Sample records for factors including lack

  1. Apathy in aging: are lack of interest and lack of initiative dissociable?

    PubMed

    Esposito, Fabienne; Rochat, Lucien; Juillerat Van der Linden, Anne-Claude; Lekeu, Françoise; Charnallet, Annik; Van der Linden, Martial

    2014-01-01

    Apathy is common in aging and generally defined on the basis of three dimensions: lack of initiative, lack of interest and emotional blunting. Curiously, no study until now has examined the associations and dissociations between these dimensions in elderly people (with or without dementia). These questions were addressed in two studies. In the first study, we explored the distribution of scores and the relationships between the three dimensions of apathy in 56 patients with dementia, focusing mainly on lack of initiative and lack of interest. Apathy was hetero-evaluated with the Apathy Inventory (AI), a scale widely used to assess the apathy dimensions in aging. In the second study, given the AI's limitations, we investigated in more detail the relationship between lack of initiative and interest in 115 elderly people using a new questionnaire specifically designed to assess these two dimensions. Results showed that lack of initiative was closely related to lack of interest (Study 1). Although we used a more specific questionnaire, these facets of apathy did not constitute two separable dimensions, but reflected a common main factor of apathy in aging (Study 2). Thus, the distinction between lack of initiative and lack of interest seems questionable. Only a multifactorial approach that includes the various psychological factors involved in apathy would enable one to gain a better understanding of the different manifestations of apathy and to highlight possible dissociations between them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition.

    PubMed

    Gibelin, Aude; Parrot, Antoine; Maitre, Bernard; Brun-Buisson, Christian; Mekontso Dessap, Armand; Fartoukh, Muriel; de Prost, Nicolas

    2016-02-01

    Some patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mimickers lacking CRF (ARDS CRF-) in comparison with others (ARDS CRF+). Retrospective study including all patients receiving invasive mechanical ventilation for ARDS admitted to the intensive care units (ICUs) of two tertiary care centers from January 2003 to December 2012. The prevalence of ARDS CRF- was 7.5 % (95 % CI [5.5-9.5]; n = 50/665). On the basis of medical history, bronchoalveolar lavage fluid cytology, and chest CT scan patterns, four etiological categories were identified: immune (n = 18; 36 %), drug-induced (n = 13; 26 %), malignant (n = 7; 14 %), and idiopathic (n = 12; 24 %). Although the ARDS CRF- patients had a lower logistic organ dysfunction score (4 [3-8] vs. 10 [6-13]; p < 0.0001) and less often shock upon ICU admission (44 vs. 80 %; p < 0.0001) than their counterparts, their overall ICU mortality rate was very high (66 % [46-74]), and the absence of CRF remained associated with ICU mortality by multivariable logistic regression analysis (adjusted OR = 2.06; 95 % CI [1.02-4.18]; p = 0.044). Among ARDS CRF- patients, the presence of potentially reversible lung lesions with corticosteroids (aOR = 0.14; 95 % CI [0.03-0.62]) was associated with ICU survival. The absence of CRF among patients with ARDS is common and associated with a higher risk of mortality. For such atypical ARDS, a complete diagnostic workup, including bronchoalveolar lavage fluid cytology and chest CT scan patterns, should be performed to identify those patients who might benefit from specific therapies, including corticosteroids.

  3. Factors associated with lack of prenatal care in a large municipality

    PubMed Central

    da Rosa, Cristiane Quadrado; da Silveira, Denise Silva; da Costa, Juvenal Soares Dias

    2014-01-01

    OBJECTIVE To analyze the factors associated with a lack of prenatal care in a large municipality in southern Brazil. METHODS In this case-control age-matched study, 716 women were evaluated; of these, 179 did not receive prenatal care and 537 received prenatal care (controls). These women were identified using the Sistema Nacional de Informação sobre Nascidos Vivos (Live Birth Information System) of Pelotas, RS, Southern Brazil, between 2009 and 2010. Multivariate analysis was performed using conditional logistic regression to estimate the odds ratios (OR). RESULTS In the final model, the variables associated with a lack of prenatal care were the level of education, particularly when it was lesser than four years [OR 4.46; 95% confidence interval (CI) 1.92;10.36], being single (OR 3.61; 95%CI 1.85;7.04), and multiparity (OR 2.89; 95%CI 1.72;4.85). The prevalence of a lack of prenatal care among administrative regions varied between 0.7% and 3.9%. CONCLUSIONS The risk factors identified must be considered when planning actions for the inclusion of women in prenatal care by both the central management and healthcare teams. These indicated the municipal areas with greater deficits in prenatal care. The reorganization of the actions to identify women with risk factors in the community can be considered to be a starting point of this process. In addition, the integration of the activities of local programs that target the mother and child is essential to constantly identify pregnant women without prenatal care. PMID:26039401

  4. TERATOGENIC RESPONSES ARE MODULATED IN MICE LACKING EXPRESSION OF EPIDERMAL GROWTH FACTOR (EGF) AND TRANSFORMING GROWTH FACTOR-ALPHA (TGF)

    EPA Science Inventory

    TITLE:
    TERATOGENIC RESPONSES ARE MODULATED IN MICE LACKING EXPRESSION OF EPIDERMAL GROWTH FACTOR (EGF) AND TRANSFORMING GROWTH FACTOR-ALPHA (TGF). AUTHORS (ALL): Abbott, Barbara D.1; Best, Deborah S.1; Narotsky, Michael G.1. SPONSOR NAME: None INSTITUTIONS (ALL): 1. Repro Tox ...

  5. Appetite and tuberculosis: is the lack of appetite an unidentified risk factor for tuberculosis?

    PubMed

    Hernández-Garduño, Eduardo; Pérez-Guzmán, Carlos

    2007-01-01

    Different risk factors have been identified as associated with tuberculosis (TB), an important and common one is malnutrition, however, the causes of malnutrition have not been studied in detail, the lack of food and poverty are among the most frequent in developing countries but others are yet to be identified. We hypothesized that chronic lack of appetite can be one of the causes of malnutrition associated to TB and therefore be a potential independent risk factor for latent tuberculosis infection (LTBI) or TB disease. If this is true, contact subjects with LTBI who have poor appetite will be at higher risk for getting the disease and people with the disease will be at risk for poor treatment outcomes.

  6. Lack of facilities rather than sociocultural factors as the primary barrier to physical activity among female Saudi university students.

    PubMed

    Samara, Anastasia; Nistrup, Anne; Al-Rammah, Tamader Y; Aro, Arja R

    2015-01-01

    The Kingdom of Saudi Arabia is experiencing a dramatic increase in physical inactivity, with women having higher levels of inactivity than men among all age groups. It is assumed that factors such as dress codes, restrictions on going outdoors, and conservative norms are the main reasons for women's low physical activity. Our aim was to explore the different parameters related to physical activity, including self-efficacy, as well as the perceived barriers to and benefits of physical activity in young Saudi females. Ninety-four first-year female Saudi university students in Riyadh, Kingdom of Saudi Arabia, participated in the present study in 2014. The students were from eight bachelor's programs in health and well-being, and each completed a questionnaire with questions divided into five parts as follows: 1) socioeconomic status, 2) physical activity, 3) self-efficacy 4) social factors, and 5) barriers and facilitators related to physical activity. The students exercised at home and alone, and there was low self-efficacy for physical activity (mean score =42±14). Among social factors, attending university was the only factor that hindered physical activity (32%). Physical activity was positively perceived overall (mean score =131±10). Students showed awareness of the benefits of physical activity for health and well-being. The most important barrier was the lack of designated areas available for physical activity. Students disagreed that family or the Islamic community were barriers to physical activity. The lack of facilities and lack of encouragement from the university, but not a lack of knowledge (a high level of knowledge is to be expected given their health and well-being studies backgrounds) and/or restrictions from families and society, seem to hinder female students' physical activity, at least young Saudi students.

  7. The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

    PubMed Central

    Diccianni, M B; Imagawa, M; Muramatsu, M

    1992-01-01

    Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis. Images PMID:1408831

  8. The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

    PubMed

    Diccianni, M B; Imagawa, M; Muramatsu, M

    1992-10-11

    Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis.

  9. The bias of experimental design, including strain background, in the determination of critical Streptococcus suis serotype 2 virulence factors

    PubMed Central

    Auger, Jean-Philippe; Chuzeville, Sarah; Roy, David; Mathieu-Denoncourt, Annabelle; Xu, Jianguo; Grenier, Daniel

    2017-01-01

    Streptococcus suis serotype 2 is an important porcine bacterial pathogen and emerging zoonotic agent mainly responsible for sudden death, septic shock, and meningitis. However, serotype 2 strains are genotypically and phenotypically heterogeneous. Though a multitude of virulence factors have been described for S. suis serotype 2, the lack of a clear definition regarding which ones are truly “critical” has created inconsistencies that have only recently been highlighted. Herein, the involvement of two factors previously described as being critical for S. suis serotype 2 virulence, whether the dipeptidyl peptidase IV and autolysin, were evaluated with regards to different ascribed functions using prototype strains belonging to important sequence types. Results demonstrate a lack of reproducibility with previously published data. In fact, the role of the dipeptidyl peptidase IV and autolysin as critical virulence factors could not be confirmed. Though certain in vitro functions may be ascribed to these factors, their roles are not unique for S. suis, probably due to compensation by other factors. As such, variations and discrepancies in experimental design, including in vitro assays, cell lines, and animal models, are an important source of differences between results. Moreover, the use of different sequence types in this study demonstrates that the role attributed to a virulence factor may vary according to the S. suis serotype 2 strain background. Consequently, it is necessary to establish standard experimental designs according to the experiment and purpose in order to facilitate comparison between laboratories. Alongside, studies should include strains of diverse origins in order to prevent erroneous and biased conclusions that could affect future studies. PMID:28753679

  10. Lack of association between some risk factors and hepatitis B surface antigenaemia in children with sickle cell anaemia.

    PubMed

    Angyo, I A; Yakubu, A M

    2001-01-01

    The risk factors for transmission of Hepatitis B virus (HBV) as well as the relationship between HBs Antigeneamia and some socio-cultural factors including socio-economic status of the families of the children, tribe, religion, rural or urban domicile and the number of persons per bedroom, were studied among 507 children with sickle cell anaemia (SCA) and 501 controls at the Jos University Teaching Hospital (JUTH). Twenty-three percent (22.7%) of the children with SCA were HBsAg positive compared with 19.6% among the control group. None of the risk factors studied, including blood transfusion, parenteral injections, intravenous infusions, hospitalization, ulcers, traditional uvulectomy, surgery, contact with case of known hepatitis, mass immunizations, circumcision, ear piercing and traditional scarifications was significantly associated with HBV infection in both children with SCA and control group and also between children with SCA compared with controls. There was also no association between HBs Antigenaemia and the number of blood transfusions, intravenous infusion or hospitalization in both children with SCA and controls. Similarly, there was no association between the socio-cultural factors studied and HBs Antigenaemia. The result of this study suggests that HBV infection is common in children in this environment and other factors yet to, be identified may play a very important role in the transmission of HBV infection. The high prevalence of HBsAg obtained in both children with SCA and controls, and the lack of identifiable association between the risk factos studied and HBsAntigenaemia suggest that these children may have equally been exposed earlier in life.

  11. What factors are associated with reporting lacking interest in sex and how do these vary by gender? Findings from the third British national survey of sexual attitudes and lifestyles

    PubMed Central

    Graham, Cynthia A; Mercer, Catherine H; Jones, Kyle G; Johnson, Anne M; Wellings, Kaye; Mitchell, Kirstin R

    2017-01-01

    Objectives To investigate factors associated with reporting lacking interest in sex and how these vary by gender. Setting British general population. Design Complex survey analyses of data collected for a cross-sectional probability sample survey, undertaken 2010–2012, specifically logistic regression to calculate age-adjusted OR (AOR) to identify associated factors. Participants 4839 men and 6669 women aged 16–74 years who reported ≥1 sexual partner (opposite-sex or same-sex) in the past year for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Main outcome measure Lacking interest in sex for ≥3 months in the past year. Results Overall, 15.0% (13.9–16.2) of men and 34.2% (32.8–35.5) of women reported lacking interest in sex. This was associated with age and physical and mental health for both men and women, including self-reported general health and current depression. Lacking interest in sex was more prevalent among men and women reporting sexually transmitted infection diagnoses (ever), non-volitional sex (ever) and holding sexual attitudes related to normative expectations about sex. Some gender similarities in associated relationship and family-related factors were evident, including partner having had sexual difficulties in the last year (men: AOR 1.41 (1.07–1.86); women: AOR 1.60 (1.32–1.94)), not feeling emotionally close to partner during sex (men: 3.74 (1.76–7.93); women: 4.80 (2.99–7.69) and ease of talking about sex (men: 1.53 (1.23–1.90);women: 2.06 (1.77–2.39)). Among women only, lack of interest in sex was higher among those in a relationship of >1 year in duration and those not sharing the same level of interest (4.57 (3.87–5.38)) or preferences (2.91 (2.22–3.83)) with a partner. Conclusions Both gender similarities and differences were found in factors associated with lacking interest in sex, with the most marked differences in relation to some relationship variables. Findings highlight

  12. What factors are associated with reporting lacking interest in sex and how do these vary by gender? Findings from the third British national survey of sexual attitudes and lifestyles.

    PubMed

    Graham, Cynthia A; Mercer, Catherine H; Tanton, Clare; Jones, Kyle G; Johnson, Anne M; Wellings, Kaye; Mitchell, Kirstin R

    2017-09-13

    To investigate factors associated with reporting lacking interest in sex and how these vary by gender. British general population. Complex survey analyses of data collected for a cross-sectional probability sample survey, undertaken 2010-2012, specifically logistic regression to calculate age-adjusted OR (AOR) to identify associated factors. 4839 men and 6669 women aged 16-74 years who reported ≥1 sexual partner (opposite-sex or same-sex) in the past year for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lacking interest in sex for ≥3 months in the past year. Overall, 15.0% (13.9-16.2) of men and 34.2% (32.8-35.5) of women reported lacking interest in sex. This was associated with age and physical and mental health for both men and women, including self-reported general health and current depression. Lacking interest in sex was more prevalent among men and women reporting sexually transmitted infection diagnoses (ever), non-volitional sex (ever) and holding sexual attitudes related to normative expectations about sex. Some gender similarities in associated relationship and family-related factors were evident, including partner having had sexual difficulties in the last year (men: AOR 1.41 (1.07-1.86); women: AOR 1.60 (1.32-1.94)), not feeling emotionally close to partner during sex (men: 3.74 (1.76-7.93); women: 4.80 (2.99-7.69) and ease of talking about sex (men: 1.53 (1.23-1.90);women: 2.06 (1.77-2.39)). Among women only, lack of interest in sex was higher among those in a relationship of >1 year in duration and those not sharing the same level of interest (4.57 (3.87-5.38)) or preferences (2.91 (2.22-3.83)) with a partner. Both gender similarities and differences were found in factors associated with lacking interest in sex, with the most marked differences in relation to some relationship variables. Findings highlight the need to assess, and if appropriate, treat lacking interest in sex in a holistic and relationship

  13. Macroenvironmental factors including GDP per capita and physical activity in Europe.

    PubMed

    Cameron, Adrian J; Van Stralen, Maartje M; Kunst, Anton E; Te Velde, Saskia J; Van Lenthe, Frank J; Salmon, Jo; Brug, Johannes

    2013-02-01

    Socioeconomic inequalities in physical activity at the individual level are well reported. Whether inequalities in economic development and other macroenvironmental variables between countries are also related to physical activity at the country level is comparatively unstudied. We examined the relationship between country-level data on macroenvironmental factors (gross domestic product (GDP) per capita, public sector expenditure on health, percentage living in urban areas, and cars per 1000 population) with country-level physical activity prevalence obtained from previous pan-European studies. Studies that assessed leisuretime physical activity (n = 3 studies including 27 countries in adults, n = 2 studies including 28 countries in children) and total physical activity (n = 3 studies in adults including 16 countries) were analyzed separately as were studies among adults and children. Strong and consistent positive correlations were observed between country prevalence of leisure-time physical activity and country GDP per capita in adults (average r = 0.70; all studies, P G 0.05). In multivariate analysis, country prevalence of leisure-time physical activity among adults remained associated with country GDP per capita (two of three studies) but not urbanization or educational attainment. Among school-age populations, no association was found between country GDP per capita and country prevalence of leisure-time physical activity. In those studies that assessed total physical activity (which also includes occupational and transport physical activity), no association with country GDP per capita was observed. Clear differences in national leisure-time physical activity levels throughout Europe may be a consequence of economic development. Lack of economic development of some countries in Europe may make increasing leisure-time physical activity more difficult. Further examination of the link between country GDP per capita and national physical activity levels (across

  14. No pain, no gain: lack of exercise obstructs neurogenesis.

    PubMed

    Watson, Nate; Ji, Xunming; Yasuhara, Takao; Date, Isao; Kaneko, Yuji; Tajiri, Naoki; Borlongan, Cesar V

    2015-01-01

    Bedridden patients develop atrophied muscles, their daily activities greatly reduced, and some display a depressive mood. Patients who are able to receive physical rehabilitation sometimes show surprising clinical improvements, including reduced depression and attenuation of other stress-related behaviors. Regenerative medicine has advanced two major stem cell-based therapies for CNS disorders, namely, transplantation of exogenous stem cells and amplification of endogenous neurogenesis. The latter strategy embraces a natural way of reinnervating the damaged brain and correcting the neurological impairments. In this study, we discussed how immobilization-induced disuse atrophy, using the hindlimb suspension model, affects neurogenesis in rats. The overarching hypothesis is that immobilization suppresses neurogenesis by reducing the circulating growth or trophic factors, such as vascular endothelial growth factor or brain-derived neurotrophic factor. That immobilization alters neurogenesis and stem cell differentiation in the CNS requires characterization of the stem cell microenvironment by examining the trophic and growth factors, as well as stress-related proteins that have been implicated in exercise-induced neurogenesis. Although accumulating evidence has revealed the contribution of "increased" exercise on neurogenesis, the reverse paradigm involving "lack of exercise," which mimics pathological states (e.g., stroke patients are often immobile), remains underexplored. This novel paradigm will enable us to examine the effects on neurogenesis by a nonpermissive stem cell microenvironment likely produced by lack of exercise. BrdU labeling of proliferative cells, biochemical assays of serum, cerebrospinal fluid and brain levels of trophic factors, growth factors, and stress-related proteins are proposed as indices of neurogenesis, while quantitative measurements of spontaneous movements will reveal psychomotor components of immobilization. Studies designed to

  15. Concept analysis: lack of anonymity.

    PubMed

    Swan, Marilyn A; Hobbs, Barbara B

    2017-05-01

    To re-examine and expand understanding of the concept 'lack of anonymity' as a component of rural nursing theory. Early healthcare literature reports lack of anonymity as part of social and working environments, particularly rural nursing. Rural nursing theory included the first published concept analysis on lack of anonymity but lacked empirical referents. Workforce, societal and rural healthcare changes support an updated analysis. To further understand lack of anonymity, its present day use and applicability to diverse environments, research from multiple disciplines was reviewed. Concept analysis. A literature search using eight terms in eleven databases was conducted of literature published between 2008-2013. Walker and Avant's concept analysis methodology guided the analysis. The previous concept analysis is supported in part by current literature. The defining attributes, 'identifiable', 'establishing boundaries for public and private self and interconnectedness' in a community were updated. Updated antecedents include: (i) environmental context; (ii) opportunities to become visible; (iii) developing relationships and (iv) unconscious or limited awareness of public or personal privacy. Consequences are: (i) familiarity; (ii) visibility; (iii) awareness of privacy and (iv) manage or balance of lack of anonymity. Cases were constructed and empirical referents identified. The concept of lack of anonymity was updated; portions of the original definition remain unchanged. Empirical referents reveal the defining attributes in daily life and may guide future research on the effect of lack of anonymity on nursing practice. This analysis advances the conceptual understanding of rural nursing theory. © 2016 John Wiley & Sons Ltd.

  16. Expansion of the lateral ventricles and ependymal deficits underlie the hydrocephalus evident in mice lacking the transcription factor NFIX.

    PubMed

    Vidovic, Diana; Harris, Lachlan; Harvey, Tracey J; Evelyn Heng, Yee Hsieh; Smith, Aaron G; Osinski, Jason; Hughes, James; Thomas, Paul; Gronostajski, Richard M; Bailey, Timothy L; Piper, Michael

    2015-08-07

    Nuclear factor one X (NFIX) has been shown to play a pivotal role during the development of many regions of the brain, including the neocortex, the hippocampus and the cerebellum. Mechanistically, NFIX has been shown to promote neural stem cell differentiation through the activation of astrocyte-specific genes and via the repression of genes central to progenitor cell self-renewal. Interestingly, mice lacking Nfix also exhibit other phenotypes with respect to development of the central nervous system, and whose underlying causes have yet to be determined. Here we examine one of the phenotypes displayed by Nfix(-/-) mice, namely hydrocephalus. Through the examination of embryonic and postnatal Nfix(-/-) mice we reveal that hydrocephalus is first seen at around postnatal day (P) 10 in mice lacking Nfix, and is fully penetrant by P20. Furthermore, we examined the subcommissural organ (SCO), the Sylvian aqueduct and the ependymal layer of the lateral ventricles, regions that when malformed and functionally perturbed have previously been implicated in the development of hydrocephalus. SOX3 is a factor known to regulate SCO development. Although we revealed that NFIX could repress Sox3-promoter-driven transcriptional activity in vitro, SOX3 expression within the SCO was normal within Nfix(-/-) mice, and Nfix mutant mice showed no abnormalities in the structure or function of the SCO. Moreover, these mutant mice exhibited no overt blockage of the Sylvian aqueduct. However, the ependymal layer of the lateral ventricles was frequently absent in Nfix(-/-) mice, suggesting that this phenotype may underlie the development of hydrocephalus within these knockout mice. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Hopelessness and Lack of Connectedness to Others as Risk Factors for Suicidal Behavior across the Lifespan: Implications for Cognitive-Behavioral Treatment

    ERIC Educational Resources Information Center

    Daniel, Stephanie S.; Goldston, David B.

    2012-01-01

    The rates of suicide attempts and death by suicide vary considerably over the lifespan, highlighting the influence of different contextual, risk, and protective factors at different points in development (Daniel & Goldston, 2009). Hopelessness and lack of connectedness to others are two factors that have been associated with increased risk for…

  18. Factors that hinder organ donation: religio-cultural or lack of information and trust.

    PubMed

    Tumin, Makmor; Noh, Abdillah; Jajri, Idris; Chong, Chin-Sieng; Manikam, Rishya; Abdullah, Nawi

    2013-06-01

    This paper examines factors that influence Malaysian persons with a tertiary level of education on their willingness to donate organs. A survey was done in the Klang Valley (Kuala Lumpur and its suburbs) at several designated locations. A total of 1420 people were approached, and we focused the sample of 688 respondents with a tertiary level of education. Respondents were given 2 sets of answers: (1) a religio-cultural category and (2) a structural category. They were allowed to choose more than 1 reason. Our findings revealed that only 47.5 percent of respondents declined becoming organ donors. The highest frequency recorded was "I am not convinced that my body part will be used beneficially " (30.1%), followed by "I do not have enough access to information " (29.2%), "I want my body to remain intact after death " (16.9%), and "It is against my religion " (9.9%). Our study revealed that religio-cultural factors are not a prime explanation for the lack of organ donation in the Malaysian case. This study suggests that better procurement methods used by dedicated agencies, as well as better education, could reduce the shortage between organ supply and demand.

  19. Lack of congruence in species diversity indices and community structures of planktonic groups based on local environmental factors.

    PubMed

    Doi, Hideyuki; Chang, Kwang-Hyeon; Nishibe, Yuichiro; Imai, Hiroyuki; Nakano, Shin-ichi

    2013-01-01

    The importance of analyzing the determinants of biodiversity and community composition by using multiple trophic levels is well recognized; however, relevant data are lacking. In the present study, we investigated variations in species diversity indices and community structures of the plankton taxonomic groups-zooplankton, rotifers, ciliates, and phytoplankton-under a range of local environmental factors in pond ecosystems. For each planktonic group, we estimated the species diversity index by using linear models and analyzed the community structure by using canonical correspondence analysis. We showed that the species diversity indices and community structures varied among the planktonic groups and according to local environmental factors. The observed lack of congruence among the planktonic groups may have been caused by niche competition between groups with similar trophic guilds or by weak trophic interactions. Our findings highlight the difficulty of predicting total biodiversity within a system, based upon a single taxonomic group. Thus, to conserve the biodiversity of an ecosystem, it is crucial to consider variations in species diversity indices and community structures of different taxonomic groups, under a range of local conditions.

  20. [Factors related to lack of autonomous mobility during out-of-hospital emergency care].

    PubMed

    Montero García, Antonio; Morales Asencio, José Miguel; Trujillo Illescas, Juan Alfonso; Martí, Celia

    2016-10-01

    To explore the frequency of lack of autonomous mobility and factors related to it in patients requiring prehospital emergency services. Cross-sectional, observational, retrospective analysis. We identified a stratified random sample of patients attended by the public health emergency service of Andalusia in 2011. The sample included 280 patients with a mean age of 56 years; 63.9% were men. The majority were attended in homes and streets or other public spaces. Most were transported to a hospital in a mobile intensive care unit. The reasons for calling the service were most often related to chest pain or injuries. Loss of autonomous mobility was seen more often in men, when care was required in a public area, when there were injuries or altered vital signs, and when the patient required transport in a mobile intensive care unit. Dependence on others was significantly associated with the presence of a prior condition before the patient required transport (odds ratio [OR], 3.27; 95% CI, 1.60-6.33), the use of immobilization strategies (OR, 7.71; 95% CI, 1.7-34.96], and the use of ambulance transport (OR, 4.35; 95% CI, 1.63-11.60]. The following 2 variables were at the limit of significance: pain during the care process (OR, 1.13; 95% CI, 0.99-1.29) and age (OR, 0.46; 95% CI, 0.97-1.01). The profile we identified for patients and situations in which patients cannot move autonomously during prehospital emergency care can be used to plan preventive strategies to ensure patient safety.

  1. p48 Activates a UV-Damaged-DNA Binding Factor and Is Defective in Xeroderma Pigmentosum Group E Cells That Lack Binding Activity

    PubMed Central

    Hwang, Byung Joon; Toering, Stephanie; Francke, Uta; Chu, Gilbert

    1998-01-01

    A subset of xeroderma pigmentosum (XP) group E cells lack a factor that binds to DNA damaged by UV radiation. This factor can be purified to homogeneity as p125, a 125-kDa polypeptide. However, when cDNA encoding p125 is translated in vitro, only a small fraction binds to UV-damaged DNA, suggesting that a second factor is required for the activation of p125. We discovered that most hamster cell lines expressed inactive p125, which was activated in somatic cell hybrids containing human chromosome region 11p11.2-11cen. This region excluded p125 but included p48, which encodes a 48-kDa polypeptide known to copurify with p125 under some conditions. Expression of human p48 activated p125 binding in hamster cells and increased p125 binding in human cells. No such effects were observed from expression of p48 containing single amino acid substitutions from XP group E cells that lacked binding activity, demonstrating that the p48 gene is defective in those cells. Activation of p125 occurred by a “hit-and-run” mechanism, since the presence of p48 was not required for subsequent binding. Nevertheless, p48 was capable of forming a complex with p125 either bound to UV-damaged DNA or in free solution. It is notable that hamster cells fail to efficiently repair cyclobutane pyrimidine dimers in nontranscribed DNA and fail to express p48, which contains a WD motif with homology to proteins that reorganize chromatin. We propose that p48 plays a role in repairing lesions that would otherwise remain inaccessible in nontranscribed chromatin. PMID:9632823

  2. Lack of motivation: a new modifiable risk factor for peritonitis in patients undergoing peritoneal dialysis?

    PubMed

    Paudel, Klara; Namagondlu, Girish; Samad, Nasreen; McKitty, Khadija; Fan, Stanley L

    2015-03-01

    Can we identify modifiable risk factors for peritonitis in patients undergoing peritoneal dialysis (PD)? We aimed to determine whether housing standard, PD exchange technique or patient motivation might be modifiable risks for peritonitis. We also explored the relationship between lack of motivation and depression. Nurse home visits assessed PD exchange technique, environment and patient motivation. Motivation scores were correlated separately with an Apathy Evaluation Score and a depression score using PHQ-9 questionnaires. Home hygiene, exchange technique and motivation were above average in 53%, 56% and 60%, respectively in 104 patients undergoing PD. After 15 months, 25.9% patients developed peritonitis but nurses' ratings of homes and exchange techniques were not predictive. Low patient motivation was predictive. Patients rated to have above or below median motivation had significantly different Apathy Scores (p = 0.0002). Unmotivated depressed patients were significantly more likely to develop peritonitis compared to motivated depressed patients. Lack of motivation predicted peritonitis particularly if associated with depression. Further studies are required focusing on specific motivation scoring schemes and the psychosocial support that might lead to better outcomes. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  3. Risk Factors for Breast Cancer, Including Occupational Exposures

    PubMed Central

    Meo, Margrethe; Vainio, Harri

    2011-01-01

    The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women. PMID:22953181

  4. Lacking "Lack": A Reply to Joldersma

    ERIC Educational Resources Information Center

    Marshall, James D.

    2007-01-01

    First I would like to thank Clarence Joldersma for his review of our "Poststructuralism, Philosophy, Pedagogy" (Marshall, 2004-PPP). In particular, I would thank him for his opening sentence: "[t]his book is a response to a lack." It is the notion of a lack, noted again later in his review, which I wish to take up mainly in this response. Rather…

  5. Social capital and administrative contextual determinants of lack of access to a regular doctor: a multilevel analysis in southern Sweden.

    PubMed

    Lindström, Martin; Axén, Elin; Lindström, Christine; Beckman, Anders; Moghaddassi, Mahnaz; Merlo, Juan

    2006-12-01

    The aim of this study was to investigate the influence of contextual (social capital and administrative/neo-materialist) and individual factors on lack of access to a regular doctor. The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (intra-class correlations, cross-level modification and odds ratios) of individual and municipality (social capital and health care district) factors on lack of access to a regular doctor was analysed using simulation method. The Deviance Information Criterion (DIC) was used as information criterion for the models. The second level municipality variance in lack of access to a regular doctor is substantial even in the final models with all individual and contextual variables included. The model that results in the largest reduction in DIC is the model including age, sex and individual social participation (which is a network aspect of social capital), but the models which include administrative and social capital second level factors also reduced the DIC values. This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

  6. Prognostic factors for head and neck cancer of unknown primary including the impact of human papilloma virus infection.

    PubMed

    Axelsson, Lars; Nyman, Jan; Haugen-Cange, Hedda; Bove, Mogens; Johansson, Leif; De Lara, Shahin; Kovács, Anikó; Hammerlid, Eva

    2017-06-10

    Head and neck cancer of unknown primary (HNCUP) is rare and prospective studies are lacking. The impact of different prognostic factors such as age and N stage is not completely known, the optimal treatment is not yet established, and the reported survival rates vary. In the last decade, human papilloma virus (HPV) has been identified as a common cause of and important prognostic factor in oropharyngeal cancer, and there is now growing interest in the importance of HPV for HNCUP. The aim of the present study on curatively treated HNCUP was to investigate the prognostic importance of different factors, including HPV status, treatment, and overall survival. A search for HNCUP was performed in the Swedish Cancer Registry, Western health district, between the years 1992-2009. The medical records were reviewed, and only patients with squamous cell carcinoma or undifferentiated carcinoma treated with curative intent were included. The tumor specimens were retrospectively analyzed for HPV with p16 immunostaining. Sixty-eight patients were included. The mean age was 59 years. The majority were males, and had N2 tumors. Sixty-nine percent of the tumors were HPV positive using p16 staining. Patients who were older than 70 years, patients with N3-stage tumors, and patients with tumors that were p16 negative had a significantly worse prognosis. The overall 5-year survival rate for patients with p16-positive tumors was 88% vs 61% for p16-negative tumors. Treatment with neck dissection and postoperative radiation or (chemo) radiation had 81 and 88% 5-year survival rates, respectively. The overall and disease-free 5-year survival rates for all patients in the study were 82 and 74%. Curatively treated HNCUP had good survival. HPV infection was common. Independent prognostic factors for survival were age over 70 years, HPV status and N3 stage. We recommend that HPV analysis should be performed routinely for HNCUP. Treatment with neck dissection and postoperative radiation or

  7. Factors Associated with a Lack of Pap Smear Utilization in Women Exposed In Utero to Diethylstilbestrol

    PubMed Central

    Camp, Elizabeth A.; Prehn, Angela W.; Shen, Ji; Herbst, Arthur L.; Strohsnitter, William C.; Hobday, Christopher D.; Robboy, Stanley J.

    2015-01-01

    Abstract Background: Women in the1940s–1960s were prescribed diethylstilbestrol (DES), a nonsteroidal estrogen, to prevent miscarriages, but the practice was terminated after it was discovered that the daughters so exposed in utero were at increased risk for developing clear cell adenocarcinoma (CCA) of the vagina or cervix at early ages. Pap smear screening is one of the principal methods used to identify tumor development and is necessary in this group of women to maintain their health. Currently, little is known about the factors associated with nonutilization of this screening tool in this high-risk population of women. Methods: National cohort data from the National Cancer Institute (NCI) DES Combined Cohort Follow-up Study during 1994, 1997, 2001, and 2006 were used to determine which factors were associated with Pap smear screening nonutilization in 2006 among DES-exposed and unexposed women. Self-reported questionnaire data from 2,861 DES-exposed and 1,027 unexposed women were analyzed using binary logistic regression models. Results: DES exposure, not having a previous gynecologic dysplasia diagnosis, lack of insurance, originating cohort, increasing age, and previous screening behavior were all factors associated with not reporting a Pap smear examination in the 2006 questionnaire, although college education reduced nonutilization. Conclusions: Understanding which factors are associated with not acquiring a screening exam can help clinicians better identify which DES-exposed women are at risk for nonutilization and possibly tailor their standard of care to aid in the early detection of cervical and vaginal adenocarcinomas in this high-risk group. PMID:25768943

  8. Hyponatremia and fractures: should hyponatremia be further studied as a potential biochemical risk factor to be included in FRAX algorithms?

    PubMed

    Ayus, J C; Bellido, T; Negri, A L

    2017-05-01

    The Fracture Risk Assessment Tool (FRAX®) was developed by the WHO Collaborating Centre for metabolic bone diseases to evaluate fracture risk of patients. It is based on patient models that integrate the risk associated with clinical variables and bone mineral density (BMD) at the femoral neck. The clinical risk factors included in FRAX were chosen to include only well-established and independent variables related to skeletal fracture risk. The FRAX tool has acquired worldwide acceptance despite having several limitations. FRAX models have not included biochemical derangements in estimation of fracture risk due to the lack of validation in large prospective studies. Recently, there has been an increasing number of studies showing a relationship between hyponatremia and the occurrence of fractures. Hyponatremia is the most frequent electrolyte abnormality measured in the clinic, and serum sodium concentration is a very reproducible, affordable, and readily obtainable measurement. Thus, we think that hyponatremia should be further studied as a biochemical risk factor for skeletal fractures prediction, particularly those at the hip which carries the greatest morbidity and mortality. To achieve this will require the collection of large patient cohorts from diverse geographical locations that include a measure of serum sodium in addition to the other FRAX variables in large numbers, in both sexes, over a wide age range and with wide geographical representation. It would also require the inclusion of data on duration and severity of hyponatremia. Information will be required both on the risk of fracture associated with the occurrence and length of exposure to hyponatremia and to the relationship with the other risk variables included in FRAX and also the independent effect on the occurrence of death which is increased by hyponatremia.

  9. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients.

    PubMed

    Nie, Sasa; Feng, Zhe; Tang, Li; Wang, Xiaolong; He, Yani; Fang, Jingai; Li, Suhua; Yang, Yibin; Mao, Huijuan; Jiao, Jundong; Liu, Wenhu; Cao, Ning; Wang, Wenge; Sun, Jifeng; Shao, Fengmin; Li, Wenge; He, Qiang; Jiang, Hongli; Lin, Hongli; Fu, Ping; Zhang, Xinzhou; Liu, Yinghong; Wu, Yonggui; Xi, ChunSheng; Liang, Meng; Qu, Zhijie; Zhu, Jun; Wu, Guangli; Zheng, Yali; Na, Yu; Li, Ying; Li, Wei; Cai, Guangyan; Chen, Xiangmei

    2017-01-01

    Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR) for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58) for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42) for a propensity score-matched set. In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI. © 2017 The Author(s). Published by S. Karger AG, Basel.

  10. Qualitative models of seat discomfort including static and dynamic factors.

    PubMed

    Ebe, K; Griffin, M J

    2000-06-01

    Judgements of overall seating comfort in dynamic conditions sometimes correlate better with the static characteristics of a seat than with measures of the dynamic environment. This study developed qualitative models of overall seat discomfort to include both static and dynamic seat characteristics. A dynamic factor that reflected how vibration discomfort increased as vibration magnitude increased was combined with a static seat factor which reflected seating comfort without vibration. The ability of the model to predict the relative and overall importance of dynamic and static seat characteristics on comfort was tested in two experiments. A paired comparison experiment, using four polyurethane foam cushions (50, 70, 100, 120 mm thick), provided different static and dynamic comfort when 12 subjects were exposed to one-third octave band random vertical vibration with centre frequencies of 2.5 and 5.5 Hz, at magnitudes of 0.00, 0.25 and 0.50 m x s(-2) rms measured beneath the foam samples. Subject judgements of the relative discomfort of the different conditions depended on both static and dynamic characteristics in a manner consistent with the model. The effect of static and dynamic seat factors on overall seat discomfort was investigated by magnitude estimation using three foam cushions (of different hardness) and a rigid wooden seat at six vibration magnitudes with 20 subjects. Static seat factors (i.e. cushion stiffness) affected the manner in which vibration influenced the overall discomfort: cushions with lower stiffness were more comfortable and more sensitive to changes in vibration magnitude than those with higher stiffness. The experiments confirm that judgements of overall seat discomfort can be affected by both the static and dynamic characteristics of a seat, with the effect depending on vibration magnitude: when vibration magnitude was low, discomfort was dominated by static seat factors; as the vibration magnitude increased, discomfort became dominated

  11. Lack of A-factor production induces the expression of nutrient scavenging and stress-related proteins in Streptomyces griseus.

    PubMed

    Birkó, Zsuzsanna; Swiatek, Magdalena; Szájli, Emília; Medzihradszky, Katalin F; Vijgenboom, Erik; Penyige, András; Keseru, Judit; van Wezel, Gilles P; Biró, Sándor

    2009-10-01

    The small gamma-butyrolactone A-factor is an important autoregulatory signaling molecule for the soil-inhabiting streptomycetes. Starvation is a major trigger for development, and nutrients are provided by degradation of the vegetative mycelium via a process of programmed cell death, reusing proteins, nucleic acids, and cell wall material. The A-factor regulon includes many extracellular hydrolases. Here we show via proteomics analysis that many nutrient-scavenging and stress-related proteins were overexpressed in an A-factor non-producing mutant of Streptomyces griseus B-2682. Transcript analysis showed that this is primarily due to differential transcription of the target genes during early development. The targets include proteins relating to nutrient stress and environmental stress and an orthologue of the Bacillus sporulation control protein Spo0M. The enhanced expression of these proteins underlines the stress that is generated by the absence of A-factor. Wild-type developmental gene expression was restored to the A-factor non-producing mutant by the signaling protein Factor C in line with our earlier observation that Factor C triggers A-factor production.

  12. Robust Programming Problems Based on the Mean-Variance Model Including Uncertainty Factors

    NASA Astrophysics Data System (ADS)

    Hasuike, Takashi; Ishii, Hiroaki

    2009-01-01

    This paper considers robust programming problems based on the mean-variance model including uncertainty sets and fuzzy factors. Since these problems are not well-defined problems due to fuzzy factors, it is hard to solve them directly. Therefore, introducing chance constraints, fuzzy goals and possibility measures, the proposed models are transformed into the deterministic equivalent problems. Furthermore, in order to solve these equivalent problems efficiently, the solution method is constructed introducing the mean-absolute deviation and doing the equivalent transformations.

  13. [Lack of assertiveness in patients with eating disorders].

    PubMed

    Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny

    2006-03-01

    Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.

  14. Lack of acculturation is a risk factor for diabetes in arab immigrants in the US.

    PubMed

    Jaber, Linda A; Brown, Morton B; Hammad, Adnan; Zhu, Qian; Herman, William H

    2003-07-01

    To examine the relationship between dysglycemia (impaired fasting glucose, impaired glucose tolerance, and diabetes) and acculturation, physical activity, and perceived stress in Arab immigrants in the U.S. In a cross-sectional population-based study, we examined 520 Arab Americans, aged 20-75 years, who were born in the Middle East and immigrated to southeastern Michigan. Dysglycemia was assessed by history and with a 2-h 75-g oral glucose tolerance test. Acculturation, physical activity, and perceived stress were measured with standardized questionnaires. Associations were found between dysglycemia in men and older age at immigration, unemployment, speaking Arabic with friends, being less active in Arabic organizations, more frequent consumption of Arabic food, and less integration into American society. Dysglycemia in women was associated with being raised in rural areas of the Middle East, older age at immigration, longer length of stay in the U.S., not being employed outside the home, less than high school education, not attending Arabic or American schools, and not being able to read Arabic. Among men, older age at immigration, shorter length of stay in the U.S., less activity in Arab organizations, and eating Arabic food were associated with dysglycemia independent of age and BMI. Among women, acculturation was very low and was confounded with age and BMI as powerful risk factors for dysglycemia. No association was found between physical activity, perceived stress, and the risk of dysglycemia in either sex. Lack of acculturation is an important risk factor for dysglycemia in immigrant Arab Americans. Intervention programs aimed at diabetes prevention should consider the acculturation process.

  15. Lack of bleeding in patients with severe factor VII deficiency.

    PubMed

    Barnett, J Mark; Demel, Kurt C; Mega, Anthony E; Butera, James N; Sweeney, Joseph D

    2005-02-01

    Factor VII deficiency, although rare, is now recognized as the most common autosomal recessive inherited factor deficiency. It is usually considered to be associated with bleeding only in the severely affected subject and heterozygotes (>10%) are not considered at risk. The general recommendation for surgery is to achieve a FVII level in excess of 15% (0.15 1U/mL). We present three cases of severe factor VII deficiency, each of whom appeared hemostatically competent based on clinical history. Subject 1 is a 33 year-old African-American female with a baseline FVII of <1%, who had a fractured tibia requiring open reduction with internal fixation without any FVII replacement and subsequently underwent successful laparoscopic knee surgery with a factor VII level measured at 6%. Subject 2 is a 58 year-old African-American female with a factor VII level of 9% who underwent an elective left total hip replacement without any factor replacement and had no excessive bleeding, but who sustained a pulmonary embolism postoperatively. Subject 3 is a 19-year-old African-American male with a baseline FVII of 1% with a history of active participation in football without noticeable injury and who underwent an emergent appendectomy without bleeding. These three cases represent individuals with the severe form of FVII deficiency who did not exhibit excessive bleeding when challenged with surgical procedures. The clinical history would appear the most valuable tool in predicting the likelihood of bleeding in these patients, and we suggest that the presumption that all patients with severe FVII deficiency should receive replacement therapy before surgical procedures may not be valid in all cases. Copyright 2005 Wiley-Liss, Inc.

  16. Evaluation of Factors Affecting Vaccine Efficacy of Recombinant Marek's Disease Virus Lacking the Meq Oncogene in Chickens

    USDA-ARS?s Scientific Manuscript database

    We have previously reported that deletion of Meq gene from oncogenic rMd5 virus rendered it apathogenic for chickens. Here we examined multiple factors affecting Marek’s disease (MD) vaccine efficacy of this non-pathogenic recombinant Meq null rMd5 virus (rMd5deltaMeq). These factors included host g...

  17. Social capital and lack of belief in the possibility to influence one's own health: a population-based study.

    PubMed

    Lindström, Martin

    2006-01-01

    To study the impact of social capital (social participation and trust) on lack of belief in possibility to influence health. The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study including 13,604 persons aged 18-80 years which was conducted in 2000 by the regional healthcare authorities in Region Skåne, southern Sweden, to investigate health-related risk factors in the population. A logistic regression model was used to investigate the association between social capital and lack of belief in possibility to influence health. The multivariate analyses analysed the importance of confounders on the differences in lack of belief in possibility to influence health according to the social capital variables. In total, 31.0% of all men and 33.5% of all women lack belief in the possibility to influence their own health. Lack of belief in possibility to influence health was positively associated with both low social participation and low trust, although stronger for social participation than for trust. Low levels of social capital, particularly low social participation, is positively associated with lack of belief in the possibility to influence one's own health.

  18. Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy.

    PubMed

    Babore, Alessandra; Stuppia, Liborio; Trumello, Carmen; Candelori, Carla; Antonucci, Ivana

    2017-04-01

    To investigate the association between male factor infertility and openness to discussing assisted reproductive technology (ART) treatment with levels of depression among men undergoing infertility treatment. Cross-sectional. Not applicable. Three hundred forty participants (170 men and their partners) undergoing ART treatments. Administration of a set of questionnaires. Depressive symptoms were detected by means of the Zung Depression Self-Rating Scale. Participants' willingness to share their infertility treatment experience with other people was assessed by means of self-report questionnaires. In this study, 51.8% of males chose not to discuss their ART treatments with people other than their partner. In addition, the decision to discuss or not discuss the ART treatments with others was significantly associated with men's depressive symptoms. Male factor infertility was significantly associated with depression when considered together with the decision not to discuss ART treatments with others. A general disposition characterized by a lack of openness with others seemed to be a significant predictor of depression. There is a need for routine fertility care to pay greater attention to men's emotional needs. Before commencing reproductive treatment, male patients may benefit from undergoing routine screening for variables (i.e., male factor infertility and openness to others about ART) that may affect their risk of depression. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Generalization of rapidly recurring seizures is suppressed in mice lacking glial cell line-derived neurotrophic factor family receptor alpha2.

    PubMed

    Nanobashvili, A; Kokaia, Z; Lindvall, O

    2003-01-01

    Recent experimental evidence indicates that neurotrophic factors play a role in the pathophysiology of epilepsy. The objective of this study was to explore whether signaling through one of the glial cell line-derived neurotrophic factor family receptors, GFRalpha2, influences the severity of kindling-evoked, rapidly recurring seizures and the subsequent development of permanent hyperexcitability. We applied the rapid kindling model to adult mice, using 40 threshold stimulations delivered with 5-min interval in the ventral hippocampus. Generalized seizures were fewer and developed later in response to kindling stimulations in mice lacking GFRalpha2. However, GFRalpha2 gene deletion did not influence the acquisition of the permanent abnormal excitability as assessed 4 weeks later. In situ hybridization revealed marked and dynamic changes of GFRalpha2 mRNA levels in several forebrain areas following the stimulus-evoked seizures. Our findings provide evidence that signaling through the GFRalpha2 receptor contributes to seizure generalization in rapid kindling.

  20. Fibroblast growth factor rescues brain endothelial cells lacking presenilin 1 from apoptotic cell death following serum starvation.

    PubMed

    Gama Sosa, Miguel A; De Gasperi, Rita; Hof, Patrick R; Elder, Gregory A

    2016-07-22

    Presenilin 1 (Psen1) is important for vascular brain development and is known to influence cellular stress responses. To understand the role of Psen1 in endothelial stress responses, we investigated the effects of serum withdrawal on wild type (wt) and Psen1-/- embryonic brain endothelial cells. Serum starvation induced apoptosis in Psen1-/- cells but did not affect wt cells. PI3K/AKT signaling was reduced in serum-starved Psen1-/- cells, and this was associated with elevated levels of phospho-p38 consistent with decreased pro-survival AKT signaling in the absence of Psen1. Fibroblast growth factor (FGF1 and FGF2), but not vascular endothelial growth factor (VEGF) rescued Psen1-/- cells from serum starvation induced apoptosis. Inhibition of FGF signaling induced apoptosis in wt cells under serum withdrawal, while blocking γ-secretase activity had no effect. In the absence of serum, FGF2 immunoreactivity was distributed diffusely in cytoplasmic and nuclear vesicles of wt and Psen1-/- cells, as levels of FGF2 in nuclear and cytosolic fractions were not significantly different. Thus, sensitivity of Psen1-/- cells to serum starvation is not due to lack of FGF synthesis but likely to effects of Psen1 on FGF release onto the cell surface and impaired activation of the PI3K/AKT survival pathway.

  1. Tissue-Specific Profiling Reveals Transcriptome Alterations in Arabidopsis Mutants Lacking Morphological Phenotypes[C][W

    PubMed Central

    Simon, Marissa; Bruex, Angela; Kainkaryam, Raghunandan M.; Zheng, Xiaohua; Huang, Ling; Woolf, Peter J.; Schiefelbein, John

    2013-01-01

    Traditional genetic analysis relies on mutants with observable phenotypes. Mutants lacking visible abnormalities may nevertheless exhibit molecular differences useful for defining gene function. To examine this, we analyzed tissue-specific transcript profiles from Arabidopsis thaliana transcription factor gene mutants with known roles in root epidermis development, but lacking a single-gene mutant phenotype due to genetic redundancy. We discovered substantial transcriptional changes in each mutant, preferentially affecting root epidermal genes in a manner consistent with the known double mutant effects. Furthermore, comparing transcript profiles of single and double mutants, we observed remarkable variation in the sensitivity of target genes to the loss of one or both paralogous genes, including preferential effects on specific branches of the epidermal gene network, likely reflecting the pathways of paralog subfunctionalization during evolution. In addition, we analyzed the root epidermal transcriptome of the transparent testa glabra2 mutant to clarify its role in the network. These findings provide insight into the molecular basis of genetic redundancy and duplicate gene diversification at the level of a specific gene regulatory network, and they demonstrate the usefulness of tissue-specific transcript profiling to define gene function in mutants lacking informative visible changes in phenotype. PMID:24014549

  2. Even One Is Too Much: Sole Presence of One of the Risk Factors Overweight, Lack of Exercise, and Smoking Reduces Physical Fitness of Young Soldiers.

    PubMed

    Leyk, Dieter; Witzki, Alexander; Willi, Gorges; Rohde, Ulrich; Rüther, Thomas

    2015-11-01

    Health and physical fitness are key factors for soldiers. Increased sedentary military work, significant sitting periods during commuting and leisure time, and unhealthy dietary habits have caused a considerable increase in the number of physically unfit soldiers. Even worse, the adoption of harmful lifestyle habits occurs increasingly earlier in life. The aim of this cross-sectional study was (a) to determine the physical fitness of young male soldiers and (b) to investigate the association between physical fitness and both the presence and frequency of the health risk factors overweight, smoking, and lack of exercise. A total of 4,553 volunteers aged 18-25 years performed the Basis Fitness Test consisting of the 3 disciplines agility (11 × 10 m shuttle sprint), strength (flexed-arm hang), and endurance (1,000-m run). The presence and frequency of risk factors were determined by means of anthropometric measures (body mass index, waist circumference) and questionnaire data. The portion of soldiers without risk factors decreased from 49.4% (18-year-olds) to 16.4% for 25-year-olds. Persons without risk factors completed the agility test in 41.1 ± 3.7 seconds, flexed-arm hang in 60.1 ± 19.7 seconds, and 1,000-m run in 235 ± 32 seconds. Physical performance in all dimensions tested (agility, strength, endurance) notably deteriorated with the sole presence of one of the risk factors overweight, smoking, and lack of exercise. Any further risk factor led to further fitness decreases (p < 0.001). Mean performances of soldiers with 3 risk factors were 46.7 ± 4.1 seconds (11 × 10 m shuttle sprint), 27.6 ± 6.4 seconds (flexed-arm hang), and 298 ± 45 seconds (1,000-m run). Impacts of unhealthy lifestyles and significant losses in physical fitness are already visible in young male soldiers. Armed Forces must intensify their efforts to maintain health and performance of their soldiers.

  3. Toward a Deeper Understanding of Student Interest or Lack of Interest in Science

    ERIC Educational Resources Information Center

    Yang, Li-Hsuan

    2010-01-01

    This study examined the nature of college students' interest or lack of interest in science and the factors to which they attributed their interest or lack of interest. Twenty-four college students were interviewed to gain an understanding of their ideas and experiences of science; their overall interest in science; their interest levels in four…

  4. Lack of Postprandial Peak in Brain-Derived Neurotrophic Factor in Adults with Prader-Willi Syndrome

    PubMed Central

    Bueno, Marta; Esteba-Castillo, Susanna; Novell, Ramon; Giménez-Palop, Olga; Coronas, Ramon; Gabau, Elisabeth; Corripio, Raquel; Baena, Neus; Viñas-Jornet, Marina; Guitart, Míriam; Torrents-Rodas, David; Deus, Joan; Pujol, Jesús; Rigla, Mercedes

    2016-01-01

    Context Prader-Willi syndrome (PWS) is characterized by severe hyperphagia. Brain-derived neurotrophic factor (BDNF) and leptin are reciprocally involved in energy homeostasis. Objectives To analyze the role of BDNF and leptin in satiety in genetic subtypes of PWS. Design Experimental study. Setting University hospital. Subjects 90 adults: 30 PWS patients; 30 age-sex-BMI-matched obese controls; and 30 age-sex-matched lean controls. Interventions Subjects ingested a liquid meal after fasting ≥10 hours. Main Outcome Measures Leptin and BDNF levels in plasma extracted before ingestion and 30’, 60’, and 120’ after ingestion. Hunger, measured on a 100-point visual analogue scale before ingestion and 60’ and 120’ after ingestion. Results Fasting BDNF levels were lower in PWS than in controls (p = 0.05). Postprandially, PWS patients showed only a truncated early peak in BDNF, and their BDNF levels at 60' and 120' were lower compared with lean controls (p<0.05). Leptin was higher in PWS patients than in controls at all time points (p<0.001). PWS patients were hungrier than controls before and after eating. The probability of being hungry was associated with baseline BDNF levels: every 50-unit increment in BDNF decreased the odds of being hungry by 22% (OR: 0.78, 95%CI: 0.65–0.94). In uniparental disomy, the odds of being hungry decreased by 66% (OR: 0.34, 90%CI: 0.13–0.9). Postprandial leptin patterns did no differ among genetic subtypes. Conclusions Low baseline BDNF levels and lack of postprandial peak may contribute to persistent hunger after meals. Uniparental disomy is the genetic subtype of PWS least affected by these factors. PMID:27685845

  5. Maturity of hospital information systems: Most important influencing factors.

    PubMed

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  6. The NLP toxin family in Phytophthora sojae includes rapidly evolving groups that lack necrosis-inducing activity.

    PubMed

    Dong, Suomeng; Kong, Guanghui; Qutob, Dinah; Yu, Xiaoli; Tang, Junli; Kang, Jixiong; Dai, Tingting; Wang, Hai; Gijzen, Mark; Wang, Yuanchao

    2012-07-01

    Necrosis- and ethylene-inducing-like proteins (NLP) are widely distributed in eukaryotic and prokaryotic plant pathogens and are considered to be important virulence factors. We identified, in total, 70 potential Phytophthora sojae NLP genes but 37 were designated as pseudogenes. Sequence alignment of the remaining 33 NLP delineated six groups. Three of these groups include proteins with an intact heptapeptide (Gly-His-Arg-His-Asp-Trp-Glu) motif, which is important for necrosis-inducing activity, whereas the motif is not conserved in the other groups. In total, 19 representative NLP genes were assessed for necrosis-inducing activity by heterologous expression in Nicotiana benthamiana. Surprisingly, only eight genes triggered cell death. The expression of the NLP genes in P. sojae was examined, distinguishing 20 expressed and 13 nonexpressed NLP genes. Real-time reverse-transcriptase polymerase chain reaction results indicate that most NLP are highly expressed during cyst germination and infection stages. Amino acid substitution ratios (Ka/Ks) of 33 NLP sequences from four different P. sojae strains resulted in identification of positive selection sites in a distinct NLP group. Overall, our study indicates that expansion and pseudogenization of the P. sojae NLP family results from an ongoing birth-and-death process, and that varying patterns of expression, necrosis-inducing activity, and positive selection suggest that NLP have diversified in function.

  7. Post-exposure vaccination with MP-12 lacking NSs protects mice against lethal Rift Valley fever virus challenge.

    PubMed

    Gowen, Brian B; Bailey, Kevin W; Scharton, Dionna; Vest, Zachery; Westover, Jonna B; Skirpstunas, Ramona; Ikegami, Tetsuro

    2013-05-01

    Rift Valley fever virus (RVFV) causes severe disease in humans and livestock. There are currently no approved antivirals or vaccines for the treatment or prevention of RVF disease in humans. A major virulence factor of RVFV is the NSs protein, which inhibits host transcription including the interferon (IFN)-β gene and promotes the degradation of dsRNA-dependent protein kinase, PKR. We analyzed the efficacy of the live-attenuated MP-12 vaccine strain and MP-12 variants that lack the NSs protein as post-exposure vaccinations. Although parental MP-12 failed to elicit a protective effect in mice challenged with wild-type (wt) RVFV by the intranasal route, significant protection was demonstrated by vaccination with MP-12 strains lacking NSs when they were administered at 20-30 min post-exposure. Viremia and virus replication in liver, spleen and brain were also inhibited by post-exposure vaccination with MP-12 lacking NSs. The protective effect was mostly lost when vaccination was delayed 6 or 24 h after intranasal RVFV challenge. When mice were challenged subcutaneously, efficacy of MP-12 lacking NSs was diminished, most likely due to more rapid dissemination of wt RVFV. Our findings suggest that post-exposure vaccination with MP-12 lacking NSs may be developed as a novel post-exposure treatment to prevent RVF. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Mouse neutrophils lacking lamin B receptor expression exhibit aberrant development and lack critical functional responses

    PubMed Central

    Gaines, Peter; Tien, Chiung W.; Olins, Ada L.; Olins, Donald E.; Shultz, Leonard D.; Carney, Lisa; Berliner, Nancy

    2008-01-01

    Objective The capacity of neutrophils to eradicate bacterial infections is dependent on normal development and the activation of functional responses, which include chemotaxis and the generation of oxygen radicals during the respiratory burst. A unique feature of the neutrophil is its highly lobulated nucleus, which is thought to facilitate chemotaxis but may also play a role in other critical neutrophil functions. Nuclear lobulation is dependent on the expression of the inner nuclear envelope protein, the lamin B receptor (LBR), mutations of which cause hypolobulated neutrophil nuclei in human Pelger-Huët anomaly (PHA) and the "ichthyosis" (ic) phenotype in mice. In this study we have investigated roles for LBR in mediating neutrophil development and the activation of multiple neutrophil functions, including chemotaxis and the respiratory burst. Materials and Methods A progenitor EML cell line was generated from an ic/ic mouse, and derived cells that lacked LBR expression were induced to mature neutrophils and then examined for abnormal morphology and functional responses. Results Neutrophils derived from EML-ic/ic cells exhibited nuclear hypolobulation identical to that observed in ichthyosis mice. The ic/ic neutrophils also displayed abnormal chemotaxis, supporting the notion that nuclear segmentation augments neutrophil extravasation. Furthermore, promyelocytic forms of ic/ic cells displayed decreased proliferative responses and produced a deficient respiratory burst upon terminal maturation. Conclusions Our studies of promyelocytes that lack LBR expression have identified roles for LBR in regulating not only the morphologic maturation of the neutrophil nucleus but also proliferative and functional responses that are critical to innate immunity. PMID:18550262

  9. Effective treatment of perinatal depression for women in debt and lacking financial empowerment in a low-income country.

    PubMed

    Rahman, Atif; Sikander, Siham; Malik, Abid; Ahmed, Ikhlaque; Tomenson, Barbara; Creed, Francis

    2012-12-01

    Poverty may moderate the effect of treatment of depression in low-income countries. To assess poverty and lack of empowerment as moderators of a cognitive-behavioural therapy (CBT)-based intervention for perinatal depression in rural Pakistan. Using secondary analysis of data from a randomised controlled trial (trial registration: ISRCTN65316374) we identified predictors of depression at 1-year follow-up and moderators of the intervention (n = 791). Predictors of follow-up depression included household debt, the participant not being empowered to manage household finance and the interaction terms for these variables with the trial arm. Effect sizes for women with and without household debt were 0.80 and 0.55 respectively. The effect size for women in debt and not empowered financially was 0.94 compared with 0.50 for women with neither of these factors. Our findings demonstrate the importance of household debt and lack of financial empowerment of women as important maintaining factors of depression in low-income countries and our locally developed intervention tackled these problems successfully.

  10. Effective treatment of perinatal depression for women in debt and lacking financial empowerment in a low-income country

    PubMed Central

    Rahman, Atif; Sikander, Siham; Malik, Abid; Ahmed, Ikhlaque; Tomenson, Barbara; Creed, Francis

    2012-01-01

    Background Poverty may moderate the effect of treatment of depression in low-income countries. Aims To assess poverty and lack of empowerment as moderators of a cognitive–behavioural therapy (CBT)-based intervention for perinatal depression in rural Pakistan. Method Using secondary analysis of data from a randomised controlled trial (trial registration: ISRCTN65316374) we identified predictors of depression at 1-year follow-up and moderators of the intervention (n = 791). Results Predictors of follow-up depression included household debt, the participant not being empowered to manage household finance and the interaction terms for these variables with the trial arm. Effect sizes for women with and without household debt were 0.80 and 0.55 respectively. The effect size for women in debt and not empowered financially was 0.94 compared with 0.50 for women with neither of these factors. Conclusions Our findings demonstrate the importance of household debt and lack of financial empowerment of women as important maintaining factors of depression in low-income countries and our locally developed intervention tackled these problems successfully. PMID:23137731

  11. Lack of evidence for hepatitis C virus infection in association with lichen planus.

    PubMed

    Stojanovic, Larisa; Lunder, Tomaz; Poljak, Mario; Mars, Tomaz; Mlakar, Bostjan; Maticic, Mojca

    2008-12-01

    The association between hepatitis C virus (HCV) infection and lichen planus (LP) is a subject of controversy. Prevalence studies of HCV infection in LP patients in various countries reveal diverse results. The Slovenian population is rather homogenous with specific geographic and epidemiological characteristics. Lack of data or contradictory results from neighboring countries urged the need for a case-controlled study in our LP patients. The retrospective study was performed on 173 LP patients. Control group included 218 patients with dermatological diseases other than LP. Anti-HCV antibodies were found in 2/173 patients (1.2%) with LP and in 0/218 controls. No statistically significant difference was found between the study and control group regarding anti-HCV antibody prevalence (P = 0.195; estimated OR 6.4, 95% CI 0.3-134.0) and risk factors for HCV infection. Based on our results, anti-HCV antibody testing is not necessarily required in LP patients with no risk factors for HCV infection in this geographic region.

  12. Develop a PWL System for Dense Graded Hot Mix Asphalt Construction, Including Pay Factors

    DOT National Transportation Integrated Search

    2015-01-01

    This research project developed a PWL system that the Nevada DOT can effectively implement on the construction of dense graded HMA mixtures. The PWL system includes pay factors that are based on pavement performance indicators such as rutting and cra...

  13. Infliximab in ulcerative colitis: real-life analysis of factors predicting treatment discontinuation due to lack of response or colectomy: ECIA (ACAD Colitis and Infliximab Study).

    PubMed

    Fernández-Salazar, Luis; Muñoz, Fernando; Barrio, Jesús; Muñoz, Concepción; Pajares, Ramón; Rivero, Montserrat; Prieto, Vanessa; Legido, Jesús; Bouhmidi, Abdel; Herranz, Maite; Fernández, Nereida; Sánchez-Ocaña, Ramón; Joao, Diana; Santos, Fernando

    2016-01-01

    To describe clinical practice with infliximab (IFX) in ulcerative colitis (UC); identification of predictive factors for IFX treatment discontinuation due to insufficient response and for colectomy. Retrospective, multicentric and observational study including every UC IFX-treated patient in 10 Spanish hospitals. Variables analyzed: epidemiological data; variables for poor prognosis; IFX prior treatments; characteristics of the IFX treatment; time from the UC diagnosis to induction with IFX; time from induction to colectomy or until data collection. Predictive and protective factors for IFX discontinuation due to lack of response and for colectomy were analyzed with binary logistic regression and Cox analysis. Follow-up time from induction with IFX to the collection of data or colectomy: 36.7 ± 25.7 months. Prior treatment with immunomodulator medications (IMM): 79%; IFX + immunosuppressant therapy: 77%; discontinuation of IFX: 26%, colectomy 16%. Independent predictive or protective factors for IFX discontinuation: IMM resistance (OR: 2.9, p = 0.022, 95% CI: 1.2-7.2), prior use of leukocytapheresis (OR: 3.3, p = 0.024, 95% CI: 1.1-9.4), IFX + IMM therapy (OR: 0.3, p = 0.022, 95% CI: 0.1-0.9, and HR: 0.4, p = 0.006, 95% CI: 0.2-0.8) and corticosteroid use in induction (HR: 1.9, p = 0.049, 95% CI: 1.0-3.8). Independent predictive or protective factors for colectomy: Use of leukocytapheresis (OR: 3.0, p = 0.036, 95% CI: 1.1-8.4), IFX + IMM therapy (OR: 0.3, p = 0.022, 95% CI: 0.1-0.8, and HR: 0.3, p = 0.011, 95% CI: 0.1-0.8) and severe cortico-resistant flare-up (HR: 2.5, p = 0.032, 95% CI: 1.1-5.9). Prior use of IMM and leukocytapheresis, the use of corticosteroids in induction and a severe cortico-resistant flare predict a worse response to IFX and the need for colectomy. Combination therapy is a protective factor for both.

  14. Regulatory iNKT cells lack expression of the transcription factor PLZF and control the homeostasis of T(reg) cells and macrophages in adipose tissue.

    PubMed

    Lynch, Lydia; Michelet, Xavier; Zhang, Sai; Brennan, Patrick J; Moseman, Ashley; Lester, Chantel; Besra, Gurdyal; Vomhof-Dekrey, Emilie E; Tighe, Mike; Koay, Hui-Fern; Godfrey, Dale I; Leadbetter, Elizabeth A; Sant'Angelo, Derek B; von Andrian, Ulrich; Brenner, Michael B

    2015-01-01

    Invariant natural killer T cells (iNKT cells) are lipid-sensing innate T cells that are restricted by the antigen-presenting molecule CD1d and express the transcription factor PLZF. iNKT cells accumulate in adipose tissue, where they are anti-inflammatory, but the factors that contribute to their anti-inflammatory nature, as well as their targets in adipose tissue, are unknown. Here we found that iNKT cells in adipose tissue had a unique transcriptional program and produced interleukin 2 (IL-2) and IL-10. Unlike other iNKT cells, they lacked PLZF but expressed the transcription factor E4BP4, which controlled their IL-10 production. The adipose iNKT cells were a tissue-resident population that induced an anti-inflammatory phenotype in macrophages and, through the production of IL-2, controlled the number, proliferation and suppressor function of regulatory T cells (Treg cells) in adipose tissue. Thus, iNKT cells in adipose tissue are unique regulators of immunological homeostasis in this tissue.

  15. Norepinephrine-deficient mice lack responses to antidepressant drugs, including selective serotonin reuptake inhibitors

    PubMed Central

    Cryan, John F.; O'Leary, Olivia F.; Jin, Sung-Ha; Friedland, Julie C.; Ouyang, Ming; Hirsch, Bradford R.; Page, Michelle E.; Dalvi, Ashutosh; Thomas, Steven A.; Lucki, Irwin

    2004-01-01

    Mice unable to synthesize norepinephrine (NE) and epinephrine due to targeted disruption of the dopamine β-hydroxylase gene, Dbh, were used to critically test roles for NE in mediating acute behavioral changes elicited by different classes of antidepressants. To this end, we used the tail suspension test, one of the most widely used paradigms for assessing antidepressant activity and depression-related behaviors in normal and genetically modified mice. Dbh–/– mice failed to respond to the behavioral effects of various antidepressants, including the NE reuptake inhibitors desipramine and reboxetine, the monoamine oxidase inhibitor pargyline, and the atypical antidepressant bupropion, even though they did not differ in baseline immobility from Dbh+/– mice, which have normal levels of NE. Surprisingly, the effects of the selective serotonin reuptake inhibitors (SSRIs) fluoxetine, sertraline, and paroxetine were also absent or severely attenuated in the Dbh–/– mice. In contrast, citalopram (the most selective SSRI) was equally effective at reducing immobility in mice with and without NE. Restoration of NE by using l-threo-3,4-dihydroxyphenylserine reinstated the behavioral effects of both desipramine and paroxetine in Dbh–/– mice, thus demonstrating that the reduced sensitivity to antidepressants is related to NE function, as opposed to developmental abnormalities resulting from chronic NE deficiency. Microdialysis studies demonstrated that the ability of fluoxetine to increase hippocampal serotonin was blocked in Dbh–/– mice, whereas citalopram's effect was only partially attenuated. These data show that NE plays an important role in mediating acute behavioral and neurochemical actions of many antidepressants, including most SSRIs. PMID:15148402

  16. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

    PubMed

    Yeom, Hye A; Fleury, Julie; Keller, Colleen

    2008-01-01

    Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

  17. DNA Damage Response Factors from Diverse Pathways, Including DNA Crosslink Repair, Mediate Alternative End Joining

    PubMed Central

    Howard, Sean M.; Yanez, Diana A.; Stark, Jeremy M.

    2015-01-01

    Alternative end joining (Alt-EJ) chromosomal break repair involves bypassing classical non-homologous end joining (c-NHEJ), and such repair causes mutations often with microhomology at the repair junction. Since the mediators of Alt-EJ are not well understood, we have sought to identify DNA damage response (DDR) factors important for this repair event. Using chromosomal break reporter assays, we surveyed an RNAi library targeting known DDR factors for siRNAs that cause a specific decrease in Alt-EJ, relative to an EJ event that is a composite of Alt-EJ and c-NHEJ (Distal-EJ between two tandem breaks). From this analysis, we identified several DDR factors that are specifically important for Alt-EJ relative to Distal-EJ. While these factors are from diverse pathways, we also found that most of them also promote homologous recombination (HR), including factors important for DNA crosslink repair, such as the Fanconi Anemia factor, FANCA. Since bypass of c-NHEJ is likely important for both Alt-EJ and HR, we disrupted the c-NHEJ factor Ku70 in Fanca-deficient mouse cells and found that Ku70 loss significantly diminishes the influence of Fanca on Alt-EJ. In contrast, an inhibitor of poly ADP-ribose polymerase (PARP) causes a decrease in Alt-EJ that is enhanced by Ku70 loss. Additionally, the helicase/nuclease DNA2 appears to have distinct effects from FANCA and PARP on both Alt-EJ, as well as end resection. Finally, we found that the proteasome inhibitor Bortezomib, a cancer therapeutic that has been shown to disrupt FANC signaling, causes a significant reduction in both Alt-EJ and HR, relative to Distal-EJ, as well as a substantial loss of end resection. We suggest that several distinct DDR functions are important for Alt-EJ, which include promoting bypass of c-NHEJ and end resection. PMID:25629353

  18. Lack of Breastfeeding: A Potential Risk Factor in the Multifactorial Genesis of Borderline Personality Disorder and Impaired Maternal Bonding.

    PubMed

    Schwarze, Cornelia E; Hellhammer, Dirk H; Stroehle, Verena; Lieb, Klaus; Mobascher, Arian

    2015-10-01

    Borderline personality disorder (BPD) is characterized by a pattern of intense but unstable interpersonal relationships. These interpersonal dysfunctions may originate from impaired bonding and attachment that is determined during early life. Remarkably, it has been reported that the quality of mother-infant relationship is influenced by the feeding mode. Thus, bottle feeding instead of breastfeeding and possible lack of maternal bonding-related behavior may increase the risk for later psychopathology and attachment problems as seen in BPD. A total of 100 BPD patients and 100 matched healthy controls underwent semistructured interviews, based on retrospective information about early risk factors and breastfeeding during infancy. The authors' analyses revealed that BPD patients were significantly less breastfed compared to healthy controls (no breastfeeding in BPD: 42.4%; no breastfeeding in controls: 18.2%; p < .001). The BPD diagnosis was significantly predicted by the variable "no breastfeeding" (p < .001; odds ratio [OR] = 3.32; confidence interval [CI] [1.74, 6.34]), even after adjustment for childhood trauma and several confounding factors (p = .001). The variable "no breastfeeding" accounts for 9.1% of the variance of the BPD diagnosis and is associated with low perceived maternal bonding (p = .006). Breastfeeding may act as an early indicator of the mother-infant relationship that seems to be relevant for bonding and attachment later in life.

