Elevated pulmonary artery systolic pressure predicts heart failure admissions in African Americans: Jackson Heart Study.

PubMed

Choudhary, Gaurav; Jankowich, Matthew; Wu, Wen-Chih

2014-07-01

Although elevated pulmonary artery systolic pressure (PASP) is associated with heart failure (HF), whether PASP measurement can help predict future HF admissions is not known, especially in African Americans who are at increased risk for HF. We hypothesized that elevated PASP is associated with increased risk of HF admission and improves HF prediction in African American population. We conducted a longitudinal analysis using the Jackson Heart Study cohort (n=3125; 32.2% men) with baseline echocardiography-derived PASP and follow-up for HF admissions. Hazard ratio for HF admission was estimated using Cox proportional hazard model adjusted for variables in the Atherosclerosis Risk in Community (ARIC) HF prediction model. During a median follow-up of 3.46 years, 3.42% of the cohort was admitted for HF. Subjects with HF had a higher PASP (35.6±11.4 versus 27.6±6.9 mm Hg; P<0.001). The hazard of HF admission increased with higher baseline PASP (adjusted hazard ratio per 10 mm Hg increase in PASP: 2.03; 95% confidence interval, 1.67-2.48; adjusted hazard ratio for highest [≥33 mm Hg] versus lowest quartile [<24 mm Hg] of PASP: 2.69; 95% confidence interval, 1.43-5.06) and remained significant irrespective of history of HF or preserved/reduced ejection fraction. Addition of PASP to the ARIC model resulted in a significant improvement in model discrimination (area under the curve=0.82 before versus 0.84 after; P=0.03) and improved net reclassification index (11-15%) using PASP as a continuous or dichotomous (cutoff=33 mm Hg) variable. Elevated PASP predicts HF admissions in African Americans and may aid in early identification of at-risk subjects for aggressive risk factor modification. © 2014 American Heart Association, Inc.

Preparing African Americans for careers in health care: the Jackson Heart Study.

PubMed

Srinivasan, Asoka; Brown, James; Fahmy, Nimr; Heitman, Elizabeth; Singh, Madhu; Szklo, Moyses; Taylor, Herman; White, Wendy

2005-01-01

The Jackson Heart Study Undergraduate Training Center (UTC) at Tougaloo College was developed to increase the numbers of African-American students entering public health and health related fields. The UTC includes a scholars program for undergraduate students at Tougaloo College, three four-week programs for high school students called the SLAM (science, language arts, and mathematics) workshops, and an introductory epidemiology course for healthcare professionals and graduate students. The scholars program recruits 12 Tougaloo College freshmen annually for the duration of their undergraduate education. As of the 2005 summer, 512 students have enrolled in the SLAM workshops. The introduction to epidemiology course has provided training for 155 individuals from 1999 to 2004. This paper documents the need for this program based on the conspicuously small proportion of African Americans who are health practitioners in Mississippi. The content and selection process for each program is described, and a summary of the enrollment history, characteristics of the program participants, and their accomplishments is presented. Finally, the methods of program assessment and tracking are discussed.

Perceived Discrimination and Hypertension Among African Americans in the Jackson Heart Study

PubMed Central

Sims, Mario; Diez-Roux, Ana V.; Dudley, Amanda; Gebreab, Samson; Wyatt, Sharon B.; Bruce, Marino A.; James, Sherman A.; Robinson, Jennifer C.; Williams, David R.; Taylor, Herman A.

2012-01-01

Objectives. Using Jackson Heart Study data, we examined whether perceived discrimination was associated with prevalent hypertension in African Americans. Methods. Everyday discrimination, lifetime discrimination, burden of discrimination, and stress from discrimination were examined among 4939 participants aged 35 to 84 years (women = 3123; men = 1816). We estimated prevalence ratios of hypertension by discrimination, and adjusted for age, gender, socioeconomic status, and risk factors. Results. The prevalence of hypertension was 64.0% in women and 59.7% in men. After adjustment for age, gender, and socioeconomic status, lifetime discrimination and burden of discrimination were associated with greater hypertension prevalence (prevalence ratios for highest vs lowest quartile were 1.08 [95% confidence interval (CI) = 1.02, 1.15] and 1.09 [95% CI = 1.02,1.16] for lifetime discrimination and burden of discrimination, respectively). Associations were slightly weakened after adjustment for body mass index and behavioral factors. No associations were observed for everyday discrimination. Conclusions. Further understanding the role of perceived discrimination in the etiology of hypertension may be beneficial in eliminating hypertension disparities. PMID:22401510

Perceived discrimination and hypertension among African Americans in the Jackson Heart Study.

PubMed

Sims, Mario; Diez-Roux, Ana V; Dudley, Amanda; Gebreab, Samson; Wyatt, Sharon B; Bruce, Marino A; James, Sherman A; Robinson, Jennifer C; Williams, David R; Taylor, Herman A

2012-05-01

Using Jackson Heart Study data, we examined whether perceived discrimination was associated with prevalent hypertension in African Americans. Everyday discrimination, lifetime discrimination, burden of discrimination, and stress from discrimination were examined among 4939 participants aged 35 to 84 years (women = 3123; men = 1816). We estimated prevalence ratios of hypertension by discrimination, and adjusted for age, gender, socioeconomic status, and risk factors. The prevalence of hypertension was 64.0% in women and 59.7% in men. After adjustment for age, gender, and socioeconomic status, lifetime discrimination and burden of discrimination were associated with greater hypertension prevalence (prevalence ratios for highest vs lowest quartile were 1.08 [95% confidence interval (CI) = 1.02, 1.15] and 1.09 [95% CI = 1.02,1.16] for lifetime discrimination and burden of discrimination, respectively). Associations were slightly weakened after adjustment for body mass index and behavioral factors. No associations were observed for everyday discrimination. Further understanding the role of perceived discrimination in the etiology of hypertension may be beneficial in eliminating hypertension disparities.

The relation of digital vascular function to cardiovascular risk factors in African-Americans using digital tonometry: the Jackson Heart Study.

PubMed

McClendon, Eric E; Musani, Solomon K; Samdarshi, Tandaw E; Khaire, Sushant; Stokes, Donny; Hamburg, Naomi M; Sheffy, Koby; Mitchell, Gary F; Taylor, Herman R; Benjamin, Emelia J; Fox, Ervin R

2017-06-01

Digital vascular tone and function, as measured by peripheral arterial tonometry (PAT), are associated with cardiovascular risk and events in non-Hispanic whites. There are limited data on relations between PAT and cardiovascular risk in African-Americans. PAT was performed on a subset of Jackson Heart Study participants using a fingertip tonometry device. Resting digital vascular tone was assessed as baseline pulse amplitude. Hyperemic vascular response to 5 minutes of ischemia was expressed as the PAT ratio (hyperemic/baseline amplitude ratio). Peripheral augmentation index (AI), a measure of relative wave reflection, also was estimated. The association of baseline pulse amplitude (PA), PAT ratio, and AI to risk factors was assessed using stepwise multivariable models. The study sample consisted of 837 participants from the Jackson Heart Study (mean age, 54 ± 11 years; 61% women). In stepwise multivariable regression models, baseline pulse amplitude was related to male sex, body mass index, and diastolic blood pressure (BP), accounting for 16% of the total variability of the baseline pulse amplitude. Age, male sex, systolic BP, diastolic BP, antihypertensive medication, and prevalent cardiovascular disease contributed to 11% of the total variability of the PAT ratio. Risk factors (primarily age, sex, and heart rate) explained 47% of the total variability of the AI. We confirmed in our cohort of African-Americans, a significant relation between digital vascular tone and function measured by PAT and multiple traditional cardiovascular risk factors. Further studies are warranted to investigate the utility of these measurements in predicting clinical outcomes in African-Americans. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Aldosterone, Renin, and Diabetes Mellitus in African Americans: The Jackson Heart Study.

PubMed

Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Kalyani, Rita R; Yeh, Hsin-Chieh; Bertoni, Alain G; Effoe, Valery S; Casanova, Ramon; Sims, Mario; Correa, Adolfo; Wu, Wen-Chih; Wand, Gary S; Golden, Sherita H

2016-04-01

Previous research has suggested that activation of the renin-angiotensin-aldosterone system may promote insulin resistance and β-cell dysfunction, but the association with incident diabetes in African Americans is unknown. We examined the association of aldosterone and renin with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. The Jackson Heart Study is a prospective study of the development and progression of cardiovascular disease in African Americans. Participants were recruited from the tricounty area of metropolitan Jackson, Mississippi. A total of 5301 African American adults, aged 21–94 years, were assessed at baseline and through 12 years of follow-up. Data on aldosterone, renin, and risk factors were collected at baseline (2000–2004). Diabetes (fasting glucose ≥ 126 mg/dL, physician diagnosis, use of diabetes drugs, or glycated hemoglobin ≥ 6.5%) was assessed at baseline and through 12 years of follow-up. Participants were excluded for missing data on baseline covariates or diabetes follow-up. Cox regression was used to estimate hazard ratios (HR) for incident diabetes using sequential modeling adjusting for age, sex, education, occupation, systolic blood pressure, current smoking, physical activity, dietary intake, and body mass index. Aldosterone, renin, and diabetes risk factors were measured. Outcomes included the homeostatic model assessment of insulin resistance (HOMA-IR) and incident diabetes. Among 3234 participants over a median of 8.0 years of follow-up, there were 554 cases of incident diabetes. Every 1% increase in log-transformed aldosterone was associated with a 0.18% higher log-transformed HOMA-IR in cross-sectional analyses of nondiabetic participants (P < .001). Log-transformed aldosterone and renin levels in the fifth vs first quintile were associated with a 78% (HR 1.78, 95% confidence interval 1.35–2.34) and 35% (HR 1.35, 95% confidence interval 1.06–1.72) increase in diabetes

Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

PubMed

Mentz, Robert J; Greiner, Melissa A; DeVore, Adam D; Dunlay, Shannon M; Choudhary, Gaurav; Ahmad, Tariq; Khazanie, Prateeti; Randolph, Tiffany C; Griswold, Michael E; Eapen, Zubin J; O'Brien, Emily C; Thomas, Kevin L; Curtis, Lesley H; Hernandez, Adrian F

2015-03-01

QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities. © 2015 American Heart Association, Inc.

Multi-variant study of obesity risk genes in African Americans: The Jackson Heart Study.

PubMed

Liu, Shijian; Wilson, James G; Jiang, Fan; Griswold, Michael; Correa, Adolfo; Mei, Hao

2016-11-30

Genome-wide association study (GWAS) has been successful in identifying obesity risk genes by single-variant association analysis. For this study, we designed steps of analysis strategy and aimed to identify multi-variant effects on obesity risk among candidate genes. Our analyses were focused on 2137 African American participants with body mass index measured in the Jackson Heart Study and 657 common single nucleotide polymorphisms (SNPs) genotyped at 8 GWAS-identified obesity risk genes. Single-variant association test showed that no SNPs reached significance after multiple testing adjustment. The following gene-gene interaction analysis, which was focused on SNPs with unadjusted p-value<0.10, identified 6 significant multi-variant associations. Logistic regression showed that SNPs in these associations did not have significant linear interactions; examination of genetic risk score evidenced that 4 multi-variant associations had significant additive effects of risk SNPs; and haplotype association test presented that all multi-variant associations contained one or several combinations of particular alleles or haplotypes, associated with increased obesity risk. Our study evidenced that obesity risk genes generated multi-variant effects, which can be additive or non-linear interactions, and multi-variant study is an important supplement to existing GWAS for understanding genetic effects of obesity risk genes. Copyright © 2016 Elsevier B.V. All rights reserved.

The Epidemiology of Coping in African American Adults in the Jackson Heart Study (JHS).

PubMed

Brenner, Allison B; Diez-Roux, Ana V; Gebreab, Samson Y; Schulz, Amy J; Sims, Mario

2017-12-07

Differences in coping within the African American population are not well understood, yet these differences may be critical to reducing stress, improving health, and reducing racial health disparities. Using a descriptive, exploratory analysis of the Jackson Heart Study (N = 5301), we examine correlations between coping responses and associations between coping and demographic, socioeconomic, psychosocial, and neighborhood factors. Overall, coping responses were not strongly correlated and patterns of associations between covariates and coping responses were largely inconsistent. The results suggest that coping varies substantially within this African American population and is driven mainly by psychosocial factors such as spirituality and interpersonal support. Understanding these complex relationships may inform strategies by which to intervene in the stress process to mitigate the effects of stress on health and to identify vulnerable subgroups of African Americans that might need targeted interventions to reduce exposure to stressors and improve coping capacities.

The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study.

PubMed

Effoe, Valery S; Carnethon, Mercedes R; Echouffo-Tcheugui, Justin B; Chen, Haiying; Joseph, Joshua J; Norwood, Arnita F; Bertoni, Alain G

2017-06-21

The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person-years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high-sensitivity C-reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74-0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79-1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Evaluating the Effects of Coping Style on Allostatic Load, by Sex: The Jackson Heart Study, 2000–2004

PubMed Central

Loucks, Eric B.; Arheart, Kristopher L.; Hickson, DeMarc A.; Kohn, Robert; Buka, Stephen L.; Gjelsvik, Annie

2015-01-01

The objective of this study was to examine the cross-sectional association between coping styles and allostatic load among African American adults in the Jackson Heart Study (2000–2004). Coping styles were assessed using the Coping Strategies Inventory-Short Form; allostatic load was measured by using 9 biomarkers standardized into z-scores. Sex-stratified multivariable linear regressions indicated that females who used disengagement coping styles had significantly higher allostatic load scores (β = 0.016; 95% CI, 0.001–0.032); no such associations were found in males. Future longitudinal investigations should examine why disengagement coping style is linked to increased allostatic load to better inform effective interventions and reduce health disparities among African American women. PMID:26425869

Ideal Cardiovascular Health, Cardiovascular Remodeling, and Heart Failure in African-Americans: the Jackson Heart Study

PubMed Central

Spahillari, Aferdita; Talegawkar, Sameera; Correa, Adolfo; Carr, J. Jeffrey; Terry, James G.; Lima, Joao; Freedman, Jane E.; Das, Saumya; Kociol, Robb; de Ferranti, Sarah; Mohebali, Donya; Mwasongwe, Stanford; Tucker, Katherine L.; Murthy, Venkatesh L.; Shah, Ravi V.

2017-01-01

Background The lifetime risk of heart failure is higher in the African-American population than in other racial groups in the United States. Methods and Results We measured the Life’s Simple 7 ideal cardiovascular health metrics in 4195 African-Americans in the Jackson Heart Study (2000–2004). We evaluated the association of Simple 7 metrics with incident HF and left ventricular (LV) structure and function by cardiac magnetic resonance (CMR; n=1188). Mean age at baseline was 54.4 years (65% women). Relative to 0–2 Simple 7 factors, African-Americans with 3 factors had 47% lower incident HF risk (HR 0.53, 95% CI 0.39–0.73, P<0.0001); those with ≥ 4 factors had 61% lower HF risk (HR 0.39, 95% CI 0.24–0.64, P=0.0002). Higher blood pressure (HR 2.32, 95% CI 1.28–4.20, P=0.005), physical inactivity (HR 1.65, 95% CI 1.07–2.55, P=0.02), smoking (HR 2.04, 95% CI 1.43–2.91, P<0.0001) and impaired glucose control (HR 1.76, 95% CI 1.34–2.29, P<0.0001) were associated with incident HF. The age-/sex-adjusted population attributable risk for these Simple 7 metrics combined was 37.1%. Achievement of ideal blood pressure, ideal body mass index, ideal glucose control, and non-smoking was associated with less likelihood of adverse cardiac remodeling by CMR. Conclusions Cardiovascular risk factors in mid-life (specifically elevated blood pressure, physical inactivity, smoking and poor glucose control) are associated with incident HF in African Americans, and represent targets for intensified HF prevention. PMID:28209767

Aldosterone, Renin, and Diabetes Mellitus in African Americans: The Jackson Heart Study

PubMed Central

Joseph, Joshua J.; Echouffo-Tcheugui, Justin B.; Kalyani, Rita R.; Yeh, Hsin-Chieh; Bertoni, Alain G.; Effoe, Valery S.; Casanova, Ramon; Sims, Mario; Correa, Adolfo; Wu, Wen-Chih; Wand, Gary S.

2016-01-01

Context: Previous research has suggested that activation of the renin-angiotensin-aldosterone system may promote insulin resistance and β-cell dysfunction, but the association with incident diabetes in African Americans is unknown. Objective: We examined the association of aldosterone and renin with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. Design: The Jackson Heart Study is a prospective study of the development and progression of cardiovascular disease in African Americans. Setting: Participants were recruited from the tricounty area of metropolitan Jackson, Mississippi. Participants: A total of 5301 African American adults, aged 21–94 years, were assessed at baseline and through 12 years of follow-up. Data on aldosterone, renin, and risk factors were collected at baseline (2000–2004). Diabetes (fasting glucose ≥ 126 mg/dL, physician diagnosis, use of diabetes drugs, or glycated hemoglobin ≥ 6.5%) was assessed at baseline and through 12 years of follow-up. Participants were excluded for missing data on baseline covariates or diabetes follow-up. Cox regression was used to estimate hazard ratios (HR) for incident diabetes using sequential modeling adjusting for age, sex, education, occupation, systolic blood pressure, current smoking, physical activity, dietary intake, and body mass index. Exposures: Aldosterone, renin, and diabetes risk factors were measured. Outcomes: Outcomes included the homeostatic model assessment of insulin resistance (HOMA-IR) and incident diabetes. Results: Among 3234 participants over a median of 8.0 years of follow-up, there were 554 cases of incident diabetes. Every 1% increase in log-transformed aldosterone was associated with a 0.18% higher log-transformed HOMA-IR in cross-sectional analyses of nondiabetic participants (P < .001). Log-transformed aldosterone and renin levels in the fifth vs first quintile were associated with a 78% (HR 1.78, 95% confidence interval 1.35�

Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

PubMed

Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

2017-08-01

Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend <0.001). This association was present among participants with baseline systolic BP <120 mm Hg and diastolic BP <80 mm Hg and separately systolic BP 120 to 139 mm Hg or diastolic BP 80 to 89 mm Hg. Blacks with better cardiovascular health have lower hypertension risk. © 2017 American Heart Association, Inc.

Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

PubMed

Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

2016-01-01

Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

Aldosterone, Renin, Cardiovascular Events, and All-Cause Mortality Among African Americans: The Jackson Heart Study.

PubMed

Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Kalyani, Rita R; Yeh, Hsin-Chieh; Bertoni, Alain G; Effoe, Valery S; Casanova, Ramon; Sims, Mario; Wu, Wen-Chih; Wand, Gary S; Correa, Adolfo; Golden, Sherita H

2017-09-01

This study examined the association of aldosterone and plasma renin activity (PRA) with incident cardiovascular disease (CVD), using a composite endpoint of coronary heart disease, stroke, and/or heart failure and mortality among African Americans in the Jackson Heart Study. There is a paucity of data for the association of aldosterone and PRA with incident CVD or all-cause mortality among community-dwelling African Americans. A total of 4,985 African American adults, 21 to 94 years of age, were followed for 12 years. Aldosterone, PRA, and cardiovascular risk factors were collected at baseline (from 2000 to 2004). Incident events included coronary heart disease and stroke (assessed from 2000 to 2011) and heart failure (assessed from 2005 to 2011). Cox models were used to estimate hazard ratios (HRs) for incident CVD and mortality, adjusting for age, sex, education, occupation, current smoking, physical activity, dietary intake, and body mass index. Among 4,160 participants without prevalent CVD over a median follow-up of 7 years, there were 322 incident CVD cases. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HR of 1.26 (95% confidence intervals [CI]: 1.14 to 1.40) and 1.16 (95% CI: 1.02 to 1.33) for incident CVD, respectively. Over a median of 8 years, 513 deaths occurred among 4,985 participants. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HRs of 1.13 (95% CI: 1.04 to 1.23) and 1.12 (95% CI: 1.01 to 1.24) for mortality, respectively. Elevated aldosterone and PRA may play a significant role in the development of CVD and all-cause mortality among African Americans. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The impact of neighborhood on physical activity in the Jackson Heart Study.

PubMed

Robinson, Jennifer C; Wyatt, Sharon B; Dubbert, Patricia M; May, Warren; Sims, Mario

2016-09-01

Physical inactivity is an independent risk factor for many diseases. Most research has focused on individual-level factors for physical activity (PA), but evidence suggests that neighborhood is also important. We examined baseline data collected between 2000 and 2004 from 5236 participants in the Jackson Heart Study to determine the effects of neighborhood on 2 types of PA: Active Living (AL), and Sports and Exercise (Sport) in an all-African American cohort. Participants were georeferenced and data from individual baseline questionnaires and US Census were analyzed using descriptive, bivariate, and multilevel models. In both types of PA, neighborhood factors had an independent and additive effect on AL and Sport. Living in an urban (p=0.003) or neighborhood with a higher percentage of residents with less than a high school education (p<0.001) was inversely associated with AL. There was an inverse interaction effect between individual and lower neighborhood education (p=0.01), as well as between age and urban neighborhoods (p=0.02) on AL. Individual level education (OR=1.30) and per capita income (OR=1.07) increased the odds of moderate-to-high sports. Future studies should focus on what contextual aspects of urban or less educated neighborhoods are influential in determining PA, as well as longitudinal multilevel analyses of neighborhood effects on PA. Copyright © 2016 Elsevier Inc. All rights reserved.

Residential distance to major roadways and cardiac structure in African Americans: cross-sectional results from the Jackson Heart Study.

PubMed

Weaver, Anne M; Wellenius, Gregory A; Wu, Wen-Chih; Hickson, DeMarc A; Kamalesh, Masoor; Wang, Yi

2017-03-08

Heart failure (HF) is a significant source of morbidity and mortality among African Americans. Ambient air pollution, including from traffic, is associated with HF, but the mechanisms remain unknown. The objectives of this study were to estimate the cross-sectional associations between residential distance to major roadways with markers of cardiac structure: left ventricular (LV) mass index, LV end-diastolic diameter, LV end-systolic diameter, and LV hypertrophy among African Americans. We studied baseline participants of the Jackson Heart Study (recruited 2000-2004), a prospective cohort of cardiovascular disease (CVD) among African Americans living in Jackson, Mississippi, USA. All cardiac measures were assessed from echocardiograms. We assessed the associations between residential distance to roads and cardiac structure indicators using multivariable linear regression or multivariable logistic regression, adjusting for potential confounders. Among 4826 participants, residential distance to road was <150 m for 103 participants, 150-299 m for 158, 300-999 for 1156, and ≥1000 m for 3409. Those who lived <150 m from a major road had mean 1.2 mm (95% CI 0.2, 2.1) greater LV diameter at end-systole compared to those who lived ≥1000 m. We did not observe statistically significant associations between distance to roads and LV mass index, LV end-diastolic diameter, or LV hypertrophy. Results did not materially change after additional adjustment for hypertension and diabetes or exclusion of those with CVD at baseline; results strengthened when modeling distance to A1 roads (such as interstate highways) as the exposure of interest. We found that residential distance to roads may be associated with LV end-systolic diameter, a marker of systolic dysfunction, in this cohort of African Americans, suggesting a potential mechanism by which exposure to traffic pollution increases the risk of HF.

The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study

PubMed Central

Johnson, Dayna A.; Lisabeth, Lynda; Lewis, Tené T.; Sims, Mario; Hickson, DeMarc A.; Samdarshi, Tandaw; Taylor, Herman; Diez Roux, Ana V.

2016-01-01

Study Objectives: Studies have shown that psychosocial stressors are related to poor sleep. However, studies of African Americans, who may be more vulnerable to the impact of psychosocial stressors, are lacking. Using the Jackson Heart Study (JHS) baseline data, we examined associations of psychosocial stressors with sleep in 4,863 African Americans. Methods: We examined cross-sectional associations between psychosocial stressors and sleep duration and quality in a large population sample of African Americans. Three measures of psychosocial stress were investigated: the Global Perceived Stress Scale (GPSS); Major Life Events (MLE); and the Weekly Stress Inventory (WSI). Sleep was assessed using self-reported hours of sleep and sleep quality rating (1 = poor; 5 = excellent). Multinomial logistic and linear regression models were used to examine the association of each stress measure (in quartiles) with continuous and categorical sleep duration (< 5 (“very short”), 5–6 h (“short”) and > 9 h (“long”) versus 7 or 8 h (“normal”); and with sleep quality after adjustment for demographics and risk factors (body mass index, hypertension, diabetes, physical activity). Results: Mean age of the sample was 54.6 years and 64% were female. Mean sleep duration was 6.4 + 1.5 hours, 54% had a short sleep duration, 5% had a long sleep duration, and 34% reported a “poor” or “fair” sleep quality. Persons in the highest GPSS quartile had higher odds of very short sleep (odds ratio: 2.87, 95% confidence interval [CI]: 2.02, 4.08), higher odds of short sleep (1.72, 95% CI: 1.40, 2.12), shorter average sleep duration (Δ = −33.6 min (95% CI: −41.8, −25.4), and reported poorer sleep quality (Δ = −0.73 (95% CI: −0.83, −0.63) compared to those in the lowest quartile of GPSS after adjustment for covariates. Similar patterns were observed for WSI and MLE. Psychosocial stressors were not associated with long sleep. For WSI, effects of stress on sleep

Masked Hypertension and Incident Clinic Hypertension Among Blacks in the Jackson Heart Study.

PubMed

Abdalla, Marwah; Booth, John N; Seals, Samantha R; Spruill, Tanya M; Viera, Anthony J; Diaz, Keith M; Sims, Mario; Muntner, Paul; Shimbo, Daichi

2016-07-01

Masked hypertension, defined as nonelevated clinic blood pressure (BP) and elevated out-of-clinic BP may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic BP and masked hypertension using ambulatory BP monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of blacks. Analyses included 317 participants with clinic BP <140/90 mm Hg, complete ambulatory BP monitoring, who were not taking antihypertensive medication at baseline in 2000 to 2004. Masked daytime hypertension was defined as mean daytime blood pressure ≥135/85 mm Hg, masked night-time hypertension as mean night-time BP ≥120/70 mm Hg, and masked 24-hour hypertension as mean 24-hour BP ≥130/80 mm Hg. Incident clinic hypertension, assessed at study visits in 2005 to 2008 and 2009 to 2012, was defined as the first visit with clinic systolic/diastolic BP ≥140/90 mm Hg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked night-time hypertension, and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% confidence interval) of incident clinic hypertension for any masked hypertension and masked daytime, night-time, and 24-hour hypertension were 2.13 (1.51-3.02), 1.79 (1.24-2.60), 2.22 (1.58-3.12), and 1.91 (1.32-2.75), respectively. These findings suggest that ambulatory BP monitoring can identify blacks at increased risk for developing clinic hypertension. © 2016 American Heart Association, Inc.

Psychometric Evaluation of a Coping Strategies Inventory Short-Form (CSI-SF) in the Jackson Heart Study Cohort

PubMed Central

Addison, Clifton C.; Campbell-Jenkins, Brenda W.; Sarpong, Daniel F.; Kibler, Jeffery; Singh, Madhu; Dubbert, Patricia; Wilson, Gregory; Payne, Thomas; Taylor, Herman

2007-01-01

This study sought to establish the psychometric properties of a Coping Strategies Inventory Short Form (CSI-SF) by examining coping skills in the Jackson Heart Study cohort. We used exploratory and confirmatory factor analysis, Pearson’s correlation, and Cronbach Alpha to examine reliability and validity in the CSI-SF that solicited responses from 5302 African American men and women between the ages of 35 and 84. One item was dropped from the 16-item CSI-SF, making it a 15-item survey. No significant effects were found for age and gender, strengthening the generalizability of the CSI-SF. The internal consistency reliability analysis revealed reliability between alpha = 0.58–0.72 for all of the scales, and all of the fit indices used to examine the CSI-SF provided support for its use as an adequate measure of coping. This study provides empirical support for utilizing this instrument in future efforts to understand the role of coping in moderating health outcomes. PMID:18180539

Inflammatory Obesity Phenotypes, Gender Effects, and Subclinical Atherosclerosis in African Americans: The Jackson Heart Study.

PubMed

Lin, Albert; Lacy, Mary E; Eaton, Charles; Correa, Adolfo; Wu, Wen-Chih

2016-12-01

Reasons for variations in atherosclerotic burden among individuals with similar levels of obesity are poorly understood, especially in African Americans. This study examines whether high-sensitivity C-reactive protein (hsCRP) is useful for discriminating between benign and high-risk obesity phenotypes for subclinical atherosclerosis in African Americans. Participants from the Jackson Heart Study (n=4682) were stratified into 4 phenotypes based on the presence of National Heart and Lung and Blood Institute definition of obesity or obesity-equivalent (body mass index ≥30 or body mass index 25-30 with waist circumference >102 cm in men and >88 cm in women) and inflammation by hsCRP ≥2 mg/L. Using multivariate regression models, we conducted cross-sectional analyses of the association between inflammatory obesity phenotypes and subclinical atherosclerosis determined by carotid intima-media thickness or coronary artery calcium scores. Sex-specific analyses were conducted given significant interaction for gender (P=0.03). The prevalence of obesity or equivalent was 65%, of which 30% did not have inflammation. Conversely, 37% of nonobese individuals had inflammation. Among nonobese men, hsCRP ≥2 mg/L identified a subset of individuals with higher carotid intima-media thickness (adjusted mean difference =0.05, 95% confidence interval 0.02, 0.08 mm) compared with their noninflammatory counterparts. Among obese men, hsCRP <2 mg/L identified a subset of individuals with lower coronary artery calcium compared with their inflammatory counterparts. Among women, associations between hsCRP and carotid intima-media thickness or coronary artery calcium were not found. In the largest African American population-based cohort to date, hsCRP was useful in identifying a subset of nonobese men with higher carotid intima-media thickness, but not in women. hsCRP did not identify a subset of obese individuals with less subclinical atherosclerosis. © 2016 American Heart Association

The utility of the apolipoprotein A1 remnant ratio in predicting incidence coronary heart disease in a primary prevention cohort: The Jackson Heart Study.

PubMed

May, Heidi T; Nelson, John R; Lirette, Seth T; Kulkarni, Krishnaji R; Anderson, Jeffrey L; Griswold, Michael E; Horne, Benjamin D; Correa, Adolfo; Muhlestein, Joseph B

2016-05-01

Dyslipidemia plays a significant role in the progression of cardiovascular disease. The apolipoprotein (apo) A1 remnant ratio (apo A1/VLDL3-C + IDL-C) has recently been shown to be a strong predictor of death/myocardial infarction risk among women >50 years undergoing angiography. However, whether this ratio is associated with coronary heart disease risk among other populations is unknown. We evaluated the apo A1 remnant ratio and its components for coronary heart disease incidence. Observational. Participants (N = 4722) of the Jackson Heart Study were evaluated. Baseline clinical characteristics and lipoprotein subfractions (Vertical Auto Profile method) were collected. Cox hazard regression analysis, adjusted by standard cardiovascular risk factors, was utilized to determine associations of lipoproteins with coronary heart disease. Those with new-onset coronary heart disease were older, diabetic, smokers, had less education, used more lipid-lowering medication, and had a more atherogenic lipoprotein profile. After adjustment, the apo A1 remnant ratio (hazard ratio = 0.67 per 1-SD, p = 0.002) was strongly associated with coronary heart disease incidence. This association appears to be driven by the IDL-C denominator (hazard ratio = 1.23 per 1-SD, p = 0.007). Remnants (hazard ratio = 1.21 per 1-SD, p = 0.017), but not apo A1 (hazard ratio = 0.85 per 1-SD, p = 0.121) or VLDL3-C (hazard ratio = 1.13 per 1-SD, p = 0.120) were associated with coronary heart disease. Standard lipids were not associated with coronary heart disease incidence. We found the apo A1 remnant ratio to be strongly associated with coronary heart disease. This ratio appears to better stratify risk than standard lipids, apo A1, and remnants among a primary prevention cohort of African Americans. Its utility requires further study as a lipoprotein management target for risk reduction. © The European Society of Cardiology 2015.

Pedometer determined physical activity tracks in African American adults: the Jackson Heart Study.

PubMed

Newton, Robert L; M, Hongmei Han; Dubbert, Patricia M; Johnson, William D; Hickson, DeMarc A; Ainsworth, Barbara; Carithers, Teresa; Taylor, Herman; Wyatt, Sharon; Tudor-Locke, Catrine

2012-04-18

This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults. African American adults (mean age 59.9 ± 0.60 years; 59 % female) enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, assessed on two to three distinct occasions, each separated by approximately one month. The stability of pedometer measured PA was described as differences in mean steps/day across time, as intraclass correlation coefficients (ICC) by sex, age, and body mass index (BMI) category, and as percent of participants changing steps/day quartiles across time. Valid data were obtained for 270 participants on either two or three different assessment occasions. Mean steps/day were not significantly different across assessment occasions (p values > 0.456). The overall ICCs for steps/day assessed on either two or three occasions were 0.57 and 0.76, respectively. In addition, 85 % (two assessment occasions) and 76 % (three assessment occasions) of all participants remained in the same steps/day quartile or changed one quartile over time. The current study shows that an overall mean steps/day estimate based on a 3-day monitoring period did not differ significantly over 4 - 6 months. The findings were robust to differences in sex, age, and BMI categories. A single 3-day monitoring period is sufficient to capture habitual physical activity in African American adults.

CADIOVASCULAR HEALTH AND INCIDENT HYPERTENSION IN AFRICAN AMERICANS: THE JACKSON HEART STUDY

PubMed Central

Booth, John N.; Abdalla, Marwah; Tanner, Rikki M.; Diaz, Keith M.; Bromfield, Samantha G.; Tajeu, Gabriel S.; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P.; Spruill, Tanya M.; Shimbo, Daichi; Muntner, Paul

2018-01-01

Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trend<0.001). This association was present among participants with baseline systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg and, separately systolic blood pressure 120–139 or diastolic blood pressure 80–89 mmHg. African-Americans with better cardiovascular health have lower hypertension risk. PMID:28652461

Residential Proximity to Major Roadways Is Not Associated with Cardiac Function in African Americans: Results from the Jackson Heart Study.

PubMed

Weaver, Anne M; Wellenius, Gregory A; Wu, Wen-Chih; Hickson, DeMarc A; Kamalesh, Masoor; Wang, Yi

2016-06-13

Cardiovascular disease (CVD), including heart failure, is a major cause of morbidity and mortality, particularly among African Americans. Exposure to ambient air pollution, such as that produced by vehicular traffic, is believed to be associated with heart failure, possibly by impairing cardiac function. We evaluated the cross-sectional association between residential proximity to major roads, a marker of long-term exposure to traffic-related pollution, and echocardiographic indicators of left and pulmonary vascular function in African Americans enrolled in the Jackson Heart Study (JHS): left ventricular ejection fraction, E-wave velocity, isovolumic relaxation time, left atrial diameter index, and pulmonary artery systolic pressure. We examined these associations using multivariable linear or logistic regression, adjusting for potential confounders. Of 4866 participants at study enrollment, 106 lived <150 m, 159 lived 150-299 m, 1161 lived 300-999 m, and 3440 lived ≥1000 m from a major roadway. We did not observe any associations between residential distance to major roads and these markers of cardiac function. Results were similar with additional adjustment for diabetes and hypertension, when considering varying definitions of major roadways, or when limiting analyses to those free from cardiovascular disease at baseline. Overall, we observed little evidence that residential proximity to major roads was associated with cardiac function among African Americans.

Pedometer determined physical activity tracks in African American adults: The Jackson Heart Study

PubMed Central

2012-01-01

Background This study investigated the number of pedometer assessment occasions required to establish habitual physical activity in African American adults. Methods African American adults (mean age 59.9 ± 0.60 years; 59 % female) enrolled in the Diet and Physical Activity Substudy of the Jackson Heart Study wore Yamax pedometers during 3-day monitoring periods, assessed on two to three distinct occasions, each separated by approximately one month. The stability of pedometer measured PA was described as differences in mean steps/day across time, as intraclass correlation coefficients (ICC) by sex, age, and body mass index (BMI) category, and as percent of participants changing steps/day quartiles across time. Results Valid data were obtained for 270 participants on either two or three different assessment occasions. Mean steps/day were not significantly different across assessment occasions (p values > 0.456). The overall ICCs for steps/day assessed on either two or three occasions were 0.57 and 0.76, respectively. In addition, 85 % (two assessment occasions) and 76 % (three assessment occasions) of all participants remained in the same steps/day quartile or changed one quartile over time. Conclusion The current study shows that an overall mean steps/day estimate based on a 3-day monitoring period did not differ significantly over 4 – 6 months. The findings were robust to differences in sex, age, and BMI categories. A single 3-day monitoring period is sufficient to capture habitual physical activity in African American adults. PMID:22512833

Comparison of risk scores for the prediction of stroke in African Americans: Findings from the Jackson Heart Study.

PubMed

Foraker, Randi E; Greiner, Melissa; Sims, Mario; Tucker, Katherine L; Towfighi, Amytis; Bidulescu, Aurelian; Shoben, Abigail B; Smith, Sakima; Talegawkar, Sameera; Blackshear, Chad; Wang, Wei; Hardy, Natalie Chantelle; O'Brien, Emily

2016-07-01

Evidence from existing cohort studies supports the prediction of incident coronary heart disease and stroke using 10-year cardiovascular disease (CVD) risk scores and the American Heart Association/American Stroke Association's cardiovascular health (CVH) metric. We included all Jackson Heart Study participants with complete scoring information at the baseline study visit (2000-2004) who had no history of stroke (n = 4,140). We used Kaplan-Meier methods to calculate the cumulative incidence of stroke and used Cox models to estimate hazard ratios and 95% CIs for stroke according to CVD risk and CVH score. We compared the discrimination of the 2 models according to the Harrell c index and plotted predicted vs observed stroke risk calibration plots for each of the 2 models. The median age of the African American participants was 54.5 years, and 65% were female. The cumulative incidence of stroke increased across worsening categories of CVD risk and CVH. A 1-unit increase in CVD risk increased the hazard of stroke (1.07, 1.06-1.08), whereas each 1-unit increase in CVH corresponded to a decreased hazard of stroke (0.76, 0.69-0.83). As evidenced by the c statistics, the CVH model was less discriminating than the CVD risk model (0.59 [0.55-0.64] vs 0.79 [0.76-0.83]). Both scores were associated with incident stroke in a dose-response fashion; however, the CVD risk model was more discriminating than the CVH model. The CVH score may still be preferable for its simplicity in application to broad patient populations and public health efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Diabetes, depressive symptoms, and functional disability in African Americans: the Jackson Heart Study.

PubMed

Kalyani, Rita Rastogi; Ji, Nan; Carnethon, Mercedes; Bertoni, Alain G; Selvin, Elizabeth; Gregg, Edward W; Sims, Mario; Golden, Sherita Hill

2017-08-01

To investigate the degree to which comorbid depression contributes to the relationship of diabetes with functional disability in African Americans (AAs), a population at high-risk for complications. We examined 2989 African Americans (AAs) in the Jackson Heart Study who had diabetes and depressive symptoms (CES-D) assessed at baseline. Overall functional disability was defined as the inability to perform at least one task of daily living. Multivariable logistic regression models explored the association of diabetes and depressive symptoms with functional disability. Prevalence of overall functional disability was highest with both diabetes and depressive symptoms (54%), similar with diabetes alone (31%) or depressive symptoms alone (33%), and lowest with neither (15%). Adjusting for demographics, smoking, BMI, cardiovascular comorbidities, and hsCRP, the association of depressive symptoms alone (OR=2.30,95% CI 1.75-3.03) and both diabetes and depressive symptoms (OR=2.75,1.88-4.04) with overall functional disability was significant, but not for diabetes alone (OR=1.26,0.95-1.67), compared to neither. In regression analyses including any diabetes and any depressive symptoms together in models, the main effect of depressive symptoms but not diabetes was associated with overall functional disability, and the interaction term was not significant (p-value=0.84). Functional disability was highest among AAs who have both diabetes and depressive symptoms; the latter was a stronger contributor. Future studies should explore mechanisms underlying functional disability in diabetes, particularly the role of depression. Copyright © 2017 Elsevier Inc. All rights reserved.

Prediction of Incident Diabetes in the Jackson Heart Study Using High-Dimensional Machine Learning

PubMed Central

Casanova, Ramon; Saldana, Santiago; Simpson, Sean L.; Lacy, Mary E.; Subauste, Angela R.; Blackshear, Chad; Wagenknecht, Lynne; Bertoni, Alain G.

2016-01-01

Statistical models to predict incident diabetes are often based on limited variables. Here we pursued two main goals: 1) investigate the relative performance of a machine learning method such as Random Forests (RF) for detecting incident diabetes in a high-dimensional setting defined by a large set of observational data, and 2) uncover potential predictors of diabetes. The Jackson Heart Study collected data at baseline and in two follow-up visits from 5,301 African Americans. We excluded those with baseline diabetes and no follow-up, leaving 3,633 individuals for analyses. Over a mean 8-year follow-up, 584 participants developed diabetes. The full RF model evaluated 93 variables including demographic, anthropometric, blood biomarker, medical history, and echocardiogram data. We also used RF metrics of variable importance to rank variables according to their contribution to diabetes prediction. We implemented other models based on logistic regression and RF where features were preselected. The RF full model performance was similar (AUC = 0.82) to those more parsimonious models. The top-ranked variables according to RF included hemoglobin A1C, fasting plasma glucose, waist circumference, adiponectin, c-reactive protein, triglycerides, leptin, left ventricular mass, high-density lipoprotein cholesterol, and aldosterone. This work shows the potential of RF for incident diabetes prediction while dealing with high-dimensional data. PMID:27727289

The Jackson Career Explorer: Two Further Validity Studies

ERIC Educational Resources Information Center

Schermer, Julie Aitken

2012-01-01

The present report consists of two further validity studies using the Jackson Career Explorer (JCE), a short form and continuous version of the Jackson Vocational Interest Survey, measuring 34 interests. The first study examined the relationships between the JCE and five personality factors, from a sample of 528 individuals. The correlations found…

The triglyceride/high-density lipoprotein cholesterol ratio fails to predict insulin resistance in African-American women: an analysis of Jackson Heart Study.

PubMed

Sumner, Anne E; Harman, Jane L; Buxbaum, Sarah G; Miller, Bernard V; Tambay, Anita V; Wyatt, Sharon B; Taylor, Herman A; Rotimi, Charles N; Sarpong, Daniel F

2010-12-01

Compared to whites, insulin-resistant African Americans have worse outcomes. Screening programs that could identify insulin resistance early enough for intervention to affect outcome often rely on triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels. Racial differences in TG and HDL-C may compromise the efficacy of these programs in African Americans. A recommendation currently exists to use the TG/HDL-C ratio ≥2.0 to predict insulin resistance in African Americans. The validity of this recommendation needs examination. Therefore, our aim was to determine the ability of TG/HDL-C ratio to predict insulin resistance in African Americans. In 1,903 African Americans [895 men, 1,008 women, age 55 ± 12 years, mean ± standard deviation (SD), range 35-80 years, body mass index (BMI) 31.0 ± 6.4 kg/m(2), range 18.5-55 kg/m(2)] participating in the Jackson Heart Study, a population-based study of African Americans, Jackson, Mississippi tricounty region, insulin resistance was defined by the upper quartile (≥4.43) of homeostasis model assessment of insulin resistance (HOMA-IR). An area under the receiver operating characteristic curve (AUC-ROC) of >0.70 was required for prediction of insulin resistance by TG/HDL-C. The optimal test cutoff was determined by the Youden index. HOMA-IR was similar in men and women (3.40 ± 2.03 vs. 3.80 ± 2.46, P = 0.60). Women had lower TG (94 ± 49 vs. 109 ± 65 mg/dL P < 0.001) and TG/HDL-C (1.9 ± 1.4 vs. 2.7 ± 2.1, P < 0.001). For men, AUC-ROC for prediction of insulin resistance by TG/HDL-C was: 0.77 ± 0.01, mean ± standard error (SE), with an optimal cutoff of ≥2.5. For women, the AUC-ROC was 0.66 ± 0.01, rendering an optimal cutoff indefinable. When women were divided in two groups according to age, 35-50 years and 51-80 years, the results did not change. In African-American men, the recommended TG/HDL-C threshold of 2.0 should be adjusted

Left Ventricular Function Across the Spectrum of Body Mass Index in African Americans: The Jackson Heart Study.

PubMed

Patel, Vivek G; Gupta, Deepak K; Terry, James G; Kabagambe, Edmond K; Wang, Thomas J; Correa, Aldolfo; Griswold, Michael; Taylor, Herman; Carr, John Jeffrey

2017-03-01

This study sought to assess whether body mass index (BMI) was associated with subclinical left ventricular (LV) systolic dysfunction in African-American individuals. Higher BMI is a risk factor for cardiovascular disease, including heart failure. Obesity disproportionately affects African Americans; however, the association between higher BMI and LV function in African Americans is not well understood. Peak systolic circumferential strain (ECC) was measured by tagged cardiac magnetic resonance in 1,652 adult African-American participants of the Jackson Heart Study between 2008 and 2012. We evaluated the association between BMI and ECC in multivariate linear regression and restricted cubic spline analyses adjusted for prevalent cardiovascular disease, conventional cardiovascular risk factors, LV mass, and ejection fraction. In exploratory analyses, we also examined whether inflammation, insulin resistance, or volume of visceral adipose tissue altered the association between BMI and ECC. The proportions of female, nonsmokers, diabetic, and hypertensive participants rose with increase in BMI. In multivariate-adjusted models, higher BMI was associated with worse ECC (β = 0.052; 95% confidence interval: 0.028 to 0.075), even in the setting of preserved LV ejection fraction. Higher BMI was also associated with worse ECC when accounting for markers of inflammation (C-reactive protein, E-selection, and P-selectin), insulin resistance, and volume of visceral adipose tissue. Higher BMI is significantly associated with subclinical LV dysfunction in African Americans, even in the setting of preserved LV ejection fraction. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Relationship between medication use and cardiovascular disease health outcomes in the Jackson Heart Study.

PubMed

Addison, Clifton C; Jenkins, Brenda W; Sarpong, Daniel; Wilson, Gregory; Champion, Cora; Sims, Jeraline; White, Monique S

2011-06-01

Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes.

Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study.

PubMed

Millard, Heather R; Musani, Solomon K; Dibaba, Daniel T; Talegawkar, Sameera A; Taylor, Herman A; Tucker, Katherine L; Bidulescu, Aurelian

2018-02-01

Several mechanisms have been described through which dietary intake of choline and its derivative betaine may be associated in both directions with subclinical atherosclerosis. We assessed the association of dietary intake of choline and betaine with cardiovascular risk and markers of subclinical cardiovascular disease. Data from 3924 Jackson Heart Study (JHS) African-American participants with complete food frequency questionnaire at baseline and follow-up measurements of heart disease measures were used. Multivariable linear regression models were employed to assess associations between choline and betaine intake with carotid intima-media thickness, coronary artery calcium, abdominal aortic calcium and left ventricular mass. Cox proportional hazards regression models were used to estimate associations with time to incident coronary heart disease (CHD), ischemic stroke and cardiovascular disease (CVD). During an average nine years of follow-up, 124 incident CHD events, 75 incident stroke events and 153 incident CVD events were documented. In women, greater choline intake was associated with lower left ventricular mass (p = 0.0006 for trend across choline quartiles) and with abdominal aortic calcium score. Among all JHS participants, there was a statistically significant inverse association between dietary choline intake and incident stroke, β = -0.33 (p = 0.04). Betaine intake was associated with greater risk of incident CHD when comparing the third quartile of intake with the lowest quartile of intake (HR 1.89, 95 % CI 1.14, 3.15). Among our African-American participants, higher dietary choline intake was associated with a lower risk of incident ischemic stroke, and thus putative dietary benefits. Higher dietary betaine intake was associated with a nonlinear higher risk of incident CHD.

Associations of adiponectin with individual European ancestry in African Americans: the Jackson Heart Study

PubMed Central

Bidulescu, Aurelian; Choudhry, Shweta; Musani, Solomon K.; Buxbaum, Sarah G.; Liu, Jiankang; Rotimi, Charles N.; Wilson, James G.; Taylor, Herman A.; Gibbons, Gary H.

2014-01-01

Background: Compared with European Americans, African Americans (AAs) exhibit lower levels of the cardio-metabolically protective adiponectin even after accounting for adiposity measures. Because few studies have examined in AA the association between adiponectin and genetic admixture, a dense panel of ancestry informative markers (AIMs) was used to estimate the individual proportions of European ancestry (PEA) for the AAs enrolled in a large community-based cohort, the Jackson Heart Study (JHS). We tested the hypothesis that plasma adiponectin and PEA are directly associated and assessed the interaction with a series of cardio-metabolic risk factors. Methods: Plasma specimens from 1439 JHS participants were analyzed by ELISA for adiponectin levels. Using pseudo-ancestral population genotype data from the HapMap Consortium, PEA was estimated with a panel of up to 1447 genome-wide preselected AIMs by a maximum likelihood approach. Interaction assessment, stepwise linear and cubic multivariable-adjusted regression models were used to analyze the cross-sectional association between adiponectin and PEA. Results: Among the study participants (62% women; mean age 48 ± 12 years), the median (interquartile range) of PEA was 15.8 (9.3)%. Body mass index (BMI) (p = 0.04) and insulin resistance (p = 0.0001) modified the association between adiponectin and PEA. Adiponectin was directly and linearly associated with PEA (β = 0.62 ± 0.28, p = 0.03) among non-obese (n = 673) and insulin sensitive participants (n = 1141; β = 0.74 ± 0.23, p = 0.001), but not among those obese or with insulin resistance. No threshold point effect was detected for non-obese participants. Conclusions: In a large AA population, the individual proportion of European ancestry was linearly and directly associated with plasma adiponectin among non-obese and non insulin-resistant participants, pointing to the interaction of genetic and metabolic factors influencing adiponectin levels. PMID:24575123

Markers of kidney disease and risk of subclinical and clinical heart failure in African Americans: the Jackson Heart Study.

PubMed

Bansal, Nisha; Katz, Ronit; Himmelfarb, Jonathan; Afkarian, Maryam; Kestenbaum, Bryan; de Boer, Ian H; Young, Bessie

2016-12-01

African Americans and patients with chronic kidney disease (CKD) are at high risk for clinical heart failure (HF). In this study, we aimed to determine the association of markers of kidney disease with subclinical HF (by echocardiogram) and risk of clinical HF among a large, well-characterized community-based cohort of African American patients. We also examined whether the association of markers of kidney disease with HF was attenuated with adjustment for echocardiographic measures. We studied participants in the Jackson Heart Study, a large community-based cohort of African Americans. Estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (ACR) were measured at baseline. We tested the association of eGFR and urine ACR with left ventricular mass (LVM), left ventricular ejection fraction (LVEF) and physician-adjudicated incident HF. Among the 3332 participants in the study, 166 (5%) had eGFR <60 mL/min/1.73 m 2 and 405 (12%) had urine ACR ≥30 mg/g. In models adjusted for demographics, comorbidity and the alternative measure of kidney disease, lower eGFR and higher urine ACR were associated with higher LVM {β-coefficient 1.54 [95% confidence interval (CI) 0.78-2.31] per 10 mL/min/1.73 m 2 decrease in eGFR and 2.87 (95% CI 1.85-3.88) per doubling of urine ACR}. There was no association of eGFR and urine ACR with LVEF [β-coefficient -0.12 (95% CI -0.28-0.04) and -0.11 (95% CI -0.35-0.12), respectively]. There was no association of eGFR with the risk of incident HF [HR 1.02 (95% CI 0.91-1.14) per 10 mL/min/1.73 m 2 decrease], while there was a significant association of urine ACR [HR 2.22 (95% CI 1.29-3.84) per doubling of urine ACR]. This association was only modestly attenuated with adjustment for LVM [HR 1.95 (95% CI 1.09-3.49)]. Among a community-based cohort of African Americans, lower eGFR and higher ACR were associated with higher LVM. Furthermore, higher urine ACR was associated with incident HF, which was not entirely explained by

The Social Patterning of Sleep in African Americans: Associations of Socioeconomic Position and Neighborhood Characteristics with Sleep in the Jackson Heart Study

PubMed Central

Johnson, Dayna A.; Lisabeth, Lynda; Hickson, DeMarc; Johnson-Lawrence, Vicki; Samdarshi, Tandaw; Taylor, Herman; Diez Roux, Ana V.

