increasing self-esteem. PMID:26383204

Links between alcohol and other drug problems and maltreatment among adolescent girls: Perceived discrimination, ethnic identity, and ethnic orientation as moderators

PubMed Central

Gray, Calonie M. K.; Montgomery, Marilyn J.

2012-01-01

Objectives This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls. Methods These relations were examined using archived data from a community sample of 168 Black and Hispanic adolescent girls who participated in a school-based substance use intervention. Results The results revealed that maltreatment was linked to AOD problems, but only through its relation with posttraumatic stress symptoms; maltreatment was positively related to posttraumatic stress symptoms, which were positively related to AOD problems. Both perceived discrimination and ethnic orientation were significant moderators. Specifically, greater perceived discrimination was associated with an increased effect of maltreatment on posttraumatic stress symptoms. Ethnic orientation demonstrated protective properties in the relation between maltreatment and AOD problem severity, such that the effect of maltreatment on AOD problem severity was less for girls with average to high ethnic orientation compared to girls with low ethnic orientation. Conclusions The findings of this study underscore the importance of developing interventions for Black and Hispanic girls that target maltreatment and AOD use concurrently and address ethnicity-specific factors. PMID:22608406

RESISTANCE AND RESILIENCE TO CORAL BLEACHING: IMPLICATIONS FOR CORAL REEF CONSERVATION AND MANAGEMENT

EPA Science Inventory

The massive scale of the 1997-1998 El Nino-associated coral bleaching event underscores the need for strategies to mitigate biodiversity losses resulting from temperature-induced coral mortality. As baseline sea surface temperatures continue to rise, climate change may represent ...

Waste management facility accident analysis (WASTE ACC) system: software for analysis of waste management alternatives

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

Kohout, E.F.; Folga, S.; Mueller, C.

1996-03-01

This paper describes the Waste Management Facility Accident Analysis (WASTE{underscore}ACC) software, which was developed at Argonne National Laboratory (ANL) to support the US Department of Energy`s (DOE`s) Waste Management (WM) Programmatic Environmental Impact Statement (PEIS). WASTE{underscore}ACC is a decision support and database system that is compatible with Microsoft{reg_sign} Windows{trademark}. It assesses potential atmospheric releases from accidents at waste management facilities. The software provides the user with an easy-to-use tool to determine the risk-dominant accident sequences for the many possible combinations of process technologies, waste and facility types, and alternative cases described in the WM PEIS. In addition, its structure willmore » allow additional alternative cases and assumptions to be tested as part of the future DOE programmatic decision-making process. The WASTE{underscore}ACC system demonstrates one approach to performing a generic, systemwide evaluation of accident risks at waste management facilities. The advantages of WASTE{underscore}ACC are threefold. First, the software gets waste volume and radiological profile data that were used to perform other WM PEIS-related analyses directly from the WASTE{underscore}MGMT system. Second, the system allows for a consistent analysis across all sites and waste streams, which enables decision makers to understand more fully the trade-offs among various policy options and scenarios. Third, the system is easy to operate; even complex scenario runs are completed within minutes.« less

Pollution prevention at Air Force Plant {number{underscore}sign}4

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

Daniels, E.D.; Brown, C.J.; Strukely, T.

1999-07-01

Air Force Plant {number{underscore}sign}4 in Fort Worth, Texas is home to Lockheed Martin Tactical Aircraft Systems (LMTAS). This multi-million square foot facility provides all of the design, fabrication, assembly, and testing capabilities necessary to produce the F-16 fighter and the center fuselage of the F-22 fighter. A large number of chemical products and processes are required to achieve the complex manufacturing goals. Since the early 1980s, a pollution prevention program has been in place at LMTAS to eliminate or minimize the use of hazardous chemicals and processes. The structure involves an interdepartmental teaming arrangement to determine satisfactory alternatives to existingmore » procedures as well as development of environmentally friendly methods for new design. Many of the successes are a result of teaming arrangements between LMTAS and the USAF.« less

Competition for light causes plant biodiversity loss after eutrophication.

PubMed

Hautier, Yann; Niklaus, Pascal A; Hector, Andy

2009-05-01

Human activities have increased the availability of nutrients in terrestrial and aquatic ecosystems. In grasslands, this eutrophication causes loss of plant species diversity, but the mechanism of this loss has been difficult to determine. Using experimental grassland plant communities, we found that addition of light to the grassland understory prevented the loss of biodiversity caused by eutrophication. There was no detectable role for competition for soil resources in diversity loss. Thus, competition for light is a major mechanism of plant diversity loss after eutrophication and explains the particular threat of eutrophication to plant diversity. Our conclusions have implications for grassland management and conservation policy and underscore the need to control nutrient enrichment if plant diversity is to be preserved.

School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011

PubMed Central

Strøm, Ida Frugård; Schultz, Jon-Håkon; Wentzel-Larsen, Tore; Dyb, Grete

2016-01-01

Background The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. Objective This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Method Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors’ registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. Results The students’ grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. Conclusion The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching. Highlights of the article School functioning among high school students following a terrorist attack. The findings showed a decline in school performance and increased absence after the event. For students who successfully completed high school, high satisfaction with school support was reported and an improvement in grades could be observed over time, indicating possible recovery. The findings underscore the importance of keeping trauma-exposed students in schools and providing support over time. PMID:27171613

RESISTANCE AND RESILIENCE TO CORAL BLEACHING: IMPLICATIONS FOR CORAL REEF CONSERVATION AND MANAGEMENT

EPA Science Inventory

The massive scale of the 1997–1998 El Nino–associated coral bleaching event underscores the need for strategies to mitigate biodiversity losses resulting from temperature-induced coral mortality. As baseline sea surface temperatures continue to rise, climate change may represent ...

Building Portals for Higher Education.

ERIC Educational Resources Information Center

Pickett, Richard A.; Hamre, William B.

2002-01-01

Presents the elements, components, and processes involved in setting and maintaining Web portals. Uses Santa Barbara City College as a case study of a portal implementation with the purpose of supporting knowledge management; underscores the role played and benefits gained by institutional research and the college as a result. (EV)

Oral Health Equity and Unmet Dental Care Needs in a Population-Based Sample: Findings From the Survey of the Health of Wisconsin

PubMed Central

Wisk, Lauren E.; Walsh, Matthew; McWilliams, Christine; Eggers, Shoshannah; Olson, Melissa

2015-01-01

Objectives. We used objective oral health screening and survey data to explore individual-, psychosocial-, and community-level predictors of oral health status in a statewide population of adults. Methods. We examined oral health status in a sample of 1453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. Results. We found significant disparities in oral health status across all individual-, psychosocial-, and community-level predictors. More than 15% of participants had untreated cavities, and 20% did not receive needed oral health care. Individuals who self-reported unmet need for dental care were 4 times as likely to have untreated cavities as were those who did not report such a need, after controlling for sociodemographic and behavioral factors. Conclusions. Our results suggested that costs were a primary predictor of access to care and poor oral health status. The results underscored the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers (e.g., the costs associated with unmet dental care) and promoting preventive health behaviors (e.g., teeth brushing). PMID:25905843

A Multimedia Interactive Education System for Prostate Cancer Patients: Development and Preliminary Evaluation

PubMed Central

Butz, Brian P

2004-01-01

Background A cancer diagnosis is highly distressing. Yet, to make informed treatment choices patients have to learn complicated disease and treatment information that is often fraught with medical and statistical terminology. Thus, patients need accurate and easy-to-understand information. Objective To introduce the development and preliminary evaluation through focus groups of a novel highly-interactive multimedia-education software program for patients diagnosed with localized prostate cancer. Methods The prostate interactive education system uses the metaphor of rooms in a virtual health center (ie, reception area, a library, physician offices, group meeting room) to organize information. Text information contained in the library is tailored to a person's information-seeking preference (ie, high versus low information seeker). We conducted a preliminary evaluation through 5 separate focus groups with prostate cancer survivors (N = 18) and their spouses (N = 15). Results Focus group results point to the timeliness and high acceptability of the software among the target audience. Results also underscore the importance of a guide or tutor who assists in navigating the program and who responds to queries to facilitate information retrieval. Conclusions Focus groups have established the validity of our approach and point to new directions to further enhance the user interface. PMID:15111269

Use of Mental Health–Related Services Among Immigrant and US-Born Asian Americans: Results From the National Latino and Asian American Study

PubMed Central

Abe-Kim, Jennifer; Takeuchi, David T.; Hong, Seunghye; Zane, Nolan; Sue, Stanley; Spencer, Michael S.; Appel, Hoa; Nicdao, Ethel; Alegría, Margarita

2007-01-01

Objectives. We examined rates of mental health–related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors. Methods. Data were derived from the National Latino and Asian American Study (2002–2003). Results. About 8.6% of the total sample (n=2095) sought any mental health–related services; 34.1% of individuals who had a probable diagnosis sought any services. Rates of mental health–related service use, subjective satisfaction, and perceived helpfulness varied by birthplace and by generation. US-born Asian Americans demonstrated higher rates of service use than did their immigrant counterparts. Third-generation or later individuals who had a probable diagnosis had high (62.6%) rates of service use in the previous 12 months. Conclusions. Asian Americans demonstrated lower rates of any type of mental health–related service use than did the general population, although there are important exceptions to this pattern according to nativity status and generation status. Our results underscore the importance of immigration-related factors in understanding service use among Asian Americans. PMID:17138905

Persistent Psychopathology in the Wake of Civil War: Long-Term Posttraumatic Stress Disorder in Nimba County, Liberia

PubMed Central

Rockers, Peter C.; Saydee, Geetor; Macauley, Rose; Varpilah, S. Tornorlah; Kruk, Margaret E.

2010-01-01

Objectives. We assessed the geographical distribution of posttraumatic stress disorder (PTSD) in postconflict Nimba County, Liberia, nearly 2 decades after the end of primary conflict in the area, and we related this pattern to the history of conflict. Methods. We administered individual surveys to a population-based sample of 1376 adults aged 19 years or older. In addition, we conducted a historical analysis of conflict in Nimba County, Liberia, where the civil war started in 1989. Results. The prevalence of PTSD in Nimba County was high at 48.3% (95% confidence interval = 45.7, 50.9; n = 664). The geographical patterns of traumatic event experiences and of PTSD were consistent with the best available information about the path of the intranational conflict that Nimba County experienced in 1989–1990. Conclusions. The demonstration of a “path of PTSD” coincident with the decades-old path of violence dramatically underscores the direct link between population burden of psychopathology and the experience of violent conflict. Persistent postconflict disruptions of social and physical context may explain some of the observed patterns. PMID:20634461

Work stress and depression among direct support professionals: the role of work support and locus of control

PubMed Central

Gray-Stanley, J. A.; Muramatsu, N.; Heller, T.; Hughes, S.; Johnson, T. P.; Ramirez-Valles, J.

2013-01-01

Background Although work stress can impede the capacity of direct support professionals and contribute to mental health challenges, external (i.e. work social support) and internal resources (i.e. an internal locus of control) have been shown to help DSPs cope more actively. We examined how work stress was associated with depression, with a particular focus on the role of resources. Method Direct support professionals (n = 323) who serve adults with intellectual and developmental disabilities from five community-based organisations completed a cross-sectional, self-administered survey which measured work stress, work support, locus of control, and depression. Results Multiple regression analyses demonstrated that work stress was positively associated with depression, while resources were negatively associated with depression. In particular, work support moderated the effects of client disability stress, supervisory support lessened the effects of role conflict, and locus of control moderated the effects of workload. Conclusions Such findings suggest the importance of external and internal resources for staff mental health. This research underscores the need for strong work social support systems and interventions to help staff manage work stressors. PMID:20633203

Parental HIV/AIDS and Psychosocial Adjustment among Rural Chinese Children

PubMed Central

Fang, Xiaoyi; Stanton, Bonita; Hong, Yan; Zhang, Liying; Zhao, Guoxiang; Zhao, Junfeng; Lin, Xiuyun; Lin, Danhua

2009-01-01

Objective To assess the relationship between parental HIV/AIDS and psychosocial adjustment of children in rural central China. Methods Participants included 296 double AIDS orphans (children who had lost both their parents to AIDS), 459 single orphans (children who had lost one parent to AIDS), 466 vulnerable children who lived with HIV-infected parents, and 404 comparison children who did not experience HIV/AIDS-related illness and death in their families. The measures included depressive symptoms, loneliness, self-esteem, future expectations, hopefulness about the future, and perceived control over the future. Results AIDS orphans and vulnerable children consistently demonstrated poorer psychosocial adjustment than comparison children in the same community. The level of psychosocial adjustment was similar between single orphans and double orphans, but differed by care arrangement among double orphans. Conclusion The findings underscore the urgency and importance of culturally and developmentally appropriate intervention efforts targeting psychosocial problems among children affected by AIDS and call for more exploration of risk and resilience factors, both individual and contextual, affecting the psychosocial wellbeing of these children. PMID:19208701

Preoperative Embolization of Extra-axial Hypervascular Tumors with Onyx

PubMed Central

Fusco, Matthew R.; Salem, Mohamed M.; Reddy, Arra S.; Ogilvy, Christopher S.; Kasper, Ekkehard M.; Thomas, Ajith J.

2016-01-01

Objective Preoperative endovascular embolization of intracranial tumors is performed to mitigate anticipated intraoperative blood loss. Although the usage of a wide array of embolic agents, particularly polyvinyl alcohol (PVA), has been described for a variety of tumors, literature detailing the efficacy, safety and complication rates for the usage of Onyx is relatively sparse. Materials and Methods We reviewed our single institutional experience with pre-surgical Onyx embolization of extra-axial tumors to evaluate its efficacy and safety and highlight nuances of individualized cases. Results Five patients underwent pre-surgical Onyx embolization of large or giant extra-axial tumors within 24 hours of surgical resection. Four patients harbored falcine or convexity meningiomas (grade I in 2 patients, grade II in 1 patient and grade III in one patient), and one patient had a grade II hemangiopericytoma. Embolization proceeded uneventfully in all cases and there were no complications. Conclusion This series augments the expanding literature confirming the safety and efficacy of Onyx in the preoperative embolization of extra-axial tumors, underscoring its advantage of being able to attain extensive devascularization via only one supplying pedicle. PMID:27114961

Community-based HIV/AIDS interventions to promote psychosocial well-being among people living with HIV/AIDS: a literature review

PubMed Central

Wu, Liyun; Li, Xiaoming

2013-01-01

Background: This review explores the current community-based psychosocial interventions among people living with HIV/AIDS (PLWHA) across the globe. Methods: Evaluation studies were retrieved and reviewed regarding study location, characteristics of participants, study design, intervention strategies, outcome indicators, and intervention findings. Results: The 28 studies spanned a broad range of intervention strategies, including coping skills, treatment and cure, cultural activities, community involvement, knowledge education, voluntary counseling and testing, peer-group support, three-layered service provision, child-directed group intervention, adult mentoring, and support group interventions. Regardless of study designs, all studies reported positive intervention effects, ranging from a reduction in HIV/AIDS stigma, loneliness, marginalization, distress, depression, anger, and anxiety to an increase in self-esteem, self-efficacy, coping skills, and quality of life. Conclusion: Although the existing studies have limitation with regard to program coverage, intensity, scope, and methodological challenges, they underscore the importance of developing community-based interventions to promote psychosocial well-being among PLWHA. Future studies need to employ more rigorous methodology and integrate contextual and institutional factors when implementing effective interventions. PMID:25264499

Perceived Social Cohesion, Frequency of Going Out, and Depressive Symptoms in Older Adults

PubMed Central

Choi, Namkee G.; Kim, Jinseok; DiNitto, Diana M.; Marti, C. Nathan

2015-01-01

Objective: To examine both cross-sectional and longitudinal relationships between older adults’ perceptions of social cohesion in their community and depressive symptoms and the potential mediating effect of the frequency of going outside one’s home/building. Method: Using two waves (T1 and T2) of the National Health and Aging Trend Study (n = 5,326), gender-stratified structural equation models were estimated to determine direct and indirect effects of perceived social cohesion on depressive symptoms. Results: At T1, both perceived cohesion and frequency of going out were directly associated with depressive symptoms; however, perceived cohesion predicted frequency of going out only for women. At T2, only frequency of going out was directly associated with depressive symptoms, although perceived cohesion predicted frequency of going out for both genders. T1 perceived cohesion did not predict T2 depressive symptoms. T1 depressive symptoms were the strongest predictor of T2 depressive symptoms. Conclusion: The findings underscore the importance of enhancing the social environment in promoting mental health in late life through active aging. PMID:28138478

Perceived Social Cohesion, Frequency of Going Out, and Depressive Symptoms in Older Adults: Examination of Longitudinal Relationships.

PubMed

Choi, Namkee G; Kim, Jinseok; DiNitto, Diana M; Marti, C Nathan

2015-01-01

Objective: To examine both cross-sectional and longitudinal relationships between older adults' perceptions of social cohesion in their community and depressive symptoms and the potential mediating effect of the frequency of going outside one's home/building. Method: Using two waves (T1 and T2) of the National Health and Aging Trend Study ( n = 5,326), gender-stratified structural equation models were estimated to determine direct and indirect effects of perceived social cohesion on depressive symptoms. Results: At T1, both perceived cohesion and frequency of going out were directly associated with depressive symptoms; however, perceived cohesion predicted frequency of going out only for women. At T2, only frequency of going out was directly associated with depressive symptoms, although perceived cohesion predicted frequency of going out for both genders. T1 perceived cohesion did not predict T2 depressive symptoms. T1 depressive symptoms were the strongest predictor of T2 depressive symptoms. Conclusion: The findings underscore the importance of enhancing the social environment in promoting mental health in late life through active aging.

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior among Gay & Bisexual Men Who Use Club Drugs

PubMed Central

Dentato, Michael P.; Halkitis, Perry N.; Orwat, John

2013-01-01

Background Few studies have examined the impact of minority stress theory upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women, however gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective This study examined sexual risk behavior from the perspective of minority stress theory upon substance using gay and bisexual men and their partners. Methods Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use and partner type, controlling for demographics. Results 396 gay and 54 bisexual respondents, ages 18-67 reported at least one time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions. PMID:24319321

Global Childhood Unintentional Injury Study: Multisite Surveillance Data

PubMed Central

He, Siran; Lunnen, Jeffrey C.; Puvanachandra, Prasanthi; Amar-Singh; Zia, Nukhba

2014-01-01

Objectives. We aimed to analyze the epidemiology of childhood unintentional injuries presenting to hospitals in 5 select sites in low- and middle-income countries (LMICs) (Bangladesh, Colombia, Egypt, Malaysia, and Pakistan). Methods. We collected standardized data from children ages 0 to 12 years at participating emergency departments (EDs) in 2007. Statistical analyses were conducted to compare the characteristics of these injuries and to explore the determinants of injury outcomes. Results. Among 2686 injured children, falls (50.4%) and road traffic injuries (16.4%) were the most common, affecting boys more often (64.7%). Home injuries were more common among younger children (average 5.41 vs 7.06 years) and girls (38.2% vs 31.7%). Following an ED visit, 24% of injured children were admitted to the hospital, and 6 died. Injury outcomes were associated with risk factors, such as age and sex, to varying extents. Conclusions. Standardized ED surveillance revealed unintentional injuries are a threat to child health. The majority of events took place inside the home, challenging traditional concepts of children’s safety and underscoring the need for intensified context-appropriate injury prevention. PMID:24432924

The Effects of Sex and Size on Status Ranking.

ERIC Educational Resources Information Center

Crosbie, Paul V.

1979-01-01

Sex, body size, several sociocultural variables, and status rank were measured in mixed-sex small groups. The intervening sociocultural variables explained some but not all of the interrelationships. Results underscore the empirical vulnerability of social-psychological explanations of sex-role behavior and signal the need for further research.…

Effects of Resource Availability on Children's Behavior and Conflict Management.

ERIC Educational Resources Information Center

Brown, Enora R.

1996-01-01

Examined the effect of resource availability on dyadic interaction of African American three- to five-year olds in a painting activity conducted under two resource conditions. Limited resources promoted more resource and task conflict, while plentiful resources promoted more nonconflictive social and task interactions. Results underscored the role…

Technology Expands in New York State Schools.

ERIC Educational Resources Information Center

Technology Applications Quarterly, 1990

1990-01-01

The results of two statewide surveys, the fall 1989 Basic Educational Data System (BEDS) survey and surveys of school district use of the services at the Board of Cooperative Educational Services (BOCES) Regional Information and Computer Centers, dramatically underscore the continued expansion and use of technology for instructional and management…

An Exploratory Approach to ATEE Output: Some Results and Some Prospects.

ERIC Educational Resources Information Center

Linne, Agneta; Tarrou, Anne-Lise Hostmark

2001-01-01

Reviews research on teacher education published by the Association for Teacher Education in Europe, examining type of content, purpose, focus of study, and (when appropriate) authors' perspectives and the educational theory perspective chosen. The inquiry underscores the importance of relating teacher education research to general social and…

Mexican American Fathers' Occupational Conditions: Links to Family Members' Psychological Adjustment

ERIC Educational Resources Information Center

Crouter, Ann C.; Davis, Kelly D.; Updegraff, Kimberly; Delgado, Melissa; Fortner, Melissa

2006-01-01

To examine the implications of fathers' occupational conditions (i.e., income, work hours, shift work, pressure, workplace racism, and underemployment) for family members' psychological adjustment, home interviews were conducted with fathers, mothers, and two adolescent offspring in each of 218 Mexican American families. Results underscored the…

Crisis Planning: Survey Results from Hurricane Katrina and Implications for Performance Improvement Professionals

ERIC Educational Resources Information Center

Hutchins, Holly M.; Annulis, Heather; Gaudet, Cyndi

2008-01-01

Modern organizations constantly face unparalleled changes and uncertainty in the competitive world, thus requiring strategic planning to mitigate crisis conditions. Underscoring crisis plans are performance interventions that prepare employees, technological systems, and the organizational culture to effectively respond to a crisis event. However,…

Teaching for Social Justice: From Conceptual Frameworks to Classroom Practices

ERIC Educational Resources Information Center

Dover, Alison G.

2013-01-01

In this article, the author presents the results of a multistate study examining how teachers, and specifically secondary English Language Arts (ELA) teachers, conceptualize and implement teaching for social justice in standards-based contexts. Additional analysis underscores how this practice both reflects and extends earlier equity-oriented…

Counselor Educator Mothers: A Quantitative Analysis of Job Satisfaction

ERIC Educational Resources Information Center

Neale-McFall, Cheryl; Eckart, Emeline; Hermann, Mary; Haskins, Natoya; Ziomek-Daigle, Jolie

2018-01-01

The authors examined the occupational satisfaction of 107 counselor educator mothers and found that work-to-family enrichment, support from colleagues, and number of children under age 6 were significant predictors of occupational satisfaction. These results underscore the importance of policies and programs to increase occupational satisfaction…

Perfluoroalkyl substances (PFASs) and ovarian hormone concentrations in naturally cycling women

PubMed Central

Barrett, Emily S.; Chen, Chongshu; Thurston, Sally W.; Haug, Line Småstuen; Sabaredzovic, Azemira; Fjeldheim, Frøydis Nyborg; Frydenberg, Hanne; Lipson, Susan F.; Ellison, Peter T.; Thune, Inger

2015-01-01

Objective To examine associations between environmental exposure to perfluoroalkyl substances (PFASs) and ovarian hormone concentrations in naturally cycling women. Design Estradiol and progesterone were measured in saliva samples collected daily for a single menstrual cycle and concentrations of PFASs (including perfluoroctane sulfonate [PFOS] and perfluoroctanoic acid [PFOA]) were measured in serum samples collected during the same cycle. Setting Tromsø, Norway. Patients 178 healthy, naturally cycling women, ages 25-35. Intervention None. Main outcome measures(s) Mean follicular estradiol (cycle days −7 to −1, where 0 is the day of ovulation); mean luteal progesterone (cycle days +2 to 10). Results Among nulliparous, but not parous women, PFOS concentrations were inversely associated with estradiol (β=−0.025, 95% CI: −0.043, −0.007) and progesterone (β=−0.027, 95% CI: −0.048, −0.007). Similar, but weaker results were observed for perfluorooctanesulfonic acid (PFOSA). No associations were observed between other PFASs (including PFOA) and ovarian steroid concentrations, nor were any associations noted in parous women. Conclusions Our results demonstrate that PFOS and PFOSA may be associated with decreased production of estradiol and progesterone in reproductive age women. These results suggest a possible mechanism by which PFASs affect women's health, and underscore the importance of parity in research on PFASs and women's reproductive health. PMID:25747128

Toward a molecular equivalent dose: use of the medaka model in comparative risk assessment

EPA Science Inventory

Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

Geology as destiny: cold waters run deep in western Oregon.

Treesearch

Sally Duncan

2002-01-01

The summer of 2001 brought the second-worst drought on record in Oregon, resulting in historically low streamflows and reservoir levels, stressed aquatic ecosystems, and even dramatic confrontations between irrigators and federal resource agencies in the Klamath basin. These events underscore the critical and growing importance of water availability and allocation in...

Multiple Role Balance, Job Satisfaction, and Life Satisfaction in Women School Counselors

ERIC Educational Resources Information Center

Bryant, Rhonda M.; Constantine, Madonna G.

2006-01-01

Many prior studies have reported that school counselors are at risk for experiencing mental health difficulties (e.g., professional burnout) as a result of their participation in a wide variety of service-oriented roles. The majority of school counselors are women, which underscores the importance of examining these individuals' unique…

Participative Leadership in Managing a Faculty Strategy

ERIC Educational Resources Information Center

Gwele, N. S.

2008-01-01

Contemporary discourse on the changed role of the Dean of an academic institution underscores the importance of aligning Faculty goals and objectives with the institution's vision and mission. This article focuses on the dean as an academic leader charged with the responsibility of shaping the character of the Faculty within a results-driven…

Behavioral changes from chronic exposure to pesticides used in aerial application : effects of Phosdrin on the performance of monkeys and pigeons on variable interval reinforcement schedules.

DOT National Transportation Integrated Search

1972-08-01

The need for study of behavioral difficulties resulting from exposure to pesticides is based upon reports of behavioral difficulties in aerial applicators following organophosphate poisoning and is underscored by a recent plane crash of a cropduster ...

Exercise and Diet in Obesity Treatment: An Integrative System Dynamics Perspective.

ERIC Educational Resources Information Center

Abdel-Hamid, Tarek K.

2003-01-01

Examined the utility of System Dynamics modeling as a vehicle for controlled experimentation to study and gain insight into the impacts of physical activity and diet on body weight and composition. Results underscored the significant interaction effects between physical activity, diet, and body composition and demonstrated the utility of…

Toward a Molecular Equivalent Dose: Use of the Medaka Model in Comparative Risk Assessment.

EPA Science Inventory

Recent challenges in risk assessment underscore the need to compare the results of toxicity and dose-response testing among a growing list of animal models and, possibly, an array of in vitro screening assays. Assays that quantify types of DNA damage that are directly relevant to...

Is It Time for Social Studies to Be Financially Fit?

ERIC Educational Resources Information Center

Schug, Mark C.; Clow, John

2002-01-01

Recent national survey results underscore the importance of economic and financial education: It appears that many Americans are making poor financial choices in such basic areas as saving for long-term goals and managing personal credit. Social studies teachers need to reexamine the contribution that the social studies curriculum can make in…

Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial

ERIC Educational Resources Information Center

Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.

2009-01-01

The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…

[The personality of psychotherapists] .

PubMed

Vymĕtal, J

2000-01-01

The profession of the psychotherapist is very demanding and his or her personality, constituting one of the effective factors of the treatment, affects the entire psychotherapeutic process. The psychotherapist's desired personality traits include inner stability and high degree of self-knowledge leading to an understanding and accepting of his or her own self. The other useful personality traits--the therapist's openness for the patient as well as his or her unconditional acceptance, empathy and authenticity--create an optimal and safe therapeutical setting enabling the patient to communicate freely and sincerely. All these traits must be expressed simultaneously, otherwise they could be destructive. They are underscored by the therapist's ethical conduct towards the patient. Ignoring these moral principals anulls any positive influence of the above traits. The conclusion makes mention of Kant's categorical imperative.

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

Kita, Keiko; Fukura, Takanobu; Nakase, Kohichi

The authors cloned and sequenced the gene encoding and NADPH-dependent aldehyde reductase (ARII) in Sporobolomyces salmonicolor AKU4429, which reduces ethyl 4-chloro-3-oxobutanoate (4-COBE) to ethyl (S)-4-chloro-3-hydroxybutanoate. The ARII gene is 1,032 bp long, is interrupted by four introns, and encodes a 37,315-Da polypeptide. The deduced amino acid sequence exhibited significant levels of similarity to the amino acid sequences of members of the mammalian 3{Beta}-hydroxysteroid dehydrogenase-plant dihydroglavonol 4-reductase superfamily but not to the amino acid sequences of members of the aldo-keto reductase superfamily or to the amino acid sequence of an aldehyde reductase previously isolated from the same organism. The ARII proteinmore » was overproduced in Escherichia coli about 2,000-fold compared to the production in the original y east cells. The enzyme expressed in E. coli was purified to homogeneity and had the same catalytic properties as ARII purified from S. Salmonicolor. To examine the contribution of the dinucleotide-binding motif G{sub 19}-X-X-G{sub 22}-X-X-A{sub 25}, which is located in the N-terminal region, during ARII catalysis, they replaced three amino acid residues in the motif and purified the resulting mutant enzymes. Substrate inhibition of the G{sub 19}{r{underscore}arrow}A and G{sub 22}{r{underscore}arrow}A mutant enzymes by 4-COBE die not occur. The A{sub 25}{r{underscore}arrow}G mutant enzyme could reduce 4-COBE when NADPH was replaced by an equimolar concentration of NADH.« less

Behavioral Risk Profiles of Homeschooled Adolescents in the United States: A Nationally Representative Examination of Substance Use Related Outcomes

PubMed Central

Hodge, David R.; Salas-Wright, Christopher P.; Vaughn, Michael G.

2016-01-01

Background The homeschool population continues to grow in size and now accounts for 3.4% of all students in the United States. Objective Given the heterogeneous nature of the population, this study examines the relationship between different types of homeschoolers and a number of substance use related outcomes. Methods To conduct this study, we used pooled data (2002–2013) from the National Survey on Drug Use and Health (NSDUH). Respondents aged 12–17 who reported they had been homeschooled at any time during the previous 12 months were classified as homeschoolers (N = 1,321). Latent profile analysis (LPA) was conducted to identify latent subgroups of homeschoolers and multinomial regression was executed to assess the relationship between the subgroups and perceived substance use risk, availability, and past 12-month use. Results The LPA yielded four subgroups, which were summarized as (1) highly religious and engaged, (2) limited parental monitoring, (3) high parental warmth and support, and (4) secular permissive. Of these, the highly religious and engaged subgroup was the least likely to report using substances. Conclusion The results underscore the variation that exists among homeschoolers and the importance of examining the relationship between different types of homeschoolers and outcomes of interest. PMID:27759472

Community based participatory research of breastfeeding disparities in African American women.

PubMed

Kulka, Tamar Ringel; Jensen, Elizabeth; McLaurin, Sue; Woods, Elizabeth; Kotch, Jonathan; Labbok, Miriam; Bowling, Mike; Dardess, Pamela; Baker, Sharon

2011-08-01

OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Using a community-based participatory approach, academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, North Carolina. METHODS: Eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of community stakeholder interviews; 41 interviews were conducted with community representatives. These findings informed the development of a support group pilot intervention. The pilot support groups were evaluated for increase in knowledge of attendees. RESULTS: Focus group and community interviews indicate that African Americans may disproportionately experience inadequate support for breastfeeding. This lack of support was reported in the home, the workplace, among peers, and from healthcare providers. The pilot support groups resulted in increased knowledge of breastfeeding among group participants OR=3.6 (95% CI: 2.5, 5.2). CONCLUSIONS: The findings from this research underscore the importance of a multi-level approach to breastfeeding support for African American women to address breastfeeding disparities.

Nutritional status of Palestinian preschoolers in the Gaza Strip: a cross-sectional study

PubMed Central

2012-01-01

Background The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. Methods This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition) and vulnerable (stunted) groups with those with moderate nutrition. Results Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Conclusions Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts. PMID:22236142

Days Out of Role Due to Mental and Physical Conditions: Results from the Singapore Mental Health Study

PubMed Central

Abdin, Edimansyah; Ong, Clarissa; Chong, Siow Ann; Vaingankar, Janhavi Ajit; Subramaniam, Mythily

2016-01-01

Objective The aim of the current study was to evaluate the relative contributions of mental and physical conditions to days out of role among adults aged 18 years and above in Singapore. Methods The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of residents aged 18 years or older. Diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. Days out of role were assessed using a WHO Disability Assessment Schedule item. Multivariate regression analyses were used to estimate individual-level and societal-level effects of disorders. Results Overall, 8.7% of respondents reported at least one day out of role, with a mean of 5.8 days. The most disabling conditions at the individual level were cancer (118.9 additional days), cardiovascular diseases (93.5), and bipolar disorder (71.0). At the societal level, cardiovascular diseases contributed the highest population attributable risk proportion (45%), followed by cancer (39.3%), and hypertension (13.5%). Conclusions Mental and physical conditions are linked to significant losses in productivity for society as well as role disability for individuals, underscoring the need to enhance prevention and intervention efforts to increase overall productivity and improve individual functioning. PMID:26840741

Quality Improvement Initiatives: The Missed Opportunity for Health Plans

PubMed Central

Fernandez-Lopez, Sara; Lennert, Barbara

2009-01-01

Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303

The outcome of tuberculosis treatment in subjects with chronic kidney disease in Brazil: a multinomial analysis*

PubMed Central

Reis-Santos, Barbara; Gomes, Teresa; Horta, Bernardo Lessa; Maciel, Ethel Leonor Noia

2013-01-01

OBJECTIVE: To analyze the association between clinical/epidemiological characteristics and outcomes of tuberculosis treatment in patients with concomitant tuberculosis and chronic kidney disease (CKD) in Brazil. METHODS: We used the Brazilian Ministry of Health National Case Registry Database to identify patients with tuberculosis and CKD, treated between 2007 and 2011. The tuberculosis treatment outcomes were compared with epidemiological and clinical characteristics of the subjects using a hierarchical multinomial logistic regression model, in which cure was the reference outcome. RESULTS: The prevalence of CKD among patients with tuberculosis was 0.4% (95% CI: 0.37-0.42%). The sample comprised 1,077 subjects. The outcomes were cure, in 58%; treatment abandonment, in 7%; death from tuberculosis, in 13%; and death from other causes, in 22%. The characteristics that differentiated the ORs for treatment abandonment or death were age; alcoholism; AIDS; previous noncompliance with treatment; transfer to another facility; suspected tuberculosis on chest X-ray; positive results in the first smear microscopy; and indications for/use of directly observed treatment, short-course strategy. CONCLUSIONS: Our data indicate the importance of sociodemographic characteristics for the diagnosis of tuberculosis in patients with CKD and underscore the need for tuberculosis control strategies targeting patients with chronic noncommunicable diseases, such as CKD. PMID:24310632

Use of Benzodiazepines in Alzheimer’s Disease: A Systematic Review of Literature

PubMed Central

Defrancesco, Michaela; Marksteiner, Josef; Fleischhacker, W. Wolfgang; Blasko, Imrich

2015-01-01

Background: Benzodiazepines are frequently prescribed in patients with Alzheimer’s disease. Unfortunately, studies evaluating their benefits and risks in these patients are limited. Methods: Clinical trials focusing on the effect of benzodiazepines on cognitive functions, disease progression, behavioral symptoms, sleep disturbances, and the general frequency of benzodiazepine use were included in this review. Published articles from January 1983 to January 2015 were identified using specific search terms in MEDLINE and PubMed Library according to the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology initiative. Results: Of the 657 articles found, 18 articles met predefined selection criteria and were included in this review (8 on frequency, 5 on cognitive functions, 5 on behavioral and sleep disturbances). The frequency of benzodiazepine use ranged from 8.5% to 20%. Five studies reported accelerated cognitive deterioration in association with benzodiazepine use. Two studies reported clinical efficacy for lorazepam and alprazolam to reduce agitation in Alzheimer’s disease patients. No evidence was found for an improvement of sleep quality using benzodiazepines. Conclusion: This systematic review shows a relatively high prevalence of benzodiazepine use but limited evidence for clinical efficacy in Alzheimer’s disease patients. However, there is a paucity of methodologically high quality controlled clinical trials. Our results underscore a need for randomized controlled trials in this area. PMID:25991652

Whole Genome Sequencing Reveals a De Novo SHANK3 Mutation in Familial Autism Spectrum Disorder

PubMed Central

Nemirovsky, Sergio I.; Córdoba, Marta; Zaiat, Jonathan J.; Completa, Sabrina P.; Vega, Patricia A.; González-Morón, Dolores; Medina, Nancy M.; Fabbro, Mónica; Romero, Soledad; Brun, Bianca; Revale, Santiago; Ogara, María Florencia; Pecci, Adali; Marti, Marcelo; Vazquez, Martin; Turjanski, Adrián; Kauffman, Marcelo A.

2015-01-01

Introduction Clinical genomics promise to be especially suitable for the study of etiologically heterogeneous conditions such as Autism Spectrum Disorder (ASD). Here we present three siblings with ASD where we evaluated the usefulness of Whole Genome Sequencing (WGS) for the diagnostic approach to ASD. Methods We identified a family segregating ASD in three siblings with an unidentified cause. We performed WGS in the three probands and used a state-of-the-art comprehensive bioinformatic analysis pipeline and prioritized the identified variants located in genes likely to be related to ASD. We validated the finding by Sanger sequencing in the probands and their parents. Results Three male siblings presented a syndrome characterized by severe intellectual disability, absence of language, autism spectrum symptoms and epilepsy with negative family history for mental retardation, language disorders, ASD or other psychiatric disorders. We found germline mosaicism for a heterozygous deletion of a cytosine in the exon 21 of the SHANK3 gene, resulting in a missense sequence of 5 codons followed by a premature stop codon (NM_033517:c.3259_3259delC, p.Ser1088Profs*6). Conclusions We reported an infrequent form of familial ASD where WGS proved useful in the clinic. We identified a mutation in SHANK3 that underscores its relevance in Autism Spectrum Disorder. PMID:25646853

Immigration, Language Proficiency, and Autobiographical Memories: Lifespan Distribution and Second-Language Access

PubMed Central

Esposito, Alena G.; Baker-Ward, Lynne

2015-01-01

This investigation examined two controversies in the autobiographical literature: how cross-language immigration affects the distribution of autobiographical memories across the lifespan and under what circumstances language-dependent recall is observed. Both Spanish/English bilingual immigrants and English monolingual non-immigrants participated in a cue word study, with the bilingual sample taking part in a within-subject language manipulation. The expected bump in the number of memories from early life was observed for non-immigrants but not immigrants, who reported more memories for events surrounding immigration. Aspects of the methodology addressed possible reasons for past discrepant findings. Language-dependent recall was influenced by second-language proficiency. Results were interpreted as evidence that bilinguals with high second-language proficiency, in contrast to those with lower second-language proficiency, access a single conceptual store through either language. The final multi-level model predicting language-dependent recall, including second-language proficiency, age of immigration, internal language, and cue word language, explained ¾ of the between-person variance and ⅕ of the within-person variance. We arrive at two conclusions. First, major life transitions influence the distribution of memories. Second, concept representation across multiple languages follows a developmental model. In addition, the results underscore the importance of considering language experience in research involving memory reports. PMID:26274061

Immigration, language proficiency, and autobiographical memories: Lifespan distribution and second-language access.

PubMed

Esposito, Alena G; Baker-Ward, Lynne

2016-08-01

This investigation examined two controversies in the autobiographical literature: how cross-language immigration affects the distribution of autobiographical memories across the lifespan and under what circumstances language-dependent recall is observed. Both Spanish/English bilingual immigrants and English monolingual non-immigrants participated in a cue word study, with the bilingual sample taking part in a within-subject language manipulation. The expected bump in the number of memories from early life was observed for non-immigrants but not immigrants, who reported more memories for events surrounding immigration. Aspects of the methodology addressed possible reasons for past discrepant findings. Language-dependent recall was influenced by second-language proficiency. Results were interpreted as evidence that bilinguals with high second-language proficiency, in contrast to those with lower second-language proficiency, access a single conceptual store through either language. The final multi-level model predicting language-dependent recall, including second-language proficiency, age of immigration, internal language, and cue word language, explained ¾ of the between-person variance and (1)/5 of the within-person variance. We arrive at two conclusions. First, major life transitions influence the distribution of memories. Second, concept representation across multiple languages follows a developmental model. In addition, the results underscore the importance of considering language experience in research involving memory reports.

An Exploration of How Foster Parents Educationally Assist Foster Children: A Qualitative Phenomenological Study

ERIC Educational Resources Information Center

Zarate, Grace

2013-01-01

Foster children are academically at risk as a result of abuse, neglect and family disruptions. Findings from previous studies have underscored the critical role played by foster parents in monitoring the academic progress of the children placed in the home. The purpose of this qualitative phenomenological research study was to identify the skill…

Using dendrochronology to measure radial growth of defoliated trees

Treesearch

Thomas W. Swetnam; Marna Ares Thompson; Elaine Kennedy Sutherland

1985-01-01

Budworms (Choristoneura spp.) have repeatedly defoliated millions of hectares of conifers throughout North America. The seriousness of the problem is underscored by research findings in eastern Canada and the northern U.S. Rocky Mountains that the extent, severity, and frequency of bud worm outbreaks have increased in the 20th century, primarily as a result of human-...

A Comparison of the Effectiveness of Three Group Treatments for Weight Loss

ERIC Educational Resources Information Center

Byom, Tianna K.

2009-01-01

Rising overweight and obesity rates in the United States and the accompanying health issues underscore the need for an effective treatment for weight loss. While most people tend to lose weight as a result of cognitive-behavioral treatment, the weight is often regained after treatment ends. Possible reasons for weight regain include not fully…

Candidiasis During Pregnancy May Result From Isogenic Commensal Strains

PubMed Central

Daniels, Wayne; Glover, Douglas D.; Essmann, Michael

2001-01-01

Objective: Our laboratory previously demonstrated that asymptomatic vaginal colonization during pregnancy is a factor predisposing patients to subsequent symptomatic vulvovaginal candidiasis. It is unknown whether symptoms result from strain replacement or a change in host relationship to the original colonizing strain. This study was undertaken to determine whether Candida albicans isolates from asymptomatic women could be responsible for subsequent symptomatic vaginitis. Methods: We retained isolates of C. albicans from women followed longitudinally through pregnancy, and identified six pairs of cultures from women who were colonized without symptoms and who later became symptomatic (average time 14 weeks). We used a random amplification of polymorphic DNA (RAPD) analysis to determine whether isolates from our study patients were genetically similar or dissimilar. Results: Analysis of these pairs of yeast strains by RAPD revealed that five of the six women had symptoms apparently due to the same yeast strain that was found initially as a commensal strain. To increase the power of these observations, we also performed RAPD analysis on six randomly selected yeast strains from other women in this study who had not become symptomatic to determine whether any of these unrelated strains matched strains from those women who became symptomatic. Conclusion: Symptomatic yeast vaginitis is usually due to strains of C. albicans already carried in the lower genital tract, underscoring the need to understand regulation of growth and virulence of the organism in vivo. PMID:11495556

Geographic and socioeconomic variation in the onset of decline of coronary heart disease mortality in white women.

PubMed Central

Wing, S; Barnett, E; Casper, M; Tyroler, H A

1992-01-01

BACKGROUND. Regional, metropolitan, and socioeconomic factors related to the onset of decline of coronary heart disease (CHD) mortality among White women are reported. Such studies are important for planning population-level interventions. METHODS. Mortality data for 1962 to 1978 were used, to estimate the year of onset of decline. Ecological analyses of socioeconomic data from the US census were used to emphasize structural and organizational aspects of changes in disease, rather than as a substitute for an individual-level design. RESULTS. Onset of decline of CHD mortality among White women was estimated to have occurred by 1962 in 53% of 507 state economic areas (SEAs), ranging from 79% in the Northeast to 39% in the South. Metropolitan areas experienced earlier onset of decline than did nonmetropolitan areas. Average income, education, and occupational levels were highest in early onset areas and declined across onset categories. CONCLUSIONS. The results provide additional evidence for previously observed geographic and social patterns of CHD decline. Emphasis on structural economic factors determining the shape of the CHD epidemic curve does not detract from the medical importance of risk factors, but underscores the importance of community development to public health improvements. The results are consistent with the idea that the course of the CHD epidemic in the United States has been strongly influenced by socioeconomic development. PMID:1739148

Preventing HIV transmission in Chinese internal migrants: a behavioral approach.

PubMed

Liu, Xiaona; Erasmus, Vicki; Sun, Xinying; Cai, Rui; Shi, Yuhui; Richardus, Jan Hendrik

2014-01-01

This study is a step towards a behavioral intervention to prevent HIV transmission among Chinese internal migrants. To explore important and changeable determinants of condom use and inspect effective and feasible methods to increase condom use for the target population, we conducted a three-round web-based Delphi study among a panel of 62 experts between October 2012 and March 2013. The panelists were purposely selected using a stepwise procedure to represent topic-related areas of expertise. The response rate per round ranges from 21% to 81%. The panelists identified 19 possible determinants of condom use and reported 16 intervention methods they considered successful. They agreed that attitude towards condom use was the most important and changeable determinant, while applying behavioral theory, increasing sexual education and condom access, performing worksite health promotion, detecting risk factors, and working closely with relevant organizations and the government were effective and feasible methods to increase condom use among internal migrants in China. In conclusion, results of this study highlight the importance of attitude in changing condom use and underscore the need to apply behavior theory and integrate multiple educational approaches for developing behavioral HIV prevention interventions targeting internal migrants in China.

Virus-Like Particle Vaccine Protects against 2009 H1N1 Pandemic Influenza Virus in Mice

PubMed Central

Quan, Fu-Shi; Vunnava, Aswani; Compans, Richard W.; Kang, Sang-Moo

2010-01-01

Background The 2009 influenza pandemic and shortages in vaccine supplies worldwide underscore the need for new approaches to develop more effective vaccines. Methodology/Principal Findings We generated influenza virus-like particles (VLPs) containing proteins derived from the A/California/04/2009 virus, and tested their efficacy as a vaccine in mice. A single intramuscular vaccination with VLPs provided complete protection against lethal challenge with the A/California/04/2009 virus and partial protection against A/PR/8/1934 virus, an antigenically distant human isolate. VLP vaccination induced predominant IgG2a antibody responses, high hemagglutination inhibition (HAI) titers, and recall IgG and IgA antibody responses. HAI titers after VLP vaccination were equivalent to those observed after live virus infection. VLP immune sera also showed HAI responses against diverse geographic pandemic isolates. Notably, a low dose of VLPs could provide protection against lethal infection. Conclusion/Significance This study demonstrates that VLP vaccination provides highly effective protection against the 2009 pandemic influenza virus. The results indicate that VLPs can be developed into an effective vaccine, which can be rapidly produced and avoid the need to isolate high growth reassortants for egg-based production. PMID:20161790

Patterns of Cigarette Smoking Initiation in Two Culturally Distinct American Indian Tribes

PubMed Central

Kanekar, Shalini; Wen, Yang; Buchwald, Dedra; Goldberg, Jack; Choi, Won; Okuyemi, Kolawole S.; Ahluwalia, Jasjit; Henderson, Jeffrey A.

2009-01-01

Objectives. To better understand patterns of initiation among American Indians we examined age-related patterns of smoking initiation during adolescence and young adulthood in 2 American Indian tribes. Methods. We used log-rank comparison and a Cox proportional hazard regression model to analyze data from a population-based study of Southwest and Northern Plains American Indians aged 18 to 95 years who initiated smoking by age 18 years or younger. Results. The cumulative incidence of smoking initiation was much higher among the Northern Plains Indians (47%) than among the Southwest Indians (28%; P < .01). In the Southwest, men were more likely than women to initiate smoking at a younger age (P < .01); there was no such difference in the Northern Plains sample. Northern Plains men and women in more recent birth cohorts initiated smoking at an earlier age than did those born in older birth cohorts. Southwest men and women differed in the pattern of smoking initiation across birth cohorts as evidenced by the significant test for interaction (P = .01). Conclusion. Our findings underscore the need to implement tobacco prevention and control measures within American Indian communities. PMID:19820215

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

Suicidal ideation, depression, and conduct disorder in a sample of adolescent and young adult twins

PubMed Central

Linker, Julie; Gillespie, Nathan A; Maes, Hermine; Eaves, Lindon; Silberg, Judy L.

2012-01-01

Background The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Method Structured interviews on 2814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and young adult follow-up (YAFU) yielded data on symptoms of depression, conduct disorder and adolescent and young adult suicidal ideation. Results Univariate analyses revealed that the familial aggregation for each trait was explained by a combination of additive genetic and shared environmental effects. Suicidal ideation in adolescence was explained in part by genetic influences, but predominantly accounted for by environmental factors. A mixture of genetic and shared environmental influences explained ideation occurring in young adulthood. Multivariate analyses revealed that there are genetic and shared environmental effects common to suicidal ideation, depression, and conduct disorder. The association between adolescent suicidal ideation and CD was attributable to the same genetic and environmental risk factors for depression. Conclusions These findings underscore that prevention and intervention strategies should reflect the different underlying mechanisms involving depression and conduct disorder to assist in identifying adolescents at suicidal risk. PMID:22646517

Content and Form in the Narratives of Children with Specific Language Impairment

PubMed Central

Colozzo, Paola; Gillam, Ronald B.; Wood, Megan; Schnell, Rebecca D.; Johnston, Judith R.

2013-01-01

Purpose: This project investigated the relationship of content and form in the narratives of school-age children. Method: Two samples of children with specific language impairment (SLI) and their age-matched peers (British Columbia sample, M age 9;0, n = 26; Texas/Kansas sample, M age 7;6, n = 40) completed the Test of Narrative Language (TNL, Gillam & Pearson, 2004). The relative strength of content elaboration and grammatical accuracy was measured for each child using variables derived from the TNL scoring system (Study 1) and from analysis of the story texts (Study 2). Results: Both studies indicated that, compared to age peers, the children with SLI were more likely to produce stories of uneven strength, either stories with poor content that were grammatically quite accurate, or stories with elaborated content that were less grammatical. Conclusions: These findings suggest that school-age children with SLI may struggle with the cumulative load of creating a story that is both elaborate and grammatical. They also show that the absence of errors is not necessarily a sign of strength. Finally, they underscore the value of comparing individual differences in multiple linguistic domains, including the elaboration of content, grammatical accuracy, and syntactic complexity. PMID:21930617

MRI-leukoaraiosis thresholds and the phenotypic expression of dementia

PubMed Central

Mitchell, Sandra M.; Brumback, Babette; Tanner, Jared J.; Schmalfuss, Ilona; Lamar, Melissa; Giovannetti, Tania; Heilman, Kenneth M.; Libon, David J.

2012-01-01

Objective: To examine the concept of leukoaraiosis thresholds on working memory, visuoconstruction, memory, and language in dementia. Methods: A consecutive series of 83 individuals with insidious onset/progressive dementia clinically diagnosed with Alzheimer disease (AD) or small vessel vascular dementia (VaD) completed neuropsychological measures assessing working memory, visuoconstruction, episodic memory, and language. A clinical MRI scan was used to quantify leukoaraiosis, total white matter, hippocampus, lacune, and intracranial volume. We performed analyses to detect the lowest level of leukoaraiosis associated with impairment on the neuropsychological measures. Results: Leukoaraiosis ranged from 0.63% to 23.74% of participants' white matter. Leukoaraiosis explained a significant amount of variance in working memory performance when it involved 3% or more of the white matter with curve estimations showing the relationship to be nonlinear in nature. Greater leukoaraiosis (13%) was implicated for impairment in visuoconstruction. Relationships between leukoaraiosis, episodic memory, and language measures were linear or flat. Conclusions: Leukoaraiosis involves specific threshold points for working memory and visuoconstructional tests in AD/VaD spectrum dementia. These data underscore the need to better understand the threshold at which leukoaraiosis affects and alters the phenotypic expression in insidious onset dementia syndromes. PMID:22843264

Adaptive Governance, Uncertainty, and Risk: Policy Framing and Responses to Climate Change, Drought, and Flood.

PubMed

Hurlbert, Margot; Gupta, Joyeeta

2016-02-01

As climate change impacts result in more extreme events (such as droughts and floods), the need to understand which policies facilitate effective climate change adaptation becomes crucial. Hence, this article answers the question: How do governments and policymakers frame policy in relation to climate change, droughts, and floods and what governance structures facilitate adaptation? This research interrogates and analyzes through content analysis, supplemented by semi-structured qualitative interviews, the policy response to climate change, drought, and flood in relation to agricultural producers in four case studies in river basins in Chile, Argentina, and Canada. First, an epistemological explanation of risk and uncertainty underscores a brief literature review of adaptive governance, followed by policy framing in relation to risk and uncertainty, and an analytical model is developed. Pertinent findings of the four cases are recounted, followed by a comparative analysis. In conclusion, recommendations are made to improve policies and expand adaptive governance to better account for uncertainty and risk. This article is innovative in that it proposes an expanded model of adaptive governance in relation to "risk" that can help bridge the barrier of uncertainty in science and policy. © 2015 Society for Risk Analysis.

Changes in mouse whole saliva soluble proteome induced by tannin-enriched diet

PubMed Central

2010-01-01

Background Previous studies suggested that dietary tannin ingestion may induce changes in mouse salivary proteins in addition to the primarily studied proline-rich proteins (PRPs). The aim of the present study was to determine the protein expression changes induced by condensed tannin intake on the fraction of mouse whole salivary proteins that are unable to form insoluble tannin-protein complexes. Two-dimensional polyacrylamide gel electrophoresis protein separation was used, followed by protein identification by mass spectrometry. Results Fifty-seven protein spots were excised from control group gels, and 21 different proteins were identified. With tannin consumption, the expression levels of one α-amylase isoform and one unidentified protein increased, whereas acidic mammalian chitinase and Muc10 decreased. Additionally, two basic spots that stained pink with Coomassie Brilliant Blue R-250 were newly observed, suggesting that some induced PRPs may remain uncomplexed or form soluble complexes with tannins. Conclusion This proteomic analysis provides evidence that other salivary proteins, in addition to tannin-precipitating proteins, are affected by tannin ingestion. Changes in the expression levels of the acidic mammalian chitinase precursor and in one of the 14 salivary α-amylase isoforms underscores the need to further investigate their role in tannin ingestion. PMID:21159160

Comparative genome sequence analysis underscores mycoparasitism as the ancestral life style of Trichoderma

PubMed Central

2011-01-01

Background Mycoparasitism, a lifestyle where one fungus is parasitic on another fungus, has special relevance when the prey is a plant pathogen, providing a strategy for biological control of pests for plant protection. Probably, the most studied biocontrol agents are species of the genus Hypocrea/Trichoderma. Results Here we report an analysis of the genome sequences of the two biocontrol species Trichoderma atroviride (teleomorph Hypocrea atroviridis) and Trichoderma virens (formerly Gliocladium virens, teleomorph Hypocrea virens), and a comparison with Trichoderma reesei (teleomorph Hypocrea jecorina). These three Trichoderma species display a remarkable conservation of gene order (78 to 96%), and a lack of active mobile elements probably due to repeat-induced point mutation. Several gene families are expanded in the two mycoparasitic species relative to T. reesei or other ascomycetes, and are overrepresented in non-syntenic genome regions. A phylogenetic analysis shows that T. reesei and T. virens are derived relative to T. atroviride. The mycoparasitism-specific genes thus arose in a common Trichoderma ancestor but were subsequently lost in T. reesei. Conclusions The data offer a better understanding of mycoparasitism, and thus enforce the development of improved biocontrol strains for efficient and environmentally friendly protection of plants. PMID:21501500

Chronic Conditions Among Children Investigated by Child Welfare: A National Sample

PubMed Central

Hurlburt, Michael S.; Heneghan, Amy M.; Zhang, Jinjin; Rolls-Reutz, Jennifer; Silver, Ellen J.; Fisher, Emily; Landsverk, John; Horwitz, Sarah McCue

2013-01-01

OBJECTIVE: To assess the presence of chronic health conditions (CHCs) among a nationally representative sample of children investigated by child welfare agencies. METHODS: The study included 5872 children, aged 0 to 17.5 years, whose families were investigated for maltreatment between February 2008 and April 2009. Using data from the second National Survey of Child and Adolescent Well-Being, we examined the proportion of children who had CHC. We developed 2 categorical and 2 noncategorical measures of CHC from the available data and analyzed them by using bivariate and multivariable analyses. RESULTS: Depending on the measure used, 30.6% to 49.0% of all children investigated were reported by their caregivers to have a CHC. Furthermore, the children identified by using diverse methods were not entirely overlapping. In the multivariable analyses, children with poorer health were more likely to be male, older, and receiving special educational services but not more likely to be in out-of-home placements. CONCLUSIONS: The finding that a much higher proportion of these children have CHC than in the general population underscores the substantial health problems of children investigated by child welfare agencies and the need to monitor their health carefully, regardless of their placement postinvestigation. PMID:23420907

Perception and intentions to quit among waterpipe smokers in Qatar: a cross-sectional survey

PubMed Central

Jaam, M.; Al-Marridi, W.; Fares, H.; Izham, M.; Kheir, N.

2016-01-01

Objective: To evaluate the perceptions and attitudes of waterpipe (shisha) smokers in Qatar regarding the health risks associated with addiction and to determine their intentions to quit. Methods: A cross-sectional survey was conducted among 181 self-reported waterpipe smokers. Participants were approached in public places as well as in shisha cafes in Qatar. The questionnaire included items related to perception, attitude and intention to quit. Both descriptive and inferential statistics were performed for data analyses, with P ≤ 0.05 considered statistically significant. Results: About 44% of the respondents believed that waterpipe smoking was safer than cigarette smoking, and more than 70% would not mind if their children became involved in waterpipe smoking. More than half of the current smokers wanted to quit smoking shisha at some point, and 17% identified health concerns as the main motivating factor for their intention to quit. Conclusion: A large proportion of shisha smokers viewed shisha as a safer alternative to cigarettes, yet they admitted to intending to quit. These findings underscore the need to design educational interventions and awareness campaigns as well as impose stringent laws on waterpipe smoking in public places in Qatar. PMID:27051611

CAP/ACMG proficiency testing for biochemical genetics laboratories: a summary of performance.

PubMed

Oglesbee, Devin; Cowan, Tina M; Pasquali, Marzia; Wood, Timothy C; Weck, Karen E; Long, Thomas; Palomaki, Glenn E

2018-01-01

PurposeTesting for inborn errors of metabolism is performed by clinical laboratories worldwide, each utilizing laboratory-developed procedures. We sought to summarize performance in the College of American Pathologists' (CAP) proficiency testing (PT) program and identify opportunities for improving laboratory quality. When evaluating PT data, we focused on a subset of laboratories that have participated in at least one survey since 2010.MethodsAn analysis of laboratory performance (2004 to 2014) on the Biochemical Genetics PT Surveys, a program administered by CAP and the American College of Medical Genetics and Genomics. Analytical and interpretive performance was evaluated for four tests: amino acids, organic acids, acylcarnitines, and mucopolysaccharides.ResultsSince 2010, 150 laboratories have participated in at least one of four PT surveys. Analytic sensitivities ranged from 88.2 to 93.4%, while clinical sensitivities ranged from 82.4 to 91.0%. Performance was higher for US participants and for more recent challenges. Performance was lower for challenges with subtle findings or complex analytical patterns.ConclusionUS clinical biochemical genetics laboratory proficiency is satisfactory, with a minority of laboratories accounting for the majority of errors. Our findings underscore the complex nature of clinical biochemical genetics testing and highlight the necessity of continuous quality management.

HIV Risk Behavior Among Men Who Have Sex with Men

PubMed Central

Silan, Vijay; Kant, Shashi; Haldar, Partha; Goswami, Kiran; Rai, Sanjay K.; Misra, Puneet

2013-01-01

Background: Sentinel surveillance reported high human immunodeficiency virus positivity rates among men who have sex with men. The current study has described the high-risk behavior and self-reported sexually transmitted infection(s) among self-identified men who have sex with men. Aims: The present study was to find out the extent of high-risk behavior and prevalence of self-reported sexually transmitted diseases among self-identified men who have sex with men, registered with selected nongovernmental organizations in Delhi. Materials and Methods: A facility-based cross-sectional study was done among 250 men who have sex with men during March 2009 to February 2010, through consecutive sampling strategy. Results: Majority (80%) were anal-receptive, received money for sex (61%) and were involved in all types of sexual intercourse with men (oral-86%, manual-97%, and anal-94%). Consistent condom use with male partner was low (46%), most common reason (52%) for not using condom was, that either the condoms were not available or the partner objected. Self-reported sexually transmitted infection(s) was 41% in the past 12 months. Conclusions: This study underscores the increased vulnerability of men who have sex with men of Delhi and need for sustained interventions. PMID:24251268

Suicide Mortality Following Nursing Home Discharge in the Department of Veterans Affairs Health System

PubMed Central

Szymanski, Benjamin R.; Karlin, Bradley E.; Katz, Ira R.

2013-01-01

Objectives. We assessed suicide rates up to 6 months following discharge from US Department of Veterans Affairs (VA) nursing homes. Methods. In VA Minimum Data Set (MDS) records, we identified 281 066 live discharges from the 137 VA nursing homes during fiscal years 2002 to 2008. We used MDS and administrative data to assess resident age, gender, behaviors, pain, and indications of psychoses, bipolar disorder, dementia, and depression. We identified vital status and suicide mortality within 6 months of discharge through National Death Index searches. Results. Suicide rates within 6 months of discharge were 88.0 per 100 000 person-years for men and 89.4 overall. Standardized mortality ratios relative to age- and gender-matched individuals in the VA patient population were 2.3 for men (95% confidence interval [CI] = 1.9, 2.8) and 2.4 overall (95% CI = 2.0, 2.9). In multivariable proportional hazards regression analyses, resident characteristics, diagnoses, behaviors, and pain were not significantly associated with suicide risk. Conclusions. Suicide risk was elevated following nursing home discharge. This underscores the importance of ongoing VA efforts to enhance discharge planning and timely postdischarge follow-up. PMID:24134359

Ab-Initio Description and Prediction of Properties of Carbon-Based and Other Non-Metallic Materials

NASA Technical Reports Server (NTRS)

Bagayoko, D.; Zhao, G. L.; Hasan, S.

2001-01-01

We have resolved the long-standing problem consisting of 30%-50% theoretical underestimates of the band gaps of non-metallic materials. We describe the Bagayoko, Zhao, and Williams (BZW) method that rigorously circumvents the basis-set and variational effect presumed to be a cause of these underestimates. We present ab-initio, computational results that are in agreement with experiment for diamond (C), silicon (Si), silicon carbides (3C-SiC and 4H-SiC), and other semiconductors (GaN, BaTiO3, AlN, ZnSe, ZnO). We illustrate the predictive capability of the BZW method in the case of the newly discovered cubic phase of silicon nitride (c-Si3N4) and of selected carbon nanotabes [(10,0), and (8,4)]. Our conclusion underscores the inescapable need for the BZW method in ab-initio calculations that employ a basis set in a variational approach. Current nanoscale trends amplify this need. We estimate that the potential impact of applications of the BZW method in advancing our understanding of nonmetallic materials, in informing experiment, and particularly in guiding device design and fabrication is simply priceless.