  19. Lacking Ketohexokinase-A Exacerbates Renal Injury in Streptozotocin-induced Diabetic Mice.

    PubMed

    Doke, Tomohito; Ishimoto, Takuji; Hayasaki, Takahiro; Ikeda, Satsuki; Hasebe, Masako; Hirayama, Akiyoshi; Soga, Tomoyoshi; Kato, Noritoshi; Kosugi, Tomoki; Tsuboi, Naotake; Lanaspa, Miguel A; Johnson, Richard J; Kadomatsu, Kenji; Maruyama, Shoichi

    2018-03-28

    Ketohexokinase (KHK), a primary enzyme in fructose metabolism, has two isoforms, namely, KHK-A and KHK-C. Previously, we reported that renal injury was reduced in streptozotocin-induced diabetic mice which lacked both isoforms. Although both isoforms express in kidney, it has not been elucidated whether each isoform plays distinct roles in the development of diabetic kidney disease (DKD). The aim of the study is to elucidate the role of KHK-A for DKD progression. Diabetes was induced by five consecutive daily intraperitoneal injections of streptozotocin (50 mg/kg) in C57BL/6 J wild-type mice, mice lacking KHK-A alone (KHK-A KO), and mice lacking both KHK-A and KHK-C (KHK-A/C KO). At 35 weeks, renal injury, inflammation, hypoxia, and oxidative stress were examined. Metabolomic analysis including polyol pathway, fructose metabolism, glycolysis, TCA (tricarboxylic acid) cycle, and NAD (nicotinamide adenine dinucleotide) metabolism in kidney and urine was done. Diabetic KHK-A KO mice developed severe renal injury compared to diabetic wild-type mice, and this was associated with further increases of intrarenal fructose, dihydroxyacetone phosphate (DHAP), TCA cycle intermediates levels, and severe inflammation. In contrast, renal injury was prevented in diabetic KHK-A/C KO mice compared to both wild-type and KHK-A KO diabetic mice. Further, diabetic KHK-A KO mice contained decreased renal NAD + level with the increase of renal hypoxia-inducible factor 1-alpha expression despite having increased renal nicotinamide (NAM) level. These results suggest that KHK-C might play a deleterious role in DKD progression through endogenous fructose metabolism, and that KHK-A plays a unique protective role against the development of DKD. Copyright © 2018. Published by Elsevier Inc.

  20. Impaired growth in Rabson-Mendenhall syndrome: lack of effect of growth hormone and insulin-like growth factor-I.

    PubMed

    Longo, N; Singh, R; Griffin, L D; Langley, S D; Parks, J S; Elsas, L J

    1994-09-01

    Mutations in the insulin receptor gene cause the severe insulin-resistant syndromes leprechaunism and Rabson-Mendenhall syndrome. There is no accepted therapy for these inherited conditions. Here we report the results of recombinant human GH (rhGH) and recombinant human insulin-like growth factor-I (rhIGF-I) treatment of a male patient, Atl-2, with Rabson-Mendenhall syndrome. The patient was small for gestational age, had premature dentition, absence of sc fat, acanthosis nigricans, fasting hypoglycemia and postprandial hyperglycemia, and extremely high concentrations of circulating insulin (up to 8500 microU/mL). Fibroblasts and lymphoblasts established from this patient had reduced insulin binding, which was 20-30% of the control value. Binding of epidermal growth factor, IGF-I, and GH to the patient's fibroblasts was normal. The growth of fibroblasts cultured from patient Atl-2 in vitro was intermediate between that of fibroblasts from patients with leprechaunism and control values. The patient's growth curve in vivo was far below the fifth percentile despite adequate nutrition. To stimulate growth, therapy with rhGH was initiated, the rationale being to stimulate hepatic IGF-I production and IGF-I receptor signaling, and bypass the inherited block in insulin receptor signaling. Therapy with rhGH (up to 0.5 mg/kg.week) did not improve growth and failed to increase the levels of circulating IGF-I and IGF-binding protein-3 over a 14-month period. As rhGH could not stimulate growth, rhIGF-I (up to 100 micrograms/kg.day) was given by daily sc injection. No increase in growth velocity was observed over a 14-month period. These results indicate that both GH and IGF-I fail to correct growth in a patient with severe inherited insulin resistance. The lack of efficacy of IGF-I treatment may be related to multiple factors, such as the poor metabolic state of the patient, the deficiency of serum carrier protein for IGF-I, an increased clearance of the growth factor, IGF

  1. Henrietta Lacks, HeLa cells, and cell culture contamination.

    PubMed

    Lucey, Brendan P; Nelson-Rees, Walter A; Hutchins, Grover M

    2009-09-01

    Henrietta Lacks died in 1951 of an aggressive adenocarcinoma of the cervix. A tissue biopsy obtained for diagnostic evaluation yielded additional tissue for Dr George O. Gey's tissue culture laboratory at Johns Hopkins (Baltimore, Maryland). The cancer cells, now called HeLa cells, grew rapidly in cell culture and became the first human cell line. HeLa cells were used by researchers around the world. However, 20 years after Henrietta Lacks' death, mounting evidence suggested that HeLa cells contaminated and overgrew other cell lines. Cultures, supposedly of tissues such as breast cancer or mouse, proved to be HeLa cells. We describe the history behind the development of HeLa cells, including the first published description of Ms Lacks' autopsy, and the cell culture contamination that resulted. The debate over cell culture contamination began in the 1970s and was not harmonious. Ultimately, the problem was not resolved and it continues today. Finally, we discuss the philosophical implications of the immortal HeLa cell line.

  2. Lack of coordination between health policy and medical education: a contributing factor to the resignation of specialist trainees in Fiji?

    PubMed

    Oman, Kimberly M; Usher, Kim; Moulds, Rob

    2009-03-13

    Specialist training was established in Fiji in 1998. This study explored whether health policy, and in particular mismatches between existing policy and the new realities of local specialist training, contributed to decisions by many trainees to ultimately leave the public sectors, often to migrate. Data was collected on the whereabouts of all specialist trainees. Semi-structured interviews were carried out with 36 of 66 Fiji trainees in order to explore reasons for continuing or not completing training, as well as the reasons behind subsequent career choices. Overall, 54.5% of doctors remained in the public sectors or were temporarily overseas. Completion of specialist training was particularly associated with improved retention. Policies that contributed to frustration and sometimes resignations included a lack of transparency in the selection of doctors to enter training pathways, and unreliable career progression following completion of training. Doctors who left training before completion mentioned family stresses, which were exacerbated by delayed age at entry into training and a lack of certainty in regards to the timing of improved working conditions through career advancement. Policy adjustments to expedite entry into training, as well as to establish predictable career progression as a reward for training may increase training completions and overall retention.

  3. Analysis of vehicle classification data, including monthly and seasonal ADT factors, hourly distribution factors, and lane distribution factors

    DOT National Transportation Integrated Search

    1998-11-01

    This report documents the development of monthly and seasonal average daily traffic (ADT) factors for performing estimating AADTs. It appears that seasonal factors can estimate AADT as well as monthly factors, and it is recommended that seasonal fact...

  4. Mice lacking the conserved transcription factor Grainyhead-like 3 (Grhl3) display increased apposition of the frontal and parietal bones during embryonic development.

    PubMed

    Goldie, Stephen J; Arhatari, Benedicta D; Anderson, Peter; Auden, Alana; Partridge, Darren D; Jane, Stephen M; Dworkin, Sebastian

    2016-10-18

    Increased apposition of the frontal and parietal bones of the skull during embryogenesis may be a risk factor for the subsequent development of premature skull fusion, or craniosynostosis. Human craniosynostosis is a prevalent, and often serious embryological and neonatal pathology. Other than known mutations in a small number of contributing genes, the aetiology of craniosynostosis is largely unknown. Therefore, the identification of novel genes which contribute to normal skull patterning, morphology and premature suture apposition is imperative, in order to fully understand the genetic regulation of cranial development. Using advanced imaging techniques and quantitative measurement, we show that genetic deletion of the highly-conserved transcription factor Grainyhead-like 3 (Grhl3) in mice (Grhl3 -/- ) leads to decreased skull size, aberrant skull morphology and premature apposition of the coronal sutures during embryogenesis. Furthermore, Grhl3 -/- mice also present with premature collagen deposition and osteoblast alignment at the sutures, and the physical interaction between the developing skull, and outermost covering of the brain (the dura mater), as well as the overlying dermis and subcutaneous tissue, appears compromised in embryos lacking Grhl3. Although Grhl3 -/- mice die at birth, we investigated skull morphology and size in adult animals lacking one Grhl3 allele (heterozygous; Grhl3 +/- ), which are viable and fertile. We found that these adult mice also present with a smaller cranial cavity, suggestive of post-natal haploinsufficiency in the context of cranial development. Our findings show that our Grhl3 mice present with increased apposition of the frontal and parietal bones, suggesting that Grhl3 may be involved in the developmental pathogenesis of craniosynostosis.

  5. Default Bayes Factors for Model Selection in Regression

    ERIC Educational Resources Information Center

    Rouder, Jeffrey N.; Morey, Richard D.

    2012-01-01

    In this article, we present a Bayes factor solution for inference in multiple regression. Bayes factors are principled measures of the relative evidence from data for various models or positions, including models that embed null hypotheses. In this regard, they may be used to state positive evidence for a lack of an effect, which is not possible…

  6. Fetal circulatory responses to oxygen lack.

    PubMed

    Jensen, A; Berger, R

    1991-10-01

    The knowledge on fetal and neonatal circulatory physiology accumulated by basic scientists and clinicians over the years has contributed considerably to the recent decline of perinatal morbidity and mortality. This review will summarize the peculiarities of the fetal circulation, the distribution of organ blood flow during normoxemia, and that during oxygen lack caused by various experimental perturbations. Furthermore, the relation between oxygen delivery and tissue metabolism during oxygen lack as well as evidence to support a new concept will be presented along with the principal cardiovascular mechanisms involved. Finally, blood flow and oxygen delivery to the principal fetal organs will be examined and discussed in relation to organ function. The fetal circulatory response to hypoxemia and asphyxia is a centralization of blood flow in favour of the brain, heart, and adrenals and at the expense of almost all peripheral organs, particularly of the lungs, carcass, skin and scalp. This response is qualitatively similar but quantitatively different under various experimental conditions. However, at the nadir of severe acute asphyxia the circulatory centralization cannot be maintained. Then there is circulatory decentralization, and the fetus will experience severe brain damage if not expire unless immediate resuscitation occurs. Future work in this field will have to concentrate on the important questions, what factors determine this collapse of circulatory compensating mechanisms in the fetus, how does it relate to neuronal damage, and how can the fetal brain be pharmacologically protected against the adverse effects of asphyxia.

  7. Special Education Placement Factors for Latino Students

    ERIC Educational Resources Information Center

    Kraemer, Robert J.

    2010-01-01

    The disproportionate representation of minority students in special education programs has been a problem for over forty years. Factors contributing to minority overrepresentation include the lack of primary prevention, inappropriate language and educational assessment, over-referral of minority students for suspected learning difficulties,…

  8. Lack of effect of drinking water barium on cardiovascular risk factors.

    PubMed Central

    Wones, R G; Stadler, B L; Frohman, L A

    1990-01-01

    Higher cardiovascular mortality has been associated in a single epidemiological study with higher levels of barium in drinking water. The purpose of this study was to determine whether drinking water barium at levels found in some U.S. communities alters the known risk factors for cardiovascular disease. Eleven healthy men completed a 10-week dose-response protocol in which diet was controlled (600 mg cholesterol; 40% fat, 40% carbohydrate, 20% protein; sodium and potassium controlled at the subject's pre-protocol estimated intake). Other aspects of the subjects' lifestyles known to affect cardiac risk factors were controlled, and the barium content (as barium chloride) of the drinking water (1.5 L/day) was varied from 0 (first 2 weeks), to 5 ppm (next 4 weeks), to 10 ppm (last 4 weeks). Multiple blood and urine samples, morning and evening blood pressure measurements, and 48-hr electrocardiographic monitoring were performed at each dose of barium. There were no changes in morning or evening systolic or diastolic blood pressures, plasma cholesterol or lipoprotein or apolipoprotein levels, serum potassium or glucose levels, or urine catecholamine levels. There were no arrhythmias related to barium exposure detected on continuous electrocardiographic monitoring. A trend was seen toward increased total serum calcium levels with exposure to barium, which was of borderline statistical significance and of doubtful clinical significance. In summary, drinking water barium at levels of 5 and 10 ppm did not appear to affect any of the known modifiable cardiovascular risk factors. PMID:2384067

  9. Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping: a multilevel study in Melbourne, Victoria.

    PubMed

    Burns, Cate; Bentley, Rebecca; Thornton, Lukar; Kavanagh, Anne

    2011-06-01

    To describe associations between demographic and individual and area-level socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping. Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables. Random selection of households from fifty small areas in Melbourne, Australia, in 2003. The main food shoppers in each household (n 2564). A lack of money was significantly more likely among the young and in households with single adults. Difficulty lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower individual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficulty lifting and reduced car access. In Melbourne, households with lower individual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.

  10. The Benefits of Including Clinical Factors in Rectal Normal Tissue Complication Probability Modeling After Radiotherapy for Prostate Cancer

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

    Defraene, Gilles, E-mail: gilles.defraene@uzleuven.be; Van den Bergh, Laura; Al-Mamgani, Abrahim

    2012-03-01

    Purpose: To study the impact of clinical predisposing factors on rectal normal tissue complication probability modeling using the updated results of the Dutch prostate dose-escalation trial. Methods and Materials: Toxicity data of 512 patients (conformally treated to 68 Gy [n = 284] and 78 Gy [n = 228]) with complete follow-up at 3 years after radiotherapy were studied. Scored end points were rectal bleeding, high stool frequency, and fecal incontinence. Two traditional dose-based models (Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) and a logistic model were fitted using a maximum likelihood approach. Furthermore, these model fits were improved by including themore » most significant clinical factors. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminating ability of all fits. Results: Including clinical factors significantly increased the predictive power of the models for all end points. In the optimal LKB, RS, and logistic models for rectal bleeding and fecal incontinence, the first significant (p = 0.011-0.013) clinical factor was 'previous abdominal surgery.' As second significant (p = 0.012-0.016) factor, 'cardiac history' was included in all three rectal bleeding fits, whereas including 'diabetes' was significant (p = 0.039-0.048) in fecal incontinence modeling but only in the LKB and logistic models. High stool frequency fits only benefitted significantly (p = 0.003-0.006) from the inclusion of the baseline toxicity score. For all models rectal bleeding fits had the highest AUC (0.77) where it was 0.63 and 0.68 for high stool frequency and fecal incontinence, respectively. LKB and logistic model fits resulted in similar values for the volume parameter. The steepness parameter was somewhat higher in the logistic model, also resulting in a slightly lower D{sub 50}. Anal wall DVHs were used for fecal incontinence, whereas anorectal wall dose best described the other two endpoints. Conclusions

  11. Perceptions of prominent neighborhood individuals regarding neighborhood factors and intimate partner violence.

    PubMed

    Yonas, Michael; Akers, Aletha Y; Burke, Jessica G; Chang, Judy C; Thomas, Alicia L; Thomas, Aletha L; O'Campo, Patricia

    2011-04-01

    Research addressing the impact of neighborhood factors on intimate partner violence (IPV) often lacks discussion of how and why such factors impact IPV. In order to address this gap, 16 prominent neighborhood individuals (PNI) from 4 low-income urban neighborhoods were asked to share through in-depth interviews their insights and perceptions of IPV as an issue in their neighborhoods, and the relationship between social and structural neighborhood-level factors and IPV. PNIs most often associated IPV with only physical violence. Several did not feel IPV was a significant issue in their neighborhood, confirming a lack of awareness and underreporting of IPV. However, other PNIs were able to speak of the relationship between IPV and neighborhood factors, including lack of opportunities for employment, vacant housing, trash management, lack of community awareness, and social capacity to act to address IPV. Results provide unique insights regarding the mechanisms linking neighborhood factors to IPV outcomes. These results contribute to a deeper understanding of contextual influences upon IPV, the development of tailored quantitative research and to the design of local multi-level public health IPV intervention and prevention efforts.

  12. Lack of supervision after residential cardiac rehabilitation increases cardiovascular risk factors.

    PubMed

    Berent, Robert; von Duvillard, Serge P; Auer, Johann; Sinzinger, Helmut; Schmid, Peter

    2010-06-01

    Cardiovascular rehabilitation (CR) is an important component of care for patients with cardiovascular disease (CVD) and has been well documented and promoted by various health organizations and position statements worldwide. The purpose of this study was to investigate whether patients readmitted to CR on average 16 months after their previous discharge, maintained the reduction in CVD risk factors, maintained or improved functional capacity, occurrence of adverse cardiovascular events, and possible modifications in prescribed medications. Five hundred and seventy patients (60+/-10 years) underwent cycle ergometry and blood sampling at the beginning, the end of 21+/-2 days of the previous CR, and again at readmission to CR. The CR consisted of cycling for 17+/-4 min at frequency of six times a week and daily walking for 45 min at 60-70% of the maximal individual heart rate. Blood total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and body mass index decreased significantly during CR. Resting blood pressure, maximal performance (watts), maximal oxygen uptake, and heart rate recovery improved significantly in 1 min (P<0.001). At readmission, all traditional CVD risk factors increased significantly, although medication was unchanged and angiotensin-converting enzyme inhibitors were partly replaced by angiotensin II receptor antagonists. Exercise performance remained unchanged. At readmission, we observed an increase in CVD risk factors, although, physical fitness remained stable. Thus, failure of lifestyle modification after CR indicates the cause for concern. Reinforcement of home setting sessions of CR patients or other strategies to enhance long-term compliance to lifestyle changes could reduce the observed attrition in CR benefits.

  13. Facilitating factors and barriers to malaria research utilization for policy development in Malawi.

    PubMed

    Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M

    2016-10-19

    Research on various determinants of health is key in providing evidence for policy development, thereby leading to successful interventions. Utilization of research is an intricate process requiring an understanding of contextual factors. The study was conducted to assess enhancing factors and barriers of research utilization for malaria policy development in Malawi. Qualitative research approach was used through in-depth interviews with 39 key informants that included malaria researchers, policy makers, programme managers, and key stakeholders. Purposive sampling and snowballing techniques were used in identifying key informants. Interview transcripts were entered in QSR Nvivo 11 software for coding and analysis. Respondents identified global efforts as key in advancing knowledge translation, while local political will has been conducive for research utilization. Other factors were availability of research, availability of diverse local researchers and stakeholders supporting knowledge translation. While barriers included: lack of platforms for researcher-public engagement, politics, researchers' lack of communication skills, lack of research collaborations, funder driven research, unknown World Health Organization policy position, and the lack of a malaria research repository. Overall, the study identified facilitating factors to malaria research utilization for policy development in Malawi. These factors need to be systematically coordinated to address the identified barriers and improve on malaria research utilization in policy development. Malaria research can be key in the implementation of evidence-based interventions to reduce the malaria burden and assist in the paradigm shift from malaria control to elimination in Malawi.

  14. Risk factors of fatigue status among Chinese adolescents.

    PubMed

    Jin, Yuelong; Peng, Baozhen; Li, Yijun; Song, Lei; He, Lianping; Fu, Rui; Wu, Qianqian; Fan, Qingxiu; Yao, Yingshui

    2015-01-01

    In recent years, fatigue is common among adolescents. The aim of this study is to evaluate fatigue status and find related factors of fatigue among students ranged from 13-26 years from Wuhu, China. This is a case-control, cross-sectional observational study. The students from six middle schools (high school? 26 years old?) in Wuhu city were recruited, Self-Rating Fatigue Scale (SFS) was used to measure the fatigue status among students ranged from 13-26 years, and some demographic characteristics of students also was determined. A total of 726 students are included in our study. A significant difference was observed between fatigue status and grade, a balanced diet, the partial eclipse, picky for food, lack of sleep, excessive fatigue, drinking (P < 0.05). The risk factors of fatigue status include myopia, partial eclipse, picky for food, lacking of sleep, drinking; grade while a balanced diet is the protective factor of fatigue. Therefore, the school should pay more attention to the fatigue among students in middle school in China, and take some properly measures to reduce the fatigue.

  15. Adhesive Small Bowel Obstruction: Predictive Factors of Lack of Response in Conservative Management with Gastrografin.

    PubMed

    Bueno-Lledó, Jose; Barber, Sebastian; Vaqué, Javier; Frasson, Mateo; Garcia-Granero, Eduardo; Juan-Burgueño, Manuel

    2016-01-01

    Gastrografin represents a useful tool in the diagnosis and management of adhesive small bowel obstruction (ASBO). The aim of this study is to identify variables with negative influence in nonoperative management with gastrografin. From August 2008 to March 2013, 223 consecutive patients with 235 episodes of ASBO were included and received gastrografin. A protocol for prospective data collection was developed. In order to explore factors related to the failure of nonoperative treatment, univariate and multivariate analysis were performed. One hundred and ninety eight episodes responded to nonoperative treatment (84.2% of success) and 33 patients (15.8%) required surgical intervention. Only 3 patients of the gastrografin cohort with contrast in colon, required surgery. Predictive factors of failure of nonoperative management with gastrografin were patients aged above 65 (p = 0.01; OR 1.791, 95% CI 1.41-2.19), with a history of 2 or more previous laparotomies (p = 0.03; OR 2.91, 95% CI 2.19-3.71), and who had undergone previous abdominal surgery due to ASBO (p = 0.002; OR 1.381, 95% CI 1.10-1.79). Patient age, the number of previous laparotomies, and the fact that previous abdominal surgery was conducted due to ASBO are indicative of unsuccessful management with gastrografin. © 2015 S. Karger AG, Basel.

  16. [Factors predicting lack of adherence to highly active antiretroviral treatment].

    PubMed

    Martín-Sánchez, Vicente; Ortega-Valín, Luis; Pérez-Simón, María del Rosario; Mostaza-Fernández, José Luis; Ortiz de Urbina-González, Juan José; Rodríguez-María, Miriam; Carro-Fernández, José Antonio; Cuevas-González, María José; Alcoba-Leza, Manuel

    2002-12-01

    Knowledge of adherence to highly active antiretroviral treatment (HAART) and the variables associated with poor compliance is useful for the follow-up of HIV infected patients. Patients were consecutively recruited from the HIV outpatient clinics of the Hospitals of Leon and El Bierzo from January to June 2000. Patients were considered non-adherent to treatment if they failed to take 10% or more of their prescribed total dose of at least one drug during the 4 days before the interview, or if they had accumulated a delay of more than 9 days over the previous 3 months in picking up their prescribed drugs from the hospital pharmacy. Logistic regression analysis was performed with variables found to be associated with adherence in the univariate analysis. The methods used to determine adherence had a Kappa index of 12.6%. Among the 206 patients interviewed, 108 were considered non-adherent (52.4%; CI 95% 5 45.6-59.2). Multivariate analysis showed that the following factors were associated with poor treatment adherence: cocaine consumption in the previous six months (adjusted OR 5 5.1); patients unsure about the proper way to take prescribed treatment; (adjusted OR 5 2.5); and patients not prescribed the zidovudine-lamivudine combination (adjusted OR 5 1.9). Over one-third of patients with no variable associated with treatment adherence were considered non-compliant. Measurement of medication adherence and its predictive factors involved methodological difficulties. With the criteria used in the present study more than half the patients were considered non-compliant. The variables found to be related to poor adherence can be modified by social, psychological or health care interventions.

  17. The seed dormancy defect of Arabidopsis mutants lacking the transcript elongation factor TFIIS is caused by reduced expression of the DOG1 gene.

    PubMed

    Mortensen, Simon A; Grasser, Klaus D

    2014-01-03

    TFIIS is a transcript elongation factor that facilitates transcription by RNA polymerase II, as it assists the enzyme to bypass blocks to mRNA synthesis. Previously, we have reported that Arabidopsis plants lacking TFIIS exhibit reduced seed dormancy. Among the genes differentially expressed in tfIIs seeds, the DOG1 gene was identified that is a known QTL for seed dormancy. Here we have analysed plants that overexpress TFIIS in wild type background, or that harbour an additional copy of DOG1 in tfIIs mutant background. These experiments demonstrate that the down-regulation of DOG1 expression causes the seed dormancy phenotype of tfIIs mutants. Copyright © 2013 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  18. 7 CFR 760.614 - Lack of access.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Lack of access. 760.614 Section 760.614 Agriculture... Lack of access. In addition to other provisions for eligibility provided for in this part, the Deputy Administrator may provide assistance to participants who suffered 2008 production losses that meet the lack of...

  19. Factors associated with physical activity promotion by allied and other non-medical health professionals: A systematic review.

    PubMed

    Crisford, Paul; Winzenberg, Tania; Venn, Alison; Schultz, Martin; Aitken, Dawn; Cleland, Verity

    2018-05-21

    To identify factors associated with non-medical health professionals' engagement in physical activity (PA) promotion. Five electronic databases were searched for studies including practising health professionals (excluding medical doctors), a PA promotion practice measure, a test of association between potential influencing factors and PA promotion practice, and written in English. Two researchers independently screened studies and extracted data. Extracted data were synthesized in a tabular format with a narrative summary (thematic analysis). Thirty studies involving 7734 non-medical health professionals were included. Self-efficacy in PA promotion, positive beliefs in the benefits of PA, assessing patients' PA, and PA promotion training were the main factors associated with engaging in PA promotion. Lack of remuneration was not associated. Common study limitations included a lack of information on non-responders, data collection by survey only and limited reliability or validity testing of measurements. There are common factors influencing PA promotion, but the absence of studies from some health professions, limitations related to study measures, and the lack of randomised controlled intervention trials highlights the need for further research. The factors identified may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by health professionals. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Factors influencing health care workers’ implementation of tuberculosis contact tracing in Kweneng, Botswana

    PubMed Central

    Tlale, Lebapotswe; Frasso, Rosemary; Kgosiesele, Onalenna; Selemogo, Mpho; Mothei, Quirk; Habte, Dereje; Steenhoff, Andrew

    2016-01-01

    Introduction TB contact tracing rates remain low in high burden settings and reasons for this are not well known. We describe factors that influence health care workers' (HCW) implementation of TB contact tracing (CT) in a high TB burden district of Botswana. Methods Data were collected using questionnaires and in-depth interviews in 31 of the 52 health facilities in Kweneng East Health District. Responses were summarized using summary statistics and comparisons between HCW groups were done using parametric or non-parametric tests as per normality of the data distribution. Results One hundred and four HCWs completed questionnaires. Factors that influenced HCW TB contact tracing were their knowledge, attitudes and practices as well as personal factors including decreased motivation and lack of commitment. Patient factors included living further away from the clinic, unknown residential address and high rates of migration and mobility. Administrative factors included staff shortages, lack of transport, poor reporting of TB cases and poor medical infrastructure e.g. suboptimal laboratory services. A national HCW strike and a restructuring of the health system emerged as additional factors during in-depth interviews of TB coordinators. Conclusion Multiple factors lead to poor TB contact tracing in this district. Interventions to increase TB contact tracing will be informed by these findings. PMID:27800084

  1. Factors influencing health care workers' implementation of tuberculosis contact tracing in Kweneng, Botswana.

    PubMed

    Tlale, Lebapotswe; Frasso, Rosemary; Kgosiesele, Onalenna; Selemogo, Mpho; Mothei, Quirk; Habte, Dereje; Steenhoff, Andrew

    2016-01-01

    TB contact tracing rates remain low in high burden settings and reasons for this are not well known. We describe factors that influence health care workers' (HCW) implementation of TB contact tracing (CT) in a high TB burden district of Botswana. Data were collected using questionnaires and in-depth interviews in 31 of the 52 health facilities in Kweneng East Health District. Responses were summarized using summary statistics and comparisons between HCW groups were done using parametric or non-parametric tests as per normality of the data distribution. One hundred and four HCWs completed questionnaires. Factors that influenced HCW TB contact tracing were their knowledge, attitudes and practices as well as personal factors including decreased motivation and lack of commitment. Patient factors included living further away from the clinic, unknown residential address and high rates of migration and mobility. Administrative factors included staff shortages, lack of transport, poor reporting of TB cases and poor medical infrastructure e.g. suboptimal laboratory services. A national HCW strike and a restructuring of the health system emerged as additional factors during in-depth interviews of TB coordinators. Multiple factors lead to poor TB contact tracing in this district. Interventions to increase TB contact tracing will be informed by these findings.

  2. Factors Associated with a Lack of Knowledge of Performing Breast Self-Examination and Unawareness of Cervical Cancer Screening Services: Evidence from the 2015 Egypt Health Issues Survey

    PubMed

    Al-Rifai, Rami H.; Loney, Tom

    2017-10-26

    Background: The incidence of breast and cervical cancers is growing rapidly among Egyptian women. In this context, we assessed the prevalence of, and factors associated with the lack of knowledge among Egyptian females of performing breast self–examination (BSE) and unawareness of cervical smear cancer screening services. Methods: Secondary data analysis was performed on a representative population-based sample of 7,518 Egyptian females aged 15–59 years from the 2015 Egypt Health Issues Survey (EHIS). Crude and adjusted odds ratios (aOR) were used to explore the relationship between sociodemographic variables and having a lack of knowledge of performing BSE or unaware of cervical smear cancer screening service amongst 6,572 and 6,942 Egyptian females aged 21–59 years, respectively. Results: Mean age of females was 36.9 years with 62% aged between 21–39 years. The proportion of women with a lack of knowledge of performing BSE or who were unaware of cervical smear cancer screening service was 87.4% and 92.3%, respectively. After adjusting for potential confounding of sociodemographic and obstetric characteristics, young women aged 21–29 years (P<0.001), primary education or below (P<0.001), residing in rural areas (aOR, 1.37 and 1.48, P=0.001), accessing different media outlets “not at all or less than once a week” (aOR, 2.81 and 1.46, P≤0.05), were associated with a greater likelihood of being with lack knowledge of performing BSE or being unaware of cervical smear cancer screening services. Conclusions: In a country burdened with breast and cervical cancers, the majority of Egyptian women have a lack of knowledge on how to perform BSE or were unaware of the available cervical smear cancer screening services. Robust health campaigns are warranted to raise public knowledge of the method of BSE and of cervical smear cancer screening services, especially amongst females aged less than 30 years, with low levels of education, or those living in rural

  3. Program factors related to women's substance abuse treatment retention and other outcomes: a review and critique.

    PubMed

    Sun, An-Pyng

    2006-01-01

    This study examined program factors related to women's substance abuse treatment outcomes. Although substance abuse research is traditionally focused on men, some more recent studies target women. A systematic review of 35 empirical studies that included solely women subjects or that analyzed female subjects separately from male subjects revealed five elements related to women's substance abuse treatment effectiveness; these are (1) single- versus mixed-sex programs, (2) treatment intensity, (3) provision for child care, (4) case management and the "one-stop shopping" model, and (5) supportive staff plus the offering of individual counseling. Although all 35 studies contribute to the knowledge base, critiques of six areas of design weakness in the studies were included to provide directions for future studies; these are (1) lack of a randomized controlled design, (2) nondisentanglement of multiple conditions, (3) lack of a consistent definition for treatment factors and outcomes, (4) small sample size, (5) lack of thorough program description, and (6) lack of thorough statistical analyses.

  4. Lacking quality in research: Is behavioral neuroscience affected more than other areas of biomedical science?

    PubMed

    Bespalov, Anton; Steckler, Thomas

    2018-04-15

    There are many reasons why novel therapeutics fail in clinical trials but these failures are often attributed to lacking quality of preclinical data. These problems are not limited to any specific therapeutic area, academic or industrial research and are due in large part to several generic factors influencing research quality (e.g., related to definition of pre-specified endpoints, principles of study design and analysis, biased reporting, and lack of proper training). Yet, neuroscience drug discovery is often said to be affected more than the other fields. Within neuroscience, behavioral studies are the most blamed for being poorly designed, underpowered and mis-reported and there are indeed several factors that may be rather unique for behavioral research, such as a multitude of environmental conditions that are difficult to control and that are often not reported, ethical concerns about in vivo research and the pressure to reduce animal numbers, contributing to under-powered studies, and the complexity of study design and analysis, creating too much room for post hoc data massaging and selective reporting. Also, the blood-brain barrier as a frequently neglected complicating factor has to be considered in CNS research. The importance of these factors is increasingly recognized and urgent efforts are needed to demonstrate that behavioral methods of preclinical neuroscience research deliver results that can be as robust as with the non-behavioral methods Until this goal is achieved, behavioral neuroscience and neuroscience in general may be losing young talent, CNS drug discovery may lack the needed investment and this field may indeed be amongst the most affected by the current preclinical data quality crisis. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Risk factors for osteoarthritis and contributing factors to current arthritic pain in South Korean older adults.

    PubMed

    Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, Seung Yeol; Won, Sung Hun; Kim, Tae Gyun; Choi, Young; Kwon, Soon Sun; Kim, Yeon Ho; Park, Moon Seok

    2015-01-01

    Although previous studies have focused on risk factors for osteoarthritis, there is some debate on this issue. Furthermore, associated factors with arthritic symptom (arthralgia) have not been sufficiently investigated, despite its clinical importance in the management of osteoarthritis. This study was performed to examine the risk factors for osteoarthritis and the contributing factors to current arthritic pain in older adults. The Fourth Korean National Health and Nutrition Examination Surveys was conducted in 2009. Therein, 720 males and 1008 females aged 65 years and older were included. Comprehensive data on habitual, socioeconomic, medical, nutritional, and psychological factors were collected along with the presence of osteoarthritis and arthritic pain. After univariate analysis, binary logistic regression analysis was performed to identify risk factors for osteoarthritis and contributing factors to current arthritic pain. Age (p=0.005), female gender (p<0.001), higher body mass index (BMI) (p<0.001), and osteoporosis (p<0.001) were significant risk factors for osteoarthritis, while higher education level (p=0.025) was a protective factor for osteoarthritis. Higher BMI (p=0.047), lack of weekly moderate intensity activity (p<0.001), and unfavorable subjective health status (p<0.001) were significant factors contributing to current arthritic pain among subjects with osteoarthritis. Both osteoarthritis and current arthritic pain adversely affected health related quality of life. Higher BMI, lack of weekly moderate intensity activity, and unfavorable subjective health status were significant factors contributing to current arthritic pain. More attention needs to be paid to psychiatric effects on osteoarthritis and joint related pain.

  6. Analysing the lack of Demand Organisation

    NASA Astrophysics Data System (ADS)

    Boxer, Philip; Cohen, Bernard

    1998-07-01

    We seek to develop means of intervention in Enterprises that will enable them to react in an effective, sustainable and timely fashion to changes in the ways that markets and demand are organized; that is, to act strategically. We take an enterprise to be some entity that seeks to provide its clients with services that they value while maintaining its ability to do so in the face of changes in the demands of its clients and in the resources at its disposal. The services that clients value form around what the organization of their demands lack. The concept of strategy therefore rests on critically evaluating the ontology and semantics of the Enterprise in relation to these holes in demand organization. We access ontology and semantics by constructing and manipulating hypothetical, first-order, mathematical models of the Enterprise's services and of its value-adding processes. Because an enterprise is an anticipatory system, its semantic domain must include representations of the enterprise's model of itself and of the market and demand organizations within which it competes. First-order (set) theory provides adequate expressive power here, but alternative, higher order, mathematical frameworks, such as Dubois' hyperincursion, provide inadequate power, particularly in relation to the analysis of the properties of emergence. Knowing exactly why and where this mathematical lack manifests in the analysis process enables effective collaboration between systems analysts and psychoanalysts, and suggest directions for mathematical research.

  7. Individuals With OCD Lack Unrealistic Optimism Bias in Threat Estimation.

    PubMed

    Zetsche, Ulrike; Rief, Winfried; Exner, Cornelia

    2015-07-01

    Overestimating the occurrence of threatening events has been highlighted as a central cognitive factor in the maintenance of obsessive-compulsive disorder (OCD). The present study examined the different facets of this cognitive bias, its underlying mechanisms, and its specificity to OCD. For this purpose, threat estimation, probabilistic classification learning (PCL) and psychopathological measures were assessed in 23 participants with OCD, 30 participants with social phobia, and 31 healthy controls. Whereas healthy participants showed an optimistic expectation bias regarding positive and negative future events, OCD participants lacked such a bias. This lack of an optimistic expectation bias was not specific to OCD. Compared to healthy controls, OCD participants overestimated their personal risk for experiencing negative events, but did not differ from controls in their risk estimation regarding other people. Finally, OCD participants' biases in the prediction of checking-related events were associated with their impairments in learning probabilistic cue-outcome associations in a disorder-relevant context. In sum, the present results add to a growing body of research demonstrating that cognitive biases in OCD are context-dependent. Copyright © 2015. Published by Elsevier Ltd.

  8. Factors affecting cardiac rehabilitation referral by physician specialty.

    PubMed

    Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

    2008-01-01

    Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P < .001), lack of standardized referral forms (P < .001), inconvenience (P = .04), program quality (P = .004), and lack of discharge communication from CR (P = .001) as factors negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P < .001). Where differences emerged, primary care physicians were more likely to perceive factors that would impede CR referral, some of which are modifiable. Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

  9. Sexual harassment: identifying risk factors.

    PubMed

    O'Hare, E A; O'Donohue, W

    1998-12-01

    A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.

  10. An Exploration of Factors Influencing Effective Teachers' Decisions to Remain in Urban School Settings

    ERIC Educational Resources Information Center

    Grizzle, Alison L.

    2010-01-01

    Existing problems identified in the literature on teacher retention and resilience include (a) a gap in understanding factors influencing urban teacher retention; (b) lack of clarity on multiple factors swaying teachers' decisions to remain despite challenges; (c) overlapping definitions of teacher retention, attrition, and resilience; and (d)…

  11. Jumping to Conclusions, a Lack of Belief Flexibility and Delusional Conviction in Psychosis

    PubMed Central

    So, Suzanne H.; Freeman, Daniel; Dunn, Graham; Kapur, Shitij; Kuipers, Elizabeth; Bebbington, Paul; Fowler, David; Garety, Philippa A.

    2012-01-01

    Two reasoning biases, jumping to conclusions (JTC) and belief inflexibility, have been found to be associated with delusions. We examined these biases and their relationship with delusional conviction in a longitudinal cohort of people with schizophrenia-spectrum psychosis. We hypothesized that JTC, lack of belief flexibility, and delusional conviction would form distinct factors, and that JTC and lack of belief flexibility would predict less change in delusional conviction over time. Two hundred seventy-three patients with delusions were assessed over twelve months of a treatment trial (Garety et al., 2008). Forty-one percent of the sample had 100% conviction in their delusions, 50% showed a JTC bias, and 50%–75% showed a lack of belief flexibility. Delusional conviction, JTC, and belief flexibility formed distinct factors although conviction was negatively correlated with belief flexibility. Conviction declined slightly over the year in this established psychosis group, whereas the reasoning biases were stable. There was little evidence that reasoning predicted the slight decline in conviction. The degree to which people believe their delusions, their ability to think that they may be mistaken and to consider alternative explanations, and their hastiness in decision making are three distinct processes although belief flexibility and conviction are related. In this established psychosis sample, reasoning biases changed little in response to medication or psychological therapy. Required now is examination of these processes in psychosis groups where there is greater change in delusion conviction, as well as tests of the effects on delusions when these reasoning biases are specifically targeted. PMID:21910515

  12. Violence against women in Pakistan: contributing factors and new interventions.

    PubMed

    Karmaliani, Rozina; Pasha, Aneeta; Hirani, Saima; Somani, Rozina; Hirani, Shela; Asad, Nargis; Cassum, Laila; McFarlane, Judith

    2012-12-01

    Pakistan ranks 125th out of 169 countries on the Gender Development Index and has high prevalence rates of Violence against Women (VAW). Contributing factors toward gender based violence at the micro, meso and macro levels include the acceptability of violence amongst both men and women, internalization of deservability, economic disempowerment, lack of formal education, joint family systems, entrenched patriarchal norms and values, and a lack of awareness of legal and other support systems. These factors have a long-lasting impact on the health of women and children. The gender disparities in the experience of women seeking health care in Pakistan are well-recognized and documented. In the past, common government policy responses to these disparities have included developing the role of community health workers (CHWs) and lady health visitors (LHVs). Despite being commendable initiatives, these too have been unsuccessful in addressing these multi-faceted disparities. Within this complex scenario, new interventions to address VAW and its impact on health in Pakistan include Group Counselling, Economic Skills Building, Health-Based Microfinance, and Family-Based models that increase male involvement, especially at the primary health care level. The purpose of this article is to outline key contributing factors to VAW, explore tested and new interventions, and highlight the opportunities that exist in implementing them.

  13. The lack of theoretical support for using person trade-offs in QALY-type models.

    PubMed

    Østerdal, Lars Peter

    2009-10-01

    Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.

  14. Broad Detection of Alterations Predicted to Confer Lack of Benefit From EGFR Antibodies or Sensitivity to Targeted Therapy in Advanced Colorectal Cancer.

    PubMed

    Rankin, Andrew; Klempner, Samuel J; Erlich, Rachel; Sun, James X; Grothey, Axel; Fakih, Marwan; George, Thomas J; Lee, Jeeyun; Ross, Jeffrey S; Stephens, Philip J; Miller, Vincent A; Ali, Siraj M; Schrock, Alexa B

    2016-09-28

    A KRAS mutation represented the first genomic biomarker to predict lack of benefit from anti-epidermal growth factor receptor (EGFR) antibody therapy in advanced colorectal cancer (CRC). Expanded RAS testing has further refined the treatment approach, but understanding of genomic alterations underlying primary and acquired resistance is limited and further study is needed. We prospectively analyzed 4,422 clinical samples from patients with advanced CRC, using hybrid-capture based comprehensive genomic profiling (CGP) at the request of the individual treating physicians. Comparison with prior molecular testing results, when available, was performed to assess concordance. We identified a RAS/RAF pathway mutation or amplification in 62% of cases, including samples harboring KRAS mutations outside of the codon 12/13 hotspot region in 6.4% of cases. Among cases with KRAS non-codon 12/13 alterations for which prior test results were available, 79 of 90 (88%) were not identified by focused testing. Of 1,644 RAS/RAF wild-type cases analyzed by CGP, 31% harbored a genomic alteration (GA) associated with resistance to anti-EGFR therapy in advanced CRC including mutations in PIK3CA, PTEN, EGFR, and ERBB2. We also identified other targetable GA, including novel kinase fusions, receptor tyrosine kinase amplification, activating point mutations, as well as microsatellite instability. Extended genomic profiling reliably detects alterations associated with lack of benefit to anti-EGFR therapy in advanced CRC, while simultaneously identifying alterations potentially important in guiding treatment. The use of CGP during the course of clinical care allows for the refined selection of appropriate targeted therapies and clinical trials, increasing the chance of clinical benefit and avoiding therapeutic futility. Comprehensive genomic profiling (CGP) detects diverse genomic alterations associated with lack of benefit to anti-epidermal growth factor receptor therapy in advanced

  15. A Survey of Women's Awareness of and Reasons for Lack of Postfracture Osteoporotic Care.

    PubMed

    Boudreau, Denise M; Yu, Onchee; Balasubramanian, Akhila; Wirtz, Heidi; Grauer, Andreas; Crittenden, Daria B; Scholes, Delia

    2017-08-01

    To identify women's beliefs and other factors associated with lack of osteoporosis (OP) pharmacotherapy (OP-RX) during the 6 months after a fragility fracture, including the woman's perspective on fracture risk, OP, and treatment. Cross-sectional. Group Health Cooperative, a mixed-model delivery system. Female Group Health Cooperative enrollees aged 55 and older with an OP-related fracture according to diagnostic and procedure codes from January 1, 2013, to March 30, 2014 (N = 985). OP-RX and participant characteristics were ascertained from electronic health records including medications dispensed. A mailed survey was used to obtain data on health behaviors; OP-related history; concern about, knowledge of, and perceived risk of future fracture; beliefs about OP-RX; sources of information on OP; postfracture discussions with providers; and provider recommendations. The response rate was 73%. Of 634 eligible respondents, 84% did not undergo OP-RX during the 6 months after fracture. Fewer than 20% of women thought that OP caused their fracture, 52% did not think they were at risk of future fracture, and 75% did not think or know whether OP-RX reduces risk of fracture. Knowledge about OP and the benefits of treatment was higher in the 16% of women who underwent OP-RX after their fracture. Women reported low levels of engagement with their healthcare providers regarding OP and fracture risk management. These findings suggest low awareness about OP and its contribution to fracture risk, lack of understanding about the benefits of pharmacotherapy, and limited discussion about OP with primary care physicians. Information about individual's beliefs and knowledge gaps can help design targeted patient and provider education to improve treatment rates. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  16. Lack of reliability in the disruption of cognitive performance following exposure to protons.

    PubMed

    Rabin, Bernard M; Heroux, Nicholas A; Shukitt-Hale, Barbara; Carrihill-Knoll, Kirsty L; Beck, Zachary; Baxter, Chelsea

    2015-08-01

    A series of three replications were run to determine the reliability with which exposure to protons produces a disruption of cognitive performance, using a novel object recognition task and operant responding on an ascending fixed-ratio task. For the first two replications, rats were exposed to head-only exposures to 1000 MeV/n protons at the NASA Space Radiation Laboratory. For the third replication, subjects were given head-only or whole-body exposures to both 1000 and 150 MeV/n protons. The results were characterized by a lack of consistency in the effects of exposure to protons on the performance of these cognitive tasks, both within and between replications. The factors that might influence the lack of consistency and the implications for exploratory class missions are discussed.

  17. Male and Female Mice Lacking Neuroligin-3 Modify the Behavior of Their Wild-Type Littermates.

    PubMed

    Kalbassi, Shireene; Bachmann, Sven O; Cross, Ellen; Roberton, Victoria H; Baudouin, Stéphane J

    2017-01-01

    In most mammals, including humans, the postnatal acquisition of normal social and nonsocial behavior critically depends on interactions with peers. Here we explore the possibility that mixed-group housing of mice carrying a deletion of Nlgn3 , a gene associated with autism spectrum disorders, and their wild-type littermates induces changes in each other's behavior. We have found that, when raised together, male Nlgn3 knockout mice and their wild-type littermates displayed deficits in sociability. Moreover, social submission in adult male Nlgn3 knockout mice correlated with an increase in their anxiety. Re-expression of Nlgn3 in parvalbumin-expressing cells in transgenic animals rescued their social behavior and alleviated the phenotype of their wild-type littermates, further indicating that the social behavior of Nlgn3 knockout mice has a direct and measurable impact on wild-type animals' behavior. Finally, we showed that, unlike male mice, female mice lacking Nlgn3 were insensitive to their peers' behavior but modified the social behavior of their littermates. Altogether, our findings show that the environment is a critical factor in the development of behavioral phenotypes in transgenic and wild-type mice. In addition, these results reveal that the social environment has a sexually dimorphic effect on the behavior of mice lacking Nlgn3 , being more influential in males than females.

  18. Male and Female Mice Lacking Neuroligin-3 Modify the Behavior of Their Wild-Type Littermates

    PubMed Central

    Kalbassi, Shireene; Cross, Ellen

    2017-01-01

    Abstract In most mammals, including humans, the postnatal acquisition of normal social and nonsocial behavior critically depends on interactions with peers. Here we explore the possibility that mixed-group housing of mice carrying a deletion of Nlgn3, a gene associated with autism spectrum disorders, and their wild-type littermates induces changes in each other’s behavior. We have found that, when raised together, male Nlgn3 knockout mice and their wild-type littermates displayed deficits in sociability. Moreover, social submission in adult male Nlgn3 knockout mice correlated with an increase in their anxiety. Re-expression of Nlgn3 in parvalbumin-expressing cells in transgenic animals rescued their social behavior and alleviated the phenotype of their wild-type littermates, further indicating that the social behavior of Nlgn3 knockout mice has a direct and measurable impact on wild-type animals’ behavior. Finally, we showed that, unlike male mice, female mice lacking Nlgn3 were insensitive to their peers’ behavior but modified the social behavior of their littermates. Altogether, our findings show that the environment is a critical factor in the development of behavioral phenotypes in transgenic and wild-type mice. In addition, these results reveal that the social environment has a sexually dimorphic effect on the behavior of mice lacking Nlgn3, being more influential in males than females. PMID:28795135

  19. Children and adolescents' internal models of food-sharing behavior include complex evaluations of contextual factors.

    PubMed

    Markovits, Henry; Benenson, Joyce F; Kramer, Donald L

    2003-01-01

    This study examined internal representations of food sharing in 589 children and adolescents (8-19 years of age). Questionnaires, depicting a variety of contexts in which one person was asked to share a resource with another, were used to examine participants' expectations of food-sharing behavior. Factors that were varied included the value of the resource, the relation between the two depicted actors, the quality of this relation, and gender. Results indicate that internal models of food-sharing behavior showed systematic patterns of variation, demonstrating that individuals have complex contextually based internal models at all ages, including the youngest. Examination of developmental changes in use of individual patterns is consistent with the idea that internal models reflect age-specific patterns of interactions while undergoing a process of progressive consolidation.

  20. Spdef Null Mice Lack Conjunctival Goblet Cells and Provide a Model of Dry Eye

    PubMed Central

    Marko, Christina K.; Menon, Balaraj B.; Chen, Gang; Whitsett, Jeffrey A.; Clevers, Hans; Gipson, Ilene K.

    2014-01-01

    Goblet cell numbers decrease within the conjunctival epithelium in drying and cicatrizing ocular surface diseases. Factors regulating goblet cell differentiation in conjunctival epithelium are unknown. Recent data indicate that the transcription factor SAM-pointed domain epithelial-specific transcription factor (Spdef) is essential for goblet cell differentiation in tracheobronchial and gastrointestinal epithelium of mice. Using Spdef−/− mice, we determined that Spdef is required for conjunctival goblet cell differentiation and that Spdef−/− mice, which lack conjunctival goblet cells, have significantly increased corneal surface fluorescein staining and tear volume, a phenotype consistent with dry eye. Microarray analysis of conjunctival epithelium in Spdef−/− mice revealed down-regulation of goblet cell–specific genes (Muc5ac, Tff1, Gcnt3). Up-regulated genes included epithelial cell differentiation/keratinization genes (Sprr2h, Tgm1) and proinflammatory genes (Il1-α, Il-1β, Tnf-α), all of which are up-regulated in dry eye. Interestingly, four Wnt pathway genes were down-regulated. SPDEF expression was significantly decreased in the conjunctival epithelium of Sjögren syndrome patients with dry eye and decreased goblet cell mucin expression. These data demonstrate that Spdef is required for conjunctival goblet cell differentiation and down-regulation of SPDEF may play a role in human dry eye with goblet cell loss. Spdef−/− mice have an ocular surface phenotype similar to that in moderate dry eye, providing a new, more convenient model for the disease. PMID:23665202

  1. Diagnostic utility of hepatocyte nuclear factor 1-beta immunoreactivity in endometrial carcinomas: lack of specificity for endometrial clear cell carcinoma.

    PubMed

    Fadare, Oluwole; Liang, Sharon X

    2012-12-01

    Hepatocyte nuclear factor 1-beta (HNF1β) has recently emerged as a relatively sensitive and specific marker for ovarian clear cell carcinoma. The purpose of this study is to assess the diagnostic utility of this marker for endometrial clear cell carcinoma. Immunohistochemical analysis was performed on 75 endometrial tissues using a goat polyclonal antibody raised against a peptide mapping at the C-terminus of human HNF1β protein. The 75 cases included 15 clear cell carcinomas, 20 endometrioid carcinomas, 15 endometrial serous carcinomas/uterine papillary serous carcinomas, 20 cases of normal endometrium, 2 cases of clear cell metaplasia, and 3 cases of Arias Stella reaction. Staining interpretations were based on a semiquantitative scoring system, a 0 to 12+ continuous numerical scale that was derived by multiplying the extent of staining (0 to 4+ scale) by the intensity of staining (0 to 3+ scale) for each case. HNF1β expression was found to be present in a wide spectrum of tissues. Twenty-seven (54%) of the 50 carcinomas displayed at least focal nuclear HNF1β expression, including 11 (73%) of 15, 9 (60%) of 15, and 7 (35%) of 20 clear cell, serous, and endometrioid carcinomas, respectively. The average nuclear staining scores for clear cell carcinomas, endometrioid carcinomas, and serous carcinomas were 5.2, 1.4, and 4.1, respectively. Clear cell carcinomas and endometrioid carcinomas displayed statistically significant differences regarding their nuclear staining scores (P = 0.0027), but clear cell carcinomas and endometrial serous carcinomas did not (P = 0.45). The calculated sensitivity of any nuclear HNF1β expression in classifying a carcinoma as being of the clear cell histotype was 73%, whereas the specificity was 54%. Nineteen of 20 normal endometrium samples displayed at least focal nuclear expression of HNF1β, and this expression was often diffuse. The 5 cases of benign histologic mimics of clear cell carcinomas (Arias Stella reaction and clear

  2. Barriers to Faculty Pedagogical Change: Lack of Training, Time, Incentives, and. . .Tensions with Professional Identity?

    ERIC Educational Resources Information Center

    Brownell, Sara E.; Tanner, Kimberly D.

    2012-01-01

    A substantial body of literature has highlighted many factors that impede faculty change, the most common of which are a lack of training, time, and incentives. However, there may be other barriers--unacknowledged and unexamined barriers--that might prove to be equally important. In particular, the tensions between a scientist's professional…

  3. Mesenchymal stem cell therapy ameliorates diabetic nephropathy via the paracrine effect of renal trophic factors including exosomes

    PubMed Central

    Nagaishi, Kanna; Mizue, Yuka; Chikenji, Takako; Otani, Miho; Nakano, Masako; Konari, Naoto; Fujimiya, Mineko

    2016-01-01

    Bone marrow-derived mesenchymal stem cells (MSCs) have contributed to the improvement of diabetic nephropathy (DN); however, the actual mediator of this effect and its role has not been characterized thoroughly. We investigated the effects of MSC therapy on DN, focusing on the paracrine effect of renal trophic factors, including exosomes secreted by MSCs. MSCs and MSC-conditioned medium (MSC-CM) as renal trophic factors were administered in parallel to high-fat diet (HFD)-induced type 2 diabetic mice and streptozotocin (STZ)-induced insulin-deficient diabetic mice. Both therapies showed approximately equivalent curative effects, as each inhibited the exacerbation of albuminuria. They also suppressed the excessive infiltration of BMDCs into the kidney by regulating the expression of the adhesion molecule ICAM-1. Proinflammatory cytokine expression (e.g., TNF-α) and fibrosis in tubular interstitium were inhibited. TGF-β1 expression was down-regulated and tight junction protein expression (e.g., ZO-1) was maintained, which sequentially suppressed the epithelial-to-mesenchymal transition of tubular epithelial cells (TECs). Exosomes purified from MSC-CM exerted an anti-apoptotic effect and protected tight junction structure in TECs. The increase of glomerular mesangium substrate was inhibited in HFD-diabetic mice. MSC therapy is a promising tool to prevent DN via the paracrine effect of renal trophic factors including exosomes due to its multifactorial action. PMID:27721418

  4. The yeast rapid tRNA decay pathway competes with elongation factor 1A for substrate tRNAs and acts on tRNAs lacking one or more of several modifications.

    PubMed

    Dewe, Joshua M; Whipple, Joseph M; Chernyakov, Irina; Jaramillo, Laura N; Phizicky, Eric M

    2012-10-01

    The structural and functional integrity of tRNA is crucial for translation. In the yeast Saccharomyces cerevisiae, certain aberrant pre-tRNA species are subject to nuclear surveillance, leading to 3' exonucleolytic degradation, and certain mature tRNA species are subject to rapid tRNA decay (RTD) if they are appropriately hypomodified or bear specific destabilizing mutations, leading to 5'-3' exonucleolytic degradation by Rat1 and Xrn1. Thus, trm8-Δ trm4-Δ strains are temperature sensitive due to lack of m(7)G(46) and m(5)C and the consequent RTD of tRNA(Val(AAC)), and tan1-Δ trm44-Δ strains are temperature sensitive due to lack of ac(4)C(12) and Um(44) and the consequent RTD of tRNA(Ser(CGA)) and tRNA(Ser(UGA)). It is unknown how the RTD pathway interacts with translation and other cellular processes, and how generally this pathway acts on hypomodified tRNAs. We provide evidence here that elongation factor 1A (EF-1A) competes with the RTD pathway for substrate tRNAs, since its overexpression suppresses the tRNA degradation and the growth defect of strains subject to RTD, whereas reduced levels of EF-1A have the opposite effect. We also provide evidence that RTD acts on a variety of tRNAs lacking one or more different modifications, since trm1-Δ trm4-Δ mutants are subject to RTD of tRNA(Ser(CGA)) and tRNA(Ser(UGA)) due to lack of m(2,2)G(26) and m(5)C, and since trm8-Δ, tan1-Δ, and trm1-Δ single mutants are each subject to RTD. These results demonstrate that RTD interacts with the translation machinery and acts widely on hypomodified tRNAs.

  5. Factors influencing nurses' job satisfaction in selected private hospitals in England.

    PubMed

    Lephalala, R P; Ehlers, V J; Oosthuizen, M J

    2008-09-01

    The quantitative descriptive survey used self-completion questionnaires to study factors influencing nurses' job satisfaction in selected private hospitals in England. Herzberg's Theory of Motivation was used to contextualise the results obtained from 85 completed questionnaires. In terms of Herzberg's Theory of Motivation, the most important extrinsic (hygiene) factor was no satisfaction with their salaries compared to nurses' salaries in other private hospitals in England, in the NHS and even at their own hospitals. However, most nurses were satisfied with the other extrinsic factors (organisation and administration policies, supervision and interpersonal relations). The most important intrinsic factors (motivators), influencing nurses' job satisfaction was their lack of satisfaction with promotions (including the fact that their qualifications were reportedly not considered for promotions), lack of advancement opportunities and being in dead-end jobs, and lack of involvement in decision- and policy-making activities. Nurses' levels of job satisfaction might be enhanced if promotion policies could be consistent, advancement opportunities implemented, qualifications considered for promotions, salary issues clarified, and if nurses could be involved in decision- and policy-making. Enhanced levels of job satisfaction could help to reduce turnover rates among registered nurses at the private hospitals in England that participated in this study.

  6. Lack of Set Theory Relevant Prerequisite Knowledge

    ERIC Educational Resources Information Center

    Dogan-Dunlap, Hamide

    2006-01-01

    Many students struggle with college mathematics topics due to a lack of mastery of prerequisite knowledge. Set theory language is one such prerequisite for linear algebra courses. Many students' mistakes on linear algebra questions reveal a lack of mastery of set theory knowledge. This paper reports the findings of a qualitative analysis of a…

  7. Fever in trauma patients: evaluation of risk factors, including traumatic brain injury.

    PubMed

    Bengualid, Victoria; Talari, Goutham; Rubin, David; Albaeni, Aiham; Ciubotaru, Ronald L; Berger, Judith

    2015-03-01

    The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. To determine whether (1) fever in the first 48 hours is related to a favorable outcome in trauma patients and (2) fever is more common in patients with head trauma. Retrospective study of trauma patients admitted to the intensive care unit for at least 2 days. Data were analyzed by using multivariate analysis. Of 162 patients studied, 40% had fever during the first 48 hours. Febrile patients had higher mortality rates than did afebrile patients. When adjusted for severity of injuries, fever did not correlate with mortality. Neither the incidence of fever in the first 48 hours after admission to the intensive care unit nor the number of days febrile in the unit differed between patients with and patients without head trauma (traumatic brain injury). About 70% of febrile patients did not have a source found for their fever. Febrile patients without an identified source of infection had lower peak white blood cell counts, lower maximum body temperature, and higher minimum platelet counts than did febrile patients who had an infectious source identified. The most common infection was pneumonia. No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients. ©2015 American Association of Critical-Care Nurses.

  8. Human Factors in Patient Safety as an Innovation

    PubMed Central

    Carayon, Pascale

    2010-01-01

    The use of Human Factors and Ergonomics (HFE) tools, methods, concepts and theories has been advocated by many experts and organizations to improve patient safety. To facilitate and support the spread of HFE knowledge and skills in health care and patient safety, we propose to conceptualize HFE as innovations whose diffusion, dissemination, implementation and sustainability need to be understood and specified. Using Greenhalgh et al. (2004) model of innovation, we identified various factors that can either hinder or facilitate the spread of HFE innovations in healthcare organizations. Barriers include lack of systems thinking, complexity of HFE innovations and lack of understanding about the benefits of HFE innovations. Positive impact of HFE interventions on task performance and the presence of local champions can facilitate the adoption, implementation and sustainability of HFE innovations. This analysis concludes with a series of recommendations for HFE professionals, researchers and educators. PMID:20106468

  9. Underlying risk factors for prescribing errors in long-term aged care: a qualitative study.

    PubMed

    Tariq, Amina; Georgiou, Andrew; Raban, Magdalena; Baysari, Melissa Therese; Westbrook, Johanna

    2016-09-01

    To identify system-related risk factors perceived to contribute to prescribing errors in Australian long-term care settings, that is, residential aged care facilities (RACFs). The study used qualitative methods to explore factors that contribute to unsafe prescribing in RACFs. Data were collected at three RACFs in metropolitan Sydney, Australia between May and November 2011. Participants included RACF managers, doctors, pharmacists and RACF staff actively involved in prescribing-related processes. Methods included non-participant observations (74 h), in-depth semistructured interviews (n=25) and artefact analysis. Detailed process activity models were developed for observed prescribing episodes supplemented by triangulated analysis using content analysis methods. System-related factors perceived to increase the risk of prescribing errors in RACFs were classified into three overarching themes: communication systems, team coordination and staff management. Factors associated with communication systems included limited point-of-care access to information, inadequate handovers, information storage across different media (paper, electronic and memory), poor legibility of charts, information double handling, multiple faxing of medication charts and reliance on manual chart reviews. Team factors included lack of established lines of responsibility, inadequate team communication and limited participation of doctors in multidisciplinary initiatives like medication advisory committee meetings. Factors related to staff management and workload included doctors' time constraints and their accessibility, lack of trained RACF staff and high RACF staff turnover. The study highlights several system-related factors including laborious methods for exchanging medication information, which often act together to contribute to prescribing errors. Multiple interventions (eg, technology systems, team communication protocols) are required to support the collaborative nature of RACF

  10. [Factors influencing self-perception of overweight people].

    PubMed

    Makara-Studzińska, Marta; Podstawka, Danuta; Goclon, Karolina

    2013-11-01

    Shaping of self-perception is among others influenced by physical, interpersonal, emotional, and cultural factors. In self-perception of overweight people an important role is played by interpersonal factors, which include the opinions of others and the relationship with the surrounding. The evaluation of the body image is also affect by sociocultural factors including the media, which create an unrealistic and impossible to achieve ideal of beauty. Contemporary ideal of beauty, where a slim figure is dominant, more frequently contributes to the occurrence of discrimination and stigmatization of overweight people. This phenomenon causes negative self-perception leading to the occurrence of such emotional problems as low self-esteem, lack of confidence, depression and anxiety disorders. Overweight children and adolescents are also frequently stigmatized and discriminated because of their body weight, which results in the development of a negative body image that may lead to low self-esteem and symptoms of depression.

  11. Growth factor independence-1 (Gfi-1) plays a role in mediating specific granule deficiency (SGD) in a patient lacking a gene-inactivating mutation in the C/EBPϵ gene

    PubMed Central

    Khanna-Gupta, Arati; Sun, Hong; Zibello, Theresa; Lee, Han Myung; Dahl, Richard; Boxer, Laurence A.

    2007-01-01

    Neutrophil-specific granule deficiency (SGD) is a rare congenital disorder marked by recurrent bacterial infections. Neutrophils from SGD patients lack secondary and tertiary granules and their content proteins and lack normal neutrophil functions. Gene-inactivating mutations in the C/EBPϵ gene have been identified in 2 SGD patients. Our studies on a third SGD patient revealed a heterozygous mutation in the C/EBPϵ gene. However, we demonstrate elevated levels of C/EBPϵ and PU.1 proteins in the patient's peripheral blood neutrophils. The expression of the transcription factor growth factor independence-1 (Gfi-1), however, was found to be markedly reduced in our SGD patient despite the absence of an obvious mutation in this gene. This may explain the elevated levels of both C/EBPϵ and PU.1, which are targets of Gfi-1 transcriptional repression. We have generated a growth factor–dependent EML cell line from the bone marrow of Gfi-1+/− and Gfi-1+/+ mice as a model for Gfi-1–deficient SGD, and demonstrate that lower levels of Gfi-1 expression in the Gfi-1+/− EML cells is associated with reduced levels of secondary granule protein (SGP) gene expression. Furthermore, we demonstrate a positive role for Gfi-1 in SGP expression, in that Gfi-1 binds to and up-regulates the promoter of neutrophil collagenase (an SGP gene), in cooperation with wild-type but not with mutant C/EBPϵ. We hypothesize that decreased Gfi-1 levels in our SGD patient, together with the mutant C/EBPϵ, block SGP expression, thereby contributing to the underlying etiology of the disease in our patient. PMID:17244686

  12. Environmental, policy, and cultural factors related to physical activity among rural, African American women.

    PubMed

    Sanderson, Bonnie; Littleton, MaryAnn; Pulley, LeaVonne

    2002-01-01

    Sixty-one African American women (ages 20-50 years) from a rural community in Alabama participated in six focus groups. Barriers to and enablers of physical activity were identified and grouped into personal, environmental (social and physical), policy, and cultural themes for qualitative analyses. Personal factors included motivation, perceived health, feeling tired, and lack of time; social environmental factors included support from friends, family, and issues related to child care; physical environmental factors included weather, access to facilities, availability of sidewalks or other places to walk; policy factors included personal safety concerns (loose dogs, traffic, etc.) and inflexible work environments. Some, but not all, women perceived cultural differences as a factor affecting physical activity levels. Differences in socioeconomic levels and time demands among women of different cultures were identified as factors that may influence physical activity. Participants provided suggestions for community-based physical activity interventions using an environmental approach.

  13. Model of a ternary complex between activated factor VII, tissue factor and factor IX.

    PubMed

    Chen, Shu-wen W; Pellequer, Jean-Luc; Schved, Jean-François; Giansily-Blaizot, Muriel

    2002-07-01

    Upon binding to tissue factor, FVIIa triggers coagulation by activating vitamin K-dependent zymogens, factor IX (FIX) and factor X (FX). To understand recognition mechanisms in the initiation step of the coagulation cascade, we present a three-dimensional model of the ternary complex between FVIIa:TF:FIX. This model was built using a full-space search algorithm in combination with computational graphics. With the known crystallographic complex FVIIa:TF kept fixed, the FIX docking was performed first with FIX Gla-EGF1 domains, followed by the FIX protease/EGF2 domains. Because the FIXa crystal structure lacks electron density for the Gla domain, we constructed a chimeric FIX molecule that contains the Gla-EGF1 domains of FVIIa and the EGF2-protease domains of FIXa. The FVIIa:TF:FIX complex has been extensively challenged against experimental data including site-directed mutagenesis, inhibitory peptide data, haemophilia B database mutations, inhibitor antibodies and a novel exosite binding inhibitor peptide. This FVIIa:TF:FIX complex provides a powerful tool to study the regulation of FVIIa production and presents new avenues for developing therapeutic inhibitory compounds of FVIIa:TF:substrate complex.

  14. A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus

    PubMed Central

    Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z

    2014-01-01

    Objectives To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. Design A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. Data sources We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Review methods Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. Results The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). Conclusions MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients’ perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. PMID:25239295

  15. Spdef null mice lack conjunctival goblet cells and provide a model of dry eye.

    PubMed

    Marko, Christina K; Menon, Balaraj B; Chen, Gang; Whitsett, Jeffrey A; Clevers, Hans; Gipson, Ilene K

    2013-07-01

    Goblet cell numbers decrease within the conjunctival epithelium in drying and cicatrizing ocular surface diseases. Factors regulating goblet cell differentiation in conjunctival epithelium are unknown. Recent data indicate that the transcription factor SAM-pointed domain epithelial-specific transcription factor (Spdef) is essential for goblet cell differentiation in tracheobronchial and gastrointestinal epithelium of mice. Using Spdef(-/-) mice, we determined that Spdef is required for conjunctival goblet cell differentiation and that Spdef(-/-) mice, which lack conjunctival goblet cells, have significantly increased corneal surface fluorescein staining and tear volume, a phenotype consistent with dry eye. Microarray analysis of conjunctival epithelium in Spdef(-/-) mice revealed down-regulation of goblet cell-specific genes (Muc5ac, Tff1, Gcnt3). Up-regulated genes included epithelial cell differentiation/keratinization genes (Sprr2h, Tgm1) and proinflammatory genes (Il1-α, Il-1β, Tnf-α), all of which are up-regulated in dry eye. Interestingly, four Wnt pathway genes were down-regulated. SPDEF expression was significantly decreased in the conjunctival epithelium of Sjögren syndrome patients with dry eye and decreased goblet cell mucin expression. These data demonstrate that Spdef is required for conjunctival goblet cell differentiation and down-regulation of SPDEF may play a role in human dry eye with goblet cell loss. Spdef(-/-) mice have an ocular surface phenotype similar to that in moderate dry eye, providing a new, more convenient model for the disease. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  16. Modifiable risk factors including sunlight exposure and fish consumption are associated with risk of hypertension in a large representative population from Macau.

    PubMed

    Ke, Liang; Ho, Jacky; Feng, Jianzhang; Mpofu, Elias; Dibley, Michael J; Feng, Xiuhua; Van, Florance; Leong, Sokman; Lau, Winne; Lueng, Petra; Kowk, Carrie; Li, Yan; Mason, Rebecca S; Brock, Kaye E

    2014-10-01

    Chinese populations are known to be at risk for vitamin D deficiency, with some evidence that this is due to lack of exposure to sunlight. Vitamin D deficiency and/or low sun exposure have been associated with higher incidence of hypertension in Caucasians. Thus, we investigated these associations in a Chinese population with a high rate of hypertension. From a random household survey of 1410 residents aged ≥18 years, height, weight and blood pressure were measured and demographic, exercise and dietary data were collected, as well as estimated hours of sunlight exposure on weekdays and weekends (in winter and summer). Modifiable predictors of hypertension in these data were lack of sunlight exposure and low intake of fish as well as smoking, obesity and lack of exercise. When investigated in a linear model, sunlight exposure was negatively associated with hypertension (β=-0.072, p<0.001) as was physical activity (β=-0.021, p<0.001) and fish consumption (β=-0.177, p<0.001). In contrast body mass index (weight/height(2)) was positively associated with hypertension (β=+0.62, p<0.001), as were pack-years of smoking (β=+0.27, p<0.001). On multivariate categorical analysis taking into account demographic risk factors in these data (age, gender and occupation) having more than half an hour's sun exposure per day compared to none was associated with less hypertension (OR=0.6, 95% CI: 0.4-0.8). Similarly, consuming either oily fish or seafood more than four times per week compared to less was also associated with less hypertension (oily fish (OR=0.4, 95% CI: 0.3-0.5); seafood consumption (OR=0.8, 95% CI: 0.7-0.9)). Having daily moderate physical activity compared to none was also associated with a lower risk of hypertension (OR=0.8, 95% CI: 0.7-0.9). In contrast, being obese compared to normal weight and having more than five pack-years of smoking compared to none were associated with a higher risk of hypertension (OR=4.6, 95% CI: 3.7-5.7; OR=1.4, 95% CI: 1

  17. Factors associated with suicide: Case-control study in South Tyrol.

    PubMed

    Giupponi, Giancarlo; Innamorati, Marco; Baldessarini, Ross J; De Leo, Diego; de Giovannelli, Francesca; Pycha, Roger; Conca, Andreas; Girardi, Paolo; Pompili, Maurizio

    2018-01-01

    As suicide is related to many factors in addition to psychiatric illness, broad and comprehensive risk-assessment for risk of suicide is required. This study aimed to differentiate nondiagnostic risk factors among suicides versus comparable psychiatric patients without suicidal behavior. We carried out a pilot, case-control comparison of 131 cases of suicide in South Tyrol matched for age and sex with 131 psychiatric controls, using psychological autopsy methods to evaluate differences in clinically assessed demographic, social, and clinical factors, using bivariate conditional Odds Risk comparisons followed by conditional regression modeling controlled for ethnicity. Based on multivariable conditional regression modeling, suicides were significantly more likely to have experienced risk factors, ranking as: [a] family history of suicide or attempt≥[b] recent interpersonal stressors≥[c] childhood traumatic events≥[d] lack of recent clinician contacts≥[e] previous suicide attempt≥[f] non-Italian ethnicity, but did not differ in education, marital status, living situation, or employment, nor by psychiatric or substance-abuse diagnoses. Both recent and early factors were associated with suicide, including lack of recent clinical care, non-Italian cultural subgroup-membership, familial suicidal behavior, and recent interpersonal distress. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Factors associated with National Council Licensure Examination-Registered Nurse success.

    PubMed

    Arathuzik, D; Aber, C

    1998-01-01

    Identification of factors associated with National Council Licensure Examination-Registered Nurse (NCLEX-RN) success is critical at public colleges of nursing with diverse student populations. This issue was the purpose of this research study. A descriptive correlational research design was used. Seventy-nine generic senior students enrolled in an urban public university participated in the study. Several internal and external blocks to success were described by the students, including family responsibilities, emotional distress, fatigue, and financial and work burdens. Significant correlations were found between success in the NCLEX-RN and cumulative undergraduate nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking. Establishment of a comprehensive data base-including factors associated with success in the NCLEX-RN and programs of advisement, tutoring, and stress management as well as classes in study skills, test taking, and NCLEX preparation-are recommended for public colleges of nursing with diverse student populations.

  19. The causes for lack of interest to blood donation in eligible individuals, mashhad, northeastern iran.

    PubMed

    Shakeri, M T; Vafaee, A; Esmaeily, H; Shafiei, N; Bazargani, R; Khayamy, Me

    2012-01-01

    Donor recruitment and retention are significant problems in blood collection agencies around the world. The Aim of this study was to determine the causes of lack of interest to blood donation in eligible individu-als in Mashhad, Northeast of Iran. This was a descriptive study. Cases were 1130 non-donor individuals. Participants were selected from eligible individuals in different regions of Mashhad. In this study, surveys included information about age groups, gender, residence area, marriage, education; living situation and job as background variables. Less than 30% of the cases had enough knowledge about blood donation. There was a significant rela-tionship between location, age, education, occupation and social status with knowledge of blood donation, but there was not a correlation between gender and marital status. There are some factors which affect the decision for blood donation. There is a need to change the negative attitude by increasing the knowledge considering the individual and the social status.