2016-01-01

Study Objectives: We investigated cross-sectional associations of individual-level socioeconomic position (SEP) and neighborhood characteristics (social cohesion, violence, problems, disadvantage) with sleep duration and sleep quality in 5,301 African Americans in the Jackson Heart Study. Methods: All measures were self-reported. Sleep duration was assessed as hours of sleep; sleep quality was reported as poor (1) to excellent (5). SEP was measured by categorized years of education and income. Multinomial logistic and linear regression models were fit to examine the associations of SEP and neighborhood characteristics (modeled dichotomously and tertiles) with sleep duration (short vs. normal, long vs. normal) and continuous sleep duration and quality after adjustment for demographics and risk factors. Results: The mean sleep duration was 6.4 ± 1.5 hours, 54% had a short (≤ 6 h) sleep duration, 5% reported long (≥ 9 h) sleep duration, and 24% reported fair to poor sleep quality. Lower education was associated with greater odds of long sleep (odds ratio [OR] = 2.19, 95% confidence interval [CI] = 1.42, 3.38) and poorer sleep quality (β = −0.17, 95% CI = −0.27, −0.07) compared to higher education after adjustment for demographics and risk factors. Findings were similar for income. High neighborhood violence was associated with shorter sleep duration (−9.82 minutes, 95% CI = −16.98, −2.66) and poorer sleep quality (β = −0.11, 95% CI = −0.20, 0.00) after adjustment for demographics and risk factors. Results were similar for neighborhood problems. In secondary analyses adjusted for depressive symptoms in a subset of participants, most associations were attenuated and only associations of low SEP with higher odds of long sleep and higher neighborhood violence with poorer sleep quality remained statistically significant. Conclusions: Social and environmental characteristics are associated with sleep duration and quality in African Americans

Neighborhood social and physical environments and type 2 diabetes mellitus in African Americans: The Jackson Heart Study.

PubMed

Gebreab, Samson Y; Hickson, DeMarc A; Sims, Mario; Wyatt, Sharon B; Davis, Sharon K; Correa, Adolfo; Diez-Roux, Ana V

2017-01-01

Using data from Jackson Heart Study, we investigated the associations of neighborhood social and physical environments with prevalence and incidence of type 2 diabetes mellitus (T2DM) in African Americans (AA). Among non-diabetic participants at baseline (n=3670), 521 (14.2%) developed T2DM during a median follow-up of 7.3 years. Measures of neighborhood social environments, and food and physical activity resources were derived using survey-and GIS-based methods. Prevalence ratios (PR) and Hazard ratios (HR) were estimated using generalized estimating equations and Cox proportional hazards models. Higher neighborhood social cohesion was associated with a 22% lower incidence of T2DM while higher density of unfavorable food stores was associated with a 34% higher incidence of T2DM after adjusting for individual-level risk factors (HR=0.78 [95% CI:0.62, 0.99] and HR=1.34 [1.12, 1.60], respectively). In addition, neighborhood problems was also associated with prevalence of T2DM (PR=1.12 [1.03, 1.21]) independent of individual-level risk factors. Our findings suggest that efforts to strengthen community ties or to attract healthy food retail outlets might be important strategies to consider for prevention of T2DM in AA. Published by Elsevier Ltd.

Neighborhood disadvantage, neighborhood safety and cardiometabolic risk factors in African Americans: biosocial associations in the Jackson Heart study.

PubMed

Clark, Cheryl R; Ommerborn, Mark J; Hickson, DeMarc A; Grooms, Kya N; Sims, Mario; Taylor, Herman A; Albert, Michelle A

2013-01-01

We examined associations between neighborhood socioeconomic disadvantage, perceived neighborhood safety and cardiometabolic risk factors, adjusting for health behaviors and socioeconomic status (SES) among African Americans. Study participants were non-diabetic African Americans (n = 3,909) in the baseline examination (2000-2004) of the Jackson Heart Study. We measured eight risk factors: the metabolic syndrome, its five components, insulin resistance and cardiovascular inflammation. We assessed neighborhood socioeconomic disadvantage with US Census 2000 data. We assessed perceived neighborhood safety, health behaviors and SES via survey. We used generalized estimating equations to estimate associations with a random intercept model for neighborhood effects. After adjustment for health behaviors and SES, neighborhood socioeconomic disadvantage was associated with the metabolic syndrome in women (PR 1.13, 95% CI 1.01, 1.27). Lack of perceived safety was associated with elevated glucose (OR 1.36, 95% CI 1.03, 1.80) and waist circumference (PR 1.06, 95% CI 1.02, 1.11) among women, and with elevated glucose (PR 1.30, 95% CI 1.02, 1.66) and insulin resistance (PR 1.25, 95% CI 1.08, 1.46) among men. Neighborhood socioeconomic disadvantage and perceived safety should be considered as targets for intervention to reduce cardiometabolic risks among African Americans.

Neighborhood Disadvantage, Neighborhood Safety and Cardiometabolic Risk Factors in African Americans: Biosocial Associations in the Jackson Heart Study

PubMed Central

Clark, Cheryl R.; Ommerborn, Mark J.; Hickson, DeMarc A.; Grooms, Kya N.; Sims, Mario; Taylor, Herman A.; Albert, Michelle A.

2013-01-01

Objective We examined associations between neighborhood socioeconomic disadvantage, perceived neighborhood safety and cardiometabolic risk factors, adjusting for health behaviors and socioeconomic status (SES) among African Americans. Methods Study participants were non-diabetic African Americans (n = 3,909) in the baseline examination (2000–2004) of the Jackson Heart Study. We measured eight risk factors: the metabolic syndrome, its five components, insulin resistance and cardiovascular inflammation. We assessed neighborhood socioeconomic disadvantage with US Census 2000 data. We assessed perceived neighborhood safety, health behaviors and SES via survey. We used generalized estimating equations to estimate associations with a random intercept model for neighborhood effects. Results After adjustment for health behaviors and SES, neighborhood socioeconomic disadvantage was associated with the metabolic syndrome in women (PR 1.13, 95% CI 1.01, 1.27). Lack of perceived safety was associated with elevated glucose (OR 1.36, 95% CI 1.03, 1.80) and waist circumference (PR 1.06, 95% CI 1.02, 1.11) among women, and with elevated glucose (PR 1.30, 95% CI 1.02, 1.66) and insulin resistance (PR 1.25, 95% CI 1.08, 1.46) among men. Conclusions Neighborhood socioeconomic disadvantage and perceived safety should be considered as targets for intervention to reduce cardiometabolic risks among African Americans. PMID:23691005

Relationship between Medication Use and Cardiovascular Disease Health Outcomes in the Jackson Heart Study

PubMed Central

Addison, Clifton C.; Jenkins, Brenda W.; Sarpong, Daniel; Wilson, Gregory; Champion, Cora; Sims, Jeraline; White, Monique S.

2011-01-01

Even though some medications have the potential to slow the progress of atherosclerosis and development of CVD, there are many at-risk individuals who continue to resist the benefits that are available by not following the advice of medical professionals. Non-adherence to prescribed drug regimens is a pervasive medical problem that negatively affects treatment outcomes. Information from standardized interviews of 5301 African Americans participating in the Jackson Heart Study was examined to determine the association between demographic parameters, behavior including adherence to prescribed medical regimens, and health outcomes. Data were also collected at Annual Follow-Up and Surveillance visits. During the two weeks prior to the examination visit, almost 52% of the participants reported taking blood pressure medication, 14% took cholesterol medication, 16% took medication for diabetes, and 19% took blood thinning medication. Of those who did not take the prescribed medications, the reasons given were the following: 47% were in a hurry, too busy, or forgot to take medications; 23% were trying to do without medications; 18% had no money to purchase medications; 19% indicated that the medications made them feel bad; 17% felt that they could not carry out daily functions when taking medications. The African American population can benefit from heightened awareness of the risk factors that are associated with CVD and the benefits of following a prescribed treatment regimen. Unacceptable secondary effects of prescribed medication comprised an important cause of non-compliance. Encouragement of this population to communicate with their healthcare providers to ensure that medication regimens are better tolerated could increase compliance and improve health outcomes. PMID:21776242

Obesity and synergistic risk factors for chronic kidney disease in African American adults: the Jackson Heart Study.

PubMed

Olivo, Robert E; Davenport, Clemontina A; Diamantidis, Clarissa J; Bhavsar, Nrupen A; Tyson, Crystal C; Hall, Rasheeda; Bidulescu, Aurelian; Young, Bessie; Mwasongwe, Stanford E; Pendergast, Jane; Boulware, L Ebony; Scialla, Julia J

2017-08-30

African Americans are at high risk for chronic kidney disease (CKD). Obesity may increase the risk for CKD by exacerbating features of the metabolic syndrome and promoting glomerular hyperfiltration. Whether other factors also affecting these pathways may amplify or mitigate obesity-CKD associations has not been investigated. We studied interactions between obesity and these candidate factors in 2043 African Americans without baseline kidney disease enrolled in the Jackson Heart Study. We quantified obesity as body mass index (BMI), sex-normalized waist circumference and visceral adipose volume measured by abdominal computed tomography at an interim study visit. Interactions were hypothesized with (i) metabolic risk factors (dietary quality and physical activity, both quantified by concordance with American Heart Association guidelines) and (ii) factors exacerbating or mitigating hyperfiltration (dietary protein intake, APOL1 risk status and use of renin-angiotensin system blocking medications). Using multivariable regression, we evaluated associations between obesity measures and incident CKD over the follow-up period, as well as interactions with metabolic and hyperfiltration factors. Assessed after a median of 8 years (range 6-11 years), baseline BMI and waist circumference were not associated with incident CKD. Higher visceral adipose volume was independently associated with incident CKD (P   =   0.008) in a nonlinear fashion, but this effect was limited to those with lower dietary quality (P   =   0.001; P-interaction = 0.04). In additional interaction models, higher waist circumference was associated with greater risk of incident CKD among those with the low-risk APOL1 genotype (P   =   0.04) but not those with a high-risk genotype (P-interaction = 0.02). Other proposed factors did not modify obesity-CKD associations. Higher risks associated with metabolically active visceral adipose volume and interactions with dietary quality suggest

Perceived Discrimination is Associated with Health Behaviors among African Americans in the Jackson Heart Study*

PubMed Central

Sims, Mario; Diez-Roux, Ana V.; Gebreab, Samson Y.; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

2016-01-01

Background Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviors among African Americans (AA). Methods The cross-sectional associations of everyday, lifetime, and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat, and sleep were examined among 4,939 35–84 year old participants after adjustment for age and socioeconomic status (SES). Results Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95%CI 1.00,1.28 and 1.19, 95%CI 1.05,1.34; mean difference in dietary fat: 0.37, p<.05 and 0.43, p<.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: −0.08, p<.05 and −0.18, p<.001, respectively; and mean difference for lifetime discrimination: −0.08, p<.05, and −0.24, p<.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Conclusions Higher levels of perceived discrimination were associated with select health behaviors among men and women. Health behaviors offer a potential mechanism through which perceived discrimination affects health in AA. PMID:26417003

Pulmonary Hypertension Is Associated With a Higher Risk of Heart Failure Hospitalization and Mortality in Patients With Chronic Kidney Disease: The Jackson Heart Study.

PubMed

Selvaraj, Senthil; Shah, Sanjiv J; Ommerborn, Mark J; Clark, Cheryl R; Hall, Michael E; Mentz, Robert J; Qazi, Saadia; Robbins, Jeremy M; Skelton, Thomas N; Chen, Jiaying; Gaziano, J Michael; Djoussé, Luc

2017-06-01

African Americans develop chronic kidney disease and pulmonary hypertension (PH) at disproportionately high rates. Little is known whether PH heightens the risk of heart failure (HF) admission or mortality among chronic kidney disease patients, including patients with non-end-stage renal disease. We analyzed African Americans participants with chronic kidney disease (estimated glomerular filtration rate <60 mL/min per 1.73 m 2 or urine albumin/creatinine >30 mg/g) and available echocardiogram-derived pulmonary artery systolic pressure (PASP) from the Jackson Heart Study (N=408). We used Cox models to assess whether PH (PASP>35 mm Hg) was associated with higher rates of HF hospitalization and mortality. In a secondary, cross-sectional analysis, we examined the relationship between cystatin C (a marker of renal function) and PASP and potential mediators, including BNP (B-type natriuretic peptide) and endothelin-1. In our cohort, the mean age was 63±13 years, 70% were female, 78% had hypertension, and 22% had PH. Eighty-five percent of the participants had an estimated glomerular filtration rate >30 mL/min per 1.73 m 2 . During follow-up, 13% were hospitalized for HF and 27% died. After adjusting for potential confounders, including BNP, PH was found to be associated with HF hospitalization (hazard ratio, 2.37; 95% confidence interval, 1.15-4.86) and the combined outcome of HF hospitalization or mortality (hazard ratio, 1.84; confidence interval, 1.09-3.10). Log cystatin C was directly associated with PASP (adjusted β =2.5 [95% confidence interval, 0.8-4.1] per standard deviation change in cystatin C). Mediation analysis showed that BNP and endothelin-1 explained 56% and 40%, respectively, of the indirect effects between cystatin C and PASP. Among African Americans with chronic kidney disease, PH, which is likely pulmonary venous hypertension, was associated with a higher risk of HF admission and mortality. © 2017 American Heart Association, Inc.

The impact of lifecourse socioeconomic position on cardiovascular disease events in African Americans: the Jackson Heart Study.

PubMed

Gebreab, Samson Y; Diez Roux, Ana V; Brenner, Allison B; Hickson, DeMarc A; Sims, Mario; Subramanyam, Malavika; Griswold, Michael E; Wyatt, Sharon B; James, Sherman A

2015-05-27

Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother's education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men. Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

D-Dimer in African Americans: Whole Genome Sequence Analysis and Relationship to Cardiovascular Disease Risk in the Jackson Heart Study.

PubMed

Raffield, Laura M; Zakai, Neil A; Duan, Qing; Laurie, Cecelia; Smith, Joshua D; Irvin, Marguerite R; Doyle, Margaret F; Naik, Rakhi P; Song, Ci; Manichaikul, Ani W; Liu, Yongmei; Durda, Peter; Rotter, Jerome I; Jenny, Nancy S; Rich, Stephen S; Wilson, James G; Johnson, Andrew D; Correa, Adolfo; Li, Yun; Nickerson, Deborah A; Rice, Kenneth; Lange, Ethan M; Cushman, Mary; Lange, Leslie A; Reiner, Alex P

2017-11-01

Plasma levels of the fibrinogen degradation product D-dimer are higher among African Americans (AAs) compared with those of European ancestry and higher among women compared with men. Among AAs, little is known of the genetic architecture of D-dimer or the relationship of D-dimer to incident cardiovascular disease. We measured baseline D-dimer in 4163 AAs aged 21 to 93 years from the prospective JHS (Jackson Heart Study) cohort and assessed association with incident cardiovascular disease events. In participants with whole genome sequencing data (n=2980), we evaluated common and rare genetic variants for association with D-dimer. Each standard deviation higher baseline D-dimer was associated with a 20% to 30% increased hazard for incident coronary heart disease, stroke, and all-cause mortality. Genetic variation near F3 was associated with higher D-dimer (rs2022030, β=0.284, P =3.24×10 -11 ). The rs2022030 effect size was nearly 3× larger among women (β=0.373, P =9.06×10 -13 ) than among men (β=0.135, P =0.06; P interaction =0.009). The sex by rs2022030 interaction was replicated in an independent sample of 10 808 multiethnic men and women ( P interaction =0.001). Finally, the African ancestral sickle cell variant ( HBB rs334) was significantly associated with higher D-dimer in JHS (β=0.507, P =1.41×10 -14 ), and this association was successfully replicated in 1933 AAs ( P =2.3×10 -5 ). These results highlight D-dimer as an important predictor of cardiovascular disease risk in AAs and suggest that sex-specific and African ancestral genetic effects of the F3 and HBB loci contribute to the higher levels of D-dimer among women and AAs. © 2017 American Heart Association, Inc.

Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study.

PubMed

Sims, Mario; Diez-Roux, Ana V; Gebreab, Samson Y; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

2016-02-01

Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES). Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, p<0.05 and 0.43, p<0.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, p<0.05 and -0.18, p<0.001, respectively; and mean difference for lifetime discrimination: -0.08, p<0.05 and -0.24, p<0.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA. 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/

Masked Hypertension and Incident Clinic Hypertension among African Americans in the Jackson Heart Study

PubMed Central

Abdalla, Marwah; Booth, John N.; Seals, Samantha R.; Spruill, Tanya M.; Viera, Anthony J.; Diaz, Keith M.; Sims, Mario; Muntner, Paul; Shimbo, Daichi

2016-01-01

Masked hypertension, defined as non-elevated clinic blood pressure and elevated out-of-clinic blood pressure may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic blood pressure and masked hypertension using ambulatory blood pressure monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of African Americans. Analyses included 317 participants with clinic blood pressure <140/90mmHg, complete ABPM, who were not taking antihypertensive medication at baseline in 2000–2004. Masked daytime hypertension was defined as mean daytime blood pressure ≥135/85mmHg; masked nighttime hypertension as mean nighttime blood pressure ≥120/70mmHg; and masked 24-hour hypertension as mean 24-hour blood pressure ≥130/80mmHg. Incident clinic hypertension, assessed at study visits in 2005–2008 and 2009–2012, was defined as the first visit with clinic systolic/diastolic blood pressure ≥140/90mmHg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked nighttime hypertension and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% CI) of incident clinic hypertension for any masked hypertension and masked daytime, nighttime, and 24-hour hypertension were 2.13 (1.51–3.02), 1.79 (1.24–2.60), 2.22 (1.58–3.12), and 1.91 (1.32–2.75), respectively. These findings suggest that ambulatory blood pressure monitoring can identify African Americans at increased risk for developing clinic hypertension. PMID:27185746

Egg consumption and risk of type 2 diabetes among African Americans: The Jackson Heart Study

PubMed Central

Djoussé, Luc; Petrone, Andrew B; Hickson, DeMarc A; Talegawkar, Sameera A.; Dubbert, Patricia M; Taylor, Herman; Tucker, Katherine L

2015-01-01

Background and Aims Type 2 diabetes (DM) disproportionally affects African Americans. Data on the association between egg consumption and risk of DM are sparse. We sought to examine whether egg consumption is associated with the prevalence and incidence of DM among African Americans. Methods We analyzed baseline data from 4,568 participants of the Jackson Heart Study. Egg consumption was obtained using a food frequency questionnaire designed for this population. We used generalized estimating equations to calculate adjusted prevalence ratios of DM and Cox regression to estimate hazard ratios of DM with corresponding 95% confidence intervals (CI). Results The average age was 55±13 years and 64% of subjects were women. The median frequency of egg consumption was 2/week for men and 1/week for women. The prevalence of DM was 22% overall (21% of men and 23% of women). Multivariable adjusted prevalence ratio [PR(95% CI)] for DM were: 1.00 (ref), 1.14 (0.90–1.44), 1.33 (1.04–1.70), 1.33 (1.06–1.68), 1.26 (0.99–1.61), and 1.52 (1.17–1.97) for egg consumption of <1/month, 1–3/month, 1/week, 2/week, 3–4/week, and 5+/week, respectively, p for linear trend 0.0024. Corresponding multivariable adjusted hazard ratios were 1.00 (ref), 0.88 (0.65–1.19), 0.94 (0.68–1.30), 0.91 (0.66–1.25), 1.11 (0.81–1.52), and 1.17 (0.81–1.70), respectively, during a mean follow up of 7.3 years (p for linear trend 0.22). Conclusions While egg consumption was positively associated with prevalent DM, prospective analysis did not show an association of egg intake with incidence of DM among African Americans. PMID:25971658

Jackson Bar Training Structure Study

DTIC Science & Technology

2015-05-01

comparison of the one-dimensional bridge hydraulic routines from: HEC - RAS , HEC -2, and WSPRO. Davis, CA: U.S. Army Corps of Engineers, Hydrologic Engineering...ER D C/ CH L TR -1 5- 4 Jackson Bar Training Structure Study Co as ta l a nd H yd ra ul ic s La bo ra to ry Jeremy A. Sharp and...The hydrodynamic model was validated with gage data from the U.S. Geological Survey 02470050 Tombigbee River at Steamplant near Leroy, AL, gage

Effects of Serum Creatinine Calibration on Estimated Renal Function in African Americans: the Jackson Heart Study

PubMed Central

Wang, Wei; Young, Bessie A.; Fülöp, Tibor; de Boer, Ian H.; Boulware, L. Ebony; Katz, Ronit; Correa, Adolfo; Griswold, Michael E.

2015-01-01

Background The calibration to Isotope Dilution Mass Spectroscopy (IDMS) traceable creatinine is essential for valid use of the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate the glomerular filtration rate (GFR). Methods For 5,210 participants in the Jackson Heart Study (JHS), serum creatinine was measured with a multipoint enzymatic spectrophotometric assay at the baseline visit (2000–2004) and re-measured using the Roche enzymatic method, traceable to IDMS in a subset of 206 subjects. The 200 eligible samples (6 were excluded, 1 for failure of the re-measurement and 5 for outliers) were divided into three disjoint sets - training, validation, and test - to select a calibration model, estimate true errors, and assess performance of the final calibration equation. The calibration equation was applied to serum creatinine measurements of 5,210 participants to estimate GFR and the prevalence of CKD. Results The selected Deming regression model provided a slope of 0.968 (95% Confidence Interval (CI), 0.904 to 1.053) and intercept of −0.0248 (95% CI, −0.0862 to 0.0366) with R squared 0.9527. Calibrated serum creatinine showed high agreement with actual measurements when applying to the unused test set (concordance correlation coefficient 0.934, 95% CI, 0.894 to 0.960). The baseline prevalence of CKD in the JHS (2000–2004) was 6.30% using calibrated values, compared with 8.29% using non-calibrated serum creatinine with the CKD-EPI equation (P < 0.001). Conclusions A Deming regression model was chosen to optimally calibrate baseline serum creatinine measurements in the JHS and the calibrated values provide a lower CKD prevalence estimate. PMID:25806862

Effects of serum creatinine calibration on estimated renal function in african americans: the Jackson heart study.

PubMed

Wang, Wei; Young, Bessie A; Fülöp, Tibor; de Boer, Ian H; Boulware, L Ebony; Katz, Ronit; Correa, Adolfo; Griswold, Michael E

2015-05-01

The calibration to isotope dilution mass spectrometry-traceable creatinine is essential for valid use of the new Chronic Kidney Disease Epidemiology Collaboration equation to estimate the glomerular filtration rate. For 5,210 participants in the Jackson Heart Study (JHS), serum creatinine was measured with a multipoint enzymatic spectrophotometric assay at the baseline visit (2000-2004) and remeasured using the Roche enzymatic method, traceable to isotope dilution mass spectrometry in a subset of 206 subjects. The 200 eligible samples (6 were excluded, 1 for failure of the remeasurement and 5 for outliers) were divided into 3 disjoint sets-training, validation and test-to select a calibration model, estimate true errors and assess performance of the final calibration equation. The calibration equation was applied to serum creatinine measurements of 5,210 participants to estimate glomerular filtration rate and the prevalence of chronic kidney disease (CKD). The selected Deming regression model provided a slope of 0.968 (95% confidence interval [CI], 0.904-1.053) and intercept of -0.0248 (95% CI, -0.0862 to 0.0366) with R value of 0.9527. Calibrated serum creatinine showed high agreement with actual measurements when applying to the unused test set (concordance correlation coefficient 0.934, 95% CI, 0.894-0.960). The baseline prevalence of CKD in the JHS (2000-2004) was 6.30% using calibrated values compared with 8.29% using noncalibrated serum creatinine with the Chronic Kidney Disease Epidemiology Collaboration equation (P < 0.001). A Deming regression model was chosen to optimally calibrate baseline serum creatinine measurements in the JHS, and the calibrated values provide a lower CKD prevalence estimate.

Roderick Jackson | NREL

Science.gov Websites

Laboratory (ORNL), where he was the group manager for Building Envelope Systems Research. One of Jackson's Manufacturing Integrated Energy (AMIE) demonstration project at ORNL. With Jackson's leadership, AMIE brought

Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study.

PubMed

Ford, Cassandra D; Sims, Mario; Higginbotham, John C; Crowther, Martha R; Wyatt, Sharon B; Musani, Solomon K; Payne, Thomas J; Fox, Ervin R; Parton, Jason M

2016-08-01

Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA. Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors. Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00-1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension. Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study

PubMed Central

Sims, Mario; Higginbotham, John C.; Crowther, Martha R.; Wyatt, Sharon B.; Musani, Solomon K.; Payne, Thomas J.; Fox, Ervin R.; Parton, Jason M.

2016-01-01

BACKGROUND Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA. METHODS Our sample consisted of 1,656 normotensive participants at baseline (2000–2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005–2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors. RESULTS Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05–1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00–1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04–1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension. CONCLUSIONS Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred. PMID:26964661

Genetic Ancestry is Associated with Measures of Subclinical Atherosclerosis in African Americans: The Jackson Heart Study

PubMed Central

Gebreab, Samson Y; Riestra, Pia; Khan, Rumana J; Xu, Ruihua; Musani, Solomon K; Tekola-Ayele, Fasil; Correa, Adolfo; Wilson, James G; Rotimi, Charles N; Davis, Sharon K

2015-01-01

Objective To determine whether genetic ancestry was associated with subclinical atherosclerosis measures after adjustment for traditional CVD risk factors, inflammatory marker, socioeconomic status (SES) and psychosocial factors in a large admixed African American population. Approach and Results Participants were drawn from Jackson Heart Study (JHS). Participant’s percent of European Ancestry (PEA) was estimated based on 1747 genetic markers using HAPMIX. Association of PEA with peripheral arterial disease (PAD) and common carotid intima media thickness (cCIMT) were investigated among 2168 participants and with coronary artery calcification (CAC >0) and abdominal aortic calcification (AAC >0) among 1139 participants. The associations were evaluated using multivariable regression models. Our results showed a 1 standard deviation increase in PEA was associated with a lower PAD prevalence after adjusting for age and gender [Prevalence ratio (PR) = 0. 90 (95% CI: 0.82, 0.99); p=0.036]. Adjustments for traditional CVD risk factors, SES, and psychosocial factors attenuated this association [PR=0.91 (0.82, 1.00); p=0.046]. There was also a non-linear association between PEA and CAC and AAC. The lowest PEA was associated with a lower CAC [PR=0.75 (0.58, 0.96); p=0.022] and a lower AAC [PR=0. 80 (0.67, 0.96); p=0.016] compared to the reference group (10th–90th percentile) after adjusting for traditional CVD risk factors, inflammatory marker, SES and psychosocial factors. However, we found no significant association between PEA and cCIMT. Conclusions Overall, our findings indicate that genetic ancestry was associated with subclinical atherosclerosis, suggesting unmeasured risk factors and/or interactions with genetic factors might contribute to the distribution of subclinical atherosclerosis among African Americans. PMID:25745061

The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study.

PubMed

Johnson, Dayna A; Lisabeth, Lynda; Lewis, Tené T; Sims, Mario; Hickson, DeMarc A; Samdarshi, Tandaw; Taylor, Herman; Diez Roux, Ana V

2016-07-01

Studies have shown that psychosocial stressors are related to poor sleep. However, studies of African Americans, who may be more vulnerable to the impact of psychosocial stressors, are lacking. Using the Jackson Heart Study (JHS) baseline data, we examined associations of psychosocial stressors with sleep in 4,863 African Americans. We examined cross-sectional associations between psychosocial stressors and sleep duration and quality in a large population sample of African Americans. Three measures of psychosocial stress were investigated: the Global Perceived Stress Scale (GPSS); Major Life Events (MLE); and the Weekly Stress Inventory (WSI). Sleep was assessed using self-reported hours of sleep and sleep quality rating (1 = poor; 5 = excellent). Multinomial logistic and linear regression models were used to examine the association of each stress measure (in quartiles) with continuous and categorical sleep duration (< 5 ("very short"), 5-6 h ("short") and > 9 h ("long") versus 7 or 8 h ("normal"); and with sleep quality after adjustment for demographics and risk factors (body mass index, hypertension, diabetes, physical activity). Mean age of the sample was 54.6 years and 64% were female. Mean sleep duration was 6.4 + 1.5 hours, 54% had a short sleep duration, 5% had a long sleep duration, and 34% reported a "poor" or "fair" sleep quality. Persons in the highest GPSS quartile had higher odds of very short sleep (odds ratio: 2.87, 95% confidence interval [CI]: 2.02, 4.08), higher odds of short sleep (1.72, 95% CI: 1.40, 2.12), shorter average sleep duration (Δ = -33.6 min (95% CI: -41.8, -25.4), and reported poorer sleep quality (Δ = -0.73 (95% CI: -0.83, -0.63) compared to those in the lowest quartile of GPSS after adjustment for covariates. Similar patterns were observed for WSI and MLE. Psychosocial stressors were not associated with long sleep. For WSI, effects of stress on sleep duration were stronger for younger (< 60 y) and college-educated African

Depth of the base of the Jackson aquifer, based on geophysical exploration, southern Jackson Hole, Wyoming, USA

USGS Publications Warehouse

Nolan, B.T.; Campbell, D.L.; Senterfit, R.M.

1998-01-01

A geophysical survey was conducted to determine the depth of the base of the water-table aquifer in the southern part of Jackson Hole, Wyoming, USA. Audio-magnetotellurics (AMT) measurements at 77 sites in the study area yielded electrical-resistivity logs of the subsurface, and these were used to infer lithologic changes with depth. A 100-600 ohm-m geoelectric layer, designated the Jackson aquifer, was used to represent surficial saturated, unconsolidated deposits of Quaternary age. The median depth of the base of the Jackson aquifer is estimated to be 200 ft (61 m), based on 62 sites that had sufficient resistivity data. AMT-measured values were kriged to predict the depth to the base of the aquifer throughout the southern part of Jackson Hole. Contour maps of the kriging predictions indicate that the depth of the base of the Jackson aquifer is shallow in the central part of the study area near the East and West Gros Ventre Buttes, deeper in the west near the Teton fault system, and shallow at the southern edge of Jackson Hole. Predicted, contoured depths range from 100 ft (30 m) in the south, near the confluences of Spring Creek and Flat Creek with the Snake River, to 700 ft (210 m) in the west, near the town of Wilson, Wyoming.

Prevalence, Determinants, and Clinical Significance of Masked Hypertension in a Population-Based Sample of African Americans: The Jackson Heart Study.

PubMed

Diaz, Keith M; Veerabhadrappa, Praveen; Brown, Michael D; Whited, Matthew C; Dubbert, Patricia M; Hickson, DeMarc A

2015-07-01

The disproportionate rates of cardiovascular disease in African Americans may, in part, be due to suboptimal assessment of blood pressure (BP) with clinic BP measurements alone. To date, however, the prevalence of masked hypertension in African Americans has not been fully delineated. The purpose of this study was to evaluate masked hypertension prevalence in a large population-based sample of African Americans and examine its determinants and association with indices of target organ damage (TOD). Clinic and 24-hour ambulatory BP monitoring were conducted in 972 African Americans enrolled in the Jackson Heart Study. Common carotid artery intima-media thickness, left ventricular mass index, and the urinary albumin:creatinine excretion ratio were evaluated as indices of TOD. Masked hypertension prevalence was 25.9% in the overall sample and 34.4% in participants with normal clinic BP. All indices of TOD were significantly higher in masked hypertensives compared to sustained normotensives and were similar between masked hypertensives and sustained hypertensives. Male gender, smoking, diabetes, and antihypertensive medication use were independent determinants of masked hypertension in multivariate analyses. In this population-based cohort of African Americans, approximately one-third of participants with presumably normal clinic BP had masked hypertension when BP was assessed in their daily environment. Masked hypertension was accompanied by a greater degree of TOD in this cohort. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

77 FR 17564 - Public Notice for Waiver of Aeronautical Land-Use Assurance; Jackson Municipal Airport, Jackson, MN

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... Aeronautical Land-Use Assurance; Jackson Municipal Airport, Jackson, MN AGENCY: Federal Aviation Administration... the Jackson Municipal Airport, Jackson MN. The City is proposing a land swap to exchange this 18 acre...-aid funding from the FAA. The disposition of proceeds from the disposal of the airport property will...

Risk Factors for Rapid Kidney Function Decline Among African Americans: The Jackson Heart Study (JHS)

PubMed Central

Young, Bessie A.; Katz, Ronit; Boulware, Ebony; Kestenbaum, Bryan; de Boer, Ian H.; Wang, Wei; Fülöp, Tibor; Bansal, Nisha; Robinson-Cohen, Cassianne; Griswold, Michael; Powe, Neil N.; Himmelfarb, Jonathan; Correa, Adolfo

2016-01-01

Background Racial differences in rapid kidney function decline exist, but less is known regarding factors associated with rapid decline among African Americans. A greater understanding of potentially modifiable risk factors for early kidney function loss may help reduce the burden of kidney failure in this high-risk population. Study Design Prospective cohort study. Setting & Participants 3653 African-American participants enrolled in the Jackson Heart Study (JHS) with kidney function data from two of three examinations (2000-2004 and 2009-2013). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI creatinine equation. Predictors Demographics, socioeconomic status, lifestyle, clinical risk factors for kidney failure. Outcomes Rapid decline was defined as a ≥ 30% decline in eGFR during follow-up. We quantified the association of risk factors with rapid decline in multivariable models. Measurements Clinical (systolic blood pressure, albuminuria [albumin-creatinine ratio]) and modifiable risk factors. Results Mean age was 54 ± 12 (SD) years, 37% were male, average body mass index was 31.8 ± 7.1 kg/m2, 19% had diabetes mellitus (DM) and mean eGFR was 96.0 ±20 ml/min/1.73m2 with an annual rate of decline of 1.27 ml/min/1.73m2. Those with rapid decline (11.5%) were older, more likely to be of low/middle income, had higher systolic blood pressure, and greater DM than those with non-rapid decline. Factors associated with ≥30% decline were older age (adjusted OR per 10 years older, 1.51; 95% CI, 1.34-1.71); cardiovascular disease (adjusted OR, 1.53; 95% CI, 1.12-2.10), higher systolic blood pressure (adjusted OR per 17 mm Hg greater, 1.22; 95% CI, 1.06-1.41); DM (adjusted OR, 2.63; 95% CI, 2.02-3.41), smoking (adjusted OR, 1.60; 95% CI, 1.10-2.31), and albumin-creatinine ratio > 30 mg/g (adjusted OR, 1.55; 95% CI, 1.08-1.21). Conversely, results did not support associations of waist circumference, C-reactive protein, and

The Journey for Jackson State

ERIC Educational Resources Information Center

Roach, Ronald

2007-01-01

This article profiles Jackson State University, a historically Black school of more than 8,000 students located at the southern end of Jackson, Mississippi's majority-Black capital city. Founded in 1877, Jackson State has emerged as one of Mississippi's leading research institutions as well as one of the top HBCUs in the country for research. Its…

Associations of Fast Food Restaurant Availability With Dietary Intake and Weight Among African Americans in the Jackson Heart Study, 2000–2004

PubMed Central

Diez Roux, Ana V.; Smith, Adam E.; Tucker, Katherine L.; Gore, Larry D.; Zhang, Lei; Wyatt, Sharon B.

2011-01-01

Objectives. We examined the associations of fast food restaurant (FFR) availability with dietary intake and weight among African Americans in the southeastern United States. Methods. We investigated cross-sectional associations of FFR availability with dietary intake and body mass index (BMI) and waist circumference in 4740 African American Jackson Heart Study participants (55.2 ±12.6 years, 63.3% women). We estimated FFR availability using circular buffers with differing radii centered at each participant's geocoded residential location. Results. We observed no consistent associations between FFR availability and BMI or waist circumference. Greater FFR availability was associated with higher energy intake among men and women younger than 55 years, even after adjustment for individual socioeconomic status. For each standard deviation increase in 5-mile FFR availability, the energy intake increased by 138 kilocalories (confidence interval [CI] = 70.53, 204.75) for men and 58 kilocalories (CI = 8.55, 105.97) for women. We observed similar associations for the 2-mile FFR availability, especially in men. FFR availability was also unexpectedly positively associated with total fiber intake. Conclusions. FFR availability may contribute to greater energy intake in younger African Americans who are also more likely to consume fast food. PMID:21551382

Validity and Calibration of Food Frequency Questionnaires used with African American Adults in the Jackson Heart Study

PubMed Central

Carithers, Teresa C.; Talegawkar, Sameera A.; Rowser, Marjuyua L.; Henry, Olivia R.; Dubbert, Patricia M.; Bogle, Margaret L; Taylor, Herman A.

2009-01-01

Objective To examine the relative validity of two Food Frequency Questionnaires (FFQs) developed for use in investigating diet and disease relationships within the adult African American population in the southern United States. Design Cross-sectional analyses of dietary nutrient intake data, comparing four 24-hour dietary recalls with a FFQ developed by the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI), and its shorter version adapted for use in the Jackson Heart Study (JHS). Subjects A representative subset of participants (n=499, 35-81 y) from the baseline JHS cohort (N=5,302) was selected for this study. Data collection took place between winter of 2000 and spring of 2004. Statistical Analyses Pearson's correlation coefficients (energy adjusted and de-attenuated) for 26 nutrients estimates from each of the FFQs, comparing them with the mean of four 24-hour dietary recalls. The ability of the FFQs to rank individuals based on nutrient intakes was compared to that of the mean of four 24-hour dietary recalls and attenuation coefficients were also calculated. Results Median nutrient intake estimates tended to be higher on the long and lower on the short FFQ compared to the median for the mean of four 24-hour dietary recalls. Energy adjusted and de-attenuated correlations of FFQ intake estimates with recalls ranged from 0.20 for sodium to 0.70 for carbohydrate for the short FFQ and from 0.23 for polyunsaturated fat to 0.75 for dietary fiber and magnesium for the long. Attenuation coefficients for men on average were 0.42 for the short and 0.49 for the long FFQ. For women, these were 0.31 for the short and 0.42 for the long FFQ. Conclusions Both FFQs appear to be reasonably valid for assessment of dietary intake of adult African Americans in the South. The Delta NIRI FFQ exhibited higher intake estimates and stronger correlations with recalls than the JHS FFQ for most nutrients analyzed, more so for women than men. PMID:19559135

The Impact of Lifecourse Socioeconomic Position on Cardiovascular Disease Events in African Americans: The Jackson Heart Study

PubMed Central

Gebreab, Samson Y; Diez Roux, Ana V; Brenner, Allison B; Hickson, DeMarc A; Sims, Mario; Subramanyam, Malavika; Griswold, Michael E; Wyatt, Sharon B; James, Sherman A

2015-01-01

Background Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. Methods and Results We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother’s education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men. Conclusions Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population. PMID:26019130

Depth of the base of the Jackson aquifer, based on geophysical exploration, southern Jackson Hole, Wyoming, USA

NASA Astrophysics Data System (ADS)

Nolan, Bernard T.; Campbell, David L.; Senterfit, Robert M.

A geophysical survey was conducted to determine the depth of the base of the water-table aquifer in the southern part of Jackson Hole, Wyoming, USA. Audio-magnetotellurics (AMT) measurements at 77 sites in the study area yielded electrical-resistivity logs of the subsurface, and these were used to infer lithologic changes with depth. A 100-600ohm-m geoelectric layer, designated the Jackson aquifer, was used to represent surficial saturated, unconsolidated deposits of Quaternary age. The median depth of the base of the Jackson aquifer is estimated to be 200ft (61m), based on 62 sites that had sufficient resistivity data. AMT-measured values were kriged to predict the depth to the base of the aquifer throughout the southern part of Jackson Hole. Contour maps of the kriging predictions indicate that the depth of the base of the Jackson aquifer is shallow in the central part of the study area near the East and West Gros Ventre Buttes, deeper in the west near the Teton fault system, and shallow at the southern edge of Jackson Hole. Predicted, contoured depths range from 100ft (30m) in the south, near the confluences of Spring Creek and Flat Creek with the Snake River, to 700ft (210m) in the west, near the town of Wilson, Wyoming. Résumé Une campagne géophysique a été entreprise pour préciser la profondeur du mur de l'aquifère dans le secteur sud de Jackson Hole (Wyoming, États-Unis). Des mesures audio-magnétotelluriques (audio MT) sur 77 sites de ce secteur ont fourni des logs de résistivitéélectrique du sous-sol ; les variations de la lithologie en fonction de la profondeur en ont été déduites. Un niveau géoélectrique à 100-600ohm.m, dénommé "aquifère de Jackson", a servi à définir des dépôts superficiels quaternaires saturés en eau et non consolidés. La profondeur médiane de la base de l'aquifère de Jackson est de l'ordre de 61m, à partir des 62 sites ayant fourni suffisamment de données de résistivité. Les valeurs audio MT mesur

Risk Factors for Rapid Kidney Function Decline Among African Americans: The Jackson Heart Study (JHS).

PubMed

Young, Bessie A; Katz, Ronit; Boulware, L Ebony; Kestenbaum, Bryan; de Boer, Ian H; Wang, Wei; Fülöp, Tibor; Bansal, Nisha; Robinson-Cohen, Cassianne; Griswold, Michael; Powe, Neil R; Himmelfarb, Jonathan; Correa, Adolfo

2016-08-01

Racial differences in rapid kidney function decline exist, but less is known regarding factors associated with rapid decline among African Americans. Greater understanding of potentially modifiable risk factors for early kidney function loss may help reduce the burden of kidney failure in this high-risk population. Prospective cohort study. 3,653 African American participants enrolled in the Jackson Heart Study (JHS) with kidney function data from 2 of 3 examinations (2000-2004 and 2009-2013). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the CKD-EPI creatinine equation. Demographics, socioeconomic status, lifestyle, and clinical risk factors for kidney failure. Rapid decline was defined as a ≥30% decline in eGFR during follow-up. We quantified the association of risk factors with rapid decline in multivariable models. Clinical (systolic blood pressure and albuminuria [albumin-creatinine ratio]) and modifiable risk factors. Mean age was 54±12 (SD) years, 37% were men, average body mass index was 31.8±7.1kg/m(2), 19% had diabetes mellitus (DM), and mean eGFR was 96.0±20mL/min/1.73m(2) with an annual rate of decline of 1.27mL/min/1.73m(2). Those with rapid decline (11.5%) were older, were more likely to be of low/middle income, and had higher systolic blood pressures and greater DM than those with nonrapid decline. Factors associated with ≥30% decline were older age (adjusted OR per 10 years older, 1.51; 95% CI, 1.34-1.71), cardiovascular disease (adjusted OR, 1.53; 95% CI, 1.12-2.10), higher systolic blood pressure (adjusted OR per 17mmHg greater, 1.22; 95% CI, 1.06-1.41), DM (adjusted OR, 2.63; 95% CI, 2.02-3.41), smoking (adjusted OR, 1.60; 95% CI, 1.10-2.31), and albumin-creatinine ratio > 30mg/g (adjusted OR, 1.55; 95% CI, 1.08-1.21). Conversely, results did not support associations of waist circumference, C-reactive protein level, and physical activity with rapid decline. No midstudy creatinine measurement at

Comparison consequences of Jackson-Pratt drain versus chest tube after coronary artery bypass grafting: A randomized controlled clinical trial.

PubMed

Mirmohammad-Sadeghi, Mohsen; Pourazari, Pejman; Akbari, Mojtaba

2017-01-01

Chest tubes are used in every case of coronary artery bypass grafting (CABG) to evacuate shed blood from around the heart and lungs. This study was designed to assess the effective of Jackson-Pratt drain in compare with conventional chest drains after CABG. This was a randomized controlled trial that conducted on 218 patients in Chamran hospital from February to December 2016. Eligible patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109 patients who received a chest tube insertion in the pleural space of the left lung and a Jackson-Pratt drain in mediastinum, and Chest tube drainage group had 109 patients who received double chest tube insertion in the pleural space of the left lung and the mediastinum. The incidence of pleural effusions in Jackson-Pratt drain group and chest tube group were not statistically different. The pain score at 2-h in Drain group was significantly higher than chest tube group ( P = 0.001), but the trend of pain score between groups was not significantly different ( P = 0.097). The frequency of tamponade and atrial fibrillation (AF) were significantly lower in Jackson-Pratt drain group ( P < 0.05). The Jackson-Pratt drain is equally effective for preventing cardiac tamponade, pleural effusions, and pain intensity in patients after CABG when compared with conventional chest tubes, but was significantly superior regarding efficacy to hospital and Intensive Care Unit length of stay and the incidence of AF.

Circadian CLOCK gene polymorphisms in relation to sleep patterns and obesity in African Americans: findings from the Jackson heart study.

PubMed

Riestra, Pia; Gebreab, Samson Y; Xu, Ruihua; Khan, Rumana J; Gaye, Amadou; Correa, Adolfo; Min, Nancy; Sims, Mario; Davis, Sharon K

2017-06-23

Circadian rhythms regulate key biological processes and the dysregulation of the intrinsic clock mechanism affects sleep patterns and obesity onset. The CLOCK (circadian locomotor output cycles protein kaput) gene encodes a core transcription factor of the molecular circadian clock influencing diverse metabolic pathways, including glucose and lipid homeostasis. The primary objective of this study was to evaluate the associations between CLOCK single nucleotide polymorphisms (SNPs) and body mass index (BMI). We also evaluated the association of SNPs with BMI related factors such as sleep duration and quality, adiponectin and leptin, in 2962 participants (1116 men and 1810 women) from the Jackson Heart Study. Genotype data for the selected 23 CLOCK gene SNPS was obtained by imputation with IMPUTE2 software and reference phase data from the 1000 genome project. Genetic analyses were conducted with PLINK RESULTS: We found a significant association between the CLOCK SNP rs2070062 and sleep duration, participants carriers of the T allele showed significantly shorter sleep duration compared to non-carriers after the adjustment for individual proportions of European ancestry (PEA), socio economic status (SES), body mass index (BMI), alcohol consumption and smoking status that reach the significance threshold after multiple testing correction. In addition, we found nominal associations of the CLOCK SNP rs6853192 with longer sleep duration and the rs6820823, rs3792603 and rs11726609 with BMI. However, these associations did not reach the significance threshold after correction for multiple testing. In this work, CLOCK gene variants were associated with sleep duration and BMI suggesting that the effects of these polymorphisms on circadian rhythmicity may affect sleep duration and body weight regulation in Africans Americans.

Prevalence, associated factors and heritabilities of metabolic syndrome and its individual components in African Americans: the Jackson Heart Study

PubMed Central

Khan, Rumana J; Gebreab, Samson Y; Sims, Mario; Riestra, Pia; Xu, Ruihua; Davis, Sharon K

2015-01-01

Objective Both environmental and genetic factors play important roles in the development of metabolic syndrome (MetS). Studies about its associated factors and genetic contribution in African Americans (AA) are sparse. Our aim was to report the prevalence, associated factors and heritability estimates of MetS and its components in AA men and women. Participants and setting Data of this cross-sectional study come from a large community-based Jackson Heart Study (JHS). We analysed a total of 5227 participants, of whom 1636 from 281 families were part of a family study subset of JHS. Methods Participants were classified as having MetS according to the Adult Treatment Panel III criteria. Multiple logistic regression analysis was performed to isolate independently associated factors of MetS (n=5227). Heritability was estimated from the family study subset using variance component methods (n=1636). Results About 27% of men and 40% of women had MetS. For men, associated factors with having MetS were older age, lower physical activity, higher body mass index, and higher homocysteine and adiponectin levels (p<0.05 for all). For women, in addition to all these, lower education, current smoking and higher stress were also significant (p<0.05 for all). After adjusting for covariates, the heritability of MetS was 32% (p<0.001). Heritability ranged from 14 to 45% among its individual components. Relatively higher heritability was estimated for waist circumference (45%), high density lipoprotein-cholesterol (43%) and triglycerides (42%). Heritability of systolic blood pressure (BP), diastolic BP and fasting blood glucose was 16%, 15% and 14%, respectively. Conclusions Stress and low education were associated with having MetS in AA women, but not in men. Higher heritability estimates for lipids and waist circumference support the hypothesis of lipid metabolism playing a central role in the development of MetS and encourage additional efforts to identify the underlying

77 FR 71429 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and... clearly unwarranted invasion of personal privacy. Name of Committee: National Heart, Lung, and Blood Institute Special Emphasis Panel Jackson Heart Study Renewal. Date: December 17, 2012. Time: 9:00 a.m. to 2...

The combined effects of genetic risk and perceived discrimination on blood pressure among African Americans in the Jackson Heart Study

PubMed Central

Taylor, Jacquelyn Y.; Sun, Yan V.; Barcelona de Mendoza, Veronica; Ifatunji, Mosi; Rafferty, Jane; Fox, Ervin R.; Musani, Solomon K.; Sims, Mario; Jackson, James S.

2017-01-01

Abstract Both genomics and environmental stressors play a significant role in increases in blood pressure (BP). In an attempt to further explain the hypertension (HTN) disparity among African Americans (AA), both genetic underpinnings (selected candidate genes) and stress due to perceived racial discrimination (as reported in the literature) have independently been linked to increased BP among AAs. Although Gene x Environment interactions on BP have been examined, the environmental component of these investigations has focused more on lifestyle behaviors such as smoking, diet, and physical activity, and less on psychosocial stressors such as perceived discrimination. The present study uses candidate gene analyses to identify the relationship between Everyday Discrimination (ED) and Major Life Discrimination (MLD) with increases in systolic BP (SBP) and diastolic BP (DBP) among AA in the Jackson Heart Study. Multiple linear regression models reveal no association between discrimination and BP after adjusting for age, sex, body mass index (BMI), antihypertensive medication use, and current smoking status. Subsequent candidate gene analysis identified 5 SNPs (rs7602215, rs3771724, rs1006502, rs1791926, and rs2258119) that interacted with perceived discrimination and SBP, and 3 SNPs (rs2034454, rs7602215, and rs3771724) that interacted with perceived discrimination and DBP. Most notably, there was a significant SNP × discrimination interaction for 2 SNPs on the SLC4A5 gene: rs3771724 (MLD: SBP P = .034, DBP P = .031; ED: DBP: P = .016) and rs1006502 (MLD: SBP P = .034, DBP P = .030; ED: DBP P = .015). This study supports the idea that SNP × discrimination interactions combine to influence clinically relevant traits such as BP. Replication with similar epidemiological samples is required to ascertain the role of genes and psychosocial stressors in the development and expression of high BP in this understudied population. PMID:29069027

The combined effects of genetic risk and perceived discrimination on blood pressure among African Americans in the Jackson Heart Study.