Reaching youth at the point of sale: cigarette marketing is more prevalent in stores where adolescents shop frequently

PubMed Central

Henriksen, L; Feighery, E; Schleicher, N; Haladjian, H; Fortmann, S

2004-01-01

Objective: Although numerous studies describe the quantity and nature of tobacco marketing in stores, fewer studies examine the industry's attempts to reach youth at the point of sale. This study examines whether cigarette marketing is more prevalent in stores where adolescents shop frequently. Design, setting, and participants: Trained coders counted cigarette ads, products, and other marketing materials in a census of stores that sell tobacco in Tracy, California (n = 50). A combination of data from focus groups and in-class surveys of middle school students (n = 2125) determined which of the stores adolescents visited most frequently. Main outcome measures: Amount of marketing materials and shelf space measured separately for the three cigarette brands most popular with adolescent smokers and for other brands combined. Results: Compared to other stores in the same community, stores where adolescents shopped frequently contained almost three times more marketing materials for Marlboro, Camel, and Newport, and significantly more shelf space devoted to these brands. Conclusions: Regardless of whether tobacco companies intentionally target youth at the point of sale, these findings underscore the importance of strategies to reduce the quantity and impact of cigarette marketing materials in this venue. PMID:15333890

Public Support for Weight-Related Antidiscrimination Laws and Policies

PubMed Central

Hilbert, Anja; Hübner, Claudia; Schmutzer, Gabriele; Danielsdottir, Sigrun; Brähler, Elmar; Puhl, Rebecca

2017-01-01

Objective Weight-related discrimination is prevalent and associated with health impairments for those who are targeted, which underscores the need of antidiscrimination legislation. This study is the first to examine public support of weight-related antidiscrimination laws or policies in Germany, compared to the US and Iceland. Methods In a representative German population sample (N = 2,513), public support for general and employment-specific weight-related antidiscrimination policies, weight-based victimization, and weight bias internalization were measured through established self-report questionnaires. Results Half of the German population sample agreed with antidiscrimination policies. General antidiscrimination laws received lower support than employment-specific laws. Support for policies considering obesity a physical disability was greatest in Germany, whereas support for employment-specific antidiscrimination laws was lower in Germany than in the US and Iceland. Total support for weight-related antidiscrimination policies was significantly predicted by lower age, female gender, obese weight status, residence in West Germany, church membership, and readiness to vote in elections. Conclusion German support for weight-related antidiscrimination policies is moderate. Increasing awareness about weight-related discrimination and laws prohibiting this behavior may help to promote policy acceptance. PMID:28384631

Ethnic Variations in Prevalence of High-Risk Sexual Behaviors Among Asian and Pacific Islander Adolescents in Hawaii

PubMed Central

Kameoka, Velma A.

2009-01-01

Objectives. We examined ethnic variations in high-risk sexual behaviors among Asian and Pacific Islander (API) adolescents in comparison with White adolescents. Methods. We obtained data from the 2003 Hawaii Youth Risk Behavior Survey on 4953 students in grades 9 through 12. We conducted χ2 and logistic regression analyses on these data to examine the prevalence of high-risk sexual behaviors among Japanese, Filipino, Native Hawaiian, and White adolescents. Results. We found significant ethnic variation in prevalence of high-risk sexual behaviors among API adolescents. Relative to White adolescents, Native Hawaiian adolescents were most likely to engage in lifetime sexual intercourse, recent sexual intercourse, and sexual initiation before age 13 years; Japanese adolescents were least likely to engage in these behaviors. Filipino adolescents were least likely to use substances before last sexual intercourse and condoms during last sexual intercourse. Conclusions. Our findings suggest divergent patterns of risk among API ethnic groups, underscoring the heterogeneity of API subgroups and emphasizing the need for health disparities research on disaggregated API ethnic groups. The findings of such research should be used to design ethnically relevant interventions aimed at mitigating the negative health consequences of high-risk sexual behaviors. PMID:19106424

Creating a Pilot Educational Psychiatry Website: Opportunities, Barriers, and Next Steps

PubMed Central

O'Connor, Ryan; Franzen, Jamie; Snow, Caitlin; Boland, Robert; Kitts, Robert

2015-01-01

Background While medical students and residents may be utilizing websites as online learning resources, medical trainees and educators now have the opportunity to create such educational websites and digital tools on their own. However, the process and theory of building educational websites for medical education have not yet been fully explored. Objective To understand the opportunities, barriers, and process of creating a novel medical educational website. Methods We created a pilot psychiatric educational website to better understand the options, opportunities, challenges, and processes involved in the creation of a psychiatric educational website. We sought to integrate visual and interactive Web design elements to underscore the potential of such Web technology. Results A pilot website (PsychOnCall) was created to demonstrate the potential of Web technology in medical and psychiatric education. Conclusions Creating an educational website is now technically easier than ever before, and the primary challenge no longer is technology but rather the creation, validation, and maintenance of information for such websites as well as translating text-based didactics into visual and interactive tools. Medical educators can influence the design and implementation of online educational resources through creating their own websites and engaging medical students and residents in the process. PMID:27731837

Asthma caused by occupational exposures is common – A systematic analysis of estimates of the population-attributable fraction

PubMed Central

Torén, Kjell; Blanc, Paul D

2009-01-01

Background The aim of this paper is to highlight emerging data on occupational attributable risk in asthma. Despite well documented outbreaks of disease and the recognition of numerous specific causal agents, occupational exposures previously had been relegated a fairly minor role relative to other causes of adult onset asthma. In recent years there has been a growing recognition of the potential importance of asthma induced by work-related exposures Methods We searched Pub Med from June 1999 through December 2007. We identified six longitudinal general population-based studies; three case-control studies and eight cross-sectional analyses from seven general population-based samples. For an integrated analysis we added ten estimates prior to 1999 included in a previous review. Results The longitudinal studies indicate that 16.3% of all adult-onset asthma is caused by occupational exposures. In an overall synthesis of all included studies the overall median PAR value was 17.6%. Conclusion Clinicians should consider the occupational history when evaluating patients in working age who have asthma. At a societal level, these findings underscore the need for further preventive action to reduce the occupational exposures to asthma-causing agents. PMID:19178702

Mandated Coverage of Preventive Care and Reduction in Disparities: Evidence From Colorectal Cancer Screening

PubMed Central

Kapinos, Kandice A.

2015-01-01

Objectives. We identified correlates of racial/ethnic disparities in colorectal cancer screening and changes in disparities under state-mandated insurance coverage. Methods. Using Behavioral Risk Factor Surveillance System data, we estimated a Fairlie decomposition in the insured population aged 50 to 64 years and a regression-adjusted difference-in-difference-in-difference model of changes in screening attributable to mandates. Results. Under mandated coverage, blood stool test (BST) rates increased among Black, Asian, and Native American men, but rates among Whites also increased, so disparities did not change. Endoscopic screening rates increased by 10 percentage points for Hispanic men and 3 percentage points for non-Hispanic men. BST rates fell among Hispanic relative to non-Hispanic men. We found no changes for women. However, endoscopic screening rates improved among lower income individuals across all races and ethnicities. Conclusions. Mandates were associated with a reduction in endoscopic screening disparities only for Hispanic men but may indirectly reduce racial/ethnic disparities by increasing rates among lower income individuals. Findings imply that systematic differences in insurance coverage, or health plan fragmentation, likely existed without mandates. These findings underscore the need to research disparities within insured populations. PMID:25905835

Characterization of the Asian Phenotype - An Emerging Paradigm with Clinicopathological and Human Research Implications.

PubMed

Leow, Melvin Khee-Shing

2017-01-01

Background : Modern medicine recognizes that salient, inherent variations between Caucasians and Asians exist. Radical changes are occurring in the health scene with increasing emphasis centered on the recognition of inter-individual variations unique to Asians that impact on medical management and outcomes. Aim : This review analyzes distinct features or outcomes in terms of epidemiology, disease thresholds, diagnostic cutoffs and treatment responses of Asian people compared with non-Asians. Methods : This review is based on a literature search via PubMed and MEDLINE for relevant articles related to the Asian phenotype and its impact on health and disease. Results : An 'Asian phenotype' could be characterized across the spectrum of biomedical disciplines and underscores the major challenges clinicians must face in their daily management of a cosmopolitan population and their extrapolation of research outcomes. Conclusion : Interventions for various ailments that have traditionally ignored population differences have now entered the age of personalized, stratified or precision medicine requiring an individualized approach being adopted as a new standard of care. Factoring in Asian phenotypes is essential for the medical research community and the development of improved clinical practice guidelines across a continuum of disciplines that will ultimately translate to better human health round the world.

Nimbus 7 earth radiation budget wide field of view climate data set improvement. II - Deconvolution of earth radiation budget products and consideration of 1982-1983 El Nino event

NASA Technical Reports Server (NTRS)

Ardanuy, Phillip E.; Hucek, Richard R.; Groveman, Brian S.; Kyle, H. Lee

1987-01-01

A deconvolution technique is employed that permits recovery of daily averaged earth radiation budget (ERB) parameters at the top of the atmosphere from a set of the Nimbus 7 ERB wide field of view (WFOV) measurements. Improvements in both the spatial resolution of the resultant fields and in the fidelity of the time averages is obtained. The algorithm is evaluated on a set of months during the period 1980-1983. The albedo, outgoing long-wave radiation, and net radiation parameters are analyzed. The amplitude and phase of the quasi-stationary patterns that appear in the spatially deconvolved fields describe the radiation budget components for 'normal' as well as the El Nino/Southern Oscillation (ENSO) episode years. They delineate the seasonal development of large-scale features inherent in the earth's radiation budget as well as the natural variability of interannual differences. These features are underscored by the powerful emergence of the 1982-1983 ENSO event in the fields displayed. The conclusion is that with this type of resolution enhancement, WFOV radiometers provide a useful tool for the observation of the contemporary climate and its variability.

An in silico evaluation of treatment regimens for recurrent Clostridium difficile infection

PubMed Central

Blanco, Natalia; Foxman, Betsy; Malani, Anurag N.; Zhang, Min; Walk, Seth; Rickard, Alexander H.

2017-01-01

Background Clostridium difficile infection (CDI) is a significant nosocomial infection worldwide, that recurs in as many as 35% of infections. Risk of CDI recurrence varies by ribotype, which also vary in sporulation and germination rates. Whether sporulation/germination mediate risk of recurrence and effectiveness of treatment of recurring CDI remains unclear. We aim to assess the role of sporulation/germination patterns on risk of recurrence, and the relative effectiveness of the recommended tapered/pulsing regimens using an in silico model. Methods We created a compartmental in-host mathematical model of CDI, composed of vegetative cells, toxins, and spores, to explore whether sporulation and germination have an impact on recurrence rates. We also simulated the effectiveness of three tapered/pulsed vancomycin regimens by ribotype. Results Simulations underscored the importance of sporulation/germination patterns in determining pathogenicity and transmission. All recommended regimens for recurring CDI tested were effective in reducing risk of an additional recurrence. Most modified regimens were still effective even after reducing the duration or dosage of vancomycin. However, the effectiveness of treatment varied by ribotype. Conclusion Current CDI vancomycin regimen for treating recurrent cases should be studied further to better balance associated risks and benefits. PMID:28800598

Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers

PubMed Central

Agaku, Israel T; Adisa, Akinyele O; Ayo-Yusuf, Olalekan A; Connolly, Gregory N

2014-01-01

Introduction This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI). Methods The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents’ concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (p<0.05). Results Most respondents expressed concerns about data breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96). Conclusions This study underscores the need for enhanced measures to secure patients’ PHI to avoid undermining their trust. PMID:23975624

Painful languages of the body: experiences of headache among women in two Peruvian communities.

PubMed

Darghouth, Sarah; Pedersen, Duncan; Bibeau, Gilles; Rousseau, Cecile

2006-09-01

This exploratory study focuses on the understandings of and experiences with headache in two settings in Peru: the Quechua-speaking district of Ayacucho, in southern Peru, and a poor urban district of Lima Metropolitana. More specifically, it explores the personal and collective meanings constructed around women's headache experiences. Structured and open-ended interviews were administered to patients suffering headache to elicit interpretations of headache episodes. An analysis of the collected narratives suggests that headache is often comprehended in a polysemic framework, where meanings ascribed in bodily, emotional, family, and social terms articulate individual and shared notions of suffering within larger contexts of social dislocation. Often woven into experiences of solitude, headache accounts are lived and told in dynamic temporal spaces, and narrate dissolution of family ties and tensions associated with women's roles. The results underscore the significance of patients' subjective interpretations of painful experiences and underscore the connections between bodily and emotional pain and distress experienced at family, community, and larger social levels.

Summary results of the 2014-2015 DARPA Chikungunya challenge

DOE PAGES

Del Valle, Sara Y.; McMahon, Benjamin Hamilton; Asher, Jason; ...

2018-05-30

Here, emerging pathogens such as Zika, chikungunya, Ebola, and dengue viruses are serious threats to national and global health security. Accurate forecasts of emerging epidemics and their severity are critical to minimizing subsequent mortality, morbidity, and economic loss. The recent introduction of chikungunya and Zika virus to the Americas underscores the need for better methods for disease surveillance and forecasting.

Summary results of the 2014-2015 DARPA Chikungunya challenge

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

Del Valle, Sara Y.; McMahon, Benjamin Hamilton; Asher, Jason

Here, emerging pathogens such as Zika, chikungunya, Ebola, and dengue viruses are serious threats to national and global health security. Accurate forecasts of emerging epidemics and their severity are critical to minimizing subsequent mortality, morbidity, and economic loss. The recent introduction of chikungunya and Zika virus to the Americas underscores the need for better methods for disease surveillance and forecasting.

"Jumping to conclusions" in delusion-prone participants: an experimental economics approach.

PubMed

van der Leer, Leslie; McKay, Ryan

2014-01-01

That delusional and delusion-prone individuals "jump to conclusions" on probabilistic reasoning tasks is a key finding in cognitive neuropsychiatry. Here we focused on a less frequently investigated aspect of "jumping to conclusions" (JTC): certainty judgments. We incorporated rigorous procedures from experimental economics to eliminate potential confounds of miscomprehension and motivation and systematically investigated the effect of incentives on task performance. Low- and high-delusion-prone participants (n = 109) completed a series of computerised trials; on each trial, they were shown a black or a white fish, caught from one of the two lakes containing fish of both colours in complementary ratios. In the betting condition, participants were given £4 to distribute over the two lakes as they wished; in the control condition, participants simply provided an estimate of how probable each lake was. Deviations from Bayesian probabilities were investigated. Whereas high-delusion-prone participants in both the control and betting conditions underestimated the Bayesian probabilities (i.e. were conservative), low-delusion-prone participants in the control condition underestimated but those in the betting condition provided accurate estimates. In the control condition, there was a trend for high-delusion-prone participants to give higher estimates than low-delusion-prone participants, which is consistent with previous reports of "jumping to conclusions" in delusion-prone participants. However, our findings in the betting condition, where high-delusion-prone participants provided lower estimates than low-delusion-prone participants (who were accurate), are inconsistent with the jumping-to-conclusions effect in both a relative and an absolute sense. Our findings highlight the key role of task incentives and underscore the importance of comparing the responses of delusion-prone participants to an objective rational standard as well as to the responses of non-delusion-prone participants.

How Kindergarten Entry Assessments Are Used in Public Schools and How They Correlate with Spring Assessments. Stated Briefly. REL 2017-183

ERIC Educational Resources Information Center

Shields, Katherine A.; Cook, Kyle DeMeo; Greller, Sara

2016-01-01

This "Stated Briefly" report is a companion piece that summarizes the results of another report of the same name. Child development research on the importance of early experiences for later life outcomes has underscored the need for effective early childhood education. With the aim of providing high-quality education, many kindergarten…

Research Ethics Considerations Regarding the Cancer Moonshot Initiative.

PubMed

Hammer, Marilyn J

2016-07-01

If the Precision Medicine Initiative was the launching pad, the Cancer Moonshot Initiative is the liftoff. A billion-dollar mission to "eliminate cancer as we know it," the Cancer Moonshot Initiative underscores the Precision Medicine Initiative's near-term focus in oncology research and translation. Spearheaded by Vice President Biden, the goal is to condense a decade of research into actionable results within five years.

Impact of a family medicine resident wellness curriculum: a feasibility study.

PubMed

Runyan, Christine; Savageau, Judith A; Potts, Stacy; Weinreb, Linda

2016-01-01

Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

Predictors and Outcomes of Childhood Primary Enuresis

PubMed Central

Kessel, Ellen M.; Allmann, Anna E. S.; Goldstein, Brandon; Finsaas, Megan; Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Klein, Daniel N.

2017-01-01

Objective Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood. Method We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 to age 9. Results We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were over twice as likely to have a lifetime diagnosis than females. Significant age 3 predictors of developing primary enuresis at age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 predicted a greater likelihood of persistence through age 9. By age 9, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of ADHD and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis. Conclusions Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis. PMID:28219491

Impact of Sleep Quality on Cardiovascular Outcomes in Hemodialysis Patients: Results from the Frequent Hemodialysis Network Study

PubMed Central

Unruh, Mark; Tamura, Manjula Kurella; Larive, Brett; Rastogi, Anjay; James, Sam; Schiller, Brigitte; Gassman, Jennifer; Chan, Christopher; Lockridge, Robert; Kliger, Alan

2011-01-01

Background Poor sleep quality is a common, persistent, and important problem to patients with end-stage renal disease (ESRD). This report examines whether sleep quality is associated with dialysis treatment factors and other modifiable clinical factors in a large group of hemodialysis (HD) patients. Methods Cross-sectional analyses were conducted on baseline data collected from participants in the Frequent Hemodialysis Network trials. Sleep quality was measured using the Medical Outcomes Study Sleep Problems Index II (SPI II), a 9-item measure of sleep quality with higher scores reflecting poorer sleep quality. Results The participants had an age of 51.2 ± 13.6 years, 61% were male, 38% were black, and 42% had diabetes. Higher pre-dialysis serum phosphorus (per 0.5 mg/ml) (OR 0.91; 95% CI 0.85, 0.96) and depression (OR 0.16; 95% CI 0.10, 0.25) were independently associated with decrements in sleep quality. There was also a difference in time to recovery from dialysis for the fourth versus the first SPI II quartile (5.1 h; p < 0.0001). Conclusion These findings underscore the link between sleep and daytime function and suggest that improving sleep may provide an opportunity to improve outcomes in ESRD. Whether sleep problems may be improved by reduction of serum phosphorus or treatment of depression in the HD population merits further investigation. PMID:21474924

Patterns of Weight Change in Black Americans: Pooled Analysis from Three Behavioral Weight Loss Trials

PubMed Central

Morales, Knashawn H.; Kumanyika, Shiriki K.; Fassbender, Jennifer E.; Good, Jerene; Localio, A. Russell; Wadden, Thomas A.

2014-01-01

Objective Differentiating trajectories of weight change and identifying associated baseline predictors can provide insights for improving behavioral obesity treatment outcomes. Design and Methods Secondary, observational analyses using growth mixture models were conducted in pooled data for 604 black American, primarily female adults in three completed clinical trials. Covariates of identified patterns were evaluated. Results The best fitting model identified three patterns over 2 years: 1) mean weight loss of approximately 2 kg (n=519); 2) mean weight loss of approximately 3 kg at 1 year, followed by ~ 4 kg regain (n=61); and 3) mean weight loss of approximately 20 kg at 1 year followed by ~ 4 kg regain (n=24, with 23 from one study). In final multivariate analyses, higher BMI predicted having pattern 2 (OR[95% CI]) 1.10[1.03, 1.17]) or 3 (OR[95% CI] 1.42[1.25, 1.63]), and higher dietary fat score was predictive of a lower odds of having patterns 2 (OR[95% CI] 0.37[0.15, 0.94]) or 3 (OR[95% CI] 0.23[0.07, 0.79]). Conclusions Findings were consistent with moderate, clinically non-significant weight loss as the predominant pattern across all studies. Results underscore the need to develop novel and more carefully targeted and tailored approaches to facilitating weight loss in black American adults. PMID:25251464

Understanding the gendered patterns of substance use initiation among adolescents living in rural, central Mexico

PubMed Central

Ayers, Stephanie; Marsiglia, Flavio; Hoffman, Steven; Urbaeva, Zhyldyz

2012-01-01

Background Little is known about the age of initiation and gender differences in substance use among adolescents in rural, central Mexico. Methods The cross-sectional data were collected from students enrolled in the Videobachillerato (VIBA) (video high school) program in Guanajuato, Mexico. Questionnaires asked students about the age at which they had used alcohol, cigarettes, or marijuana for the first time. Kaplan-Meier Survival Functions were used to estimate if males and females were significantly different in their cumulative probabilities of initiating substances over time. Results On average, alcohol is initiated at 14.7 years of age, cigarettes at 15.1 years of age, and marijuana at 16.5 years of age. Over time, males had a significantly higher probability of initiating alcohol (Kaplan-Meier Failure Curve: Χ2=26.35, p<0.001), cigarettes (Kaplan-Meier Failure Curve: Χ2=41.90, p<0.001), and marijuana (Kaplan-Meier Failure Curve: Χ2=38.01, p<0.001) compared to females. Conclusions These results highlight the gendered patterns of substance use initiation among adolescents in rural, central Mexico and underscore the need for gendered substance use prevention interventions with these adolescents. By putting forth efforts to understand substance use initiation patterns of adolescents living in rural, central Mexico, culturally specific and efficacious prevention efforts can be tailor-made to create lasting differences. PMID:22421555

Predicting the fear of assault at school and while going to and from school in an adolescent population.

PubMed

Alvarez, A; Bachman, R

1997-01-01

Recent research investigating the fear of crime has shown that when crime and behavior-specific measures of fear are utilized, the young are more likely than the elderly to be the most fearful. Research investigating the etiology of fear within adolescent populations, however, remains very limited. Using a sample of over 10,000 junior high and high school students from a supplement to the National Crime Victimization Survey, this paper examines the factors contributing to students' fear of assault both at school and while going to and from school. Results indicate that recent victimization experiences, the presence of a violent subculture at the school (e.g., gang presence and attacks on teachers) and availability of drugs/alcohol were related to fear in both contexts. The predictability of fear from individual characteristics, however, was context specific. Contrary to findings from earlier research, it was found that young females were not more fearful than their male counterparts in all contexts. While they were more fearful of an attack while going to and from school, there were no differences in fear levels while at school between males and females after controlling for other environmental and experiential factors. Conclusions largely support the contention that fear is a rational calculation based on objective criteria. Moreover, results underscore the need for more specificity when operationalizing the context and content of fearfulness.

Arteriogenesis in murine adipose tissue is contingent on CD68+/CD206+ macrophages

PubMed Central

Seaman, Scott A.; Cao, Yiqi; Campbell, Chris A.; Peirce, Shayn M.

2016-01-01

Objective The surgical transfer of skin, fat, and/or muscle from a donor site to a recipient site within the same patient, is a widely performed procedure in reconstructive surgeries. A surgical pre-treatment strategy that is intended to increase perfusion in the flap, termed “flap delay”, is a commonly employed technique by plastic surgeons prior to flap transplantation. Here, we explored whether CD68+/CD206+ macrophages are required for arteriogenesis within the flap by performing gain-of-function and loss-of-function studies in a previously published flap delay murine model. Methods and Results Local injection of M2-polarized macrophages into the flap resulted in an increase in collateral vessel diameter. Application of a thin biomaterial film loaded with a pharmacological agent (FTY720), which has been previously shown to recruit CD68+/CD206+ macrophages to remodeling tissue, increased CD68+/CD206+ cell recruitment and collateral vessel enlargement. Conversely, when local macrophage populations were depleted within the inguinal fat pad via clodronate liposome delivery, we observed fewer CD68+ cells accompanied by diminished collateral vessel enlargement. Conclusions Our study underscores the importance of macrophages during microvascular adaptations that are induced by flap delay. These studies suggest a mechanism for a translatable therapeutic target that may be used to enhance the clinical flap delay procedure. PMID:27976451

Hallucinations, dreaming and frequent dozing in Parkinson’s disease: Impact of right-hemisphere neural networks

PubMed Central

Stavitsky, Karina; McNamara, Patrick; Durso, Raymon; Harris, Erica; Auerbach, Sanford; Cronin-Golomb, Alice

2008-01-01

Objective To relate sleep disturbances in Parkinson’s disease (PD) to hemispheric asymmetry of initial presentation. Background Sleep disturbances are common in PD arising from the neurodegenerative process underlying the disease, which is usually lateralized at onset. Patients with left-side onset (LPD: right hemisphere dysfunction) exhibit reduced vigilance relative to those with right-side onset (RPD: left hemisphere dysfunction), leading us to hypothesize that sleep-related disturbances, particularly excessive daytime sleepiness, would be more severe for LPD than for RPD. Methods Thirty-one non-demented participants with PD (17 RPD and 14 LPD) and 17 age-matched control participants with chronic health conditions (CO) were administered the Parkinson’s Disease Sleep Scale and polysomnography was performed on a subset of the PD participants. Results Both PD subgroups exhibited more nighttime motor symptoms than the CO group, but only LPD endorsed more nocturnal hallucinations and daytime dozing. Controlling for mood additionally revealed more vivid dreaming in LPD than RPD. There were no significant differences between LPD and RPD on measures of sleep architecture. Conclusions Increased dreaming, hallucinations, and daytime somnolescence in LPD may be related to changes in right-hemisphere neural networks implicated in the generation and control of visual images, arousal and vigilance. Our results underscore the need to consider side of onset in regard to sleep disturbances in PD. PMID:18797256

Opportunistic biases: Their origins, effects, and an integrated solution.

PubMed

DeCoster, Jamie; Sparks, Erin A; Sparks, Jordan C; Sparks, Glenn G; Sparks, Cheri W

2015-09-01

Researchers commonly explore their data in multiple ways before deciding which analyses they will include in the final versions of their papers. While this improves the chances of researchers finding publishable results, it introduces an "opportunistic bias," such that the reported relations are stronger or otherwise more supportive of the researcher's theories than they would be without the exploratory process. The magnitudes of opportunistic biases can often be stronger than those of the effects being investigated, leading to invalid conclusions and a lack of clarity in research results. Authors typically do not report their exploratory procedures, so opportunistic biases are very difficult to detect just by reading the final version of a research report. In this article, we explain how a number of accepted research practices can lead to opportunistic biases, discuss the prevalence of these practices in psychology, consider the different effects that opportunistic biases have on psychological science, evaluate the strategies that methodologists have proposed to prevent or correct for the effects of these biases, and introduce an integrated solution to reduce the prevalence and influence of opportunistic biases. The recent prominence of articles discussing questionable research practices both in scientific journals and in the public media underscores the importance of understanding how opportunistic biases are created and how we might undo their effects. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Does Quantitative Research in Child Maltreatment Tell the Whole Story? The Need for Mixed-Methods Approaches to Explore the Effects of Maltreatment in Infancy.

PubMed

Glass, Samuel; Gajwani, Ruchika; Turner-Halliday, Fiona

Background and Aims. Research on child maltreatment has largely overlooked the under-five age group and focuses primarily on quantitative measurement. This mixed-methods study of maltreated children (N = 92) entering care (age 6-60 months) combines a quantitative focus on the associations between care journey characteristics and mental health outcomes with a qualitative exploration of maltreatment in four different families. Methods. Care journey data was obtained from social care records; mental health and attachment assessments were carried out following entry to care; qualitative data comprised semistructured interviews with professionals, foster carers, and parents. Results. Significant associations were found between suspected sexual abuse and increased DAI inhibited attachment symptoms (p = 0.001) and between reported domestic violence and decreased DAI inhibited (p = 0.016) and disinhibited (p = 0.004) attachment symptoms. Qualitative results: two themes demonstrate the complexity of assessing maltreatment: (1) overlapping maltreatment factors occur in most cases and (2) maltreatment effects may be particularly challenging to isolate. Conclusions. Qualitative exploration has underscored the complexity of assessing maltreatment, indicating why expected associations were not found in this study and posing questions for the quantitative measurement of maltreatment in general. We therefore suggest a new categorisation of maltreatment and call for the complimentary research lenses of further mixed-methods approaches.

Race, punishment, and the Michael Vick experience.

PubMed

Piquero, Alex R; Piquero, Nicole Leeper; Gertz, Marc; Baker, Thomas; Batton, Jason; Barnes, J C

2011-01-01

Objective. The relationship between race and crime has been contentious, focusing primarily on offending and incarceration patterns among minorities. There has been some limited work on public perceptions of criminal punishment, and findings show that while minorities believe in the role and rule of law, they simultaneously perceive the justice system as acting in a biased and/or unfair manner. Two limitations have stalled this literature. First, research has focused mainly on criminal punishments to the neglect of noncriminal punishments. Second, most studies have not examined whether race remains salient after considering other demographic variables or discrimination and legitimacy attitudes.Methods. Using data from 400 adults, we examine how race affects perceptions of criminal punishment and subsequent reinstatement into the National Football League in the case of Michael Vick, a star professional quarterback who pled guilty to charges of operating an illegal dog-fighting ring.Results. Findings show that whites are more likely to view Vick's punishment as too soft and that he should not be reinstated, while nonwhites had the opposite views. Race remained significant after controlling for other variables believed to be related to punishment perceptions.Conclusion. Attitudes toward both criminal punishment and NFL reinstatement vary across race such that there exists important divides in how individuals perceive the system meting out punishment and subsequently reintegrating offenders back into society. These results underscore that white and nonwhites perceive the law and its administration differently.

Racial/Ethnic Differences Moderate Associations of Coping Strategies and Posttraumatic Stress Disorder Symptom Clusters among Women Experiencing Partner Violence: A Multigroup Path Analysis

PubMed Central

Weiss, Nicole H.; Johnson, Clinesha D.; Contractor, Ateka; Peasant, Courtney; Swan, Suzanne C.; Sullivan, Tami P.

2017-01-01

Background Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal). Methods Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters. Results The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans. Conclusion Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally-informed PTSD treatments. PMID:27575609

The Roles and Mechanisms of Intestinal Oxalate Transport in Oxalate Homeostasis

PubMed Central

Hatch, Marguerite; Freel, Robert W.

2008-01-01

The mammalian intestine has an important role in the dynamics of oxalate exchange and thereby is significant in the etiology of calcium oxalate nephrolithiasis. Here we review some of the phenomenological observations that have led to the conclusion that anion exchangers (antiporters) are important mediators of secondarily active, net oxalate transport along the intestine (both absorptive and secretory). Understanding the mechanisms of transepithelial oxalate transport has been radically advanced in recent years by the identification of the SLC26 family of anion transporters which has facilitated the identification of specific proteins mediating individual apical or basolateral oxalate transport pathways. Moreover, identification of specific exchangers has underscored their relative importance to oxalate homeostasis as revealed by using knockout mouse models and facilitated studies of oxalate transport regulation in heterologous expression systems. Finally, the significance of oxalate degrading bacteria to oxalate homeostasis is considered from basic and applied perspectives. PMID:18359395

Student Perceptions of a Flipped Pharmacotherapy Course

PubMed Central

Khanova, Julia; McLaughlin, Jacqueline E.; Rhoney, Denise H.; Roth, Mary T.

2015-01-01

Objective. To evaluate student perception of the flipped classroom redesign of a required pharmacotherapy course. Design. Key foundational content was packaged into interactive, text-based online modules for self-paced learning prior to class. Class time was used for active and applied—but primarily case-based—learning. Assessment. For students with a strong preference for traditional lecture learning, the perception of the learning experience was negatively affected by the flipped course design. Module length and time required to complete preclass preparation were the most frequently cited impediments to learning. Students desired instructor-directed reinforcement of independently acquired knowledge to connect foundational knowledge and its application. Conclusion. This study illustrates the challenges and highlights the importance of designing courses to effectively balance time requirements and connect preclass and in-class learning activities. It underscores the crucial role of the instructor in bridging the gap between material learned as independent study and its application. PMID:26839429

The president's role in advancing civic engagement: The Widener-Chester Partnership.

PubMed

Harris, James T

2009-01-01

Efforts by metropolitan universities to engage in meaningful and democratic partnerships with community organizations require much time, effort, and considerable resources from the university and its various constituents. Widener University is located in a distressed urban environment. This study, presented from the perspective of the university's president, highlights the challenges associated with engaging in such work and provides insight into possible future directions for advancing an institution-wide civic engagement agenda. It outlines in detail the initiatives created between Widener and the Chester, Pennsylvania, school district over six years and explains how after many failures, the university came to the conclusion that its best chance for success would be to develop a separately chartered university partnership school. The account forcefully underscores that the costs associated with civic engagement are worth the investment in spite of the number of setbacks and frustrations inherent in this type of work.

A Rhesus Monkey Model of Self Injury: Effects of Relocation Stress on Behavior and Neuroendocrine Function

PubMed Central

Davenport, Matthew D.; Lutz, Corrine K.; Tiefenbacher, Stefan; Novak, Melinda A.; Meyer, Jerrold S.

2008-01-01

Background Self-injurious behavior (SIB), a disorder that afflicts many individuals within both clinical and non-clinical populations, has been linked to states of heightened stress and arousal. However, there are no published longitudinal data on the relationship between increases in stress and changes in the incidence of SIB. The present study investigated the short- and long-term behavioral and neuroendocrine responses of SIB and control monkeys to the stress of relocation. Methods Twenty adult male rhesus macaques were exposed to the stress of relocation to a new housing arrangement in a newly constructed facility. Daytime behavior, sleep, and multiple measures of hypothalamic-pituitary-adrenocortical (HPA) axis function were investigated before and after the move. Results Relocation induced a complex pattern of short- and long-term effects in the animals. The SIB animals showed a long-lasting increase in self-biting behavior as well as evidence of sleep disturbance. Both groups exhibited elevated cortisol levels in saliva, serum, and hair, and also an unexpected delayed increase in circulating concentrations of corticosteroid binding globulin (CBG). Conclusions Our results indicate that relocation is a significant stressor for rhesus macaques, and that this stressor triggers an increase in self-biting behavior as well as sleep disturbance in monkeys previously identified as suffering from SIB. These findings suggest that life stresses may similarly exacerbate SIB in humans with this disorder. The HPA axis results underscore the potential role of CBG in regulating long-term neuroendocrine responses to major stressors. PMID:18164279

Mechanisms of Dietary Response in Mice and Primates: A Role for EGR1 in Regulating the Reaction to Human-Specific Nutritional Content

PubMed Central

Weng, Kai; Hu, Haiyang; Xu, Augix Guohua; Khaitovich, Philipp; Somel, Mehmet

2012-01-01

Background Humans have a widely different diet from other primate species, and are dependent on its high nutritional content. The molecular mechanisms responsible for adaptation to the human diet are currently unknown. Here, we addressed this question by investigating whether the gene expression response observed in mice fed human and chimpanzee diets involves the same regulatory mechanisms as expression differences between humans and chimpanzees. Results Using mouse and primate transcriptomic data, we identified the transcription factor EGR1 (early growth response 1) as a putative regulator of diet-related differential gene expression between human and chimpanzee livers. Specifically, we predict that EGR1 regulates the response to the high caloric content of human diets. However, we also show that close to 90% of the dietary response to the primate diet found in mice, is not observed in primates. This might be explained by changes in tissue-specific gene expression between taxa. Conclusion Our results suggest that the gene expression response to the nutritionally rich human diet is partially mediated by the transcription factor EGR1. While this EGR1-driven response is conserved between mice and primates, the bulk of the mouse response to human and chimpanzee dietary differences is not observed in primates. This result highlights the rapid evolution of diet-related expression regulation and underscores potential limitations of mouse models in dietary studies. PMID:22937124

Estimating the prevalence of heterozygous familial hypercholesterolaemia: a systematic review and meta-analysis

PubMed Central

Akioyamen, Leo E; Genest, Jacques; Shan, Shubham D; Reel, Rachel L; Albaum, Jordan M; Chu, Anna; Tu, Jack V

2017-01-01

Objectives Heterozygous familial hypercholesterolaemia (FH) confers a significant risk for premature cardiovascular disease (CVD). However, the estimated prevalence of FH varies substantially among studies. We aimed to provide a summary estimate of FH prevalence in the general population and assess variations in frequency across different sociodemographic characteristics. Setting, participants and outcome measures We searched MEDLINE, EMBASE, Global Health, the Cochrane Library, PsycINFO and PubMed for peer-reviewed literature using validated strategies. Results were limited to studies published in English between January 1990 and January 2017. Studies were eligible if they determined FH prevalence using clinical criteria or DNA-based analyses. We determined a pooled point prevalence of FH in adults and children and assessed the variation of the pooled frequency by age, sex, geographical location, diagnostic method, study quality and year of publication. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were investigated through subgroups, meta-regression and sensitivity analyses. Results The pooled prevalence of FH from 19 studies including 2 458 456 unique individuals was 0.40% (95% CI 0.29% to 0.52%) which corresponds to a frequency of 1 in 250 individuals. FH prevalence was found to vary by age and geographical location but not by any other covariates. Results were consistent in sensitivity analyses. Conclusions Our systematic review suggests that FH is a common disorder, affecting 1 in 250 individuals. These findings underscore the need for early detection and management to decrease CVD risk. PMID:28864697

Pilot study for supervised target detection applied to spatially registered multiparametric MRI in order to non-invasively score prostate cancer.

PubMed

Mayer, Rulon; Simone, Charles B; Skinner, William; Turkbey, Baris; Choykey, Peter

2018-03-01

Gleason Score (GS) is a validated predictor of prostate cancer (PCa) disease progression and outcomes. GS from invasive needle biopsies suffers from significant inter-observer variability and possible sampling error, leading to underestimating disease severity ("underscoring") and can result in possible complications. A robust non-invasive image-based approach is, therefore, needed. Use spatially registered multi-parametric MRI (MP-MRI), signatures, and supervised target detection algorithms (STDA) to non-invasively GS PCa at the voxel level. This study retrospectively analyzed 26 MP-MRI from The Cancer Imaging Archive. The MP-MRI (T2, Diffusion Weighted, Dynamic Contrast Enhanced) were spatially registered to each other, combined into stacks, and stitched together to form hypercubes. Multi-parametric (or multi-spectral) signatures derived from a training set of registered MP-MRI were transformed using statistics-based Whitening-Dewhitening (WD). Transformed signatures were inserted into STDA (having conical decision surfaces) applied to registered MP-MRI determined the tumor GS. The MRI-derived GS was quantitatively compared to the pathologist's assessment of the histology of sectioned whole mount prostates from patients who underwent radical prostatectomy. In addition, a meta-analysis of 17 studies of needle biopsy determined GS with confusion matrices and was compared to the MRI-determined GS. STDA and histology determined GS are highly correlated (R = 0.86, p < 0.02). STDA more accurately determined GS and reduced GS underscoring of PCa relative to needle biopsy as summarized by meta-analysis (p < 0.05). This pilot study found registered MP-MRI, STDA, and WD transforms of signatures shows promise in non-invasively GS PCa and reducing underscoring with high spatial resolution. Copyright © 2018 Elsevier Ltd. All rights reserved.

1,1-dimethylhydrazine as a high purity nitrogen source for MOVPE-water reduction and quantification using nuclear magnetic resonance, gas chromatography-atomic emission detection spectroscopy and cryogenic-mass spectroscopy analytical techniques

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

Odedra, R.; Smith, L.M.; Rushworth, S.A.

2000-01-01

Hydrazine derivatives are attractive low temperature nitrogen sources for use in MOVPE due to their low thermal stability. However their purification and subsequent analysis has not previously been investigated in depth for this application. A detailed study on 1,1-dimethylhydrazine {l{underscore}brace}(CH{sub 3}){sub 2}N-NH{sub 2}{r{underscore}brace} purified by eight different methods and the subsequent quantitative measurements of water present in the samples obtained is reported here. A correlation between {sup 1}H nuclear magnetic resonance spectroscopy (NMR), gas chromatography-atomic emission detection (GC-AED) and cryogenic mass spectroscopy (Cryogenic-MS) has been performed. All three analysis techniques can be used to measure water in the samples andmore » with the best purification the water content can be lowered well below 100 ppm. The high purity of this material has been demonstrated by growth results and the state-of-the-art performance of laser diodes.« less

PDGF-mediated protection of SH-SY5Y cells against Tat toxin involves regulation of extracellular glutamate and intracellular calcium

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

Zhu Xuhui; Department of Laboratory Medicine, Tongji Hospital and Tongji Medical College of Huazhong University of Science and Technology, Wuhan; Yao Honghong

2009-10-15

The human immunodeficiency virus (HIV-1) protein Tat has been implicated in mediating neuronal apoptosis, one of the hallmark features of HIV-associated dementia (HAD). Mitigation of the toxic effects of Tat could thus be a potential mechanism for reducing HIV toxicity in the brain. In this study we demonstrated that Tat-induced neurotoxicity was abolished by NMDA antagonist-MK801, suggesting the role of glutamate in this process. Furthermore, we also found that pretreatment of SH-SY5Y cells with PDGF exerted protection against Tat toxicity by decreasing extracellular glutamate levels. We also demonstrated that extracellular calcium chelator EGTA was able to abolish PDGF-mediated neuroprotection, therebymore » underscoring the role of calcium signaling in PDGF-mediated neuroprotection. We also showed that Erk signaling pathway was critical for PDGF-mediated protection of cells. Additionally, blocking calcium entry with EGTA resulted in suppression of PDGF-induced Erk activation. These findings thus underscore the role of PDGF-mediated calcium signaling and Erk phosphorylation in the protection of cells against HIV Tat toxicity.« less

[Food hygiene training of members of corporate public catering committees].

PubMed

Quaranta, Gianluigi; Laurenti, Patrizia; Gerardo Cairo, Antonio; Ricciardi, Gualtiero

2007-01-01

A food hygiene training course was offered to 25 members of the public catering committees of seven corporate restaurants. In order to evaluate the effectiveness of the course and identify critical topics, participants were asked to complete a questionnaire before and after completing the training course. Results are presented in this article and underscore the importance of training members of public catering committees in addition to food handlers.

In-flight speech intelligibility evaluation of a service member with sensorineural hearing loss: case report.

PubMed

Casto, Kristen L; Cho, Timothy H

2012-09-01

This case report describes the in-flight speech intelligibility evaluation of an aircraft crewmember with pure tone audiometric thresholds that exceed the U.S. Army's flight standards. Results of in-flight speech intelligibility testing highlight the inability to predict functional auditory abilities from pure tone audiometry and underscore the importance of conducting validated functional hearing evaluations to determine aviation fitness-for-duty.

Modern vitiligo genetics sheds new light on an ancient disease

PubMed Central

SPRITZ, Richard A.

2013-01-01

Vitiligo is a complex disorder in which autoimmune destruction of melanocytes results in white patches of skin and overlying hair. Over the past several years, extensive genetic studies have outlined a biological framework of vitiligo pathobiology that underscores its relationship to other autoimmune diseases. This biological framework offers insight into both vitiligo pathogenesis and perhaps avenues towards more effective approaches to treatment and even disease prevention. PMID:23668538

A Primer for Preventing Teen Dating Violence? The Representation of Teen Dating Violence in Young Adult Literature and Its Implications for Prevention.

PubMed

Storer, Heather L; Strohl, Katyayani R

2016-09-18

Teen dating violence (TDV) is a significant public health issue. Preventing TDV requires attention to risk and protective factors across ecological system levels. The media is one of the primary cultural drivers of societal-level social scripts about the causes of TDV. Framing theory asserts that the media's portrayal of social issues, including what contextual information is included and/or excluded, affects individual-level attitudes about TDV and potential policy responses. This study investigates the representation of TDV in young adult (YA) literature, a media genre that is marketed to adolescent audiences. Data include all YA novels (N = 8) that have a primary focus on TDV. Texts were analyzed systematically using thematic content analysis methods. Results indicate that the antecedents of TDV were portrayed as being related to victim personal characteristics such as inexperience in relationships and low self-esteem. Rather than underscoring how societal-level factors contribute to TDV, perpetration was seen as stemming from family dysfunction and mental health issues. These results underscore how the structural determinants of TDV have been overshadowed in the media's portrayal of TDV, in favor of narrow portrayals of victimization and perpetration. Implications for TDV prevention programs including the importance of media literacy are discussed. © The Author(s) 2016.

Smoking-related deaths averted due to three years of policy progress

PubMed Central

Ellis, Jennifer A; Mays, Darren; Huang, An-Tsun

2013-01-01

Abstract Objective To evaluate the global impact of adopting highest-level MPOWER tobacco control policies in different countries and territories from 2007 to 2010. Methods Policy effect sizes based on previously-validated SimSmoke models were applied to determine the reduction in the number of smokers as a result of policy adoption during this period. Based on previous research suggesting that half of all smokers die from smoking, we also derived the estimated smoking-attributable deaths (SADs) averted due to MPOWER policy implementation. The results from use of this simple yet powerful method are consistent with those predicted by using previously validated SimSmoke models. Findings In total, 41 countries adopted at least one highest-level MPOWER policy between 2007 and 2010. As a result of all policies adopted during this period, the number of smokers is estimated to have dropped by 14.8 million, with a total of 7.4 million SADs averted. The largest number of SADs was averted as a result of increased cigarette taxes (3.5 million), smoke-free air laws (2.5 million), health warnings (700 000), cessation treatments (380 000), and bans on tobacco marketing (306 000). Conclusion From 2007 to 2010, 41 countries and territories took action that will collectively prevent nearly 7.5 million smoking-related deaths globally. These findings demonstrate the magnitude of the actions already taken by countries and underscore the potential for millions of additional lives to be saved with continued adoption of MPOWER policies. PMID:23825878

Patterns of Care for Craniopharyngioma: Survey of members of the American Association of Neurological Surgeons

PubMed Central

Hankinson, Todd C.; Palmeri, Nicholas O.; Williams, Sarah A.; Torok, Michelle R.; Serrano, Cesar A.; Foreman, Nicholas K.; Handler, Michael H.; Liu, Arthur K.

2014-01-01

Background/Significance Initial therapy for craniopharyngioma remains controversial. Population-based datasets indicate that traditional algorithms (GTR versus STR +/− XRT) are often not employed. We investigated neurosurgical practice patterns. Methods A ten-question survey was electronically distributed to members of the American Association of Neurological Surgeons. Responses were analyzed using standard statistical techniques. Results One hundred-two responses were collected, with a median 25 craniopharyngiomas managed per respondent. 36% estimated their practice included ≥75% pediatrics and 61% had an academic practice. 36% would recommend observation or radiation therapy for a suspected craniopharyngioma in the absence of a tissue diagnosis, with 46% of these indicating this recommendation in ≥10% of cases. Following STR, 35% always recommend XRT and 59% recommend it in over half of cases. However, following STR or biopsy alone, 18% and 11% never recommend XRT. There was no association between type of practice (i.e. academic or ≥75% pediatrics) and practice patterns. Conclusions This survey verifies that deviation from established algorithms is common, underscoring the clinical complexity of these patients and recent secondary data analyses This should influence clinical researchers to investigate outcomes for patients treated using alternative methods. This will lend insight into appropriate treatment options and contribute to quality of life outcomes studies for craniopharyngioma. PMID:24577430

Hazards of New Media: Youth’s Exposure to Tobacco Ads/Promotions

PubMed Central

2014-01-01

Background: A gap in knowledge exists about the youth’s exposure to protobacco campaigns via new electronic media outlets. In response, we use national data to delineate the associations between tobacco ads/promotions delivered through new media outlets (i.e., social network sites and text messages) and youth attitudes/beliefs about tobacco and intent to use (among youth who had not yet used tobacco). Methods: Data were derived from the 2011 National Youth Tobacco Survey, a nationally representative sample of U.S. youth enrolled in both public and private schools (N = 15,673). Logistic regression models were used to examine associations between demographic characteristics and reported exposure to tobacco ads/promotions via social networking sites and text messages. Logistic regression models were also used to investigate associations between exposure tobacco ads/promotions and attitudes toward tobacco. Results: We found that highly susceptible youth (i.e., minorities, very young youth, and youth who have not yet used tobacco) have observed tobacco ads/promotions on social networking sites and text messages. These youth are more likely to have favorable attitudes toward tobacco, including the intention to use tobacco among those who had not yet used tobacco. Conclusions: Our findings underscore the need for policy strategies to more effectively monitor and regulate tobacco advertising via new media outlets. PMID:24163285

Clostridium difficile infection in returning travellers

PubMed Central

Stevens, A. Michal; Esposito, Douglas H.; Stoney, Rhett J.; Hamer, Davidson H.; Flores-Figueroa, Jose; Bottieau, Emmanuel; Connor, Bradley A.; Gkrania-Klotsas, Effrossyni; Goorhuis, Abraham; Hynes, Noreen A.; Libman, Michael; Lopez-Velez, Rogelio; McCarthy, Anne E.; von Sonnenburg, Frank; Schwartz, Eli; van Genderen, Perry J.J.; Benson, L. Scott; Leung, Daniel T.

2017-01-01

Background There is increasing recognition of the contribution of community-acquired cases to the global burden of Clostridium difficile infection (CDI). The epidemiology of CDI among international travellers is poorly understood, and factors associated with international travel, such as antibiotic use and changes in gut microbiota, could potentially put travellers at higher risk. Methods We summarized demographic, travel-associated and geographic characteristics of travellers with CDI in the GeoSentinel database from 1997 to 2015. We also surveyed GeoSentinel sites to compare various testing indications, approaches, and diagnostic modalities. Results We identified 260 GeoSentinel records, including 187 that satisfied criteria for analysis (confirmed cases in non-immigrant travellers aged >2 years, seen <12 weeks post-travel). CDI was reported in all age groups and in travellers to all world regions; the largest proportions of cases having destinations in Asia (31%), Central/South America or the Caribbean (30%) and Africa (24%). Our site survey revealed substantial heterogeneity of testing approaches between sites; the most commonly used test was the C. difficile toxin gene PCR. Conclusions CDI is encountered in returning international travellers, although there is considerable variability in testing practices. These data underscore the importance of awareness of C. difficile as a potential cause of travel-associated diarrhoea. PMID:28355613

The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia

PubMed Central

El-Bassel, Nabila; Gilbert, Louisa; Shaw, Stacey A.; Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Hunt, Tim; West, Brooke; Wu, Elwin; Beyrer, Chris

2016-01-01

Objectives We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). Methods We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Results Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Conclusion Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population. PMID:26967159

Prevalence of HIV and Syphilis Infection among Men Who Have Sex with Men in China: A Meta-Analysis

PubMed Central

Zhou, Yunhua; Li, Dongliang; Lu, Dabing; Ruan, Yuhua; Qi, Xiao

2014-01-01

Objectives. To figure out the most current prevalence of HIV and syphilis in MSM in China. Methods. A meta-analysis was conducted on the studies searched through PubMed, CNKI, and Wanfang published between 1 January 2009 and 11 April 2013. Results. Eighty-four eligible studies, either in Chinese or in English, were included in this review. The pooled prevalence of HIV and syphilis infection in MSM in China was 6.5% and 11.2%, respectively. The subgroup analyses indicated that the prevalence of HIV infection was higher in the economically less developed cities than that in the developed cities (7.5% versus 6.1%, P < 0.05). In contrast, the prevalence of syphilis infection was lower in less developed cities than in developed cities (8.6% versus 15.1%). Studies with a sample size smaller than 500 had a lower prevalence of HIV and syphilis infection than those with a sample size greater than 500 (5.9% versus 7.2% for HIV; 11.0% versus 11.5% for syphilis, respectively). Conclusions. HIV and syphilis infection are prevalent in MSM in China. The different prevalence of HIV and syphilis infection between developing and developed cities underscores the need to target prevention strategies based on economic conditions. PMID:24868533

Morbidity and Mortality in Late Preterm Infants with Severe Hypoxic Respiratory Failure on ECMO

PubMed Central

Ramachandrappa, Ashwin; Rosenberg, Eli S.; Wagoner, Scott; Jain, Lucky

2011-01-01

Objectives To evaluate morbidity, mortality, and associated risk factors in late preterm term infants (34 0/7-36 6/7 wk) requiring extra-corporeal membrane oxygenation (ECMO). Study design We reviewed a total of 21,218 neonatal ECMO runs in Extracorporeal Life Support Organization (ELSO) registry data from 1986 to 2006. Infants were divided into 3 groups: Late Preterm (34 0/7 to 36 6/7), Early Term (37 0/7 to 38 6/7), and Full Term (39 0/7 to 42 6/7). Results There were 14,528 neonatal ECMO runs which met inclusion criteria. Late preterm infants experienced the highest mortality on ECMO (late preterm 26.2%, early term 18%, full term 11.2%. p<0.001) and had longer ECMO runs; they also had higher rates of serious complications. GA was a highly significant predictor for mortality. Late preterm infants with a primary diagnosis of sepsis and PPHN had 3-fold higher risk of mortality on ECMO than those with meconium aspiration. Conclusion Late preterm infants treated with ECMO havehigher morbidity and mortality than term infants. This underscores the need for special consideration of this vulnerable population in the diagnosis and treatment of hypoxic respiratory failure. PMID:21459387

Early adolescent adversity inflates threat estimation in females and promotes alcohol use initiation in both sexes.

PubMed

Walker, Rachel A; Andreansky, Christopher; Ray, Madelyn H; McDannald, Michael A

2018-06-01

Childhood adversity is associated with exaggerated threat processing and earlier alcohol use initiation. Conclusive links remain elusive, as childhood adversity typically co-occurs with detrimental socioeconomic factors, and its impact is likely moderated by biological sex. To unravel the complex relationships among childhood adversity, sex, threat estimation, and alcohol use initiation, we exposed female and male Long-Evans rats to early adolescent adversity (EAA). In adulthood, >50 days following the last adverse experience, threat estimation was assessed using a novel fear discrimination procedure in which cues predict a unique probability of footshock: danger (p = 1.00), uncertainty (p = .25), and safety (p = .00). Alcohol use initiation was assessed using voluntary access to 20% ethanol, >90 days following the last adverse experience. During development, EAA slowed body weight gain in both females and males. In adulthood, EAA selectively inflated female threat estimation, exaggerating fear to uncertainty and safety, but promoted alcohol use initiation across sexes. Meaningful relationships between threat estimation and alcohol use initiation were not observed, underscoring the independent effects of EAA. Results isolate the contribution of EAA to adult threat estimation, alcohol use initiation, and reveal moderation by biological sex. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evidence of an inflammatory-like response in non-normally pigmented tissues of two scleractinian corals

PubMed Central

Palmer, Caroline V; Mydlarz, Laura D; Willis, Bette L

2008-01-01

Increasing evidence of links between climate change, anthropogenic stress and coral disease underscores the importance of understanding the mechanisms by which reef-building corals resist infection and recover from injury. Cellular inflammation and melanin-producing signalling pathway are two mechanisms employed by invertebrates to remove foreign organisms such as pathogens, but they have not been recorded previously in scleractinian corals. This study demonstrates the presence of the phenoloxidase (PO) activating melanin pathway in two species of coral, Acropora millepora and a massive species of Porites, which both develop local pigmentation in response to interactions with a variety of organisms. l-DOPA (3-(3,4-dihydroxyphenyl)-l-alanine) substrate-based enzyme activation assays demonstrated PO activity in healthy tissues of both species and upregulation in pigmented tissues of A. millepora. Histological staining conclusively identified the presence of melanin in Porites tissues. These results demonstrate that the PO pathway is active in both coral species. Moreover, the upregulation of PO activity in areas of non-normal pigmentation in A. millepora and increased melanin production in pigmented Porites tissues suggest the presence of a generalized defence response to localized stress. Interspecific differences in the usage of pathways involved in innate immunity may underlie the comparative success of massive Porites sp. as long-lived stress tolerators. PMID:18700208

Missing the target: including perspectives of women with overweight and obesity to inform stigma‐reduction strategies

PubMed Central

Himmelstein, M. S.; Gorin, A. A.; Suh, Y. J.

2017-01-01

Summary Objective Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma‐reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight‐based stigma. Methods Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma‐reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self‐report measures assessing experienced and internalized weight stigma. Results Most participants assigned high importance to all stigma‐reduction strategies, with school‐based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti‐harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. Conclusion These findings underscore the importance of including people with stigmatized identities in stigma‐reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight‐based inequities and prioritize such efforts. PMID:28392929

Flow condensation on copper-based nanotextured superhydrophobic surfaces.

PubMed

Torresin, Daniele; Tiwari, Manish K; Del Col, Davide; Poulikakos, Dimos

2013-01-15

Superhydrophobic surfaces have shown excellent ability to promote dropwise condensation with high droplet mobility, leading to enhanced surface thermal transport. To date, however, it is unclear how superhydrophobic surfaces would perform under the stringent flow condensation conditions of saturated vapor at high temperature, which can affect superhydrophobicity. Here, we investigate this issue employing "all-copper" superhydrophobic surfaces with controlled nanostructuring for minimal thermal resistance. Flow condensation tests performed with saturated vapor at a high temperature (110 °C) showed the condensing drops penetrate the surface texture (i.e., attain the Wenzel state with lower droplet mobility). At the same time, the vapor shear helped ameliorate the mobility and enhanced the thermal transport. At the high end of the examined vapor velocity range, a heat flux of ~600 kW m(-2) was measured at 10 K subcooling and 18 m s(-1) vapor velocity. This clearly highlights the excellent potential of a nanostructured superhydrophobic surface in flow condensation applications. The surfaces sustained dropwise condensation and vapor shear for five days, following which mechanical degradation caused a transition to filmwise condensation. Overall, our results underscore the need to investigate superhydrophobic surfaces under stringent and realistic flow condensation conditions before drawing conclusions regarding their performance in practically relevant condensation applications.

Unusual presentation of cactus spines in the flank of an elderly man: a case report

PubMed Central

2010-01-01

Introduction Splinters and spines of plant matter are common foreign bodies in skin wounds of the extremities, and often present embedded in the dermis or subcutaneous tissue. Vegetative foreign bodies are highly inflammatory and, if not completely removed, can cause infection, toxic reactions, or granuloma formation. Older patients are at increased risk for infection from untreated plant foreign bodies. The most common error in plant splinter and spine management is failure to detect their presence. Case presentation Here we report a case of cactus spines in an 84-year-old Caucasian man presenting on the right flank as multiple, red papules with spiny extensions. This presentation was unusual both in location and the spinous character of the lesions, and only after punch biopsy analysis was a diagnosis of cactus matter spines made. Conclusions Our patient presented with an unusual case of cactus spines that required histopathology for identification. Skin lesions with neglected foreign bodies are a common cause of malpractice claims. If not removed, foreign bodies of the skin, particularly in elderly individuals, can result in inflammatory and infectious sequela. This report underscores the importance of thoroughly evaluating penetrating skin lesions for the presence of foreign bodies, such as splinters and spines. PMID:20500838

Obstructive Sleep Apnea: A Cluster Analysis at Time of Diagnosis

PubMed Central

Grillet, Yves; Richard, Philippe; Stach, Bruno; Vivodtzev, Isabelle; Timsit, Jean-Francois; Lévy, Patrick; Tamisier, Renaud; Pépin, Jean-Louis

2016-01-01

Background The classification of obstructive sleep apnea is on the basis of sleep study criteria that may not adequately capture disease heterogeneity. Improved phenotyping may improve prognosis prediction and help select therapeutic strategies. Objectives: This study used cluster analysis to investigate the clinical clusters of obstructive sleep apnea. Methods An ascending hierarchical cluster analysis was performed on baseline symptoms, physical examination, risk factor exposure and co-morbidities from 18,263 participants in the OSFP (French national registry of sleep apnea). The probability for criteria to be associated with a given cluster was assessed using odds ratios, determined by univariate logistic regression. Results: Six clusters were identified, in which patients varied considerably in age, sex, symptoms, obesity, co-morbidities and environmental risk factors. The main significant differences between clusters were minimally symptomatic versus sleepy obstructive sleep apnea patients, lean versus obese, and among obese patients different combinations of co-morbidities and environmental risk factors. Conclusions Our cluster analysis identified six distinct clusters of obstructive sleep apnea. Our findings underscore the high degree of heterogeneity that exists within obstructive sleep apnea patients regarding clinical presentation, risk factors and consequences. This may help in both research and clinical practice for validating new prevention programs, in diagnosis and in decisions regarding therapeutic strategies. PMID:27314230

Hyperforin plasma level as a marker of treatment adherence in the National Institutes of Health Hypericum Depression Trial.

PubMed

Vitiello, Benedetto; Shader, Richard I; Parker, Corette B; Ritz, Louise; Harlan, William; Greenblatt, David J; Gadde, Kishore M; Krishnan, K Ranga R; Davidson, Jonathan R T

2005-06-01

A previously reported clinical trial of Hypericum perforatum (St John's wort) in depression did not demonstrate efficacy. We assessed treatment adherence by measuring plasma hyperforin and evaluated the possible impact of adherence on study results. Outpatients with major depression (N = 340) were randomized to an 8-week trial of H. perforatum (900-1500 mg/d), sertraline (50-100 mg/d) as active comparator, or placebo. Plasma was available from 292 patients (86% of randomized). Samples from the placebo and H. perforatum groups were assayed for hyperforin, and samples from the sertraline group for sertraline/N-desmethyl-sertraline. Of the 104 patients randomized to placebo, 18 (17%) had detectable plasma hyperforin. Of the 97 patients randomized to H. perforatum, 17 (17%) had no detectable plasma hyperforin. All the assayed sertraline patients (N = 91) had plasma sertraline/N-desmethyl-sertraline. The clinical trial conclusions remained unchanged when only patients with plasma assay consistent with random assignment were included in the analyses. One of every 6 patients assigned to placebo had plasma hyperforin, and 1 of every 6 patients assigned to H. perforatum had no detectable plasma hyperforin. The finding underscores the difficulty of enforcing treatment adherence in clinical trials of preparations that are readily available in the community.

The floristic heterogeneity of the Pantanal and the occurrence of species with different adaptive strategies to water stress.

PubMed

Scremin-Dias, E; Lorenz-Lemke, A P; Oliveira, A K M

2011-04-01

The Pantanal is characterised by a diversity of environments with areas ranging from periodic or permanent heavy flooding to areas with low flood levels, and even environments that never flood. Plant species which inhabit the floodplain are distributed in specific niches, with influence of various phytogeographic domains, including the Seasonal Semi-deciduous Forest, Amazon Rainforest, Cerrado and Chaco, as well rocky remnants, with a wide ecological span in their components. In intensely flooded areas, aquatic macrophytes are widely distributed, with their dynamics closely linked to time, depth and extent of flooding. Although the term "Pantanal" suggests a huge swamp-type wetland, water level variation during a seasonal cycle does not directly reach the root system of many plants. The landscape diversity of the Pantanal wetland is molded by the flood pulse, which interferes with the dynamics of plant communities. Therefore, the retraction and expansion of populations or communities is reflected in important ecological characteristics, considering the variety of morphological, anatomical and ecophysiological features of the species, whose phenotype is the result of a particular genotype. The present study discusses peculiar issues in the adaptation of species distributed in the Pantanal biome and underscores the importance of multidisciplinary approaches to obtain conclusive data on adaptive studies.

Risk of HIV/AIDS in China: subpopulations of special importance

PubMed Central

Qian, Z; Vermund, S; Wang, N

2005-01-01

Objective: To describe the HIV/AIDS epidemic in mainland China. Methods: We review the magnitude of the HIV/AIDS epidemic and the social characteristics and geographic distribution of at-risk groups in China based on published literature and unpublished official data. Results: Injection drug use has been the dominant route for HIV infection in China, and will continue to be a major risk factor with increasing numbers of new drug users and needle sharing. Commercial plasma donation with unhygienic re-infusion of red blood cells was common in rural communities in the early 1990s. While this is unlikely to constitute a major factor for future HIV spread, those already infected represent a formidable treatment challenge. Huge seasonal work migration facilitates disease spread across regions. Many homosexual men have unprotected sex with men, women, or both, and may contract or spread HIV. Though commercial sex workers have contributed to a small proportion of the reported epidemic thus far, flourishing commercial sex is of growing concern and may have a bridging role in transmitting HIV from core groups to the general population. Conclusion: Increasing numbers of sex workers and drug users, internal migration, high risk behaviours, and low condom use suggest a future upward trend for HIV/AIDS and underscore the urgency of scaling up interventions in China. PMID:16326842

Characterization of the Asian Phenotype - An Emerging Paradigm with Clinicopathological and Human Research Implications

PubMed Central

Leow, Melvin Khee-Shing

2017-01-01

Background: Modern medicine recognizes that salient, inherent variations between Caucasians and Asians exist. Radical changes are occurring in the health scene with increasing emphasis centered on the recognition of inter-individual variations unique to Asians that impact on medical management and outcomes. Aim: This review analyzes distinct features or outcomes in terms of epidemiology, disease thresholds, diagnostic cutoffs and treatment responses of Asian people compared with non-Asians. Methods: This review is based on a literature search via PubMed and MEDLINE for relevant articles related to the Asian phenotype and its impact on health and disease. Results: An 'Asian phenotype' could be characterized across the spectrum of biomedical disciplines and underscores the major challenges clinicians must face in their daily management of a cosmopolitan population and their extrapolation of research outcomes. Conclusion: Interventions for various ailments that have traditionally ignored population differences have now entered the age of personalized, stratified or precision medicine requiring an individualized approach being adopted as a new standard of care. Factoring in Asian phenotypes is essential for the medical research community and the development of improved clinical practice guidelines across a continuum of disciplines that will ultimately translate to better human health round the world. PMID:28824295

The Narrative Impact of Active Video Games on Physical Activity Among Children: A Feasibility Study

PubMed Central

Baranowski, Tom; Hong, S Lee; Buday, Richard; Thompson, Debbe; Beltran, Alicia; Dadabhoy, Hafza Razak; Chen, Tzu-An

2016-01-01

Background Active video games (AVGs) capable of inducing physical activity offer an innovative approach to combating childhood obesity. Unfortunately, children’s AVG game play decreases quickly, underscoring the need to identify novel methods for player engagement. Narratives have been demonstrated to influence behaviors. Objective The objective of this study was to test the hypothesis that a narrative would motivate increased AVG play, though a feasibility study that investigated the motivational effect of adding a previously developed narrative cutscene to an originally nonnarrative AVG, Nintendo Wii Sports Resort: Swordplay Showdown. Methods A total of 40 overweight and obese 8- to 11-year-olds equally divided by sex played the AVG. Half (n=20) were randomly assigned to a narrative group that watched the narrative cutscene before game play. The other half played the game without watching it. Results Children in the narrative group had significantly (P<.05) more steps per 10-second period (mean 3.2, SD 0.7) and overall (mean 523, SD 203) during game play compared with the nonnarrative group (10-second period: mean 2.7, SD 0.7; overall: mean 366, SD 172). Conclusions The AVG with narrative induced increased physical activity. Additional research is needed to understand the mechanisms through which narrative increases physical activity during AVG game play. PMID:27742605

'Troubling' moments in health promotion: unpacking the ethics of empowerment.