  20. Supportive and palliative care for patients with chronic mental illness including dementia.

    PubMed

    Lloyd-Williams, Mari; Abba, Katharine; Crowther, Jacqueline

    2014-09-01

    People with preexisting mental illness are known to have difficulty accessing healthcare services including palliative care and people with dementia have similar issues accessing palliative care. The review addressed the time period from January 2013 to March 2014. There were few articles addressing issues for palliative and supportive care for patients with preexisting mental health issues. The main factor that would improve care is interdisciplinary working between mental healthcare teams and palliative care teams. In contrast, there were many published articles on the palliative and supportive care needs for people with dementia. These articles included consensus statements, models of care; studies of why models of care, for example Advanced Care Planning were not being implemented; and carer reports of care in the last year of life. Urgent research is required as to how support for people with preexisting mental illness who require palliative care can be improved--excellent liaison between mental health and palliative care teams is essential. There is much research on palliative care needs for people with dementia but an apparent lack of innovative approaches to care including care of people within their family home.

  1. Five reasons for the lack of nursing students' motivation to learn public health.

    PubMed

    Kudo, Yasushi; Hayashi, Sachiko; Yoshimura, Emiko; Tsunoda, Masashi; Tsutsumi, Akizumi; Shibuya, Akitaka; Aizawa, Yoshiharu

    2013-11-01

    Prevention is better than cure. Public health plays an important role in promoting prevent medicine. To obtain the abilities to provide appropriate nursing services, learning public health is necessary for students who want to become registered nurses. When teachers teach public health to nursing students, it is important to motivate them to learn it. Therefore, we investigated the reasons for the lack of motivation to learn public health by conducting a questionnaire survey. The subjects were female nursing students in 29 vocational schools in Kanagawa and Chiba prefectures of Japan that allow graduation after a 3-year study period. We asked the students whether or not they had completed the subject of public health and analyzed those students who answered affirmatively. We analyzed 1,553 respondents whose average age was 22.6 ± 5.2 years (range, 18 to 45). Using factor analysis, we discovered the 5 reasons that lead to the lack of nursing students' motivation to learn public health: "Difficulties acquiring knowledge of public health," "Inappropriate attitudes of public health teachers," "Thinking lightly about the national examination in the field of public health," "Lack of understanding the importance of learning public health," and "Future plans that do not specialize in public health." Using multiple linear regression analysis, these 5 reasons were significant predictors for the lack of students' motivation. Older students also had significantly less motivation to learn public health than did younger students. When teachers instruct their students, they should teach public health better with the present knowledge.

  2. [Hygiene and motivation factors of nursing work in a cardiology ward].

    PubMed

    Somense, Carolina Bueno; Duran, Erika Christiane Marocco

    2014-09-01

    The present study aimed to identify hygienic and motivational factors in the nursing work according to the Two-Factor Theory, as well as their relation with professional satisfaction/dissatisfaction. This exploratory-descriptive study involved nine nurses from the cardiology ward of a hospital in the interior of the State of São Paulo, between August and September 2013. A self-applied questionnaire was used, including open and closed questions. The data were categorized as hygienic and motivational. Results show the nurses' satisfaction with autonomy, work itself and teamwork, duties, content and responsibilities of the job. Dissatisfaction is related to career growth possibilities; work, political and administrative conditions at the institution, supervision and lack of institutional support. Satisfaction and dissatisfaction factors include relationships, acknowledgements and remuneration. Nurses' satisfaction is determined by multiple and often controversial factors.

  3. The Candida albicans Hwp2p can complement the lack of filamentation of a Saccharomyces cerevisiae flo11 null strain.

    PubMed

    Younes, Samer S; Khalaf, Roy A

    2013-06-01

    The opportunistic fungal pathogen Candida albicans is one of the leading agents of life-threatening infections affecting immunocompromised individuals. Many factors make C. albicans a successful pathogen. These include the ability to switch between yeast and invasive hyphal morphologies in addition to an arsenal of cell wall virulence factors such as lipases, proteases, dismutases and adhesins that promote the attachment to the host, a prerequisite for invasive growth. We have previously characterized Hwp2, a C. albicans cell wall protein which we found necessary for proper oxidative stress, biofilm formation and adhesion to host cells. Baker's yeast Saccharomyces cerevisiae also possesses adhesins that promote aggregation and flocculence. Flo11 is one such adhesin that has sequence similarity to Hwp2. Here we determined that transforming an HWP2 cassette can complement the lack of filamentation of an S. cerevisiae flo11 null strain and impart on S. cerevisiae adhesive properties similar to those of a pathogen.

  4. Childhood Sexual Abuse Severity Reconsidered: A Factor Structure of CSA Characteristics

    ERIC Educational Resources Information Center

    Young, T. Lorraine; Riggs, Matt; Robinson, Jill L.

    2011-01-01

    To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and…

  5. Accurate expressions for solar cell fill factors including series and shunt resistances

    NASA Astrophysics Data System (ADS)

    Green, Martin A.

    2016-02-01

    Together with open-circuit voltage and short-circuit current, fill factor is a key solar cell parameter. In their classic paper on limiting efficiency, Shockley and Queisser first investigated this factor's analytical properties showing, for ideal cells, it could be expressed implicitly in terms of the maximum power point voltage. Subsequently, fill factors usually have been calculated iteratively from such implicit expressions or from analytical approximations. In the absence of detrimental series and shunt resistances, analytical fill factor expressions have recently been published in terms of the Lambert W function available in most mathematical computing software. Using a recently identified perturbative relationship, exact expressions in terms of this function are derived in technically interesting cases when both series and shunt resistances are present but have limited impact, allowing a better understanding of their effect individually and in combination. Approximate expressions for arbitrary shunt and series resistances are then deduced, which are significantly more accurate than any previously published. A method based on the insights developed is also reported for deducing one-diode fits to experimental data.

  6. Factors That Influence the Practice of Elective Induction of Labor

    PubMed Central

    Moore, Jennifer; Low, Lisa Kane

    2012-01-01

    Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction. A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. Under each category, the words/phrases were further clustered until a construct could be named. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged. Only 4 of the articles identified were evidence based. Patient factors were divided into preferences/convenience, communication, fear, pressure/influence, trust, external influences, and technology. Provider factors were then divided into practice preferences/convenience, lack of information, financial incentives, fear, patient desire/demand, and technology. Organization factors were divided into lack of enforcement/accountability, hospital culture, scheduling of staff, and market share issues. Currently, there is limited data-based information focused on factors that influence elective induction of labor. Despite patient and provider convenience/preferences being cited in the literature, the evidence does not support this practice. PMID:22843006

  7. Lack of correlation between preoperative and intraoperative liver hemodynamics: a descriptive analysis.

    PubMed

    Sánchez-Cabús, Santiago; Abraldes, Juan G; Taurá, Pilar; Calatayud, David; Fondevila, Constantino; Fuster, José; Ferrer, Joana; García-Pagán, Juan Carlos; García-Valdecasas, Juan Carlos

    2014-01-15

    Adult living-donor liver transplantation recipients undergo important hemodynamic changes during the procedure, which in turn have proven to be of the upmost importance when dealing with small grafts, to avoid the so-called "small-for-size" syndrome. Back in 2003, we started a hemodynamic monitoring protocol in adult living-donor liver transplantation recipients, which evaluated the hemodynamic status of the patient 24 hr before, during, and 3 days after transplantation. We analyzed the correlation between the same hemodynamic variables measured in the hemodynamic laboratory and those taken in the operating room. With the exception of cardiac index and indexed systemic vascular resistance, all the other hepatic and systemic hemodynamic parameters measured before and during the intervention, as well as during and after the intervention, showed a lack of correlation. The observed lack of correlation may happen due to many factors, such as the influence of vasoactive and anesthetic drugs, total muscular relaxation, or the presence of an open abdomen. As a result, a direct comparison between hemodynamic values should only be done when measured in the same conditions.

  8. Mitochondrial Impairment as a Key Factor for the Lack of Attachment after Cold Storage of Hepatocyte Suspensions

    PubMed Central

    Pless-Petig, Gesine; Walter, Björn; Bienholz, Anja

    2018-01-01

    with subsequent energy deficiency is a key factor for the lack of attachment of cold-stored hepatocyte suspensions. PMID:29390882

  9. Mitochondrial Impairment as a Key Factor for the Lack of Attachment after Cold Storage of Hepatocyte Suspensions.

    PubMed

    Pless-Petig, Gesine; Walter, Björn; Bienholz, Anja; Rauen, Ursula

    2017-12-01

    with subsequent energy deficiency is a key factor for the lack of attachment of cold-stored hepatocyte suspensions.

  10. The POU Factor Ventral Veins Lacking/Drifter Directs the Timing of Metamorphosis through Ecdysteroid and Juvenile Hormone Signaling

    PubMed Central

    Chaieb, Leila; Koyama, Takashi; Sarwar, Prioty; Mirth, Christen K.; Smith, Wendy A.; Suzuki, Yuichiro

    2014-01-01

    Although endocrine changes are known to modulate the timing of major developmental transitions, the genetic mechanisms underlying these changes remain poorly understood. In insects, two developmental hormones, juvenile hormone (JH) and ecdysteroids, are coordinated with each other to induce developmental changes associated with metamorphosis. However, the regulation underlying the coordination of JH and ecdysteroid synthesis remains elusive. Here, we examined the function of a homolog of the vertebrate POU domain protein, Ventral veins lacking (Vvl)/Drifter, in regulating both of these hormonal pathways in the red flour beetle, Tribolium castaneum (Tenebrionidae). RNA interference-mediated silencing of vvl expression led to both precocious metamorphosis and inhibition of molting in the larva. Ectopic application of a JH analog on vvl knockdown larvae delayed the onset of metamorphosis and led to a prolonged larval stage, indicating that Vvl acts upstream of JH signaling. Accordingly, vvl knockdown also reduced the expression of a JH biosynthesis gene, JH acid methyltransferase 3 (jhamt3). In addition, ecdysone titer and the expression of the ecdysone response gene, hormone receptor 3 (HR3), were reduced in vvl knockdown larvae. The expression of the ecdysone biosynthesis gene phantom (phm) and spook (spo) were reduced in vvl knockdown larvae in the anterior and posterior halves, respectively, indicating that Vvl might influence ecdysone biosynthesis in both the prothoracic gland and additional endocrine sources. Injection of 20-hydroxyecdysone (20E) into vvl knockdown larvae could restore the expression of HR3 although molting was never restored. These findings suggest that Vvl coordinates both JH and ecdysteroid biosynthesis as well as molting behavior to influence molting and the timing of metamorphosis. Thus, in both vertebrates and insects, POU factors modulate the production of major neuroendocrine regulators during sexual maturation. PMID:24945490

  11. Temporal expression and mitochondrial localization of a Foxp2 isoform lacking the forkhead domain in developing Purkinje cells.

    PubMed

    Tanabe, Yuko; Fujiwara, Yuji; Matsuzaki, Ayumi; Fujita, Eriko; Kasahara, Tadashi; Yuasa, Shigeki; Momoi, Takashi

    2012-07-01

    FOXP2, a forkhead box-containing transcription factor, forms homo- or hetero-dimers with FOXP family members and localizes to the nucleus, while FOXP2(R553H), which contains a mutation related to speech/language disorders, features reduced DNA binding activity and both cytoplasmic and nuclear localization. In addition to being a loss-of-function mutation, it is possible that FOXP2(R553H) also may act as a gain-of-function mutation to inhibit the functions of FOXP2 isoforms including FOXP2Ex10+ lacking forkhead domain. Foxp2(R552H) knock-in mouse pups exhibit impaired ultrasonic vocalization and poor dendritic development in Purkinje cells. However, expressions of Foxp2 isoforms in the developing Purkinje are unclear. The appearance of 'apical cytoplasmic swelling' (mitochondria-rich regions that are the source of budding processes) correlates with dendritic development of Purkinje cells. In the present study, we focused on Foxp2 isoforms localizing to the apical cytoplasmic swelling and identified two isoforms lacking forkhead domain: Foxp2Ex12+ and Foxp2Ex15. They partly localized to the membrane fraction that includes mitochondria. Foxp2Ex12+ mainly localized to the apical cytoplasmic swelling in early developing Purkinje cells at the stellate stage (P2-P4). Mitochondrial localization of Foxp2Ex12+ in Purkinje cells was confirmed by immune-electron microscopic analysis. Foxp2Ex12+ may play a role in dendritic development in Purkinje cells. © 2011 The Authors. Journal of Neurochemistry © 2011 International Society for Neurochemistry.

  12. A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.

    PubMed

    Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z

    2014-09-19

    To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Organizational and Teamwork Factors of Tele-Intensive Care Units.

    PubMed

    Wilkes, Michael S; Marcin, James P; Ritter, Lois A; Pruitt, Sherilyn

    2016-09-01

    Use of tele-intensive care involves organizational and teamwork factors across geographic locations. This situation adds to the complexity of collaboration in providing quality patient-centered care. To evaluate cross-agency teamwork of health care professionals caring for patients in tele-intensive care units in rural and urban regions. A national qualitative study was conducted in 3 US geographic regions with tele-intensive care programs. Discussions and interviews were held with key participants during site visits at 3 hub sites (specialist services location) and 8 rural spoke sites (patient location). The effects of communication and culture between the hub team and the spoke team on use of the services and effectiveness of care were evaluated. A total of 34 participants were interviewed. Specific organizational and teamwork factors significantly affect the functionality of a tele-intensive care unit. Key operational and cultural barriers that limit the benefits of the units include unrealistic expectations about operational capabilities, lack of trust, poorly defined leadership, and a lack of communication policies. Potential solutions include education on spoke facility resources, clearly defined expectations and role reversal education, team-building activities, and feedback mechanisms to share concerns, successes, and suggestions. Proper administration and attention to important cultural and teamwork factors are essential to making tele-intensive care units effective, practical, and sustainable. ©2016 American Association of Critical-Care Nurses.

  14. Restricted growth and insulin-like growth factor-1 deficiency in mice lacking presenilin-1 in the neural crest cell lineage

    PubMed Central

    Nakajima, Mitsunari; Watanabe, Sono; Okuyama, Satoshi; Shen, Jie; Furukawa, Yoshiko

    2012-01-01

    Presenilin-1 (PS1) is a transmembrane protein that is in many cases responsible for the development of early-onset familial Alzheimer’s disease. PS1 is essential for neurogenesis, somitogenesis, angiogenesis, and cardiac morphogenesis. We report here that PS1 is also required for maturation and/or maintenance of the pituitary gland. We generated PS1-conditional knockout (PS1-cKO) mice by crossing floxed PS1 and Wnt1-cre mice, in which PS1 was lacking in the neural crest-derived cell lineage. Although the PS1-cKO mice exhibited no obvious phenotypic abnormalities for several days after birth, reduced body weight in the mutant was evident by the age of 3 to 5 weeks. Pituitary weight and serum insulin-like growth factor (IGF)-1 level were also reduced in the mutant. Histologic analysis revealed severe atrophy of the cytosol in the anterior and intermediate pituitary lobes of the mutant. Immunohistochemistry did not reveal clear differences in the expression levels of thyroid-stimulating hormone, adrenocorticotropic hormone, or prolactin in the mutant pituitary. In contrast, growth hormone expression levels were reduced in the anterior lobe of the mutant. PS1 was defective in the posterior lobe, but not the anterior or intermediate lobes, in the mutant pituitary. These findings suggest that PS1 indirectly mediates the development and/or maintenance of the anterior and intermediate lobes in the pituitary gland via actions in other regions, such as the posterior lobe. PMID:19665542

  15. 29 CFR 18.602 - Lack of personal knowledge.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Lack of personal knowledge. 18.602 Section 18.602 Labor... OFFICE OF ADMINISTRATIVE LAW JUDGES Rules of Evidence Witnesses § 18.602 Lack of personal knowledge. A... witness has personal knowledge of the matter. Evidence to prove personal knowledge may, but need not...

  16. Lack of supportive leadership behavior predicts suboptimal self-rated health independent of job strain after 10 years of follow-up: findings from the population-based MONICA/KORA study.

    PubMed

    Schmidt, Burkhard; Herr, Raphael M; Jarczok, Marc N; Baumert, Jens; Lukaschek, Karoline; Emeny, Rebecca T; Ladwig, Karl-Heinz

    2018-04-23

    Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain. The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline. Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19-3.46)] and at follow-up [OR 2.33, (95% CI 1.40-3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20-3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH. Lack of supportive leadership was associated with suboptimal SRH at 10 years' follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.

  17. [Study on the relationship between childhood obesity and various determinants, including socioeconomic factors, in an urban area].

    PubMed

    Kang, Hee-Tae; Ju, Young-Su; Park, Kyung-Hee; Kwon, Young-Jun; Im, Hyoung-June; Paek, Do-Myung; Lee, Hyun-Joo

    2006-09-01

    This study was conducted to investigate the prevalence of childhood obesity, the association between the undesirable lifestyles and socioeconomic factors, the association between childhood obesity and various risk factors, including socioeconomic factors, and the agreement between the body mass index (BMI) classification and the body fat percentage. The study subjects were all the 5th grade students from all the elementary schools in Gunpo City, Kyunggi Province, South Korea (4043 children at 22 schools). The subjects were measured for their height, weight and percent body fat etc. and they were also surveyed by questionnaire from March 18th to April 25th, 2005. To determine whether the children were within normal limits or not, standardized BMIs for each age group were used. The data was analyzed by logistic regression analysis using SAS 9.0 version. The prevalence of childhood obesity prevalence was 25.1%. Boys had a higher prevalence of obesity (27.5%) than did the girls (22.5%). Children had tendencies of having undesirable lifestyles and getting obese if they had a lower socioeconomic status. The risk factors for childhood obesity were low paternal education (OR: 1.17, 95% CI: 0.97-1.42) and non-parental caregivers (OR: 1.34, 95% CI: 0.98-1.82). Other risk factors for childhood obesity were a high birth-weight, longer TV/computer-using time, a lower fruit-eating frequency, short sleeping hours and parental obesity. The agreement rate between the BMI classification and the body fat percentage was 93.1%. This study showed the children had a higher prevalence of obesity: further, not only individual lifestyles, but also socioeconomic factors could influence childhood obesity. Childhood obesity was especially more problematic for children with a low socioeconomic status.

  18. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

    PubMed

    Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

    2017-08-01

    Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Factors influencing intentions to stay and retention of nurse managers: a systematic review.

    PubMed

    Brown, Pamela; Fraser, Kimberly; Wong, Carol A; Muise, Melanie; Cummings, Greta

    2013-04-01

    This systematic review aimed to explore factors known to influence intentions to stay and retention of nurse managers in their current position. Retaining staff nurses and recruiting nurses to management positions are well documented; however, there is sparse research examining factors that influence retention of nurse managers. Thirteen studies were identified through a systematic search of the literature. Eligibility criteria included both qualitative and quantitative studies that examined factors related to nurse manager intentions to stay and retention. Quality assessments, data extraction and analysis were completed on all studies included. Twenty-one factors were categorized into three major categories: organizational, role and personal. Job satisfaction, organizational commitment, organizational culture and values, feelings of being valued and lack of time to complete tasks leading to work/life imbalance, were prominent across all categories. These findings suggest that intentions to stay and retention of nurse managers are multifactoral. However, lack of robust literature highlights the need for further research to develop strategies to retain nurse managers. ImplICATIONS FOR NURSE MANAGEMENT: Health-care organizations and senior decision-makers should feel a responsibility to support front-line managers in relation to workload and span of control, and in understanding work/life balance issues faced by managers. © 2012 Blackwell Publishing Ltd.

  20. Part II--Factors associated with school nurse ratios: key state informants' perceptions.

    PubMed

    Maughan, Erin

    2009-08-01

    This paper is the second of a two-part series examining factors influencing school nurse to pupil staffing ratios. The paper reports data from a qualitative study exploring the social and political factors that potentially influence ratios. Interviews were conducted with 30 key state informants from these states. Content analysis of the data identified common themes. Positive factors reported to influence ratios included: the approach taken to effect change, value placed upon school nurses, local support (from both educators and parents) and community buy-in, fear of litigation, and dynamic leadership. Barriers to improving ratios included: lack of funding and misunderstanding of the role of the school nurse. Philosophical beliefs and state geography were "swing" factors that influenced staffing positively or negatively. This study adds to our knowledge of the factors influencing staffing and highlights important social and political factors that school nurses can target to improve nurse to pupil ratios.

  1. Depression and associated factors in older adults in South Africa.

    PubMed

    Peltzer, Karl; Phaswana-Mafuya, Nancy

    2013-01-18

    Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among older adults.

  2. Unhealthy lifestyle factors and depressive symptoms: A Japanese general adult population survey.

    PubMed

    Furihata, Ryuji; Konno, Chisato; Suzuki, Masahiro; Takahashi, Sakae; Kaneita, Yoshitaka; Ohida, Takashi; Uchiyama, Makoto

    2018-07-01

    To investigate the relationship between unhealthy lifestyles factors and depressive symptoms among the general adult population in Japan. Participants were randomly selected from the Japanese general adult population. Data from 2334 people aged 20 years or older were analyzed. This cross-sectional survey was conducted in August and September 2009. Participants completed a face-to-face interview about unhealthy lifestyle factors, including lack of exercise, skipping breakfast, a poorly balanced diet, snacking between meals, insufficient sleep, current smoking, alcohol drinking, and obesity. Presence of depressive symptoms was defined as a score of ≥ 16 on the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Relationships between unhealthy lifestyle factors and depressive symptoms were evaluated by multivariate logistic regression analysis adjusting for sociodemographic variables and other unhealthy lifestyle factors. Multivariate logistic regression analysis revealed that insufficient sleep, a poorly balanced diet, snacking between meals and lack of exercise were significantly associated with the prevalence of depressive symptoms, with odds ratios ranging from 1.56 for lack of exercise to 3.98 for insufficient sleep. Since this study was a cross-sectional study, causal relationships could not be determined. These results suggest that promoting a healthy lifestyle focused on sleep, food intake and exercise may be important for individuals with depressive symptoms. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Hepatocyte growth factor (HGF) modulates GABAergic inhibition and seizure susceptibility

    PubMed Central

    Bae, Mihyun H.; Bissonette, Gregory B.; Mars, Wendy M.; Michalopoulos, George K.; Achim, Cristian L.; Depireux, Didier A.; Powell, Elizabeth M.

    2009-01-01

    Disrupted ontogeny of forebrain inhibitory interneurons leads to neurological disorders, including epilepsy. Adult mice lacking the urokinase plasminogen activator receptor (Plaur) have decreased numbers of neocortical GABAergic interneurons and spontaneous seizures, attributed to a reduction of hepatocyte growth factor/scatter factor (HGF/SF). We report that by increasing endogenous HGF/SF concentration in the postnatal Plaur null mouse brain maintains the interneuron populations in the adult, reverses the seizure behavior and stabilizes the spontaneous electroencephalogram activity. The perinatal intervention provides a pathway to reverse potential birth defects and ameliorate seizures in the adult. PMID:19853606

  4. Personal and situational factors influencing coaches' perceptions of stress.

    PubMed

    Knight, Camilla J; Reade, Ian L; Selzler, Anne-Marie; Rodgers, Wendy M

    2013-01-01

    Coaching has been recognised as a demanding occupation, associated with a range of stressors. The extent to which coaches perceive stress is likely to be influenced by various personal and situational factors. The purpose of this study was to identify coaches' levels of perceived stress and examine the personal and situational factors that may influence coaches' perceptions of stress. In total, 502 coaches working with university, college, Canada Games, and/or nationally identified athletes completed this study. Coaches completed an online survey, which included questions regarding demographics, work/job-related considerations, and aspects relating to their contract. Coaches also completed the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983). Overall coaches indicated slightly below average levels of perceived stress (M = 15.13 out of 40) compared with norm-values (Cohen & Janicki-Deverts, 2012). Demographic factors, job-related characteristics, and certain aspects of their contract were associated with coaches' perceptions of stress. In particular, unclear expectations, long-working hours (>40), lack of agreed evaluation criteria, higher salaries, and a lack of social support were related to higher perceptions of stress. As such, the findings of the current study indicate that a reduction in perceived stress is likely to be achieved through a multifaceted approach that addresses multiple factors associated with coaching.

  5. Lack of pre-antiretroviral care and competition from traditional healers, crucial risk factors for very late initiation of antiretroviral therapy for HIV--a case-control study from eastern Uganda.

    PubMed

    Muhamadi, Lubega; Tumwesigye, Nazarius Mbona; Kadobera, Daniel; Marrone, Gaetano; Wabwire-Mangen, Fred; Pariyo, George; Peterson, Stefan; Ekström, Anna Mia

    2011-01-01

    Although WHO recommends starting antiretroviral treatment at a CD4 count of 350 cells/[µ]L, many Ugandan districts still struggle with large proportions of clients initiating ART very late at CD4<50 cells/[µ]L. This study seeks to establish crucial risk factors for very late ART initiation in eastern Uganda. All adult HIV-infected clients on ART in Iganga who enrolled between 2005 and 2009 were eligible for this case-control study. Clients who started ART at CD4 cell count of <50 cells/[µ]L (very late initiators) were classified as cases and 50-200 cells/[µ]L (late initiators) as control subjects. A total of 152 cases and 202 controls were interviewed. Multivariate analyses were performed to calculate adjusted odds ratios and 95% confidence intervals. Reported health system-related factors associated with very late ART initiation were stock-outs of antiretroviral drugs stock-outs (affecting 70% of the cases and none of the controls), competition from traditional/spiritual healers (AOR 7.8, 95 CI% 3.7-16.4), and lack of pre-ARV care (AOR 4.6, 95% CI: 2.3-9.3). Men were 60% more likely and subsistence farmers six times more likely (AOR 6.3, 95% CI: 3.1-13.0) to initiate ART very late. Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6). Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility. ART services should be more affordable, accessible and user-friendly to make them more attractive than traditional healers.

  6. Pesticide exposure as risk factor for non-Hodgkin lymphoma including histopathological subgroup analysis.

    PubMed

    Eriksson, Mikael; Hardell, Lennart; Carlberg, Michael; Akerman, Måns

    2008-10-01

    We report a population based case-control study of exposure to pesticides as risk factor for non-Hodgkin lymphoma (NHL). Male and female subjects aged 18-74 years living in Sweden were included during December 1, 1999, to April 30, 2002. Controls were selected from the national population registry. Exposure to different agents was assessed by questionnaire. In total 910 (91 %) cases and 1016 (92%) controls participated. Exposure to herbicides gave odds ratio (OR) 1.72, 95% confidence interval (CI) 1.18-2.51. Regarding phenoxyacetic acids highest risk was calculated for MCPA; OR 2.81, 95% CI 1.27-6.22, all these cases had a latency period >10 years. Exposure to glyphosate gave OR 2.02, 95% CI 1.10-3.71 and with >10 years latency period OR 2.26, 95% CI 1.16-4.40. Insecticides overall gave OR 1.28, 95% CI 0.96-1.72 and impregnating agents OR 1.57, 95% CI 1.07-2.30. Results are also presented for different entities of NHL. In conclusion our study confirmed an association between exposure to phenoxyacetic acids and NHL and the association with glyphosate was considerably strengthened.

  7. Lack of Detection of Bt Sugarcane Cry1Ab and NptII DNA and Proteins in Sugarcane Processing Products Including Raw Sugar

    PubMed Central

    Cheavegatti-Gianotto, Adriana; Gentile, Agustina; Oldemburgo, Danielle Angeloni; Merheb, Graciela do Amaral; Sereno, Maria Lorena; Lirette, Ron Peter; Ferreira, Thais Helena Silva; de Oliveira, Wladecir Salles

    2018-01-01

    Brazil is the largest sugarcane producer and the main sugar exporter in the world. The industrial processes applied by Brazilian mills are very efficient in producing highly purified sugar and ethanol. Literature presents evidence of lack of DNA/protein in these products, regardless of the nature of sugarcane used as raw material. Recently CTNBio, the Brazilian biosafety authority, has approved the first biotechnology-derived sugarcane variety for cultivation, event CTC175-A, which expresses the Cry1Ab protein to control the sugarcane borer (Diatraea saccharalis). The event also expresses neomycin-phosphotransferase type II (NptII) protein used as selectable marker during the transformation process. Because of the high purity of sugar and ethanol produced from genetically modified sugarcane, these end-products should potentially be classified as “pure substances, chemically defined,” by Brazilian Biosafety Law No. 11.105. If this classification is to be adopted, these substances are not considered as “GMO derivatives” and fall out of the scope of Law No. 11.105. In order to assess sugar composition and quality, we evaluate Cry1Ab and NptII expression in several sugarcane tissues and in several fractions from laboratory-scale processing of event CTC175-A for the presence of these heterologous proteins as well as for the presence of traces of recombinant DNA. The results of these studies show that CTC175-A presents high expression of Cry1Ab in leaves and barely detectable expression of heterologous proteins in stalks. We also evaluated the presence of ribulose-1,5-bisphosphate carboxylase/oxygenase protein and DNA in the fractions of the industrial processing of conventional Brazilian sugarcane cultivars. Results from both laboratory and industrial processing were concordant, demonstrating that DNA and protein are not detected in the clarified juice and downstream processed fractions, including ethanol and raw sugar, indicating that protein and DNA are

  8. The relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus.

    PubMed

    Noh, Jin-Won; Jung, Jin Hee; Park, Jeong Eun; Lee, Jung Hwa; Sim, Kang Hee; Park, Jumin; Kim, Min Hee; Yoo, Ki-Bong

    2018-02-01

    [Purpose] The purpose of the present study was to assess the relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus (T2D). [Subjects and Methods] Subjects with T2D patients who received outpatient care for blood sugar control were randomly sampled at 13 general hospitals and 969 subjects were included. Cox proportional hazard models were used to confirm associations between age of onset and risk factors including family history and life style in Korean population with T2D. [Results] Parent history of T2D was significantly associated with age of onset. Compared to none of family members with T2D, those whose both father and mother had a history showed the highest the risk of early-onset (HR=2.36; 95% CI=1.45-3.85). Mother and father's history of T2D (HR=1.73; 95% CI=1.46-2.05; HR=1.83; 95% CI=1.40-2.37) were associated with the risk of early-onset. Moreover, exercise (HR=1.23, CI=1.08-1.40) smoking status (HR=1.62, CI=1.32-1.99), and drinking (HR=1.32, CI=1.13-1.54) were associated with a higher risk for the early-onset. [Conclusion] Family history as well as life style including exercise, smoking, and drinking are the risk factors for early-onset factor in Korean population with T2D.

  9. Characterisation of Mycobacterium tuberculosis isolates lacking IS6110 in Viet Nam.

    PubMed

    Huyen, M N T; Tiemersma, E W; Kremer, K; de Haas, P; Lan, N T N; Buu, T N; Sola, C; Cobelens, F G J; van Soolingen, D

    2013-11-01

    The molecular diagnosis of tuberculosis (TB) in Viet Nam is often based on the detection of insertion sequence (IS) 6110 in Mycobacterium tuberculosis. However, 8-11% of M. tuberculosis strains in South-East Asia do not contain this target and this undermines the validity of these molecular tests. We quantified the frequency of M. tuberculosis strains lacking IS6110 in rural Viet Nam and studied their epidemiological and clinical characteristics. Consecutively diagnosed adult TB patients in rural Southern Viet Nam submitted two sputum samples for culture, IS6110 restriction fragment length polymorphism (RFLP) spoligotyping and 15-loci variable number tandem repeat typing. Polymerase chain reaction (PCR) was performed to confirm the absence of IS6110 elements in strains lacking IS6110 hybridisation in RFLP. Among 2664 TB patient isolates examined, 109 (4.1%) had no IS6110 element. Compared to other strains, these no-copy strains were less often resistant to anti-tuberculosis drugs, particularly to streptomycin (adjusted OR 0.2, 95%CI 0.1-0.5), and showed significant geographic variation. No associations with TB history or demographic factors were found. Strains without the IS6110 target pose a problem in Viet Nam as regards false-negative molecular TB diagnosis in PCR. Compared to other strains circulating in Viet Nam, no-copy strains are more susceptible to anti-tuberculosis drugs.

  10. Factors that regulate embryonic gustatory development

    PubMed Central

    Krimm, Robin F

    2007-01-01

    Numerous molecular factors orchestrate the development of the peripheral taste system. The unique anatomy/function of the taste system makes this system ideal for understanding the mechanisms by which these factors function; yet the taste system is underutilized for this role. This review focuses on some of the many factors that are known to regulate gustatory development, and discusses a few topics where more work is needed. Some attention is given to factors that regulate epibranchial placode formation, since gustatory neurons are thought to be primarily derived from this region. Epibranchial placodes appear to arise from a pan-placodal region and a number of regulatory factors control the differentiation of individual placodes. Gustatory neuron differentiation is regulated by a series of transcription factors and perhaps bone morphongenic proteins (BMP). As neurons differentiate, they also proliferate such that their numbers exceed those in the adult, and this is followed by developmental death. Some of these cell-cycling events are regulated by neurotrophins. After gustatory neurons become post-mitotic, axon outgrowth occurs. Axons are guided by multiple chemoattractive and chemorepulsive factors, including semaphorins, to the tongue epithelium. Brain derived neurotrophic factor (BDNF), functions as a targeting factor in the final stages of axon guidance and is required for gustatory axons to find and innervate taste epithelium. Numerous factors are involved in the development of gustatory papillae including Sox-2, Sonic hedge hog and Wnt-β-catenin signaling. It is likely that just as many factors regulate taste bud differentiation; however, these factors have not yet been identified. Studies examining the molecular factors that regulate terminal field formation in the nucleus of the solitary tract are also lacking. However, it is possible that some of the factors that regulate geniculate ganglion development, outgrowth, guidance and targeting of peripheral

  11. Cross-cultural comparison of lack of regular physical activity among college students: Universal versus transversal.

    PubMed

    Seo, Dong-Chul; Torabi, Mohammad R; Jiang, Nan; Fernandez-Rojas, Xinia; Park, Bock-Hee

    2009-01-01

    This study examined cultural influence on personal and behavioral correlates of lack of regular physical activity (PA) among college students in four countries, i.e., the United States, Costa Rica, India, and South Korea. Public universities were randomly chosen among the four countries. A total of 4,685 students participated in the study during the 2006-2007 academic year with a response rate of 90.1%. The vast majority of the questions on the instrument were adopted from the Youth Risk Behavior Survey and the Behavioral Risk Factor Surveillance System questionnaires. The instrument was translated into Spanish and Korean and then back-translated into English to check accuracy of the translation. Low fruit consumption was a culture-universal predictor of lack of regular PA. Gender, perceived body weight, vegetable consumption, and cigarette smoking were culture-specific predictors, indicating PA might be a transversal value. Body mass index, binge drinking, and TV/video watching were not associated with lack of regular PA in any of the four countries. While PA is valued across different segments of many cultures, given the several culture-specific predictors, PA appears to be more transversal than universal. Therefore, culturally sensitive interventions are necessary to promote PA among young adults.

  12. Factors Influencing Professional Help-Seeking for Suicidality.

    PubMed

    Han, Jin; Batterham, Philip J; Calear, Alison L; Randall, Rebecca

    2018-05-01

    Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. To systematically evaluate the factors that influence professional help-seeking for suicidality. Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

  13. 10 CFR 503.21 - Lack of alternate fuel supply.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New Facilities § 503.21 Lack of alternate fuel supply. (a) Eligibility. Section 211(a)(1) of the Act provides for...

  14. Reducing School Factors That Lead to Student Dropout at Sussex Central High School

    ERIC Educational Resources Information Center

    Jerns, Pamela Renee

    2012-01-01

    The focus of this Executive Position Paper (EPP) is to address the dropout rate at Sussex Central High School (SCHS) in the Indian River School District (IRSD). Studies conducted for this EPP align with current research--student dropout is a result of culminating school-based factors that include poor attendance and lack of exposure to rigorous…

  15. The relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus

    PubMed Central

    Noh, Jin-Won; Jung, Jin Hee; Park, Jeong Eun; Lee, Jung Hwa; Sim, Kang Hee; Park, Jumin; Kim, Min Hee; Yoo, Ki-Bong

    2018-01-01

    [Purpose] The purpose of the present study was to assess the relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus (T2D). [Subjects and Methods] Subjects with T2D patients who received outpatient care for blood sugar control were randomly sampled at 13 general hospitals and 969 subjects were included. Cox proportional hazard models were used to confirm associations between age of onset and risk factors including family history and life style in Korean population with T2D. [Results] Parent history of T2D was significantly associated with age of onset. Compared to none of family members with T2D, those whose both father and mother had a history showed the highest the risk of early-onset (HR=2.36; 95% CI=1.45–3.85). Mother and father’s history of T2D (HR=1.73; 95% CI=1.46–2.05; HR=1.83; 95% CI=1.40–2.37) were associated with the risk of early-onset. Moreover, exercise (HR=1.23, CI=1.08–1.40) smoking status (HR=1.62, CI=1.32–1.99), and drinking (HR=1.32, CI=1.13–1.54) were associated with a higher risk for the early-onset. [Conclusion] Family history as well as life style including exercise, smoking, and drinking are the risk factors for early-onset factor in Korean population with T2D. PMID:29545678

  16. Lumbar foraminal stenosis, the hidden stenosis including at L5/S1.

    PubMed

    Orita, Sumihisa; Inage, Kazuhide; Eguchi, Yawara; Kubota, Go; Aoki, Yasuchika; Nakamura, Junichi; Matsuura, Yusuke; Furuya, Takeo; Koda, Masao; Ohtori, Seiji

    2016-10-01

    In patients with lower back and leg pain, lumbar foraminal stenosis (LFS) is one of the most important pathologies, especially for predominant radicular symptoms. LFS pathology can develop as a result of progressing spinal degeneration and is characterized by exacerbation with foraminal narrowing caused by lumbar extension (Kemp's sign). However, there is a lack of critical clinical findings for LFS pathology. Therefore, patients with robust and persistent leg pain, which is exacerbated by lumbar extension, should be suspected of LFS. Radiological diagnosis is performed using multiple radiological modalities, such as magnetic resonance imaging, including plain examination and novel protocols such as diffusion tensor imaging, as well as dynamic X-ray, and computed tomography. Electrophysiological testing can also aid diagnosis. Treatment options include both conservative and surgical approaches. Conservative treatment includes medication, rehabilitation, and spinal nerve block. Surgery should be considered when the pathology is refractory to conservative treatment and requires direct decompression of the exiting nerve root, including the dorsal root ganglia. In cases with decreased intervertebral height and/or instability, fusion surgery should also be considered. Recent advancements in minimally invasive lumbar lateral interbody fusion procedures enable effective and less invasive foraminal enlargement compared with traditional fusion surgeries such as transforaminal lumbar interbody fusion. The lumbosacral junction can cause L5 radiculopathy with greater incidence than other lumbar levels as a result of anatomical and epidemiological factors, which should be better addressed when treating clinical lower back pain.

  17. How are Treatment Decisions Made about Artificial Nutrition for Individuals at Risk of Lacking Capacity? A Systematic Literature Review

    PubMed Central

    Clarke, Gemma; Harrison, Katy; Holland, Anthony; Kuhn, Isla; Barclay, Stephen

    2013-01-01

    Background Worldwide, the number of individuals lacking the mental capacity to participate in decisions about their own healthcare is increasing. Due to the ageing global population and advancing medical treatments, there are now many more people living longer with neurological disorders, such as dementia, acquired brain injuries, and intellectual disabilities. Many of these individuals have feeding difficulties and may require artificial nutrition. However, little is known about the decision-making process; the evidence base is uncertain and often ethically complex. Using the exemplar of artificial nutrition, the objective of this review is to examine how treatment decisions are made when patients are at risk of lacking capacity. Methods and Findings We undertook a systematic review according to PRISMA guidelines to determine who was involved in decisions, and what factors were considered. We searched PubMed, AMED, CINAHL, EMBASE, PsychINFO, and OpenSigle for quantitative and qualitative studies (1990–2011). Citation, reference, hand searches and expert consultation were also undertaken. Data extraction and quality assessment were undertaken independently and in duplicate. We utilised Thomas and Harden’s ‘Thematic Synthesis’ for analysis. Sixty-six studies met inclusion criteria, comprising data from 40 countries and 34,649 patients, carers and clinicians. Six themes emerged: clinical indications were similar across countries but were insufficient alone for determining outcomes; quality of life was the main decision-making factor but its meaning varied; prolonging life was the second most cited factor; patient’s wishes were influential but not determinative; families had some influence but were infrequently involved in final recommendations; clinicians often felt conflicted about their roles. Conclusions When individuals lack mental capacity, decisions must be made on their behalf. Dynamic interactive factors, such as protecting right to life, not

  18. Modifiable risk factors of hypertension: A hospital-based case-control study from Kerala, India.

    PubMed

    Pilakkadavath, Zarin; Shaffi, Muhammed

    2016-01-01

    Hypertension is a major cause of cardiovascular morbidity and mortality in Kerala. Excess dietary salt, low dietary potassium, overweight and obesity, physical inactivity, excess alcohol, smoking, socioeconomic status, psychosocial stressors, and diabetes are considered as modifiable risk factors for hypertension. To estimate and compare the distribution of modifiable risk factors among hypertensive (cases) and nonhypertensive (controls) patients and to estimate the effect relationship of risk factors. Age- and sex-matched case-control study was conducted in a tertiary care hospital in Kerala using a pretested interviewer-administered structured questionnaire based on the WHO STEPS instrument for chronic disease risk factor surveillance. Bivariate and multiple logistic regression analyses were done. A total of 296 subjects were included in the study. The mean age of study sample was 50.13 years. All modifiable risk factors studied vis-ΰ-vis obesity, lack of physical activity, inadequate fruits and vegetable intake, diabetes, smoking, and alcohol use were significantly different in proportion among cases and controls. Obesity, lack of physical activity, smoking, and diabetes were found to be significant risk factors for hypertension after adjusting for other risk factors. Hypertension is strongly driven by a set of modifiable risk factors. Massive public awareness campaign targeting risk factors is essential in controlling hypertension in Kerala, especially focusing on physical exercise and control of diabetes, obesity, and on quitting smoking.

  19. Factors Implicated in Safety-related Firefighter Fatalities.

    PubMed

    Kahn, Steven A; Palmieri, Tina L; Sen, Soman; Woods, Jason; Gunter, Oliver L

    Firefighting is wrought with risk, as 80-100 firefighters (FFs) die on the job each year in the United States. Many of the fatalities have been analyzed by the National Institute for Occupational Safety and Health (NIOSH) to determine contributing factors. The purpose of this study is to determine variables that put FFs at risk for potentially preventable workplace mortality such as use of personal protective equipment (PPE), seat belts, and appropriate training/fitness/clearance for duty. The NIOSH FF Fatality Database reports from 2009 to 2014 were analyzed. Data including age, gender, years on the job, weather, other calls on the same shift, and department type were compared between FFs who employed PPE, seat belts, or wellness/fitness and those who did not. A second group of FFs was determined by NIOSH to have inexperience, lack of training, or inappropriate clearance for duty implicated in their fatalities. Comparisons for the second group were between those whose department used training and safety-related standard operating protocols and those who did not. In 84/176 deaths, PPE/seat belts/fitness was implicated in the fatality. Lack of PPE was more likely on clear days (P = .03) but less likely on cloudy and windy days (P < .001). These FFs dying with lack of PPE had more time on the job in a single department, 18 vs 13 years (P = .03), and more time in a volunteer department, 17 vs 8 years (P < .01). Being deployed on another call during the same shift was associated with lack of PPE-34 vs 16% of those who had not been on another call (P = .005). Lack of training, experience, or medical clearance was implicated in fatalities for 100/176 FFs. FFs who worked in departments that lacked standard operating protocols for respirator fit testing, PPE, fitness testing, rapid intervention, medical clearance, safety/distress alarms, vehicle maintenance, or incident command were statistically more likely to have lack of experience/training/clearance implicated in the

  20. Choosing child and adolescent psychiatry: factors influencing medical students.

    PubMed

    Volpe, Tiziana; Boydell, Katherine M; Pignatiello, Antonio

    2013-11-01

    To examine the factors influencing medical students to choose child and adolescent psychiatry as a career specialty. Quantitative and qualitative methods were used. A web-based survey was distributed to child and adolescent psychiatrists at the University of Toronto. In-depth interviews were held with select child and adolescent psychiatrists as well as a focus group with psychiatry residents. Retrospective accounts of the factors that influenced their decision to choose psychiatry and/or child and adolescent psychiatry as a specialty were collected. Ninety-two percent of participants indicated that recruitment of child psychiatrists in Canada is a problem. The recent decision by the Royal College of Physicians and Surgeons to recognize child and adolescent psychiatry as a subspecialty and introduce an extra year of training was identified as a further challenge to recruitment efforts. Other deterrents included lower salary than other subspecialties, lack of exposure during training, stigma, and lack of interest in treating children. Recruitment into psychiatry was enhanced by good role modeling, early exposure in medical school, an interest in brain research, and career and lifestyle issues. A rebranding of the role and perception of psychiatry is needed to attract future psychiatrists. Early exposure to innovations in child and adolescent psychiatry and positive role models are critical in attracting medical students. Recruitment should begin in the first year of medical school and include an enriched paediatric curriculum.

  1. Human Factors of Remotely Piloted Aircraft

    NASA Technical Reports Server (NTRS)

    Hobbs, Alan Neville

    2014-01-01

    The civilian use of remotely piloted, or unmanned aircraft is expected to increase rapidly in the years ahead. Despite being referred to as unmanned some of the major challenges confronting this emerging sector relate to human factors. As unmanned aircraft systems (UAS) are introduced into civil airspace, a failure to adequately consider human factors could result in preventable accidents that may not only result in loss of life, but may also undermine public confidence in remotely piloted operations. Key issues include pilot situational awareness, collision avoidance in the absence of an out-the-window view, the effects of time delays in communication and control systems, control handovers, the challenges of very long duration flights, and the design of the control station. Problems have included poor physical layout of controls, non-intuitive automation interfaces, an over-reliance on text displays, and complicated sequences of menu selection to perform routine tasks. Some of the interface problems may have been prevented had an existing regulation or cockpit design principle been applied. In other cases, the design problems may indicate a lack of suitable guidance material.

  2. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review

    PubMed Central

    Medic, Goran; Littlewood, Kavi J.; Diez, Teresa; Granström, Ola; De Hert, Marc

    2013-01-01

    Background: Nonadherence to medication is a recognized problem and may be the most challenging aspect of treatment. Methods: We performed a systematic review of factors that influence adherence and the consequences of nonadherence to the patient, healthcare system and society, in patients with schizophrenia. Particular attention was given to the effect of nonadherence on hospitalization rates, as a key driver of increased costs of care. A qualitative systematic literature review was conducted using a broad search strategy using disease and adherence terms. Due to the large number of abstracts identified, article selection was based on studies with larger sample sizes published after 2001. Thirty-seven full papers were included: 15 studies on drivers and 22 on consequences, of which 12 assessed the link between nonadherence and hospitalization. Results: Key drivers of nonadherence included lack of insight, medication beliefs and substance abuse. Key consequences of nonadherence included greater risk of relapse, hospitalization and suicide. Factors positively related to adherence were a good therapeutic relationship with physician and perception of benefits of medication. The most frequently reported driver and consequence were lack of insight and greater risk of hospitalization respectively. Conclusions: Improving adherence in schizophrenia may have a considerable positive impact on patients and society. This can be achieved by focusing on the identified multitude of factors driving nonadherence. PMID:24167693

  3. Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

    PubMed

    Abdullah, Asnawi; Hort, Krishna; Butu, Yuli; Simpson, Louise

    2016-01-01

    Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990-2010, with a high proportion of deaths in the first week of life. This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. A matched case-control study of neonatal deaths reported from selected community health centres (puskesmas) was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score) were significantly associated with early neonatal death at age 0-7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs) were found to be associated with a higher risk of neonatal death. The study identified a number of factors amenable to health service intervention associated with neonatal deaths in normal and low

  4. [Lack of neonatologists: vocational crisis or mistaken policies?].

    PubMed

    Justich, Pablo R

    2012-10-01

    In Argentina, the difficulty in covering neonatologist's positions represent an increasing problem. The absence of a coordinated and organized health system on one hand, and the lack of adaptation of the neonatologist's role to the current situation of the maternal and child care on the other, prevent the correct assistential coverage. The inadequate work conditions, the professional risks, the wide amount of time devoted to formation and studying, and the lack of knowledge of the professionals necessities and difficulties have a negative impact when it comes to incorporate new specialists. A global approach of the problem is essential to reach enduring answers.

  5. [Psychosocial functioning in non-psychiatric acute and chronic inpatients: depression, alexithymia and lack of assertiveness].

    PubMed

    Arancibia, Marcelo; Behar, Rosa; Marín, Sofía; Inzunza, Nicolás; Madrid, Eva

    2016-11-01

    Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses.

  6. Lack of spontaneous and radiation-induced chromosome breakage at interstitial telomeric sites in murine scid cells.

    PubMed

    Wong, H-P; Mozdarani, H; Finnegan, C; McIlrath, J; Bryant, P E; Slijepcevic, P

    2004-01-01

    Interstitial telomeric sites (ITSs) in chromosomes from DNA repair-proficient mammalian cells are sensitive to both spontaneous and radiation-induced chromosome breakage. Exact mechanisms of this chromosome breakage sensitivity are not known. To investigate factors that predispose ITSs to chromosome breakage we used murine scid cells. These cells lack functional DNA-PKcs, an enzyme involved in the repair of DNA double-strand breaks. Interestingly, our results revealed lack of both spontaneous and radiation-induced chromosome breakage at ITSs found in scid chromosomes. Therefore, it is possible that increased sensitivity of ITSs to chromosome breakage is associated with the functional DNA double-strand break repair machinery. To investigate if this is the case we used scid cells in which DNA-PKcs deficiency was corrected. Our results revealed complete disappearance of ITSs in scid cells with functional DNA-PKcs, presumably through chromosome breakage at ITSs, but their unchanged frequency in positive and negative control cells. Therefore, our results indicate that the functional DNA double-strand break machinery is required for elevated sensitivity of ITSs to chromosome breakage. Interestingly, we observed significant differences in mitotic chromosome condensation between scid cells and their counterparts with restored DNA-PKcs activity suggesting that lack of functional DNA-PKcs may cause a defect in chromatin organization. Increased condensation of mitotic chromosomes in the scid background was also confirmed in vivo. Therefore, our results indicate a previously unanticipated role of DNA-PKcs in chromatin organisation, which could contribute to the lack of ITS sensitivity to chromosome breakage in murine scid cells. Copyright 2003 S. Karger AG, Basel

  7. Deriving allowable daily intakes for systemic toxicants lacking chronic toxicity data

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

    Layton, D.W.; Mallon, B.J.; Rosenblatt, D.H.

    1987-03-01

    The lack of human toxicological data for most chemical compounds makes it difficult to quickly assess health risks associated with exposure to contaminants at hazardous waste sites. It would therefore be advantageous to have a technique for estimating acceptable daily intakes (ADIs) of potentially toxic substances based on more widely available animal toxicity data. This article focuses on the use of LD50 data to derive provisional ADIs, and it suggests multiplying oral LD50 values (expressed in mg/kg of body wt) by a factor in the range of 5 X 10(-6) to 1 X 10(-5) day-1 to convert them to suchmore » ADIs. It is emphasized that these interim ADI values are no substitute for toxicity testing, but that such testing would most likely result in higher ADI estimates.« less

  8. Report: EPA Travel Program Lacks Necessary Controls

    EPA Pesticide Factsheets

    Report #10-P-0078, March 9, 2010. The EPA travel program, which comprises EPA policies and GovTrip, lacks necessary control procedures to assure all travel authorizations were necessary and in the best interest of the government.

  9. Frontotemporoparietal asymmetry and lack of illness awareness in schizophrenia.

    PubMed

    Gerretsen, Philip; Chakravarty, M Mallar; Mamo, David; Menon, Mahesh; Pollock, Bruce G; Rajji, Tarek K; Graff-Guerrero, Ariel

    2013-05-01

    Lack of illness awareness or anosognosia occurs in both schizophrenia and right hemisphere lesions due to stroke, dementia, and traumatic brain injury. In the latter conditions, anosognosia is thought to arise from unilateral hemispheric dysfunction or interhemispheric disequilibrium, which provides an anatomical model for exploring illness unawareness in other neuropsychiatric disorders, such as schizophrenia. Both voxel-based morphometry using Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) and a deformation-based morphology analysis of hemispheric asymmetry were performed on 52 treated schizophrenia subjects, exploring the relationship between illness awareness and gray matter volume. Analyses included age, gender, and total intracranial volume as covariates. Hemispheric asymmetry analyses revealed illness unawareness was significantly associated with right < left hemisphere volumes in the anteroinferior temporal lobe (t = 4.83, P = 0.051) using DARTEL, and the dorsolateral prefrontal cortex (t = 5.80, P = 0.003) and parietal lobe (t = 4.3, P = 0.050) using the deformation-based approach. Trend level associations were identified in the right medial prefrontal cortex (t = 4.49, P = 0.127) using DARTEL. Lack of illness awareness was also strongly associated with reduced total white matter volume (r = 0.401, P < 0.01) and illness severity (r = 0.559, P < 0.01). These results suggest a relationship between anosognosia and hemispheric asymmetry in schizophrenia, supporting previous volume-based MRI studies in schizophrenia that found a relationship between illness unawareness and reduced right hemisphere gray matter volume. Functional imaging studies are required to examine the neural mechanisms contributing to these structural observations. Copyright © 2012 Wiley Periodicals, Inc.

  10. Factors Influencing Amount of Weekly Exercise Time in Colorectal Cancer Survivors.

    PubMed

    Chou, Yun-Jen; Lai, Yeur-Hur; Lin, Been-Ren; Liang, Jin-Tung; Shun, Shiow-Ching

    Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.

  11. Conceptualising the lack of health insurance coverage.

    PubMed

    Davis, J B

    2000-01-01

    This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

  12. [Symptoms of Depression, Anxiety and Stress Among Dental Students: Prevalence and Related Factors].

    PubMed

    Arrieta Vergara, Katherine; Cárdenas, Shyrley Díaz; Martínez, Farith González

    2013-06-01

    To estimate the relationship between depressive symptoms, anxiety and stress and socio-demographic, academic and social factors among dental students. A cross-sectional study was carried out on dental students from a university in Cartagena, selected by simple random sampling. Students answered a self-report anonymous questionnaire of 20 questions that included demographic characteristics, depression, anxiety and stress symptoms (DASS scale 21), family function (APGAR family) and other factors associated with the academic, economic and social context. Data were analyzed computing odds ratios by binomial logistic regression. The prevalence of symptoms of anxiety, depression and stress were 37.4%, 56.6% and 45.4%, respectively. Factors associated with depressive symptoms were lack of support from friends (OR=6.2; 95%CI, 2.6-14.5), family dysfunction (OR=3.6; 95%CI, 1.9-6.6) and economic hardship (OR=2.2; 95%CI, 1.2-3.9). The anxiety symptoms were associated with family dysfunction (OR=3.1; 95%CI, 1.8-5.3) and lack of support from friends (OR=2.1; 95%CI, 1.1-5.8). Also for symptoms of stress factors family dysfunction (OR=2.3; 95%CI, 1.4-4.1), income (OR=2.4; 95%CI, 1.2-4.9) and time to rest (OR=2.3; 95%CI, 1.4-4.0). Dental students report a high prevalence of symptoms of anxiety, depression and stress. Associated factors are economic resources, family function, lack of time for rest, and social support. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  13. Quantitative trait loci for a neurocranium deformity, lack of operculum, in gilthead seabream (Sparus aurata L.).

    PubMed

    Negrín-Báez, D; Navarro, A; Afonso, J M; Toro, M A; Zamorano, M J

    2016-04-01

    Lack of operculum, a neurocranial deformity, is the most common external abnormality to be found among industrially produced gilthead seabream (Sparus aurata L.), and this entails significant financial losses. This study conducts, for the first time in this species, a quantitative trait loci (QTL) analysis of the lack of operculum. A total of 142 individuals from a paternal half-sibling family (six full-sibling families) were selected for QTL mapping. They had previously shown a highly significant association with the prevalence of lack of operculum in a segregation analysis. All the fish were genotyped for 106 microsatellite markers using a set of multiplex PCRs (ReMsa1-ReMsa13). A linear regression methodology was used for the QTL analysis. Four QTL were detected for this deformity, two of which (QTLOP1 and QTLOP2) were significant. They were located at LG (linkage group) nine and LG10 respectively. Both QTL showed a large effect (about 27%), and furthermore, the association between lack of operculum and sire allelic segregation observed was statistically significant in the QTLOP1 analysis. These results represent a significant step towards including marker-assisted selection for this deformity in genetic breeding programmes to reduce the incidence of the deformity in the species. © 2016 Stichting International Foundation for Animal Genetics.

  14. Factors associated with lack of postnatal care among Palestinian women: A cross-sectional study of three clinics in the West Bank

    PubMed Central

    Dhaher, Enas; Mikolajczyk, Rafael T; Maxwell, Annette E; Krämer, Alexander

    2008-01-01

    Background Only about one-third of women in Palestine (West Bank and Gaza) obtain postpartum care. Therefore, the goal of this study was to assess factors associated with lack of postnatal care, women's reasons for not obtaining postnatal care, and their attitudes towards its importance. Methods In early 2006, a cross-sectional survey was conducted at three clinics run by the Ministry of Health providing Mother and Child Health Care in West Bank, Palestine. A total of 264 postpartum women attending the clinics were interviewed face-to-face, using a structured questionnaire. Results Although the majority of women considered postnatal care necessary (66.1%), only 36.6% of women obtained postnatal care. The most frequent reason for not obtaining postnatal care was that women did not feel sick and therefore did not need postnatal care (85%), followed by not having been told by their doctor to come back for postnatal care (15.5%). Based on a multivariable analysis, use of postnatal care was higher among women who had experienced problems during their delivery, had a cesarean section, or had an instrumental vaginal delivery than among women who had a spontaneous vaginal delivery. Use of postnatal care was also higher among women who delivered in a private hospital as compared to those who delivered in a public hospital. In addition, we found regional differences. Conclusion The higher use of postnatal care among high-risk women is appropriate, but some clinically dangerous conditions can also occur in low-risk women. Future efforts should therefore focus on providing postnatal care to a larger number of low-risk women. PMID:18638395

  15. A Trunk Support System to Identify Posture Control Mechanisms in Populations Lacking Independent Sitting

    PubMed Central

    Goodworth, Adam D.; Wu, Yen-Hsun; Felmlee, Duffy; Dunklebarger, Ellis; Saavedra, Sandra

    2016-01-01

    Populations with moderate-to-severe motor control impairments often exhibit degraded trunk control and/or lack the ability to sit unassisted. These populations need more research, yet their underdeveloped trunk control complicates identification of neural mechanisms behind their movements. The purpose of this study was to overcome this barrier by developing the first multi-articulated trunk support system to identify visual, vestibular, and proprioception contributions to posture in populations lacking independent sitting. The system provided external stability at a user-specific level on the trunk, so that body segments above the level of support required active posture control. The system included a tilting surface (controlled via servomotor) as a stimulus to investigate sensory contributions to postural responses. Frequency response and coherence functions between the surface tilt and trunk support were used to characterize system dynamics and indicated that surface tilts were accurately transmitted up to 5Hz. Feasibility of collecting kinematic data in participants lacking independent sitting was demonstrated in two populations: two typically developing infants, ~2-8 months, in a longitudinal study (8 sessions each) and four children with moderate-to-severe cerebral palsy (GMFCS III-V). Adaptability in the system was assessed by testing 16 adults (ages 18-63). Kinematic responses to continuous pseudorandom surface tilts were evaluated across 0.046–2Hz and qualitative feedback indicated that the trunk support and stimulus were comfortable for all subjects. Concepts underlying the system enable both research for, and rehabilitation in, populations lacking independent sitting. PMID:27046877

  16. Lack of motivation for treatment associated with greater care needs and psychosocial problems.

    PubMed

    Stobbe, Jolanda; Wierdsma, Andre I; Kok, Rob M; Kroon, Hans; Depla, Marja; Roosenschoon, Bert-Jan; Mulder, Cornelis L

    2013-01-01

    To compare the care needs and severity of psychosocial problems in older patients with severe mental illness (SMI) between those who were and were not motivated for treatment. Cross-sectional study in which we enrolled 141 outpatients with SMI aged 55 and older. Needs were measured using the Camberwell Assessment of Needs for the Elderly, and psychosocial problems with the Health of the Nation Outcome Scale 65+. Motivation for treatment was assessed using a motivation-for-change scale. Parametric and non-parametric tests were used to analyze differences between motivated and non-motivated patients. Explorative logistic regression analyses were used to establish, which unmet needs were associated with motivation. Less-motivated patients had greater unmet care needs and more psychosocial problems than those who were motivated. Logistic regression analyses showed that lack of motivation was associated with greater unmet needs regarding daytime activities, psychotic symptoms, behavioral problems, and addiction problems. Lack of treatment motivation was associated with more unmet needs and more severe psychosocial problems. Further research will be needed to identify other factors associated with motivation in older people with SMI and to investigate whether this group of patient benefits from interventions such as assertive outreach, integrated care or treatment-adherence therapy.

  17. The last common ancestor of animals lacked the HIF pathway and respired in low-oxygen environments

    PubMed Central

    Vargas, Sergio; Larsen, Morten; Elemans, Coen PH; Canfield, Donald E

    2018-01-01

    Animals have a carefully orchestrated relationship with oxygen. When exposed to low environmental oxygen concentrations, and during periods of increased energy expenditure, animals maintain cellular oxygen homeostasis by enhancing internal oxygen delivery, and by enabling the anaerobic production of ATP. These low-oxygen responses are thought to be controlled universally across animals by the hypoxia-inducible factor (HIF). We find, however, that sponge and ctenophore genomes lack key components of the HIF pathway. Since sponges and ctenophores are likely sister to all remaining animal phyla, the last common ancestor of extant animals likely lacked the HIF pathway as well. Laboratory experiments show that the marine sponge Tethya wilhelma maintains normal transcription under oxygen levels down to 0.25% of modern atmospheric saturation, the lowest levels we investigated, consistent with the predicted absence of HIF or any other HIF-like pathway. Thus, the last common ancestor of all living animals could have metabolized aerobically under very low environmental oxygen concentrations. PMID:29402379

  18. Risk factors for stillbirth in developing countries: a systematic review of the literature.

    PubMed

    Di Mario, Simona; Say, Lale; Lincetto, Ornella

    2007-07-01

    To identify risk factors for stillbirth in developing countries and to measure their impact by calculating the population attributable fraction (PAF) for each risk factor. Systematic review of published studies on risk factors for stillbirth within 3 broadly defined categories: infections, other clinical conditions, and context-dependent conditions such as socioeconomic status, maternal literacy, and receipt of antenatal care. Where statistically significant associations were found between a risk factor and occurrence of stillbirth, the PAF (the proportion of cases occurring in the total population that would be avoided if the exposure was removed) was calculated. A total of 33 studies, conducted in 31 developing countries, were included in the review. The definition of stillbirth varied widely in these studies. Risk factors for stillbirth having a PAF higher than 50% were maternal syphilis, chorioamnionitis, maternal malnutrition, lack of antenatal care, and maternal socioeconomic disadvantage. Maternal syphilis prevention, screening and treatment together with other interventions targeting universal use of antenatal care (that includes screening for syphilis) and improving the socioeconomic conditions including nutritional status of the mother, could effectively contribute towards reducing the unacceptably high burden due to stillbirth in developing countries.

  19. Maternal perceptions and factors affecting Kangaroo mother care continuum at home: a descriptive study.

    PubMed

    Raajashri, R; Adhisivam, B; Vishnu Bhat, B; Palanivel, C

    2018-03-01

    To estimate the proportion of mothers who continued to practice Kangaroo mother care (KMC) at home and evaluate potential factors influencing this practice. This descriptive study was conducted in a tertiary care teaching hospital in south India. Mothers of preterm and low birth weight infants were trained in KMC during hospital stay. During follow up after 45 days, data regarding their perceptions and the practice of KMC at home and the factors influencing them were collected using questionnaires. Among 200 mothers interviewed, 82.5% continued to practice KMC at home after discharge. The mean total duration of KMC was 30.2 days and average duration per day was 1.3 h. Support of family members was facilitatory in 70% and lack of privacy at home was hindering in 25%. After KMC training in hospital, majority of the post natal mothers were able to continue the practice satisfactorily at home despite hindering factors including lack of privacy. KMC training modules should emphasize continuing the practice at home after discharge and address the potential barriers for KMC continuum in the community.

  20. Factors associated with anemia in children under three years of age in Perú: analysis of the Encuesta Demográfica y de Salud Familiar, ENDES, 2007-2013.

    PubMed

    Velásquez-Hurtado, José Enrique; Rodríguez, Yuleika; Gonzáles, Marco; Astete-Robilliard, Laura; Loyola-Romaní, Jessica; Vigo, Walter Eduardo; Rosas-Aguirre, Ángel Martín

    2016-06-03

    Despite the reduction of poverty in Perú, the prevalence of anemia in the country remains high.  To identify socio-demographic, child and maternal-child care factors associated with anemia in children between 6 and 35 months in Perú.  We conducted an analytical and descriptive study that included registered data from the national survey on demography and family health, 2007-2013, on children between 6 and 35 months old, including the measurement of blood hemoglobin. Anemia was confirmed by hemoglobin-altitude corrected values below 11 mg/dl. We used multivariate logistic regression models to assess potential associated factors for anemia.  Anemia prevalence was high (47.9%). Twelve factors were independently associated with anemia in children: Socio-demographic factors such as living outside Lima and Callao, in a low socioeconomic household, and having an adolescent mother with low education level; child-related factors as being male, younger than 24 months of age, and having fever in the previous two weeks, and maternal-child care factors such as lack of prenatal control in the first trimester of pregnancy, lack or short period of iron supplementation during pregnancy, house delivery, anemia detection at the moment of the survey, and lack of intestinal anti-parasite preventive treatment in the child.  The analysis of survey data provided valuable information about factors associated with anemia in children between 6 and 35 months, which can be used to increase the coverage and effectiveness of maternal-child care practices.

  1. EBF factors drive expression of multiple classes of target genes governing neuronal development.

    PubMed

    Green, Yangsook S; Vetter, Monica L

    2011-04-30

    Early B cell factor (EBF) family members are transcription factors known to have important roles in several aspects of vertebrate neurogenesis, including commitment, migration and differentiation. Knowledge of how EBF family members contribute to neurogenesis is limited by a lack of detailed understanding of genes that are transcriptionally regulated by these factors. We performed a microarray screen in Xenopus animal caps to search for targets of EBF transcriptional activity, and identified candidate targets with multiple roles, including transcription factors of several classes. We determined that, among the most upregulated candidate genes with expected neuronal functions, most require EBF activity for some or all of their expression, and most have overlapping expression with ebf genes. We also found that the candidate target genes that had the most strongly overlapping expression patterns with ebf genes were predicted to be direct transcriptional targets of EBF transcriptional activity. The identification of candidate targets that are transcription factor genes, including nscl-1, emx1 and aml1, improves our understanding of how EBF proteins participate in the hierarchy of transcription control during neuronal development, and suggests novel mechanisms by which EBF activity promotes migration and differentiation. Other candidate targets, including pcdh8 and kcnk5, expand our knowledge of the types of terminal differentiated neuronal functions that EBF proteins regulate.

  2. Allele frequency distribution of 1691G >A F5 (which confers Factor V Leiden) across Europe, including Slavic populations.

    PubMed

    Clark, Jeremy S C; Adler, Grażyna; Salkic, Nermin N; Ciechanowicz, Andrzej

    2013-11-01

    The allele 1691A F5, conferring Factor V Leiden, is a common risk factor in venous thromboembolism. The frequency distribution for this allele in Western Europe has been well documented; but here data from Central, Eastern and South-Eastern Europe has been included. In order to assess the significance of the collated data, a chi-squared test was applied, and Tukey tests and z-tests with Bonferroni correction were compared. A distribution with a North-Southeast band of high frequency of the 1691A F5 allele was discovered with a pocket including some Southern Slavic populations with low frequency. European countries/regions can be arbitrarily delimited into low (group 1, <2.8 %, mean 1.9 % 1691A F5 allele) or high (group 2, ≥2.8 %, mean 4.0 %) frequency groups, with many significant differences between groups, but only one intra-group difference (the Tukey test is suggested to be superior to the z-tests). In Europe a North-Southeast band of 1691A F5 high frequency has been found, clarified by inclusion of data from Central, Eastern and South-Eastern Europe, which surrounds a pocket of low frequency in the Balkans which could possibly be explained by Slavic migration. There seem to be no indications of variation in environmental selection due to geographical location.

  3. The effects of work-related and individual factors on the Work Ability Index: a systematic review.

    PubMed

    van den Berg, T I J; Elders, L A M; de Zwart, B C H; Burdorf, A

    2009-04-01

    This paper systematically reviews the scientific literature on the effects of individual and work-related factors on the Work Ability Index (WAI). Studies on work ability published from 1985 to 2006 were identified through a structured search in PubMed, and Web of Science. Studies were included if the WAI was used as measure of work ability and if quantitative information was presented on determinants of work ability. In total, 20 studies were included with 14 cross-sectional studies and six longitudinal studies. Factors associated with poor work ability, as defined by WAI, were lack of leisure-time vigorous physical activity, poor musculoskeletal capacity, older age, obesity, high mental work demands, lack of autonomy, poor physical work environment, and high physical work load. The WAI is associated with individual characteristics, lifestyle, demands at work, and physical condition. This multifactorial nature of work ability should be taken into account in health promotion programmes aimed at maintaining and promoting the participation of the labour force and improvement of the performance at work.

  4. Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks.

    PubMed

    Beaudoin, A L; Kitikoon, P; Schreiner, P J; Singer, R S; Sasipreeyajan, J; Amonsin, A; Gramer, M R; Pakinsee, S; Bender, J B

    2014-08-01

    Free-grazing ducks (FGD) have been associated with highly pathogenic avian influenza (HPAI) H5N1 outbreaks and may be a viral reservoir. In July-August 2010, we assessed influenza exposure of Thai FGD and risk factors thereof. Serum from 6254 ducks was analysed with enzyme-linked immunosorbent assay (ELISA) to detect antibodies to influenza A nucleoprotein (NP), and haemagglutinin H5 protein. Eighty-five per cent (5305 ducks) were seropositive for influenza A. Of the NP-seropositive sera tested with H5 assays (n = 1423), 553 (39%) were H5 ELISA positive and 57 (4%) suspect. Twelve per cent (74 of 610) of H5 ELISA-positive/suspect ducks had H5 titres ≥ 1 : 20 by haemagglutination inhibition. Risk factors for influenza A seropositivity include older age, poultry contact, flock visitors and older purchase age. Study flocks had H5 virus exposure as recently as March 2010, but no HPAI H5N1 outbreaks have been identified in Thailand since 2008, highlighting a need for rigorous FGD surveillance. © 2012 Blackwell Verlag GmbH.

  5. Irregularity and lack of p waves in short tachycardia episodes predict atrial fibrillation and ischemic stroke.

    PubMed

    Johnson, Linda S B; Persson, Anders P; Wollmer, Per; Juul-Möller, Steen; Juhlin, Tord; Engström, Gunnar

    2018-02-13

    Atrial fibrillation (AF) is defined as an irregular supraventricular tachycardia (SVT) without p waves, with duration >30 seconds. Whether AF characteristics during short SVT episodes predict AF and stroke is not known. The purpose of this study was to determine whether irregularity and lack of p waves, alone or in combination, during short SVT episodes increase the risk of incident AF and ischemic stroke. The population-based Malmö Diet and Cancer study includes 24-hour ECG screening of 377 AF-free individuals (mean age 64.5 years; 43% men) who were prospectively followed for >13 years. There were 65 AF events and 25 ischemic stroke events during follow-up. Subjects with an SVT episode ≥5 beats were identified, and the longest SVT episode was assessed for irregularity and lack of p waves. The association between SVT classification and AF and stroke was assessed using multivariable adjusted Cox regression. The incidence of AF increased with increasing abnormality of the SVTs. The risk-factor adjusted hazard ratio for AF was 4.95 (95% confidence interval 2.06-11.9; P <.0001) for those with short irregular SVTs (<70 beats) without p waves. The incidence of ischemic stroke was highest in the group with regular SVT episodes without p waves (hazard ratio 14.2; 95% confidence interval 3.76-57.6; P <.0001, adjusted for age and sex). Characteristics of short SVT episodes detected at 24-hour ECG screening are associated with incident AF and ischemic stroke. Short irregular SVTs without p waves likely represent early stages of AF or atrial myopathy. Twenty-four-hour ECG could identify subjects suitable for primary prevention efforts. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  6. Lack of sexual privacy affects psychological and marital domains of male sexual dysfunction.