PubMed

Taylor, Jacquelyn Y; Sun, Yan V; Barcelona de Mendoza, Veronica; Ifatunji, Mosi; Rafferty, Jane; Fox, Ervin R; Musani, Solomon K; Sims, Mario; Jackson, James S

2017-10-01

Both genomics and environmental stressors play a significant role in increases in blood pressure (BP). In an attempt to further explain the hypertension (HTN) disparity among African Americans (AA), both genetic underpinnings (selected candidate genes) and stress due to perceived racial discrimination (as reported in the literature) have independently been linked to increased BP among AAs. Although Gene x Environment interactions on BP have been examined, the environmental component of these investigations has focused more on lifestyle behaviors such as smoking, diet, and physical activity, and less on psychosocial stressors such as perceived discrimination.The present study uses candidate gene analyses to identify the relationship between Everyday Discrimination (ED) and Major Life Discrimination (MLD) with increases in systolic BP (SBP) and diastolic BP (DBP) among AA in the Jackson Heart Study. Multiple linear regression models reveal no association between discrimination and BP after adjusting for age, sex, body mass index (BMI), antihypertensive medication use, and current smoking status.Subsequent candidate gene analysis identified 5 SNPs (rs7602215, rs3771724, rs1006502, rs1791926, and rs2258119) that interacted with perceived discrimination and SBP, and 3 SNPs (rs2034454, rs7602215, and rs3771724) that interacted with perceived discrimination and DBP. Most notably, there was a significant SNP × discrimination interaction for 2 SNPs on the SLC4A5 gene: rs3771724 (MLD: SBP P = .034, DBP P = .031; ED: DBP: P = .016) and rs1006502 (MLD: SBP P = .034, DBP P = .030; ED: DBP P = .015).This study supports the idea that SNP × discrimination interactions combine to influence clinically relevant traits such as BP. Replication with similar epidemiological samples is required to ascertain the role of genes and psychosocial stressors in the development and expression of high BP in this understudied population.

Comparison consequences of Jackson-Pratt drain versus chest tube after coronary artery bypass grafting: A randomized controlled clinical trial

PubMed Central

Mirmohammad-Sadeghi, Mohsen; Pourazari, Pejman; Akbari, Mojtaba

2017-01-01

Background: Chest tubes are used in every case of coronary artery bypass grafting (CABG) to evacuate shed blood from around the heart and lungs. This study was designed to assess the effective of Jackson-Pratt drain in compare with conventional chest drains after CABG. Materials and Methods: This was a randomized controlled trial that conducted on 218 patients in Chamran hospital from February to December 2016. Eligible patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109 patients who received a chest tube insertion in the pleural space of the left lung and a Jackson-Pratt drain in mediastinum, and Chest tube drainage group had 109 patients who received double chest tube insertion in the pleural space of the left lung and the mediastinum. Results: The incidence of pleural effusions in Jackson-Pratt drain group and chest tube group were not statistically different. The pain score at 2-h in Drain group was significantly higher than chest tube group (P = 0.001), but the trend of pain score between groups was not significantly different (P = 0.097). The frequency of tamponade and atrial fibrillation (AF) were significantly lower in Jackson-Pratt drain group (P < 0.05). Conclusion: The Jackson-Pratt drain is equally effective for preventing cardiac tamponade, pleural effusions, and pain intensity in patients after CABG when compared with conventional chest tubes, but was significantly superior regarding efficacy to hospital and Intensive Care Unit length of stay and the incidence of AF. PMID:29387121

77 FR 43343 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and... unwarranted invasion of personal privacy. Name of Committee: National Heart, Lung, and Blood Institute Special Emphasis Panel; Jackson Heart Study RFA Review. Date: August 15, 2012. Time: 8:00 a.m. to 5:30 p.m. Agenda...

Double-jeopardy: The joint impact of neighborhood disadvantage and low social cohesion on cumulative risk of disease among African American men and women in the Jackson Heart Study.

PubMed

Barber, Sharrelle; Hickson, DeMarc A; Kawachi, Ichiro; Subramanian, S V; Earls, Felton

2016-03-01

Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)-a measure of accumulated risk across multiple physiological systems. Our analysis included 4408 African American women and men ages 21-85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender. The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p = 0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B = 0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p = 0.05) but not for women (p = 0.50). Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may face a unique set of challenges

Double-Jeopardy: The Joint Impact of Neighborhood Disadvantage and Low Social Cohesion on Cumulative Risk of Disease Among African American Men and Women in the Jackson Heart Study

PubMed Central

Barber, Sharrelle; Hickson, DeMarc A.; Kawachi, Ichiro; Subramanian, S.V.; Earls, Felton

2016-01-01

Objectives Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)—a measure of accumulated risk across multiple physiological systems. Methods Our analysis included 4,408 African American women and men ages 21–85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender. Results The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p=0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B=0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p=0.05) but not for women (p=0.50). Conclusion Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may

Neighborhood Disadvantage and Cumulative Biological Risk Among a Socioeconomically Diverse Sample of African American Adults: An Examination in the Jackson Heart Study.

PubMed

Barber, Sharrelle; Hickson, DeMarc A; Kawachi, Ichiro; Subramanian, S V; Earls, Felton

2016-09-01

Neighborhoods characterized by disadvantage influence multiple risk factors for chronic disease and are considered potential drivers of racial and ethnic health inequities in the USA. The objective of the present study was to examine the relationship between neighborhood disadvantage and cumulative biological risk (CBR) and the extent to which the association differs by individual income and education among a large, socioeconomically diverse sample of African American adults. Data from the baseline examination of the Jackson Heart Study (2000-2004) were used for the analyses. The sample consisted of African American adults ages 21-85 with complete, geocoded data on CBR biomarkers and behavioral covariates (n = 4410). Neighborhood disadvantage was measured using a composite score of socioeconomic indicators from the 2000 US Census. Eight biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were used to create a CBR score. We fit two-level linear regression models with random intercepts and included cross-level interaction terms between neighborhood disadvantage and individual socioeconomic status (SES). Living in a disadvantaged neighborhood was associated with greater CBR after covariate adjustment (B = 0.18, standard error (SE) 0.07, p < 0.05). Interactions showed a weaker association for individuals with ≤high school education but were not statistically significant. Disadvantaged neighborhoods contribute to poor health among African American adults via cumulative biological risk. Policies directly addressing the socioeconomic conditions of these environments should be considered as viable options to reduce disease risk in this group and mitigate racial/ethnic health inequities.

Neighborhood Disadvantage and Cumulative Biological Risk Among a Socioeconomically Diverse Sample of African American Adults: An Examination in the Jackson Heart Study

PubMed Central

Barber, Sharrelle; Hickson, DeMarc A.; Kawachi, Ichiro; Subramanian, S.V.; Earls, Felton

2015-01-01

Objectives Neighborhoods characterized by disadvantage influence multiple risk factors for chronic disease and are considered potential drivers of racial and ethnic health inequities in the United States. The objective of the present study was to examine the relationship between neighborhood disadvantage and cumulative biological risk (CBR) and the extent to which the association differs by individual income and education among a large, socio-economically diverse sample of African American adults. Methods Data from the baseline examination of the Jackson Heart Study (2000-2004) were used for the analyses. The sample consisted of African American adults ages 21-85 with complete, geocoded data on CBR biomarkers and behavioral covariates (n=4,410). Neighborhood disadvantage was measured using a composite score of socioeconomic indicators from the 2000 US Census. Eight biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were used to create a CBR score. We fit two-level linear regression models with random intercepts and included cross-level interaction terms between neighborhood disadvantage and individual SES. Results Living in a disadvantaged neighborhood was associated with greater CBR after covariate adjustment (B=0.18, SE: 0.07, p<0.05). Interactions showed a weaker association for individuals with ≤ high school education, but were not statistically significant. Conclusion Disadvantaged neighborhoods contribute to poor health among African American adults via cumulative biological risk. Policies directly addressing the socioeconomic conditions of these environments should be considered as viable options to reduce disease risk in this group and mitigate racial/ethnic health inequities. PMID:27294737

The association between individual and combined components of metabolic syndrome and chronic kidney disease among African Americans: the Jackson Heart Study.

PubMed

Mendy, Vincent L; Azevedo, Mario J; Sarpong, Daniel F; Rosas, Sylvia E; Ekundayo, Olugbemiga T; Sung, Jung Hye; Bhuiyan, Azad R; Jenkins, Brenda C; Addison, Clifton

2014-01-01

Approximately 26.3 million people in the United States have chronic kidney disease and many more are at risk of developing the condition. The association between specific metabolic syndrome components and chronic kidney disease in African American individuals is uncertain. Baseline data from 4,933 participants of the Jackson Heart Study were analyzed. Logistic regression models were used to estimate the odds and 95% confidence intervals of chronic kidney disease associated with individual components, metabolic syndrome, the number of components, and specific combinations of metabolic syndrome components. Metabolic syndrome was common with a prevalence of 42.0%. Chronic kidney disease was present in 19.4% of participants. The prevalence of metabolic components was high: elevated blood pressure (71.8%), abdominal obesity (65.8%), low fasting high density lipoprotein cholesterol (37.3%), elevated fasting glucose (32.2%) and elevated triglycerides (16.2%). Elevated blood pressure, triglycerides, fasting blood glucose, and abdominal obesity were significantly associated with increased odds of chronic kidney disease. Participants with metabolic syndrome had a 2.22-fold (adjusted odds ratio (AOR) 2.22; 95% CI, 1.78-2.78) increase in the odds of chronic kidney disease compared to participants without metabolic syndrome. The combination of elevated fasting glucose, elevated triglycerides, and abdominal obesity was associated with the highest odds for chronic kidney disease (AOR 25.11; 95% CI, 6.94-90.90). Metabolic syndrome as well as individual or combinations of metabolic syndrome components are independently associated with chronic kidney disease in African American adults.

Association of the Joint Effect of Menopause and Hormone Replacement Therapy and Cancer in African American Women: The Jackson Heart Study

PubMed Central

Campbell Jenkins, Brenda W.; Addison, Clifton; Wilson, Gregory; Liu, Jiankang; Fortune, Melody; Robinson, Kiana; White, Monique; Sarpong, Daniel

2011-01-01

Cancer is the second leading cause of death in the US and in Mississippi. Breast cancer (BC) is the most common cancer among women, and the underlying pathophysiology remains unknown, especially among African American (AA) women. The study purpose was to examine the joint effect of menopause status (MS) and hormone replacement therapy (HRT) on the association with cancers, particularly BC using data from the Jackson Heart Study. The analytic sample consisted of 3202 women between 35 and 84 years of which 73.7% and 22.6% were postmenopausal and on HRT, respectively. There were a total of 190 prevalent cancer cases (5.9%) in the sample with 22.6% breast cancer cases. Menopause (p < 0.0001), but not HRT (p = 0.6402), was independently associated with cancer. Similar results were obtained for BC. BC, cancer, hypertension, type 2 diabetes, prevalent cardiovascular disease, physical activity and certain dietary practices were all significantly associated with the joint effect of menopause and HRT in the unadjusted analyses. The family history of cancer was the only covariate that was significantly associated with cancer in the age-adjusted models. In examining the association of cancer and the joint effect of menopause and HRT, AA women who were menopausal and were not on HRT had a 1.97 (95% CI: 1.15, 3.38) times odds of having cancer compared to pre-menopausal women after adjusting for age; which was attenuated after further adjusting for family history of cancer. Given that the cancer and BC cases were small and key significant associations were attenuated after adjusting for the above mentioned covariates, these findings warrant further investigation in studies with larger sample sizes of cancer (and BC) cases. PMID:21776241

Dietary Potential Renal Acid Load and Risk of Albuminuria and Reduced Kidney Function in the Jackson Heart Study.

PubMed

Banerjee, Tanushree; Tucker, Katherine; Griswold, Michael; Wyatt, Sharon B; Harman, Jane; Young, Bessie; Taylor, Herman; Powe, Neil R

2018-07-01

Diets high in sulfur-rich protein and low in fruit and vegetables affect human acid-base balance adversely and may have a harmful effect on progression of chronic kidney disease (CKD). Little is known about the relationship of participant characteristics, dietary acid load (DAL), and kidney injury in African-Americans with high risk of CKD progression. We examined the association of DAL with CKD in 3,257 African-Americans aged >20 years in Jackson Heart Study. DAL was measured with nutrient intakes assessed with a food frequency questionnaire, using a model described by Remer and Manz. We tested associations of participant characteristics with DAL using median regression, and associations of DAL with albuminuria (>17 mg/g for men, >25 mg/g for women), reduced kidney function (eGFR <60 mL/minute/1.73 m 2 ), or CKD defined as albuminuria or reduced kidney function using logistic regression. We further explored whether endothelin and aldosterone production in participants with hypertension mediated risk of albuminuria or reduced kidney function due to the intake of an acid-inducing diet. Younger adults, men, and those with higher body mass index had higher DAL. Higher DAL, compared with lower, was associated with greater odds of reduced kidney function (OR [95% CI]: 2.82 [1.40-4.75]). Higher DAL was also associated with greater risk of CKD, and this persisted after adjustment for confounders. Results were similar in adults with hypertension; the OR [95% CI] for highest, versus lowest, tertile of DAL with albuminuria was 1.66 [1.01-2.59]. Aldosterone and endothelin mediated the association between DAL and albuminuria; the OR [95% CI] in the highest tertile was no longer significant 1.53 [0.97-2.40] after their inclusion. Higher DAL was associated with higher prevalence of CKD and with reduced kidney function. DAL may be an important target for future interventions in African-Americans at high risk of CKD. Copyright © 2018 National Kidney Foundation, Inc

High-Sensitivity C-Reactive Protein Is Associated With Incident Type 2 Diabetes Among African Americans: The Jackson Heart Study.

PubMed

Effoe, Valery S; Correa, Adolfo; Chen, Haiying; Lacy, Mary E; Bertoni, Alain G

2015-09-01

Previous studies on the association between hs-CRP and incident type 2 diabetes among African Americans have been inconclusive. We examined the association between hs-CRP and incident diabetes in a large African American cohort (Jackson Heart Study). hs-CRP was measured in 3,340 participants. Incident diabetes was defined by fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or A1C ≥6.5% (48 mmol/mol) at follow-up. Cox regression was used to estimate hazard ratios (HRs) for incident diabetes, adjusting for age, sex, education, diabetes family history, alcohol, HDL, triglycerides, hypertension status, hypertension medications, physical activity, BMI, HOMA-insulin resistance (HOMAIR), and waist circumference. Participants (63% women) were aged 53.3 ± 12.5 years. During a median follow-up of 7.5 years, 17.4% developed diabetes (23.1/1,000 person-years, 95% CI 21.3-25.1). After adjustment, the HR (hs-CRP third vs. first tertile) was 1.64 (95% CI 1.26-2.13). In separate models, further adjustment for BMI and waist circumference attenuated this association (HR 1.28 [95% CI 0.97-1.69] and 1.35 [95% CI 1.03-1.78, P < 0.05 for trend], respectively). Upon adding HOMAIR in the models, the association was no longer significant. In adjusted HOMAIR-stratified analysis, the hs-CRP-diabetes association appeared stronger in participants with HOMAIR <3.0 compared with HOMAIR ≥3.0 (P < 0.0001 for interaction). The association was also stronger among nonobese participants, although not significant when adjusted for HOMAIR. Low-grade inflammation, as measured by hs-CRP level, may have an important role in the development of diabetes among African Americans with a lesser degree of insulin resistance. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Prevalence, associated factors and heritabilities of metabolic syndrome and its individual components in African Americans: the Jackson Heart Study.

PubMed

Khan, Rumana J; Gebreab, Samson Y; Sims, Mario; Riestra, Pia; Xu, Ruihua; Davis, Sharon K

2015-11-01

Both environmental and genetic factors play important roles in the development of metabolic syndrome (MetS). Studies about its associated factors and genetic contribution in African Americans (AA) are sparse. Our aim was to report the prevalence, associated factors and heritability estimates of MetS and its components in AA men and women. Data of this cross-sectional study come from a large community-based Jackson Heart Study (JHS). We analysed a total of 5227 participants, of whom 1636 from 281 families were part of a family study subset of JHS. Participants were classified as having MetS according to the Adult Treatment Panel III criteria. Multiple logistic regression analysis was performed to isolate independently associated factors of MetS (n=5227). Heritability was estimated from the family study subset using variance component methods (n=1636). About 27% of men and 40% of women had MetS. For men, associated factors with having MetS were older age, lower physical activity, higher body mass index, and higher homocysteine and adiponectin levels (p<0.05 for all). For women, in addition to all these, lower education, current smoking and higher stress were also significant (p<0.05 for all). After adjusting for covariates, the heritability of MetS was 32% (p<0.001). Heritability ranged from 14 to 45% among its individual components. Relatively higher heritability was estimated for waist circumference (45%), high density lipoprotein-cholesterol (43%) and triglycerides (42%). Heritability of systolic blood pressure (BP), diastolic BP and fasting blood glucose was 16%, 15% and 14%, respectively. Stress and low education were associated with having MetS in AA women, but not in men. Higher heritability estimates for lipids and waist circumference support the hypothesis of lipid metabolism playing a central role in the development of MetS and encourage additional efforts to identify the underlying susceptibility genes for this syndrome in AA. Published by the BMJ

Hughlings Jackson. The man and his time.

PubMed

Critchley, M

1986-05-01

This article is a brief account of the personality of Hughlings Jackson, his mode of life, and his intimate friends. He grew up when worldwide developments were taking place in biological thinking. The philosopher Herbert Spencer impressed him with his exciting concept of evolution, a principle which Jackson realized was applicable to the functions and disorders of the nervous system. Jackson and Spencer corresponded over a period of at least 37 years but they were not friends, their personal qualities being very different. Revered by his colleagues, even though they may not have fully understood what he was trying to say, Jackson became a legend in his own lifetime and an inspiration to neurologists who succeeded him.

76 FR 19150 - Jackson National Life Insurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... Life Insurance Company, et al. March 31, 2011. AGENCY: The Securities and Exchange Commission...: Jackson National Life Insurance Company (``Jackson''), Jackson National Separate Account--I (the ``JNL Separate Account''), Jackson National Life Insurance Company of New York (``JNLNY'') and collectively with...

Serum potassium is a predictor of incident diabetes in African Americans with normal aldosterone: the Jackson Heart Study12

PubMed Central

Chatterjee, Ranee; Davenport, Clemontina A; Svetkey, Laura P; Batch, Bryan C; Lin, Pao-Hwa; Ramachandran, Vasan S; Fox, Ervin R; Harman, Jane; Yeh, Hsin-Chieh; Selvin, Elizabeth; Correa, Adolfo; Butler, Kenneth; Edelman, David

2017-01-01

Background: Low-normal potassium is a risk factor for diabetes and may account for some of the racial disparity in diabetes risk. Aldosterone affects serum potassium and is associated with insulin resistance. Objectives: We sought to confirm the association between potassium and incident diabetes in an African-American cohort, and to determine the effect of aldosterone on this association. Design: We studied participants from the Jackson Heart Study, an African-American adult cohort, who were without diabetes at baseline. With the use of logistic regression, we characterized the associations of serum, dietary, and urinary potassium with incident diabetes. In addition, we evaluated aldosterone as a potential effect modifier of these associations. Results: Of 2157 participants, 398 developed diabetes over 8 y. In a minimally adjusted model, serum potassium was a significant predictor of incident diabetes (OR: 0.83; 95% CI: 0.74, 0.92 per SD increment in serum potassium). In multivariable models, we found a significant interaction between serum potassium and aldosterone (P = 0.046). In stratified multivariable models, in those with normal aldosterone (<9 ng/dL, n = 1163), participants in the highest 2 potassium quartiles had significantly lower odds of incident diabetes than did those in the lowest potassium quartile [OR (95% CI): 0.61 (0.39, 0.97) and 0.54 (0.33, 0.90), respectively]. Among those with high-normal aldosterone (≥9 ng/dL, n = 202), we found no significant association between serum potassium and incident diabetes. In these stratified models, serum aldosterone was not a significant predictor of incident diabetes. We found no statistically significant associations between dietary or urinary potassium and incident diabetes. Conclusions: In this African-American cohort, we found that aldosterone may modify the association between serum potassium and incident diabetes. In participants with normal aldosterone, high-normal serum potassium was associated with

Process and progress: John Hughlings Jackson's philosophy of science.

PubMed

Jacyna, L Stephen

2011-10-01

Some scepticism has been voiced over whether the work of John Hughlings Jackson possesses any significant philosophical orientation. This article argues that Hughlings Jackson was acquainted with the work of a wide range of philosophers. In particular, certain aspects of the writings of John Stuart Mill are reflected in Hughlings Jackson's own work. From early in his career, Hughlings Jackson adopted a critical stance in his neurological papers, seeking to expose shortcomings in the conventional practices of his peers and urging greater methodological rigour and sophistication in order to advance their science. This critical and 'procedurist' bias endows Hughlings Jackson's writings with a characteristically modern character.

75 FR 18908 - Jackson National Life Insurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... Life Insurance Company, et al. April 7, 2010. AGENCY: The Securities and Exchange Commission... purchase payments made under certain deferred variable annuity contracts. APPLICANTS: Jackson National Life...''), Jackson National Life Insurance Company of New York (``JNL New York'' and collectively with Jackson...

75 FR 60833 - Jackson National Life Insurance Company, et al.;

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

...] Jackson National Life Insurance Company, et al.; Notice of Application September 27, 2010. AGENCY... National Life Insurance Company (``Jackson''), Jackson National Life Insurance Company of New York... Companies and serve as the underlying investment vehicles for the variable life insurance contracts and...

Independent associations between a metabolic syndrome severity score and future diabetes by sex and race: the Atherosclerosis Risk In Communities Study and Jackson Heart Study.

PubMed

Gurka, Matthew J; Golden, Sherita H; Musani, Solomon K; Sims, Mario; Vishnu, Abhishek; Guo, Yi; Cardel, Michelle; Pearson, Thomas A; DeBoer, Mark D

2017-07-01

The study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome. We assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8 years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n = 10,957) and the Jackson Heart Study (n = 2137). The ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0. Use of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

75 FR 20773 - Establishment of Class E Airspace; Jackson, AL

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 71 [Docket No. FAA-2009-0937; Airspace Docket No. 09-ASO-27] Establishment of Class E Airspace; Jackson, AL AGENCY: Federal... December 7, 2009 that establishes Class E airspace at Jackson Muni, Jackson, AL. DATES: Effective Date...

Gene-environment interaction between SCN5A-1103Y and hypokalemia influences QT interval prolongation in African Americans: the Jackson Heart Study.

PubMed

Akylbekova, Ermeg L; Payne, John P; Newton-Cheh, Christopher; May, Warren L; Fox, Ervin R; Wilson, James G; Sarpong, Daniel F; Taylor, Herman A; Maher, Joseph F

2014-01-01

African-American ancestry, hypokalemia, and QT interval prolongation on the electrocardiogram are all risk factors for sudden cardiac death (SCD), but their interactions remain to be characterized. SCN5A-1103Y is a common missense variant, of African ancestry, of the cardiac sodium channel gene. SCN5A-1103Y is known to interact with QT-prolonging factors to promote ventricular arrhythmias in persons at high risk for SCD, but its clinical impact in the general African-American population has not been established. We genotyped SCN5A-S1103Y in 4,476 participants of the Jackson Heart Study, a population-based cohort of African Americans. We investigated the effect of SCN5A-1103Y, including interaction with hypokalemia, on QT interval prolongation, a widely-used indicator of prolonged myocardial repolarization and predisposition to SCD. We then evaluated the two sub-components of the QT interval: QRS duration and JT interval. The carrier frequency for SCN5A-1103Y was 15.4%. SCN5A-1103Y was associated with QT interval prolongation (2.7 milliseconds; P < .001) and potentiated the effect of hypokalemia on QT interval prolongation (14.6 milliseconds; P = .02). SCN5A-1103Y had opposing effects on the two sub-components of the QT interval, with shortening of QRS duration (-1.5 milliseconds; P = .001) and prolongation of the JT interval (3.4 milliseconds; P < .001). Hypokalemia was associated with diuretic use (78%; P < .001). SCN5A-1103Y potentiates the effect of hypokalemia on prolonging myocardial repolarization in the general African-American population. These findings have clinical implications for modification of QT prolonging factors, such as hypokalemia, in the 15% of African Americans who are carriers of SCN5A-1103Y. © 2014.

The association of endothelial function and tone by digital arterial tonometry with MRI left ventricular mass in African Americans: the Jackson Heart Study.

PubMed

Tripathi, Avnish; Benjamin, Emelia J; Musani, Solomon K; Hamburg, Naomi M; Tsao, Connie W; Saraswat, Arti; Vasan, Ramachandran S; Mitchell, Gary F; Fox, Ervin R

2017-05-01

Peripheral vascular endothelial dysfunction assessed by digital peripheral arterial tonometry (PAT) has been associated with risk for adverse cardiovascular events. We examined the relations of peripheral microvascular dysfunction and left ventricular mass in a community-based cohort of African Americans. We examined participants of the Jackson Heart Study who had PAT and cardiac magnetic resonance imaging evaluations between 2007 and 2013. Consistent with pertinent literature, left ventricular mass index (LVMI) was adjusted for body size by indexing to height 2.7 . Pearson's correlation and general linear regression analyses were used to relate reactive hyperemia index, baseline pulse amplitude (BPA), and augmentation index (markers of microvascular vasodilator function, baseline vascular pulsatility, and relative wave reflection, respectively) to LVMI after adjusting for traditional cardiovascular risk factors. A total of 440 participants (mean age 59 ± 10 years, 60% women) were included. Age- and sex-adjusted Pearson's correlation analysis suggested that natural log transformed LVMI was negatively correlated with reactive hyperemia index (coefficient: -0.114; P = .02) and positively correlated with BPA (coefficient: 0.272; P < .001). In multivariable analyses, higher log e LVMI was associated with higher BPA (β: 0.210; P = .03) after accounting for age, sex, body mass index, diabetes, hypertension, ratio of total cholesterol and high-density lipoprotein cholesterol, smoking, and history of cardiovascular disease. In a community-based sample of African Americans, higher baseline pulsatility measured by PAT was associated with higher LVMI by cardiac magnetic resonance imaging after adjusting for traditional risk factors. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Nepotism and the Jackson County School Board

ERIC Educational Resources Information Center

Heisler, William; Hanlin, Lesa

2017-01-01

In 2015, the superintendent of the Jackson County School District revised the existing nepotism policy, and, subsequently, his wife was hired to a newly created position of director of innovation at a salary nearly twice the average paid to teachers in the district. Because of community reaction, the Jackson County School Board met in special…

77 FR 5170 - Amendment of Class D Airspace; Jackson, MI

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

...-1143; Airspace Docket No. 11-AGL-23] Amendment of Class D Airspace; Jackson, MI AGENCY: Federal... Class D airspace within the Jackson, MI, area by changing the name of the airport from Jackson County... Class D airspace to coincide with the FAA's aeronautical database. This is an administrative change and...

John Hughlings-Jackson: a sesquicentennial tribute.

PubMed

Swash, M

1986-09-01

One hundred and fifty years have elapsed since the birth of John Hughlings-Jackson, a pivotal figure in the development of clinical neuroscience. In this review the origin of Jackson's postulate of a hierarchical organisation of function in the nervous system is described in the context of his education and his contacts with contemporaries, both in his clinical practice at The London Hospital and at the National Hospital, Queen Square, and in relation to the evolutionary approach to the organisation and ideas on biology and society set out by the philosopher Herbert Spencer.

Political goals versus scientific truths: a response to Jackson (2003).

PubMed

Kendler, Howard H

2003-05-01

Three fundamental issues separate Jackson's (2003) methodological views from mine. One, whereas he believes an absolute moral view can prevail in a democracy, I assume moral pluralism is an inevitable byproduct of an open society. Two, Jackson feels that psychology can identify a correct moral position, whereas I postulate natural science psychology is only capable of revealing the empirical consequences of competing social policies and their moral implications. Three, Jackson espouses a politically active psychology that from my perspective is antithetical to a democratic and scientific ethic. In sum, Jackson's coupling of science with political advocacy will lead to a mistrust of psychology that will deny a democracy the opportunity to base its social policies on reliable psychological information.

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2018-03-01

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.

The Context for Planning: A Report to the Jackson-George Regional Library System.

ERIC Educational Resources Information Center

McCook, Kathleen de la Pena; And Others

This report describes a study of the Jackson-George Regional Library (JGRL) System, which serves a 2-county area in Mississippi with a population of 131,918. The purpose of the study, which built on the planning and administration goals identified in "Planning for Progress: The Long Range Plan of the Jackson George Regional Library," was to…

Road surface erosion on the Jackson Demonstration State Forest: results of a pilot study

Treesearch

Brian Barrett; Rosemary Kosaka; David. Tomberlin

2012-01-01

This paper presents results of a 3 year pilot study of surface erosion on forest roads in the Jackson Demonstration State Forest in California’s coastal redwood region. Ten road segments representing a range of surface, grade, and ditch conditions were selected for the study. At each segment, settling basins with tipping buckets were installed to measure...

Eocene Yegua Formation (Claiborne group) and Jackson group lignite deposits of Texas

USGS Publications Warehouse

Hook, Robert W.; Warwick, Peter D.; Swanson, Sharon M.; Hackley, Paul C.; Warwick, Peter D.; Karlsen, Alexander K.; Merrill, Matthew D.; Valentine, Brett J.

2011-01-01

The lignite deposits within the upper Eocene Yegua Formation (Claiborne Group) and the overlying Jackson Group are among the coal resources that were not quantitatively assessed as part of the U.S. Geological Survey's (USGS) National Coal Resource Assessment (NCRA) program in the Gulf Coastal Plain coal province. In the past, these lignite-bearing stratigraphic units often have been evaluated together because of their geographic and stratigraphic proximity (Fisher, 1963; Kaiser, 1974; Kaiser et al., 1980; Jackson and Garner, 1982; Kaiser, 1996) (Figures 1, 2). The term “Yegua-Jackson trend“ is used informally herein for the lignite-bearing outcrops of these Late Eocene deposits in Texas. Lignite beds in the Yegua-Jackson trend generally are higher both in ash yield and sulfur content than those of the underlying Wilcox Group (Figure 2). Recent studies (Senkayi et al., 1987; Ruppert et al., 1994; Warwick et al., 1996, 1997) have shown that some lignite beds within the Yegua-Jackson trend contain partings of volcanic ash and host elevated levels of trace elements that have been identified as potentially hazardous air pollutants (HAPs) in the United States Clean Air Amendments of 1990. Lignite beds within the Yegua Formation are thin (less than or equal to 6 ft) and laterally discontinuous in comparison with most Wilcox Group deposits (Ayers, 1989a); in contrast, the Jackson Group lignite beds range up to 12 ft in total thickness and are relatively continuous laterally, extending nearly 32 mi along strike.

The Social Patterning of Sleep in African Americans: Associations of Socioeconomic Position and Neighborhood Characteristics with Sleep in the Jackson Heart Study.

PubMed

Johnson, Dayna A; Lisabeth, Lynda; Hickson, DeMarc; Johnson-Lawrence, Vicki; Samdarshi, Tandaw; Taylor, Herman; Diez Roux, Ana V

2016-09-01

We investigated cross-sectional associations of individual-level socioeconomic position (SEP) and neighborhood characteristics (social cohesion, violence, problems, disadvantage) with sleep duration and sleep quality in 5,301 African Americans in the Jackson Heart Study. All measures were self-reported. Sleep duration was assessed as hours of sleep; sleep quality was reported as poor (1) to excellent (5). SEP was measured by categorized years of education and income. Multinomial logistic and linear regression models were fit to examine the associations of SEP and neighborhood characteristics (modeled dichotomously and tertiles) with sleep duration (short vs. normal, long vs. normal) and continuous sleep duration and quality after adjustment for demographics and risk factors. The mean sleep duration was 6.4 ± 1.5 hours, 54% had a short (≤ 6 h) sleep duration, 5% reported long (≥ 9 h) sleep duration, and 24% reported fair to poor sleep quality. Lower education was associated with greater odds of long sleep (odds ratio [OR] = 2.19, 95% confidence interval [CI] = 1.42, 3.38) and poorer sleep quality (β = -0.17, 95% CI = -0.27, -0.07) compared to higher education after adjustment for demographics and risk factors. Findings were similar for income. High neighborhood violence was associated with shorter sleep duration (-9.82 minutes, 95% CI = -16.98, -2.66) and poorer sleep quality (β = -0.11, 95% CI = -0.20, 0.00) after adjustment for demographics and risk factors. Results were similar for neighborhood problems. In secondary analyses adjusted for depressive symptoms in a subset of participants, most associations were attenuated and only associations of low SEP with higher odds of long sleep and higher neighborhood violence with poorer sleep quality remained statistically significant. Social and environmental characteristics are associated with sleep duration and quality in African Americans. Depressive symptoms may explain at least part of this association. �

Jackson, Todd, and the concept of "discharge" in epilepsy.

PubMed

Reynolds, Edward H

2007-11-01

To explore the historical origins of the modern concept of electrical discharges in the brain in epilepsy. I have examined the writings of Hughlings Jackson (1835-1911) and Robert Bentley Todd (1809-1860), especially their Lumleian Lectures on convulsive disorders to the Royal College of Physicians of 1890 and 1849, respectively; and also the influence of Herbert Spencer (1820-1903) on the former and Michael Faraday (1791-1867) on the latter. Contrary to the widely taught view that Jackson was the first to propose electrical discharges in epilepsy it is clear that the discharges suggested by Jackson, influenced by the evolutionary philosopher, Herbert Spencer, were chemical, based on katabolism and anabolism. Jackson had no understanding or proposal based on physics or electricity. On the other hand, Todd had earlier proposed and described electrical concepts of discharges in epilepsy, influenced by his contemporary and colleague in London, Michael Faraday, who at the time was laying the foundations of our modern understanding of electricity and magnetism. Todd and Faraday saw "nervous polarity" as another polar force interchangeable with the polar forces of electricity and magnetism.

Pleistocene glaciation of the Jackson Hole area, Wyoming

USGS Publications Warehouse

Pierce, Kenneth L.; Licciardi, Joseph M.; Good, John M.; Jaworowski, Cheryl

2018-01-24

Pleistocene glaciations and late Cenozoic offset on the Teton fault have played central roles in shaping the scenic landscapes of the Teton Range and Jackson Hole area in Wyoming. The Teton Range harbored a system of mountain-valley glaciers that produced the striking geomorphic features in these mountains. However, the comparatively much larger southern sector of the Greater Yellowstone glacial system (GYGS) is responsible for creating the more expansive glacial landforms and deposits that dominate Jackson Hole. The glacial history is also inextricably associated with the Yellowstone hotspot, which caused two conditions that have fostered extensive glaciation: (1) uplift and consequent cold temperatures in greater Yellowstone; and (2) the lowland track of the hotspot (eastern Snake River Plain) that funneled moisture to the Yellowstone Plateau and the Yellowstone Crescent of High Terrain (YCHT).The penultimate (Bull Lake) glaciation filled all of Jackson Hole with glacial ice. Granitic boulders on moraines beyond the south end of Jackson Hole have cosmogenic 10Be exposure ages of ~150 thousand years ago (ka) and correlate with Marine Isotope Stage 6. A thick loess mantle subdues the topography of Bull Lake moraines and caps Bull Lake outwash terraces with a reddish buried soil near the base of the loess having a Bk horizon that extends down into the outwash gravel. The Bull Lake glaciation of Jackson Hole extended 48 kilometers (km) farther south than the Pinedale, representing the largest separation of these two glacial positions in the Western United States. The Bull Lake is also more extensive than the Pinedale on the west (22 km) and southwest (23 km) margins of the GYGS but not on the north and east. This pattern is explained by uplift and subsidence on the leading and trailing “bow-wave” of the YCHT, respectively.During the last (Pinedale) glaciation, mountain-valley glaciers of the Teton Range extended to the western edge of Jackson Hole and built

Caspar Creek Watershed Study--North Fork Phase, Jackson Demonstration State Forest, Status and Plans, 1983-1990

Treesearch

Norm Henry; Karen Sendek

1985-01-01

Abstract - The California Department of Forestry and U.S. Forest Service, Pacific Southwest Forest and Range Experiment Station have been conducting a paired watershed study on Jackson Demonstration State Forest for 24 years. The South Fork watershed phase of the study involved monitoring the impacts of road construction (1967) and selective tractor logging (1971-1973...

Smoke over Jackson Hole, Wyoming

NASA Image and Video Library

2001-08-01

This anaglyph from the MISR instrument aboard NASA Terra spacecraft shows the area around Jackson Hole, Wyoming, where the Green Knoll forest fire raged for many days in July, 2001. 3D glasses are necessary to view this image.

Freud's psychoanalysis of Edith Banfield Jackson, 1930-1936.

PubMed

Lynn, David J

2003-01-01

This paper is a historical study of Sigmund Freud's psychoanalysis of Edith Banfield Jackson. It relies on primary sources, including unpublished correspondence, to describe her background, the analysis itself, and her subsequent life. This analysis, which began in 1930, had both clinical and training purposes. Freud's actual methods are contrasted with his published recommendations in terms of anonymity, neutrality, and confidentiality. During this analysis, Sigmund Freud took on a number of roles in Edith Jackson's life, including teacher, commentator, social intermediary, recipient of her translation services, and recipient of her philanthropic donations. These roles are described in detail. The implications of Freud's actual methods in this case are fully discussed. Since Freud did not describe the methods he used in this case, they cannot be replicated, and, for clinical purposes, they are lost to history.

Interference filter photometry of periodic comet Ashbrook-Jackson

NASA Technical Reports Server (NTRS)

Newburn, R. L., Jr.; Bell, J. F.; Mccord, T. B.

1980-01-01

P/Ashbrook-Jackson has a period of 7.43 years and comes to perihelion at 2.284 AU. It is a low inclination object (12.5 deg) of moderate eccentricity (0.400). In 1963, it made the best possible apparition, coming to perihelion and opposition virtually simultaneously, but no one made physical observations of faint periodic comets in 1963. In 1978 Ashbrook-Jackson came to opposition on Sept. 28, just 40 days after perihelion. It will be just over 100 years before an equally favorable apparition recurs. P/Ashbrook-Jackson was recovered by Pereyra at Cordoba Observatory on April 28, 1977, more than a year and a quarter before perilhelion and already showing a diffuse coma with central condensation. Its helio-centric distance was then 3.7 AU. An extensive program was planned, but equipment problems and weather ultimately limited it to the two nights of data reported here.

Sporomorphs from the Jackson Group (upper Eocene) and adjacent strata of Mississippi and western Alabama

USGS Publications Warehouse

Frederiksen, Norman O.

1980-01-01

This palynological study is based on 71 outcrop and core samples of the Jackson Group and adjacent strata from the type area of the group in western Mississippi and also from eastern Mississippi and western Alabama. The Jackson Group consists entirely of marine strata in the region of study. It includes the fossiliferous greensands of the Moodys Branch Formation at the base and the calcareous Yazoo Clay at the top. One hundred seventy-four sporomorph (spore and pollen) types are known from the Jackson Group and adjacent strata in the area of study; all but four of them were observed by the writer. The 174 types are assigned to 74 form genera, 37 modern genera, and 25 new species. Eleven species of pollen grains appear to have accurately determined restricted stratigraphic ranges within the sequence studied. Parsonsidites conspicuus Frederiksen and Ericipites aff. E. ericius (Potonie) Potonie have first occurrences (range bottoms) at the base of the Jackson Group. Aglaoreidia pristina Fowler has its first occurrence near the top of the Jackson. Eight species have last occurrences at or just below the top of the Jackson Group. These are Casuarinidites cf. C. granilabratus (Stanley) Srivastava, Chrysophyllum brevisulcatum (Frederiksen) n. comb., Cupanieidites orthoteichus Cookson and Pike, Symplocos gemroota n. sp., Nudopollis terminalis (Pflug and Thomson) Elsik, Sabal cf. S. granopollenites Rouse, Caprifoliipites tantulus n. sp., and Nypa echinata (Muller) n. comb. From the upper part of the Claiborne Group up through most of the Jackson, the dominant sporomorph types are Cupuliferdipollenites spp., Momipites coryloides Wodehouse, Cupuliferoidaepollenites liblarensis (Thomson) Potonie, Momipites micTofoveolatus (Stanley) Nichols, Quercoidites microhenricii (Potonie) Potonie, and Araliaceoipollenites granulatus (Potonie) n. comb. All these were probably produced by trees of the Juglandaceae and Fagaceae. Relative frequencies of each of these pollen types fluctuate

Correlation of Gerkin, Queen's College, George, and Jackson methods in estimating maximal oxygen consumption.

PubMed

Heydari, Payam; Varmazyar, Sakineh; Variani, Ali Safari; Hashemi, Fariba; Ataei, Seyed Sajad

2017-10-01

Test of maximal oxygen consumption is the gold standard for measuring cardio-pulmonary fitness. This study aimed to determine correlation of Gerkin, Queen's College, George, and Jackson methods in estimating maximal oxygen consumption, and demographic factors affecting maximal oxygen consumption. This descriptive cross-sectional study was conducted in a census of medical emergency students (n=57) in Qazvin University of Medical Sciences in 2016. The subjects firstly completed the General Health Questionnaire (PAR-Q) and demographic characteristics. Then eligible subjects were assessed using exercise tests of Gerkin treadmill, Queen's College steps and non-exercise George, and Jackson. Data analysis was carried out using independent t-test, one way analysis of variance and Pearson correlation in the SPSS software. The mean age of participants was 21.69±4.99 years. The mean of maximal oxygen consumption using Gerkin, Queen's College, George, and Jackson tests was 4.17, 3.36, 3.64, 3.63 liters per minute, respectively. Pearson statistical test showed a significant correlation among fours tests. George and Jackson tests had the greatest correlation (r=0.85, p>0.001). Results of tests of one-way analysis of variance and t-test showed a significant relationship between independent variable of weight and height in four tests, and dependent variable of maximal oxygen consumption. Also, there was a significant relationship between variable of body mass index in two tests of Gerkin and Queen's College and variable of exercise hours per week with the George and Jackson tests (p>0.001). Given the obtained correlation, these tests have the potential to replace each other as necessary, so that the non-exercise Jackson test can be used instead of the Gerkin test.

Genetics Home Reference: Jackson-Weiss syndrome

MedlinePlus

... People with Jackson-Weiss syndrome usually have normal intelligence and a normal life span. Related Information What ... called fibroblast growth factor receptor 2. Among its multiple functions, this protein signals immature cells to become ...

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2016-01-07

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Functionalizing Conflict: Jesse Jackson's Rhetorical Strategy at the 1984 Democratic National Convention.

ERIC Educational Resources Information Center

Di Mare, Lesley A.

1987-01-01

Examines Jesse Jackson's rhetorical strategy of functionalizing conflict among divisive Democrats during the 1984 national convention. Applies conflict theory to Jackson's convention address, which serves as the basis for this rhetorical analysis. (JD)

Jesse Jackson and Television: Black Image Presentation and Affect in the 1984 Democratic Campaign Debates.

ERIC Educational Resources Information Center

Merritt, Bishetta D.

A study analyzed the visual content of the 1984 New Hampshire and California Democratic candidate debates to determine how Jesse Jackson was portrayed by television. The New Hampshire debate was chosen because it offered the first opportunity for Jackson to be heard and compared to the other, more media-prominent candidates. The California debate…

To systematics of the genus Saetheria Jackson (Diptera, Chironomidae) from the Russian Far East.

PubMed

Orel, Oksana V

2014-05-23

The genus Saetheria Jackson from the Russian Far East is reviewed. The males of S. reissi Jackson, 1977, S. tamanipparai (Sasa, 1983) and S. tylus (Townes, 1945) are redescribed and figured. The pupa of S. reissi is redescribed and illustrated. The larva of S. reissi Jackson is described for the first time. Comments on the systematics and distribution of each species are provided. Paracladopelma kisopediformis Sasa, Kondo, 1993 is designated a new junior synonym of S. reissi Jackson, 1977. Keys to the males, pupae and larvae of the Russian Saetheria are given.

Tweeting Prayers and Communicating Grief over Michael Jackson Online

ERIC Educational Resources Information Center

Sanderson, Jimmy; Cheong, Pauline Hope

2010-01-01

Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…

Sleepless vigilance: "Stonewall" Jackson and the duty hours controversy.

PubMed

Mackowiak, Philip A; Billings, Frederic T; Wasserman, Steven S

2012-02-01

Confederate general "Stonewall" Jackson has been called "one of the greatest military geniuses the world ever saw." However, on critical review of his command decisions during the course of 12 of the 20 battles he fought during the American Civil War, historians have rated his performance as poor. In this investigation, the authors examined the effect of sleep deprivation on Jackson's battle decisions in light of experimental data driving current calls for limiting the duty hours of physicians.

77 FR 70461 - Jackson Rancheria-Tribal Council Ordinance No. 2012-01-Sale, Consumption & Possession of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... members. 4. The Tribe is the owner and operator of the Jackson Rancheria Casino & Hotel which includes an... at the Jackson Rancheria Casino & Hotel (including its outdoor entertainment area) for on-premises... Jackson Rancheria Casino & Hotel and its outdoor entertainment area. 2. The sale of alcohol at the Tribe's...

The Jackson Career Explorer in Relation to the Career Directions Inventory

ERIC Educational Resources Information Center

Schermer, Julie Aitken; MacDougall, Robyn

2011-01-01

The Jackson Career Explorer (JCE) is a short form and continuous version of the Jackson Vocational Interest Survey (JVIS). The 34 scales of the JCE were investigated in relation to the Career Directions Inventory (CDI). Participants (N = 282) aged 14-57 years were volunteers from local high schools and colleges and completed both measures. The…

Reply to Jackson, O'Keefe, and Jacobs.

ERIC Educational Resources Information Center

Morley, Donald Dean

1988-01-01

Replies to Sally Jackson, Daniel O'Keefe, and Scott Jacobs' article (same issue), maintaining that randomness requirements can not be relaxed for generalizing from message samples, since systematic samples are not truly random. (MS)

75 FR 27377 - Jackson National Life Insurance Company of New York, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Life Insurance Company of New York, et al. May 10, 2010. AGENCY: The Securities and Exchange Commission... purchase payments made under certain deferred variable annuity contracts. Applicants: Jackson National Life...''), and Jackson National Life Distributors LLC (``Distributor,'' and collectively ``Applicants''). Summary...

RadNet Air Data From Jackson, MS

EPA Pesticide Factsheets

This page presents radiation air monitoring and air filter analysis data for Jackson, MS from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

Hydrogeology and water quality in the Snake River alluvial aquifer at Jackson Hole Airport, Jackson, Wyoming, September 2008-June 2009

USGS Publications Warehouse

Wright, Peter R.

2010-01-01

The hydrogeology and water quality of the Snake River alluvial aquifer, at the Jackson Hole Airport in northwest Wyoming, was studied by the U.S. Geological Survey in cooperation with the Jackson Hole Airport Board and the Teton Conservation District during September 2008-June 2009. Hydrogeologic conditions were characterized using data collected from 14 Jackson Hole Airport wells. Groundwater levels are summarized in this report and the direction of groundwater flow, hydraulic gradients, and estimated groundwater velocity rates in the Snake River alluvial aquifer underlying the study area are presented. Analytical results of chemical, dissolved gas, and stable isotopes are presented and summarized. Seasonally, the water table at Jackson Hole Airport was lowest in early spring and reached its peak in July, with an increase of 12 to 14 feet between April and July 2009. Groundwater flow was predominantly horizontal but had the hydraulic potential for downward flow. The direction of groundwater flow was from the northeast to the west-southwest. Horizontal groundwater velocities within the Snake River alluvial aquifer at the airport were estimated to be about 26 to 66 feet per day. This indicates that the traveltime from the farthest upgradient well to the farthest downgradient well was approximately 53 to 138 days. This estimate only describes the movement of groundwater because some solutes may move at a rate much slower than groundwater flow through the aquifer. The quality of the water in the alluvial aquifer generally was considered good. The alluvial aquifer was a fresh, hard to very hard, calcium carbonate type water. No constituents were detected at concentrations exceeding U.S. Environmental Protection Agency Maximum Contaminant Levels, and no anthropogenic compounds were detected at concentrations greater than laboratory reporting levels. The quality of groundwater in the alluvial aquifer generally was suitable for domestic and other uses; however, dissolved

Meet EPA Biologist Laura Jackson, Ph.D.

EPA Pesticide Factsheets

Research Biologist Laura Jackson, Ph.D., has worked for the EPA for 22 years, leading research initiatives in a diversity of disciplines, including environmental monitoring, land use planning, and the impacts that urbanization has on an area's ecology

Geologic map of the South Jackson Mountains Wilderness Study Area, Humboldt County, Nevada

USGS Publications Warehouse

Sorensen, Martin L.

1986-01-01

The South Jackson Mountains Wilderness Study Area is in south-central Humboldt County, approximately 50 miles northwest of Winnemucca, Nevada. The boundaries originally specified for the wilderness study area encompassed an area of 60,211 acres. The draft Environmental Impact Statement issued in 1983 by the U.S. Bureau of Land Management (BLM) identified 20,094 acres within the wilderness study area as potentially suitable for inclusion into the National Wilderness Preservation System. Subsequent (August 27, 1984) deletions by the BLM have resulted in the present study area of approximately 10,300 acres. The boundaries of the study area are approximated by the range crestline to the east and the 4,400-ft contour along the west side of the range from King Lear Peak north to the divide between Hobo and Christiorsson Canyons.

John Hughlings Jackson and the conceptual foundations of the neurosciences.

PubMed

Greenblatt, S H

1999-01-01

Cerebral localization, including hierarchical organization of the nervous system, was the critical conceptual advance that made possible the development of modern neuroscience in the nineteenth century. Some of our most basic ideas about neural organization were contributed by Hughlings Jackson. In the early twentieth century, Charles Sherrington combined localization with the neurone theory to create the paradigm of neurophysiological integration. Because Sherrington was educated in the Jacksonian tradition of British neurology, Sherringtonian integration contains ideas that are derived from Jackson and from Herbert Spencer.

Using the numerical method in 1836, James Jackson bridged French therapeutic epistemology and American medical pragmatism.

PubMed

Kahn, Linda G; Morabia, Alfredo

2015-04-01

To review James Jackson's analysis of bloodletting among pneumonitis patients at the newly founded Massachusetts General Hospital, in which he implemented the numerical method advocated by Pierre-Charles-Alexandre Louis. The study sample included 34 cases of clinically diagnosed pneumonitis admitted to Massachusetts General Hospital between April 19, 1825, and May 10, 1835, and discharged alive. Patient data were extracted from meticulously kept case books. Jackson calculated mean number of venesections, ounces of blood taken, and days of convalescence within groups stratified by day of the disease when first bloodletting occurred. He also calculated average convalescence within groups stratified by age, sex, prior health, vesication, and day of the disease when the patients were admitted to the hospital. To Jackson's surprise, it "seemed to be of less importance, whether our patients were bled or not, than whether they entered the hospital early or late" after the onset of the pneumonitis. Bloodletting was ineffective. Our multivariate reanalysis of his data confirms his conclusion. Outstandingly for his time, Jackson ruled out unwarranted effects of covariates by tabulating their numerical relations to the duration of pneumonia. Using novel gathering of patient clinical data from hospital records and quantitative analytical methods, Jackson contributed results that challenged conventional wisdom and bridged French therapeutic epistemology and American medical pragmatism. Copyright © 2015 Elsevier Inc. All rights reserved.