PubMed

Spencer, Grace

2015-12-01

Concepts of empowerment feature strongly in global health discourses. Empowerment is frequently advocated as a positive approach to addressing individual and community-level health needs. Despite its popularity, relatively little has been said about the unintended consequences of empowerment, which may give rise to some troubling ethical issues or, indeed, result in outcomes that may not be considered health promoting. Drawing on current uses of empowerment within health promotion, along with insights from an ethnographic study on young people's health, this paper raises some critical questions about the ethics of empowerment. By doing so, the paper troubles the idea that empowerment is a 'good thing' without some careful attention to the varying ways in which the ethics of empowerment may unfold in practice. Findings revealed young people's different perspectives on health and priorities for health promotion. The present analysis highlights how these alternative framings prompt a number of ethical tensions for understanding and operationalising empowerment. In conclusion, the findings underscore the importance of promoting ethical reflexivity in health promotion and, crucially, attending to the unintended and potentially ethically problematic consequences of empowerment. So what? This paper raises some critical questions about the ethics of empowerment and calls for a more thorough engagement with the unintended consequences of empowerment within health promotion.

Metabolic effects of polycystic ovary syndrome in adolescents

PubMed Central

Han, Yejin; Lee, Hye-Jin; Oh, Jee-Young; Sung, Yeon-Ah

2015-01-01

Purpose Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenic anovulation in women of reproductive age. We investigated the metabolic effects of lean and overweight adolescents with PCOS. Methods Anthropometric measurements and biochemical parameters were evaluated in 49 adolescents with PCOS and 40 age- and body mass index (BMI)-matched controls. We further divided both PCOS and control groups into those having BMI within the normal range of less than 85th percentile and those being overweight and obese with a BMI greater than 85th percentile. Results Hemoglobin, gamma-glutamyl transferase (r-GT), total cholesterol, low-density lipoprotein-cholesterol and 2-hour postglucose load plasma insulin levels were significantly elevated in the lean PCOS group than in the lean control group. In the overweight/obese PCOS group, hemoglobin and r-GT levels were significantly elevated than in the overweight/obese control group. In the normal weight group, none of the subjects had metabolic syndrome according to the Adult Treatment Panel III criteria, but the incidence of metabolic syndrome in the overweight/obese PCOS group was 8.3% and that in the overweight/obese control group was 6.7%. Conclusion PCOS in adolescents causes metabolic abnormalities, underscoring the importance of early diagnosis of PCOS in oligomenorrheic adolescents. PMID:26512349

Colorectal Cancer Deaths Attributable to Nonuse of Screening in the United States

PubMed Central

Meester, Reinier G.S.; Doubeni, Chyke A.; Lansdorp-Vogelaar, Iris; Goede, S.L.; Levin, Theodore R.; Quinn, Virginia P.; van Ballegooijen, Marjolein; Corley, Douglas A.; Zauber, Ann G.

2015-01-01

Purpose Screening is a major contributor to colorectal cancer (CRC) mortality reductions in the U.S., but is underutilized. We estimated the fraction of CRC deaths attributable to nonuse of screening to demonstrate the potential benefits from targeted interventions. Methods The established MISCAN-colon microsimulation model was used to estimate the population attributable fraction (PAF) in people aged ≥50 years. The model incorporates long-term patterns and effects of screening by age and type of screening test. PAF for 2010 was estimated using currently available data on screening uptake; PAF was also projected assuming constant future screening rates to incorporate lagged effects from past increases in screening uptake. We also computed PAF using Levin's formula to gauge how this simpler approach differs from the model-based approach. Results There were an estimated 51,500 CRC deaths in 2010, about 63% (N∼32,200) of which were attributable to non-screening. The PAF decreases slightly to 58% in 2020. Levin's approach yielded a considerably more conservative PAF of 46% (N∼23,600) for 2010. Conclusions The majority of current U.S. CRC deaths are attributable to non-screening. This underscores the potential benefits of increasing screening uptake in the population. Traditional methods of estimating PAF underestimated screening effects compared with model-based approaches. PMID:25721748

Sleep Quality and Sleep Patterns in Relation to Consumption of Energy Drinks, Caffeinated Beverages and Other Stimulants among Thai College Students

PubMed Central

Lohsoonthorn, Vitool; Khidir, Hazar; Casillas, Gardenia; Lertmaharit, Somrat; Tadesse, Mahlet G.; Pensuksan, Wipawan C.; Rattananupong, Thanapoom; Gelaye, Bizu; Williams, Michelle A.

2012-01-01

Purpose Poor sleep and heavy use of caffeinated beverages have been implicated as risk factors for a number of adverse health outcomes. Caffeine consumption and use of other stimulants are common among college students globally. However, to our knowledge, no studies have examined the influence of caffeinated beverages on sleep quality of college students in Southeast Asian populations. We conducted this study to evaluate the patterns of sleep quality; and to examine the extent to which poor sleep quality is associated with consumption of energy drinks, caffeinated beverages and other stimulants among 2,854 Thai college students. Methods A questionnaire was administered to ascertain demographic and behavioral characteristics. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep habits and quality. Chi-square tests and multivariate logistic regression models were used to identify statistically significant associations. Results Overall, the prevalence of poor sleep quality was found to be 48.1%. A significant percent of students used stimulant beverages (58.0%). Stimulant use (OR 1.50; 95%CI 1.28-1.77) was found to be statistically significant and positively associated with poor sleep quality. Alcohol consumption (OR 3.10; 95% CI 1.72-5.59) and cigarette smoking (OR 1.43; 95% CI 1.02-1.98) also had statistically significant association with increased daytime dysfunction. In conclusion, stimulant use is common among Thai college students and is associated with several indices of poor sleep quality. Conclusion Our findings underscore the need to educate students on the importance of sleep and the influences of dietary and lifestyle choices on their sleep quality and overall health. PMID:23239460

Declines in Crime and Teen Childbearing: Identifying Potential Explanations for Contemporaneous Trends

PubMed Central

Colen, Cynthia G.; Ramey, David M.; Browning, Christopher R.

2016-01-01

Objectives The previous 25 years have witnessed remarkable upheavals in the social landscape of the United States. Two of the most notable trends have been dramatic declines in levels of crime as well as teen childbearing. Much remains unknown about the underlying conditions that might be driving these changes. More importantly, we do not know if the same distal factors that are responsible for the drop in the crime rate are similarly implicated in falling rates of teen births. We examine four overarching potential explanations: fluctuations in economic opportunity, shifting population demographics, differences in state-level policies, and changes in expectations regarding health and mortality. Methods We combine state-specific data from existing secondary sources and model trajectories of violent crime, homicides, robberies, and teen fertility over a 20-year period from 1990 to 2010 using simultaneous fixed-effects regression models. Results We find that 4 of the 21 predictors examined - growth in the service sector of the labor market, increasing racial diversity especially among Hispanics, escalating levels of migration, and the expansion of family planning services to low-income women – offer the most convincing explanations for why rates of violent crime and teen births have been steadily decreasing over time. Moreover, we are able to account for almost a quarter of the joint declines in violent crime and teen births. Conclusions Our conclusions underscore the far reaching effects that aggregate level demographic conditions and policies are likely to have on important social trends that might, at first glance, seem unrelated. Furthermore, the effects of policy efforts designed to target outcomes in one area are likely to spill over into other domains. PMID:27695160

Misclassification of childhood homicide on death certificates.

PubMed Central

Lapidus, G D; Gregorio, D I; Hansen, H

1990-01-01

Suspect classification of homicide deaths of Connecticut residents under 20 years of age was noted for 29 percent of cases examined. Misclassification was attributed to incomplete or erroneous information recorded on the death certificates, rather than errors in the designation of ICD-9 homicide codes. The results have important implications in the interpretation of vital statistics when homicide is listed as the cause of death and underscore the value of record linkage systems. PMID:2297072

Alkali metal-templated assembly of cyanometalate ``boxes'' (NEt{sub 4}){sub 3}{l{underscore}brace}M[Cp*Rh(CN){sub 3}]{sub 4}[Mo(CO){sub 3}]{sub 4}{r{underscore}brace} (M = K, Cs). Selective binding of Cs{sup +}

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

Klausmeyer, K.K.; Wilson, S.R.; Rauchfuss, T.B.

1999-03-31

The box-like cages {l{underscore}brace}M[Cp*Rh(CN){sub 3}]{sub 4}[Mo(CO){sub 3}]{sub 4}{r{underscore}brace}{sup 3{minus}} form as the sole metal-containing products of the reaction of [Cp*Rh(CN){sub 3}]{sup {minus}} and ({eta}{sup 6}-C{sub 6}H{sub 3}Me{sub 3})Mo(CO){sub 3} in the presence of K{sup +} and Cs{sup +}. Well-defined species could not be identified in solutions of Cp*Rh(CN){sub 3}{sup {minus}} ({eta}{sup 6}-C{sub 6}H{sub 3}Me{sub 3})Mo(CO){sub 3} in the absence of alkali metal cations. The new cages were isolated as their Et{sub 4}N{sup +} salts, M = K{sup +} (1), Cs{sup +} (2). Crystallographic characterization of 1 and 2 reveals box-like M{sub 8}({micro}-CN){sub 12} cages containing alkali metal cations. The cagesmore » feature 12 external CO and 4 external C{sub 5}Me{sub 5} ligands. In 1, the K{sup +} is disordered over two off-center positions, whereas in the case of 2, the Cs{sup +} is centered in the cage with a formal coordination number of 24. Otherwise, the structures of the two compounds are virtually indistinguishable. The persistence of the solid-state structures in solution was established through {sup 13}C NMR spectroscopy and electrospray mass spectrometric measurements. {sup 133}Cs NMR spectroscopy, which readily distinguishes free from included Cs{sup +}, shows that the boxes preferentially bind Cs{sup +} relative to K{sup +}.« less

Intermittent exercise in response to cigarette cravings in the context of an Internet-based smoking cessation program

PubMed Central

Linke, Sarah E.; Rutledge, Thomas; Myers, Mark G.

2013-01-01

Background Interventions using sustained aerobic exercise programs to aid smoking cessation have resulted in modest, short-term cessation rates comparable to conventional cessation methods. No smoking cessation trial to date has prescribed intermittent bouts of exercise in response to nicotine cravings. Objectives This pilot randomized controlled trial examined the feasibility and efficacy of an Internet-based smoking cessation program alone (CON) vs. the same Internet-based program + intermittent exercise in response to cigarette cravings (EX). Study population Participants (N = 38; mean age = 43.6 [SD = 11.5]; 60.5% women) were generally healthy, inactive adult smokers who desired to quit. Results The overall retention rate was 60.5% (n = 23), and no significant retention rate differences were found between groups (EX vs. CON). Although retained participants achieved a higher cessation rate (26.1%) than all enrolled participants (15.8%), adjusted intent-to-treat and per-protocol binary logistic regression analyses revealed no significant cessation rate differences between EX and CON groups. Linear regression results indicated that additional days of self-reported exercise on the study website during the intervention phase predicted significantly higher reduction rates among EX group participants, F(2, 16) = 31.08, p < .001. Conclusions Results were mixed with regard to the incremental benefit of exercise in the presence of the apparently valuable Internet-based smoking cessation program. The results support findings from related research and underscore the need for additional investigation into both the mechanisms underlying the effect of exercise on cigarette cravings and the challenges of poor adherence in the context of exercise-based smoking cessation interventions. PMID:23956792

Impact of a family medicine resident wellness curriculum: a feasibility study

PubMed Central

Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

2016-01-01

Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

Consensus Treatment Plans for New-Onset Systemic Juvenile Idiopathic Arthritis

PubMed Central

DeWitt, Esi Morgan; Kimura, Yukiko; Beukelman, Timothy; Nigrovic, Peter A.; Onel, Karen; Prahalad, Sampath; Schneider, Rayfel; Stoll, Matthew L.; Angeles-Han, Sheila; Milojevic, Diana; Schikler, Kenneth N.; Vehe, Richard K.; Weiss, Jennifer E.; Weiss, Pamela; Ilowite, Norman T.; Wallace, Carol A.

2012-01-01

Objective There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (sJIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of sJIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies. Methods Case-based surveys were administered to CARRA members to identify prevailing treatments for new-onset sJIA. A 2-day consensus conference in April 2010 employed modified nominal group technique to formulate preliminary treatment plans and determine important data elements for collection. Follow-up surveys were employed to refine the plans and assess clinical acceptability. Results The initial case-based survey identified significant variability among current treatment approaches for new onset sJIA, underscoring the utility of standardized plans to evaluate comparative effectiveness. We developed four consensus treatment plans for the first 9 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The four treatment regimens included glucocorticoids only, or therapy with methotrexate, anakinra or tocilizumab, with or without glucocorticoids. This approach was approved by >78% of CARRA membership. Conclusion Four standardized treatment plans were developed for new-onset sJIA. Coupled with data collection at defined intervals, use of these treatment plans will create the opportunity to evaluate comparative effectiveness in an observational setting to optimize initial management of sJIA. PMID:22290637

Effect of tumor size on breast cancer-specific survival stratified by joint hormone receptor status in a SEER population-based study

PubMed Central

Zheng, Yi-Zi; Wang, Lei; Hu, Xin; Shao, Zhi-Ming

2015-01-01

Background & Aims The prognostic value of tumor size is variable. We aimed to characterize the interaction between tumor size and hormone receptor (HoR) status to determine breast cancer-specific mortality (BCSM). Methods We used the Surveillance, Epidemiology and End Results (SEER) registry to identify 328, 870 female patients diagnosed with invasive breast cancer from 1990 through 2010. Primary study variables included tumor size, joint HoR status and their corresponding relationship. Kaplan-Meier and adjusted Cox proportional hazards models with interaction terms were utilized. Results The multivariable analysis revealed a significant interaction between tumor size and HoR status (P < 0.001). Using tumors 61–70 mm in size as the reference for estrogen receptor-negative (ER−) and progesterone receptor-negative (PR−) disease, the hazard ratio (HR) for BCSM increased with increasing tumor size across nearly all categories. In the ER-positive (ER+) and PR-positive (PR+) group, however, patients with tumors > 50 mm had nearly identical BCSM rates (P = 0.127, P = 0.099 and P = 0.370 for 51–60 mm, 71–80 mm and > 80 mm tumors, respectively), whereas BCSM was positively correlated with tumors < 51 mm. Conclusions The observation of identical HRs for BCSM among patients with ER+ and PR+ tumors >50 mm underscores the importance of individualized treatment. Our findings may contribute to a better understanding of breast cancer biology. PMID:26036636

Mapping the literature of nursing: 1996–2000

PubMed Central

Allen, Margaret (Peg); Jacobs, Susan Kaplan; Levy, June R.

2006-01-01

Introduction: This project is a collaborative effort of the Task Force on Mapping the Nursing Literature of the Nursing and Allied Health Resources Section of the Medical Library Association. This overview summarizes eighteen studies covering general nursing and sixteen specialties. Method: Following a common protocol, citations from source journals were analyzed for a three-year period within the years 1996 to 2000. Analysis included cited formats, age, and ranking of the frequency of cited journal titles. Highly cited journals were analyzed for coverage in twelve health sciences and academic databases. Results: Journals were the most frequently cited format, followed by books. More than 60% of the cited resources were published in the previous seven years. Bradford's law was validated, with a small core of cited journals accounting for a third of the citations. Medical and science databases provided the most comprehensive access for biomedical titles, while CINAHL and PubMed provided the best access for nursing journals. Discussion: Beyond a heavily cited core, nursing journal citations are widely dispersed among a variety of sources and disciplines, with corresponding access via a variety of bibliographic tools. Results underscore the interdisciplinary nature of the nursing profession. Conclusion: For comprehensive searches, nurses need to search multiple databases. Libraries need to provide access to databases beyond PubMed, including CINAHL and academic databases. Database vendors should improve their coverage of nursing, biomedical, and psychosocial titles identified in these studies. Additional research is needed to update these studies and analyze nursing specialties not covered. PMID:16636714

Sad and lonely: body dissatisfaction among adolescent girls.

PubMed

Forste, Renata; Potter, Marina; Erickson, Lance

2017-06-21

Purpose To further understand the association between body dissatisfaction and sadness/loneliness among adolescent girls, we examine how this association, as reported by pre-teen and adolescent girls, is mediated or moderated by the quality of peer and family relationships. Methods Our data are from the Health Behavior of School-Aged Children 2009-2010, a nationally representative survey of school-aged children in the US. We analyze a sample of 5658 girls in Grades 5 through 10. We utilize ordinary least squares (OLS) regression techniques and adjust for the complex sampling design. We explore how the link between body dissatisfaction and sadness/loneliness is mediated or moderated by family and peer relationships and also include controls for age, race, media exposure, and physical health. Results We find that body dissatisfaction is predictive of sadness/loneliness for girls at all grade levels and that the quality of peer and family relationships mediates 27%-38% of this association, particularly among early adolescent girls. Positive peer relationships also moderate or help mitigate the association between body dissatisfaction and sadness/loneliness among pre-teens. Conclusion Our findings underscore the association between body dissatisfaction and sadness/loneliness among early adolescent girls. In addition, our results highlight the importance of quality peer and family relationships in terms of how girls think about their bodies and respond emotionally to them. To evaluate feelings of sadness and loneliness among early adolescent girls, health care professionals need to consider not only body dissatisfaction but also the context of peer and family relationships.

A Two-site Randomized Clinical Trial of Integrated Psychosocial Treatment for ADHD-Inattentive Type

PubMed Central

Pfiffner, Linda J.; Hinshaw, Stephen P.; Owens, Elizabeth; Zalecki, Christine; Kaiser, Nina M.; Villodas, Miguel; McBurnett, Keith

2014-01-01

Objective This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with Attention Deficit Hyperactivity Disorder-Inattentive Type (ADHD-I). Method In a two-site randomized controlled trial, 199 children (ages 7-11) were randomized to CLAS (N=74), parent-focused treatment (PFT, N=74), or treatment as usual (TAU, N=51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at post-treatment, and also at follow-up during the subsequent school year. Results CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at post-treatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at post-treatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions These findings extend support for CLAS across two study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I. PMID:24865871

Drug use in business bathrooms: An exploratory study of manager encounters in New York City

PubMed Central

Wolfson-Stofko, Brett; Bennett, Alex S.; Elliott, Luther; Curtis, Ric

2017-01-01

Background Though public bathroom drug injection has been documented from the perspective of people who inject drugs, no research has explored the experiences of the business managers who oversee their business bathrooms and respond to drug use. These managers, by default, are first-responders in the event of a drug overdose and thus of intrinsic interest during the current epidemic of opioid-related overdoses in the United States. This exploratory study assists in elucidating the experiences that New York City business managers have with people who inject drugs, their paraphernalia, and their overdoses. Methods A survey instrument was designed to collect data on manager encounters with drug use occurring in their business bathrooms. Recruitment was guided by convenience and purposive approaches. Results More than half of managers interviewed (58%, n = 50/86) encountered drug use in their business bathrooms, more than a third (34%) of these managers also found syringes, and the vast majority (90%) of managers had received no overdose recognition or naloxone training. Seven managers encountered unresponsive individuals who required emergency assistance. Conclusion The results from this study underscore the need for additional research on the experiences that community stakeholders have with public injection as well as educational outreach efforts among business managers. This research also suggests that there is need for a national dialogue about potential interventions, including expanded overdose recognition and naloxone training and supervised injection facilities (SIF)/drug consumption rooms (DCR), that could reduce public injection and its associated health risks. PMID:27768996

Diurnal Salivary Cortisol Patterns Prior to Pregnancy Predict Infant Birth Weight

PubMed Central

Guardino, Christine M.; Schetter, Christine Dunkel; Saxbe, Darby E.; Adam, Emma K.; Ramey, Sharon Landesman; Shalowitz, Madeleine U.

2016-01-01

Objective Elevated maternal psychosocial stress during pregnancy and accompanying changes in stress hormones may contribute to risk of adverse birth outcomes such as low birth weight and preterm birth. Relatedly, research on fetal programming demonstrates intriguing associations between maternal stress processes during pregnancy and outcomes in offspring that extend into adulthood. The purpose of this study was to test whether HPA patterns in mothers during the period between two pregnancies (i.e., the interpregnancy interval) and the subsequent pregnancy predict infant birth weight, a key birth outcome. Methods This study sampled salivary cortisol both before and during pregnancy in a diverse community sample of 142 women in the Community Child Health Network (CCHN) study. Results Using multilevel modeling, we found that flatter diurnal cortisol slopes in mothers during the interval between one birth and a subsequent pregnancy predicted lower infant birth weight of the subsequent child. This interpregnancy cortisol pattern in mothers also correlated with significantly shorter inter-pregnancy intervals, such that women with flatter cortisol slopes had more closely spaced pregnancies. After adding demographic covariates of household income, cohabitation with partner, and race to the model, these results were unchanged. For participants who provided both interpregnancy and pregnancy cortisol data (n = 73), we found that interpregnancy cortisol slopes predicted infant birth weight independent of pregnancy cortisol slopes. Conclusions These novel findings on interpregnancy HPA axis function and subsequent pregnancy outcomes strongly support lifespan health approaches and underscore the importance of maternal stress physiology between pregnancies. PMID:26844584

Drug- and Alcohol-Facilitated, Incapacitated, and Forcible Rape in Relation to Mental Health among a National Sample of Women

PubMed Central

Zinzow, Heidi M.; Resnick, Heidi S.; Amstadter, Ananda B.; McCauley, Jenna L.; Ruggiero, Kenneth J.; Kilpatrick, Dean G.

2009-01-01

Objective Rape is a well-established risk factor for mental health disorders such as posttraumatic stress disorder (PTSD) and depression. However, most studies have focused on forcible rape tactics and have not distinguished these from tactics that involve drug or alcohol intoxication. Our aim was to examine correlates of PTSD and depression in a community sample of women, with particular emphasis on evaluating the unique effects of lifetime exposure to three specific rape tactics. Methods A nationally representative sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18–86 years) participated in a structured telephone interview by use of Computer-Assisted Telephone Interviewing technology. Results Multivariable models showed that history of drug or alcohol facilitated rape tactics (OR = 1.87, p< .05) and history of forcible rape tactics (OR = 3.46, p<.001) were associated with PTSD. History of forcible rape was associated with depression (OR = 3.65, p<.001). Forcible rape tactics were associated with a number of factors that may have contributed to their stronger association with mental health outcomes, including force, injury, lower income, revictimization history, and labeling the event as rape. Conclusions Our results underscore the importance of using a behaviorally specific assessment of rape history, as rape tactic and multiple rape history differentially predicted psychopathology outcomes. The association between drug or alcohol facilitated rape tactics and PTSD suggests that these are important rape tactics to include in assessments and future studies. PMID:20100896

Functional Impairment and Changes in Depression Subtypes for Women in STAR*D: A Latent Transition Analysis

PubMed Central

Rothschild, Anthony J.; Lapane, Kate L.

2016-01-01

Abstract Objective: To characterize the association between functional impairment and major depression subtypes at baseline and to characterize changes in subtypes by functional impairment level in women receiving citalopram in level 1 of the Sequenced Treatment Alternatives to Relieve Depression trial. Method: Women who completed baseline and week 12 study visits were included. Items from the self-reported Quick Inventory of Depressive Symptomatology were used to define the latent depression subtypes. The Work and Social Adjustment Scale was used to classify baseline functional impairment. A latent transition analysis model provided estimates of the prevalence of subtype membership and transition probabilities by functional impairment level. Results: Of the 755 women included, 69% had major functional impairment at baseline. Regardless of functional impairment level, the subtypes were differentiated by depression severity, appetite changes, psychomotor disturbances, and insomnia. Sixty-seven percent of women with normal/significant functional impairment and 60% of women with major impairment were likely to transition to a symptom resolution subtype at week 12. Women with baseline major impairment who were in the severe with psychomotor agitation subtype at the beginning of the study were least likely to transition to the symptom resolution subtype (4% chance). Conclusions: Functional impairment level was related to both the baseline depression subtype and the likelihood of moving to a different subtype. These results underscore the need to incorporate not only depression symptoms but also functioning in the assessment and treatment of depression. PMID:26488110

Self Assessment in Schizophrenia: Accuracy of Evaluation of Cognition and Everyday Functioning

PubMed Central

Gould, Felicia; McGuire, Laura Stone; Durand, Dante; Sabbag, Samir; Larrauri, Carlos; Patterson, Thomas L.; Twamley, Elizabeth W.; Harvey, Philip D.

2015-01-01

Objective Self-assessment deficits, often referred to as impaired insight or unawareness of illness, are well established in people with schizophrenia. There are multiple levels of awareness, including awareness of symptoms, functional deficits, cognitive impairments, and the ability to monitor cognitive and functional performance in an ongoing manner. The present study aimed to evaluate the comparative predictive value of each aspect of awareness on the levels of everyday functioning in people with schizophrenia. Method We examined multiple aspects of self-assessment of functioning in 214 people with schizophrenia. We also collected information on everyday functioning rated by high contact clinicians and examined the importance of self-assessment for the prediction of real world functional outcomes. The relative impact of performance based measures of cognition, functional capacity, and metacognitive performance on everyday functioning was also examined. Results Misestimation of ability emerged as the strongest predictor of real world functioning and exceeded the influences of cognitive performance, functional capacity performance, and performance-based assessment of metacognitive monitoring. The relative contribution of the factors other than self-assessment varied according to which domain of everyday functioning was being examined, but in all cases, accounted for less predictive variance. Conclusions These results underscore the functional impact of misestimating one’s current functioning and relative level of ability. These findings are consistent with the use of insight-focused treatments and compensatory strategies designed to increase self-awareness in multiple functional domains. PMID:25643212

Physical growth and non-verbal intelligence: Associations in Zambia

PubMed Central

Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

2014-01-01

Objectives To investigate normative developmental BMI trajectories and associations of physical growth indicators (ie, height, weight, head circumference [HC], body mass index [BMI]) with non-verbal intelligence in an understudied population of children from Sub-Saharan Africa. Study design A sample of 3981 students (50.8% male), grades 3 to 7, with a mean age of 12.75 years was recruited from 34 rural Zambian schools. Children with low scores on vision and hearing screenings were excluded. Height, weight and HC were measured, and non-verbal intelligence was assessed using UNIT-symbolic memory and KABC-II-triangles. Results Results showed that students in higher grades have a higher BMI over and above the effect of age. Girls showed a marginally higher BMI, although that for both boys and girls was approximately 1 SD below the international CDC and WHO norms. Controlling for the effect of age, non-verbal intelligence showed small but significant positive relationships with HC (r = .17) and BMI (r = .11). HC and BMI accounted for 1.9% of the variance in non-verbal intelligence, over and above the contribution of grade and sex. Conclusions BMI-for-age growth curves of Zambian children follow observed worldwide developmental trajectories. The positive relationships between BMI and intelligence underscore the importance of providing adequate nutritional and physical growth opportunities for children worldwide and in sub-Saharan Africa in particular. Directions for future studies are discussed with regard to maximizing the cognitive potential of all rural African children. PMID:25217196

Physical Activity and Body Mass Index

PubMed Central

Nelson, Candace C.; Wagner, Gregory R.; Caban-Martinez, Alberto J.; Buxton, Orfeu M.; Kenwood, Christopher T.; Sabbath, Erika L.; Hashimoto, Dean M.; Hopcia, Karen; Allen, Jennifer; Sorensen, Glorian

2014-01-01

Background The workplace is an important domain for adults, and many effective interventions targeting physical activity and weight reduction have been implemented in the workplace. However, the U.S. workforce is aging and few studies have examined the relationship of BMI, physical activity, and age as they relate to workplace characteristics. Purpose This paper reports on the distribution of physical activity and BMI by age in a population of hospital-based healthcare workers and investigates the relationships among workplace characteristics, physical activity, and BMI. Methods Data from a survey of patient care workers in two large academic hospitals in the Boston area were collected in late 2009 and analyzed in early 2013. Results In multivariate models, workers reporting greater decision latitude (OR=1.02; 95% CI=1.01, 1.03) and job flexibility (OR=1.05; 95% CI=1.01, 1.10) reported greater physical activity. Overweight and obesity increased with age (p<0.01), even after adjusting for workplace characteristics. Sleep deficiency (OR=1.56; 95% CI=1.15, 2.12) and workplace harassment (OR= 1.62; 95% CI=1.20, 2.18) were also associated with obesity. Conclusions These findings underscore the persistent impact of the work environment for workers of all ages. Based on these results, programs or policies aimed at improving the work environment, especially decision latitude, job flexibility and workplace harassment should be included in the design of worksite-based health promotion interventions targeting physical activity or obesity. PMID:24512930

Priority setting of ICU resources in an influenza pandemic: a qualitative study of the Canadian public's perspectives

PubMed Central

2012-01-01

Background Pandemic influenza may exacerbate existing scarcity of life-saving medical resources. As a result, decision-makers may be faced with making tough choices about who will receive care and who will have to wait or go without. Although previous studies have explored ethical issues in priority setting from the perspective of clinicians and policymakers, there has been little investigation into how the public views priority setting during a pandemic influenza, in particular related to intensive care resources. Methods To bridge this gap, we conducted three public town hall meetings across Canada to explore Canadian's perspectives on this ethical challenge. Town hall discussions group discussions were digitally recorded, transcribed, and analyzed using thematic analysis. Results Six interrelated themes emerged from the town hall discussions related to: ethical and empirical starting points for deliberation; criteria for setting priorities; pre-crisis planning; in-crisis decision-making; the need for public deliberation and input; and participants' deliberative struggle with the ethical issues. Conclusions Our findings underscore the importance of public consultation in pandemic planning for sustaining public trust in a public health emergency. Participants appreciated the empirical and ethical uncertainty of decision-making in an influenza pandemic and demonstrated nuanced ethical reasoning about priority setting of intensive care resources in an influenza pandemic. Policymakers may benefit from a better understanding the public's empirical and ethical 'starting points' in developing effective pandemic plans. PMID:22449119

Cannabis Use Behaviors and Social Anxiety: The Roles of Perceived Descriptive and Injunctive Social Norms

PubMed Central

Ecker, Anthony H.; Buckner, Julia D.

2014-01-01

Objective: Individuals with greater social anxiety are particularly vulnerable to cannabis-related impairment. Descriptive norms (beliefs about others’ use) and injunctive norms (beliefs regarding others’ approval of risky use) may be particularly relevant to cannabis-related behaviors among socially anxious persons if they use cannabis for fear of evaluation for deviating from what they believe to be normative behaviors. Yet, little research has examined the impact of these social norms on the relationships between social anxiety and cannabis use behaviors. Method: The current study investigated whether the relationships of social anxiety to cannabis use and use-related problems varied as a function of social norms. The sample comprised 230 (63.0% female) current cannabis-using undergraduates. Results: Injunctive norms (regarding parents, not friends) moderated the relationship between social anxiety and cannabis-related problem severity. Post hoc probing indicated that among participants with higher (but not lower) social anxiety, those with greater norm endorsement reported the most severe impairment. Injunctive norms (parents) also moderated the relationship between social anxiety and cannabis use frequency such that those with higher social anxiety and lower norm endorsement used cannabis less frequently. Descriptive norms did not moderate the relationship between social anxiety and cannabis use frequency. Conclusions: Socially anxious cannabis users appear to be especially influenced by beliefs regarding parents’ approval of risky cannabis use. Results underscore the importance of considering reference groups and the specific types of norms in understanding factors related to cannabis use behaviors among this vulnerable population. PMID:24411799

Identification of fibrillin 1 gene mutations in patients with bicuspid aortic valve (BAV) without Marfan syndrome

PubMed Central

2014-01-01

Background Bicuspid aortic valve (BAV) is the most frequent congenital heart disease with frequent involvement in thoracic aortic dilatation, aneurysm and dissection. Although BAV and Marfan syndrome (MFS) share some clinical features, and some MFS patients with BAV display mutations in FBN1, the gene encoding fibrillin-1, the genetic background of isolated BAV is poorly defined. Methods Ten consecutive BAV patients [8 men, age range 24–42 years] without MFS were clinically characterized. BAV phenotype and function, together with evaluation of aortic morphology, were comprehensively assessed by Doppler echocardiography. Direct sequencing of each FBN1 exon with flanking intron sequences was performed on eight patients. Results We detected three FBN1 mutations in two patients (aged 24 and 25 years) displaying aortic root aneurysm ≥50 mm and moderate aortic regurgitation. In particular, one patient had two mutations (p.Arg2726Trp and p.Arg636Gly) one of which has been previously associated with variable Marfanoid phenotypes. The other patient showed a pArg529Gln substitution reported to be associated with an incomplete MFS phenotype. Conclusions The present findings enlarge the clinical spectrum of isolated BAV to include patients with BAV without MFS who have involvement of FBN1 gene. These results underscore the importance of accurate phenotyping of BAV aortopathy and of clinical characterization of BAV patients, including investigation of systemic connective tissue manifestations and genetic testing. PMID:24564502

Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases

PubMed Central

2013-01-01

Background Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. Methods The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970–2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated. Results The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22). Conclusions Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment. PMID:24354705

Migraine Headache and Ischemic Stroke Risk: An Updated Meta-analysis

PubMed Central

Spector, June T.; Kahn, Susan R.; Jones, Miranda R.; Jayakumar, Monisha; Dalal, Deepan; Nazarian, Saman

2010-01-01

Background Observational studies, including recent large cohort studies which were unavailable for prior meta-analysis, have suggested an association between migraine headache and ischemic stroke. We performed an updated meta-analysis to quantitatively summarize the strength of association between migraine and ischemic stroke risk. Methods We systematically searched electronic databases, including MEDLINE and EMBASE, through February 2009 for studies of human subjects in the English language. Study selection using a priori selection criteria, data extraction, and assessment of study quality were conducted independently by reviewer pairs using standardized forms. Results Twenty-one (60%) of 35 studies met the selection criteria, for a total of 622,381 participants (13 case-control, 8 cohort studies) included in the meta-analysis. The pooled adjusted odds ratio of ischemic stroke comparing migraineurs to non-migraineurs using a random effects model was 2.30 (95% confidence interval [CI], 1.91-2.76). The pooled adjusted effect estimates for studies that reported relative risks and hazard ratios, respectively, were 2.41 (95% CI, 1.81-3.20) and 1.52 (95% CI, 0.99-2.35). The overall pooled effect estimate was 2.04 (95% CI, 1.72-2.43). Results were robust to sensitivity analyses excluding lower quality studies. Conclusions Migraine is associated with increased ischemic stroke risk. These findings underscore the importance of identifying high-risk migraineurs with other modifiable stroke risk factors. Future studies of the effect of migraine treatment and modifiable risk factor reduction on stroke risk in migraineurs are warranted. PMID:20493462

Hepatitis C Infection in Non-Treatment-Seeking Heroin Users: The Burden of Cocaine Injection

PubMed Central

Roux, P.; Fugon, L.; Jones, J.D.; Comer, S.D.

2014-01-01

Background and Objectives In heroin dependent individuals, the HIV epidemic has been controlled in countries where access to opioid maintenance treatment (OMT) and needle exchange programs (NEP) have been implemented. However, despite similar routes of contamination for both viruses, the prevalence of hepatitis C (HCV) infection remains high in drug users. The objective of this analysis was to identify the prevalence of HCV and the correlates of being HCV-positive in a sample of out-of-treatment heroin-dependent individuals. Methods Data were collected from five inpatient studies (n = 120 participants) conducted at the New York State Psychiatric Institute. A logistic regression was used to identify correlates of being HCV-positive at baseline. Results Among the 120 heroin-dependent volunteers, 42 were HCV-positive. Participants who had heavier alcohol use, a longer duration of heroin use, or who reported using heroin by injection were more likely to be HCV-positive. Interestingly, participants who had injected cocaine during the previous month had a ninefold greater risk of being HCV-positive compared to non-cocaine users and those who used cocaine by a non-injecting route. Conclusions and Scientific Significance These findings confirm the risk of being HCV-infected through intravenous drug use, especially with cocaine use. These results underscore the importance of rethinking interventions to prevent HCV infection with combined strategies using pharmacological approaches for cocaine dependence and tailored prevention for cocaine users. PMID:24131170

Pathogenic and likely pathogenic variant prevalence among the first 10,000 patients referred for next-generation cancer panel testing

PubMed Central

Susswein, Lisa R.; Marshall, Megan L.; Nusbaum, Rachel; Vogel Postula, Kristen J.; Weissman, Scott M.; Yackowski, Lauren; Vaccari, Erica M.; Bissonnette, Jeffrey; Booker, Jessica K.; Cremona, M. Laura; Gibellini, Federica; Murphy, Patricia D.; Pineda-Alvarez, Daniel E.; Pollevick, Guido D.; Xu, Zhixiong; Richard, Gabi; Bale, Sherri; Klein, Rachel T.; Hruska, Kathleen S.; Chung, Wendy K.

2016-01-01

Purpose: Germ-line testing for panels of cancer genes using next-generation sequencing is becoming more common in clinical care. We report our experience as a clinical laboratory testing both well-established, high-risk cancer genes (e.g., BRCA1/2, MLH1, MSH2) as well as more recently identified cancer genes (e.g., PALB2, BRIP1), many of which have increased but less well-defined penetrance. Genet Med 18 8, 823–832. Methods: Clinical genetic testing was performed on over 10,000 consecutive cases referred for evaluation of germ-line cancer genes, and results were analyzed for frequency of pathogenic or likely pathogenic variants, and were stratified by testing panel, gene, and clinical history. Genet Med 18 8, 823–832. Results: Overall, a molecular diagnosis was made in 9.0% of patients tested, with the highest yield in the Lynch syndrome/colorectal cancer panel. In patients with breast, ovarian, or colon/stomach cancer, positive yields were 9.7, 13.4, and 14.8%, respectively. Approximately half of the pathogenic variants identified in patients with breast or ovarian cancer were in genes other than BRCA1/2. Genet Med 18 8, 823–832. Conclusion: The high frequency of positive results in a wide range of cancer genes, including those of high penetrance and with clinical care guidelines, underscores both the genetic heterogeneity of hereditary cancer and the usefulness of multigene panels over genetic tests of one or two genes. Genet Med 18 8, 823–832. PMID:26681312

Strengthening systems for communicable disease surveillance: creating a laboratory network in Rwanda

PubMed Central

2011-01-01

Background The recent emergence of a novel strain of influenza virus with pandemic potential underscores the need for quality surveillance and laboratory services to contribute to the timely detection and confirmation of public health threats. To provide a framework for strengthening disease surveillance and response capacities in African countries, the World Health Organization Regional Headquarters for Africa (AFRO) developed Integrated Disease Surveillance and Response (IDSR) aimed at improving national surveillance and laboratory systems. IDSR emphasizes the linkage of information provided by public health laboratories to the selection of relevant, appropriate and effective public health responses to disease outbreaks. Methods We reviewed the development of Rwanda's National Reference Laboratory (NRL) to understand essential structures involved in creating a national public health laboratory network. We reviewed documents describing the NRL's organization and record of test results, conducted site visits, and interviewed health staff in the Ministry of Health and in partner agencies. Findings were developed by organizing thematic categories and grouping examples within them. We purposefully sought to identify success factors as well as challenges inherent in developing a national public health laboratory system. Results Among the identified success factors were: a structured governing framework for public health surveillance; political commitment to promote leadership for stronger laboratory capacities in Rwanda; defined roles and responsibilities for each level; coordinated approaches between technical and funding partners; collaboration with external laboratories; and use of performance results in advocacy with national stakeholders. Major challenges involved general infrastructure, human resources, and budgetary constraints. Conclusions Rwanda's experience with collaborative partnerships contributed to creation of a functional public health laboratory network. PMID:21702948

Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers

PubMed Central

Tomko, Rachel L.; Saladin, Michael E.; McClure, Erin A.; Squeglia, Lindsay M.; Carpenter, Matthew J.; Tiffany, Stephen T.; Baker, Nathaniel L.; Gray, Kevin M.

2017-01-01

Background and rationale The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse. Objective The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants’ daily lives. Methods Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493–5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were reassessed following cue exposure. Results Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving. Conclusions Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues. PMID:27838746

Affect and Craving: Positive and Negative Affect are Differentially Associated with Approach and Avoidance Inclinations

PubMed Central

Schlauch, Robert C.; Gwynn-Shapiro, Daniel; Stasiewicz, Paul R.; Molnar, Danielle S.; Lang, Alan R.

2012-01-01

Background Research on reactivity to alcohol and drug cues has either ignored affective state altogether or has focused rather narrowly on the role of negative affect in craving. Moreover, until recently, the relevant analyses of affect and craving have rarely addressed the ambivalence often associated with craving itself. The current study investigated how both negative and positive affect moderate approach and avoidance inclinations associated with cue-elicited craving in a clinical sample diagnosed with substance use disorders. Methods One hundred forty-four patients (age range 18–65, mean 42.0; n = 92 male) were recruited from an inpatient detoxification unit for substance abuse. Participants completed a baseline assessment of both positive and negative affect prior to completing a cue-reactivity paradigm for which they provided self-report ratings of inclinations to approach (use) and avoid (not use) alcohol, cigarettes, and non-psychoactive control substances (food and beverages). Results Participants with elevated negative affect reported significantly higher approach ratings for cigarette and alcohol cues, whereas those high in positive affect showed significantly higher levels of avoidance inclinations for both alcohol and cigarette cues and also significantly lower approach ratings for alcohol cues, all relative to control cues. Conclusions Results for negative affect are consistent with previous cue reactivity research, whereas results for positive affect are unique and call attention to its clinical potential for attenuating approach inclinations to substance use cues. Further, positive affect was related to both approach and avoidance inclinations, underscoring the utility of a multidimensional conceptualization of craving in the analysis. PMID:23380493

Influenza Pandemic: Gaps in Pandemic Planning and Preparedness Need to Be Addressed. Testimony before the Committee on Homeland Security, House of Representatives. GAO-09-909T

ERIC Educational Resources Information Center

Steinhardt, Bernice

2009-01-01

As the current H1N1 outbreak underscores, an influenza pandemic remains a real threat to our nation. Over the past 3 years, the US Government Accountability Office (GAO) conducted a body of work, consisting of 12 reports and 4 testimonies, to help the nation better prepare for a possible pandemic. In February 2009, GAO synthesized the results of…

Is neuroinflammation in the injured spinal cord different than in the brain? Examining intrinsic differences between the brain and spinal cord.

PubMed

Zhang, B; Gensel, J C

2014-08-01

The field of neuroimmunology is rapidly advancing. There is a growing appreciation for heterogeneity, both in inflammatory composition and region-specific inflammatory responses. This understanding underscores the importance of developing targeted immunomodulatory therapies for treating neurological disorders. Concerning neurotrauma, there is a dearth of publications directly comparing inflammatory responses in the brain and spinal cord after injury. The question therefore remains as to whether inflammatory cells responding to spinal cord vs. brain injury adopt similar functions and are therefore amenable to common therapies. In this review, we address this question while revisiting and modernizing the conclusions from publications that have directly compared inflammation across brain and spinal cord injuries. By examining molecular differences, anatomical variations, and inflammatory cell phenotypes between the injured brain and spinal cord, we provide insight into how neuroinflammation relates to neurotrauma and into fundamental differences between the brain and spinal cord. Copyright © 2014 Elsevier Inc. All rights reserved.

Laboratory Studies of Cometary Materials - Continuity Between Asteroid and Comet

NASA Technical Reports Server (NTRS)

Messenger, Scott; Walker, Robert M.

2015-01-01

Laboratory analysis of cometary samples have been enabled by collection of cometary dust in the stratosphere by high altitude aircraft and by the direct sampling of the comet Wild-2 coma by the NASA Stardust spacecraft. Cometary materials are composed of a complex assemblage of highly primitive, unprocessed interstellar and primordial solar system materials as well as a variety of high temperature phases that must have condensed in the inner regions of the protoplanetary disk. These findings support and contradict conclusions of comet properties based solely on astronomical observations. These sample return missions have instead shown that there is a continuity of properties between comets and asteroids, where both types of materials show evidence for primitive and processed materials. Furthermore, these findings underscore the importance and value of direct sample return. There will be great value in comparing the findings of the Stardust cometary coma sample return mission with those of future asteroid surface sample returns OSIRIS-REx and Hayabusa II as well as future comet nucleus sample returns.

A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities

PubMed Central

Walls, Melissa L.; Whitbeck, Les; Armenta, Brian

2016-01-01

Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (M age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (M age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs. PMID:28138417

[How therapists view the contribution of cultural resources for community-based integrative therapy].

PubMed

de Oliveira, Danielle Samara Tavares; Ferreira Filha, Maria de Oliveira

2011-09-01

This study aims to investigate the contribution of cultural resources to Community-Based Integrative Care (CBIC), to consolidate it as a model of community-based mental health and a political strategy for local health, and to identify the cultural strategies most used in CBIC sessions. This is a qualitative study, conducted in the city of João Pessoa, state of Paraíba, Brazil, with ten therapists. We used semi-structured interviews and afield diary, from September, 2008, to March, 2009, then proceeded to the interpretive analysis of the data. It was evident that the inclusion of cultural resources contributes to the consolidation of CBIC, for it reclaims and strengthen values, and it underscores the personal and social identity of individuals, encouraging effective participation. The main cultural resources used were music, dynamics and prayers. The conclusion was that cultural resources are an important resource for the work of the therapist, for it strengthens bonds and helps people to give a new meaning to their suffering.

Gender, globalisation, and democracy.

PubMed

Walby, S

2000-03-01

This article discusses the link between gender, globalization and democracy in relation to women¿s empowerment. Analyzing gender relations within the processes of development planning involves five approaches: 1) welfare, 2) equity, 3) anti-poverty, 4) efficiency, and 5) empowerment. In addition, a new approach, which combines efficiency and empowerment, must be added to highlight the problematic nature of the direction of causality assumed by traditional theory of development. The rise on women's representation in national parliament can be attributed to the increase of women's economic power and women's political struggles. However, promotion of globalization produces new opportunities for feminist politics, as well as difficulties, which include: the emergent position of productive engagement in which an efficient economy and democratic society are seen as interdependent; and increase in parliamentary representation correlates with increased paid employment for women. In conclusion, the author underscores that globalization is a gendered process which is restructuring social relations on a large scale and the challenges it bring provide opportunities for women in development.

Conceptual-level workflow modeling of scientific experiments using NMR as a case study

PubMed Central

Verdi, Kacy K; Ellis, Heidi JC; Gryk, Michael R

2007-01-01

Background Scientific workflows improve the process of scientific experiments by making computations explicit, underscoring data flow, and emphasizing the participation of humans in the process when intuition and human reasoning are required. Workflows for experiments also highlight transitions among experimental phases, allowing intermediate results to be verified and supporting the proper handling of semantic mismatches and different file formats among the various tools used in the scientific process. Thus, scientific workflows are important for the modeling and subsequent capture of bioinformatics-related data. While much research has been conducted on the implementation of scientific workflows, the initial process of actually designing and generating the workflow at the conceptual level has received little consideration. Results We propose a structured process to capture scientific workflows at the conceptual level that allows workflows to be documented efficiently, results in concise models of the workflow and more-correct workflow implementations, and provides insight into the scientific process itself. The approach uses three modeling techniques to model the structural, data flow, and control flow aspects of the workflow. The domain of biomolecular structure determination using Nuclear Magnetic Resonance spectroscopy is used to demonstrate the process. Specifically, we show the application of the approach to capture the workflow for the process of conducting biomolecular analysis using Nuclear Magnetic Resonance (NMR) spectroscopy. Conclusion Using the approach, we were able to accurately document, in a short amount of time, numerous steps in the process of conducting an experiment using NMR spectroscopy. The resulting models are correct and precise, as outside validation of the models identified only minor omissions in the models. In addition, the models provide an accurate visual description of the control flow for conducting biomolecular analysis using NMR spectroscopy experiment. PMID:17263870

The effect of family sex composition on fertility desires and family planning behaviors in urban Uttar Pradesh, India

PubMed Central

2013-01-01

Background A cultural preference for sons has been well documented in India, resulting in skewed sex ratios, especially exhibited in northwest India. Previous research has shown that family sex composition is associated with family planning (FP) use and couples’ desire for more children. This study examines family sex composition and fertility and FP behaviors in urban Uttar Pradesh, India; little work has examined these issues in urban settings where family sizes are smaller and FP use is common. Methods Data for this analysis comes from a 2010 representative survey of married, non-pregnant fecund women aged 15–49 from six cities in Uttar Pradesh, India. Multivariate analyses are used to examine the association between family sex composition and fertility desires and FP use. Results The multivariate results indicate that family sex composition is associated with fertility desires and FP use. Women without living children and without at least one child of each sex are significantly less likely to want no more children and women with both sons and daughters but more sons are significantly more likely to want no more children as compared to women that have both sons and daughters but more daughters. Women with no living children and women with daughters but no sons are less likely to be modern FP users than nonusers whereas women with both sons and daughters but more sons are more likely to be modern FP users than nonusers as compared to women with both sons and daughters but more daughters. Conclusions These findings confirm that family sex composition affects fertility behavior and also reveals that preference for sons persists in urban Uttar Pradesh. These results underscore the importance of programs and policies that work to enhance the value of girl children. PMID:24025670

Targeting Functional Decline: Results from the Alzheimer’s Disease Multiple Intervention Trial

PubMed Central

Callahan, Christopher M.; Boustani, Malaz A.; Schmid, Arlene A.; LaMantia, Michael A.; Austrom, Mary G.; Miller, Douglas K.; Gao, Sujuan; Ferguson, Denisha Y.; Lane, Kathleen A.; Hendrie, Hugh C.

2017-01-01

Background Alzheimer’s disease (AD) results in progressive functional decline leading to loss of independence Objective To determine whether collaborative care plus two years of home-based occupational therapy delays functional decline Design Randomized controlled clinical trial Setting Urban public health system Patients 180 community-dwelling subjects who were diagnosed with AD and their informal caregivers Interventions All subjects received collaborative care for dementia. Intervention patients also received in-home occupational therapy delivered in 24 sessions over 2 years. Measurements The primary outcome measures was the Alzheimer’s Disease Cooperative Studies Group Activities of Daily Living Scale (ADCS ADL); performance based measures included the Short Physical Performance Battery (SPPB) and Short Portable Sarcopenia Measure (SPSM) Results At baseline, there were no significant between group differences in clinical characteristics; the mean MMSE for both groups was 19 (SD=7). The intervention group received a median of 18 home visits from the study occupational therapists. Both groups declined in ADCS ADL scores over 24 months. At the primary endpoint of 24 months, there were no between group differences in ADCS ADL scores (mean difference 2.34, 95% CI −5.27, 9.96). We were also unable to definitively demonstrate between-group differences in the mean SPPB or SPSM. Limitations The results of this trial are indeterminate and do not rule out potentially clinically important effects of the intervention. Conclusions We were unable to definitively demonstrate whether the addition of two years of in-home occupational therapy to a collaborative care management model slows the rate of functional decline among persons with AD. This trial underscores the burden undertaken by family caregivers as they provide care for persons with AD and the difficulty in slowing functional decline. PMID:27893087

The imperative for controlled mechanical stresses in unraveling cellular mechanisms of mechanotransduction

PubMed Central

Anderson, Eric J; Falls, Thomas D; Sorkin, Adam M; Tate, Melissa L Knothe

2006-01-01

Background In vitro mechanotransduction studies are designed to elucidate cell behavior in response to a well-defined mechanical signal that is imparted to cultured cells, e.g. through fluid flow. Typically, flow rates are calculated based on a parallel plate flow assumption, to achieve a targeted cellular shear stress. This study evaluates the performance of specific flow/perfusion chambers in imparting the targeted stress at the cellular level. Methods To evaluate how well actual flow chambers meet their target stresses (set for 1 and 10 dyn/cm2 for this study) at a cellular level, computational models were developed to calculate flow velocity components and imparted shear stresses for a given pressure gradient. Computational predictions were validated with micro-particle image velocimetry (μPIV) experiments. Results Based on these computational and experimental studies, as few as 66% of cells seeded along the midplane of commonly implemented flow/perfusion chambers are subjected to stresses within ±10% of the target stress. In addition, flow velocities and shear stresses imparted through fluid drag vary as a function of location within each chamber. Hence, not only a limited number of cells are exposed to target stress levels within each chamber, but also neighboring cells may experience different flow regimes. Finally, flow regimes are highly dependent on flow chamber geometry, resulting in significant variation in magnitudes and spatial distributions of stress between chambers. Conclusion The results of this study challenge the basic premise of in vitro mechanotransduction studies, i.e. that a controlled flow regime is applied to impart a defined mechanical stimulus to cells. These results also underscore the fact that data from studies in which different chambers are utilized can not be compared, even if the target stress regimes are comparable. PMID:16672051

Temperature characteristics of the radiation detector using TlBr crystals

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

Shoji, T.; Hitomi, K.; Muroi, O.

1999-12-01

The radiation detector was fabricated from the TlBr crystals grown by TMZ (traveling molten zone) method and the FWHM and transit time of electrons and holes were measured as a function of temperature. The TlBr radiation detector shows the best response characteristics at about 313 K (3.19K{sup {sm{underscore}bullet}1}) in cases where holes mainly contributed to the output pulses. However, in the temperatures higher than 300 K (2.22 K{sup {sm{underscore}bullet}1}), the FWHM for {sup 241}Am {alpha}-particles (5.498 MeV) becomes worse. An activation energy of about 0.90eV has been deduced from the resistivity measurement.

Characterization of the Interaction of Staphylococcal Entertoxin B with CD1d Expressed in Human Renal Proximal Tubule Epithelial Cells

DTIC Science & Technology

2015-02-04

underscored by its influences on the performances of natural killer T- cells and thereby mediates the innate and adaptive immune systems. Results... cells to the non- lymphoid cell types derived from kidney [13], spleen [14], lungs [15], and gut [16]. Recent findings demonstrating the translocation...pathogenesis has been in- vestigated in the past, primarily focused on the lymphoid cells [37-41], while the knowledge gap exists in compre- hending

Stereotypes of professional roles.

PubMed

Kaler, S R; Levy, D A; Schall, M

1989-01-01

To determine the current public image of the nursing profession, this survey investigated the nature of stereotyping. Subjects approached in a shopping mall (N = 110) were asked to rate the degree to which 12 characteristics typify individuals in 14 professions. The results indicate that the public image of the nurse continues to turn on feminine and nurturant characteristics. The need for increased public awareness that nurses are scholars and leaders is underscored. Asserting the right to practice may produce a new stereotype of the nurse as intelligent and autonomous.

Recruitment of mitofusin 2 into “lipid rafts” drives mitochondria fusion induced by Mdivi-1

PubMed Central

Ciarlo, Laura; Vona, Rosa; Manganelli, Valeria; Gambardella, Lucrezia; Raggi, Carla; Marconi, Matteo; Malorni, Walter; Sorice, Maurizio; Garofalo, Tina; Matarrese, Paola

2018-01-01

The regulation of the mitochondrial dynamics and the balance between fusion and fission processes are crucial for the health and fate of the cell. Mitochondrial fusion and fission machinery is controlled by key proteins such as mitofusins, OPA-1 and several further molecules. In the present work we investigated the implication of lipid rafts in mitochondrial fusion induced by Mdivi-1. Our results underscore the possible implication of lipid “rafts” in mitochondrial morphogenetic changes and their homeostasis. PMID:29721168

Obstetric and birth outcomes in pregnant women with epilepsy: A hospital-based study

PubMed Central

Othman, Noor Haslina; Ab Rahman, Ab Fatah

2013-01-01

Introduction: In addition to changes in seizure frequency, pregnant women with epilepsy (WWE) are at increased risk of complications during pregnancy or delivery. In the absence of a nationwide WWE registry, hospital-based studies may provide important information regarding current management and outcomes in these patients. Objectives: The aims of this study were to determine changes in seizure frequency, and pregnancy and birth outcomes among pregnant WWE. Materials and Methods: We conducted a retrospective review of medical records of pregnant patients with epilepsy, who obtained medical care (from 2006 to 2011) at one of the general hospitals in the North-Eastern State of Malaysia. Data were collected for seizure frequency before and during the pregnancy, concurrent medications, pregnancy complications, and neonatal outcomes. Results: We reviewed records of 25 patients with a total of 33 different pregnancies. All patients were treated with antiepileptic medications during their pregnancies, with 42% monotherapy and 58% polytherapy. Seizure frequency decreased in 5 (15.2%), increased in 18 (54.5%) and unchanged in 10 (30.3%) cases of pregnancies. Pregnancy complications were anemia, gestational diabetes mellitus, gestational hypertension, intrauterine growth retardation, premature rupture of membrane, and vaginal bleeding. Preterm deliveries were recorded in 11 (33.3%) infants. Conclusion: In our setting, many patients were being on polytherapy during their pregnancies. This underscores the need for planned pregnancies so that antiepileptic medications can be optimized prior to pregnancy. PMID:24339574

Acute alcohol effects on facial expressions of emotions in social drinkers: a systematic review

PubMed Central

Capito, Eva Susanne; Lautenbacher, Stefan; Horn-Hofmann, Claudia

2017-01-01

Background As known from everyday experience and experimental research, alcohol modulates emotions. Particularly regarding social interaction, the effects of alcohol on the facial expression of emotion might be of relevance. However, these effects have not been systematically studied. We performed a systematic review on acute alcohol effects on social drinkers’ facial expressions of induced positive and negative emotions. Materials and methods With a predefined algorithm, we searched three electronic databases (PubMed, PsycInfo, and Web of Science) for studies conducted on social drinkers that used acute alcohol administration, emotion induction, and standardized methods to record facial expressions. We excluded those studies that failed common quality standards, and finally selected 13 investigations for this review. Results Overall, alcohol exerted effects on facial expressions of emotions in social drinkers. These effects were not generally disinhibiting, but varied depending on the valence of emotion and on social interaction. Being consumed within social groups, alcohol mostly influenced facial expressions of emotions in a socially desirable way, thus underscoring the view of alcohol as social lubricant. However, methodical differences regarding alcohol administration between the studies complicated comparability. Conclusion Our review highlighted the relevance of emotional valence and social-context factors for acute alcohol effects on social drinkers’ facial expressions of emotions. Future research should investigate how these alcohol effects influence the development of problematic drinking behavior in social drinkers. PMID:29255375

Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis.

PubMed

Wang, Kaiwen; Zhong, Shuang; Wang, Xiaoye; Wang, Zhe; Yang, Lianping; Wang, Qiong; Wang, Suhan; Sheng, Rongrong; Ma, Rui; Lin, Shao; Liu, Wenyu; Zu, Rongqiang; Huang, Cunrui

2017-10-10

(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing's Center for Disease Control and Prevention (CDC) and Funing People's Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

Chronic Pain and Health Care Spending: An Analysis of Longitudinal Data from the Medical Expenditure Panel Survey

PubMed Central

Stockbridge, Erica L; Suzuki, Sumihiro; Pagán, José A

2015-01-01

Objective To estimate average incremental health care expenditures associated with chronic pain by health care service category, expanding on prior research that focused on specific pain conditions instead of general pain, excluded low levels of pain, or did not incorporate pain duration. Data Source Medical Expenditure Panel Survey (MEPS) data (2008–2011; N = 26,671). Study Design Differences in annual expenditures for adults at different levels of pain that interferes with normal work, as measured by the SF-12, were estimated using recycled predictions from two-part logit-generalized linear regression models. Principal Findings “A little bit” of chronic pain-related interference was associated with a $2,498 increase in total adjusted expenditures over no pain interference (p < .0001) and a $1,008 increase over nonchronic pain interference (p = .0001). Moderate and severe chronic pain-related interference was associated with a $3,707 and $5,804 increase in expenditures over no pain interference and a $2,218 and $4,315 increase over nonchronic interference, respectively (p < .0001). Expenditure increases were most pronounced for inpatient and hospital outpatient expenditures compared to other types of health care expenditures. Conclusions Chronic pain limitations are associated with higher health care expenditures. Results underscore the substantial cost of pain to the health care system. PMID:25424348

Engineered T cells for pancreatic cancer treatment

PubMed Central

Katari, Usha L; Keirnan, Jacqueline M; Worth, Anna C; Hodges, Sally E; Leen, Ann M; Fisher, William E; Vera, Juan F

2011-01-01

Objective Conventional chemotherapy and radiotherapy produce marginal survival benefits in pancreatic cancer, underscoring the need for novel therapies. The aim of this study is to develop an adoptive T cell transfer approach to target tumours expressing prostate stem cell antigen (PSCA), a tumour-associated antigen that is frequently expressed by pancreatic cancer cells. Methods Expression of PSCA on cell lines and primary tumour samples was confirmed by immunohistochemistry. Healthy donor- and patient-derived T cells were isolated, activated in vitro using CD3/CD28, and transduced with a retroviral vector encoding a chimeric antigen receptor (CAR) targeting PSCA. The ability of these cells to kill tumour cells was analysed by chromium-51 (Cr51) release. Results Prostate stem cell antigen was expressed on >70% of the primary tumour samples screened. Activated, CAR-modified T cells could be readily generated in clinically relevant numbers and were specifically able to kill PSCA-expressing pancreatic cancer cell lines with no non-specific killing of PSCA-negative target cells, thus indicating the potential efficacy and safety of this approach. Conclusions Prostate stem cell antigen is frequently expressed on pancreatic cancer cells and can be targeted for immune-mediated destruction using CAR-modified, adoptively transferred T cells. The safety and efficacy of this approach indicate that it deserves further study and may represent a promising novel treatment for patients with pancreatic cancer. PMID:21843265

Reaction on Twitter to a Cluster of Perinatal Deaths: A Mixed Method Study

PubMed Central

2016-01-01

Background Participation in social networking sites is commonplace and the micro-blogging site Twitter can be considered a platform for the rapid broadcasting of news stories. Objective The aim of this study was to explore the Twitter status updates and subsequent responses relating to a number of perinatal deaths which occurred in a small maternity unit in Ireland. Methods An analysis of Twitter status updates, over a two month period from January to March 2014, was undertaken to identify the key themes arising in relation to the perinatal deaths. Results Our search identified 3577 tweets relating to the reported perinatal deaths. At the height of the controversy, Twitter updates generated skepticism in relation to the management of not only of the unit in question, which was branded as unsafe, but also the governance of the entire Irish maternity service. Themes of concern and uncertainty arose whereby the professional motives of the obstetric community and staffing levels in the maternity services were called into question. Conclusions Twitter activity provides a useful insight into attitudes towards health-related events. The role of the media in influencing opinion is well-documented and this study underscores the challenges that clinicians face in light of an obstetric media scandal. Further study to identify how the obstetric community could develop tools to utilize Twitter to disseminate valid health information could be beneficial. PMID:27466002

Early Risk Factors for Alcohol Use Across High School and Its Covariation With Deviant Friends

PubMed Central

Armstrong, Jeffrey M.; Ruttle, Paula L.; Burk, Linnea R.; Costanzo, Philip R.; Strauman, Timothy J.; Essex, Marilyn J.