    PubMed

    Boddi, Valentina; Fisher, Alessandra Daphne; Maseroli, Elisa; Rastrelli, Giulia; Corona, Giovanni; Jannini, Emmanuele; Ricca, Valdo; Mannucci, Edoardo; Maggi, Mario

    2014-02-01

    Sexual dysfunctions (SDs) are dictated by predisposing, precipitating, maintaining, and contextual factors, the latter of which can help sexual problems to emerge. Even if the lack of sexual privacy is one of the most common contextual issues, it has not been extensively studied. Investigation of sexual privacy in a large sample of men consulting for SD was the aim of this study. A consecutive series of 3,736 men, attending the outpatient clinic for SD for the first time, was retrospectively studied. Privacy during sexual intercourse was investigated with the following question, "During the last three months, have you had enough privacy during your sexual activity?" and rated 0 = yes, 1 = sometimes, 2 = rarely, and 3 = never. Several clinical, biochemical, and psychological (Middlesex Hospital Questionnaire [MHQ]) parameters were studied. Among the 3,736 patients studied, 83.9% reported enough privacy during sexual intercourse, while 8.6%, 5.7%, and 1.7% declared a decrease of sexual privacy of increasing severity. Lack of sexual privacy was associated with ejaculatory dysfunctions and with the inability to maintain an erection during intercourse. Subjects reporting lack of sexual privacy had a higher risk of relational and intrapsychic impairments, as well as psychopathology at MHQ questionnaire, even after adjusting for confounders. Fatherhood was associated with sexual privacy issues only in the lowest quartiles. In subjects without children, the absence of cohabitation with the partner was associated with an increasing risk of not having enough privacy (hazard ratio [HR] = 1.837 [1.269-2.659], P = 0.001); data confirmed, after stratification for age, only in the youngest subjects (I quartile HR = 2.159 [1.211-3.848], P = 0.009). This study indicates that sexual privacy is often a poorly investigated item, which is important to evaluate in male SD. © 2013 International Society for Sexual Medicine.

  7. Protective factors for youth considered at risk of criminal behaviour: does participation in extracurricular activities help?

    PubMed

    Burton, Jodi M; Marshall, Lisa A

    2005-01-01

    There is a lack of research investigating the potential protective effect of participation in extracurricular activities on youth who are at risk of engaging in delinquent activity. This study examined the potential for participation in extracurricular activities to act as a protective factor for youth deemed at risk of engaging in delinquent activity. One hundred and sixty-nine secondary students from Glasgow, Scotland completed two questionnaires (the Youth Self-Report and an additional information sheet) requesting information about their participation in extracurricular and delinquent activities as well as their possible risk factors. Activities included sports, non-sports (hobbies and games), current activities (youth clubs and other organisations) and previous involvement in activities. Risk factors included residing in a broken home, having four or more siblings, academic failure and lacking a non-parental very important person. Delinquent activities included rule-breaking and aggressive behaviours. Independent samples t-tests found that females participated in significantly more non-sports and previous activities than males and that males participated in significantly more rule-breaking behaviour than females. Hierarchical multiple regression analyses found that gender and participation in sports were strong predictors of rule-breaking behaviour. A significant positive correlation was found between participation in sports and involvement in aggressive behaviour. The results suggest that participation in extracurricular activities does not act as a protective factor for youth, regardless of whether or not they are considered to be at risk of engaging in delinquent activity. The significant correlation found between participation in sports and involvement in aggressive behaviour suggests that youth participation in sports may act as a risk factor.

  8. [Lack of insight in schizophrenia: a review].

    PubMed

    Raffard, S; Bayard, S; Capdevielle, D; Garcia, F; Boulenger, J-P; Gely-Nargeot, M-C

    2008-10-01

    Relative to other psychiatric disorders, patients with schizophrenia are often unaware of the consequences of their disease and their need for treatment. These deficits in awareness referred in general in the English literature as "poor insight", have been the focus of many clinical studies over recent years. This phenomenon, which is considered as fundamental in clinical evaluations of schizophrenia, should be understood as a multidimensional process rather than a dichotomic phenomenon, as is presently the case. The links between insight deficits and responses to vocational rehabilitation efforts represent a major interest in research, including those related to medication compliance and clinical outcome. To conduct such studies, various evaluation tools have been developed, enabling the assessment of insight, of its time-course and of its components in psychosis and schizophrenia spectrum disorders. The Scale to Assess Unawareness of illness in Mental Disorders (SUMD) developed by Amador and Strauss appears to be the most frequently used scale for the evaluation of awareness of the disorder in schizophrenia. Although the model proposed by Amador and Strauss is considered as the privileged model in the multidimensional approach of insight, it corresponds only to a phenomenological analysis of this concept. In the second part of this article, we thus review the current models attempting to explain the lack of insight in schizophrenia. Four current explanatory models of lack of insight will be described as follows: resulting either from adaptation or defence mechanisms to environmental stressors, resulting from cognitive bias of data processing, resulting from neuropsychological functional deficits and resulting from metacognitive deficits. Several hypotheses concerning these deficits arise from clinical studies. Although coping, and defence mechanisms to the consequences and stigmatization of the disease were hardly studied, the fact that poor insight does not

  9. Possible risk factors for increased suicide following bariatric surgery.

    PubMed

    Mitchell, James E; Crosby, Ross; de Zwaan, Martina; Engel, Scott; Roerig, James; Steffen, Kristine; Gordon, Kathryn H; Karr, Trisha; Lavender, Jason; Wonderlich, Steve

    2013-04-01

    There is a growing research literature suggesting that there may be elevated risk of suicide following bariatric surgery. Most of the data reported thus far has been cross-sectional and observational, and very little is known about the possible specific causal variables involved. The purpose of this report is to review this literature and to review possible risk factors for increased suicidal risk following bariatric surgery, to delineate future research directions. First a variety of medical, biological, and genetic factors, including the persistence or recurrence of medical comorbidities after bariatric surgery, the disinhibition and impulsivity secondary to changes in the absorption of alcohol, hypoglycemia, as well as pharmacokinetic changes that may affect the absorption of various medications including antidepressant medications are reviewed. Also reviewed are possible mediating factors involving changes in various peptidergic systems such as GLP-1 and Ghrelin. A number of psychosocial issues that might be involved are discussed, including lack of improvement in quality of life after surgery, continued or recurrent physical mobility restrictions, persistence or recurrence of sexual dysfunction and relationship problems, low self-esteem, and a history of child maltreatment. Inadequate weight loss or weight regain are also discussed. A number of possible contributing factors have been identified. Possible theoretical models involved and directions for research are suggested. Copyright © 2012 The Obesity Society.

  10. Modifiable worker risk factors contributing to workplace absence: a stakeholder-centred best-evidence synthesis of systematic reviews.

    PubMed

    Wagner, Shannon; White, Marc; Schultz, Izabela; Murray, Eleanor; Bradley, Susan M; Hsu, Vernita; McGuire, Lisa; Schulz, Werner

    2014-01-01

    A challenge facing stakeholders is the identification and translation of relevant high quality research to inform policy and practice. This study engaged academic and community stakeholders in conducting a best evidence-synthesis to identify modifiable risk and protective worker factors across health conditions impacting work-related absence. To identify modifiable worker disability risk and protective factors across common health conditions impacting work-related absence. We searched Medline, Embase, CINHAL, The Cochrane Library, PsycINFO, BusinessSourceComplete, and ABI/Inform from 2000 to 2011. Quantitative, qualitative, or mixed methods systematic reviews of work-focused population were considered for inclusion. Two or more reviewers independently reviewed articles for inclusion and methodological screening. The search strategy, expert input and grey literature identified 2,467 unique records. One hundred and forty-two full text articles underwent comprehensive review. Twenty-four systematic reviews met eligibility criteria. Modifiable worker factors found to have consistent evidence across two or more health conditions included emotional distress, negative enduring psychology/personality factors, negative health and disability perception, decreased physical activity, lack of family support, poor general health, increased functional disability, increased pain, increased fatigue and lack of motivation to return to work. Systematic reviews are limited by availability of high quality studies, lack of consistency of methodological screening and reporting, and variability of outcome measures used.

  11. Choosing Child and Adolescent Psychiatry: Factors Influencing Medical Students

    PubMed Central

    Volpe, Tiziana; Boydell, Katherine M.; Pignatiello, Antonio

    2013-01-01

    Objective: To examine the factors influencing medical students to choose child and adolescent psychiatry as a career specialty. Method: Quantitative and qualitative methods were used. A web-based survey was distributed to child and adolescent psychiatrists at the University of Toronto. In-depth interviews were held with select child and adolescent psychiatrists as well as a focus group with psychiatry residents. Retrospective accounts of the factors that influenced their decision to choose psychiatry and/or child and adolescent psychiatry as a specialty were collected. Results: Ninety-two percent of participants indicated that recruitment of child psychiatrists in Canada is a problem. The recent decision by the Royal College of Physicians and Surgeons to recognize child and adolescent psychiatry as a subspecialty and introduce an extra year of training was identified as a further challenge to recruitment efforts. Other deterrents included lower salary than other subspecialties, lack of exposure during training, stigma, and lack of interest in treating children. Recruitment into psychiatry was enhanced by good role modeling, early exposure in medical school, an interest in brain research, and career and lifestyle issues. Conclusions: A rebranding of the role and perception of psychiatry is needed to attract future psychiatrists. Early exposure to innovations in child and adolescent psychiatry and positive role models are critical in attracting medical students. Recruitment should begin in the first year of medical school and include an enriched paediatric curriculum. PMID:24223044

  12. Associations between errors and contributing factors in aircraft maintenance

    NASA Technical Reports Server (NTRS)

    Hobbs, Alan; Williamson, Ann

    2003-01-01

    In recent years cognitive error models have provided insights into the unsafe acts that lead to many accidents in safety-critical environments. Most models of accident causation are based on the notion that human errors occur in the context of contributing factors. However, there is a lack of published information on possible links between specific errors and contributing factors. A total of 619 safety occurrences involving aircraft maintenance were reported using a self-completed questionnaire. Of these occurrences, 96% were related to the actions of maintenance personnel. The types of errors that were involved, and the contributing factors associated with those actions, were determined. Each type of error was associated with a particular set of contributing factors and with specific occurrence outcomes. Among the associations were links between memory lapses and fatigue and between rule violations and time pressure. Potential applications of this research include assisting with the design of accident prevention strategies, the estimation of human error probabilities, and the monitoring of organizational safety performance.

  13. Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner.

    PubMed

    Nishimura, Akiko; Fujita, Yuichi; Katsuta, Mayumi; Ishihara, Aya; Ohashi, Kazutomo

    2015-05-31

    A negative effect of paternal depression on child development has been revealed in several previous studies. The aims of this study were to examine the prevalence and relevant factors associated with paternal postnatal depression at four months postpartum, including age, part-time work or unemployment, experience of visiting a medical institution due to a mental health problem, economic anxiety, unexpected pregnancy, pregnancy with infertility treatment, first child, partner's depression, and lower marital relationship satisfaction. We distributed 2032 self-report questionnaires to couples (one mother and one father) with a 4-month old infant between January and April 2013. Data from 807 couples (39.7 %) were analyzed. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). In order to clarify the factors related with paternal depression, a logistic regression analysis was conducted. One hundred and ten fathers (13.6 %) and 83 mothers (10.3 %) were depressed. According to the logistic regression analysis, paternal depression was positively associated with partner's depression (adjusted odds ratio (AOR) 1.91, 95 % confidence interval (CI) 1.05-3.47), and negatively with marital relationship satisfaction (AOR 0.83, 95 % CI 0.77-0.89). History of infertility treatment (AOR 2.37, 95 % CI 1.32-4.24), experience of visiting a medical institution due to a mental health problem (AOR 4.56, 95 % CI 2.06-10.08), and economic anxiety (AOR 2.15, 95 % CI 1.34-3.45) were also correlated with paternal depression. This study showed that the prevalence of paternal depression at four months after childbirth was 13.6 % in Japan. The presence of partner's depression and low marital relationship satisfaction were significantly correlated with paternal postpartum depression, suggesting that health professionals need to pay attention to the mental status of both fathers and mothers, and to their relationship.

  14. Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders in Early Childhood - United States, 2011-2012.

    PubMed

    Bitsko, Rebecca H; Holbrook, Joseph R; Robinson, Lara R; Kaminski, Jennifer W; Ghandour, Reem; Smith, Camille; Peacock, Georgina

    2016-03-11

    Sociodemographic, health care, family, and community attributes have been associated with increased risk for mental, behavioral, and developmental disorders (MBDDs) in children (1,2). For example, poverty has been shown to have adverse effects on cognitive, socio-emotional, and physical development (1). A safe place to play is needed for gross motor development, and accessible health care is needed for preventive and illness health care (3). Positive parenting and quality preschool interventions have been shown to be associated with prosocial skills, better educational outcomes, and fewer health risk behaviors over time (2). Protective factors for MBDDs are often shared (4) and conditions often co-occur; therefore, CDC considered MBDDs together to facilitate the identification of factors that could inform collaborative, multidisciplinary prevention strategies. To identify specific factors associated with MBDDs among U.S. children aged 2-8 years, parent-reported data from the most recent (2011-2012) National Survey of Children's Health (NSCH) were analyzed. Factors associated with having any MBDD included inadequate insurance, lacking a medical home, fair or poor parental mental health, difficulties getting by on the family's income, employment difficulties because of child care issues, living in a neighborhood lacking support, living in a neighborhood lacking amenities (e.g., sidewalks, park, recreation center, and library), and living in a neighborhood in poor condition. In a multivariate analysis, fair or poor parental mental health and lacking a medical home were significantly associated with having an MBDD. There was significant variation in the prevalence of these and the other factors by state, suggesting that programs and policies might use collaborative efforts to focus on specific factors. Addressing identified factors might prevent the onset of MBDDs and improve outcomes among children who have one or more of these disorders.

  15. Regulatory iNKT cells lack PLZF expression and control Treg cell and macrophage homeostasis in adipose tissue

    PubMed Central

    Lynch, Lydia; Michelet, Xavier; Zhang, Sai; Brennan, Patrick J.; Moseman, Ashley; Lester, Chantel; Besra, Gurdyal; Vomhof-Dekrey, Emilie E.; Tighe, Mike; Koay, Hui-Fern; Godfrey, Dale I.; Leadbetter, Elizabeth A.; Sant’Angelo, Derek B.; von Andrian, Ulrich; Brenner, Michael B.

    2015-01-01

    iNKT cells are CD1d-restricted lipid-sensing innate T cells that express the transcription factor PLZF. iNKT cells accumulate in adipose tissue, where they are anti-inflammatory, but the factors that contribute to their anti-inflammatory nature, and their targets in adipose tissue are unknown. Here we report that adipose tissue iNKT cells have a unique transcriptional program and produce interleukin 2 (IL-2) and IL-10. Unlike other iNKT cells, they lack PLZF, but express the transcription factor E4BP4, which controls their IL-10 production. Adipose iNKT cells are a tissue resident population that induces an anti-inflammatory phenotype in macrophages and, through production of IL-2, controls the number, proliferation and suppressor function of adipose regulatory T (Treg) cells. Thus, adipose tissue iNKT cells are unique regulators of immune homeostasis in this tissue. PMID:25436972

  16. Factors affecting compliance with measles vaccination in Lao PDR.

    PubMed

    Phimmasane, Maniphet; Douangmala, Somthana; Koffi, Paulin; Reinharz, Daniel; Buisson, Yves

    2010-09-24

    In line with WHO objectives, the Lao Government is committed to eliminate measles by 2012. Yet from 1992 to 2007, the annual incidence of measles remained high while the vaccination coverage showed a wide diversity across provinces. A descriptive study was performed to determine factors affecting compliance with vaccination against measles, which included qualitative and quantitative components. The qualitative study used a convenience sample of 13 persons in charge of the vaccination program, consisting of officials from different levels of the health care structure and members of vaccination teams. The quantitative study performed on the target population consisted of a matched, case-control survey conducted on a stratified random sample of parents of children aged 9-23 months. Overall, 584 individuals (292 cases and 292 controls) were interviewed in the three provinces selected because of low vaccination coverage. On the provision of services side (supply), the main problems identified were a lack of vaccine supply and diluent, a difficulty in maintaining the cold chain, a lack of availability and competence among health workers, a lack of coordination and a limited capacity to assess needs and make coherent decisions. In the side of the consumer (demand), major obstacles identified were poor knowledge about measles immunization and difficulties in accessing vaccination centers because of distance and cost. In multivariate analysis, a low education level of the father was a factor of non-immunization while the factors of good compliance were high incomes, spacing of pregnancies, a feeling that children must be vaccinated, knowledge about immunization age, presenting oneself to the hospital rather than expecting the mobile vaccination teams and last, immunization of other family members or friends' children. The main factors affecting the compliance with vaccination against measles in Laos involve both the supply side and the demand side. Obtaining an effective

  17. Bell's palsy. A prospective, longitudinal, descriptive, and observational analysis of prognosis factors for recovery in Mexican patients.

    PubMed

    Sánchez-Chapul, Laura; Reyes-Cadena, Susana; Andrade-Cabrera, José Luis; Carrillo-Soto, Irma A; León-Hernández, Saúl R; Paniagua-Pérez, Rogelio; Olivera-Díaz, Hiram; Baños-Mendoza, Teresa; Flores-Mondragón, Gabriela; Hernández-Campos, Norma A

    2011-01-01

    To determine the prognosis factors in Mexican patients with Bell's palsy. We designed a prospective, longitudinal, descriptive, and observational analysis. Two hundred and fifty one patients diagnosed with Bell's palsy at the National Institute of Rehabilitation were included. We studied the sociodemographic characteristics, seasonal occurrence, sidedness, symptoms, and therapeutic options to determine the prognostic factors for their recovery. Thirty-nine percent of patients had a complete recovery and 41.5% had an incomplete recovery. Marital status, gender, etiology, symptoms, sidedness, House-Brackmann grade, and treatments did not represent significant prognostic factors for recovery. Age > 40 years (OR = 2.4, IC 95% 1.3-4.3, p = 0.002) and lack of physical therapy (OR = 6.4, IC 95% 1.4-29.6, p = 0.006) were significant prognostic factors for incomplete recovery. Familial palsy resulted to be a protective prognostic factor against an incomplete recovery (OR = 0.54, IC 95% 0.28-1.01, p = 0.039). This protection factor was only significant in female patients (OR = 0.41, p = 0.22) but not in male patients (OR = 1.0, p = 0.61). The proportion of cases with incomplete recovery was high. The age > 40 years and lack of physical therapy were the only significant prognostic factors for an incomplete recovery.

  18. Factors that influence the practice of elective induction of labor: what does the evidence tell us?

    PubMed

    Moore, Jennifer; Low, Lisa Kane

    2012-01-01

    Elective induction of labor has been linked to increased rates of prematurity and rising rates of cesarean birth. The purpose of this investigation was to evaluate current trends in induction of labor scholarship focusing on evidence-based factors that influence the practice of elective induction. A key word search was conducted to identify studies on the practice of elective induction of labor. Analysis of the findings included clustering and identification of recurrent themes among the articles with 3 categories being identified. Under each category, the words/phrases were further clustered until a construct could be named. A total of 49 articles met inclusion criteria: 7 patient, 6 maternity care provider, and 4 organization factors emerged. Only 4 of the articles identified were evidence based. Patient factors were divided into preferences/convenience, communication, fear, pressure/influence, trust, external influences, and technology. Provider factors were then divided into practice preferences/convenience, lack of information, financial incentives, fear, patient desire/demand, and technology. Organization factors were divided into lack of enforcement/accountability, hospital culture, scheduling of staff, and market share issues. Currently, there is limited data-based information focused on factors that influence elective induction of labor. Despite patient and provider convenience/preferences being cited in the literature, the evidence does not support this practice.

  19. Call It a Monster for Lack of Anything Else

    PubMed Central

    Roe, David; Hasson-Ohayon, Ilanit; Kravetz, Shlomo; Yanos, Phil T.; Lysaker, Paul H.

    2011-01-01

    Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include “narrative insight” may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness. PMID:19077852

  20. Ocular abnormalities in mice lacking the immunoglobulin superfamily member Cdo.

    PubMed

    Zhang, Wei; Mulieri, Philip J; Gaio, Ursula; Bae, Gyu-Un; Krauss, Robert S; Kang, Jong-Sun

    2009-10-01

    Vertebrate eye development requires a series of complex morphogenetic and inductive events to produce a lens vesicle centered within the bilayered optic cup and a posteriorly positioned optic stalk. Multiple congenital eye defects, including microphthalmia and coloboma, result from defects in early eye morphogenesis. Cdo is a multifunctional cell surface immunoglobulin superfamily member that interacts with and mediates signaling by cadherins and netrins to regulate myogenesis. In addition, Cdo plays an essential role in early forebrain development by functioning as coreceptor for sonic hedgehog. It is reported here that Cdo is expressed in a dynamic, but dorsally restricted, fashion during early eye development, and that mice lacking Cdo display multiple eye defects. Anomalies seen in Cdo(-/-) mice include coloboma (failure to close the optic fissure); failure to form a proper boundary between the retinal pigmented epithelium and optic stalk; defective lens formation, including failure to separate from the surface ectoderm; and microphthalmia. Consistent with this wide array of defects, developing eyes of Cdo(-/-) mice show altered expression of several regulators of dorsoventral eye patterning, including Pax6, Pax2, and Tbx5. Taken together, these findings show that Cdo is required for normal eye development and is required for normal expression of patterning genes in both the ventral and dorsal domains. The multiple eye development defects seen in Cdo(-/-) mice suggest that mutations in human Cdo could contribute to congenital eye anomalies, such as Jacobsen syndrome, which is frequently associated with ocular defects, including coloboma and Peters' anomaly.

  1. Factors influencing worker use of personal protective eyewear.

    PubMed

    Lombardi, David A; Verma, Santosh K; Brennan, Melanye J; Perry, Melissa J

    2009-07-01

    To identify and describe the array of factors that influence a workers' decision to wear personal protective eyewear (PPE) and the barriers that exist in preventing their use. A series of focus groups enrolled workers and supervisors primarily from manufacturing, construction, or service/retail industries that had potential exposure to eye injury hazards in their job tasks. Focus group sessions were facilitated to collect qualitative and quantitative data in two categories, "sought information" and "emergent themes", related to the factors influencing use of PPE. We conducted a series of 7 groups with 51 participants, 36 (71%) males and 15 (29%) females ranging in age from 19 to 64 years old, from a variety of occupations including construction (24%), production (22%), installation, repair and maintenance (14%), and healthcare (10%). Most were highly experienced in their occupation (>10 years); males (86%) and females (53%), and had received some safety training in the past (82%). The majority of workers in this study were required to wear PPE on their worksite (78%), however only 55% had a dedicated safety officer. A conceptual model that summarizes the "sought information" and "emergent themes" is presented that depicts the decision making process for the factors influencing use of PPE and consists of three primary branches; perceptions of hazards and risks, "barriers" to PPE usage, and enforcement and reinforcement. Lack of comfort/fit, and fogging and scratching of the eyewear were suggested as the most important barriers to PPE usage. Younger age and lack of safety training were other important factors affecting use of PPE. Several potentially modifiable factors identified would lead to an increase in workers' PPE use and encourage supervisors to provide ongoing positive feedback on the continuous use of PPE by workers at risk for an eye injury.

  2. Ultrasonographic findings of placenta lacunae and a lack of a clear zone in cases with placenta previa and normal placenta.

    PubMed

    Hamada, Shoko; Hasegawa, Junichi; Nakamura, Masamitsu; Matsuoka, Ryu; Ichizuka, Kiyotake; Sekizawa, Akihiko; Okai, Takashi

    2011-11-01

    To evaluate whether the frequencies of placenta lacunae and lack of a clear zone are higher in cases of placenta previa compared with those without it. Ultrasonographic findings just before delivery, including placenta lacunae and lack of a clear zone were prospectively evaluated in consecutive subjects. After collection, a case-control study with 1:5 matched pairs was conducted. The frequencies of ultrasonographic findings were analyzed in cases with placenta previa and normal placenta. Seventy cases with placenta previa and 350 cases with normal placentas were observed. Five and zero cases with abnormal placental adherence were observed in cases with placenta previa and normal placenta, respectively. Lack of a clear zone was observed in 60 and 1.5% of cases with and without the placental adherence (p = 0.001). Placenta lacunae and lack of a clear zone were observed in 31.4 and 9.7% of cases with and without placenta previa [odds ratio (OR) 4.2]. Lack of a clear zone was observed in 5.7 and 0.9% of cases with and without placenta previa (OR 7.0). Placenta lacunae and lack of a clear zone are frequently observed in placenta previa even when there is no adherence of the placenta. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents.

    PubMed

    Neumark-Sztainer, D; Story, M; Perry, C; Casey, M A

    1999-08-01

    To assess adolescents' perceptions about factors influencing their food choices and eating behaviors. Data were collected in focus-group discussions. The study population included 141 adolescents in 7th and 10th grade from 2 urban schools in St Paul, Minn, who participated in 21 focus groups. Data were analyzed using qualitative research methodology, specifically, the constant comparative method. Factors perceived as influencing food choices included hunger and food cravings, appeal of food, time considerations of adolescents and parents, convenience of food, food availability, parental influence on eating behaviors (including the culture or religion of the family), benefits of foods (including health), situation-specific factors, mood, body image, habit, cost, media, and vegetarian beliefs. Major barriers to eating more fruits, vegetables, and dairy products and eating fewer high-fat foods included a lack of sense of urgency about personal health in relation to other concerns, and taste preferences for other foods. Suggestions for helping adolescents eat a more healthful diet include making healthful food taste and look better, limiting the availability of unhealthful options, making healthful food more available and convenient, teaching children good eating habits at an early age, and changing social norms to make it "cool" to eat healthfully. The findings suggest that if programs to improve adolescent nutrition are to be effective, they need to address a broad range of factors, in particular environmental factors (e.g., the increased availability and promotion of appealing, convenient foods within homes schools, and restaurants).

  4. A Phenomenological Study on Lack of Motivation

    ERIC Educational Resources Information Center

    Educational Research and Reviews, 2013

    2013-01-01

    The aim of this research is to point out the underlying reasons about the lack of motivation at academic activities concerning Attribution Theory. Attribution Theory trys to understand how the people answer "why" question and how they do casual explanations. This research is a qualitative based research. It used the phenomenological…

  5. Factors that impact access to ongoing health care for First Nation children with a chronic condition.

    PubMed

    Coombes, Julieann; Hunter, Kate; Mackean, Tamara; Holland, Andrew J A; Sullivan, Elizabeth; Ivers, Rebecca

    2018-06-14

    Access to multidisciplinary health care services for First Nation children with a chronic condition is critical for the child's health and well-being, but disparities and inequality in health care systems have been almost impossible to eradicate for First Nation people globally. The objective of this review is to identify the factors that impact access and ongoing care for First Nation children globally with a chronic condition. An extensive systematic search was conducted of nine electronic databases to identify primary studies that explored factors affecting access to ongoing services for First Nation children with a chronic disease or injury. Due to the heterogeneity of included studies the Mixed Method Appraisal Tool (MMAT) was used to assess study quality. A total of six studies from Australia, New Zealand and Canada were identified and included in this review. Four studies applied qualitative approaches using in-depth semi structured interviews, focus groups and community fora. Two of the six studies used quantitative approaches. Facilitators included the utilisation of First Nation liaison workers or First Nation Health workers. Key barriers that emerged included lack of culturally appropriate health care, distance, language and cultural barriers, racism, the lack of incorporation of First Nation workers in services, financial difficulties and transport issues. There are few studies that have identified positive factors that facilitate access to health care for First Nation children. There is an urgent need to develop programs and processes to facilitate access to appropriate health care that are inclusive of the cultural needs of First Nation children.

  6. Drinking Motives as Mediators of the Impulsivity-Substance Use Relation: Pathways for Negative Urgency, Lack of Premeditation, and Sensation Seeking

    PubMed Central

    Adams, Zachary W.; Kaiser, Alison J.; Lynam, Donald R.; Charnigo, Richard J.; Milich, Richard

    2012-01-01

    Trait impulsivity is a reliable, robust predictor of risky, problematic alcohol use. Mounting evidence supports a multidimensional model of impulsivity, whereby several distinct traits serve as personality pathways to rash action. Different impulsivity-related traits may predispose individuals to drink for different reasons (e.g., to enhance pleasure, to cope with distress) and these different motives may, in turn, influence drinking behavior. Previous findings support such a mediational model for two well-studied traits: sensation seeking and lack of premeditation. This study addresses other impulsivity-related traits, including negative urgency. College students (N = 432) completed questionnaires assessing personality, drinking motives, and multiple indicators of problematic drinking. Negative urgency, sensation seeking, and lack of premeditation were all significantly related to problematic drinking. When drinking motives were included in the model, direct effects for sensation seeking and lack of premeditation remained significant, and indirect effects of sensation seeking and lack of premeditation on problematic drinking were observed through enhancement motives. A distinct pathway was observed for negative urgency. Negative urgency bore a significant total effect on problematic drinking through both coping and enhancement motives. This study highlights unique motivational pathways through which different impulsive traits may operate, suggesting that interventions aimed at preventing or reducing problematic drinking should be tailored to individuals' personalities. For instance, individuals high in negative urgency may benefit from learning healthier strategies for coping with distress. PMID:22472524

  7. Endocytosis and recycling of AMPA receptors lacking GluR2/3.

    PubMed

    Biou, Virginie; Bhattacharyya, Samarjit; Malenka, Robert C

    2008-01-22

    Excitatory synapses in the mammalian brain contain two types of ligand-gated ion channels: AMPA receptors (AMPARs) and NMDA receptors (NMDARs). AMPARs are responsible for generating excitatory synaptic responses, whereas NMDAR activation triggers long-lasting changes in these responses by modulating the trafficking of AMPARs toward and away from synapses. AMPARs are tetramers composed of four subunits (GluR1-GluR4), which current models suggest govern distinct AMPAR trafficking behavior during synaptic plasticity. Here, we address the roles of GluR2 and GluR3 in controlling the recycling- and activity-dependent endocytosis of AMPARs by using cultured hippocampal neurons prepared from knockout (KO) mice lacking these subunits. We find that synapses and dendritic spines form normally in cells lacking GluR2/3 and that upon NMDAR activation, GluR2/3-lacking AMPARs are endocytosed in a manner indistinguishable from GluR2-containing AMPARs in wild-type (WT) neurons. AMPARs lacking GluR2/3 also recycle to the plasma membrane identically to WT AMPARs. However, because of their permeability to calcium, GluR2-lacking but not WT AMPARs exhibited robust internalization throughout the dendritic tree in response to AMPA application. Dendritic endocytosis of AMPARs also was observed in GABAergic neurons, which express a high proportion of GluR2-lacking AMPARs. These results demonstrate that GluR2 and GluR3 are not required for activity-dependent endocytosis of AMPARs and suggest that the most important property of GluR2 in the context of AMPAR trafficking may be its influence on calcium permeability.

  8. Factors Controlling the Position of the Martian Magnetic Pileup Boundary

    NASA Technical Reports Server (NTRS)

    Crider, D. H.; Acuna, M.; Vignes, D.; Krymskii, A.; Breus, T.; Ness, N.

    2003-01-01

    The magnetic pileup boundary (MPB) at Mars is the position where the dominant ion of the plasma changes from solar wind protons to heavy ions of planetary origin. As such, it is the obstacle to solar wind ions. We investigate the factors that influence the shape and position of the magnetic pileup boundary at Mars in order to better understand the Martian obstacle to the solar wind. Employing MGS data, we determine how the Martian MPB moves in response to factors including solar wind pressure and crustal magnetic fields. We also study the factors affecting the thickness of the MPB. Further, we compare the magnetic pileup boundary to the magnetic barrier at Venus. Direct comparison aids in our interpretation of the physics involved in the solar wind interaction with planets lacking a significant intrinsic magnetic field.

  9. Repeated or long-duration TASER electronic control device exposures: acidemia and lack of respiration.

    PubMed

    Jauchem, James R

    2010-03-01

    Conducted energy weapons (CEWs), such as TASER devices, may be applied to subjects in repeated or long-duration modes. Such applications may result in more potentially harmful effects (as reflected in blood factor changes) than shorter exposures. In this review, results from a number of studies of repeated and long-duration CEW exposures in an animal model are examined. Additionally, a few limited investigations of shorter CEW applications to human subjects are considered. Specifically, in anesthetized swine, increased blood acidity (acidemia) and lack of effective respiration were found to be common during or immediately after CEW exposure. The acidemia could have been due to both metabolic and respiratory acidosis. A relatively rapid recovery toward baseline pH levels occurred. The lack of effective respiration has not been verified in experiments of CEW applications to human subjects; however, in some incidents of human deaths after CEW exposures subjects have been reported to stop breathing immediately after the exposure. It is not known if all human subjects exposed to CEW applications in the field (often "on drugs" or "in excited delirium") would be able to maintain adequate breathing. Since a limited number of short CEW applications would be less likely to cause adverse effects, however, CEWs can still be a valuable tool for law enforcement activities.

  10. Lack of chart reminder effectiveness on family medicine resident JNC-VI and NCEP III guideline knowledge and attitudes.

    PubMed

    Echlin, Paul S; Upshur, Ross E G; Markova, Tsveti P

    2004-07-05

    The literature demonstrates that medical residents and practicing physicians have an attitudinal-behavioral discordance concerning their positive attitudes towards clinical practice guidelines (CPG), and the implementation of these guidelines into clinical practice patterns. A pilot study was performed to determine if change in a previously identified CPG compliance factor (accessibility) would produce a significant increase in family medicine resident knowledge and attitude toward the guidelines. The primary study intervention involved placing a summary of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) and the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP III) CPGs in all patient (>18 yr.) charts for a period of three months. The JNC VI and NCEP III CPGs were also distributed to each Wayne State family medicine resident, and a copy of each CPG was placed in the preceptor's area of the involved clinics. Identical pre- and post- intervention questionnaires were administered to all residents concerning CPG knowledge and attitude. Post-intervention analysis failed to demonstrate a significant difference in CPG knowledge. A statistically significant post-intervention difference was found in only on attitude question. The barriers to CPG compliance were identified as 1) lack of CPG instruction; 2) lack of critical appraisal ability; 3) insufficient time; 4) lack of CPG accessibility; and 5) lack of faculty modeling. This study demonstrated no significant post intervention changes in CPG knowledge, and only one question that reflected attitude change. Wider resident access to dedicated clinic time, increased faculty modeling, and the implementation of an electronic record/reminder system that uses a team-based approach are compliance factors that should be considered for further investigation. The

  11. Sociability and synapse subtype-specific defects in mice lacking SRPX2, a language-associated gene

    PubMed Central

    Cong, Qifei; Palmer, Christian R.

    2018-01-01

    The FoxP2 transcription factor and its target genes have been implicated in developmental brain diseases with a prominent language component, such as developmental verbal dyspraxia and specific language impairment. How FoxP2 affects neural circuitry development remains poorly understood. The sushi domain protein SRPX2 is a target of FoxP2, and mutations in SRPX2 are associated with language defects in humans. We have previously shown that SRPX2 is a synaptogenic protein that increases excitatory synapse density. Here we provide the first characterization of mice lacking the SRPX2 gene, and show that these mice exhibit defects in both neural circuitry and communication and social behaviors. Specifically, we show that mice lacking SRPX2 show a specific reduction in excitatory VGlut2 synapses in the cerebral cortex, while VGlut1 and inhibitory synapses were largely unaffected. SRPX2 KO mice also exhibit an abnormal ultrasonic vocalization ontogenetic profile in neonatal pups, and reduced preference for social novelty. These data demonstrate a functional role for SRPX2 during brain development, and further implicate FoxP2 and its targets in regulating the development of vocalization and social circuits. PMID:29920554

  12. Exploratory and Confirmatory Factor Analysis of the Career Decision-Making Difficulties Questionnaire

    PubMed Central

    Farrokhi, Farahman; Mahdavi, Ali; Moradi, Samad

    2012-01-01

    Objective The present study aimed at validating the structure of Career Decision-making Difficulties Questionnaire (CDDQ). Methods Five hundred and eleven undergraduate students took part in this research; from these participants, 63 males and 200 females took part in the first study, and 63 males and 185 females completed the survey for the second study. Results The results of exploratory factor analysis (EFA) indicated strong support for the three-factor structure, consisting of lack of information about the self, inconsistent information, lack of information and lack of readiness factors. A confirmatory factor analysis was run with the second sample using structural equation modeling. As expected, the three-factor solution provided a better fit to the data than the alternative models. Conclusion CDDQ was recommended to be used for college students in this study due to the fact that this instrument measures all three aspects of the model. Future research is needed to learn whether this model would fit other different samples. PMID:22952549

  13. Risk factors for fishermen's health and safety in Greece.

    PubMed

    Frantzeskou, Elpida; Kastania, Anastasia N; Riza, Elena; Jensen, Olaf C; Linos, Athena

    2012-01-01

    This is, to the best of our knowledge, the first occupational health study in Greek fishing. The aim of the study is to determine the risks for health and safety in Greek fisheries workers by exploring their health status and the health risk factors present in their occupational environment, thus providing a current baseline for further research in the future and for documentation of the needs for prevention. A questionnaire pilot study was carried out in a random sample of 100 Greek fishermen. Twenty-eight per cent (28%) had experienced at least one injury, of which half caused more than one day absence, while 14% had a near drowning experience. The health risks factors studied include excessive weight, cardiovascular incidents and dermatological, musculoskeletal, respiratory, hearing, stress, and anxiety problems. The occupational health risk factors include alcohol, fatty food consumption, smoking, and lack of physical exercise. The health effects observed are causally related to diet, smoking, and exercise, which in turn relate to the specific working conditions and culture in small-scale fishing that need to be taken into consideration in prevention programmes. The results are comparable with international fisheries experience, mainly from Poland, Denmark, and Turkey.

  14. Risk factors for child pneumonia - focus on the Western Pacific Region.

    PubMed

    Nguyen, T K P; Tran, T H; Roberts, C L; Fox, G J; Graham, S M; Marais, B J

    2017-01-01

    Pneumonia is a major cause of disease and death in infants and young children (aged <5 years) globally, as it is in the World Health Organization Western Pacific region. A better understanding of the underlying risk factors associated with child pneumonia is important, since pragmatic primary prevention strategies are likely to achieve major reductions in pneumonia-associated morbidity and mortality in children. This review focuses on risk factors with high relevance to the Western Pacific region, including a lack of exclusive breastfeeding, cigarette smoke and air pollution exposure, malnutrition and conditions of poverty, as well as common co-morbidities. Case management and vaccination coverage have been considered elsewhere. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Behavioral risk factors associated with listeriosis in the home: a review of consumer food safety studies.

    PubMed

    Evans, Ellen W; Redmond, Elizabeth C

    2014-03-01

    Listeria monocytogenes causes human listeriosis, which is associated with the highest hospitalization and mortality rates of all foodborne illnesses. In recent years, the incidence of listeriosis has doubled in Europe, almost exclusively among older adults (≥ 60 years of age). Food safety factors associated with increased risk of listeriosis include lack of adherence to "use by" dates and ineffective refrigerated storage of foods. Consequently, older adult consumers' implementation of safe food practices should be evaluated. This article is a review of consumer food safety cognitive and behavioral data relating to risk factors associated with listeriosis in the home as reported in 165 consumer food safety studies. Overall, only 41% of studies included assessment of consumer cognitive or behavioral data associated with listeriosis; of these studies 59% included data on safe refrigeration, 54% included data on storage time for opened ready-to-eat foods, and 49% included data on adherence to use-by dates. In most (83%) of the studies, survey-based data collection methods (questionnaires/interviews) were used; thus, the majority of findings were based on self-report (74%) and knowledge (44%). Observation (31%) and focus groups (12%) were less commonly used, resulting in a lack of actual behaviors and attitudinal data relating to listeriosis risk factors. Only 7% of studies included food safety data for older adults. Although older adults may fail to implement recommended practices, this review reveals a need for in-depth research to determine food safety attitudes and actual behaviors of older adults in conjunction with knowledge and selfreport of practices linked to increased risks of listeriosis. Such data combined with review findings would inform targeted food safety education to reduce risks associated with listeriosis in the home.

  16. A narrative systematic review of factors affecting diabetes prevention in primary care settings

    PubMed Central

    Eyles, Emily

    2017-01-01

    Background Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient’s primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults. Aim To understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries. Methods For this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data. Results A database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient’s motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on

  17. Mice lacking the extracellular matrix protein MAGP1 display delayed thrombotic occlusion following vessel injury

    PubMed Central

    Werneck, Claudio C.; Vicente, Cristina P.; Weinberg, Justin S.; Shifren, Adrian; Pierce, Richard A.; Broekelmann, Thomas J.; Tollefsen, Douglas M.

    2008-01-01

    Mice lacking the extracellular matrix protein microfibril-associated glycoprotein-1 (MAGP1) display delayed thrombotic occlusion of the carotid artery following injury as well as prolonged bleeding from a tail vein incision. Normal occlusion times were restored when recombinant MAGP1 was infused into deficient animals prior to vessel wounding. Blood coagulation was normal in these animals as assessed by activated partial thromboplastin time and prothrombin time. Platelet number was lower in MAGP1-deficient mice, but the platelets showed normal aggregation properties in response to various agonists. MAGP1 was not found in normal platelets or in the plasma of wild-type mice. In ligand blot assays, MAGP1 bound to fibronectin, fibrinogen, and von Willebrand factor, but von Willebrand factor was the only protein of the 3 that bound to MAGP1 in surface plasmon resonance studies. These findings show that MAGP1, a component of microfibrils and vascular elastic fibers, plays a role in hemostasis and thrombosis. PMID:18281502

  18. Poor drug adherence and lack of awareness of hypertension among hypertensive stroke patients in Kampala, Uganda: a cross sectional study.

    PubMed

    Mugwano, Isaac; Kaddumukasa, Mark; Mugenyi, Levi; Kayima, James; Ddumba, Edward; Sajatovic, Martha; Sila, Cathy; DeGeorgia, Michael; Katabira, Elly

    2016-01-02

    Raised blood pressure (BP) remains an important risk factor for cardiovascular diseases such as stroke. Adherence to therapeutic recommendations especially antihypertensive drugs is important in BP control. The aim of the study was to assess the stroke risk factors and levels of adherence among hypertensive patients with stroke in Kampala Uganda. In a cross-sectional study we describe 112 hypertensive subjects with stroke from two Kampala city hospitals. A standardized pre-tested questionnaire was used to collect medical history, clinical details, radiological findings and laboratory data. A total of 112 hypertensive subjects with stroke were enrolled between May 2013 and April 2014. The median ages were 63.5 years (52.5-75.0) for the cases. Seventy percent (78/112) of the study participants had ischemic strokes. Only 17% were adherent to anti-hypertensive medications. The main cause of non-adherence appears to be lack of knowledge. Poor adherence of anti-hypertensive medications among hypertensive patients remains a big challenge in our setting. This has been attributed to lack of adequate knowledge and cost of the prescribed drugs. There is therefore an urgent need to promptly diagnose and educate hypertensive patients with emphasis on adherence to anti hypertensive drugs.

  19. Factors associated with lack of effective contraception among obese women in the United States.

    PubMed

    Callegari, Lisa S; Nelson, Karin M; Arterburn, David E; Prager, Sarah W; Schiff, Melissa A; Schwarz, Eleanor Bimla

    2014-09-01

    To identify factors associated with contraceptive nonuse and use of less effective methods among obese women in the US. We analyzed data from sexually active obese women (body mass index >30 kg/m²) age 20-44 using the 2006-2010 National Survey of Family Growth. We conducted multinomial logistic regression to assess associations between current contraceptive use and demographic, reproductive and health services factors. Specifically, we compared contraceptive nonusers, behavioral method users (withdrawal and fertility awareness) and barrier method users (condoms) to prescription method users (pill, patch, ring, injection, implant and intrauterine device). Of 1345 obese respondents, 21.5% used no method, 10.3% behavioral methods, 20.8% barrier methods and 47.4% prescription methods. Only 42.4% of respondents overall and 20.4% of nonprescription method users reported discussing contraception with a provider in the past year. Similar to findings in the general population, behavioral method users were more likely to have previously discontinued a contraceptive method due to dissatisfaction [adjusted RR (aRR), 1.93; 95% confidence interval (CI), 1.09-3.44], and nonusers were more likely to perceive difficulty becoming pregnant (aRR, 3.86; 95% CI, 2.04-7.29), compared to prescription method users. Respondents using nonprescription methods were significantly less likely to have discussed contraception with a healthcare provider (nonusers: aRR, 0.16; 95% CI, 0.10-0.27; behavioral methods: aRR, 0.13; 95% CI, 0.06-0.25, barrier methods: aRR, 0.15; 95% CI, 0.09-0.25) than prescription method users. Obese women who discuss contraception with a provider are more likely to use effective contraception and may be less likely to experience unintended pregnancy; however, over half report no recent discussion of contraception with a provider. Efforts are needed to increase contraceptive counseling for obese women, who face increased risks of morbidity from unintended pregnancy

  20. Sewer deterioration modeling with condition data lacking historical records.

    PubMed

    Egger, C; Scheidegger, A; Reichert, P; Maurer, M

    2013-11-01

    Accurate predictions of future conditions of sewer systems are needed for efficient rehabilitation planning. For this purpose, a range of sewer deterioration models has been proposed which can be improved by calibration with observed sewer condition data. However, if datasets lack historical records, calibration requires a combination of deterioration and sewer rehabilitation models, as the current state of the sewer network reflects the combined effect of both processes. Otherwise, physical sewer lifespans are overestimated as pipes in poor condition that were rehabilitated are no longer represented in the dataset. We therefore propose the combination of a sewer deterioration model with a simple rehabilitation model which can be calibrated with datasets lacking historical information. We use Bayesian inference for parameter estimation due to the limited information content of the data and limited identifiability of the model parameters. A sensitivity analysis gives an insight into the model's robustness against the uncertainty of the prior. The analysis reveals that the model results are principally sensitive to the means of the priors of specific model parameters, which should therefore be elicited with care. The importance sampling technique applied for the sensitivity analysis permitted efficient implementation for regional sensitivity analysis with reasonable computational outlay. Application of the combined model with both simulated and real data shows that it effectively compensates for the bias induced by a lack of historical data. Thus, the novel approach makes it possible to calibrate sewer pipe deterioration models even when historical condition records are lacking. Since at least some prior knowledge of the model parameters is available, the strength of Bayesian inference is particularly evident in the case of small datasets. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. The Relationship Between Shift Work and Metabolic Risk Factors: A Systematic Review of Longitudinal Studies.

    PubMed

    Proper, Karin I; van de Langenberg, Daniëlla; Rodenburg, Wendy; Vermeulen, Roel C H; van der Beek, Allard J; van Steeg, Harry; van Kerkhof, Linda W M

    2016-05-01

    Although the metabolic health effects of shift work have been extensively studied, a systematic synthesis of the available research is lacking. This review aimed to systematically summarize the available evidence of longitudinal studies linking shift work with metabolic risk factors. A systematic literature search was performed in 2015. Studies were included if (1) they had a longitudinal design; (2) shift work was studied as the exposure; and (3) the outcome involved a metabolic risk factor, including anthropometric, blood glucose, blood lipid, or blood pressure measures. Eligible studies were assessed for their methodologic quality in 2015. A best-evidence synthesis was used to draw conclusions per outcome. Thirty-nine articles describing 22 studies were included. Strong evidence was found for a relation between shift work and increased body weight/BMI, risk for overweight, and impaired glucose tolerance. For the remaining outcomes, there was insufficient evidence. Shift work seems to be associated with body weight gain, risk for overweight, and impaired glucose tolerance. Overall, lack of high-methodologic quality studies and inconsistency in findings led to insufficient evidence in assessing the relation between shift work and other metabolic risk factors. To strengthen the evidence, more high-quality longitudinal studies that provide more information on the shift work schedule (e.g., frequency of night shifts, duration in years) are needed. Further, research to the (mediating) role of lifestyle behaviors in the health effects of shift work is recommended, as this may offer potential for preventive strategies. Copyright © 2016. Published by Elsevier Inc.

  2. Using Bayes factors for multi-factor, biometric authentication

    NASA Astrophysics Data System (ADS)

    Giffin, A.; Skufca, J. D.; Lao, P. A.

    2015-01-01

    Multi-factor/multi-modal authentication systems are becoming the de facto industry standard. Traditional methods typically use rates that are point estimates and lack a good measure of uncertainty. Additionally, multiple factors are typically fused together in an ad hoc manner. To be consistent, as well as to establish and make proper use of uncertainties, we use a Bayesian method that will update our estimates and uncertainties as new information presents itself. Our algorithm compares competing classes (such as genuine vs. imposter) using Bayes Factors (BF). The importance of this approach is that we not only accept or reject one model (class), but compare it to others to make a decision. We show using a Receiver Operating Characteristic (ROC) curve that using BF for determining class will always perform at least as well as the traditional combining of factors, such as a voting algorithm. As the uncertainty decreases, the BF result continues to exceed the traditional methods result.

  3. Impact of product-related factors on immunogenicity of biotherapeutics.

    PubMed

    Singh, Satish Kumar

    2011-02-01

    All protein therapeutics have the potential to be immunogenic. Several factors, including patient characteristics, disease state, and the therapy itself, influence the generation of an immune response. Product-related factors such as the molecule design, the expression system, post-translational modifications, impurities, contaminants, formulation and excipients, container, closure, as well as degradation products are all implicated. However, a critical examination of the available data shows that clear unequivocal evidence for the impact of these latter factors on clinical immunogenicity is lacking. No report could be found that clearly deconvolutes the clinical impact of the product attributes on patient susceptibility. Aggregation carries the greatest concern as a risk factor for immunogenicity, but the impact of aggregates is likely to depend on their structure as well as on the functionality (e.g., immunostimulatory or immunomodulatory) of the therapeutic. Preclinical studies are not yet capable of assessing the clinically relevant immunogenicity potential of these product-related factors. Simply addressing these risk factors as part of product development will not eliminate immunogenicity. Minimization of immunogenicity has to begin at the molecule design stage by reducing or eliminating antigenic epitopes and building in favorable physical and chemical properties. Copyright © 2010 Wiley-Liss, Inc.

  4. Functional characterization of Bombyx mori nucleopolyhedrovirus mutant lacking late expression factor 9.

    PubMed

    Zhang, Y; Shi, Y; Yu, H; Li, J; Quan, Y; Shu, T; Nie, Z; Zhang, Y; Yu, W

    Baculoviridae is a family of invertebrate viruses with large double-stranded DNA genomes. Proteins encoded by some late expression factor (lef ) genes are involved in the regulation of viral gene expression. Lef-9 is one of four transcription-specific Lefs, which are components of the virus-encoded RNA polymerase, and can initiate and transcribe late and very late genes. As a multifunctional protein encoded by the Bombyx mori nucleopolyhedrovirus (BmNPV), Lef-9 may be involved in the regulation of viral propagation. However, the underlying mechanism remains unclear. To determine the role of lef-9 in baculovirus infection, lef-9-knockout virus (lef-9-KO-Bacmid virus) was constructed using the Red recombination system, and the Bac-to-Bac system was used to prepare lef-9-repaired virus (lef-9-Re-Bacmid virus). The lef-9-KO virus did not produce infectious viruses or show infection activity, while the lef-9-repaired virus recovered both. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis of the transcription levels in wild-type-Bacmid, lef-9-KO-Bacmid, and lef-9-Re-Bacmid viruses showed that the lef-9-KO bacmid had little effect on viral genome replication. However, the transcription levels of the early and late viral genes, lef-3, ie-1, vp39, and p10, were significantly lower in BmN cells transfected with lef-9-KO-Bacmids than in the controls. Electron microscopy showed no visible enveloped virions in cells transfected with lef-9-KO-Bacmids, while many mature virions in cells transfected with lef-9-Re-Bacmid and wt-Bacmid were present. Thus, lef-9 was not essential for viral genome replication, but significantly affected viral gene transcription and expression in all periods of cell life cycle.

  5. Subthreshold depression: characteristics and risk factors among vulnerable elders.

    PubMed

    Adams, Kathryn Betts; Moon, Heehyul

    2009-09-01

    This study examines symptoms of subthreshold depression among older adults in congregate housing, compared with their nondepressed peers, and tests a conceptual model of subthreshold depression. Hypotheses included that subthreshold depression would be characterized and distinguished by low energy, social withdrawal, and depletion, rather than sadness, and that subthreshold depressed elders would be distinguished by poorer health and functioning, loneliness, and grieving a recent loss. A self-administered survey was followed by a diagnostic interview by telephone to (N = 166) white and African-American residents of independent and assisted living apartments from six retirement communities, average age 82.9 years. The Mini International Neuropsychiatric Interview (MINI) determined depression status. The 30-item Geriatric Depression Scale was used to measure symptoms. Forty-six individuals (27.7%) were identified as subthreshold depressed, seven as suffering from major depression, and 113 as non-depressed. Subthreshold depression was characterized by low energy, difficulty with initiative, worries about the future, lack of positive affect, sadness and irritability. Negative affect symptoms such as sadness and irritability best discriminated the subthreshold group from the nondepressed. Risk factors for subthreshold depression in this sample included less education, lower socio-economic status, African-American race, grieving, and social loneliness. Subthreshold depression in this group of residents of congregate housing was similar to the depletion experienced by many nondepressed elders, but further characterized by negative affect and lack of hope for the future. Social factors, such as socioeconomic status and personal losses, constituted greater risks for subthreshold depression than did health and functioning.

  6. Lack of Day/Night variation in fibroblast growth factor 21 levels in young healthy men.

    PubMed

    Foo, J-P; Aronis, K N; Chamberland, J P; Mantzoros, C S

    2015-06-01

    Fibroblast growth factor (FGF) 21 is an endocrine factor with an emerging role as a metabolic regulator. We previously reported the presence of a significant day/night variation of FGF-21 in energy-replete, healthy female subjects. However the day/night patterns of secretion in male subjects remain to be fully elucidated. To elucidate day/night pattern of FGF-21 levels in male subjects in the energy-replete state, its relationship to FFA and to investigate whether a sexual dimorphism exists in FGF-21 physiology. Eight healthy lean male subjects were studied for up to 5 days while on an isocaloric diet. Blood samples were obtained for measurement of FGF-21 and free fatty acids (FFA) hourly from 0800 AM on day 4 till 0800AM on day 5. FGF-21 did not exhibit any statistically significant day/night variation pattern of circulating FGF-21 levels during the isocaloric fed state in male subjects. FGF-21 levels in male subjects are closely cross-correlated with FFA levels, similar to female subjects. A sexual dimorphism exists in FGF-21 physiology; that as opposed to female subjects, no significant day/night variation exists in FGF-21 rhythm in male subjects in the energy-replete state. Circulating pattern of FGF-21, similar to the female subjects, was highly cross-correlated to the FFA levels in the male subjects, signifying that the sexual dimorphism in FGF-21 physiology may be related to the differing lipid metabolism in both the genders.

  7. Usefulness of thyrogastric immune features as predictors of pernicious anaemia that lacks intrinsic factor antibody.

    PubMed

    Chan, J; Chan, H Y F

    2011-08-01

    The study aims to evaluate the diagnostic utility of thyrogastric immune features in the identification of intrinsic factor antibody negative (IFA -ve) pernicious anaemia (PA) patients. Clinico-pathological features of 'intrinsic factor antibody positive (IFA +ve) PA' and 'IFA -ve presumed PA' Chinese patients in a single hospital (2001-2009) were studied. Coefficients of independent variables identified were used as weighted scores. The result was validated by patients (1994-2000) with Schilling test done. Comparison of 127 'IFA +ve PA' and 130 'IFA -ve presumed PA' patients showed four independent variables, namely (+) gastric parietal cell (GPC) antibody (OR, 2.907, 95%; CI, 2.346-3.468; P < 0.001), (+) antithyroid antibodies (OR, 3.098, 95%; CI, 2.496-3.70; P < 0.001), (+) gastric atrophy (OR, 3.827, 95%; CI, 3.041-4.64; P = 0.001), and (-) Helicobacter pylori (HP) organisms (OR, 0.134, 95%; CI, -1.60-1.869; P = 0.023). The respective scores were 1.067, 1.131, 1.342 and -2.012. Total scores for each patient ranged from 3.54 to -2.012. When the cut-off score 1.528 was applied to the validation sample (n = 75), the specificity of identifying IFA -ve PA was 100%, sensitivity 53%, positive predictive value 100%, and negative predictive value 36%. Patients with two out of three features, GPC, antithyroid antibodies, gastric atrophy, but without HP organisms; or three features with HP organisms, can be predicted to have PA. © 2011 Blackwell Publishing Ltd.

  8. Drinking motives as mediators of the impulsivity-substance use relation: pathways for negative urgency, lack of premeditation, and sensation seeking.

    PubMed

    Adams, Zachary W; Kaiser, Alison J; Lynam, Donald R; Charnigo, Richard J; Milich, Richard

    2012-07-01

    Trait impulsivity is a reliable, robust predictor of risky, problematic alcohol use. Mounting evidence supports a multidimensional model of impulsivity, whereby several distinct traits serve as personality pathways to rash action. Different impulsivity-related traits may predispose individuals to drink for different reasons (e.g., to enhance pleasure, to cope with distress) and these different motives may, in turn, influence drinking behavior. Previous findings support such a mediational model for two well-studied traits: sensation seeking and lack of premeditation. This study addresses other impulsivity-related traits, including negative urgency. College students (N=432) completed questionnaires assessing personality, drinking motives, and multiple indicators of problematic drinking. Negative urgency, sensation seeking, and lack of premeditation were all significantly related to problematic drinking. When drinking motives were included in the model, direct effects for sensation seeking and lack of premeditation remained significant, and indirect effects of sensation seeking and lack of premeditation on problematic drinking were observed through enhancement motives. A distinct pathway was observed for negative urgency. Negative urgency bore a significant total effect on problematic drinking through both coping and enhancement motives. This study highlights unique motivational pathways through which different impulsive traits may operate, suggesting that interventions aimed at preventing or reducing problematic drinking should be tailored to individuals' personalities. For instance, individuals high in negative urgency may benefit from learning healthier strategies for coping with distress. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Nociceptive tuning by stem cell factor/c-Kit signaling.

    PubMed

    Milenkovic, Nevena; Frahm, Christina; Gassmann, Max; Griffel, Carola; Erdmann, Bettina; Birchmeier, Carmen; Lewin, Gary R; Garratt, Alistair N

    2007-12-06

    The molecular mechanisms regulating the sensitivity of sensory circuits to environmental stimuli are poorly understood. We demonstrate here a central role for stem cell factor (SCF) and its receptor, c-Kit, in tuning the responsiveness of sensory neurons to natural stimuli. Mice lacking SCF/c-Kit signaling displayed profound thermal hypoalgesia, attributable to a marked elevation in the thermal threshold and reduction in spiking rate of heat-sensitive nociceptors. Acute activation of c-Kit by its ligand, SCF, resulted in a reduced thermal threshold and potentiation of heat-activated currents in isolated small-diameter neurons and thermal hyperalgesia in mice. SCF-induced thermal hyperalgesia required the TRP family cation channel TRPV1. Lack of c-Kit signaling during development resulted in hypersensitivity of discrete mechanoreceptive neuronal subtypes. Thus, c-Kit can now be grouped with a small family of receptor tyrosine kinases, including c-Ret and TrkA, that control the transduction properties of sensory neurons.

  10. NIH–Lacks Family Partnership Gives Henrietta Lacks’ Descendants a Seat at the Table | Poster

    Cancer.gov

    The NIH Bethesda campus recently welcomed several special guests for a presentation titled Given a Voice: Update on the NIH–Lacks Family Partnership. Henrietta Lacks’ grandchildren Jeri Lacks-Whye (who is also the Lacks family spokesperson) and David Lacks, Jr. came to speak with NIH Director Francis S. Collins, Ph.D., M.D. about the importance of protecting patients and their

  11. The proportional lack of archaeal pathogens: Do viruses/phages hold the key?

    PubMed Central

    Gill, Erin E; Brinkman, Fiona S L

    2011-01-01

    Although Archaea inhabit the human body and possess some characteristics of pathogens, there is a notable lack of pathogenic archaeal species identified to date. We hypothesize that the scarcity of disease-causing Archaea is due, in part, to mutually-exclusive phage and virus populations infecting Bacteria and Archaea, coupled with an association of bacterial virulence factors with phages or mobile elements. The ability of bacterial phages to infect Bacteria and then use them as a vehicle to infect eukaryotes may be difficult for archaeal viruses to evolve independently. Differences in extracellular structures between Bacteria and Archaea would make adsorption of bacterial phage particles onto Archaea (i.e. horizontal transfer of virulence) exceedingly hard. If phage and virus populations are indeed exclusive to their respective host Domains, this has important implications for both the evolution of pathogens and approaches to infectious disease control. PMID:21328413

  12. Minor cell-death defects but reduced tumor latency in mice lacking the BH3-only proteins Bad and Bmf.

    PubMed

    Baumgartner, F; Woess, C; Pedit, V; Tzankov, A; Labi, V; Villunger, A

    2013-01-31

    Proapoptotic Bcl-2 family members of the Bcl-2 homology (BH)3-only subgroup are critical for the establishment and maintenance of tissue homeostasis and can mediate apoptotic cell death in response to developmental cues or exogenously induced forms of cell stress. On the basis of the biochemical experiments as well as genetic studies in mice, the BH3-only proteins Bad and Bmf have been implicated in different proapoptotic events such as those triggered by glucose- or trophic factor-deprivation, glucocorticoids, or histone deacetylase inhibition, as well as suppression of B-cell lymphomagenesis upon aberrant expression of c-Myc. To address possible redundancies in cell death regulation and tumor suppression, we generated compound mutant mice lacking both genes. Our studies revealed lack of redundancy in most paradigms of lymphocyte apoptosis tested in tissue culture. Only spontaneous cell death of thymocytes kept in low glucose or that of pre-B cells deprived of cytokines was significantly delayed when both genes were lacking. Of note, despite these minor apoptosis defects we observed compromised lymphocyte homeostasis in vivo that affected mainly the B-cell lineage. Long-term follow-up revealed significantly reduced latency to spontaneous tumor formation in aged mice when both genes were lacking. Together our study suggests that Bad and Bmf co-regulate lymphocyte homeostasis and limit spontaneous transformation by mechanisms that may not exclusively be linked to the induction of lymphocyte apoptosis.

  13. Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science.

    PubMed

    Kim, Hyejin; Song, Mi-Kyung

    2018-01-01

    Adults who lack decision-making capacity and a surrogate ("unbefriended" adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Six electronic databases were searched using 4 keywords: "unbefriended," "unrepresented patients," "adult orphans," and "incapacitated patients without surrogates." After screening, the final sample included 10 data-based articles for synthesis. Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.

  14. Factors that contribute to biomarker responses in humans including a study in individuals taking Vitamin C supplementation.

    PubMed

    Anderson, D

    2001-09-01

    It is possible in many situations to identify humans exposed to potentially toxic materials in the workplace and in the environment. As in most human studies, there tends to be a high degree of interindividual variability in response to chemical insults. Some non-exposed control individuals exhibit as high a level of damage as some exposed individuals and some of these have levels of damage as low as many of the controls. Thus, it is only the mean values of the groups that can substantiate an exposure-related problem; the data on an individual basis are still of limited use. While human lymphocytes remain the most popular cell type for monitoring purposes, sperm, buccal, nasal, epithelial and placental cells are also used. However, for interpretation of responses, the issue of confounding factors must be addressed. There are endogenous confounding factors, such as age, gender, and genetic make-up and exogenous ones, including lifestyle habits (smoking, drinking, etc.) There are biomarkers of exposure, effect/response and susceptibility and the last may be influenced by the genotype and polymorphism genes existing in a population. From our own studies, confounding effects on cytogenetic damage and ras oncoproteins will be considered in relation to workers exposed to vinyl chloride and petroleum emissions and to volunteers taking Vitamin C supplementation. Smoking history, exposure and duration of employment affected the worker studies. For petroleum emissions, so did gender and season of exposure. For the non-smoking volunteer Vitamin C supplementation study, cholesterol levels, plasma Vitamin C levels, lipid peroxidation products and DNA damage in the Comet assay were also measured. Gender affected differences in Vitamin C levels, antioxidant capacity and the number of chromosome aberrations induced by bleomycin challenge in vitro. The results were the same for both high and low cholesterol subjects. The relationship between biomarkers and the various factors which

  15. Antenatal psychosocial risk factors associated with adverse postpartum family outcomes.

    PubMed Central

    Wilson, L M; Reid, A J; Midmer, D K; Biringer, A; Carroll, J C; Stewart, D E

    1996-01-01

    OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involutional," "child abuse," "child neglect," "domestic violence," "family," "marital adjustment," "family health," "newborn health," "child health," "physical illness," "social support," "psychosocial risk," "prediction," "risk factors," "obstetrics" and "prenatal care." Further articles were identified from bibliographies. STUDY SELECTION: Of the 370 articles identified through the search, 118 were included for review. Studies were included if they examined the association between psychosocial risk factors and the outcomes of interest. Articles were excluded if they were reviews of poor quality or they had one or more of the following features: insufficient description of the sample, a high attrition rate, a lack of standardized outcome measures, outcomes other than the ones of interest or results that had already been reported in a previous study. DATA EXTRACTION: The strength of evidence of each study was evaluated. On the basis of the evidence, each risk factor was assigned a rating of the strength of its association with each of the postpartum outcomes. The ratings were class A (good evidence of association), class B (fair evidence) and class C (no clear evidence). Of the 129 antenatal psychosocial risk factors studied, 15 were found to have a class A association with at least one of the postpartum outcomes. DATA SYNTHESIS: Child abuse and abuse of the mother by her partner were most strongly correlated (class A evidence) with a history of lack of social support, recent life

  16. Effective Factors on Shortage of Breastfeeding According to Iranian Traditional Medicine.

    PubMed

    Ghorat, Fereshteh; Nejatbakhsh, Fatemeh; Ahmadi, Mohammad; Namazi, Nazli

    2016-05-01

    Support for breastfeeding is a public health priority. One of the major factors that can negatively affect breastfeeding is the lack of breast milk. There are many instructions on the subject of breast milk in Iranian traditional medicine resources. This article attempts to investigate causes and reasons for the lack of breast milk from the perspective of the great scholars in this field. This study reviews the literature based on the Iranian traditional medicine. The literature review included traditional medicine resources and a survey of reputable databases using keywords such as "morzae", "sady", "pestan", "sheer", "sheerkhar", and "hifzossehhe". The content analysis was used after collecting data. According to the viewpoint stated in traditional medicine literature, the primary substance for milk production is blood that transforms to milk after crossing the breast glandular tissue. The main causes of milk shortage can be classified into four categories, namely food-related factors, factors related to blood impaired, factors related to breast tissue and psychological and physical factors. One of the main reasons for milk shortage is the impaired quality and quantity of food. Appropriate mizaj of breast tissue is required for adequate milk production as it develops sufficient ability to absorb and transform the substance into milk. On the other hand, the ability of breast tissue is greatly influenced by the main organs of the body, particularly the heart; being the core of understanding psychological factors. Thus, psychological factors can have a significant effect on the process of milk production. Due to the importance of breastfeeding, reflection on other viewpoints, such as those mentioned in Iranian traditional medicine, could pave the way towards new research areas. It could also steer policies towards an extra focus on breastfeeding by mothers.

  17. [The use of anthropologic methods for studying the causes of lack of vaccination. The case of Nativitas, Xochimilco].

    PubMed

    Nigenda-López, G; Orozco-Núñez, E

    1990-01-01

    The relationship between the socio-cultural characteristics of a population and their participation in immunization programs is described in this paper. An anthropological approach was utilized to study the reasons why certain population groups do not participate in the immunization programs or do so inadequately. The study was undertaken in a community south of Mexico City. The paper contains the description of the community's contextual elements, the organization of the medical care services and the participation of the population in the immunization programs. It was found that a wide millieu of socio-cultural factors are related with people's behavior toward vaccination, such as: lack of information about diseases and vaccines, lack of trust on modern health services, and the strong influence of traditional medicine. Clear implications can be derived from the analysis with regards to the need for revision and modification of strategies of the health education programs, in order to promote a wider participation in immunization programs.

  18. Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors.

    PubMed

    Latimer, K; Wilson, P; Kemp, J; Thompson, L; Sim, F; Gillberg, C; Puckering, C; Minnis, H

    2012-09-01

    Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables. © 2012 Blackwell Publishing Ltd.

  19. Determining the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant: a cross-sectional survey.

    PubMed

    Fernandez, Ritin S; Sheppard-Law, Suzanne; Manning, Vicki

    2017-06-01

    Globally, many nurses and midwives are working at an advanced practice level. The role of a Nurse and/or Midwife Consultant encompasses a diverse and complex interaction between five specified domains namely Clinical Service and Consultancy, Clinical Leadership, Research, Education, and Clinical Services Planning and Management. The objective of this replication study was to identify the key drivers and mitigating factors that impact the role of Australian Nurse and/or Midwife Consultants. Cross-sectional survey. The study was conducted in a large metropolitan health district in Sydney, Australia. Participants for this study consisted of all Nurse and/or Midwife Consultants working within a health district in New South Wales (NSW). Data were collected by an anonymous online survey. Key drivers and mitigating factors perceived to influence their role were identified using previously implemented instruments. Data were analysed using SPSS version 21. Responses were obtained from 122 Nurse and/or Midwife Consultants. The number of years of experience as a Nurse and/or Midwife Consultant ranged from 6 months to 25.5 years. Personal attributes which included personal motivation and own communication skills were identified as key drivers to role performance with a mean score of 7.7±0.6. Other key drivers included peer support, organisational culture, personal attributes, professional learning, Nurse and/or Midwife Consultant experience, and collaborative relationships. Of the 14 mitigating factors to the role, the most common factors were lack of resources to set up and develop the role (2.6 ± 0.9), lack of secretarial support (2.6 ± 1.1), lack of managerial support (2.45 ± 1.1), and lack of understanding of the role by other health professionals (2.40 ± 0.8). Understanding the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant is important for healthcare managers. Given the changing landscape of nursing

  20. Risk Factors of Sudden Infant Death Syndrome and Risk Factors for Sleep Disturbances

    ERIC Educational Resources Information Center

    Kelmanson, Igor A.

    2011-01-01

    Relationship between major risk factors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro-environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre-term delivery and/or infant low birth weight, prone sleep…

  1. Why Employed Latinos Lack Health Insurance: A Study in California

    ERIC Educational Resources Information Center

    Greenwald, Howard P.; O'Keefe, Suzanne; DiCamillo, Mark

    2005-01-01

    This article assesses the relative importance of several factors believed to reduce the likelihood of health insurance coverage among working Latinos in California, including cost, immigration history, availability of insurance, beliefs about insurance, and beliefs about health and health care. According to a survey of 1,000 randomly selected…

  2. Effective factors on menstrual health among female students in Bam city: a qualitative study

    PubMed Central

    Morowatisharifabad, Mohammad Ali; Vaezi, Aliakbar

    2018-01-01

    Background Menarche is an independent puberty event in a girl’s life, and is associated with physical growth, ability in marriage and fertility. Therefore, poor menstrual health can be a major determinant of morbidity, as well as physical, mental and social problems in this age group. Objective The aim of this study was to explore the effective factors on menstrual health among female students in Bam city. Methods The qualitative study was conducted using content analysis approach in 2017. The participants were 32 individuals consisting of 13 students, 10 mothers of the same students, 9 school associates and health educators of 5 secondary schools in Bam city, who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were semi-structured and in-depth interview. Data analysis was performed using the steps suggested by Graneheim and Landman. Results There were two categories (easy interaction and inappropriate adaptation to changes in health behavior), 13 sub-categories and 52 initial codes. The positive factors included easy access to sanitary pads, appropriate school education, easy access to health and therapeutic services and school flexibility on menstrual issues, while the negative factors included inadequate facilities for sanitary pad disposal, lack of access to informed people about menstrual issues, insufficient attention to menstrual problems, feeling ashamed, the high cost of menstrual health, self-medication with traditional medicines, inadequate self-directed education, lack of awareness and trust in health center staff, and following family and teachers in menstrual problems. Conclusion Overall, this study indicated that economic, social, cultural and educational factors affect menstrual health. Therefore, the identification of each of these factors helps planners to apply the most appropriate methods and strategies for menstrual health improvement. PMID:29629053

  3. Elevated FGF23 Levels in Mice Lacking the Thiazide-Sensitive NaCl cotransporter (NCC).

    PubMed

    Pathare, Ganesh; Anderegg, Manuel; Albano, Giuseppe; Lang, Florian; Fuster, Daniel G

    2018-02-26

    Fibroblast growth factor 23 (FGF23) participates in the orchestration of mineral metabolism by inducing phosphaturia and decreasing the production of 1,25(OH) 2 D 3 . It is known that FGF23 release is stimulated by aldosterone and extracellular volume depletion. To characterize this effect further in a model of mild hypovolemia, we studied mice lacking the thiazide sensitive NaCl cotransporter (NCC). Our data indicate that NCC knockout mice (KO) have significantly higher FGF23, PTH and aldosterone concentrations than corresponding wild type (WT) mice. However, 1,25(OH) 2 D 3 , fractional phosphate excretion and renal brush border expression of the sodium/phosphate co-transporter 2a were not different between the two genotypes. In addition, renal expression of FGF23 receptor FGFR1 and the co-receptor Klotho were unaltered in NCC KO mice. FGF23 transcript was increased in the bone of NCC KO mice compared to WT mice, but treatment of primary murine osteoblasts with the NCC inhibitor hydrochlorothiazide did not elicit an increase of FGF23 transcription. In contrast, the mineralocorticoid receptor blocker eplerenone reversed excess FGF23 levels in KO mice but not in WT mice, indicating that FGF23 upregulation in NCC KO mice is primarily aldosterone-mediated. Together, our data reveal that lack of renal NCC causes an aldosterone-mediated upregulation of circulating FGF23.

  4. Sociodemographic factors associated with self-reported exercise and physical activity behaviors and attitudes of South Australians: results of a population-based survey.

    PubMed

    Thomas, Susie; Halbert, Julie; Mackintosh, Shylie; Quinn, Stephen; Crotty, Maria

    2012-03-01

    To determine self-reported physical activity barriers, behaviors, and beliefs about exercise of a representative sample and to identify associated sociodemographic factors. Face-to-face interviews conducted between September and December 2008, using a random stratified sampling technique. Barriers injury and illness were associated with being older, single, and not engaged in full-time work; lack of time was associated with being married, younger, female, and working full-time; and lack of motivation and cost were associated with being younger than 65 years. Advancing age was significantly associated (p < .001) with reduced physical activity. Factors including age, education, marital status, and area of residence were all associated with preferences for environment to exercise in, while all age groups (74%) felt that walking was the most important type of exercise for older adults. A better understanding of these factors may improve uptake of and adherence to exercise programs across the ages.