Reusability of EMR Data for Applying Cubbin and Jackson Pressure Ulcer Risk Assessment Scale in Critical Care Patients

PubMed Central

Kim, Eunkyung; Lee, JuHee; Kim, Young Ah

2013-01-01

Objectives The purposes of this study were to examine the predictive validity of the Cubbin and Jackson pressure ulcer risk assessment scale for the development of pressure ulcers in intensive care unit (ICU) patients retrospectively and to evaluate the reusability of Electronic Medical Records (EMR) data. Methods A retrospective design was used to examine 829 cases admitted to four ICUs in a tertiary care hospital from May 2010 to April 2011. Patients who were without pressure ulcers at admission to ICU, 18 years or older, and had stayed in ICU for 24 hours or longer were included. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) were calculated. Results The reported incidence rate of pressure ulcers among the study subjects was 14.2%. At the cut-off score of 24 of the Cubbin and Jackson scale, the sensitivity, specificity, positive predictive value, negative predictive value, and AUC were 72.0%, 68.8%, 27.7%, 93.7%, and 0.76, respectively. Eight items out 10 of the Cubbin and Jackson scale were readily available in the EMR data. Conclusions The Cubbin and Jackson scale performed slightly better than the Braden scale to predict pressure ulcer development. Eight items of the Cubbin and Jackson scale except mobility and hygiene can be extracted from the EMR, which initially demonstrated the reusability of EMR data for pressure ulcer risk assessment. If the Cubbin and Jackson scale is a part of the EMR assessment form, it would help nurses perform tasks to effectively prevent pressure ulcers with an EMR alert for high-risk patients. PMID:24523990

75 FR 61173 - Jackson Hole Airport Agreement Extension, Final Environmental Impact Statement, Grand Teton...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... DEPARTMENT OF THE INTERIOR National Park Service Jackson Hole Airport Agreement Extension, Final Environmental Impact Statement, Grand Teton National Park, Wyoming AGENCY: National Park Service, Department of... Jackson Hole Airport Agreement Extension, Grand Teton National Park. SUMMARY: Pursuant to the National...

James Taylor (1859-1946): favourite disciple of Hughlings Jackson and William Gowers.

PubMed

Eadie, M J

2013-01-01

In neurological circles today the name James Taylor (1859-1946) is probably remembered mainly for his role in editing the Selected Writings of John Hughlings Jackson, the most readily available source of Jackson's contributions to neurological knowledge. Taylors' own neurological achievements are largely or entirely forgotten, but in his day he was an influential figure whose career linked the great figures of the golden era of late nineteenth century British neurology to the neurology of the first half of the twentieth century. Not only was he a junior professional colleague and close friend of both John Hughlings Jackson and William Gowers, he also produced a substantial corpus of neurological writings in his own right, including a textbook of child neurology and the first English language account of subacute combined degeneration of the spinal cord.

An interview with Murray Jackson by Jan Wiener.

PubMed

Jackson, Murray

2011-04-01

Murray Jackson was among the early trainees at the Society of Analytical Psychology (SAP) drawn to Jungian ideas during the 1950s when the training was still relatively informal. He was born in Australia where he became a doctor and came to London to study psychiatry with a particular interest in psychosis. He was influenced by Michael Fordham with whom he had an analysis and his four papers, published in the Journal of Analytical Psychology in the early 1960s, contributed significantly to the growing interest in clinical technique, particularly transference, that developed in the Society at that time. Later, he retrained at the British Institute of Psychoanalysis in the Kleinian tradition and was the first consultant at the Maudsley Hospital to run a 10-bed unit for severely mentally ill patients applying psychoanalytic principles. In April 2010, Jan Wiener interviewed Murray Jackson in France, where he now lives in retirement, about his interest and subsequent disappointment in Jungian ideas as well as his involvement with the Society of Analytical Psychology at a particular point in its history. After a brief introduction, the interview is reproduced in full. © 2011, The Society of Analytical Psychology.

Physician/chemist/geologist: Charles Thomas Jackson's life of conflict and controversy

USGS Publications Warehouse

Landa, E.R.

1995-01-01

After a brief medical career, Charles Thomas Jackson (1805-1880) began work as a consulting chemist and geologist in Boston. He serves as State Geologist in Maine, Rhode Island, and New Hampshire from 1837 to 1884, and completed geological surveys of those States. In 1847, he was appointed United States Geologist to undertake a survey of the public lands of the Lake Superior region of Michigan. This survey was beset by strife, and Jackson was forced to resign in 1849. -from Author

Tuberculosis Containment among the Homeless in Metropolitan Jackson, Mississippi.

PubMed

Azevedo, Mario J; Conwill, David E; Lawrence, Shonda; Jackson, Ann; Bhuiyan, Azad R; Hall, Dianne; Anderson, Brian; Franklin, Donald; Brown, David; Wilkerson, Patricia; Beckett, Gloria

2015-08-01

Preventing tuberculosis among the homeless has emerged as an especially difficult challenge. We assessed a 2008-2009 tuberculosis (TB) outbreak ad subsequent prevention strategies among homeless persons in metropolitan Jackson, Hinds County, Mississippi. We compared data about cases and subclinical TB infections (LTBI) among homeless persons during the outbreak and post-outbreak years, interviewed involved homeless persons, compiled observations from visits to Jackson homeless shelters and conducted literature reviews on homelessness and infectious diseases. We reviewed homeless shelter TB prevention methods adopted by other municipalities, guidelines developed by the Centers for Disease Control and Prevention (CDC), and recommendations from other official and ad hoc groups and considered their applicability to metropolitan Jackson. The Mississippi State Department of Health TB Program assisted by the CDC and other agencies, contained the Jackson-area outbreak by the end of 2009 as reflected by progressively lower TB rates among homeless persons thereafter. However, some follow-up activities and enforcement of shelter preventive measures have not been consistently maintained. Resources to prevent further outbreaks continue to be inadequate, and over-reliance on private organizations has continued. In the process, appreciation of the dynamic interaction enhancing TB risk among the homeless and incarcerated persons has emerged. Major outbreak contributors were lack of periodic TB screening among homeless shelter clients, preventive treatment compliance and follow-up difficulties among those with subclinical tuberculosis infections, interrupted preventive measures among infected persons incarcerated in local correctional facilities who disproportionately re-join Jackson's homeless community when released, inadequate attention to shelter environmental preventive strategies such as ultraviolet light germicidal irradiators and proper air-exchange/ventilation, costs of

Hughlings Jackson and the "doctrine of concomitance": mind-brain theorising between metaphysics and the clinic.

PubMed

Chirimuuta, M

2017-09-11

John Hughlings Jackson (1835-1911) is a major figure at the origins of neurology and neuroscience in Britain. Alongside his contributions to clinical medicine, he left a large corpus of writing on localisation of function in the nervous system and other theoretical topics. In this paper I focus on Jackson's "doctrine of concomitance"-his parallelist theory of the mind-brain relationship. I argue that the doctrine can be given both an ontological and a causal interpretation, and that the causal aspect of the doctrine is especially significant for Jackson and his contemporaries. I interpret Jackson's engagement with the metaphysics of mind as an instance of what I call meta-science-the deployment by scientists of metaphysical positions and arguments which help streamline empirical investigations by bracketing off unanswerable questions and focussing attention on matters amenable to the current tools of experimental research.

Jackson State University: Documentation of the Teachers for a New Era Learning Network. Case Study

ERIC Educational Resources Information Center

Academy for Educational Development, 2009

2009-01-01

The Academy for Educational Development (AED) sent a research team to Jackson State University (JSU) on October 13-14, 2008 to conduct interviews with individuals who play important roles in the university's teacher preparation program (see Appendix A). These interviews, along with additional documentation provided by JSU and identified by the AED…

76 FR 7230 - Environmental Impact Statement for the Proposed Mississippi Band of Choctaw Casino, Jackson...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-09

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Environmental Impact Statement for the Proposed Mississippi Band of Choctaw Casino, Jackson County, MS AGENCY: Bureau of Indian Affairs, Interior... of Choctaw Casino, Jackson County Mississippi. FOR FURTHER INFORMATION CONTACT: Kurt G. Chandler...

John Hughlings Jackson's evolutionary neurology: a unifying framework for cognitive neuroscience.

PubMed

Franz, Elizabeth A; Gillett, Grant

2011-10-01

John Hughlings Jackson was a pioneer in neurology who thought deeply about the structure of the brain and how that manifested itself in the various syndromes that he saw in the clinic. He enunciated a theory of the evolution and dissolution of neural function based on the idea that basic sensorimotor processes become embedded in networks of connections that relate them in successively more complex ways to allow for performance of more and more nuanced and adaptive functions. Hughlings Jackson noted the curious link between human thought, action and speech. He further recognized that disinhibition or release from control and direction marked neurological damage. His integrative framework remains deeply relevant to the plethora of results being produced by the careful and diverse experimentation currently undertaken with the aid of brain imaging techniques of which he could only dream. In celebration of the memory of John Hughlings Jackson, we revisit his concept of neural evolution and development, which led to what eventually became a leading model of brain organization, whereby a new order of behavioural control--the conscious mind--is created out of simpler elements, in a manner similar to Herbert Spencer's evolutionary theory. By this Hughlings Jackson did not mean anything dualistic but merely that the highest layer of evolution of nervous arrangements was 'highly complicated' and that dissolution of that higher level leaves 'a lower consciousness and a shallower nervous system'.

75 FR 25313 - Stillwater Central Railroad, Inc.-Trackage Rights Exemption-Wichita, Tillman and Jackson Railway...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... Railroad, Inc.--Trackage Rights Exemption-- Wichita, Tillman and Jackson Railway Company, Inc., and Hollis & Eastern Railroad Company Pursuant to a written trackage rights agreement (Trackage Agreement) dated January 22, 1992, Wichita, Tillman & Jackson Railway Co. (WTJ) granted approximately 4.6 miles of...

From 1960s Evans County Georgia to present-day Jackson, Mississippi: an exploration of the evolution of cardiovascular disease in African Americans.

PubMed

Crook, Errol D; Clark, Bobby L; Bradford, Shayna T J; Golden, Kimberly; Calvin, Rosie; Taylor, Herman A; Flack, John M

2003-06-01

Cardiovascular disease (CVD) is the No. 1 cause of mortality in the United States and it disproportionately affects African Americans. However, there are earlier reports that African Americans had significantly less CVD than whites. This racial discrepancy in CVD rates was noticed primarily for coronary heart disease (CHD). This issue was examined in the Evans County (Georgia) Cardiovascular Disease Study conducted in the 1960s. It showed that African American men had significantly lower rates of CHD than white men. Over the last couple of decades, the rates of CVD have been declining. However, the rate of decline of CVD in African Americans has not been equal to that seen in whites, such that African Americans now have a disproportionate share of CVD in the United States. In the 1990s, the Jackson Heart Study was designed to explore the reasons for the current racial discrepancy. This articles reviews the findings of the Evans County Study and explores various hypotheses for why CVD in African Americans has evolved from a disease from which African Americans may have been "protected" to one in which they shoulder a disproportionate burden.

75 FR 80894 - Wichita, Tillman & Jackson Railway Company-Lease Renewal Exemption-Union Pacific Railroad Company

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... & Jackson Railway Company--Lease Renewal Exemption--Union Pacific Railroad Company Wichita, Tillman & Jackson Railway Company (WTJR) has filed a verified notice of exemption to renew its lease of... by Union Pacific Railroad Company (UP),\\2\\ extending between milepost 0.99 at Wichita Falls, Tex...

76 FR 5119 - Television Broadcasting Services; Jackson, MS

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 [DA 11-96; MB Docket No. 11-8; RM-11618] Television Broadcasting Services; Jackson, MS AGENCY: Federal Communications Commission. ACTION: Proposed... reply comments on or before March 14, 2011. ADDRESSES: Federal Communications Commission, Office of the...

76 FR 19275 - Television Broadcasting Services; Jackson, MS

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 [MB Docket No. 11-8; RM-11618, DA 11-516] Television Broadcasting Services; Jackson, MS AGENCY: Federal Communications Commission. ACTION: Final rule... document may be purchased from the Commission's duplicating contractor, Best Copy and Printing, Inc., 445...

Reconnaissance of Water Quality at Four Swine Farms in Jackson County, Florida, 1993

DTIC Science & Technology

1996-01-01

applications on agricultural land. (Krider, 1987). Since the estimated annual wet manure product in pounds per animal is: 3,407 for breeding swine , and...Reconnaissance of Water Quality at Four Swine Farms in Jackson County, Florida, 1993 By Jerilyn J. Collins U.S. Geological Survey Open File Report...COVERED - 4. TITLE AND SUBTITLE Reconnaissance of Water Quality at Four Swine Farms in Jackson County, Florida, 1993 5a. CONTRACT NUMBER 5b. GRANT

The Jackson Presidential Campaign: Setting the Public Agenda.

ERIC Educational Resources Information Center

Dates, Jannette Lake; Gandy, Oscar, Jr.

Print news media coverage of Jesse Jackson's 1984 presidential campaign was analyzed to determine whether publishers followed their roles as liberal, moderate, or conservative publications in their coverage. It was hypothesized that print media coverage would be similar across publications regardless of editorial slant, because of the dominance of…

Identification and Consubstantiation in the 1988 California Primary Campaign Rhetoric of Jesse Jackson: A Burkeian Approach.

ERIC Educational Resources Information Center

Porter, Laurinda W.

In 1988, Jesse Jackson was the second most successful candidate for the Democratic presidential nomination, finishing behind Michael Dukakis. While Jackson displayed extraordinary rhetorical talent and articulated a view of America unlike that of other candidates, little scholarly attention has been paid to his rhetoric. Examination of four of…

Translation, adaptation, and validation of the Sunderland Scale and the Cubbin & Jackson Revised Scale in Portuguese

PubMed Central

Sousa, Bruno

2013-01-01

Objective To translate into Portuguese and evaluate the measuring properties of the Sunderland Scale and the Cubbin & Jackson Revised Scale, which are instruments for evaluating the risk of developing pressure ulcers during intensive care. Methods This study included the process of translation and adaptation of the scales to the Portuguese language, as well as the validation of these tools. To assess the reliability, Cronbach alpha values of 0.702 to 0.708 were identified for the Sunderland Scale and the Cubbin & Jackson Revised Scale, respectively. The validation criteria (predictive) were performed comparatively with the Braden Scale (gold standard), and the main measurements evaluated were sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve, which were calculated based on cutoff points. Results The Sunderland Scale exhibited 60% sensitivity, 86.7% specificity, 47.4% positive predictive value, 91.5% negative predictive value, and 0.86 for the area under the curve. The Cubbin & Jackson Revised Scale exhibited 73.3% sensitivity, 86.7% specificity, 52.4% positive predictive value, 94.2% negative predictive value, and 0.91 for the area under the curve. The Braden scale exhibited 100% sensitivity, 5.3% specificity, 17.4% positive predictive value, 100% negative predictive value, and 0.72 for the area under the curve. Conclusions Both tools demonstrated reliability and validity for this sample. The Cubbin & Jackson Revised Scale yielded better predictive values for the development of pressure ulcers during intensive care. PMID:23917975

Project U-Turn: increasing active transportation in Jackson, Michigan.

PubMed

TenBrink, David S; McMunn, Randall; Panken, Sarah

2009-12-01

Jackson, Michigan, is a medium-sized city suffering from a bad economy and obesity-related health issues. Nearly 20% of the 36,000 residents live below the poverty line. It is a relatively young city (median age of 30 years) with a mixed ethnicity (20% black, 73% white, 4% Hispanic). The city offers many structured, active recreational opportunities, but has not integrated physical activity into daily life. Project U-Turn aimed to increase active transportation (e.g., biking, walking, and transit use) through an integrated approach to Active Living by Design's community action model and the Michigan Safe Routes to School model. Resources were focused on active living promotions and programs; partnership meetings were the source of changes in policy and physical projects. Each initiative was designed to introduce each of the 5Ps (preparation, promotion, programs, policy, and physical projects) to build support for the partnership's overall work. The partnership collected snapshot data of community walking and biking behavior, percentage of students walking to school, participation in events and programs, and new physical projects. Jackson saw a vast improvement in physical infrastructure and policy and a related increase in walking and biking in the community. The project engaged in purposeful partnership building to implement effective programs and promotions that built support for policy and physical projects. Limited resources were best used by encouraging partners to contribute and coordinate activities using existing staff, funding, and resources. Jackson has seen a shift toward awareness of the benefits of active living on community health, economic development, and environmental awareness.

Augusta, Georgia and Jackson State University: Southern Episodes in a National Tragedy.

ERIC Educational Resources Information Center

Southern Regional Council, Atlanta, GA.

This report presents an indepth study of the events and psychology in the past of Augusta, Georgia which help explain the violence and the killing of six Blacks on the night of May 11, 1970. The second study in this report deals with the events and killings of two young black men at Jackson State College on May 15, 1970. These two events had…

Note: On the relation between Lifson-Jackson and Derrida formulas for effective diffusion coefficient

NASA Astrophysics Data System (ADS)

Kalnin, Juris R.; Berezhkovskii, Alexander M.

2013-11-01

The Lifson-Jackson formula provides the effective free diffusion coefficient for a particle diffusing in an arbitrary one-dimensional periodic potential. Its counterpart, when the underlying dynamics is described in terms of an unbiased nearest-neighbor Markovian random walk on a one-dimensional periodic lattice is given by the formula obtained by Derrida. It is shown that the latter formula can be considered as a discretized version of the Lifson-Jackson formula with correctly chosen position-dependent diffusion coefficient.

Preferences for body type and body characteristics associated with attractive and unattractive bodies: Jackson and McGill revisited.

PubMed

Rosenfeld, L B; Stewart, S C; Stinnett, H J; Jackson, L A

1999-10-01

The present investigation replicates Jackson and McGill's study (1996) and extends it by considering the effects of respondents' own height, weight, and body mass on perceptions of attractiveness. Results, although generally supportive of those found by Jackson and McGill, point to the influence of respondents' own physical characteristics in the process of perceptions of attractiveness: only 1 of Jackson and McGill's 3 (of a possible 19) differences between responses of African- and Euro-American women was corroborated (the importance of silky hair for Euro-American women), whereas a second difference (the importance of round buttocks for African-American women) disappeared when controlling for respondents' weight, height, and body mass. Although differences between the two investigations may be attributed to regional differences in the surveyed students (Michigan and North Carolina), the small effect of one's own weight, height, and body mass in assessing an other-sex person's attractiveness may reflect adherence to norms learned very early in life that are subject to regional variations.

Chancroid detected by polymerase chain reaction--Jackson, Mississippi, 1994-1995.

PubMed

1995-08-04

Chancroid is a sexually transmitted disease (STD) caused by infection with Haemophilus ducreyi and is characterized by genital ulceration. Chancroid is underreported in the United States (1), reflecting, in part, difficulties in diagnosis because of clinical similarities between chancroid and other ulcerative STDs. In addition, laboratory confirmation by culture is 53%-84% sensitive and often is unavailable in clinical settings (2). In September 1994, clinicians at the District V STD clinic of the Mississippi State Department of Health (MSDH) in Jackson reported examining patients with genital ulcers characteristic of chancroid but lacked capacity to confirm the diagnosis. To determine the cause of the ulcers, MSDH, in conjunction with CDC, conducted an investigation of all patients with genital ulcers examined at the Jackson STD clinic during October 20, 1994-February 1, 1995. This report summarizes the findings of the investigation.

Consolidation of geologic studies of geopressured-geothermal resources in Texas: Barrier-bar tidal-channel reservoir facies architecture, Jackson Group, Prado Field, South Texas

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

Seni, S.J.; Choh, S.J.

1993-09-01

Sandstone reservoirs in the Jackson barrier/strandplain play are characterized by low recovery efficiencies and thus contain a large hydrocarbon resource target potentially amenable to advanced recovery techniques. Prado field, Jim Hogg County, South Texas, has produced over 23 million bbl of oil and over 32 million mcf gas from combination structural-stratigraphic traps in the Eocene lower Jackson Group. Hydrocarbon entrapment at Prado field is a result of anticlinal nosing by differential compaction and updip pinch-out of barrier bar sandstone. Relative base-level lowering resulted in forced regression that established lower Jackson shoreline sandstones in a relatively distal location in central Jimmore » Hogg County. Reservoir sand bodies at Prado field comprise complex assemblages of barrier-bar, tidal-inlet fill, back-barrier bar, and shoreface environments. Subsequent progradation built the barrier-bar system seaward 1 to 2 mi. With the barrier-bar system, favorable targets for hydrocarbon reexploration are concentrated in tidal-inlet facies because they possess the greatest degree of depositional heterogeneity.« less

Queer Figurations in the Media: Critical Reflections on the Michael Jackson Sex Scandal.

ERIC Educational Resources Information Center

Erni, John Nguyet

1998-01-01

Discusses the significance to media studies of queer theory. Examines (1) the commodification of "witness testimony" relating to the question of sexual innocence in the case of child molestation; (2) the effeminization of Jackson as a homophobic containment of him by the press; and (3) interpretive excess in the media's focus of an…

Thomas Jonathan ’Stonewall’ Jackson Fought by the Old Testament, Lived by the New

DTIC Science & Technology

1992-04-15

the paternal Jacksons. Sometime in 1835, Laura went to live with their maternal relatives, the Neales.14 At seven years old, Jackson had become a...document may not be Maed for openi pub&hcdos unti it h- s been delrd by the appropriat militMs ftwvic@ o r~erment apncy. THOMAS JONATHAN "STONEWALL...SCHEDULE Distribution is unlimited. 4 PERFORMING ORGANIZATION REPORT NUMBER( S ) 5. MONITORING ORGANIZATION REPORT NUMBER( S ) 6a. NAME OF PERFORMING

Developing a Sexual Harassment Policy for Sheldon Jackson College.

ERIC Educational Resources Information Center

Craddick, Jan

A practicum to determine the need for a sexual harassment policy and to develop an appropriate policy for Sheldon Jackson College, Alaska, is described. The objective of the practicum was to determine the impact of equal opportunity legislation, specifically as it relates to sexual harassment of students, on the private college campus. The…

Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study.

PubMed

Brewer, LaPrincess C; Redmond, Nicole; Slusser, Joshua P; Scott, Christopher G; Chamberlain, Alanna M; Djousse, Luc; Patten, Christi A; Roger, Veronique L; Sims, Mario

2018-06-05

Ideal cardiovascular health metrics (defined by the American Heart Association Life's Simple 7 [LS7]) are suboptimal among blacks, which results in high risk of cardiovascular disease. We examined the association of multiple stressors with LS7 components among blacks. Using a community-based cohort of blacks (N=4383), we examined associations of chronic stress, minor stressors, major life events, and a cumulative stress score with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting plasma glucose) and an LS7 composite score. Multivariable logistic regression assessed the odds of achieving intermediate/ideal levels of cardiovascular health adjusted for demographic, socioeconomic, behavioral, and biomedical factors. The LS7 components with the lowest percentages of intermediate/ideal cardiovascular health levels were diet (39%), body mass index (47%), and physical activity (51%). Higher chronic, minor, and cumulative stress scores were associated with decreased odds (odds ratio [OR]) of achieving intermediate/ideal levels for smoking (OR [95% confidence interval], 0.80 [0.73-0.88], 0.84 [0.75-0.94], and 0.81 [0.74-0.90], respectively). Participants with more major life events had decreased odds of achieving intermediate/ideal levels for smoking (OR, 0.84; 95% confidence interval, 0.76-0.92) and fasting plasma glucose (OR, 0.90; 95% confidence interval, 0.82-0.98). Those with higher scores for minor stressors and major life events were less likely to achieve intermediate or ideal LS7 composite scores (OR [95% confidence interval], 0.89 [0.81-0.97] and 0.91 [0.84-0.98], respectively). Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall cardiovascular health (LS7 composite score), specific behaviors (smoking), and biological factors (fasting plasma glucose). © 2018 The Authors and Mayo Clinic. Published on behalf of the American Heart

Evaluation of burned aspen communities in Jackson Hole, Wyoming

Treesearch

Charles E. Kay

2001-01-01

Aspen has been declining in Jackson Hole for many years, a condition generally attributed to the fact that lightning fires have been aggressively suppressed since the early 1900s. It is also believed that burning will successfully regenerate aspen stands despite high elk numbers. To test this hypothesis, I evaluated 467 burned and 495 adjacent, unburned aspen stands at...

Consolidation of geologic studies of geopressured-geothermal resources in Texas: Barrier-bar tidal-channel reservoir facies architecture, Jackson Group, Prado field, South Texas; Final report

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

Seni, S.J.; Choh, S.J.

1994-01-01

Sandstone reservoirs in the Jackson barrier/strandplain play are characterized by low recovery efficiencies and thus contain a large hydrocarbon resource target potentially amenable to advanced recovery techniques. Prado field, Jim Hogg County, South Texas, has produced over 23 million bbl of oil and over 32 million mcf gas from combination structural-stratigraphic traps in the Eocene lower Jackson Group. Hydrocarbon entrapment at Prado field is a result of anticlinal nosing by differential compaction and updip pinch-out of barrier bar sandstone. Relative base-level lowering resulted in forced regression that established lower Jackson shoreline sandstones in a relatively distal location in central Jimmore » Hogg County. Reservoir sand bodies at Prado field comprise complex assemblages of barrier-bar, tidal-inlet fill, back-barrier bar, and shoreface environments. Subsequent progradation built the barrier-bar system seaward 1 to 2 mi. Within the barrier-bar system, favorable targets for hydrocarbon reexploration are concentrated in tidal-inlet facies because they possess the greatest degree of depositional heterogeneity. The purpose of this report is (1) to describe and analyze the sand-body architecture, depositional facies variations, and structure of Prado field, (2) to determine controls on distribution of hydrocarbons pertinent to reexploration for bypassed hydrocarbons, (3) to describe reservoir models at Prado field, and (4) to develop new data affecting the suitability of Jackson oil fields as possible candidates for thermally enhanced recovery of medium to heavy oil.« less

"It's Different Now:" How Exit Exams Are Affecting Teaching and Learning in Jackson and Austin

ERIC Educational Resources Information Center

Zabala, Dalia; Minnici, Angela; Kober, Nancy, Ed.

2007-01-01

Since much of the previous research on exit exams, including CEP's own work, has looked at national patterns of implementation and passing rates, this study aimed to benefit policy and practice by focusing on the local level. Specifically, case studies were conducted in Jackson, MS and Austin, TX that examined how classroom instruction and other…

Argument of the Excluded Middle: The Jackson-Falwell Apartheid Debate.

ERIC Educational Resources Information Center

Dudczak, Craig A.

Since South Africa declared the first "State of Emergency" in July 1985, the issue of South African apartheid has sparked direct and sustained debates between Jerry Falwell and Jesse Jackson at Lynchburg, Virginia, as well as on ABC's "Nightline." On "Nightline," while Falwell's position on disinvestment (after a…

78 FR 21565 - Television Broadcasting Services; Jackson, Wyoming to Wilmington, DE

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 [MB Docket No. 13-73; RM-11695; DA 13-450] Television Broadcasting Services; Jackson, Wyoming to Wilmington, DE AGENCY: Federal Communications... document may be purchased from the Commission's duplicating contractor, Best Copy and Printing, Inc., 445...

Jackson Park Hospital Green Building Medical Center

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

William Dorsey; Nelson Vasquez

2010-03-31

Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work. The new green building houses the hospital's Family Medicine Residency Program and Specialty Medical Offices. The residency program has been vital inmore » attracting new, young physicians to this medically underserved area. The new outpatient center will also help to allure needed medical providers to the community. The facility also has areas designated to women's health and community education. The Community Education Conference Room will provide learning opportunities to area residents. Emphasis will be placed on conserving resources and protecting our environment, as well as providing information on healthcare access and preventive medicine. The new Medical Office Building was constructed with numerous energy saving features. The exterior cladding of the building is an innovative, locally-manufactured precast concrete panel system with integral insulation that achieves an R-value in excess of building code requirements. The roof is a 'green roof' covered by native plantings, lessening the impact solar heat gain on the building, and reducing air conditioning requirements. The windows are low-E, tinted, and insulated to reduce cooling requirements in summer and heating requirements in winter. The main entrance has an air lock to prevent unconditioned air from entering the building and impacting interior air temperatures. Since much of the traffic in and out of the office building comes from the adjacent Jackson Park Hospital, a pedestrian bridge connects the two buildings, further

["The aim is familiarity with the infant". Work and research in the Jackson Nursery (Vienna 1937/38)].

PubMed

Krivanek, Roman

2014-01-01

The "Jackson Nursery", existing from February 1937 until March 1938, was directed by Anna Freud and financed by Edith Jackson and Dorothy Burlingham. It took care of infants from the poorest strata of Vienna and also gave material support to their families. On the other hand, it was a training institution for psychoanalysts, offering the opportunity of observing children during their first two years, e. g. their feeding habits and social sense. In addition, the Jackson Nursery was a place for research where psychoanalytic theories of infantile development were checked against the findings of direct observation. The work started here was then continued by A. Freud and D. Burlingham on a larger scale in their War Nurseries.--This paper examines the many-sided activities in the nursery mainly on the basis of unpu blished archival documents.

A TWO-YEAR FOLLOW-UP SURVEY OF ANTIBODY TO CRYPTOSPORIDIUM IN JACKSON COUNTY, OREGON FOLLOWING AN OUTBREAK OF WATERBORNE DISEASE

EPA Science Inventory

To estimate the duration of Cryptosporidium-specific antibody, a Western blot assay measured antibody in paired sera from 124 residents of Jackson County, Oregon collected 0.5 and 2.5 years after the end of an outbreak in Talent, Jackson County. The outcome measure was the intens...

Cervical spine motion in manual versus Jackson table turning methods in a cadaveric global instability model.

PubMed

DiPaola, Matthew J; DiPaola, Christian P; Conrad, Bryan P; Horodyski, MaryBeth; Del Rossi, Gianluca; Sawers, Andrew; Bloch, David; Rechtine, Glenn R

2008-06-01

A study of spine biomechanics in a cadaver model. To quantify motion in multiple axes created by transfer methods from stretcher to operating table in the prone position in a cervical global instability model. Patients with an unstable cervical spine remain at high risk for further secondary injury until their spine is adequately surgically stabilized. Previous studies have revealed that collars have significant, but limited benefit in preventing cervical motion when manually transferring patients. The literature proposes multiple methods of patient transfer, although no one method has been universally adopted. To date, no study has effectively evaluated the relationship between spine motion and various patient transfer methods to an operating room table for prone positioning. A global instability was surgically created at C5-6 in 4 fresh cadavers with no history of spine pathology. All cadavers were tested both with and without a rigid cervical collar in the intact and unstable state. Three headrest permutations were evaluated Mayfield (SM USA Inc), Prone View (Dupaco, Oceanside, CA), and Foam Pillow (OSI, Union City, CA). A trained group of medical staff performed each of 2 transfer methods: the "manual" and the "Jackson table" transfer. The manual technique entailed performing a standard rotation of the supine patient on a stretcher to the prone position on the operating room table with in-line manual cervical stabilization. The "Jackson" technique involved sliding the supine patient to the Jackson table (OSI, Union City, CA) with manual in-line cervical stabilization, securing them to the table, then initiating the table's lock and turn mechanism and rotating them into a prone position. An electromagnetic tracking device captured angular motion between the C5 and C6 vertebral segments. Repeated measures statistical analysis was performed to evaluate the following conditions: collar use (2 levels), headrest (3 levels), and turning technique (2 levels). For all

Water-surface elevations and channel characteristics for a selected reach of the Applegate River, Jackson County, Oregon

USGS Publications Warehouse

Harris, David Dell; Alexander, Clyde W.

1970-01-01

In land-use planning for the Applegate River and its flood plain, consideration should be given to (1) preservation of the recreational attributes of the area, (2) allowance for optimum development of the flood plain's natural resources, and (3) protection of the rights of private landowners. Major factors that influence evaluation of the above considerations are the elevations and characteristics of floods. Heretofore, such flood data for the Applegate River have been inadequate to evaluate the flood potential or to use as a basis for delineating reasonable land-use zones. Therefore, at the request of Jackson County, this study was made to provide flood elevations, water-surface profiles, and channel characteristics (geometry and slope) for a reach of the Applegate River from the Jackson-Josephine County line upstream to the Applegate damsite (fig. 1). A similar study was previously made for reaches of adjacent Rogue River and Elk Creek (Harris, 1970).

Increasing Walking in the Hartsfield-Jackson Atlanta International Airport: The Walk to Fly Study.

PubMed

Fulton, Janet E; Frederick, Ginny M; Paul, Prabasaj; Omura, John D; Carlson, Susan A; Dorn, Joan M

2017-07-01

To test the effectiveness of a point-of-decision intervention to prompt walking, versus motorized transport, in a large metropolitan airport. We installed point-of-decision prompt signage at 4 locations in the airport transportation mall at Hartsfield-Jackson Atlanta International Airport (Atlanta, GA) at the connecting corridor between airport concourses. Six ceiling-mounted infrared sensors counted travelers entering and exiting the study location. We collected traveler counts from June 2013 to May 2016 when construction was present and absent (preintervention period: June 2013-September 2014; postintervention period: September 2014-May 2016). We used a model that incorporated weekly walking variation to estimate the intervention effect on walking. There was an 11.0% to 16.7% relative increase in walking in the absence of airport construction where 580 to 810 more travelers per day chose to walk. Through May 2016, travelers completed 390 000 additional walking trips. The Walk to Fly study demonstrated a significant and sustained increase in the number of airport travelers choosing to walk. Providing signage about options to walk in busy locations where reasonable walking options are available may improve population levels of physical activity and therefore improve public health.

JacksonBot - Design, Simulation and Optimal Control of an Action Painting Robot

NASA Astrophysics Data System (ADS)

Raschke, Michael; Mombaur, Katja; Schubert, Alexander

We present the robotics platform JacksonBot which is capable to produce paintings inspired by the Action Painting style of Jackson Pollock. A dynamically moving robot arm splashes color from a container at the end effector on the canvas. The paintings produced by this platform rely on a combination of the algorithmic generation of robot arm motions with random effects of the splashing color. The robot can be considered as a complex and powerful tool to generate art works programmed by a user. Desired end effector motions can be prescribed either by mathematical functions, by point sequences or by data glove motions. We have evaluated the effect of different shapes of input motions on the resulting painting. In order to compute the robot joint trajectories necessary to move along a desired end effector path, we use an optimal control based approach to solve the inverse kinematics problem.

Solar heating system installed at Jackson, Tennessee. Final report

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

None

1980-10-01

The solar energy heating system installed at the Coca-Cola Bottling Works in Jackson, Tennessee is described. The system consists of 9480 square feet of Owens-Illinois evacuated tubular solar collectors with attached specular cylindrical reflectors and will provide space heating for the 70,000 square foot production building in the winter, and hot water for the bottle washing equipment the remainder of the year. Component specifications and engineering drawings are included. (WHK)

American Idol's Randy Jackson He doesn't miss a beat controlling his diabetes

MedlinePlus

... Jackson is a well-known name in the music world. He has played bass guitar with such musical legends as jazz violinist Jean Luc Ponty, the pop-rock band Journey, and many others. And he's produced ...

The Jackson Career Explorer: Correlates With Self-Monitoring and Social Desirability.

PubMed

Schermer, Julie Aitken

2018-01-01

The Jackson Career Explorer (JCE) is a short form and continuous version of the Jackson Vocational Interest Survey measuring 34 vocational interest dimensions which can be reduced to seven factors (six vocational interest factors and one work style factor). Both the scales and factors were examined for possible significant correlations with social desirability and self-monitoring. Volunteer participants ( N = 779) aged 14 to 92 years completed the JCE, a social desirability scale, and a self-monitoring scale. Social desirability did not correlate significantly with the JCE scales and factors. Self-monitoring was found to correlate significantly with only a few of the JCE dimensions, including the performing arts, dominant leadership, and law scales as well as the business factor. Interestingly, the accountability JCE work style scale, which assesses a preference to work in an environment requiring high levels of honesty, had a significant negative correlation with self-monitoring. These results add to the validity of the JCE and add information to the area of vocational interest assessment.

Hydrogeology and water quality in the Snake River alluvial aquifer at Jackson Hole Airport, Jackson, Wyoming, water years 2011 and 2012

USGS Publications Warehouse

Wright, Peter R.

2013-01-01

The hydrogeology and water quality of the Snake River alluvial aquifer at the Jackson Hole Airport in northwest Wyoming was studied by the U.S. Geological Survey, in cooperation with the Jackson Hole Airport Board, during water years 2011 and 2012 as part of a followup to a previous baseline study during September 2008 through June 2009. Hydrogeologic conditions were characterized using data collected from 19 Jackson Hole Airport wells. Groundwater levels are summarized in this report and the direction of groundwater flow, hydraulic gradients, and estimated groundwater velocity rates in the Snake River alluvial aquifer underlying the study area are presented. Analytical results of groundwater samples collected from 10 wells during water years 2011 and 2012 are presented and summarized. The water table at Jackson Hole Airport was lowest in early spring and reached its peak in July or August, with an increase of 12.5 to 15.5 feet between April and July 2011. Groundwater flow was predominantly horizontal but generally had the hydraulic potential for downward flow. Groundwater flow within the Snake River alluvial aquifer at the airport was from the northeast to the west-southwest, with horizontal velocities estimated to be about 25 to 68 feet per day. This range of velocities slightly is broader than the range determined in the previous study and likely is due to variability in the local climate. The travel time from the farthest upgradient well to the farthest downgradient well was approximately 52 to 142 days. This estimate only describes the average movement of groundwater, and some solutes may move at a different rate than groundwater through the aquifer. The quality of the water in the alluvial aquifer generally was considered good. Water from the alluvial aquifer was fresh, hard to very hard, and dominated by calcium carbonate. No constituents were detected at concentrations exceeding U.S. Environmental Protection Agency maximum contaminant levels or health

Vegetation of loess bluff ravines in the Jackson Purchase Region of Kentucky

Treesearch

William S. Bryant

1993-01-01

Forest vegetation of some loess bluff ravines in the Jackson Purchase Region of Kentucky was sampled. A total of 27 tree species comprised the mixed mesophytic association with Acer saccharum, Fagus grandifolia and Liquidambar styraciflua as the dominants. This assemblage of species agrees with that reported for...

Educational health disparities in hypertension and diabetes mellitus among African descent populations in the Caribbean and the USA: a comparative analysis from the Spanish town cohort (Jamaica) and the Jackson heart study (USA).

PubMed

Bidulescu, Aurelian; Ferguson, Trevor S; Hambleton, Ian; Younger-Coleman, Novie; Francis, Damian; Bennett, Nadia; Griswold, Michael; Fox, Ervin; MacLeish, Marlene; Wilks, Rainford; Harris, E Nigel; Sullivan, Louis W

2017-02-14

Studies have suggested that social inequalities in chronic disease outcomes differ between industrialized and developing countries, but few have directly compared these effects. We explored inequalities in hypertension and diabetes prevalence between African-descent populations with different levels of educational attainment in Jamaica and in the United States of America (USA), comparing disparities within each location, and between countries. We analyzed baseline data from the Jackson Heart Study (JHS) in the USA and Spanish Town Cohort (STC) in Jamaica. Participants reported their highest level of educational attainment, which was categorized as 'less than high school' (HS). Educational disparities in the prevalence of hypertension and diabetes were examined using prevalence ratios (PR), controlling for age, sex and body mass index (BMI). Analyses included 7248 participants, 2382 from STC and 4866 from JHS, with mean age of 47 and 54 years, respectively (p < 0.001). Prevalence for both hypertension and diabetes was significantly higher in the JHS compared to STC, 62% vs. 25% (p < 0.001) and 18% vs. 13% (p < 0.001), respectively. In bivariate analyses there were significant disparities by education level for both hypertension and diabetes in both studies; however, after accounting for confounding or interaction by age, sex and BMI these effects were attenuated. For hypertension, after adjusting for age and BMI, a significant education disparity was found only for women in JHS, with PR of 1.10 (95% CI 1.04-1.16) for < HS vs > HS and 1.07 (95% CI 1.01-1.13) for HS vs > HS. For diabetes; when considering age-group and sex specific estimates adjusted for BMI, among men: significant associations were seen only in the 45-59 years age-group in JHS with PR 1.84 (95% CI 1.16-2.91) for < HS vs > HS. Among women, significant PR comparing < HS to > HS was seen for all three age

Who's Afraid of Secularisation? Reframing the Debate between Gearon and Jackson

ERIC Educational Resources Information Center

Lewin, David

2017-01-01

This paper examines the debate between Liam Gearon and Robert Jackson concerning the politicisation of religious education. The debate concerns the extent to which secularisation frames religious education by inculcating politically motivated commitments to tolerance, respect and human rights. Gearon is critical of a supposed…

Performance evaluation of an importance sampling technique in a Jackson network

NASA Astrophysics Data System (ADS)

brahim Mahdipour, E.; Masoud Rahmani, Amir; Setayeshi, Saeed

2014-03-01

Importance sampling is a technique that is commonly used to speed up Monte Carlo simulation of rare events. However, little is known regarding the design of efficient importance sampling algorithms in the context of queueing networks. The standard approach, which simulates the system using an a priori fixed change of measure suggested by large deviation analysis, has been shown to fail in even the simplest network settings. Estimating probabilities associated with rare events has been a topic of great importance in queueing theory, and in applied probability at large. In this article, we analyse the performance of an importance sampling estimator for a rare event probability in a Jackson network. This article carries out strict deadlines to a two-node Jackson network with feedback whose arrival and service rates are modulated by an exogenous finite state Markov process. We have estimated the probability of network blocking for various sets of parameters, and also the probability of missing the deadline of customers for different loads and deadlines. We have finally shown that the probability of total population overflow may be affected by various deadline values, service rates and arrival rates.

Chaos, Fractals, and the Pedagogical Challenge of Jackson Pollock's "All-Over" Paintings

ERIC Educational Resources Information Center

Halsall, Francis

2008-01-01

The "all-over" abstract canvases that Jackson Pollock produced between 1943 and 1951 present a pedagogical challenge in how to account for their apparently chaotic structure. One reason that they are difficult to teach about is that they have proved notoriously difficult for art historians to come to terms with. This is undoubtedly a consequence…

Changing migratory patterns in the Jackson elk herd

USGS Publications Warehouse

Cole, Eric K.; Foley, Aaron M.; Warren, Jeffrey M.; Smith, Bruce L.; Dewey, Sarah R.; Brimeyer, Douglas G.; Fairbanks, W. Sue; Sawyer, Hall; Cross, Paul C.

2015-01-01

Migratory behavior in ungulates has declined globally and understanding the causative factors (environmental change vs. human mediated) is needed to formulate effective management strategies. In the Jackson elk herd of northwest Wyoming, demographic differences between summer elk (Cervus elaphus) population segments have led to changes in migratory patterns over a 35-year time period. The proportion of short-distance migrants (SDM) has increased and the proportion of long-distance migrants (LDM) has concurrently declined. The probability of winter-captured elk on the National Elk Refuge being LDM decreased from 0.99 (95% CI = 0.97–1.00) to 0.59 (95% CI = 0.47–0.70) from 1978 to 2012. We tested 4 hypotheses that could contribute toward the decline in the LDM segment: behavioral switching from LDM to SDM, differential survival, harvest availability, and calf recruitment. Switching rates from LDM to SDM were very low (0.2% each elk-year). Survival rates were similar between LDM and SDM, although harvest availability was relatively low for SDM that tended to use areas close to human development during the hunting season. Average summer calf/cow ratios of LDM declined from 42 to 23 calves per 100 cows from 1978–1984 to 2006–2012. Further, during 2006–2012, LDM summer calf/cow ratios were less than half of SDM (23 vs. 47 calves per 100 cows). Our data suggest recruitment is the driving factor behind the declining proportion of LDM in this region. Effectiveness of altering harvest management strategies to conserve the LDM portion of the Jackson elk herd may be limited.

75 FR 34735 - Adequacy Status of the Alabama Portion (Jackson County) of the Chattanooga, Tennessee Tri-State...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

...In this notice, EPA is notifying the public that EPA has made an insignificance finding through the transportation conformity adequacy process for directly emitted fine particulate matter (PM2.5) and nitrogen oxides (NOX) emissions as contained in the 1997 PM2.5 attainment demonstration for the Alabama portion of the tri-state Chattanooga, Tennessee nonattainment area (hereafter referred to as the ``Jackson County Area''). On October 14, 2009, the State of Alabama, through the Alabama Department of Environmental Management (ADEM), submitted an attainment demonstration plan for the 1997 annual PM2.5 standard for Jackson County, Alabama as part of the tri-state Chattanooga 1997 PM2.5 nonattainment area. The tri-state Chattanooga 1997 annual PM2.5 nonattainment area is comprised of a portion of Jackson County, Alabama; Catoosa and Walker Counties, Georgia; and Hamilton County, Tennessee. As a result of EPA's finding, the portion of Jackson County within the tri-state Chattanooga 1997 PM2.5 nonattainment area is no longer required to perform a regional emissions analysis for either directly emitted PM2.5 or NOX as part of future PM2.5 conformity determinations for the 1997 annual PM2.5 standard. This finding only relates to the Alabama portion of this Area, and does not relieve the Georgia or Tennessee portions of the tri-state 1997 PM2.5 nonattainment area from the requirement of performing the regional emissions analyses for direct PM2.5 and NOX. EPA will review the adequacy of the Georgia and Tennessee submittals with regard to the motor vehicle emission budgets or insignificance findings (if any and if appropriate) in separate actions.

Air quality modeling for the urban Jackson, Mississippi Region using a high resolution WRF/Chem model.

PubMed

Yerramilli, Anjaneyulu; Dodla, Venkata B; Desamsetti, Srinivas; Challa, Srinivas V; Young, John H; Patrick, Chuck; Baham, Julius M; Hughes, Robert L; Yerramilli, Sudha; Tuluri, Francis; Hardy, Mark G; Swanier, Shelton J

2011-06-01

In this study, an attempt was made to simulate the air quality with reference to ozone over the Jackson (Mississippi) region using an online WRF/Chem (Weather Research and Forecasting-Chemistry) model. The WRF/Chem model has the advantages of the integration of the meteorological and chemistry modules with the same computational grid and same physical parameterizations and includes the feedback between the atmospheric chemistry and physical processes. The model was designed to have three nested domains with the inner-most domain covering the study region with a resolution of 1 km. The model was integrated for 48 hours continuously starting from 0000 UTC of 6 June 2006 and the evolution of surface ozone and other precursor pollutants were analyzed. The model simulated atmospheric flow fields and distributions of NO2 and O3 were evaluated for each of the three different time periods. The GIS based spatial distribution maps for ozone, its precursors NO, NO2, CO and HONO and the back trajectories indicate that all the mobile sources in Jackson, Ridgeland and Madison contributing significantly for their formation. The present study demonstrates the applicability of WRF/Chem model to generate quantitative information at high spatial and temporal resolution for the development of decision support systems for air quality regulatory agencies and health administrators.

[Contribution of John Hughlings Jackson to the understanding of epilepsy].

PubMed

Balcells Riba, M

1999-01-01

The figure of J.H. Jackson is one of the most relevant in the history of neurology. His longest period not only during his training but also during his professional plenitude took place in the National Hospital. Jackson was a great clinician, wrote many articles and gave a lot of lectures, but never wrote either a treatise or a monograph about his special field. He did not carry out animal experiments. He introduced in Britain the use of the ophthalmoscope in the neurological exploration and founded the journal Brain. He was specially interested in language disorders, paralysis, vertigo, mental disorders, cerebral tumours and above all epilepsy. He systematized what we today know as complex partial crisis, establishing the link between the function of the temporal lobe and the sensorial auras, automatism's, déjà-vu and jamais vu phenomena. He described the uncinate crisis, the topographic progression of the motor partial crisis and its posterior generalisation, establishing the motor pattern of cerebral cortex. The clinical observations of epileptic phenomena, with the influence of the evolutive ideas from Spencer, were the seeds for the elaboration of the evolutive development of the function of the nervous system. His theory about evolution and dissolution of the neurological functions was the starting point for Freud's clinical investigation. The Jacksonian set of ideas were experimentally proved by the neurophysiological work of Sherrington.

Commercial aircraft engine emissions characterization of in-use aircraft at Hartsfield-Jackson Atlanta International Airport

DOT National Transportation Integrated Search

2008-01-31

The emissions from in-use commercial aircraft engines have been analyzed for selected gas-phase species and particulate characteristics using continuous extractive sampling 1-2 min downwind from operational taxi- and runways at Hartsfield-Jackson Atl...

Chemical Prey Luring in Jackson's Chameleons.

PubMed

Preest, Marion R; Ward, Matthew J; Poon, Thomas; Hermanson, John W

2016-01-01

Lizards in the family Chamaeleonidae have been described as wiping a viscous substance from a pouch (the temporal pouch) at the angle of the jaw on branches and then capturing flies that land near the area where the wiping occurs. We confirmed the presence of this pouch in Jackson's chameleons. Histological work suggested that the material contained within is a result of decomposition of food and sloughed skin that has been trapped in the pouch rather than a glandular secretion. Gas chromatography-mass spectrometry indicated the presence of compounds that are both volatile and odiferous and similar to insect pheromones. Choice tests with houseflies revealed attraction to the temporal pouch material. Some authors have speculated that the temporal pouch material serves a function in territory marking and/or predator deterrence. While it may play these roles, our results suggest that it also plays a role in chemical luring of prey.

The Politics of Racial Disparities: Desegregating the Hospitals in Jackson, Mississippi

PubMed Central

Smith, David Barton

2005-01-01

As health care policymakers and providers focus on eliminating the persistent racial disparities in treatment, it is useful to explore how resistance to hospital desegregation was overcome. Jackson, Mississippi, provides an instructive case study of how largely concealed deliberations achieved the necessary concessions in a still rigidly segregated community. The Veterans Administration hospital, the medical school hospital, and the private nonprofit facilities were successively desegregated, owing mainly to the threatened loss of federal dollars. Many of the changes, however, were cosmetic. In contrast to the powerful financial incentives offered to hospitals to desegregate and ensure equal access in the early years of the Medicare program, current trends in federal reimbursement encourage segregation and disparities in treatment. PMID:15960771

78 FR 49254 - Foreign-Trade Zone 158-Vicksburg/Jackson, Mississippi; Authorization of Production Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

.../Jackson, Mississippi; Authorization of Production Activity; Extension of Production Authority; Bauhaus USA... Foreign-Trade Zone, Inc., grantee of FTZ 158, submitted a notification of proposed production activity to... determined that no further review of the activity is warranted at this time. The production activity...

78 FR 20888 - Foreign-Trade Zone (FTZ) 158-Vicksburg/Jackson, Mississippi; Notification of Proposed Production...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

...--Vicksburg/Jackson, Mississippi; Notification of Proposed Production Activity; Lane Furniture Industries, Inc., (Upholstered Furniture), Belden, Saltillo, and Verona, Mississippi The Greater Mississippi Foreign-Trade Zone... Furniture Industries, Inc. (Lane), located in Belden, Saltillo, and Verona, Mississippi. The notification...

78 FR 49254 - Foreign-Trade Zone 158-Vicksburg/Jackson, Mississippi; Authorization of Production Activity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

.../Jackson, Mississippi; Authorization of Production Activity; Extension of Production Authority; H.M... the Foreign-Trade Zones (FTZ) Board on behalf of H.M. Richards, Inc., in Guntown, Mississippi. The...) is limited to 6.5 million square yards. 2. H.M. Richards, Inc., must admit all foreign upholstery...

A protocol to study ex vivo mouse working heart at human-like heart rate.