2013-01-01

Objective: Past research has associated childhood characteristics and experiences with alcohol use at single time points in adolescence. Other work has focused on drinking trajectories across adolescence but with risk factors typically no earlier than middle or high school. Similarly, although the connection between underage drinking and affiliation with deviant friends is well established, early risk factors for their covariation across adolescence are uncertain. The present study examines the influence of early individual and contextual factors on (a) trajectories across high school of per-occasion alcohol use and (b) the covariation of alcohol use and deviant friends over time. Method: In a longitudinal community sample (n = 374; 51% female), temperamental disinhibition, authoritarian and authoritative parenting, and parental alcohol use were assessed during childhood, and adolescents reported on alcohol use and affiliation with deviant friends in the spring of Grades 9, 10, 11, and 12. Results: Early parental alcohol use predicted the intercept of adolescent drinking. Subsequent patterns of adolescent alcohol use were predicted by sex and interactions of sex and childhood disinhibition with early authoritarian parenting. Additionally, childhood disinhibition interacted with parental alcohol use to moderate the covariation of drinking and deviant friends. Conclusions: These findings highlight early individual and contextual risk factors for alcohol use across high school, extending previous work and underscoring the importance of developmental approaches and longitudinal techniques for understanding patterns of growth in underage drinking. PMID:23948534

Assessing exposure to granite countertops--Part 2: Radon.

PubMed

Allen, Joseph G; Minegishi, Taeko; Myatt, Theodore A; Stewart, James H; McCarthy, John F; Macintosh, David L

2010-05-01

Radon gas ((222)Rn) is a natural constituent of the environment and a risk factor for lung cancer that we are exposed to as a result of radioactive decay of radium ((226)Ra) in stone and soil. Granite countertops, in particular, have received recent media attention regarding their potential to emit radon. Radon flux was measured on 39 full slabs of granite from 27 different varieties to evaluate the potential for exposure and examine determinants of radon flux. Flux was measured at up to six pre-selected locations on each slab and also at areas identified as potentially enriched after a full-slab scan using a Geiger-Muller detector. Predicted indoor radon concentrations were estimated from the measured radon flux using the CONTAM indoor air quality model. Whole-slab average emissions ranged from less than limit of detection to 79.4 Bq/m(2)/h (median 3.9 Bq/m(2)/h), similar to the range reported in the literature for convenience samples of small granite pieces. Modeled indoor radon concentrations were less than the average outdoor radon concentration (14.8 Bq/m(3); 0.4 pCi/l) and average indoor radon concentrations (48 Bq/m(3); 1.3 pCi/l) found in the United States. Significant within-slab variability was observed for stones on the higher end of whole slab radon emissions, underscoring the limitations of drawing conclusions from discrete samples.

Cryopyrin-associated Periodic Syndrome Caused by a Myeloid-Restricted Somatic NLRP3 Mutation

PubMed Central

Zhou, Qing; Aksentijevich, Ivona; Wood, Geryl M.; Walts, Avram D.; Hoffmann, Patrycja; Remmers, Elaine F.; Kastner, Daniel L.; Ombrello, Amanda K.

2015-01-01

Objective To identify the cause of disease in an adult patient presenting with recent onset fevers, chills, urticaria, fatigue, and profound myalgia, who was negative for cryopyrin-associated periodic syndrome (CAPS) NLRP3 mutations by conventional Sanger DNA sequencing. Methods We performed whole-exome sequencing and targeted deep sequencing using DNA from the patient’s whole blood to identify a possible NLRP3 somatic mutation. We then screened for this mutation in subcloned NLRP3 amplicons from fibroblasts, buccal cells, granulocytes, negatively-selected monocytes, and T and B lymphocytes and further confirmed the somatic mutation by targeted sequencing of exon 3. Results We identified a previously reported CAPS-associated mutation, p.Tyr570Cys, with a mutant allele frequency of 15% based on exome data. Targeted sequencing and subcloning of NLRP3 amplicons confirmed the presence of the somatic mutation in whole blood at a ratio similar to the exome data. The mutant allele frequency was in the range of 13.3%–16.8% in monocytes and 15.2%–18% in granulocytes; Notably, this mutation was either absent or present at a very low frequency in B and T lymphocytes, buccal cells, and in the patient’s cultured fibroblasts. Conclusion These data document the possibility of myeloid-restricted somatic mosaicism in the pathogenesis of CAPS, underscoring the emerging role of massively-parallel sequencing in clinical diagnosis. PMID:25988971

Predictors of Second Language Acquisition in Latino Children With Specific Language Impairment

PubMed Central

Gutiérrez-Clellen, Vera; Simon-Cereijido, Gabriela; Sweet, Monica

2012-01-01

Purpose This study evaluated the extent to which the language of intervention, the child’s development in Spanish, and the effects of English vocabulary, use, proficiency, and exposure predict differences in the rates of acquisition of English in Latino children with specific language impairment (SLI). Method In this randomized controlled trial, 188 Latino preschoolers with SLI participated in a small-group academic enrichment program for 12 weeks and were followed up 3 and 5 months later. Children were randomly assigned to either a bilingual or an English-only program. Predictors of English growth included measures of Spanish language skills and English vocabulary, use, proficiency, and exposure. Performance on English outcomes (i.e., picture description and narrative sample) was assessed over time. A series of longitudinal models were tested via multilevel modeling with baseline and posttreatment measures nested within child. Results Children demonstrated growth on the English outcomes over time. The language of intervention, Spanish skills, English vocabulary, and English use significantly predicted differences in rates of growth across children for specific measures of English development. Conclusions This study underscores the role of the child’s first language skills, the child’s level of English vocabulary development, and level of English use for predicting differences in English acquisition in Latino preschoolers with SLI. These factors should be carefully considered in making clinical decisions. PMID:22230174

Adverse childhood experiences and suicide attempts among those with mental and substance use disorders.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Segal, Steven P

2017-07-01

Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions data, we examined the associations of ten types of adverse childhood experiences (ACEs) with (1) lifetime suicide attempts and (2) number and age of attempts among U.S. adults aged 18+. In a case-control design, suicide attempters (5.14% of the full sample) were matched with never attempters (matched sample N=3912) on nine mental and substance use disorders. ACE rates were higher among attempters (3.30 [SE=0.07]) than their matched controls (2.19 [SE=0.06]). Results from multivariable logistic regression analyses showed that sexual abuse and parental/other family member's mental illness were associated with increased odds of having attempted suicide among both genders, and emotional neglect was also a factor for men. Population attributable risk fractions for sexual abuse were 25.75% for women and 8.56% for men. Sexual abuse and a higher number of ACEs were also related to repeated suicide attempts. A higher number of ACEs was associated with a younger first attempt age. Gay/bisexual orientation in men and the lack of college education in both genders were significant covariates. In conclusion, this study underscores that ACEs are significantly associated with lifetime suicide attempts even when mental and substance use disorders are controlled. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictors of repeat visits to the emergency room by asthmatic children in primary care.

PubMed Central

Mohammed, Fawwaz; Bootoor, Sarita; Panday, Avidesh; Ramdass, Avinash; Reemaul, Jeanine; Sharma, Anu; Ivey, Marsha; Pinto Pereira, Lexley M.

2006-01-01

BACKGROUND: Subsets of asthmatic children, particularly in the Caribbean, burden the health system through repeated emergency room (ER) visits. We examined children to determine predictors of repeated ER visits in Trinidad. METHODS: Caregivers of 300 asthmatic children in primary healthcare in Trinidad reported on perceived factors of exacerbated wheeze requiring ER services. RESULTS: Prevalence of ER utilization in the past 12 months was 59.7% and 40.3% for repeated visits. Average age of wheezing onset was 2.8 (SD = 2.5) years. From the logistic regression analyses, independent predictors of repeat ER visits were mothers with a history of asthma (OR = 2.0, 95%Cl = 1.0-4.0), exposure to perfumes/odors (OR = 2.4, 95% Cl = 1.4-4.2), using inhaled corticosteroids (ICS) (OR = 2.2, 95% Cl = 1.2-4.0), and young age group (1-5 vs. 13-16 years) (OR = 2.7, 95% Cl = 1.1-6.4). More 1-5 year-olds (63.8%) and 6-12-year-olds (60.2%) wheezed in the dry and wet seasons, respectively (p = 0.04). Follow-up was poor (32.3%), and disease management did not include educational interventions. CONCLUSIONS: Repeated ER use in pediatric asthma underscores a pressing need for health providers and caregivers to develop an asthma management plan noting the identified predictors to assist in reducing Trinidad's asthma burden. PMID:16916125

hCG stimulates angiogenic signals in lymphatic endothelial and circulating angiogenic cells.

PubMed

Schanz, Andrea; Lukosz, Margarete; Hess, Alexandra P; Baston-Büst, Dunja M; Krüssel, Jan S; Heiss, Christian

2015-08-01

Human chorionic gonadotropin (hCG) has long been associated with the initiation and maintenance of pregnancy, where angiogenesis plays an important role. However, the function of hCG in angiogenesis and the recruitment of vascular active cells are not fully understood. In this study, the role of hCG and its receptor in circulating angiogenic and human endothelial cells, including lymphatic, uterine microvascular, and umbilical vein endothelial cells, was examined. Immunohistochemistry and immunoblot analysis were used to detect LH/hCG receptor expression and the expression of hCG-induced angiogenic molecules. HIF-1α was determined via ELISA and downstream molecules, such as CXCL12 and CXCR4, via real-time PCR. Chemotaxis was analyzed using Boyden chambers. Our results show that the LH/hCG receptor was present in all tested cells. Furthermore, hCG was able to stimulate LH/hCG-receptor-specific migration in a dose-dependent fashion and induce key angiogenic molecules, including HIF-1α, CXCL12, and CXCR4. In conclusion, our findings underscore the importance of hCG as one of the first angiogenic molecules produced by the conceptus. hCG itself alters endothelial motility, recruitment, and expression of pro-angiogenic molecules and may therefore play an important role in vascular adaption during implantation and early placental formation. Copyright © 2015. Published by Elsevier Ireland Ltd.

Cervical Fracture With Transient Tetraplegia in a Youth Football Player: Case Report and Review of the Literature

PubMed Central

Molinari, Robert; Molinari, William J

2010-01-01

Background/Objective: Serious cervical spinal injuries in organized youth football are rare. Cervical fracture with neurologic injury is rarely reported in organized youth football players with no pre-existing risk fractures for transient tetraplegia. Methods: Case report and literature review. Results: After being improperly tackled by an opponent of significantly larger body size, a player sustained a C7 posterior cervical fracture with transient tetraplegia. He was immobilized in a cervical collar and sent to a level 1 trauma center for evaluation. Initial examination showed bilateral paresthesia of the limbs with normal motor function (ASIA D). Initial radiographs of the cervical spine showed a displaced extension-compression fracture of the C7 spinous process. Magnetic resonance imaging of the cervical spine showed edema in the spinal cord in the region of the injury along with significant posterior injury. Imaging studies showed normal volumetric measurements of the spinal canal and no pre-existing risk factors for spinal stenosis or spinal cord injury. Radiographs showed that cervical fracture was healed at 9-month follow-up examination. At 1-year follow-up, the patient was asymptomatic. Radiographs showed healed fracture with no residual instability and full range of cervical spine motion on flexion–extension views. Conclusions: This case underscores the potential for serious cervical spinal injuries in organized youth sports when players are physically overmatched, and improper tackling technique is used. PMID:20486536

Aboriginal Street-involved Youth Experience Elevated Risk of Incarceration

PubMed Central

Barker, Brittany; Alfred, Gerald Taiaiake; Fleming, Kim; Nguyen, Paul; Wood, Evan; Kerr, Thomas; DeBeck, Kora

2015-01-01

Objectives Past research has identified risk factors associated with incarceration among adult Aboriginal populations; however, less is known about incarceration among street-involved Aboriginal youth. Therefore, we undertook this study to longitudinally investigate recent reports of incarceration among a prospective cohort of street-involved youth in Vancouver, Canada. Study Design Prospective cohort study. Methods Data were collected from a cohort of street-involved, drug-using youth from September 2005 to May 2013. Multivariate generalized estimating equation analyses were employed to examine the potential relationship between Aboriginal ancestry and recent incarceration. Results Among our sample of 1050 youth, 248 (24%) reported being of aboriginal ancestry, and 378 (36%) reported being incarcerated in the previous six months at some point during the study period. In multivariate analysis controlling for a range of potential confounders including drug use patterns and other risk factors, Aboriginal ancestry remained significantly associated with recent incarceration (adjusted odds ratio [AOR]=1.44; 95% confidence interval [CI]: 1.12–1.86). Conclusions Even after adjusting for drug use patterns and other risk factors associated with incarceration, this study found that Aboriginal street-involved youth were still significantly more likely to be incarcerated than their non-Aboriginal peers. Given the established harms associated with incarceration these findings underscore the pressing need for systematic reform including culturally appropriate interventions to prevent Aboriginal youth from becoming involved with the criminal justice system. PMID:26390949

Novel features of ARS selection in budding yeast Lachancea kluyveri

PubMed Central

2011-01-01

Background The characterization of DNA replication origins in yeast has shed much light on the mechanisms of initiation of DNA replication. However, very little is known about the evolution of origins or the evolution of mechanisms through which origins are recognized by the initiation machinery. This lack of understanding is largely due to the vast evolutionary distances between model organisms in which origins have been examined. Results In this study we have isolated and characterized autonomously replicating sequences (ARSs) in Lachancea kluyveri - a pre-whole genome duplication (WGD) budding yeast. Through a combination of experimental work and rigorous computational analysis, we show that L. kluyveri ARSs require a sequence that is similar but much longer than the ARS Consensus Sequence well defined in Saccharomyces cerevisiae. Moreover, compared with S. cerevisiae and K. lactis, the replication licensing machinery in L. kluyveri seems more tolerant to variations in the ARS sequence composition. It is able to initiate replication from almost all S. cerevisiae ARSs tested and most Kluyveromyces lactis ARSs. In contrast, only about half of the L. kluyveri ARSs function in S. cerevisiae and less than 10% function in K. lactis. Conclusions Our findings demonstrate a replication initiation system with novel features and underscore the functional diversity within the budding yeasts. Furthermore, we have developed new approaches for analyzing biologically functional DNA sequences with ill-defined motifs. PMID:22204614

Enculturation, Perceived Stress, and Physical Activity: Implications for Metabolic Risk among the Yup’ik – The Center for Alaska Native Health Research Study

PubMed Central

Bersamin, Andrea; Wolsko, Christopher; Luick, Bret; Boyer, Bert; Lardon, Cecile; Hopkins, Scarlett; Stern, Judith S.; Zidenberg-Cherr, Sheri

2013-01-01

Objectives American Indians and Alaska Natives report among the lowest levels of physical activity in the U.S, but there is very little systematic research examining the determinants of physical activity patterns in these populations. This study investigated the relationships between enculturation (or, cultural traditionality), psychosocial stress, and physical activity in a community-based sample of Yup’ik women and men living in rural Alaska Native communities. Associations between these variables and several metabolic risk factors were also examined. Design A sample of 488 Yup’ik participants (284 women and 204 men) from 6 villages in the Yukon-Kuskokwim Delta region completed a wellness survey and an array of physiological assessments (e.g., BMI, blood pressure). A subset of 179 participants also completed a 3-day pedometer assessment of physical activity. Results Multivariate linear regression models indicated that participants who were more enculturated (i.e. living more of a traditional lifestyle) and who experienced lower levels of psychosocial stress were significantly more physically active. In turn, lower levels of psychosocial stress and higher levels of physical activity were both associated with lower BMI, lower percent body fat, and lower waist circumference. Conclusions Findings underscore the importance of gaining a culturally-specific understanding of physical activity patterns in indigenous groups in order to inform effective health promotion strategies. PMID:23297688

Transactional Pathways of Transgender Identity Development in Transgender and Gender Nonconforming Youth and Caregivers from the Trans Youth Family Study

PubMed Central

Katz-Wise, Sabra L.; Budge, Stephanie L.; Fugate, Ellen; Flanagan, Kaleigh; Touloumtzis, Currie; Rood, Brian; Perez-Brumer, Amaya; Leibowitz, Scott

2017-01-01

Background A growing body of research has examined transgender identity development, but no studies have investigated developmental pathways as a transactional process between youth and caregivers, incorporating perspectives from multiple family members. The aim of this study was to conceptualize pathways of transgender identity development using narratives from both transgender and gender nonconforming (TGN) youth and their cisgender (non-transgender) caregivers. Methods The sample included 16 families, with 16 TGN youth, ages 7–18 years, and 29 cisgender caregivers (N = 45 family members). TGN youth represented multiple gender identities, including trans boy (n = 9), trans girl (n = 5), gender fluid boy (n = 1), and girlish boy (n = 1). Caregivers included mothers (n = 17), fathers (n = 11), and one grandmother. Participants were recruited from LGBTQ community organizations and support networks for families with transgender youth in the Midwest, Northeast, and South regions of the United States. Each family member completed a one-time in-person semi-structured qualitative interview that included questions about transgender identity development. Results Analyses revealed seven overarching themes of transgender identity development, which were organized into a conceptual model: Trans identity development, sociocultural influences/societal discourse, biological influences, family adjustment/impact, stigma/cisnormativity, support/resources, and gender affirmation/actualization. Conclusions Findings underscore the importance of assessing developmental processes among TGN youth as transactional, impacting both youth and their caregivers. PMID:29527139

Qualitative Inquiry into Premarital Sexual Behaviours and Contraceptive Use among Multiethnic Young Women: Implications for Education and Future Research

PubMed Central

Wong, Li Ping

2012-01-01

Background This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. Methods A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. Results The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. Conclusion This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs. PMID:23272156

Psychiatric Comorbidity in Depressed HIV-infected Individuals: Common and Clinically Consequential

PubMed Central

Gaynes, Bradley N.; O'Donnell, Julie; Nelson, Elise; Heine, Amy; Zinski, Anne; Edwards, Malaika; McGuinness, Teena; Riddhi, Modi A.; Montgomery, Charita; Pence, Brian W

2015-01-01

Objective To report on the prevalence of psychiatric comorbidity and its association with illness severity in depressed HIV patients. Methods As part of a multi-site randomized controlled trial of depression treatment for HIV patients, 304 participants meeting criteria for current Major Depressive Disorder (MDD) were assessed for other mood, anxiety and substance use disorders with the Mini-International Neuropsychiatric Interview, a structured psychiatric diagnostic interview. We also assessed baseline adherence, risk, and health measures. Results Complicated depressive illness was common. Only 18% of participants experienced MDD with no comorbid psychiatric diagnoses; 49% had comorbid dysthymia, 62% had ≥1 comorbid anxiety disorder, and 28% had a comorbid substance use disorder. Self-reported antiretroviral adherence did not differ by the presence of psychiatric comorbidity. However, psychiatric comorbidity was associated with worse physical health and functioning: compared to those with MDD alone, individuals with ≥1 comorbidity reported more HIV symptoms (5.1 vs. 4.1, p-value=0.01), and worse mental health-related quality of life on the SF-12 (29 vs. 35, p<0.01). Conclusion For HIV patients with MDD, chronic depression and psychiatric comorbidity are strikingly common, and this complexity is associated with greater HIV disease severity and worse quality of life. Appreciating this comorbidity can help clinicians better target those at risk of harder-to-treat HIV disease, and underscores the challenge of treating depression in this population. PMID:25892152

Antisocial Behavioral Syndromes and Three-Year Quality of Life Outcomes in United States Adults

PubMed Central

Goldstein, Risë B.; Dawson, Deborah A.; Smith, Sharon M.; Grant, Bridget F.

2013-01-01

Objective To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 (AABS, not a DSM-IV diagnosis), or no antisocial behavioral syndrome at baseline. Method Face-to-face interviews (n= 34,653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships. Results ASPD and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women. Conclusion Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes. PMID:22375904

IDENTIFYING COMPLEMENTARY AND ALTERNATIVE MEDICINE USAGE INFORMATION FROM INTERNET RESOURCES: A SYSTEMATIC REVIEW

PubMed Central

Sharma, V.; Holmes, J.H.; Sarkar, I.N.

2016-01-01

SUMMARY Objective Identify and highlight research issues and methods used in studying Complementary and Alternative Medicine (CAM) information needs, access, and exchange over the Internet. Methods A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines from PubMed to identify articles that have studied Internet use in the CAM context. Additional searches were conducted at Nature.com and Google Scholar. Results The Internet provides a major medium for attaining CAM information and can also serve as an avenue for conducting CAM related surveys. Based on the literature analyzed in this review, there seems to be significant interest in developing methodologies for identifying CAM treatments, including the analysis of search query data and social media platform discussions. Several studies have also underscored the challenges in developing approaches for identifying the reliability of CAM-related information on the Internet, which may not be supported with reliable sources. The overall findings of this review suggest that there are opportunities for developing approaches for making available accurate information and developing ways to restrict the spread and sale of potentially harmful CAM products and information. Conclusions Advances in Internet research are yet to be used in context of understanding CAM prevalence and perspectives. Such approaches may provide valuable insights into the current trends and needs in context of CAM use and spread. PMID:27352304

Library roles in disaster response: an oral history project by the National Library of Medicine*†

PubMed Central

Featherstone, Robin M.; Lyon, Becky J.; Ruffin, Angela B.

2008-01-01

Objectives: To develop a knowledgebase of stories illustrating the variety of roles that librarians can assume in emergency and disaster planning, preparedness, response, and recovery, the National Library of Medicine conducted an oral history project during the summer of 2007. The history aimed to describe clearly and compellingly the activities—both expected and unusual—that librarians performed during and in the aftermath of the disasters. While various types of libraries were included in interviews, the overall focus of the project was on elucidating roles for medical libraries. Methods: Using four broad questions as the basis for telephone and email interviews, the investigators recorded the stories of twenty-three North American librarians who responded to bombings and other acts of terrorism, earthquakes, epidemics, fires, floods, hurricanes, and tornados. Results: Through the process of conducting the oral history, an understanding of multiple roles for libraries in disaster response emerged. The roles fit into eight categories: institutional supporters, collection managers, information disseminators, internal planners, community supporters, government partners, educators and trainers, and information community builders. Conclusions: Librarians—particularly health sciences librarians—made significant contributions to preparedness and recovery activities surrounding recent disasters. Lessons learned from the oral history project increased understanding of and underscored the value of collaborative relationships between libraries and local, state, and federal disaster management agencies and organizations. PMID:18974811

Toxoplasma Serotype Is Associated With Development of Ocular Toxoplasmosis

PubMed Central

Shobab, Leila; Pleyer, Uwe; Johnsen, Joerdis; Metzner, Sylvia; James, Erick R.; Torun, N.; Fay, Michael P.; Liesenfeld, Oliver; Grigg, Michael E.

2013-01-01

Background. Worldwide, ocular toxoplasmosis (OT) is the principal cause of posterior uveitis, a severe, life-altering disease. A Toxoplasma gondii enzyme-linked immunoassay that detects strain-specific antibodies present in serum was used to correlate serotype with disease. Methods. Toxoplasma serotypes in consecutive serum samples from German uveitis patients with OT were compared with non-OT seropositive patients with noninfectious autoimmune posterior uveitis. OT patients were tested for association of parasite serotype with age, gender, location, clinical onset, size, visual acuity, or number of lesions (mean follow-up, 3.8 years) to determine association with recurrences. Results. A novel, nonreactive (NR) serotype was detected more frequently in serum samples of OT patients (50/114, 44%) than in non-OT patients (4/56, 7%) (odds ratio, 10.0; 95% confidence interval 3.4–40.8; P < .0001). Non-OT patients were predominantly infected with Type II strains (39/56; 70%), consistent with expected frequencies in Central Europe. Among OT patients, those with NR serotypes experienced more frequent recurrences (P = .037). Polymerase chain reaction detected parasite DNA in 8/60 OT aqueous humor specimens but failed to identify Type II strain alleles. Conclusions. Toxoplasma NR and Type II serotypes predominate in German OT patients. The NR serotype is associated with OT recurrences, underscoring the value of screening for management of disease. PMID:23878321

Biologic Activity of Porphyromonas endodontalis complex lipids

PubMed Central

Mirucki, Christopher S.; Abedi, Mehran; Jiang, Jin; Zhu, Qiang; Wang, Yu-Hsiung; Safavi, Kamran E.; Clark, Robert B.; Nichols, Frank C.

2014-01-01

Introduction Periapical infections secondary to pulpal necrosis are associated with bacterial contamination of the pulp. Porphyromonas endodontalis, a Gram-negative organism, is considered to be a pulpal pathogen. P. gingivalis is phylogenetically related to P. endodontalis and synthesizes several classes of novel complex lipids that possess biological activity, including the capacity to promote osteoclastogenesis and osteoclast activation. The purpose of this study was to extract and characterize constituent lipids of P. endodontalis, and evaluate their capacity to promote pro-inflammatory secretory responses in the macrophage cell line, RAW 264.7, as well as their capacity to promote osteoclastogenesis and inhibit osteoblast activity. Methods Constituent lipids of both organisms were fractionated by HPLC and were structurally characterized using electrospray-mass spectrometry (ESI-MS) or ESI-MS/MS. The virulence potential of P. endodontalis lipids was then compared with known biologically active lipids isolated from P. gingivalis. Results P. endodontalis total lipids were shown to promote TNF-α secretion from RAW 264.7 cells and the serine lipid fraction appeared to account for the majority of this effect. P. endodontalis lipid preparations also increased osteoclast formation from RAW 264.7 cells but osteoblast differentiation in culture was inhibited and appeared to be dependent on TLR2 expression. Conclusions These effects underscore the importance of P. endodontalis lipids in promoting inflammatory and bone cell activation processes that could lead to periapical pathology. PMID:25146013

Knowledge and use of prevention measures for chikungunya virus among visitors — Virgin Islands National Park, 2015

PubMed Central

Cherry, Cara C.; Beer, Karlyn D.; Fulton, Corey; Wong, David; Buttke, Danielle; Staples, J. Erin; Ellis, Esther M.

2016-01-01

Summary Background In June 2014, the mosquito-borne chikungunya virus (CHIKV) emerged in the U.S. Virgin Islands (USVI), a location where tourists comprise the majority of the population during peak season (January–April). Limited information is available concerning visitors’ CHIKV awareness and prevention measures. Methods We surveyed a convenience sample of Virgin Islands National Park visitors aged ≥18 years. Respondents completed a questionnaire assessing CHIKV knowledge, attitudes, and practices; health information-seeking practices; and demographics. Results Of 783 persons contacted, 443 (57%) completed the survey. Fewer than half (208/441 [47%]) were aware of CHIKV. During trip preparation, 28% of respondents (126/443) investigated USVI-specific health concerns. Compared with persons unaware of CHIKV, CHIKV-aware persons were more likely to apply insect repellent (134/207 [65%] versus 111/231 [48%]; p < 0.001), wear long-sleeves and long pants (84/203 [41%] versus 57/227 [25%]; p < 0.001), and wear insect repellent-treated clothing (36/204 [18%] versus 22/227 [10%]; p = 0.02). Conclusions The majority of visitors surveyed did not research destination-related health concerns and were unaware of CHIKV. However, CHIKV awareness was associated with using multiple prevention measures to reduce disease risk. These findings underscore the importance of providing tourists with disease education upon destination arrival. PMID:27597388

An Evaluation of the Cost-effectiveness of Policy Navigators to Improve Access to Care for the Poor in the Philippines

PubMed Central

Solon, Orville; Peabody, John W.; Woo, Kimberly; Quimbo, Stella A.; Florentino, Jhiedon; Shimkhada, Riti

2009-01-01

Objectives Even when health insurance coverage is available, health policies may not be effective at increasing coverage among vulnerable populations. New approaches are needed to improve access to care. We experimentally introduced a novel intervention that uses Policy Navigators to increase health insurance enrollment in a poor population. Methods We used data from the Quality Improvement Demonstration Study (QIDS), a randomized experiment taking place at the district level in the Visayas region of the Philippines. In two arms of the study, we compared the effects of introducing Policy Navigators to controls. The Policy Navigators advocated for improved access to care by providing regular system-level expertise directly to the policy-makers, municipal mayors and governors responsible for paying for and enrolling poor households into the health insurance program. Using regression models, we compared levels of enrollment in our intervention versus control sites. We also assessed the cost effectiveness of marginal increases in enrollment. Results We found that Policy Navigators improved enrollment in health insurance between 39 and 102% compared to the controls. Policy navigators were cost-effective at $0.86 USD per enrollee. However, supplementary national government campaigns, which were implemented to further increase coverage, attenuated normal enrollment efforts. Conclusion Policy Navigators appear to be effective in improving access to care and their success underscores the importance of local-level strategies for improving enrollment. PMID:19349090

An Outbreak of Wild Poliovirus in the Republic of Congo, 2010–2011

PubMed Central

Patel, Minal K.; Konde, Mandy Kader; Didi-Ngossaki, Boris Hermann; Ndinga, Edouard; Yogolelo, Riziki; Salla, Mbaye; Shaba, Keith; Everts, Johannes; Armstrong, Gregory L.; Daniels, Danni; Burns, Cara; Wassilak, Steve; Pallansch, Mark; Kretsinger, Katrina

2015-01-01

Background The Republic of Congo has had no cases of wild poliovirus type 1 (WPV1) since 2000. In October 2010, a neurologist noted an abnormal number of cases of acute flaccid paralysis (AFP) among adults, which were later confirmed to be caused by WPV1. Methods Those presenting with AFP underwent clinical history, physical examination, and clinical specimen collection to determine if they had polio. AFP cases were classified as laboratory-confirmed, clinical, or nonpolio AFP. Epidemiologic features of the outbreak were analyzed. Results From 19 September 2010 to 22 January 2011, 445 cases of WPV1 were reported in the Republic of Congo; 390 cases were from Pointe Noire. Overall, 331 cases were among adults; 378 cases were clinically confirmed, and 64 cases were laboratory confirmed. The case-fatality ratio (CFR) was 43%. Epidemiologic characteristics differed among polio cases reported in Pointe Noire and cases reported in the rest of the Republic of Congo, including age distribution and CFR. The outbreak stopped after multiple vaccination rounds with oral poliovirus vaccine, which targeted the entire population. Conclusions This outbreak underscores the need to maintain high vaccination coverage to prevent outbreaks, the need to maintain timely high-quality surveillance to rapidly identify and respond to any potential cases before an outbreak escalates, and the need to perform ongoing risk assessments of immunity gaps in polio-free countries. PMID:22911642

Surface catalysis of uranium(VI) reduction by iron(II)

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

Liger, E.; Charlet, L.; Van Cappellen, P.

1999-10-01

Colloidal hematite ({alpha}-Fe{sub 2}O{sub 3}) is used as model solid to investigate the kinetic effect of specific adsorption interactions on the chemical reduction of uranyl (U{sup VI}O{sub 2}{sup 2+}) by ferrous iron. Acid-base titrations and Fe(II) and uranyl adsorption experiments are performed on hematite suspensions, under O{sub 2}- and CO{sub 2}-free conditions. The results are explained in terms of a constant capacitance surface complexation model of the hematite-aqueous solution interface. Two distinct Fe(II) surface complexes are required to reproduce the data: ({equivalent{underscore}to}Fe{sup III}OFe{sup II}){sup +} (or {equivalent{underscore}to}Fe{sup III}OFe{sup II}(OH{sub 2}){sub n}{sup +}) and {equivalent{underscore}to}Fe{sup III}OFe{sup II}OH{sup 0} (or {equivalent{underscore}to}Fe{sup III}OFe{supmore » II}(OH{sub 2}){sub n{minus}1}OH{sup 0}). The latter complex represents a significant fraction of total adsorbed Fe(II) at pH {gt} 6.5. Uranyl binding to the hematite particles is characterized by a sharp adsorption edge between pH 4 and pH 5.5. Because of the absence of competing aqueous carbonate complexes, uranyl remains completely adsorbed at pH {gt} 7. A single mononuclear surface complex accounts for the adsorption of uranyl over the entire range of experimental conditions. Although thermodynamically feasible, no reaction between uranyl and Fe(II) is observed in homogeneous solution at pH 7.5, for periods of up to three days. In hematite suspensions, however, surface-bound uranyl reacts on a time scale of hours. Based on Fourier Transformed Infrared spectra, chemical reduction of U(VI) is inferred to be the mechanism responsible for the disappearance of uranyl. The kinetics of uranyl reduction are quantified by measuring the decrease with time of the concentration of U(VI) extractable from the hematite particles by NaHCO{sub 3}. In the presence of excess Fe(II), the initial rate of U(VI) reduction exhibits a first-order dependence on the concentration of adsorbed uranyl. The pseudo-first-order rate constant varies with pH (range, 6--7.5) and the total (dissolved + adsorbed) concentration of Fe(II) (range, 2--160 {micro}M). When analyzing the rate data in terms of the calculated surface speciation, the variability of the rate constant can be accounted for entirely by changes in the concentration of the Fe(II) monohydroxo surface complex {equivalent{underscore}to}Fe{sup III}OFe{sup II}OH{sup 0}. Therefore, the rate law is derived for the hematite-catalyzed reduction of uranyl by Fe(II), where the bimolecular rate constant {kappa} has a value of 399 {+-} 25 M{sup {minus}1} min{sup {minus}1} at 25 C. The hydroxo surface complex is the rate-controlling reductant species, because it provides the most favorable coordination environment in which electrons are removed from Fe(II). Natural particulate matter collected in the hypolimnion of a seasonally stratified lake also causes the rapid reduction of uranyl by Fe(II), Ferrihydrite, identified in the particulate matter by X-ray diffraction, is one possible mineral phase accelerating the reaction between U(VI) and Fe(II). At near-neutral pH and total Fe(II) levels less than 1 mM, the pseudo-first-order rate constants of chemical U(VI) reduction, measured in the presence of the hematite and lake particles, are of the same order of magnitude as the highest corresponding rate coefficients for enzymatic U(VI) reduction in bacterial cultures. Hence, based on the results of this study, surface-catalyzed U(VI) reduction by Fe(II) is expected to be a major pathway of uranium immobilization in a wide range of redox-stratified environments.« less

Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group.

PubMed

Barazzoni, R; Deutz, N E P; Biolo, G; Bischoff, S; Boirie, Y; Cederholm, T; Cuerda, C; Delzenne, N; Leon Sanz, M; Ljungqvist, O; Muscaritoli, M; Pichard, C; Preiser, J C; Sbraccia, P; Singer, P; Tappy, L; Thorens, B; Van Gossum, A; Vettor, R; Calder, P C

2017-04-01

Growing evidence underscores the important role of glycemic control in health and recovery from illness. Carbohydrate ingestion in the diet or administration in nutritional support is mandatory, but carbohydrate intake can adversely affect major body organs and tissues if resulting plasma glucose becomes too high, too low, or highly variable. Plasma glucose control is especially important for patients with conditions such as diabetes or metabolic stress resulting from critical illness or surgery. These patients are particularly in need of glycemic management to help lessen glycemic variability and its negative health consequences when nutritional support is administered. Here we report on recent findings and emerging trends in the field based on an ESPEN workshop held in Venice, Italy, 8-9 November 2015. Evidence was discussed on pathophysiology, clinical impact, and nutritional recommendations for carbohydrate utilization and management in nutritional support. The main conclusions were: a) excess glucose and fructose availability may exacerbate metabolic complications in skeletal muscle, adipose tissue, and liver and can result in negative clinical impact; b) low-glycemic index and high-fiber diets, including specialty products for nutritional support, may provide metabolic and clinical benefits in individuals with obesity, insulin resistance, and diabetes; c) in acute conditions such as surgery and critical illness, insulin resistance and elevated circulating glucose levels have a negative impact on patient outcomes and should be prevented through nutritional and/or pharmacological intervention. In such acute settings, efforts should be implemented towards defining optimal plasma glucose targets, avoiding excessive plasma glucose variability, and optimizing glucose control relative to nutritional support. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Risk of Salivary Gland Cancer After Childhood Cancer: A Report From the Childhood Cancer Survivor Study

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

Boukheris, Houda; Stovall, Marilyn; Gilbert, Ethel S.

Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 casesmore » of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.« less

Religion, Spirituality, and Physical Health in Cancer Patients: A Meta-Analysis

PubMed Central

Jim, Heather S.L.; Pustejovsky, James; Park, Crystal L.; Danhauer, Suzanne C.; Sherman, Allen C.; Fitchett, George; Merluzzi, Thomas V.; Munoz, Alexis R.; George, Login; Snyder, Mallory A.; Salsman, John M.

2015-01-01

Background Whereas religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, we conducted a meta-analysis of the relationship between R/S and patient-reported physical health in cancer patients. Methods A search of PubMed, PsycInfo, CINAHL, and Cochrane Library yielded 2,073 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 497 effect sizes from 101 unique samples encompassing over 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and ‘other’ dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher's z) were calculated using generalized estimating equations with robust variance estimation. Results Overall R/S was associated with overall physical health (z=.153, p<.001); this relationship was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z=.167, p<.001), functional well-being (z=.343, p<.001), and physical symptoms (z=.282, p<.001). Cognitive R/S was associated with physical well-being (z=.079, p<.05) and functional well-being (z=.090, p<.01). ‘Other’ R/S was associated with functional well-being (z=.100, p<.05). Conclusions Results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients’ religious and spiritual needs as part of comprehensive cancer care. PMID:26258868

Effect of hydroxychloroquine treatment on pro-inflammatory cytokines and disease activity in SLE patients: data from LUMINA (LXXV), a multiethnic US cohort

PubMed Central

Willis, R; Seif, AM; McGwin, G; Martinez-Martinez, LA; González, EB; Dang, N; Papalardo, E; Liu, J; Vilá, LM; Reveille, JD; Alarcón, GS; Pierangeli, SS

2013-01-01

Objective We sought to determine the effect of hydroxychloroquine therapy on the levels proinflammatory/prothrombotic markers and disease activity scores in patients with systemic lupus erythematosus (SLE) in a multiethnic, multi-center cohort (LUMINA). Methods Plasma/serum samples from SLE patients (n=35) were evaluated at baseline and after hydroxychloroquine treatment. Disease activity was assessed using SLAM-R scores. Interferon (IFN)-α2, interleukin (IL)-1β, IL-6, IL-8, inducible protein (IP)-10, monocyte chemotactic protein-1, tumor necrosis factor (TNF)-α and soluble CD40 ligand (sCD40L) levels were determined by a multiplex immunoassay. Anticardiolipin antibodies were evaluated using ELISA assays. Thirty-two frequency-matched plasma/serum samples from healthy donors were used as controls. Results Levels of IL-6, IP-10, sCD40L, IFN-α and TNF-α were significantly elevated in SLE patients versus controls. There was a positive but moderate correlation between SLAM-R scores at baseline and levels of IFN-α (p=0.0546). Hydroxychloroquine therapy resulted in a significant decrease in SLAM-R scores (p=0.0157), and the decrease in SLAM-R after hydroxychloroquine therapy strongly correlated with decreases in IFN-α (p=0.0087). Conclusions Hydroxychloroquine therapy resulted in significant clinical improvement in SLE patients, which strongly correlated with reductions in IFN-α levels. This indicates an important role for the inhibition of endogenous TLR activation in the action of hydroxychloroquine in SLE and provides additional evidence for the importance of type I interferons in the pathogenesis of SLE. This study underscores the use of hydroxychloroquine in the treatment of SLE. PMID:22343096

Differences in Insulin Resistance in Mexican and U.S. Pima Indians with Normal Glucose Tolerance

PubMed Central

Esparza-Romero, Julian; Valencia, Mauro E.; Martinez, Maria Elena; Ravussin, Eric; Schulz, Leslie O.; Bennett, Peter H.

2010-01-01

Context: Insulin resistance is a major risk factor for the development of type 2 diabetes in Pima Indians, a population with the highest prevalence of type 2 diabetes mellitus in the world. Their Mexican counterpart, living a traditional lifestyle in the mountains of Sonora, have at least 5 times less diabetes than the U.S. Pima Indians. Objective: We evaluated whether Mexican Pima Indians had lower insulin resistance than U.S. Pima Indians. Design and Patients: We compared fasting insulin and homeostasis model assessment for insulin resistance (HOMA-IR) in 194 Mexican Pima Indians (100 females, 94 males) and 449 U.S. Pima Indians (246 females, 203 males) with normal glucose tolerance from a cross-sectional study. Adjusted differences of log-transformed outcomes (fasting insulin and HOMA-IR) between groups were evaluated using multiple linear regression models and paired t test in a matched subset. Results: Unadjusted fasting insulin and HOMA-IR were much lower in the Mexican Pima Indians than in their U.S. counterparts. After adjusting by obesity, age, and sex, mean (95% confidence interval) for fasting insulin was 6.22 (5.34–7.24) vs. 13.56 μU/ml (12.27–14.97) and for HOMA-IR 1.40 (1.20–1.64) vs. 3.07 (2.77–3.40), respectively, for Mexican Pima and U.S. Pima Indians. Results were confirmed in subset matched for age, sex, and body fat. Conclusion: Our results indicate that Mexican Pima Indians have lower insulin resistance in comparison with their genetically related U.S. counterparts, even after controlling for differences in obesity, age, and sex. This finding underscores the importance of lifestyle factors as protecting factors against insulin resistance in individuals with a high propensity to develop diabetes. PMID:20668044

Disruption of Ah Receptor Signaling during Mouse Development Leads to Abnormal Cardiac Structure and Function in the Adult

PubMed Central

Carreira, Vinicius S.; Fan, Yunxia; Kurita, Hisaka; Wang, Qin; Ko, Chia-I; Naticchioni, Mindi; Jiang, Min; Koch, Sheryl; Zhang, Xiang; Biesiada, Jacek; Medvedovic, Mario; Xia, Ying; Rubinstein, Jack; Puga, Alvaro

2015-01-01

The Developmental Origins of Health and Disease (DOHaD) Theory proposes that the environment encountered during fetal life and infancy permanently shapes tissue physiology and homeostasis such that damage resulting from maternal stress, poor nutrition or exposure to environmental agents may be at the heart of adult onset disease. Interference with endogenous developmental functions of the aryl hydrocarbon receptor (AHR), either by gene ablation or by exposure in utero to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a potent AHR ligand, causes structural, molecular and functional cardiac abnormalities and altered heart physiology in mouse embryos. To test if embryonic effects progress into an adult phenotype, we investigated whether Ahr ablation or TCDD exposure in utero resulted in cardiac abnormalities in adult mice long after removal of the agent. Ten-months old adult Ahr -/- and in utero TCDD-exposed Ahr +/+ mice showed sexually dimorphic abnormal cardiovascular phenotypes characterized by echocardiographic findings of hypertrophy, ventricular dilation and increased heart weight, resting heart rate and systolic and mean blood pressure, and decreased exercise tolerance. Underlying these effects, genes in signaling networks related to cardiac hypertrophy and mitochondrial function were differentially expressed. Cardiac dysfunction in mouse embryos resulting from AHR signaling disruption seems to progress into abnormal cardiac structure and function that predispose adults to cardiac disease, but while embryonic dysfunction is equally robust in males and females, the adult abnormalities are more prevalent in females, with the highest severity in Ahr -/- females. The findings reported here underscore the conclusion that AHR signaling in the developing heart is one potential target of environmental factors associated with cardiovascular disease. PMID:26555816

Non-fatal work-related traumatic brain injuries treated in US hospital emergency departments, 1998–2007

PubMed Central

Konda, Srinivas; Reichard, Audrey; Tiesman, Hope M; Hendricks, Scott

2015-01-01

Purpose Little is known about work-related traumatic brain injuries (WRTBI). This study describes non-fatal WRTBIs treated in US emergency departments (ED) from 1998 through 2007. Methods Non-fatal WRTBIs were identified from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work) using the diagnoses of concussion, internal organ injury to the head and skull fracture. WRTBI rates and rate ratios were calculated, and the trend in rates was assessed. Results An estimated 586 600 (95% CI=±150 000) WRTBIs were reported during the 10-year period at a rate of 4.3 (CI=±1.1) per 10 000 full-time equivalent (FTE) workers (1 FTE=2000 h per year). From 1998 through 2007, the rate of WRTBIs increased at an average of 0.21 per 10 000 FTE per year (p<0.0001) and the rate of fall-related WRTBIs increased at an average of 0.10 per 10 000 FTE (p<0.0001). During the same period, the annual rate of WRTBIs resulting in hospitalisation increased 0.04 per 10 000 FTE (p<0.0001). Ten percent of WRTBIs were hospitalised, compared with hospitalisation of 2% all NEISS-Work injuries. Also, workers with highest fall-related TBI rates per 10 000 FTE were the youngest (2.4; CI=±1.4) and oldest (55 and older) workers (1.9; CI=±0.8). Conclusions Non-fatal WRTBIs are one of the most serious workplace injuries among ED-treated work-related injuries. Non-fatal WRTBIs are much more likely to result in hospitalisation compared with other types of injuries. The upward trend of WRTBI rates from 1998 through 2007 underscore the need for more directed effective prevention methods to reduce WRTBI injuries. PMID:25216672

Perspectives of health care professionals on cancer cachexia: results from three global surveys

PubMed Central

Muscaritoli, M.; Rossi Fanelli, F.; Molfino, A.

2016-01-01

Background Cachexia has a high prevalence in cancer patients and negatively impacts prognosis, quality of life (QOL), and tolerance/response to treatments. This study reports the results of three surveys designed to gain insights into cancer cachexia (CC) awareness, understanding, and treatment practices among health care professionals (HCPs). Methods Surveys were conducted globally among HCPs involved in CC management. Topics evaluated included definitions and synonyms of CC, diagnosis and treatment practices, and goals and desired improvements of CC treatment. Results In total, 742 HCPs from 14 different countries participated in the surveys. The majority (97%) of participants were medical oncologists or hematologists. CC was most frequently defined as weight loss (86%) and loss of appetite (46%). The terms loss of weight and decreased appetite (51% and 34%, respectively) were often provided as synonyms of CC. Almost half (46%) of the participants reported diagnosing CC and beginning treatment if a patient experienced a weight loss of 10%. However, 48% of the participants would wait until weight loss was ≥15% to diagnose CC and start treatment. HCPs also reported that 61%–77% of cancer patients do not receive any prescription medication for CC before Stage IV of disease is reached. Ability to promote weight gain was rated as the most important factor for selecting CC treatment. Key goals of treatment included ensuring that patients can cope with the cancer and treatment and have a QOL benefit. HCPs expressed desire for treatments with a more CC-specific mode of action and therapies that enhance QOL. Conclusions These surveys underscore the need for increased awareness among HCPs of CC and its management. PMID:28007753

Prevalence, awareness, treatment and control of dyslipidemia among adults in Northwestern China: the cardiovascular risk survey

PubMed Central

2014-01-01

Aim The aim of this study was to estimate the prevalence, awareness, treatment, and control of dyslipidemia in Xinjiang, China. Method Stratified sampling method was used to select a representative sample of the general population including Chinese Han, Uygur, and Kazak in this geographic area. Seven cities were chosen. Based on the government records of registered residences, one participant was randomly selected from each household. The eligibility criterion for the study was ≥ 35 years of age. Results A total of 14,618 participants (5,757 Han, 4,767 Uygur, and 4,094 Kazak), were randomly selected from 26 villages in 7 cities. The prevalence of dyslipidemia was 52.72% in the all participants. The prevalence of dyslipidemia was higher in Han than that in the other two ethnic (58.58% in Han, 48.27% in Uygur, and 49.60% in Kazak, P < 0.000). The prevalence of dyslipidemia was higher in men than that in women (56.4% vs. 49.3%, P < 0.000). Among the participants with dyslipidemia, the proportion of those who aware, treat, control of dyslipidemia were 53.67%, 22.51%, 17.09% in Han, 42.19%, 27.78%, 16.20% in Uygur, 37.02%, 21.11%, 17.77% in Kazak. Conclusion Dyslipidemia is highly prevalent in Xinjiang. The proportion of participants with dyslipidemia who were aware, treated, and controlled is unacceptably low. These results underscore the urgent need to develop national strategies to improve the prevention, detection, and treatment of dyslipidemia in Xinjiang. PMID:24393232

Stability of Geriatric Syndromes in Hospitalized Medicare Patients Discharged to Skilled Nursing Facilities

PubMed Central

Simmons, Sandra F.; Bell, Susan; Saraf, Avantika A.; Coelho, Chris Simon; Long, Emily A.; Jacobsen, J. Mary Lou; Schnelle, John F.; Vasilevskis, Eduard E.

2016-01-01

Objectives The purpose of this study was to assess multiple geriatric syndromes in a sample of older hospitalized patients discharged to skilled nursing facilities and, subsequently, to home to determine the prevalence and stability of each geriatric syndrome at the point of these care transitions. Design Descriptive, prospective study. Setting One large university-affiliated hospital and four area SNFs. Participants Fifty-eight hospitalized Medicare beneficiaries discharged to SNF. Measurements Research personnel conducted standardized assessments of the following geriatric syndromes at hospital discharge and two weeks following SNF discharge to home: cognitive impairment, depression, incontinence, unintentional weight loss, loss of appetite, pain, pressure ulcers, history of falls, mobility impairment and polypharmacy. Results The average number of geriatric syndromes per patient was 4.4 (± 1.2) at hospital discharge and 3.8 (±1.5) following SNF discharge. There was low to moderate stability for most syndromes. On average, participants had 2.9 syndromes that persisted across both care settings, 1.4 syndromes that resolved, and 0.7 new syndromes that developed between hospital and SNF discharge. Conclusion Geriatric syndromes were prevalent at the point of each care transition but also reflected significant within-individual variability. These findings suggest that multiple geriatric syndromes present during a hospital stay are not transient nor are most syndromes resolved prior to SNF discharge. These results underscore the importance of conducting standardized screening assessments at the point of each care transition and effectively communicating this information to the next provider to support the management of geriatric conditions. PMID:27590032

Neurotic Disorders of General Medical Outpatients in Xi’an, China: Knowledge, Attitudes, and Help-Seeking Preferences

PubMed Central

Ni, Chunping; Ma, Lihua; Wang, Bo; Yan, Yongping; Huang, Yueqin; Wallen, Gwenyth R.; Li, Lu; Lang, Hongjuan; Hua, Qianzhen

2014-01-01

Objective This study assessed knowledge of neurotic disorders, and attitudes and preferences toward professional help and treatment for them, among general medical outpatients in general hospitals in Xi’an, China. Methods General medical outpatients (N=372) from general hospitals in China were recruited by using a stratified cluster sampling method between June and September 2010. In face-to-face interviews, participants age 16 years or older were assessed for their knowledge, attitudes, and help-seeking preferences in regard to neurotic disorders (obsessive-compulsive disorder, social phobia, and panic disorder). Demographic data were also collected. Results Lack of insight into neurotic disorders was common among medical outpatients in general hospitals of Xi’an, China. Twenty-four percent to 58% of the outpatients had some knowledge of the symptoms and treatment of neurotic disorders. Only 11% of the outpatients would reveal to others that they or a family member suffered from neurotic disorders. When faced with the problem of neurotic disorders, the preference of the respondents was to visit a psychiatrist in a general hospital (44%), and only 17% would visit a physician in a psychiatric hospital. Major ways for the outpatients to obtain knowledge regarding neurotic disorders were via radio and television (36%), and only 18%223% of outpatients obtained knowledge about neurotic disorders through printed public health materials and by attending lectures. Conclusions Study results underscore the need for information campaigns aimed at improving the mental health literacy of general medical outpatients. Such campaigns must consider culturally relevant beliefs to facilitate the development of specific educational programs. PMID:24733481

Sleep-Wake Functioning Along the Cancer Continuum: Focus Group Results From the Patient-Reported Outcomes Measurement Information System (PROMIS™)

PubMed Central

Flynn, Kathryn E.; Shelby, Rebecca A.; Mitchell, Sandra A.; Fawzy, Maria R.; Hardy, N. Chantelle; Husain, Aatif M.; Keefe, Francis J.; Krystal, Andrew D.; Porter, Laura S.; Reeve, Bryce B.; Weinfurt, Kevin P.

2009-01-01

Objective Cancer and its treatments disturb sleep-wake functioning; however, there is little information available on the characteristics and consequences of sleep problems associated with cancer. As part of an effort to improve measurement of sleep-wake functioning, we explored the scope of difficulties with sleep in a diverse group of patients diagnosed with cancer. Methods We conducted 10 focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics. Separate groups were held with patients scheduled to begin or currently undergoing treatment for breast, prostate, lung, colorectal, hematological, and other cancer types and with patients who were in posttreatment follow-up. The content of the focus group discussions was transcribed and analyzed for major themes by independent coders. Results Participants reported causes of sleep disturbance common in other populations, such as pain and restless legs, but they also reported causes that may be unique to cancer populations, including abnormal dreams, anxiety about cancer diagnosis and recurrence, night sweats, and problems with sleep positioning. Many participants felt that sleep problems reduced their productivity, concentration, social interactions, and overall quality of life. Many also shared beliefs about the increased importance of sleep when fighting cancer. Conclusions The findings underscore the need for interventions that minimize the negative impact of cancer and its treatments on sleep. This study will inform efforts now underway to develop a patient-reported measure of sleep-wake functioning that reflects the breadth of concepts considered important by patients with cancer. PMID:20013938

Effects of Buprenorphine and Hepatitis C on Liver Enzymes in Adolescents and Young Adults

PubMed Central

Bogenschutz, Michael P.; Abbott, Patrick J.; Kushner, Robert; Tonigan, J. Scott; Woody, George E.

2010-01-01

Objective The purpose of this study was to explore changes in transaminase values associated with buprenorphine treatment and hepatitis C status among opioid dependent subjects aged 15–21. Methods 152 subjects seeking treatment for opioid dependence were randomized to 2-week detoxification with buprenorphine/naloxone (DETOX) or 12 weeks buprenorphine/naloxone (BUP). Liver chemistries including transaminases were obtained baseline and at 4, 8, and 12 weeks. 111 patients had at least one set of transaminases during treatment and were included in analyses of treatment effects. Results Overall, 8/60 BUP participants vs. 12/51 DETOX participants had at least one elevated ALT value during follow-up (Chi-square n.s.). 5/60 BUP participants vs. 11/51 DETOX participants had at least one elevated AST value (Chi-square = 3.194, p = .048). Twenty-eight out of 152 participants were hepatitis C (HCV) positive at baseline, and 4 seroconverted within 12 weeks, 2 in each group. HCV status was significantly associated with transaminase abnormalities (p = .009 and p = .006 for ALT an AST, respectively). HCV status had a strong effect on transaminase abnormalities among participants assigned to DETOX, but not among those assigned to BUP. Conclusions No evidence was found for hepatotoxicity of buprenorphine in this exploratory analysis. HCV was present in a significant minority of participants and was a significant predictor of transaminase elevation. Results suggest that stabilization on buprenorphine may decrease the frequency of transaminase abnormalities associated with HCV in opioid dependent young people. The high rate of seroconversion underscores the importance of effective treatment and prevention. PMID:21170166

Correlating Cognitive Decline with White Matter Lesion and Brain Atrophy MRI Measurements in Alzheimer’s Disease

PubMed Central

Bilello, Michel; Doshi, Jimit; Nabavizadeh, S. Ali; Toledo, Jon B.; Erus, Guray; Xie, Sharon X.; Trojanowski, John Q.; Han, Xiaoyan; Davatzikos, Christos

2015-01-01

Background Vascular risk factors are increasingly recognized as risks factors for Alzheimer’s disease (AD) and early conversion from mild cognitive impairment (MCI) to dementia. While neuroimaging research in AD has focused on brain atrophy, metabolic function or amyloid deposition, little attention has been paid to the effect of cerebrovascular disease to cognitive decline. Objective To investigate the correlation of brain atrophy and white matter lesions with cognitive decline in AD, MCI, and control subjects. Methods Patients with AD and MCI, and healthy subjects were included in this study. Subjects had a baseline MRI scan, and baseline and follow-up neuropsychological battery (CERAD). Regional volumes were measured, and white matter lesion segmentation was performed. Correlations between rate of CERAD score decline and white matter lesion load and brain structure volume were evaluated. In addition, voxel-based correlations between baseline CERAD scores and atrophy and white matter lesion measures were computed. Results CERAD rate of decline was most significantly associated with lesion loads located in the fornices. Several temporal lobe ROI volumes were significantly associated with CERAD decline. Voxel-based analysis demonstrated strong correlation between baseline CERAD scores and atrophy measures in the anterior temporal lobes. Correlation of baseline CERAD scores with white matter lesion volumes achieved significance in multilobar subcortical white matter. Conclusion Both baseline and declines in CERAD scores correlate with white matter lesion load and gray matter atrophy. Results of this study highlight the dominant effect of volume loss, and underscore the importance of small vessel disease as a contributor to cognitive decline in the elderly. PMID:26402108

Katrina's Legacy: Processes for Patient Disaster Preparation have Improved but Important Gaps Remain

PubMed Central

Icenogle, Marjorie; Eastburn, Sasha; Arrieta, Martha

2016-01-01

Background Ensuring continuity of care for the chronically ill, who are elderly or indigent presents unique challenges after disasters; this population has fewer financial resources, is less likely to evacuate, has limited access to recovery resources, and is significantly dependent on charitable and government-funded institutions for care. This study expands a previous investigation of the extent to which healthcare providers in coastal Mississippi and Alabama have made changes to facilitate continued care to these populations after disasters. Methods Key informants representing healthcare and social services organizations serving health disparate residents of the Mississippi and Alabama Gulf Coast were interviewed regarding disaster preparation planning for the period 2009-2012. Interview transcripts were qualitatively coded and analyzed for emerging themes using Atlas.ti® software. Results Participant organizations have implemented changes to ensure continuity of care for the chronically ill in case of disasters. Changes include patient assistance with pre-disaster preparation and training; evacuation planning and assistance; support to find resources in evacuation destinations; equipping patients with prescription information, diagnoses, treatment plans, and advance medications when a disaster is imminent; multiple methods for patients to communicate with providers; and more mandated medical needs shelters. Patients whose chronic conditions were diagnosed post-Katrina are more likely to underestimate the need to prepare. Further, patients' lack of compliance tends to increase as time passes from disasters. Conclusions Although changes were implemented, results indicate these may be inadequate to completely address patient needs. Thus, additional efforts may be needed, underscoring the complexity of adequate disaster preparation among disparate populations. PMID:27865292

Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units

PubMed Central

da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

2015-01-01

Objective To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. Methods This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. Results The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Conclusion Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome. PMID:26340152

Alcohol binding in the C1 (C1A + C1B) domain of protein kinase C epsilon

PubMed Central

Pany, Satyabrata; Das, Joydip

2015-01-01

Background Alcohol regulates the expression and function of protein kinase C epsilon (PKCε). In a previous study we identified an alcohol binding site in the C1B, one of the twin C1 subdomains of PKCε. Methods In this study, we investigated alcohol binding in the entire C1 domain (combined C1A and C1B) of PKCε. Fluorescent phorbol ester, SAPD and fluorescent diacylglycerol (DAG) analog, dansyl-DAG were used to study the effect of ethanol, butanol, and octanol on the ligand binding using fluorescence resonance energy transfer (FRET). To identify alcohol binding site(s), PKCεC1 was photolabeled with 3-azibutanol and 3-azioctanol, and analyzed by mass spectrometry. The effects of alcohols and the azialcohols on PKCε were studied in NG108-15 cells. Results In the presence of alcohol, SAPD and dansyl-DAG showed different extent of FRET, indicating differential effects of alcohol on the C1A and C1B subdomains. Effects of alcohols and azialcohols on PKCε in NG108-15 cells were comparable. Azialcohols labeled Tyr-176 of C1A and Tyr-250 of C1B. Inspection of the model structure of PKCεC1 reveals that these residues are 40 Å apart from each other indicating that these residues form two different alcohol binding sites. Conclusions The present results provide evidence for the presence of multiple alcohol-binding sites on PKCε and underscore the importance of targeting this PKC isoform in developing alcohol antagonists. PMID:26210390

Histopathologic and Immunohistochemical Sequelae of Bariatric Embolization in a Porcine Model

PubMed Central

Paxton, Ben E.; Alley, Christopher L.; Crow, Jennifer H.; Burchette, James; Weiss, Clifford R.; Kraitchman, Dara L.; Arepally, Aravind; Kim, Charles Y.