  5. [Prevalence of the attempts to stop pregnancy and associated factors in a marginal suburban community in Lima-Peru, 2006].

    PubMed

    Tarqui-Mamani, Carolina; Barreda, Alejandro; Barreda, Milagros; Sanabria-Rojas, Hernán

    2010-03-01

    To estimate the prevalence for the attempts to stop pregnancy among women with history of previous pregnancies, and to determine the factors associated. A cross-sectional study was performed during 2006. Samples included 1057 women with background of pregnancy, living in Pamplona Alta, selected by a systematic random sampling. We applied descriptive and inferential statistics, including a logistic regression model. The prevalence for the attempt to stop pregnancy was 13.9% (99% CI: 11.1-16.7). The factors associated identified by multivariate analysis were: Unwanted pregnancy (OR=5.7; CI: 1.9-16.7), lack of pre-natal care (OR=4.7; CI: 1.8-12.2), prostitution (OR=11.4; CI: 1.5-87.9), age below 20 years (OR=2.9; CI: 1.1-7.9), and having more than two partners (OR=3.3; CI: 1.1-10.2). The estimated prevalence for the attempt to stop pregnancy among women with history of previous pregnancies in a marginal suburban area from Lima was low when compared to the national estimated prevalence of abortion. The associated factors identified for the attempts to stop pregnancy are: unwanted pregnancy, prostitution, age below 20 years, having more than two partners and lack of pre-natal care.

  6. A review of the factors influencing antimicrobial prescribing.

    PubMed

    Calbo, Esther; Alvarez-Rocha, Luis; Gudiol, Francisco; Pasquau, Juan

    2013-09-01

    There are multiple benefits of appropriate antimicrobial prescribing: it has a direct impact on clinical outcomes, avoids adverse effects, is cost effective and, perhaps most importantly, it helps to prevent the emergence of resistance. However, any physician can prescribe antibiotics, which is not the case with other clinically relevant drugs. There is great variability in the prescribing physician's (PP) training, motivation, workload and setting, including accessibility to infectious diseases consultants and/or diagnostic techniques, and therefore there is a high risk of inappropriate prescription. Many antibiotic prescribing errors occur around the selection and duration of treatment. This includes a low threshold for the indication of antibiotics, delayed initiation of treatment when indicated, limited knowledge of local antimicrobial resistance patterns by the PPs, errors in the final choice of dose, route or drug and a lack of de-escalation. Similarly, the prescription of prophylactic antibiotics to prevent surgical site infections, despite being commonly accepted, is suboptimal. Factors that may explain suboptimal use are related to the absence of well-defined protocols, poor knowledge of prophylactic protocols, miscommunication or disagreement between physicians, logistical problems, and a lack of audits. A proper understanding of the prescribing process can guide interventions to improve the PP's practices. Some of the potential interventions included in a stewardship program are education in antimicrobial prescribing, information on the local resistance patterns and accessibility to a qualified infectious diseases consultant. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  7. Increased depression and anxiety in infertile Japanese women resulting from lack of husband's support and feelings of stress.

    PubMed

    Matsubayashi, Hidehiko; Hosaka, Takashi; Izumi, Shun-ichiro; Suzuki, Takahiro; Kondo, Akane; Makino, Tsunehisa

    2004-01-01

    We report that infertile women in Japan as well as in the Western world have high levels of emotional distress, anxiety, and depression. The reasons for anxiety and depression in infertile women are easy to presume but remain unclear. We conducted the present study to assess the relationship between the anxiety and depression of infertile Japanese women and their thought processes and emotional well-being with regard to their infertility. A cross-sectional questionnaire was administered to 101 infertile Japanese women who visited the infertility clinic at Tokai University. Inventories included the Hospital Anxiety and Depression Scale (HADS) and our original infertility questionnaire, which is composed of 22 questions to assess attitudes and emotional status in facing the stigma of infertility. After factor analysis, comparison between the HADS and the infertility questionnaire was made with simultaneous multiple regression analyses. Anxiety and depression in childless Japanese women were significantly associated with lack of husband's support and feeling stress. Our findings should prove useful in designing and implementing psychological support programs for infertile Japanese women. Psychological interventions to relieve or diminish these conditions might have significant therapeutic benefits for women attending infertility clinics in Japan.

  8. Factors that influence rural African American males' aspirations to attend college

    NASA Astrophysics Data System (ADS)

    Stuart, Alesia K.

    This study was conducted to research factors which influence rural African American males in their college attendance decision. The study was an attempt to discover specific influences in the higher education pursuit from aspiration to enrollment. As African American males and low income students represent lower enrollment figures in higher education, this study attempts to provide research which may improve these numbers. The literature which provides the theoretical frame is related to Hossler (et al., 1999) and his research entitled Going to College. Hossler's study recommended additional research to study African American males. Hossler concluded this participant segment was influenced by different factors than the majority of study participants. This qualitative study includes student interviews. Three high schools in three counties in the Black Belt of rural Alabama were the sites selected for participants. Thirty African American male seniors' responses were transcribed and coded to identify themes related to influences stated by the participants. The students' voices provided insight into their college enrollment pursuit. The findings indicate rural students lack the resources and academic preparation significant for higher education admission. African American males in rural Alabama tend to be first generation students and lack information important to college enrollment. The rural high schools lack the personnel, college and career guidance to ensure participants are aware and prepared to traverse the process of college enrollment. This study identifies policy development needs to address inadequacies that African American males attending rural schools encounter during secondary enrollment. Research participants state college aspirations. Problems arise as participants move from the aspiration stage toward enrollment. Several factors will limit higher education opportunities for the participants. Inadequate knowledge on ACT scores, college cost financial

  9. Lack of liver glycogen causes hepatic insulin resistance and steatosis in mice.

    PubMed

    Irimia, Jose M; Meyer, Catalina M; Segvich, Dyann M; Surendran, Sneha; DePaoli-Roach, Anna A; Morral, Nuria; Roach, Peter J

    2017-06-23

    Disruption of the Gys2 gene encoding the liver isoform of glycogen synthase generates a mouse strain (LGSKO) that almost completely lacks hepatic glycogen, has impaired glucose disposal, and is pre-disposed to entering the fasted state. This study investigated how the lack of liver glycogen increases fat accumulation and the development of liver insulin resistance. Insulin signaling in LGSKO mice was reduced in liver, but not muscle, suggesting an organ-specific defect. Phosphorylation of components of the hepatic insulin-signaling pathway, namely IRS1, Akt, and GSK3, was decreased in LGSKO mice. Moreover, insulin stimulation of their phosphorylation was significantly suppressed, both temporally and in an insulin dose response. Phosphorylation of the insulin-regulated transcription factor FoxO1 was somewhat reduced and insulin treatment did not elicit normal translocation of FoxO1 out of the nucleus. Fat overaccumulated in LGSKO livers, showing an aberrant distribution in the acinus, an increase not explained by a reduction in hepatic triglyceride export. Rather, when administered orally to fasted mice, glucose was directed toward hepatic lipogenesis as judged by the activity, protein levels, and expression of several fatty acid synthesis genes, namely, acetyl-CoA carboxylase, fatty acid synthase, SREBP1c, chREBP, glucokinase, and pyruvate kinase. Furthermore, using cultured primary hepatocytes, we found that lipogenesis was increased by 40% in LGSKO cells compared with controls. Of note, the hepatic insulin resistance was not associated with increased levels of pro-inflammatory markers. Our results suggest that loss of liver glycogen synthesis diverts glucose toward fat synthesis, correlating with impaired hepatic insulin signaling and glucose disposal. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  10. Environmental and lifestyle risk factors of gastric cancer.

    PubMed

    Lee, Yeong Yeh; Derakhshan, Mohammad H

    2013-06-01

    Effective prevention and early diagnostic strategies are the most important public health interventions in gastric cancer, which remains a common malignancy worldwide. Preventive strategies require identification and understanding of environmental risk factors that lead to carcinogenesis. Helicobacter pylori (H. pylori) is the primary carcinogen as this ancient bacterium has a complex ability to interact with its human host. Smoking and salt are strong independent risk factors for gastric cancer whereas alcohol is only a risk when it is heavily consumed. Red meat and high fat increase the risk of gastric cancer however fresh fruits, vegetables (allium family) and certain micronutrients (selenium, vitamin C) reduce the risk, with evidence lacking for fish, coffee and tea. Foods that inhibit H. pylori viability, colonization and infection may reduce cancer risk. Obesity is increasingly recognized as a contributory factor in gastric cardia carcinogenesis. Therefore, modest daily physical activities can be protective against cancer. Foundry workers are at risk for developing gastric cancer with dust iron being an important cause. Other risk factors include Epstein-Barr virus (EBV), possibly JC virus and radiation but the effects of these are likely to remain small.

  11. [Lack of insight in schizophrenia: a review. Part I: theoretical concept, clinical aspects and Amador's model].

    PubMed

    Raffard, S; Bayard, S; Capdevielle, D; Garcia, F; Boulenger, J-P; Gely-Nargeot, M-C

    2008-12-01

    Schizophrenia is the psychiatric disorder in which the awareness of pathology (or insight) is most frequently altered. A review of the literature shows that between 50 and 80% of patients with schizophrenia do not believe they have a disorder. Studies published on this subject over the two last decades stressed the specificity of this phenomenon in schizophrenic patients, taking into account both its prevalence and its clinical consequences comparatively to other mental disorders. If in bipolar disorders a lack of insight is linked with the intensity and acuteness of symptomatology, there is only a limited relationship between these factors in schizophrenia, thus making lack of insight a trait rather than a state-related symptom. Though defined for a very long time as a dichotomic phenomenon, the recent interest on insight in psychosis and the development of assessment tools for its evaluation have made it possible to underline its multifactorial and dynamic characteristics. Although lack of insight related to pathologies may vary across time in bipolar disorders, the results of clinical studies suggest that this phenomenon remains stable in schizophrenia. CONCEPTUAL PROPOSALS: In this review, we will reconsider the evolution of this concept in psychiatry and its definition. The clinical characteristics, which are specifically associated with the lack of insight in schizophrenia will be outlined. We will describe more specifically the model of Amador and Strauss and their assessment tool: the Scale to Assess Unawareness of Mental Disorder (SUMD). This model developed since the 1990s takes into account the time-related evolution of insight, and can be applied both to bipolar and psychotic disorders. The SUMD has six general items and four subscales. The general items estimate the three most widely used definitions of insight: awareness of having a mental disorder, awareness of the achieved effects of medication and awareness of the social consequences of having a

  12. Biological risk factors for suicidal behaviors: a meta-analysis

    PubMed Central

    Chang, B P; Franklin, J C; Ribeiro, J D; Fox, K R; Bentley, K H; Kleiman, E M; Nock, M K

    2016-01-01

    Prior studies have proposed a wide range of potential biological risk factors for future suicidal behaviors. Although strong evidence exists for biological correlates of suicidal behaviors, it remains unclear if these correlates are also risk factors for suicidal behaviors. We performed a meta-analysis to integrate the existing literature on biological risk factors for suicidal behaviors and to determine their statistical significance. We conducted a systematic search of PubMed, PsycInfo and Google Scholar for studies that used a biological factor to predict either suicide attempt or death by suicide. Inclusion criteria included studies with at least one longitudinal analysis using a biological factor to predict either of these outcomes in any population through 2015. From an initial screen of 2541 studies we identified 94 cases. Random effects models were used for both meta-analyses and meta-regression. The combined effect of biological factors produced statistically significant but relatively weak prediction of suicide attempts (weighted mean odds ratio (wOR)=1.41; CI: 1.09–1.81) and suicide death (wOR=1.28; CI: 1.13–1.45). After accounting for publication bias, prediction was nonsignificant for both suicide attempts and suicide death. Only two factors remained significant after accounting for publication bias—cytokines (wOR=2.87; CI: 1.40–5.93) and low levels of fish oil nutrients (wOR=1.09; CI: 1.01–1.19). Our meta-analysis revealed that currently known biological factors are weak predictors of future suicidal behaviors. This conclusion should be interpreted within the context of the limitations of the existing literature, including long follow-up intervals and a lack of tests of interactions with other risk factors. Future studies addressing these limitations may more effectively test for potential biological risk factors. PMID:27622931

  13. Profile of atrial fibrillation inpatients: Cardiovascular risk factors and cardiac rehabilitation programme delivery and referral patterns.

    PubMed

    Gallagher, Robyn; Zhang, Ling; Roach, Kellie; Sadler, Leonie; Belshaw, Julie; Kirkness, Ann; Proctor, Ross; Neubeck, Lis

    2015-12-01

    Atrial fibrillation (AF) is increasingly common; however, the cardiovascular risk factor profile and the patterns of delivery and referral to cardiac rehabilitation (CR) in this population are poorly described. We conducted an audit of medical records (n = 145) of patients admitted with AF in one local health district in Sydney, Australia. Patients were aged a mean 72 years, and 51% were male. Lack of risk factor documentation was common. Despite this, 65% had two or more modifiable cardiovascular risk factors, including hypertension (63%) and hypercholesterolaemia (52%). Referral to Phase II CR occurred for 25% and was decreased with permanent AF diagnosis and increased with more risk factors. AF patients admitted to hospital have multiple cardiovascular risk factors but limited risk factor screening and/or referral to outpatient CR programmes. © 2014 Wiley Publishing Asia Pty Ltd.

  14. Lack of endogenous parathyroid hormone delays fracture healing by inhibiting vascular endothelial growth factor‑mediated angiogenesis.

    PubMed

    Ding, Qingfeng; Sun, Peng; Zhou, Hao; Wan, Bowen; Yin, Jian; Huang, Yao; Li, Qingqing; Yin, Guoyong; Fan, Jin

    2018-07-01

    Intermittent low‑dose injections of parathyroid hormone (PTH) have been reported to exert bone anabolic effects and to promote fracture healing. As an important proangiogenic cytokine, vascular endothelial growth factor (VEGF) is secreted by bone marrow mesenchymal stem cells (BMSCs) and osteoblasts, and serves a crucial regulatory role in the process of vascular development and regeneration. To investigate whether lack of endogenous PTH causes reduced angiogenic capacity and thereby delays the process of fracture healing by downregulating the VEGF signaling pathway, a PTH knockout (PTHKO) mouse fracture model was generated. Fracture healing was observed using X‑ray and micro‑computerized tomography. Bone anabolic and angiogenic markers were analyzed by immunohistochemistry and western blot analysis. The expression levels of VEGF and associated signaling pathways in murine BMSC‑derived osteoblasts were measured by quantitative polymerase chain reaction and western blot analysis. The expression levels of protein kinase A (PKA), phosphorylated‑serine/threonine protein kinase (pAKT), hypoxia‑inducible factor‑1α (HIF1α) and VEGF were significantly decreased in BMSC‑derived osteoblasts from PTHKO mice. In addition, positive platelet endothelial cell adhesion molecule staining was reduced in PTHKO mice, as determined by immunohistochemistry. The expression levels of HIF1α, VEGF, runt‑related transcription factor 2, osteocalcin and alkaline phosphatase were also decreased in PTHKO mice, and fracture healing was delayed. In conclusion, lack of endogenous PTH may reduce VEGF expression in BMSC‑derived osteoblasts by downregulating the activity of the PKA/pAKT/HIF1α/VEGF pathway, thus affecting endochondral bone formation by causing a reduction in angiogenesis and osteogenesis, ultimately leading to delayed fracture healing.

  15. Relationship of hyposalivation and xerostomia in Mexican elderly with socioeconomic, sociodemographic and dental factors

    PubMed Central

    Islas-Granillo, Horacio; Borges-Yáñez, Aida; Fernández-Barrera, Miguel Ángel; Ávila-Burgos, Leticia; Patiño-Marín, Nuria; Márquez-Corona, María de Lourdes; Mendoza-Rodríguez, Martha; Medina-Solís, Carlo Eduardo

    2017-01-01

    We determined the prevalence of hyposalivation and xerostomia in older Mexicans (≥60 years), and its relationship with diverse factors. A cross-sectional study was realized in elderly subjects from Pachuca, Mexico. Chewing-stimulated saliva was collected under standardized conditions and salivary flow was measured; subjects were considered to have hyposalivation if their stimulated salivary flow was less than 0.7 mL per minute. Xerostomia was evaluated by asking subjects ‘Does your mouth feel dry?’. Hyposalivation was present in 59.7%, and xerostomia in 25.2% of subjects. 16.5% of subjects had both conditions. Xerostomia was present in 27.7% of subjects with hyposalivation and 21.4% of subjects without hyposalivation, but the difference was not significant (p > 0.05). Thus, 68.3% of older Mexicans had xerostomia and/or hyposalivation. Factors associated with hyposalivation were: using fewer devices in oral hygiene, lacking social benefits for retirement/pension, living in a public retirement home, brushing teeth less than twice a day and lacking teeth without dentures. None of the factors included in this study were associated with xerostomia. We concluded that several variables studied were associated with hyposalivation, but none for xerostomia. Additional research should examine the amount of hyposalivation and factors associated with hyposalivation especially in elderly with increased risk for hyposalivation. PMID:28094800

  16. Lack of oblique astigmatism in the chicken eye.

    PubMed

    Maier, Felix M; Howland, Howard C; Ohlendorf, Arne; Wahl, Siegfried; Schaeffel, Frank

    2015-04-01

    Primate eyes display considerable oblique off-axis astigmatism which could provide information on the sign of defocus that is needed for emmetropization. The pattern of peripheral astigmatism is not known in the chicken eye, a common model of myopia. Peripheral astigmatism was mapped out over the horizontal visual field in three chickens, 43 days old, and in three near emmetropic human subjects, average age 34.7years, using infrared photoretinoscopy. There were no differences in astigmatism between humans and chickens in the central visual field (chicks -0.35D, humans -0.65D, n.s.) but large differences in the periphery (i.e. astigmatism at 40° in the temporal visual field: humans -4.21D, chicks -0.63D, p<0.001, unpaired t-test). The lack of peripheral astigmatism in chicks was not due to differences in corneal shape. Perhaps related to their superior peripheral optics, we found that chickens had excellent visual performance also in the far periphery. Using an automated optokinetic nystagmus paradigm, no difference was observed in spatial visual performance with vision restricted to either the central 67° of the visual field or to the periphery beyond 67°. Accommodation was elicited by stimuli presented far out in the visual field. Transscleral images of single infrared LEDs showed no sign of peripheral astigmatism. The chick may be the first terrestrial vertebrate described to lack oblique astigmatism. Since corneal shape cannot account for the difference in astigmatism in humans and chicks, it must trace back to the design of the crystalline lens. The lack of peripheral astigmatism in chicks also excludes a role in emmetropization. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Facilitating and obstructing factors for development of learning in clinical practice: a student perspective.

    PubMed

    Löfmark, A; Wikblad, K

    2001-04-01

    The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice. Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that they will be expected to perform as new graduate nurses. The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries. The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the 'total picture'. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self-reliance were drawbacks for some students. Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students' experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students' transition into the nursing profession.

  18. Factors influencing the patient education: A qualitative research.

    PubMed

    Farahani, Mansoureh A; Mohammadi, Eesa; Ahmadi, Fazlollah; Mohammadi, Nooredin

    2013-03-01

    The related literatures revealed that there is a lack of effective patient/family education in the health care centers. Several studies indicate that patients, while getting discharged from hospitals, receive insufficient information about their illness and self-care. The purpose of the study was to explore the factors influencing patient education from the perspectives of nurses in Iran. We conducted a qualitative study using a content analysis approach. We used a purposive sampling technique to recruit and interview 18 nurses with at least 2 years of working experience in the cardiac care unit (CCU) and post-CCU ward of two educational hospitals in Tehran related to Tehran University. Data were collected through face-to-face audio-taped interviews and field observations. The interviews were transcribed verbatim and analyzed concurrently with data collection. THE MAJOR THEME EXTRACTED IN THIS STUDY WAS THE INAPPROPRIATE ORGANIZATIONAL CULTURE WHICH INCLUDES EIGHT CATEGORIES LISTED AS FOLLOWS: Not putting value on education, non-professional activities, physician-oriented atmosphere, conflict and lack of coherence in education, inappropriate communication skills, ignoring patient's right in education, lack of motivation, rewarding system in the organization, and poor supervision and control. The results of this study show that according to the participants' perspective, organizational culture is in a poor level. So, to improve the performance of nurses, it is necessary to increase their motivation through optimization of organizational culture.

  19. Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse.

    PubMed

    Qatawneh, Ayman; Thekrallah, Fida; Bata, Majed; Al-Kazaleh, Fawaz; Almustafa, Mahmoud; Abu-Kader, Ilham

    2013-06-01

    Trans-vaginal sacrospinous colpopexy is one of the surgical procedures used to repair varying degrees of vaginal vault and uterovaginal prolapse. The purpose of this study is to analyse the potential risk factors of surgical failure following sacrospinous colpopexy. A retrospective study of 114 women who underwent unilateral sacrospinous colpopexy at Jordan University Hospital from January 2005 to January 2008 were included. Patient demographics, clinical characteristics and concomitant pelvic organ prolapse surgery were assessed. The patients were evaluated at 6 weeks, and every 6 months thereafter. Twelve (11 %) had recurrent apical (vaginal cuff) prolapse, 26 (23 %) had recurrent prolapse at any compartment were compared with those who had successful surgery. Univariate and logistic regression analyses were used to assess the independent prognostic values of the variables associated with surgical failure. After a mean follow-up of 40 months, the statistically significant predictors of surgical failure included the presence of advanced pre-operative stages of prolapse (stages III and IV), the more distally located points Ba, Bp and C and a lack of mesh augmentation of the anterior vaginal wall during surgery (P = 0.01, 0.027, 0.024, 0.034 and 0.006, respectively). However, a history of prior vaginal repair, the more distally located point Ba and a lack of anterior vaginal wall mesh augmentation were defined as independent predictive variables based on logistic regression analyses (P = 0.04, 0.005 and 0.046, respectively). The presence of advanced anterior vaginal wall prolapse, prior vaginal repair and a lack of mesh augmentation of the anterior compartment are significant risk factors for the surgical failure of sacrospinous suspension surgery.

  20. Do student nurses feel a lack of comfort in providing support for Lesbian, Gay, Bisexual or Questioning adolescents: what factors influence their comfort level?

    PubMed

    Richardson, Brian P; Ondracek, Anton E; Anderson, Dee

    2017-05-01

    The aim of this study was to find out if student nurses feel comfortable in caring by providing support for Lesbian, Gay, Bisexual or Questioning adolescents and what factors influence their level of comfort. Research indicates that nurses and nursing students experience varying levels of comfort when caring for adults who are Lesbian, Gay, Bisexual or Questioning: adult patients feel that nurse's attitudes change towards them once they disclose their sexuality. There has been minimal research to date on nursing attitudes to working with adolescents who are Lesbian, Gay, Bisexual or Questioning. Both quantitative and qualitative methods were used in this descriptive study. Questionnaires were completed by 152 nursing students and nine took part in semi-structured focus groups. A two-way ANOVA was used to analyse the questionnaires. Thematic analysis was used to identify the themes arising from the focus groups. Data were collected between August 2013 - July 2014. The results and findings of the study were that student nurse's felt discomfort in providing support; due to a lack of knowledge of Lesbian, Gay or Bisexual sexuality, personal and religious beliefs and the perceptions of others. However, all students indicated they had a positive attitude towards Lesbian, Gay, Bisexual and Questioning adolescents. More needs to be done to raise self-awareness and improve the level of knowledge in relation to Lesbian, Gay and Bisexual issues amongst student nurses. Educational institutions and practice areas need to recognize this fact and reflect this in their educational programmes. © 2016 John Wiley & Sons Ltd.

  1. Socioeconomic factors and low birth weight in Mexico

    PubMed Central

    Torres-Arreola, Laura P; Constantino-Casas, Patricia; Flores-Hernández, Sergio; Villa-Barragán, Juan Pablo; Rendón-Macías, Enrique

    2005-01-01

    Background Low birth weight (LBW) is a public health problem linked to lack of equity in populations. Despite efforts to decrease the proportion of newborns with LBW, success has been quite limited. In recent years, studies focused on explaining how social factors influence this problem have shown that populations with greater inequities have a greater proportion of newborns with LBW. Methods The objective was to describe socioeconomic factors related to LBW adjusted by demographic, reproductive and health services variables in Mexico City. A case-control study was carried out in three hospitals with gynaecological and obstetrics services in Mexico City during the first half of 1996. During the recruiting period all children with LBW (cases), defined as newborns weighing <2500 grams, were matched with children born on the same day to control for time of birth. Upon arrival at the hospital for delivery, women were interviewed to determine if they met our inclusion criteria. Women with a history of chronic conditions and those with twin or multiple pregnancies were excluded. Variables with clinical and statistical significance were included in a multivariate model (logistic regression). Results We found that low socioeconomic level was the most important risk factor for LBW and was independent of other factors, including those related to reproduction and nutrition, smoking, morbidity during pregnancy, accessibility to health services and prenatal care (OR 2.68; 95% CI 1.19, 6.03). Conclusion We found that socioeconomic factors are relevant to LBW. However further research should be done in different population groups as well as developing precise ways of measuring socioeconomic factors and their role in reproductive health. PMID:15745443

  2. Risk factors for lack of recent exercise in adults with self-reported, professionally diagnosed arthritis.

    PubMed

    Fontaine, Kevin R; Haaz, Steffany

    2006-04-01

    It is important to identify predictors of exercise/physical activity in adults with arthritis. The objective of this study was to estimate the association between selected factors and recent exercise/physical activity in adults with self-reported, professionally diagnosed arthritis. Using population-based survey data from the 2004 Behavioral Risk Factor Surveillance Survey (BRFSS), we classified respondents according to their arthritis status, race, age, general health, education, body mass index, limitations resulting from joint symptoms, whether or not they received weight management and/or exercise advice from health professionals, and whether or not they engaged in exercise/physical activity within the past month. Over one third (34.7%) of U.S. adults who completed the BRFSS Arthritis Burden Module reported having professionally diagnosed arthritis and 68% of those respondents reported engaging in exercise/physical activity within the past month. Respondents who were more likely to have engaged in recent exercise/physical activity were men, those with higher levels of education, those who were advised by a health professional that exercise/physical activity might benefit their arthritis, and those who have taken an arthritis education course. Older age, black race, overweight or obesity, poorer self-reported general health, and limitations resulting from joint symptoms were associated with not engaging in recent exercise/physical activity. Several demographic, behavioral, and disease characteristics associate with whether or not adults with arthritis engaged in exercise/physical activity during the past month. These should be considered by clinicians to appropriately encourage continued activity among physically active patients while assessing and addressing barriers to activity for less active populations. Findings such as these might also inform efforts to develop targeted physical activity interventions to promote increased activity in subgroups that tend to

  3. Socio-Structural Barriers, Protective Factors, and HIV Risk Among Central-Asian Female Migrants in Moscow

    PubMed Central

    Zabrocki, Christopher; Weine, Stevan; Chen, Stephanie; Brajkovic, Ivana; Bahromov, Mahbat; Loue, Sana; Jonbekov, Jonbek; Shoakova, Farzona

    2013-01-01

    Objective This study aimed to build formative knowledge on socio-structural barriers, protective factors, and HIV sexual risk amongst Central-Asian female migrants in Moscow. Methods Data collection included ethnographic interviews in Moscow with a purposive sample of 30 unmarried female migrants, 15 from Kyrgyzstan and 15 from Tajikistan. Results Study participants reported difficulties with acquiring documents for legal status, financial insecurity, discrimination, sexual harassment, and lack of support. Based on analysis of the cases, one pathway linked lack of legal documentation and instrumental support with elevated sexual risk. Another pathways linked traditional cultural attitudes with both no and moderate sexual risk. Conclusion Future HIV prevention efforts with Central Asian female migrants in Moscow should be multilevel and include: increasing HIV and prevention knowledge and skills, promoting condom use with regular partners, identifying and supporting cultural attitudes that protect against HIV sexual risk behaviors, facilitating legal status, building community support, and increasing economic options. PMID:25360392

  4. People with epilepsy lack knowledge about their disease.

    PubMed

    Mameniskiene, R; Sakalauskaite-Juodeikiene, E; Budrys, V

    2015-05-01

    For people with epilepsy, knowledge of their disease is an important factor in optimizing the control of their seizures. Better-informed patients can more easily participate in the treatment process, reducing disease-related anxiety and coping better with stigma. This study was developed in a Lithuanian tertiary epilepsy center to assess knowledge of disease among people with epilepsy, to estimate differences in disease knowledge between patient groups, and to evaluate how epilepsy influences patients' daily lives. We asked patients to complete a questionnaire and collected information from outpatient cards on epilepsy etiology, type of seizures, findings of diagnostic tests, and information about patients' antiepileptic drugs. Our results showed that people with epilepsy have poor knowledge about their disease: almost half of the patients did not identify the cause of their illness or their type of seizures; most did not know the results of their EEG and neuroimaging studies. Patients also lacked general knowledge about their disease and implications for lifestyle. However, cognitive deficits were not assessed in this study, and this may have affected the answers where patients were required to recall and name their drugs or the dosage of medication. Almost half of them believed that epilepsy had changed their lives significantly and reported anxiety and constant fear of seizures. Patients were also afraid to have because of the possibility they would also have epilepsy. There is clearly a great need for improved educational intervention for people with epilepsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Temporal Stability, Correlates, and Longitudinal Outcomes of Career Indecision Factors

    ERIC Educational Resources Information Center

    Nauta, Margaret M.

    2012-01-01

    A confirmatory factor analysis (CFA) tested the fit of Kelly and Lee's six-factor model of career decision problems among 188 college students. The six-factor model did not fit the data well, but a five-factor (Lack of Information, Need for Information, Trait Indecision, Disagreement with Others, and Choice Anxiety) model did provide a good fit.…

  6. Health Promotion Behavior of Chinese International Students in Korea Including Acculturation Factors: A Structural Equation Model.

    PubMed

    Kim, Sun Jung; Yoo, Il Young

    2016-03-01

    The purpose of this study was to explain the health promotion behavior of Chinese international students in Korea using a structural equation model including acculturation factors. A survey using self-administered questionnaires was employed. Data were collected from 272 Chinese students who have resided in Korea for longer than 6 months. The data were analyzed using structural equation modeling. The p value of final model is .31. The fitness parameters of the final model such as goodness of fit index, adjusted goodness of fit index, normed fit index, non-normed fit index, and comparative fit index were more than .95. Root mean square of residual and root mean square error of approximation also met the criteria. Self-esteem, perceived health status, acculturative stress and acculturation level had direct effects on health promotion behavior of the participants and the model explained 30.0% of variance. The Chinese students in Korea with higher self-esteem, perceived health status, acculturation level, and lower acculturative stress reported higher health promotion behavior. The findings can be applied to develop health promotion strategies for this population. Copyright © 2016. Published by Elsevier B.V.

  7. Contributions of occupational hazards and human factors in occupational injuries and their associations with job, age and type of injuries in railway workers.

    PubMed

    Chau, Nearkasen; Gauchard, Gerome C; Dehaene, Dominique; Benamghar, Lahoucine; Touron, Christian; Perrin, Philippe P; Mur, Jean-Marie

    2007-05-01

    To assess the contributions of environmental hazards, technical dysfunctions, lack of work organization, know-how and job knowledge, and other human factors in occupational injuries and their relationships with job, age and type of accidents in railway workers. The sample included 1,604 male workers, having had at least one occupational injury with sick leave during a 2-year period in voluntary French railway services. A standardized questionnaire was filled in by the person-in-charge of prevention, with the injured worker. Data analysis was performed via the chi(2) independence test and adjusted odds ratios (OR) with Mantel-Haenszel test. The environmental hazards were implicated in 24.7%, technical dysfunctions in 16.0%, lack of work organization in 13.7%, lack of know-how in 17.6%, lack of job knowledge in 5.2%, and the other human factors in 31.9% of occupational injuries. The injuries caused by lack of know-how or job knowledge were more represented in workers aged less than 30 (ORs adjusted for job 1.45, 95% CI 1.02-2.06 and 2.06, 1.22-3.49, respectively), those by environmental hazards in energy and electrical traction maintenance operators and train drivers (ORs adjusted for age 2.04, 1.16-3.58 and 1.80, 1.01-3.20, respectively), and those by lack of work organization in mechanical maintenance operators and in energy and electrical traction maintenance operators (ORs adjusted for age 2.24, 1.13-4.45 and 1.83, 1.30-2.57, respectively). The causes considered were strongly related with the type of injuries. This study found that environmental hazards, technical dysfunctions, lack of work organization, lack of knowledge and other human factors had important contributions in injuries, and they were related to job, age and type of injuries. These findings are useful for prevention. Training is necessary for young workers. The occupational physician could help the workers to be more aware of the risks.

  8. [Incidence and risk factors for congenital syphilis in Belo Horizonte, Minas Gerais, 2001-2008].

    PubMed

    Lima, Marina Guimarães; Santos, Rejane Ferreira Reis dos; Barbosa, Guilherme José Antonini; Ribeiro, Guilherme de Sousa

    2013-02-01

    Congenital syphilis continues to be a public health problem in Brazil. The scope of this study is to describe the trends in the incidence of congenital syphilis in Belo Horizonte between 2001 and 2008 and determine risk factors associated with disease diagnosis. Data on cases of congenital syphilis and on the population of live births were obtained from the National Notifiable Diseases Information System (SINAN) and from the National Live Birth Information System (SINASC), respectively. Multivariate logistic regression analysis used the population of live births as the reference group to identify independent risk factors for congenital syphilis. The annual incidence of congenital syphilis revealed a rising trend from 0.9 to 1.6 cases per 1,000 live births between 2001 and 2008. Independent risk factors for congenital syphilis included: maternal schooling <8 years (OR: 1,3; 95% CI: 1,2-1,4); black or mixed maternal race (2,1; 1,5-2,8) and lack of antenatal care (11,4; 8,5-15,4). The strong association between the lack of antenatal care and congenital syphilis indicates that universalization of antenatal care is critical for the control of congenital syphilis. The effective control of the disease in Brazil will depend on actions to reduce social inequities in health.

  9. The concept of lifestyle factors, based on the teaching of avicenna (ibn sina).

    PubMed

    Choopani, Rasool; Emtiazy, Majid

    2015-01-01

    According to the definition stated in the beginning of the "Al-Qanun fi al-Tibb" (the Qanun of Medicine); medicine is a science, from which one learns the states of the human body; health and disease and what causes them, in order to preserve good health when it exists, and restore it when it is lacking. Based on this issue, Avicenna believes that medical science belongs to all human without any limitation, and maintenance of health is one of its prime objectives. He states that many disorders are related to errors in the 6 factors, which are essential for maintaining health and preventing diseases. Avicenna described these six essential factors (lifestyle factors) in his masterpiece, Qanun of Medicine, as "Asbab-e-Settah-e-Zaruriah." Based on the teaching of Avicenna, the first step for maintaining health and approaches to treatment is modification of lifestyle factors, including of nutrition, physical activity, etc.

  10. Factors Related to Suicide in LGBT Populations.

    PubMed

    Skerrett, Delaney Michael; Kõlves, Kairi; De Leo, Diego

    2016-09-01

    There is evidence of heightened vulnerability to nonfatal suicidal behaviors among LGBT populations yet a paucity of studies into fatal behaviors. The specific aim of this article was to identify factors related to suicide in LGBT individuals in Australia. The psychological autopsy (PA) method with a matched case-control study design was used. PA interviews were conducted with 27 next-of-kin of an LGBT person that had died by suicide. Three living LGBT controls per suicide case, matched by age and gender, were also interviewed. The key factors relating to suicide in LGBT people were a lack of acceptance by family and self (reflected in higher internalized homophobia and shame), negative feelings about own sexuality/gender, and dissatisfaction with appearance. LGBT people who died by suicide also tended to go through coming out milestones 2 years earlier than controls. There was a higher prevalence of aggressive behaviors and a more predominant history of physical and sexual abuse. Additionally, there was greater incidence of depression and anxiety and alcohol and substance use disorders. Specific predictive factors for suicide in LGBT populations in Australia were identified, including significantly poorer mental health outcomes and more violence across an array of measures.

  11. The two-factor model of psychopathic personality: evidence from the psychopathic personality inventory.

    PubMed

    Marcus, David K; Fulton, Jessica J; Edens, John F

    2013-01-01

    Psychopathy or psychopathic personality disorder represents a constellation of traits characterized by superficial charm, egocentricity, irresponsibility, fearlessness, persistent violation of social norms, and a lack of empathy, guilt, and remorse. Factor analyses of the Psychopathic Personality Inventory (PPI)typically yield two factors: Fearless Dominance (FD) and Self-Centered Impulsivity (SCI). Additionally, the Coldheartedness (CH) subscale typically does not load on either factor. The current paper includes a meta-analysis of studies that have examined theoretically important correlates of the two PPI factors and CH. Results suggest that (a) FD and SCI are orthogonal or weakly correlated, (b) each factor predicts distinct (and sometimes opposite) correlates, and (c) the FD factor is not highly correlated with most other measures of psychopathy. This pattern of results raises important questions about the relation between FD and SCI and the role of FD in conceptualizations of psychopathy. Our findings also indicate the need for future studies using the two-factor model of the PPI to conduct moderational analyses to examine potential interactions between FD and SCI in the prediction of important criterion measures.

  12. Psychosocial factors associated with flourishing among Australian HIV-positive gay men.

    PubMed

    Lyons, Anthony; Heywood, Wendy; Rozbroj, Tomas

    2016-09-15

    Mental health outcomes among HIV-positive gay men are generally poorer than in the broader population. However, not all men in this population experience mental health problems. Although much is known about factors associated with depression and anxiety among HIV-positive gay men, little is known about factors associated with positive mental health. Such knowledge can be useful for optimizing well-being support programs for HIV-positive gay men. In this study, we examined flourishing, which broadly covers most aspects of positive mental health. A sample of 357 Australian HIV-positive gay men completed a survey on their mental health and well-being, including the Flourishing Scale. Given the lack of previous research, we explored a wide range of psychosocial factors, including demographics, stigma, discrimination, and social support, to identify key factors linked to flourishing. The sample showed a similar level of flourishing to those in general population samples. Several independent factors were found to be associated with flourishing outcomes. Those who were most likely to be flourishing tended to have low or no internalized HIV-related stigma, were employed, received higher levels of practical support, had a sense of companionship with others, and felt supported by family. These and other findings presented in this article may be used to help inform strategies for promoting optimal levels of mental health, and its associated general health benefits, among HIV-positive gay men.

  13. Lack of the PGA exopolysaccharide in Salmonella as an adaptive trait for survival in the host

    PubMed Central

    Echeverz, Maite; García, Begoña; Sabalza, Amaia; Valle, Jaione; Lasa, Iñigo

    2017-01-01

    Many bacteria build biofilm matrices using a conserved exopolysaccharide named PGA or PNAG (poly-β-1,6-N-acetyl-D-glucosamine). Interestingly, while E. coli and other members of the family Enterobacteriaceae encode the pgaABCD operon responsible for PGA synthesis, Salmonella lacks it. The evolutionary force driving this difference remains to be determined. Here, we report that Salmonella lost the pgaABCD operon after the divergence of Salmonella and Citrobacter clades, and previous to the diversification of the currently sequenced Salmonella strains. Reconstitution of the PGA machinery endows Salmonella with the capacity to produce PGA in a cyclic dimeric GMP (c-di-GMP) dependent manner. Outside the host, the PGA polysaccharide does not seem to provide any significant benefit to Salmonella: resistance against chlorine treatment, ultraviolet light irradiation, heavy metal stress and phage infection remained the same as in a strain producing cellulose, the main biofilm exopolysaccharide naturally produced by Salmonella. In contrast, PGA production proved to be deleterious to Salmonella survival inside the host, since it increased susceptibility to bile salts and oxidative stress, and hindered the capacity of S. Enteritidis to survive inside macrophages and to colonize extraintestinal organs, including the gallbladder. Altogether, our observations indicate that PGA is an antivirulence factor whose loss may have been a necessary event during Salmonella speciation to permit survival inside the host. PMID:28542593

  14. Risk factors for depression in community-treated epilepsy: systematic review.

    PubMed

    Lacey, Cameron J; Salzberg, Michael R; D'Souza, Wendyl J

    2015-02-01

    Depression is one of the most common psychiatric comorbidities in epilepsy; however, the factors contributing to this association remain unclear. There is a growing consensus that methodological limitations, particularly selection bias, affect many of the original studies. A systematic review focussed on community-based studies offers an alternative approach for the identification of the risk factors for depression. Searches were performed in MEDLINE (Ovid), 2000 to 31 December 2013, EMBASE, and Google Scholar to identify studies examining risk factors for depression in epilepsy. Community-based studies of adults with epilepsy that reported at least one risk factor for depression were included. The search identified 17 studies that met selection criteria, representing a combined total of 12,212 people with epilepsy with a mean sample size of 718. The most consistent risk factors for depression were sociodemographic factors, despite the fact that most studies focus on epilepsy-related factors. Most studies lacked a systematic conceptual approach to investigating depression, and few risk factors were consistently well studied. Future community-based studies require a detailed systematic approach to improve the ability to detect risk factors for depression in epilepsy. Psychological factors were rarely studied in community-based samples with epilepsy, although the consistent association with depression in the few studies that did suggests this warrants further examination. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Influencing factors on compliance of timely visits among patients with proliferative diabetic retinopathy in southern China: a qualitative study

    PubMed Central

    Duan, Fang; Liu, Yuhong; Chen, Xiang; Congdon, Nathan; Zhang, Jian; Chen, Qianyun; Chen, Lingling; Chen, Xi; Zhang, Xiulan; Yu, Chengpu; Liu, Yizhi

    2017-01-01

    Objective To identify the reasons for low adherence among patients with diabetic retinopathy (DR) in southern China using a qualitative method. Methods Exploratory indepth interviews were conducted in 27 diabetic patients with proliferative diabetic retinopathy who required vitrectomy surgery at Zhongshan Ophthalmic Centre, Sun Yat-sen University, from March to August 2015. Qualitative data analysis and research software (ATLAS.ti7) was used for data processing and analysis. Results Factors influencing the occurrence of timely visits included lack of DR related knowledge, fear and worries about insulin, interactions between patients and society combined with the complexity of emotions and social culture, and the economic burden of treatment. Conclusions Although the reasons for low adherence involved social, emotional, cultural and economic factors, the key issue was the lack of awareness and knowledge of DR. Our findings have several practical implications for health policymakers and programme planners in China. PMID:28348188

  16. The U.S. Air Force Academy Lacked Effective Controls Over Heritage Assets and Guest House Inventories, and Inappropriately Solicited and Accepted Monetary Gifts

    DTIC Science & Technology

    2013-09-23

    during that time frame. Finding B 10 │ DODIG-2013-138 Finding B USAFA Heritage Program Lacked Adequate Controls USAFA officials did not have effective ...E M B E R 2 3 , 2 0 1 3 Report No. DODIG-2013-138 The U.S. Air Force Academy Lacked Effective Controls Over Heritage Assets and Guest House...for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data

  17. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications.

    PubMed

    Pressman, Mark R

    2007-02-01

    Sleepwalking and related disorders are the result of factors that predispose, prime and precipitate episodes. In the absence of one or more of these factors sleepwalking is unlikely to occur. Predisposition to sleepwalking is based on genetic susceptibility and has a familial pattern. Priming factors include conditions and substances that increase slow wave sleep (SWS) or make arousal from sleep more difficult. These factors include sleep deprivation, alcohol, medications, situational stress and fever among others. The patient with a genetic predisposition to sleepwalking and with priming factors still requires a precipitating factor or trigger to set the sleepwalking episode in motion. Classical theories of sleepwalking were based primarily on case reports. Recently some of these theories have been tested in the sleep laboratory. Experimental sleep deprivation studies of sleepwalkers generally report an increase in complex behaviors during SWS, although one prominent study reported the opposite effect. However, the generally accepted theory that alcohol and medications can induce sleepwalking episodes remains entirely based on clinical and forensic case reports. Alleged cases of alcohol related sleepwalking often involve individuals lacking the generally accepted characteristics of sleepwalkers but with very high blood alcohol levels that could in and of itself account for complex behaviors noted without the presence of sleepwalking. Further, the effects of high levels of alcohol dramatically decrease SWS, a finding inconsistent with sleepwalking. Case reports of medication-related induction of apparent sleepwalking most often present a complex medical and psychiatric history associated with multiple medications. These patients often lack the clinical history and other criteria currently required for the diagnosis of sleepwalking. The medication-related behaviors may instead represent some other condition in an awake, but impaired patient. Sleep laboratory

  18. Increased Bone Mass in Female Mice Lacking Mast Cell Chymase

    PubMed Central

    Lind, Thomas; Gustafson, Ann-Marie; Calounova, Gabriela; Hu, Lijuan; Rasmusson, Annica; Jonsson, Kenneth B.; Wernersson, Sara; Åbrink, Magnus; Andersson, Göran; Larsson, Sune; Melhus, Håkan; Pejler, Gunnar

    2016-01-01

    Here we addressed the potential impact of chymase, a mast-cell restricted protease, on mouse bone phenotype. We show that female mice lacking the chymase Mcpt4 acquired a persistent expansion of diaphyseal bone in comparison with wild type controls, reaching a 15% larger diaphyseal cross sectional area at 12 months of age. Mcpt4-/- mice also showed increased levels of a bone anabolic serum marker and higher periosteal bone formation rate. However, they were not protected from experimental osteoporosis, suggesting that chymase regulates normal bone homeostasis rather than the course of osteoporosis. Further, the absence of Mcpt4 resulted in age-dependent upregulation of numerous genes important for bone formation but no effects on osteoclast activity. In spite of the latter, Mcpt4-/- bones had increased cortical porosity and reduced endocortical mineralization. Mast cells were found periosteally and, notably, bone-proximal mast cells in Mcpt4-/- mice were degranulated to a larger extent than in wild type mice. Hence, chymase regulates degranulation of bone mast cells, which could affect the release of mast cell-derived factors influencing bone remodelling. Together, these findings reveal a functional impact of mast cell chymase on bone. Further studies exploring the possibility of using chymase inhibitors as a strategy to increase bone volume may be warranted. PMID:27936149

  19. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

    PubMed

    Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

    2013-10-01

    The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

  20. Mannose-binding lectin and its associated proteases (MASPs) mediate coagulation and its deficiency is a risk factor in developing complications from infection, including disseminated intravascular coagulation

    PubMed Central

    Takahashi, Kazue; Chang, Wei-Chuan; Takahashi, Minoru; Pavlov, Vasile; Ishida, Yumi; La Bonte, Laura; Shi, Lei; Fujita, Teizo; Stahl, Gregory L.; Van Cott, Elizabeth M.

    2010-01-01

    The first line of host defense is the innate immune system that includes coagulation factors and pattern recognition molecules, one of which is mannose-binding lectin (MBL). Previous studies have demonstrated that MBL deficiency increases susceptibility to infection. Several mechanisms are associated with increased susceptibility to infection, including reduced opsonophagocytic killing and reduced lectin complement pathway activation. In this study, we demonstrate that MBL and MBL-associated serine protease (MASP)-1/3 together mediate coagulation factor-like activities, including thrombin-like activity. MBL and/or MASP-1/3 deficient hosts demonstrate in vivo evidence that MBL and MASP-1/3 are involved with hemostasis following injury. Staphylococcus aureus infected MBL null mice developed disseminated intravascular coagulation (DIC), which was associated with elevated blood IL-6 levels (but not TNF-α and multi-organ inflammatory responses). Infected MBL null mice also develop liver injury. These findings suggest that MBL deficiency may manifest into DIC and organ failure during infectious diseases. PMID:20399528

  1. Factors associated with intended staff turnover and job search behaviour in services for people with intellectual disability.

    PubMed

    Hatton, C; Emerson, E; Rivers, M; Mason, H; Swarbrick, R; Mason, L; Kiernan, C; Reeves, D; Alborz, A

    2001-06-01

    Staff turnover is a major problem in services for people with intellectual disability (ID). Therefore, understanding the reasons for staff turnover is vital for organizations seeking to improve their performance. The present study investigates the factors directly and indirectly associated with an intention to leave an organization and actual job search behaviour amongst staff in services for people with ID. As part of a large-scale survey of staff in services for people with ID, information was collected from 450 staff concerning intended turnover, job search behaviour and a wide range of factors potentially associated with these outcomes. Path analyses revealed that work satisfaction, job strain, younger staff age and easier subjective labour conditions were directly associated with intended turnover. The same factors, with the exception of younger staff age, were also directly associated with job search behaviour. Factors indirectly associated with these outcomes included wishful thinking, alienative commitment to the organization, lack of staff support, role ambiguity, working longer contracted hours, having a low-status job, a lack of influence over decisions at work and less orientation to working in community settings with people with ID. The models of staff turnover empirically derived in the present study confirm and extend previous research in this area. The implications for organizations are discussed.

  2. Confirmatory Factor Analysis and Test-Retest Reliability of the Alcohol and Drug Confrontation Scale (ADCS)

    PubMed Central

    Polcin, Douglas L.; Galloway, Gantt P.; Bond, Jason; Korcha, Rachael; Greenfield, Thomas K.

    2008-01-01

    The addiction field lacks an accepted definition and reliable measure of confrontation. The Alcohol and Drug Confrontation Scale (ADCS) defines confrontation as warnings about the potential consequences of substance use. To assess psychometric properties, 323 individual entering recovery houses in U.S. urban and suburban areas were interviewed between 2003 and 2005 (20% women, 68% white). Analyses included test-retest reliability, confirmatory factor analysis, and measures of internal consistency. Findings support the ADCS as a reliable way of assessing two factors: Internal Support and External intensity. Confrontation was experienced as supportive, accurate and helpful. Additional studies should assess confrontation in different contexts. PMID:20686635

  3. Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis.

    PubMed

    Li, Ying; Ehiri, John; Tang, Shenglan; Li, Daikun; Bian, Yongqiao; Lin, Hui; Marshall, Caitlin; Cao, Jia

    2013-07-02

    Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country. This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure). We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)). Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB

  4. Towards a Four-Dimensional Model of Burnout: A Multigroup Factor-Analytic Study Including Depersonalization and Cynicism

    ERIC Educational Resources Information Center

    Salanova, Marisa; Llorens, Susana; Garcia-Renedo, Monica; Burriel, Raul; Breso, Edgar; Schaufeli, Wilmar B.

    2005-01-01

    This article investigated whether cynicism and depersonalization are two different dimensions of burnout or whether they may be collapsed into one construct of mental distance. Using confirmatory factor analyses in two samples of teachers (n = 483) and blue-collar workers (n = 474), a superior fit was found for the four-factor model that contained…

  5. Identifying the factors underlying discontinuation of triptans.

    PubMed

    Wells, Rebecca E; Markowitz, Shira Y; Baron, Eric P; Hentz, Joseph G; Kalidas, Kavita; Mathew, Paul G; Halker, Rashmi; Dodick, David W; Schwedt, Todd J

    2014-02-01

    -5 scale (1 = disagree, 5 = agree), triptan users felt they had more: control over their migraine attacks (2.9 vs. 2.1), confidence in their prescribing provider (4.5 vs. 4.0), and were more educated about triptan use (4.2 vs. 3.7) compared with triptan discontinuers (P < .001 for all comparisons). Although both current and prior users reported similar rates of side effects (48 vs. 43%, P = .44), of those who discontinued use, the main reasons were for lack of effect (44%) and side effects (29%). Our multivariable modeling revealed that the strongest correlate of triptan discontinuation was lack of efficacy (odds ratio = 17, 95% confidence interval [8.8, 33.0]). Other factors associated with discontinuation included MIDAS > 24 (2.6, [1.5, 4.6]), BDI >4 (2.5, [1.4, 4.5]), and a history of ever using opioids for migraine therapy (2.2, [1.3, 3.8]). Having a triptan prescribed by a specialist and using at least 1 other abortive medication with the triptan were associated with a decreased likelihood of triptan discontinuation (0.41, [0.2-0.7] and 0.44 [0.3, 0.8], respectively). As expected, discontinuation was most correlated with lack of efficacy, but other important factors associated with those who had discontinued use included greater migraine-related disability, depression, and the use of opioids for migraine attacks. Compared with patients who had discontinued triptans, current triptan users felt more: educated about their triptan, control over their migraine attacks, and confidence in their prescribing provider. Current triptan users had their triptan prescribed by a specialist and used other abortive medications with their triptan more often compared with patients who had discontinued triptans. Given the cross-sectional nature of this study, we cannot determine if these factors contributed to triptan discontinuation or reflect the impact of such discontinuation. Interventions that address modifiable risk factors for triptan discontinuation may

  6. Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

    PubMed

    Parry, Selina M; Knight, Laura D; Connolly, Bronwen; Baldwin, Claire; Puthucheary, Zudin; Morris, Peter; Mortimore, Jessica; Hart, Nicholas; Denehy, Linda; Granger, Catherine L

    2017-04-01

    To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454. Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment. The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

  7. Lack of health risk awareness in low-income Chinese youth migrants: assessment and associated factors.

    PubMed

    Shi, Yuhui; Ji, Ying; Sun, Jing; Wang, Yanling; Sun, Xinying; Li, Chaoyang; Wang, Dongxu; Chang, Chun

    2012-09-01

    To analyze and assess health risk awareness of youth migrants in China and the factors that influence it, and to provide evidence for making health promotion interventions and decreasing health risks among Chinese youth migrants. This was a cross-sectional survey conducted in 2009 among rural-to-urban migrants aged 15-24 years in Tianjin and Xi'an, China. A total of 1,838 youth migrants were enrolled by the stratified cluster sampling method. An anonymous questionnaire was self-administered to investigate health risk awareness. The t test and χ(2) test were used to analyze differences between different groups. Logistic regression analysis was used to test the influence of various sociodemographic, living condition, and occupational factors. The smoking rate of men (66.8%) was higher than that of women (6.8%; P < 0.05), the rate of sexual intercourse in men was higher than in women (56.8 vs 27.7%; P < 0.05), and 75.7% of participants had written into medical care systems with 40.4% of them having undergone a physical examination during the last year. Only 438 of the participants (26% of 1,647) were considered to have a satisfactory level of health risk awareness [273 (32.4% of 958) from Tianjin and 165 (28.8% of 689) from Xi'an]. No significant difference was found between the youth migrant populations of the two cities. The percentage of youth migrants with a satisfactory level of health risk awareness who thought they had a good health status was higher than that with an unsatisfactory health risk awareness who thought they had a good health status (P < 0.05). Logistic regression analysis showed that gender, age, education, reading the newspaper, and occupation significantly influenced on health risk awareness. Youth migrants in China have a low health risk awareness. Combined and targeted health education interventions should be promoted to increase their health risk awareness.

  8. Developer and realtor perspectives on factors that influence development, sale, and perceived demand for activity-friendly communities.

    PubMed

    Carnoske, Cheryl; Hoehner, Christine; Ruthmann, Nicholas; Frank, Lawrence; Handy, Susan; Hill, James; Ryan, Sherry; Sallis, James; Glanz, Karen; Brownson, Ross

    2010-03-01

    Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs. A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers' decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building). Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago. Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities.

  9. Developer and Realtor Perspectives on Factors That Influence Development, Sale, and Perceived Demand for Activity-Friendly Communities

    PubMed Central

    Carnoske, Cheryl; Hoehner, Christine; Ruthmann, Nicholas; Frank, Lawrence; Handy, Susan; Hill, James; Ryan, Sherry; Sallis, James; Glanz, Karen; Brownson, Ross

    2013-01-01

    Background Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs. Methods A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers’ decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building). Results Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago. Conclusions Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities. PMID:20440012

  10. Lack of genetic interaction between Tbx20 and Tbx3 in early mouse heart development.

    PubMed

    Gavrilov, Svetlana; Harvey, Richard P; Papaioannou, Virginia E

    2013-01-01

    Members of the T-box family of transcription factors are important regulators orchestrating the complex regionalization of the developing mammalian heart. Individual mutations in Tbx20 and Tbx3 cause distinct congenital heart abnormalities in the mouse: Tbx20 mutations result in failure of heart looping, developmental arrest and lack of chamber differentiation, while hearts of Tbx3 mutants progress further, loop normally but show atrioventricular convergence and outflow tract defects. The two genes have overlapping areas of expression in the atrioventricular canal and outflow tract of the heart but their potential genetic interaction has not been previously investigated. In this study we produced compound mutants to investigate potential genetic interactions at the earliest stages of heart development. We find that Tbx20; Tbx3 double heterozygous mice are viable and fertile with no apparent abnormalities, while double homozygous mutants are embryonic lethal by midgestation. Double homozygous mutant embryos display abnormal cardiac morphogenesis, lack of heart looping, expression patterns of cardiac genes and time of death that are indistinguishable from Tbx20 homozygous mutants. Prior to death, the double homozygotes show an overall developmental delay similar to Tbx3 homozygous mutants. Thus the effects of Tbx20 are epistatic to Tbx3 in the heart but Tbx3 is epistatic to Tbx20 with respect to developmental delay.

  11. Lack of follow-up exams after failed school vision screenings: an investigation of contributing factors.

    PubMed

    Kimel, Linda S

    2006-06-01

    Programs to facilitate professional eye exams after failed school vision screenings often are based on the assumption that funding and access to services are major obstacles to care. Despite such programs, many children do not receive professional exams. The purpose of this study was to identify additional barriers to follow-up eye care. School nurses in an urban, midwestern public school district identified elementary school students who had not received follow-up eye exams after failed school vision screenings. Parents of these students were interviewed during the summer to determine financial, logistical, social/family, and perceptual barriers to care. Family issues, parental perceptions of vision problems, and difficulty planning ahead were found to be significant factors. Strategies to increase follow-up compliance and recommendations for overcoming barriers to care were also identified.

  12. Prevalence of tuberculosis respiratory symptoms and associated factors in the indigenous populations of Paraguay (2012).

    PubMed

    Aguirre, Sarita; Cuellar, Celia Martínez; Herrero, María Belén; Cortesi, Gustavo Chamorro; Romero, Nilda Gimenez de; Alvarez, Mirian; Braga, Jose Ueleres

    2017-07-01

    The prevalence of respiratory symptoms and confirmed tuberculosis (TB) among indigenous groups in Paraguay is unknown. This study assessed the prevalence of respiratory symptoms, confirmed pulmonary TB, and associated socio-economic factors among indigenous Paraguayan populations. Indigenous persons residing in selected communities were included in the study. A total of 24,352 participants were interviewed at home between October and December 2012. Respiratory symptomatic individuals were defined as those with respiratory symptoms of TB. A hierarchical Poisson regression analysis was performed with four levels: individual characteristics, living conditions and environmental characteristics, source of food, and type of nutrition. In this study, 1,383 participants had respiratory symptoms (5.7%), but only 10 had culture-confirmed TB (41/100,000 inhabitants). The small number of cases did not allow evaluation of the risk factors for TB. Age older than 37 years was associated with a two-fold increased risk of symptoms. Female sex; family history of TB; type of housing; home heating; a lack of hunting, fishing, or purchasing food; and a lack of vegetable consumption were also associated with the presence of symptoms. A lack of cereal consumption had a protective effect. Members of the Ayoreo or Manjui ethnic groups had a three-fold increased risk of symptoms. Individual characteristics, dietary habits, and belonging to specific ethnic groups were associated with respiratory symptoms.

  13. Prevalence of tuberculosis respiratory symptoms and associated factors in the indigenous populations of Paraguay (2012)

    PubMed Central

    Aguirre, Sarita; Cuellar, Celia Martínez; Herrero, María Belén; Cortesi, Gustavo Chamorro; de Romero, Nilda Gimenez; Alvarez, Mirian; Braga, Jose Ueleres

    2017-01-01

    BACKGROUND The prevalence of respiratory symptoms and confirmed tuberculosis (TB) among indigenous groups in Paraguay is unknown. METHODS This study assessed the prevalence of respiratory symptoms, confirmed pulmonary TB, and associated socio-economic factors among indigenous Paraguayan populations. Indigenous persons residing in selected communities were included in the study. A total of 24,352 participants were interviewed at home between October and December 2012. Respiratory symptomatic individuals were defined as those with respiratory symptoms of TB. A hierarchical Poisson regression analysis was performed with four levels: individual characteristics, living conditions and environmental characteristics, source of food, and type of nutrition. FINDINGS In this study, 1,383 participants had respiratory symptoms (5.7%), but only 10 had culture-confirmed TB (41/100,000 inhabitants). The small number of cases did not allow evaluation of the risk factors for TB. Age older than 37 years was associated with a two-fold increased risk of symptoms. Female sex; family history of TB; type of housing; home heating; a lack of hunting, fishing, or purchasing food; and a lack of vegetable consumption were also associated with the presence of symptoms. A lack of cereal consumption had a protective effect. Members of the Ayoreo or Manjui ethnic groups had a three-fold increased risk of symptoms. MAIN CONCLUSION Individual characteristics, dietary habits, and belonging to specific ethnic groups were associated with respiratory symptoms. PMID:28591308

  14. Effects of poverty and lack of insurance on perceptions of racial and ethnic bias in health care.

    PubMed

    Stepanikova, Irena; Cook, Karen S

    2008-06-01

    To investigate whether poverty and lack of insurance are associated with perceived racial and ethnic bias in health care. 2001 Survey on Disparities in Quality of Health Care, a nationally representative telephone survey. We use data on black, Hispanic, and white adults who have a regular physician (N=4,556). We estimate multivariate logistic regression models to examine the effects of poverty and lack of health insurance on perceived racial and ethnic bias in health care for all respondents and by racial, ethnic, and language groups. Controlling for sociodemographic and other factors, uninsured blacks and Hispanics interviewed in English are more likely to report racial and ethnic bias in health care compared with their privately insured counterparts. Poor whites are more likely to report racial and ethnic bias in health care compared with other whites. Good physician-patient communication is negatively associated with perceived racial and ethnic bias. Compared with their more socioeconomically advantaged counterparts, poor whites, uninsured blacks, and some uninsured Hispanics are more likely to perceive that racial and ethnic bias operates in the health care they receive. Providing health insurance for the uninsured may help reduce this perceived bias among some minority groups.

  15. Factors affecting patients' knowledge about dispensed medicines: A Qualitative study of healthcare professionals and patients in Pakistan.

    PubMed

    Saqib, Anum; Atif, Muhammad; Ikram, Raazeyah; Riaz, Fatima; Abubakar, Muhammad; Scahill, Shane

    2018-01-01

    Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan. This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19) and healthcare providers (n = 16) i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist) through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis. The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12), 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional liabilities

  16. Burnout and its Associated Factors in Medical Students of Lahore, Pakistan.

    PubMed

    Muzafar, Yumna; Khan, Hibbah H; Ashraf, Huma; Hussain, Waqas; Sajid, Hifsa; Tahir, Marium; Rehman, Abdul; Sohail, Aleena; Waqas, Ahmed; Ahmad, Waqas

    2015-11-29

    Burnout is a widely known phenomenon. It is defined as a state of prolonged physical and psychological exhaustion and is experienced virtually by every medical student due to the highly demanding nature of medical education. This study probes into the prevalence and psychosocial determinants of burnout in Pakistani medical students. A descriptive, cross-sectional study design and convenience (non-probability) sampling technique were employed in undergraduate medical students from years 1-5. A total of 777 medical students from two medical colleges were included in the study from May-August, 2014. An English version of the Copenhagen Burnout Inventory (CBI) and a series of demographic questions, intermixed with questions from other topics, were included in the questionnaire. Data was analysed by using SPSS ver.21. The majority of students were females and enrolled in the third year of MBBS. Of the medical students involved, 30.6% were found to have high/very high levels of burnout (Kristenson's burnout scoring). Although 38.7% of students said that they did not feel burned out after reading the definition of burnout given in the questionnaire, 35.9% out of these students actually had high levels of burnout according to CBI. According to the multiple regression analysis, burnout in medical students was significantly associated with age, gender, doctor parents, no help or no supportive resources (e.g., from colleagues), lack of time off, lack of belief in what you do, fear of big consequences of failure, family responsibilities, and uncertain future. Perception of teachers lacking leadership skills and doing too much study with little balance was associated with low burnout scores. There is a high prevalence of burnout in Pakistani medical students. The present study identifies several factors associated with burnout in Pakistani medical students. Although these factors are a part of daily life of medical students, their identification should prompt the use of

  17. Burnout and its Associated Factors in Medical Students of Lahore, Pakistan

    PubMed Central

    Muzafar, Yumna; Khan, Hibbah H; Ashraf, Huma; Hussain, Waqas; Sajid, Hifsa; Tahir, Marium; Rehman, Abdul; Sohail, Aleena; Waqas, Ahmed

    2015-01-01

    Introduction: Burnout is a widely known phenomenon. It is defined as a state of prolonged physical and psychological exhaustion and is experienced virtually by every medical student due to the highly demanding nature of medical education. This study probes into the prevalence and psychosocial determinants of burnout in Pakistani medical students. Methods: A descriptive, cross-sectional study design and convenience (non-probability) sampling technique were employed in undergraduate medical students from years 1-5. A total of 777 medical students from two medical colleges were included in the study from May-August, 2014. An English version of the Copenhagen Burnout Inventory (CBI) and a series of demographic questions, intermixed with questions from other topics, were included in the questionnaire. Data was analysed by using SPSS ver.21. Results: The majority of students were females and enrolled in the third year of MBBS. Of the medical students involved, 30.6% were found to have high/very high levels of burnout (Kristenson’s burnout scoring). Although 38.7% of students said that they did not feel burned out after reading the definition of burnout given in the questionnaire, 35.9% out of these students actually had high levels of burnout according to CBI. According to the multiple regression analysis, burnout in medical students was significantly associated with age, gender, doctor parents, no help or no supportive resources (e.g., from colleagues), lack of time off, lack of belief in what you do, fear of big consequences of failure, family responsibilities, and uncertain future. Perception of teachers lacking leadership skills and doing too much study with little balance was associated with low burnout scores. Conclusion: There is a high prevalence of burnout in Pakistani medical students. The present study identifies several factors associated with burnout in Pakistani medical students. Although these factors are a part of daily life of medical students, their

  18. Risk Factors for Pressure Ulcers Including Suspected Deep Tissue Injury in Nursing Home Facility Residents: Analysis of National Minimum Data Set 3.0.

    PubMed

    Ahn, Hyochol; Cowan, Linda; Garvan, Cynthia; Lyon, Debra; Stechmiller, Joyce

    2016-04-01

    To provide information on risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home residents in the United States. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Examine the literature related to risk factors for the development of PrUs.2. Compare risk factors associated with the prevalence of PrUs and sDTI from the revised Minimum Data Set 3.0 2012 using a modified Defloor's conceptual model of PrUs as a theoretical framework. This study aims to characterize and compare risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home (NH) residents in the United States. Secondary analysis of the 2012 Minimum Data Set (MDS 3.0). Medicare- or Medicaid-certified NHs in the United States. Nursing home residents (n = 2,936,146) 18 years or older with complete PrU data, who received comprehensive assessments from January to December 2012. Pressure ulcer by stage was the outcome variable. Explanatory variables (age, gender, race and ethnicity, body mass index, skin integrity, system failure, disease, infection, mobility, and cognition) from the MDS 3.0 were aligned with the 4 elements of Defloor's conceptual model: compressive forces, shearing forces, tissue tolerance for pressure, and tissue tolerance for oxygen. Of 2,936,146 NH residents who had complete data for PrU, 89.9% had no PrU; 8.4% had a Stage 2, 3, or 4 or unstagable PrU; and 1.7% had an sDTI. The MDS variables corresponding to the 4 elements of Defloor's model were significantly predictive of both PrU and sDTI. Black residents had the highest risk of any-stage PrU, and Hispanic residents had the highest risk of sDTI. Skin integrity, system failure, infection, and disease risk factors had larger effect sizes for sDTI than for other PrU stages

  19. Factors influencing nurse absenteeism in a general hospital in Durban, South Africa.

    PubMed

    Mudaly, P; Nkosi, Z Z

    2015-07-01

    To establish reasons for absenteeism amongst professional nurses, enrolled nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to recommend strategies that could decrease absenteeism. Nurses endure increased workload, resulting in burnout and absenteeism in workplace environments that already suffer staff shortages. This study was a quantitative, non-experimental survey. The study population consisted of 60 nurses, including professional and enrolled nurses and enrolled nurse auxiliaries. The survey consisted of closed-ended questions to options of 'agree' and 'disagree' and an open-ended section. Family matters, lack of motivation to attend work, illness, finance, favouritism, unfriendly nurse managers, long work hours, increased workload, unsatisfactory work conditions, lack of equipment, unfair promotions and selection of nurses for training, staff shortages, lack of a reward system and incoherent decision-making caused nurse absenteeism. Personal, professional and organisational factors may cause nurse absenteeism, crippling the health sector further against the backdrop of human and mechanical resource shortage. Nurse managers have an important role in reducing absenteeism by addressing the employees' concerns, which can lead to productivity, increased staff morale, decreased medical hazards and satisfied patients. © 2013 John Wiley & Sons Ltd.

  20. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

    PubMed Central

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-01-01

    -income countries. Data collection and analysis One review author extracted data and assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review. Main results We included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America. Our synthesis pointed to a number of factors affecting SBAs’ provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always given sufficient training during their education or after they had begun clinical work. Also, inadequate staffing of facilities could increase the workloads of skilled birth attendants, make it difficult to provide supervision and result in mothers being offered poorer care. In addition, SBAs did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues were seen to increase stress and to negatively affect family life. Some SBAs also felt that managers lacked capacity and skills, and felt unsupported when their workplace concerns were not addressed. Possible causes of staff shortages in facilities included problems with hiring and assigning health workers to facilities where they were needed; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled

  1. Innate Immune Factors in Mothers' Breast Milk and Their Lack of Association With Rotavirus Vaccine Immunogenicity in Nicaraguan Infants.

    PubMed

    Becker-Dreps, Sylvia; Choi, Wan Suk; Stamper, Lisa; Vilchez, Samuel; Velasquez, Daniel E; Moon, Sung-Sil; Hudgens, Michael G; Jiang, Baoming; Permar, Sallie R

    2017-03-01

    To better understand underlying causes of lower rotavirus vaccine effectiveness in low-middle income countries (LMICs), we measured innate antiviral factors in Nicaraguan mothers' milk and immune response to the first dose of the pentavalent rotavirus vaccine in corresponding infants. No relationship was found between concentrations of innate factors and rotavirus vaccine response. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Neurotrophic factors and receptors in the immature and adult spinal cord after mechanical injury or kainic acid.

    PubMed

    Widenfalk, J; Lundströmer, K; Jubran, M; Brene, S; Olson, L

    2001-05-15

    Delivery of neurotrophic factors to the injured spinal cord has been shown to stimulate neuronal survival and regeneration. This indicates that a lack of sufficient trophic support is one factor contributing to the absence of spontaneous regeneration in the mammalian spinal cord. Regulation of the expression of neurotrophic factors and receptors after spinal cord injury has not been studied in detail. We investigated levels of mRNA-encoding neurotrophins, glial cell line-derived neurotrophic factor (GDNF) family members and related receptors, ciliary neurotrophic factor (CNTF), and c-fos in normal and injured spinal cord. Injuries in adult rats included weight-drop, transection, and excitotoxic kainic acid delivery; in newborn rats, partial transection was performed. The regulation of expression patterns in the adult spinal cord was compared with that in the PNS and the neonate spinal cord. After mechanical injury of the adult rat spinal cord, upregulations of NGF and GDNF mRNA occurred in meningeal cells adjacent to the lesion. BDNF and p75 mRNA increased in neurons, GDNF mRNA increased in astrocytes close to the lesion, and GFRalpha-1 and truncated TrkB mRNA increased in astrocytes of degenerating white matter. The relatively limited upregulation of neurotrophic factors in the spinal cord contrasted with the response of affected nerve roots, in which marked increases of NGF and GDNF mRNA levels were observed in Schwann cells. The difference between the ability of the PNS and CNS to provide trophic support correlates with their different abilities to regenerate. Kainic acid delivery led to only weak upregulations of BDNF and CNTF mRNA. Compared with several brain regions, the overall response of the spinal cord tissue to kainic acid was weak. The relative sparseness of upregulations of endogenous neurotrophic factors after injury strengthens the hypothesis that lack of regeneration in the spinal cord is attributable at least partly to lack of trophic support.

  3. Exploring the Factor Structure of the Job Demands-Resources Measure With Patient Violence on Direct Care Workers in the Home Setting.

    PubMed

    Byon, Ha Do; Harrington, Donna; Storr, Carla L; Lipscomb, Jane

    2017-08-01

    Workplace violence research in health care settings using the Job Demands-Resources (JD-R) framework is hindered by the lack of comprehensive examination of the factor structure of the JD-R measure when it includes patient violence. Is patient violence a component of job demands or its own factor as an occupational outcome? Exploratory factor analysis and confirmatory factor analysis were conducted using a sample of direct care workers in the home setting (n = 961). The overall 2-construct JD-R structure persisted. Patient violence was not identified as a separate factor from job demands; rather, two demand factors emerged: violence/emotional and workload/physical demands. Although the three-factor model fits the data, the two-factor model with patient violence being a component of job demands is a parsimonious and effective measurement framework.