PubMed

Feng, Han-Zhong; Jin, Jian-Ping

2018-01-01

Genetically modified mice are widely used as experimental models to study human heart function and diseases. However, the fast rate of normal mouse heart at 400-600bpm limits its capacity of assessing kinetic parameters that are important for the physiology and pathophysiology of human heart that beats at a much slower rate (75-180bpm). To extend the value of mouse models, we established a protocol to study ex vivo mouse working hearts at a human-like heart rate. In the presence of 300μM lidocaine to lower pacemaker and conductive activities and prevent arrhythmia, a stable rate of 120-130bpm at 37°C is achieved for ex vivo mouse working hearts. The negative effects of decreased heart rate on force-frequency dependence and lidocaine as a myocardial depressant on intracellular calcium can be compensated by using a higher but still physiological level of calcium (2.75mM) in the perfusion media. Multiple parameters were studied to compare the function at the human-like heart rate with that of ex vivo mouse working hearts at the standard rate of 480bpm. The results showed that the conditions for slower heart rate in the presence of 300μM lidocaine did not have depressing effect on left ventricular pressure development, systolic and diastolic velocities and stroke volume with maintained positive inotropic and lusitropic responses to β-adrenergic stimulation. Compared with that at 480bpm, the human-like heart rate increased ventricular filling and end diastolic volume with enhanced Frank-Starling responses. Coronary perfusion was increased from longer relaxation time and interval between beats whereas cardiac efficiency was significantly improved. Although the intrinsic differences between mouse and human heart remain, this methodology for ex vivo mouse hearts to work at human-like heart rate extends the value of using genetically modified mouse models to study cardiac function and human heart diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Snow supporting structures for avalanche hazard reduction, 151 Avalanche, US 89/191, Jackson, Wyoming.

DOT National Transportation Integrated Search

2009-04-01

The 151 Avalanche, near Jackson, Wyoming has, historically, avalanched to the road below 1.5 to 2 times a year. The road, US 89/191 is four lanes and carries an estimated 8,000 vehicles per day in the winter months. The starting zone of the 151 Avala...

Snow supporting structures for milepost 151 Avalanche, Highway US 89/191, Jackson, Wyoming : plans.

DOT National Transportation Integrated Search

2009-04-01

The 151 Avalanche, near Jackson, Wyoming has, historically, avalanched to the road below 1.5 to 2 times a year. The road, US 89/191 is four lanes and carries an estimated 8,000 vehicles per day in the winter months. The starting zone of the 151 Avala...

Outcomes of Fort Jackson's Physical Training and Rehabilitation Program in army basic combat training: return to training, graduation, and 2-year retention.

PubMed

Hauret, Keith G; Knapik, Joseph J; Lange, Jeffrey L; Heckel, Heidi A; Coval, Dana L; Duplessis, David H

2004-07-01

Basic trainees at Fort Jackson, South Carolina, who were unable to continue basic combat training (BCT) because of a serious injury were assigned to the Physical Training and Rehabilitation Program (PTRP). Between January 3, 1998 and July 24, 2001, 4258 trainees were assigned to the PTRP. Using a retrospective cohort study design, return to training and BCT graduation rates were evaluated. PTRP graduates were compared with matched non-PTRP graduates for 2-year retention in the Army. More PTRP women than men were discharged from the PTRP (60% and 48%, respectively, p < 0.01). Of PTRP trainees returning to BCT, 10% and 12% of men and women, respectively, were discharged from the Army compared with overall Fort Jackson discharge rates of 9% and 15% for men and women, respectively. Comparing PTRP graduates to matched non-PTRP graduates, there were no differences in 2-year retention for men (14.9% and 14.7%, respectively; p = 0.93) or women (26.6% and 30.1%, respectively; p = 0.19). Despite the high discharge rate in the PTRP, the BCT discharge rate for trainees who successfully rehabilitated was similar to the overall discharge rate at Fort Jackson. The 2-year retention in service for PTRP trainees who graduated from BCT was similar to that of non-PTRP trainees.

Air Quality Modeling for the Urban Jackson, Mississippi Region Using a High Resolution WRF/Chem Model

PubMed Central

Yerramilli, Anjaneyulu; Dodla, Venkata B.; Desamsetti, Srinivas; Challa, Srinivas V.; Young, John H.; Patrick, Chuck; Baham, Julius M.; Hughes, Robert L.; Yerramilli, Sudha; Tuluri, Francis; Hardy, Mark G.; Swanier, Shelton J.

2011-01-01

In this study, an attempt was made to simulate the air quality with reference to ozone over the Jackson (Mississippi) region using an online WRF/Chem (Weather Research and Forecasting–Chemistry) model. The WRF/Chem model has the advantages of the integration of the meteorological and chemistry modules with the same computational grid and same physical parameterizations and includes the feedback between the atmospheric chemistry and physical processes. The model was designed to have three nested domains with the inner-most domain covering the study region with a resolution of 1 km. The model was integrated for 48 hours continuously starting from 0000 UTC of 6 June 2006 and the evolution of surface ozone and other precursor pollutants were analyzed. The model simulated atmospheric flow fields and distributions of NO2 and O3 were evaluated for each of the three different time periods. The GIS based spatial distribution maps for ozone, its precursors NO, NO2, CO and HONO and the back trajectories indicate that all the mobile sources in Jackson, Ridgeland and Madison contributing significantly for their formation. The present study demonstrates the applicability of WRF/Chem model to generate quantitative information at high spatial and temporal resolution for the development of decision support systems for air quality regulatory agencies and health administrators. PMID:21776240

78 FR 5188 - Proposed Collection; Comment Request: The Jackson Heart Study (JHS)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... cardiovascular disease in African American men and women. Recruitment of 5,500 JHS participants began in... JHS study, review of their medical records, and interviews with doctors and family to identify disease occurrence. Interviewers will contact doctors and hospitals to ascertain participants' cardiovascular events...

Long‐term Cardiovascular Risks Associated With an Elevated Heart Rate: The Framingham Heart Study

PubMed Central

Ho, Jennifer E.; Larson, Martin G.; Ghorbani, Anahita; Cheng, Susan; Coglianese, Erin E.; Vasan, Ramachandran S.; Wang, Thomas J.

2014-01-01

Background Higher heart rate has been associated with an adverse prognosis, but most prior studies focused on individuals with known cardiovascular disease or examined a limited number of outcomes. We sought to examine the association of baseline heart rate with both fatal and nonfatal outcomes during 2 decades of follow‐up. Methods and Results Our study included 4058 Framingham Heart Study participants (mean age 55 years, 56% women). Cox models were performed with multivariable adjustment for clinical risk factors and physical activity. A total of 708 participants developed incident cardiovascular disease (303 heart failure, 343 coronary heart disease, and 216 stroke events), 48 received a permanent pacemaker, and 1186 died. Baseline heart rate was associated with incident cardiovascular disease (hazard ratio [HR] 1.15 per 1 SD [11 bpm] increase in heart rate, 95% CI 1.07 to 1.24, P=0.0002), particularly heart failure (HR 1.32, 95% CI 1.18 to 1.48, P<0.0001). Higher heart rate was also associated with higher all‐cause (HR 1.17, 95% CI 1.11 to 1.24, P<0.0001) and cardiovascular mortality (HR 1.18, 95% CI 1.04 to 1.33, P=0.01). Spline analyses did not suggest a lower threshold beyond which the benefit of a lower heart rate abated or increased. In contrast, individuals with a higher heart rate had a lower risk of requiring permanent pacemaker placement (HR 0.55, 95% CI 0.38 to 0.79, P=0.001). Conclusions Individuals with a higher heart rate are at elevated long‐term risk for cardiovascular events, in particular, heart failure, and all‐cause death. On the other hand, a higher heart rate is associated with a lower risk of future permanent pacemaker implantation. PMID:24811610

75 FR 68319 - Paulina Ranger District; Ochoco National Forest; Crook and Wheeler Counties, OR; Jackson...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... and Wheeler Counties, OR; Jackson Vegetation Management Project EIS AGENCY: Forest Service, USDA... fuels and vegetation management activities in the project area by comparing the existing condition to.... Excessive fuel from management activities in this project and past projects would be reduced on...

78 FR 20889 - Foreign-Trade Zone (FTZ) 158-Vicksburg/Jackson, Mississippi; Notification of Proposed Production...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [B-21-2013] Foreign-Trade Zone (FTZ) 158--Vicksburg/Jackson, Mississippi; Notification of Proposed Production Activity; H.M. Richards, Inc... 158, submitted a notification of proposed production activity on behalf of H.M. Richards, Inc. (HMRI...

Jackson State University's Center for Spatial Data Research and Applications: New facilities and new paradigms

NASA Technical Reports Server (NTRS)

Davis, Bruce E.; Elliot, Gregory

1989-01-01

Jackson State University recently established the Center for Spatial Data Research and Applications, a Geographical Information System (GIS) and remote sensing laboratory. Taking advantage of new technologies and new directions in the spatial (geographic) sciences, JSU is building a Center of Excellence in Spatial Data Management. New opportunities for research, applications, and employment are emerging. GIS requires fundamental shifts and new demands in traditional computer science and geographic training. The Center is not merely another computer lab but is one setting the pace in a new applied frontier. GIS and its associated technologies are discussed. The Center's facilities are described. An ARC/INFO GIS runs on a Vax mainframe, with numerous workstations. Image processing packages include ELAS, LIPS, VICAR, and ERDAS. A host of hardware and software peripheral are used in support. Numerous projects are underway, such as the construction of a Gulf of Mexico environmental data base, development of AI in image processing, a land use dynamics study of metropolitan Jackson, and others. A new academic interdisciplinary program in Spatial Data Management is under development, combining courses in Geography and Computer Science. The broad range of JSU's GIS and remote sensing activities is addressed. The impacts on changing paradigms in the university and in the professional world conclude the discussion.

Reply to “Earthquake prediction evaluation standards applied to the VAN Method,” by D. D. Jackson

NASA Astrophysics Data System (ADS)

Varotsos, P.; Lazaridou, M.; Hadjicontis, V.

Our earlier publications show that VAN method does not fail requirements (1) and (2) suggested by Jackson [1996]. No subjective ex-post facto decission was necessary for the evaluation of the success because, for the large majority of VAN predictions, the values of ΔM, Δr and Δt were published before the period 1987-1989 under discussion; in a few cases only (three out of 29), related with the observation of the new phenomenon of the SES electrical activity, the value of Δt was determined in 1988. Furthermore, a careful inspection-from physical point of view-shows that the three plausibility criteria, suggested by Jackson (to be obeyed by a candidate prediction technique), are actually met by VAN-method.

The revolution in risk assessment and disease detection made possible with non-invasive imaging: implications for population science.

PubMed

Carr, J Jeffrey

2012-01-01

The ability to quantify subclinical disease to assess cardiovascular disease is greatly enhanced by modern medical imaging techniques that incorporate concepts from biomedical engineering and computer science. These techniques' numerical results, known as quantitative phenotypes, can be used to help us better understand both health and disease states. In this report, we describe our efforts in using the latest imaging technologies to assess cardiovascular disease risk by quantifying subclinical disease of participants in the Jackson Heart Study. The CT and MRI exams of the Jackson Heart Study have collected detailed information from approximately 3,000 participants. Analyses of the images from these exams provide information on several measures including the amount of plaque in the coronary arteries and the ability of the heart to pump blood. These measures can then be added to the wealth of information on JHS participants to understand how these conditions, as well as how clinical events, such as heart attacks and heart failure, occur in African Americans.

75 FR 61817 - Adrian & Blissfield Rail Road Company-Continuance in Control Exemption-Jackson & Lansing Railroad...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... Southern Railroad Company; the Detroit Connecting Railroad Company; and the Lapeer Industrial Railroad... segments of the Lansing Industrial Track; and Docket No. FD 35418, Jackson & Lansing Railroad Company... historical rounding error in NSR's engineering maps. This transaction may not be consummated until October 20...

Analysis of borehole geophysical information across a uranium deposit in the Jackson Group, Karnes County, Texas

USGS Publications Warehouse

Daniels, Jeffrey J.; Scott, James Henry; Smith, Bruce D.

1979-01-01

Borehole geophysical studies across a uranium deposit in the Jackson Group, South Texas, show the three geochemical environments often associated with uranium roll-type deposits: an altered (oxidized) zone, an ore zone, and an unaltered (reduced) zone. Mineralogic analysis of the total sulfides contained in the drill core shows only slight changes in the total sulfide content among the three geochemical regimes. However, induced polarization measurements on the core samples indicate that samples obtained from the reduced side of the ore zone are more electrically polarizable than those from the oxidized side of the ore zone, and therefore probably contain more pyrite. Analysis of the clay-size fraction in core samples indicates that montmorillonite is the dominant clay mineral. High resistivity values within the ore zone indicate the presence of calcite cement concentrations that are higher than those seen outside of the ore zone. Between-hole resistivity and induced polarization measurements show the presence of an extensive zone of calcite cement within the ore zone, and electrical polarizable material (such as pyrite) within and on the reduced side of the ore zone. A quantitative analysis of the between-hole resistivity data, using a layered-earth model, and a qualitative analysis of the between-hole induced polarization measurements showed that mineralogic variations among the three geochemical environments were more pronounced than were indicated by the geophysical and geologic well logs. Uranium exploration in the South Texas Coastal Plain area has focused chiefly in three geologic units: the Oakville Sandstone, the Catahoula Tuff, and the Jackson Group. The Oakville Sandstone and the Catahoula Tuff are of Miocene age, and the Jackson Group is of Eocene age (Eargle and others, 1971). Most of the uranium mineralization in these formations is low grade (often less than 0.02 percent U3O8) and occurs in shallow deposits that are found by concentrated exploratory

Hydrologic effects of hypothetical earthquake-caused floods below Jackson Lake, northwestern Wyoming

USGS Publications Warehouse

Glass, W.R.; Keefer, T.N.; Rankl, J.G.

1976-01-01

Jackson Lake, located in Grand Teton National Park, Wyoming, is in an area of seismic instability. There is a possibility of flooding in the Snake River downstream from Jackson Lake Dam in the event of a severe earthquake. Hypothetical floods were routed 38 miles (61 kilometers) downstream from the dam for three cases: (1) Instantaneous destruction of the dam outlet structure, (2) instantaneous destruction of the entire dam, and (3) for waves overtopping the dam without failure of the dam. In each case, a full reservoir was assumed. Hydrographs for outflow from the reservoir for the two cases of dam failure were developed utilizing an accelerated discharge due to the travel of a negative wave through the reservoir, and Muskingum storage routing. For the case of waves overtopping the dam, a 10-foot (3-meter) wave was assumed to be propagated from the upstream end of the reservori. A multiple-linearization technique was used to route the flow through the reach. The model was calibrated from U.S. Geological Survey streamflow records. Most extensive flooding and largest water velocities would occur if the entire dam were destroyed; floods for the other two cases were smaller. An inundation map was prepared from channel conveyance curves and profiles of the water surface. (Woodard-USGS)

Geohydrology of the North Park area, Jackson County, Colorado; with a section on water law

USGS Publications Warehouse

Robson, Stanley G.; Graham, Glenn

1996-01-01

Increasing population in rural and suburban areas of Colorado is causing greater reliance on ground water as a source of domestic supply. In the primarily rural area of Jackson County, for example, the number of registered water wells increased from about 100 in 1972 to about 500 in 1995. Most of the new wells were drilled after 1988 and supply water to ranches and summer homes. In Jackson County, ground water is pumped from a series of shallow alluvial aquifers along principal stream valleys and from deeper, more extensive, bedrock aquifers. In much of the area, the alluvial aquifers are thin and can be dewatered by moderate water- level declines. Knowledge of the nature and extent of the alluvial and bedrock aquifers, the sources of recharge and discharge, and the effects of ground- water withdrawal on water levels in the aquifers is vital if management of the area's water resources is to ensure continued availability of a dependable water supply.

A Conversation with the Reverend Jesse Jackson: The Quest for Economic and Educational Parity.

ERIC Educational Resources Information Center

American Enterprise Inst. for Public Policy Research, Washington, DC.

This booklet contains an edited transcript of a visit by the black civil rights leader to the American Enterprise Institute (AEI) in May 1978. Reverend Jackson addresses issues that go beyond the freedoms won in the civil rights movement toward the goals of educational and economic parity for all Americans. AEI scholars and fellows,…

Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

PubMed

Ekúndayò, Olúgbémiga T; Tataw, David B

2013-01-01

This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi.

Perceptual and Physiological Responses to Jackson Pollock's Fractals

PubMed Central

Taylor, Richard P.; Spehar, Branka; Van Donkelaar, Paul; Hagerhall, Caroline M.

2011-01-01

Fractals have been very successful in quantifying the visual complexity exhibited by many natural patterns, and have captured the imagination of scientists and artists alike. Our research has shown that the poured patterns of the American abstract painter Jackson Pollock are also fractal. This discovery raises an intriguing possibility – are the visual characteristics of fractals responsible for the long-term appeal of Pollock's work? To address this question, we have conducted 10 years of scientific investigation of human response to fractals and here we present, for the first time, a review of this research that examines the inter-relationship between the various results. The investigations include eye tracking, visual preference, skin conductance, and EEG measurement techniques. We discuss the artistic implications of the positive perceptual and physiological responses to fractal patterns. PMID:21734876

Data requirements for simulation of hydrogeologic effects of liquid waste injection, Harrison and Jackson Counties, Mississippi

USGS Publications Warehouse

Rebich, Richard A.

1994-01-01

Available literature and data were reviewed to quantify data requirements for computer simulation of hydrogeologic effects of liquid waste injection in southeastern Mississippi. Emphasis of each review was placed on quantifying physical properties of current Class I injection zones in Harrison and Jackson Counties. Class I injection zones are zones that are used for injection of hazardous or non-hazardous liquid waste below a formation containing the lowermost underground source of drinking water located within one-quarter of a mile of the injection well. Several mathematical models have been developed to simulate injection effects. The Basic Plume Method was selected because it is commonly used in permit applications, and the Intercomp model was selected because it is generally accepted and used in injection-related research. The input data requirements of the two models were combined into a single data requirement list inclusive of physical properties of injection zones only; injected waste and well properties are not included because such information is site-specific by industry, which is beyond the scope of this report. Results of the reviews of available literature and data indicated that Class I permit applications and standard-reference chemistry and physics texts were the primary sources of information to quantify physical properties of injection zones in Harrison and Jackson Counties. With the exception of a few reports and supplementary data for one injection zone in Jackson County, very little additional information pertaining to physical properties of the injection zones was available in sources other than permit applications and standard-reference texts.

The Effect of Treatment with Hydrogen Peroxide and the Mehra-Jackson Reagent on X-ray Diffraction Patterns of Clay Fractions

NASA Astrophysics Data System (ADS)

Sokolova, T. A.; Tolpeshta, I. I.; Izosimova, Yu. G.; Umnova, V. A.; Lashukov, P. V.

2017-12-01

X-ray diffraction patterns of clay fractions from the AEL and EL horizons of pale-podzolic soil before and after treatment with 10% H2O2 and the Mehra-Jackson reagent in different sequences have been examined. The successive treatment with 10% H2O2 and then with the Mehra-Jackson reagent causes dissolution of Al-hydroxy-interlayers in pedogenic chlorites and the respective increase in the content of labile minerals because of a dramatic decrease in pH upon the treatment with hydrogen peroxide. The rate of these changes depends on the degree of chloritization of pedogenic chlorites in the initial samples. The result of the reverse sequence of the treatments of clay fractions (initially with the Mehra-Jackson reagent and then with hydrogen peroxide) is opposite: the chloritization of labile minerals becomes more intensive. It is provided by pH values that do not drop below 7.5 at any treatment stage. At particular stages, pH values favors the mobilization of Al compounds and their subsequent polymerization in the interlayer space of labile structures. We suppose that hydroxyl-aluminosilicate layers may be formed in the interlayer space upon this treatment sequence.

Carotenoid Intakes, Assessed by food frequency questionnaires are associated with serum carotenoid concentrations in the Jackson Heart Study: Validation of the Jackson Heart Study Delta NIRI Adult Food Frequency Questionnaire

USDA-ARS?s Scientific Manuscript database

Objectives: Intake and status of carotenoids have been associated with chronic disease. The objectives of this study were to examine the association between carotenoid intakes as measured by two regional food-frequency questionnaires (FFQs) and their corresponding measures in serum, and to report ...

Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

PubMed

Wytenbroek, Lydia

2015-01-01

From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role.

Application of sediment quality guidelines in the assessment and management of contaminated surficial sediments in Port Jackson (Sydney Harbour), Australia.

PubMed

Birch, Gavin F; Taylor, Stuart E

2002-06-01

Sediments in the Port Jackson estuary are polluted by a wide range of toxicants and concentrations are among the highest reported for any major harbor in the world. Sediment quality guidelines (SQGs), developed by the National Oceanographic and Atmospheric Administration (NOAA) in the United States are used to estimate possible adverse biological effects of sedimentary contaminants in Port Jackson to benthic animals. The NOAA guidelines indicate that Pb, Zn, DDD, and DDE are the most likely contaminants to cause adverse biological effects in Port Jackson. On an individual chemical basis, the detrimental effects due to these toxicants may occur over extensive areas of the harbor, i.e., about 40%, 30%, 15% and 50%, respectively. The NOAA SQGs can also be used to estimate the probability of sediment toxicity for contaminant mixtures by determining the number of contaminants exceeding an upper guideline value (effects range medium, or ERM), which predicts probable adverse biological effects. The exceedence approach is used in the current study to estimate the probability of sediment toxicity and to prioritize the harbour in terms of possible adverse effects on sediment-dwelling animals. Approximately 1% of the harbor is mantled with sediment containing more than ten contaminants exceeding their respective ERM concentrations and, based on NOAA data, these sediments have an 80% probability of being toxic. Sediment with six to ten contaminants exceeding their respective ERM guidelines extend over approximately 4% of the harbor and have a 57% probability of toxicity. These areas are located in the landward reaches of embayments in the upper and central harbor in proximity to the most industrialised and urbanized part of the catchment. Sediment in a further 17% of the harbor has between one and five exceedences and has a 32% probability of being toxic. The application of SQGs developed by NOAA has not been tested outside North America, and the validity of using them in Port

Individual personality differences in Port Jackson sharks Heterodontus portusjacksoni.

PubMed

Byrnes, E E; Brown, C

2016-08-01

This study examined interindividual personality differences between Port Jackson sharks Heterodontus portusjacksoni utilizing a standard boldness assay. Additionally, the correlation between differences in individual boldness and stress reactivity was examined, exploring indications of individual coping styles. Heterodontus portusjacksoni demonstrated highly repeatable individual differences in boldness and stress reactivity. Individual boldness scores were highly repeatable across four trials such that individuals that were the fastest to emerge in the first trial were also the fastest to emerge in subsequent trials. Additionally, individuals that were the most reactive to a handling stressor in the first trial were also the most reactive in a second trial. The strong link between boldness and stress response commonly found in teleosts was also evident in this study, providing evidence of proactive-reactive coping styles in H. portusjacksoni. These results demonstrate the presence of individual personality differences in sharks for the first time. Understanding how personality influences variation in elasmobranch behaviour such as prey choice, habitat use and activity levels is critical to better managing these top predators which play important ecological roles in marine ecosystems. © 2016 The Fisheries Society of the British Isles.

Xenopus: An Emerging Model for Studying Congenital Heart Disease

PubMed Central

Kaltenbrun, Erin; Tandon, Panna; Amin, Nirav M.; Waldron, Lauren; Showell, Chris; Conlon, Frank L.

2011-01-01

Congenital heart defects affect nearly 1% of all newborns and are a significant cause of infant death. Clinical studies have identified a number of congenital heart syndromes associated with mutations in genes that are involved in the complex process of cardiogenesis. The African clawed frog, Xenopus, has been instrumental in studies of vertebrate heart development and provides a valuable tool to investigate the molecular mechanisms underlying human congenital heart diseases. In this review, we discuss the methodologies that make Xenopus an ideal model system to investigate heart development and disease. We also outline congenital heart conditions linked to cardiac genes that have been well-studied in Xenopus and describe some emerging technologies that will further aid in the study of these complex syndromes. PMID:21538812

Heart Repair and Regeneration: Recent Insights from Zebrafish Studies

PubMed Central

Lien, Ching-Ling; Harrison, Michael R.; Tuan, Tai-Lan; Starnes, Vaughn A

2012-01-01

Cardiovascular disease is the leading cause of death in United States and worldwide. Failure to properly repair or regenerate damaged cardiac tissues after myocardial infarction is a major cause of heart failure. In contrast to humans and other mammals, zebrafish hearts regenerate after substantial injury or tissue damage. Here, we review recent progress in studying zebrafish heart regeneration, addressing the molecular and cellular responses in the three tissue layers of the heart: myocardium, epicardium, and endocardium. We also compare different injury models utilized to study zebrafish heart regeneration, and discuss the differences in responses to injury between mammalian and zebrafish hearts. By learning how zebrafish hearts regenerate naturally, we can better design therapeutic strategies for repairing human hearts after myocardial infarction. PMID:22818295

Pulse Pressure: An Indicator of Heart Health?

MedlinePlus

... ESH/ESC guidelines for the management of arterial hypertension. Journal of Hypertension. 2013;31:1281. Winston GJ, et al. Pulse ... in the multi-ethnic study of atherosclerosis. American Journal of Hypertension. 2013; 26:636. Jackson CE, et al. Differing ...

Title IX and Retaliation: The Impact of "Jackson v. Birmingham Board of Education" on Higher Education

ERIC Educational Resources Information Center

Melear, Kerry Brian

2007-01-01

In 2005, the United States Supreme Court rendered a closely divided opinion that extends the protections against discrimination provided by Title IX of the Education Amendments of 1972 to include a private cause of action for retaliation in "Jackson v. Birmingham Board of Education." Therefore, "whistleblowers," or employees who report allegedly…

Genome-wide association studies and resting heart rate.

PubMed

Kilpeläinen, Tuomas O

Genome-wide association studies (GWASs) have revolutionized the search for genetic variants regulating resting heart rate. In the last 10years, GWASs have led to the identification of at least 21 novel heart rate loci. These discoveries have provided valuable insights into the mechanisms and pathways that regulate heart rate and link heart rate to cardiovascular morbidity and mortality. GWASs capture majority of genetic variation in a population sample by utilizing high-throughput genotyping chips measuring genotypes for up to several millions of SNPs across the genome in thousands of individuals. This allows the identification of the strongest heart rate associated signals at genome-wide level. While GWASs provide robust statistical evidence of the association of a given genetic locus with heart rate, they are only the starting point for detailed follow-up studies to locate the causal variants and genes and gain further insights into the biological mechanisms underlying the observed associations. Copyright © 2016 Elsevier Inc. All rights reserved.

76 FR 2145 - Masco Builder Cabinet Group Including On-Site Leased Workers From Reserves Network, Jackson, OH...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

...,287B; TA-W-71,287C] Masco Builder Cabinet Group Including On-Site Leased Workers From Reserves Network, Jackson, OH; Masco Builder Cabinet Group, Waverly, OH; Masco Builder Cabinet Group, Seal Township, OH; Masco Builder Cabinet Group, Seaman, OH; Amended Certification Regarding Eligibility To Apply for Worker...

Letter from Galo Jackson Final Comments on November 2012 Draft ofthe Remedial Investigation Report fpr Operable Unit 3-Upland Soils

EPA Pesticide Factsheets

Letter from Galo Jackson contains the Final Comments on November 2012 Draft ofthe Remedial Investigation Report for Operable Unit 3-Upland Soils: LCP Chemical National Priorities List Site, Brunswick, Glynn County, GA.

Jackson District Library, Final Performance Report for Library Services and Construction Act (LSCA) Title VI, Library Literacy Program.

ERIC Educational Resources Information Center

Rosynek, Joy

This final performance report provides project outcome information and data to the U.S. Department of Education for the federally-funded Library Literacy Program. The Jackson District Library (Michigan) conducted a project that involved recruitment, retention, public awareness, training, basic literacy, collection development, tutoring, employment…

Left ventricular ejection time is an independent predictor of incident heart failure in a community-based cohort.

PubMed

Biering-Sørensen, Tor; Querejeta Roca, Gabriela; Hegde, Sheila M; Shah, Amil M; Claggett, Brian; Mosley, Thomas H; Butler, Kenneth R; Solomon, Scott D

2017-09-04

Systolic time intervals change in the progress of cardiac dysfunction. The usefulness of left ventricular ejection time (LVET) to predict cardiovascular morbidity, however, is unknown. We studied middle-aged African-Americans from one of four cohorts of the Atherosclerosis Risk in Communities study (Jackson cohort, n=1980) who underwent echocardiography between 1993 and 1995. Left ventricular ejection time was measured by pulsed-wave Doppler of the left ventricular outflow tract and related to outcomes. A shorter LVET was associated with younger age, male sex, higher diastolic blood pressure, higher proportion of diabetes, higher heart rate, higher blood glucose levels and worse fractional shortening. During a median follow-up of 17.6 years, 384 (19%) had incident heart failure (HF), 158 (8%) had a myocardial infarction, and 587 (30%) died. In univariable analysis, a lower LVET was significantly associated with increased risk of all events (P<0.05 for all). However, after multivariable adjustment for age, sex, hypertension, diabetes, body mass index, heart rate, systolic and diastolic blood pressure, fractional shortening and left atrial diameter, LVET remained an independent predictor only of incident HF [hazard ratio 1.07 (1.02-1.14), P=0.010 per 10 ms decrease]. In addition, LVET provided incremental prognostic information to the known risk factors included in the Framingham risk score, in regard to predicting all outcomes except for myocardial infarction. Left ventricular ejection time is an independent predictor of incident HF in a community-based cohort and provides incremental prognostic information on the risk of future HF and death when added to known risk prediction models. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Water quality of Bear Creek basin, Jackson County, Oregon

USGS Publications Warehouse

Wittenberg, Loren A.; McKenzie, Stuart W.

1980-01-01

Water-quality data identify surface-water-quality problems in Bear Creek basin, Jackson County, Oreg., where possible, their causes or sources. Irrigation and return-flow data show pastures are sources of fecal coliform and fecal streptococci bacteria and sinks for suspended sediment and nitrite-plus-nitrate nitrogen. Bear Creek and its tributaries have dissolved oxygen and pH values that do not meet State standards. Forty to 50% of the fecal coliform and fecal streptococci concentrations were higher than 1,000 bacteria colonies per 100 milliliters during the irrigation season in the lower two-thirds of the basin. During the irrigation season, suspended-sediment concentrations, average 35 milligrams per liter, were double those for the nonirrigation season. The Ashland sewage-treatment plant is a major source of nitrite plus nitrate, ammonia, and Kjeldahl nitrogen, and orthophosphate in Bear Creek. (USGS)

Isolated heart models: cardiovascular system studies and technological advances.

PubMed

Olejnickova, Veronika; Novakova, Marie; Provaznik, Ivo

2015-07-01

Isolated heart model is a relevant tool for cardiovascular system studies. It represents a highly reproducible model for studying broad spectrum of biochemical, physiological, morphological, and pharmaceutical parameters, including analysis of intrinsic heart mechanics, metabolism, and coronary vascular response. Results obtained in this model are under no influence of other organ systems, plasma concentration of hormones or ions and influence of autonomic nervous system. The review describes various isolated heart models, the modes of heart perfusion, and advantages and limitations of various experimental setups. It reports the improvements of perfusion setup according to Langendorff introduced by the authors.

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College. Sixth Progress Report.

ERIC Educational Resources Information Center

Seifert, Mel

The sixth semi-annual report of the Sheldon Jackson College Aquaculture Program covers the period January 1 through June 30, 1977, and summarizes the last half of the second year of operation of the educational program and the entire year for the hatchery. The educational component of the program is described in terms of the academic program,…

Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

PubMed

Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

2011-01-01

In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

History of Lung and Heart-Lung Transplantation, With Special Emphasis on German-Speaking Countries.

PubMed

Margreiter, R

2016-10-01

The first experimental lung transplants were performed in 1947 by the Russian surgeon V.P. Demikhov. Thereafter, various aspects associated with lung transplantation were studied by groups from Italy, France, and mainly the United States. The first clinical lung transplant took place in Jackson, Mississippi, in 1963 and was performed by D. Hardy. Until 1983, a total of 45 lung transplants were carried out at various centers, but only one patient transplanted in Ghent by F. Derom in 1968 survived for 10 months, whereas all other patients survived only hours to a few days. In 1983 at Toronto General Hospital, a single-lung transplant was performed that survived almost 7 years. From the same institution, the first long-term survivor after double-lung transplantation was reported in 1986. The first lobar transplant from a live donor was performed by V.A. Starnes at Stanford in 1990. The first heart-lung transplantation was performed in Houston by D.A. Cooley in 1968. Even though the girl who received this transplant survived only for 14 hours, this case showed that this kind of procedure can work. The first long-term survival was achieved by B. Reitz in 1981 in Stanford. In the German-speaking countries, successful lung and lung-heart transplants were reported between 1984 and 1993 and are described in detail. Copyright © 2016 Elsevier Inc. All rights reserved.

Headquarters, 172nd Military Airlift Group Mississippi Air National Guard, A.C. Thompson Field, Jackson, Mississippi

DTIC Science & Technology

1988-07-01

purchased from: National Technical Information Service 5285 Port Royal Road Springfield, Virginia 22161 Federal Government agencies and their contractors...Bi-1 APPDFrMIX A - Restaes of Search Team V?_7ibers .... .............. ... A-i APP2-EDIX B - Outside Agency Contact List...ANGB, ,when the land at Site No. 1, which was owned by the city of 3 Jackson, was leased to the National Weather Service . A mre elaborate systz of

Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study

PubMed Central

Taylor, Clare J; Roalfe, Andrea K; Tait, Lynda; Davis, Russell C; Iles, Rachel; Derit, Marites; Hobbs, F D Richard

2014-01-01

Objectives Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. Design Observational longitudinal cohort study. Setting 16 socioeconomically diverse practices in central England. Participants Participants from the original Echocardiographic Heart of England Screening (ECHOES) study were invited to attend for rescreening. Outcome measures Prevalence of heart failure at rescreening overall and for each original ECHOES subgroup. Test performance of N Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels at different thresholds for screening. Results 1618 of 3408 participants underwent screening which represented 47% of survivors and 26% of the original ECHOES cohort. A total of 176 (11%, 95% CI 9.4% to 12.5%) participants were classified as having heart failure at rescreening; 103 had heart failure with reduced ejection fraction (HFREF) and 73 had heart failure with preserved ejection fraction (HFPEF). Sixty-eight out of 1232 (5.5%, 95% CI 4.3% to 6.9%) participants who were recruited from the general population over the age of 45 and did not have heart failure in the original study, had heart failure on rescreening. An NT-proBNP cut-off of 400 pg/mL had sensitivity for a diagnosis of heart failure of 79.5% (95% CI 72.4% to 85.5%) and specificity of 87% (95% CI 85.1% to 88.8%). Conclusions Rescreening identified new cases of HFREF and HFPEF. Progression to heart failure poses a significant threat over time. The natriuretic peptide cut-off level for ruling out heart failure must be low enough to ensure cases are not missed at screening. PMID:25015472

Secularisation and the Securitisation of the Sacred: A Response to Lewin's Framing of the Gearon-Jackson Debate

ERIC Educational Resources Information Center

Gearon, Liam

2017-01-01

In this article, I make a response to Lewin's insightful and judicious contribution to the Gearon-Jackson debate. I address the central and important arguments made by Lewin in relation to three aspects of my theoretical orientations on religion in education: (1) what Lewin rightly identifies as my "propositional" interpretation of…

Highlights of the 34th Annual Ralph E. Hopkins at Jackson Hole Seminars (JHS) on February 7-12, 2014, Jackson Hole, WY, USA.

PubMed

da Silva, Rodrigo Donalisio; Schulte, Mary Beth; Miano, Roberto; Gustafson, Diedra; Nogueira, Leticia; Kim, Fernando J

2014-04-01

The prestigious Jackson Hole Seminars (JHS) successfully gathered several world leaders in academic urology and urologists in private practice for a unique scientific experience in Wyoming, USA. Unfortunately, this year Dr. Ralph Hopkins' seat was empty but his spirit continue to be the driving force for the meeting's excellence and friendship. The JHS has pioneered the concept of a Critique Panel comprised of previous speakers that would discuss in depth the presentations of the faculty chosen by the scientific board of the JHS. The 2014 JHS featured Dr. Fernando J. Kim, the President of JHS, Dr. Robert Flanigan, the Program Chair, and the Critique Panel that included: Drs. Peter Albertsen, Arthur Burnett, Michael Coburn, Ann Gormley, and Marshal Stoller. The invited speakers were: Drs. Leonard Gomella (1st prize), Olivier Traxer (2nd prize), Jennifer Anger, Anthony Bella, Jim Hu, and Allen Morey. Some of the in depth discussions and topics are highlighted.

The pediatric heart network: meeting the challenges to multicenter studies in pediatric heart disease

PubMed Central

Burns, Kristin M.; Pemberton, Victoria L.; Pearson, Gail D.

2017-01-01

Purpose of review Because of the relatively small numbers of pediatric patients with congenital heart disease cared for in any individual center, there is a significant need for multicenter clinical studies to validate new medical or surgical therapies. The Pediatric Heart Network (PHN), with 15 years of experience in multicenter clinical research, has tackled numerous challenges when conducting multicenter studies. Recent findings This review describes the challenges encountered and the strategies employed to conduct high-quality, collaborative research in pediatric cardiovascular disease. Summary Sharing lessons learned from the PHN can provide guidance to investigators interested in conducting pediatric multicenter studies. PMID:26196261

African American Clergy Perspectives About the HIV Care Continuum: Results From a Qualitative Study in Jackson, Mississippi.

PubMed

Nunn, Amy; Parker, Sharon; McCoy, Katryna; Monger, Mauda; Bender, Melverta; Poceta, Joanna; Harvey, Julia; Thomas, Gladys; Johnson, Kendra; Ransome, Yusuf; Sutten Coats, Cassandra; Chan, Phil; Mena, Leandro

2018-01-01

Mississippi has some of the most pronounced racial disparities in HIV infection in the country; African Americans comprised 37% of the Mississippi population but represented 80% of new HIV cases in 2015. Improving outcomes along the HIV care continuum, including linking and retaining more individuals and enhancing adherence to medication, may reduce the disparities faced by African Americans in Mississippi. Little is understood about clergy's views about the HIV care continuum. We assessed knowledge of African American pastors and ministers in Jackson, Mississippi about HIV and the HIV care continuum. We also assessed their willingness to promote HIV screening and biomedical prevention technologies as well as efforts to enhance linkage and retention in care with their congregations. Four focus groups were conducted with 19 African American clergy. Clergy noted pervasive stigma associated with HIV and believed they had a moral imperative to promote HIV awareness and testing; they provided recommendations on how to normalize conversations related to HIV testing and treatment. Overall, clergy were willing to promote and help assist with linking and retaining HIV positive individuals in care but knew little about how HIV treatment can enhance prevention or new biomedical technologies such as pre-exposure prophylaxis (PrEP). Clergy underscored the importance of building coalitions to promote a collective local response to the epidemic. The results of this study highlight important public health opportunities to engage African American clergy in the HIV care continuum in order to reduce racial disparities in HIV infection.

Deposits of Claiborne and Jackson age in Georgia

USGS Publications Warehouse

Cooke, Charles Wythe; Shearer, Harold Kurtz

1919-01-01

In 1911 the Geological Survey of Georgia published as Bulletin 26 a "Preliminary report on the geology of the Coastal Plain of Georgia," by Otto Veatch and Lloyd William Stephenson, prepared in cooperation with the United States Geological Survey under the supervision of T. Wayland Vaughan, a geologist in charge of Coastal Plain investigations, who contributed the determinations of the invertebrate fossils of the Tertiary and Quaternary formations. Although this report constituted a decided advance in our knowledge of the geology of the Coastal Plain of Georgia, it was admittedly of reconnaissance character, and corrections and additions to it were to be expected. During the last few years field work has been prosecuted vigorously in the Coastal Plain of Georgia, and the additional information thus accumulated throws light upon certain problems of stratigraphy left unsolved by Veatch and Stephenson and alters considerably some of their correlations. The object of the present paper is to present the new evidence regarding the age and correlation of the Eocene formations of Georgia and to revise in accordance with present knowledge the descriptions of the deposits of Claiborne and Jackson age.

Sudden death after pediatric heart transplantation: analysis of data from the Pediatric Heart Transplant Study Group.

PubMed

Daly, Kevin P; Chakravarti, Sujata B; Tresler, Margaret; Naftel, David C; Blume, Elizabeth D; Dipchand, Anne I; Almond, Christopher S

2011-12-01

Sudden death is a well-recognized complication of heart transplantation. Little is known about the incidence and risk factors for sudden death after transplant in children. The purpose of this study was to determine the incidence of and risk factors for sudden death. This retrospective multicenter cohort study used the Pediatric Heart Transplant Study Group (PHTS) database, an event-driven registry of children aged <18 at listing undergoing heart transplantation between 1993 and 2007. Standard Kaplan-Meier and parametric analyses were used for survival analysis. Multivariate analysis in the hazard-function domain was used to identify risk factors for sudden death after transplant. Of 604 deaths in 2,491 children who underwent heart transplantation, 94 (16%) were classified as sudden. Freedom from sudden death was 97% at 5 years, and the hazard for sudden death remained constant over time at 0.01 deaths/year. Multivariate risk factors associated with sudden death included black race (hazard ratio [HR], 2.6; p < 0.0001), United Network of Organ Sharing (UNOS) status 2 at transplant (HR, 1.8; p = 0.008), older age (HR, 1.4/10 years of age; p = 0.03), and an increased number of rejection episodes in the first post-transplant year (HR, 1.6/episode; p = 0.03). Sudden death accounts for 1 in 6 deaths after heart transplant in children. Older recipient age, recurrent rejection within the first year, black race, and UNOS status 2 at listing were associated with sudden death. Patients with 1 or more of these risk factors may benefit from primary prevention efforts. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Cost-of-illness studies in heart failure: a systematic review 2004-2016.

PubMed

Lesyuk, Wladimir; Kriza, Christine; Kolominsky-Rabas, Peter

2018-05-02

Heart failure is a major and growing medical and economic problem worldwide as 1-2% of the healthcare budget are spent for heart failure. The prevalence of heart failure has increased over the past decades and it is expected that there will be further raise due to the higher proportion of elderly in the western societies. In this context cost-of-illness studies can significantly contribute to a better understanding of the drivers and problems which lead to the increasing costs in heart failure. The aim of this study was to perform a systematic review of published cost-of-illness studies related to heart failure to highlight the increasing cost impact of heart failure. A systematic review was conducted from 2004 to 2016 to identify cost-of-illness studies related to heart failure, searching PubMed (Medline), Cochrane, Science Direct (Embase), Scopus and CRD York Database. Of the total of 16 studies identified, 11 studies reported prevalence-based estimates, 2 studies focused on incidence-based data and 3 articles presented both types of cost data. A large variation concerning cost components and estimates can be noted. Only three studies estimated indirect costs. Most of the included studies have shown that the costs for hospital admission are the most expensive cost element. Estimates for annual prevalence-based costs for heart failure patients range from $868 for South Korea to $25,532 for Germany. The lifetime costs for heart failure patients have been estimated to $126.819 per patient. Our review highlights the considerable and growing economic burden of heart failure on the health care systems. The cost-of-illness studies included in this review show large variations in methodology used and the cost results vary consequently. High quality data from cost-of-illness studies with a robust methodology applied can inform policy makers about the major cost drivers of heart failure and can be used as the basis of further economic evaluations.

Statistical summaries of water-quality data for two coal areas of Jackson County, Colorado

USGS Publications Warehouse

Kuhn, Gerhard

1982-01-01

Statistical summaries of water-quality data are compiled for eight streams in two separate coal areas of Jackson County, Colo. The quality-of-water data were collected from October 1976 to September 1980. For inorganic constituents, the maximum, minimum, and mean concentrations, as well as other statistics are presented; for minor elements, only the maximum, minimum, and mean values are included. Least-squares equations (regressions) are also given relating specific conductance of the streams to the concentration of the major ions. The observed range of specific conductance was 85 to 1,150 micromhos per centimeter for the eight sites. (USGS)

Genetics of the Framingham Heart Study Population

PubMed Central

Govindaraju, Diddahally R.; Cupples, L. Adrienne; Kannel, William B.; O’Donnell, Christopher J.; Atwood, Larry D.; D’Agostino, Ralph B.; Fox, Caroline S.; Larson, Marty; Levy, Daniel; Morabito, Joanne; Vasan, Ramachandran S.; Splansky, Greta Lee; Wolf, Philip A.; Benjamin, Emelia J.

2010-01-01

This article provides an introduction to the Framingham Heart Study (FHS) and the genetic research related to cardiovascular diseases conducted in this unique population1. It briefly describes the origins of the study, the risk factors that contribute to heart disease and the approaches taken to discover the genetic basis of some of these risk factors. The genetic architecture of several biological risk factors has been explained using family studies, segregation analysis, heritability, phenotypic and genetic correlations. Many quantitative trait loci underlying cardiovascular diseases have been discovered using different molecular markers. Additionally, results from genome-wide association studies using 100,000 markers, and the prospects of using 550,000 markers for association studies are presented. Finally, the use of this unique sample in genotype and environment interaction is described. PMID:19010253

Resting Heart Rate as Predictor for Left Ventricular Dysfunction and Heart Failure: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

Opdahl, Anders; Venkatesh, Bharath Ambale; Fernandes, Veronica R. S.; Wu, Colin O.; Nasir, Khurram; Choi, Eui-Young; Almeida, Andre L. C.; Rosen, Boaz; Carvalho, Benilton; Edvardsen, Thor; Bluemke, David A.; Lima, Joao A. C.

2014-01-01

OBJECTIVE To investigate the relationship between baseline resting heart rate and incidence of heart failure (HF) and global and regional left ventricular (LV) dysfunction. BACKGROUND The association of resting heart rate to HF and LV function is not well described in an asymptomatic multi-ethnic population. METHODS Participants in the Multi-Ethnic Study of Atherosclerosis had resting heart rate measured at inclusion. Incident HF was registered (n=176) during follow-up (median 7 years) in those who underwent cardiac MRI (n=5000). Changes in ejection fraction (ΔEF) and peak circumferential strain (Δεcc) were measured as markers of developing global and regional LV dysfunction in 1056 participants imaged at baseline and 5 years later. Time to HF (Cox model) and Δεcc and ΔEF (multiple linear regression models) were adjusted for demographics, traditional cardiovascular risk factors, calcium score, LV end-diastolic volume and mass in addition to resting heart rate. RESULTS Cox analysis demonstrated that for 1 bpm increase in resting heart rate there was a 4% greater adjusted relative risk for incident HF (Hazard Ratio: 1.04 (1.02, 1.06 (95% CI); P<0.001). Adjusted multiple regression models demonstrated that resting heart rate was positively associated with deteriorating εcc and decrease in EF, even in analyses when all coronary heart disease events were excluded from the model. CONCLUSION Elevated resting heart rate is associated with increased risk for incident HF in asymptomatic participants in MESA. Higher heart rate is related to development of regional and global LV dysfunction independent of subclinical atherosclerosis and coronary heart disease. PMID:24412444

Alvermann & Jackson: Response to "Beyond the Common Core: Examining 20 Years of Literacy Priorities and Their Impact on Struggling Readers"

ERIC Educational Resources Information Center

Alvermann, Donna E.; Jackson, Glen

2016-01-01

When the editors of "Literacy Research and Instruction" invited Donna Alvermann and Glenn Jackson to respond to "Beyond the Common Core: Examining 20 Years of Literacy Priorities and Their Impact on Struggling Readers," they both instantly recognized the strengths and limitations in their collaboration. In the strengths corner,…

Creating a Forest-Wide Context for Adaptive Management at Jackson Demonstration State Forest

NASA Astrophysics Data System (ADS)

Liquori, M.; Helms, J.; Porter, D.

2010-12-01

At nearly 50,000 acres, Jackson Demonstration State Forest (JDSF) is the largest State-owned forest in California. In 2008, the CALFIRE Director appointed a 13-member Jackson Advisory Group to provide recommendations to the California State Board of Forestry for how to transition JDSF into a “world-class research forest”. After nearly 3 years of deliberations, we have developed a draft Research-Oriented Management Framework (ROMF) that, if adopted, will introduce a new model for adaptive management within the forestry sector. Our approach integrates several core elements. Scientific “Centers of Excellence” (including one focused on Coho recovery and/or watershed processes) would be developed around a Research-Oriented Landscape Allocation, that considers the existing distribution of forest attributes both within JDSF as well as within the broader coastal Redwood Region. The ROMF would establish an Experimental Basis for Management that seeks to leverage harvest activities with explicit experimental designs and monitoring objectives. Like many of the forests that comprise its customer-base, JDSF has a mandate to produce timber revenues. We view this as an opportunity to mimic the management constraint imposed on most private and conservation trust landowners to routinely harvest timber to support operational and capital costs. Timber revenues on JDSF would be used (in part) to support the research and monitoring program. Such a system would support both passive and active modes of forest manipulation and research, and would make JDSF research activities more relevant to stakeholders, potentially increasing opportunities for collaborative, landscape-scale studies that seek to resolve outstanding management issues and uncertainties. The ROMF also would seek to develop and improve practices related to sustainable forestry. Both Late-Seral Development Areas and Old-Forest Structure Zones would be established that will utilize uneven-aged management treatments to

Sex, Obesity, and Blood Pressure Among African American Adolescents: The Jackson Heart KIDS Pilot Study.

PubMed

Bruce, Marino A; Beech, Bettina M; Norris, Keith C; Griffith, Derek M; Sims, Mario; Thorpe, Roland J

2017-09-01

This study examined the degree to which sex, weight status, and the presence of hypertension and obesity in parents/grandparents were associated with systolic (SBP) and diastolic (DBP) blood pressure (BP) among African American youth in a pilot offspring study examining obesity-related cardiovascular disease (CVD) risks among adolescents. Fully adjusted linear regression models of the total sample produced results indicating that obesity was associated with BP (SBP: β = 7.08, P < 0.01; DBP: β = 8.14, P < 0.001). Sex-stratified analyses indicated that overweight and obesity were associated with SBP (overweight: β = 6.77, P < 0.01; obese: β = 11.65, P < 0.001) and obesity was correlated with DBP (β = 9.86, P < 0.001) among males. For females, overweight was correlated with SBP (β = 4.11, P < 0.05) while obesity was associated with DBP (β = 6.98, P < 0.01). Attempting to lose weight was inversely related to SBP (β = -4.01, P < 0.05) in the full sample and among males (β = -11.94, P < 0.001). Familial presence of hypertension and/or obesity was significantly associated with SBP among adolescent females but not males. The relationship between weight status, familial hypertension and obesity status, and BP among adolescents vary by sex. This study underscores the need for additional research investigating the relationship between individual sex, weight status, BP and familial BP, and obesity status on risk among African American adolescents. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

On Murray Jackson's 1961 'Chair, couch and countertransference'.

PubMed

Connolly, Angela

2015-09-01

One of the problems facing psychoanalysts of all schools is that theory has evolved at a much faster pace than practice. Whereas there has been an explosion of theory, practice has remained, at least officially, static and unchanging. It is in this sense that Murray Jackson's 1961 paper is still relevant today. Despite the rise of the new relational and intersubjective paradigms, most psychoanalysts, and not a few Jungian analysts, still seem to feel that the couch is an essential component of the analytical setting and process. If the use of the couch is usually justified by the argument that it favours regression, facilitates analytical reverie and protects the patient from the influence of the analyst, over time many important psychoanalysts have come to challenge this position. Increasingly these analysts suggest that the use of the couch may actually be incompatible with the newer theoretical models. This contention is strengthened by some of the findings coming from the neurosciences and infant research. This underlines the necessity of empirical research to verify the clinical effectiveness of these different positions, couch or face-to-face, but it is exactly this type of research that is lacking. © 2015, The Society of Analytical Psychology.