2014-01-01

Purpose To evaluate the histopathologic sequelae of bariatric embolization on the gastric mucosa and to correlate with immunohistochemical evaluation of the gastric fundus, antrum, and duodenum. Materials and Methods This study was performed on 12 swine stomach and duodenum specimens after necropsy. Of the 12 swine, 6 had previously undergone bariatric embolization of the gastric fundus, and the 6 control swine had undergone a sham procedure with saline. Gross pathologic, histopathologic, and immunohistochemical examinations of the stomach and duodenum were performed. Specifically, mucosal integrity, fibrosis, ghrelin-expressing cells, and gastrin-expressing cells were assessed. Results Gross and histopathologic evaluation of treatment animals showed healing or healed mucosal ulcers in 50% of animals, with gastritis in 100% of treatment animals and in five of six control animals. The ghrelin-immunoreactive mean cell density was significantly lower in the gastric fundus in the treated animals compared with control animals (15.3 vs 22.0, P < .01) but similar in the gastric antrum (9.3 vs 14.3, P = .08) and duodenum (8.5 vs 8.6, P = .89). The gastrin-expressing cell density was significantly lower in the antrum of treated animals compared with control animals (82.2 vs 126.4, P = .03). A trend toward increased fibrosis was suggested in the gastric fundus of treated animals compared with controls (P = .07). Conclusions Bariatric embolization resulted in a significant reduction in ghrelin-expressing cells in the gastric fundus without evidence of upregulation of ghrelin-expressing cells in the duodenum. Healing ulcerations in half of treated animals underscores the need for additional refinement of this procedure. PMID:24462005

Health-related quality of life across the anxiety disorders

PubMed Central

Comer, Jonathan S.; Blanco, Carlos; Hasin, Deborah S.; Liu, Shang-Min; Grant, Bridget F.; Turner, J. Blake; Olfson, Mark

2009-01-01

Objective Although clinical studies have documented that specific anxiety disorders are associated with impaired psychosocial functioning, little is known regarding their comparative effects on health-related quality of life within a general population. The current analysis compares health-related quality of life in a U.S. community-dwelling sample of adults with DSM-IV social anxiety disorder (SAD), generalized anxiety disorders (GAD), panic disorder (PD), and specific phobia (SP). Method Face-to-face survey of a U.S. nationally representative sample of over 43,000 adults aged 18 years and older residing in households and group quarters. Prevalence of DSM-IV anxiety disorders and relative associations with health-related quality of life indicators were examined. Results Roughly 9.8% of respondents met diagnostic criteria for at least one 12-month DSM-IV anxiety disorder which, relative to the non-anxiety-disordered general population, were each associated with lower personal income, increased rates of 12-month physical conditions, and greater numbers of Axis I and Axis II DSM-IV psychiatric conditions. After adjusting for socio-demographic and clinical correlates including other anxiety disorders, GAD was associated with significant decrements in the SF-12 Mental Component Summary score. In similar models, GAD and to a lesser extent PD were significantly associated with impairment in social functioning, role emotional, and mental health SF subscales. Conclusion GAD, followed by PD, appears to exact significant and independent tolls on health-related quality of life. Results underscore the importance of prompt and accurate clinical identification and improving access to effective interventions for these disorders. PMID:20816036

Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil

PubMed Central

Bourroul, Maria Lúcia Moraes; Fink, Günther; Grisi, Sandra; Scoleze Ferrer, Ana Paula; Diniz, Edna Maria de Albuquerque; Brentani, Alexandra

2017-01-01

Background Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. Methods We used data from the Brazilian Ministry of Health’s repository on births, fetal, and neonatal deaths (2010–2014) to calculate stillbirth and neonatal mortality rates for São Paulo state’s 645 municipalities. Results At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. Conclusions This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth. PMID:29272295

Acculturative stress negatively impacts maternal depressive symptoms in Mexican-American women during pregnancy

PubMed Central

D’Anna-Hernandez, Kimberly L.; Aleman, Brenda; Flores, Ana-Mercedes

2015-01-01

Background Mexican-American women exhibit high rates of prenatal maternal depressive symptoms relative to the general population. Though pregnant acculturated Mexican-American women experience cultural stressors such as acculturation, acculturative stress and discrimination that may contribute to elevated depressive symptoms, the contribution of these socio-cultural correlates to depressive symptomology is unknown. Method Ninety-eight pregnant women of Mexican descent were recruited from a community hospital clinic during their first trimester. Women completed surveys about acculturation, acculturative stress, perceived discrimination, general perceived stress, and maternal depressive symptoms as well as the potential protective factor of Mexican cultural values. Results Women who experienced greater acculturative and perceived stress, but not perceived discrimination or acculturation, reported significantly elevated depressive symptoms during pregnancy. Also, women who experienced greater acculturative stress identified with a mixture of Mexican and American cultural values. However, only the Mexican cultural value of respect was protective against maternal depressive symptoms while adhering to the Anglo value of independence and self-reliance was a risk factor. Limitations A limitation in the study is the cross-sectional and descriptive self-report nature of the work, underscoring the need for additional research. Moreover, physiological measures of stress were not analyzed in the current study. Conclusions Results point to acculturative stress, above other cultural stressors, as a potential intervention target in culturally competent obstetric care. These findings have implications for maternal mental health treatment during pregnancy, which likely affects maternal-fetal programming and may favorably affect perinatal outcomes in the vulnerable Mexican-American population. PMID:25699668

‘Never testing for HIV’ among Men who have Sex with Men in Viet Nam: results from an internet-based cross-sectional survey

PubMed Central

2013-01-01

Background Men who have sex with men in Viet Nam have been under-studied as a high-risk group for HIV infection, and this population’s percentage and determinants of HIV testing have not been comprehensively investigated. Methods A national Internet-based survey of self-reported sexual and health seeking behaviours was conducted between August and October 2011 with 2077 Vietnamese men who had sex with men in the last twelve months to identify the frequency of ‘never testing for HIV’ among Internet-using MSM living in Viet Nam, as well as the factors associated with this HIV-related high-rish behavior. Logistic regression analyses were conducted to assess the demographic characteristics and behaviours predicting never testing for HIV. Results A total of 76.5% of men who have sex with men who were surveyed reported never having been voluntarily tested for HIV. Predictors of never being tested included having a monthly income less than VND 5 Million, being a student, using the Internet less than 15 hour per week, and not participating in a behavioural HIV intervention. Conclusions Never testing for HIV is common among Internet-using men who have sex with men in Viet Nam. Given the dangerously high prevalence of this high-risk behaviour, our findings underscore the urgent need for segmented and targeted HIV prevention, care and treatment strategies, focusing on drastically reducing the number of men who have sex with men never testing for HIV in Viet Nam. PMID:24373483

Redressing the Epidemics of Opioid Overdose and HIV among People who Inject Drugs in Central Asia: The Need for a Syndemic Approach

PubMed Central

Gilbert, Louisa; Primbetova, Sholpan; Nikitin, Danil; Hunt, Timothy; Terlikbayeva, Assel; Momenghalibaf, Azzi; Ruziev, Murodali; El-Bassel, Nabila

2013-01-01

Background Accumulating evidence suggests that opioid overdose and HIV infection are burgeoning intertwined epidemics among people who inject drugs (PWID) in Central Asia. To date, however, research on overdose and its associations with HIV risks among PWID in Central Asia remains virtually absent. This paper aims to provide a regional overview of the hidden epidemic of overdose and how it is linked to HIV among PWID in Central Asia, using a syndemic framework that is guided by risk environment research. Methods We conducted a comprehensive literature search of peer-reviewed publications and grey literature on opioid overdose and its associations with HIV in five countries of Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) as well as on policies and programs that address these co-occurring epidemics. Results Regional data indicate high rates of fatal and non-fatal overdose among PWID. Evidence suggests mortality rates from overdose exceed HIV/AIDS as the leading cause of death among PWID. The syndemic framework suggests multiple macro-level and micro-level environmental risk factors that drive the co-occurring epidemics of HIV and overdose. This framework identifies several interacting biological and behavioral risks that result in additive effects for HIV and overdose. Conclusion The high rates of overdose and its associations with HIV underscore the need for a syndemic approach that considers overdose on parity with HIV. Such an approach should focus on the biological, behavioral and structural interactions between these epidemics to reduce social suffering, morbidity and mortality among PWID in Central Asia. PMID:23954070

The Nature and Extent of Flavored Alcoholic Beverage Consumption among Underage Youth: Results of a National Brand-specific Survey

PubMed Central

Giga, Noreen M.; Binakonsky, Jane; Ross, Craig; Siegel, Michael

2011-01-01

Background Flavored alcoholic beverages are popular among underage drinkers. Existing studies that assessed flavored alcoholic beverage use among youth relied upon respondents to correctly classify the beverages they consume, without defining what alcohol brands belong to this category. Objectives To demonstrate a new method for analyzing the consumption of flavored alcoholic beverages among youth on a brand-specific basis, without relying upon youth to correctly classify brands they consume. Methods Using a pre-recruited internet panel developed by Knowledge Networks, we measured the brands of alcohol consumed by a national sample of youth drinkers, ages 16-20 years, in the United States. The sample consisted of 108 youths who had consumed at least one drink of an alcoholic beverage in the past 30 days. We measured the brand-specific consumption of alcoholic beverages within the past 30 days, ascertaining the consumption of 380 alcohol brands, including 14 brands of flavored alcoholic beverages. Results Measuring the brand-specific consumption of flavored alcoholic beverages was feasible. Based on a brand-specific identification of flavored alcoholic beverages, nearly half of youth drinkers in the sample reported having consumed such beverages in the past 30 days. Flavored alcoholic beverage preference was concentrated among the top four brands, which accounted for nearly all of the consumption volume reported in our study. Conclusions and Scientific Significance These findings underscore the need to assess youth alcohol consumption at the brand level and the potential value of such data in better understanding underage youth drinking behavior and the factors that influence it. PMID:21517708

Elevated Glucose Oxidation, Reduced Insulin Secretion, and a Fatty Heart May Be Protective Adaptions in Ischemic CAD

PubMed Central

Hannukainen, J. C.; Lautamäki, R.; Mari, A.; Pärkkä, J. P.; Bucci, M.; Guzzardi, M. A.; Kajander, S.; Tuokkola, T.; Knuuti, J.

2016-01-01

Background: Insulin resistance, β-cell dysfunction, and ectopic fat deposition have been implicated in the pathogenesis of coronary artery disease (CAD) and type 2 diabetes, which is common in CAD patients. We investigated whether CAD is an independent predictor of these metabolic abnormalities and whether this interaction is influenced by superimposed myocardial ischemia. Methods and Results: We studied CAD patients with (n = 8) and without (n = 14) myocardial ischemia and eight non-CAD controls. Insulin sensitivity and secretion and substrate oxidation were measured during fasting and oral glucose tolerance testing. We used magnetic resonance imaging/spectroscopy, positron emission and computerized tomography to characterize CAD, cardiac function, pericardial and abdominal adipose tissue, and myocardial, liver, and pancreatic triglyceride contents. Ischemic CAD was characterized by elevated oxidative glucose metabolism and a proportional decline in β-cell insulin secretion and reduction in lipid oxidation. Cardiac function was preserved in CAD groups, whereas cardiac fat depots were elevated in ischemic CAD compared to non-CAD subjects. Liver and pancreatic fat contents were similar in all groups and related with surrounding adipose masses or systemic insulin sensitivity. Conclusions: In ischemic CAD patients, glucose oxidation is enhanced and correlates inversely with insulin secretion. This can be seen as a mechanism to prevent glucose lowering because glucose is required in oxygen-deprived tissues. On the other hand, the accumulation of cardiac triglycerides may be a physiological adaptation to the limited fatty acid oxidative capacity. Our results underscore the urgent need of clinical trials that define the optimal/safest glycemic range in situations of myocardial ischemia. PMID:27045985

Cognitive and Family Correlates of Current Suicidal Ideation in Children with Bipolar Disorder

PubMed Central

Weinstein, Sally M.; Van Meter, Anna; Katz, Andrea C.; Peters, Amy T.; West, Amy E.

2014-01-01

Background Suicidality among youth with bipolar disorder is an extreme, but largely unaddressed, public health problem. The current study examined the psychosocial characteristics differentiating youth with varying severities of suicidal ideation that may dictate targets for suicide prevention interventions. Methods Participants included 72 youth aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or NOS and a parent/caregiver. Current suicidal ideation and correlates were assessed at intake, including: demographics and clinical factors (diagnosis, symptom severity, psychiatric comorbidity); child factors (cognitive risk and quality of life); and family factors (parenting stress, family cohesion, and family rigidity). Results Current ideation was prevalent in this young sample: 41% endorsed any ideation, and 31% endorsed active forms. Depression symptoms, quality of life, hopelessness, self-esteem, and family rigidity differentiated youth with increasing ideation severity. Separate logistic regressions examined all significant child- and family-level factors, controlling for demographic and clinical variables. Greater family rigidity and lower self-esteem remained significant predictors of current planful ideation. Diagnosis, index episode, comorbidity, and mania severity did not differentiate non-ideators from those with current ideation. Limitations Limitations include the small sample to examine low base-rate severe ideation, cross-sectional analyses and generalizability of findings beyond the outpatient clinical sample. Conclusions Findings underscore the importance of assessing and addressing suicidality in preadolescent youth with bipolar disorder, before youth progress to more severe suicidal behaviors. Results also highlight child self-esteem and family rigidity as key treatment targets to reduce suicide risk in pediatric bipolar disorder. PMID:25462390

Life satisfaction and health related quality of life among low-income medical patients: the mediating influence of self-esteem.

PubMed

Cox, Jared; Loughran, Mary Jo; Adams, Eve M; Navarro, Rachel L

2012-01-01

This study investigated the relationship between life satisfaction, self-esteem, and perceived health for an ethnically diverse, low SES sample of primary care patients. Results indicated that several specific domains of health-related quality of life (HRQL), including health perception, social functioning, mental health, and energy/fatigue, significantly predicted life satisfaction in this sample of 60 patients. Self-esteem mediated this relationship, partially with health perception and fully with the remaining three domains. The results of this study underscore the importance of healthcare interventions that consider the bidirectional relationship between physical and emotional well-being.

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

DeTuri, V.F.; Ervin, K.M.

Energy-resolved competitive collision-induced dissociation methods are used to measure the gas-phase acidities of a series of alcohols (methanol, ethanol, 2-propanol, and 2-methyl-2-propanol). The competitive dissociation reactions of fluoride-alcohol, [F{sup {minus}}{center{underscore}dot}HOR], alkoxide-water, [RO{sup {minus}}{center{underscore}dot}HOH], and alkoxide-methanol [RO{+-}{center{underscore}dot}HOCH{sub 3}] proton-bound complexes are studied using a guided ion beam tandem mass spectrometer. The reaction cross sections and product branching fractions to the two proton transfer channels are measured as a function of collision energy. The enthalpy difference between the two product channels is found by modeling the reaction cross sections near threshold using RRKM theory to account for the energy-dependent product branching ratiomore » and kinetic shift. From the enthalpy difference, the alcohol gas-phase acidities are determined relative to the well-known values of HF and H{sub 2}O. The measured gas-phase acidities are {Delta}{sub acid}H{sub 298}(CH{sub 3}OH) = 1599 {+-} 3 kJ/mol, {Delta}{sub acid}H{sub 298}(CH{sub 3}CH{sub 2}OH) = 1586 {+-} 5 kJ/mol, {Delta}{sub acid}H{sub 298}((CH{sub 3}){sub 2}CHOH) = 1576 {+-} 4 kJ/mol, and {Delta}{sub acid}H{sub 298}((CH{sub 3}){sub 3}COH) = 1573 {+-} 3 kJ/mol.« less

The utility of assessing musical preference before implementation of noncontingent music to reduce vocal stereotypy.

PubMed

Lanovaz, Marc J; Rapp, John T; Ferguson, Stéphanie

2012-01-01

We conducted a modified paired-choice preference assessment and used a multielement design to examine the effects of noncontingent access to high- and low-preference music on vocal stereotypy exhibited by children with autism. For 3 of the 4 participants, high-preference music (a) produced lower levels of vocal stereotypy than low-preference music and (b) reduced vocal stereotypy when compared to a no-interaction condition. Results underscore the potential importance of assessing musical preference prior to using noncontingent music to reduce vocal stereotypy.

Genetic and environmental origins of health anxiety: a twin study

PubMed Central

TAYLOR, STEVEN; THORDARSON, DANA S; JANG, KERRY L; ASMUNDSON, GORDON J.G

2006-01-01

Excessive health anxiety - which is anxiety about one's health that is disproportionate to the person's medical status - is a common and often debilitating problem. Little is known about its etiology. The present study investigated the role of genetic and environmental factors using a classic twin study method. Results indicated that, after controlling for medical morbidity, environmental influences accounted for most of individual differences in health anxiety. These findings underscore the importance of psychosocial interventions, which have been shown to be among the most effective interventions for excessive health anxiety. PMID:16757996

Imaging-guided preclinical trials of vascular targeting in prostate cancer

NASA Astrophysics Data System (ADS)

Kalmuk, James

Purpose: Prostate cancer is the most common non-cutaneous malignancy in American men and is characterized by dependence on androgens (Testosterone/Dihydrotestosterone) for growth and survival. Although reduction of serum testosterone levels by surgical or chemical castration transiently inhibits neoplastic growth, tumor adaptation to castrate levels of androgens results in the generation of castration-resistant prostate cancer (CRPC). Progression to CRPC following androgen deprivation therapy (ADT) has been associated with changes in vascular morphology and increased angiogenesis. Based on this knowledge, we hypothesized that targeting tumor vasculature in combination with ADT would result in enhanced therapeutic efficacy against prostate cancer. Methods: To test this hypothesis, we examined the therapeutic activity of a tumor-vascular disrupting agent (tumor-VDA), EPC2407 (Crolibulin(TM)), alone and in combination with ADT in a murine model of prostate cancer (Myc-CaP). A non-invasive multimodality imaging approach based on magnetic resonance imaging (MRI), bioluminescence imaging (BLI), and ultrasound (US) was utilized to characterize tumor response to therapy and to guide preclinical trial design. Imaging results were correlated with histopathologic (H&E) and immunohistochemical (CD31) assessment as well as tumor growth inhibition and survival analyses. Results: Our imaging techniques were able to capture an acute reduction (within 24 hours) in tumor perfusion following castration and VDA monotherapy. BLI revealed onset of recurrent disease 5-7 days post castration prior to visible tumor regrowth suggestive of vascular recovery. Administration of VDA beginning 1 week post castration for 3 weeks resulted in sustained vascular suppression, inhibition of tumor regrowth, and conferred a more pronounced survival benefit compared to either monotherapy. Conclusion: The high mortality rate associated with CRPC underscores the need for investigating novel treatment strategies for this patient population. The results of our preclinical studies demonstrated the therapeutic potential of vascular targeting in combination with ADT against prostate cancer as well as highlight the capability of imaging to guide study design. Further investigation into the utility of VDAs in combination with ADT in prostate cancer is warranted.

Results of continuous monitoring of the performance of rubella virus IgG and hepatitis B virus surface antibody assays using trueness controls in a multicenter trial.

PubMed

Kruk, Tamara; Ratnam, Sam; Preiksaitis, Jutta; Lau, Allan; Hatchette, Todd; Horsman, Greg; Van Caeseele, Paul; Timmons, Brian; Tipples, Graham

2012-10-01

We conducted a multicenter trial in Canada to assess the value of using trueness controls (TC) for rubella virus IgG and hepatitis B virus surface antibody (anti-HBs) serology to determine test performance across laboratories over time. TC were obtained from a single source with known international units. Seven laboratories using different test systems and kit lots included the TC in routine assay runs of the analytes. TC measurements of 1,095 rubella virus IgG and 1,195 anti-HBs runs were plotted on Levey-Jennings control charts for individual laboratories and analyzed using a multirule quality control (MQC) scheme as well as a single three-standard-deviation (3-SD) rule. All rubella virus IgG TC results were "in control" in only one of the seven laboratories. Among the rest, "out-of-control" results ranged from 5.6% to 10% with an outlier at 20.3% by MQC and from 1.1% to 5.6% with an outlier at 13.4% by the 3-SD rule. All anti-HBs TC results were "in control" in only two laboratories. Among the rest, "out-of-control" results ranged from 3.3% to 7.9% with an outlier at 19.8% by MQC and from 0% to 3.3% with an outlier at 10.5% by the 3-SD rule. In conclusion, through the continuous monitoring of assay performance using TC and quality control rules, our trial detected significant intra- and interlaboratory, test system, and kit lot variations for both analytes. In most cases the assay rejections could be attributable to the laboratories rather than to kit lots. This has implications for routine diagnostic screening and clinical practice guidelines and underscores the value of using an approach as described above for continuous quality improvement in result reporting and harmonization for these analytes.

A Comparison of Lung Nodule Segmentation Algorithms: Methods and Results from a Multi-institutional Study.

PubMed

Kalpathy-Cramer, Jayashree; Zhao, Binsheng; Goldgof, Dmitry; Gu, Yuhua; Wang, Xingwei; Yang, Hao; Tan, Yongqiang; Gillies, Robert; Napel, Sandy

2016-08-01

Tumor volume estimation, as well as accurate and reproducible borders segmentation in medical images, are important in the diagnosis, staging, and assessment of response to cancer therapy. The goal of this study was to demonstrate the feasibility of a multi-institutional effort to assess the repeatability and reproducibility of nodule borders and volume estimate bias of computerized segmentation algorithms in CT images of lung cancer, and to provide results from such a study. The dataset used for this evaluation consisted of 52 tumors in 41 CT volumes (40 patient datasets and 1 dataset containing scans of 12 phantom nodules of known volume) from five collections available in The Cancer Imaging Archive. Three academic institutions developing lung nodule segmentation algorithms submitted results for three repeat runs for each of the nodules. We compared the performance of lung nodule segmentation algorithms by assessing several measurements of spatial overlap and volume measurement. Nodule sizes varied from 29 μl to 66 ml and demonstrated a diversity of shapes. Agreement in spatial overlap of segmentations was significantly higher for multiple runs of the same algorithm than between segmentations generated by different algorithms (p < 0.05) and was significantly higher on the phantom dataset compared to the other datasets (p < 0.05). Algorithms differed significantly in the bias of the measured volumes of the phantom nodules (p < 0.05) underscoring the need for assessing performance on clinical data in addition to phantoms. Algorithms that most accurately estimated nodule volumes were not the most repeatable, emphasizing the need to evaluate both their accuracy and precision. There were considerable differences between algorithms, especially in a subset of heterogeneous nodules, underscoring the recommendation that the same software be used at all time points in longitudinal studies.

Are Total, Intensity- and Domain-Specific Physical Activity Levels Associated with Life Satisfaction among University Students?

PubMed Central

Pedišić, Željko; Greblo, Zrinka; Phongsavan, Philayrath; Milton, Karen; Bauman, Adrian E.

2015-01-01

Background Thorough information about the relationship between physical activity (PA) and life satisfaction is still lacking. Therefore, this study examined the cross-sectional relationships between life satisfaction and meeting the World Health Organization (WHO) moderate to vigorous-intensity PA recommendations, total volume and duration of PA, intensity-specific PA (walking, moderate- and vigorous-intensity), domain-specific PA (work, transport-related, domestic, and leisure-time), and 11 domain and intensity-specific PA types among university students. Additionally, we examined the associations between life satisfaction and gender, age, disposable income, community size, smoking, alcohol intake, body mass index (BMI), and self-rated health. Methods The study included a random sample of 1750 university students in Zagreb, Croatia (response rate = 71.7%; 62.4% females; mean age 21.5 ± 1.8 years), using the International Physical Activity Questionnaire — long form and the Satisfaction with Life Scale. Results Higher life satisfaction was associated with female gender (β = 0.13; p = <0.001), younger age (β = -0.07; p = 0.024), higher disposable income (β = 0.10; p = 0.001), and better self-rated health (β = 0.30; p = <0.001). No significant association was found between life satisfaction and size of community (p = 0.567), smoking status (p = 0.056), alcohol consumption (p = 0.058), or BMI (p = 0.508). Among all PA variables, only leisure-time vigorous-intensity PA was significantly associated with life satisfaction after adjustments for socio-demographic characteristics, lifestyle and self-rated general health (β = 0.06; p = 0.045). Conclusions This study indicated a weak positive relationship between leisure-time vigorous-intensity PA and life satisfaction, whilst no such association was found for other PA variables. These findings underscore the importance of analyzing domain and intensity-specific PA levels in future studies among university students, as drawing conclusions about the relationship between PA and life satisfaction based on total PA levels only may be misleading. PMID:25695492

Development of a Mapped Diabetes Community Program Guide for a Safety Net Population

PubMed Central

Zallman, Leah; Ibekwe, Lynn; Thompson, Jennifer W.; Ross-Degnan, Dennis; Oken, Emily

2014-01-01

Purpose Enhancing linkages between patients and community programs is increasingly recognized as a method for improving physical activity, nutrition and weight management. Although interactive mapped community program guides may be beneficial, there remains a dearth of articles that describe the processes and practicalities of creating such guides. This article describes the development of an interactive, web-based mapped community program guide at a safety net institution and the lessons learned from that process. Conclusions This project demonstrated the feasibility of creating two maps – a program guide and a population health map. It also revealed some key challenges and lessons for future work in this area, particularly within safety-net institutions. Our work underscores the need for developing partnerships outside of the health care system and the importance of employing community-based participatory methods. In addition to facilitating improvements in individual wellness, mapping community programs also has the potential to improve population health management by healthcare delivery systems such as hospitals, health centers, or public health systems, including city and state departments of health. PMID:24752180

PD-1–Mediated Attrition of Polyfunctional Memory CD8+ T Cells in Chronic Toxoplasma Infection

PubMed Central

Bhadra, Rajarshi; Gigley, Jason P.; Khan, Imtiaz A.

2012-01-01

We reported earlier that during chronic toxoplasmosis CD8+ T cells become functionally exhausted with concomitant PD-1 upregulation, leading to eventual host mortality. However, how immune exhaustion specifically mediates attrition of CD8 polyfunctionality, a hallmark of potent T-cell response, during persistent infections has not been addressed. In this study, we demonstrate that PD-1 is preferentially expressed on polyfunctional memory CD8+ T cells, which renders them susceptible to apoptosis. In vitro blockade of the PD-1–PD-L1 pathway dramatically reduces apoptosis of polyfunctional and interferon γ+/granzyme B− memory but not effector CD8+ T cells. In summary, the present report underscores the critical role of the PD-1–PD-L1 pathway in mediating attrition of this important CD8+ T-cell subset and addresses the mechanistic basis of how αPD-L1 therapy reinvigorates polyfunctional CD8 response during chronic infections. The conclusions of this study can have profound immunotherapeutic implications in combating recrudescent toxoplasmosis as well other chronic infections. PMID:22539813

The rise of politics and the decline of vulnerability as criteria in disaster decisions of the United States, 1953-2009.

PubMed

Daniels, R Steven

2013-10-01

This paper examines the shift from vulnerability to political responsiveness in presidential and gubernatorial disaster decisions in the United States from 1953-2009 (President Dwight D. Eisenhower to President Barack Obama) using annual request, declaration, and approval data from multiple sources. It makes three key conclusions: first, the 1988 Stafford Act expanded federal coverage to all categories of disasters, added a significant range of individual types of assistance, and provided extensive funding for recovery planning. Second, the election effects on disaster decisions increased over time whereas the impact of social and economic vulnerability (measured by scope of disaster) declined. Third, the changes affected governors more than presidents, and the choices of governors drove those of presidents. The analysis underscores the increasingly political nature of the disaster decision-making process, as well as the difficulty in emphasising mitigation and preparedness as intensively as response and recovery. Proactive intervention yields fewer political rewards than responsiveness. © 2013 The Author(s). Disasters © Overseas Development Institute, 2013.

Power in methods: language to infants in structured and naturalistic contexts.

PubMed

Tamis-LeMonda, Catherine S; Kuchirko, Yana; Luo, Rufan; Escobar, Kelly; Bornstein, Marc H

2017-11-01

Methods can powerfully affect conclusions about infant experiences and learning. Data from naturalistic observations may paint a very different picture of learning and development from those based on structured tasks, as illustrated in studies of infant walking, object permanence, intention understanding, and so forth. Using language as a model system, we compared the speech of 40 mothers to their 13-month-old infants during structured play and naturalistic home routines. The contrasting methods yielded unique portrayals of infant language experiences, while simultaneously underscoring cross-situational correspondence at an individual level. Infants experienced substantially more total words and different words per minute during structured play than they did during naturalistic routines. Language input during structured play was consistently dense from minute to minute, whereas language during naturalistic routines showed striking fluctuations interspersed with silence. Despite these differences, infants' language experiences during structured play mirrored the peak language interactions infants experienced during naturalistic routines, and correlations between language inputs in the two conditions were strong. The implications of developmental methods for documenting the nature of experiences and individual differences are discussed. © 2017 John Wiley & Sons Ltd.

Interplay of Itch and Psyche in Psoriasis: An Update.

PubMed

Reich, Adam; Mędrek, Karolina; Szepietowski, Jacek C

2016-08-23

Itch or pruritus is defined as an unpleasant subjective sensation leading to the need or to the idea of scratching. A number of studies have shown that pruritus is often responsible for marked morbidity, quality of life impairment, and even for increased mortality. Patients suffering from chronic pruritus had also decreased self-esteem, suffer from anxiety or depression and have problems to cope with negative feelings. Several studies documented that itching is a very prevalent symptom of psoriasis affecting more than 70% of individuals and for many patient it is the most bothersome symptom of the disease. While assessing various aspects of itch in psoriatic patients it was found that individuals with pruritus had a significantly lower health-related QoL; patients with pruritus, moreover, were more depressed than those without itching. In conclusion, pruritus is closely related to decreased psychosocial well-being of patients with chronic pruritic skin diseases, including psoriasis. It is important to underscore that itch may interfere with various aspects of patient functioning, emotions and social status and should therefore be adequately addressed while treating patients with psoriasis.

The Madoffization of Irish society: from Ponzi finance to sociological critique.

PubMed

Monaghan, Lee F; O'Flynn, Micheal

2017-12-01

Financialization and neoliberal policy created the Celtic Tiger. This economic 'miracle' furthered creditors' and property developers' speculative interests, leading to an unstable financial pyramid that eventually imploded in 2008 with catastrophic consequences for Irish society. Using the sociological imagination as social critique, this paper offers a lens on fictitious capital and Ponzi finance in the context of Ireland's boom and bust. Critique is advanced using the Madoffization of society thesis, a sociological heuristic that draws formal comparisons between Bernie Madoff's US$65 billion Ponzi scheme, which collapsed in 2008, and financialized capitalism. The Madoff case exhibits five main elements or forms which, it has been argued, underlie the varying content of life on a much broader scale: accumulation by debt expansion, mass deception, efforts to maintain secrecy and silence, obfuscation, and scapegoating. In conclusion, a crucial difference between the Madoff case and the Madoffization of Irish society is underscored. Discussion also moves from critique to hope amidst calls to renew sociology and transform financialized capitalism. © London School of Economics and Political Science 2017.

Forging e-health partnerships: strategic perspectives from international executives.

PubMed

Caro, Denis H J

2005-01-01

International executives underscore the key management frontiers of strategic e-health partnerships between information and communication technology and health care sectors for innovative growth, systems integration, and social responsibility.

Twelve Years Since Importance of Cross-Cultural Competency Recognized: Where Are We Now?

PubMed Central

Kessler, Remi A.; Coates, Wendy C.; Chanmugam, Arjun

2017-01-01

Introduction The objective of this study was to analyze the content and volume of literature that has been written on cultural competency in emergency medicine (EM) since its educational imperative was first described by the Institute of Medicine in 2002. Methods We conducted a comprehensive literature search through the PubMed portal in January 2015 to identify all articles and reviews that addressed cultural competency in EM. Articles were included in the review if cultural competency was described or if its impact on healthcare disparities or curriculum development was described. Two reviewers independently investigated all relevant articles. These articles were then summarized. Results Of the 73 abstracts identified in the initial search, only 10 met criteria for inclusion. A common theme found among these 10 articles is that cultural competency in EM is essential to reducing healthcare disparities and improving patient care. These articles were consistent in their support for cross-cultural educational advancements in the EM curriculum. Conclusion Despite the documented importance of cultural competency education in medicine, there appears to be only 10 articles over the past 12 years regarding its development and implementation in EM. This comprehensive literature review underscores the relative dearth of publications related to cultural competency in EM. The limited number of articles found is striking when compared to the growth of EM research over the same time period and can serve as a stimulus for further research in this significant area of EM education. PMID:28210356

Age at Menarche: 50-Year Socioeconomic Trends Among US-Born Black and White Women

PubMed Central

Kiang, Mathew V.; Kosheleva, Anna; Waterman, Pamela D.; Chen, Jarvis T.; Beckfield, Jason

2015-01-01

Objectives. We investigated 50-year US trends in age at menarche by socioeconomic position (SEP) and race/ethnicity because data are scant and contradictory. Methods. We analyzed data by income and education for US-born non-Hispanic Black and White women aged 25 to 74 years in the National Health Examination Survey (NHES) I (1959–1962), National Health Examination and Nutrition Surveys (NHANES) I–III (1971–1994), and NHANES 1999–2008. Results. In NHES I, average age at menarche among White women in the 20th (lowest) versus 80th (highest) income percentiles was 0.26 years higher (95% confidence interval [CI] = −0.09, 0.61), but by NHANES 2005–2008 it had reversed and was −0.33 years lower (95% CI = −0.54, −0.11); no socioeconomic gradients occurred among Black women. The proportion with onset at younger than 11 years increased only among women with low SEP, among Blacks and Whites (P for trend < .05), and high rates of change occurred solely among Black women (all SEP strata) and low-income White women who underwent menarche before 1960. Conclusions. Trends in US age at menarche vary by SEP and race/ethnicity in ways that pose challenges to several leading clinical, public health, and social explanations for early age at menarche and that underscore why analyses must jointly include data on race/ethnicity and socioeconomic position. Future research is needed to explain these trends. PMID:25033121

Implications of Supermarket Access, Neighborhood Walkability, and Poverty Rates for Diabetes Risk in an Employee Population

PubMed Central

Herrick, Cynthia J.; Yount, Byron W.; Eyler, Amy A.

2016-01-01

Objective Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of this study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. Design This was a retrospective cross-sectional analysis. Home environment variables were derived using employee zip code. Descriptive statistics were run on all individual and zip code level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. Setting Data was collected from employee health fairs in a Midwestern health system 2009–2012. Subjects The dataset contains 25,227 unique individuals across four years of data. From this group, using an individual’s first entry into the database, 15,522 individuals had complete data for analysis. Results The prevalence of high diabetes risk in this population was 2.3%. There was significant variability in individual and zip code level variables across worksites. From the multivariable analysis, living in a zip code with higher percent poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. Conclusions Our study underscores the important relationship between poverty, home neighborhood environment, and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health. PMID:26638995

Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis

PubMed Central

Wang, Kaiwen; Zhong, Shuang; Wang, Xiaoye; Wang, Zhe; Yang, Lianping; Wang, Qiong; Wang, Suhan; Sheng, Rongrong; Ma, Rui; Lin, Shao; Liu, Wenyu; Zu, Rongqiang; Huang, Cunrui

2017-01-01

(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing’s Center for Disease Control and Prevention (CDC) and Funing People’s Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China. PMID:28994741

Prevalence of nutritional deficiency in patients with pulmonary tuberculosis*

PubMed Central

Piva, Silvana Gomes Nunes; Costa, Maria da Conceição Nascimento; Barreto, Florisneide Rodrigues; Pereira, Susan Martins

2013-01-01

OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age) residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9%) were in males, and 21 (29.2%) of the patients were in the 40-49 year age bracket. The majority (85.3%) described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions. PMID:24068270

White blood cell counts mediate the effects of physical activity on prostate-specific antigen levels.

PubMed

Loprinzi, Paul D; Richart, Sarah M

2014-09-01

The purpose of this study was to examine whether white blood cell (WBC) level mediated the relationship between physical activity and prostate-specific antigen (PSA) levels. Data from the 2003-2006 National Health and Nutrition Examination Survey were used; 1,726 U.S. adult men (aged 40 years or older) provided complete data on the study variables. Participants wore an ActiGraph 7164 accelerometer for a 7-day period to measure their physical activity behavior, and PSA and WBC levels were obtained from a blood sample. After adjustments, results showed that moderate-to-vigorous physical activity (MVPA) was inversely associated with WBC count (b = - .03; 95% CI [ - 0.04, - 0.006; p = .01), and WBC count (b = .10; 95% CI [0.009, 0.18; p = .04) was positively associated with PSA. Both the Sobel (coef. = - .004, SE = .002; z = - 2.0; p = .03) and the Aroian (coef. = - .004, SE = .002; z = - 1.9; p = .03) tests demonstrated that WBC mediated the relationship between physical activity and PSA. Additionally, among 107 participants with prostate cancer, survivors engaging in more MVPA had lower levels of WBC (b = - .04; 95% CI [ - 0.09, - 0.0009; p = .04). Conclusion Physical activity may influence PSA levels through WBC modulation; however, future research is needed to determine the direction of causality. Additionally, prostate cancer survivors engaging in higher levels of MVPA had lower levels of WBC, underscoring the importance of promoting physical activity among prostate cancer survivors.

Early-Onset Basal Cell Carcinoma and Indoor Tanning: A Population-Based Study

PubMed Central

Zens, M. Scot; Li, Zhigang; Stukel, Therese A.; Perry, Ann E.; Gilbert-Diamond, Diane; Sayarath, Vicki; Stephenson, Rita S.; Barton, Dorothea; Nelson, Heather H.; Spencer, Steven K.

2014-01-01

OBJECTIVE: Indoor tanning with UV radiation–emitting lamps is common among adolescents and young adults. Rising incidence rates of basal cell carcinoma (BCC) have been reported for the United States and elsewhere, particularly among those diagnosed at younger ages. Recent epidemiologic studies have raised concerns that indoor tanning may be contributing to early occurrence of BCC, and younger people may be especially vulnerable to cancer risk associated with this exposure. Therefore, we sought to address these issues in a population-based case–control study from New Hampshire. METHODS: Data on indoor tanning were obtained on 657 cases of BCC and 452 controls ≤50 years of age. RESULTS: Early-onset BCC was related to indoor tanning, with an adjusted odds ratio (OR) of 1.6 (95% confidence interval, 1.3–2.1). The strongest association was observed for first exposure as an adolescent or young adult, with a 10% increase in the OR with each age younger at first exposure (OR per year of age ≤23 = 1.1; 95% confidence interval, 1.0–1.2). Associations were present for each type of device examined (ie, sunlamps, tanning beds, and tanning booths). CONCLUSIONS: Our findings suggest early exposure to indoor tanning increases the risk of early development of BCC. They also underscore the importance of counseling adolescents and young adults about the risks of indoor tanning and for discouraging parents from consenting minors to this practice. PMID:24958589

Understanding AIDS-Risk Behavior Among Adolescents in Psychiatric Care: Links to Psychopathology and Peer Relationships

PubMed Central

DONENBERG, GERI R.; EMERSON, ERIN; BRYANT, FRED B.; WILSON, HELEN; WEBER-SHIFRIN, ERYN

2005-01-01

Objective: Severely mentally ill youths are at elevated risk for human immunodeficiency virus infection, but little is known about acquired immunodeficiency syndrome (AIDS) risk behavior in adolescents who seek outpatient mental health services or about the links between psychiatric problems and particular high-risk behaviors. This pilot study used structural equation modeling to conduct a path analysis to explore the direct and indirect effects of adolescent psychopathology on risky sex, drug/alcohol use, and needle use. Method: Ethnically diverse youths (N = 86) and their caregivers who sought outpatient psychiatric services in Chicago completed questionnaires of adolescent psychopathology. Youths reported their relationship attitudes, peer influence, sexual behavior, and drug/alcohol use. Results: Different AIDS-risk behaviors were associated with distinct forms of adolescent psychopathology (e.g., delinquency was linked to drug/alcohol use, whereas aggression was related to risky sexual behavior), and peer influence mediated these linkages. Some patterns were similar for caregiver- and adolescent-reported problems (e.g., peer influence mediated the relation between delinquency and drug/alcohol use), but others were different (e.g., caregiver-reported delinquency was associated with risky sex, whereas adolescent-reported delinquency was not). Conclusions: Findings underscore the complexity of factors (types of informants and dimensions of psychopathology) that underlie AIDS risk in troubled youths, and they offer specific directions for designing and implementing uniquely tailored AIDS prevention programs, for example, by targeting delinquent behavior and including high-risk peers and important family members in interventions. PMID:11392341

Health Care Workplace Discrimination and Physician Turnover

PubMed Central

Nunez-Smith, Marcella; Pilgrim, Nanlesta; Wynia, Matthew; Desai, Mayur M.; Bright, Cedric; Krumholz, Harlan M.; Bradley, Elizabeth H.

2013-01-01

Objective To examine the association between physician race/ethnicity, workplace discrimination, and physician job turnover. Methods Cross-sectional, national survey conducted in 2006–2007 of practicing physicians [n = 529] randomly identified via the American Medical Association Masterfile and The National Medical Association membership roster. We assessed the relationships between career racial/ethnic discrimination at work and several career-related dependent variables, including 2 measures of physician turnover, career satisfaction, and contemplation of career change. We used standard frequency analyses, odds ratios and χ2 statistics, and multivariate logistic regression modeling to evaluate these associations. Results Physicians who self-identified as nonmajority were significantly more likely to have left at least 1 job because of workplace discrimination (black, 29%; Asian, 24%; other race, 21%; Hispanic/Latino, 20%; white, 9%). In multivariate models, having experienced racial/ethnic discrimination at work was associated with high job turnover [adjusted odes ratio, 2.7; 95% CI, 1.4–4.9]. Among physicians who experienced work-place discrimination, only 45% of physicians were satisfied with their careers (vs 88% among those who had not experienced workplace discrimination, p value < .01], and 40% were con-templating a career change (vs 10% among those who had not experienced workplace discrimination, p value < .001). Conclusion Workplace discrimination is associated with physician job turnover, career dissatisfaction, and contemplation of career change. These findings underscore the importance of monitoring for workplace discrimination and responding when opportunities for intervention and retention still exist. PMID:20070016

Migraine prophylaxis, ischemic depolarizations and stroke outcomes in mice

PubMed Central

Eikermann-Haerter, Katharina; Lee, Jeong Hyun; Yalcin, Nilufer; Yu, Esther Sori; Daneshmand, Ali; Wei, Ying; Zheng, Yi; Can, Anil; Sengul, Buse; Ferrari, Michel D.; van den Maagdenberg, Arn M. J. M.; Ayata, Cenk

2014-01-01

Background and Purpose Migraine with aura is an established stroke risk factor, and excitatory mechanisms such as spreading depression are implicated in the pathogenesis of both migraine and stroke. Spontaneous spreading depression waves originate within the peri-infarct tissue and exacerbate the metabolic mismatch during focal cerebral ischemia. Genetically enhanced spreading depression susceptibility facilitates anoxic depolarizations and peri-infarct spreading depressions and accelerates infarct growth, suggesting that susceptibility to spreading depression is a critical determinant of vulnerability to ischemic injury. Because chronic treatment with migraine prophylactic drugs suppresses spreading depression susceptibility, we tested whether migraine prophylaxis can also suppress ischemic depolarizations and improve stroke outcome. Methods We measured the cortical susceptibility to spreading depression and ischemic depolarizations, and determined tissue and neurological outcome after middle cerebral artery occlusion in wild type and familial hemiplegic migraine type 1 knock-in mice treated with vehicle, topiramate or lamotrigine daily for 7 weeks or as a single dose shortly before testing. Results Chronic treatment with topiramate or lamotrigine reduces the susceptibility to KCl- or electrical stimulation-induced spreading depressions as well as ischemic depolarizations in both wild-type and familial hemiplegic migraine type 1 mutant mice. Consequently, both tissue and neurological outcomes are improved. Notably, treatment with a single dose of either drug is ineffective. Conclusions These data underscore the importance of hyperexcitability as a mechanism for increased stroke risk in migraineurs, and suggest that migraine prophylaxis may not only prevent migraine attacks but also protect migraineurs against ischemic injury. PMID:25424478

Associations between mental disorders and subsequent onset of hypertension

PubMed Central

Stein, Dan J.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bruffaerts, Ronny; de Jonge, Peter; Liu, Zharoui; Caldas-de-Almeida, Jose Miguel; O’Neill, Siobhan; Viana, Maria Carmen; Al-Hamzawi, Ali Obaid; Angermeyer, Mattias C.; Benjet, Corina; de Graaf, Ron; Ferry, Finola; Kovess-Masfety, Viviane; Levinson, Daphna; de Girolamo, Giovanni; Florescu, Silvia; Hu, Chiyi; Kawakami, Norito; Haro, Josep Maria; Piazza, Marina; Wojtyniak, Bogdan J; Xavier, Miguel; Lim, Carmen C.W.; Kessler, Ronald C.; Scott, Kate

2013-01-01

Background Previous work has suggested significant associations between various psychological symptoms (e.g. depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remains unclear. Further, there is little data available on how such associations vary by gender or over life course. Methods Data from the World Mental Health Surveys (comprising 19 countries, and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated. Results After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse, and drug abuse were significantly associated with subsequent diagnosis of hypertension (with ORs ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier onset hypertension. Conclusions Depression, anxiety, impulsive eating disorders, and substance use disorders disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.. PMID:24342112

Alcohol Use Among Female Sex Workers and Male Clients: An Integrative Review of Global Literature

PubMed Central

Li, Qing; Li, Xiaoming; Stanton, Bonita

2010-01-01

Aims: To review the patterns, contexts and impacts of alcohol use associated with commercial sex reported in the global literature. Methods: We identified peer-reviewed English-language articles from 1980 to 2008 reporting alcohol consumption among female sex workers (FSWs) or male clients. We retrieved 70 articles describing 76 studies, in which 64 were quantitative (52 for FSWs, 12 for male clients) and 12 qualitative. Results: Studies increased over the past three decades, with geographic concentration of the research in Asia and North America. Alcohol use was prevalent among FSWs and clients. Integrating quantitative and qualitative studies, multilevel contexts of alcohol use in the sex work environment were identified, including workplace and occupation-related use, the use of alcohol to facilitate the transition into and practice of commercial sex among both FSWs and male clients, and self-medication among FSWs. Alcohol use was associated with adverse physical health, illicit drug use, mental health problems, and victimization of sexual violence, although its associations with HIV/sexually transmitted infections and unprotected sex among FSWs were inconclusive. Conclusions: Alcohol use in the context of commercial sex is prevalent, harmful among FSWs and male clients, but under-researched. Research in this area in more diverse settings and with standardized measures is required. The review underscores the importance of integrated intervention for alcohol use and related problems in multilevel contexts and with multiple components in order to effectively reduce alcohol use and its harmful effects among FSWs and their clients. PMID:20089544

Detection of asymptomatic renal Leptospira infection in abattoir slaughtered cattle in southeastern Georgia, United States

PubMed Central

Ilha, Marcia; Woldemeskel, Moges; Berghaus, Roy D; Pence, Mel E

2014-01-01

Objectives: Leptospirosis is one of the most widespread zoonotic infectious diseases affecting humans and animals. Several animal species, including cattle, can act as potential asymptomatic carriers facilitating zoonotic transmission of Leptospira. This study was conducted to assess the occurrence of asymptomatic renal Leptospira carriers among cattle slaughtered in southeastern Georgia, United States. Methods: A battery of diagnostic tests, including dark field microscopy, direct fluorescent antibody staining, polymerase chain reaction, and culture, were performed on a set of bovine kidneys (n = 37) collected from an abattoir in southeastern Georgia, United States. Virulence of a field isolate obtained from this study was tested in a hamster experimental model. Results: Motile spirochete-like structures were observed by dark field microscopy in 23 (59%) out of 37 kidney samples tested. In all, 29 samples (78%) were positive by direct fluorescent antibody staining. Only 11 (29.7%) samples by polymerase chain reaction and 3 (8.1%) by culture were positive for Leptospira sp. The isolates obtained by culture were confirmed as Leptospira borgpetersenii. Hamsters experimentally infected with one of the Leptospira field isolates obtained from this study did not show clinical signs but developed renal infection with interstitial nephritis and tubular necrosis. Conclusions: This study confirms that asymptomatic Leptospira renal infection is present among cattle in the region. Our findings underscore the need for future studies to assess the potential environmental contamination and transmission to humans in contact with infected cattle. PMID:26770734

Weight Fluctuation and Postmenopausal Breast Cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study

PubMed Central

Komaroff, Marina

2016-01-01

Objective. The aim of this study is to investigate if weight fluctuation is an independent risk factor for postmenopausal breast cancer (PBC) among women who gained weight in adult years. Methods. NHANES I Epidemiologic Follow-Up Study (NHEFS) database was used in the study. Women that were cancers-free at enrollment and diagnosed for the first time with breast cancer at age 50 or greater were considered cases. Controls were chosen from the subset of cancers-free women and matched to cases by years of follow-up and status of body mass index (BMI) at 25 years of age. Weight fluctuation was measured by the root-mean-square-error (RMSE) from a simple linear regression model for each woman with their body mass index (BMI) regressed on age (started at 25 years) while women with the positive slope from this regression were defined as weight gainers. Data were analyzed using conditional logistic regression models. Results. A total of 158 women were included into the study. The conditional logistic regression adjusted for weight gain demonstrated positive association between weight fluctuation in adult years and postmenopausal breast cancers (odds ratio/OR = 1.67; 95% confidence interval/CI: 1.06–2.66). Conclusions. The data suggested that long-term weight fluctuation was significant risk factor for PBC among women who gained weight in adult years. This finding underscores the importance of maintaining lost weight and avoiding weight fluctuation. PMID:26953120

Early language development in Indian children: A population-based pilot study

PubMed Central

Sidhu, Manjit; Malhi, Prahbhjot; Jerath, Jagat

2013-01-01

Objectives: To study the prevalence of language delay and to examine its socio-economic correlates in children less than 3 years. Materials and Methods: Participants were 130 children (males = 56%) aged 12-35 months (mean age = 1.81 years, SD = 0.58), from an urban center in north India. The language quotient (LQ) of the child was measured by the Clinical Linguistic Auditory Milestone Scale (CLAMS). Children with an LQ score of less than 70 were considered language delayed. Results: Overall, 6.2% of the children were language delayed with a higher prevalence found for girls (7%) than for boys (5.5%), although the difference was not statistically significant. Several significant correlations between socio-economic and demographic variables and the LQ of the child were found. Stepwise multiple regression analysis revealed that 31.4% of the variance in the LQ scores of girls was accounted for by income (F = 23.80, P = 0.000) and 18.1% of the variance in the LQ scores of boys was accounted for by education of the mother and income (F = 15.67, P = 0.000). Conclusions: Developmental problems in early years are often precursors of problems in later life and early intervention can facilitate favorable outcomes among children with multiple risks. The high prevalence of language difficulties in young children underscores the need to target language delay in early years, to reduce the likelihood of adverse outcomes and thus optimize chances of improvement. PMID:24101819

Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI–2008)

PubMed Central

Lissner, L; Wijnhoven, T M A; Mehlig, K; Sjöberg, A; Kunesova, M; Yngve, A; Petrauskiene, A; Duleva, V; Rito, A I; Breda, J

2016-01-01

Background: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity. Subjects and Methods: In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Results: Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators. Conclusions: These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions. PMID:27136760

An Ill Wind? Climate Change, Migration, and Health

PubMed Central

Barnett, Jon

2012-01-01

Background: Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. Objectives: In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. Methods: This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Discussion: Climate-change–related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Conclusions: Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change. PMID:22266739

Differences in Supratentorial Damage of White Matter in Pediatric Survivors of Posterior Fossa Tumors With and Without Adjuvant Treatment as Detected by Magnetic Resonance Diffusion Tensor Imaging

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

Rueckriegel, Stefan Mark, E-mail: stefan.rueckriegel@charite.d; Driever, Pablo Hernaiz; Blankenburg, Friederike

2010-03-01

Purpose: To elucidate morphologic correlates of brain dysfunction in pediatric survivors of posterior fossa tumors by using magnetic resonance diffusion tensor imaging (DTI) to examine neuroaxonal integrity in white matter. Patients and Methods: Seventeen medulloblastoma (MB) patients who had received surgery and adjuvant treatment, 13 pilocytic astrocytoma (PA) patients who had been treated only with surgery, and age-matched healthy control subjects underwent magnetic resonance imaging on a 3-Tesla system. High-resolution conventional T1- and T2-weighted magnetic resonance imaging and DTI data sets were obtained. Fractional anisotropy (FA) maps were analyzed using tract-based spatial statistics, a part of the Functional MRI ofmore » the Brain Software Library. Results: Compared with control subjects, FA values of MB patients were significantly decreased in the cerebellar midline structures, in the frontal lobes, and in the callosal body. Fractional anisotropy values of the PA patients were not only decreased in cerebellar hemispheric structures as expected, but also in supratentorial parts of the brain, with a distribution similar to that in MB patients. However, the amount of significantly decreased FA was greater in MB than in PA patients, underscoring the aggravating neurotoxic effect of the adjuvant treatment. Conclusions: Neurotoxic mechanisms that are present in PA patients (e.g., internal hydrocephalus and damaged cerebellar structures affecting neuronal circuits) contribute significantly to the alteration of supratentorial white matter in pediatric posterior fossa tumor patients.« less

Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

PubMed Central

2013-01-01

Background Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are complications causing weakness of respiratory and limb muscles in critically ill patients. As an important differential diagnosis of Guillain-Barré syndrome (GBS), CIP and CIM should be diagnosed with caution, after a complete clinical and laboratory examination. Although not uncommon in ICU, CIP and CIM as severe complications of percutaneous nephrostolithotomy (PNL) have not been documented in literature. Case presentation A 48-year-old Chinese woman was referred to our hospital, complaining of occasional pain in the right lower back for one month. Lithiasis was diagnosed by ultrasonographical and radiological examinations on the urinary system. PNL was indicated and performed. The patient developed CIP and CIM on the fourth day after PNL. Early recognition and treatment of the severe complications contributed to a satisfactory recovery of the patient. Conclusion This case expands our understanding of the complications of PNL and underscores the importance of differentiating CIP/CIM from GBS in case of such patients developing weakness after the treatment. Clinical characteristics and examination results should be carefully evaluated to make the diagnosis of CIP or CIM. Both anti-septic prophylaxis and control of hyperglycemia might be effective for the prevention of CIP or CIM; aggressive treatment on sepsis and multiple organ failure is considered to be the most effective measure to reduce the incidence of CIP/CIM. PMID:23409743

Differences in delay discounting between smokers and nonsmokers remain when both rewards are delayed

PubMed Central

Mitchell, Suzanne H.; Wilson, Vanessa B.

2013-01-01

Rationale When offered a choice between a small monetary reward available immediately (SmallNow) versus a larger reward available after a delay (LargeLater), smokers select the SmallNow alternative more than nonsmokers. That is, smokers discount the value of the LargeLater reward more than nonsmokers. Objectives To investigate whether this group difference was due to smokers overweighing the value of rewards available immediately compared with nonsmokers, we examined whether the group difference was also seen when both alternatives were delayed, i.e., when choosing between a SmallSoon reward and a LargeLater reward. Methods In Experiment 1, smokers and nonsmokers completed a task including SmallNow versus LargeLater choices and SmallSoon versus LargeLater choices. In Experiment 2, smokers and nonsmokers completed the same task but with hypothetical choices. Results Analyses using hyperbolic and double exponential (β-δ) models replicate prior findings that smokers discount the LargeLater reward more than nonsmokers when the smaller reward is available immediately. The smoker-nonsmoker difference was also seen when the smaller reward was slightly delayed, though this effect was primarily driven by heightened discounting in male smokers. However, for potentially real rewards only, this smoker-nonsmoker difference was significantly reduced when the smaller reward was delayed. Conclusions The smoker-nonsmoker difference in discounting is not confined to situations involving immediate rewards. Differences associated with potentially real vs. hypothetical rewards and gender underscore the complexity of the smoking-delay discounting relationship. PMID:21983917

Do Alcohol and Marijuana Increase the Risk for Female Dating Violence Victimization? A Prospective Daily Diary Investigation

PubMed Central

Shorey, Ryan C.; Moore, Todd M.; McNulty, James K.; Stuart, Gregory L.

2015-01-01

Objective Dating violence is a serious and prevalent problem, with females being victimized by partners at high rates with numerous negative health consequences. Previous research has been equivocal on whether substance use on the part of the victim temporally precedes and, thus, increases the odds of victimization. While the sole responsibility for violence is always with the perpetrator, knowing this information could provide useful information for theory as well as interventions designed to keep women safe. Method Participants were female college students in a current dating relationship who had consumed alcohol in the previous month (N = 173). Students completed daily surveys on their violence victimization, alcohol use, and marijuana use for up to 90 consecutive days. Results On any drinking days, heavy drinking days, and as the number of alcoholic drinks consumed increased, women were more likely to be victimized by psychological, physical, and sexual dating violence. Marijuana use also preceded and increased the odds of sexual victimization. Relationship length moderated some of these temporal associations, such that the odds of victimization on a drinking day, or marijuana use day, were increased for participants in longer relationships. Conclusions Findings underscore the importance of considering the role that alcohol and marijuana use play in increasing the risk for dating violence victimization among women. Intervention programs for dating violence may benefit by attempting to decrease substance use in order to reduce risk for female victims. PMID:27818840

Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors

PubMed Central

2015-01-01

Objectives. I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries. Methods. I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months. Results. Partner’s problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands. Conclusions. My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions. PMID:26378858

The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys

PubMed Central

Krill, Patrick R.; Johnson, Ryan; Albert, Linda

2016-01-01

Objectives: Rates of substance use and other mental health concerns among attorneys are relatively unknown, despite the potential for harm that attorney impairment poses to the struggling individuals themselves, and to our communities, government, economy, and society. This study measured the prevalence of these concerns among licensed attorneys, their utilization of treatment services, and what barriers existed between them and the services they may need. Methods: A sample of 12,825 licensed, employed attorneys completed surveys, assessing alcohol use, drug use, and symptoms of depression, anxiety, and stress. Results: Substantial rates of behavioral health problems were found, with 20.6% screening positive for hazardous, harmful, and potentially alcohol-dependent drinking. Men had a higher proportion of positive screens, and also younger participants and those working in the field for a shorter duration (P < 0.001). Age group predicted Alcohol Use Disorders Identification Test scores; respondents 30 years of age or younger were more likely to have a higher score than their older peers (P < 0.001). Levels of depression, anxiety, and stress among attorneys were significant, with 28%, 19%, and 23% experiencing symptoms of depression, anxiety, and stress, respectively. Conclusions: Attorneys experience problematic drinking that is hazardous, harmful, or otherwise consistent with alcohol use disorders at a higher rate than other professional populations. Mental health distress is also significant. These data underscore the need for greater resources for lawyer assistance programs, and also the expansion of available attorney-specific prevention and treatment interventions. PMID:26825268

Mental Illness Drives Hospitalizations for Detained California Youth

PubMed Central

Anoshiravani, Arash; Saynina, Olga; Chamberlain, Lisa; Goldstein, Benjamin A; Huffman, Lynne C; Wang, N Ewen; Wise, Paul H

2015-01-01

Objective To describe inpatient hospitalization patterns among detained and non-detained youth in a large, total population of hospitalized adolescents in California. Methods We examined the unmasked California Office of Statewide Health Planning and Development Patient Discharge Dataset from 1997-2011. We considered hospitalized youth aged 11-18 years “detained” if admitted to California hospitals from detention, transferred from hospital to detention, or both. We compared discharge diagnoses and length of stay (LOS) between detained youth and their non-detained counterparts in the general population. Results There were 11,367 hospitalizations for detained youth. Hospitalizations differed for detained versus non-detained youth: 63% of all detained youth had a primary diagnosis of mental health disorder (compared to 19.8% of non-detained youth). Detained girls were disproportionately affected, with 74% hospitalized for a primary mental health diagnosis. Detained youth hospitalized for mental health disorder had an increased median LOS compared to non-detained inpatient youth with mental illness (≥6 days versus 5 days, respectively). This group difference was heightened in the presence of minority status, public insurance, and concurrent substance abuse. Hospitalized detained youth discharged to chemical dependency treatment facilities had the longest hospital stays (≥43 days). Conclusions Detained juvenile offenders are hospitalized for very different reasons than the general adolescent population. Mental illness, often with comorbid substance abuse, requiring long inpatient stays, represents the major cause for hospitalization. These findings underscore the urgent need for effective, well-coordinated mental health services for youth before, during, and after detention. PMID:26208862

Tobacco Withdrawal Components and Their Relations with Cessation Success

PubMed Central

Piper, Megan E.; Schlam, Tanya R.; Cook, Jessica W.; Sheffer, Megan A.; Smith, Stevens S.; Loh, Wei-Yin; Bolt, Daniel M.; Kim, Su-Young; Kaye, Jesse T.; Hefner, Kathryn R.; Baker, Timothy B.

2011-01-01

Rationale Tobacco withdrawal is a key factor in smoking relapse, but important questions about the withdrawal phenomenon remain. Objectives This research was intended to provide information about two core components of withdrawal (negative affect and craving): 1) how various withdrawal symptom profile dimensions (e.g., mean level, volatility, extreme values) differ between negative affect and craving; and 2) how these dimensions relate to cessation outcome. Methods Adult smokers (N=1504) in a double-blind randomized placebo-controlled smoking cessation trial provided real-time withdrawal symptom data four times per day for 4 weeks (2 weeks pre-quit and 2 weeks post-quit) via palmtop computers. Cessation outcome was biochemically confirmed 8-week point-prevalence abstinence. Results Examination of craving and negative affect dimensions following a cessation attempt revealed that craving symptoms differed from negative affect symptoms, with higher means, greater variability, and a greater incidence of extreme peaks. Regression analyses revealed that abstinence was associated with lower mean levels of both craving and negative affect and fewer incidences of extreme craving peaks. In a multivariate model, the increase in mean craving and negative affect scores each uniquely predicted relapse. Conclusions Real-time reports revealed different patterns of abstinence-related negative affect and craving and that dimensions of both predict cessation outcome, suggesting that negative affect and craving dimensions each has motivational significance. This underscores the complexity of withdrawal as a determinant of relapse and the need to measure its distinct components and dimensions. PMID:21416234

Contrasting Olfaction, Vision, and Audition as Predictors of Cognitive Change and Impairment in Non-Demented Older Adults

PubMed Central

MacDonald, Stuart W.S.; Keller, Connor J.C.; Brewster, Paul W.H.; Dixon, Roger A.

2017-01-01

Objective This study examines the relative utility of a particular class of non-invasive functional biomarkers -- sensory functions -- for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether: (1) olfactory function, vision, and audition exhibited significant longitudinal declines in non-demented older adults, (2) multi-wave change for these sensory function indicators predicted risk of mild cognitive impairment, and (3) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. Method A longitudinal sample (n=408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively (NIC), single assessment mild cognitive impairment (SA-MCI), and multiple assessment mild cognitive impairment (MA-MCI). Results We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. Conclusions These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multi-step screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. PMID:29809033

Cerebellar volume and executive function in Parkinson disease with and without freezing of gait

PubMed Central

Myers, Peter S.; McNeely, Marie E.; Koller, Jonathan M.; Earhart, Gammon M.; Campbell, Meghan C.

2017-01-01

BACKGROUND Freezing of gait (FOG) affects approximately 50% of people with Parkinson Disease (PD), impacting quality of life and placing financial and emotional strain on the individual and caregivers. People with PD and FOG have similar deficits in motor adaptation and cognition as individuals with cerebellar lesions, indicating the cerebellum may play a role in FOG. OBJECTIVE To examine potential differences in cerebellar volumes and their relationships with cognition between PD with (FOG+) and without FOG (FOG−). METHODS Sixty-three participants were divided into two groups, FOG+ (n=25) and FOG− (n=38), based on the New Freezing of Gait Questionnaire. Cognitive assessment included Trail Making, Stroop, Verbal Fluency, and Go-NoGo executive function tasks. All participants completed structural T1- and T2-weighted MRI scans. Imaging data were processed with FreeSurfer and the Spatially Unbiased Infratentorial toolbox to segment the cerebellum into individual lobules. RESULTS FOG+ performed significantly worse on phonemic verbal fluency (F(1, 22)=7.06, p=0.01) as well as the Go-NoGo task (F(1, 22)=9.00, p=0.004). We found no differences in cerebellar volumes between groups (F(4, 55)=1.42, p=0.24), but there were significant relationships between verbal fluency measures and lobule volumes in FOG−. CONCLUSIONS These findings underscore the need for longitudinal studies to better characterize potential changes in cerebellar volume, cognitive function, and functional connectivity between people with PD with and without FOG. PMID:28106569

Stroke care programme in Aragon (PAIA): strategy and outcomes for the period 2009-2014.

PubMed

Marta Moreno, J; Bestué Cardiel, M; Giménez Muñoz, A; Palacín Larroy, M

2018-06-01

In 2008, stroke mortality, morbidity, and disability rates in Aragon were higher than the average in Spain. These data underscored the need to develop a stroke care programme (PAIA). We present the dynamics of planning, implementation, evaluation, and improvement developed between 2009 and 2014 as well as the results of the PAIA after that 5-year period. Structure, processes, and outcomes have improved with reference to the key indicators of healthcare (audit: 2008, 2010, 2012) among others: stroke rate in 2013 was 2.07 (2.36 in 2008); 78% of strokes were managed in stroke units in 2014 (30% in 2008); rate of fibrinolysis was 8.3% in 2014 (4.4% in 2010); fibrinolysis was administered in secondary hospitals (30% of the total); fibrinolysis was administered by Telestroke in 9%; stroke mortality decreased (38%); 67.7 years of potential life lost (YPLL) in 2013 (144 in 2008); nurse training; development of neurosonology; networking; sharing protocols and best practices between health sectors, etc. CONCLUSIONS: Integrated process management and multidisciplinary teams distributed and deployed over an entire territory with established protocols, references, evaluations, and continuous development, have been proven powerful tools to ensure both quality and equality. The PAIA is a good example of clinical governance and networking due to its dynamic and sustained improvement and cooperation between clinicians. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Naturalistic distraction and driving safety in older drivers

PubMed Central

Aksan, Nazan; Dawson, Jeffrey D.; Emerson, Jamie L.; Yu, Lixi; Uc, Ergun Y.; Anderson, Steven W.; Rizzo, Matthew

2013-01-01

Objective This study aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and predict older driver performance given functioning in visual, motor, and cognitive domains. Background Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. Methods Two hundred and three drivers, 120 healthy older (61 men and 59 women, ages 65 years or greater) and 83 middle-aged drivers (38 men and 45 women, ages 40–64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Results Older drivers identified fewer landmarks and drove slower but committed more safety errors than middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers. Visual cognition predicted both traffic sign identification and safety errors while executive function predicted traffic sign identification over and above vision. Conclusion Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older driver management of driving tasks at multiple levels, and can help inform the design of on-road tests and interventions for older drivers. PMID:23964422

Epidemiology of Lung Cancer

PubMed Central

Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

2013-01-01

Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

Alternative and antioxidant therapies used by a sample of infertile males in Jordan: a cross-sectional survey

PubMed Central

2014-01-01

Background Complementary and alternative medicine (CAM) is frequently used in the Middle East, especially to treat chronic diseases such as infertility. We aimed to examine the prevalence, characteristics, and determinants of CAM use, particularly herbs and antioxidant therapies, among infertile males presenting for infertility evaluation in Jordan. Methods Demographic information, use of alternative and antioxidant therapies for infertility treatment, and patients’ belief in efficacy and safety of the therapies used were collected using a face-to-face questionnaire. Data were collected from 428 infertile male patients presenting at infertility clinics in Amman, the capital city of Jordan. The study was conducted between April 2013 and September 2013. Results Of the 428 men who completed the questionnaire, 184 (43%) used at least one of the alternative and antioxidant therapies specified in the questionnaire. Nutritional regime; vitamins, such as vitamins C and E; and medicinal herbs, such as ginger, saw palmetto, and ginseng were the most commonly used therapies reported. A correlation between the use of alternative and antioxidant therapies versus infertility duration was found. Additionally, the majority of males using CAM did not inform their health care providers about their usage. Conclusions The high prevalence of CAM use among infertile male patients underscores the urge to assimilate CAM into the education and training of health professionals, as well as to improve infertile patients’ knowledge of the safe use of CAM modalities. PMID:25026980

When the tobacco industry controls the news: KKR, RJR Nabisco, and the Weekly Reader Corporation

PubMed Central

DeJong, W.