  4. Lack of consensus in the diagnosis and treatment for ocular tuberculosis among uveitis specialists.

    PubMed

    Lou, Susan M; Larkin, Kelly L; Winthrop, Kevin; Rosenbaum, James T

    2015-02-01

    To assess the approach of specialists to ocular tuberculosis (TB). The American Uveitis Society (AUS) Listserv was surveyed using two clinical cases and general questions. Of 196 members, 87 responded (44.4%), of whom 64 were affiliated with practices in North America, while 23 were outside of North America. The survey provided normative data on how physicians evaluate patients with uveitis as well as opinions about ocular TB. Responses varied widely on such issues as (1) the pretest probability that a patient with granulomatous panuveitis had TB uveitis (range 1-75%) or that a patient with a risk factor for TB had ocular TB (range 0-90%); (2) the optimal duration of anti-TB therapy; and (3) whether therapy should be discontinued after 2 months in nonresponders. Consensus is lacking among uveitis specialists for the diagnosis or management of ocular TB.

  5. Lack of consensus in social systems

    NASA Astrophysics Data System (ADS)

    Benczik, I. J.; Benczik, S. Z.; Schmittmann, B.; Zia, R. K. P.

    2008-05-01

    We propose an exactly solvable model for the dynamics of voters in a two-party system. The opinion formation process is modeled on a random network of agents. The dynamical nature of interpersonal relations is also reflected in the model, as the connections in the network evolve with the dynamics of the voters. In the infinite time limit, an exact solution predicts the emergence of consensus, for arbitrary initial conditions. However, before consensus is reached, two different metastable states can persist for exponentially long times. One state reflects a perfect balancing of opinions, the other reflects a completely static situation. An estimate of the associated lifetimes suggests that lack of consensus is typical for large systems.

  6. Characterization of a hypoallergenic wheat line lacking ω-5 gliadin.

    PubMed

    Kohno, Kunie; Takahashi, Hitoshi; Endo, Takashi R; Matsuo, Hiroaki; Shiwaku, Kuninori; Morita, Eishin

    2016-10-01

    There is no curative treatment for wheat-dependent exercise-induced anaphylaxis (WDEIA). ω-5 Gliadin is one of the dominant allergens affecting WDEIA patients. The use of ω-5 gliadin-free wheat flour in the regular diet is considered one of the prophylactic approaches against the elicitation of allergic symptoms and sensitization to ω-5 gliadin. We sought to find hypoallergenic bread wheat (or common wheat) that lacked the genes encoding ω-5 gliadin and to evaluate its in vitro allergenicity. We also aimed to evaluate the sensitization ability of one of the selected hypoallergenic wheat lines by using a possible animal model of wheat allergy. We screened the deletion lines of bread wheat by western blotting to ascertain common wheat lines lacking the ω-5 gliadin locus. The deletion lines we used have partial deficiency of chromosome 1B (Endo and Gill, 1996). To assess sensitization ability of gluten from the selected deletion line, guinea pigs were fed with either the gluten from the selected deletion line or commercially available gluten, and allergic score was evaluated after challenging the same gluten preparations. We found that a deletion line 1BS-18 had the least deficiency of chromosome 1B among the deletion stocks lacking the ω-5 gliadin locus. The challenge test using the guinea pigs revealed that the symptoms induced by application of the 1BS-18 gluten were much less than that of commercially available gluten. The deletion line 1BS-18, which lacked the ω-5 gliadin locus, is likely to have a low sensitization capacity in the guinea pig. The use of the wheat products of the 1BS-18 line in daily life may provide a feasible solution for the onset of wheat allergy. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  7. Sphincter of Oddi Function and Risk Factors for Dysfunction.

    PubMed

    Afghani, Elham; Lo, Simon K; Covington, Paul S; Cash, Brooks D; Pandol, Stephen J

    2017-01-01

    The sphincter of Oddi (SO) is a smooth muscle valve regulating the flow of biliary and pancreatic secretions into the duodenum, initially described in 1887 by the Italian anatomist, Ruggero Oddi. SO dysfunction (SOD) is a broad term referring to numerous biliary, pancreatic, and hepatic disorders resulting from spasms, strictures, and relaxation of this valve at inappropriate times. This review brings attention to various factors that may increase the risk of SOD, including but not limited to: cholecystectomy, opiates, and alcohol. Lack of proper recognition and treatment of SOD may be associated with clinical events, including pancreatitis and biliary symptoms with hepatic enzyme elevation. Pharmacologic and non-pharmacologic approaches are discussed to help recognize, prevent, and treat SOD. Future studies are needed to assess the treatment benefit of agents such as calcium-channel blockers, glyceryl trinitrate, or tricyclic antidepressants in patients with SOD.

  8. An exploratory review on critical factors of IBS formwork implementation for Malaysian construction stakeholders

    NASA Astrophysics Data System (ADS)

    Baharuddin, Mohd Nurfaisal; Bahardin, Nur Fadhilah; Zaidi, Mohd Azian; Lokman, Ikhwan; Nawi, Mohd Nasrun Mohd

    2016-08-01

    The goals of this paper is to analysed the critical factors of driving or hindering the used of Industrialised Building System (IBS) formwork system in the Malaysian construction industry. Based on the reviews of a previous research and related literature, this paper was identified four (4) critical factor that classified as a difficulties to the success of IBS formwork system application; The issues related to the lack of knowledge and awareness, high cost and financial barriers, lack of incentive and promotion and lack of enforcement for government policy were highlight as a key dimension for the uses of IBS formwork system to success. The objective of this paper is to determine the importance factors in implementing IBS formwork in Malaysia. A preliminary survey which qualitative research approach has been adopted for this study as to validate the factors which found in the literature study. Based on the result analysis, it can be confirmed that the entire factors in literature review are strongly related with challenges in construction industry.

  9. Risk factors for the development of metabolic syndrome in obese children and adolescents.

    PubMed

    Folić, Nevena; Folić, Marko; Marković, Slavica; Andjelković, Marija; Janković, Slobodan

    2015-01-01

    High prevalence of metabolic syndrome (MetS) in children and adolescents is a great concern of the modern society. bjective: Our aim was to determine the influence of previously investigated, but also and potentially novel risk factors for the development of metabolic syndrome in children and adolescents. Observational case-control clinical study was conducted involving children and adolescents with obesity/metabolic syndrome, treated on inpatient basis from January 2008 to January 2012 at the Pediatric Clinic of the Clinical Centre Kragujevac, Kragujevac, Serbia. The group of"cases"(n=28) included patients aged 10-16 years with the diagnosis of metabolic syndrome according to the International Diabetes Federation (IDF) criteria, while the control group included twice as many obese patients (n=56) matched to the compared group. Presence of maternal gestational diabates (ORadjusted: 39.426; 95% Cl: 1.822-853.271; p=0.019), and/or lack of breastfeeding in the first six months of life (ORadjusted: 0.079; 95% CI: 0.009-0.716; p=0.024) were significant predictors for developing MetS. Also, microalbuminuria is associated with MetS in obese children and adolescants (ORadjusted: 1.686; 95% Cl: 1.188-2.393; p=0.003) CONCLUSION: Presence of maternal gestational diabetes and/or lack of infant breastfeeding are considered as relevant factors that may contribute to the increased risk of developing MetS syndrome, while microalbuminuria is frequently associated with MetS in obese children and adolescents.

  10. Lack of tolerable treatment options for patients with schizophrenia.

    PubMed

    Citrome, Leslie; Eramo, Anna; Francois, Clement; Duffy, Ruth; Legacy, Susan N; Offord, Steve J; Krasa, Holly B; Johnston, Stephen S; Guiraud-Diawara, Alice; Kamat, Siddhesh A; Rohman, Patricia

    2015-01-01

    Atypical antipsychotics (AAs), an effective treatment for schizophrenia, have a range of pharmacologic properties leading to differences in tolerability as well as heterogeneity in treatment response. Individual patient characteristics must be considered when making treatment choices, especially from an adverse event (AE) or tolerability perspective. Despite the availability of numerous AAs, after appraising patient characteristics at the time of treatment selection, physicians may quickly run out of tolerable treatment options. AE risk factors, defined as having either a prior history of an AE or a risk factor for that AE, were determined for Medicaid-insured and Commercially insured patients using database analysis. Patients receiving AA treatment between January 1, 2010 and December 31, 2012 defined the index date of first observed AA prescription during this period. Nine AAs were evaluated for association with AE risk factors as informed by drug prescribing information from the different manufacturers and published meta-analyses. The proportion of patients with pre-index AE risk factors prescribed an AA associated with that risk factor was then determined. A high proportion of patients (>80%) were prescribed an AA associated with extrapyramidal symptoms or akathisia despite experiencing extrapyramidal symptoms or akathisia prior to AA treatment initiation. Similar trends were observed among patients with diabetes (>60%) and obesity (>40%). From the nine treatment options available, the number of optimal choices for individual patient segments were limited based on their prior history, including those with cardiometabolic and cardiovascular comorbidities (four); experiencing prolactin elevation-related problems (seven); needing to avoid excessive sedation (four); or at risk of extrapyramidal symptoms or akathisia (two). Options were then further restricted among patients in more than one segment when multiple pre-index AE risk factors were combined. When

  11. batman Interacts with polycomb and trithorax group genes and encodes a BTB/POZ protein that is included in a complex containing GAGA factor.

    PubMed

    Faucheux, M; Roignant, J-Y; Netter, S; Charollais, J; Antoniewski, C; Théodore, L

    2003-02-01

    Polycomb and trithorax group genes maintain the appropriate repressed or activated state of homeotic gene expression throughout Drosophila melanogaster development. We have previously identified the batman gene as a Polycomb group candidate since its function is necessary for the repression of Sex combs reduced. However, our present genetic analysis indicates functions of batman in both activation and repression of homeotic genes. The 127-amino-acid Batman protein is almost reduced to a BTB/POZ domain, an evolutionary conserved protein-protein interaction domain found in a large protein family. We show that this domain is involved in the interaction between Batman and the DNA binding GAGA factor encoded by the Trithorax-like gene. The GAGA factor and Batman codistribute on polytene chromosomes, coimmunoprecipitate from nuclear embryonic and larval extracts, and interact in the yeast two-hybrid assay. Batman, together with the GAGA factor, binds to MHS-70, a 70-bp fragment of the bithoraxoid Polycomb response element. This binding, like that of the GAGA factor, requires the presence of d(GA)n sequences. Together, our results suggest that batman belongs to a subset of the Polycomb/trithorax group of genes that includes Trithorax-like, whose products are involved in both activation and repression of homeotic genes.

  12. batman Interacts with Polycomb and trithorax Group Genes and Encodes a BTB/POZ Protein That Is Included in a Complex Containing GAGA Factor

    PubMed Central

    Faucheux, M.; Roignant, J.-Y.; Netter, S.; Charollais, J.; Antoniewski, C.; Théodore, L.

    2003-01-01

    Polycomb and trithorax group genes maintain the appropriate repressed or activated state of homeotic gene expression throughout Drosophila melanogaster development. We have previously identified the batman gene as a Polycomb group candidate since its function is necessary for the repression of Sex combs reduced. However, our present genetic analysis indicates functions of batman in both activation and repression of homeotic genes. The 127-amino-acid Batman protein is almost reduced to a BTB/POZ domain, an evolutionary conserved protein-protein interaction domain found in a large protein family. We show that this domain is involved in the interaction between Batman and the DNA binding GAGA factor encoded by the Trithorax-like gene. The GAGA factor and Batman codistribute on polytene chromosomes, coimmunoprecipitate from nuclear embryonic and larval extracts, and interact in the yeast two-hybrid assay. Batman, together with the GAGA factor, binds to MHS-70, a 70-bp fragment of the bithoraxoid Polycomb response element. This binding, like that of the GAGA factor, requires the presence of d(GA)n sequences. Together, our results suggest that batman belongs to a subset of the Polycomb/trithorax group of genes that includes Trithorax-like, whose products are involved in both activation and repression of homeotic genes. PMID:12556479

  13. Life stories of people with rheumatoid arthritis who retired early: how gender and other contextual factors shaped their everyday activities, including paid work.

    PubMed

    Stamm, T A; Machold, K P; Smolen, J; Prodinger, B

    2010-06-01

    The aim of the present study was to explore how contextual factors affect the everyday activities of women and men with rheumatoid arthritis (RA), as evident in their life stories. Fifteen people with RA, who had retired early due to the disease, were interviewed up to three times, according to a narrative biographic interview style. The life stories of the participants, which were reconstructed from the biographical data and from the transcribed 'told story' were analysed from the perspective of contextual factors, including personal and environmental factors. The rigour and accuracy of the analysis were enhanced by reflexivity and peer-review of the results. The life stories of the participants in this study reflected how contextual factors (such as gender, the healthcare system, the support of families and social and cultural values) shaped their everyday activities. In a society such as in Austria, which is based on traditional patriarchal values, men were presented with difficulties in developing a non-paid-work-related role. For women, if paid work had to be given up, they were more likely to engage in alternative challenging activities which enabled them to develop reflective skills, which in turn contributed to a positive and enriching perspective on their life stories. Health professionals may thus use some of the women's strategies to help men. Interventions by health professionals in people with RA may benefit from an approach sensitive to personal and environmental factors.

  14. Reduced alcohol consumption in mice lacking preprodynorphin.

    PubMed Central

    Blednov, Yuri A.; Walker, Danielle; Martinez, Marni; Harris., R. Adron

    2007-01-01

    Many studies suggest a role for endogenous opioid peptides and their receptors in regulation of ethanol intake. It is commonly accepted that the κ-opioid receptors and their endogenous ligands, dynorphins, produce a dysphoric state and therefore may be responsible for avoidance of alcohol. We used mutant mice lacking preprodynorphin in a variety of behavioral tests of alcohol actions. Null mutant female, but not male, mice showed significantly lower preference for alcohol and consumed lower amounts of alcohol in a two-bottle choice test as compared with wild-type littermates. In the same test, knockout mice of both sexes showed a strong reduction of preference for saccharin compared to control mice. In contrast, under conditions of limited (4 hours) access (light phase of the light/dark cycle), null mutant mice did not show any differences in consumption of saccharin but they showed significantly reduced intake of sucrose. To determine the possible cause for reduction of ethanol preference and intake, we studied other ethanol-related behaviors in mice lacking the preprodynorphin gene. There were no differences between null mutant and wild type mice in ethanol-induced loss of righting reflex, acute ethanol withdrawal, ethanol-induced conditioned place preference or conditioned taste aversion to ethanol. These results indicate that deletion of preprodynorphin leads to substantial reduction of alcohol intake in female mice, and suggest thath this is caused by decreased orosensory reward of alcohol (sweet taste and/or palatability). PMID:17307643

  15. Reduced alcohol consumption in mice lacking preprodynorphin.

    PubMed

    Blednov, Yuri A; Walker, Danielle; Martinez, Marni; Harris, R Adron

    2006-10-01

    Many studies suggest a role for endogenous opioid peptides and their receptors in regulation of ethanol intake. It is commonly accepted that the kappa-opioid receptors and their endogenous ligands, dynorphins, produce a dysphoric state and therefore may be responsible for avoidance of alcohol. We used mutant mice lacking preprodynorphin in a variety of behavioral tests of alcohol actions. Null mutant female, but not male, mice showed significantly lower preference for alcohol and consumed lower amounts of alcohol in a two-bottle choice test as compared with wild-type littermates. In the same test, knockout mice of both sexes showed a strong reduction of preference for saccharin compared to control mice. In contrast, under conditions of limited (4 h) access (light phase of the light/dark cycle), null mutant mice did not show any differences in consumption of saccharin, but they showed significantly reduced intake of sucrose. To determine the possible cause for reduction of ethanol preference and intake, we studied other ethanol-related behaviors in mice lacking the preprodynorphin gene. There were no differences between null mutant and wild-type mice in ethanol-induced loss of righting reflex, acute ethanol withdrawal, ethanol-induced conditioned place preference, or conditioned taste aversion to ethanol. These results indicate that deletion of preprodynorphin leads to substantial reduction of alcohol intake in female mice, and suggest that this is caused by decreased orosensory reward of alcohol (sweet taste and/or palatability).

  16. [Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses].

    PubMed

    Citolino, Clairton Marcos Filho; Santos, Eduesley Santana; Silva, Rita de Cassia Gengo E; Nogueira, Lilia de Souza

    2015-12-01

    To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR) in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. The majority of nurses reported that the high number of professionals in the scenario (75.5%), the lack of harmony (77.6%) or stress of any member of staff (67.3%), lack of material and/or equipment failure (57.1%), lack of familiarity with the emergency trolleys (98.0%) and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1%) are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

  17. 5 CFR 950.107 - Lack of a qualified PCFO.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... VOLUNTARY ORGANIZATIONS General Provisions § 950.107 Lack of a qualified PCFO. There is no authority in... 950.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... campaign that has a qualified PCFO or identifying an eligible organization to function as the campaign's...

  18. 5 CFR 950.107 - Lack of a qualified PCFO.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... VOLUNTARY ORGANIZATIONS General Provisions § 950.107 Lack of a qualified PCFO. There is no authority in... 950.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... campaign that has a qualified PCFO or identifying an eligible organization to function as the campaign's...

  19. 5 CFR 950.107 - Lack of a qualified PCFO.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... VOLUNTARY ORGANIZATIONS General Provisions § 950.107 Lack of a qualified PCFO. There is no authority in... 950.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... campaign that has a qualified PCFO or identifying an eligible organization to function as the campaign's...

  20. 5 CFR 950.107 - Lack of a qualified PCFO.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... VOLUNTARY ORGANIZATIONS General Provisions § 950.107 Lack of a qualified PCFO. There is no authority in... 950.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... campaign that has a qualified PCFO or identifying an eligible organization to function as the campaign's...

  1. 5 CFR 950.107 - Lack of a qualified PCFO.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... VOLUNTARY ORGANIZATIONS General Provisions § 950.107 Lack of a qualified PCFO. There is no authority in... 950.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... campaign that has a qualified PCFO or identifying an eligible organization to function as the campaign's...

  2. Response to Bile Salts in Clinical Strains of Acinetobacter baumannii Lacking the AdeABC Efflux Pump: Virulence Associated with Quorum Sensing

    PubMed Central

    López, Maria; Blasco, Lucia; Gato, Eva; Perez, Astrid; Fernández-Garcia, Laura; Martínez-Martinez, Luis; Fernández-Cuenca, Felipe; Rodríguez-Baño, Jesús; Pascual, Alvaro; Bou, German; Tomás, Maria

    2017-01-01

    Introduction: Acinetobacter baumannii is an opportunistic nosocomial pathogen associated with multiple infections. This pathogen usually colonizes (first stage of microbial infection) host tissues that are in contact with the external environment. As one of the sites of entry in human hosts is the gastrointestinal tract, the pathogen must be capable of tolerating bile salts. However, studies analyzing the molecular characteristics involved in the response to bile salts in clinical strains of A. baumannii are scarce. Material and Methods: Microbiological and transcriptional studies (arrays and RT-PCR) in the response to bile salts were carried out in isogenic (A. baumanni ΔadeB ATCC 17978 and A. baumannii ΔadeL ATCC 17978) and clinical strains from clone ST79/PFGE-HUI-1 which is characterized by lacking the AdeABC efflux pump and by overexpression the AdeFGH efflux pump. Results and Discussion: In presence of bile salts, in addition to the glutamate/aspartate transporter were found overexpressed in A. baumannii ΔadeB ATCC 17978, the virulence factors (surface motility, biofilm, and Type VI Secretion System) which are associated with activation of the Quorum Sensing system. Overexpression of these factors was confirmed in clinical strains of clone ST79/PFGE-HUI-1. Conclusions: This the first study about the adaptive response to bile salts investigating the molecular and microbiological characteristics in response to bile salts of an isogenic model of A. baumannii ATCC 17978 and clinical isolates of A. baumannii (clinical strains of ST79/PFGE-HUI-1) lacking the main RND efflux pump (AdeABC). Clinical isolates of A. baumannii lacking the AdeABC efflux pump (clone ST79/PFGE-HUI-1) displayed a new clinical profile (increased invasiveness) possibly associated with the response to stress conditions (such as the presence of bile salts). PMID:28536672

  3. Sleep apneas are increased in mice lacking monoamine oxidase A.

    PubMed

    Real, Caroline; Popa, Daniela; Seif, Isabelle; Callebert, Jacques; Launay, Jean-Marie; Adrien, Joëlle; Escourrou, Pierre

    2007-10-01

    Alterations in the serotonin (5-HT) system have been suggested as a mechanism of sleep apnea in humans and rodents. The objective is to evaluate the contribution of 5-HT to this disorder. We studied sleep and breathing (whole-body plethysmography) in mutant mice that lack monoamine oxidase A (MAOA) and have increased concentrations of monoamines, including 5-HT. Compared to wild-type mice, the mutants showed similar amounts of slow wave sleep (SWS) and rapid eye movement sleep (REMS), but exhibited a 3-fold increase in SWS and REMS apnea indices. Acute administration of the MAOA inhibitor clorgyline decreased REMS amounts and increased the apnea index in wild-type but not mutant mice. Parachlorophenylalanine, a 5-HT synthesis inhibitor, reduced whole brain concentrations of 5-HT in both strains, and induced a decrease in apnea index in mutant but not wild-type mice. Our results show that MAOA deficiency is associated with increased sleep apnea in mice and suggest that an acute or chronic excess of 5-HT contributes to this phenotype.

  4. Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

    PubMed

    Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

    2018-01-03

    In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and

  5. Law tightened to protect adults who lack capacity.

    PubMed

    2009-05-21

    VULNERABLE OLDER people will be better protected from abuse and poor care after new legislation came into force last month. Under the Mental Capacity Act Deprivation of Liberty Safeguards, a care home or hospital wanting to deprive a person who lacks capacity of their liberty, for their own safety or wellbeing, must now apply for permission. A rigorous, standardised assessment and authorisation process must then be completed.

  6. HIV infection risk factors among male-to-female transgender persons: a review of the literature.

    PubMed

    De Santis, Joseph P

    2009-01-01

    Male-to-female (MTF) transgender women experience a host of psychosocial issues such as discrimination, stigmatization, and marginalization. These challenges often limit economic opportunities, affect mental health, and may place members of this population at an increased risk for HIV infection. This report presents a review of the literature that focuses on risk factors for HIV infection specific to the MTF population. Factors including needle sharing and substance abuse, high-risk sexual behaviors, commercial sex work, health care access, lack of knowledge regarding HIV transmission, violence, stigma and discrimination, and mental health issues have been identified in the literature as risk factors for the acquisition of HIV infection by members of this population. Implications for care provided to MTF transgender persons are presented, and suggestions for future research are identified.

  7. Factors Associated with Non-disclosure of HIV Status in a Cohort of Childbearing HIV-Positive Women in Ukraine.

    PubMed

    Ahn, Jane V; Bailey, Heather; Malyuta, Ruslan; Volokha, Alla; Thorne, Claire

    2016-01-01

    Ukraine has one of the largest populations of persons living with HIV in Europe. Data on 2019 HIV-positive married or cohabiting women enrolled in a postnatal cohort from 2007 to 2012 were analysed to investigate prevalence and factors associated with self-reported non-disclosure of HIV status. Median age at enrolment was 27.5 years, with two-thirds diagnosed during their most recent pregnancy. Almost all had received antenatal antiretroviral therapy and 24 % were taking it currently. One-tenth (n = 198) had not disclosed their HIV status to their partner and 1 in 20 (n = 93) had disclosed to no-one. Factors associated with non-disclosure were: unmarried status (AOR 2.99 (95 % CI 1.51-5.92), younger age at leaving full-time education (AOR 0.41 (95 % CI 0.19-0.88) for ≥19 years vs ≤16 years) and lack of knowledge of partner's HIV status (AOR 2.01 (95 % CI 1.09-3.66). Further work is needed to support disclosure in some groups and to explore relationships between disclosure and psychological factors in this setting, including depression, lack of support and perception of stigma.

  8. Designing medical technology for resilience: integrating health economics and human factors approaches.

    PubMed

    Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B

    2018-01-01

    The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.

  9. [Cardiovascular risk factors in a group of health care workers].

    PubMed

    Kramer, Verónica; Adasme, Marcela; Bustamante, M José; Jalil, Jorge; Navarrete, Carlos; Acevedo, Mónica

    2012-05-01

    Health promotion can be carried out at work places. To assess cardiovascular risk factors among workers of a University hospital. Cross sectional study of 888 participants (aged 41 ± 11 years, 76% women), who answered a survey about cardiovascular risk factors. Body mass index, waist, blood pressure and total cholesterol (TC) by capillary method were determined. Self reported prevalence of risk factors were as follows: 19% of participants had high blood pressure, 30% hypercholesterolemia, 6% diabetes, 41% smoked, 88% were sedentary and 26% had a family history of cardiovascular diseases. Five percent of participants did not have any risk factor, 20% had one risk factor, 32% had two and 43% had three or more. The highest frequency of lack of awareness was about blood glucose values. A high blood cholesterol level was found in 27% of those reporting normal cholesterol levels. Likewise, a high body mass index was found in 18% of those reporting a normal weight. The prevalence of cardiovascular risk factors in this group of participants is similar to that found in the last national health survey in Chile. Noteworthy is the lack of awareness about these risk factors.

  10. Factors affecting behavior and welfare of service dogs for children with autism spectrum disorder.

    PubMed

    Burrows, Kristen E; Adams, Cindy L; Millman, Suzanne T

    2008-01-01

    The use of service dogs for children with autism spectrum disorder is a relatively new and growing assistance-dog application. The objectives of this article were to identify and describe the factors influencing an autism service dog's performance and the impact of this type of placement on the dog's welfare. A qualitative approach uses interview and observational data to characterize the dogs' behaviors and welfare with relevancy to the dogs' home environments. Identification of potential physical stressors included lack of rest or recovery time after working, unintentional maltreatment and prodding by children with autism, lack of predictability in daily routines, and insufficient opportunities for recreational activities. Results revealed that these dogs formed social relationships primarily with the parents and second with the children with autism. Failure to recognize and respond to the identified physical, emotional, and social needs can have serious impacts on the behavior, welfare, and performance of these autism service dogs, as well as parental satisfaction. As applications of service dogs expand to new domains, there is a need to assess and understand factors and variables affecting the relationship between family and service dog to ensure continued success of these programs.

  11. Prevalence and associated factors of common mental disorders among Ethiopian migrant returnees from the Middle East and South Africa.

    PubMed

    Habtamu, Kassahun; Minaye, Abebaw; Zeleke, Waganesh A

    2017-04-19

    Ethiopian migrants to the Middle East and South Africa experience a range of problems at various stages of their migration including overwork, sleep deprivation, denial of food, emotional abuse, difficulty adapting to the host culture, salary denial, sexual abuse, labor exploitation, confiscation of their travel documents, confinement, denial of medication, lack of access to legal service and degrading attitude by employers, traffickers and smugglers. These experiences can be associated with different types of mental disorders. This study sought to determine the prevalence of common mental disorders (CMD) and socio-demographic and other migration related associated factors among Ethiopian migrant returnees from the Middle East and South Africa. A cross-sectional study was conducted using non-probability (i.e. purposive, availability and snowball) sampling techniques. Migrant returnees (n = 1036) were contacted individually at their homes in eight high prevalent immigrant returnee locations in Ethiopia. Common mental disorders were assessed using the self-reporting questionnaire (SRQ-20) and a structured questionnaire was employed to collect data on socio-demographic and migration related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. The prevalence of CMD among migrant returnees was found to be 27.6%. Highly prevalent specific CMD symptoms included headaches, poor appetite, being tired, sleeping problems, and feeling unhappy or nervous. Being originally from Amhara and Oromia regions, being Christian, being divorced, not receiving salary on time, not being able to contact family, unable to prepare for domestic labor abroad, lack of cross- cultural awareness, and lack of knowledge and skills for work were all important risk factors for CMD. Migrants experienced adversities at different stages of their migration which are associated with psychological distress and even to long

  12. Lack of large-angle TT correlations persists in WMAP and Planck

    NASA Astrophysics Data System (ADS)

    Copi, Craig J.; Huterer, Dragan; Schwarz, Dominik J.; Starkman, Glenn D.

    2015-08-01

    The lack of large-angle correlations in the observed microwave background temperature fluctuations persists in the final-year maps from Wilkinson Microwave Anisotropy Probe (WMAP) and the first cosmological data release from Planck. We find a statistically robust and significant result: p-values for the missing correlations lying below 0.24 per cent (i.e. evidence at more than 3σ) for foreground cleaned maps, in complete agreement with previous analyses based upon earlier WMAP data. A cut-sky analysis of the Planck HFI 100 GHz frequency band, the `cleanest CMB channel' of this instrument, returns a p-value as small as 0.03 per cent, based on the conservative mask defined by WMAP. These findings are in stark contrast to expectations from the inflationary Lambda cold dark matter model and still lack a convincing explanation. If this lack of large-angle correlations is a true feature of our Universe, and not just a statistical fluke, then the cosmological dipole must be considerably smaller than that predicted in the best-fitting model.

  13. Stress Causing Factors Among Teachers in Elementary Schools and Their Relationship with Demographic and Job Characteristics.

    PubMed

    Agai-Demjaha, Teuta; Minov, Jordan; Stoleski, Sasho; Zafirova, Beti

    2015-09-15

    Once high levels of work-related stress among teachers were confirmed many studies concentrated on identifying and investigating key stress factors among school teachers. Unfortunately there are very few researches made on stress causing factors among teachers in Republic of Macedonia. To determine the most frequent stress causing factors among teachers in elementary schools and to investigate their relationship with demographic and job characteristics. We performed a descriptive-analytical model of a cross-sectional study which involved 300 teachers employed in nine elementary schools. Evaluation of examined subjects included completion of a specially designed questionnaire. Among six categories of factors that generate work related stress (job demands, control, relationships, role, changes and support) control and support had the highest mean scores. Within the control category the highest levels of perceived teacher's work-related stress were caused by the following factors - changes in terms and conditions without consultation and given responsibility without the authority to take decisions. 141 out of the interviewed teachers (47%) have mentioned changes in terms and conditions without consultation as very stressful, while another 50 (16.67%) have reported it as stressful. 123 out of interviewed teachers (41%) have stated given responsibility without the authority to take decisions as very stressful, with another 105 (35%) have reported it as stressful. In the category support the highest levels of perceived teacher's work-related stress were caused by stress factors - lack of funds/resources to do the job and limited or no access to training. Out of 300 interviewed teachers, 179 (59.67%) have reported lack of funds/resources to do the job as very stressful, while another 50 (16.67%) as stressful. There is no significant relationship between the stress factor limited or no access to training and demographic and job characteristics. Our findings confirm that

  14. Stress Causing Factors Among Teachers in Elementary Schools and Their Relationship with Demographic and Job Characteristics

    PubMed Central

    Agai–Demjaha, Teuta; Minov, Jordan; Stoleski, Sasho; Zafirova, Beti

    2015-01-01

    BACKGROUND: Once high levels of work-related stress among teachers were confirmed many studies concentrated on identifying and investigating key stress factors among school teachers. Unfortunately there are very few researches made on stress causing factors among teachers in Republic of Macedonia. AIM: To determine the most frequent stress causing factors among teachers in elementary schools and to investigate their relationship with demographic and job characteristics. METHODOLOGY: We performed a descriptive-analytical model of a cross-sectional study which involved 300 teachers employed in nine elementary schools. Evaluation of examined subjects included completion of a specially designed questionnaire. RESULTS: Among six categories of factors that generate work related stress (job demands, control, relationships, role, changes and support) control and support had the highest mean scores. Within the control category the highest levels of perceived teacher’s work-related stress were caused by the following factors - changes in terms and conditions without consultation and given responsibility without the authority to take decisions. 141 out of the interviewed teachers (47%) have mentioned changes in terms and conditions without consultation as very stressful, while another 50 (16.67%) have reported it as stressful. 123 out of interviewed teachers (41%) have stated given responsibility without the authority to take decisions as very stressful, with another 105 (35%) have reported it as stressful. In the category support the highest levels of perceived teacher’s work-related stress were caused by stress factors - lack of funds/resources to do the job and limited or no access to training. Out of 300 interviewed teachers, 179 (59.67%) have reported lack of funds/resources to do the job as very stressful, while another 50 (16.67%) as stressful. There is no significant relationship between the stress factor limited or no access to training and demographic and job

  15. Mice completely lacking immunoproteasomes display major alterations in antigen presentation

    PubMed Central

    Kincaid, Eleanor Z; Che, Jenny W; York, Ian; Escobar, Hernando; Reyes-Vargas, Eduardo; Delgado, Julio C.; Welsh, Raymond M; Karow, Margaret L.; Murphy, Andrew J.; Valenzuela, David M.; Yancopoulos, George D.; Rock, Kenneth L

    2011-01-01

    The importance of immunoproteasomes to antigen presentation has been unclear because animals totally lacking immunoproteasomes have not been previously developed. Here we show that dendritic cells from mice lacking the three immunoproteasome catalytic subunits display defects in presenting multiple major histocompatability (MHC) class I epitopes. During viral infection in vivo, the presentation of a majority of MHC class I epitopes is markedly reduced in immunoproteasome-deficient animals, while presentation of MHC class II peptides is unaffected. By mass spectrometry the repertoire of MHC class I-presented peptides is ~50% different and these differences are sufficient to stimulate robust transplant rejection of wild type cells in mutant mice. These results indicate that immunoproteasomes play a much more important role in antigen presentation than previously thought. PMID:22197977

  16. Pathogenesis of persistent hyperplastic primary vitreous in mice lacking the arf tumor suppressor gene.

    PubMed

    Martin, Amy C; Thornton, J Derek; Liu, Jiewiu; Wang, XiaoFei; Zuo, Jian; Jablonski, Monica M; Chaum, Edward; Zindy, Frederique; Skapek, Stephen X

    2004-10-01

    Persistent hyperplastic primary vitreous (PHPV) is an idiopathic developmental eye disease associated with failed involution of the hyaloid vasculature. The present work addressed the pathogenesis of PHPV in a mouse model that replicates many aspects of the human disease. Ophthalmoscopic and histologic analyses documented pathologic processes in eyes of mice lacking the Arf gene compared with Ink4a-deficient and wild-type control animals. Immunohistochemical staining, in situ hybridization, and RT-PCR demonstrated the expression of relevant gene products. Arf gene expression was determined by in situ hybridization using wholemounts of wild-type mouse eyes and by immunofluorescence staining for green fluorescent protein (GFP) in Arf(+/GFP) heterozygous knock-in mouse eyes. Abnormalities in Arf(-/-) mice mimicked those found in patients with severe PHPV. The mice had microphthalmia; fibrovascular, retrolental tissue containing retinal pigment epithelial cells and remnants of the hyaloid vascular system; posterior lens capsule destruction with lens degeneration and opacity; and severe retinal dysplasia and detachment. Eyes of mice lacking the overlapping Ink4a gene were normal. Arf was selectively expressed in perivascular cells within the vitreous of the postnatal eye. Cells composing the retrolental mass in Arf(-/-) mice expressed the Arf promoter. The remnant hyaloid vessels expressed Flk-1. Its ligand, vascular endothelial growth factor (Vegf), was expressed in the retrolental tissue and the adjacent dysplastic neuroretina. Arf(-/-) mice have features that accurately mimic severe PHPV. In the HVS, Arf expression in perivascular cells may block their accumulation or repress Vegf expression to promote HVS involution and prevent PHPV.

  17. A very early-branching Staphylococcus aureus lineage lacking the carotenoid pigment staphyloxanthin.

    PubMed

    Holt, Deborah C; Holden, Matthew T G; Tong, Steven Y C; Castillo-Ramirez, Santiago; Clarke, Louise; Quail, Michael A; Currie, Bart J; Parkhill, Julian; Bentley, Stephen D; Feil, Edward J; Giffard, Philip M

    2011-01-01

    Here we discuss the evolution of the northern Australian Staphylococcus aureus isolate MSHR1132 genome. MSHR1132 belongs to the divergent clonal complex 75 lineage. The average nucleotide divergence between orthologous genes in MSHR1132 and typical S. aureus is approximately sevenfold greater than the maximum divergence observed in this species to date. MSHR1132 has a small accessory genome, which includes the well-characterized genomic islands, νSAα and νSaβ, suggesting that these elements were acquired well before the expansion of the typical S. aureus population. Other mobile elements show mosaic structure (the prophage ϕSa3) or evidence of recent acquisition from a typical S. aureus lineage (SCCmec, ICE6013 and plasmid pMSHR1132). There are two differences in gene repertoire compared with typical S. aureus that may be significant clues as to the genetic basis underlying the successful emergence of S. aureus as a pathogen. First, MSHR1132 lacks the genes for production of staphyloxanthin, the carotenoid pigment that confers upon S. aureus its characteristic golden color and protects against oxidative stress. The lack of pigment was demonstrated in 126 of 126 CC75 isolates. Second, a mobile clustered regularly interspaced short palindromic repeat (CRISPR) element is inserted into orfX of MSHR1132. Although common in other staphylococcal species, these elements are very rare within S. aureus and may impact accessory genome acquisition. The CRISPR spacer sequences reveal a history of attempted invasion by known S. aureus mobile elements. There is a case for the creation of a new taxon to accommodate this and related isolates.

  18. Types and Factors Associated With Online Health Information Seeking Among College Men in Latino Fraternities: A Qualitative Study

    PubMed Central

    Chavarria, Enmanuel Antonio; Chaney, Elizabeth Hensleigh; Stellefson, Michael Leland; Chaney, J. Don; Chavarria, Nikita; Dodd, Virginia Jones

    2016-01-01

    Despite the fact that a large percentage of Americans go online to seek health information, literature pertaining to online health information (OHI) seeking among college men in Latino fraternities (CMLF) has been nonexistent. Thus, the purpose of this study was to (a) identify the types of OHI that CMLF seek and (b) to determine the factors motivating OHI seeking among CMLF. Four 1- to 1.5-hour focus groups were conducted in two public universities in Florida with 41 college-aged Latino males in an established Latino fraternity. E-mails were used to recruit fraternity members. Qualitative analysis of the focus group transcripts identified that CMLF search for a variety of OHI types including searches on symptoms, diagnoses, weight loss, and treatments for conditions or diseases among other types of OHI. Factors motivating OHI seeking included informational needs of others and concerns for others, worries due to lack of health insurance, preoccupations with health condition, concerns over physical appearance, and clarification through social media. CMLF may be elicited to serve as information conduits to increase access to health information on chronic diseases for older non-English-speaking Latino adults. Lack of health insurance along with other factors in this segment of the population have led to self-diagnosis and self-treatment of illness. Thus, empirical research and health promotion on the potential risks due to self-diagnosing and self-treatment of illness is warranted among CMLF. PMID:26783157

  19. Types and Factors Associated With Online Health Information Seeking Among College Men in Latino Fraternities: A Qualitative Study.

    PubMed

    Chavarria, Enmanuel Antonio; Chaney, Elizabeth Hensleigh; Stellefson, Michael Leland; Chaney, J Don; Chavarria, Nikita; Dodd, Virginia Jones

    2017-11-01

    Despite the fact that a large percentage of Americans go online to seek health information, literature pertaining to online health information (OHI) seeking among college men in Latino fraternities (CMLF) has been nonexistent. Thus, the purpose of this study was to (a) identify the types of OHI that CMLF seek and (b) to determine the factors motivating OHI seeking among CMLF. Four 1- to 1.5-hour focus groups were conducted in two public universities in Florida with 41 college-aged Latino males in an established Latino fraternity. E-mails were used to recruit fraternity members. Qualitative analysis of the focus group transcripts identified that CMLF search for a variety of OHI types including searches on symptoms, diagnoses, weight loss, and treatments for conditions or diseases among other types of OHI. Factors motivating OHI seeking included informational needs of others and concerns for others, worries due to lack of health insurance, preoccupations with health condition, concerns over physical appearance, and clarification through social media. CMLF may be elicited to serve as information conduits to increase access to health information on chronic diseases for older non-English-speaking Latino adults. Lack of health insurance along with other factors in this segment of the population have led to self-diagnosis and self-treatment of illness. Thus, empirical research and health promotion on the potential risks due to self-diagnosing and self-treatment of illness is warranted among CMLF.

  20. Population pharmacokinetic characterization of BAY 81-8973, a full-length recombinant factor VIII: lessons learned - importance of including samples with factor VIII levels below the quantitation limit.

    PubMed

    Garmann, D; McLeay, S; Shah, A; Vis, P; Maas Enriquez, M; Ploeger, B A

    2017-07-01

    The pharmacokinetics (PK), safety and efficacy of BAY 81-8973, a full-length, unmodified, recombinant human factor VIII (FVIII), were evaluated in the LEOPOLD trials. The aim of this study was to develop a population PK model based on pooled data from the LEOPOLD trials and to investigate the importance of including samples with FVIII levels below the limit of quantitation (BLQ) to estimate half-life. The analysis included 1535 PK observations (measured by the chromogenic assay) from 183 male patients with haemophilia A aged 1-61 years from the 3 LEOPOLD trials. The limit of quantitation was 1.5 IU dL -1 for the majority of samples. Population PK models that included or excluded BLQ samples were used for FVIII half-life estimations, and simulations were performed using both estimates to explore the influence on the time below a determined FVIII threshold. In the data set used, approximately 16.5% of samples were BLQ, which is not uncommon for FVIII PK data sets. The structural model to describe the PK of BAY 81-8973 was a two-compartment model similar to that seen for other FVIII products. If BLQ samples were excluded from the model, FVIII half-life estimations were longer compared with a model that included BLQ samples. It is essential to assess the importance of BLQ samples when performing population PK estimates of half-life for any FVIII product. Exclusion of BLQ data from half-life estimations based on population PK models may result in an overestimation of half-life and underestimation of time under a predetermined FVIII threshold, resulting in potential underdosing of patients. © 2017 Bayer AG. Haemophilia Published by John Wiley & Sons Ltd.

  1. Characterization of a mast cell line that lacks the extracellular domain of membrane c-kit.

    PubMed

    Mekori, Y A; Oh, C K; Dastych, J; Goff, J P; Adachi, S; Bianchine, P J; Worobec, A; Semere, T; Pierce, J H; Metcalfe, D D

    1997-04-01

    Expression of the c-kit proto-oncogene receptor on mast cells is essential for their normal proliferation and maturation as well as for several biological responses such as chemotaxis and attachment. In the present study we report that the interleukin-3 (IL-3)-dependent mast cell line CFTL-15 lacks the extracellular domain of the c-kit receptor. This observation was made after noting that the c-kit ligand stem cell factor (SCF) could not prevent IL-3 deprivation-induced mast cell apoptosis and that CFTL-15 cells did not proliferate in response to SCF. Flow cytometric analysis employing monoclonal anti-c-kit antibodies, and immunogold labelling with analysis by electron microscopy, subsequently showed a diminished expression of c-kit on CFTL-15 cells. There was no identifiable message for the extracellular domain of c-kit in these cells, as determined by reverse transcriptase-polymerase chain reaction (RT-PCR). These previously unrecognized properties of the CFTL-15 mast cell line allowed the examination of other biological consequences of the lack of c-kit on mast cells. Analysing the ability of these cells to adhere to surface-bound fibronectin, it was found that addition of SCF did not increase their adhesion to this substrate, in opposition to what is reported with other mast cells. Similarly, CFTL-15 mast cells did not adhere to fibroblasts, which is known to require c-kit expression. Also, there was no protein tyrosine phosphorylation in these cells in response to SCF. CFTL-15 cells underwent apoptosis on removal of IL-3 coincident with a decrease in endogenous Bcl-2 mRNA. Overexpression of Bcl-2 cDNA prolonged survival of Bcl-2-transfected CFTL-15 cells upon withdrawal of IL-3. Thus, the CFTL-15 cell line that lacks surface c-kit is not able to proliferate in response to SCF, undergoes apoptosis in the presence of SCF, and does not adhere to fibroblasts. These results confirm earlier studies on the functional consequences of c-kit and provide a novel

  2. [Evaluation of Contextual Factors in Psychosomatic Rehabilitation].

    PubMed

    Bülau, N I; Kessemeier, F; Petermann, F; Bassler, M; Kobelt, A

    2016-12-01

    Objectives: Although individualized and ICF-oriented implementation of rehabilitation treatment requires knowledge of relevant contextual factors, there is a lack of operationalized documentation and measurement tools to evaluate these factors. Therefore, an ICF-oriented semi-structured interview was designed. Methods: 20 contextual factors were externally assessed whether they negatively affected mental functioning and participation of psychosomatic patients. Additionally, psychometric scales were applied. Results: Six relevant impairing contextual factors were identified. Contextual factors significantly correlated with psychometric scales. Patients with higher contextual impairment showed significantly higher psychological stress levels. Conclusions: Anamnesis of contextual factors at the beginning of psychosomatic rehabilitation yields important information for therapy planning. Further research on contextual factors in medical rehabilitation is needed. © Georg Thieme Verlag KG Stuttgart · New York.

  3. [Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis].

    PubMed

    de Dios, M; Cordero-Ampuero, J

    2015-01-01

    To carry out a statistical analysis on the significant risk factors for deep late infection (prosthetic joint infection, PJI) in patients with a knee arthroplasty (TKA). A retrospective observational case-control study was conducted on a case series of 32 consecutive knee infections, using an analysis of all the risk factors reported in the literature. A control series of 100 randomly selected patients operated in the same Department of a University General Hospital during the same period of time, with no sign of deep infection in their knee arthroplasty during follow-up. Statistical comparisons were made using Pearson for qualitative and ANOVA for quantitative variables. The significant (p>0.05) factors found in the series were: Preoperative previous knee surgery, glucocorticoids, immunosuppressants, inflammatory arthritis. prolonged surgical time, inadequate antibiotic prophylaxis, intraoperative fractures. Postoperative secretion of the wound longer than 10 days, deep palpable haematoma, need for a new surgery, and deep venous thrombosis in lower limbs. Distant infections cutaneous, generalized sepsis, urinary tract, pneumonia, abdominal. This is the first report of intraoperative fractures and deep venous thrombosis as significantly more frequent factors in infected TKAs. Other previously described risk factors for TKA PJI are also confirmed. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  4. 30 CFR 721.14 - Failure to give notice and lack of reasonable belief.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Failure to give notice and lack of reasonable belief. 721.14 Section 721.14 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... and lack of reasonable belief. No notice of violation or cessation order may be vacated by reason of...

  5. 30 CFR 721.14 - Failure to give notice and lack of reasonable belief.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Failure to give notice and lack of reasonable belief. 721.14 Section 721.14 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... and lack of reasonable belief. No notice of violation or cessation order may be vacated by reason of...

  6. 30 CFR 721.14 - Failure to give notice and lack of reasonable belief.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Failure to give notice and lack of reasonable belief. 721.14 Section 721.14 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... and lack of reasonable belief. No notice of violation or cessation order may be vacated by reason of...

  7. 30 CFR 721.14 - Failure to give notice and lack of reasonable belief.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Failure to give notice and lack of reasonable belief. 721.14 Section 721.14 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... and lack of reasonable belief. No notice of violation or cessation order may be vacated by reason of...

  8. 30 CFR 721.14 - Failure to give notice and lack of reasonable belief.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Failure to give notice and lack of reasonable belief. 721.14 Section 721.14 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... and lack of reasonable belief. No notice of violation or cessation order may be vacated by reason of...

  9. Factors affecting nurse retention at an academic Magnet® hospital.

    PubMed

    Buffington, Annsley; Zwink, Jennifer; Fink, Regina; Devine, Deborah; Sanders, Carolyn

    2012-05-01

    : The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.

  10. [Environmental risk factors in Crohn's disease and ulcerative colitis (excluding tobacco and appendicectomy)].

    PubMed

    Jantchou, Prévost; Monnet, Elisabeth; Carbonnel, Franck

    2006-01-01

    A rapid increase in the incidence of Crohn's disease and ulcerative colitis in developed countries, the occurrence of Crohn's disease in spouses, and a lack of complete concordance in monozygotic twins are strong arguments for the role of environmental factors in inflammatory bowel disease (IBD). Research in the field of environmental factors in IBD is based upon epidemiological (geographical and case-control), clinical and experimental studies. The role of two environmental factors has clearly been established in IBD. Smoking is a risk factor for Crohn's disease and a protective factor for ulcerative colitis; appendectomy is a protective factor for ulcerative colitis. Many other environmental factors for IBD have been investigated, including infectious agents, diet, drugs, stress and social status. They are detailed in the present review. Among them, atypical Mycobacteria, oral contraceptives and antibiotics could play a role in Crohn's disease. To date, three hypotheses associate environmental factors with the pathophysiology of IBD (loss of tolerance of intestinal immune system towards commensal bacterial flora): the hygiene, infection and cold chain hypotheses. Much work remains to be done to identify risk factors for IBD. Research identifying environmental factors that might cause a predisposition to IBD is useful. It may lead to disease prevention in subjects who are genetically predisposed and disease improvement in patients.

  11. Computational Prediction and Experimental Verification of New MAP Kinase Docking Sites and Substrates Including Gli Transcription Factors

    PubMed Central

    Whisenant, Thomas C.; Ho, David T.; Benz, Ryan W.; Rogers, Jeffrey S.; Kaake, Robyn M.; Gordon, Elizabeth A.; Huang, Lan; Baldi, Pierre; Bardwell, Lee

    2010-01-01

    In order to fully understand protein kinase networks, new methods are needed to identify regulators and substrates of kinases, especially for weakly expressed proteins. Here we have developed a hybrid computational search algorithm that combines machine learning and expert knowledge to identify kinase docking sites, and used this algorithm to search the human genome for novel MAP kinase substrates and regulators focused on the JNK family of MAP kinases. Predictions were tested by peptide array followed by rigorous biochemical verification with in vitro binding and kinase assays on wild-type and mutant proteins. Using this procedure, we found new ‘D-site’ class docking sites in previously known JNK substrates (hnRNP-K, PPM1J/PP2Czeta), as well as new JNK-interacting proteins (MLL4, NEIL1). Finally, we identified new D-site-dependent MAPK substrates, including the hedgehog-regulated transcription factors Gli1 and Gli3, suggesting that a direct connection between MAP kinase and hedgehog signaling may occur at the level of these key regulators. These results demonstrate that a genome-wide search for MAP kinase docking sites can be used to find new docking sites and substrates. PMID:20865152

  12. Lack of international consensus in low-risk drinking guidelines.

    PubMed

    Furtwaengler, Nina A F F; de Visser, Richard O

    2013-01-01

    To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  13. Understanding the Lack of Female Leadership in Collegiate Athletics

    ERIC Educational Resources Information Center

    Camarco, Lisa

    2016-01-01

    This study sought an understanding of the current trends in the lack of females in leadership positions within collegiate athletic departments amongst California Community Colleges. The passage of Title IX created a new funding stream for women's athletics, resulting in male coaches and administrators entering into the female realm, therefore…

  14. T Cell Development in Mice Lacking All T Cell Receptor ζ Family Members (ζ, η, and FcεRIγ)

    PubMed Central

    Shores, Elizabeth W.; Ono, Masao; Kawabe, Tsutomo; Sommers, Connie L.; Tran, Tom; Lui, Kin; Udey, Mark C.; Ravetch, Jeffrey; Love, Paul E.

    1998-01-01

    The ζ family includes ζ, η, and FcεRIγ (Fcγ). Dimers of the ζ family proteins function as signal transducing subunits of the T cell antigen receptor (TCR), the pre-TCR, and a subset of Fc receptors. In mice lacking ζ/η chains, T cell development is impaired, yet low numbers of CD4+ and CD8+ T cells develop. This finding suggests either that pre-TCR and TCR complexes lacking a ζ family dimer can promote T cell maturation, or that in the absence of ζ/η, Fcγ serves as a subunit in TCR complexes. To elucidate the role of ζ family dimers in T cell development, we generated mice lacking expression of all of these proteins and compared their phenotype to mice lacking only ζ/η or Fcγ. The data reveal that surface complexes that are expressed in the absence of ζ family dimers are capable of transducing signals required for α/β–T cell development. Strikingly, T cells generated in both ζ/η−/− and ζ/η−/−–Fcγ−/− mice exhibit a memory phenotype and elaborate interferon γ. Finally, examination of different T cell populations reveals that ζ/η and Fcγ have distinct expression patterns that correlate with their thymus dependency. A possible function for the differential expression of ζ family proteins may be to impart distinctive signaling properties to TCR complexes expressed on specific T cell populations. PMID:9529325

  15. Critical factors for the return-to-work process among people with affective disorders: Voices from two vocational approaches.

    PubMed

    Porter, Susann; Lexén, Annika; Johansson, Suzanne; Bejerholm, Ulrika

    2018-05-22

    Depression is among the major causes of disability with a negative impact on both daily life and work performance. Whilst depression is the primary cause of sick-leave and unemployment in today's workplace there is a lack of knowledge of the needs of individuals with depression regarding their return-to-work (RTW) process. To explore which factors are of critical importance for people suffering from depression and who also are unemployed in their RTW-process and to explore the impact of two vocational approaches on the service users' experiences. The study included participants in two vocational rehabilitation approaches; Individual Enabling and Support (IES) and Traditional Vocational Rehabilitation (TVR). Qualitative methods were applied to explore critical factors in the RTW-process. Individuals with affective disorders including depression and bipolar disorder were included.RESULTSThree themes emerged as critical factors; Experiencing hope and power, Professionals' positive attitudes, beliefs and behaviours, and Employing a holistic perspective and integrating health and vocational service.CONCLUSIONThis study has demonstrated critical factors for the return-to-work process as experienced by persons with depression. To experience hope and power, to meet professionals that believe "you can work", who use a person-centred and holistic service approach, are such factors necessary for gaining a real job. In particular, professionals in TVR need to embrace this understanding since their services were not experienced as including these elements.

  16. Social and demographic factors that influence the diagnosis of autistic spectrum disorders.

    PubMed

    Russell, Ginny; Steer, Colin; Golding, Jean

    2011-12-01

    Recent studies in epidemiology have highlighted the existence of children with autistic difficulties who remain undiagnosed. Other studies have identified 'access barriers' to clinics which include factors mediated by parents as well as health and education services. The purpose of this study was to examine whether social and demographic factors play a role in receiving a diagnosis of autistic spectrum disorder (ASD) independently of symptom severity. Retrospective secondary analysis of a longitudinal UK cohort study, namely, the Avon Longitudinal Study of Parents and Children (ALSPAC). With the severity of autistic traits held constant, boys were more likely to receive an ASD diagnosis than girls. Younger mothers and mothers of first-born children were significantly less likely to have children diagnosed with ASD. Maternal depression before and around the time of their children's autistic difficulties was associated with lack of diagnosis. The study provides evidence that social as well as biological factors can influence whether children are brought to the clinic.

  17. Motivating factors for small and midsized businesses to implement worksite health promotion.

    PubMed

    Witt, Laurel B; Olsen, Delane; Ablah, Elizabeth

    2013-11-01

    This study explores the decision-making process, including motivating factors, for small and midsized businesses in the Midwest to implement health promotion initiatives. This a replication of a study conducted in the Pacific Northwest. Semistructured qualitative interviews were conducted with key informants from 12 Midwestern metropolitan employers with fewer than 1,000 employees. Informants were interviewed regarding their companies' policies and practices around workplace health promotion programming adoption and valuation. Workplace health promotion adoption at these small and midsized businesses was motivated by three goals: to lower health care costs, to address human relations objectives, and to improve productivity. Low upfront cost was the most frequently considered criterion in choosing which workplace health promotion program to offer. Barriers to implementation included lack of employee buy-in, prohibitive costs, and personnel or time constraints. Aids to implementation included employee buy-in and affordability. This study suggests that cost considerations predominate in the workplace health promotion decision-making process at small to midsized businesses. Furthermore, employee buy-in cannot be underestimated as a factor in successful program implementation or longevity. Employees, along with executives and human resources management, must be appropriately targeted by health promotion practitioners in workplace health promotion efforts.

  18. Health disparity in black women: lack of pharmaceutical advertising in black vs. white-oriented magazines.

    PubMed

    Omonuwa, S C

    2001-01-01

    Racial disparities in health care between black women and white women may be attributed in part to socioeconomic status and lack of insurance, but also may be due to lack of the dissemination of health information in black communities via black popular magazines. Comparison of the number and type of pharmaceutical advertisements between black-oriented magazines and white-oriented magazines. Descriptive study. Morehouse School of Medicine. Recording of the type and number of over-the-counter and prescription drug advertisements. Five black-oriented magazines (Black Woman, Black Elegance, Essence, Ebony, and Upscale) and 5 white-oriented magazines (Family Circle, Working Mother, Good Housekeeping, Ladies' Home Journal, Women's Day) were evaluated for 3 months from June-August, 2000. White-oriented magazines had four to eight times more pharmaceutical ads than black-oriented magazines. Types of medications advertised in the white-oriented magazines and not the black-oriented magazines were, for example, cholinesterase inhibitors, calcium supplements, COX II-inhibitors, intranasal steroids, anorexiants, proton pump inhibitors, and smoking deterrent agents. Conversely, medications advertised in the black-oriented magazines and not the white-oriented magazines were antiviral agents and oral contraceptives. Pharmaceutical companies gave several reasons for the disparity, including the explanation that their particular company was advertising about HIV in the black community. A barrier to equitable health care for black women may be a low prioritization for health prevention and health management. This low prioritization or disinterest may be a reflection of the black magazine that she is reading due to the lack of pharmaceutical advertisements in black-oriented magazines. The result of this disinterest of black females may be seen in the increased morbidity and mortality for selected diseases.

  19. De-novo discovery of differentially abundant transcription factor binding sites including their positional preference.

    PubMed

    Keilwagen, Jens; Grau, Jan; Paponov, Ivan A; Posch, Stefan; Strickert, Marc; Grosse, Ivo

    2011-02-10

    Transcription factors are a main component of gene regulation as they activate or repress gene expression by binding to specific binding sites in promoters. The de-novo discovery of transcription factor binding sites in target regions obtained by wet-lab experiments is a challenging problem in computational biology, which has not been fully solved yet. Here, we present a de-novo motif discovery tool called Dispom for finding differentially abundant transcription factor binding sites that models existing positional preferences of binding sites and adjusts the length of the motif in the learning process. Evaluating Dispom, we find that its prediction performance is superior to existing tools for de-novo motif discovery for 18 benchmark data sets with planted binding sites, and for a metazoan compendium based on experimental data from micro-array, ChIP-chip, ChIP-DSL, and DamID as well as Gene Ontology data. Finally, we apply Dispom to find binding sites differentially abundant in promoters of auxin-responsive genes extracted from Arabidopsis thaliana microarray data, and we find a motif that can be interpreted as a refined auxin responsive element predominately positioned in the 250-bp region upstream of the transcription start site. Using an independent data set of auxin-responsive genes, we find in genome-wide predictions that the refined motif is more specific for auxin-responsive genes than the canonical auxin-responsive element. In general, Dispom can be used to find differentially abundant motifs in sequences of any origin. However, the positional distribution learned by Dispom is especially beneficial if all sequences are aligned to some anchor point like the transcription start site in case of promoter sequences. We demonstrate that the combination of searching for differentially abundant motifs and inferring a position distribution from the data is beneficial for de-novo motif discovery. Hence, we make the tool freely available as a component of the open

  20. Lack of diversity in behavioral healthcare leadership reflected in services.

    PubMed

    Rosenberg, Linda

    2008-04-01

    America's rapidly changing demographics present an enormous challenge for today's healthcare leaders to redesign the organization and delivery of care to accommodate people who now represent every language, culture and religious belief in the world. So will mental health and addictions services in this country be ready to address the unique needs of these multicultural patients? A survey of the present landscape in 2008 tells us that we have a long, long way to go. Not only are mental health and addictions fields lacking in cultural competency, but there is little diversity in our leadership ranks. Top administrators and executives in behavioral health today are overwhelmingly non-Hispanic whites. This lack of cultural diversity among our leaders will lead to an ever-widening gap in the current chasm of racial and ethnic disparities in healthcare.

  1. Motor hypertonia and lack of locomotor coordination in mutant mice lacking DSCAM.

    PubMed

    Lemieux, Maxime; Laflamme, Olivier D; Thiry, Louise; Boulanger-Piette, Antoine; Frenette, Jérôme; Bretzner, Frédéric

    2016-03-01

    Down syndrome cell adherence molecule (DSCAM) contributes to the normal establishment and maintenance of neural circuits. Whereas there is abundant literature regarding the role of DSCAM in the neural patterning of the mammalian retina, less is known about motor circuits. Recently, DSCAM mutation has been shown to impair bilateral motor coordination during respiration, thus causing death at birth. DSCAM mutants that survive through adulthood display a lack of locomotor endurance and coordination in the rotarod test, thus suggesting that the DSCAM mutation impairs motor control. We investigated the motor and locomotor functions of DSCAM(2J) mutant mice through a combination of anatomical, kinematic, force, and electromyographic recordings. With respect to wild-type mice, DSCAM(2J) mice displayed a longer swing phase with a limb hyperflexion at the expense of a shorter stance phase during locomotion. Furthermore, electromyographic activity in the flexor and extensor muscles was increased and coactivated over 20% of the step cycle over a wide range of walking speeds. In contrast to wild-type mice, which used lateral walk and trot at walking speed, DSCAM(2J) mice used preferentially less coordinated gaits, such as out-of-phase walk and pace. The neuromuscular junction and the contractile properties of muscles, as well as their muscle spindles, were normal, and no signs of motor rigidity or spasticity were observed during passive limb movements. Our study demonstrates that the DSCAM mutation induces dystonic hypertonia and a disruption of locomotor gaits. Copyright © 2016 the American Physiological Society.

  2. Competency to stand trial and defendants who lack insight into their mental illness.

    PubMed

    Reisner, Andrew D; Piel, Jennifer; Makey, Miller

    2013-01-01

    Forensic evaluators often assess patients who lack insight into their mental illnesses. This lack of insight can have a significant impact on the defendant's ability to make legal strategy decisions that rely on their acceptance of their mental illness. In this article, the relationship between refusing an insanity plea and competency to stand trial will be explored in the context of defendants who lack insight into their mental illness. The authors argue that an adequate competency assessment should take into account the defendant's ability to consider his available pleas rationally. Such evaluations may have the effect of negating the necessity of a Frendak inquiry in those jurisdictions that can impose the insanity defense on defendants.

  3. Sphincter of Oddi Function and Risk Factors for Dysfunction

    PubMed Central

    Afghani, Elham; Lo, Simon K.; Covington, Paul S.; Cash, Brooks D.; Pandol, Stephen J.

    2017-01-01

    The sphincter of Oddi (SO) is a smooth muscle valve regulating the flow of biliary and pancreatic secretions into the duodenum, initially described in 1887 by the Italian anatomist, Ruggero Oddi. SO dysfunction (SOD) is a broad term referring to numerous biliary, pancreatic, and hepatic disorders resulting from spasms, strictures, and relaxation of this valve at inappropriate times. This review brings attention to various factors that may increase the risk of SOD, including but not limited to: cholecystectomy, opiates, and alcohol. Lack of proper recognition and treatment of SOD may be associated with clinical events, including pancreatitis and biliary symptoms with hepatic enzyme elevation. Pharmacologic and non-pharmacologic approaches are discussed to help recognize, prevent, and treat SOD. Future studies are needed to assess the treatment benefit of agents such as calcium-channel blockers, glyceryl trinitrate, or tricyclic antidepressants in patients with SOD. PMID:28194398

  4. Factors influencing primary health care professionals' physical activity promotion behaviors: a systematic review.

    PubMed

    Huijg, Johanna M; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; de Vries, Juriena D; Middelkoop, Barend J C; Crone, Mathilde R

    2015-02-01

    Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired. To help understand why efficacious PHC-based PA interventions are not effectively translated to practice, this study systematically reviewed the literature on factors influencing PHC professionals' PA promotion practices. Literature searches were conducted in Web of Science, PubMed, and PsycINFO for peer-reviewed articles published in English from 1990 onwards. Studies were included that met the following criteria: (1) involving PHC-based PA interventions, and (2) reporting factors influencing PHC professionals' PA promotion behaviors. Two researchers independently screened studies and extracted data. A narrative synthesis using thematic analysis was conducted to identify factors. Of the 4,469 identified articles, 59 were included in the review. Factors were identified by qualitative methods, barrier/facilitator ratings, and the examination of the relationship between factors and PA promotion, and the effectiveness of introduction strategies. Many factors related to the development, delivery, and effects of the innovation, the sociopolitical and organizational culture, resources, and support, patient and PHC professional characteristics, and innovation strategies were identified as potential influences on PHC professionals' PA promotion practices. However, the lack of evidence on the relationship between factors and PA promotion indicated insufficient evidence on PA promotion determinants. This extensive overview of potential factors can inform intervention developers and implementers on which factors may play a role when introducing PA interventions in PHC. Future research should further investigate relationships between factors and PA promotion, which should be guided by qualitative in-depth knowledge on influencing factors.

  5. Evaluation of community health screening participants' knowledge of cardiovascular risk factors.

    PubMed

    Mooney, Leslie A; Franks, Amy M

    2009-01-01

    To assess knowledge of cardiovascular disease (CVD) risk factors among a group of health screening participants and to compare knowledge between participants with high and low CVD risk. Cross-sectional pilot study. Jonesboro, AR, during June 2007. 121 adult volunteers participating in a community health screening. 34-item self-administered written questionnaire. Ability to identify CVD risk factors and healthy values for CVD risk factors and the differences in these abilities between participants with high and low CVD risk. Participants demonstrated good knowledge of traditional CVD risk factors such as high blood pressure, high cholesterol, lack of exercise, and overweight or obese status. Knowledge of other CVD risk factors and healthy values for major CVD risk factors was limited. Participants with high CVD risk were significantly more likely to correctly identify high triglycerides as a CVD risk factor and to identify healthy values for fasting blood glucose and total cholesterol compared with participants with low CVD risk. Overall, participants lacked knowledge of the risk factor status and healthy values for many CVD risk factors. Participants with high CVD risk may have better knowledge of some CVD risk factors than participants with low CVD risk. These findings highlight the need for more education to improve knowledge in both risk groups.

  6. 10 CFR 503.21 - Lack of alternate fuel supply.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New... substantially exceed the cost of using imported petroleum as a primary energy source as defined in § 503.6 (Cost...

  7. 10 CFR 503.21 - Lack of alternate fuel supply.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New... substantially exceed the cost of using imported petroleum as a primary energy source as defined in § 503.6 (Cost...

  8. 10 CFR 503.21 - Lack of alternate fuel supply.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New... substantially exceed the cost of using imported petroleum as a primary energy source as defined in § 503.6 (Cost...

  9. 10 CFR 503.21 - Lack of alternate fuel supply.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New... substantially exceed the cost of using imported petroleum as a primary energy source as defined in § 503.6 (Cost...

  10. Barriers to College: Lack of Preparation vs. Financial Need

    ERIC Educational Resources Information Center

    Cavanagh, Sean

    2004-01-01

    As politicians, academic leaders, and researchers decry the impact of college tuition fee increases for needy students, others say such concerns mask a more serious barrier for college aspirants: lack of academic preparation. The debate was renewed last week with the publication of a book from the Century Foundation analyzing the reasons…

  11. Factors affecting job motivation among health workers: a study from Iran.

    PubMed

    Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

    2014-11-26

    Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers' motivation in Shahid Beheshti University of Medical Sciences (SBUMS). This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. The main motivating factors for health workers were good management, supervisors and managers' support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Strengthening management capacities in health services can increase job motivation and improve health workers' performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal.

  12. Mechanisms of collective cell movement lacking a leading or free front edge in vivo.

    PubMed

    Uechi, Hiroyuki; Kuranaga, Erina

    2017-08-01

    Collective cell movement is one of the strategies for achieving the complex shapes of tissues and organs. In this process, multiple cells within a group held together by cell-cell adhesion acquire mobility and move together in the same direction. In some well-studied models of collective cell movement, the mobility depends strongly on traction generated at the leading edge by cells located at the front. However, recent advances in live-imaging techniques have led to the discovery of other types of collective cell movement lacking a leading edge or even a free edge at the front, in a diverse array of morphological events, including tubule elongation, epithelial sheet extension, and tissue rotation. We herein review some of the developmental events that are organized by collective cell movement and attempt to elucidate the underlying cellular and molecular mechanisms, which include membrane protrusions, guidance cues, cell intercalation, and planer cell polarity, or chirality pathways.

  13. Identification of risk factors associated with onset and progression of amyotrophic lateral sclerosis using systematic review and meta-analysis.

    PubMed

    Wang, Ming-Dong; Little, Julian; Gomes, James; Cashman, Neil R; Krewski, Daniel

    2017-07-01

    Although amyotrophic lateral sclerosis (ALS) was identified as a neurological condition 150 years ago, risk factors related to the onset and progression of ALS remain largely unknown. Monogenic mutations in over 30 genes are associated with about 10% of ALS cases. The age at onset of ALS and disease types has been found to influence ALS progression. The present study was designed to identify additional putative risk factors associated with the onset and progression of ALS using systematic review and meta-analysis of observational studies. Risk factors that may be associated with ALS include: 1) genetic mutations, including the intermediate CAG repeat expansion in ATXN2; 2) previous exposure to heavy metals such as lead and mercury; 3) previous exposure to organic chemicals, such as pesticides and solvents; 4) history of electric shock; 5) history of physical trauma/injury (including head trauma/injury); 6) smoking (a weak risk factor for ALS in women); and 6) other risk factors, such as participating in professional sports, lower body mass index, lower educational attainment, or occupations requiring repetitive/strenuous work, military service, exposure to Beta-N-methylamino-l-alanin and viral infections. Risk factors that may be associated with ALS progression rate include: 1) nutritional status, including vitamin D deficiency; 2) comorbidities; 3) ethnicity and genetic factors; 4) lack of supportive care; and 4) smoking. The extent to which these associations may be causal is discussed, with further research recommended to strengthen the evidence on which determinations of causality may be based. Copyright © 2016. Published by Elsevier B.V.

  14. Clinical and epidemiological profiles including meteorological factors of low respiratory tract infection due to human rhinovirus in hospitalized children.

    PubMed

    Yan, Yongdong; Huang, Li; Wang, Meijuan; Wang, Yuqing; Ji, Wei; Zhu, Canhong; Chen, Zhengrong

    2017-03-07

    Lower respiratory tract infection (LRTI) is a major cause of morbidity and mortality in children. Human rhinovirus (HRV) is confirmed to be associated with pediatric lower respiratory tract infection. Seasonal and meteorological factors may play a key role in the epidemiology of HRV. The purposes of this study were to investigate the frequency, seasonal distribution, and clinical characteristics of hospitalized children with LRTI caused by HRVs. In addition, associations between incidence of HRVs and meteorological factors in a subtropical region of China were discussed. Hospitalized children <14 years old admitted to the Respiratory Department of the Children's Hospital, which is affiliated to Soochow University, between January 1, 2013 and December 31, 2015, were enrolled in this study. Multi-pathogens were detected in nasopharyngeal aspirate samples. Meanwhile, meteorological factors were recorded. The average incidence of HRVs infection was 11.4% (707/6194) and 240 cases of which were co-infection cases with other pathogens. Children with co-infection presented more frequent fever and tachypnea compared to children infected with HRVs only (both P < 0.05). Among 707 HRV positive children, the mean age was 23.2 months (range 1 to 140 months). Among all respiratory infections, the highest incidence of HRVs cases occurred in children age 13-36 months old (15.1%, 203/1341). Of all 228 HRV cases in 2014, 85 cases (37.3%) were HRV-C positive. HRVs and HRV-C infection occurred throughout the year during the study period, although a higher incidence was observed in summer and autumn seasons. HRVs or HRV-C incidence in hospitalized children with LRTI was associated with the monthly mean temperature (both P < 0.05). HRV was one of the most common viral pathogen detected in hospitalized children with LRTI at the Children's Hospital of Suzhou, China, and had its own seasonal distribution including HRV-C, which was partly caused by temperature.

  15. Prevalence and risk factors for giardiasis and soil-transmitted helminthiasis in three municipalities of Southeastern Minas Gerais State, Brazil: risk factors for giardiasis and soil-transmitted helminthiasis.

    PubMed

    Pinheiro, Izabella de Oliveira; de Castro, Milton Ferreira; Mitterofhe, Adalberto; Pires, Flávia Alves Condé; Abramo, Clarice; Ribeiro, Luiz Cláudio; Tibiriçá, Sandra Helena Cerrato; Coimbra, Elaine Soares

    2011-05-01

    Giardiasis and soil-transmitted helminthiasis (STH) are parasitic diseases that are among the major health concerns observed in economically disadvantaged populations of developing countries, and have clear social and environmental bases. In Brazil, there is a lack of epidemiologic data concerning these infections in the study area, whose inhabitants have plenty of access to health care services, including good dwelling and adequate sanitary conditions. In this survey we investigated the risk factors for giardiasis and STH in three municipalities with good sanitation, situated in Minas Gerais state, Brazil. A cross-sectional survey was conducted in the municipalities of Piau, Coronel Pacheco and Goianá, in both urban and rural areas. The fieldwork consisted of a questionnaire and the examination of 2,367 stool samples using the Hoffmann, Pons and Janer method. Of all individuals from the population sample, 6.1% were found infected with the parasitic diseases included in this work. Hookworm infection was the most prevalent disease, followed by giardiasis, trichuriasis and ascariasis. Infection was more prevalent in males (8.1%, p < 0.001; odds ratio [OR] = 1.975) and in individuals living in rural areas (8.6%, p = 0.003; OR = 1.693). Multivariate analysis showed that variables such as inadequate sewage discharge (p < 0.001), drinking of unsafe water (p < 0.001), lack of sanitary infrastructure (p = 0.015), and host sex (p < 0.001) were the risk factors more strongly associated with infection status (95% confidence interval [CI]). In this study we demonstrate that giardiasis and STH still persist, infecting people who have good housing conditions and free access to public health care and education.

  16. [Longitudinal analysis of personal and work-related factors associated with turnover among nurses].