Community: The Heart of Honors Study

ERIC Educational Resources Information Center

McDonald, Craig

2010-01-01

In this article, the author argues that honors study flourishes most when rooted in a strong community, a community of learners (both students and faculty members) from different disciplines and levels of experience, who sustain a broad and ongoing conversation with one another. To him, it is the "heart" of honors study, whatever other goals a…

Hydrologic data for the Cache Creek-Bear Thrust environmental impact statement near Jackson, Wyoming

USGS Publications Warehouse

Craig, G.S.; Ringen, B.H.; Cox, E.R.

1981-01-01

Information on the quantity and quality of surface and ground water in an area of concern for the Cache Creek-Bear Thrust Environmental Impact Statement in northwestern Wyoming is presented without interpretation. The environmental impact statement is being prepared jointly by the U.S. Geological Survey and the U.S. Forest Service and concerns proposed exploration and development of oil and gas on leased Federal land near Jackson, Wyoming. Information includes data from a gaging station on Cache Creek and from wells, springs, and miscellaneous sites on streams. Data include streamflow, chemical and suspended-sediment quality of streams, and the occurrence and chemical quality of ground water. (USGS)

Effects of Jackson Lake Dam on the Snake River and its floodplain, Grand Teton National Park, Wyoming, USA

NASA Astrophysics Data System (ADS)

Marston, Richard A.; Mills, John D.; Wrazien, David R.; Bassett, Beau; Splinter, Dale K.

2005-10-01

In 1906, the Bureau of Reclamation created Jackson Lake Dam on the Snake River in what later became Grand Teton National Park. The geomorphic, hydrologic and vegetation adjustments downstream of the dam have yet to be documented. After a larger reservoir was completed further downstream in 1957, the reservoir release schedule from Jackson Lake Dam was changed in a manner that lowered the magnitude and frequency of floods. The stability of the Snake River exhibited a complex response to the change in flow regime. Close to major tributaries, the Snake River increased in total sinuosity and rates of lateral channel migration. Away from the influence of tributaries, the river experienced fewer avulsions and a decrease in sinuosity. Vegetation maps were constructed from 1945 and 1989 aerial photography and field surveys. Using these data, we determined how vegetation is directly related to the number of years since each portion of the floodplain was last occupied by the channel. The vegetation has changed from a flood-pulse dominated mosaic to a more terrestrial-like pattern of succession. Changes in the Snake River and its floodplain have direct implications on bald eagle habitat, moose habitat, fish habitat, safety of rafting and canoeing, and biodiversity at the community and species levels.

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Second Progress Report, 1 July 1975.

ERIC Educational Resources Information Center

Poon, Derek

Covering the period January 1 through June 30, 1975, this second semi-annual report on the Applied Fishery Science Program operative at Sheldon Jackson College in Sitka, Alaska presents information regarding program progress and Alaska Native students involved in science education. Specifically, this report details: Planning and Coordination…

Building MapObjects attribute field in cadastral database based on the method of Jackson system development

NASA Astrophysics Data System (ADS)

Chen, Zhu-an; Zhang, Li-ting; Liu, Lu

2009-10-01

ESRI's GIS components MapObjects are applied in many cadastral information system because of its miniaturization and flexibility. Some cadastral information was saved in cadastral database directly by MapObjects's Shape file format in this cadastral information system. However, MapObjects didn't provide the function of building attribute field for map layer's attribute data file in cadastral database and user cann't save the result of analysis. This present paper designed and realized the function of building attribute field in MapObjects based on the method of Jackson's system development.

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Fourth Progress Report, 1 July 1976.

ERIC Educational Resources Information Center

Seifert, Mel

Covering the period January 1 through June 30, 1976, this fourth and final semi-annual report of the first two-year grant for the Applied Fishery Science Program operating at Sheldon Jackson College in Sitka, Alaska presents the following information; Background (program objectives, advisory committee, and program staff); Program Progress…

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Third Progress Report, 1 January 1976.

ERIC Educational Resources Information Center

Seifert, Mel

Covering the period between July 1 to December 31, 1976, this third semi-annual report on the Applied Fishery Science Program operative at Sheldon Jackson College in Sitka, Alaska deals primarily with the first quarter of hatchery and educational program operation. Specifically, this report addresses the following: Program Objectives; Advisory…

Improving awareness, knowledge and heart-related lifestyle of coronary heart disease among working population through a mHealth programme: study protocol.

PubMed

Wang, Wenru; Zhang, Hui; Lopez, Violeta; Wu, Vivien Xi; Poo, Danny Chiang Choon; Kowitlawakul, Yanika

2015-09-01

To develop a mHealth programme, entitled 'Care4Heart' for the working population in Singapore and thereafter examine its feasibility and effectiveness in increasing the awareness and knowledge of coronary heart disease and improving their heart-related lifestyle. Teaching and encouraging the working population to adopt a healthier lifestyle could result in preventing and/or decreasing the incidence of coronary heart disease among this population. The use of mobile application (app) is the next logical wave of healthcare support tools to prevent and manage chronic diseases like coronary heart disease. A quasi-experimental longitudinal study design. The study will be conducted in a tertiary university in Singapore. A non-probability, quota sampling of 200 participants will be recruited including 100 academic and research staff, 50 administrative staff and 50 support staff and business owners. Once consent is obtained, the newly developed mobile app will be installed onto the participants' smartphones and a well-trained research assistant will brief the participant on the use of the app. The main outcomes will be measured using the survey questionnaires: Awareness of coronary heart disease, Heart Disease Fact Questionnaire-2, Behavioural Risk Factor Surveillance System and Perceived Stress Scale. Data will be collected at baseline and at the 4th week and 6th month thereafter. If this project is successful, Care4Heart - a mHealth and novel prevention educational programme for the working population in Singapore - can be used to promote knowledge and positive heart-related lifestyle changes to prevent coronary heart disease. © 2015 John Wiley & Sons Ltd.

32 CFR Appendix A to Subpart L of... - Partial List of Other Publications Applicable on Fort Jackson Which List Prohibited Practices

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Partial List of Other Publications Applicable on Fort Jackson Which List Prohibited Practices A Appendix A to Subpart L of Part 552 National Defense..., South Carolina Pt. 552, Subpt. L, App. A Appendix A to Subpart L of Part 552—Partial List of Other...

Reconnaissance evaluation of surface-water quality in Eagle, Grand, Jackson, Pitkin, Routt, and Summit counties, Colorado

USGS Publications Warehouse

Britton, Linda J.

1979-01-01

Water-quality data were collected from streams in a six-county area in northwest Colorado to determine if the streams were polluted and, if so, to determine the sources of the pollution. Eighty-three stream sites were selected for sampling in Eagle, Grand, Jackson, Pitkin, Routt, and Summit Counties. A summary of data collected prior to this study, results of current chemical and biological sampling, and needs for future water-quality monitoring are reported for each county. Data collected at selected sites included temperature, pH, specific conductance, dissolved oxygen, and stream discharge. Chemical data collected included nutrients, inorganics, organics, and trace elements. Biological data collected included counts and species composition of total and fecal-coliform bacteria, fecal-streptococcus bacteria, benthic invertebrates, and phytoplankton. Most of the sites were sampled three times: in April-June 1976, August 1976, and January 1977. (Woodard-USGS)

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease.

PubMed

Karsdorp, Petra A; Kindt, Merel; Everaerd, Walter; Mulder, Barbara J M

2007-08-01

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized heart-related (heart rate) or neutral sensations (constant vibration) as either heart or neutral. Both sensations were evoked using a bass speaker that was attached on the chest of the participant. Before each physical sensation, a subliminal heart-related or neutral prime was presented. Biased perception of heart-sensations would become evident by a delayed categorization of the heart-related sensations. In line with the prediction, a combination of high trait anxiety and ConHD resulted in slower responses after a heart-related sensation that was preceded by a subliminal heart cue. Preattentive processing of harmless heart cues may easily elicit overperception of heart symptoms in highly trait anxious patients with ConHD.

The Copenhagen City Heart Study (Østerbroundersøgelsen)

PubMed Central

Aguib, Yasmine; Al Suwaidi, Jassim

2015-01-01

The Copenhagen City Heart Study, also known as “Østerbroundersøgelsen”, is a large prospective cardio-vascular population study of 20,000 women and men that was launched in 1975 by Dr Peter Schnohr and Dr Gorm Jensen together with statistician Jørgen Nyboe and Prof. A. Tybjærg Hansen. The original purpose of the study was to focus on prevention of coronary heart disease and stroke. During the years many other aspects have been added to the study: pulmonary diseases, heart failure, arrhythmia, alcohol, arthrosis, eye diseases, allergy, epilepsia, dementia, stress, vital exhaustion, social network, sleep-apnoe, ageing and genetics. In this review we highlight unique aspects of the Copenhagen City Heat Study (CCHS) and its outcome in investigations of clinical and molecular aspects of health and disease in the regional and global population. To increase the impact of population studies with a focus on risk and prevention of cardiovascular and related diseases and to maximize the likelihood of identifying disease causes and effective therapeutics, lessons learned from past research should be applied to the design, implementation and interpretation of future studies. PMID:26779513

Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.

PubMed

Djoussé, Luc; Hopkins, Paul N; North, Kari E; Pankow, James S; Arnett, Donna K; Ellison, R Curtis

2011-04-01

Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. We studied in a cross-sectional design 4970 participants aged 25-93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]. These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population. Published by Elsevier Ltd.

Maternal obesity and congenital heart defects: a population-based study123

PubMed Central

Mills, James L; Troendle, James; Conley, Mary R; Carter, Tonia; Druschel, Charlotte M

2010-01-01

Background: Obesity affects almost one-third of pregnant women and causes many complications, including neural tube defects. It is not clear whether the risk of congenital heart defects, the most common malformations, is also increased. Objective: This study was conducted to determine whether obesity is associated with an increased risk of congenital heart defects. Design: A population-based, nested, case-control study was conducted in infants born with congenital heart defects and unaffected controls from the cohort of all births (n = 1,536,828) between 1993 and 2003 in New York State, excluding New York City. The type of congenital heart defect, maternal body mass index (BMI; in kg/m2), and other risk factors were obtained from the Congenital Malformations Registry and vital records. Mothers of 7392 congenital heart defect cases and 56,304 unaffected controls were studied. Results: All obese women (BMI ≥ 30) were significantly more likely than normal-weight women (BMI: 19–24.9) to have children with a congenital heart defect [odds ratio (OR): 1.15; 95% CI: 1.07, 1.23; P < 0.0001]. Overweight women were not at increased risk (OR: 1.00; 95% CI: 0.94, 1.06). The risk in morbidly obese women (BMI ≥ 40) was higher (OR: 1.33; 95% CI: 1.15, 1.54; P = 0.0001) than that in obese women with a BMI of 30–39.9 (OR: 1.11; 95% CI: 1.04, 1.20; P = 0.004). There was a highly significant trend of increasing OR for congenital heart defects with increasing maternal obesity (P < 0.0001). The offspring of obese women had significantly higher ORs for atrial septal defects, hypoplastic left heart syndrome, aortic stenosis, pulmonic stenosis, and tetralogy of Fallot. Conclusions: Obese, but not overweight, women are at significantly increased risk of bearing children with a range of congenital heart defects, and the risk increases with increasing BMI. Weight reduction as a way to reduce risk should be investigated. PMID:20375192

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Fifth Progress Report, 1 February 1977.

ERIC Educational Resources Information Center

Seifert, Mel

Summarizing the beginning of the second year of operation of the hatchery and educational program provided by the Applied Fisheries Science Program at Sheldon Jackson College in Sitka, Alaska for Alaska Natives and non-Native groups interested in salmon ranching, this fifth semi-annual report covers the period July 1 through December 31, 1976 and…

2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

PubMed

Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

2014-03-01

This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

A Matter of the Heart: The African Clawed Frog Xenopus as a Model for Studying Vertebrate Cardiogenesis and Congenital Heart Defects

PubMed Central

Hempel, Annemarie; Kühl, Michael

2016-01-01

The African clawed frog, Xenopus, is a valuable non-mammalian model organism to investigate vertebrate heart development and to explore the underlying molecular mechanisms of human congenital heart defects (CHDs). In this review, we outline the similarities between Xenopus and mammalian cardiogenesis, and provide an overview of well-studied cardiac genes in Xenopus, which have been associated with congenital heart conditions. Additionally, we highlight advantages of modeling candidate genes derived from genome wide association studies (GWAS) in Xenopus and discuss commonly used techniques. PMID:29367567

Effect of uterine contractions on fetal heart rate in pregnancy: a prospective observational study.

PubMed

Sletten, Julie; Kiserud, Torvid; Kessler, Jörg

2016-10-01

The new Holter monitoring technology enables long-term electrocardiographic recording of the fetal heart rate without discomfort for the mother. The aim of the study was to assess the feasibility of a fetal Holter monitor. This technology was further used to study fetal heart rate outside the hospital setting during normal daily activities and to test the hypothesis that uterine activity during pregnancy influences fetal heart rate. Prospective observational study including 12 healthy pregnant women at 20-40 weeks of gestation. Data were collected using the Monica AN24 system. Outcome measures were fetal heart rate, maternal heart rate, and uterine activity categorized according to the strength of the electrohysterographic signal. The recordings had a median length of 18.8 h, and fetal heart rate and maternal heart rate were obtained with success rates of 73.1 and 99.9%, respectively. Uterine activity was found to affect fetal heart rate in all participants. Compared with the basal tone and mild levels of uterine activity, moderate and strong levels of uterine activity were associated with increases in fetal heart rate of 4.0 and 5.7 beats/min, respectively. At night, the corresponding increases were 4.9 and 7.6 beats/min. Linear correlations were found between maternal heart rate and fetal heart rate in 11 of the 12 cases, with a mean coefficient beta of 0.189. Both maternal heart rate and fetal heart rate exhibited a diurnal pattern, with lower heart rates being recorded at night. Uterine activity during pregnancy is associated with a graded response in fetal heart rate and may represent a physiological challenge for the development and adaptation of the fetal cardiovascular system. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

A randomised, simulated study assessing auscultation of heart rate at birth.

PubMed

Voogdt, Kevin G J A; Morrison, Allison C; Wood, Fiona E; van Elburg, Ruurd M; Wyllie, Jonathan P

2010-08-01

Heart rate is a primary clinical indicator directing newborn resuscitation. The time taken to assess the heart rate by auscultation in relation to accuracy during newborn resuscitation is not known. To assess both the accuracy and time taken to assess heart rate by stethoscope in simulated resuscitation scenarios. The VitalSim((c)) manikin (Laerdal Medical, Stavanger, Norway) was used in this randomised, single blind study. Four heart rate settings (0, 40, 80, 120 beats per minute (bpm)) were randomly assigned. Participants assessed them by auscultation in three different scenarios. The first scenario was to assess the actual heart rate at birth. In the second scenario, heart rate was assessed during ventilation and assigned to standard ranges (<60, 60-100, >100bpm). In the third scenario, heart rate was assessed after three cycles of compressions and ventilation and assigned to standard ranges. In total 61 midwives, nurses and doctors performed 183 assessments. Mean time to estimate heart rate for scenarios 1, 2 and 3 was: 17.0, 9.8 and 7.8s respectively. Heart rate assessments were inaccurate in 31% (scenario 1), 28% (scenarios 2) and 26% (scenario 3). There was a trend for assessors who were accurate to be quicker and this achieved significance in scenario 2 (p<0.02). Inaccurate assessment would have made a difference to management in 28% of all cases. Mean time to estimate heart rate for the scenarios varied between 7.8 and 17.0s. Twenty-eight percent of all heart rate assessments would have prompted incorrect management during resuscitation or stabilization. Of incorrect assessments, 73% were overestimations. Further research is required to develop a rapid and accurate method for determining heart rate during newborn resuscitation. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Music therapy, emotions and the heart: a pilot study.

PubMed

Raglio, Alfredo; Oasi, Osmano; Gianotti, Marta; Bellandi, Daniele; Manzoni, Veronica; Goulene, Karine; Imbriani, Chiara; Badiale, Marco Stramba

2012-01-01

The autonomic nervous system plays an important role in the control of cardiac function. It has been suggested that sound and music may have effects on the autonomic control of the heart inducing emotions, concomitantly with the activation of specific brain areas, i.e. the limbic area, and they may exert potential beneficial effects. This study is a prerequisite and defines a methodology to assess the relation between changes in cardiac physiological parameters such as heart rate, QT interval and their variability and the psychological responses to music therapy sessions. We assessed the cardiac physiological parameters and psychological responses to a music therapy session. ECG Holter recordings were performed before, during and after a music therapy session in 8 healthy individuals. The different behaviors of the music therapist and of the subjects have been analyzed with a specific music therapy assessment (Music Therapy Checklist). After the session mean heart rate decreased (p = 0.05), high frequency of heart rate variability tended to be higher and QTc variability tended to be lower. During music therapy session "affect attunements" have been found in all subjects but one. A significant emotional activation was associated to a higher dynamicity and variations of sound-music interactions. Our results may represent the rational basis for larger studies in diferent clinical conditions.

Hydrology of the Jackson, Tennessee, area and delineation of areas contributing ground water to the Jackson well fields

USGS Publications Warehouse

Bailey, Z.C.

1993-01-01

A comprehensive hydrologic investigation of the Jackson area in Madison County, Tennessee, was conducted to provide information for the development of a wellhead-protection program for two municipal well fields. The136-square-mile study area is between the Middle Fork Forked Deer and South Fork Forked Deer Rivers and includes the city of Jackson. The formations that underlie and crop out in the study area, in descending order, are the Memphis Sand, Fort Pillow Sand, and Porters Creek Clay. The saturated thickness of the Memphis Sand ranges from 0 to 270 feet; the Fort Pillow Sand, from 0 to 180 feet. The Porters Creek Clay, which ranges from 130 to 320 feet thick, separates a deeper formation, the McNairy Sand, from the shallower units. Estimates by other investigators of hydraulic conductivity for the Memphis Sand range from 80 to 202 feet per day. Estimates of transmissivity of the Memphis Sand range from 2,700 to 33,000 feet squared per day. Estimates of hydraulic conductivity for the Fort Pillow Sand range from 68 to 167 feet per day, and estimates of transmissivity of that unit range from 6,700 to 10,050 feet squared per day. A finite-difference, ground-water flow model was calibrated to steady-state hydrologic conditions of April 1989, and was used to simulate hypothetical pumping plans for the North and South Well Fields. The aquifers were represented as three layers in the model to simulate the ground-water flow system. Layer 1 is the saturated part of the Memphis Sand; layer 2 is the upper half of the Fort Pillow Sand; and layer 3 is the lower half of the Fort Pillow Sand. The steady-state water budget of the simulated system showed that more than half of the inflow to the ground-water system is underflow from the model boundaries. Most of this inflow is discharged as seepage to the rivers and to pumping wells. Slightly less than half of the inflow is from areal recharge and recharge from streams. About 75 percent of the discharge from the system is into

Refusal to participate in heart failure studies: do age and gender matter?

PubMed Central

Harrison, Jordan M; Jung, Miyeon; Lennie, Terry A; Moser, Debra K; Smith, Dean G; Dunbar, Sandra B; Ronis, David L; Koelling, Todd M; Giordani, Bruno; Riley, Penny L; Pressler, Susan J

2018-01-01

Aims and objectives The objective of this retrospective study was to evaluate reasons heart failure patients decline study participation, to inform interventions to improve enrollment. Background Failure to enrol older heart failure patients (age > 65) and women in studies may lead to sampling bias, threatening study validity. Design This study was a retrospective analysis of refusal data from four heart failure studies that enrolled 788 patients in four states. Methods Chi-Square and a pooled t-test were computed to analyse refusal data (n = 300) obtained from heart failure patients who were invited to participate in one of the four studies but declined. Results Refusal reasons from 300 patients (66% men, mean age 65 33) included: not interested (n = 163), too busy (n = 64), travel burden (n = 50), too sick (n = 38), family problems (n = 14), too much commitment (n = 13) and privacy concerns (n = 4). Chi-Square analyses showed no differences in frequency of reasons (p > 0 05) between men and women. Patients who refused were older, on average, than study participants. Conclusions Some reasons were patient-dependent; others were study-dependent. With ‘not interested’ as the most common reason, cited by over 50% of patients who declined, recruitment measures should be targeted at stimulating patients’ interest. Additional efforts may be needed to recruit older participants. However, reasons for refusal were consistent regardless of gender. Relevance to clinical practice Heart failure researchers should proactively approach a greater proportion of women and patients over age 65. With no gender differences in type of reasons for refusal, similar recruitment strategies can be used for men and women. However, enrolment of a representative proportion of women in heart failure studies has proven elusive and may require significant effort from researchers. Employing strategies to stimulate interest in studies is essential for recruiting heart failure patients, who

Chocolate Consumption is Inversely Associated with Prevalent Coronary Heart Disease: The National Heart, Lung, and Blood Institute Family Heart Study

PubMed Central

Djoussé, Luc; Hopkins, Paul N.; North, Kari E.; Pankow, James S.; Arnett, Donna K.; Ellison, R. Curtis

2010-01-01

Background and Aims Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. Methods We studied in a cross-sectional design 4,970 participants aged 25 to 93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Results Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR=1.49 (0.96-2.32)]. Conclusions These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general population. PMID:20858571

Leonardo da Vinci's studies of the heart.

PubMed

Shoja, Mohammadali M; Agutter, Paul S; Loukas, Marios; Benninger, Brion; Shokouhi, Ghaffar; Namdar, Husain; Ghabili, Kamyar; Khalili, Majid; Tubbs, R Shane

2013-08-20

Leonardo da Vinci's detailed drawings are justly celebrated; however, less well known are his accounts of the structures and functions of the organs. In this paper, we focus on his illustrations of the heart, his conjectures about heart and blood vessel function, his experiments on model systems to test those conjectures, and his unprecedented conclusions about the way in which the cardiovascular system operates. In particular, da Vinci seems to have been the first to recognize that the heart is a muscle and that systole is the active phase of the pump. He also seems to have understood the functions of the auricles and pulmonary veins, identified the relationship between the cardiac cycle and the pulse, and explained the hemodynamic mechanism of valve opening and closure. He also described anatomical variations and changes in structure and function that occurred with age. We outline da Vinci's varied career and suggest ways in which his personality, experience, skills and intellectual heritage contributed to these advances in understanding. We also consider his influence on later studies in anatomy and physiology. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Congenital heart defects in cats: A retrospective study of 162 cats (1996-2013).

PubMed

Tidholm, Anna; Ljungvall, Ingrid; Michal, Jenny; Häggström, Jens; Höglund, Katja

2015-12-01

To study the prevalence and distribution of congenital heart defects in cats presented at two referral centers in Sweden between 1996 and 2013. 162 client-owned cats with congenital heart defects. Case records of cats diagnosed with congenital heart disease were reviewed retrospectively. The overall prevalence of congenital heart disease was 0.2% of the total number of patient cats, and 8% of cats diagnosed with heart disease. A total of 182 heart defects were identified as 16 cats were diagnosed with more than one defect. Ventricular septal defect (VSD) was most prevalent, found in 50% of cats, followed by tricuspid valve dysplasia (11%), pulmonic stenosis (10%), atrial septal defect (10%), aortic stenosis (9%), mitral valve dysplasia (9%), tetralogy of Fallot (5%), patent ductus arteriosus (3%), common atrioventricular canal (2%), and the following defects that each accounted for 0.6% of cats: double chamber right ventricle, double outlet right ventricle, endocardial fibroelastosis, dextroposition of the aorta, persistent right aortic arch, and pulmonary atresia. The prevalence of congenital heart disease was 0.2% of the total number of patient cats, and 8% of cats diagnosed with heart disease. Ventricular septal defect was the most common congenital heart defect in this study. Copyright © 2014 Elsevier B.V. All rights reserved.

Taxonomic status and relationships of Sorex obscurus parvidens Jackson, 1921, from California

USGS Publications Warehouse

Woodman, Neal

2012-01-01

The San Bernardino shrew, Sorex obscurus parvidens Jackson, 1921, is a population inhabiting the San Bernardino and San Gabriel mountains of southern California. For the past 9 decades, this population has been considered either a subspecies of S. obscurus Merriam, 1895, S. vagrans Baird, 1857, or S. monticola Merriam, 1890; or an undifferentiated population of S. ornatus Merriam, 1895. Aside from the changing taxonomic landscape that contextualizes the genus Sorex, previous study of S. obscurus parvidens has been retarded by the perception of limited available samples (typically, fewer than 8 specimens); misinterpretation of the provenance of specimens identified as S. obscurus parvidens; misunderstanding of the type locality; and inclusion of specimens of this taxon in the type series of another species with which S. obscurus parvidens has been both contrasted and allied at different times. My investigation of S. obscurus parvidens indicates that it is a distinctive population that is morphologically closest to S. ornatus, and it corresponds to the Southern Clade of that species. However, the appropriate names for deep clades within S. ornatus remain uncertain. Until this uncertainty is resolved, S. obscurus parvidens should be considered a distinctive population within S. ornatus; for conservation purposes, it should be recognized as S. ornatus parvidens.

Social Studies: The Heart of the Curriculum

ERIC Educational Resources Information Center

Passe, Jeff

2006-01-01

In a speech delivered by the author, he used the metaphor of a meal to structure his address. His topic was about social studies and food. He states, that the way to the curriculum's heart is through social studies. It can be through the stomach, as well as the brain, and the spirit. He added, that in social studies, people tend to look at things…

Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure and mortality: A cohort study

PubMed Central

Muntner, Paul; Whittle, Jeff; Lynch, Amy I.; Colantonio, Lisandro D.; Simpson, Lara M.; Einhorn, Paula T.; Levitan, Emily B.; Whelton, Paul K; Cushman, William C.; Louis, Gail T.; Davis, Barry R.; Oparil, Suzanne

2016-01-01

Background Variability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient’s underlying BP. Objective: Examine the association between visit-to-visit variability (VVV) of systolic and diastolic BP (SBP and DBP) on cardiovascular disease and mortality outcomes. Design Prospective cohort study Setting Post-hoc analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Participants 25,814 ALLHAT participants. Measurements VVV of SBP was defined as the standard deviation (SD) across BP measurements obtained at 7 visits conducted from 6 to 28 months following ALLHAT enrollment. Participants free of cardiovascular disease events during the first 28 months of follow-up were followed from the month 28 study visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease or non-fatal myocardial infarction, all-cause mortality, stroke and heart failure. Results There were 1194 cases of fatal CHD or non-fatal MI, 1948 deaths, 606 cases of stroke and 921 cases of heart failure during follow-up. After multivariable adjustment including mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mmHg versus <6.5 mmHg) was 1.30 (1.06–1.59) for fatal coronary heart disease or non-fatal myocardial infarction, 1.58 (1.32–1.90) for all-cause mortality, 1.46 (1.06–2.01) for stroke, and 1.25 (0.97–1.61) for heart failure. Higher VVV of DBP was also associated with cardiovascular disease events and mortality. Limitations Long-term outcomes were not available. Conclusions Higher VVV of SBP is associated with increased cardiovascular disease and mortality risk. Future studies should examine whether reducing VVV of BP lowers this risk. Primary funding source National Institutes of Health PMID:26215765

A bioprosthetic total artificial heart for end-stage heart failure: Results from a pilot study.

PubMed

Latrémouille, Christian; Carpentier, Alain; Leprince, Pascal; Roussel, Jean-Christian; Cholley, Bernard; Boissier, Elodie; Epailly, Eric; Capel, Antoine; Jansen, Piet; Smadja, David M

2018-01-01

The electro-hydraulically actuated Carmat total artificial heart (C-TAH) is designed to replace the heart in patients with end-stage heart failure, either as bridge to transplant or destination therapy. It provides pulsatile flow and contains bio-prosthetic blood contacting materials. A clinical feasibility study was conducted to evaluate the C-TAH safety and performance. Hospitalized patients, at imminent risk of death from irreversible biventricular failure despite optimal medical management, and not eligible for transplant or eligible but on extracorporeal life support, were enrolled. The primary endpoint was 30-days survival. Four patients were implanted with the C-TAH, three as destination therapy (ages 76, 68, 74) and one as bridge to transplant (age 58). They had implant times of 74, 270, 254 and 20 days respectively. All patients were free from hemolysis, clinical neurologic events, clinical evidence of thrombus and device-related infections. Hemodynamic and physical recovery allowed two patients to be discharged home for a cumulative duration of 7 months. The anticoagulation management strategy comprised initial unfractionated heparin, from postoperative day 2, followed by low molecular weight heparin and aspirin. An increased D-dimer level was observed in all patients during months 1 to 4. Temporary suspension of heparin anticoagulation resulted in thrombocytopenia and increased fibrin monomer, reversed by resuming anticoagulation with heparin. Causes of death were device-related (2 cases), respiratory failure and multi-organ failure. Preliminary clinical results with the C-TAH demonstrated good safety and performance profiles in patients suffering from biventricular failure, which need to be confirmed in a pivotal study. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

The effect of competition on heart rate during kart driving: A field study.

PubMed

Matsumura, Kenta; Yamakoshi, Takehiro; Yamakoshi, Yasuhiro; Rolfe, Peter

2011-09-09

Both the act of competing, which can create a kind of mental stress, and participation in motor sports, which induces physical stress from intense g-forces, are known to increase heart rate dramatically. However, little is known about the specific effect of competition on heart rate during motor sports, particularly during four-wheel car driving. The goal of this preliminary study, therefore, was to investigate whether competition increases heart rate under such situations. The participants drove an entry-level formula kart during two competitive races and during solo driving against the clock while heart rate and g-forces were measured. Analyses showed that heart rate values during the races (168.8 beats/min) were significantly higher than those during solo driving (140.9 beats/min) and rest (75.1 beats/min). The results of this preliminary study indicate that competition heightens heart rate during four-wheel car driving. Kart drivers should be concerned about maintaining good health and developing physical strength.

The effect of competition on heart rate during kart driving: A field study

PubMed Central

2011-01-01

Background Both the act of competing, which can create a kind of mental stress, and participation in motor sports, which induces physical stress from intense g-forces, are known to increase heart rate dramatically. However, little is known about the specific effect of competition on heart rate during motor sports, particularly during four-wheel car driving. The goal of this preliminary study, therefore, was to investigate whether competition increases heart rate under such situations. Findings The participants drove an entry-level formula kart during two competitive races and during solo driving against the clock while heart rate and g-forces were measured. Analyses showed that heart rate values during the races (168.8 beats/min) were significantly higher than those during solo driving (140.9 beats/min) and rest (75.1 beats/min). Conclusions The results of this preliminary study indicate that competition heightens heart rate during four-wheel car driving. Kart drivers should be concerned about maintaining good health and developing physical strength. PMID:21906298

Increased sodium/calcium exchanger activity enhances beta-adrenergic-mediated increase in heart rate: Whole-heart study in a homozygous sodium/calcium exchanger overexpressor mouse model.

PubMed

Kaese, Sven; Bögeholz, Nils; Pauls, Paul; Dechering, Dirk; Olligs, Jan; Kölker, Katharina; Badawi, Sascha; Frommeyer, Gerrit; Pott, Christian; Eckardt, Lars

2017-08-01

The cardiac sodium/calcium (Na + /Ca 2+ ) exchanger (NCX) contributes to diastolic depolarization in cardiac pacemaker cells. Increased NCX activity has been found in heart failure and atrial fibrillation. The influence of increased NCX activity on resting heart rate, beta-adrenergic-mediated increase in heart rate, and cardiac conduction properties is unknown. The purpose of this study was to investigate the influence of NCX overexpression in a homozygous transgenic whole-heart mouse model (NCX-OE) on sinus and AV nodal function. Langendorff-perfused, beating whole hearts of NCX-OE and the corresponding wild-type (WT) were studied ± isoproterenol (ISO; 0.2 μM). Epicardial ECG, AV nodal Wenckebach cycle length (AVN-WCL), and retrograde AVN-WCL were obtained. At baseline, basal heart rate was unaltered between NCX-OE and WT (WT: cycle length [CL] 177.6 ± 40.0 ms, no. of hearts [n] = 20; NCX-OE: CL 185.9 ± 30.5 ms, n = 18; P = .21). In the presence of ISO, NCX-OE exhibited a significantly higher heart rate compared to WT (WT: CL 133.4 ± 13.4 ms, n = 20; NCX-OE: CL 117.7 ± 14.2 ms, n = 18; P <.001). ISO led to a significant shortening of the anterograde and retrograde AVN-WCL without differences between NCX-OE and WT. This study is the first to demonstrate that increased NCX activity enhances beta-adrenergic increase of heart rate. Mechanistically, increased NCX inward mode activity may promote acceleration of diastolic depolarization in sinus nodal pacemaker cells, thus enhancing chronotropy in NCX-OE. These findings suggest a novel potential therapeutic target for heart rate control in the presence of increased NCX activity, such as heart failure. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Michael Jackson, Bin Laden and I: functions of positive and negative, public and private flashbulb memories.

PubMed

Demiray, Burcu; Freund, Alexandra M

2015-01-01

This study examined the perceived psychosocial functions of flashbulb memories: It compared positive and negative public flashbulb memories (positive: Bin Laden's death, negative: Michael Jackson's death) with private ones (positive: pregnancy, negative: death of a loved one). A sample of n = 389 young and n = 176 middle-aged adults answered canonical category questions used to identify flashbulb memories and rated the personal significance, the psychological temporal distance, and the functions of each memory (i.e., self-continuity, social-boding, directive functions). Hierarchical regressions showed that, in general, private memories were rated more functional than public memories. Positive and negative private memories were comparable in self-continuity and directionality, but the positive private memory more strongly served social functions. In line with the positivity bias in autobiographical memory, positive flashbulb memories felt psychologically closer than negative ones. Finally, middle-aged adults rated their memories as less functional regarding self-continuity and social-bonding than young adults. Results are discussed regarding the tripartite model of autobiographical memory functions.

Education and coronary heart disease: mendelian randomisation study.

PubMed

Tillmann, Taavi; Vaucher, Julien; Okbay, Aysu; Pikhart, Hynek; Peasey, Anne; Kubinova, Ruzena; Pajak, Andrzej; Tamosiunas, Abdonas; Malyutina, Sofia; Hartwig, Fernando Pires; Fischer, Krista; Veronesi, Giovanni; Palmer, Tom; Bowden, Jack; Davey Smith, George; Bobak, Martin; Holmes, Michael V

2017-08-30

Objective  To determine whether educational attainment is a causal risk factor in the development of coronary heart disease. Design  Mendelian randomisation study, using genetic data as proxies for education to minimise confounding. Setting  The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D and SSGAC), comprising 112 studies from predominantly high income countries. Findings from mendelian randomisation analyses were then compared against results from traditional observational studies (164 170 participants). Finally, genetic data from six additional consortia were analysed to investigate whether longer education can causally alter the common cardiovascular risk factors. Participants  The main analysis was of 543 733 men and women (from CARDIoGRAMplusC4D and SSGAC), predominantly of European origin. Exposure  A one standard deviation increase in the genetic predisposition towards higher education (3.6 years of additional schooling), measured by 162 genetic variants that have been previously associated with education. Main outcome measure  Combined fatal and non-fatal coronary heart disease (63 746 events in CARDIoGRAMplusC4D). Results  Genetic predisposition towards 3.6 years of additional education was associated with a one third lower risk of coronary heart disease (odds ratio 0.67, 95% confidence interval 0.59 to 0.77; P=3×10 -8 ). This was comparable to findings from traditional observational studies (prevalence odds ratio 0.73, 0.68 to 0.78; incidence odds ratio 0.80, 0.76 to 0.83). Sensitivity analyses were consistent with a causal interpretation in which major bias from genetic pleiotropy was unlikely, although this remains an untestable possibility. Genetic predisposition towards longer education was additionally associated with less smoking, lower body mass index, and a favourable blood lipid profile. Conclusions  This mendelian randomisation study found support for the hypothesis that low education is a causal risk

Education and coronary heart disease: mendelian randomisation study

PubMed Central

Vaucher, Julien; Okbay, Aysu; Pikhart, Hynek; Peasey, Anne; Kubinova, Ruzena; Pajak, Andrzej; Tamosiunas, Abdonas; Malyutina, Sofia; Hartwig, Fernando Pires; Fischer, Krista; Veronesi, Giovanni; Palmer, Tom; Bowden, Jack; Davey Smith, George; Bobak, Martin; Holmes, Michael V

2017-01-01

Objective To determine whether educational attainment is a causal risk factor in the development of coronary heart disease. Design Mendelian randomisation study, using genetic data as proxies for education to minimise confounding. Setting The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D and SSGAC), comprising 112 studies from predominantly high income countries. Findings from mendelian randomisation analyses were then compared against results from traditional observational studies (164 170 participants). Finally, genetic data from six additional consortia were analysed to investigate whether longer education can causally alter the common cardiovascular risk factors. Participants The main analysis was of 543 733 men and women (from CARDIoGRAMplusC4D and SSGAC), predominantly of European origin. Exposure A one standard deviation increase in the genetic predisposition towards higher education (3.6 years of additional schooling), measured by 162 genetic variants that have been previously associated with education. Main outcome measure Combined fatal and non-fatal coronary heart disease (63 746 events in CARDIoGRAMplusC4D). Results Genetic predisposition towards 3.6 years of additional education was associated with a one third lower risk of coronary heart disease (odds ratio 0.67, 95% confidence interval 0.59 to 0.77; P=3×10−8). This was comparable to findings from traditional observational studies (prevalence odds ratio 0.73, 0.68 to 0.78; incidence odds ratio 0.80, 0.76 to 0.83). Sensitivity analyses were consistent with a causal interpretation in which major bias from genetic pleiotropy was unlikely, although this remains an untestable possibility. Genetic predisposition towards longer education was additionally associated with less smoking, lower body mass index, and a favourable blood lipid profile. Conclusions This mendelian randomisation study found support for the hypothesis that low education is a causal risk factor in

Heart rate is an independent predictor of all-cause mortality in individuals with type 2 diabetes: The diabetes heart study.

PubMed

Prasada, Sameer; Oswalt, Cameron; Yeboah, Phyllis; Saylor, Georgia; Bowden, Donald; Yeboah, Joseph

2018-01-15

To assess the association of resting heart rate with all-cause and cardiovascular disease (CVD) mortality in the Diabetes Heart Study (DHS). Out of a total of 1443 participants recruited into the DHS, 1315 participants with type 2 diabetes who were free of atrial fibrillation and supraventricular tachycardia during the baseline exam were included in this analysis. Heart rate was collected from baseline resting electrocardiogram and mortality (all-cause and CVD) was obtained from state and national death registry. Kaplan-Meier (K-M) and Cox proportional hazard analyses were used to assess the association. The mean age, body mass index (BMI) and systolic blood pressure (SBP) of the cohort were 61.4 ± 9.2 years, 32.0 ± 6.6 kg/m 2 , and 139.4 ± 19.4 mmHg respectively. Fifty-six percent were females, 85% were whites, 15% were blacks, 18% were smokers. The mean ± SD heart rate was 69.8 (11.9) beats per minute (bpm). After a median follow-up time of 8.5 years (maximum follow-up time is 14.0 years), 258 participants were deceased. In K-M analysis, participants with heart rate above the median had a significantly higher event rate compared with those below the median (log-rank P = 0.0223). A one standard deviation increase in heart rate was associated with all-cause mortality in unadjusted (hazard ratio 1.16, 95%CI: 1.03-1.31) and adjusted (hazard ratio 1.20, 95%CI: 1.05-1.37) models. Similar results were obtained with CVD mortality as the outcome of interest. Heart rate is an independent predictor of all-cause mortality in this population with type 2 diabetes. In this study, a 1-SD increase in heart rate was associated with a 20% increase in risk suggesting that additional prognostic information may be gleaned from this ubiquitously collected vital sign.

Review of lignite resources of western Tennessee and the Jackson Purchase area, western Kentucky

USGS Publications Warehouse

Hackley, Paul C.; Warwick, Peter D.; Thomas, Roger E.; Nichols, Douglas J.

2006-01-01

Introduction: This review of the lignite deposits of western Tennessee and the Jackson Purchase area in western Kentucky (Fig. 1) is a preliminary report on part of the U.S. Geological Survey's National Coal Resource Assessment of the Gulf Coastal Plain Coal Province. Lignite deposits of western Kentucky and Tennessee are an extension of the Gulf Coastal Plain Coal Province (Cushing and others, 1964), and currently are not economic to mine. These deposits have not been extensively investigated or developed as an energy resource. This review includes a description of the geology of the lignite-bearing units, a discussion of the available coal quality data, and information on organic petrology. Palynological data for lignite samples collected in Kentucky and Tennessee as part of this work are presented in an Appendix.

Intrapartum electrocardiogram alteration in fetuses with congenital heart disease: a case-control study.

PubMed

Gay, Estelle; Bornallet, Géraldine; Gaucherand, Pascal; Doret, Muriel

2015-11-01

To assess if the fetal electrocardiogram especially ST segment is modified by congenital heart diseases: modifications in frequencies of the different ST events and modifications in signal quality. A retrospective case-control study, comparing frequencies of the different ST events and the quality of the signal between fetuses with congenital heart diseases and fetuses without congenital heart disease. From 2000 to 2011, fifty-eight fetuses with congenital heart disease had their heart rate recording using a STAN device during labor. Control group was fetuses who were born just before a case and had a STAN as a second line for intrapartum surveillance. Cases and controls were matched on parity, gestational age at birth, presence of growth restriction and umbilical artery pH. Frequencies of the different ST event and quality of the signal were first analyzed for the global labor recording, and then separately for the first and the second phase of labor. No statistically significant difference in ST event frequencies between fetuses with congenital heart disease and the control group was found. Regarding the quality of the signal, 11.49% (±18.82) of recording time is a signal loss for fetus with congenital heart disease whereas only 5.18% (±10.67) for the control group (p=0.028). This is the first study investigating for intrapartum electrocardiogram modification in fetus with congenital heart disease. Congenital heart diseases do not modify frequencies of ST events. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sex differences in time from self-reported heart trouble to heart disease death in the Alameda County Study. Significance of time dependence of risk variable effects.

PubMed

Cohn, B A; Wingard, D L; Cohen, R D; Cirillo, P M; Kaplan, G A

1990-03-01

In a previous analysis from the Alameda County Study, it was observed that although men had higher heart disease mortality rates than women, there was no male excess in the prevalence of self-reported heart disease morbidity at baseline or in new reports of morbidity 9 years past baseline. This apparent contradiction might occur because women report less severe heart disease than men. In the present study, this hypothesis was evaluated by examining whether self-reported heart trouble was more strongly associated with subsequent heart disease mortality for men than for women in a representative sample of the population of Alameda County, California, selected in 1965 and followed for mortality for 19 years (n = 3,742). In a time-dependent Cox model, self-reported heart trouble was a stronger predictor of heart disease mortality for men, but only during the early years of follow-up (p = 0.00). This effect was due to a shorter time to death for men who reported heart trouble. The relative hazard for men reporting heart trouble was 6.6 (95% confidence interval (CI) 3.7-11.6) at baseline, declining to 3.2 (95% CI 2.2-4.5) by 5 years past baseline and 1.5 (95% CI 0.9-2.5) by 10 years past baseline. Self-reported heart trouble was a consistent predictor of subsequent heart disease mortality for women over the 19-year follow-up period (relative hazard = 2.0, 95% CI 1.4-2.8). Sex differences in the prognosis of self-reported heart trouble were masked in non-time-dependent analyses. These results illustrate that consideration of time dependence may be required for meaningful analysis of long-term cohort studies. Possible explanations of the shorter time to death for men who reported heart trouble are discussed.

Vasodilators in Acute Heart Failure: Review of the Latest Studies.

PubMed

Levy, Phillip D; Laribi, Said; Mebazaa, Alexandre

2014-06-01

Vasodilators play an important role in the management of acute heart failure, particularly when increased afterload is the precipitating cause of decompensation. The time-honored approach to afterload reduction has been largely focused on use of intravenous nitrovasodilators and, when properly dosed, this class of agents does provide substantial symptom relief for patients with acute hypertensive heart failure. Despite this, nitrovasodilators have never been shown to diminish mortality or provide any post-discharge outcome benefit leading to an on-going search for viable and more effective alternatives. While no new vasodilators have been approved for use in acute heart failure since nesiritide more than a decade ago, a number of novel agents have been developed, with some showing significant promise in recent clinical trials. In this review, we summarize the latest study data as it relates to vasodilator therapy and provide a glimpse into the not too distant future state of acute heart failure care.

Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.

PubMed

Cahill, Sean; Taylor, S Wade; Elsesser, Steven A; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H

2017-11-01

Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM.

Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts

PubMed Central

Cahill, Sean; Taylor, S. Wade; Elsesser, Steven A.; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H.

2017-01-01

Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM. PMID:28286983

Discovery of Modern Anesthesia: A Counterfactual Narrative about Crawford W. Long, Horace Wells, Charles T. Jackson, and William T. G. Morton.

PubMed

Desai, Manisha S; Desai, Sukumar P

2015-12-01

The discovery of anesthesia occurred during a narrow time span in the mid-19th century, but there is no agreement about who deserves credit for this important American contribution to medicine. Based mostly on an examination of primary sources, we explore how formal and informal interactions between the principals affected their careers, lives, and attribution of credit for the discovery of anesthesia. There should be no controversy as to which individual deserves credit for the discovery of anesthesia if credit is ascribed for specific contributions. We suggest that credit for the discovery of anesthesia be divided among 4 individuals who played specific roles. Crawford W. Long first used ether as an anesthetic during surgery, Horace Wells introduced nitrous oxide for pain relief during dental surgery, and William T. G. Morton gave the first public demonstration of ether anesthesia and spread the word about its efficacy. Charles T. Jackson suggested the use of ether as an anesthetic agent to Morton. We also assert that had these individuals not known one another, the discovery of anesthesia would have proceeded in approximately the same timeframe, but Wells, Morton, and Jackson would have enjoyed more productive careers as well as longer, more peaceful lives.

Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR): study protocol for a randomised clinical trial.

PubMed

Sibilitz, Kirstine Laerum; Berg, Selina Kikkenborg; Hansen, Tina Birgitte; Risom, Signe Stelling; Rasmussen, Trine Bernholdt; Hassager, Christian; Køber, Lars; Steinbrüchel, Daniel; Gluud, Christian; Winkel, Per; Thygesen, Lau Caspar; Hansen, Jane Lindschou; Schmid, Jean Paul; Conraads, Viviane; Brocki, Barbara Christina; Zwisler, Ann-Dorthe

2013-04-22

Heart valve diseases are common with an estimated prevalence of 2.5% in the Western world. The number is rising due to an ageing population. Once symptomatic, heart valve diseases are potentially lethal, and heavily influence daily living and quality of life. Surgical treatment, either valve replacement or repair, remains the treatment of choice. However, post surgery, the transition to daily living may become a physical, mental and social challenge. We hypothesise that a comprehensive cardiac rehabilitation programme can improve physical capacity and self-assessed mental health and reduce hospitalisation and healthcare costs after heart valve surgery. A randomised clinical trial, CopenHeartVR, aims to investigate whether cardiac rehabilitation in addition to usual care is superior to treatment as usual after heart valve surgery. The trial will randomly allocate 210 patients, 1:1 intervention to control group, using central randomisation, and blinded outcome assessment and statistical analyses. The intervention consists of 12 weeks of physical exercise, and a psycho-educational intervention comprising five consultations. Primary outcome is peak oxygen uptake (VO2 peak) measured by cardiopulmonary exercise testing with ventilatory gas analysis. Secondary outcome is self-assessed mental health measured by the standardised questionnaire Short Form 36. Also, long-term healthcare utilisation and mortality as well as biochemistry, echocardiography and cost-benefit will be assessed. A mixed-method design is used to evaluate qualitative and quantitative findings encompassing a survey-based study before the trial and a qualitative pre- and post-intervention study. The study is approved by the local regional Research Ethics Committee (H-1-2011-157), and the Danish Data Protection Agency (j.nr. 2007-58-0015). ClinicalTrials.gov (http://NCT01558765).

Computational models for the study of heart-lung interactions in mammals.

PubMed

Ben-Tal, Alona

2012-01-01

The operation and regulation of the lungs and the heart are closely related. This is evident when examining the anatomy within the thorax cavity, in the brainstem and in the aortic and carotid arteries where chemoreceptors and baroreceptors, which provide feedback affecting the regulation of both organs, are concentrated. This is also evident in phenomena such as respiratory sinus arrhythmia where the heart rate increases during inspiration and decreases during expiration, in other types of synchronization between the heart and the lungs known as cardioventilatory coupling and in the association between heart failure and sleep apnea where breathing is interrupted periodically by periods of no-breathing. The full implication and physiological significance of the cardiorespiratory coupling under normal, pathological, or extreme physiological conditions are still unknown and are subject to ongoing investigation both experimentally and theoretically using mathematical models. This article reviews mathematical models that take heart-lung interactions into account. The main ideas behind low dimensional, phenomenological models for the study of the heart-lung synchronization and sleep apnea are described first. Higher dimensions, physiology-based models are described next. These models can vary widely in detail and scope and are characterized by the way the heart-lung interaction is taken into account: via gas exchange, via the central nervous system, via the mechanical interactions, and via time delays. The article emphasizes the need for the integration of the different sources of heart-lung coupling as well as the different mathematical approaches. Copyright © 2011 Wiley Periodicals, Inc.

Loss of Resistance to Angiotensin II-Induced Hypertension in the Jackson Laboratory Recombination-Activating Gene Null Mouse on the C57BL/6J Background.

PubMed

Ji, Hong; Pai, Amrita V; West, Crystal A; Wu, Xie; Speth, Robert C; Sandberg, Kathryn

2017-06-01

Resistance to angiotensin II (Ang II)-induced hypertension in T-cell-deficient male mice with a targeted mutation in the recombination-activating gene-1 ( Rag1 ) on the C57BL/6J background (B6. Rag1 -/- -M), which was reported by 5 independent laboratories including ours before 2015, has been lost. In mice purchased from Jackson Laboratory in 2015 and 2016, the time course and magnitude increase in mean arterial pressure induced by 2 weeks of Ang II infusion at 490 ng/kg per minute was identical between B6. Rag1 -/- -M and male wild-type littermates. Moreover, there were no differences in the time course or magnitude increase in mean arterial pressure at the lowest dose of Ang II (200 ng/kg per minute) that increased mean arterial pressure. This loss in Ang II resistance is independent of T cells. Angiotensin type 1-receptor binding was 1.4-fold higher in glomeruli isolated from recently purchased B6. Rag1 -/- -M suggesting an increase in renal angiotensin type 1-receptor activity masks the blood pressure protection afforded by the lack of T cells. The phenotypic change in B6. Rag1 -/- -M has implications for investigators using this strain to study mechanisms of T-cell modulation of Ang II-dependent blood pressure control. These findings also serve as a reminder that the universal drive for genetic variation occurs in all animals including inbred mouse strains and that spontaneous mutations leading to phenotypic change can compromise experimental reproducibility over time and place. Finally, these observations illustrate the importance of including experimental details about the location and time period over which animals are bred in publications involving animal studies to promote rigor and reproducibility in the scientific literature. © 2017 American Heart Association, Inc.

Effect of heart rate on the hemodynamics of bileaflet mechanical heart valves' prostheses (St. Jude Medical) in the aortic position and in the opening phase: A computational study.