1996-01-01

BACKGROUND: The Weekly Reader Corporation was acquired in 1991 by K-III Communications, whose majority shareholder is Kohlberg Kravis Roberts & Co. (KKR), best known for its leveraged buyout of tobacco conglomerate RJR Nabisco. Among other student newspapers, Weekly Reader publishes Current Events for students in grades 6-10 (ages 11-16). OBJECTIVE: To explore how KKR's ownership might have affected the content of tobacco- related news stories in Current Events, which reaches students at the very ages when many begin to experiment with tobacco. METHODS: A content analysis was conducted of 182 issues of Current Events, 71 pre- acquisition and 111 post-acquisition. Tobacco-related news was reported in four articles in the pre-acquisition issues and in 12 articles in the post-acquisition issues. RESULTS: The content of tobacco-related news stories shifted after KKR's acquisition to portray tobacco as a "forbidden fruit" that is attractive to teenagers. This was done by focusing on new policies and programmes to discourage teenagers from smoking, the mythical threat of prohibition, and the supposed popularity of smoking, while giving relatively little attention to the health consequences of tobacco use. CONCLUSIONS: After engineering a stock swap with Bordens in 1995, KKR no longer directly owns RJR Nabisco stock. This case study underscores the need for public health advocates to be watchful of the tobacco industry's efforts to control public access to news about tobacco. 


 PMID:8910997

Antiretroviral Therapy Outcomes of HIV-infected children in the TREAT Asia Pediatric HIV Observational Database

PubMed Central

Hansudewechakul, Rawiwan; Sirisanthana, Virat; Kurniati, Nia; Puthanakit, Thanyawee; Lumbiganon, Pagakrong; Yusoff, Nik Khairulddin Nik; Fong, Siew Moy; Nallusamy, Revathy; Srasuebkul, Preeyaporn; Law, Matthew; Sohn, Annette H.; Chokephaibulkit, Kulkanya

2010-01-01

Introduction We report responses to combination antiretroviral therapy (cART) in the TREAT Asia Pediatric HIV Observational Database. Methods Children included were those who had received cART (i.e., ≥3 antiretrovirals) at <18 years. The analysis was intention-to-treat by the first cART regimen. Median values are provided with interquartile ranges; hazard ratios (HR) with 95% confidence intervals. Results Of the 1655 children included, 50.4% were male, with a median age at cART of 7.0 (3.9, 9.8) years and CD4 of 8 (2.0, 15)%; 92.5% were started on an NNRTI; median duration of follow-up was 2.9 (1.4, 4.6) years. Loss-to-follow-up and death rates were 4.2 (3.7, 4.8) and 2.1 (1.7, 2.5) per 100 person-years, respectively. At 36 months, median CD4 was 26 (21, 31)%; 81% of those with viral load (N=302) were <400 copies/mL. Children who reached CD4 ≥25% within five years were more likely to be females (HR 1.4; 1.2, 1.7), start before 18 months old (HR 3.8; 2.4, 6.2), lack a history of mono/dual-therapy (HR 1.7; 1.4, 2.5), and have a higher baseline CD4 (per 10% increase: HR 2; 1.9, 2.2). Conclusion These data underscore the need for early diagnosis and cART initiation to preserve immune function. PMID:20842043

Simulation of a G-tolerance curve using the pulsatile cardiovascular model

NASA Technical Reports Server (NTRS)

Solomon, M.; Srinivasan, R.

1985-01-01

A computer simulation study, performed to assess the ability of the cardiovascular model to reproduce the G tolerance curve (G level versus tolerance time) is reported. A composite strength duration curve derived from experimental data obtained in human centrifugation studies was used for comparison. The effects of abolishing automomic control and of blood volume loss on G tolerance were also simulated. The results provide additional validation of the model. The need for the presence of autonomic reflexes even at low levels of G is pointed out. The low margin of safety with a loss of blood volume indicated by the simulation results underscores the necessity for protective measures during Shuttle reentry.

Health and labor supply in the context of HIV/AIDS: the long-run economic impacts on antiretroviral therapy*

PubMed Central

Thirumurthy, Harsha; Zivin, Joshua Graff

2011-01-01

Using longitudinal survey data collected in Kenya, this paper estimates the longer-term impacts of antiretroviral therapy (ART) on the labor supply of treated adults and their household members. Building upon previous work in Kenya, data collected from 2004–2006 indicate that early evidence on the short-run impacts of ART tends to be upheld over the long-term as well. The results show that the labor supply response among treated adults occurs rapidly and is sustained through the 3-year observation period in our study. These results underscore the strong relationship between health and labor supply that has been observed in other contexts. PMID:22984292

Tea, cocoa, coffee, and affective disorders: vicious or virtuous cycle?

PubMed

García-Blanco, Tatiana; Dávalos, Alberto; Visioli, Francesco

2017-12-15

The prevalence of psychiatric disorders is increasing worldwide, which underscores the importance of increasing research in this field, in terms of better detection, prevention based on improvement of lifestyle and diet, and effectiveness of treatment. Increasing evidence suggest that diet and exercise can affect proper neuronal development and physiology and protect the brain from neurological illnesses or injuries. Of note, cocoa, tea, and coffee are being actively investigated because they are rich in (poly)phenolic compounds that can modulate mental health, namely brain plasticity, behavior, mood, depression, and cognition. We here systematically review human studies conducted on tea, cocoa, and coffee as related to affective disorders such as depression and anxiety. We carried out a systematic literature search in April 2016, using MEDLINE, on data from the last 10 years. After screening 955 articles, we selected 17 articles that met the criteria of being human studies and that used whole foods or their components. The results of our systematic review indicate that consumption of tea, cocoa, or coffee might have protective effects against depression. Even though this is encouraging, it should be underscored that the near totality of the current evidence comes from observational studies. Ad-hoc human trials and mechanistic, basic science studies are needed before we can provide sound advice to the public. Copyright © 2016 Elsevier B.V. All rights reserved.

Field-scale experiments reveal persistent yield gaps in low-input and organic cropping systems

PubMed Central

Kravchenko, Alexandra N.; Snapp, Sieglinde S.; Robertson, G. Philip

2017-01-01

Knowledge of production-system performance is largely based on observations at the experimental plot scale. Although yield gaps between plot-scale and field-scale research are widely acknowledged, their extent and persistence have not been experimentally examined in a systematic manner. At a site in southwest Michigan, we conducted a 6-y experiment to test the accuracy with which plot-scale crop-yield results can inform field-scale conclusions. We compared conventional versus alternative, that is, reduced-input and biologically based–organic, management practices for a corn–soybean–wheat rotation in a randomized complete block-design experiment, using 27 commercial-size agricultural fields. Nearby plot-scale experiments (0.02-ha to 1.0-ha plots) provided a comparison of plot versus field performance. We found that plot-scale yields well matched field-scale yields for conventional management but not for alternative systems. For all three crops, at the plot scale, reduced-input and conventional managements produced similar yields; at the field scale, reduced-input yields were lower than conventional. For soybeans at the plot scale, biological and conventional managements produced similar yields; at the field scale, biological yielded less than conventional. For corn, biological management produced lower yields than conventional in both plot- and field-scale experiments. Wheat yields appeared to be less affected by the experimental scale than corn and soybean. Conventional management was more resilient to field-scale challenges than alternative practices, which were more dependent on timely management interventions; in particular, mechanical weed control. Results underscore the need for much wider adoption of field-scale experimentation when assessing new technologies and production-system performance, especially as related to closing yield gaps in organic farming and in low-resourced systems typical of much of the developing world. PMID:28096409

Pan-Cancer Molecular Classes Transcending Tumor Lineage Across 32 Cancer Types, Multiple Data Platforms, and over 10,000 Cases.

PubMed

Chen, Fengju; Zhang, Yiqun; Gibbons, Don L; Deneen, Benjamin; Kwiatkowski, David J; Ittmann, Michael; Creighton, Chad J

2018-05-01

Purpose: The Cancer Genome Atlas data resources represent an opportunity to explore commonalities across cancer types involving multiple molecular levels, but tumor lineage and histology can represent a barrier in moving beyond differences related to cancer type. Experimental Design: On the basis of gene expression data, we classified 10,224 cancers, representing 32 major types, into 10 molecular-based "classes." Molecular patterns representing tissue or histologic dominant effects were first removed computationally, with the resulting classes representing emergent themes across tumor lineages. Results: Key differences involving mRNAs, miRNAs, proteins, and DNA methylation underscored the pan-cancer classes. One class expressing neuroendocrine and cancer-testis antigen markers represented ∼4% of cancers surveyed. Basal-like breast cancers segregated into an exclusive class, distinct from all other cancers. Immune checkpoint pathway markers and molecular signatures of immune infiltrates were most strongly manifested within a class representing ∼13% of cancers. Pathway-level differences involving hypoxia, NRF2-ARE, Wnt, and Notch were manifested in two additional classes enriched for mesenchymal markers and miR200 silencing. Conclusions: All pan-cancer molecular classes uncovered here, with the important exception of the basal-like breast cancer class, involve a wide range of cancer types and would facilitate understanding the molecular underpinnings of cancers beyond tissue-oriented domains. Numerous biological processes associated with cancer in the laboratory setting were found here to be coordinately manifested across large subsets of human cancers. The number of cancers manifesting features of neuroendocrine tumors may be much higher than previously thought, which disease is known to occur in many different tissues. Clin Cancer Res; 24(9); 2182-93. ©2018 AACR . ©2018 American Association for Cancer Research.

Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors

PubMed Central

Dewa, Carolyn S.; Trojanowski, Lucy; Tamminga, Sietske J.; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S.

2016-01-01

Purpose The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice would you give someone who has been newly diagnosed with head and neck cancer? (2) What advice would you give to employers of these people? Methods Data were gathered through 10 individual semi-structured in-depth interviews with HNC clinic patients at a regional cancer center’s head and neck clinic in Ontario, Canada. A constant comparative method of theme development was used. Codes identified in and derived from the data were discussed by research team members until consensus was reached. Codes with similar characteristics were grouped together and used to develop overarching themes. Results Work-related advice for peers focused on personal self-care and interactions within workplaces. Work-related advice to employers focused on demonstrating basic human values as well as the importance of communication. Discussion The study results suggest HNC clinic patients should be proactive with employers and help to set reasonable expectations and provide a realistic plan for work to be successfully completed. HNC clinic patients should develop communication skills to effectively disclose their cancer and treatment to employers. Conclusions In this exploratory study, HNC clinic patients’ advice was solution-focused underscoring the importance of self-care and pro-active communication and planning with employers. Employers were advised to demonstrate core human values throughout all phases of the work disability episode beginning at diagnosis. PMID:27070654

Multidisciplinary management of patent foramen ovale (PFO) and cryptogenic stroke/TIA

PubMed Central

Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Eriksson, Peter; Dellborg, Mikael

2013-01-01

Purpose Patent foramen ovale (PFO) has been implicated as a risk factor for cryptogenic ischemic stroke (CS). However, there is still a lack of widely accepted, undisputed indications for PFO closure. The present study describes the concept of the multidisciplinary PFO conference and a decision making process for closure versus no closure that was developed into a formalized clinical algorithm, and presents the results of implementing these, in terms of number and proportion of PFO closures as well as repeat referrals. Design Five specialists in neurology, cardiology, internal medicine, thromboembolism, and echocardiography evaluated the clinical data of 311 patients at PFO conferences during 2006 to 2009. The main criteria for closure were patients with first-ever CS with PFO and atrial septal aneurysm, or patients with recurrent CS and PFO without atrial septal aneurysm. Results A total of 143 patients (46%) were accepted for closure and 167 patients were rejected. Patients accepted for closure were younger (mean 50 years versus 58 years) (P < 0.001). The acceptance rate for PFO closure was similar throughout these years, with an average of 45%. Three of 167 patients (1.8%) initially rejected for PFO closure were re-referred due to recurrent stroke, and the PFO closure was subsequently performed. Conclusion The acceptance rate of less than 50% in the present study underscores the complex relationship between CS and PFO. Whatever the criteria used for PFO closure, any unit caring for these patients needs to have a rigorous process to avoid overtreatment as well as undertreatment and to ensure that personal preferences and economic incentives do not steer the selection process. Our algorithm provides a stable acceptance rate and a low rate of repeat referrals. PMID:24082787

Associations Between Adult and Childhood Secondhand Smoke Exposures with Fecundity and Fetal Loss Among Women who Visited a Cancer Hospital

PubMed Central

Peppone, Luke J.; Piazza, Kenneth M.; Mahoney, Martin C.; Morrow, Gary R.; Mustian, Karen; Palesh, Oxana G.; Hyland, Andrew

2010-01-01

BACKGROUND A large percentage of the population continues to be exposed to secondhand smoke (SHS). Although studies have consistently linked active smoking to various pregnancy outcomes, results from the few studies examining SHS exposure and pregnancy difficulties have been inconsistent. METHODS Approximately 4,800 women who presented to Roswell Park Cancer Institute between 1982 and 1998 and reported being pregnant at least once were queried about their childhood and adult exposures to SHS using a standardized questionnaire. Women were asked to report on selected prenatal pregnancy outcomes (fetal loss and difficulty becoming pregnant). RESULTS Approximately 11.3% of women reported difficulty becoming pregnant, while 32% reported a fetal loss or 12.4% reported multiple fetal losses. Forty percent reported any prenatal pregnancy difficulty (fetal loss and/or difficulty becoming pregnant). SHS exposures from their parents were associated with difficulty becoming pregnant (OR=1.26, 95%CI 1.07–1.48) and lasting > 1 year (OR=1.34, 95%CI 1.12–1.60). Exposure to SHS in both at home during childhood and at the time of survey completion was also associated with fetal loss (OR=1.39, 95%CI 1.17–1.66) and multiple fetal losses (OR=1.62, 95%CI 1.25–2.11). Increasing current daily hours of SHS exposure as an adult was related to the occurrence of both multiple fetal loss and reduced fecundity (ptrend<0.05). CONCLUSIONS Reports of exposures to SHS during childhood and as an adult were associated with increased odds for prenatal pregnancy difficulties. These findings underscore the public health perspective that all persons, especially women in their reproductive years, should be fully protected from tobacco smoke. PMID:19039010

Neurohemodynamic Correlates of Washing Symptoms in Obsessive-compulsive Disorder: A Pilot fMRI Study Using Symptom Provocation Paradigm

PubMed Central

Agarwal, Sri Mahavir; Jose, Dania; Baruah, Upasana; Shivakumar, Venkataram; Kalmady, Sunil Vasu; Venkatasubramanian, Ganesan; Mataix-Cols, David; Reddy, Yemmigannur Chandrashekhar Janardhan

2013-01-01

Background: Obsessive-compulsive disorder (OCD) is increasingly being viewed as a multidimensional heterogeneous disorder caused due to the dysfunction of several closely related, overlapping frontostriatal circuits. A study investigating the dimensional construct in treatment naïve, co-morbidity free patients with identical handedness is likely to provide the necessary homogeneity and power to elicit neural correlates of the various symptom dimensions, and overcome the limitations of previous studies. Materials and Methods: Nine DSM-IV OCD patients with predominant contamination-related obsessive-compulsive symptoms (age=29.8±7.1 years; five males: four females; years-of-education=13.9±1.6, YBOCS total score=28.8±4.7, DYBOCS Contamination dimension score=10.7±1.8) and nine healthy controls matched one to one with the patients for age, sex, and years of education (age=27.8±5.4, five males: four females; years-of-education=14.9±3.0), were examined during symptom provocation task performance in 3TMRI. Paired samples t test of brain activation differences (contamination relevant pictures – neutral pictures), limited to apriori regions of interest was done using SPM8 (uncorrected P<0.005). Results: Patients found significantly more pictures to be anxiety provoking in comparison to healthy controls. Patients were found to have deficient activation in the following areas in comparison with healthy controls: bilateral anterior prefrontal, dorsolateral prefrontal, orbitofrontal, anterior cingulate, insular and parietal cortices, precuneus, and caudate. Conclusions: Results underscore the importance of frontal, striatal, parietal, and occipital areas in the pathophysiology of OCD. Divergence of findings from previous studies might be attributed to the absence of confounding factors in the current study and may be due to production of intense anxiety in patients. PMID:23833345

Reporting Crime Victimizations to the Police and the Incidence of Future Victimizations: A Longitudinal Study

PubMed Central

Ranapurwala, Shabbar I.; Berg, Mark T.; Casteel, Carri

2016-01-01

Background Law enforcement depends on cooperation from the public and crime victims to protect citizens and maintain public safety; however, many crimes are not reported to police because of fear of repercussions or because the crime is considered trivial. It is unclear how police reporting affects the incidence of future victimization. Objective To evaluate the association between reporting victimization to police and incident future victimization. Methods We conducted a retrospective cohort study using National Crime Victimization Survey 2008–2012 data. Participants were 12+ years old household members who may or may not be victimized, were followed biannually for 3 years, and who completed at least one follow-up survey after their first reported victimization between 2008 and 2012. Crude and adjusted generalized linear mixed regression for survey data with Poisson link were used to compare rates of future victimization. Results Out of 18,657 eligible participants, 41% participants reported to their initial victimization to police and had a future victimization rate of 42.8/100 person-years (PY) (95% CI: 40.7, 44.8). The future victimization rate of those who did not report to the police (59%) was 55.0/100 PY (95% CI: 53.0, 57.0). The adjusted rate ratio comparing police reporting to not reporting was 0.78 (95%CI: 0.72, 0.84) for all future victimizations, 0.80 (95% CI: 0.72, 0.90) for interpersonal violence, 0.73 (95% CI: 0.68, 0.78) for thefts, and 0.95 (95% CI: 0.84, 1.07) for burglaries. Conclusions Reporting victimization to police is associated with fewer future victimization, underscoring the importance of police reporting in crime prevention. This association may be attributed to police action and victim services provisions resulting from reporting. PMID:27466811

Learning from other people’s fear: amygdala-based social reference learning in social anxiety disorder

PubMed Central

Blair, K. S.; Otero, M.; Teng, C.; Geraci, M.; Lewis, E.; Hollon, N.; Blair, R. J. R.; Ernst, Monique; Grillon, C.; Pine, D. S.

2016-01-01

Background Social anxiety disorder involves fear of social objects or situations. Social referencing may play an important role in the acquisition of this fear and could be a key determinant in future biomarkers and treatment pathways. However, the neural underpinnings mediating such learning in social anxiety are unknown. Using event-related functional magnetic resonance imaging, we examined social reference learning in social anxiety disorder. Specifically, would patients with the disorder show increased amygdala activity during social reference learning, and further, following social reference learning, show particularly increased response to objects associated with other people’s negative reactions? Method A total of 32 unmedicated patients with social anxiety disorder and 22 age-, intelligence quotient- and gender-matched healthy individuals responded to objects that had become associated with others’ fearful, angry, happy or neutral reactions. Results During the social reference learning phase, a significant group × social context interaction revealed that, relative to the comparison group, the social anxiety group showed a significantly greater response in the amygdala, as well as rostral, dorsomedial and lateral frontal and parietal cortices during the social, relative to non-social, referencing trials. In addition, during the object test phase, relative to the comparison group, the social anxiety group showed increased bilateral amygdala activation to objects associated with others’ fearful reactions, and a trend towards decreased amygdala activation to objects associated with others’ happy and neutral reactions. Conclusions These results suggest perturbed observational learning in social anxiety disorder. In addition, they further implicate the amygdala and dorsomedial prefrontal cortex in the disorder, and underscore their importance in future biomarker developments. PMID:27476529

E-cigarette Availability and Promotion Among Retail Outlets Near College Campuses in Two Southeastern States

PubMed Central

Song, Eunyoung Y.; Egan, Kathleen L.; Sutfin, Erin L.; Reboussin, Beth A.; Spangler, John; Wolfson, Mark

2014-01-01

Introduction: E-cigarettes are relatively new products that simulate the smoking experience. This descriptive study assessed changes in e-cigarette availability and promotions among retailers in 11 college communities in North Carolina and Virginia during a 1-year period. Methods: During the spring of 2012 and 2013, observers completed assessments in 320 tobacco-selling retailers, including grocery and convenience stores, pharmacies, and tobacco shops. Assessors collected e-cigarette availability, advertising, price, and promotions. Results: E-cigarette availability increased among retailers from 24.7% in 2012 to 59.9% in 2013. They were available in the form of disposables and reusable kits and were most frequently available in tobacco shops, convenience stores, and pharmacies. The average price for disposables was $9.70 (SD = 1.07) in 2012 and $9.61 (SD = 2.10) in 2013; the average price for kits was $39.58 (SD = 15.79) in 2012 and $32.59 (SD = 18.65) in 2013. The presence of interior advertising increased from 12.7% to 50.6% (p < .0001), and the presence of exterior advertising increased from 7.6% to 22.8% (p = .0002). Convenience stores with gas (16.4%–70.4%; p < .0001) and without gas (6.0%–48.4%; p < .0001) had significant increases in the presence of interior advertising. Convenience stores with gas also had a significant increase in the presence of exterior advertising (8.2%–33.3%; p < .0001). Only 3% of retailers offered price promotions. Conclusions: Availability of e-cigarettes, including rechargeable kits and disposables, more than doubled during the study. The presence of interior and exterior advertising also significantly increased. Results underscore the need for further surveillance to understand how these environmental characteristics impact individual exposure and use of e-cigarettes. PMID:24847099

Caloric restriction coupled with radiation decreases metastatic burden in triple negative breast cancer

PubMed Central

Simone, Brittany A.; Dan, Tu; Palagani, Ajay; Jin, Lianjin; Han, Sunny Y.; Wright, Christopher; Savage, Jason E.; Gitman, Robert; Lim, Meng Kieng; Palazzo, Juan; Mehta, Minesh P.; Simone, Nicole L.

2016-01-01

ABSTRACT Purpose: Metastatic breast cancer is devastating and triple negative breast cancers (TNBC) have a higher propensity for metastasis. Improved local control upfront in this aggressive cancer could potentially decrease its propensity toward metastasis. We sought to determine if using caloric restriction (CR) as a systemic therapy, combined with radiation therapy (IR) to the primary tumor, may impact metastatic disease. Methods: An orthotopic mouse model using a highly metastatic, luciferase-tagged TNBC cell line (4T1), was used to generate palpable tumors. Mice were then treated with CR, IR, and a combination of the two. In vivo imaging was performed for metastatic evaluation. Molecular evaluation of the tumors was performed, generating a mechanistic hypothesis for CR, which was then tested with pertinent pathway inhibition in the model. Results: CR significantly increased the time to developing metastases, decreased the overall number and volume of lung metastases, and increased survival. CR decreased proliferation, increased apoptosis and globally downregulated the IGF-1R signaling pathway. Adding an IGF-1R/INSR inhibitor to local IR in vivo accomplished a decrease in metastases similar to CR plus IR, demonstrating the importance of the IGF-1R signaling pathway, and underscoring it as a possible mechanism for CR. Conclusions: CR decreased metastatic burden and therefore may complement cytotoxic therapies being used in the clinical setting for metastatic disease. Downregulation of the IGF-1R pathway, is in part responsible for this response and modulating IGF-1R directly resulted in similar improved progression-free survival. The novel use of CR has the potential to enhance clinical outcomes for patients with metastatic breast cancer. PMID:27027731

Examination of the Dynamic Interplay between Posttraumatic Stress Symptoms and Alcohol Misuse among Combat-Exposed Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans

PubMed Central

Langdon, Kirsten J.; Fox, Annie B.; King, Lynda A.; King, Daniel W.; Eisen, Susan; Vogt, Dawne

2016-01-01

Background Although alcohol misuse co-occurs with PTSD symptoms at a strikingly high rate (i.e., nearly 52% of men and 28% of women with PTSD also meet diagnostic criteria for an Alcohol Use Disorder; Kessler et al., 1995), the functional associations between these symptom types remain unclear. Methods The current study sought to clarify the nature of posttraumatic stress-alcohol misuse relations by employing a prospective longitudinal methodology - the latent difference score approach - to examine dynamic change in posttraumatic stress symptoms and alcohol misuse among 478 combat-exposed Veterans completing a longitudinal survey of post-deployment mental and physical health. This study builds on the existing literature, as most prior research has been limited to cross-sectional studies and has not explored prospective relations between specific PTSD symptom clusters and alcohol misuse. Results Consistent with the self-medication model, results indicated that PTSD symptoms demonstrate a prospective and proximal association with alcohol misuse during the assessment period; however, alcohol misuse did not appear to be a unique contributor to overall PTSD symptom exacerbation over time. Examination of individual PTSD symptom clusters revealed that more severe symptoms of intrusion and numbing, but not avoidance and hyperarousal, predicted greater alcohol misuse at subsequent time intervals. Limitations The constructs examined within this investigation relied on self-report data; diagnostic criteria for PTSD and/or Alcohol Use Disorders were not assessed. Future work may benefit from replicating these findings in clinical populations formally diagnosed with PTSD via clinician-administered structured interviews. Conclusions Findings underscore the importance of addressing PTSD symptoms in the context of alcohol treatment to facilitate improved drinking outcomes. PMID:26938966

Long-term supplementation of decaffeinated green tea extract does not modify body weight or abdominal obesity in a randomized trial of men at high risk for prostate cancer

PubMed Central

Kumar, Nagi B.; Patel, Roshni; Pow-Sang, Julio; Spiess, Philippe E.; Salup, Raoul; Williams, Christopher R.; Schell, Michael J.

2017-01-01

Background Evidence continues to demonstrate the role of obesity in prostate carcinogenesis and prognosis, underscoring the need to identify and continue to evaluate the effective interventions to reduce obesity in populations at high risk. The aim of the study was to determine the effect of daily consumption of decaffeinated green tea catechins (GTC) formulation (Polyphenon E® (PolyE)) for 1 year on biomarkers of obesity in men who are at high risk for prostate cancer. Materials and Methods A randomized, double-blinded trial was conducted targeting 97 men diagnosed with HGPIN or ASAP. Subjects were randomized to receive GTC (PolyE) (n = 49) or placebo (n = 48) for 1 year. Anthropometric data were collected at baseline, 6 and 12 months and data analyzed to observe change in weight, body mass index (indicator of obesity) and waist: hip ratio (indicator of abdominal obesity). Results Decaffeinated GTC containing 400 mgs of the bioactive catechin, EGCG administered for 1 year to men diagnosed with ASAP and HGPIN appears to be bioavailable, well tolerated but not effective in reducing biomarkers of obesity including body weight, body mass index and waist: hip ratio. Conclusions The results of our trial demonstrates that men who are obese and at high risk for prostate cancer should resort to effective weight management strategies to reduce obesity and not resort to ineffective measures such as taking supplements of green tea to reduce biomarkers of obesity. Changes in body mass index and abdominal obesity seen in other studies were potentially due to caffeine and not GTC. PMID:29228755

Maternal neglect with reduced depressive-like behavior and blunted c-fos activation in Brattleboro mothers, the role of central vasopressin.

PubMed

Fodor, Anna; Klausz, Barbara; Pintér, Ottó; Daviu, Nuria; Rabasa, Cristina; Rotllant, David; Balazsfi, Diana; Kovacs, Krisztina B; Nadal, Roser; Zelena, Dóra

2012-09-01

Early mother-infant relationships exert important long-term effects in offspring and are disturbed by factors such as postpartum depression. We aimed to clarify if lack of vasopressin influences maternal behavior paralleled by the development of a depressive-like phenotype. We compared vasopressin-deficient Brattleboro mothers with heterozygous and homozygous normal ones. The following parameters were measured: maternal behavior (undisturbed and separation-induced); anxiety by the elevated plus maze; sucrose and saccharin preference and forced swim behavior. Underlying brain areas were examined by c-fos immunocytochemistry among rest and after swim-stress. In another group of rats, vasopressin 2 receptor agonist was used peripherally to exclude secondary changes due to diabetes insipidus. Results showed that vasopressin-deficient rats spend less time licking-grooming their pups through a centrally driven mechanism. There was no difference between genotypes during the pup retrieval test. Vasopressin-deficient mothers tended to explore more the open arms of the plus maze, showed more preference for sucrose and saccharin and struggled more in the forced swim test, suggesting that they act as less depressive. Under basal conditions, vasopressin-deficient mothers had more c-fos expression in the medial preoptic area, shell of nucleus accumbens, paraventricular nucleus of the hypothalamus and amygdala, but not in other structures. In these areas the swim-stress-induced activation was smaller. In conclusion, vasopressin-deficiency resulted in maternal neglect due to a central effect and was protective against depressive-like behavior probably as a consequence of reduced activation of some stress-related brain structures. The conflicting behavioral data underscores the need for more sex specific studies. Copyright © 2012 Elsevier Inc. All rights reserved.

Field-scale experiments reveal persistent yield gaps in low-input and organic cropping systems.

PubMed

Kravchenko, Alexandra N; Snapp, Sieglinde S; Robertson, G Philip

2017-01-31

Knowledge of production-system performance is largely based on observations at the experimental plot scale. Although yield gaps between plot-scale and field-scale research are widely acknowledged, their extent and persistence have not been experimentally examined in a systematic manner. At a site in southwest Michigan, we conducted a 6-y experiment to test the accuracy with which plot-scale crop-yield results can inform field-scale conclusions. We compared conventional versus alternative, that is, reduced-input and biologically based-organic, management practices for a corn-soybean-wheat rotation in a randomized complete block-design experiment, using 27 commercial-size agricultural fields. Nearby plot-scale experiments (0.02-ha to 1.0-ha plots) provided a comparison of plot versus field performance. We found that plot-scale yields well matched field-scale yields for conventional management but not for alternative systems. For all three crops, at the plot scale, reduced-input and conventional managements produced similar yields; at the field scale, reduced-input yields were lower than conventional. For soybeans at the plot scale, biological and conventional managements produced similar yields; at the field scale, biological yielded less than conventional. For corn, biological management produced lower yields than conventional in both plot- and field-scale experiments. Wheat yields appeared to be less affected by the experimental scale than corn and soybean. Conventional management was more resilient to field-scale challenges than alternative practices, which were more dependent on timely management interventions; in particular, mechanical weed control. Results underscore the need for much wider adoption of field-scale experimentation when assessing new technologies and production-system performance, especially as related to closing yield gaps in organic farming and in low-resourced systems typical of much of the developing world.

Collaboration challenges in systematic reviews: a survey of health sciences librarians

PubMed Central

Nicholson, Joey; McCrillis, Aileen; Williams, Jeff D.

2017-01-01

Objective: While many librarians have been asked to participate in systematic reviews with researchers, often these researchers are not familiar with the systematic review process or the appropriate role for librarians. The purpose of this study was to identify the challenges and barriers that librarians face when collaborating on systematic reviews. To take a wider view of the whole process of collaborating on systematic reviews, the authors deliberately focused on interpersonal and methodological issues other than searching itself. Methods: To characterize the biggest challenges that librarians face while collaborating on systematic review projects, we used a web-based survey. The thirteen-item survey included seventeen challenges grouped into two categories: methodological and interpersonal. Participants were required to indicate the frequency and difficulty of the challenges listed. Open-ended questions allowed survey participants to describe challenges not listed in the survey and to describe strategies used to overcome challenges. Results: Of the 17 challenges listed in the survey, 8 were reported as common by over 40% of respondents. These included methodological issues around having too broad or narrow research questions, lacking eligibility criteria, having unclear research questions, and not following established methods. The remaining challenges were interpersonal, including issues around student-led projects and the size of the research team. Of the top 8 most frequent challenges, 5 were also ranked as most difficult to handle. Open-ended responses underscored many of the challenges included in the survey and revealed several additional challenges. Conclusions: These results suggest that the most frequent and challenging issues relate to development of the research question and general communication with team members. Clear protocols for collaboration on systematic reviews, as well as a culture of mentorship, can help librarians prevent and address these challenges. PMID:28983202

Personality and HIV Disease Progression: Role of NEO-PI-R Openness, Extraversion, and Profiles of Engagement

PubMed Central

O'Cleirigh, Conall; Schneiderman, Neil; Weiss, Alexander; Costa, Paul T.

2008-01-01

Objective To examine the role of the big five personality domains (Neuroticism, Extraversion, Openness, Agreeableness, Conscientiousness) and their respective facets and profiles on change in CD4 and log HIV-RNA copies/ml (VL) over 4 years. The examination of psychosocial predictors of disease progression in human immunodeficiency virus (HIV) has focused primarily on depression, coping, and stress, with little attention paid to stable individual differences. Methods A diverse sample of HIV-seropositive patients (n = 104) completed personality assessment (NEO-PI-R), underwent comprehensive psychological assessment and blood samples every 6 months for 4 years. Linear rates of change for CD4 cells and VL were modeled using Hierarchical Linear Modeling controlling for antiretrovirals (time dependent covariate), initial disease status, age, gender, ethnicity, and education. Results Domains that were significantly associated with slower disease progression over 4 years included Openness (CD4, VL), Extraversion (CD4, VL), and Conscientiousness (VL). Facets of the above domains that were significantly related to slower disease progression were assertiveness, positive emotions, and gregariousness (Extraversion); ideas, esthetics (Openness); achievement striving and order (Conscientiousness). In addition, profile analyses suggested personality styles which seem to underscore the importance of remaining engaged (e.g., Creative Interactors (E+O+), Upbeat Optimists (N−E+), Welcomers (E+A+), Go Getters (C+E+), and Directed (N−C+)) had slower disease progression, whereas the “homebody” profile (Low Extraversion-Low Openness) was significantly associated with faster disease progression. Conclusions These results provide good initial evidence of the relationship between personality and disease progression in HIV and suggest protective aspects of profiles of engagement. These finding may help identify those individuals at risk for poorer disease course and specify targets for psychosocial interventions. PMID:18256349

Effect of Ebola Progression on Transmission and Control in Liberia

PubMed Central

Yamin, Dan; Gertler, Shai; Ndeffo-Mbah, Martial L.; Skrip, Laura A.; Fallah, Mosoka; Nyenswah, Tolbert G.; Altice, Frederick L.; Galvani, Alison P.

2015-01-01

Background The Ebola outbreak that is sweeping across West Africa is the largest, most volatile, and deadliest Ebola epidemic ever recorded. Liberia is the most profoundly affected country, with more than 3500 infections and 2000 deaths recorded in the past 3 months. Objective To evaluate the contribution of disease progression and case fatality on transmission and to examine the potential for targeted interventions to eliminate the disease. Design Stochastic transmission model that integrates epidemiologic and clinical data on incidence and case fatality, daily viral load among survivors and nonsurvivors evaluated on the basis of the 2000–2001 outbreak in Uganda, and primary data on contacts of patients with Ebola in Liberia. Setting Montserrado County, Liberia, July to September 2014. Measurements Ebola incidence and case-fatality records from 2014 Liberian Ministry of Health and Social Welfare. Results The average number of secondary infections generated throughout the entire infectious period of a single infected case, R, was estimated as 1.73 (95% CI, 1.66 to 1.83). There was substantial stratification between survivors (RSurvivors), for whom the estimate was 0.66 (CI, 0.10 to 1.69), and nonsurvivors (RNonsurvivors), for whom the estimate was 2.36 (CI, 1.72 to 2.80). The nonsurvivors had the highest risk for transmitting the virus later in the course of disease progression. Consequently, the isolation of 75% of infected individuals in critical condition within 4 days from symptom onset has a high chance of eliminating the disease. Limitation Projections are based on the initial dynamics of the epidemic, which may change as the outbreak and interventions evolve. Conclusion These results underscore the importance of isolating the most severely ill patients with Ebola within the first few days of their symptomatic phase. Primary Funding Source National Institutes of Health. PMID:25347321

Influence of family dynamics on burden among family caregivers in aging Japan

PubMed Central

Kusaba, Tesshu; Sato, Kotaro; Fukuma, Shingo; Yamada, Yukari; Matsui, Yoshinori; Matsuda, Satoshi; Ando, Takashi; Sakushima, Ken; Fukuhara, Shunichi

2016-01-01

Background. Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. Objective. To examine the influence of family dynamics on burden experienced by family caregivers. Methods. We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver’s activity of daily living and cognitive function. Results. Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). Conclusion. Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver’s degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers. PMID:27450988

K-RAS(V12) Induces Autocrine Production of EGFR Ligands and Mediates Radioresistance Through EGFR-Dependent Akt Signaling and Activation of DNA-PKcs

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

Minjgee, Minjmaa; Toulany, Mahmoud; Kehlbach, Rainer

2011-12-01

Purpose: It is known that postirradiation survival of tumor cells presenting mutated K-RAS is mediated through autocrine activation of epidermal growth factor receptor (EGFR). In this study the molecular mechanism of radioresistance of cells overexpressing mutated K-RAS(V12) was investigated. Methods and Materials: Head-and-neck cancer cells (FaDu) presenting wild-type K-RAS were transfected with empty vector or vector expressing mutated K-RAS(V12). The effect of K-RAS(V12) on autocrine production of EGFR ligands, activation of EGFR downstream pathways, DNA damage repair, and postirradiation survival was analyzed. Results: Conditioned medium collected from K-RAS(V12)-transfected cells enhanced activation of the phosphatidylinositol-3-kinase-Akt pathway and increased postirradiation survival ofmore » wild-type K-RAS parental cells when compared with controls. These effects were reversed by amphiregulin (AREG)-neutralizing antibody. In addition, secretion of the EGFR ligands AREG and transforming growth factor {alpha} was significantly increased upon overexpression of K-RAS(V12). Expression of mutated K-RAS(V12) resulted in an increase in radiation-induced DNA-dependent protein kinase catalytic subunit (DNA-PKcs) phosphorylation at S2056. This increase was accompanied by increased repair of DNA double-strand breaks. Abrogation of DNA-PKcs phosphorylation by serum depletion or AREG-neutralizing antibody underscored the role of autocrine production of EGFR ligands, namely, AREG, in regulating DNA-PKcs activation in K-RAS mutated cells. Conclusions: These data indicate that radioresistance of K-RAS mutated tumor cells is at least in part due to constitutive production of EGFR ligands, which mediate enhanced repair of DNA double-strand breaks through the EGFR-phosphatidylinositol-3-kinase-Akt cascade.« less

Urine proteome analysis in Dent's disease shows high selective changes potentially involved in chronic renal damage.

PubMed

Santucci, Laura; Candiano, Giovanni; Anglani, Franca; Bruschi, Maurizio; Tosetto, Enrica; Cremasco, Daniela; Murer, Luisa; D'Ambrosio, Chiara; Scaloni, Andrea; Petretto, Andrea; Caridi, Gianluca; Rossi, Roberta; Bonanni, Alice; Ghiggeri, Gian Marco

2016-01-01

Definition of the urinary protein composition would represent a potential tool for diagnosis in many clinical conditions. The use of new proteomic technologies allows detection of genetic and post-trasductional variants that increase sensitivity of the approach but complicates comparison within a heterogeneous patient population. Overall, this limits research of urinary biomarkers. Studying monogenic diseases are useful models to address this issue since genetic variability is reduced among first- and second-degree relatives of the same family. We applied this concept to Dent's disease, a monogenic condition characterised by low-molecular-weight proteinuria that is inherited following an X-linked trait. Results are presented here on a combined proteomic approach (LC-mass spectrometry, Western blot and zymograms for proteases and inhibitors) to characterise urine proteins in a large family (18 members, 6 hemizygous patients, 6 carrier females, and 6 normals) with Dent's diseases due to the 1070G>T mutation of the CLCN5. Gene ontology analysis on more than 1000 proteins showed that several clusters of proteins characterised urine of affected patients compared to carrier females and normal subjects: proteins involved in extracellular matrix remodelling were the major group. Specific analysis on metalloproteases and their inhibitors underscored unexpected mechanisms potentially involved in renal fibrosis. Studying with new-generation techniques for proteomic analysis of the members of a large family with Dent's disease sharing the same molecular defect allowed highly repetitive results that justify conclusions. Identification in urine of proteins actively involved in interstitial matrix remodelling poses the question of active anti-fibrotic drugs in Dent's patients. Copyright © 2015 Elsevier B.V. All rights reserved.

Explaining Andean Potato Weevils in Relation to Local and Landscape Features: A Facilitated Ecoinformatics Approach

PubMed Central

Parsa, Soroush; Ccanto, Raúl; Olivera, Edgar; Scurrah, María; Alcázar, Jesús; Rosenheim, Jay A.

2012-01-01

Background Pest impact on an agricultural field is jointly influenced by local and landscape features. Rarely, however, are these features studied together. The present study applies a “facilitated ecoinformatics” approach to jointly screen many local and landscape features of suspected importance to Andean potato weevils (Premnotrypes spp.), the most serious pests of potatoes in the high Andes. Methodology/Principal Findings We generated a comprehensive list of predictors of weevil damage, including both local and landscape features deemed important by farmers and researchers. To test their importance, we assembled an observational dataset measuring these features across 138 randomly-selected potato fields in Huancavelica, Peru. Data for local features were generated primarily by participating farmers who were trained to maintain records of their management operations. An information theoretic approach to modeling the data resulted in 131,071 models, the best of which explained 40.2–46.4% of the observed variance in infestations. The best model considering both local and landscape features strongly outperformed the best models considering them in isolation. Multi-model inferences confirmed many, but not all of the expected patterns, and suggested gaps in local knowledge for Andean potato weevils. The most important predictors were the field's perimeter-to-area ratio, the number of nearby potato storage units, the amount of potatoes planted in close proximity to the field, and the number of insecticide treatments made early in the season. Conclusions/Significance Results underscored the need to refine the timing of insecticide applications and to explore adjustments in potato hilling as potential control tactics for Andean weevils. We believe our study illustrates the potential of ecoinformatics research to help streamline IPM learning in agricultural learning collaboratives. PMID:22693551

Imaging Intratumoral Convection: Pressure Dependent Enhancement in Chemotherapeutic Delivery to Solid Tumors

PubMed Central

Gade, Terence P.F.; Buchanan, Ian M.; Motley, Matthew W.; Mazaheri, Yousef; Spees, William M.; Koutcher, Jason A.

2014-01-01

Purpose Low molecular weight (LMW) chemotherapeutics are believed to reach tumors through diffusion across capillary beds as well as membrane transporters. Unexpectedly, the delivery of these agents appears to be augmented by reductions in tumor interstitial fluid pressure (TIFP), an effect typically associated with high molecular weight molecules which reach tumors principally through convection. We investigated the hypothesis that improved intratumoral convection can alter tumor metabolism and enhance the delivery of a LMW chemotherapeutic agent to solid tumors. Experimental Design For this purpose we applied 31P/19F MR spectroscopy and spectroscopic imaging to examine the influence of type I collagenase on tumor bioenergetics and the delivery of 5-fluorouracil (5FU) to HT29 human colorectal tumors grown subcutaneously in mice. Results Collagenase effected a 34% reduction in TIFP with an attendant disintegration of intratumoral collagen. Neither mice administered collagenase nor controls receiving PBS demonstrated changes in 31PMRS-measured tumor bioenergetics; however, a time-dependent increase in the content of extracellular inorganic phosphate (Pie) was observed in tumors of collagenase-treated animals. 31PMRSI demonstrated that this increase underscored a more homogeneous distribution of Pie in tumors of experimental mice. 19FMRS showed that these changes were associated with a 50% increase in 5FU uptake in tumors of experimental versus control animals; however, this increase resulted in an increase in 5FU catabolites rather than fluoronucleotide intermediates that are required for subsequent cytotoxicity. Conclusions These data indicate that the modulation of convective flow within tumors can improve the delivery of (LMW) chemotherapeutics and demonstrate the potential role for non-invasive imaging of this process in vivo. PMID:19118052

Comparing the Maryland Comprehensive Cancer Control Plan With Federal Cancer Prevention and Control Recommendations

PubMed Central

Platz, Elizabeth A.; Diener-West, Marie; Hokenmaier, Sarah; Truss, Meredith; Lewis, Courtney; Kanarek, Norma F.

2015-01-01

Introduction Since the introduction of the Affordable Care Act (ACA) in 2012, 11 million more Americans now have access to preventive services via health care coverage. Several prevention-related recommendations issued by the US Preventive Services Task Force (USPSTF), Centers for Disease Control and Prevention (CDC), and Advisory Committee on Immunization Practices (ACIP) are covered under the ACA. State cancer plans often provide prevention strategies, but whether these strategies correspond to federal evidence-based recommendations is unclear. The objective of this article is to assess whether federal evidence-based recommendations, including those covered under the ACA, are included in the Maryland Comprehensive Cancer Control Plan (MCCCP). Methods A total of 19 federal recommendations pertaining to cancer prevention and control were identified. Inclusion of federal cancer-related recommendations by USPSTF, CDC, and ACIP in the MCCCP’s goals, objectives, and strategies was examined. Results Nine of the federal recommendations were issued after the MCCCP’s publication. MCCCP recommendations corresponded completely with 4 federal recommendations and corresponded only partially with 3. Reasons for partial correspondence included specification of less restrictive at-risk populations or different intervention implementers. Three federal recommendations were not mentioned in the MCCCP’s goals, objectives, and strategies. Conclusion Many cancer-related federal recommendations were released after the MCCCP’s publication and therefore do not appear in the most current version. We recommend that the results of this analysis be considered in the update of the MCCCP. Our findings underscore the need for a periodic scan for changes to federal recommendations and for adjusting state policies and programs to correspond with federal recommendations, as appropriate for Marylanders. PMID:26425867

A spatial analysis of amyotrophic lateral sclerosis (ALS) cases in the United States and their proximity to multidisciplinary ALS clinics, 2013

PubMed Central

Horton, D. Kevin; Graham, Shannon; Punjani, Reshma; Wilt, Grete; Kaye, Wendy; Maginnis, Kimberly; Webb, Lauren; Richman, Judy; Bedlack, Richard; Tessaro, Edward; Mehta, Paul

2017-01-01

Background Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease that typically results in death within 2–5 years of initial symptom onset. Multidisciplinary ALS clinics (MDCs) have been established to provide specialty care to people living with the disease. Objective To estimate the proximity of ALS prevalence cases to the nearest MDC in the US to help evaluate one aspect of access to care. Methods Using 2013 prevalence data from the National ALS Registry, cases were geocoded by city using geographic information system (GIS) software, along with the locations of all MDCs in operation during 2013. Case-to-MDC proximity was calculated and analyzed by sex, race, and age group. Results During 2013, there were 72 MDCs in operation in 30 different states. A total of 15,633 ALS cases were geocoded and were distributed throughout all 50 states. Of these, 62.6% were male, 77.9% were white, and 76.2% were 50–79 years old. For overall case-to-MDC proximity, nearly half (44.9%) of all geocoded cases in the US lived >50 miles from an MDC, including approximately a quarter who lived >100 miles from an MDC. There was a statistically significant difference between distance to MDC by race and age group. Conclusions The high percentage of those living more than 50 miles from the nearest specialized clinic underscores one of the many challenges of ALS. Having better access to care, whether at MDCs or through other modalities, is likely key to increasing survivability and obtaining appropriate end-of-life treatment and support for people with ALS. PMID:29262737

Neuropsychiatric symptoms as the main determinant of caregiver burden in Alzheimer’s disease

PubMed Central

Kochhann, Renata; Borba, Ericksen; Cerveira, Maria Otília; Onyszko, Diego; de Jesus, Alyne; Forster, Letícia; Franciscatto, Luisa; Godinho, Cláudia; Camozzato, Ana Luiza; Chaves, Márcia Lorena F.

2011-01-01

Caregiver burden is common in Alzheimer’s disease (AD), decreasing the quality of life among caregivers and patients. Projections of aging and aging-related diseases such as AD in developing countries justify additional data about this issue because people living in these countries have shown similarly high levels of caregiver strain as in the developed world. Objective The aim of this study was to analyze the association of AD caregivers’ burden with patients’ neuropsychiatric symptoms (NPS), cognitive status, severity of dementia, functional capacity, caregiver sociodemographic characteristics, and the characteristics of care provided by caregivers. Methods A cross-sectional study was conducted in a sample of 39 consecutive AD patients and their primary caregivers. NPS were evaluated using the Neuropsychiatric Inventory (NPI). Severity of dementia was assessed with the Clinical Dementia Rating (CDR) scale. Functional capacity was assessed using the Katz and Lawton scales. The burden level was rated using the Burden Interview (BI). Sociodemographic characteristics of caregivers and the characteristics of care provided by them were evaluated. The Mann-Whitney U-test, Kruskal-Wallis test and Spearman’s rho coefficient were performed. Results The BI had a moderate correlation with NPI intensity (rho=0.563), p<001. Female caregivers reported a greater level of burden (p=0.031) than male caregivers. The other variables were not significantly associated to caregiver burden. Conclusion NPS were the main determinant of burden in primary caregivers of AD patients. This result underscores the need for prevention and treatment of these symptoms. Sex also had an effect on caregiver burden, but the small male sample in this study precludes the generalization of this finding. PMID:29213745

DRUG USE PATTERNS PREDICT RISK OF NON-FATAL OVERDOSE AMONG STREET-INVOLVED YOUTH IN A CANADIAN SETTING

PubMed Central

Mitra, Goldis; Wood, Evan; Nguyen, Paul; Kerr, Thomas; DeBeck, Kora

2015-01-01

Background Non-fatal drug overdose is a major cause of morbidity among people who use drugs, although few studies have examined this risk among street-involved youth. We sought to determine the risk factors associated with non-fatal overdose among Canadian street-involved youth who reported illicit drug use. Methods Using data from a prospective cohort of street-involved youth in Vancouver, Canada, we identified youth without a history of overdose and employed Cox regression analyses to determine factors associated with time to non-fatal overdose between September 2005 and May 2012. Results Among 615 participants, 98 (15.9%) reported a non-fatal overdose event during follow-up, resulting in an incidence density of 7.67 cases per 100 person-years. In multivariate Cox regression analyses, binge drug use (adjusted hazard ratio [AHR] = 1.85; 95% confidence interval [CI] = 1.20 – 2.84), non-injection crystal methamphetamine use (AHR = 1.70; 95% CI = 1.12 – 2.58), non-injection prescription opiate use (AHR = 2.56; 95% CI = 1.36 – 4.82), injection prescription opiate use (AHR = 2.49; 95% CI = 1.40 – 4.45) and injection heroin use (AHR = 1.85; 95% CI = 1.14 – 3.00) were positively associated with time to non-fatal overdose. Social, behavioural and demographic factors were not significantly associated with time to non-fatal overdose event. Conclusions Rates of non-fatal overdose were high among street-involved youth. Drug use patterns, in particular prescription opiate use, were associated with overdose. These findings underscore the importance of addiction treatment and prevention efforts aimed at reducing the risk of overdose among youth. PMID:26096535

Leveraging health information technology to achieve the “triple aim” of healthcare reform

PubMed Central

Sood, Harpreet S; Bates, David W

2015-01-01

Objective To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. Materials and methods In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. Results The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to “kick the legs from underneath the fee-for-service model” and replace it with a data-driven reimbursement system that rewards high quality care. Conclusions The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm—addressing these issues therefore needs to be the federal government’s main policy target. PMID:25882032

The Effect of Virus-Blocking Wolbachia on Male Competitiveness of the Dengue Vector Mosquito, Aedes aegypti

PubMed Central

Segoli, Michal; Hoffmann, Ary A.; Lloyd, Jane; Omodei, Gavin J.; Ritchie, Scott A.

2014-01-01

Background The bacterial endosymbiont Wolbachia blocks the transmission of dengue virus by its vector mosquito Aedes aegypti, and is currently being evaluated for control of dengue outbreaks. Wolbachia induces cytoplasmic incompatibility (CI) that results in the developmental failure of offspring in the cross between Wolbachia-infected males and uninfected females. This increases the relative success of infected females in the population, thereby enhancing the spread of the beneficial bacterium. However, Wolbachia spread via CI will only be feasible if infected males are sufficiently competitive in obtaining a mate under field conditions. We tested the effect of Wolbachia on the competitiveness of A. aegypti males under semi-field conditions. Methodology/Principal Findings In a series of experiments we exposed uninfected females to Wolbachia-infected and uninfected males simultaneously. We scored the competitiveness of infected males according to the proportion of females producing non-viable eggs due to incompatibility. We found that infected males were equally successful to uninfected males in securing a mate within experimental tents and semi-field cages. This was true for males infected by the benign wMel Wolbachia strain, but also for males infected by the virulent wMelPop (popcorn) strain. By manipulating male size we found that larger males had a higher success than smaller underfed males in the semi-field cages, regardless of their infection status. Conclusions/Significance The results indicate that Wolbachia infection does not reduce the competitiveness of A. aegypti males. Moreover, the body size effect suggests a potential advantage for lab-reared Wolbachia-males during a field release episode, due to their better nutrition and larger size. This may promote Wolbachia spread via CI in wild mosquito populations and underscores its potential use for disease control. PMID:25502564

Correction of hypophosphatasia (HPP) associated mineralization deficiencies in vitro by phosphate/pyrophosphate modulation in periodontal ligament cells

PubMed Central

Rodrigues, Thaisângela L.; Foster, Brian L.; Silverio, Karina G.; Martins, Luciane; Casati, Marcio Z.; Sallum, Enilson A.; Somerman, Martha J.; Nociti, Francisco H.

2013-01-01

Background Mutations in the Alpl gene in hypophosphatasia (HPP) reduce the function of tissue nonspecific alkaline phosphatase (TNAP), resulting in increased pyrophosphate (PPi) and a severe deficiency in acellular cementum. We hypothesized that exogenous phosphate (Pi) would rescue the in vitro mineralization capacity of periodontal ligament (PDL) cells harvested from HPP-diagnosed subjects, by correcting Pi/PPi ratio and modulating expression of genes involved with Pi/PPi metabolism. Methods Ex vivo and in vitro analyses were employed to identify mechanisms involved in HPP-associated PDL/tooth root deficiencies. Constitutive expression of PPi-associated genes was contrasted in PDL versus pulp tissues obtained from healthy subjects. Primary PDL cell cultures from HPP subjects (monozygotic twin males) were established to assay alkaline phosphatase activity (ALP), in vitro mineralization, and gene expression. Exogenous Pi was provided to correct Pi/PPi ratio. Results PDL tissues obtained from healthy individuals featured higher basal expression of key PPi regulators, genes Alpl, progressive ankylosis protein (Ankh) and ectonucleotide pyrophosphatase/phosphodiesterase 1 (Enpp1), versus paired pulp tissues. A novel Alpl mutation was identified in the twin HPP subjects enrolled in this study. Compared to controls, HPP-PDL cells exhibited significantly reduced ALP and mineralizing capacity, which were rescued by addition of 1mM Pi. Dysregulated expression of PPi regulatory genes Alpl, Ankh, and Enpp1 was also corrected by adding Pi, though other matrix markers evaluated in our study remained down-regulated. Conclusions These findings underscore the importance of controlling Pi/PPi ratio toward development of a functional periodontal apparatus, and support Pi/PPi imbalance as the etiology of HPP-associated cementum defects. PMID:22014174

Impact of San Francisco’s Toy Ordinance on Restaurants and Children’s Food Purchases, 2011–2012

PubMed Central

Saelens, Brian E.; Kapphahn, Kristopher I.; Hekler, Eric B.; Buman, Matthew P.; Goldstein, Benjamin A.; Krukowski, Rebecca A.; O’Donohue, Laura S.; Gardner, Christopher D.; King, Abby C.

2014-01-01

Introduction In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children’s meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children’s menus), and the energy and nutrient content of all orders and children’s-meal–only orders purchased for children aged 0 through 12 years. Methods Restaurant responses were examined from January 2010 through March 2012. Parent–caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012. Results Both restaurant chains responded to the ordinance by selling toys separately from children’s meals, but neither changed their menus to meet ordinance-specified nutrition criteria. Among children for whom children’s meals were purchased, significant decreases in kilocalories, sodium, and fat per order were likely due to changes in children’s side dishes and beverages at Chain A. Conclusion Although the changes at Chain A did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results underscore the importance of policy wording, support the concept that more healthful defaults may be a powerful approach for improving dietary intake, and suggest that public policies may contribute to positive restaurant changes. PMID:25032837

High throughput RNAi assay optimization using adherent cell cytometry

PubMed Central

2011-01-01

Background siRNA technology is a promising tool for gene therapy of vascular disease. Due to the multitude of reagents and cell types, RNAi experiment optimization can be time-consuming. In this study adherent cell cytometry was used to rapidly optimize siRNA transfection in human aortic vascular smooth muscle cells (AoSMC). Methods AoSMC were seeded at a density of 3000-8000 cells/well of a 96well plate. 24 hours later AoSMC were transfected with either non-targeting unlabeled siRNA (50 nM), or non-targeting labeled siRNA, siGLO Red (5 or 50 nM) using no transfection reagent, HiPerfect or Lipofectamine RNAiMax. For counting cells, Hoechst nuclei stain or Cell Tracker green were used. For data analysis an adherent cell cytometer, Celigo® was used. Data was normalized to the transfection reagent alone group and expressed as red pixel count/cell. Results After 24 hours, none of the transfection conditions led to cell loss. Red fluorescence counts were normalized to the AoSMC count. RNAiMax was more potent compared to HiPerfect or no transfection reagent at 5 nM siGLO Red (4.12 +/-1.04 vs. 0.70 +/-0.26 vs. 0.15 +/-0.13 red pixel/cell) and 50 nM siGLO Red (6.49 +/-1.81 vs. 2.52 +/-0.67 vs. 0.34 +/-0.19). Fluorescence expression results supported gene knockdown achieved by using MARCKS targeting siRNA in AoSMCs. Conclusion This study underscores that RNAi delivery depends heavily on the choice of delivery method. Adherent cell cytometry can be used as a high throughput-screening tool for the optimization of RNAi assays. This technology can accelerate in vitro cell assays and thus save costs. PMID:21518450

Insurance continuity and receipt of diabetes preventive care in a network of Federally Qualified Health Centers

PubMed Central

Gold, Rachel; DeVoe, Jennifer; Shah, Amit; Chauvie, Susan

2009-01-01

Background and Objectives Having health insurance is usually associated with better access to care and better health outcomes. For patients receiving care at Federally Qualified Health Centers (FQHCs), where care is provided regardless of insurance status, the role health insurance status plays in affecting receipt of services is less well understood. Research Design We used practice management data from a coalition of FQHCs in Oregon, and linked to Oregon’s electronic insurance data, to examine whether receipt of diabetes preventive care services was associated with continuity of insurance coverage among adult FQHC patients receiving diabetes care in 2005. Results About one-third (32%) of patients with diabetes received a flu vaccination in 2005, 36% an LDL screening, 54% at least one HbA1c screening, and 21% a nephropathy screening. Compared to the continuously insured, the continuously uninsured were less likely to receive an LDL screening, a flu vaccination, and/or a nephropathy screening; those with partial coverage were less likely than the continuously insured to receive a flu shot, at least one HbA1c screening, or an LDL screening. Conclusions Our results suggest that FQHCs do an excellent job in delivering most services to their uninsured and partially insured patients, but also underscore that for diabetic patients from underserved communities, having both an FQHC medical home and continuous health insurance plays a critical role in receiving optimal chronic disease management. Our study is one of the first to demonstrate how electronic administrative data from a network of FQHCs can be successfully used to gauge the state of healthcare delivery. PMID:19330890

The Influence of Supervisory Neglect on Subtypes of Emerging Adult Substance Use After Controlling for Familial Factors, Relationship Status, and Individual Traits

PubMed Central

Snyder, Susan M.; Merritt, Darcey H.

2016-01-01

Background This study is the first to explore how child supervisory neglect influences patterns of substance use among young adults. This study investigated patterns of substance use among males and females, 18 to 24 years old, after controlling for adolescent parental drinking, living with parents, relationship status, delinquency, and depression. Methods The study sample (N = 10,618) included individuals who participated in Waves I (1994–1995) and III (2001–2002) of the National Longitudinal Study of Adolescent Health (Add Health). The study used latent class analysis to ascertain how patterns of substance use emerged as distinct classes. Results For both males and females, we identified the following 4 classes of substance use: (1) heavy polysubstance use, (2) moderate polysubstance use, (3) alcohol and marijuana, and (4) low-use substance use patterns. Multinomial logistic regression indicated that, for both males and females 18 to 24 years old, experiencing supervisory neglect, being depressed, being single, and engaging in adolescent delinquency serve as risk factors for heavy polysubstance use class membership. Conversely, being black or Hispanic lowered the likelihood of polysubstance use for males and females. For females only, living with parents served as a protective factor that reduced the risk of membership in heavy polysubstance use, moderate polysubstance use, and alcohol and marijuana classes. For males only, being less educated increased the risk of heavy polysubstance use class membership. Conclusions Results from this exploratory study underscore the enduring effect of supervisory neglect on substance use among male and female young adults. Future studies should explore whether these relationships hold over time. PMID:25775372

Recent trends in the probability of high out-of-pocket medical expenses in the United States

PubMed Central

Baird, Katherine E

2016-01-01

Objective: This article measures the probability that out-of-pocket expenses in the United States exceed a threshold share of income. It calculates this probability separately by individuals’ health condition, income, and elderly status and estimates changes occurring in these probabilities between 2010 and 2013. Data and Method: This article uses nationally representative household survey data on 344,000 individuals. Logistic regressions estimate the probabilities that out-of-pocket expenses exceed 5% and alternatively 10% of income in the two study years. These probabilities are calculated for individuals based on their income, health status, and elderly status. Results: Despite favorable changes in both health policy and the economy, large numbers of Americans continue to be exposed to high out-of-pocket expenditures. For instance, the results indicate that in 2013 over a quarter of nonelderly low-income citizens in poor health spent 10% or more of their income on out-of-pocket expenses, and over 40% of this group spent more than 5%. Moreover, for Americans as a whole, the probability of spending in excess of 5% of income on out-of-pocket costs increased by 1.4 percentage points between 2010 and 2013, with the largest increases occurring among low-income Americans; the probability of Americans spending more than 10% of income grew from 9.3% to 9.6%, with the largest increases also occurring among the poor. Conclusion: The magnitude of out-of-pocket’s financial burden and the most recent upward trends in it underscore a need to develop good measures of the degree to which health care policy exposes individuals to financial risk, and to closely monitor the Affordable Care Act’s success in reducing Americans’ exposure to large medical bills. PMID:27651901

Overweight and obesity in relation to cardiovascular disease risk factors among medical students in Crete, Greece

PubMed Central

Bertsias, George; Mammas, Ioannis; Linardakis, Manolis; Kafatos, Anthony

2003-01-01

Background Recent data indicate increasing rates of adult obesity and mortality from cardiovascular disease (CVD) in Greece. No data, however, are available on prevalence of overweight and obesity in relation to CVD risk factors among young adults in Greece. Methods A total of 989 third-year medical students (527 men, 462 women), aged 22 ± 2 years, were recruited from the University of Crete during the period 1989–2001. Anthropometric measures and blood chemistries were obtained. The relationships between obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHpR], waist-to-height ratio [WHtR]) and CVD risk factor variables (blood pressure, glucose, serum lipoproteins) were investigated. Results Approximately 40% of men and 23% of women had BMI ≥ 25.0 kg/m2. Central obesity was found in 33.4% (average percentage corresponding to WC ≥ 90 cm, WHpR ≥ 0.9 and WHtR ≥ 50.0) of male and 21.7% (using WC ≥ 80 cm, WHpR ≥ 0.8, WHtR ≥ 50.0) of female students. Subjects above the obesity indices cut-offs had significantly higher values of CVD risk factor variables. BMI was the strongest predictor of hypertension. WHtR in men and WC in women were the most important indicators of dyslipidaemia. Conclusion A substantial proportion of Greek medical students were overweight or obese, obesity status being related to the presence of hypertension and dyslipidaemia. Simple anthropometric indices can be used to identify these CVD risk factors. Our results underscore the need to implement health promotion programmes and perform large-scale epidemiological studies within the general Greek young adult population. PMID:12517305

Dose Titration Algorithm Tuning (DTAT) should supersede 'the' Maximum Tolerated Dose (MTD) in oncology dose-finding trials.