    PubMed

    Estryn-Behar, Madelaine; Van Der Heijden, Béatrice I J M; Fry, Clémentine; Hasselhorn, Hans-Martin

    2010-12-01

    While many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called 'stayers' and 'leavers' within the nursing profession, and identifies risk factors for premature leaving by comparing nurses who have left their job, or the nursing profession, with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions, and comprised two measurements with a one-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their health care institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months, than among those who stayed (24.0% versus 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were: working conditions (e.g., relationship problems, emotional difficulties,time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Health care organizations should pay attention to preventive measures in order to protect labor market potential. Recommendations are made for human resource development in health care

  17. Longitudinal analysis of personal and work-related factors associated with turnover among nurses.

    PubMed

    Estryn-Behar, Madeleine; van der Heijden, Beatrice I J M; Fry, Clementine; Hasselhorn, Hans-Martin

    2010-01-01

    Although many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called "stayers" and "leavers" within the nursing profession and identifies risk factors for premature leaving by comparing nurses who have left their job or the nursing profession with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions and was composed of two measurements with a 1-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their healthcare institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months than those among nurses who stayed (24.0% vs. 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were (a) working conditions (e.g., relationship problems, emotional difficulties, time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) and (b) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Healthcare organizations should pay attention to preventive measures to protect labor market potential. Recommendations are made for human resource development in

  18. Lack of genetic polymorphism among peregrine falcons Falco peregrinus of Fiji

    USGS Publications Warehouse

    Talbot, Sandra; Palmer, Angela G.; Sage, George K.; Sonsthagen, Sarah A.; Swem, Ted; Brimm, Daniel J.; White, Clayton M

    2014-01-01

    We compared levels of genetic diversity and isolation among peregrine falcons Falco peregrinus from two South Pacific island complexes (Fiji and Vanuatu: F. p. nesiotes), relative to other island and mainland populations. Fragment data from 12 microsatellite loci and sequence information from the control region of the mitochondrial DNA indicated levels of genetic variation in the South Pacific populations were lower than other island and mainland populations. Indeed, diversity varied from extremely low (Vanuatu) to completely absent (Fiji). We find little support for a hypothesis that populations on Fiji or Vanuatu were colonized via Australia. The complete lack of polymorphism in peregrine falcons of Fiji is remarkable, and to our knowledge has not been observed in a natural avian population. This lack of polymorphism, and the inability to test for decrease in polymorphism using museum samples, precludes testing whether the lack of genetic diversity in the population on Fiji is due to a recent bottleneck, or sustained isolation over evolutionary time. Increased fertility in eggs of Fiji peregrines upon outbreeding with males from other areas is consistent with inbreeding depression within a population typified by heterozygote deficiency.

  19. Exposure to psychosocial risk factors in the context of work: a systematic review.

    PubMed

    Fernandes, Cláudia; Pereira, Anabela

    2016-01-01

    To analyze the scientific literature about the effects of exposure to psychosocial risk factors in work contexts. A systematic review was performed using the terms "psychosocial factors" AND "COPSOQ" in the databases PubMed, Medline, and Scopus. The period analyzed was from January 1, 2004 to June 30, 2012. We have included articles that used the Copenhagen Psychosocial Questionnaire (COPSOQ) as a measuring instrument of the psychosocial factors and the presentation of quantitative or qualitative results. German articles, psychometric studies or studies that did not analyze individual or work factors were excluded. We included 22 articles in the analysis. Individual factors, such as gender, age, and socioeconomic status, were analyzed along with work-related factors such as labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, justice and respect, personality, health and well-being, and offensive behaviors. We analyzed the sample type and the applied experimental designs. Some population groups, such as young people and migrants, are more vulnerable. The deteriorated working psychosocial environment is associated with physical health indicators and weak mental health. This environment is also a risk factor for the development of moderate to severe clinical conditions, predicting absenteeism or intention of leaving the job. The literature shows the contribution of exposure to psychosocial risk factors in work environments and their impact on mental health and well-being of workers. It allows the design of practical interventions in the work context to be based on scientific evidences. Investigations in specific populations, such as industry, and studies with more robust designs are lacking.

  20. NSRD-10: Leak Path Factor Guidance Using MELCOR

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

    Louie, David; Humphries, Larry L.

    Estimates of the source term from a U.S. Department of Energy (DOE) nuclear facility requires that the analysts know how to apply the simulation tools used, such as the MELCOR code, particularly for a complicated facility that may include an air ventilation system and other active systems that can influence the environmental pathway of the materials released. DOE has designated MELCOR 1.8.5, an unsupported version, as a DOE ToolBox code in its Central Registry, which includes a leak-path-factor guidance report written in 2004 that did not include experimental validation data. To continue to use this MELCOR version requires additional verificationmore » and validations, which may not be feasible from a project cost standpoint. Instead, the recent MELCOR should be used. Without any developer support and lack of experimental data validation, it is difficult to convince regulators that the calculated source term from the DOE facility is accurate and defensible. This research replaces the obsolete version in the 2004 DOE leak path factor guidance report by using MELCOR 2.1 (the latest version of MELCOR with continuing modeling development and user support) and by including applicable experimental data from the reactor safety arena and from applicable experimental data used in the DOE-HDBK-3010. This research provides best practice values used in MELCOR 2.1 specifically for the leak path determination. With these enhancements, the revised leak-path-guidance report should provide confidence to the DOE safety analyst who would be using MELCOR as a source-term determination tool for mitigated accident evaluations.« less

  1. Lack of Emphasis on Nutrition in Medical School Curriculum.

    ERIC Educational Resources Information Center

    Friedman, Suanne

    The need and concern for the apparent lack of nutrition education provided in training programs for physicians was the impetus for begining a 10-session nutrition lecture series program. The program was developed and implemented in a large teaching medical center hospital and given to 16 third-year medical students. The program's purpose was to…

  2. Physician, Patient and Contextual Factors Affecting Treatment Decisions in Older Adults with Cancer: A Literature Review

    PubMed Central

    Tariman, J. D.; Berry, D. L.; Cochrane, B.; Doorenbos, A.; Schepp, K.

    2010-01-01

    Purpose/Objectives To review physician, patient, and contextual factors that affect treatment decision-making in older adults diagnosed with cancer and relate these factors to theoretical models of decision-making. Data Sources PubMed (1966-April 2010), PsycINFO (1967-April 2010) and CINAHL (1982-April 2010) databases were searched to access relevant medical, psychological and nursing literature. Data Synthesis Physician factors in treatment decisions include physician personal beliefs and values, expertise, practice type, perception of lowered life expectancy, medical factors, power, and communication style. Patient factors include personal beliefs and values, ethnicity, decisional control preferences, previous health-related experience, perception of the decision-making process, and personal factors. Contextual factors include availability of caregiver, lack of insurance, poor financial status, and geographical barrier. The interplay of physician, patient, and contextual factors are not well understood. Existing models of decision-making are not sufficient to explicate TDM process in older adults diagnosed with cancer. Conclusions Clinical studies in older adult patient population using a longitudinal and prospective design are needed to examine real-time interplay of patient, physician, and contextual factors and to better understand how these divergent factors influenced actual treatment decisions. Implications for Nursing Oncology nurses can advocate for a patient’s autonomy during TDM by coaching them to seek evidence-based discussion of various treatment options, benefits and risks assessments, and truthful discussion of the probability of success for each treatment option from their physicians. Oncology nurses must promote an informed treatment decisions that are consistent with a patient’s personal preference and values within the limits of the patient’s personal contexts. PMID:22201670

  3. [Factors conditioning taking up sport activity by disabled people].

    PubMed

    Plinta, Ryszard; Sobiecka, Joanna

    2002-01-01

    The aim of the study was to answer the following questions: What factors determine that disabled people take up systematic sport activity or should make such a decision? What reasons are able to eliminate the handicapped from process of regular going in for sport? Three groups of men participated. The group of disabled sportsmen included 39 subjects, the group of non-active disabled people 36 subjects and the group of able-bodied students 45 subjects. All the involved people answered the questions of the questionnaire, which concerned factors associated with sport activity of the handicapped and their socio-demographic characteristics, among other things. The opportunity of improvement of the health status is the main advantage of the sport for disabled people (53%). The chance of self-testing and sport competition was pointed out by 47% of subjects. The most common reason for taking up sport activity was sport passion (over 50%). The others were: possibility of creating new contacts with people, improvement of the physical condition, chance of self-testing and passing free time (23%). The lack of free time was the factor eliminating from sport activity in the second group (28%). The other problem was the shortage of appropriate clubs, equipment, infrastructure etc. (almost 25%). Students concluded that sport for disabled people aims to improve the mental condition mainly (42%). Quite similar percentage of the group (38%) didn't see any reason that was able to exclude the handicapped from goingin for sport. (1) Not only does active going in for sport improve the physical condition of the handicapped but strengthen them psychically as well. (2) The lack of sport activity in disabled people is to a high degree a result of low number of sport clubs, organisations, buildings as well as presence of architectural barriers.

  4. Using contingent valuation to value a noxious weeds control program: the effects of including an unsure response category

    Treesearch

    Patricia A. Champ; Anna Alberini; Ignacio Correas

    2005-01-01

    The National Oceanic and Atmospheric Administration Contingent Valuation panel recommended that a response category be included along with the vote in favor and vote against options associated with a referendum contingent valuation question that allows individuals to express lack of a well defined opinion. However, the recommendation did not include guidance on how to...

  5. Acetylated Histone H3K9 is associated with meiotic recombination hotspots, and plays a role in recombination redundantly with other factors including the H3K4 methylase Set1 in fission yeast

    PubMed Central

    Yamada, Shintaro; Ohta, Kunihiro; Yamada, Takatomi

    2013-01-01

    Histone modifications are associated with meiotic recombination hotspots, discrete sites with augmented recombination frequency. For example, trimethylation of histone H3 lysine4 (H3K4me3) marks most hotspots in budding yeast and mouse. Modified histones are known to regulate meiotic recombination partly by promoting DNA double-strand break (DSB) formation at hotspots, but the role and precise landscape of involved modifications remain unclear. Here, we studied hotspot-associated modifications in fission yeast and found general features: acetylation of H3 lysine9 (H3K9ac) is elevated, and H3K4me3 is not significantly enriched. Mutating H3K9 to non-acetylatable alanine mildly reduced levels of the DSB-inducing protein Rec12 (the fission yeast homologue of Spo11) and DSB at hotspots, indicating that H3K9ac may be involved in DSB formation by enhancing the interaction between Rec12 and hotspots. In addition, we found that the lack of the H3K4 methyltransferase Set1 generally increased Rec12 binding to chromatin but partially reduced DSB formation at some loci, suggesting that Set1 is also involved in DSB formation. These results suggest that meiotic DSB formation is redundantly regulated by multiple chromatin-related factors including H3K9ac and Set1 in fission yeast. PMID:23382177

  6. Alimentary tract innervation deficits and dysfunction in mice lacking GDNF family receptor alpha2.

    PubMed

    Rossi, Jari; Herzig, Karl-Heinz; Võikar, Vootele; Hiltunen, Païvi H; Segerstråle, Mikael; Airaksinen, Matti S

    2003-09-01

    Subsets of parasympathetic and enteric neurons require neurturin signaling via glial cell line-derived neurotrophic factor family receptor alpha2 (GFRalpha2) for development and target innervation. Why GFRalpha2-deficient (Gfra2-/-) mice grow poorly has remained unclear. Here, we analyzed several factors that could contribute to the growth retardation. Neurturin mRNA was localized in the gut circular muscle. GFRalpha2 protein was expressed in most substance P-containing myenteric neurons, in most intrapancreatic neurons, and in surrounding glial cells. In the Gfra2-/- mice, density of substance P-containing myenteric ganglion cells and nerve bundles in the myenteric ganglion cell layer was significantly reduced, and transit of test material through small intestine was 25% slower compared to wild-type mice. Importantly, the knockout mice had approximately 80% fewer intrapancreatic neurons, severely impaired cholinergic innervation of the exocrine but not the endocrine pancreas, and increased fecal fat content. Vagally mediated stimulation of pancreatic secretion by 2-deoxy-glucose in vivo was virtually abolished. Retarded growth of the Gfra2-/- mice was accompanied by reduced fat mass and elevated basal metabolic rate. Moreover, the knockout mice drank more water than wild-type controls, and wet-mash feeding resulted in partial growth rescue. Taken together, the results suggest that the growth retardation in mice lacking GFRalpha2 is largely due to impaired salivary and pancreatic secretion and intestinal dysmotility.

  7. Regional centromeres in the yeast Candida lusitaniae lack pericentromeric heterochromatin

    PubMed Central

    Kapoor, Shivali; Zhu, Lisha; Froyd, Cara; Liu, Tao; Rusche, Laura N.

    2015-01-01

    Point centromeres are specified by a short consensus sequence that seeds kinetochore formation, whereas regional centromeres lack a conserved sequence and instead are epigenetically inherited. Regional centromeres are generally flanked by heterochromatin that ensures high levels of cohesin and promotes faithful chromosome segregation. However, it is not known whether regional centromeres require pericentromeric heterochromatin. In the yeast Candida lusitaniae, we identified a distinct type of regional centromere that lacks pericentromeric heterochromatin. Centromere locations were determined by ChIP-sequencing of two key centromere proteins, Cse4 and Mif2, and are consistent with bioinformatic predictions. The centromeric DNA sequence was unique for each chromosome and spanned 4–4.5 kbp, consistent with regional epigenetically inherited centromeres. However, unlike other regional centromeres, there was no evidence of pericentromeric heterochromatin in C. lusitaniae. In particular, flanking genes were expressed at a similar level to the rest of the genome, and a URA3 reporter inserted adjacent to a centromere was not repressed. In addition, regions flanking the centromeric core were not associated with hypoacetylated histones or a sirtuin deacetylase that generates heterochromatin in other yeast. Interestingly, the centromeric chromatin had a distinct pattern of histone modifications, being enriched for methylated H3K79 and H3R2 but lacking methylation of H3K4, which is found at other regional centromeres. Thus, not all regional centromeres require flanking heterochromatin. PMID:26371315

  8. An attenuated Shigella mutant lacking the RNA-binding protein Hfq provides cross-protection against Shigella strains of broad serotype.

    PubMed

    Mitobe, Jiro; Sinha, Ritam; Mitra, Soma; Nag, Dhrubajyoti; Saito, Noriko; Shimuta, Ken; Koizumi, Nobuo; Koley, Hemanta

    2017-07-01

    Few live attenuated vaccines protect against multiple serotypes of bacterial pathogen because host serotype-specific immune responses are limited to the serotype present in the vaccine strain. Here, immunization with a mutant of Shigella flexneri 2a protected guinea pigs against subsequent infection by S. dysenteriae type 1 and S. sonnei strains. This deletion mutant lacked the RNA-binding protein Hfq leading to increased expression of the type III secretion system via loss of regulation, resulting in attenuation of cell viability through repression of stress response sigma factors. Such increased antigen production and simultaneous attenuation were expected to elicit protective immunity against Shigella strains of heterologous serotypes. Thus, the vaccine potential of this mutant was tested in two guinea pig models of shigellosis. Animals vaccinated in the left eye showed fewer symptoms upon subsequent challenge via the right eye, and even survived subsequent intestinal challenge. In addition, oral vaccination effectively induced production of immunoglobulins without severe side effects, again protecting all animals against subsequent intestinal challenge with S. dysenteriae type 1 or S. sonnei strains. Antibodies against common virulence proteins and the O-antigen of S. flexneri 2a were detected by immunofluorescence microscopy. Reaction of antibodies with various strains, including enteroinvasive Escherichia coli, suggested that common virulence proteins induced protective immunity against a range of serotypes. Therefore, vaccination is expected to cover not only the most prevalent serotypes of S. sonnei and S. flexneri 2a, but also various Shigella strains, including S. dysenteriae type 1, which produces Shiga toxin.

  9. The quality of risk factor screening during antenatal consultations in Niger.

    PubMed

    Prual, A; Toure, A; Huguet, D; Laurent, Y

    2000-03-01

    A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health programmes over the last decade. The effectiveness of antenatal care as a tool to prevent or predict obstetric complications is being questioned more and more. In addition to the scarcity of reliable data about the predictivity of most risk factors, the quality of the screening must be questioned. The goal of this study was to assess the frequency of risk factors among a sample of pregnant women attending antenatal care in Niger and to assess the quality of the screening of those risk factors. Overall, 330 pregnant women were enrolled in the study. Each woman was examined twice: the first time by a midwife, the second time by one of the authors but without knowledge of the results of the first consultation. Fifty-five percent of pregnant women had at least one risk factor, 31% had more than one. Ninety-one percent of the risk factors were detected at interview. The following risk factors were not systematically searched for by midwives: height (48.5%), blood pressure (43.6%), glycosuria (40.6%), vaginal bleeding (38.2%), oedema (37.3%), parity (17%), age (16%), previous caesarean section (15.2%), previous stillbirth (15.2%) and previous miscarriages (14.8%). This study has shown that, in Niger, the quality of screening for risk factors during antenatal consultation is poor. In the urban settings where this study took place, lack of personnel, lack of equipment, lack of time and poor compliance by women cannot be made responsible for this situation. While screening of these risk factors continues as policy, the quality of screening must be dramatically improved.

  10. Do state characteristics matter? State level factors related to tobacco cessation quitlines

    PubMed Central

    Keller, Paula A; Koss, Kalsea J; Baker, Timothy B; Bailey, Linda A; Fiore, Michael C

    2007-01-01

    Background Quitline services are an effective population‐wide tobacco cessation strategy adopted widely in the United States as part of state comprehensive tobacco control efforts. Despite widespread evidence supporting quitlines' effectiveness, many states lack sufficient financial resources to adequately fund and promote this service. Efforts to augment state tobacco control efforts might be fostered by greater knowledge of state level factors associated with the funding and implementation of those efforts. Methods We analysed data from the 2004 North American Quitline Consortium survey and from publicly available sources to identify state level factors related to quitline implementation and funding. Factors included in the analyses were state demographic characteristics, tobacco use variables, state tobacco control spending, and economic and political climate variables. Univariate and multivariate regression analyses were conducted. Results The best fitting multivariate model that significantly predicted the presence or absence of a state quitline included only cigarette excise tax rate (p = 0.020). In terms of funding levels, states with high rates of cigarette consumption (p = 0.047) and with higher per capita expenditures for tobacco control programmes (p = 0 .0.004) were most likely to spend more on per capita operations budget for quitlines. Conclusion State level factors appear to play a part in whether states had established quitlines by mid‐2004 and the amount of per capita quitline funding. PMID:18048637

  11. A review of factors affecting the transfer of sexual and reproductive health training into practice in low and lower-middle income country humanitarian settings.

    PubMed

    Beek, Kristen; Dawson, Angela; Whelan, Anna

    2017-01-01

    A lack of access to sexual and reproductive health (SRH) care is the leading cause of morbidity and mortality among displaced women and girls of reproductive age. Efforts to address this public health emergency in humanitarian settings have included the widespread delivery of training programmes to address gaps in health worker capacity for SRH. There remains a lack of data on the factors which may affect the ability of health workers to apply SRH knowledge and skills gained through training programmes in humanitarian contexts. We searched four electronic databases and ten key organizations' websites to locate literature on SRH training for humanitarian settings in low and lower-middle income countries. Papers were examined using content analysis to identify factors which contribute to health workers' capacity to transfer SRH knowledge, skills and attitudes learned in training into practice in humanitarian settings. Seven studies were included in this review. Six research papers focused on the response stage of humanitarian crises and five papers featured the disaster context of conflict. A range of SRH components were addressed including maternal, newborn health and sexual violence. The review identified factors, including appropriate resourcing, organisational support and confidence in health care workers that were found to facilitate the transfer of learning. The findings suggest the presence of factors that moderate the transfer of training at the individual, training, organisational, socio-cultural, political and health system levels. Supportive strategies are necessary to best assist trainees to apply newly acquired knowledge and skills in their work settings. These interventions must address factors that moderate the success of learning transfer. Findings from this review suggest that these are related to the individual trainee, the training program itself and the workplace as well as the broader environmental context. Organisations which provide SRH

  12. Parental concern about vaccine safety in Canadian children partially immunized at age 2: a multivariable model including system level factors.

    PubMed

    MacDonald, Shannon E; Schopflocher, Donald P; Vaudry, Wendy

    2014-01-01

    Children who begin but do not fully complete the recommended series of childhood vaccines by 2 y of age are a much larger group than those who receive no vaccines. While parents who refuse all vaccines typically express concern about vaccine safety, it is critical to determine what influences parents of 'partially' immunized children. This case-control study examined whether parental concern about vaccine safety was responsible for partial immunization, and whether other personal or system-level factors played an important role. A random sample of parents of partially and completely immunized 2 y old children were selected from a Canadian regional immunization registry and completed a postal survey assessing various personal and system-level factors. Unadjusted odds ratios (OR) and adjusted ORs (aOR) were calculated with logistic regression. While vaccine safety concern was associated with partial immunization (OR 7.338, 95% CI 4.138-13.012), other variables were more strongly associated and reduced the strength of the relationship between concern and partial immunization in multivariable analysis (aOR 2.829, 95% CI 1.151-6.957). Other important factors included perceived disease susceptibility and severity (aOR 4.629, 95% CI 2.017-10.625), residential mobility (aOR 3.908, 95% CI 2.075-7.358), daycare use (aOR 0.310, 95% CI 0.144-0.671), number of needles administered at each visit (aOR 7.734, 95% CI 2.598-23.025) and access to a regular physician (aOR 0.219, 95% CI 0.057-0.846). While concern about vaccine safety may be addressed through educational strategies, this study suggests that additional program and policy-level strategies may positively impact immunization uptake.

  13. Lack of SARS transmission among public hospital workers, Vietnam.

    PubMed

    Le, Dang Ha; Bloom, Sharon A; Nguyen, Quang Hien; Maloney, Susan A; Le, Quynh Mai; Leitmeyer, Katrin C; Bach, Huy Anh; Reynolds, Mary G; Montgomery, Joel M; Comer, James A; Horby, Peter W; Plant, Aileen J

    2004-02-01

    The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.

  14. Predictors of dropout in an outpatient treatment for problem drinkers including cognitive-behavioral therapy and the opioid antagonist naltrexone.

    PubMed

    Vuoristo-Myllys, Salla; Lahti, Jari; Alho, Hannu; Julkunen, Juhani

    2013-11-01

    This study investigated predictors of dropout in an outpatient treatment program for problem drinking that included individual cognitive-behavioral therapy combined with naltrexone. Specifically, we investigated whether sociodemographic factors, severity of alcohol dependence, history of problem drinking, or intensity of alcohol craving assessed at the beginning of the treatment predicted dropout from an outpatient program among a sample of 372 patients (65% male). We also investigated whether the effectiveness of the treatment (the change in alcohol consumption and symptoms of alcohol craving) or adherence to naltrexone was related to dropout. Predictors of dropout were investigated using an analysis of covariance with the number of attended treatment sessions as an independent variable. Our results demonstrated that the treatment entry factors predictive of dropout were younger age, lower severity of alcohol dependence, better ability to resist and control alcohol use, and lower obsession with alcohol. In addition, those who dropped out were more likely to begin the program by abstaining from alcohol and had lower adherence to naltrexone use than those who completed the program. The length of stay for treatment was not related to change in alcohol consumption. Patients with less severe alcohol-related problems may lack motivation for treatment, specifically cognitive-behavioral therapy and naltrexone. These patients may benefit more from less intensive treatments.

  15. Lack of P4H-TM in mice results in age-related retinal and renal alterations.

    PubMed

    Leinonen, Henri; Rossi, Maarit; Salo, Antti M; Tiainen, Päivi; Hyvärinen, Jaana; Pitkänen, Marja; Sormunen, Raija; Miinalainen, Ilkka; Zhang, Chi; Soininen, Raija; Kivirikko, Kari I; Koskelainen, Ari; Tanila, Heikki; Myllyharju, Johanna; Koivunen, Peppi

    2016-09-01

    Age-related macular degeneration (AMD), affecting the retinal pigment epithelium (RPE), is the leading cause of blindness in middle-aged and older people in developed countries. Genetic and environmental risk factors have been identified, but no effective cure exists. Using a mouse model we show that a transmembrane prolyl 4-hydroxylase (P4H-TM), which participates in the oxygen-dependent regulation of the hypoxia-inducible factor (HIF), is a potential novel candidate gene for AMD. We show that P4h-tm had its highest expression levels in the mouse RPE and brain, heart, lung, skeletal muscle and kidney. P4h-tm -/- mice were fertile and had a normal life span. Lack of P4h-tm stabilized HIF-1α in cortical neurons under normoxia, while in hypoxia it increased the expression of certain HIF target genes in tissues with high endogenous P4h-tm expression levels more than in wild-type mice. Renal erythropoietin levels increased in P4h-tm -/- mice with aging, but the resulting ∼2-fold increase in erythropoietin serum levels did not lead to erythrocytosis. Instead, accumulation of lipid-containing lamellar bodies in renal tubuli was detected in P4h-tm -/- mice with aging, resulting in inflammation and fibrosis, and later glomerular sclerosis and albuminuria. Lack of P4h-tm was associated with retinal thinning, rosette-like infoldings and drusen-like structure accumulation in RPE with aging, as is characteristic of AMD. Photoreceptor recycling was compromised, and electroretinograms revealed functional impairment of the cone pathway in adult P4h-tm -/- mice and cone and rod deficiency in middle-aged mice. P4H-TM is therefore imperative for normal vision, and potentially a novel candidate for age-induced diseases, such as AMD. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Does lack of resources impair access to breast and cervical cancer screening in Japan?

    PubMed

    Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

    2017-01-01

    To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.

  17. Does lack of resources impair access to breast and cervical cancer screening in Japan?

    PubMed Central

    Goto, Rei; Hamashima, Chisato

    2017-01-01

    Objectives To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Methods Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. Results The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Conclusions Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening. PMID:28704430

  18. Growth and differentiation of embryonic stem cells that lack an intact c-fos gene.

    PubMed Central

    Field, S J; Johnson, R S; Mortensen, R M; Papaioannou, V E; Spiegelman, B M; Greenberg, M E

    1992-01-01

    The c-fos protooncogene encodes a transcription factor that is thought to play a critical role in proliferation and differentiation as well as in the physiological response of mature cells to their environment. To test directly the role of c-fos in growth and differentiation, we generated mouse embryonic stem cell lines in which both copies of the c-fos gene were specifically disrupted by homologous recombination. Remarkably, the disruption of both copies of c-fos in these cells has no detectable effect on embryonic stem cell viability, growth rate, or differentiation potential. Embryonic stem cells lacking c-fos can differentiate into a wide range of cell types in tissue culture and also in chimeric mice. We conclude that despite a large body of literature suggesting an important role for c-fos in cell growth and differentiation, in at least some cell types this gene is not essential for these processes. Images PMID:1329091

  19. Pathogenesis of Persistent Hyperplastic Primary Vitreous in Mice Lacking the Arf Tumor Suppressor Gene

    PubMed Central

    Martin, Amy C.; Thornton, J. Derek; Liu, Jiewiu; Wang, XiaoFei; Zuo, Jian; Jablonski, Monica M.; Chaum, Edward; Zindy, Frederique; Skapek, Stephen X.

    2006-01-01

    Purpose Persistent hyperplastic primary vitreous (PHPV) is an idiopathic developmental eye disease associated with failed involution of the hyaloid vasculature. The present work addressed the pathogenesis of PHPV in a mouse model that replicates many aspects of the human disease. Methods Ophthalmoscopic and histologic analyses documented pathologic processes in eyes of mice lacking the Arf gene compared with Ink4a-deficient and wild-type control animals. Immunohistochemical staining, in situ hybridization, and RT-PCR demonstrated the expression of relevant gene products. Arf gene expression was determined by in situ hybridization using wholemounts of wild-type mouse eyes and by immunofluorescence staining for green fluores-cent protein (GFP) in Arf+/GFP heterozygous knock-in mouse eyes. Results Abnormalities in Arf−/− mice mimicked those found in patients with severe PHPV. The mice had microphthalmia; fibrovascular, retrolental tissue containing retinal pigment epithelial cells and remnants of the hyaloid vascular system; posterior lens capsule destruction with lens degeneration and opacity; and severe retinal dysplasia and detachment. Eyes of mice lacking the overlapping Ink4a gene were normal. Arf was selectively expressed in perivascular cells within the vitreous of the postnatal eye. Cells composing the retrolental mass in Arf−/− mice expressed the Arf promoter. The remnant hyaloid vessels expressed Flk-1. Its ligand, vascular endothelial growth factor (Vegf), was expressed in the retrolental tissue and the adjacent dysplastic neuroretina. Conclusions Arf−/− mice have features that accurately mimic severe PHPV. In the HVS, Arf expression in perivascular cells may block their accumulation or repress Vegf expression to promote HVS involution and prevent PHPV. PMID:15452040

  20. Environmental Determinants of Cardiovascular Diseases Risk Factors: A Qualitative Directed Content Analysis

    PubMed Central

    Sabzmakan, Leila; Mohammadi, Eesa; Morowatisharifabad, Mohammad Ali; Afaghi, Ahmad; Naseri, Mohammad Hassan; Mirzaei, Masoud

    2014-01-01

    Background: Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior. Objectives: This study aims to understand the patients and healthcare providers’ experiences about the environmental determinants of CVD risk factors based on the Precede Model. Patients and Methods: This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method. Results: Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including “availability and accessibility of health resources”, “new skills”, and “law and policies” which are located in enabling category and social environment including “social support”, “motivation to comply” and “consequences of behavior” which are located in reinforcing category. The most barriers to performing health behaviors were often structural. Conclusions: The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients’ education but also should provide specific facilities to enhance economic, social and cultural status. PMID:25031848

  1. Understanding factors that influence participation in physical activity among people with a neuromusculoskeletal condition: a review of qualitative studies.

    PubMed

    Newitt, Rosemarie; Barnett, Fiona; Crowe, Melissa

    2016-01-01

    This review aims to describe the factors that influence participation in physical activity (PA) in people with neuromusculoskeletal (NMS) conditions. A systematic search of six databases was conducted. Articles were included if the study qualitatively explored factors that influence participation in PA by individuals with a NMS condition. Fifteen peer-reviewed articles published between 2003 and 2013 were analysed for common themes and critically appraised. Results were categorised using the International Classification of Functioning, Disability and Health framework. The most common demotivators reported for the three areas of functioning, body function and structures, activities and participation were lack of walking balance, muscle weakness, pain, stiffness, bladder and blower problems, depression, thermoregulation and fear of injury. Fluctuating symptoms and fatigue were mentioned as demotivators in all of the progressive conditions. Maintaining independence, function and weight, and the prevention of secondary conditions were the leading motivators reported in this domain. Most common environmental barriers include accessibility, costs, transport and insufficient information and knowledge from health professionals. Social support is a consistent determinate of PA and is reported as a facilitator in every study. The most common personal demotivators include lack of motivation, feelings of self-consciousness and embarrassment in public, anxiety, frustration and anger. Personal motivators include goal setting and achieving, enjoyment, feeling good, feeling "normal", motivation and optimism, redefining self and escapism from everyday boundaries. Individuals with NMS conditions report complex common barriers, facilitators, demotivators and motivators to participation in PA. The way these factors influence participation in PA is unique to the individual; therefore, it is necessary to adopt an individually tailored approach when designing interventions. Individuals

  2. Lack of association between ENAM gene polymorphism and dental caries in primary and permanent teeth in Czech children.

    PubMed

    Borilova Linhartova, Petra; Deissova, Tereza; Musilova, Kristina; Zackova, Lenka; Kukletova, Martina; Kukla, Lubomir; Izakovicova Holla, Lydie

    2018-05-01

    The enamelin gene (ENAM) polymorphism (rs12640848) was recently associated with dental caries in primary teeth in Polish children. The aims of the present study were to prove this association in primary dentition and to find a possible effect of this variant on caries development in permanent dentition in Czech children. This study comprised 905 Czech children. Totally, 187 children aged 2-6 years with primary dentition [78 healthy subjects (with decayed/missing/filled teeth, dmft = 0) and 109 patients with early childhood caries (ECC; dmft ≥ 1)] were included in this case-control study. In addition, 177 subjects aged 13-15 years without caries (DMFT = 0) and 541 children with dental caries (DMFT ≥ 1) in permanent dentition were selected from the ELSPAC study. Genotype determination of the ENAM polymorphism (rs12640848) was based on the TaqMan method. No significant differences in the allele or genotype frequencies between the caries-free children and those affected by dental caries were observed in both primary and permanent dentitions. Lack of association between the ENAM polymorphism (rs12640848) and dental caries in Czech children was detected. Although ENAM is considered as a candidate gene for dental caries, the presence of the ENAM variant (rs12640848) cannot be used as a risk factor of this multifactorial disease in the Czech population.

  3. Fibroblast growth factor-2 stimulates adipogenic differentiation of human adipose-derived stem cells

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

    Kakudo, Natsuko; Shimotsuma, Ayuko; Kusumoto, Kenji

    2007-07-27

    Adipose-derived stem cells (ASCs) have demonstrated a capacity for differentiating into a variety of lineages, including bone, cartilage, or fat, depending on the inducing stimuli and specific growth and factors. It is acknowledged that fibroblast growth factor-2 (FGF-2) promotes chondrogenic and inhibits osteogenic differentiation of ASCs, but thorough investigations of its effects on adipogenic differentiation are lacking. In this study, we demonstrate at the cellular and molecular levels the effect of FGF-2 on adipogenic differentiation of ASCs, as induced by an adipogenic hormonal cocktail consisting of 3-isobutyl-1-methylxanthine (IBMX), dexamethasone, insulin, and indomethacin. FGF-2 significantly enhances the adipogenic differentiation of humanmore » ASCs. Furthermore, in cultures receiving FGF-2 before adipogenic induction, mRNA expression of peroxisome proliferator-activated receptor {gamma}2 (PPAR{gamma}2), a key transcription factor in adipogenesis, was upregulated. The results of FGF-2 supplementation suggest the potential applications of FGF-2 and ASCs in adipose tissue regeneration.« less

  4. [Risk factors and incidence of relapse in lung tuberculosis patients].

    PubMed

    Moreno-Martínez, Roberto; Rodríguez-Abrego, Gabriela; Martínez-Montañez, Olga G

    2007-01-01

    To determine the incidence of relapse in patients with lung tuberculosis and its associated risk factors. A follow up study was conducted with 237 patients who were cured after receiving treatment in rural medical facilities from the State of Chiapas. The global incidence of relapse was 1.04 cases per 100 month/person. The risk factors for relapse were lack of knowledge about treatment (OR = 2.28; 95% CI = 1.06-4.89); drug adverse effects (OR = 2.78; 95% CI = 1.31-5.90), waiting time for more than 15 minutes to receive medical care (OR = 3.07; 95% CI = 1.06-12.94) and lack of medical supervision (OR = 4.77; 95% CI = 1.30-17.41). Most of the risk factors for relapse are susceptible to modification and are related with the quality of medical care provided to lung tuberculosis patients.

  5. Health disparity in black women: lack of pharmaceutical advertising in black vs. white-oriented magazines.

    PubMed Central

    Omonuwa, S. C.

    2001-01-01

    CONTEXT: Racial disparities in health care between black women and white women may be attributed in part to socioeconomic status and lack of insurance, but also may be due to lack of the dissemination of health information in black communities via black popular magazines. OBJECTIVE: Comparison of the number and type of pharmaceutical advertisements between black-oriented magazines and white-oriented magazines. DESIGN: Descriptive study. SETTING: Morehouse School of Medicine. MAIN OUTCOME MEASURES: Recording of the type and number of over-the-counter and prescription drug advertisements. RESULTS: Five black-oriented magazines (Black Woman, Black Elegance, Essence, Ebony, and Upscale) and 5 white-oriented magazines (Family Circle, Working Mother, Good Housekeeping, Ladies' Home Journal, Women's Day) were evaluated for 3 months from June-August, 2000. White-oriented magazines had four to eight times more pharmaceutical ads than black-oriented magazines. Types of medications advertised in the white-oriented magazines and not the black-oriented magazines were, for example, cholinesterase inhibitors, calcium supplements, COX II-inhibitors, intranasal steroids, anorexiants, proton pump inhibitors, and smoking deterrent agents. Conversely, medications advertised in the black-oriented magazines and not the white-oriented magazines were antiviral agents and oral contraceptives. Pharmaceutical companies gave several reasons for the disparity, including the explanation that their particular company was advertising about HIV in the black community. CONCLUSIONS: A barrier to equitable health care for black women may be a low prioritization for health prevention and health management. This low prioritization or disinterest may be a reflection of the black magazine that she is reading due to the lack of pharmaceutical advertisements in black-oriented magazines. The result of this disinterest of black females may be seen in the increased morbidity and mortality for selected

  6. Environmental and policy factors related to physical activity in rural white women.

    PubMed

    Eyler, Amy A; Vest, Joshua R

    2002-01-01

    Physical activity is an important aspect of health promotion and disease prevention. However, women often have lower rates of physical activity than men. The purpose of this study was to identify environmental and policy determinants to physical activity among rural white women. Six focus groups were conducted with women aged 20-50 years who were not currently regular exercisers. Women reported that the social environment had a strong impact on physical activity level. Factors of the social environment included guilt, family responsibility, and social support. Environmental and policy barriers such as lack of access to places to exercise and safety concerns were also discussed. Intervention suggestions included family exercise and work-site programs. Information gained from this study can be used to fuel further research and inform future physical activity interventions.

  7. Resources–tasks imbalance: Experiences of nurses from factors influencing workload to increase

    PubMed Central

    Khademi, Mojgan; Mohammadi, Easa; Vanaki, Zohreh

    2015-01-01

    Background: While nursing workload is a worldwide challenge, less attention has been given to the determining factors. Understanding these factors is important and could help nursing managers to provide suitable working environment and to manage the adverse outcomes of nursing workload. The aim of this study was to discover nurses’ experiences of determinant factors of their workload. Materials and Methods: In this qualitative study, the participants included 15 nurses working in two hospitals in Tehran, Iran. The data were collected through 26 unstructured interviews and were analyzed using conventional content analysis. The rigor has been guaranteed with prolonged engagement, maximum variance sampling, member check, and audit trail. Results: Resource–task imbalance was the main theme of nurses’ experiences. It means that there was an imbalance between necessary elements to meet patients’ needs in comparison with expectation and responsibility. Resource–task imbalance included lack of resource, assignment without preparation, assigning non-care tasks, and patients’ and families’ needs/expectations. Conclusions: A deep and comprehensive imbalance between recourses and tasks and expectations has been perceived by the participants to be the main source of work overload. Paying more attention to resource allocation, education of quality workforce, and job description by managers is necessary. PMID:26257804

  8. Special Relativity in Week One: 4) Lack of Simultaneity

    ERIC Educational Resources Information Center

    Huggins, Elisha

    2011-01-01

    This is our final article on teaching special relativity in the first week of an introductory physics course. One of the profound changes in our view of the world was Einstein's discovery of the lack of simultaneity. He illustrated this result with a thought experiment in which we observe a railroad car passing by us. We see the two ends of the…

  9. Lack of centrioles and primary cilia in STIL(-/-) mouse embryos.

    PubMed

    David, Ahuvit; Liu, Fengying; Tibelius, Alexandra; Vulprecht, Julia; Wald, Diana; Rothermel, Ulrike; Ohana, Reut; Seitel, Alexander; Metzger, Jasmin; Ashery-Padan, Ruth; Meinzer, Hans-Peter; Gröne, Hermann-Josef; Izraeli, Shai; Krämer, Alwin

    2014-01-01

    Although most animal cells contain centrosomes, consisting of a pair of centrioles, their precise contribution to cell division and embryonic development is unclear. Genetic ablation of STIL, an essential component of the centriole replication machinery in mammalian cells, causes embryonic lethality in mice around mid gestation associated with defective Hedgehog signaling. Here, we describe, by focused ion beam scanning electron microscopy, that STIL(-/-) mouse embryos do not contain centrioles or primary cilia, suggesting that these organelles are not essential for mammalian development until mid gestation. We further show that the lack of primary cilia explains the absence of Hedgehog signaling in STIL(-/-) cells. Exogenous re-expression of STIL or STIL microcephaly mutants compatible with human survival, induced non-templated, de novo generation of centrioles in STIL(-/-) cells. Thus, while the abscence of centrioles is compatible with mammalian gastrulation, lack of centrioles and primary cilia impairs Hedgehog signaling and further embryonic development.

  10. Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients.

    PubMed

    Calvo-Alén, J; Alarcón, G S; Campbell, R; Fernández, M; Reveille, J D; Cooper, G S

    2005-09-01

    To determine to what extent the diagnosis of systemic lupus erythematosus (SLE) in deceased lupus patients is under-reported in death certificates, and the patient characteristics associated with such an occurrence. The death certificates of 76 of the 81 deceased SLE patients from two US lupus cohorts (LUMINA for Lupus in Minorities: Nature vs Nurture and CLU for Carolina Lupus Study), including 570 and 265 patients, respectively, were obtained from the Offices of Vital Statistics of the states where the patients died (Alabama, Georgia, North Carolina, South Carolina, Tennessee and Texas). Both cohorts included patients with SLE as per the American College of Rheumatology criteria, aged > or =16 yr, and disease duration at enrolment of < or =5 yr. The median duration of follow-up in each cohort at the time of these analyses ranged from 38.1 to 53.0 months. Standard univariable analyses were performed comparing patients with SLE recorded anywhere in the death certificate and those without it. A multivariable logistic regression model was performed to identify the variables independently associated with not recording SLE in death certificates. In 30 (40%) death certificates, SLE was not recorded anywhere in the death certificate. In univariable analyses, older age was associated with lack of recording of SLE in death certificates [mean age (standard deviation) 50.9 (15.6) years and 39.1 (18.6) yr among those for whom SLE was omitted and included on the death certificates, respectively, P = 0.005]. Patients without health insurance, those dying of a cardiovascular event and those of Caucasian ethnicity were also more likely to be in the non-recorded group. In the multivariable analysis, variables independently associated with not recording SLE as cause of death were older age [odds ratio = (95% confidence interval) 1.043 (1.005-1.083 per yr increase); P = 0.023] and lack of health insurance [4.649 (1.152-18.768); P = 0.031]. A high proportion of SLE diagnoses are not

  11. Self-appraisals and episodic memory: Different psychological factors related to patient versus informant reports of apathy in severe traumatic brain injury.

    PubMed

    Arnould, Annabelle; Rochat, Lucien; Azouvi, Philippe; van der Linden, Martial

    2018-01-09

    Apathy is a core feature in patients with traumatic brain injury (TBI). The psychological processes underlying apathy are still unclear, and the few studies conducted on this subject have essentially focused on cognitive processes and informant reports of apathetic manifestations. The aims of the present study were to examine self-reports versus informant reports of diminished initiative/interest, as well as their relationship with different cognitive factors (attention/executive mechanisms, episodic memory, and multitasking) and personal identity factors (self-esteem and self-efficacy beliefs). To this end, 74 participants (38 patients with severe TBI matched with 36 control participants) were given three questionnaires to assess self-esteem, general self-efficacy beliefs, and anxio-depressive symptoms and five tasks to assess cognitive processes, including real-life multitasking. In addition, a questionnaire that assessed self-awareness of functional competencies and a questionnaire that assessed lack of initiative/interest were administered to each participant and their relatives. The main results showed that patients demonstrated an awareness of their lack of initiative/interest and that self-reported lack of initiative/interest was best predicted by low general self-efficacy beliefs and self-esteem, whereas informant-reported lack of initiative/interest was predicted by episodic memory difficulties. These results shed new light on the psychological processes related to apathetic manifestations, as well as the differing perspectives and lived experiences of patients and external observers in the TBI population, which opens interesting prospects for psychological interventions.

  12. Multi-Omics Factor Analysis-a framework for unsupervised integration of multi-omics data sets.

    PubMed

    Argelaguet, Ricard; Velten, Britta; Arnol, Damien; Dietrich, Sascha; Zenz, Thorsten; Marioni, John C; Buettner, Florian; Huber, Wolfgang; Stegle, Oliver

    2018-06-20

    Multi-omics studies promise the improved characterization of biological processes across molecular layers. However, methods for the unsupervised integration of the resulting heterogeneous data sets are lacking. We present Multi-Omics Factor Analysis (MOFA), a computational method for discovering the principal sources of variation in multi-omics data sets. MOFA infers a set of (hidden) factors that capture biological and technical sources of variability. It disentangles axes of heterogeneity that are shared across multiple modalities and those specific to individual data modalities. The learnt factors enable a variety of downstream analyses, including identification of sample subgroups, data imputation and the detection of outlier samples. We applied MOFA to a cohort of 200 patient samples of chronic lymphocytic leukaemia, profiled for somatic mutations, RNA expression, DNA methylation and ex vivo drug responses. MOFA identified major dimensions of disease heterogeneity, including immunoglobulin heavy-chain variable region status, trisomy of chromosome 12 and previously underappreciated drivers, such as response to oxidative stress. In a second application, we used MOFA to analyse single-cell multi-omics data, identifying coordinated transcriptional and epigenetic changes along cell differentiation. © 2018 The Authors. Published under the terms of the CC BY 4.0 license.

  13. Reviewing audit: barriers and facilitating factors for effective clinical audit.

    PubMed

    Johnston, G; Crombie, I K; Davies, H T; Alder, E M; Millard, A

    2000-03-01

    To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost

  14. "You are such a disappointment!": negative emotions and parents' perceptions of adult children's lack of success.

    PubMed

    Cichy, Kelly E; Lefkowitz, Eva S; Davis, Eden M; Fingerman, Karen L

    2013-11-01

    Parents' perceptions of their adult children's successes (or lack thereof) may be associated in different ways with discrete negative emotions (e.g., guilt, anger, disappointment, and worry). Furthermore, mothers and fathers may vary in their reactions to children's success in different domains. Participants included 158 mothers and fathers from the same families (N = 316) and their adult child. Mothers and fathers evaluated their adult children's successes in (a) career and (b) relationship domains. Mothers and fathers also reported on several negative emotions in the parent-child tie: guilt, anger, disappointment, and worry. For fathers, perceptions of children's poorer career success were associated with disappointment, anger, and guilt. Mothers' perceptions of children's lack of career success were associated with disappointment and worry. Mothers' perceptions of children's poorer success in relationships were associated with each of the negative emotions, with the exception of anger. Parents experience emotions associated with unmet goals and future concerns in relationships with less successful children. Mothers may respond emotionally to career and relationship success, whereas fathers may respond emotionally primarily to their child's career success. Findings underscore the importance of considering the context of parents' negative emotional experiences in ties to adult children.

  15. Lack of nephrotoxicity of gadodiamide in unselected hospitalized patients.

    PubMed

    Trivedi, Hariprasad; Raman, Lakshmi; Benjamin, Heather; Batwara, Ruchika

    2009-09-01

    The nephrotoxicity of gadolinium-based magnetic resonance contrast media has not been adequately studied. We evaluated the nephrotoxicity of gadolinium-based contrast media in hospitalized patients who underwent magnetic resonance imaging (MRI) as part of routine clinical care. Subjects who had a serum creatinine measurement during the 7 days before MRI and at least 1 other measurement 2 to 3 days after MRI were included. Patients who underwent noncontrasted MRI served as controls. There were 162 subjects (mean age, 57.8 +/- 16.9 years; 91 men and 71 women) and 125 controls (mean age, 64.6 +/- 18 years; 62 men and 63 women). All contrast-enhanced MRI studies utilized gadodiamide (Omniscan; GE Healthcare, Waukesha, WI). Subjects who received gadodiamide showed no difference in the incidence of acute renal insufficiency compared with controls (increase in serum creatinine >or= 25%, 11.1% vs 12.9%, respectively; P = 0.6; increase in serum creatinine by 0.5 mg/dL, 5.6% vs 3.2%, respectively; P = 0.4). There was no significant increase in serum creatinine baseline versus 48 hours in either the subjects who received gadodiamide (0.95 +/- 0.58 vs 0.96 +/- 0.65 mg/dL; P = 0.7) or controls (0.96 +/- 0.65 vs 0.88 +/- 0.43 mg/dL; P = 0.7). Our findings showed a lack of significant nephrotoxicity of gadodiamide in unselected hospitalized patients.

  16. A systematic review including meta-analysis of work environment and depressive symptoms.

    PubMed

    Theorell, Töres; Hammarström, Anne; Aronsson, Gunnar; Träskman Bendz, Lil; Grape, Tom; Hogstedt, Christer; Marteinsdottir, Ina; Skoog, Ingmar; Hall, Charlotte

    2015-08-01

    Depressive symptoms are potential outcomes of poorly functioning work environments. Such symptoms are frequent and cause considerable suffering for the employees as well as financial loss for the employers. Accordingly good prospective studies of psychosocial working conditions and depressive symptoms are valuable. Scientific reviews of such studies have pointed at methodological difficulties but still established a few job risk factors. Those reviews were published some years ago. There is need for an updated systematic review using the GRADE system. In addition, gender related questions have been insufficiently reviewed. Inclusion criteria for the studies published 1990 to June 2013: 1. European and English speaking countries. 2. Quantified results describing the relationship between exposure (psychosocial or physical/chemical) and outcome (standardized questionnaire assessment of depressive symptoms or interview-based clinical depression). 3. Prospective or comparable case-control design with at least 100 participants. 4. Assessments of exposure (working conditions) and outcome at baseline and outcome (depressive symptoms) once again after follow-up 1-5 years later. 5. Adjustment for age and adjustment or stratification for gender. Studies filling inclusion criteria were subjected to assessment of 1.) relevance and 2.) quality using predefined criteria. Systematic review of the evidence was made using the GRADE system. When applicable, meta-analysis of the magnitude of associations was made. Consistency of findings was examined for a number of possible confounders and publication bias was discussed. Fifty-nine articles of high or medium high scientific quality were included. Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms. Limited evidence (grade two) was shown for psychological

  17. Lack of Toll-like receptor 2 results in higher mortality of bacterial meningitis by impaired host resistance.

    PubMed

    Böhland, Martin; Kress, Eugenia; Stope, Matthias B; Pufe, Thomas; Tauber, Simone C; Brandenburg, Lars-Ove

    2016-10-15

    Bacterial meningitis is - despite therapeutical progress during the last decades - still characterized by high mortality and severe permanent neurogical sequelae. The brain is protected from penetrating pathogens by both the blood-brain barrier and the innate immune system. Invading pathogens are recognized by so-called pattern recognition receptors including the Toll-like receptors (TLR) which are expressed by glial immune cells in the central nervous system. Among these, TLR2 is responsible for the detection of Gram-positive bacteria such as the meningitis-causing pathogen Streptococcus pneumoniae. Here, we used TLR2-deficient mice to investigate the effects on mortality, bacterial growth and inflammation in a mouse model of pneumococcal meningitis. Our results revealed a significantly increased mortality rate and higher bacterial burden in TLR2-deficient mice with pneumococcal meningitis. Furthermore, infected TLR2-deficient mice suffered from a significantly increased pro-inflammatory cytokine tumor necrosis factor-α (TNF-α) and Chemokine (C-C motif) ligand 2 (CCL2) or CCL3 chemokine expression and decreased expression of anti-inflammatory cytokines and antimicrobial peptides. In contrast, glial cell activation assessed by glial cell marker expression was comparable to wildtype mice. Taken together, the results suggest that TLR2 is essential for an efficient immune response against Streptococcus pneumoniae meningitis since lack of the receptor led to a worse outcome by higher mortality due to increased bacterial burden, weakened innate immune response and reduced expression of antimicrobial peptides. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Psychosocial factors associated with failure to use contraception among adolescents with repeat pregnancies in Puerto Rico.

    PubMed

    Colón, Malieri; Martínez, Rosa; Tulla, Michelle; Pérez, José; Santaella, Yadiris; Laras, Linda

    2014-01-01

    Social, medical, psychological and economic problems are often associated to teen pregnancy. This is a reality worldwide; Puerto Rico is not an exception, documented in statistics and previous research projects. There are many risks associated with pregnancies among adolescents, including increased maternal morbidity and infant morbidity. In Puerto Rico, the adolescent repeat births reed are 22% for a second child and 6% for a third child. Repeated teen pregnancy has a higher than expected incidence; therefore the investigation of psychosocial factors associated with failure to use contraception is needed,especially to address the intervention at clinics with this population of different needs, mainly when these patients with repeated teen pregnancies have been through the health care system already. The project is a cross sectional survey study, seventy articipants between 12-19 years of age who attended obstetrics or postpartum clinics at an adult University Hospital. A self-administered questionnaire included some psychosocial factors that have been associated withthe failure to use contraceptives as well as demographics tion, education, socioeconomic status and support system. Their partner's age ranged from 15 to 38 years of age. Most participants lived with their partner. Their main activity at the time of the study was housework. Most had left school beforebecoming pregnant and received government help. Of all participants, a small number was legally married. The lack of use of contraceptive was found to be significantly associated to partner (p < 0.05). The lack of contraceptive use is a key factor in adolescent pregnancy. It is expected that this data can be helpful for documentation and intervention measurements something canbe done at an educational level, family planning and medical care.

  19. Key factors affecting dying children and their families.

    PubMed

    Hinds, Pamela S; Schum, Lisa; Baker, Justin N; Wolfe, Joanne

    2005-01-01

    The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a "good death"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. Key factors described here include suffering (physical, psychological, and spiritual), communication, decision making, prognostic ambiguities, ability of the seriously ill child to give assent to research participation, and educational preparation of health care providers to give competent end-of-life care.

  20. Linking Professional, School, Demographic, and Motivational Factors to Desire for Principalship

    ERIC Educational Resources Information Center

    Walker, Allan; Kwan, Paula

    2009-01-01

    Purpose: This study attempts to link four groups of contextual factors to vice principals' desire for principalship using regression analysis. Relevant items representing context are grouped under professional, school, demographic, and motivational factors. The findings aim to provide greater understanding of the desire, or lack thereof, of vice…

  1. Factors influencing African-American mothers' concerns about immunization safety: a summary of focus group findings.

    PubMed Central

    Shui, Irene; Kennedy, Allison; Wooten, Karen; Schwartz, Benjamin; Gust, Deborah

    2005-01-01

    OBJECTIVE: To examine the vaccine safety concerns of African-American mothers who, despite concerns, have their children immunized. METHODS: Six focus groups of Atlanta-area African-American mothers who were very concerned about vaccine safety but whose children were fully vaccinated were conducted. RESULTS: Major factors influencing participants' concerns about immunizations included: lack of information and mistrust of the medical community and government. Factors that convinced parents to have their child immunized despite their concerns included social norms and/or laws supporting immunization and fear of the consequences of not immunizing. Suggestions given to reduce concerns included improving available information that addressed their concerns and provider-patient communication. CONCLUSIONS: Addressing mothers' concerns about immunization is important both from an ethical perspective, in assuring that they are fully informed of the risks and benefits of immunizations, as well as from a practical one, in reducing the possibility that they will decide not to immunize their child. Changes in the childhood immunization process should be made to reduce parental concern about vaccine safety. Some changes that may be considered include improved provider communication about immunizations and additional tailored information about the necessity and safety of vaccines. PMID:15926642

  2. [Clinical risk factors for progressive myopia].

    PubMed

    Schaeffel, F

    2012-08-01

    The average worldwide frequency of myopia is approximately 30 % and is traditionally subdivided into school myopia and pathological myopia. A further distinction is made between progressive myopia and stationary myopia. There is a high correlation between the frequency of myopia and urbanization and training. Risk factors for development of myopia are close-up work, lack of outdoor activity, biometrical variables of the eye and genetic risk factors. Development of myopia can be positively influenced by peripheral focusing, increased exposure to light and in the future possibly pharmacologically.

  3. [Factors that influence treatment adherence in chronic disease patients undergoing hemodialysis].

    PubMed

    Maldaner, Cláudia Regina; Beuter, Margrid; Brondani, Cecília Maria; Budó, Maria de Lourdes Denardin; Pauletto, Macilene Regina

    2008-12-01

    The following bibliographical research wanted to identify the main factors that influence adherence to treatment in chronic disease. The study focused on patients undergoing hemodialysis, as well as on the support nurses require for the promotion of health education among individuals with low treatment adherence. The identification of bibliographical sources was conducted at Health Virtual Library and Scientific Electronic Library Online (SciELO) data bases. Some printed magazines were also used. The results indicated nine factors influencing treatment adherence or non-adherence: team trust, support nets, educational level; accepting disease, treatment side effects, lack of access to medicines, long-term treatment, complex therapeutic approach, and lack of symptoms. It is advisable that nurses take into account these factors when dealing with chronic-disease patients that present low treatment adherence, getting family and multidisciplinary team support seeking treatment adherence.

  4. The lack of CD131 and the inhibition of Neuro-2a growth by carbamylated erythropoietin.

    PubMed

    Ding, Jing; Li, Qin-Ying; Yu, Jie-Zhong; Wang, Xin; Lu, Chuan-Zhen; Ma, Cun-Gen; Xiao, Bao-Guo

    2015-02-01

    Recombinant human erythropoietin (EPO), a glycohormone, is one of the leading biopharmaceutical products, while carbamylated erythropoietin (CEPO), an EPO derivative, is attracting widespread interest due to its neuroprotective effects without erythropoiesis in several cells and animal models. However, exogenous EPO promotes an angiogenic response from tumor cells and is associated with tumor growth, but knowledge of CEPO on tumor growth is lacking. Here we show that CEPO, but not EPO, inhibited Neuro-2a growth and viability. As expected, CEPO--unlike EPO--did not activate JAK-2 either in primary neurons or in Neuro-2a cells. Interestingly, CEPO did not induce GDNF expression and subsequent AKT activation in Neuro-2a cells. Before CEPO/EPO treatment, glial cell line-derived neurotrophic factor (GDNF) neutralization and GFR receptor blocking decreased the viability of EPO-treated Neuro-2a cells but did not influence CEPO-treated Neuro-2a cells. As compared to primary neurons, the expression of CD131, as a receptor complex binding to CEPO, is almost lacking in Neuro-2a cells. In BABL/C-nu mice, CEPO did not promote the growth of Neuro-2a cells nor extended the survival time compared to mice treated with EPO. The results indicate that CEPO did not promote tumor growth because of lower expression of CD131 and subsequent dysfunction of CD131/GDNF/AKT pathway in Neuro-2a cells, revealing its therapeutic potential in future clinical application.

  5. In vivo and in vitro analyses of a Bombyx mori nucleopolyhedrovirus mutant lacking functional vfgf.

    PubMed

    Katsuma, Susumu; Horie, Satoshi; Daimon, Takaaki; Iwanaga, Masashi; Shimada, Toru

    2006-11-10

    All lepidopteran baculovirus genomes sequenced to date encode a viral fibroblast growth factor homolog (vfgf), suggesting that vfgf may play an important role in the infection cycle of lepidopteran baculoviruses. Here, we describe the characterization of a Bombyx mori nucleopolyhedrovirus (BmNPV) mutant lacking functional vfgf. We constructed a vfgf deletion mutant (BmFGFD) and characterized it in BmN cells and B. mori larvae. We observed that budded virus (BV) production was reduced in BmFGFD-infected BmN cells and B. mori larvae. The larval bioassays also revealed that deletion of vfgf did not reduce the infectivity; however, the mutant virus did take 20 h longer to kill B. mori larvae than wild-type BmNPV, when tested either by BV injection or by polyhedrin-inclusion body ingestion. These results suggest that BmNPV vfgf is involved in efficient virus production in BmN cells and B. mori larvae.

  6. Psychosocial factors at work and in every day life are associated with irritable bowel syndrome.

    PubMed

    Faresjö, Ashild; Grodzinsky, Ewa; Johansson, Saga; Wallander, Mari-Ann; Timpka, Toomas; Akerlind, Ingemar

    2007-01-01

    The etiology of irritable bowel syndrome (IBS) tends to be complex and multi-factorial and there is still a lack of understanding of how different psychosocial factors are associated with the syndrome. Our aim was to examine the occurrence of psychosocial and behavioural factors among patients diagnosed with IBS in primary care. The study had an epidemiological population-based case-control design comparing 347 IBS cases to 1041 age and sex matched controls from the general population. A survey was directed to cases and controls based on validated questions asking for mood status, job strain, family history of IBS, and sleeping habits as well as education, nutritional and exercise habits and medication. In multivariate analyses, independent associations were found between IBS and lack of influence on work planning, a family history of IBS, anxiety, and sleeping disturbances. Important factors associated with IBS diagnosis among females were anxiety as well as family history of IBS and lack of co-determination at work. For males, only lack of influence on working pace and family history of IBS remained independently associated with an IBS diagnosis. The causal associations of the complex risk factor panorama for IBS warrants further study. This study indicates that there should be a special focus on investigating the psychosocial working conditions and their associations to IBS.

  7. Authors report lack of time as main reason for unpublished research presented at biomedical conferences: a systematic review.

    PubMed

    Scherer, Roberta W; Ugarte-Gil, Cesar; Schmucker, Christine; Meerpohl, Joerg J

    2015-07-01

    To systematically review reports that queried abstract authors about reasons for not subsequently publishing abstract results as full-length articles. Systematic review of MEDLINE, EMBASE, The Cochrane Library, ISI Web of Science, and study bibliographies for empirical studies in which investigators examined subsequent full publication of results presented at a biomedical conference and reasons for nonpublication. The mean full publication rate was 55.9% [95% confidence interval (CI): 54.8%, 56.9%] for 24 of 27 eligible reports providing this information and 73.0% (95% CI: 71.2%, 74.7%) for seven reports of abstracts describing clinical trials. Twenty-four studies itemized 1,831 reasons for nonpublication, and six itemized 428 reasons considered the most important reason. "Lack of time" was the most frequently reported reason [weighted average = 30.2% (95% CI: 27.9%, 32.4%)] and the most important reason [weighted average = 38.4% (95% CI: 33.7%, 43.2%)]. Other commonly stated reasons were "lack of time and/or resources," "publication not an aim," "low priority," "incomplete study," and "trouble with co-authors." Across medical specialties, the main reasons for not subsequently publishing an abstract in full lie with factors related to the abstract author rather than with journals. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Influencing factors on compliance of timely visits among patients with proliferative diabetic retinopathy in southern China: a qualitative study.

    PubMed

    Duan, Fang; Liu, Yuhong; Chen, Xiang; Congdon, Nathan; Zhang, Jian; Chen, Qianyun; Chen, Lingling; Chen, Xi; Zhang, Xiulan; Yu, Chengpu; Liu, Yizhi

    2017-03-27

    To identify the reasons for low adherence among patients with diabetic retinopathy (DR) in southern China using a qualitative method. Exploratory indepth interviews were conducted in 27 diabetic patients with proliferative diabetic retinopathy who required vitrectomy surgery at Zhongshan Ophthalmic Centre, Sun Yat-sen University, from March to August 2015. Qualitative data analysis and research software (ATLAS.ti7) was used for data processing and analysis. Factors influencing the occurrence of timely visits included lack of DR related knowledge, fear and worries about insulin, interactions between patients and society combined with the complexity of emotions and social culture, and the economic burden of treatment. Although the reasons for low adherence involved social, emotional, cultural and economic factors, the key issue was the lack of awareness and knowledge of DR. Our findings have several practical implications for health policymakers and programme planners in China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Risk factors for proper oral language development in children: a systematic literature review.

    PubMed

    Gurgel, Léia Gonçalves; Vidor, Deisi Cristina Gollo Marques; Joly, Maria Cristina Rodrigues Azevedo; Reppold, Caroline Tozzi

    2014-01-01

    To conduct a systematic review of literature production related to risk factors for proper oral language development in children. We used the terms "child language," "risk factors," and "randomized controlled trial" in MEDLINE (accessed via PubMed), Lilacs, SciELO, and The Cochrane Library from January 1980 to February 2014. Randomized controlled trials involving the study of some risk factors related to child language were included. Works with individuals who were not from the age group 0-12 years and presented no reliable definition of risk factors were excluded. The research findings were classified according to their theme and categorized methodological aspects. We observed the lack of a standardized list of risk factors for language available for health professionals. The main risk factor mentioned was family dynamics, followed by interaction with parents, immediate social environment, and encouragement given to the child in the first years of life. It was also observed that organic hazards such as brain injury, persistent otitis media, and cardiac surgery, besides the type of food and parental counseling, may be related to language disorders. More randomized controlled trials involving the evaluation of risk factors for child language and the creation of further studies involving children above 6 years of age and males are needed.

  10. Early Childhood Caries: Prevalence, Risk Factors, and Prevention

    PubMed Central

    Anil, Sukumaran; Anand, Pradeep S.

    2017-01-01

    Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC. PMID:28770188

  11. The impact of race on metabolic disease risk factors in women with and without posttraumatic stress disorder.

    PubMed

    Dedert, Eric A; Harper, Leia A; Calhoun, Patrick S; Dennis, Michelle F; Beckham, Jean C

    2013-03-01

    The literature on PTSD and metabolic disease risk factors has been limited by lacking investigation of the potential influence of commonly comorbid disorders and the role of race. In this study data were provided by a sample of 134 women (63 PTSD and 71 without PTSD). Separate sets of models examining associations of psychiatric disorder classifications with metabolic disease risk factors were used. Each model included race (African American or Caucasian), psychiatric disorder, and their interaction. There was an interaction of race and PTSD on body mass index, abdominal obesity, and triglycerides. While PTSD was not generally associated with deleterious health effects in African American participants, PTSD was related to worse metabolic disease risk factors in Caucasians. MDD was associated with metabolic disease risk factors, but there were no interactions with race. Results support the importance of race in the relationship between PTSD and metabolic disease risk factors. Future research would benefit from analysis of cultural factors to explain how race might influence metabolic disease risk factors in PTSD.

  12. Meta-Analysis of Early Nonmotor Features and Risk Factors for Parkinson Disease

    PubMed Central

    Noyce, Alastair J; Bestwick, Jonathan P; Silveira-Moriyama, Laura; Hawkes, Christopher H; Giovannoni, Gavin; Lees, Andrew J; Schrag, Anette

    2012-01-01

    Objective To evaluate the association between diagnosis of Parkinson disease (PD) and risk factors or early symptoms amenable to population-based screening. Methods A systematic review and meta-analysis of risk factors for PD. Results The strongest associations with later diagnosis of PD were found for having a first-degree or any relative with PD (odds ratio [OR], 3.23; 95% confidence interval [CI], 2.65–3.93 and OR, 4.45; 95% CI, 3.39–5.83) or any relative with tremor (OR, 2.74; 95% CI, 2.10–3.57), constipation (relative risk [RR], 2.34; 95% CI, 1.55–3.53), or lack of smoking history (current vs never: RR, 0.44; 95% CI, 0.39–0.50), each at least doubling the risk of PD. Further positive significant associations were found for history of anxiety or depression, pesticide exposure, head injury, rural living, beta-blockers, farming occupation, and well-water drinking, and negative significant associations were found for coffee drinking, hypertension, nonsteroidal anti-inflammatory drugs, calcium channel blockers, and alcohol, but not for diabetes mellitus, cancer, oral contraceptive pill use, surgical menopause, hormone replacement therapy, statins, acetaminophen/paracetamol, aspirin, tea drinking, history of general anesthesia, or gastric ulcers. In the systematic review, additional associations included negative associations with raised serum urate, and single studies or studies with conflicting results. Interpretation The strongest risk factors associated with later PD diagnosis are having a family history of PD or tremor, a history of constipation, and lack of smoking history. Further factors also but less strongly contribute to risk of PD diagnosis or, as some premotor symptoms, require further standardized studies to demonstrate the magnitude of risk associated with them. ANN NEUROL 2012 PMID:23071076

  13. An Analysis of Factor Extraction Strategies: A Comparison of the Relative Strengths of Principal Axis, Ordinary Least Squares, and Maximum Likelihood in Research Contexts That Include Both Categorical and Continuous Variables

    ERIC Educational Resources Information Center

    Coughlin, Kevin B.

    2013-01-01

    This study is intended to provide researchers with empirically derived guidelines for conducting factor analytic studies in research contexts that include dichotomous and continuous levels of measurement. This study is based on the hypotheses that ordinary least squares (OLS) factor analysis will yield more accurate parameter estimates than…

  14. Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study.

    PubMed

    de Jong, Mark H; Oorschot, Margreet; Kamperman, Astrid M; Brussaard, Petra E; Knijff, Esther M; van de Sande, Roland; Van Gool, Arthur R; Mulder, Cornelis L

    2017-10-24

    Compulsory admissions have a strong effect on psychiatric patients and represent a deprivation of personal liberty. Although the rate of such admissions is tending to rise in several Western countries, there is little qualitative research on the mental health-care process preceding compulsory admission. The objective of the study was to identify crucial factors in the mental health-care process preceding compulsory admission of adult psychiatric patients. This retrospective, qualitative multiple-case study was based on the patient records of patients with severe mental illness, mainly schizophrenia and other psychotic disorders. Twenty two patient records were analyzed. Patients' demographic and clinical characteristics were heterogeneous. All were treated by Flexible Assertive Community Treatment teams (FACT teams) at two mental health institutions in the greater Rotterdam area in the Netherlands and had a compulsory admission in a predefined inclusion period. The data were analyzed according to the Prevention and Recovery System for Monitoring and Analysis (PRISMA) method, assessing acts, events, conditions, and circumstances, failing protective barriers and protective recovery factors. The most important patient factors in the process preceding compulsory admission were psychosis, aggression, lack of insight, care avoidance, and unauthorized reduction or cessation of medication. Neither were health-care professionals as assertive as they could be in managing early signs of relapse and care avoidance of these particular patients. The health-care process preceding compulsory admission is complex, being influenced by acts, events, conditions and circumstances, failing barriers, and protective factors. The most crucial factors are patients' lack of insight and cessation of medication, and health-care professionals' lack of assertiveness.

  15. Characterization of a mast cell line that lacks the extracellular domain of membrane c-kit.

    PubMed Central

    Mekori, Y A; Oh, C K; Dastych, J; Goff, J P; Adachi, S; Bianchine, P J; Worobec, A; Semere, T; Pierce, J H; Metcalfe, D D

    1997-01-01

    Expression of the c-kit proto-oncogene receptor on mast cells is essential for their normal proliferation and maturation as well as for several biological responses such as chemotaxis and attachment. In the present study we report that the interleukin-3 (IL-3)-dependent mast cell line CFTL-15 lacks the extracellular domain of the c-kit receptor. This observation was made after noting that the c-kit ligand stem cell factor (SCF) could not prevent IL-3 deprivation-induced mast cell apoptosis and that CFTL-15 cells did not proliferate in response to SCF. Flow cytometric analysis employing monoclonal anti-c-kit antibodies, and immunogold labelling with analysis by electron microscopy, subsequently showed a diminished expression of c-kit on CFTL-15 cells. There was no identifiable message for the extracellular domain of c-kit in these cells, as determined by reverse transcriptase-polymerase chain reaction (RT-PCR). These previously unrecognized properties of the CFTL-15 mast cell line allowed the examination of other biological consequences of the lack of c-kit on mast cells. Analysing the ability of these cells to adhere to surface-bound fibronectin, it was found that addition of SCF did not increase their adhesion to this substrate, in opposition to what is reported with other mast cells. Similarly, CFTL-15 mast cells did not adhere to fibroblasts, which is known to require c-kit expression. Also, there was no protein tyrosine phosphorylation in these cells in response to SCF. CFTL-15 cells underwent apoptosis on removal of IL-3 coincident with a decrease in endogenous Bcl-2 mRNA. Overexpression of Bcl-2 cDNA prolonged survival of Bcl-2-transfected CFTL-15 cells upon withdrawal of IL-3. Thus, the CFTL-15 cell line that lacks surface c-kit is not able to proliferate in response to SCF, undergoes apoptosis in the presence of SCF, and does not adhere to fibroblasts. These results confirm earlier studies on the functional consequences of c-kit and provide a novel

  16. Identification of influencing factors and strategies to improve communication between general practitioners and community nurses: a qualitative focus group study.

    PubMed

    Nieuwboer, Minke S; Perry, Marieke; van der Sande, Rob; Maassen, Irma T H M; Olde Rikkert, Marcel G M; van der Marck, Marjolein A

    2018-02-26

    As the number of patients with complex healthcare needs grows, inter-professional collaboration between primary care professionals must be constantly optimized. General practitioners (GPs) and community nurses (CNs) are key professions in primary care; however, poor GP-CN communication is common, and research into the factors influencing its quality is limited. To explore patient-related GP-CN communication and facilitating and hindering factors, and to identify strategies to enhance this communication. A qualitative focus group design was used to identify the facilitating and hindering factors and strategies for improvement. In a Dutch primary care setting, 6 mono-professional focus group interviews (3 meetings of 13 GPs; 3 meetings of 18 CNs) were organized between June 2015 and April 2016, recorded and transcribed verbatim. Two independent researchers performed the coding of these interviews, identifying their categories and themes. Results show that, despite the regular contact between GPs and CNs, communication was generally perceived as poor in effectiveness and efficiency by both professions. Mutual trust was considered the most important facilitating factor for effective communication. Profession-specific factors (e.g. differences in responsibility and profession-specific language) and organizational factors (e.g. lack of shared care plans, no in-person communication, lack of time) may be of influence on communication. Participants' suggestions for improvement included organizing well-structured and reimbursed team meetings and facilitating face-to-face contact. GP-CN patient-related communication benefits most from trusting inter-personal relationships. Inter-professional training programmes should address both professional and organizational factors and should be evaluated for their effect on quality of care.

  17. Plasma granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor levels in critical illness including sepsis and septic shock: relation to disease severity, multiple organ dysfunction, and mortality.