PubMed

Jahandardoost, Mehdi; Fradet, Guy; Mohammadi, Hadi

2016-03-01

To date, to the best of the authors' knowledge, in almost all of the studies performed around the hemodynamics of bileaflet mechanical heart valves, a heart rate of 70-72 beats/min has been considered. In fact, the heart rate of ~72 beats/min does not represent the entire normal physiological conditions under which the aortic or prosthetic valves function. The heart rates of 120 or 50 beats/min may lead to hemodynamic complications, such as plaque formation and/or thromboembolism in patients. In this study, the hemodynamic performance of the bileaflet mechanical heart valves in a wide range of normal and physiological heart rates, that is, 60-150 beats/min, was studied in the opening phase. The model considered in this study was a St. Jude Medical bileaflet mechanical heart valve with the inner diameter of 27 mm in the aortic position. The hemodynamics of the native valve and the St. Jude Medical valve were studied in a variety of heart rates in the opening phase and the results were carefully compared. The results indicate that peak values of the velocity profile downstream of the valve increase as heart rate increases, as well as the location of the maximum velocity changes with heart rate in the St. Jude Medical valve model. Also, the maximum values of shear stress and wall shear stresses downstream of the valve are proportional to heart rate in both models. Interestingly, the maximum shear stress and wall shear stress values in both models are in the same range when heart rate is <90 beats/min; however, these values significantly increase in the St. Jude Medical valve model when heart rate is >90 beats/min (up to ~40% growth compared to that of the native valve). The findings of this study may be of importance in the hemodynamic performance of bileaflet mechanical heart valves. They may also play an important role in design improvement of conventional prosthetic heart valves and the design of the next generation of prosthetic valves, such as

Improving Neurodevelopmental Outcomes in Children with Congenital Heart Disease: An Intervention Study

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-16-1-0741 TITLE: Improving Neurodevelopmental Outcomes in Children with Congenital Heart Disease: An Intervention Study ...2017 4. TITLE AND SUBTITLE Improving Neurodevelopmental Outcomes in Children with Congenital Heart Disease: An Intervention Study 5a. CONTRACT NUMBER...executive function in several pediatric populations, but has not been studied in the CHD population. 15. SUBJECT TERMS- 16. SECURITY CLASSIFICATION OF

Needs of caregivers in heart failure management: A qualitative study

PubMed Central

Frost, Julia; Britten, Nicky; Jolly, Kate; Greaves, Colin; Abraham, Charles; Dalal, Hayes

2015-01-01

Objectives To identify the needs of caregivers supporting a person with heart failure and to inform the development of a caregiver resource to be used as part of a home-based self-management programme. Methods A qualitative study informed by thematic analysis involving 26 caregivers in individual interviews or a focus group. Results Three distinct aspects of caregiver support in heart failure management were identified. Firstly, caregivers identified needs about supporting management of heart failure including: coping with the variability of heart failure symptoms, what to do in an emergency, understanding and managing medicines, providing emotional support, promoting exercise and physical activity, providing personal care, living with a cardiac device and supporting depression management. Secondly, as they make the transition to becoming a caregiver, they need to develop skills to undertake difficult discussions about the role; communicate with health professionals; manage their own mental health, well-being and sleep; and manage home and work. Thirdly, caregivers require skills to engage social support, and voluntary and formal services while recognising that the long-term future is uncertain. Discussion The identification of the needs of caregiver has been used to inform the development of a home-based heart failure intervention facilitated by a trained health care practitioner. PMID:25795144

[Beta blockers in heart failure therapy with special reference to the COPERNICUS Study].

PubMed

Hartmann, Franz; Katus, Hugo A

2002-08-01

During the past 15 years, the pathophysiological concept of heart failure as a neurohormonal disease has influenced heart failure therapy substantially. ACE-inhibitors have become the mainstay of heart failure therapy. In addition, beta blocker evolved to be effective in improving survival in this disease. Recently, the COPERNICUS study established the efficacy of carvedilol in severe heart failure and extended the benefits of this drug first observed in patients with mild and moderate symptoms to those with advanced disease. In this study, carvedilol resulted in a significant reduction of all-cause mortality and combined mortality and hospitalization, the frequency of hospitalizations, the risk of repeated hospitalizations, the number of days in hospital, the average duration of each admission and the utilization of treatments and procedures for heart failure. Carvedilol was well tolerated, improved the sense of well-being, was associated with a lower risk of a serious adverse event, particularly one related to the progression of heart failure and fewer patients requiring withdrawal of treatment for an adverse event. These favourable results were equally seen in all subgroups. Carvedilol treatment was even cost-effective in severe disease. Therefore, this new therapeutic option should be available to all patients with symptomatic systolic heart failure.

Home telemonitoring in heart failure patients: the HHH study (Home or Hospital in Heart Failure)

PubMed Central

Mortara, Andrea; Pinna, Gian Domenico; Johnson, Paul; Maestri, Roberto; Capomolla, Soccorso; La Rovere, Maria Teresa; Ponikowski, Piotr; Tavazzi, Luigi; Sleight, Peter

2009-01-01

Aims The Home or Hospital in Heart failure (HHH) study was a European Community-funded, multinational, randomized controlled clinical trial, conducted in the UK, Poland, and Italy, to assess the feasibility of a new system of home telemonitoring (HT). The HT system was used to monitor clinical and physiological parameters, and its effectiveness (compared with usual care) in reducing cardiac events in heart failure (HF) patients was evaluated. Measurements were patient-managed. Methods and results From 2002 to 2004, 461 HF patients (age 60 ± 11 years, New York Heart Association class 2.4 ± 0.6, left ventricular ejection fraction 29 ± 7%) were enrolled at 11 centres and randomized (1:2) to either usual outpatient care or HT administered as three randomized strategies: (i) monthly telephone contact; (ii) strategy 1 plus weekly transmission of vital signs; and (iii) strategy 2 plus monthly 24 h recording of cardiorespiratory activity. Patients completed 81% of vital signs transmissions, as well as 92% of cardiorespiratory recordings. Over a 12-month follow-up, there was no significant effect of HT in reducing bed-days occupancy for HF or cardiac death plus HF hospitalization. Post hoc analysis revealed a heterogeneous effect of HT in the three countries with a trend towards a reduction of events in Italy. Conclusion Home or Hospital in Heart failure indicates that self-managed HT of clinical and physiological parameters is feasible in HF patients, with surprisingly high compliance. Whether HT contributes to a reduction of cardiac events requires further investigation. PMID:19228800

Laterality strength is linked to stress reactivity in Port Jackson sharks (Heterodontus portusjacksoni).

PubMed

Byrnes, Evan E; Vila Pouca, Catarina; Brown, Culum

2016-05-15

Cerebral lateralization is an evolutionarily deep-rooted trait, ubiquitous among the vertebrates and present even in some invertebrates. Despite the advantages of cerebral lateralization in enhancing cognition and facilitating greater social cohesion, large within population laterality variation exists in many animal species. It is proposed that this variation is maintained due links with inter-individual personality trait differences. Here we explored for lateralization in Port Jackson sharks (Heterodontus portusjacksoni) using T-maze turn and rotational swimming tasks. Additionally, we explored for a link between personality traits, boldness and stress reactivity, and cerebral lateralization. Sharks demonstrated large individual and sex biased laterality variation, with females demonstrating greater lateralization than males overall. Stress reactivity, but not boldness, was found to significantly correlate with lateralization strength. Stronger lateralized individuals were more reactive to stress. Demonstrating laterality in elasmobranchs for the first time indicates ancient evolutionary roots of vertebrate lateralization approximately 240 million years old. Greater lateralization in female elasmobranchs may be related enhancing females' ability to process multiple stimuli during mating, which could increase survivability and facilitate insemination. Despite contrasting evidence in teleost fishes, the results of this study suggest that stress reactivity, and other personality traits, may be linked to variation in lateralization. Copyright © 2016 Elsevier B.V. All rights reserved.

[The Lived Experience of Patients with Heart Transplantation: A Phenomenological Study].

PubMed

Hwang, Younghui; Yi, Myungsun

2017-02-01

The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation. © 2017 Korean Society of Nursing Science

Experiences of Patients Living With Heart Failure: A Descriptive Qualitative Study.

PubMed

Seah, Alvin Chuen Wei; Tan, Khoon Kiat; Huang Gan, Juvena Chew; Wang, Wenru

2016-07-01

The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure. © The Author(s) 2015.

Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR): study protocol for a randomised clinical trial

PubMed Central

2013-01-01

Background Heart valve diseases are common with an estimated prevalence of 2.5% in the Western world. The number is rising due to an ageing population. Once symptomatic, heart valve diseases are potentially lethal, and heavily influence daily living and quality of life. Surgical treatment, either valve replacement or repair, remains the treatment of choice. However, post surgery, the transition to daily living may become a physical, mental and social challenge. We hypothesise that a comprehensive cardiac rehabilitation programme can improve physical capacity and self-assessed mental health and reduce hospitalisation and healthcare costs after heart valve surgery. Methods A randomised clinical trial, CopenHeartVR, aims to investigate whether cardiac rehabilitation in addition to usual care is superior to treatment as usual after heart valve surgery. The trial will randomly allocate 210 patients, 1:1 intervention to control group, using central randomisation, and blinded outcome assessment and statistical analyses. The intervention consists of 12 weeks of physical exercise, and a psycho-educational intervention comprising five consultations. Primary outcome is peak oxygen uptake (VO2 peak) measured by cardiopulmonary exercise testing with ventilatory gas analysis. Secondary outcome is self-assessed mental health measured by the standardised questionnaire Short Form 36. Also, long-term healthcare utilisation and mortality as well as biochemistry, echocardiography and cost-benefit will be assessed. A mixed-method design is used to evaluate qualitative and quantitative findings encompassing a survey-based study before the trial and a qualitative pre- and post-intervention study. Discussion The study is approved by the local regional Research Ethics Committee (H-1-2011-157), and the Danish Data Protection Agency (j.nr. 2007-58-0015). Trial registration ClinicalTrials.gov (http://NCT01558765). PMID:23782510

Prenatal chromosomal microarray analysis in fetuses with congenital heart disease: a prospective cohort study.

PubMed

Wang, Yan; Cao, Li; Liang, Dong; Meng, Lulu; Wu, Yun; Qiao, Fengchang; Ji, Xiuqing; Luo, Chunyu; Zhang, Jingjing; Xu, Tianhui; Yu, Bin; Wang, Leilei; Wang, Ting; Pan, Qiong; Ma, Dingyuan; Hu, Ping; Xu, Zhengfeng

2018-02-01

Currently, chromosomal microarray analysis is considered the first-tier test in pediatric care and prenatal diagnosis. However, the diagnostic yield of chromosomal microarray analysis for prenatal diagnosis of congenital heart disease has not been evaluated based on a large cohort. Our aim was to evaluate the clinical utility of chromosomal microarray as the first-tier test for chromosomal abnormalities in fetuses with congenital heart disease. In this prospective study, 602 prenatal cases of congenital heart disease were investigated using single nucleotide polymorphism array over a 5-year period. Overall, pathogenic chromosomal abnormalities were identified in 125 (20.8%) of 602 prenatal cases of congenital heart disease, with 52.0% of them being numerical chromosomal abnormalities. The detection rates of likely pathogenic copy number variations and variants of uncertain significance were 1.3% and 6.0%, respectively. The detection rate of pathogenic chromosomal abnormalities in congenital heart disease plus additional structural anomalies (48.9% vs 14.3%, P < .0001) or intrauterine growth retardation group (50.0% vs 14.3%, P = .044) was significantly higher than that in isolated congenital heart disease group. Additionally, the detection rate in congenital heart disease with additional structural anomalies group was significantly higher than that in congenital heart disease with soft markers group (48.9% vs 19.8%, P < .0001). No significant difference was observed in the detection rates between congenital heart disease with additional structural anomalies and congenital heart disease with intrauterine growth retardation groups (48.9% vs 50.0%), congenital heart disease with soft markers and congenital heart disease with intrauterine growth retardation groups (19.8% vs 50.0%), or congenital heart disease with soft markers and isolated congenital heart disease groups (19.8% vs 14.3%). The detection rate in fetuses with congenital heart disease plus mild

Charting a Roadmap for Heart Failure Biomarker Studies

PubMed Central

Ahmad, Tariq; Fiuzat, Mona; Pencina, Michael J.; Geller, Nancy L.; Zannad, Faiez; Cleland, John G. F.; Snider, James V.; Blankenberg, Stephan; Adams, Kirkwood F.; Redberg, Rita F.; Kim, Jae B.; Mascette, Alice; Mentz, Robert J.; O'Connor, Christopher M.; Felker, G. Michael; Januzzi, James L.

2014-01-01

Heart failure is a syndrome with a pathophysiological basis that can be traced to dysfunction in several interconnected molecular pathways. Identification of biomarkers of heart failure that allow measurement of the disease on a molecular level has resulted in enthusiasm for their use in prognostication and selection of appropriate therapies. However, despite considerable amounts of information available on numerous biomarkers, inconsistent research methodologies and lack of clinical correlations have made bench-to-bedside translations rare and left the literature with countless publications of varied quality. There is a need for a systematic and collaborative approach aimed at definitively studying the clinical benefits of novel biomarkers. In this review, on the basis of input from academia, industry, and governmental agencies, we propose a systematized approach based on adherence to specific quality measures for studies looking to augment current prediction model or use biomarkers to tailor therapeutics. We suggest that study quality, rather than results, should determine publication and propose a system for grading biomarker studies. We outline the need for collaboration between clinical investigators and statisticians to introduce more advanced statistical methodologies into the field of biomarkers that would allow for data from a large number of variables to be distilled into clinically actionable information. Lastly, we propose the creation of a heart failure biomarker consortium that would allow for a comprehensive list of biomarkers to be concomitantly analyzed in a pooled sample of randomized clinical trials and hypotheses to be generated for testing in biomarker-guided trials. Such a consortium could collaborate in sharing samples to identify biomarkers, undertake meta- analyses on completed trials, and spearhead clinical trials to test the clinical utility of new biomarkers. PMID:24929535

Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF): study design and methods.

PubMed

Masterson Creber, Ruth; Patey, Megan; Dickson, Victoria Vaughan; DeCesaris, Marissa; Riegel, Barbara

2015-03-01

Lack of engagement in self-care is common among patients needing to follow a complex treatment regimen, especially patients with heart failure who are affected by comorbidity, disability and side effects of poly-pharmacy. The purpose of Motivational Interviewing Tailored Interventions for Heart Failure (MITI-HF) is to test the feasibility and comparative efficacy of an MI intervention on self-care, acute heart failure physical symptoms and quality of life. We are conducting a brief, nurse-led motivational interviewing randomized controlled trial to address behavioral and motivational issues related to heart failure self-care. Participants in the intervention group receive home and phone-based motivational interviewing sessions over 90-days and those in the control group receive care as usual. Participants in both groups receive patient education materials. The primary study outcome is change in self-care maintenance from baseline to 90-days. This article presents the study design, methods, plans for statistical analysis and descriptive characteristics of the study sample for MITI-HF. Study findings will contribute to the literature on the efficacy of motivational interviewing to promote heart failure self-care. We anticipate that using an MI approach can help patients with heart failure focus on their internal motivation to change in a non-confrontational, patient-centered and collaborative way. It also affirms their ability to practice competent self-care relevant to their personal health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

HEART OF MYTH – HEART OF SCIENCE Part I

PubMed Central

Bound Alberti, Fay

2015-01-01

This article explores the history and meanings of the heart and its diseases as aspects of the histories of science and emotion. Analyzing the twofold meanings of the heart as both bodily object and cultural symbol, it explores the reasons for the apparent conflict in meanings of the heart of science and the heart of emotion in Western medical culture since the 19th century. In Part I, a case study of the writer, economist, and philosopher Harriet Martineau is used to demonstrate and trace that conflict, while Part II highlights the manifold meanings of the heart both in the past and in the present. PMID:26167117

Natural history of coronary heart disease and heart disease of uncertain etiology: Findings from a 50-year population study.

PubMed

Puddu, Paolo Emilio; Menotti, Alessandro

2015-10-15

To describe the natural history of common heart disease incidence on a population study. A sample of 1712 men aged 40-59 was enrolled in 1960 and followed-up for 50years. Coronary heart disease (CHD) was categorized if manifested as sudden death, fatal and non-fatal myocardial infarction and other acute coronary syndromes, and as Heart Disease of Uncertain Etiology (HDUE) if manifested as heart failure, chronic arrhythmia, blocks, diagnoses of chronic CHD or hypertensive heart disease. Their characteristics and prognosis in terms of age at event, mortality and expectancy of life up to 50years were analyzed. Incidence of first CHD and HDUE event or diagnosis was of 26.9 and 20.6%, respectively. First events were equally manifested as fatal or non-fatal occurrences among CHD, while non-fatal occurrences were almost always observed among HDUE. Cases of HDUE presented at a more advanced age and also average age at death was significantly more advanced than in CHD, respectively around 79 and 76years. Expectancy of life was significantly longer for HDUE (30.7years) than for CHD (27.6years). Strokes were more frequently ascertained among HDUE (14%) while 14% of death causes were due to cancer in both CHD and HDUE. Cancers were much higher (40%) among those never diagnosed CHD or HDUE who also had more stroke-due deaths (17%). This is the first investigation to report heart disease incidence and its natural history in a quasi-extinction cohort data from Italy in a pre-cardiac surgery era. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessment of habitat of wildlife communities on the Snake River, Jackson, Wyoming

USGS Publications Warehouse

Schroeder, Richard L.; Allen, Arthur W.

1992-01-01

The composition of the wildlife community in western riparian habitats is influenced by the horizontal and vertical distribution of vegetation, the physical complexity of the channel, and barriers to movement along the corridor. Based on information from the literature and a workshop, a model was developed to evaluate the wildlife community along the Snake River near Jackson, Wyoming. The model compares conditions of the current or future years with conditions in 1956, before constructions of levees along the river. Conditions in 1956 are assumed to approximate the desirable distribution of plant cover types and the associated wildlife community and are used as a standard of comparison in the model. The model may be applied with remotely sensed data and is compatible with a geographic information systems analysis. In addition to comparing existing or future conditions with conditions in 1956, the model evaluated floodplain and channel complexity and assesses anthropogenic disturbance and its potential effect on the quality of wildlife habitat and movements of wildlife in the riparian corridor.

Medical costs in patients with heart failure after acute heart failure events: one-year follow-up study.

PubMed

Kim, Eugene; Kwon, Hye-Young; Baek, Sang Hong; Lee, Haeyoung; Yoo, Byung-Su; Kang, Seok-Min; Ahn, Youngkeun; Yang, Bong-Min

2018-03-01

This study investigated annual medical costs using real-world data focusing on acute heart failure. The data were retrospectively collected from six tertiary hospitals in South Korea. Overall, 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. Data were collected on their follow-up medical visits for 1 year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded. Annual per patient medical costs were estimated according to the type of medical services, and factors contributing to the costs using Gamma Generalized Linear Models (GLM) with log link were analyzed. On average, total annual medical costs for each patient were USD 6,199 (±9,675), with hospitalization accounting for 95% of the total expenses. Hospitalization cost USD 5,904 (±9,666) per patient. Those who are re-admitted have 88.5% higher medical expenditure than those who have not been re-admitted in 1 year, and patients using intensive care units have 19.6% higher expenditure than those who do not. When the number of hospital days increased by 1 day, medical expenses increased by 6.7%. Outpatient drug costs were not included. There is a possibility that medical expenses for AHF may have been under-estimated. It was found that hospitalization resulted in substantial costs for treatment of heart failure in South Korea, especially in patients with an acute heart failure event. Prevention strategies and appropriate management programs that would reduce both frequency of hospitalization and length of stay for patients with the underlying risk of heart failure are needed.

75 FR 17744 - Submission for OMB Review; Comment Request; the Jackson Heart Study (JHS)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... doctors and hospitals to ascertain participants' cardiovascular events. Information gathered will be used to further describe the risk factors, occurrence rates, and consequences of cardiovascular disease in... coronary disease, left ventricular dysfunction, progression of carotid atherosclerosis and left ventricular...

Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study.

PubMed

Khan, Sarah; Khoory, Ayesha; Al Zaffin, Dhabia; Al Suwaidi, Meera

2016-11-07

Cardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region. Social constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings. Emirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment. This study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to

A Study of Junior College Level Physics in German Speaking Europe.

ERIC Educational Resources Information Center

Riggs, Roderick D.

The purpose of this study was to analyze physics instruction in West Germany, Austria, and German-speaking Switzerland at levels comparable to junior colleges in the United States, and to compare this with the physics instruction offered at Jackson Community College (Jackson, Michigan). The investigator spent four months interviewing faculty and…

Unique challenges of hospice for patients with heart failure: A qualitative study of hospice clinicians.

PubMed

Lum, Hillary D; Jones, Jacqueline; Lahoff, Dana; Allen, Larry A; Bekelman, David B; Kutner, Jean S; Matlock, Daniel D

2015-09-01

Patients with heart failure have end-of-life care needs that may benefit from hospice care. The goal of this descriptive study was to understand hospice clinicians' perspectives on the unique aspects of caring for patients with heart failure to inform approaches to improving end-of-life care. This qualitative study explored experiences, observations, and perspectives of hospice clinicians regarding hospice care for patients with heart failure. Thirteen hospice clinicians from a variety of professional disciplines and clinical roles, diverse geographic regions, and varying lengths of time working in hospice participated in semistructured interviews. Through team-based, iterative qualitative analysis, we identified 3 major themes. Hospice clinicians identified 3 themes regarding care for patients with heart failure. First, care for patients with heart failure involves clinical complexity and a tailored approach to cardiac medications and advanced cardiac technologies. Second, hospice clinicians describe the difficulty patients with heart failure have in trusting hospice care due to patient optimism, prognostic uncertainty, and reliance on prehospice health care providers. Third, hospice clinicians described opportunities to improve heart failure-specific hospice care, highlighting the desire for collaboration with referring cardiologists. From a hospice clinician perspective, caring for patients with heart failure is unique compared with other hospice populations. This study suggests potential opportunities for hospice clinicians and referring providers who seek to collaborate to improve care for patients with heart failure during the transition to hospice care. Published by Elsevier Inc.

An intervention to promote physical activity and self-management in people with stable chronic heart failure The Home-Heart-Walk study: study protocol for a randomized controlled trial

PubMed Central

2011-01-01

Background Chronic heart failure (CHF) is a chronic debilitating condition with economic consequences, mostly because of frequent hospitalisations. Physical activity and adequate self-management capacity are important risk reduction strategies in the management of CHF. The Home-Heart-Walk is a self-monitoring intervention. This model of intervention has adapted the 6-minute walk test as a home-based activity that is self-administered and can be used for monitoring physical functional capacity in people with CHF. The aim of the Home-Heart-Walk program is to promote adherence to physical activity recommendations and improving self-management in people with CHF. Methods/Design A randomised controlled trial is being conducted in English speaking people with CHF in four hospitals in Sydney, Australia. Individuals diagnosed with CHF, in New York Heart Association Functional Class II or III, with a previous admission to hospital for CHF are eligible to participate. Based on a previous CHF study and a loss to follow-up of 10%, 166 participants are required to be able to detect a 12-point difference in the study primary endpoint (SF-36 physical function domain). All enrolled participant receive an information session with a cardiovascular nurse. This information session covers key self-management components of CHF: daily weight; diet (salt reduction); medication adherence; and physical activity. Participants are randomised to either intervention or control group through the study randomisation centre after baseline questionnaires and assessment are completed. For people in the intervention group, the research nurse also explains the weekly Home-Heart-Walk protocol. All participants receive monthly phone calls from a research coordinator for six months, and outcome measures are conducted at one, three and six months. The primary outcome of the trial is the physical functioning domain of quality of life, measured by the physical functioning subscale of the Medical Outcome

An intervention to promote physical activity and self-management in people with stable chronic heart failure The Home-Heart-Walk study: study protocol for a randomized controlled trial.

PubMed

Du, Hui Y; Newton, Phillip J; Zecchin, Robert; Denniss, Robert; Salamonson, Yenna; Everett, Bronwyn; Currow, David C; Macdonald, Peter S; Davidson, Patricia M

2011-03-02

Chronic heart failure (CHF) is a chronic debilitating condition with economic consequences, mostly because of frequent hospitalisations. Physical activity and adequate self-management capacity are important risk reduction strategies in the management of CHF. The Home-Heart-Walk is a self-monitoring intervention. This model of intervention has adapted the 6-minute walk test as a home-based activity that is self-administered and can be used for monitoring physical functional capacity in people with CHF. The aim of the Home-Heart-Walk program is to promote adherence to physical activity recommendations and improving self-management in people with CHF. A randomised controlled trial is being conducted in English speaking people with CHF in four hospitals in Sydney, Australia. Individuals diagnosed with CHF, in New York Heart Association Functional Class II or III, with a previous admission to hospital for CHF are eligible to participate. Based on a previous CHF study and a loss to follow-up of 10%, 166 participants are required to be able to detect a 12-point difference in the study primary endpoint (SF-36 physical function domain).All enrolled participant receive an information session with a cardiovascular nurse. This information session covers key self-management components of CHF: daily weight; diet (salt reduction); medication adherence; and physical activity. Participants are randomised to either intervention or control group through the study randomisation centre after baseline questionnaires and assessment are completed. For people in the intervention group, the research nurse also explains the weekly Home-Heart-Walk protocol. All participants receive monthly phone calls from a research coordinator for six months, and outcome measures are conducted at one, three and six months. The primary outcome of the trial is the physical functioning domain of quality of life, measured by the physical functioning subscale of the Medical Outcome Study Short Form -36

Heart Health - Brave Heart

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

Mandibular angle augmentation with the use of distraction and homologous lyophilized cartilage in a case of morphing to Michael Jackson surgery.

PubMed

Mommaerts, M Y; Abeloos, J S; Gropp, H

2001-08-01

Correction of an ill-defined mandibular angle is not an easy task, whether it is requested by the "congenital, orthognathic or cosmetic" patient. Deliberate over-correction has not been reported to our knowledge. This article presents a combination of distraction osteogenesis and lyophilized cartilage used to three-dimensionally over-augment the mandibular angle of a long-face prognathic patient who had the wish to be morphed to Michael Jackson or at least as far as current technique and his endogenic features allowed.

Estimated GFR and incident cardiovascular disease events in American Indians: the Strong Heart Study.

PubMed

Shara, Nawar M; Wang, Hong; Mete, Mihriye; Al-Balha, Yaman Rai; Azalddin, Nameer; Lee, Elisa T; Franceschini, Nora; Jolly, Stacey E; Howard, Barbara V; Umans, Jason G

2012-11-01

In populations with high prevalences of diabetes and obesity, estimating glomerular filtration rate (GFR) by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation may predict cardiovascular disease (CVD) risk better than by using the Modification of Diet in Renal Disease (MDRD) Study equation. Longitudinal cohort study comparing the association of GFR estimated using either the CKD-EPI or MDRD Study equation with incident CVD outcomes. American Indians participating in the Strong Heart Study, a longitudinal population-based cohort with high prevalences of diabetes, CVD, and CKD. Estimated GFR (eGFR) predicted using the CKD-EPI and MDRD Study equations. Fatal and nonfatal cardiovascular events, consisting of coronary heart disease, stroke, and heart failure. The association between eGFR and outcomes was explored in Cox proportional hazards models adjusted for traditional risk factors and albuminuria; the net reclassification index and integrated discrimination improvement were determined for the CKD-EPI versus MDRD Study equations. In 4,549 participants, diabetes was present in 45%; CVD, in 7%; and stages 3-5 CKD, in 10%. During a median of 15 years, there were 1,280 cases of incident CVD, 929 cases of incident coronary heart disease, 305 cases of incident stroke, and 381 cases of incident heart failure. Reduced eGFR (<90 mL/min/1.73 m2) was associated with adverse events in most models. Compared with the MDRD Study equation, the CKD-EPI equation correctly reclassified 17.0% of 2,151 participants without incident CVD to a lower risk (higher eGFR) category and 1.3% (n=28) were reclassified incorrectly to a higher risk (lower eGFR) category. Single measurements of eGFR and albuminuria at study visits. Although eGFR based on either equation had similar associations with incident CVD, coronary heart disease, stroke, and heart failure events, in those not having events, reclassification of participants to eGFR categories was superior using the

Participation in Heart-Healthy Behaviors: A Secondary Analysis of the American Heart Association Go Red Heart Match Data.

PubMed

Arslanian-Engoren, Cynthia; Eastwood, Jo-Ann; De Jong, Marla J; Berra, Kathy

2015-01-01

The American Heart Association created Go Red Heart Match, a free and secure online program that enables women to connect with each other to fight heart disease either personally or as a caregiver for someone with heart disease. Through these connections, participants have an opportunity to develop a personal, private, and supportive relationship with other women; share common experiences; and motivate and encourage each other to follow a heart-healthy lifestyle. The aims of this study were to describe the demographic characteristics of the Go Red Heart Match responders and to determine whether participation in the program prompted participants to engage in heart-healthy behaviors. A secondary analysis of data collected as part of a needs assessment survey from the American Heart Association Go Red Heart Match was conducted. A total of 117 (35%) of the 334 invited women completed the survey. Most responders were female, married, and college educated. A total of 105 (90%) responders were diagnosed with a type of heart disease or stroke and 77 (73%) responders had undergone treatment. As a result of participating in the program, 75% of the responders reported the following improvements in heart-healthy behaviors: eating a more heart-healthy diet (54%), exercising more frequently (53%), losing weight (47%), and quitting smoking (10%). Responders who had a diagnosis of heart attack (n = 48) were more likely (P = .003) to quit smoking than were those with other diagnoses (n = 69). Notably, 48% of responders reported encouraging someone else in their life to speak to their doctor about their risk for heart disease. Most women who participated in Heart Match reported engaging in new heart-healthy behaviors. The findings support expanding the existing program in a more diverse population as a potentially important way to reach women and encourage cardiovascular disease risk reduction for those with heart disease and stroke.

Mineralocorticoid receptor antagonists for heart failure: a real‐life observational study

PubMed Central

Bruno, Noemi; Sinagra, Gianfranco; Paolillo, Stefania; Bonomi, Alice; Corrà, Ugo; Piepoli, Massimo; Veglia, Fabrizio; Salvioni, Elisabetta; Lagioia, Rocco; Metra, Marco; Limongelli, Giuseppe; Cattadori, Gaia; Scardovi, Angela B.; Carubelli, Valentina; Scrutino, Domenico; Badagliacca, Roberto; Guazzi, Marco; Raimondo, Rosa; Gentile, Piero; Magrì, Damiano; Correale, Michele; Parati, Gianfranco; Re, Federica; Cicoira, Mariantonietta; Frigerio, Maria; Bussotti, Maurizio; Vignati, Carlo; Oliva, Fabrizio; Mezzani, Alessandro; Vergaro, Giuseppe; Di Lenarda, Andrea; Passino, Claudio; Sciomer, Susanna; Pacileo, Giuseppe; Ricci, Roberto; Contini, Mauro; Apostolo, Anna; Palermo, Pietro; Mapelli, Massimo; Carriere, Cosimo; Clemenza, Francesco; Binno, Simone; Belardinelli, Romualdo; Lombardi, Carlo; Perrone Filardi, Pasquale; Emdin, Michele

2018-01-01

Abstract Aims Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population‐based analysis, the long‐term effects of MRA treatment in HFrEF patients. Methods and results We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log‐rank test and propensity score matching. At 10 years' follow‐up, the MRA‐untreated group had a significantly lower number of events than the MRA‐treated group (P < 0.001). MRA‐treated patients had more severe heart failure (higher New York Heart Association class and lower left ventricular ejection fraction, kidney function, and peak VO2). At a propensity‐score‐matching analysis performed on 1587 patients, MRA‐treated and MRA‐untreated patients showed similar study endpoint values. Conclusions In conclusion, MRA treatment does not affect the composite of cardiovascular death, urgent heart transplantation or left ventricular assist device implantation in a real‐life setting. A meticulous patient follow‐up, as performed in trials, is likely needed to match the positive MRA‐related benefits observed in clinical trials. PMID:29397584

Using additional information on working hours to predict coronary heart disease: a cohort study

PubMed Central

Kivimäki, Mika; Batty, G. David; Hamer, Mark; Ferrie, Jane E.; Vahtera, Jussi; Virtanen, Marianna; Marmot, Michael G.; Singh-Manoux, Archana; Shipley, Martin J.

2011-01-01

Background Long hours are associated with increased risk of coronary heart disease. Adding information on long hours to traditional risk factors could potentially help improve risk prediction. Objective To examine whether information on long working hours improves the ability of the Framingham risk model to predict coronary heart disease in a low-risk employed population. Design Prospective cohort study; baseline medical examination (1991-1993) and coronary heart disease follow-up to 2004. Settings Civil service departments in London (the Whitehall II study). Participants 7095 adults (2109 women) aged 39 to 62, working full time, and free of coronary heart disease at baseline. Measurements Working hours and the Framingham risk score were measured at baseline. Coronary death and non-fatal myocardial infarction were ascertained from three sources: medical screenings every 5 years, hospital data and register linkage. Results 192 persons had incident coronary heart disease during a median 12.3 year follow-up. After adjustment for the Framingham score, participants working ≥11 hours per day had a 1.67-fold (95% CI: 1.10-2.55) increased risk of coronary heart disease relative to those working 7-8 hours. The addition of working hours to the Framingham score led to a net reclassification improvement of 4.7% (p=0.034), resulting from a better identification of individuals who later developed coronary heart disease (sensitivity gain). Limitations The findings may not be generalizable to populations with a larger proportion of high-risk individuals. Furthermore, the predictive utility of working hours was not validated in an independent cohort. Conclusion Information on working hours may improve prediction of coronary heart disease risk based on the Framingham risk score in low-risk working populations. Primary Funding Source Medical Research Council, British Heart Foundation, BUPA Foundation, UK; National Heart, Lung and Blood Institute and National Institute on Aging, NIH

Coronary Heart Disease Incidence in Sleep Disordered Breathing: The Wisconsin Sleep Cohort Study

PubMed Central

Hla, Khin Mae; Young, Terry; Hagen, Erika W.; Stein, James H.; Finn, Laurel A.; Nieto, F. Javier; Peppard, Paul E.

2015-01-01

Study Objectives: The aim of the study was to determine the association of objectively measured sleep disordered breathing (SDB) with incident coronary heart disease (CHD) or heart failure (HF) in a nonclinical population. Design: Longitudinal analysis of a community-dwelling cohort followed up to 24 y. Setting: Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospital and Clinics. Participants: There were 1,131 adults who completed one or more overnight polysomnography studies, were free of CHD or HF at baseline, were not treated by continuous positive airway pressure (CPAP), and followed over 24 y. Interventions: None. Measurements and Results: In-laboratory overnight polysomnography was used to assess SDB, defined by the apnea-hypopnea index (AHI) using apnea and hypopnea events per hour of sleep. Incident CHD or HF was defined by new reports of myocardial infarction, coronary revascularization procedures, congestive heart failure, and cardiovascular deaths. We used baseline AHI as the predictor variable in survival analysis models predicting CHD or HF incidence adjusted for traditional confounders. The incidence of CHD or HF was 10.9/1,000 person-years. The mean time to event was 11.2 ± 5.8 y. After adjusting for age, sex, body mass index, and smoking, estimated hazard ratios (95% confidence interval) of incident CHD or HF were 1.5 (0.9–2.6) for AHI > 0–5, 1.9 (1.05–3.5) for AHI 5 ≤ 15, 1.8 (0.85–4.0) for AHI 15 ≤ 30, and 2.6 (1.1–6.1) for AHI > 30 compared to AHI = 0 (P trend = 0.02). Conclusions: Participants with untreated severe sleep disordered breathing (AHI > 30) were 2.6 times more likely to have an incident coronary heart disease or heart failure compared to those without sleep disordered breathing. Our findings support the postulated adverse effects of sleep disordered breathing on coronary heart disease and heart failure. Citation: Hla KM, Young T, Hagen EW, Stein JH, Finn LA, Nieto FJ, Peppard PE. Coronary

The Congenital Heart Disease Genetic Network Study

PubMed Central

2013-01-01

Congenital heart defects (CHD) are the leading cause of infant mortality among birth defects, and later morbidities and premature mortality remain problematic. Although genetic factors contribute significantly to cause CHD, specific genetic lesions are unknown for most patients. The National Heart, Lung, and Blood Institute-funded Pediatric Cardiac Genomics Consortium established the Congenital Heart Disease Genetic Network Study to investigate relationships between genetic factors, clinical features, and outcomes in CHD. The Pediatric Cardiac Genomics Consortium comprises 6 main and 4 satellite sites at which subjects are recruited, and medical data and biospecimens (blood, saliva, cardiovascular tissue) are collected. Core infrastructure includes an administrative/data-coordinating center, biorepository, data hub, and core laboratories (genotyping, whole-exome sequencing, candidate gene evaluation, and variant confirmation). Eligibility includes all forms of CHD. Annual follow-up is obtained for probands <1-year-old. Parents are enrolled whenever available. Enrollment from December 2010 to June 2012 comprised 3772 probands. One or both parents were enrolled for 72% of probands. Proband median age is 5.5 years. The one third enrolled at age <1 year are contacted annually for follow-up information. The distribution of CHD favors more complex lesions. Approximately, 11% of probands have a genetic diagnosis. Adequate DNA is available from 97% and 91% of blood and saliva samples, respectively. Genomic analyses of probands with heterotaxy, atrial septal defects, conotruncal, and left ventricular outflow tract obstructive lesions are underway. The scientific community’s use of Pediatric Cardiac Genomics Consortium resources is welcome. PMID:23410879

Lifestyle modification with diet and exercise in obese patients with heart failure - A pilot study

USDA-ARS?s Scientific Manuscript database

There is a paucity of data regarding intentional weight loss in obese heart failure patients. This study sought to ascertain the safety and effectiveness of a lifestyle modification program in patients with systolic heart failure and metabolic syndrome. Patients (n=20) with systolic heart failure (e...

Exploratory study into awareness of heart disease and health care seeking behavior among Emirati women (UAE) - Cross sectional descriptive study.

PubMed

Khan, Sarah; Ali, Syed Adnan

2017-09-26

Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually happen in older women thus symptoms of heart disease may be masked by symptoms of chronic diseases, which could explain the delay in seeking health care and higher mortality following an ischaemic episode among women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women's health care seeking behaviour in UAE. A cross sectional, descriptive study was conducted using a survey instrument adapted from the American Heart Association National survey. A convenience sample of 676 Emirati women between the ages of 18-55 years completed the questionnaire. The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p < 0.05) among all the other emirates and in the 18-45 years age group (OR 2.74, p < 0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking health care. Interestingly, just 49.1% Emirati women believed that good quality and affordable health care was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries. Emirati women clearly lack the knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific awareness on heart disease risks and symptoms. The study has also highlighted potential modifiable barriers in seeking health care that should be overcome to reduce morbidity and mortality due to heart

Survival analysis of heart failure patients: A case study.

PubMed

Ahmad, Tanvir; Munir, Assia; Bhatti, Sajjad Haider; Aftab, Muhammad; Raza, Muhammad Ali

2017-01-01

This study was focused on survival analysis of heart failure patients who were admitted to Institute of Cardiology and Allied hospital Faisalabad-Pakistan during April-December (2015). All the patients were aged 40 years or above, having left ventricular systolic dysfunction, belonging to NYHA class III and IV. Cox regression was used to model mortality considering age, ejection fraction, serum creatinine, serum sodium, anemia, platelets, creatinine phosphokinase, blood pressure, gender, diabetes and smoking status as potentially contributing for mortality. Kaplan Meier plot was used to study the general pattern of survival which showed high intensity of mortality in the initial days and then a gradual increase up to the end of study. Martingale residuals were used to assess functional form of variables. Results were validated computing calibration slope and discrimination ability of model via bootstrapping. For graphical prediction of survival probability, a nomogram was constructed. Age, renal dysfunction, blood pressure, ejection fraction and anemia were found as significant risk factors for mortality among heart failure patients.

Prospective assessment of the occurrence of anemia in patients with heart failure: results from the Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry.

PubMed

Adams, Kirkwood F; Patterson, James H; Patterson, John H; Oren, Ron M; Mehra, Mandeep R; O'Connor, Christopher M; Piña, Ileana L; Miller, Alan B; Chiong, Jun R; Dunlap, Stephanie H; Cotts, William G; Felker, Gary M; Schocken, Douglas D; Schwartz, Todd A; Ghali, Jalal K

2009-05-01

Although a potentially important pathophysiologic factor in heart failure, the prevalence and predictors of anemia have not been well studied in unselected patients with heart failure. The Study of Anemia in a Heart Failure Population (STAMINA-HFP) Registry prospectively studied the prevalence of anemia and the relationship of hemoglobin to health-related quality of life and outcomes among patients with heart failure. A random selection algorithm was used to reduce bias during enrollment of patients seen in specialty clinics or clinics of community cardiologists with experience in heart failure. In this initial report, data on prevalence and correlates of anemia were analyzed in 1,076 of the 1,082 registry patients who had clinical characteristics and hemoglobin determined by finger-stick at baseline. Overall (n = 1,082), the registry patients were 41% female and 73% white with a mean age (+/-SD) of 64 +/- 14 years (68 +/- 13 years in community and 57 +/- 14 years in specialty sites, P < .001). Among the 1,076 patients in the prevalence analysis, mean hemoglobin was 13.3 +/- 2.1 g/dL (median 13.2 g/dL); and anemia (defined by World Health Organization criteria) was present in 34%. Age identified patients at risk for anemia, with 40% of patients >70 years affected. Initial results from the STAMINA-HFP Registry suggest that anemia is a common comorbidity in unselected outpatients with heart failure. Given the strong association of anemia with adverse outcomes in heart failure, this study supports further investigation concerning the importance of anemia as a therapeutic target in this condition.

Simultaneous fluorometry and phosphorometry of Langendorff perfused rat heart: ex vivo animal studies

NASA Astrophysics Data System (ADS)

Ranji, Mahsa; Jaggard, Dwight L.; Apreleva, Sofia V.; Vinogradov, Sergei A.; Chance, Britton

2006-10-01

Fluorescence imaging of intrinsic fluorophores of tissue is a powerful method to assess metabolic changes at the cellular and intracellular levels. At the same time, exogenous phosphorescent probes can be used to accurately measure intravascular tissue oxygenation. Heart failure is the leading cause of death in America. A rat heart can potentially model the human heart to study failures or other abnormalities optically. We report simultaneous fluorescence and phosphorescence measurements performed on a rat heart. We have used two different optical systems to acquire fluorescence signals of flavoprotein and nicotinamide adenine dinucleotide—the two intrinsic fluorophores of mitochondria—and the phosphorescence signal of an intravascular oxygen probe to extract intracellular and intravascular metabolism loads, respectively.

Terminal branching pattern of the right coronary artery in left-dominant hearts: a cadaveric study.

PubMed

Gupta, Tulika; Saini, Abhimanyu; Sahni, Daisy

2013-01-01

Left coronary dominance has been reported to be associated with increased mortality and severity in case of myocardial ischemia involving left coronary artery. The present cadaveric study was proposed to objectively study and document the termination and branching pattern of the right coronary artery in left-coronary-dominant hearts in relation to the blood supply to the posterior surface of the right ventricle. Seventy-five cadaveric hearts were studied. The coronary vessels were injected with colored cellulose acetate butyrate and dissected. The coronary dominance was determined. In left-dominant hearts, branches and termination of the right coronary artery were studied. Left coronary dominance was found in 13% of the specimens. The number of ventricular branches was found to be present as 0, 1, 2, and 4 in two, four, two, and two of the cases, respectively. The average length of the ventricular branch was 12.7 mm with a range of 5-35 mm. The atrial branch was found in 50% of hearts, varying from 2 to 3 mm in length. In three hearts, the acute marginal artery did not give any posterior ventricular branch, while two, three, and five posterior ventricular branches were seen in four, two, and one heart(s), respectively. The length of the posterior ventricular arteries was between 5 and 15 mm. The RCA is an inconstant and unreliable source of posterior right ventricular perfusion in a significant percentage of population with left-coronary-dominant hearts. This might be the reason for the increased morbidity and mortality seen in the event of left coronary ischemia. Copyright © 2013 Elsevier Inc. All rights reserved.

Reappearance of beriberi heart disease in Japan. A study of 23 cases.

PubMed

Kawai, C; Wakabayashi, A; Matsumura, T; Yui, Y

1980-09-01

Twenty-three Japanese patients with beriberi heart disease, 17 of them teenagers, were studied. The recent tendency for teenagers to take excessive sweet carbonated soft drinks, instant noodles and powermill-polished rice readily induces relative thiamine deficiency. A sudden increase in thiamine requirements due to strenuous exercise can result in overt beriberi heart disease. Alcohol had nothing to do with the development of the disease. Characteristic features commonly seen in teenage patients include peripheral edema, low peripheral vascular resistance, increased venous pressure enlarged heart, T wave abnormalities, hyperkinetic circulatory state and increased circulating blood volume. Thiamine deficiency was confirmed by a decrease in blood thiamine concentration, a decrease in erythrocyte transketolase activity and an increase in thiamine pyrophosphate (TPP) effect. Improvement was rapidly achieved with thiamine administration, balanced nutrition and rest, especially in the teenage patients. Increased circulating blood volume was useful in differentiating beriberi heart disease from hyperthyroidism.

Oral health and later coronary heart disease: Cohort study of one million people.

PubMed

Batty, G David; Jung, Keum Ji; Mok, Yejin; Lee, Sun Ju; Back, Joung Hwan; Lee, Sunmi; Jee, Sun Ha

2018-04-01

Aims Systematic reviews report an association between poorer oral health and an increased risk of coronary heart disease. This contentious relationship may not be causal but existing studies have been insufficiently well powered comprehensively to examine the role of confounding, particularly by cigarette smoking. Accordingly, we sought to examine the role of smoking in generating the relationship between oral health and coronary heart disease in life-long non-smokers. Methods and results In the Korean Cancer Prevention Study, 975,685 individuals (349,579 women) aged 30-95 years had an oral examination when tooth loss, a widely used indicator of oral health, was ascertained. Linkage to national mortality and hospital registers over 21 years of follow-up gave rise to 64,784 coronary heart disease events (19,502 in women). In the whole cohort, after statistical adjustment for age, there was a moderate, positive association between tooth loss and coronary heart disease in both men (hazard ratio for seven or more missing teeth vs. none; 95% confidence interval 1.08; 1.02, 1.14; P trend across tooth loss groups <0.0001) and women (1.09; 1.01, 1.18; P trend 0.0016). Restricting analyses to a subgroup of 464,145 never smokers (25,765 coronary heart disease events), however, resulted in an elimination of this association in men (1.01; 0.85, 1.19); P trend 0.7506) but not women (1.08; 0.99, 1.18; P trend 0.0086). Conclusion In men in the present study, the relationship between poor oral health and coronary heart disease risk appeared to be explained by confounding by cigarette smoking so raising questions about a causal link.

Simultaneous measurement of instantaneous heart rate and chest wall plethysmography in short-term, metronome guided heart rate variability studies: suitability for assessment of autonomic dysfunction.

PubMed

Perring, S; Jones, E

2003-08-01

Instantaneous heart rate and chest wall motion were measured using a 3-lead ECG and an air pressure chest wall plethysmography system. Chest wall plethysmography traces were found to accurately represent the breathing pattern as measured by spirometry (average correlation coefficient 0.944); though no attempt was made to calibrate plethysmography voltage output to tidal volume. Simultaneous measurements of heart rate and chest wall motion were made for short periods under metronome guided breathing at 6 breaths per minute. The average peak to trough heart rate change per breath cycle (AVEMAX) and maximum correlation between heart rate and breathing cycle (HRBRCORR) were measured. Studies of 44 normal volunteers indicated clear inverse correlation of heart rate variability parameters with age (AVEMAX R = -0.502, P < 0.001) but no significant change in HRBRCORR with age (R = -0.115). Comparison of normal volunteers with diabetics with no history of symptoms associated with autonomic failure indicated significant lower heart rate variability in diabetics (P = 0.005 for AVEMAX) and significantly worse correlation between heart rate and breathing (P < 0.001 for HRBRCORR). Simultaneous measurement of heart rate and breathing offers the possibility of more sensitive diagnosis of autonomic failure in a simple bedside test and gives further insight into the nature of cardio-ventilatory coupling.

Winter habitat use by cutthroat trout in the Snake River near Jackson, Wyoming

USGS Publications Warehouse

Harper, D.D.; Farag, A.M.

2004-01-01

Winter habitat use by Yellowstone cutthroat trout Oncorhynchus clarki bouvieri was monitored with radiotelemetry during November-March 1998-2001 in channelized and unaltered sections of the Snake River near Jackson, Wyoming. The use of run and off-channel pool habitat was significantly correlated to water temperature; run use was most frequent when mean water temperature exceeded 1.0°C, and off-channel pool use was greatest when mean water temperature was below 1.0°C. Available habitat was surveyed during winter 1999-2000 and was compared with actual habitat use. This comparison indicated that cutthroat trout avoided riffle habitat, selected deep runs, and strongly selected off-channel pool habitat. Large, deep, off-channel pools with groundwater influence were uncommon in the study area but were frequently selected as over-wintering habitat in the channelized section during all three study years. During 2000-2001, mainstem water temperatures were significantly colder than in 1998-1999 or 1999-2000, and anchor ice was observed more frequently in 2000-2001 than in 1998-1999 or 1999-2000 (on 18 d versus 5 d and 3 d, respectively). Mean water temperatures in off-channel pools were not significantly different among years. Depth and shelf ice were most frequently identified as cover elements in the channelized section. Run habitat was more common and used more frequently upstream of the channelized section. Large woody debris was more common and selected more frequently as cover in the unaltered section than in the channelized section.

Dipeptidyl Peptidase-4 Inhibitors and Heart Failure Exacerbation in the Veteran Population: An Observational Study.

PubMed

Cobretti, Michael R; Bowman, Benjamin; Grabarczyk, Ted; Potter, Emily

2018-03-01

The dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) are effective modulators of fasting and postprandial hyperglycemia in patients with type 2 diabetes mellitus (T2DM). In 2013 the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53 (SAVOR-TIMI 53) clinical trial found an increased risk of heart failure exacerbation, as a secondary outcome, among patients treated with saxagliptin. This study examines the safety of DPP-4 inhibitors as a class in T2DM in relation to risk of heart failure exacerbations. Retrospective cohort study of two groups of patients using data from the national Department of Veteran's Affairs (VA) Health Care System: patients initially prescribed DPP-4 inhibitors with or without second-generation sulfonylureas and/or metformin (exposed group) compared with patients initially prescribed only second-generation sulfonylureas and/or metformin (unexposed group) between August 1, 2013, and August 30, 2016. The primary aim of this study was to determine the difference in 1-year heart failure exacerbation rate in patients with T2DM between the exposed and unexposed groups. Data were analyzed using the χ 2 Student t test and Kaplan-Meier analysis. Significance was set at p<0.05. The study evaluated 672,265 patients: 33,614 patients in the exposed group and 638,651 patients in the unexposed group. Overall, 130 (0.38%) heart failure exacerbations were documented in the exposed group, and 2222 (0.34%) heart failure exacerbations were documented in the unexposed group; the difference in exacerbation rate was nonsignificant between groups (p=0.24). In a subgroup analysis of patients with a baseline diagnosis of heart failure, the difference in rate of heart failure exacerbations remained nonsignificant (p=0.334). Patients in the veteran population with T2DM treated with DPP-4 inhibitors did not demonstrate a significant increase in risk for heart failure exacerbation

In vivo carbon-13 nuclear magnetic resonance studies of heart metabolism.