PubMed

Norris, David C

2017-01-01

Background . Absent adaptive, individualized dose-finding in early-phase oncology trials, subsequent 'confirmatory' Phase III trials risk suboptimal dosing, with resulting loss of statistical power and reduced probability of technical success for the investigational therapy. While progress has been made toward explicitly adaptive dose-finding and quantitative modeling of dose-response relationships, most such work continues to be organized around a concept of 'the' maximum tolerated dose (MTD). The purpose of this paper is to demonstrate concretely how the aim of early-phase trials might be conceived, not as 'dose-finding', but as dose titration algorithm (DTA) -finding. Methods. A Phase I dosing study is simulated, for a notional cytotoxic chemotherapy drug, with neutropenia constituting the critical dose-limiting toxicity. The drug's population pharmacokinetics and myelosuppression dynamics are simulated using published parameter estimates for docetaxel. The amenability of this model to linearization is explored empirically. The properties of a simple DTA targeting neutrophil nadir of 500 cells/mm 3 using a Newton-Raphson heuristic are explored through simulation in 25 simulated study subjects. Results. Individual-level myelosuppression dynamics in the simulation model approximately linearize under simple transformations of neutrophil concentration and drug dose. The simulated dose titration exhibits largely satisfactory convergence, with great variance in individualized optimal dosing. Some titration courses exhibit overshooting. Conclusions. The large inter-individual variability in simulated optimal dosing underscores the need to replace 'the' MTD with an individualized concept of MTD i . To illustrate this principle, the simplest possible DTA capable of realizing such a concept is demonstrated. Qualitative phenomena observed in this demonstration support discussion of the notion of tuning such algorithms. Although here illustrated specifically in relation to cytotoxic chemotherapy, the DTAT principle appears similarly applicable to Phase I studies of cancer immunotherapy and molecularly targeted agents.

Family Caregiver Social Problem-Solving Abilities and Adjustment to Caring for a Relative with Vision Loss

PubMed Central

Bambara, Jennifer K.; Owsley, Cynthia; Wadley, Virginia; Martin, Roy; Porter, Chebon; Dreer, Laura E.

2009-01-01

Purpose To examine the prevalence of persons at risk for depression among family caregivers of visually impaired persons and the extent to which social problem-solving abilities are associated with caregiver depressive symptomatology and life satisfaction. Methods Family caregivers were defined as adults who accompanied their adult relative to an appointment at a low-vision rehabilitation clinic and self-identified themselves as the primary family caregiver responsible for providing some form of assistance for their relative due to vision impairment. Demographic variables, depressive symptoms, life satisfaction, caregiver burden, and social problem-solving abilities were assessed in caregivers. The patient’s visual acuity and depressive symptoms and their relationship to the caregiver’s depressive symptoms and life satisfaction were also examined. Results Ninety-six family caregivers were enrolled. Of those, 35.4% were identified as at risk for depression. Among caregivers, dysfunctional or ineffective social problem-solving abilities were significantly associated with greater depressive symptomatology and decreased life satisfaction after adjustment for caregiver burden and demographic and medical variables for both the caregiver and the visually impaired patient. Problem orientation or motivation to solving problems was also significantly associated with caregiver depression and satisfaction with life. Conclusions A substantial number of caregivers of visually impaired adults experience psychosocial distress, particularly among those who possess poor social problem-solving abilities. These results underscore the need for routine screening and treatment of emotional distress among individuals caring for relatives with vision impairments. Future research should examine the extent to which psychosocial interventions targeting caregiver social problem-solving skills may be useful not only in improving caregiver quality of life but also in subsequently enhancing rehabilitation outcomes for the visually impaired care recipient. PMID:19060279

Pregnancy Intent Among a Sample of Recently Diagnosed HIV-Positive Women and Men Practicing Unprotected Sex in Cape Town, South Africa

PubMed Central

Exner, Theresa M.; Cooper, Diane; Bai, Dan; Leu, Cheng-Shiun; Hoffman, Susie; Myer, Landon; Moodley, Jennifer; Kelvin, Elizabeth A.; Constant, Debbie; Jennings, Karen; Zweigenthal, Virginia; Stein, Zena A.

2014-01-01

Background: Sexual and reproductive health (SRH) services for HIV-positive women and men often neglect their fertility desires. We examined factors associated with pregnancy intent among recently diagnosed HIV-positive women (N = 106) and men (N = 91) who reported inconsistent condom use and were enrolled in an SRH intervention conducted in public sector HIV care clinics in Cape Town. Methods: Participants were recruited when receiving their first CD4+ results at the clinic. All reported unprotected sex in the previous 3 months. Logistic regression identified predictors of pregnancy intent for the total sample and by gender. Results: About three fifths of men and one fifth of women reported intent to conceive in the next 6 months. In the full-sample multiple regression analysis, men [adjusted odds ratio (AOR = 6.62)] and those whose main partner shared intent to conceive (AOR = 3.80) had significantly higher odds of pregnancy intent; those with more years of education (AOR = 0.81) and more biological children (AOR = 0.62) had lower odds of intending pregnancy. In gender-specific analyses, partner sharing pregnancy intent was positively associated with intent among both men (AOR = 3.53) and women (AOR = 13.24). Among men, odds were lower among those having more biological children (AOR = 0.71) and those unemployed (AOR = 0.30). Among women, relying on hormonal contraception was negatively associated with intent (AOR = 0.08), and main partner knowing her HIV status (AOR = 5.80) was positively associated with intent to conceive. Conclusions: Findings underscore the importance of providing integrated SRH services, and we discuss implications for clinical practice and care. PMID:25436819

Paternal education status significantly influences infants’ measles vaccination uptake, independent of maternal education status

PubMed Central

2012-01-01

Background Despite increased funding of measles vaccination programs by national governments and international aid agencies, structural factors encumber attainment of childhood measles immunisation to levels which may guarantee herd immunity. One of such factors is parental education status. Research on the links between parental education and vaccination has typically focused on the influence of maternal education status. This study aims to demonstrate the independent influence of paternal education status on measles immunisation. Methods Comparable nationally representative survey data were obtained from six countries with the highest numbers of children missing the measles vaccine in 2008. Logistic regression analysis was applied to examine the influence of paternal education on uptake of the first dose of measles vaccination, independent of maternal education, whilst controlling for confounding factors such as respondent’s age, urban/rural residence, province/state of residence, religion, wealth and occupation. Results The results of the analysis show that even if a mother is illiterate, having a father with an education of Secondary (high school) schooling and above is statistically significant and positively correlated with the likelihood of a child being vaccinated for measles, in the six countries analysed. Paternal education of secondary or higher level was significantly and independently correlated with measles immunisation uptake after controlling for all potential confounders. Conclusions The influence of paternal education status on measles immunisation uptake was investigated and found to be statistically significant in six nations with the biggest gaps in measles immunisation coverage in 2008. This study underscores the imperative of utilising both maternal and paternal education as screening variables to identify children at risk of missing measles vaccination prospectively. PMID:22568861

Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

PubMed Central

Calzo, Jerel P.; Horton, Nicholas J.; Sonneville, Kendrin R.; Swanson, Sonja; Crosby, Ross D.; Micali, Nadia; Eddy, Kamryn T.; Field, Alison E.

2016-01-01

Objective Research on the manifestations and health correlates of eating disorder symptoms among males is lacking. This study identified patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood and their health correlates. Method Participants were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999–2007 (spanning ages 13–26 years) provided repeated measures data on: muscularity and leanness concerns; eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products); and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms). Results Latent class analyses of observations at ages 13–15, 16–18, 19–22, and 23–26 identified one large Asymptomatic class and four symptomatic patterns: Body Image Disturbance (high appearance concerns, low eating disorder behaviors; 1.0%–6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%–2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%–5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%–1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes. Conclusion Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings. PMID:27453083

Identification and Prediction of Group-Based Glycemic Control Trajectories during the Transition to Adolescence

PubMed Central

Rohan, Jennifer M.; Rausch, Joseph R.; Pendley, Jennifer Shroff; Delamater, Alan M.; Dolan, Lawrence; Reeves, Grafton; Drotar, Dennis

2014-01-01

Objective To identify trajectories of glycemic control over a period of three years in a pediatric sample of youth diagnosed with type 1 diabetes transitioning to adolescence. A second aim was to examine a set of modifiable individual and family-level baseline predictors of glycemic control group membership. Methods This multisite, prospective study included 239 children and adolescents (ages 9–11 years at baseline) diagnosed with type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c (HbA1c) collected at six month intervals over a period of three years. Predictors of glycemic control membership included baseline global executive functioning, diabetes self-management, diabetes-specific family conflict, blood glucose monitoring frequency, and relevant individual and family level covariates. Results Group-based trajectory analyses were used to describe patterns of glycemic control from baseline to 36 months and three trajectories were identified: low risk (42.9%), elevated risk (44.6%), and high risk (12.1%) subgroups. Baseline maternal-reported family conflict, blood glucose monitoring frequency, and gender were significant predictors of glycemic control group membership. Higher levels of baseline family conflict, lower frequency of blood glucose monitoring, and female gender were associated with elevated and high risk group membership. Conclusions These findings underscore the importance of examining trajectories of HbA1c across time. These results suggest that problematic trajectories of glycemic control are evident during the transition to adolescence. Furthermore, there are modifiable individual and family-level characteristics that predict group membership and hence could be targeted in interventions to ensure adequate glycemic control is maintained over time and that risks for diabetes-related complications are reduced. PMID:24274797

Rapid fixation of non-native alleles revealed by genome-wide SNP analysis of hybrid tiger salamanders

PubMed Central

Fitzpatrick, Benjamin M; Johnson, Jarrett R; Kump, D Kevin; Shaffer, H Bradley; Smith, Jeramiah J; Voss, S Randal

2009-01-01

Background Hybrid zones represent valuable opportunities to observe evolution in systems that are unusually dynamic and where the potential for the origin of novelty and rapid adaptation co-occur with the potential for dysfunction. Recently initiated hybrid zones are particularly exciting evolutionary experiments because ongoing natural selection on novel genetic combinations can be studied in ecological time. Moreover, when hybrid zones involve native and introduced species, complex genetic patterns present important challenges for conservation policy. To assess variation of admixture dynamics, we scored a large panel of markers in five wild hybrid populations formed when Barred Tiger Salamanders were introduced into the range of California Tiger Salamanders. Results At three of 64 markers, introduced alleles have largely displaced native alleles within the hybrid populations. Another marker (GNAT1) showed consistent heterozygote deficits in the wild, and this marker was associated with embryonic mortality in laboratory F2's. Other deviations from equilibrium expectations were idiosyncratic among breeding ponds, consistent with highly stochastic demographic effects. Conclusion While most markers retain native and introduced alleles in expected proportions, strong selection appears to be eliminating native alleles at a smaller set of loci. Such rapid fixation of alleles is detectable only in recently formed hybrid zones, though it might be representative of dynamics that frequently occur in nature. These results underscore the variable and mosaic nature of hybrid genomes and illustrate the potency of recombination and selection in promoting variable, and often unpredictable genetic outcomes. Introgression of a few, strongly selected introduced alleles should not necessarily affect the conservation status of California Tiger Salamanders, but suggests that genetically pure populations of this endangered species will be difficult to maintain. PMID:19630983

[The endoscopic therapy of benign stenoses of the esophagus and cardioesophageal junction using Eder-Puestow instrumentation].

PubMed

Donev, Sht; Bosekert, N; Belchev, B

1995-01-01

The results of palliative endoscopic treatment by bougienage using Eder-Puestow instrumentation, performed in a limited contingent of patients presenting benign esophageal strictures, are analyzed. It is underscored that the method is readily carried out and effective, and seldom leads to noteworthy complications, such as esophageal perforations--one patient alone presenting cicatricial stricture out of the total of 42 cases given treatment with bougienage over a 10-year period. The commonest cause of benign strictures of the esophagus in the series being examined is reflux (peptic) esophagitis against the background of hiatus hernia.

Spatial reconstruction of semi-quantitative precipitation fields over Africa during the nineteenth century from documentary evidence and gauge data

NASA Astrophysics Data System (ADS)

Nicholson, Sharon E.; Klotter, Douglas; Dezfuli, Amin K.

2012-07-01

The article presents a newly created precipitation data set for the African continent and describes the methodology used in its creation. It is based on a combination of proxy data and rain gauge records. The data set is semi-quantitative, with a "wetness" index of - 3 to + 3 to describe the quality of the rainy season. It covers the period AD 1801 to 1900 and includes data for 90 geographical regions of the continent. The results underscore a multi-decadal period of aridity early in the nineteenth century.

A Helicene Nanoribbon with Greatly Amplified Chirality.

PubMed

Schuster, Nathaniel J; Hernández Sánchez, Raúl; Bukharina, Daria; Kotov, Nicholas A; Berova, Nina; Ng, Fay; Steigerwald, Michael L; Nuckolls, Colin

2018-05-14

We report the synthesis and characterization of a chiral, shape-persistent, perylene-diimide-based nanoribbon. Specifically, the fusion of three perylene-diimide monomers with intervening naphthalene subunits resulted in a helical superstructure with two [6]helicene subcomponents. This π-helix-of-helicenes exhibits very intense electronic circular dichroism, including one of the largest Cotton effects ever observed in the visible range. It also displays more than an order of magnitude increase in circular dichroism for select wavelengths relative to its smaller homologue. These impressive chiroptical properties underscore the potential of this new nanoribbon architecture in the context of chiral electronic materials.

Solution-processed small molecule:fullerene bulk-heterojunction solar cells: impedance spectroscopy deduced bulk and interfacial limits to fill-factors.

PubMed

Guerrero, Antonio; Loser, Stephen; Garcia-Belmonte, Germà; Bruns, Carson J; Smith, Jeremy; Miyauchi, Hiroyuki; Stupp, Samuel I; Bisquert, Juan; Marks, Tobin J

2013-10-21

Using impedance spectroscopy, we demonstrate that the low fill factor (FF) typically observed in small molecule solar cells is due to hindered carrier transport through the active layer and hindered charge transfer through the anode interfacial layer (IFL). By carefully tuning the active layer thickness and anode IFL in BDT(TDPP)2 solar cells, the FF is increased from 33 to 55% and the PCE from 1.9 to 3.8%. These results underscore the importance of simultaneously optimizing active layer thickness and IFL in small molecule solar cells.

The Sexual Victimization of Older Women Living in Nursing Homes.

PubMed

Teaster, Pamela B; Ramsey-Klawsnik, Holly; Abner, Erin L; Kim, Sujee

2015-01-01

This study examined 64 cases of sexual victimization of women ages 65+ (mean = 81) living in facilities that were investigated by APS and regulatory agencies in five states over a six-month period. Typically, abuse involved molestation (53%) and unwelcome sexual interest in the body (20%). Abilities and needs of women in substantiated and unsubstantiated cases were comparable. Resident perpetrators were more likely to be substantiated than staff or any other perpetrator (p = 0.008). Our results underscore the need to evaluate differences associated with gender, age, and residence, and to train on reporting and intervention by disciplines serving victims.

Vaccines against 'the other' Ebolavirus species.

PubMed

Kozak, Robert A; Kobinger, Gary P

2016-09-01

The Ebolavirus genus includes five member species, all of which pose a threat to global public health. These viruses cause fatal hemorrhagic fever in humans and nonhuman primates, and are considered category A pathogens due to the risk of their use as a bioweapon. The potential for an outbreak, either as a result of a natural emergence, deliberate release, or imported case underscores the need for protective vaccines. Recent progress in advancing vaccines for use against the strain of Zaire ebolavirus (EBOV) responsible for the West African Ebola outbreak offers reasons for optimism against EBOV, and demonstrates that protection against other Ebolavirus species is achievable.

Psychological and emotional effects of the September 11 attacks on the World Trade Center--Connecticut, New Jersey, and New York, 2001.

PubMed

2002-09-06

To measure the psychological and emotional effects of the September 11, 2001, terrorist attacks on the World Trade Center (WTC), Connecticut, New Jersey, and New York added a terrorism module to their ongoing Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of the survey, which suggest widespread psychological and emotional effects in all segments of the three states' populations. The findings underscore the importance of collaboration among public health professionals to address the physical and emotional needs of persons affected by the September 11 attacks.

Causes of death among laundry and dry cleaning workers.

PubMed Central

Blair, A; Decoufle, P; Grauman, D

1979-01-01

To make a preliminary determination as to whether a potential health hazard exists for workers exposed to dry cleaning solvents (carbon tetrachloride, trichloroethylene, and tetrachloroethylene), we analyzed the causes of death of 330 deceased laundry and dry cleaning workers by the proportionate mortality method. The increased risk for malignant neoplasms resulted primarily from an excess of lung and cervical cancer and slight excesses of leukemia and liver cancer. Although the number of deaths was small, the increased risk of cancer noted in this investigation underscores the need for additional epidemiologic studies of this occupational group. PMID:434285

Optimizing the function of upstanding activities in adult patients with acquired lesions of the central nervous system by using the Bobath concept approach - A case report.

PubMed

Jelica, Stjepan; Seper, Vesna; Davidović, Erna; Bujisić, Gordana

2011-01-01

Nonspecific medical gymnastic therapy may help patients after stroke achieve certain results in terms of efficiency but not in terms of quality of movement. The goal of treatment by Bobath concept is development of movement (effectiveness) and optimization of movement (efficiency). This article presents the case of a 62-year old patient who had experienced a stroke and has difficulties with standing up activities. It underscores the importance of not only recovery of function but also optimization of the function in such patients.

Toward a Biology of Menopause.

ERIC Educational Resources Information Center

Goodman, Madeleine

1980-01-01

Discusses research dealing with the study of menopause. Underscores the problems with the case study method. Discusses two population-based studies and the problems of age adjustment and measurement in menopause research. Highlights alternate research strategies. (MK)

The Future of Student Engagement

ERIC Educational Resources Information Center

Buskist, William; Groccia, James E.

2018-01-01

This chapter underscores the importance of conceptualizing student engagement as a responsibility shared by all members of the academy and describes how Groccia's multidimensional model can serve as blueprint for future thinking and research on student engagement.

RISK FACTORS FOR PRESSURE INJURIES AMONG CRITICAL-CARE PATIENTS: A SYSTEMATIC REVIEW

PubMed Central

Alderden, Jenny; Rondinelli, June; Pepper, Ginette; Cummins, Mollie; Whitney, JoAnne

2017-01-01

Objective To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients Design We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. Data Sources We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction. Method A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one investigator extracted data and a second investigator reviewed the data for accuracy. Based on a literature search, we developed a tool for assessing study quality using a combination of currently available tools and expert input. We used the method developed by Coleman and colleagues in 2014 to generate evidence tables and a summary narrative synthesis by domain and subdomain. Results Of 1753 abstracts reviewed, 158 were identified as potentially eligible and 18 fulfilled eligibility criteria. Five studies were classified as high quality, two were moderate quality, nine were low quality, and two were of very low quality. Age, mobility/activity, perfusion, and vasopressor infusion emerged as important risk factors for pressure injury development, whereas results for risk categories that are theoretically important, including nutrition, and skin/pressure injury status, were mixed. Methodological limitations across studies limited the generalizability of the results, and future research is needed, particularly to evaluate risk conferred by altered nutrition and skin/pressure injury status, and to further elucidate the effects of perfusion-related variables. Conclusions Results underscore the importance of avoiding overinterpretation of a single study, and the importance of taking study quality into consideration when reviewing risk factors. Maximal pressure injury prevention efforts are particularly important among critical-care patients who are older, have altered mobility, experience poor perfusion, or who are receiving a vasopressor infusion. PMID:28384533

Towards transformational change: UNDP's work in environment and sustainable development 2008-2012

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

Mordt, Matilde; Hildebrandt, Laura; Iyer, Devika

2013-03-15

This report highlights significant advances in sustainable development from almost 60 country reports and underscores the challenges and bottlenecks to moving beyond the economic-led growth strategies of the past 20 years.

Implementing the global health security agenda: lessons from global health and security programs.

PubMed

Paranjape, Suman M; Franz, David R

2015-01-01

The Global Health Security Agenda (GHSA) describes a vision for a world that is safe and secure from infectious disease threats; it underscores the importance of developing the international capacity to prevent, detect, and respond to pandemic agents. In February 2014, the United States committed to support the GHSA by expanding and intensifying ongoing efforts across the US government. Implementing these goals will require interagency coordination and harmonization of diverse health security elements. Lessons learned from the Global Health Initiative (GHI), the President's Emergency Program for AIDS Relief (PEPFAR), and the Cooperative Threat Reduction (CTR) program underscore that centralized political, technical, and fiscal authority will be key to developing robust, sustainable, and integrated global health security efforts across the US government. In this article, we review the strengths and challenges of GHI, PEPFAR, and CTR and develop recommendations for implementing a unified US global health security program.

Challenges to the transition to independent investigator in geriatric mental health.

PubMed

Bruce, Martha L

2003-01-01

The author reports on the extent to which junior investigators in geriatric mental health successfully make the transition to independent scientists. The NIH CRISP database identified all NIMH Level-1 career awards (K01/K07/K08/K23/ R29) in geriatric mental health completed from 1992 to 2001. Of 46 awardees, 14 (30.4%) achieved R01 funding within 1 year of completion. An additional six investigators subsequently achieved R01s in the remaining follow-up period (ranging from 2 to 10 years), for a total of 43.5% (20/46). These data underscore the relatively small number of junior investigators who successfully make the transition to independent scientist. Their numbers underscore the importance of efforts by the field of geriatric mental health aimed at both increasing the flow into this career as well as ensuring the retention and success of junior investigators at the critical transition to independent investigators.

Characterizing the Intersection of Co-Occurring Risk Factors for Illicit Drug Abuse and Dependence in a U.S. Nationally Representative Sample

PubMed Central

Kurti, Allison N.; Keith, Diana R.; Noble, Alyssa; Priest, Jeff S.; Sprague, Brian; Higgins, Stephen T.

2016-01-01

Few studies have attempted to characterize how co-occurring risk factors for substance use disorders intersect. A recent study examined this question regarding cigarette smoking and demonstrated that co-occurring risk factors generally act independently. The present study examines whether that same pattern of independent intersection of risk factors extends to illicit drug abuse/dependence using a U.S. nationally representative sample (National Survey on Drug Use and Health, 2011–2013). Logistic regression and classification and regression tree (CART) modeling were used to examine risk of past-year drug abuse/dependence associated with a well-established set of risk factors for substance use (age, gender, race/ethnicity, education, poverty, smoking status, alcohol abuse/dependence, mental illness). Each of these risk factors was associated with significant increases in the odds of drug abuse/dependence in univariate logistic regressions. Each remained significant in a multivariate model examining all eight risk factors simultaneously. CART modeling of these 8 risk factors identified subpopulation risk profiles wherein drug abuse/dependence prevalence varied from < 1% to > 80% corresponding to differing combinations of risk factors present. Alcohol abuse/dependence and cigarette smoking had the strongest associations with drug abuse/dependence risk. These results demonstrate that co-occurring risk factors for illicit drug/abuse dependence generally intersect in the same independent manner as risk factors for cigarette smoking, underscoring further fundamental commonalities across these different types of substance use disorders. These results also underscore the fundamental importance of differences in the presence of co-occurring risk factors when considering the often strikingly different prevalence rates of illicit drug abuse/dependence in U.S. population subgroups. PMID:27687534

What community-level strategies are needed to secure women’s property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention

PubMed Central

Dworkin, Shari L.; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women’s HIV risks, few science-based programs have focused on securing women’s land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24–30%) and property rights violations were common. The program was designed to reduce women’s HIV risk at the community level by protecting and enhancing women’s access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women’s property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention. PMID:24116828

Sirtuin-1 regulates acinar-to-ductal metaplasia and supports cancer cell viability in pancreatic cancer.

PubMed

Wauters, Elke; Sanchez-Arévalo Lobo, Victor J; Pinho, Andreia V; Mawson, Amanda; Herranz, Daniel; Wu, Jianmin; Cowley, Mark J; Colvin, Emily K; Njicop, Erna Ngwayi; Sutherland, Rob L; Liu, Tao; Serrano, Manuel; Bouwens, Luc; Real, Francisco X; Biankin, Andrew V; Rooman, Ilse

2013-04-01

The exocrine pancreas can undergo acinar-to-ductal metaplasia (ADM), as in the case of pancreatitis where precursor lesions of pancreatic ductal adenocarcinoma (PDAC) can arise. The NAD(+)-dependent protein deacetylase Sirtuin-1 (Sirt1) has been implicated in carcinogenesis with dual roles depending on its subcellular localization. In this study, we examined the expression and the role of Sirt1 in different stages of pancreatic carcinogenesis, i.e. ADM models and established PDAC. In addition, we analyzed the expression of KIAA1967, a key mediator of Sirt1 function, along with potential Sirt1 downstream targets. Sirt1 was co-expressed with KIAA1967 in the nuclei of normal pancreatic acinar cells. In ADM, Sirt1 underwent a transient nuclear-to-cytoplasmic shuttling. Experiments where during ADM, we enforced repression of Sirt1 shuttling, inhibition of Sirt1 activity or modulation of its expression, all underscore that the temporary decrease of nuclear and increase of cytoplasmic Sirt1 stimulate ADM. Our results further underscore that important transcriptional regulators of acinar differentiation, that is, Pancreatic transcription factor-1a and β-catenin can be deacetylated by Sirt1. Inhibition of Sirt1 is effective in suppression of ADM and in reducing cell viability in established PDAC tumors. KIAA1967 expression is differentially downregulated in PDAC and impacts on the sensitivity of PDAC cells to the Sirt1/2 inhibitor Tenovin-6. In PDAC, acetylation of β-catenin is not affected, unlike p53, a well-characterized Sirt1-regulated protein in tumor cells. Our results reveal that Sirt1 is an important regulator and potential therapeutic target in pancreatic carcinogenesis. ©2012 AACR.

What community-level strategies are needed to secure women's property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention.

PubMed

Dworkin, Shari L; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women's HIV risks, few science-based programs have focused on securing women's land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24-30%) and property rights violations were common. The program was designed to reduce women's HIV risk at the community level by protecting and enhancing women's access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women's property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention.

Social support mediates the association between benefit finding and quality of life in caregivers.

PubMed

Brand, Charles; Barry, Lorna; Gallagher, Stephen

2016-06-01

The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life. © The Author(s) 2014.

Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children.

PubMed

Kazdin, A E

1995-03-01

The present study examined factors that predicted favorable treatment outcomes among clinically referred conduct problem children (N = 105, ages 7-13) who received cognitive-behavioral treatment. Three domains (severity and breadth of child impairment, parent stress and psychopathology and family dysfunction) assessed at pretreatment were predicted to affect treatment outcome. The results only partially supported the prediction. Less dysfunction in each of the domains predicted who responded favorably to treatment on parent ratings of deviance and prosocial functioning but not on teacher ratings of these outcomes. The findings have implications for identifying youths who respond to available treatments. The results also underscore fundamental questions about the assessment of treatment effects and the criteria for evaluating outcome.

Structure and energetics of vinoxide and the X({sup 2}A{double{underscore}prime}) and A({sup 2}A{prime}) vinoxy radicals

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

Alconcel, L.S.; Deyerl, H.J.; Zengin, V.

1999-11-18

Enolate anions are intermediates in many organic reactions that involve carbon-carbon or carbon-oxygen food formation. They also play a key role in the development of stereoselective and stereocontrolled syntheses of complex compounds. Enolate radicals are important intermediates in combustion and photochemical smog cycles. In particular, the vinoxy radical, C{sub 2}H{sub 3}O{sup {sm{underscore}bullet}} is a major product of the reaction of odd oxygen and ethylene. The photoelectron spectrum of binoxide, C{sub 2}H{sub 3}O{sup {minus}}, at 355 nm is reported, showing photodetachment to both the X({sup 2}A{double{underscore}prime}) ground and first excited A({sup 2}A{prime}) states of the vinoxy radical. Both direct interpretations andmore » Franck-Condon simulations of the photoelectron spectrum of this simple enolate anion have been used to obtain insights into the energetics and structures of the anion and the ground and first excited state of the neutral radical. Franck-Condon simulations were generated from ab initio geometry and frequency calculations using the CASSCF method and showed good agreement with the vibrational structure visible in the experimental spectrum. The electron affinity (E.A.{sub exp} = 1.795 {+-} 0.015 eV; E.A.{sub calc} = 1.82 eV) and separation energy of the ground and first excited states (T{sub 0,exp} = 1.015 {+-} 0.015 eV; T{sub 0,calc} = 0.92 eV) obtained from the ab initio calculations are in good accord with the experimental values.« less

Preservice elementary teachers learning of astronomy

NASA Astrophysics Data System (ADS)

Fidler, Chuck Gary

The dissertation presents a new approach for the study of preservice elementary teacher astronomy education. The approach suggests that learning astronomical concepts are facilitated by greater sophistication in scale perception and spatial-aptitude. This dissertation is underscored by the national call for elementary science education reform efforts and suggests certain strategies shown more effective for the development of accurate astronomical comprehension. The present research study describes how preservice elementary teachers conceptualize and communicate ideas about Space. Instead of assuming a universal mental conception of cosmic orientations and relationships, the dissertation claims that the perception of Space related dimensions vary among preservice elementary teachers. Furthermore, the dissertation suggests individual perceptions of the scale sizes and orientations of celestial systems have direct influences on mental models used to organize and communicate astronomical information. The development of inaccurate mental models of the scaled dimensions of Space may perpetuate the teacher-student cycle of misconception and naive-theory generation among children in elementary education settings. The ability to conceptualize the vast cosmos is facilitated by the minds ability to think about vast scales and orientations of celestial objects. The Earth-based perspective of astronomy education compels the learner to think about astronomical principles within imaginary frames of reference and across unfamiliar scaled dimensions. Therefore, mental astronomical model building is underscored by the perception of scale and cosmic spatiality. This study suggests these cognitive skill sets are interconnected and facilitate the learning of accurate astronomy principles; as well as play an important role when designing an astronomy education program for preservice elementary teachers. This research study is comprised of three separate standalone articles designed and formatted for journal submission. Chapter 1 outlines the intent, rationale, and design of the overall dissertation process and format. Chapter 2 describes an in-depth review of the specific astronomy curricula used for comparison by subsequent chapters and is not intended as a standalone article, but rather as an informative outline of events and activities to help the reader understand the differences of instruction between the two sections of sample populations. Chapter 3 uses qualitative interviews to explore the cosmic dimensions associated with learning of astronomy and finds diverse perceptions of astronomical scales may influence preservice teachers' mental organization of astronomical information. Chapter 4 further analyzes cosmic dimensions using quantitative analyses and specifically examines preservice teachers perceptions of scale and spatiality within the context of astronomy education. Findings from Chapter 4 show that perceptions of scale and spatiality are an interconnected set of learning skills which may greatly enhance the learning of astronomy. Chapter 5 describes how concepts of scale and spatiality may be operationalized within a secondary school science classroom in order to better understand the scaled distances of stars though an inquiry-based three-dimensional modeling activity. Chapter 6 briefly concludes the dissertation work. Due to the nature of this dissertation design, the conclusions chapter is quite succinct as previous chapters are designed with conclusions sections embedded within the body of the text as outlined by specific journal submission guidelines. These dissertation ideas are presented in a formal setting so that the various research undertakings can be studied and analyzed. Qualitative and quantitative analyses of research data are present to support the claims made in this study. The results of this research combine with features of previous research in order to advance our understanding of how preservice elementary teachers think about and learn astronomy.

Dice and Disease in the Classroom.

ERIC Educational Resources Information Center

Stor, Marilyn; Briggs, William L.

1998-01-01

Presents a mathematics activity to model the exponential growth of the common cold, AIDS, or any other communicable disease. Underscores the effect that a friend's or partner's previous behavior may have on a current relationship and on society at large. (ASK)

School Development a la Richard the Lion-Hearted.

ERIC Educational Resources Information Center

Virgadomo, Steven J.

1984-01-01

Underscores the important role played by the case statement in a comprehensive resource development program. Looks at themes to be addressed and offers suggestions for preparing case statements to encourage individual and corporate financial support for the school. (DMM)

Cholesterol, inflammasomes, and atherogenesis

USDA-ARS?s Scientific Manuscript database

Plasma cholesterol levels have been strongly associated with atherogenesis, underscoring the role of lipid metabolism in defining cardiovascular disease risk. However, atherosclerotic plaque is highly dynamic and contains elements of both the innate and adaptive immune system that respond to the abe...

Logarithms in the Year 10 A.C.

ERIC Educational Resources Information Center

Kalman, Dan; Mitchell, Charles E.

1981-01-01

An alternative application of logarithms in the high school algebra curriculum that is not undermined by the existence and widespread availability of calculators is presented. The importance and use of linear relationships are underscored in the proposed lessons. (MP)

Moral Fiber?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2000-01-01

Discusses a 2000 federal trial court decision upholding a Kentucky district's termination of a tenured teacher who presented a curricular segment on industrial hemp as part of a "save-the-trees" unit. The decision underscores teachers' severely limited constitutional rights in the curricular context. (MLH)

Muscle-specific gene expression is underscored by differential stressor responses and coexpression changes.

PubMed

Moreno-Sánchez, Natalia; Rueda, Julia; Reverter, Antonio; Carabaño, María Jesús; Díaz, Clara

2012-03-01

Variations on the transcriptome from one skeletal muscle type to another still remain unknown. The reliable identification of stable gene coexpression networks is essential to unravel gene functions and define biological processes. The differential expression of two distinct muscles, M. flexor digitorum (FD) and M. psoas major (PM), was studied using microarrays in cattle to illustrate muscle-specific transcription patterns and to quantify changes in connectivity regarding the expected gene coexpression pattern. A total of 206 genes were differentially expressed (DE), 94 upregulated in PM and 112 in FD. The distribution of DE genes in pathways and biological functions was explored in the context of system biology. Global interactomes for genes of interest were predicted. Fast/slow twitch genes, genes coding for extracellular matrix, ribosomal and heat shock proteins, and fatty acid uptake centred the specific gene expression patterns per muscle. Genes involved in repairing mechanisms, such as ribosomal and heat shock proteins, suggested a differential ability of muscles to react to similar stressing factors, acting preferentially in slow twitch muscles. Muscle attributes do not seem to be completely explained by the muscle fibre composition. Changes in connectivity accounted for 24% of significant correlations between DE genes. Genes changing their connectivity mostly seem to contribute to the main differential attributes that characterize each specific muscle type. These results underscore the unique flexibility of skeletal muscle where a substantial set of genes are able to change their behavior depending on the circumstances.

Untrivial Pursuit: Measuring Motor Procedures Learning in Children with Autism.

PubMed

Sparaci, Laura; Formica, Domenico; Lasorsa, Francesca Romana; Mazzone, Luigi; Valeri, Giovanni; Vicari, Stefano

2015-08-01

Numerous studies have underscored prevalence of motor impairments in children with autism spectrum disorders (ASD), but only few of them have analyzed motor strategies exploited by ASD children when learning a new motor procedure. To evaluate motor procedure learning and performance strategies in both ASD and typically developing (TD) children, we built a virtual pursuit rotor (VPR) task, requiring tracking a moving target on a computer screen using a digitalized pen and tablet. Procedural learning was measured as increased time on target (TT) across blocks of trials on the same day and consolidation was assessed after a 24-hour rest. The program and the experimental setting (evaluated in a first experiment considering two groups of TD children) allowed also measures of continuous time on target (CTT), distance from target (DT) and distance from path (DP), as well as 2D reconstructions of children's trajectories. Results showed that the VPR was harder for children with ASD than for TD controls matched for chronological age and intelligence quotient, but both groups displayed comparable motor procedure learning (i.e., similarly incremented their TT). However, closer analysis of CTT, DT, and DP as well as 2D trajectories, showed different motor performance strategies in ASD, highlighting difficulties in overall actions planning. Data underscore the need for deeper investigations of motor strategies exploited by children with ASD when learning a new motor procedure. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Targeted proteins for diagnostic imaging: does chemistry make a difference?

PubMed

Fritzberg, A R; Beaumier, P L

1992-03-01

The Oyen et al. study is valuable in that it systematically evaluates several of the factors involved in radiolabeled protein uptake and retention in infectious foci. The role of particular proteins and their receptor specific interactions seems to be inconsequential in agreement with the findings of other. However, the role of the radiolabel was shown to be important and significant differences were delineated from comparisons of the radionuclides and their associated chemistries. The conclusion implicating radionuclide chemistry and associated linkages underscores the need to optimize the attachment and labeling chemical modifications of protein carriers. Evaluation criteria should include serum stability, determination and assessment of the effect of molar substitution ratio, and potential for improving blood clearance without reducing the target-to-non-target ratio. Important areas for future study include characterization of radioactive metabolites and the design and synthesis of new ligands which direct the disposition of metabolites reducing retention in normal organs or accelerating renal excretion. Additionally, intracellular processing of radiolabel, compartmental distribution and strategies for augmenting internalization and retention within the target cell merit detailed exploration. For each radionuclide of interest, 111In, radioiodines, 99mTc and others, improved chemical moieties exist for controlling radiolabel fate. When carrying out mechanistic and evaluative studies, clear-cut conclusions will only be reached when defined and controlled chemistry is used. Having established a "gold standard," simplifications in radiolabeling and other chemical refinements can then be pursued with a quantitative understanding of the trade-offs in targeting agent performance versus other considerations such as cost reduction, simplicity, and convenience.

HiveScience: A Citizen Science Project for Beekeepers##

EPA Science Inventory

Over the past decade, beekeepers have been experiencing unacceptably high colony losses while the demand for insect-pollinated crops has tripled during the same time period. Underscoring the need to develop reliable methods for predicting colony health, the United States Departme...

3 CFR 8891 - Proclamation 8891 of October 19, 2012. National Character Counts Week, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... to envision a dream, and the drive and discipline it takes to realize one. We should also underscore... dreams and vision to boost others toward theirs. As we mark this important occasion, let us rededicate...

Student Development and Developmental Studies.

ERIC Educational Resources Information Center

Champaigne, John

1982-01-01

Reviews the nine-stage Perry Scheme of Intellectual and Ethical Development, detailing three major student orientations--dualism, multiplicity, and commitments in relativism. Suggests techniques developmental educators can use to communicate with, support, and challenge students to promote intellectual development. Underscores the importance of…

Women in Administration.

ERIC Educational Resources Information Center

Whitaker, Colbert; Hales, William

That women hold less than 3 percent of secondary school principalships underscores society's contuinuing use of sexual stereotypes. Among the misguided assumptions hindering women's professional aspirations are beliefs about their lack of interest in promotions and their ineffectiveness as authority models. There is also the behavioral…

Deus Ex Machina: Tradition, Technology, and the Chicanafuturist Art of Marion C. Martinez

ERIC Educational Resources Information Center

Ramirez, Catherine S.

2004-01-01

The visual art of Marion C. Martinez is examined. Through technology, Martinez reproduces and transforms traditional Indo-Hispanic art forms, at the same time, underscores New Mexico's history as a dumping ground for technological waste.

Underrepresentation and the Question of Diversity.

ERIC Educational Resources Information Center

Gillett-Karam, Rosemary; And Others

1991-01-01

Considers the underrepresentation of women and minorities in community colleges, discussing barriers that have these groups out of administrative positions. Underscores the importance of leadership and vision in removing these barriers. Identifies inclusionary practices of community colleges, graduate programs, and professional organizations that…

VOC sink behaviour on building materials--model evaluation

EPA Science Inventory

The event of 11 September 2001 underscored the need to study the vulnerability of buildings to weapons of mass destruction (WMD), including chemical, biological, physical, and radiological agents. Should these agents be released inside a building, they would interact with interio...

Maintaining an Environmental Balance

ERIC Educational Resources Information Center

Environmental Science and Technology, 1976

1976-01-01

A recent conference of the National Environmental Development Association focused on the concepts of environment, energy and economy and underscored the necessity for balancing the critical needs embodied in these issues. Topics discussed included: nuclear energy and wastes, water pollution control, federal regulations, environmental technology…

Substance use by soldiers who abuse their spouses.

PubMed

Martin, Sandra L; Gibbs, Deborah A; Johnson, Ruby E; Sullivan, Kristen; Clinton-Sherrod, Monique; Walters, Jennifer L Hardison; Rentz, E Danielle

2010-11-01

Data on 7,424 soldier spouse abuse offenders were analyzed to determine the prevalence of substance use during abusive incidents, and to examine differences between substance-using and non-substance-using offenders. Results showed that 25% of all offenders used substances during abusive incidents, with males and non-Hispanic Whites being more likely to hav e used substances. Substance-using offenders were more likely to perpetrate physical spouse abuse and more severe spouse abuse. These findings underscore the importance of educating military personnel (including commanders) about links between substance use and domestic violence, and of coordinating preventive and therapeutic substance abuse and violence-related interventions.

Nest site selection by diamond-backed terrapins (Malaclemys terrapin) on a Mid-Atlantic Barrier Island

USGS Publications Warehouse

Mitchell, Joseph C.; Walls, Susan C.

2013-01-01

We scored 48 Malaclemys terrapin nests destroyed by raccoons on Fisherman Island, Virginia, for the presence or absence of tree canopy, shrub canopy, no canopy, bare sand, grass cover, and herbaceous cover. Significantly more nests than expected were found in the open with no vegetation cover and observed distances of predator-destroyed nests from the edge of the nearest habitat island of woody vegetation were significantly different from a normal distribution; most were placed near the island margin. Our results underscore the need to understand the influence of predator search behavior on terrapin nest survival in different habitat types.

First direct dating of a presumed Pleistocene hominid from China: AMS radiocarbon age of a femur from the Ordos Plateau.

PubMed

Keates, Susan G; Hodgins, Gregory W L; Kuzmin, Yaroslav V; Orlova, Lyobov A

2007-07-01

Human remains from the Xarusgol Valley, Ordos Plateau, northwestern China, have been considered to date to the Late Pleistocene. In order to ascertain their true age, direct AMS (14)C dating of a femur collected in the early 1920s was conducted. The results demonstrate that the femur is very young, with one sample of 'post-bomb' age and the other sample c. 200 years old. This first direct dating of a Chinese fossil hominid underscores the need to apply the same methodology to other Chinese modern human fossils currently believed to be of Pleistocene age.

Comparison of the Host Immune Response to Herpes Simplex Virus 1 (HSV-1) and HSV-2 at Two Different Mucosal Sites

PubMed Central

Zheng, Min; Conrady, Christopher D.; Ward, Julie M.; Bryant-Hudson, Katie M.

2012-01-01

A study was undertaken to compare the host immune responses to herpes simplex virus 1 (HSV-1) and HSV-2 infection by the ocular or genital route in mice. Titers of HSV-2 from tissue samples were elevated regardless of the route of infection. The elevation in titers of HSV-2, including cell infiltration and cytokine/chemokine levels in the central nervous system relative to those found following HSV-1 infection, was correlative with inflammation. These results underscore a dichotomy between the host immune responses to closely related alphaherpesviruses. PMID:22532684

Advanced Heart Failure Therapies for Cancer Therapeutics-Related Cardiac Dysfunction.

PubMed

Bianco, Christopher M; Al-Kindi, Sadeer G; Oliveira, Guilherme H

2017-04-01

End-stage heart failure in cancer survivors may result from cardiotoxic chemotherapy and/or chest radiation and require advanced therapies, including left ventricular assist devices (LVADs) and transplantation. Traditionally, such therapies have been underutilized in cancer survivors owing to lack of experience and perceived risk of cancer recurrence. Recent data from large registries, however, have shown excellent outcomes of LVADs and transplantation in cancer survivors, albeit subject to careful selection and special considerations. This article summarizes all aspects of advanced heart failure therapies in patients with cancer therapy-related cardiac dysfunction and underscores the need for careful selection of these candidates. Copyright © 2016 Elsevier Inc. All rights reserved.

Imagining the alternatives to life prolonging treatments: elders' beliefs about the dying experience.

PubMed

Winter, Laraine; Parker, Barbara; Schneider, Melissa

2007-08-01

Deciding for or against a life-prolonging treatment represents a choice between prolonged life and death. When the death alternative is not described, individuals must supply their own assumptions. How do people imagine the experience of dying? We asked 40 elderly people open-ended questions about dying without 4 common life-prolonging treatments, eliciting beliefs about pain, length of time, loneliness, and palliative care. Beliefs were diverse, loneliness was commonly assumed, and palliation was rarely mentioned spontaneously. Results underscore needs for improved understanding of the dying process and palliative care and for fuller communication between patients and healthcare providers.

Relationship marketing and disadvantaged health care segments: using internal marketing to improve the vocational rehabilitation process.

PubMed

Peltier, James W; Scovotti, Carol

2004-01-01

The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.

Anorexia Nervosa, Major Depression, and Suicide Attempts: Shared Genetic Factors

PubMed Central

Thornton, Laura M.; Welch, Elisabeth; Munn-Chernoff, Melissa A.; Lichtenstein, Paul; Bulik, Cynthia M.

2015-01-01

We evaluated the extent to which genetic and environmental factors influenced anorexia nervosa (AN), major depressive disorder (MDD), and suicide attempts (SA). Participants were 6,899 women from the Swedish Twin study of Adults Genes and Environment. A Cholesky decomposition assessed independent and overlapping genetic and environmental contributions to AN, MDD, and SA. Genetic factors accounted for a substantial amount of liability to all three traits; unique environmental factors accounted for most of the remaining liability. Shared genetic factors may underlie the co-expression of these traits. Results underscore the importance of assessing for signs of suicide among individuals with AN. PMID:26916469

Anorexia Nervosa, Major Depression, and Suicide Attempts: Shared Genetic Factors.

PubMed

Thornton, Laura M; Welch, Elisabeth; Munn-Chernoff, Melissa A; Lichtenstein, Paul; Bulik, Cynthia M

2016-10-01

The extent to which genetic and environmental factors influenced anorexia nervosa (AN), major depressive disorder (MDD), and suicide attempts (SA) were evaluated. Participants were 6,899 women from the Swedish Twin Study of Adults: Genes and Environment. A Cholesky decomposition assessed independent and overlapping genetic and environmental contributions to AN, MDD, and SA. Genetic factors accounted for a substantial amount of liability to all three traits; unique environmental factors accounted for most of the remaining liability. Shared genetic factors may underlie the coexpression of these traits. Results underscore the importance of assessing for signs of suicide among individuals with AN. © 2016 The American Association of Suicidology.

Cognitive representations of flight-deck information attributes

NASA Technical Reports Server (NTRS)

Ricks, Wendell R.; Jonsson, Jon E.; Rogers, William H.

1994-01-01

A large number of aviation issues are generically being called fligh-deck information management issues, underscoring the need for an organization or classification structure. One objective of this study was to empirically determine how pilots organize flight-deck information attributes and -- based upon that data -- develop a useful taxonomy (in terms of better understanding the problems and directing solutions) for classifying flight-deck information management issues. This study also empirically determined how pilots model the importance of flight-deck information attributes for managing information. The results of this analysis suggest areas in which flight-deck researchers and designers may wish to consider focusing their efforts.

Exploratory study of the role of family in the treatment of eating disorders among Puerto Ricans

PubMed Central

Guadalupe-Rodríguez, Elizabeth; Reyes-Rodríguez, Mae Lynn; Bulik, Cynthia M.

2012-01-01

In Latino culture, the family is a major source of social support. We explored the needs and the role of the Puerto Rican eating disorders patient’s family in the treatment process by conducting a focus group with five close relatives of youth with eating disorders. Qualitative analyses indicated the need to integrate the family into treatment and to provide management guidelines to assist with the resolution of situations that emerge frequently during recovery. These results underscored the importance of developing and incorporating psychosocial interventions that include family support and guidance for relatives of Puerto Rican youth patients with eating disorders. PMID:24971160

Music therapy for mental disorder and mental health: the untapped potential of Indian classical music.

PubMed

Hegde, Shantala

2017-05-01

Music is a universal human trait. The healing power of music has been acknowledged in almost all traditions of music. Music therapy is moving from a social-science model focusing on overall health and well-being towards a neuroscience model focusing on specific elements of music and its effect on sensorimotor, language and cognitive functions. The handful of evidence-based music therapy studies on psychiatric conditions have shown promising results. Traditional music, such as Indian classical music, has only recently been evaluated in evidence-based research into music therapy. The need for systematic research in this area is underscored.

Seroconversion risk perception among jail populations: a call for gender-specific HIV prevention programming.

PubMed

Alarid, Leanne Fiftal; Hahl, Jeannie M

2014-04-01

The prevalence of HIV/AIDS infection among prisoners is 3 to 4 times higher than in the U.S. population. Given that one in seven HIV-positive Americans pass through a correctional facility every year, the criminal justice system is in an ideal position to aggressively implement effective HIV education, treatment, and prevention. This study examines barriers to the effective delivery of these services and evaluates differences in risk perception among nearly 600 female and male inmates. The results underscore gender differences in Perceived Risk of Seroconversion and Exposure to HIV Education, suggesting that jails should implement gender-specific HIV prevention programming.

Elder mediation in theory and practice: study results from a national caregiver mediation demonstration project.

PubMed

Crampton, Alexandra

2013-01-01

Mediation is a process through which a third party facilitates discussion among disputing parties to help them identify interests and ideally reach an amicable solution. Elder mediation is a growing subspecialty to address conflicts involving older adults, primarily involving caregiving or finances. Mediation is theorized to empower participants but critics argue that it can exacerbate power imbalances among parties and coerce consensus. These contested claims are examined through study of a national caregiver mediation demonstration project. Study implications underscore the importance of gerontological social work expertise to ensure the empowerment of vulnerable older adults in mediation sessions.

Detection of antibodies against spotted fever group Rickettsia (SFGR), typhus group Rickettsia (TGR), and Coxiella burnetii in human febrile patients in the Philippines.

PubMed

Camer, Gerry Amor; Alejandria, Marissa; Amor, Miguel; Satoh, Hiroshi; Muramatsu, Yasukazu; Ueno, Hiroshi; Morita, Chiharu

2003-02-01

A total of 157 sera from febrile patients in the Philippine General Hospital in Manila, Luzon, and the Northern Samar Provincial Hospital, the Philippines, were used. Serum antibodies against spotted fever group Rickettsia (SFGR) and typhus group Rickettsia (TGR) were detected by indirect immunofluorescence test. Antibody positive rates were 1.3% for SFGR (Rickettsia japonica) and 2.5% for TGR (R. typhus), respectively. Rickettsial antibodies in humans in the Philippines were found for the first time. These results underscore the need for further epidemiological study of clinical rickettsioses in the Philippines.

An event-level examination of successful condom negotiation strategies among young women.

PubMed

Peasant, Courtney; Montanaro, Erika A; Kershaw, Trace S; Parra, Gilbert R; Weiss, Nicole H; Meyer, Jaimie P; Murphy, James G; Ritchwood, Tiarney D; Sullivan, Tami P

2017-01-01

This study examines the effect of condom negotiation strategies on condom use and partner type and substance use before sex as moderators of strategy effectiveness. Women reported their daily sexual behavior during the last month. Withholding sex was more strongly associated with condom use when utilized with a non-casual sex partner. Directly requesting condom use was more strongly and using deceptive reasons to influence condom use was less strongly related to condom use during substance use. Results underscore the importance of understanding the contexts in which condom negotiation strategies are successful in order to improve HIV/sexually transmitted infection prevention efforts among women.

Eliciting an antibody response against a recombinant TSH containing fusion protein.

PubMed

Mard-Soltani, Maysam; Rasaee, Mohamad Javad; Sheikhi, AbdolKarim; Hedayati, Mehdi

2017-01-01

Designing novel antigens to rise specific antibodies for Thyroid Stimulating Hormone (TSH) detection is of great significance. A novel fusion protein consisting of the C termini sequence of TSH beta subunit and a fusion sequence was designed and produced for rabbit immunization. Thereafter, the produced antibodies were purified and characterized for TSH detection. Our results indicate that the produced antibody is capable of sensitive and specific detection of TSH with low cross reactivity. This study underscores the applicability of designed fusion protein for specific and sensitive polyclonal antibody production and the importance of selecting an amenable region of the TSH for immunization.

Elder Mediation in Theory and Practice: Study Results From a National Caregiver Mediation Demonstration Project

PubMed Central

Crampton, Alexandra

2014-01-01

Mediation is a process through which a third party facilitates discussion among disputing parties to help them identify interests and ideally reach an amicable solution. Elder mediation is a growing subspecialty to address conflicts involving older adults, primarily involving caregiving or finances. Mediation is theorized to empower participants but critics argue that it can exacerbate power imbalances among parties and coerce consensus. These contested claims are examined through study of a national caregiver mediation demonstration project. Study implications underscore the importance of gerontological social work expertise to ensure the empowerment of vulnerable older adults in mediation sessions. PMID:23767767

Temporal regulation of Stat5 activity in determination of cell differentiation program

PubMed Central

Hoshino, Akemi; Fujii, Hodaka

2007-01-01

Although Stat5 is activated by various cytokines, only ethrytopoietin (Epo) and a small number of cytokines induce Stat5-dependent erythroid differentiation. Here, by using a reporter gene system to monitor transcriptional activity of Stat5, we showed that Epo but not interleukin (IL)-3 supports sustained activation of Stat5, which induces globin gene expression. IL-3 or IL-2 stimulation inhibits Epo-induced globin gene expression. The acidic region of the IL-2 receptor β chain was essential for this inhibition. These results underscore the importance of temporal regulation of Stat activity for regulation of cytokine-specific cell differentiation. PMID:17511959

Teenagers' attitudes about seeking help from telephone crisis services (hotlines).

PubMed

Gould, Madelyn S; Greenberg, Ted; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie; Lubell, Keri

2006-12-01

The purpose of this study was to examine the attitudes toward the use of telephone crisis services (hotlines) among 519 adolescents in 9th through 12th grade mandatory health courses in six high schools in New York State. Few adolescents (2.1%) used hotlines and negative attitudes were stronger toward hotlines than they were toward other formal sources of help. The most common reasons for hotline nonuse related to feelings of self-reliance and shame. Objections to hotlines were strongest among students most in need of help by virtue of impaired functioning or feelings of hopelessness. The results underscore needed outreach efforts to youth.

Lymphatic deletion of calcitonin receptor–like receptor exacerbates intestinal inflammation

PubMed Central

Davis, Reema B.; Kechele, Daniel O.; Blakeney, Elizabeth S.; Pawlak, John B.

2017-01-01

Lymphatics play a critical role in maintaining gastrointestinal homeostasis and in the absorption of dietary lipids, yet their roles in intestinal inflammation remain elusive. Given the increasing prevalence of inflammatory bowel disease, we investigated whether lymphatic vessels contribute to, or may be causative of, disease progression. We generated a mouse model with temporal and spatial deletion of the key lymphangiogenic receptor for the adrenomedullin peptide, calcitonin receptor–like receptor (Calcrl), and found that the loss of lymphatic Calcrl was sufficient to induce intestinal lymphangiectasia, characterized by dilated lacteals and protein-losing enteropathy. Upon indomethacin challenge, Calcrlfl/fl/Prox1-CreERT2 mice demonstrated persistent inflammation and failure to recover and thrive. The epithelium and crypts of Calcrlfl/fl/Prox1-CreERT2 mice exhibited exacerbated hallmarks of disease progression, and the lacteals demonstrated an inability to absorb lipids. Furthermore, we identified Calcrl/adrenomedullin signaling as an essential upstream regulator of the Notch pathway, previously shown to be critical for intestinal lacteal maintenance and junctional integrity. In conclusion, lymphatic insufficiency and lymphangiectasia caused by loss of lymphatic Calcrl exacerbates intestinal recovery following mucosal injury and underscores the importance of lymphatic function in promoting recovery from intestinal inflammation. PMID:28352669

Zircon age-temperature-compositional spectra in plutonic rocks

DOE PAGES

Samperton, Kyle M.; Bell, Elizabeth A.; Barboni, Mélanie; ...

2017-08-23

We present that geochronology can resolve dispersed zircon dates in plutonic rocks when magma cooling time scales exceed the temporal precision of individual U-Pb analyses; such age heterogeneity may indicate protracted crystallization between the temperatures of zircon saturation (T sat) and rock solidification (T solid). Diffusive growth models predict asymmetric distributions of zircon dates and crystallization temperatures in a cooling magma, with volumetrically abundant old, hot crystallization at T sat decreasing continuously to volumetrically minor young, cold crystallization at T solid. We present integrated geochronological and geochemical data from Bergell Intrusion tonalites (Central Alps, Europe) that document zircon compositional changemore » over hundreds of thousands of years at the hand-sample scale, indicating melt compositional evolution during solidification. Ti-in-zircon thermometry, crystallization simulation using MELTS software, and U-Pb dates produce zircon mass-temperature-time distributions that are in excellent agreement with zircon growth models. In conclusion, these findings provide the first quantitative validation of longstanding expectations from zircon saturation theory by direct geochronological investigation, underscoring zircon’s capacity to quantify supersolidus cooling rates in magmas and resolve dynamic differentiation histories in the plutonic rock record.« less

Structural and elemental changes in glioblastoma cells in situ: complementary imaging with high resolution visible light- and X-ray microscopy

DOE PAGES

Ducic, Tanja; Paunesku, Tatjana; Chen, Si; ...

2016-12-09

The glioblastoma (GBM) is characterized by a short median survival and an almost 100% tumor related mortality. GBM cells exhibit highly invasive behavior whose mechanisms are not yet fully understood. The present study explores application of X-ray and visible light microscopy to display the elemental and structural images of cells from 3 patient derived GMB samples and an established GMB cell line. Slight differences in elemental concentrations, in actin cytoskeleton organization and cell morphology were noted between all cells types by X-ray fluorescence and full field soft X-ray microscopy, as well as the Structured Illumination Super-resolution Microscope (SIM). Different samplemore » preparation approaches were used to match each imaging technique. While preparation for SIM included cell fixation and staining, intact frozen hydrated cells were used for the trace element imaging by hard X-ray fluorescence and exploration of the structural features by soft X-ray absorption tomography. In conclusion, each technique documented differences between samples with regard to morphology and elemental composition and underscored the importance of use of multiple patient derived samples for detailed GBM study.« less

Structural and elemental changes in glioblastoma cells in situ: complementary imaging with high resolution visible light- and X-ray microscopy

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

Ducic, Tanja; Paunesku, Tatjana; Chen, Si

The glioblastoma (GBM) is characterized by a short median survival and an almost 100% tumor related mortality. GBM cells exhibit highly invasive behavior whose mechanisms are not yet fully understood. The present study explores application of X-ray and visible light microscopy to display the elemental and structural images of cells from 3 patient derived GMB samples and an established GMB cell line. Slight differences in elemental concentrations, in actin cytoskeleton organization and cell morphology were noted between all cells types by X-ray fluorescence and full field soft X-ray microscopy, as well as the Structured Illumination Super-resolution Microscope (SIM). Different samplemore » preparation approaches were used to match each imaging technique. While preparation for SIM included cell fixation and staining, intact frozen hydrated cells were used for the trace element imaging by hard X-ray fluorescence and exploration of the structural features by soft X-ray absorption tomography. In conclusion, each technique documented differences between samples with regard to morphology and elemental composition and underscored the importance of use of multiple patient derived samples for detailed GBM study.« less

Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults.

PubMed

Loprinzi, Paul D

2016-06-01

Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P < 0.001). Compared to those not engaging in aerobic exercise and not meeting muscle-strengthening activity guidelines, those doing 1 (βadjusted = 3.7; 95% CI: 1.9-5.4; P < 0.001) and both (βadjusted = 6.6; 95% CI: 4.8-8.3; P < 0.001) of these behaviors had a significantly higher executive cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults. © The Author(s) 2016.

Shareholder Value and the Performance of a Large Nursing Home Chain

PubMed Central

Kitchener, Martin; O'Meara, Janis; Brody, Ab; Lee, Hyang Yuol; Harrington, Charlene

2008-01-01

Objective To analyze corporate governance arrangements and quality and financial performance outcomes among large multi-facility nursing home corporations (chains) that pursue stakeholder value (profit maximization) strategies. Study Design To establish a foundation of knowledge about the focal phenomenon and processes, we conducted an historical (1993–2005) case study of one of the largest chains (Sun Helathcare Inc.) that triangulated qualitative and quantitative data sources. Data Sources Two main sets of information were compared: (1) corporate sources including Sun's Security Exchange Commission (SEC) Form 10-K annual reports, industry financial reports, and the business press; and (2) external sources including, legal documents, press reports, and publicly available California facility cost reports and quality data. Principal Findings Shareholder value was pursued at Sun through three inter-linked strategies: (1) rapid growth through debt-financed mergers; (2) labor cost constraint through low nurse staffing levels; and (3) a model of corporate governance that views sanctions for fraud and poor quality as a cost of business. Conclusions Study findings and evidence from other large nursing home chains underscore calls from the Institute of Medicine and other bodies for extended oversight of the corporate governance and performance of large nursing home chains. PMID:18454781

Zircon age-temperature-compositional spectra in plutonic rocks

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

Samperton, Kyle M.; Bell, Elizabeth A.; Barboni, Mélanie

We present that geochronology can resolve dispersed zircon dates in plutonic rocks when magma cooling time scales exceed the temporal precision of individual U-Pb analyses; such age heterogeneity may indicate protracted crystallization between the temperatures of zircon saturation (T sat) and rock solidification (T solid). Diffusive growth models predict asymmetric distributions of zircon dates and crystallization temperatures in a cooling magma, with volumetrically abundant old, hot crystallization at T sat decreasing continuously to volumetrically minor young, cold crystallization at T solid. We present integrated geochronological and geochemical data from Bergell Intrusion tonalites (Central Alps, Europe) that document zircon compositional changemore » over hundreds of thousands of years at the hand-sample scale, indicating melt compositional evolution during solidification. Ti-in-zircon thermometry, crystallization simulation using MELTS software, and U-Pb dates produce zircon mass-temperature-time distributions that are in excellent agreement with zircon growth models. In conclusion, these findings provide the first quantitative validation of longstanding expectations from zircon saturation theory by direct geochronological investigation, underscoring zircon’s capacity to quantify supersolidus cooling rates in magmas and resolve dynamic differentiation histories in the plutonic rock record.« less

A meteorite crater on Earth formed on September 15, 2007: The Carancas hypervelocity impact

NASA Astrophysics Data System (ADS)

Tancredi, G.; Ishitsuka, J.; Schultz, P. H.; Harris, R. S.; Brown, P.; Revelle, D. O.; Antier, K.; Le Pichon, A.; Rosales, D.; Vidal, E.; Varela, M. E.; Sánchez, L.; Benavente, S.; Bojorquez, J.; Cabezas, D.; Dalmau, A.

2009-01-01

On September 15, 2007, a bright fireball was observed and a big explosion was heard by many inhabitants near the southern shore of Lake Titicaca. In the community of Carancas (Peru), a 13.5 m crater and several fragments of a stony meteorite were found close to the site of the impact. The Carancas event is the first impact crater whose formation was directly observed by several witnesses as well as the first unambiguous seismic recording of a crater-forming meteorite impact on Earth. We present several lines of evidence that suggest that the Carancas crater was a hypervelocity impact. An event like this should have not occurred according to the accepted picture of stony meteoroids ablating in the Earth’s atmosphere, therefore it challenges our present models of entry dynamics. We discuss alternatives to explain this particular event. This emphasizes the weakness in the pervasive use of “average” parameters (such as tensile strength, fragmentation behavior and ablation behavior) in current modeling efforts. This underscores the need to examine a full range of possible values for these parameters when drawing general conclusions from models about impact processes.

A topological approach unveils system invariances and broken symmetries in the brain.

PubMed

Tozzi, Arturo; Peters, James F

2016-05-01

Symmetries are widespread invariances underscoring countless systems, including the brain. A symmetry break occurs when the symmetry is present at one level of observation but is hidden at another level. In such a general framework, a concept from algebraic topology, namely, the Borsuk-Ulam theorem (BUT), comes into play and sheds new light on the general mechanisms of nervous symmetries. The BUT tells us that we can find, on an n-dimensional sphere, a pair of opposite points that have the same encoding on an n - 1 sphere. This mapping makes it possible to describe both antipodal points with a single real-valued vector on a lower dimensional sphere. Here we argue that this topological approach is useful for the evaluation of hidden nervous symmetries. This means that symmetries can be found when evaluating the brain in a proper dimension, although they disappear (are hidden or broken) when we evaluate the same brain only one dimension lower. In conclusion, we provide a topological methodology for the evaluation of the most general features of brain activity, i.e., the symmetries, cast in a physical/biological fashion that has the potential to be operationalized. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state

PubMed Central

Mazumdar, Soumya; Learnihan, Vincent; Cochrane, Thomas; Phung, Hai; O'Connor, Bridget; Davey, Rachel

2016-01-01

Objectives To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. Design A cross-sectional analysis of public hospital episode data (2007–2013). Setting Hospitalisations from the ACT, Australia at very small geographic areas. Participants Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity. Main exposure measures Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability. Main outcome measures Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers. Results Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers. Conclusions Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health. PMID:27932340

The Healthy Class of 2010: Utilization of the School Health Index to Build Collaboration Between a University and an Urban School District

PubMed Central

Fryer, Craig S.; Reed, Ernestine A.; Thomas, Stephen B.