    PubMed

    Presneill, J J; Waring, P M; Layton, J E; Maher, D W; Cebon, J; Harley, N S; Wilson, J W; Cade, J F

    2000-07-01

    To define the circulating levels of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) during critical illness and to determine their relationship to the severity of illness as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the development of multiple organ dysfunction, or mortality. Prospective cohort study. University hospital intensive care unit. A total of 82 critically ill adult patients in four clinically defined groups, namely septic shock (n = 29), sepsis without shock (n = 17), shock without sepsis (n = 22), and nonseptic, nonshock controls (n = 14). None. During day 1 of septic shock, peak plasma levels of G-CSF, interleukin (IL)-6, and leukemia inhibitory factor (LIF), but not GM-CSF, were greater than in sepsis or shock alone (p < .001), and were correlated among themselves (rs = 0.44-0.77; p < .02) and with the APACHE II score (rs = 0.25-0.40; p = .03 to .18). G-CSF, IL-6, and UF, and sepsis, shock, septic shock, and APACHE II scores were strongly associated with organ dysfunction or 5-day mortality by univariate analysis. However, multiple logistic regression analysis showed that only septic shock remained significantly associated with organ dysfunction and only APACHE II scores and shock with 5-day mortality. Similarly, peak G-CSF, IL-6, and LIF were poorly predictive of 30-day mortality. Plasma levels of G-CSF, IL-6, and LIF are greatly elevated in critical illness, including septic shock, and are correlated with one another and with the severity of illness. However, they are not independently predictive of mortality, or the development of multiple organ dysfunction. GM-CSF was rarely elevated, suggesting different roles for G-CSF and GM-CSF in human septic shock.

  18. Factors supporting dentist leaders' retention in leadership.

    PubMed

    Tuononen, T; Lammintakanen, J; Suominen, A L

    2017-12-01

    The aim was to study factors associated with staying in a dentist leadership position. We used an electronic questionnaire to gather data from 156 current or former Finnish dentist leaders in 2014. Principal component analysis categorized statements regarding time usage and opportunities in managerial work into five main components. Associations between these main component scores and the tendency to stay as a leader were analyzed with logistic regression. Out of the five main components, two were significantly associated with staying as a leader: 'career intentions', which represented intent to continue or to leave the leadership position; and 'work time control opportunities', which represented how leaders could control their own work time. Other factors that supported staying were leadership education, more work time available for leadership work, and lower age. The main component 'work pressure' decreased, although not significantly, the odds of continuing; it included lack of leadership work time, and pressure from superiors or subordinates. Leaders have important roles in health care, ensuring everyday operations as well as developing their organizations to meet future challenges. Knowledge of these supporting factors will enable dentist leaders and their organizations to improve working conditions in order to recruit and retain motivated and competent persons. In addition, well-designed education is important to inspire and encourage future leaders. Copyright© 2017 Dennis Barber Ltd.

  19. Parental Suicidality as a Risk Factor for Delinquency among Hispanic Youth

    ERIC Educational Resources Information Center

    Jennings, Wesley G.; Maldonado-Molina, Mildred M.; Piquero, Alex R.; Canino, Glorisa

    2010-01-01

    Several studies have examined the factors associated with juvenile delinquency, but this literature remains limited largely because it has not moved beyond traditional factors generally and because of the lack of research conducted on minority--especially Hispanic--youth. This study seeks to overcome these two limitations by using data from a…

  20. Adult hematopoietic stem cells lacking Hif-1α self-renew normally

    PubMed Central

    Vukovic, Milica; Sepulveda, Catarina; Subramani, Chithra; Guitart, Amélie V.; Mohr, Jasmine; Allen, Lewis; Panagopoulou, Theano I.; Paris, Jasmin; Lawson, Hannah; Villacreces, Arnaud; Armesilla-Diaz, Alejandro; Gezer, Deniz; Holyoake, Tessa L.; Ratcliffe, Peter J.

    2016-01-01

    The hematopoietic stem cell (HSC) pool is maintained under hypoxic conditions within the bone marrow microenvironment. Cellular responses to hypoxia are largely mediated by the hypoxia-inducible factors, Hif-1 and Hif-2. The oxygen-regulated α subunits of Hif-1 and Hif-2 (namely, Hif-1α and Hif-2α) form dimers with their stably expressed β subunits and control the transcription of downstream hypoxia-responsive genes to facilitate adaptation to low oxygen tension. An initial study concluded that Hif-1α is essential for HSC maintenance, whereby Hif-1α–deficient HSCs lost their ability to self-renew in serial transplantation assays. In another study, we demonstrated that Hif-2α is dispensable for cell-autonomous HSC maintenance, both under steady-state conditions and following transplantation. Given these unexpected findings, we set out to revisit the role of Hif-1α in cell-autonomous HSC functions. Here we demonstrate that inducible acute deletion of Hif-1α has no impact on HSC survival. Notably, unstressed HSCs lacking Hif-1α efficiently self-renew and sustain long-term multilineage hematopoiesis upon serial transplantation. Finally, Hif-1α–deficient HSCs recover normally after hematopoietic injury induced by serial administration of 5-fluorouracil. We therefore conclude that despite the hypoxic nature of the bone marrow microenvironment, Hif-1α is dispensable for cell-autonomous HSC maintenance. PMID:27060169

  1. Factors Influencing the Choice of Anesthesia as a Career by Undergraduates of the University of Rwanda.

    PubMed

    Chan, Denise M; Wong, Rex; Runnels, Sean; Muhizi, Epaphrodite; McClain, Craig D

    2016-08-01

    Rwanda currently faces a severe shortage of trained medical personnel, including physician anesthesiologists. The recruitment of residents into the anesthesia program has been consistently low. This study aimed at determining the factors that influence undergraduates' decision to pursue anesthesia as a career choice. A questionnaire was created and administered to final year undergraduate medical students at the University of Rwanda. The questionnaire was created based on factors identified from literature review and key informant interviews. The questionnaire was translated, field-tested, and refined. The final survey questionnaire contains 27 4-point Likert scale items and 4 free-text questions. Seventy-nine final year undergraduate medical students responded to the survey. Only 2 students (2.5%) chose anesthesia as their top choice for postgraduate training. The most frequently named factors for not choosing anesthesiology were long work hours and high stress level, insufficient mentorship, and low job opportunity. The issues identified by our survey must be considered when making efforts toward increasing anesthesia recruitment in Rwanda. Factors such as lack of material resources and high workload will not be easily addressed. Others can be addressed through changes in medical student anesthesiology rotations and better mentorship by anesthesiologists during formative years. Focusing on factors that can be changed now may increase enrollment into anesthesiology. Future studies will include broadening the survey population and further investigating the influencing factors elucidated by this study.

  2. Outcomes and factors influencing prognosis in patients with vascular pythiosis.

    PubMed

    Sermsathanasawadi, Nuttawut; Praditsuktavorn, Banjerd; Hongku, Kiattisak; Wongwanit, Chumpol; Chinsakchai, Khamin; Ruangsetakit, Chanean; Hahtapornsawan, Suteekhanit; Mutirangura, Pramook

    2016-08-01

    Vascular pythiosis, caused by Pythium insidiosum, is associated with a high mortality rate. We reviewed the outcomes and established the factors predicting prognosis of patients treated in our institution with surgery, antifungal therapy, or immunotherapy. We undertook a retrospective record review of patients with vascular pythiosis treated in Siriraj Hospital, Bangkok, Thailand, between January 2005 and January 2015. Patient characteristics, type of surgery, adjunctive antifungal treatment, adjunctive immunotherapy, and disease status of surgical arterial and surrounding soft tissue margins were recorded. We calculated the mortality rate and established factors predicting prognosis. The records of 11 patients were reviewed. All patients had thalassemia. Nine patients (81.8%) had a history of contact with contaminated water. The clinical presentations were chronic ulcers (45.5%), toe gangrene (27.3%), pulsatile mass (27.3%), and acute limb ischemia (27.3%). Above-knee amputation was required in 10 patients (90.9%). The mortality rate was 36.4%. Independent variables between survivors and nonsurvivors were lack of an arterial disease-free surgical margin (P = .003), lack of a surrounding soft tissue disease-free surgical margin (P < .05), a suprainguinal lesion (P < .05) and duration of symptoms (P < .05). Adjuvant itraconazole, terbinafine, and Pythium vaccine have a role to play in patients with a disease-free arterial surgical margin but in whom infected surrounding soft tissue could not be completely excised. Achieving adequate disease-free surgical margins-especially the arterial margin-at amputation or débridement is the most important prognostic factor in patients with vascular pythiosis. Early detection combined with a multidisciplinary approach to treatment, including surgery, antifungal agents, and immunotherapy, allows the best possible outcome to be obtained. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights

  3. Factors Affecting Adherence to Osteoporosis Medications: A Focus Group Approach Examining Viewpoints of Patients and Providers

    PubMed Central

    Iversen, Maura D; Vora, Ruchita R; Servi, Amber; Solomon, Daniel H

    2011-01-01

    This is a qualitative study using a focus group approach, conducted to determine factors influencing adherence to osteoporosis medications among older adults. Thirty-two patients aged 65 to 85 years from the greater Boston area who were prescribed an osteoporosis medication, 11 general medicine physicians and 1 nurse practitioner were recruited from Boston based hospitals affiliated with a large healthcare system. Focus groups consisting of 6 to 8 subjects including males and females were held separately for providers and patients and conducted until thematic saturation was reached. Responses were obtained from patients and providers during the focus group interviews conducted by a trained focus group moderator. All interviews were audio taped and transcribed by a medical transcriptionist. According to patients, factors affecting adherence to osteoporosis drugs included lack of knowledge about osteoporosis, dissatisfaction with their doctor visits, side effects, and difficulty or failure to remember instructions for taking medications. Physicians reported lack of patient knowledge, structural barriers, medication side effects, and the inability to track patients’ adherence to their medications as barriers to adherence. This study identifies the extent of and reasons for non-adherence as perceived by patients and providers, and provides insights into strategies to modify treatment plans to address non-adherence. The results from this study were used to develop a RCT to conduct and evaluate patient and physician targeted interventions to improve adherence to osteoporosis medications and to examine cost effectiveness of alternative strategies. PMID:21937896

  4. Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China.

    PubMed

    Mi, Te; Sun, Shangwen; Du, Yifeng; Guo, Shougang; Cong, Lin; Cao, Mingfeng; Sun, Qinjian; Sun, Yi; Qu, Chuanqiang

    2016-05-01

    Considering the program of screening for risk factors of stroke in Eastern China, the aim of this study was to compare the distribution differences in risk factors for stroke among the high-risk population living in urban and rural areas. A total of 231,289 residents were screened and basic information collected. Risk factors for stroke among the high-risk population were compared between the urban and rural groups. A total of 117,776 high-risk residents from urban areas and 113,513 from rural areas were included in the analysis. The prevalence of hypertension was much higher in rural areas (73.3%) than that in urban areas (64.1%). Dyslipidemia (48.9% vs. 26.9%), sport lack (46.6% vs. 31.6%), diabetes mellitus (21.3% vs. 16.5%), and atrial fibrillation (18.7% vs. 9.8%) were more prevalent in the urban group, while smoking (26.5% vs. 28.8%), previous stroke (10.1% vs. 16.9%), and transient ischemic attack (20.9% vs. 24.6%) were less prevalent. Among the population at high risk of stroke, there were significant differences in the distribution of the following risk factors between the urban and rural groups: hypertension, atrial fibrillation, dyslipidemia, lack of physical exercise, and a previous stroke.

  5. Factors associated with mental health services referrals for children investigated by child welfare.

    PubMed

    Fong, Hiu-Fai; Alegria, Margarita; Bair-Merritt, Megan H; Beardslee, William

    2018-05-01

    Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers' decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed data from 1956 children 2-17 years old from the Second National Survey of Child and Adolescent Well-being. We examined associations of children's predisposing, enabling, and need-related factors and caseworkers' work environment characteristics with referral to mental health services. Caseworkers referred 21.0% of children to mental health services. In multivariable analyses controlling for potential covariates, factors associated with increased odds of caseworker referral included: older child age; child sexual abuse (versus neglect); child out-of-home placement; caregiver mental health problems; prior maltreatment reports; clinically significant child behavioral problems; and child welfare agency collaborative ties with mental health providers (all p < .05). Factors associated with decreased odds of caseworker referral included child Black race (versus White race) and lack of insurance (versus Private insurance) (all p < .05). In summary, children's need for mental health services was positively associated with caseworker referral to services but certain predisposing and enabling factors and caseworker work environment characteristics also correlated with services referral. Interventions to reduce disparities in services referral by race and insurance type are critically needed. These may include child welfare agency implementation of policies for mental health screening, assessment, and services referral based on clinical need and establishment of child welfare-mental health agency collaborative ties. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Factor Analysis of the Brazilian Version of UPPS Impulsive Behavior Scale

    PubMed Central

    Sediyama, Cristina Y. N.; Moura, Ricardo; Garcia, Marina S.; da Silva, Antonio G.; Soraggi, Carolina; Neves, Fernando S.; Albuquerque, Maicon R.; Whiteside, Setephen P.; Malloy-Diniz, Leandro F.

    2017-01-01

    Objective: To examine the internal consistency and factor structure of the Brazilian adaptation of the UPPS Impulsive Behavior Scale. Methods: UPPS is a self-report scale composed by 40 items assessing four factors of impulsivity: (a) urgency, (b) lack of premeditation; (c) lack of perseverance; (d) sensation seeking. In the present study 384 participants (278 women and 106 men), who were recruited from schools, universities, leisure centers and workplaces fulfilled the UPPS scale. An exploratory factor analysis was performed by using Varimax factor rotation and Kaiser Normalization, and we also conducted two confirmatory analyses to test the independency of the UPPS components found in previous analysis. Results: Results showed a decrease in mean UPPS total scores with age and this analysis showed that the youngest participants (below 30 years) scored significantly higher than the other groups over 30 years. No difference in gender was found. Cronbach’s alpha, results indicated satisfactory values for all subscales, with similar high values for the subscales and confirmatory factor analysis indexes also indicated a poor model fit. The results of two exploratory factor analysis were satisfactory. Conclusion: Our results showed that the Portuguese version has the same four-factor structure of the original and previous translations of the UPPS. PMID:28484414

  7. Factor Analysis of the Brazilian Version of UPPS Impulsive Behavior Scale.

    PubMed

    Sediyama, Cristina Y N; Moura, Ricardo; Garcia, Marina S; da Silva, Antonio G; Soraggi, Carolina; Neves, Fernando S; Albuquerque, Maicon R; Whiteside, Setephen P; Malloy-Diniz, Leandro F

    2017-01-01

    Objective: To examine the internal consistency and factor structure of the Brazilian adaptation of the UPPS Impulsive Behavior Scale. Methods: UPPS is a self-report scale composed by 40 items assessing four factors of impulsivity: (a) urgency, (b) lack of premeditation; (c) lack of perseverance; (d) sensation seeking. In the present study 384 participants (278 women and 106 men), who were recruited from schools, universities, leisure centers and workplaces fulfilled the UPPS scale. An exploratory factor analysis was performed by using Varimax factor rotation and Kaiser Normalization, and we also conducted two confirmatory analyses to test the independency of the UPPS components found in previous analysis. Results: Results showed a decrease in mean UPPS total scores with age and this analysis showed that the youngest participants (below 30 years) scored significantly higher than the other groups over 30 years. No difference in gender was found. Cronbach's alpha, results indicated satisfactory values for all subscales, with similar high values for the subscales and confirmatory factor analysis indexes also indicated a poor model fit. The results of two exploratory factor analysis were satisfactory. Conclusion: Our results showed that the Portuguese version has the same four-factor structure of the original and previous translations of the UPPS.

  8. Factors Affecting Job Motivation among Health Workers: A Study From Iran

    PubMed Central

    Daneshkohan, Abbas; Zarei, Ehsan; Mansouri, Tahere; Maajani, Khadije; Ghasemi, Mehri Siyahat; Rezaeian, Mohsen

    2015-01-01

    Objective: Human resources are the most vital resource of any organizations which determine how other resources are used to accomplish organizational goals. This research aimed to identity factors affecting health workers’ motivation in Shahid Beheshti University of Medical Sciences (SBUMS). Method: This is a cross-sectional survey conducted with participation of 212 health workers of Tehran health centers in November and December 2011. The data collection tool was a researcher-developed questionnaire that included 17 motivating factors and 6 demotivating factors and 8 questions to assess the current status of some factors. Validity and reliability of the tool were confirmed. Data were analyzed with descriptive and analytical statistical tests. Results: The main motivating factors for health workers were good management, supervisors and managers’ support and good working relationship with colleagues. On the other hand, unfair treatment, poor management and lack of appreciation were the main demotivating factors. Furthermore, 47.2% of health workers believed that existing schemes for supervision were unhelpful in improving their performance. Conclusion: Strengthening management capacities in health services can increase job motivation and improve health workers’ performance. The findings suggests that special attention should be paid to some aspects such as management competencies, social support in the workplace, treating employees fairly and performance management practices, especially supervision and performance appraisal. PMID:25948438

  9. Constructing the tree-level Yang-Mills S-matrix using complex factorization

    NASA Astrophysics Data System (ADS)

    Schuster, Philip C.; Toro, Natalia

    2009-06-01

    A remarkable connection between BCFW recursion relations and constraints on the S-matrix was made by Benincasa and Cachazo in 0705.4305, who noted that mutual consistency of different BCFW constructions of four-particle amplitudes generates non-trivial (but familiar) constraints on three-particle coupling constants — these include gauge invariance, the equivalence principle, and the lack of non-trivial couplings for spins > 2. These constraints can also be derived with weaker assumptions, by demanding the existence of four-point amplitudes that factorize properly in all unitarity limits with complex momenta. From this starting point, we show that the BCFW prescription can be interpreted as an algorithm for fully constructing a tree-level S-matrix, and that complex factorization of general BCFW amplitudes follows from the factorization of four-particle amplitudes. The allowed set of BCFW deformations is identified, formulated entirely as a statement on the three-particle sector, and using only complex factorization as a guide. Consequently, our analysis based on the physical consistency of the S-matrix is entirely independent of field theory. We analyze the case of pure Yang-Mills, and outline a proof for gravity. For Yang-Mills, we also show that the well-known scaling behavior of BCFW-deformed amplitudes at large z is a simple consequence of factorization. For gravity, factorization in certain channels requires asymptotic behavior ~ 1/z2.

  10. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.

    PubMed

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-11-17

    assessed study quality, and another review author checked the data. We synthesised data using the best fit framework synthesis approach and assessed confidence in the evidence using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether the factors identified by health workers in our synthesis as important for providing maternity care were reflected in the interventions evaluated in the studies in a related intervention review. We included 31 studies that explored the views and experiences of different types of SBAs, including doctors, midwives, nurses, auxiliary nurses and their managers. The included studies took place in Africa, Asia, and Latin America.Our synthesis pointed to a number of factors affecting SBAs' provision of quality care. The following factors were based on evidence assessed as of moderate to high confidence. Skilled birth attendants reported that they were not always given sufficient training during their education or after they had begun clinical work. Also, inadequate staffing of facilities could increase the workloads of skilled birth attendants, make it difficult to provide supervision and result in mothers being offered poorer care. In addition, SBAs did not always believe that their salaries and benefits reflected their tasks and responsibilities and the personal risks they undertook. Together with poor living and working conditions, these issues were seen to increase stress and to negatively affect family life. Some SBAs also felt that managers lacked capacity and skills, and felt unsupported when their workplace concerns were not addressed.Possible causes of staff shortages in facilities included problems with hiring and assigning health workers to facilities where they were needed; lack of funding; poor management and bureaucratic systems; and low salaries. Skilled birth attendants and their managers suggested factors that could help recruit, keep, and motivate

  11. Speed and Accuracy of Rapid Speech Output by Adolescents with Residual Speech Sound Errors Including Rhotics

    ERIC Educational Resources Information Center

    Preston, Jonathan L.; Edwards, Mary Louise

    2009-01-01

    Children with residual speech sound errors are often underserved clinically, yet there has been a lack of recent research elucidating the specific deficits in this population. Adolescents aged 10-14 with residual speech sound errors (RE) that included rhotics were compared to normally speaking peers on tasks assessing speed and accuracy of speech…

  12. Fibroblast growth factor receptor signaling is essential for lens fiber cell differentiation.

    PubMed

    Zhao, Haotian; Yang, Tianyu; Madakashira, Bhavani P; Thiels, Cornelius A; Bechtle, Chad A; Garcia, Claudia M; Zhang, Huiming; Yu, Kai; Ornitz, David M; Beebe, David C; Robinson, Michael L

    2008-06-15

    The vertebrate lens provides an excellent model to study the mechanisms that regulate terminal differentiation. Although fibroblast growth factors (FGFs) are thought to be important for lens cell differentiation, it is unclear which FGF receptors mediate these processes during different stages of lens development. Deletion of three FGF receptors (Fgfr1-3) early in lens development demonstrated that expression of only a single allele of Fgfr2 or Fgfr3 was sufficient for grossly normal lens development, while mice possessing only a single Fgfr1 allele developed cataracts and microphthalmia. Profound defects were observed in lenses lacking all three Fgfrs. These included lack of fiber cell elongation, abnormal proliferation in prospective lens fiber cells, reduced expression of the cell cycle inhibitors p27(kip1) and p57(kip2), increased apoptosis and aberrant or reduced expression of Prox1, Pax6, c-Maf, E-cadherin and alpha-, beta- and gamma-crystallins. Therefore, while signaling by FGF receptors is essential for lens fiber differentiation, different FGF receptors function redundantly.

  13. Increased Alzheimer's disease-like pathology in the APP/ PS1ΔE9 mouse model lacking Nrf2 through modulation of autophagy.

    PubMed

    Joshi, Gururaj; Gan, Kok Ann; Johnson, Delinda A; Johnson, Jeffrey A

    2015-02-01

    The presence of senile plaques is one of the major pathologic hallmarks of the brain with Alzheimer's disease (AD). The plaques predominantly contain insoluble amyloid β-peptide, a cleavage product of the larger amyloid precursor protein (APP). Two enzymes, named β and γ secretase, generate the neurotoxic amyloid-β peptide from APP. Mature APP is also turned over endogenously by autophagy, more specifically by the endosomal-lysosomal pathway. A defective lysosomal system is known to be pathogenic in AD. Modulation of NF-E2 related factor 2 (Nrf2) has been shown in several neurodegenerative disorders, and Nrf2 has become a potential therapeutic target for various neurodegenerative disorders, including AD, Parkinson's disease, and amyotrophic lateral sclerosis. In the current study, we explored the effect of genetic ablation of Nrf2 on APP/Aβ processing and/or aggregation as well as changes in autophagic dysfunction in APP/PS1 mice. There was a significant increase in inflammatory response in APP/PS1 mice lacking Nrf2. This was accompanied by increased intracellular levels of APP, Aβ (1-42), and Aβ (1-40), without a change total full-length APP. There was a shift of APP and Aβ into the insoluble fraction, as well as increased poly-ubiquitin conjugated proteins in mice lacking Nrf2. APP/PS1-mediated autophagic dysfunction is also enhanced in Nrf2-deficient mice. Finally, neurons in the APP/PS1/Nrf2-/- mice had increased accumulation of multivesicular bodies, endosomes, and lysosomes. These outcomes provide a better understanding of the role of Nrf2 in modulating autophagy in an AD mouse model and may help design better Nrf2 targeted therapeutics that could be efficacious in the treatment of AD. Published by Elsevier Inc.

  14. Lack of serotonin1B receptor expression leads to age-related motor dysfunction, early onset of brain molecular aging and reduced longevity.

    PubMed

    Sibille, E; Su, J; Leman, S; Le Guisquet, A M; Ibarguen-Vargas, Y; Joeyen-Waldorf, J; Glorioso, C; Tseng, G C; Pezzone, M; Hen, R; Belzung, C

    2007-11-01

    Normal aging of the brain differs from pathological conditions and is associated with increased risk for psychiatric and neurological disorders. In addition to its role in the etiology and treatment of mood disorders, altered serotonin (5-HT) signaling is considered a contributing factor to aging; however, no causative role has been identified in aging. We hypothesized that a deregulation of the 5-HT system would reveal its contribution to age-related processes and investigated behavioral and molecular changes throughout adult life in mice lacking the regulatory presynaptic 5-HT(1B) receptor (5-HT(1B)R), a candidate gene for 5-HT-mediated age-related functions. We show that the lack of 5-HT(1B)R (Htr1b(KO) mice) induced an early age-related motor decline and resulted in decreased longevity. Analysis of life-long transcriptome changes revealed an early and global shift of the gene expression signature of aging in the brain of Htr1b(KO) mice. Moreover, molecular changes reached an apparent maximum effect at 18-months in Htr1b(KO) mice, corresponding to the onset of early death in that group. A comparative analysis with our previous characterization of aging in the human brain revealed a phylogenetic conservation of age-effect from mice to humans, and confirmed the early onset of molecular aging in Htr1b(KO) mice. Potential mechanisms appear independent of known central mechanisms (Bdnf, inflammation), but may include interactions with previously identified age-related systems (IGF-1, sirtuins). In summary, our findings suggest that the onset of age-related events can be influenced by altered 5-HT function, thus identifying 5-HT as a modulator of brain aging, and suggesting age-related consequences to chronic manipulation of 5-HT.

  15. [Similarities between disaster areas and developing countries in terms of the lack of facilities for clinical examinations].

    PubMed

    Suganami, Shigeru

    2012-03-01

    From the experience of more than 130 emergency medical relief missions in over 50 countries/areas, the AMDA would like to propose a system of mobile clinical examinations to prepare for possible natural disasters in Japan. Such a system will require the development of vehicles equipped with a full range of laboratory equipment, which I believe will become a public property in the world, and contribute to the enhancement of medical services in disaster areas as well as in areas with less developed medical technologies. AMDA's recent medical relief activities include the support of the victims of the earthquakes in Haiti (2010) and Turkey (2011), and the flood in Thailand (2012). In these countries, the AMDA faced the lack of a clinical examination system which resulted in a huge number of patients who could not receive proper treatment after injury, or those who suffered from infectious diseases. Domestically, when the AMDA sent medical teams to the affected areas of the Great East Japan Earthquake and tsunami (2011), their activities took place mainly in evacuation shelters, where survivors needed treatment for chronic diseases and preventive care. All of these experiences highlight the importance of clinical examination in disaster areas, as well as in developing countries/areas similarly lacking basic medical services. The Japanese Society of Laboratory Medicine will surely play an important role in the development of the proposed system of mobile clinical examinations. The AMDA would like to collaborate with the JSLM in emergency relief activities and medical aid projects in areas affected by disasters or lack basic medical services.

  16. Determination of velocity correction factors for real-time air velocity monitoring in underground mines.

    PubMed

    Zhou, Lihong; Yuan, Liming; Thomas, Rick; Iannacchione, Anthony

    2017-12-01

    When there are installations of air velocity sensors in the mining industry for real-time airflow monitoring, a problem exists with how the monitored air velocity at a fixed location corresponds to the average air velocity, which is used to determine the volume flow rate of air in an entry with the cross-sectional area. Correction factors have been practically employed to convert a measured centerline air velocity to the average air velocity. However, studies on the recommended correction factors of the sensor-measured air velocity to the average air velocity at cross sections are still lacking. A comprehensive airflow measurement was made at the Safety Research Coal Mine, Bruceton, PA, using three measuring methods including single-point reading, moving traverse, and fixed-point traverse. The air velocity distribution at each measuring station was analyzed using an air velocity contour map generated with Surfer ® . The correction factors at each measuring station for both the centerline and the sensor location were calculated and are discussed.

  17. Determination of velocity correction factors for real-time air velocity monitoring in underground mines

    PubMed Central

    Yuan, Liming; Thomas, Rick; Iannacchione, Anthony

    2017-01-01

    When there are installations of air velocity sensors in the mining industry for real-time airflow monitoring, a problem exists with how the monitored air velocity at a fixed location corresponds to the average air velocity, which is used to determine the volume flow rate of air in an entry with the cross-sectional area. Correction factors have been practically employed to convert a measured centerline air velocity to the average air velocity. However, studies on the recommended correction factors of the sensor-measured air velocity to the average air velocity at cross sections are still lacking. A comprehensive airflow measurement was made at the Safety Research Coal Mine, Bruceton, PA, using three measuring methods including single-point reading, moving traverse, and fixed-point traverse. The air velocity distribution at each measuring station was analyzed using an air velocity contour map generated with Surfer®. The correction factors at each measuring station for both the centerline and the sensor location were calculated and are discussed. PMID:29201495

  18. The association between insured male expatriates' knowledge of health insurance benefits and lack of access to health care in Saudi Arabia.

    PubMed

    Alkhamis, Abdulwahab A

    2018-03-15

    Insufficient knowledge of health insurance benefits could be associated with lack of access to health care, particularly for minority populations. This study aims to assess the association between expatriates' knowledge of health insurance benefits and lack of access to health care. A cross-sectional study design was conducted from March 2015 to February 2016 among 3398 insured male expatriates in Riyadh, Saudi Arabia. The dependent variable was binary and expresses access or lack of access to health care. Independent variables included perceived and validated knowledge of health insurance benefits and other variables. Data were summarized by computing frequencies and percentage of all quantities of variables. To evaluate variations in knowledge, personal and job characteristics with lack of access to health care, the Chi square test was used. Odds ratio (OR) and 95% confidence interval (CI) were recorded for each independent variable. Multiple logistic regression and stepwise logistic regression were performed and adjusted ORs were extracted. Descriptive analysis showed that 15% of participants lacked access to health care. The majority of these were unskilled laborers, usually with no education (17.5%), who had been working for less than 3 years (28.1%) in Saudi Arabia. A total of 23.3% worked for companies with less than 50 employees and 16.5% earned less than 4500 Saudi Riyals monthly ($1200). Many (20.3%) were young (< 30 years old) or older (17.9% ≥ 56 years old) and had no formal education (24.7%). Nearly half had fair or poor health status (49.5%), were uncomfortable conversing in Arabic (29.7%) or English (16.7%) and lacked previous knowledge of health insurance (18%). For perceived knowledge of health insurance, 55.2% scored 1 or 0 from total of 3. For validated knowledge, 16.9% scored 1 or 0 from total score of 4. Multiple logistic regression analysis showed that only perceived knowledge of health insurance had significant associations with lack

  19. Risk factors for intimate partner violence in women in the Rakai Community Cohort Study, Uganda, from 2000 to 2009

    PubMed Central

    2013-01-01

    Background Intimate partner violence (IPV) is a significant public health problem. There is a lack of data on IPV risk factors from longitudinal studies and from low and middle income countries. Identifying risk factors is needed to inform the design of appropriate IPV interventions. Methods Data were from the Rakai Community Cohort Study annual surveys between 2000 and 2009. Female participants who had at least one sexual partner during this period and had data on IPV over the study period were included in analyses (N = 15081). Factors from childhood and early adulthood as well as contemporary factors were considered in separate models. Logistic regression was used to assess early risk factors for IPV during the study period. Longitudinal data analysis was used to assess contemporary risk factors in the past year for IPV in the current year, using a population-averaged multivariable logistic regression model. Results Risk factors for IPV from childhood and early adulthood included sexual abuse in childhood or adolescence, earlier age at first sex, lower levels of education, and forced first sex. Contemporary risk factors included younger age, being married, relationships of shorter duration, having a partner who is the same age or younger, alcohol use before sex by women and by their partners, and thinking that violence is acceptable. HIV infection and pregnancy were not associated with an increased odds of IPV. Conclusions Using longitudinal data, this study identified a number of risk factors for IPV. These findings are useful for the development of prevention strategies to prevent and mitigate IPV in women. PMID:23759123

  20. Attitudes to lifestyle risk factors for coronary heart disease amongst South Asians in Leicester: a focus group study.

    PubMed

    Farooqi, A; Nagra, D; Edgar, T; Khunti, K

    2000-08-01

    South Asians have a significantly higher risk of mortality from coronary heart disease (CHD) compared with the general population in the UK. There is a lack of evidence on attitudes to and knowledge of risk factors for CHD amongst South Asians. Such information is important for the provision of effective health promotion services. The aim of the study was to identify key issues relating to knowledge of and attitudes to lifestyle risk factors for CHD amongst South Asians aged over 40 years in Leicester, UK. A qualitative focus group analysis was carried out using randomly selected South Asians from GP lists and South Asians attending community centres. Group discussions were taped, translated and transcribed. The transcripts were analysed using qualitative methodology to identify key issues and themes. Participants expressed a range of attitudes to and different levels of knowledge of lifestyle risk factors for CHD. Barriers to improving lifestyle with respect to diet and exercise were identified; these included lack of information (e.g. of how to cook traditional Indian food more healthily) and cultural barriers, such as lack of women-only exercise facilities. Participants perceived stress as an important cause of CHD, and stress directly related to ethnic minority status was described frequently. Language was identified as a key barrier to accessing health services. Health professionals need to provide individually tailored health promotion for South Asians which avoids stereotyping, but recognizes potential cultural obstacles to change. The issue of stress amongst South Asians requires more research and needs to be recognized as an important issue by health professionals. South Asians still face problems accessing health and leisure services due to language and cultural issues.

  1. Including adverse drug events in economic evaluations of anti-tumour necrosis factor-α drugs for adult rheumatoid arthritis: a systematic review of economic decision analytic models.

    PubMed

    Heather, Eleanor M; Payne, Katherine; Harrison, Mark; Symmons, Deborah P M

    2014-02-01

    Anti-tumour necrosis factor-α drugs (anti-TNFs) have revolutionised the treatment of rheumatoid arthritis (RA). More effective than standard non-biological disease-modifying anti-rheumatic drugs (nbDMARDs), anti-TNFs are also substantially more expensive. Consequently, a number of model-based economic evaluations have been conducted to establish the relative cost-effectiveness of anti-TNFs. However, anti-TNFs are associated with an increased risk of adverse drug events (ADEs) such as serious infections relative to nbDMARDs. Such ADEs will likely impact on both the costs and consequences of anti-TNFs, for example, through hospitalisations and forced withdrawal from treatment. The aim of this review was to identify and critically appraise if, and how, ADEs have been incorporated into model-based cost-effectiveness analyses of anti-TNFs for adult patients with RA. A systematic literature review was performed. Electronic databases (Ovid MEDLINE; Ovid EMBASE; Web of Science; NHS Economic Evaluations Database) were searched for literature published between January 1990 and October 2013 using electronic search strategies. The reference lists of retrieved studies were also hand searched. In addition, the National Institute for Health and Care Excellence technology appraisals were searched to identify economic models used to inform UK healthcare decision making. Only full economic evaluations that had used an economic model to evaluate biological DMARDs (bDMARDs) (including anti-TNFs) for adult patients with RA and had incorporated the direct costs and/or consequences of ADEs were critically appraised. To be included, studies also had to be available as a full text in English. Data extracted included general study characteristics and information concerning the methods used to incorporate ADEs and any associated assumptions made. The extracted data were synthesised using a tabular and narrative format. A total of 43 model-based economic evaluations of bDMARDs for adult RA

  2. Iatrogenic effects of psychosocial interventions: treatment, life context, and personal risk factors.

    PubMed

    Moos, Rudolf H

    2012-01-01

    Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.

  3. Factors associated with help-seeking behaviour among individuals with major depression: A systematic review

    PubMed Central

    Magaard, Julia Luise; Seeralan, Tharanya; Schulz, Holger; Brütt, Anna Levke

    2017-01-01

    Psychological models can help to understand why many people suffering from major depression do not seek help. Using the ‘Behavioral Model of Health Services Use’, this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed. PMID:28493904

  4. Factors associated with help-seeking behaviour among individuals with major depression: A systematic review.

    PubMed

    Magaard, Julia Luise; Seeralan, Tharanya; Schulz, Holger; Brütt, Anna Levke

    2017-01-01

    Psychological models can help to understand why many people suffering from major depression do not seek help. Using the 'Behavioral Model of Health Services Use', this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed.

  5. Failures of metacognition and lack of insight in neuropsychiatric disorders

    PubMed Central

    David, Anthony S.; Bedford, Nicholas; Wiffen, Ben; Gilleen, James

    2012-01-01

    Lack of insight or unawareness of illness are the hallmarks of many psychiatric disorders, especially schizophrenia (SCZ) and other psychoses and could be conceived of as a failure in metacognition. Research in this area in the mental health field h as burgeoned with the development and widespread use of standard assessment instruments and the mapping out of the clinical and neuropsychological correlates of insight and its loss. There has been a growing appreciation of the multi-faceted nature of the concept and of the different ‘objects’ of insight, such as the general awareness that one is ill, to more specific metacognitive awareness of individual symptoms, impairments and performance. This in turn has led to the notion that insight may show modularity and may fractionate across different domains and disorders, supported by work that directly compares metacognition of memory deficits and illness awareness in patients with SCZ, Alzheimer's disease and brain injury. The focus of this paper will be on the varieties of metacognitive failure in psychiatry, particularly the psychoses. We explore cognitive models based on self-reflectiveness and their possible social and neurological bases, including data from structural and functional MRI. The medial frontal cortex appears to play an important role in self-appraisal in health and disease. PMID:22492754

  6. Human Factors Effecting Forensic Decision Making: Workplace Stress and Well-being.

    PubMed

    Jeanguenat, Amy M; Dror, Itiel E

    2018-01-01

    Over the past decade, there has been a growing openness about the importance of human factors in forensic work. However, most of it focused on cognitive bias, and neglected issues of workplace wellness and stress. Forensic scientists work in a dynamic environment that includes common workplace pressures such as workload volume, tight deadlines, lack of advancement, number of working hours, low salary, technology distractions, and fluctuating priorities. However, in addition, forensic scientists also encounter a number of industry-specific pressures, such as technique criticism, repeated exposure to crime scenes or horrific case details, access to funding, working in an adversarial legal system, and zero tolerance for "errors". Thus, stress is an important human factor to mitigate for overall error management, productivity and decision quality (not to mention the well-being of the examiners themselves). Techniques such as mindfulness can become powerful tools to enhance work and decision quality. © 2017 American Academy of Forensic Sciences.

  7. The General Factor of Personality: A General Critique.

    PubMed

    Revelle, William; Wilt, Joshua

    2013-10-01

    Recently, it has been proposed that all non-cognitive measures of personality share a general factor of personality. A problem with many of these studies is a lack of clarity in defining a general factor. In this paper we address the multiple ways in which a general factor has been identified and argue that many of these approaches find factors that are not in fact general. Through the use of artificial examples, we show that a general factor is not: The first factor or component of a correlation or covariance matrix.The first factor resulting from a bifactor rotation or biquartimin transformationNecessarily the result of a confirmatory factor analysis forcing a bifactor solution We consider how the definition of what constitutes a general factor can lead to confusion, and we will demonstrate alternative ways of estimating the general factor saturation that are more appropriate.

  8. The General Factor of Personality: A General Critique

    PubMed Central

    Revelle, William; Wilt, Joshua

    2013-01-01

    Recently, it has been proposed that all non-cognitive measures of personality share a general factor of personality. A problem with many of these studies is a lack of clarity in defining a general factor. In this paper we address the multiple ways in which a general factor has been identified and argue that many of these approaches find factors that are not in fact general. Through the use of artificial examples, we show that a general factor is not: The first factor or component of a correlation or covariance matrix.The first factor resulting from a bifactor rotation or biquartimin transformationNecessarily the result of a confirmatory factor analysis forcing a bifactor solution We consider how the definition of what constitutes a general factor can lead to confusion, and we will demonstrate alternative ways of estimating the general factor saturation that are more appropriate. PMID:23956474

  9. Impact of intravitreal pharmacotherapies including antivascular endothelial growth factor and corticosteroid agents on diabetic retinopathy.

    PubMed

    Wykoff, Charles C

    2017-05-01

    Diabetic retinopathy is common and increasing in prevalence. Pharmacologic management of diabetic macular edema (DME) has improved tremendously over the last decade with the use of two families of intravitreally administered medications: antivascular endothelial growth factor-specific agents and corticosteroids. Clinical evaluation of these pharmaceuticals has demonstrated that they can have a substantial impact on diabetic retinopathy severity levels and the underlying retinal vasculature itself. Phase 3 trials employing ranibizumab, aflibercept, and fluocinolone acetonide enrolling eyes with center-involving DME causing visual acuity loss have demonstrated impressive alteration of the natural history of progressive diabetic retinopathy worsening over time through blunted progression to proliferative diabetic retinopathy, improving diabetic retinopathy severity levels, and slowing progressive retinal nonperfusion, the underlying disease process central to diabetic retinopathy itself. Accumulating data indicate that the threshold to initiate ocular-specific pharmacologic treatment for diabetic retinopathy, previously predominately limited to eyes with visual loss because of center-involved DME or proliferative diabetic retinopathy, is being lowered to earlier stages of diabetic retinopathy. Ongoing clinical trials and secondary analyses continue to further explore the impact and durability of vascular endothelial growth factor blockade and corticosteroids on modification of diabetic retinopathy and the underlying retinal vasculature itself.

  10. Lack of activity of cadmium in in vitro estrogenicity assays

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

    Silva, Elisabete; Lopez-Espinosa, Maria Jose; Molina-Molina, Jose-Manuel

    2006-10-01

    Prompted by reports about strong estrogenic effects of cadmium, attempts were made to reproduce these observations using the yeast estrogen screen (YES) and the E-Screen assays. For the first time, possible activation of the Src/MAPK pathway was also investigated. In the YES, only a slight activation (10% of a maximal effect) of the estrogen receptor alpha (ER{alpha}) was observed at cadmium concentrations between 5 x 10{sup -7} M and 5 x 10{sup -6} M. In the E-Screen assay, carried out by two laboratories, the heavy metal was without observable cell proliferative effects when tested in the range between 6 xmore » 10{sup -11} M and 1 x 10{sup -5} M. However, in both assays, cadmium led to a reduction of the effects of 17{beta}-estradiol (E2). Treatment of MCF-7 human breast cancer cells with 1 x 10{sup -7} M cadmium failed to induce phosphorylation of Src and the MAP kinases Erk1 and Erk2-effects shown to occur with E2 and epidermal growth factor (EGF). In summary, we were unable to confirm the strong estrogenicity of cadmium reported recently by a number of laboratories. This apparent absence of effects in our hands is not due to a lack of uptake of the metal or to effective protection against cadmium by high levels of glutathione or metallothionein, since toxicity and an antagonism of E2 responses were observed both in the YES and the E-Screen.« less

  11. Extrapolation, uncertainty factors, and the precautionary principle.

    PubMed

    Steel, Daniel

    2011-09-01

    This essay examines the relationship between the precautionary principle and uncertainty factors used by toxicologists to estimate acceptable exposure levels for toxic chemicals from animal experiments. It shows that the adoption of uncertainty factors in the United States in the 1950s can be understood by reference to the precautionary principle, but not by cost-benefit analysis because of a lack of relevant quantitative data at that time. In addition, it argues that uncertainty factors continue to be relevant to efforts to implement the precautionary principle and that the precautionary principle should not be restricted to cases involving unquantifiable hazards. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Ethnic identity: Factor structure and measurement invariance across ethnic groups.

    PubMed

    Feitosa, Jennifer; Lacerenza, Christina N; Joseph, Dana L; Salas, Eduardo

    2017-09-01

    Considering a historically diversified (and growing) population in the United States, one's ethnic identification is often an important psychological-as well as social and political-construct because it can serve as a hindrance to interpersonal interaction. Despite the importance of ethnic identity in psychological research, the most widely developed ethnic identity measurement tool, the Multigroup Ethnic Identity Measure (MEIM; Phinney, 1992), lacks consensus regarding its psychometric properties. The purpose of this article is to identify the factor structure of this measure and identify whether it exhibits measurement equivalence/invariance (ME/I) across ethnicities. The current findings offer several contributions to the state of the literature. First, our data suggests a two-factor model, including affirmation/commitment and exploration factors, is the most appropriate structure when considering fit and parsimony indices via confirmatory factor analysis. Second, configural and metric measurement equivalence was found across Caucasian and non-Caucasian participants. Interestingly, partial scalar invariance was established when comparing Caucasians with the minority groups with the exception of the Hispanic subgroup, which exhibited no scalar invariance. Third, differences in ethnic identity factor means were found, especially across Caucasians and African Americans. In conclusion, the use of the two-factor model of the MEIM is recommended, and results suggest that the MEIM is an appropriate measure of ethnic identity in most ethnic groups. Limitations and future research are also discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Some anemonefish lack personality: a comparative assessment of behavioral variation and repeatability in relation to environmental and social factors

    NASA Astrophysics Data System (ADS)

    Wong, Marian Y. L.; Beasley, Amanda L.; Douglass, Tasman; Whalan, Steve; Scott, Anna

    2017-12-01

    Determining the extent of repeatable differences in the behavior of animals and the factors that influence behavioral expression is important for understanding individual fitness and population processes, thereby aiding in species conservation. However, little is known about the causes of variation in the repeatability of behavioral differences among species because rarely have comparative studies been undertaken to examine the repeatability of behavioral differences among individuals within their natural ecological settings. Using two species of endemic subtropical anemonefishes, Amphiprion mccullochi and A. latezonatus at Lord Howe and North Solitary Islands, Australia, we conducted an in situ comparative analysis of personality traits, examining the repeatability of boldness, sociability and aggression as well as the potential role of environmental and social factors on behavioral expression. For A. mccullochi, only boldness and aggression were highly repeatable and these behaviors formed a behavioral syndrome. For A. latezonatus, none of the three behaviors were repeatable due to low-inter-individual variation in behavior. We suggest that the harsher and more variable environmental and social conditions experienced by A. latezonatus have resulted in reduced repeatability in behavior, in contrast to A. mccullochi which typically inhabits a more stable lagoonal reef environment. Additionally, group size and size rank, rather than nearest-neighbor distance and anemone size, influenced the expression of these behaviors in both species, suggesting that behavioral variation was more sensitive to social than environmental factors. Overall, differences in repeatability between these closely related species likely reflect adaptations to contrasting environmental and social conditions, although alternative explanations must be considered. The differences in behavioral consistency between these two endemic anemonefishes could lead to disparity in their resilience to

  14. Central nervous system-specific knockout of steroidogenic factor 1 results in increased anxiety-like behavior.

    PubMed

    Zhao, Liping; Kim, Ki Woo; Ikeda, Yayoi; Anderson, Kimberly K; Beck, Laurel; Chase, Stephanie; Tobet, Stuart A; Parker, Keith L

    2008-06-01

    Steroidogenic factor 1 (SF-1) plays key roles in adrenal and gonadal development, expression of pituitary gonadotropins, and development of the ventromedial hypothalamic nucleus (VMH). If kept alive by adrenal transplants, global knockout (KO) mice lacking SF-1 exhibit delayed-onset obesity and decreased locomotor activity. To define specific roles of SF-1 in the VMH, we used the Cre-loxP system to inactivate SF-1 in a central nervous system (CNS)-specific manner. These mice largely recapitulated the VMH structural defect seen in mice lacking SF-1 in all tissues. In multiple behavioral tests, mice with CNS-specific KO of SF-1 had significantly more anxiety-like behavior than wild-type littermates. The CNS-specific SF-1 KO mice had diminished expression or altered distribution in the mediobasal hypothalamus of several genes whose expression has been linked to stress and anxiety-like behavior, including brain-derived neurotrophic factor, the type 2 receptor for CRH (Crhr2), and Ucn 3. Moreover, transfection and EMSAs support a direct role of SF-1 in Crhr2 regulation. These findings reveal important roles of SF-1 in the hypothalamic expression of key regulators of anxiety-like behavior, providing a plausible molecular basis for the behavioral effect of CNS-specific KO of this nuclear receptor.

  15. 31 CFR 240.18 - Lack of authority to shift liability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Lack of authority to shift liability. 240.18 Section 240.18 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... depositor(s) under authority of state law. (b) A financial institution's liability under this part is not...

  16. Exposure to psychosocial risk factors in the context of work: a systematic review

    PubMed Central

    Fernandes, Cláudia; Pereira, Anabela

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the scientific literature about the effects of exposure to psychosocial risk factors in work contexts. METHODS A systematic review was performed using the terms “psychosocial factors” AND “COPSOQ” in the databases PubMed, Medline, and Scopus. The period analyzed was from January 1, 2004 to June 30, 2012. We have included articles that used the Copenhagen Psychosocial Questionnaire (COPSOQ) as a measuring instrument of the psychosocial factors and the presentation of quantitative or qualitative results. German articles, psychometric studies or studies that did not analyze individual or work factors were excluded. RESULTS We included 22 articles in the analysis. Individual factors, such as gender, age, and socioeconomic status, were analyzed along with work-related factors such as labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, justice and respect, personality, health and well-being, and offensive behaviors. We analyzed the sample type and the applied experimental designs. Some population groups, such as young people and migrants, are more vulnerable. The deteriorated working psychosocial environment is associated with physical health indicators and weak mental health. This environment is also a risk factor for the development of moderate to severe clinical conditions, predicting absenteeism or intention of leaving the job. CONCLUSIONS The literature shows the contribution of exposure to psychosocial risk factors in work environments and their impact on mental health and well-being of workers. It allows the design of practical interventions in the work context to be based on scientific evidences. Investigations in specific populations, such as industry, and studies with more robust designs are lacking. PMID:27253900

  17. Impaired olfaction in mice lacking aquaporin-4 water channels

    PubMed Central

    Lu, Daniel C.; Zhang, Hua; Zador, Zsolt; Verkman, A. S.

    2008-01-01

    Aquaporin-4 (AQP4) is a water-selective transport protein expressed in glial cells throughout the central nervous system. AQP4 deletion in mice produces alterations in several neuroexcitation phenomena, including hearing, vision, epilepsy, and cortical spreading depression. Here, we report defective olfaction and electroolfactogram responses in AQP4-null mice. Immunofluorescence indicated strong AQP4 expression in supportive cells of the nasal olfactory epithelium. The olfactory epithelium in AQP4-null mice had identical appearance, but did not express AQP4, and had ∼12-fold reduced osmotic water permeability. Behavioral analysis showed greatly impaired olfaction in AQP4-null mice, with latency times of 17 ± 0.7 vs. 55 ± 5 s in wild-type vs. AQP4-null mice in a buried food pellet test, which was confirmed using an olfactory maze test. Electroolfactogram voltage responses to multiple odorants were reduced in AQP4-null mice, with maximal responses to triethylamine of 0.80 ± 0.07 vs. 0.28 ± 0.03 mV. Similar olfaction and electroolfactogram defects were found in outbred (CD1) and inbred (C57/bl6) mouse genetic backgrounds. Our results establish AQP4 as a novel determinant of olfaction, the deficiency of which probably impairs extracellular space K+ buffering in the olfactory epithelium.—Lu, D. C., Zhang, H., Zador, Z., Verkman, A. S. Impaired olfaction in mice lacking aquaporin-4 water channels. PMID:18511552

  18. Using agent-based modeling to study multiple risk factors and multiple health outcomes at multiple levels.

    PubMed

    Yang, Yong

    2017-11-01

    Most health studies focus on one health outcome and examine the influence of one or multiple risk factors. However, in reality, various pathways, interactions, and associations exist not only between risk factors and health outcomes but also among the risk factors and among health outcomes. The advance of system science methods, Big Data, and accumulated knowledge allows us to examine how multiple risk factors influence multiple health outcomes at multiple levels (termed a 3M study). Using the study of neighborhood environment and health as an example, I elaborate on the significance of 3M studies. 3M studies may lead to a significantly deeper understanding of the dynamic interactions among risk factors and outcomes and could help us design better interventions that may be of particular relevance for upstream interventions. Agent-based modeling (ABM) is a promising method in the 3M study, although its potentials are far from being fully explored. Future challenges include the gap of epidemiologic knowledge and evidence, lack of empirical data sources, and the technical challenges of ABM. © 2017 New York Academy of Sciences.

  19. A single factor underlies the metabolic syndrome: a confirmatory factor analysis.

    PubMed

    Pladevall, Manel; Singal, Bonita; Williams, L Keoki; Brotons, Carlos; Guyer, Heidi; Sadurni, Josep; Falces, Carles; Serrano-Rios, Manuel; Gabriel, Rafael; Shaw, Jonathan E; Zimmet, Paul Z; Haffner, Steven

    2006-01-01

    Confirmatory factor analysis (CFA) was used to test the hypothesis that the components of the metabolic syndrome are manifestations of a single common factor. Three different datasets were used to test and validate the model. The Spanish and Mauritian studies included 207 men and 203 women and 1,411 men and 1,650 women, respectively. A third analytical dataset including 847 men was obtained from a previously published CFA of a U.S. population. The one-factor model included the metabolic syndrome core components (central obesity, insulin resistance, blood pressure, and lipid measurements). We also tested an expanded one-factor model that included uric acid and leptin levels. Finally, we used CFA to compare the goodness of fit of one-factor models with the fit of two previously published four-factor models. The simplest one-factor model showed the best goodness-of-fit indexes (comparative fit index 1, root mean-square error of approximation 0.00). Comparisons of one-factor with four-factor models in the three datasets favored the one-factor model structure. The selection of variables to represent the different metabolic syndrome components and model specification explained why previous exploratory and confirmatory factor analysis, respectively, failed to identify a single factor for the metabolic syndrome. These analyses support the current clinical definition of the metabolic syndrome, as well as the existence of a single factor that links all of the core components.

  20. The impact of individual factors on healthcare staff's computer use in psychiatric hospitals.

    PubMed

    Koivunen, Marita; Välimäki, Maritta; Koskinen, Anita; Staggers, Nancy; Katajisto, Jouko

    2009-04-01

    The study examines whether individual factors of healthcare staff are associated with computer use in psychiatric hospitals. In addition, factors inhibiting staff's optimal use of computers were explored. Computer applications have developed the content of clinical practice and changed patterns of professional working. Healthcare staff need new capacities to work in clinical practice, including the basic computers skills. Computer use amongst healthcare staff has widely been studied in general, but cogent information is still lacking in psychiatric care. Staff's computer use was assessed using a structured questionnaire (The Staggers Nursing Computer Experience Questionnaire). The study population was healthcare staff working in two psychiatric hospitals in Finland (n = 470, response rate = 59%). The data were analysed with descriptive statistics and manova with main effects and two-way interaction effects of six individual factors. Nurses who had more experience of computer use or of the implementation processes of computer systems were more motivated to use computers than those who had less experience of these issues. Males and administrative personnel who were younger had also participated more often than women in implementation processes of computer systems. The most significant factor inhibiting the use of computers was lack of interest in them. In psychiatric hospitals, more direct attention should focus on staff's capacities to use computers and to increase their understanding of the benefits in clinical care, especially for women and ageing staff working in psychiatric hospitals. To avoid exclusion amongst healthcare personnel in information society and to ensure that they have capacities to guide patients on how to use computers or to evaluate the quality of health information on the web, staff's capacities and motivation to use computers in mental health and psychiatric nursing should be ensured.

  1. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review.

    PubMed

    Boerleider, Agatha W; Wiegers, Therese A; Manniën, Judith; Francke, Anneke L; Devillé, Walter L J M

    2013-03-27

    Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a systematic review of factors affecting non-western women's use of prenatal care (both medical care and prenatal classes) in industrialized western countries. Eleven databases (PubMed, Embase, PsycINFO, Cochrane, Sociological Abstracts, Web of Science, Women's Studies International, MIDIRS, CINAHL, Scopus and the NIVEL catalogue) were searched for relevant peer-reviewed articles from between 1995 and July 2012. Qualitative as well as quantitative studies were included. Quality was assessed using the Mixed Methods Appraisal Tool. Factors identified were classified as impeding or facilitating, and categorized according to a conceptual framework, an elaborated version of Andersen's healthcare utilization model. Sixteen articles provided relevant factors that were all categorized. A number of factors (migration, culture, position in host country, social network, expertise of the care provider and personal treatment and communication) were found to include both facilitating and impeding factors for non-western women's utilization of prenatal care. The category demographic, genetic and pregnancy characteristics and the category accessibility of care only included impeding factors.Lack of knowledge of the western healthcare system and poor language proficiency were the most frequently reported impeding factors. Provision of information and care in women's native languages was the most frequently reported facilitating factor. The factors found in this review provide specific indications for identifying non-western women who are at risk of not using prenatal care adequately and for developing interventions and appropriate policy aimed at improving their prenatal care utilization.

  2. Meta-analyses including data from observational studies.

    PubMed

    O'Connor, Annette M; Sargeant, Jan M

    2014-02-15

    Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Lack of evidence that avian oncogenic viruses are infectious for humans: a review.

    PubMed

    Schat, Karel A; Erb, Hollis N

    2014-09-01

    Chickens may be infected with three different oncogenic viruses: avian leukosis virus (ALV), reticuloendotheliosis virus (REV), and Marek's disease herpesvirus (MDV). Several epidemiological studies have suggested a link between these viruses and different types of cancer in people working in poultry processing plants and with multiple sclerosis. In this article, we analyze the epidemiological evidence that these viruses are causative agents for human cancer, followed by description of the relevant key characteristics of ALV, REV, and MDV. Finally, we discuss the biological evidence or lack thereof that avian tumor viruses are involved in the etiology of human cancer and multiple sclerosis (MS). The recent primary epidemiologic articles that we reviewed as examples were only hypothesis-generating studies examining massive numbers of risk factors for associations with various imprecise, non-viral-specific outcomes. The studies lacked precise evidence of exposure to the relevant viruses and the statistical methods failed to adjust for the large risks of false-positive claims. ALV subgroups A-D and J have been eradicated in the United States from the pure lines down to the parent stocks by the breeder companies, which have greatly reduced the incidence of infection in layer flocks and broilers. As a consequence, potential exposure of humans to these viruses has greatly diminished. Infection of humans working in processing plants with ALV-A and ALV-B is unlikely, because broilers are generally resistant to infection with these two subgroups. Moreover, these viruses enter cells by specific receptors present on chicken, but not on mammalian, cells. Infection of mammalian cell cultures or animals with ALV-A, ALV-B, and ALV-J has not been reported. Moreover, humans vaccinated with exogenous or endogenous ALV-contaminated vaccines against yellow fever, measles, and mumps did not become antibody- or virus-positive for ALV. The risks for human infection with REV are similarly

  4. Relative importance of natural and anthropogenic factors influencing karst rocky desertification

    NASA Astrophysics Data System (ADS)

    Xu, Erqi; Zhang, Hongqi

    2017-04-01

    As the most severe ecological issue in southwest China, karst rocky desertification (KRD) has both threatened and constrained regional sustainable development. Comprehensively understanding the relationship between the evolution of KRD and relevant driving data would provide more information to combat KRD in such complex karst environments. Past studies have been limited in quantifying the relative importance of driving factors influencing fine-scale KRD evolution, and have also lacked insight into their interactive impacts. To address these issues, we have used geographical information system techniques and a geographical detector model to explore the spatial consistency of driving factors and their interactions in relation to the evolution of KRD. Changshun County in China was selected as a representative area for the study. Nine relevant driving factors, including both natural and anthropogenic factors, were studied in regard to their relationships with KRD transformation between 2000 and 2010. Our results demonstrate the relative importance of driving data in influencing the improvement and deterioration of KRD. Lithology, soil type and road influence are identified as the leading factors. Interestingly, to our study at least, there is no significant difference between the impacts of natural and anthropogenic factors influencing KRD improvement, and even natural factors have a higher impact on KRD deterioration. Factors were found to enhance the influence of each other for KRD transformation. In particular, the results show a non-linearly enhanced effect between driving factors, which significantly aggravates KRD. New information found in our study helps to effectively control and restore areas afflicted by KRD.

  5. Children's Lack of Playtime Seen as Troubling Health, School Issue

    ERIC Educational Resources Information Center

    Jacobson, Linda

    2008-01-01

    Teachers and parents are frequently warned that students in the United States are lacking the academic skills they need for the 21st century. But a growing contingent of educators, psychologists, and other professionals are voicing worries that today's children are also growing up without the chance to play. Test preparation in kindergarten,…

  6. Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

    PubMed

    Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

    2015-06-11

    Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision

  7. Asynchronous hatching and food limitation: A test of Lack's hypothesis

    USGS Publications Warehouse

    Skagen, Susan Knight

    1988-01-01

    Lack's (1954, 1968) hypothesis that asynchronous hatching of altricial birds is an adaptive response to unpredictable food shortages during the breeding season was examined in the highly granivorous Zebra Finch (Poephila guttata). I compared growth and survival of nestlings in asynchronous and artificially created synchronous broods reared under food-limited and food-abundant conditions in an aviary. I also examined the role of parental experience on survival and growth of nestlings.There was no differential mortality of Zebra Finch nestlings due to either asynchrony or food abundance. Young in abundant food treatments grew more rapidly, however, than those in food-restricted treatments. Heaviest Zebra Finch nestlings in a brood grew more quickly than their lightest siblings when food was limited, supporting Lack's hypothesis. Further, differential survival of light and heavy siblings occurred when food was abundant, suggesting that asynchronous hatching can be maladaptive under some ecological conditions. Nestlings reared by inexperienced parents suffered greater mortality and slower growth when food was abundant than nestlings raised by experienced parents. Prefledging mass was correlated with size at adulthood

  8. Factors influencing nurses' readiness to care for hospitalised older people.

    PubMed

    Baumbusch, Jennifer; Leblanc, Marie-Eve; Shaw, Maureen; Kjorven, Mary

    2016-06-01

    To gain a better understanding of nurses' perspectives on factors that influence their readiness to provide appropriate care for hospitalised older people. Hospitals have consistently been criticised for failing to address the unique, complex needs of older people. Research suggests that multiple issues have led to this situation, including a lack of educational preparation for nurses, limited attention to environmental factors, and an absence of organisational preparedness that ensures hospitals are adapted to meet the needs of older people. An exploratory, qualitative approach was used. Forty-one Registered Nurses participated (24 point-of-care nurses; 17 organisational leaders). Six focus groups and one individual interview were conducted. Thematic data analysis was employed to generate the main study findings. An overarching theme of 'Poor Fit' emerged. While participants identified the shifting needs of patients towards more complex and relational care, the broader organisational and societal contexts were, largely, unchanging. This resulted in nurses recognising the factors needed to be ready to care for older patients and their families, but working in hospitals that were not suited to these needs. The findings identify factors at the point-of-care, the organisational level, and in broader societal attitudes that shape nurses' readiness to care for hospitalised older people. However, many of these factors are modifiable and care for older people could be improved through quality improvement initiatives and nursing leadership. This study offers insight into ways to re-imagine nursing care that can be responsive to older people's complex needs in hospitals. With a growing contingent of hospitalised older people, it is imperative that nurses, who comprise the largest workforce in this setting, be included in the planning and delivery of healthcare services to ensure readiness to meet the needs of this population. © 2015 John Wiley & Sons Ltd.

  9. Bias, misleading information and lack of respect for alternative views have distorted perceptions of myalgic encephalomyelitis/chronic fatigue syndrome and its treatment.

    PubMed

    Goudsmit, Ellen; Howes, Sandra

    2017-08-01

    The PACE trial is one of the most recent studies evaluating cognitive behavioural therapy and graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome. These interventions are based on a model which assumes that symptoms are perpetuated by factors such as misguided beliefs and a lack of activity. Our analysis indicates that the researchers have shown significant bias in their accounts of the literature and may also have overstated the effectiveness of the above treatments. We submit that their approach to criticisms undermines the scientific process and is inconsistent with best practice.

  10. Nickel Nanoparticles cause exaggerated lung and airway remodeling in mice lacking the T-box transcription factor, TBX21 (T-bet)

    PubMed Central

    2014-01-01

    Background Nickel nanoparticles (NiNPs) are increasingly used in a variety of industrial applications, including the manufacturing of multi-walled carbon nanotubes (MWCNTs). While occupational nickel exposure is a known cause of pulmonary alveolitis, fibrosis, and cancer, the health risks of NiNPs are not well understood, especially in susceptible individuals such as asthmatics. The T-box transcription factor Tbx21 (T-bet) maintains Th1 cell development and loss of T-bet is associated with a shift towards Th2 type allergic airway inflammation that characterizes asthma. The purpose of this study was to determine the role of T-bet in susceptibility to lung remodeling by NiNPs or MWCNTs. Methods Wild-type (WT) and T-bet-/- mice were exposed to NiNPs or MWCNTs (4 mg/kg) by oropharyngeal aspiration (OPA). Necropsy was performed at 1 and 21 days. Bronchoalveolar lavage fluid (BALF) was collected for differential counting of inflammatory cells and for measurement of cytokines by ELISA. The left lung was collected for histopathology. The right lung was analyzed for cytokine or mucin (MUC5AC and MUC5B) mRNAs. Results Morphometry of alcian-blue/periodic acid Schiff (AB/PAS)-stained lung tissue showed that NiNPs significantly increased mucous cell metaplasia in T-bet-/- mice at 21 days (p < 0.001) compared to WT mice, and increased MUC5AC and MUC5B mRNAs (p < 0.05). MWCNTs also increased mucous cell metaplasia in T-bet-/- mice, but to a lesser extent than NiNPs. Chronic alveolitis was also increased by NiNPs, but not MWCNTs, in T-bet-/- mice compared to WT mice at 21 days (P < 0.001). NiNPs also increased IL-13 and eosinophils (p < 0.001) in BALF from T-bet-/- mice after 1 day. Interestingly, the chemokine CCL2 in the BALF of T-bet-/- mice was increased at 1 and 21 days (p < 0.001 and p < 0.05, respectively) by NiNPs, and to a lesser extent by MWCNTs at 1 day. Treatment of T-bet-/- mice with a monoclonal anti-CCL2 antibody enhanced Ni

  11. Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.

    PubMed

    Shoemaker, Sarah J; Staub-DeLong, Leah; Wasserman, Melanie; Spranca, Mark

    2013-01-01

    Pharmacies are key sources of medication information for patients, yet few effectively serve patients with low health literacy. The Agency for Healthcare Research and Quality (AHRQ) supported the development of four health literacy tools for pharmacists to address this problem, and to help assess and improve pharmacies' health literacy practices. This study aimed to understand the facilitators and barriers to the adoption and implementation of AHRQ's health literacy tools, particularly a tool to assess a pharmacy's health literacy practices. We conducted a comparative, multiple-case study of eight pharmacies, guided by an adaptation of Rogers's Diffusion of Innovations model. Data were collected and triangulated through interviews, site visit observations, and the review of documents, and analyzed on the factors affecting pharmacies' adoption decisions and implementation of the tools. Factors important to pharmacies' decision to adopt the health literacy tools included awareness of health literacy; a culture of innovation; a change champion; the relative advantage and compatibility of the tools; and an invitation to utilize and receive support to use the tools. The barriers included a lack of leadership support, limited staff time, and a perception of the tools as complex with limited value. For implementation, the primary facilitators were buy-in from leadership, qualified staff, college-affiliated change champions, the adaptability and organization of the tool, and support. Barriers to implementation were limited leadership buy-in, prioritization of other activities, lack of qualified staff, and tool complexity. If pharmacists are provided tools that could ultimately improve their health literacy practices and patient-centered services; and the tools have a clear relative advantage, are simple as well adaptable, and the pharmacists are supported in their efforts - either by colleagues or by collaborating with colleges of pharmacy-then there could be important

  12. Lack of airborne transmission during outbreak of pandemic (H1N1) 2009 among tour group members, China, June 2009.

    PubMed

    Han, Ke; Zhu, Xiaoping; He, Fan; Liu, Lunguang; Zhang, Lijie; Ma, Huilai; Tang, Xinyu; Huang, Ting; Zeng, Guang; Zhu, Bao Ping

    2009-10-01

    During June 2-8, 2009, an outbreak of influenza A pandemic (H1N1) 2009 occurred among 31 members of a tour group in China. To identify the mode of transmission and risk factors, we conducted a retrospective cohort investigation. The index case-patient was a female tourist from the United States. Secondary cases developed in 9 (30%) tour group members who had talked with the index case-patient and in 1 airline passenger (not a tour group member) who had sat within 2 rows of her. None of the 14 tour group members who had not talked with the index case-patient became ill. This outbreak was apparently caused by droplet transmission during coughing or talking. That airborne transmission was not a factor is supported by lack of secondary cases among fellow bus and air travelers. Our findings highlight the need to prevent transmission by droplets and fomites during a pandemic.

  13. Lack of Airborne Transmission during Outbreak of Pandemic (H1N1) 2009 among Tour Group Members, China, June 2009

    PubMed Central

    Han, Ke; Zhu, Xiaoping; He, Fan; Liu, Lunguang; Zhang, Lijie; Ma, Huilai; Tang, Xinyu; Huang, Ting; Zhu, Bao-Ping

    2009-01-01

    During June 2–8, 2009, an outbreak of influenza A pandemic (H1N1) 2009 occurred among 31 members of a tour group in China. To identify the mode of transmission and risk factors, we conducted a retrospective cohort investigation. The index case-patient was a female tourist from the United States. Secondary cases developed in 9 (30%) tour group members who had talked with the index case-patient and in 1 airline passenger (not a tour group member) who had sat within 2 rows of her. None of the 14 tour group members who had not talked with the index case-patient became ill. This outbreak was apparently caused by droplet transmission during coughing or talking. That airborne transmission was not a factor is supported by lack of secondary cases among fellow bus and air travelers. Our findings highlight the need to prevent transmission by droplets and fomites during a pandemic. PMID:19861048

  14. 45 CFR 46.118 - Applications and proposals lacking definite plans for involvement of human subjects.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Applications and proposals lacking definite plans for involvement of human subjects. 46.118 Section 46.118 Public Welfare Department of Health and Human... Research Subjects § 46.118 Applications and proposals lacking definite plans for involvement of human...

  15. 45 CFR 46.118 - Applications and proposals lacking definite plans for involvement of human subjects.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Applications and proposals lacking definite plans for involvement of human subjects. 46.118 Section 46.118 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Research Subjects § 46.118 Applications and proposals lacking definite plans for involvement of human...

  16. 45 CFR 46.118 - Applications and proposals lacking definite plans for involvement of human subjects.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Applications and proposals lacking definite plans for involvement of human subjects. 46.118 Section 46.118 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Research Subjects § 46.118 Applications and proposals lacking definite plans for involvement of human...

  17. 45 CFR 46.118 - Applications and proposals lacking definite plans for involvement of human subjects.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Applications and proposals lacking definite plans for involvement of human subjects. 46.118 Section 46.118 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... Research Subjects § 46.118 Applications and proposals lacking definite plans for involvement of human...

  18. Biosocial factors influencing women to become prostitutes in India.

    PubMed

    Chattopadhyay, M; Bandyopadhyay, S; Duttagupta, C

    1994-01-01

    Based on materials collected during a study of risk factors associated with cervix cancer among prostitutes in Domjur, Howrah, West Bengal, this report explores various biosocial factors which may lead women to prostitution. When family and marital ties fail or disintegrate for various reasons, the life situations which a woman encounters may themselves generate a "process" of anchorlessness. The failure of family support along with the lack of ability to provide for themselves due to poverty and illiteracy were key factors why the women in this study had adopted prostitution.

  19. Lifestyle factors and sperm aneuploidy.

    PubMed

    Jurewicz, Joanna; Radwan, Michał; Sobala, Wojciech; Radwan, Paweł; Jakubowski, Lucjusz; Hawuła, Wanda; Ulańska, Anna; Hanke, Wojciech

    2014-09-01

    Different environmental and lifestyle factors may interfere with the normal disjunction of sister chromatids/chromosomes during meiosis and may cause aneuploidy. The aim of the study was to examine the association between lifestyle factors and sperm aneuploidy. The study population consisted of 212 healthy men under 45 years of age attending an infertility clinic for diagnostic purposes and who had a normal semen concentration of 20-300×10⁶mL or slight oligozoospermia (semen concentration of 15-20×10⁶/mL). All participants were interviewed and provided a semen sample. Sperm aneuploidy was assessed using multicolor FISH (DNA probes specific for chromosomes X, Y, 18, 13, 21). Results from the study suggest that lifestyle factors are related to sperm aneuploidy. A positive relationship was found between coffee drinking everyday and the lack of chromosome X or Y, as well as coffee drinking 1-6 times per week and additional chromosome 18. Wearing boxer shorts decrease the copy number changes in the whole chromosome 18, the number of additional chromosome 18 and the lack of chromosome 13. Additionally, obesity (BMI 30-40 kg/m²) was positively associated with additional chromosome 21 after being adjusted for potential confounders. These findings demonstrate that changing the men's lifestyle habits may contribute to reduction of the incidence of sperm aneuploidy. It is necessary that men continue to follow sensible health advice concerning excess weight, coffee drinking and wearing tight fitting underwear. As this is the first such study to examine different lifestyle factors and sperm aneuploidy, the results need to be confirmed on larger population. Copyright © 2014 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  20. Mannitol-Enhanced Delivery of Stem Cells and Their Growth Factors Across the Blood–Brain Barrier

    PubMed Central

    Gonzales-Portillo, Gabriel S.; Sanberg, Paul R.; Franzblau, Max; Gonzales-Portillo, Chiara; Diamandis, Theo; Staples, Meaghan; Sanberg, Cyndy D.; Borlongan, Cesar V.

    2014-01-01

    Ischemic brain injury in adults and neonates is a significant clinical problem with limited therapeutic interventions. Currently, clinicians have only tPA available for stroke treatment and hypothermia for cerebral palsy. Owing to the lack of treatment options, there is a need for novel treatments such as stem cell therapy. Various stem cells including cells from embryo, fetus, perinatal, and adult tissues have proved effective in preclinical and small clinical trials. However, a limiting factor in the success of these treatments is the delivery of the cells and their by-products (neurotrophic factors) into the injured brain. We have demonstrated that mannitol, a drug with the potential to transiently open the blood–brain barrier and facilitate the entry of stem cells and trophic factors, as a solution to the delivery problem. The combination of stem cell therapy and mannitol may improve therapeutic outcomes in adult stroke and neonatal cerebral palsy. PMID:24480552