2014-01-01

BACKGROUND Insufficient attention has been paid to the process of conducting the Centers for Disease Control and Prevention’s School Health Index (SHI) to promote collaboration between universities and urban school districts when developing adolescent health promotion initiatives. This article provides an overview of the real world contextual challenges and opportunities this type of collaboration can pose. METHODS The SHI and selected collaboration principles were used to facilitate partnership and increase stakeholder buy-in, which led to developing and implementing an eight year health promotion campaign, The Healthy Class of 2010 (HC 2010). RESULTS The focus on planning brought together key stakeholders and allowed for HC 2010 programming to take place despite the competing demands on the schools. The SHI allowed for input from stakeholders to develop campaign activities and inform school- and district-wide policy. Universities and school districts desiring to develop and implement school-based, adolescent health promotion programs should: 1) identify the hierarchical structure of the school district; 2) establish credibility for the program and the university staff; 3) emphasize the benefits to all partners; 4) maintain a cooperative partnership with teachers and administrators; 5) appreciate the need for planning; and, 6) provide as many resources as possible to on an already overburdened school system. CONCLUSIONS Promoting healthy behaviors among students is an important part of the fundamental mission of schools. HC 2010 underscored the significance of collaboration using the SHI in the development and implementation of this health promotion campaign with input from students, teachers, administrators and university partners. PMID:22070509

Precautionary Practices of Healthcare Workers Who Disinfect Medical and Dental Devices Using High-Level Disinfectants

PubMed Central

Henn, Scott A.; Boiano, James M.; Steege, Andrea L.

2016-01-01

Background High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of which are respiratory and skin irritants and sensitizers. Objective To evaluate exposure controls used and to better understand impediments to healthcare workers using personal protective equipment while handling HLDs. Design Web-based survey. Participants A targeted sample of members of professional practice organizations representing nurses, technologists/technicians, dental professionals, respiratory therapists, and others who reported handling HLDs in the previous 7 calendar days. Participating organizations invited either all or a random sample of members via email, which included a hyperlink to the survey. Methods Descriptive analyses were conducted including simple frequencies and prevalences. Results A total of 4,657 respondents completed the survey. The HLDs used most often were glutaraldehyde (59%), peracetic acid (16%), and ortho-phthalaldehyde (15%). Examples of work practices or events that could increase exposure risk included failure to wear water-resistant gowns (44%); absence of standard procedures for minimizing exposure (19%); lack of safe handling training (17%); failure to wear protective gloves (9%); and a spill/leak of HLD during handling (5%). Among all respondents, 12% reported skin contact with HLDs, and 33% of these respondents reported that they did not always wear gloves. Conclusion Findings indicated that precautionary practices were not always used, underscoring the importance of improved employer and worker training and education regarding HLD hazards. PMID:25633000

Determinants of Quality of Life in the Acute Stage Following Stroke

PubMed Central

Jeong, Bo-Ok; Kang, Hee-Ju; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun; Yoon, Jin-Sang

2012-01-01

Objective This study aimed to investigate the factors influence the quality of life (QOL) of survivors of an acute stroke. Methods For 422 stroke patients, assessments were made within two weeks of the index event. QOL was measured using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF), which has four domains related to physical factors, psychological factors, social relationships, and environmental context. Associations of each four WHOQOL-BREF domain score with socio-demographic characteristics (age, sex, education, marital status, religion, and occupation), stroke severity (National Institutes of Health Stroke Scale), physical disability (Barthel Index), cognitive function (Mini-Mental Status Examination: MMSE), grip strength, and psychological distress (Hospital Anxiety and Depression Scale depression and anxiety subscale: HADS-D and HADS-A) were investigated using the linear regression models. Results Higher physical domain scores were independently associated with higher MMSE scores, stronger hand-grip strength, and lower HADS-D and HADS-A scores; higher psychological domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D and HADS-A scores; higher social relationships domain scores were independently associated with lower HADS-D and HADS-A scores; and higher environmental domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D scores. Conclusion Psychological distress and impaired cognitive function were independently associated with lower QOL in patients with acute stroke. However, stroke severity, physical disability and other socio-demographic factors were less significantly associated with QOL. These findings underscore the importance of psychological interventions for improving QOL during the acute phase following stroke. PMID:22707962

Genetic anticipation in BRCA1/2 families after controlling for ascertainment bias and cohort effect

PubMed Central

Guindalini, Rodrigo Santa Cruz; Song, Andrew; Fackenthal, James D.; Olopade, Olufunmilayo I.; Huo, Dezheng

2016-01-01

Background Genetic anticipation, the earlier onset of disease in successive generations, has been reported in hereditary breast and ovarian cancer syndrome (HBOC), but little is known about its underlying mechanisms. Ascertainment bias is a reason that has been suggested in previous studies. Likewise, cohort effect, which may be due to environmental factors, can be misinterpreted as genetic anticipation. Methods We conducted a review of pedigrees in 176 kindreds segregating deleterious mutations in BRCA1/2 genes who had at least two consecutive generations of the same cancer (breast or ovarian). Using mutation probabilities as analytical weights in weighted random-effect models, we calculated generational differences in age of onset of breast/ovarian cancer. Then we further controlled for ascertainment bias by excluding probands and adjusted for birth cohort effect in the anticipation models. Results The mean age of breast cancer for the probands’ generation was 41.9 years, which was 6.8 years and 9.8 years earlier than the parents’ and grandparents’ generations, respectively. The anticipation effect for breast cancer remained significant after excluding probands. There was a birth cohort effect: patients born in 1930s and 1940s had breast cancer 5.0 and 7.6 years earlier than patients born before 1920. The difference in breast cancer age of onset across generations was no longer significant after adjusting for birth cohort effect. Conclusions The observed anticipation effect was mainly driven by a decrease in age of onset across birth cohorts, underscoring the need for risk reducing interventions that target changing environmental/lifestyle factors in BRCA1/2 carriers. PMID:26992017

Malaria resurgence: a systematic review and assessment of its causes

PubMed Central

2012-01-01

Background Considerable declines in malaria have accompanied increased funding for control since the year 2000, but historical failures to maintain gains against the disease underscore the fragility of these successes. Although malaria transmission can be suppressed by effective control measures, in the absence of active intervention malaria will return to an intrinsic equilibrium determined by factors related to ecology, efficiency of mosquito vectors, and socioeconomic characteristics. Understanding where and why resurgence has occurred historically can help current and future malaria control programmes avoid the mistakes of the past. Methods A systematic review of the literature was conducted to identify historical malaria resurgence events. All suggested causes of these events were categorized according to whether they were related to weakened malaria control programmes, increased potential for malaria transmission, or technical obstacles like resistance. Results The review identified 75 resurgence events in 61 countries, occurring from the 1930s through the 2000s. Almost all resurgence events (68/75 = 91%) were attributed at least in part to the weakening of malaria control programmes for a variety of reasons, of which resource constraints were the most common (39/68 = 57%). Over half of the events (44/75 = 59%) were attributed in part to increases in the intrinsic potential for malaria transmission, while only 24/75 (32%) were attributed to vector or drug resistance. Conclusions Given that most malaria resurgences have been linked to weakening of control programmes, there is an urgent need to develop practical solutions to the financial and operational threats to effectively sustaining today’s successful malaria control programmes. PMID:22531245

Suicidality in pediatric bipolar disorder: predictor or outcome of family processes and mixed mood presentation?

PubMed Central

Algorta, Guillermo Pérez; Youngstrom, Eric A; Frazier, Thomas W; Freeman, Andrew J; Youngstrom, Jennifer Kogos; Findling, Robert L

2011-01-01

Objective Pediatric bipolar disorder (PBD) involves a potent combination of mood dysregulation and interpersonal processes, placing these youth at significantly greater risk of suicide. We examined the relationship between suicidal behavior, mood symptom presentation, family functioning, and quality of life (QoL) in youth with PBD. Methods Participants were 138 youths aged 5–18 years presenting to outpatient clinics with DSM-IV diagnoses of bipolar I disorder (n = 27), bipolar II disorder (n = 18), cyclothymic disorder (n = 48), and bipolar disorder not otherwise specified (n = 45). Results Twenty PBD patients had lifetime suicide attempts, 63 had past or current suicide ideation, and 55 were free of suicide ideation and attempts. Attempters were older than nonattempters. Suicide ideation and attempts were linked to higher depressive symptoms, and rates were even higher in youths meeting criteria for the mixed specifier proposed for DSM-5. Both suicide ideation and attempts were associated with lower youth QoL and poorer family functioning. Parent effects (with suicidality treated as outcome) and child effects (where suicide was the predictor of poor family functioning) showed equally strong evidence in regression models, even after adjusting for demographics. Conclusions These findings underscore the strong association between mixed features and suicidality in PBD, as well as the association between QoL, family functioning, and suicidality. It is possible that youths are not just a passive recipient of family processes, and their illness may play an active role in disrupting family functioning. Replication with longitudinal data and qualitative methods should investigate both child and parent effect models. PMID:21320255

Multiple spinal metastases from a well-differentiated liposarcoma of the iliac wing: a case report

PubMed Central

Ben Nsir, A; Boubaker, A; Kassar, AZ; Abderrahmen, K; Kchir, N; Jemel, H

2015-01-01

Study design: A case report. Objectives: To report an unusual case of multiple spinal metastases from an undiagnosed well-differentiated liposarcoma (WDLPS) of the iliac wing and to stress the need of a meticulous clinical examination and further screening of patients with chronic and asymptomatic bony lesions. Setting: University of medicine of Monastir, Department of neurological surgery, Fattouma Bourguiba University Hospital, Monastir, Tunisia and University of Medicine of Tunis EL Manar, Department of neurological surgery, Tunisian National Institute of Neurology, Tunis, Tunisia. Methods: A 39-year-old man presented with signs of spinal cord compression for the past 2 weeks. His medical history was consistent for an asymptomatic right iliac wing mass that appeared 3 years ago and for which he has not consulted. Magnetic resonance imaging revealed multiple bony lesions of the thoraco-lumbar spine associated with a 6-cm right paravertebral mass at the T4 level extending posteriorly through the intervertebral foramina to the spinal canal causing major spinal cord compression. An emergent T2–T6 laminectomy allowed for a complete resection of the epidural mass. Pathological examination confirmed the diagnosis of well-differentiated liposarcoma. Adjunctive radiation therapy was administered. Results: The patient’s neurological status improved remarkably under an intensive care and rehabilitation program. He was ambulatory without assistance in the second postoperative week. Conclusion: The case reported in this paper represents a genuine example of the possible metastatic potential of WDLPSs of the bone and underscores the importance of examining patients thoroughly, especially when they have chronic and asymptomatic lesions. PMID:28053711

Dyadic Coping in Metastatic Breast Cancer

PubMed Central

Badr, Hoda; Carmack, Cindy L.; Kashy, Deborah A.; Cristofanilli, Massimo; Revenson, Tracey A.

2011-01-01

Objective Couples facing metastatic breast cancer (MBC) must learn to cope with stressors that can affect both partners' quality of life as well as the quality of their relationship. Common dyadic coping involves taking a “we” approach, whereby partners work together to maintain their relationship while jointly managing their shared stress. This study prospectively evaluated whether common dyadic coping was associated with less cancer-related distress and greater dyadic adjustment for female MBC patients and their male partners. Design Couples (N = 191) completed surveys at the start of treatment for MBC (baseline), and 3 and 6 months later. Main Outcome Measures Cancer-related distress was assessed with the Impact of Events Scale; dyadic adjustment was assessed using the short-form of the Dyadic Adjustment Scale. Results Multilevel models using the couple as the unit of analysis showed that the effects of common positive dyadic coping on cancer-related distress significantly differed for patients and their partners. Whereas partners experienced slightly lower levels of distress, patients experienced slightly higher levels of distress. Although patients and partners who used more common negative dyadic coping experienced significantly greater distress at all times, the association was stronger for patients. Finally, using more common positive dyadic coping and less common negative dyadic coping was mutually beneficial for patients and partners in terms of greater dyadic adjustment. Conclusion Our findings underscore the importance of couples working together to manage the stress associated with MBC. Future research may benefit from greater focus on the interactions between patients and their partners to address ways that couples can adaptively cope together. PMID:20230090

Views on mandatory reporting of impaired health practitioners by their treating practitioners: a qualitative study from Australia

PubMed Central

Bismark, Marie M; Mathews, Ben; Morris, Jennifer M; Thomas, Laura A; Studdert, David M

2016-01-01

Objective To explore the views and experiences of health sector professionals in Australia regarding a new national law requiring treating practitioners to report impaired health practitioners whose impairments came to their attention in the course of providing treatment. Method We conducted a thematic analysis of in-depth, semistructured interviews with 18 health practitioners and 4 medicolegal advisors from Australia's 6 states, each of whom had experience with applying the new mandatory reporting law in practice. Results Interviewees perceived the introduction of a mandatory reporting law as a response to failures of the profession to adequately protect the public from impaired practitioners. Mandatory reporting of impaired practitioners was reported to have several benefits: it provides treating practitioners with a ‘lever’ to influence behaviour, offers protections to those who make reports and underscores the duty to protect the public from harm. However, many viewed it as a blunt instrument that did not sufficiently take account of the realities of clinical practice. In deciding whether or not to make a report, interviewees reported exercising clinical discretion, and being influenced by three competing considerations: protection of the public, confidentiality of patient information and loyalty to their profession. Conclusions Competing ethical considerations limit the willingness of Australian health practitioners to report impaired practitioner-patients under a mandatory reporting law. Improved understanding and implementation of the law may bolster the public protection offered by mandatory reports, reduce the need to breach practitioner-patient confidentiality and help align the law with the loyalty that practitioners feel to support, rather than punish, their impaired colleagues. PMID:27993902

Parents Know Best, But Are They Accurate? Parental Normative Misperceptions and Their Relationship to Students' Alcohol-Related Outcomes*

PubMed Central

LaBrie, Joseph W.; Hummer, Justin F.; Lac, Andrew; Ehret, Phillip J.; Kenney, Shannon R.

2011-01-01

Objective: Parents often look to other parents for guidance, but how accurate are their perceptions? Expanding on existing normative literature to include parents of college students, this study first sought to determine whether parents accurately estimated the attitudes of other parents concerning their college student's alcohol-related behaviors. The effect of these (mis)perceived injunctive norms on the alcohol-related attitudes and behaviors of the parents' own children was then examined. Method: Participants were 270 college student-parent dyadic pairs who completed independent online surveys. The student sample was 59% female; the parent sample was 78% female. Results: A structural equation model demonstrated that parents significantly overestimated other parents' approval of alcohol use by their respective child and, further, that these misperceptions strongly influenced parental attitudes toward their own child's drinking. Parental attitudes were sub-sequently found to be significantly associated with their child's attitudes toward drinking but were only marginally associated with the child's actual drinking, thereby underscoring the mediational effect of the child's attitudes. Conclusions: This is the first study to document the influence of parental normative misperceptions regarding alcohol use by their college-age children, reinforcing the importance of parental attitudes on children's alcohol-related attitudes and behaviors in college. These findings support the need to complement student-based interventions with parent-based interventions aimed at increasing parental awareness and involvement. Further, the current findings indicate that normative interventions targeting parents offer a promising avenue by which to indirectly and positively influence college students' alcohol use. PMID:21683033

History of sex trafficking, recent experiences of violence, and HIV vulnerability among female sex workers in coastal Andhra Pradesh, India

PubMed Central

Gupta, Jhumka; Reed, Elizabeth; Kershaw, Trace; Blankenship, Kim M.

2011-01-01

Synopsis Findings from female sex workers in southern India indicate that women who enter sex work via trafficking are exposed to unique HIV vulnerabilities. Objectives To estimate the prevalence of sex trafficking as a mode of entry into sex work, and to examine associations between sex trafficking and recent violence experiences and HIV vulnerability among female sex workers (FSWs). Methods In a cross-sectional study in 2006 in coastal Andhra Pradesh, India, 812 FSWs were recruited via respondent-driven sampling to take part in an oral survey of their experiences in sex work. Results One in 5 (19.3%) FSWs met the UN definition of sex trafficking. Women trafficked into sex work were more likely than other FSWs to report recent violence experiences (adjusted odds ratio [AOR], 1.93; 95% confidence interval [CI], 1.32–2.81), more clients per week (AOR, 1.63; 95% CI, 1.11–2.41), and more days of sex work per week (AOR, 1.76; 95% CI, 1.18–2.63), and were less likely to report use of FSW-focused services (AOR, 0.60; 95% CI, 0.42–0.86). No significant differences emerged regarding HIV knowledge or consistent condom use. Conclusion There was a high prevalence of sex trafficking. A history of sex trafficking was associated with a greater vulnerability to recent violence and HIV risk behaviors, underscoring the need for increased attention to the public health needs of trafficked populations. PMID:21620402

Protobacco Media Exposure and Youth Susceptibility to Smoking Cigarettes, Cigarette Experimentation, and Current Tobacco Use among US Youth

PubMed Central

Fulmer, Erika B.; Neilands, Torsten B.; Dube, Shanta R.; Kuiper, Nicole M.; Arrazola, Rene A.; Glantz, Stanton A.

2015-01-01

Purpose Youth are exposed to many types of protobacco influences, including smoking in movies, which has been shown to cause initiation. This study investigates associations between different channels of protobacco media and susceptibility to smoking cigarettes, cigarette experimentation, and current tobacco use among US middle and high school students. Methods By using data from the 2012 National Youth Tobacco Survey, structural equation modeling was performed in 2013. The analyses examined exposure to tobacco use in different channels of protobacco media on smoking susceptibility, experimentation, and current tobacco use, accounting for perceived peer tobacco use. Results In 2012, 27.9% of respondents were never-smokers who reported being susceptible to trying cigarette smoking. Cigarette experimentation increased from 6.3% in 6th grade to 37.1% in 12th grade. Likewise, current tobacco use increased from 5.2% in 6th grade to 33.2% in 12th grade. Structural equation modeling supported a model in which current tobacco use is associated with exposure to static advertising through perception of peer use, and by exposure to tobacco use depicted on TV and in movies, both directly and through perception of peer use. Exposure to static advertising appears to directly increase smoking susceptibility but indirectly (through increased perceptions of peer use) to increase cigarette experimentation. Models that explicitly incorporate peer use as a mediator can better discern the direct and indirect effects of exposure to static advertising on youth tobacco use initiation. Conclusions These findings underscore the importance of reducing youth exposure to smoking in TV, movies, and static advertising. PMID:26308217

Socioeconomic Outcomes in Adults Malnourished in the First Year of Life: A 40-Year Study

PubMed Central

Bryce, Cyralene; Waber, Deborah P.; Zichlin, Miriam L.; Fitzmaurice, Garret M.; Eaglesfield, David

2012-01-01

OBJECTIVE: Lifelong functional, adaptive, and economic outcomes of moderate to severe infantile malnutrition are not well known. We assessed social status and income at midlife in a cohort of Barbadian adults, hospitalized for protein-energy malnutrition (PEM) during the first year of life, with good nutrition and health thereafter, in the context of a 40-year longitudinal case-control study. We also examined to what extent childhood IQ mediated any group differences. METHODS: Educational achievement, occupational status, and standard of living were assessed by the Hollingshead scales and a site-specific Ecology Questionnaire in Barbadian adults (aged 37–43 years) with a history of malnutrition (n = 80) and a matched healthy control group (n = 63), classmates of the index cases. Malnutrition effects, adjusted for childhood standard of living, were estimated by longitudinal multiple regression analyses, with and without childhood IQ, in the models. RESULTS: PEM predicted poorer socioeconomic outcomes with medium to large effect sizes (0.50–0.94), but childhood IQ substantially attenuated the magnitude of these effects (adjusted effect sizes: 0.17–0.34). The gap in weekly household income between the PEM and control groups increased substantially over the life span (P < .001). CONCLUSIONS: Moderate to severe PEM during the first year of life with adequate nutrition and health care thereafter is associated with significant depression of socioeconomic outcomes in adulthood, mediated in part by cognitive compromise in affected individuals. This finding underscores the potential long-term economic burden of infant malnutrition, which is of major concern given the continued high prevalence of malnutrition worldwide. PMID:22732170

Phylostratigraphic profiles reveal a deep evolutionary history of the vertebrate head sensory systems

PubMed Central

2013-01-01

Background The vertebrate head is a highly derived trait with a heavy concentration of sophisticated sensory organs that allow complex behaviour in this lineage. The head sensory structures arise during vertebrate development from cranial placodes and the neural crest. It is generally thought that derivatives of these ectodermal embryonic tissues played a central role in the evolutionary transition at the onset of vertebrates. Despite the obvious importance of head sensory organs for vertebrate biology, their evolutionary history is still uncertain. Results To give a fresh perspective on the adaptive history of the vertebrate head sensory organs, we applied genomic phylostratigraphy to large-scale in situ expression data of the developing zebrafish Danio rerio. Contrary to traditional predictions, we found that dominant adaptive signals in the analyzed sensory structures largely precede the evolutionary advent of vertebrates. The leading adaptive signals at the bilaterian-chordate transition suggested that the visual system was the first sensory structure to evolve. The olfactory, vestibuloauditory, and lateral line sensory organs displayed a strong link with the urochordate-vertebrate ancestor. The only structures that qualified as genuine vertebrate innovations were the neural crest derivatives, trigeminal ganglion and adenohypophysis. We also found evidence that the cranial placodes evolved before the neural crest despite their proposed embryological relatedness. Conclusions Taken together, our findings reveal pre-vertebrate roots and a stepwise adaptive history of the vertebrate sensory systems. This study also underscores that large genomic and expression datasets are rich sources of macroevolutionary information that can be recovered by phylostratigraphic mining. PMID:23587066

Use of Complementary and Alternative Medicine Treatments by Patients with Obstructive Sleep Apnea Hypopnea Syndrome

PubMed Central

Sood, Amit; Narayanan, Sujata; Wahner-Roedler, Dietlind L.; Knudsen, Kayla; Sood, Richa; Loehrer, Laura L.; Hanson, Andrew C.; Kuzniar, Tomasz J.; Olson, Eric J.

2007-01-01

Study Objectives: To assess the proportion of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) reporting previous or current use and interest in future use of complementary and alternative medicine (CAM) therapies. Design: Cross-sectional, point-of-care, anonymous survey. Setting: Sleep disorders center at a Midwest tertiary care center. Participants: Six hundred forty-six consecutive patients undergoing polysomnography. Measurements: The survey instrument comprised 45 items specifically related to CAM therapies, in addition to obtaining baseline data. Results: Response rate was 81% (522/646). A total of 406/522 (78%) patients were diagnosed with OSAHS. Mean age ± SD was 57 ± 14 years, and 267 participants (66%) were men. Overall, 237 (58%) participants reported ever using CAM. Ever and current CAM use specifically for improving sleep was reported by 20% and 7% of the participants, respectively. Twenty-six percent of participants reported ever using biologic products, and 52% reported ever using nonbiologic CAM treatments. A high proportion (58%) of the participants showed interest in future CAM use for improving sleep. Conclusion: A high proportion of patients with OSAHS report previous or current use, and interest in future use, of CAM treatments. This underscores the need to conduct further research in this field. Citation: Sood A; Narayanan S; Wahner-Roedler DL; Knudsen K; Sood R; Loehrer LL; Hanson AC; Kuzniar TJ; Olson EJ. Use of complementary and alternative medicine treatments by patients with obstructive sleep apnea hypopnea syndrome. J Clin Sleep Med 2007;3(6):575-579. PMID:17993037

Effect of Right Ventricular versus Biventricular Pacing on Electrical Remodeling in the Normal Heart

PubMed Central

Saba, Samir; Mehdi, Haider; Mathier, Michael A.; Islam, M. Zahadul; Salama, Guy; London, Barry

2010-01-01

Background Biventricular (BIV) pacing can improve cardiac function in heart failure by altering the mechanical and electrical substrates. We investigated the effect of BIV versus right ventricular (RV) pacing on the normal heart. Methods and Results Male New Zealand White rabbits (n=33) were divided into 3 groups: sham-operated (control), RV pacing, and BIV pacing groups. Four weeks after surgery, the native QT (p=0.004) interval was significantly shorter in the BIV group compared to the RV or sham-operated groups. Also, compared to rabbits in the RV group, rabbits in the BIV group had shorter RV ventricular effective refractory period (VERP) at all cycle lengths, and shorter LV paced QT interval during the drive train of stimuli and close to refractoriness (p<0.001 for all comparisons). Protein expression of the KVLQT1 was significantly increased in the BIV group compared to the RV and control groups, while protein expression of SCN5A and connexin43 was significantly decreased in the RV compared to the other study groups. Erg protein expression was significantly increased in both pacing groups compared to the controls. Conclusions In this rabbit model, we demonstrate a direct effect of BIV but not RV pacing on shortening the native QT interval as well as the paced QT interval during burst pacing and close to the VERP. These findings underscore the fact that the effect of BIV pacing is partially mediated through direct electrical remodeling and may have implications as to the effect of BIV pacing on arrhythmia incidence and burden. PMID:20042767

Angiographic core laboratory reproducibility analyses: implications for planning clinical trials using coronary angiography and left ventriculography end-points.

PubMed

Steigen, Terje K; Claudio, Cheryl; Abbott, David; Schulzer, Michael; Burton, Jeff; Tymchak, Wayne; Buller, Christopher E; John Mancini, G B

2008-06-01

To assess reproducibility of core laboratory performance and impact on sample size calculations. Little information exists about overall reproducibility of core laboratories in contradistinction to performance of individual technicians. Also, qualitative parameters are being adjudicated increasingly as either primary or secondary end-points. The comparative impact of using diverse indexes on sample sizes has not been previously reported. We compared initial and repeat assessments of five quantitative parameters [e.g., minimum lumen diameter (MLD), ejection fraction (EF), etc.] and six qualitative parameters [e.g., TIMI myocardial perfusion grade (TMPG) or thrombus grade (TTG), etc.], as performed by differing technicians and separated by a year or more. Sample sizes were calculated from these results. TMPG and TTG were also adjudicated by a second core laboratory. MLD and EF were the most reproducible, yielding the smallest sample size calculations, whereas percent diameter stenosis and centerline wall motion require substantially larger trials. Of the qualitative parameters, all except TIMI flow grade gave reproducibility characteristics yielding sample sizes of many 100's of patients. Reproducibility of TMPG and TTG was only moderately good both within and between core laboratories, underscoring an intrinsic difficulty in assessing these. Core laboratories can be shown to provide reproducibility performance that is comparable to performance commonly ascribed to individual technicians. The differences in reproducibility yield huge differences in sample size when comparing quantitative and qualitative parameters. TMPG and TTG are intrinsically difficult to assess and conclusions based on these parameters should arise only from very large trials.

Major Depression in the National Comorbidity Survey- Adolescent Supplement: Prevalence, Correlates, and Treatment

PubMed Central

Avenevoli, Shelli; Swendsen, Joel; He, Jian-Ping; Burstein, Marcy; Merikangas, Kathleen

2015-01-01

Objective To present the 12-month prevalence of DSM-IV major depressive disorder (MDD) and severe MDD, examine sociodemographic correlates and comorbidity, and describe impairment and service utilization. Method Data are from the National Comorbidity Survey-Adolescent Supplement (NCS-A), a nationally representative survey of 10,123 adolescents aged 13 to 18 years that assesses DSM-IV disorders using the Composite International Diagnostic Interview (CIDI) Version 3.0. One parent or surrogate of each participating adolescent was also asked to complete a self-administered questionnaire. Results Lifetime and 12-month prevalence of MDD were 11.0% and 7.5%, respectively. The corresponding rates of severe MDD were 3.0% and 2.3%. The prevalence of MDD increased significantly across adolescence, with markedly greater increases among females than males. Most cases of MDD were associated with psychiatric comorbidity and severe role impairment, and a substantial minority reported suicidality. The prevalence of severe MDD was about a quarter of that of all MDD cases; estimates of impairment and clinical correlates were of 2- to 5-fold greater magnitude for severe versus mild/moderate depression, with markedly higher rates for suicidal thoughts and behaviors. Treatment in any form was received by the majority of adolescents with 12-month DSM-IV MDD (60.4%), but only a minority received treatment that was disorder-specific or from the mental health sector. Conclusion Findings underscore the important public health significance of depression among US adolescents and the urgent need to improve screening and treatment access in this population. PMID:25524788

Research Priorities for Studies Linking Intake of Low-Calorie Sweeteners and Potentially Related Health Outcomes

PubMed Central

Bright, Oliver-John M; Wang, Ding Ding; Shams-White, Marissa; Bleich, Sara N; Foreyt, John; Franz, Marion; Johnson, Guy; Manning, Beth Trickett; Mattes, Rick; Pi-Sunyer, Xavier; Schneeman, Barbara; Parrott, James Scott; Steffen, Dan; Sylvetsky, Allison; Ziegler, Paula

2017-01-01

Abstract Background: In a world of finite research funding, efforts to prioritize future research topics are increasingly necessary. Objective: The aim of this study was to identify and prioritize the direction of future research in the broad area of low-calorie sweetener (LCS) intake and potentially related health outcomes by using a novel method that incorporates evidence mapping in the Agency for Healthcare Research and Quality's Future Research Needs (FRN) process. Methods: A diverse expert stakeholder panel was convened and engaged to identify research gaps and prioritize future research needs. An independent research team hosted a number of interactive webinars and elicited feedback through surveys and individual interviews with the stakeholder panel, which included policymakers, lay audience members, health providers, a research funder, individuals with food industry experience, and researchers of several different specialties. Results: The stakeholder panel generated and ranked a list of 18 FRN questions across 5 broad research areas. Overall, stakeholder panel members unanimously agreed that the research questions that will have the largest public health impact are those that address outcomes related to body weight, appetite, and dietary intake. Although the LCSs included in this FRN project have all been Generally Recognized as Safe by the FDA or approved as food additives, the recurrent concerns and confusions with regard to the “safety” of LCSs by consumers underscore the importance of communicating the science to the general public. Conclusion: Our project provides evidence that engaging a diverse expert stakeholder panel is an effective method of translating gaps in nutrition research into prioritized areas of future research.

Consumption of ultra-processed foods and their impact on the diet of young adults

PubMed Central

Bielemann, Renata M; Motta, Janaína V Santos; Minten, Gicele C; Horta, Bernardo L; Gigante, Denise P

2015-01-01

OBJECTIVE To evaluate the consumption of ultra-processed foods, its associated factors, and its influence on nutrient intake in young adults. METHODS In 2004-2005, the individuals belonging to the Pelotas birth cohort of 1982 were identified for a home interview. A total of 4,297 individuals were interviewed and 4,202 individuals were included in the study (follow-up rate of 77.4%). Diet was assessed using a questionnaire on dietary intake and the percentage of daily caloric intake attributed to ultra-processed foods as well as the intake of macro- and micronutrients were estimated. The association between cohort characteristics and the consumption of ultra-processed foods was assessed using linear regression. Analysis of variance and Pearson’s Chi-square test were used to evaluate the association between the quintiles of the consumption of ultra-processed food, nutrient intake and adequacy of nutrient intake, respectively. RESULTS The consumption of ultra-processed foods corresponded to 51.2% of the total caloric intake. The consumption of ultra-processed foods was higher among women, individuals with higher education, and individuals who were never poor and eutrophic. The increased consumption of ultra-processed foods was positively correlated with the consumption of fat, cholesterol, sodium, iron, calcium, and calories (p < 0.001) and was negatively correlated with the consumption of carbohydrates, protein, and dietary fiber (p < 0.001). CONCLUSIONS The high consumption of ultra-processed foods and its positive correlation with the intake of sodium, cholesterol, and fats underscores the need to perform interventions aimed at decreasing the intake of this food group. PMID:26018785

Current use and acceptability of novel diagnostic tests for active tuberculosis: a worldwide survey

PubMed Central

Amicosante, Massimo; D’Ambrosio, Lia; Munoz, Marcela; Mello, Fernanda Carvalho de Queiroz; Tebruegge, Marc; Chegou, Novel Njweipi; Seghrouchni, Fouad; Centis, Rosella; Goletti, Delia; Bothamley, Graham; Migliori, Giovanni Battista

2017-01-01

ABSTRACT Objective: To determine the current use and potential acceptance (by tuberculosis experts worldwide) of novel rapid tests for the diagnosis of tuberculosis that are in line with World Health Organization target product profiles. Methods: A multilingual survey was disseminated online between July and November of 2016. Results: A total of 723 individuals from 114 countries responded to the survey. Smear microscopy was the most commonly used rapid tuberculosis test (available to 90.9% of the respondents), followed by molecular assays (available to 70.7%). Only a small proportion of the respondents in middle- and low-income countries had access to interferon-gamma-release assays. Serological and lateral flow immunoassays were used by more than a quarter (25.4%) of the respondents. Among the respondents who had access to molecular tests, 46.7% were using the Xpert assay overall, that proportion being higher in lower middle-income countries (55.6%) and low-income countries (76.6%). The data also suggest that there was some alignment of pricing for molecular assays. Respondents stated they would accept novel rapid tuberculosis tests if available, including molecular assays (acceptable to 86.0%) or biomarker-based serological assays (acceptable to 81.7%). Simple biomarker-based assays were more commonly deemed acceptable in middle- and low-income countries. Conclusions: Second-generation molecular assays have become more widely available in high- and low-resource settings. However, the development of novel rapid tuberculosis tests continues to be considered important by tuberculosis experts. Our data also underscore the need for additional training and education of end users. PMID:29160384

Comparing Individual Differences in Inconsistency and Plasticity as Predictors of Cognitive Function in Older Adults

PubMed Central

Grand, Jacob H.G.; Stawski, Robert S.; MacDonald, Stuart W.S.

2016-01-01

Introduction Recent theorizing differentiates key constraints on cognition, including one’s current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function. Method Participants included 304 adults (aged 64 to 92 years: M=74.02, SD=5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time measures (choice RT and one-back choice RT), baseline measures of response time (RT) inconsistency (intraindividual standard deviation (ISD) across-trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed, and then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6 year) rates of cognitive change. Results Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change. Conclusions These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults. PMID:26898536

Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers

PubMed Central

Sundstrup, Emil; Hansen, Åse Marie; Mortensen, Erik Lykke; Poulsen, Otto Melchior; Clausen, Thomas; Rugulies, Reiner; Møller, Anne; Andersen, Lars L

2018-01-01

Objective To determine the prospective association between retrospectively assessed physical work environment during working life and prospectively assessed sickness absence and labour market exit among older workers. Methods Using Cox regression analyses we estimated the 4-year to 6-year prospective risk of register-based long-term sickness absence (LTSA), disability pension, early retirement and unemployment from exposure to different physical work environmental factors during working life among 5076 older workers (age 49–63 at baseline) from the Copenhagen Aging and Midlife Biobank cohort. Results Very hard physical work throughout working life was a risk factor for LTSA (HR 1.66,95% CI 1.32 to 2.07), disability pension (HR 2.21,95% CI 1.04 to 4.72) and early retirement (HR 1.57,95% CI 1.13 to 2.17). Both short-term (<10 years) and long-term (≥20 years) exposures to lifting or carrying of heavy burdens predicted the risk of LTSA (HRs 1.49–1.56) and disability pension (HRs 2.26–3.29). In contrast, exposure to dust was associated with LTSA and disability pension only following 20 or more exposure years. Conclusions Retrospectively assessed hard physical work during working life and exposure to several factors in the physical work environment, especially heavy lifting, were important for labour market exit and sickness absence. This study underscores the importance of reducing physical work exposures throughout the working life course for preventing sickness absence and premature exit from the labour market. PMID:28819019

Is testosterone important in LUT function in men and women? ICI-RS 2015.

PubMed

Badawi, Jasmin Katrin; Bosch, Ruud; Djurhuus, Jens Christian; Hanna-Mitchell, Ann T

2017-04-01

This review article is a collaborative report based upon the Authors' presentations and Group discussion on the role of testosterone (T) in the male and female lower urinary tract (LUT) which took place at the 6th International Consultation on Incontinence Research Society's (ICI-RS) annual meeting, in Bristol, UK (September 8-10, 2015). It comprises overviews and opinions on both the current state of knowledge of the role of T in LUT function and dysfunction in both sexes. Results from animal studies suggest that T treatment may be beneficial for disorders of the LUT in women including urinary incontinence and pelvic organ prolapse. The need for clinical studies to evaluate the effect of T treatment in peri- and post-menopausal women, taking into account the type of applied androgen, the application form, timing and dosage, is especially emphasized. In males, findings on the impact of T on the male external urethral sphincter underscores that there is still much to learn about its role in male LUT physiology. The important topic of the use of T therapy in the treatment of enuresis in the young, both sexes, is also discussed. The importance of understanding the steroidogenic pathways linking T with estradiol is discussed as being of paramount importance in researching the unique actions of T in the LUT. The overall conclusion is that further research into the role of T in LUT function and dysfunction across genders and age groups (young to old) is extremely important. Neurourol. Urodynam. 36:859-862, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Increasing Lung Cancer Death Rates Among Young Women in Southern and Midwestern States

PubMed Central

Jemal, Ahmedin; Ma, Jiemin; Rosenberg, Philip S.; Siegel, Rebecca; Anderson, William F.

2012-01-01

Purpose Previous studies reported that declines in age-specific lung cancer death rates among women in the United States abruptly slowed in women younger than age 50 years (ie, women born after the 1950s). However, in view of substantial geographic differences in antitobacco measures and sociodemographic factors that affect smoking prevalence, it is unknown whether this change in the trend was similar across all states. Methods We examined female age-specific lung cancer death rates (1973 through 2007) by year of death and birth in each state by using age-period-cohort models. Cohort relative risks adjusted for age and period effects were used to compare the lung cancer death rate for a given birth cohort to a referent birth cohort (ie, the 1933 cohort herein). Results Age-specific lung cancer death rates declined continuously in white women in California, but the rates declined less quickly or even increased in the remaining states among women younger than age 50 years and women born after the 1950s, especially in several southern and midwestern states. For example, in some southern states (eg, Alabama), lung cancer death rates among women born in the 1960s were approximately double those of women born in the 1930s. Conclusion The unfavorable lung cancer trend in white women born after circa 1950 in southern and midwestern states underscores the need for additional interventions to promote smoking cessation in these high-risk populations, which could lead to more favorable future mortality trends for lung cancer and other smoking-related diseases. PMID:22734032

Smoking estimates from around the world: data from the first 17 participating countries in the World Mental Health Survey Consortium

PubMed Central

Storr, Carla L; Cheng, Hui; Alonso, Jordi; Angermeyer, Matthias; Bruffaerts, Ronny; de Girolamo, Giovanni; de Graaf, Ron; Gureje, Oye; Karam, Elie G; Kostyuchenko, Stanislav; Lee, Sing; Lepine, Jean-Pierre; Mora, Maria Elena Medina; Myer, Landon; Neumark, Yehuda; Posada-Villa, Jose; Watanabe, Makoto; Wells, J Elisabeth; Kessler, Ronald C; Anthony, James C

2014-01-01

Objective To contribute new multinational findings on basic descriptive features of smoking and cessation, based upon standardised community surveys of adults residing in seven low-income and middle-income countries and 10 higher-income countries from all regions of the world. Methods Data were collected using standardised interviews and community probability sample survey methods conducted as part of the WHO World Mental Health Surveys Initiative. Demographic and socioeconomic correlates of smoking are studied using cross-tabulation and logistic regression approaches. Within-country sample weights were applied with variance estimation appropriate for complex sample survey designs. Results Estimated prevalence of smoking experience (history of ever smoking) and current smoking varied across the countries under study. In all but four countries, one out of every four adults currently smoked. In higher-income countries, estimated proportions of former smokers (those who had quit) were roughly double the corresponding estimates for most low-income and middle-income countries. Characteristics of smokers varied within individual countries, and in relation to the World Bank's low-medium-high gradient of economic development. In stark contrast to a sturdy male-female difference in the uptake of smoking seen in each country, there is no consistent sex-associated pattern in the odds of remaining a smoker (versus quitting). Conclusion The World Mental Health Surveys estimates complement existing global tobacco monitoring efforts. The observed global diversity of associations with smoking and smoking cessation underscore reasons for implementation of the Framework Convention on Tobacco Control provisions and prompt local adaptation of prevention and control interventions. PMID:19965796

Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: an interrupted time series analysis

PubMed Central

Socías, M. Eugenia; Wood, Evan; McNeil, Ryan; Kerr, Thomas; Dong, Huiru; Shoveller, Jean; Montaner, Julio; Milloy, M-J

2018-01-01

Background In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. Methods Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted time series analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrollment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015. Results A total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed. Conclusions We observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies. PMID:28454044

Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting

PubMed Central

Whittle, Henry J; Palar, Kartika; Napoles, Tessa; Hufstedler, Lee Lemus; Ching, Irene; Hecht, Frederick M; Frongillo, Edward A; Weiser, Sheri D

2015-01-01

Background Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM). Methods Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were coded and analyzed according to content analysis methods using an inductive-deductive approach. Results Food insecurity was reported to be a strong contributor to risky sexual practices among MSM and female participants. Individuals described engaging in transactional sex for food or money to buy food, often during times of destitution. Participants also explained how food insecurity could lead to condomless sex despite knowledge of and desire to use safe sexual practices, largely because the need to obtain food in the short term was prioritized over the desire to use barrier protection. Conclusions Our data extend previous research by demonstrating that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among MSM. These findings underscore the importance of public health and social intervention efforts focused on structural inequalities. PMID:26546789

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

PubMed Central

2017-01-01

Objectives As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes. PMID:28372353

Folic Acid Education for Hispanic Women: The Promotora de Salud Model

PubMed Central

Flores, Alina L.; Isenburg, Jennifer; Hillard, Christina L.; deRosset, Leslie; Colen, Lisa; Bush, Troy; Mai, Cara T.

2017-01-01

Background Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited. Methods An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised: 1) a written pre-test survey to establish baseline levels of folic acid awareness, knowledge, and consumption; 2) a small group education intervention along with a 90-day supply of multivitamins; and 3) a post-intervention (post-test) assessment conducted four months following the intervention. Results Statistically significant differences in pre- and post-tests were observed for general awareness about folic acid and vitamins, and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study. Conclusions The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner. PMID:28067585

Relative Roles of the Cellular and Humoral Responses in the Drosophila Host Defense against Three Gram-Positive Bacterial Infections

PubMed Central

Cho, Ju Hyun; Lee, Janice; Lafarge, Marie-Céline; Kocks, Christine; Ferrandon, Dominique

2011-01-01

Background Two NF-kappaB signaling pathways, Toll and immune deficiency (imd), are required for survival to bacterial infections in Drosophila. In response to septic injury, these pathways mediate rapid transcriptional activation of distinct sets of effector molecules, including antimicrobial peptides, which are important components of a humoral defense response. However, it is less clear to what extent macrophage-like hemocytes contribute to host defense. Methodology/Principal Findings In order to dissect the relative importance of humoral and cellular defenses after septic injury with three different Gram-positive bacteria (Micrococcus luteus, Enterococcus faecalis, Staphylococcus aureus), we used latex bead pre-injection to ablate macrophage function in flies wildtype or mutant for various Toll and imd pathway components. We found that in all three infection models a compromised phagocytic system impaired fly survival – independently of concomitant Toll or imd pathway activation. Our data failed to confirm a role of the PGRP-SA and GNBP1 Pattern Recognition Receptors for phagocytosis of S. aureus. The Drosophila scavenger receptor Eater mediates the phagocytosis by hemocytes or S2 cells of E. faecalis and S. aureus, but not of M. luteus. In the case of M. luteus and E. faecalis, but not S. aureus, decreased survival due to defective phagocytosis could be compensated for by genetically enhancing the humoral immune response. Conclusions/Significance Our results underscore the fundamental importance of both cellular and humoral mechanisms in Drosophila immunity and shed light on the balance between these two arms of host defense depending on the invading pathogen. PMID:21390224

The Functional Impact of Subsyndromal Depressive Symptoms in Bipolar Disorder: Data from STEP-BD

PubMed Central

Marangell, Lauren B.; Dennehy, Ellen B.; Miyahara, Sachiko; Wisniewski, Stephen R.; Bauer, Mark S.; Rapaport, Mark Hyman; Allen, Michael H.

2009-01-01

Background This report describes baseline characteristics and functional outcomes of subjects who have prospectively observed subsyndromal symptoms after a major depressive episode (MDE). Methods All subjects were participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). We identified subjects with at least 2 years of observation whose prior or current episode was a MDE, and who were in a stable clinical state of either recovered (no more than 2 moderate symptoms for at least 8 weeks), a MDE by DSM IV criteria, or with continued subsyndromal symptoms. The subsyndromal group was defined a priori as 3 or more moderate affective symptoms but without meeting diagnostic criteria for major depression. Results The final cohort included 1094 recovered, 112 subsyndromal, and 310 individuals in a MDE. The average time spent in each clinical status ranged from 120 to 132 days. The subsyndromal group was most similar to those in a MDE, differing only on the intensity of depressive symptoms and the number of work days missed due to ongoing symptoms. Reported sadness, inability to feel and lassitude were each associated with multiple measures of impairment. Limitations This study is limited by the cross sectional approach to defining outcomes. Conclusions These findings are consistent with studies in unipolar major depression that indicate that functional impairment observed in the context of subsyndromal depressive symptoms is comparable to that of a full episode. This work underscores the need to include subsyndromal symptoms in study outcomes and to target full remission in clinical practice. PMID:18708263

Methicillin Resistant Staphylococcus aureus Transmission in a Ghanaian Burn Unit: The Importance of Active Surveillance in Resource-Limited Settings.

PubMed

Amissah, Nana Ama; Buultjens, Andrew H; Ablordey, Anthony; van Dam, Lieke; Opoku-Ware, Ampomah; Baines, Sarah L; Bulach, Dieter; Tetteh, Caitlin S; Prah, Isaac; van der Werf, Tjip S; Friedrich, Alexander W; Seemann, Torsten; van Dijl, Jan Maarten; Stienstra, Ymkje; Stinear, Timothy P; Rossen, John W

2017-01-01

Objectives: Staphylococcus aureus infections in burn patients can lead to serious complications and death. The frequency of S. aureus infection is high in low- and middle-income countries presumably due to limited resources, misuse of antibiotics and poor infection control. The objective of the present study was to apply population genomics to precisely define, for the first time, the transmission of antibiotic resistant S. aureus in a resource-limited setting in sub-Saharan Africa. Methods: Staphylococcus aureus surveillance was performed amongst burn patients and healthcare workers during a 7-months survey within the burn unit of the Korle Bu Teaching Hospital in Ghana. Results: Sixty-six S. aureus isolates (59 colonizing and 7 clinical) were obtained from 31 patients and 10 healthcare workers. Twenty-one of these isolates were ST250-IV methicillin-resistant S. aureus (MRSA). Notably, 25 (81%) of the 31 patients carried or were infected with S. aureus within 24 h of admission. Genome comparisons revealed six distinct S. aureus clones circulating in the burn unit, and demonstrated multiple transmission events between patients and healthcare workers. Further, the collected S. aureus isolates exhibited a wide range of genotypic resistances to antibiotics, including trimethoprim (21%), aminoglycosides (33%), oxacillin (33%), chloramphenicol (50%), tetracycline (59%) and fluoroquinolones (100%). Conclusion: Population genomics uncovered multiple transmission events of S. aureus , especially MRSA, within the investigated burn unit. Our findings highlight lapses in infection control and prevention, and underscore the great importance of active surveillance to protect burn victims against multi-drug resistant pathogens in resource-limited settings.

Longitudinal Trajectories and Associated Baseline Predictors in Youths With Bipolar Spectrum Disorders

PubMed Central

Birmaher, Boris; Gill, Mary Kay; Axelson, David A.; Goldstein, Benjamin I.; Goldstein, Tina R.; Yu, Haifeng; Liao, Fangzi; Iyengar, Satish; Diler, Rasim S.; Strober, Michael; Hower, Heather; Yen, Shirley; Hunt, Jeffrey; Merranko, John A.; Ryan, Neal D.; Keller, Martin B.

2014-01-01

Objective The authors sought to identify and evaluate longitudinal mood trajectories and associated baseline predictors in youths with bipolar disorder. Method A total of 367 outpatient youths (mean age, 12.6 years) with bipolar disorder with at least 4 years of follow-up were included. After intake, participants were interviewed on average 10 times (SD=3.2) over a mean of 93 months (SD=8.3). Youths and parents were interviewed for psychopathology, functioning, treatment, and familial psychopathology and functioning. Results Latent class growth analysis showed four different longitudinal mood trajectories: “predominantly euthymic” (24.0%), “moderately euthymic” (34.6%), “ill with improving course” (19.1%), and “predominantly ill” (22.3%). Within each class, youths were euthymic on average 84.4%, 47.3%, 42.8%, and 11.5% of the follow-up time, respectively. Multivariate analyses showed that better course was associated with higher age at onset of mood symptoms, less lifetime family history of bipolar disorder and substance abuse, and less history at baseline of severe depression, manic symptoms, suicidality, subsyndromal mood episodes, and sexual abuse. Most of these factors were more noticeable in the “predominantly euthymic” class. The effects of age at onset were attenuated in youths with lower socioeconomic status, and the effects of depression severity were absent in those with the highest socioeconomic status. Conclusions A substantial proportion of youths with bipolar disorder, especially those with adolescent onset and the above-noted factors, appear to be euthymic over extended periods. Nonetheless, continued syndromal and subsyndromal mood symptoms in all four classes underscore the need to optimize treatment. PMID:24874203

Consumption of ultra-processed foods and their impact on the diet of young adults.

PubMed

Bielemann, Renata M; Motta, Janaína V Santos; Minten, Gicele C; Horta, Bernardo L; Gigante, Denise P

2015-01-01

OBJECTIVE To evaluate the consumption of ultra-processed foods, its associated factors, and its influence on nutrient intake in young adults. METHODS In 2004-2005, the individuals belonging to the Pelotas birth cohort of 1982 were identified for a home interview. A total of 4,297 individuals were interviewed and 4,202 individuals were included in the study (follow-up rate of 77.4%). Diet was assessed using a questionnaire on dietary intake and the percentage of daily caloric intake attributed to ultra-processed foods as well as the intake of macro- and micronutrients were estimated. The association between cohort characteristics and the consumption of ultra-processed foods was assessed using linear regression. Analysis of variance and Pearson's Chi-square test were used to evaluate the association between the quintiles of the consumption of ultra-processed food, nutrient intake and adequacy of nutrient intake, respectively. RESULTS The consumption of ultra-processed foods corresponded to 51.2% of the total caloric intake. The consumption of ultra-processed foods was higher among women, individuals with higher education, and individuals who were never poor and eutrophic. The increased consumption of ultra-processed foods was positively correlated with the consumption of fat, cholesterol, sodium, iron, calcium, and calories (p < 0.001) and was negatively correlated with the consumption of carbohydrates, protein, and dietary fiber (p < 0.001). CONCLUSIONS The high consumption of ultra-processed foods and its positive correlation with the intake of sodium, cholesterol, and fats underscores the need to perform interventions aimed at decreasing the intake of this food group.

Has the Reform of the Japanese Healthcare Provision System Improved the Value in Healthcare? A Cost-Consequence Analysis of Organized Care for Hip Fracture Patients

PubMed Central

Fukuda, Haruhisa; Shimizu, Sayuri; Ishizaki, Tatsuro

2015-01-01

Objectives To assess the value of organized care by comparing the clinical outcomes and healthcare expenditure between the conventional Japanese “integrated care across specialties within one hospital” mode of providing healthcare and the prospective approach of “organized care across separate facilities within a community”. Design Retrospective cohort study. Setting Two groups of hospitals were categorized according to healthcare delivery approach: the first group included 3 hospitals autonomously providing integrated care across specialties, and the second group included 4 acute care hospitals and 7 rehabilitative care hospitals providing organized care across separate facilities. Participants Patients aged 65 years and above who had undergone hip fracture surgery. Measurements Regression models adjusting for patient characteristics and clinical variables were used to investigate the impact of organized care on the improvements to the mobility capability of patients before and after hospitalization and the differences in healthcare resource utilization. Results The sample for analysis included 837 hip fracture surgery cases. The proportion of patients with either unchanged or improved mobility capability was not statistically associated with the healthcare delivery approaches. Total adjusted mean healthcare expenditure for integrated care and organized care were US$28,360 (95% confidence interval: 27,787-28,972) and US$21,951 (21,511-22,420), respectively, indicating an average increase of US$6,409 in organized care. Conclusion Our cost-consequence analysis underscores the need to further investigate the actual contribution of organized care to the provision of efficient and high-quality healthcare. PMID:26208322

Familial Mediterranean fever with a single MEFV mutation: Where is the second hit?

PubMed Central

Booty, Matthew G.; Chae, Jae Jin; Masters, Seth L.; Remmers, Elaine F.; Barham, Beverly; Lee, Julie M.; Barron, Karyl S.; Holland, Steve; Kastner, Daniel L.; Aksentijevich, Ivona

2009-01-01

Objective FMF has traditionally been considered an autosomal recessive disease; however, it has been observed that a substantial number of patients with clinical FMF possess only one demonstrable MEFV mutation. Here, an extensive search for a second MEFV mutation was performed in 46 patients clinically diagnosed with FMF and carrying only one high-penetrance FMF mutation. Methods MEFV and other candidate genes were sequenced by standard capillary electrophoresis. The entire 15 kb MEFV genomic region was re-sequenced in 10 patients using a hybridization-based chip technology. MEFV gene expression levels were determined by qRT-PCR and pyrin protein levels were examined by Western blotting. Results A second MEFV mutation was not identified in any of the screened patients. Haplotype analysis did not identify a common haplotype that might be associated with the transmission of a second FMF allele. Western blots did not demonstrate a significant difference in pyrin levels between single and double variant patients; however, FMF patients of both types showed higher protein expression compared to controls and non-FMF patients with active inflammation. Screening of genes encoding pyrin-interacting proteins identified rare variants in a small number of patients, suggesting the possibility of digenic inheritance. Conclusion Our data underscore the existence of a significant subset of FMF patients who are carriers of only one MEFV mutation and demonstrate that complete MEFV sequencing is not likely to yield a second mutation. Screening for the set of most common mutations appears sufficient in the presence of clinical symptoms to diagnose FMF and initiate a trial of colchicine. PMID:19479870

Global Phosphorus Fertilizer Market and National Policies: A Case Study Revisiting the 2008 Price Peak.

PubMed

Khabarov, Nikolay; Obersteiner, Michael

2017-01-01

The commodity market super-cycle and food price crisis have been associated with rampant food insecurity and the Arab spring. A multitude of factors were identified as culprits for excessive volatility on the commodity markets. However, as it regards fertilizers, a clear attribution of market drivers explaining the emergence of extreme price events is still missing. In this paper, we provide a quantitative assessment of the price spike of the global phosphorus fertilizer market in 2008 focusing on diammonium phosphate (DAP). We find that fertilizer market policies in India, the largest global importer of phosphorus fertilizers and phosphate rock, turned out to be a major contributor to the global price spike. India doubled its import of P-fertilizer in 2008 at a time when prices doubled. The analysis of a wide set of factors pertinent to the 2008 price spike in phosphorus fertilizer market leads us to the discovery of a price spike magnification and triggering mechanisms. We find that the price spike was magnified on the one hand by protective trade measures of fertilizer suppliers leading to a 19% drop in global phosphate fertilizer export. On the other hand, the Indian fertilizer subsidy scheme led to farmers not adjusting their demand for fertilizer. The triggering mechanism appeared to be the Indian production outage of P-fertilizer resulting in the additional import demand for DAP in size of about 20% of annual global supply. The main conclusion is that these three factors have jointly caused the spike, underscoring the need for ex ante improvements in fertilizer market regulation on both national and international levels.

The Spatial-Temporal Pattern of Policing Following a Drug Policy Reform: Triangulating Self-Reported Arrests With Official Crime Statistics

PubMed Central

Gaines, Tommi L.; Werb, Daniel; Arredondo, Jaime; Alaniz, Victor M.; Vilalta, Carlos; Beletsky, Leo

2017-01-01

Background In 2009, Mexico enacted a drug policy reform (Narcomenudeo) designed to divert persons possessing small amounts of illicit drugs to treatment rather than incarceration. To assess reform impact, this study examines the spatial-temporal trends of drug-related policing in Tijuana, Mexico post-enactment. Method Location of self-reported arrests (N=1,160) among a prospective, community-recruited cohort of people who inject drugs (PWID) in Tijuana (N=552) was mapped across city neighborhoods. Official police reports detailing drug-related arrests was triangulated with PWID self-reported arrests. Exploratory spatial data analysis examined the distribution of arrests and spatial association between both datasets across three successive years, 2011–2013. Results In 2011, over half of PWID reported being detained but not officially charged with a criminal offense; in 2013, 90% of arrests led to criminal charges. Official drug-related arrests increased by 67.8% (p < 0.01) from 2011 to 2013 despite overall arrest rates remaining stable throughout Tijuana. For each successive year, we identified a high degree of spatial association between the location of self-reported and official arrests (p < 0.05). Conclusion Two independent data sources suggest that intensity of drug law enforcement had risen in Tijuana despite the promulgation of a public health-oriented drug policy reform. The highest concentrations of arrests were in areas traditionally characterized by higher rates of drug crime. High correlation between self-reported and official arrest data underscores opportunities for future research on the role of policing as a structural determinant of public health. PMID:27767367

Prevalence and Correlates of “Vaping” as a Route of Cannabis Administration in Medical Cannabis Patients

PubMed Central

Cranford, James A.; Bohnert, Kipling M.; Perron, Brian E.; Bourque, Carrie; Ilgen, Mark

2016-01-01

Purpose To examine the prevalence and correlates of vaporization (i.e., “vaping”) as a route of cannabis administration in a sample of medical cannabis patients. Procedures Adults ages 21 and older (N = 1,485 M age = 45.1) who were seeking medical cannabis certification (either for the first time or as a renewal) at medical cannabis clinics in southern Michigan completed a screening assessment. Participants completed measures of route of cannabis administration, cannabis use, alcohol and other substance use. Findings An estimated 39% (n=511) of the sample reported past-month cannabis vaping, but vaping as the sole route of cannabis administration was rare. Specifically, only 30 participants (2.3% of the full sample and 5.9% of those who reported any vaping) indicated vaping as the sole route of cannabis administration. The majority (87.3%) of those who reported vaping also reported smoking (combustion) as a route of cannabis administration. Being younger than age 44, having more than a high school education, engaging in nonmedical stimulant use, being a returning medical cannabis patient, and greater frequency of cannabis use were associated with higher odds of vaping at the bivariate level and with all variables considered simultaneously. Conclusions Vaping appears to be relatively common among medical cannabis patients, but is seldom used as the sole route of cannabis administration. Results highlight the importance of monitoring trends in vaping and other substance use behaviors in this population and underscore the need for longitudinal research into the motives, correlates, and consequences of cannabis vaping in medical cannabis patients. PMID:27770657

Accelerated model of lupus autoimmunity and vasculopathy driven by toll-like receptor 7/9 imbalance

PubMed Central

Liu, Yudong; Seto, Nickie L; Carmona-Rivera, Carmelo; Kaplan, Mariana J

2018-01-01

Objectives Activation of endosomal toll-like receptor (TLR)7 or TLR9 has been proposed as a critical step for the initiation and development of SLE. Traditional spontaneous lupus models normally introduce multiple risk alleles, thereby adding additional confounding factors. In the induced lupus models, the role of TLR9 remains unclear. In the present study, we explored the role of an imbalance between TLR7 and TLR9 pathways in the pathogenesis of lupus and its associated vasculopathy using the imiquimod model in TLR9 KO/B6 background. Methods Wild type (WT) and Tlr9-/- mice were epicutaneously treated with imiquimod cream 5% on both ears three times per week for indicated times. At euthanasia, mice were analysed for organ involvement, endothelium-dependent vasorelaxation, serum autoantibodies, and innate and adaptive immune responses. Results Compared with the lupus-like phenotype that develops in imiquimod-treated WT mice, Tlr9-/- mice exposed to imiquimod have increased severity of autoimmunity features and inflammatory phenotype that develops at earlier stages. These abnormalities are characterised by enhanced TLR7 expression and immune activation, increased immune complex deposition, Th1 T cells and dendritic cell kidney infiltration and significant impairments in endothelial function. Modulation of TLR7 expression was observed in the Tlr9-/- mice. Conclusions These findings further underscore the protective role of TLR9 in TLR7-driven autoimmunity and also in the development of vasculopathy, further strengthening the importance of tightly manipulating TLRs in putative therapeutic strategies. This study provides a new model of accelerated lupus phenotype driven by danger-associated molecular patterns. PMID:29765617

Breast MRI at 7 Tesla with a bilateral coil and T1-weighted acquisition with robust fat suppression: image evaluation and comparison with 3 Tesla

PubMed Central

Brown, Ryan; Storey, Pippa; Geppert, Christian; McGorty, KellyAnne; Leite, Ana Paula Klautau; Babb, James; Sodickson, Daniel K.; Wiggins, Graham C.; Moy, Linda

2014-01-01

Objectives To evaluate the image quality of T1-weighted fat-suppressed breast MRI at 7 T, and to compare 7-T and 3-T images. Methods Seventeen subjects were imaged using a 7-T bilateral transmit-receive coil and adiabatic inversion-based fat suppression (FS). Images were graded on a five-point scale and quantitatively assessed through signal-to-noise ratio (SNR), fibroglandular/fat contrast and signal uniformity measurements. Results Image scores at 7 T and 3 T were similar on standard-resolution images (1.1× 1.1×1.1−1.6 mm3), indicating that high-quality breast imaging with clinical parameters can be performed at 7 T. The 7-T SNR advantage was underscored on 0.6-mm isotropic images, where image quality was significantly greater than at 3 T (4.2 versus 3.1, P≤0.0001). Fibroglandular/fat contrast was more than two times higher at 7 T over 3 T, owing to effective adiabatic inversion-based FS and the inherent 7 T signal advantage. Signal uniformity was comparable at 7 T and 3 T (P<0.05). Similar 7-T image quality was observed in all subjects, indicating robustness against anatomical variation. Conclusion The 7-T bilateral transmit-receive coil and adiabatic inversion-based FS technique mitigate the impact of high-field heterogeneity to produce image quality that is as good as or better than at 3 T PMID:23896763

Chromosomal abnormalities and molecular landscape of metastasizing mucinous salivary adenocarcinoma

PubMed Central

Panaccione, Alex; Zhang, Yi; Mi, Yanfang; Mitani, Yoshitsugu; Yan, Guo; Prasad, Manju L.; McDonald, W. Hayes; El-Naggar, Adel K.; Yarbrough, Wendell G.; Ivanov, Sergey V.

2017-01-01

Background Mucinous adenocarcinoma of the salivary gland (MAC) is a lethal cancer with unknown molecular etiology and a high propensity to lymph node metastasis. Mostly due to its orphan status, MAC remains one of the least explored cancers that lacks cell lines and mouse models that could help translational and pre-clinical studies. Surgery with or without radiation remains the only treatment modality but poor overall survival (10-year, 44%) underscores the urgent need for mechanism-based therapies. Methods We developed the first patient-derived xenograft (PDX) model for pre-clinical MAC studies and a cell line that produces aggressively growing tumors after subcutaneous injection into nude mice. We performed cytogenetic, exome, and proteomic profiling of MAC to identify driving mutations, therapeutic targets, and pathways involved in aggressive cancers based on TCGA database mining and GEO analysis. Results: We identified in MAC KRAS (G13D) and TP53 (R213X) mutations that have been previously reported as drivers in a variety of highly aggressive cancers. Somatic mutations were also found in KDM6A, KMT2D, and other genes frequently mutated in colorectal and other cancers: FAT1, NBEA, RELN, RLP1B, and ZFHX3. Proteomic analysis of MAC implied epigenetic up-regulation of a genetic program involved in proliferation and cancer stem cell maintenance. Conclusion Genomic and proteomic analyses provided the first insight into potential molecular drivers of MAC metastases pointing at common mechanisms of CSC propagation in aggressive cancers. The in vitro/in vivo models that we created should aid in the development and validation of new treatment strategies against MAC. PMID:28249646