PubMed Central

Neurohr, K J; Barrett, E J; Shulman, R G

1983-01-01

Guinea pig heart metabolism was studied in vivo by 13C NMR at 20.18 MHz. High-quality proton-decoupled 13C NMR spectra with excellent signal-to-noise ratios and resolution could be obtained in 6 min. Natural-abundance spectra showed resonances that could be assigned to fatty acids, but glycogen was not seen. During intravenous infusion of D-[1-13C]glucose and insulin, the time course of myocardial glycogen synthesis was followed serially for up to 4 hr. Anoxia resulted in degradation of the labeled glycogen within 6 min and appearance of 13C label in lactic acid. Infusion of sodium [2-13C]acetate resulted in incorporation of label into the C-4, C-2, and C-3 positions of glutamate and glutamine, reflecting "scrambling" of the label expected from tricarboxylic acid cycle activity. Examination of the 31P NMR spectrum of the guinea pig heart in vivo demonstrated no change in the high-energy phosphates during the time periods of the 13C NMR experiments. Our studies indicate that 13C NMR is a unique non-destructive tool for the study of heart metabolism in vivo. PMID:6572924

Heart failure.

PubMed

Metra, Marco; Teerlink, John R

2017-10-28

Heart failure is common in adults, accounting for substantial morbidity and mortality worldwide. Its prevalence is increasing because of ageing of the population and improved treatment of acute cardiovascular events, despite the efficacy of many therapies for patients with heart failure with reduced ejection fraction, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists, and advanced device therapies. Combined angiotensin receptor blocker neprilysin inhibitors (ARNIs) have been associated with improvements in hospital admissions and mortality from heart failure compared with enalapril, and guidelines now recommend substitution of ACE inhibitors or ARBs with ARNIs in appropriate patients. Improved safety of left ventricular assist devices means that these are becoming more commonly used in patients with severe symptoms. Antidiabetic therapies might further improve outcomes in patients with heart failure. New drugs with novel mechanisms of action, such as cardiac myosin activators, are under investigation for patients with heart failure with reduced left ventricular ejection fraction. Heart failure with preserved ejection fraction is a heterogeneous disorder that remains incompletely understood and will continue to increase in prevalence with the ageing population. Although some data suggest that spironolactone might improve outcomes in these patients, no therapy has conclusively shown a significant effect. Hopefully, future studies will address these unmet needs for patients with heart failure. Admissions for acute heart failure continue to increase but, to date, no new therapies have improved clinical outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Cohort study of ischemic heart disease among 1817 workers in a foundry].

PubMed

Lu, Yang; Zhang, Min

2012-09-01

To determine the risk of ischemic heart disease among foundry workers and the exposure-response relationship between the risk and foundry work and cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing ischemic heart disease by a given length of employment and exposure to silica dust in foundry workers. Cohort study was conducted, following-up workers in an automobile foundry employed for more than one year during January 1, 1980 to December 31, 1996 as cohort members. In total, 30 years were followed to December 31, 2009. In cohort, workers exposed to pouring, sand preparation, cast shakeout and finishing, melting, overhead crane operation, moulding and core-making were in foundry group, and auxiliary workers at the same factory, such as electricians, fitters, and inspectors were in control group. The risk of ischemic heart disease among foundry workers and the exposure-response relationship between the risk and foundry work and cumulative exposure to silica dust were analyzed with cox regression model using SPSS software, and a logistic regression model was established for prediction of risk for developing ischemic heart disease at a given length of employment and exposure to silica dust in foundry workers. Totally, 1817 workers were followed-up for 45 553.05 person-years during 30 years, with 156 cases of ischemic heart disease and incidence of 342.46 per 100 000 person-years. And the average age at onset was 51.46 years and duration of employment at onset was 21.61 years. Results showed that male, smoking, alcohol drinking, age and duration of employment were risk factors for ischemic heart disease. Risk of ischemic heart disease in foundry workers positively correlated with cumulative silica exposure, and the risk of ischemic heart disease increased by 75.8 percent (RR = 1.758, 95% CI 1.221-2.532) with cumulative silica exposure of 1 mg/m3 x year, adjusted for smoking. And risk of ischemic heart disease was

Serum magnesium and risk of new onset heart failure in men: the Kuopio Ischemic Heart Disease Study.

PubMed

Kunutsor, Setor K; Khan, Hassan; Laukkanen, Jari A

2016-10-01

Serum magnesium is an essential intracellular cation involved in processes that regulate cardiovascular function and has been linked to the risk of several cardiovascular disease outcomes. We aimed to investigate the association of serum magnesium concentrations with risk of incident heart failure (HF). We studied 2181 middle-aged men without prevalent HF (aged 42-61 years) enrolled in the finnish Kuopio Ischemic Heart Disease prospective cohort study with serum magnesium measurements made at baseline. Hazard ratios (95 % confidence intervals [CI]) for HF were assessed. During a median follow-up of 24.8 years, 278 HF events occurred. Baseline serum magnesium was weakly and inversely associated with several clinical markers and was continuously associated with risk of HF. The age-adjusted HR (95 % CIs) for HF per 1 standard deviation (SD) higher serum magnesium levels was 0.86 (0.76-0.97). The HR (95 % CIs) was 0.87 (0.76-0.98) after controlling for measures of adiposity, socio-economic variables, medical history, blood pressure, renal function, alcohol consumption, and lipids. These findings remained consistent in analyses accounting for incident coronary heart disease. The results were comparable across several clinically relevant subgroups and analyses with atrial fibrillation as a competing risk yielded similar results. Serum magnesium was continuously, inversely and independently associated with future risk of HF. Further research is needed to assess any potential relevance of serum magnesium in HF prevention.

Selection of reference genes for gene expression studies in heart failure for left and right ventricles.

PubMed

Li, Mengmeng; Rao, Man; Chen, Kai; Zhou, Jianye; Song, Jiangping

2017-07-15

Real-time quantitative reverse transcriptase-PCR (qRT-PCR) is a feasible tool for determining gene expression profiles, but the accuracy and reliability of the results depends on the stable expression of selected housekeeping genes in different samples. By far, researches on stable housekeeping genes in human heart failure samples are rare. Moreover the effect of heart failure on the expression of housekeeping genes in right and left ventricles is yet to be studied. Therefore we aim to provide stable housekeeping genes for both ventricles in heart failure and normal heart samples. In this study, we selected seven commonly used housekeeping genes as candidates. By using the qRT-PCR, the expression levels of ACTB, RAB7A, GAPDH, REEP5, RPL5, PSMB4 and VCP in eight heart failure and four normal heart samples were assessed. The stability of candidate housekeeping genes was evaluated by geNorm and Normfinder softwares. GAPDH showed the least variation in all heart samples. Results also indicated the difference of gene expression existed in heart failure left and right ventricles. GAPDH had the highest expression stability in both heart failure and normal heart samples. We also propose using different sets of housekeeping genes for left and right ventricles respectively. The combination of RPL5, GAPDH and PSMB4 is suitable for the right ventricle and the combination of GAPDH, REEP5 and RAB7A is suitable for the left ventricle. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of acoustic technology to aid in the regulation of Ross Barnett Reservoir near Jackson, Mississippi: Trials and tribulations

USGS Publications Warehouse

Storm, J.B.

2004-01-01

The U.S. Geological Survey is computing continuous discharge of the Pearl River at the upper end of the Ross Barnett Reservoir near Jackson, Mississippi, using acoustic technology and conventional streamgaging methods. The computed inflow is posted "real-time" to the Mississippi District's web page where it can be monitored by the Pearl River Valley Water Supply District (PRVWSD) to aid in reservoir regulation. The use of this technology to determine discharge allows the PRVWSD to prepare for headwater flooding conditions ahead of time and adjust reservoir outflow accordingly. Hydraulic and acoustic problems inherent to this site have presented problems not normally encountered at a typical streamgaging site. Copyright ASCE 2004.

Positive affect and survival in patients with stable coronary heart disease: findings from the Heart and Soul Study.

PubMed

Hoen, Petra W; Denollet, Johan; de Jonge, Peter; Whooley, Mary A

2013-07-01

Positive affect can improve survival, but the mechanisms responsible for this association are unknown. We sought to evaluate the association between positive affect and mortality in patients with stable coronary heart disease and to determine biological and behavioral factors that might explain this association. The Heart and Soul Study is a prospective cohort study of 1,018 outpatients with stable coronary heart disease. Participants were recruited between September 11, 2000, and December 20, 2002, and were followed up to June 2011. Baseline positive affect was assessed by using the 10-item positive affect subscale of the Positive and Negative Affect Schedule. Cox proportional hazards regression was used to estimate the risk of mortality (primary outcome measure) and cardiovascular events (heart failure, myocardial infarction, stroke, transient ischemic attack) associated with positive affect, adjusting for baseline cardiac disease severity and depression. We also evaluated the extent to which these associations were explained by potential biological and behavioral mediators. A total of 369 patients (36%) died during a mean ± SD follow-up period of 7.1 ± 2.5 years. Positive affect was not significantly associated with cardiovascular events (hazard ratio [HR]: 0.89; 95% CI, 0.79-1.00; P = .06). However, each standard deviation (8.8-point) increase in positive affect score was associated with a 16% decreased risk of all-cause mortality (HR: 0.84; 95% CI, 0.76-0.92; P = .001). After adjustment for cardiac disease severity and depressive symptoms, positive affect remained significantly associated with improved survival (HR: 0.87; 95% CI, 0.78-0.97; P = .01). The association was no longer significant after adjustment for behavioral factors, and particularly physical activity (HR: 0.92; 95% CI, 0.82-1.03; P = .16). Further adjustment for C-reactive protein and omega-3 fatty acids did not result in any meaningful changes (HR: 0.94; 95% CI, 0.84-1.06; P = .31). In this

An association between migraines and heart anomalies-true or false? A heart ultrasound study using cTTE in migraine patients and control participants.

PubMed

Domitrz, Izabela; Styczynski, Grzegorz; Wilczko, Justyna; Marczewska, Malgorzata M; Domitrz, Wojciech; Kaminska, Anna

2014-12-01

A migraine is a common neurological disorder that often coexists with other illnesses including heart abnormalities, such as patent foramen ovale (PFO), atrial septal aneurysm (ASA), and mitral valve prolapse (MVP). The aim of our study was to evaluate the occurrence of some heart abnormalities in migraine patients by routine and contrast transthoracic echocardiography. We assessed the occurrence of PFO, ASA, and MVP in 96 patients with migraine without aura (87 females), in 62 patients with migraine with aura (41 females) and in 53 healthy persons (40 females). In comparison with our control group, only the prevalence of PFO was statistically higher in patients with migraine (P = 0.03) and especially with aura (P = 0.01). We did not find any statistically significant differences between the occurrence of ASA or MVP in migraine and control groups. The results of our study raise the question of the heart's role in the mechanism of migraine attacks. If the occurrence of migraine with aura had been related to some heart abnormalities, the pathophysiology of migraine attacks may have some connection to some heart dysfunction. Resolving the association between migraine and comorbid cardiac conditions might shed light on the underlying mechanisms of migraines and even result in a different treatment strategy. However, we do not find any clear connection between PFP, ASA, and MVP, and migraine occurrence. Wiley Periodicals, Inc.

The Missing Link in the Pathophysiology of Vascular Cognitive Impairment: Design of the Heart-Brain Study

PubMed Central

Hooghiemstra, Astrid M.; Bertens, Anne Suzanne; Leeuwis, Anna E.; Bron, Esther E.; Bots, Michiel L.; Brunner-La Rocca, Hans-Peter; de Craen, Anton J.M.; van der Geest, Rob J.; Greving, Jacoba P.; Kappelle, L. Jaap; Niessen, Wiro J.; van Oostenbrugge, Robert J.; van Osch, Matthias J.P.; de Roos, Albert; van Rossum, Albert C.; Biessels, Geert Jan; van Buchem, Mark A.; Daemen, Mat J.A.P.; van der Flier, Wiesje M.

2017-01-01

Background Hemodynamic balance in the heart-brain axis is increasingly recognized as a crucial factor in maintaining functional and structural integrity of the brain and thereby cognitive functioning. Patients with heart failure (HF), carotid occlusive disease (COD), and vascular cognitive impairment (VCI) present themselves with complaints attributed to specific parts of the heart-brain axis, but hemodynamic changes often go beyond the part of the axis for which they primarily seek medical advice. The Heart-Brain Study hypothesizes that the hemodynamic status of the heart and the brain is an important but underestimated cause of VCI. We investigate this by studying to what extent hemodynamic changes contribute to VCI and what the mechanisms involved are. Here, we provide an overview of the design and protocol. Methods The Heart-Brain Study is a multicenter cohort study with a follow-up measurement after 2 years among 645 participants (175 VCI, 175 COD, 175 HF, and 120 controls). Enrollment criteria are the following: 1 of the 3 diseases diagnosed according to current guidelines, age ≥50 years, no magnetic resonance contraindications, ability to undergo cognitive testing, and independence in daily life. A core clinical dataset is collected including sociodemographic factors, cardiovascular risk factors, detailed neurologic, cardiac, and medical history, medication, and a physical examination. In addition, we perform standardized neuropsychological testing, cardiac, vascular and brain MRI, and blood sampling. In subsets of participants we assess Alz­heimer biomarkers in cerebrospinal fluid, and assess echocardiography and 24-hour blood pressure monitoring. Follow-up measurements after 2 years include neuropsychological testing, brain MRI, and blood samples for all participants. We use centralized state-of-the-art storage platforms for clinical and imaging data. Imaging data are processed centrally with automated standardized pipelines. Results and Conclusions The

Study of heart-brain interactions through EEG, ECG, and emotions

NASA Astrophysics Data System (ADS)

Ramasamy, Mouli; Varadan, Vijay K.

2017-04-01

Neurocardiology is the exploration of neurophysiological, neurological and neuroanatomical facets of neuroscience's influence in cardiology. The paraphernalia of emotions on the heart and brain are premeditated because of the interaction between the central and peripheral nervous system. This is an investigative attempt to study emotion based neurocardiology and the factors that influence this phenomenon. The factors include: interaction between sleep EEG (electroencephalogram) and ECG (electrocardiogram), relationship between emotion and music, psychophysiological coherence between the heart and brain, emotion recognition techniques, and biofeedback mechanisms. Emotions contribute vitally to the mundane life and are quintessential to a numerous biological and everyday-functional modality of a human being. Emotions are best represented through EEG signals, and to a certain extent, can be observed through ECG and body temperature. Confluence of medical and engineering science has enabled the monitoring and discrimination of emotions influenced by happiness, anxiety, distress, excitement and several other factors that influence the thinking patterns and the electrical activity of the brain. Similarly, HRV (Heart Rate Variability) widely investigated for its provision and discerning characteristics towards EEG and the perception in neurocardiology.

Impact of persistence and non-persistence in leisure time physical activity on coronary heart disease and all-cause mortality: The Copenhagen City Heart Study.

PubMed

Schnohr, Peter; O'Keefe, James H; Lange, Peter; Jensen, Gorm Boje; Marott, Jacob Louis

2017-10-01

Aims The aim of this study was to investigate the impact of persistence and non-persistence in leisure time physical activity on coronary heart disease and all-cause mortality. Methods and results In the Copenhagen City Heart Study, we prospectively followed 12,314 healthy subjects for 33 years of maximum follow-up with at least two repeated measures of physical activity. The association between persistence and non-persistence in leisure time physical activity, coronary heart disease and all-cause mortality were assessed by multivariable Cox regression analyses. Coronary heart disease mortality for persistent physical activity in leisure compared to persistent sedentary activity were: light hazard ratio (HR) 0.76; 95% confidence interval (CI) 0.63-0.92, moderate HR 0.52; 95% CI 0.41-0.67, and high physical activity HR 0.51; 95% CI, 0.30-0.88. The differences in longevity were 2.8 years for light, 4.5 years for moderate and 5.5 years for high physical activity. A substantial increase in physical activity was associated with lower coronary heart disease mortality (HR 0.75; 95% CI 0.52-1.08) corresponding to 2.4 years longer life, whereas a substantial decrease in physical activity was associated with higher coronary heart disease mortality (HR 1.61; 95% CI 1.11-2.33) corresponding to 4.2 years shorter life than the unchanged group. A similar pattern was observed for all-cause mortality. Conclusion We found inverse dose-response relationships between persistent leisure time physical activity and both coronary heart disease and all-cause mortality. A substantial increase in physical activity was associated with a significant gain in longevity, whereas a decrease in physical activity was associated with even greater loss of longevity.

Emotions, the meaning of food and heart failure: a grounded theory study.

PubMed

Jacobsson, Anna; Pihl, Emma; Mårtensson, Jan; Fridlund, Bengt

2004-06-01

Many patients with heart failure have generalized wasting, referred to as cardiac cachexia. This leads to skeletal muscle wasting, impaired mobility, reduced functional capacity and poor prognosis. Patients with heart failure have symptoms that can affect their food intake, for example breathing difficulties, fatigue, nausea, loss of appetite, early feeling of fullness and ascites. These dietary problems and patients' nutritional status, can be significantly improved by means of simple nursing interventions. This paper reports a grounded theory study which developed a theoretical model of experiences of food and food intake among patients with heart failure. A descriptive and exploratory design, with a grounded theory analysis, was used. Data were collected in 2002 through interviews with 11 patients with heart failure. Two core categories emerged: emotions and the meaning of food. Psychosocial meaning could be associated with positive feelings of well-being, or negative feelings of sorrow. Physiological meaning could be associated with positive feelings of comfort or negative feelings of burden. Patients' experiences of food and eating changed during the development of the disease. Feelings of fatigue and lack of appetite gave rise to a feeling of deprivation because of missing both eating and the related social environment. This could lead to a loss of personal identity. Although the findings of a qualitative study cannot be generalized, they raise important clinical nursing issues. With increasingly shorter hospital stays, these problems will need to be addressed by community healthcare staff and family carers. Therefore, all healthcare professionals need knowledge about heart disease and information techniques if they are to be able to give appropriate care to this group. Ignorance about food and eating can easily lead to malnourishment, with an increased risk of the patients falling into a vicious circle. Implications of the study for health care practice and

[Risk factors for ischemic heart disease in Mexico: a case control study].

PubMed

Camacho-Hernández, R; Corona-Muñiz, I; Vázquez-Martínez, J L; Martínez-Rodríguez, F; Escobedo-de la Peña, J

1995-01-01

A case control study was developed in order to assess the strength of the association of modifiable risk factors and the occurrence of coronary heart disease in Mexicans. A total of 284 incident cases of acute myocardial infarction and 284 age and sex matched hospitalized controls were included in the study. Information was obtained in all subjects regarding socio-demographic variables, history of diabetes, hypertension, smoking, obesity and serum cholesterol. A conditional logistic regression model, showed that diabetes mellitus, hypertension, smoking, hypercholesterolemia and obesity, explained the occurrence of coronary heart disease in the studied population. The risk of an acute myocardial infarction heavily increases in the extreme levels of exposure; and this risk is six fold higher in those who daily smoke more than 20 cigarettes, and it is eight fold higher in those subjects with a serum cholesterol greater than 240 mg/dl. Due to the increase in the occurrence of coronary heart disease in Mexico, and the strength of the association observed with these modifiable risk factors, a public health program to decrease its prevalence, is justified.

Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study.

PubMed

Böhm, Michael; Borer, Jeffrey; Ford, Ian; Gonzalez-Juanatey, Jose R; Komajda, Michel; Lopez-Sendon, Jose; Reil, Jan-Christian; Swedberg, Karl; Tavazzi, Luigi

2013-01-01

We analysed the effect of ivabradine on outcomes in heart failure (HF) patients on recommended background therapies with heart rates ≥75 bpm and <75 bpm in the SHIFT trial. A cut-off value of ≥75 bpm was chosen by the EMEA for approval for the use of ivabradine in chronic heart failure. The SHIFT population was divided by baseline heart rate ≥75 or <75 bpm. The effect of ivabradine was analysed for primary composite endpoint (cardiovascular death or HF hospitalization) and other endpoints. In the ≥75 bpm group, ivabradine reduced primary endpoint (HR 0.76, 95 % CI 0.68-0.85, P < 0.0001), all-cause mortality (HR 0.83, 95 % CI, 0.72-0.96, P = 0.0109), cardiovascular mortality (HR 0.83, 95 % CI, (0.71-0.97, P = 0.0166), HF death (HR 0.61, 95 % CI, 0.46-0.81, P < 0.0006), and HF hospitalization (HR 0.70, 95 % CI, 0.61-0.80, P < 0.0001). Risk reduction depended on heart rate after 28 days, with the best protection for heart rates <60 bpm or reductions >10 bpm. None of the endpoints was significantly reduced in the <75 bpm group, though there were trends for risk reductions in HF death and hospitalization for heart rate <60 bpm and reductions >10 bpm. Ivabradine was tolerated similarly in both groups. The effect of ivabradine on outcomes is greater in patients with heart rate ≥75 bpm with heart rates achieved <60 bpm or heart rate reductions >10 bpm predicting best risk reduction. Our findings emphasize the importance of identification of high-risk HF patients by high heart rates and their treatment with heart rate-lowering drugs such as ivabradine.

Cost-effectiveness of homograft heart valve replacement surgery: an introductory study.

PubMed

Yaghoubi, Mohsen; Aghayan, Hamid Reza; Arjmand, Babak; Emami-Razavi, Seyed Hassan

2011-05-01

The clinical effectiveness of heart valve replacement surgery has been well documented. Mechanical and homograft valves are used routinely for replacement of damaged heart valves. Homograft valves are produced in our country but we import the mechanical valves. To our knowledge the cost-effectiveness of homograft valve has not been assessed. The objective of the present study was to compare the cost-effectiveness of homograft valve replacement with mechanical valve replacement surgery. Our samples were selected from 200 patients that underwent homograft and mechanical heart valve replacement surgery in Imam-Khomeini hospital (2000-2005). In each group we enrolled 30 patients. Quality of life was measured using the SF-36 questionnaire and utility was measured in quality-adjusted life years (QALYs). For each group we calculated the price of heart valve and hospitalization charges. Finally the cost-effectiveness of each treatment modalities were summarized as costs per QALYs gained. Forty male and twenty female participated in the study. The mean score of quality of life was 66.06 (SD = 9.22) in homograft group and 57.85 (SD = 11.30) in mechanical group (P < 0.05). The mean QALYs gained in homograft group was 0.67 more than mechanical group. The incremental cost-effectiveness ratio (ICER) revealed a cost savings of 1,067 US$ for each QALY gained in homograft group. Despite limitation of this introductory study, we concluded that homograft valve replacement was more effective and less expensive than mechanical valve. These findings can encourage healthcare managers and policy makers to support the production of homograft valves and allocate more recourse for developing such activities.

Aircraft, road and railway traffic noise as risk factors for heart failure and hypertensive heart disease-A case-control study based on secondary data.

PubMed

Seidler, Andreas; Wagner, Mandy; Schubert, Melanie; Dröge, Patrik; Römer, Karin; Pons-Kühnemann, Jörn; Swart, Enno; Zeeb, Hajo; Hegewald, Janice

2016-11-01

Several studies point to an elevated risk for cardiovascular diseases induced by traffic noise. We examined the association between aircraft, road traffic and railway noise and heart failure or hypertensive heart disease (HHD) in a large case-control study. The study population consisted of individuals that were insured by three large statutory health insurance funds in the Rhine-Main area of Germany. Based on insurance claims and prescription data, 104,145 cases of heart failure or HHD diagnosed 2006-10 were identified and compared with 654,172 control subjects. Address-specific exposure to aircraft, road and railway traffic noise in 2005 was estimated. Odds Ratios were calculated using logistic regression analysis, adjusted for age, sex, local proportion of persons receiving unemployment benefits, and individual socioeconomic status (available for 39% of the individuals). A statistically significant linear exposure-risk relationship with heart failure or hypertensive heart disease was found for aircraft traffic noise (1.6% risk increase per 10dB increase in the 24-h continuous noise level; 95% CI 0.3-3.0%), road traffic noise (2.4% per 10dB; 95% CI 1.6-3.2%), and railway noise (3.1% per 10dB; 95% CI 2.2-4.1%). For individuals with 24-h continuous aircraft noise levels <40dB and nightly maximum aircraft noise levels exceeding 50dB six or more times, a significantly increased risk was observed. In general, risks of HHD were considerably higher than the risks of heart failure. Regarding the high prevalence of traffic noise from various sources, even low risk increases for frequent diseases are relevant for the population as a whole. Copyright © 2016 Elsevier GmbH. All rights reserved.

Hormones and heart disease.

PubMed

Kent, S

1979-06-01

Because the advantage that women have over men in a lower heart attack rate is gradually lost after menopause, it has been suggested that estrogen may exert a protective effect against heart disease. The situation is complex, and the available data are open to various interpretations. Available data show a gradual, predictable increase in the death rate from heart disease among women with advancing age, despite the apparent increase in cardiovascular events around the time of menopause. This suggests that men may be particularly susceptible to heart disease, rather than that women have an immunity to the disease. The theory that estrogen exerts a protective effect against heart disease was examined when men who had had heart attacks were treated with estrogen in the Coronary Drug Project. The practice was discontinued when it was found that men receiving estrogen had an elevated incidence of myocardial infarction, a finding that suggests that estrogen may promote heart disease. Additional evidence that estrogen may have a harmful effect on the cardiovascular system comes from a recent study by Gerald B. Phillips who found that men who had suffered heart attacks before age 43 had higher levels of estradiol in their blood than men who had not had heart attacks. A noteworthy finding from th e Framingham study was the fact that the relative risk of cardiovascular events in postmenopausal compared with premenopausal women seemed to decrease with age. Hans Selye identifies stress as "the final, decisive eliciting factor" in precipitating heart attack. Broda O. Barnes also maintains that stress is a major cause of heart attack, but adds that most stress-prone individuals suffer from thyroid deficiency, which is the underlying cause of their increased susceptibility to heart attacks.

Heart Disease

MedlinePlus

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Responding to a Social Studies Classic--"Decision Making: The Heart of Social Studies Instruction"

ERIC Educational Resources Information Center

Gerwin, David

2003-01-01

In 1960, Shirley Engle published an article in "Social Education," entitled "Decision Making: The Heart of Social Studies Instruction," that he hoped would end the conflict over a definition of social studies. He argued that social studies instruction should emphasize decision making in two senses: first, as a decision about the meaning of data…

Zebrafish heart as a model to study the integrative autonomic control of pacemaker function

PubMed Central

Stoyek, Matthew R.; Quinn, T. Alexander; Croll, Roger P.

2016-01-01

The cardiac pacemaker sets the heart's primary rate, with pacemaker discharge controlled by the autonomic nervous system through intracardiac ganglia. A fundamental issue in understanding the relationship between neural activity and cardiac chronotropy is the identification of neuronal populations that control pacemaker cells. To date, most studies of neurocardiac control have been done in mammalian species, where neurons are embedded in and distributed throughout the heart, so they are largely inaccessible for whole-organ, integrative studies. Here, we establish the isolated, innervated zebrafish heart as a novel alternative model for studies of autonomic control of heart rate. Stimulation of individual cardiac vagosympathetic nerve trunks evoked bradycardia (parasympathetic activation) and tachycardia (sympathetic activation). Simultaneous stimulation of both vagosympathetic nerve trunks evoked a summative effect. Effects of nerve stimulation were mimicked by direct application of cholinergic and adrenergic agents. Optical mapping of electrical activity confirmed the sinoatrial region as the site of origin of normal pacemaker activity and identified a secondary pacemaker in the atrioventricular region. Strong vagosympathetic nerve stimulation resulted in a shift in the origin of initial excitation from the sinoatrial pacemaker to the atrioventricular pacemaker. Putative pacemaker cells in the sinoatrial and atrioventricular regions expressed adrenergic β2 and cholinergic muscarinic type 2 receptors. Collectively, we have demonstrated that the zebrafish heart contains the accepted hallmarks of vertebrate cardiac control, establishing this preparation as a viable model for studies of integrative physiological control of cardiac function by intracardiac neurons. PMID:27342878

The Faber–Jackson relation and Fundamental Plane from halo abundance matching

DOE PAGES

Desmond, Harry; Wechsler, Risa H.

2016-11-02

The Fundamental Plane (FP) describes the relation between the stellar mass, size, and velocity dispersion of elliptical galaxies; the Faber–Jackson relation (FJR) is its projection on to {mass, velocity} space. In this work, we re-deploy and expand the framework of Desmond & Wechsler to ask whether abundance matching-based Λ-cold dark matter models which have shown success in matching the spatial distribution of galaxies are also capable of explaining key properties of the FJR and FP, including their scatter. Within our framework, agreement with the normalization of the FJR requires haloes to expand in response to disc formation. We find thatmore » the tilt of the FP may be explained by a combination of the observed non-homology in galaxy structure and the variation in mass-to-light ratio produced by abundance matching with a universal initial mass function, provided that the anisotropy of stellar motions is taken into account. However, the predicted scatter around the FP is considerably increased by situating galaxies in cosmologically motivated haloes due to the variations in halo properties at fixed stellar mass and appears to exceed that of the data. Finally, this implies that additional correlations between galaxy and halo variables may be required to fully reconcile these models with elliptical galaxy scaling relations.« less

Heart Rate Dynamics During A Treadmill Cardiopulmonary Exercise Test in Optimized Beta-Blocked Heart Failure Patients

PubMed Central

Carvalho, Vitor Oliveira; Guimarães, Guilherme Veiga; Ciolac, Emmanuel Gomes; Bocchi, Edimar Alcides

2008-01-01

BACKGROUND Calculating the maximum heart rate for age is one method to characterize the maximum effort of an individual. Although this method is commonly used, little is known about heart rate dynamics in optimized beta-blocked heart failure patients. AIM The aim of this study was to evaluate heart rate dynamics (basal, peak and % heart rate increase) in optimized beta-blocked heart failure patients compared to sedentary, normal individuals (controls) during a treadmill cardiopulmonary exercise test. METHODS Twenty-five heart failure patients (49±11 years, 76% male), with an average LVEF of 30±7%, and fourteen controls were included in the study. Patients with atrial fibrillation, a pacemaker or noncardiovascular functional limitations or whose drug therapy was not optimized were excluded. Optimization was considered to be 50 mg/day or more of carvedilol, with a basal heart rate between 50 to 60 bpm that was maintained for 3 months. RESULTS Basal heart rate was lower in heart failure patients (57±3 bpm) compared to controls (89±14 bpm; p<0.0001). Similarly, the peak heart rate (% maximum predicted for age) was lower in HF patients (65.4±11.1%) compared to controls (98.6±2.2; p<0.0001). Maximum respiratory exchange ratio did not differ between the groups (1.2±0.5 for controls and 1.15±1 for heart failure patients; p=0.42). All controls reached the maximum heart rate for their age, while no patients in the heart failure group reached the maximum. Moreover, the % increase of heart rate from rest to peak exercise between heart failure (48±9%) and control (53±8%) was not different (p=0.157). CONCLUSION No patient in the heart failure group reached the maximum heart rate for their age during a treadmill cardiopulmonary exercise test, despite the fact that the percentage increase of heart rate was similar to sedentary normal subjects. A heart rate increase in optimized beta-blocked heart failure patients during cardiopulmonary exercise test over 65% of the

Heart transplantation in adults with congenital heart disease.

PubMed

Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

2017-05-01

With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes. Copyright © 2017. Published by Elsevier Masson SAS.

Fitbit Charge HR Wireless Heart Rate Monitor: Validation Study Conducted Under Free-Living Conditions.

PubMed

Gorny, Alexander Wilhelm; Liew, Seaw Jia; Tan, Chuen Seng; Müller-Riemenschneider, Falk

2017-10-20

Many modern smart watches and activity trackers feature an optical sensor that estimates the wearer's heart rate. Recent studies have evaluated the performance of these consumer devices in the laboratory. The objective of our study was to examine the accuracy and sensitivity of a common wrist-worn tracker device in measuring heart rates and detecting 1-min bouts of moderate to vigorous physical activity (MVPA) under free-living conditions. Ten healthy volunteers were recruited from a large university in Singapore to participate in a limited field test, followed by a month of continuous data collection. During the field test, each participant would wear one Fitbit Charge HR activity tracker and one Polar H6 heart rate monitor. Fitbit measures were accessed at 1-min intervals, while Polar readings were available for 10-s intervals. We derived intraclass correlation coefficients (ICCs) for individual participants comparing heart rate estimates. We applied Centers for Disease Control and Prevention heart rate zone cut-offs to ascertain the sensitivity and specificity of Fitbit in identifying 1-min epochs falling into MVPA heart rate zone. We collected paired heart rate data for 2509 1-min epochs in 10 individuals under free-living conditions of 3 to 6 hours. The overall ICC comparing 1-min Fitbit measures with average 10-s Polar H6 measures for the same epoch was .83 (95% CI .63-.91). On average, the Fitbit tracker underestimated heart rate measures by -5.96 bpm (standard error, SE=0.18). At the low intensity heart rate zone, the underestimate was smaller at -4.22 bpm (SE=0.15). This underestimate grew to -16.2 bpm (SE=0.74) in the MVPA heart rate zone. Fitbit devices detected 52.9% (192/363) of MVPA heart rate zone epochs correctly. Positive and negative predictive values were 86.1% (192/223) and 92.52% (2115/2286), respectively. During subsequent 1 month of continuous data collection (270 person-days), only 3.9% of 1-min epochs could be categorized as MVPA according

Quality of Life for Saudi Patients With Heart Failure: A Cross-Sectional Correlational Study.

PubMed

AbuRuz, Mohannad Eid; Alaloul, Fawwaz; Saifan, Ahmed; Masa'deh, Rami; Abusalem, Said

2015-06-25

Heart failure is a major public health issue and a growing concern in developing countries, including Saudi Arabia. Most related research was conducted in Western cultures and may have limited applicability for individuals in Saudi Arabia. Thus, this study assesses the quality of life of Saudi patients with heart failure. A cross-sectional correlational design was used on a convenient sample of 103 patients with heart failure. Data were collected using the Short Form-36 and the Medical Outcomes Study-Social Support Survey. Overall, the patients' scores were low for all domains of Quality of Life. The Physical Component Summary and Mental Component Summary mean scores and SDs were (36.7±12.4, 48.8±6.5) respectively, indicating poor Quality of Life. Left ventricular ejection fraction was the strongest predictor of both physical and mental summaries. Identifying factors that impact quality of life for Saudi heart failure patients is important in identifying and meeting their physical and psychosocial needs.

Theory of heart

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

Glass, L.; Hunter, P.; McCulloch, A.

1991-01-01

In recent years there has been a growth in interest in studying the heart from the perspective of the physical sciences: mechanics, fluid flow, electromechanics. This volume is the result of a workshop held in July 1989 at the Institute for Nonlinear Sciences at the University of California at San Diego that brought together scientists and clinicians with graduate students and postdoctoral fellows who share an interest in the heart. The chapters were prepared by the invited speakers as didactic reviews of their subjects but also include up-to-date results in their fields. Topics covered include the structure, mechanical properties, andmore » function of the heart and the myocardium, electrical activity of the heart and myocardium, and mathematical models of heart function. Individual chapters are abstracted separately.« less

The relationship between calcium intake, obesity, and cardiovascular disease risk factors: the jackson heart study

USDA-ARS?s Scientific Manuscript database

Cardiovascular disease (CVD) is a major health risk in the United States. Major indicators of CVD risk include obesity, blood lipids, and blood pressure. Modifiable risk factors associated with CVD include body composition (body mass index and waist circumference), serum lipids, and blood pressure. ...

Women's Heart Disease: Heart Attack Symptoms

MedlinePlus

... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

Heart rate as an independent risk factor in patients with multiple organ dysfunction: a prospective, observational study.

PubMed

Hoke, Robert S; Müller-Werdan, Ursula; Lautenschläger, Christine; Werdan, Karl; Ebelt, Henning

2012-02-01

To study the association between baseline heart rate and outcome in patients with multiple organ dysfunction (MODS) as well as the course of heart rate over the first 4 days during MODS. Prospective observational study in 89 patients with MODS, defined as an APACHE-II score ≥20. Baseline heart rate (HR(0)) was determined over a 60-minute period at the time of MODS diagnosis. 28-day all-cause mortality was the primary endpoint of the study, a fall of the APACHE-II score by 4 points or more from day 0 to day 4 constituted the secondary endpoint. Hazard ratios for heart rate of 90 beats per minute (bpm) or greater relative to less than 90 bpm were calculated using Cox proportional hazards model and adjusted for confounding variables. Median baseline heart rate was 83 bpm in survivors and 92 bpm in non-survivors (p = 0.048). 28-day mortality was 32 and 61% in patients with HR(0) < 90 bpm and HR(0) ≥ 90 bpm, respectively. The adjusted hazard ratio for 28-day mortality was 2.30 (95% confidence interval 1.21-4.36, p = 0.001) for HR(0) ≥ 90 bpm relative to HR(0) < 90 bpm. No correlation was found between baseline heart rate and the secondary endpoint. From day 0 to day 4, heart rate remained elevated in all patients, as well as in survivors and non-survivors. A heart rate ≥90 bpm at the time of MODS diagnosis is an independent risk factor for increased 28-day mortality. As in patients with cardiovascular conditions such as coronary heart disease or chronic heart failure, heart rate might constitute a target for heart rate-lowering therapy in the narrow initial treatment window of MODS.

Coronary heart disease incidence in sleep disordered breathing: the Wisconsin Sleep Cohort Study.

PubMed

Hla, Khin Mae; Young, Terry; Hagen, Erika W; Stein, James H; Finn, Laurel A; Nieto, F Javier; Peppard, Paul E

2015-05-01

The aim of the study was to determine the association of objectively measured sleep disordered breathing (SDB) with incident coronary heart disease (CHD) or heart failure (HF) in a nonclinical population. Longitudinal analysis of a community-dwelling cohort followed up to 24 y. Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospital and Clinics. There were 1,131 adults who completed one or more overnight polysomnography studies, were free of CHD or HF at baseline, were not treated by continuous positive airway pressure (CPAP), and followed over 24 y. None. In-laboratory overnight polysomnography was used to assess SDB, defined by the apnea-hypopnea index (AHI) using apnea and hypopnea events per hour of sleep. Incident CHD or HF was defined by new reports of myocardial infarction, coronary revascularization procedures, congestive heart failure, and cardiovascular deaths. We used baseline AHI as the predictor variable in survival analysis models predicting CHD or HF incidence adjusted for traditional confounders. The incidence of CHD or HF was 10.9/1,000 person-years. The mean time to event was 11.2 ± 5.8 y. After adjusting for age, sex, body mass index, and smoking, estimated hazard ratios (95% confidence interval) of incident CHD or HF were 1.5 (0.9-2.6) for AHI > 0-5, 1.9 (1.05-3.5) for AHI 5 ≤ 15, 1.8 (0.85-4.0) for AHI 15 ≤ 30, and 2.6 (1.1-6.1) for AHI > 30 compared to AHI = 0 (P trend = 0.02). Participants with untreated severe sleep disordered breathing (AHI > 30) were 2.6 times more likely to have an incident coronary heart disease or heart failure compared to those without sleep disordered breathing. Our findings support the postulated adverse effects of sleep disordered breathing on coronary heart disease and heart failure. © 2015 Associated Professional Sleep Societies, LLC.

The first multicenter, randomized, controlled trial of home telemonitoring for Japanese patients with heart failure: home telemonitoring study for patients with heart failure (HOMES-HF).

PubMed

Kotooka, Norihiko; Kitakaze, Masafumi; Nagashima, Kengo; Asaka, Machiko; Kinugasa, Yoshiharu; Nochioka, Kotaro; Mizuno, Atsushi; Nagatomo, Daisuke; Mine, Daigo; Yamada, Yoko; Kuratomi, Akiko; Okada, Norihiro; Fujimatsu, Daisuke; Kuwahata, So; Toyoda, Shigeru; Hirotani, Shin-Ichi; Komori, Takahiro; Eguchi, Kazuo; Kario, Kazuomi; Inomata, Takayuki; Sugi, Kaoru; Yamamoto, Kazuhiro; Tsutsui, Hiroyuki; Masuyama, Tohru; Shimokawa, Hiroaki; Momomura, Shin-Ichi; Seino, Yoshihiko; Sato, Yasunori; Inoue, Teruo; Node, Koichi

2018-02-15

Home telemonitoring is becoming more important to home medical care for patients with heart failure. Since there are no data on home telemonitoring for Japanese patients with heart failure, we investigated its effect on cardiovascular outcomes. The HOMES-HF study was the first multicenter, open-label, randomized, controlled trial (RCT) to elucidate the effectiveness of home telemonitoring of physiological data, such as body weight, blood pressure, and pulse rate, for Japanese patients with heart failure (UMIN Clinical Trials Registry 000006839). The primary end-point was a composite of all-cause death or rehospitalization due to worsening heart failure. We analyzed 181 recently hospitalized patients with heart failure who were randomly assigned to a telemonitoring group (n = 90) or a usual care group (n = 91). The mean follow-up period was 15 (range 0-31) months. There was no statistically significant difference in the primary end-point between groups [hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.548-1.648; p = 0.572]. Home telemonitoring for Japanese patients with heart failure was feasible; however, beneficial effects in addition to those of usual care were not demonstrated. Further investigation of more patients with severe heart failure, participation of home medical care providers, and use of a more integrated home telemonitoring system emphasizing communication as well as monitoring of symptoms and physiological data are required.

Heart Transplant in Patients with Predominantly Rheumatic Valvular Heart Disease.

PubMed

Rosa, Vitor E E; Lopes, Antonio S S A; Accorsi, Tarso A D; Fernandes, Joao Ricardo C; Spina, Guilherme S; Sampaio, Roney O; Bacal, Fernando; Tarasoutchi, Flavio

2015-09-01

International records indicate that only 2.6% of patients with heart transplants have valvular heart disease. The study aim was to evaluate the epidemiological and clinical profile of patients with valvular heart disease undergoing heart transplantation. Between 1985 and 2013, a total of 569 heart transplants was performed at the authors' institution. Twenty patients (13 men, seven women; mean age 39.5 +/- 15.2 years) underwent heart transplant due to structural (primary) valvular disease. Analyses were made of the patients' clinical profile, laboratory data, echocardiographic and histopathological data, and mortality and rejection. Of the patients, 18 (90%) had a rheumatic etiology, with 85% having undergone previous valve surgery (45% had one or more operations), and 95% with a normal functioning valve prosthesis at the time of transplantation. Atrial fibrillation was present in seven patients (35%), while nine (45%) were in NYHA functional class IV and eight (40%) in class III. The indication for cardiac transplantation was refractory heart failure in seven patients (35%) and persistent NYHA class III/IV in ten (50%). The mean left ventricular ejection fraction (LVEF) was 26.6 +/- 7.9%. The one-year mortality was 20%. Histological examination of the recipients' hearts showed five (27.7%) to have reactivated rheumatic myocarditis without prior diagnosis at the time of transplantation. Univariate analysis showed that age, gender, LVEF, rheumatic activity and rejection were not associated with mortality at one year. Among the present patient cohort, rheumatic heart disease was the leading cause of heart transplantation, and a significant proportion of these patients had reactivated myocarditis diagnosed in the histological analyses. Thus, it appears valid to investigate the existence of rheumatic activity, especially in valvular cardiomyopathy with severe systolic dysfunction before transplantation.

Heart murmurs

MedlinePlus

Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

Early illness experiences related to unexpected heart surgery: A qualitative descriptive study.

PubMed

Chang, Yu-Ling; Tsai, Yun-Fang

2017-09-01

Most studies on patients' experiences following emergency cardiac surgery focus on evaluation of patients after their discharge. Few studies have evaluated patients' experiences after being transferred from intensive care and before being discharged. This study aimed to describe patients' experiences in the early stages of recovery following emergency heart surgery. For this exploratory qualitative descriptive study, 13 patients were recruited from a medical centre in northern Taiwan. Participants had undergone emergency heart surgery and had resided in the cardiothoracic surgical ward for ≥6 days following transfer from the ICU; all expected to be discharged from the hospital within 3 days. Semi-structured, face-to-face interviews were conducted in private after the patients had been transferred to the cardiothoracic surgical wards. Audiotaped interviews were transcribed and analysed using content analysis. Data analysis identified four themes, which represented different recovery stages: sudden and serious symptoms, nightmares and vivid dreams, physical and emotional disturbances, and establishing a new life after emergency surgery. A fifth theme, support for a new lifestyle, occurred between the four stages. Participants experienced symptoms of physical and psychological stress during the early recovery stages following emergency heart surgery. A lack of understanding of the process of recovery increased these difficulties; participants wanted and needed multidisciplinary care and education. Emergency heart surgery does not allow healthcare professionals to inform patients of what to expect post-surgery. Our findings suggest that rather than waiting until discharge to offer disease information and treatment plans, multidisciplinary care should be initiated as soon as possible to facilitate recovery. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

[Respiratory infections, Down's syndrome and congenital heart disease: the CIVIC 21 study].

PubMed

Medrano López, C; García-Guereta Silva, L; Lirio Casero, J; García Pérez, J

2009-07-01

We compare hospitalisation rates for acute respiratory tract infection in children younger than 24 months with significant congenital heart disease without Down's syndrome with those with Down's syndrome with or without congenital heart disease. This was an epidemiological, multicentre (53 Spanish hospitals), observational and prospective study, from October 2006 to April 2007. A total of 1085 patients were followed-up, of which 806 did not have Down's syndrome and 279 with Down's syndrome: 135 with significant, 38 with non significant and 105 without congenital heart disease. A total of 147 patients (13.1%; 95% CI, 11.2-15.2%) required hospitalisation due to respiratory infection. Rates in patients without and with Down's syndrome were 11% vs 19.1%. In the Down's group, 26.3% had no significant, a 23% had significant and 11.4% had no congenital heart disease. The main diagnosis was bronchiolitis (59.4%). An infectious agent was found in 36.2% cases. The specific admission rate due to respiratory syncytial virus was 4.4%, with differences in children without vs with Down's syndrome (3.2% vs 7.8%). In the Down's patients we found rates of 15.8%, 9.3% and 3% in the non-significant, significant and no congenital heart disease. Immunoprophylaxis against respiratory syncytial virus rates were 83.4% vs 39.9% in no Down's versus Down's syndrome patients. No differences were found in hospital stay or the severity. Hospital admission rates due to respiratory infection, and specifically respiratory syncytial virus, were higher in the Down's patients, particularly in the group with no significant congenital heart disease and low immunoprophylaxis against respiratory syncytial virus.

Prospective Heart Tracking for Whole-heart Magnetic Resonance Angiography

PubMed Central

Moghari, Mehdi H.; Geva, Tal; Powell, Andrew J.

2015-01-01

Purpose To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced 3D inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. Methods With Heart-NAV, 1 of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its 1-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10 mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5 mm acceptance window. Results For non-contrast whole-heart MRA with both the 5 and 10 mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p<0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Conclusion Compared to a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. PMID:26843458

Heart Failure in Women

PubMed Central

Bozkurt, Biykem; Khalaf, Shaden

2017-01-01

Heart failure is an important cause of morbidity and mortality in women, and they tend to develop it at an older age compared to men. Heart failure with preserved ejection fraction is more common in women than in men and accounts for at least half the cases of heart failure in women. When comparing men and women who have heart failure and a low left ventricular ejection fraction, the women are more symptomatic and have a similarly poor outcome. Overall recommendations for guideline-directed medical therapies show no differences in treatment approaches between men and women. Overall, women are generally underrepresented in clinical trials for heart failure. Further studies are needed to shed light into different mechanisms, causes, and targeted therapies of heart failure in women. PMID:29744014

Progression of Coronary Artery Calcium and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis.

PubMed

Bakhshi, Hooman; Ambale-Venkatesh, Bharath; Yang, Xiaoying; Ostovaneh, Mohammad R; Wu, Colin O; Budoff, Matthew; Bahrami, Hossein; Wong, Nathan D; Bluemke, David A; Lima, João A C

2017-04-20

Although the association between coronary artery calcium (CAC) and future heart failure (HF) has been shown previously, the value of CAC progression in the prediction of HF has not been investigated. In this study, we investigated the association of CAC progression with subclinical left ventricular (LV) dysfunction and incident HF in the Multi-Ethnic Study of Atherosclerosis. The Multi-Ethnic Study of Atherosclerosis is a population-based study consisting of 6814 men and women aged 45 to 84, free of overt cardiovascular disease at enrollment, who were recruited from 4 ethnicities. We included 5644 Multi-Ethnic Study of Atherosclerosis participants who had baseline and follow-up cardiac computed tomography and were free of HF and coronary heart disease before the second cardiac computed tomography. Mean (±SD) age was 61.7±10.2 years and 47.2% were male. The Cox proportional hazard models and multivariable linear regression models were deployed to determine the association of CAC progression with incident HF and subclinical LV dysfunction, respectively. Over a median follow-up of 9.6 (interquartile range: 8.8-10.6) years, 182 participants developed incident HF. CAC progression of 10 units per year was associated with 3% of increased risk of HF independent of overt coronary heart disease ( P =0.008). In 2818 participants with available cardiac magnetic resonance images, CAC progression was associated with increased LV end diastolic volume (β=0.16; P =0.03) and LV end systolic volume (β=0.12; P =0.006) after excluding participants with any coronary heart disease. CAC progression was associated with incident HF and modestly increased LV end diastolic volume and LV end systolic volume at follow-up exam independent of overt coronary heart disease. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Music and the heart.

PubMed

Koelsch, Stefan; Jäncke, Lutz

2015-11-21

Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Prospective heart tracking for whole-heart magnetic resonance angiography.

PubMed

Moghari, Mehdi H; Geva, Tal; Powell, Andrew J

2017-02-01

To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced three-dimensional (3D) inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. With Heart-NAV, one of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its one-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10-mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5-mm acceptance window. For non-contrast whole-heart MRA with both the 5 and 10-mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p < 0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Compared with a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. Magn Reson Med 77:759-765, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Quality of Life for Saudi Patients With Heart Failure: A Cross-Sectional Correlational Study

PubMed Central

AbuRuz, Mohannad Eid; Alaloul, Fawwaz; Saifan, Ahmed; Masa’Deh, Rami; Abusalem, Said

2016-01-01

Introduction: Heart failure is a major public health issue and a growing concern in developing countries, including Saudi Arabia. Most related research was conducted in Western cultures and may have limited applicability for individuals in Saudi Arabia. Thus, this study assesses the quality of life of Saudi patients with heart failure. Materials and Methods: A cross-sectional correlational design was used on a convenient sample of 103 patients with heart failure. Data were collected using the Short Form-36 and the Medical Outcomes Study-Social Support Survey. Results: Overall, the patients’ scores were low for all domains of Quality of Life. The Physical Component Summary and Mental Component Summary mean scores and SDs were (36.7±12.4, 48.8±6.5) respectively, indicating poor Quality of Life. Left ventricular ejection fraction was the strongest predictor of both physical and mental summaries. Conclusion: Identifying factors that impact quality of life for Saudi heart failure patients is important in identifying and meeting their physical and psychosocial needs. PMID:26493415

Optimization of pharmacotherapy in chronic heart failure: is heart rate adequately addressed?

PubMed

Franke, Jennifer; Wolter, Jan Sebastian; Meme, Lillian; Keppler, Jeannette; Tschierschke, Ramon; Katus, Hugo A; Zugck, Christian

2013-01-01

The aim of the study is to evaluate the use of beta-blockers in chronic heart failure (CHF) and the extent of heart rate reduction achieved in clinical practice and to determine differences in outcome of patients who fulfilled select inclusion criteria of the SHIFT study according to resting heart rate modulated by beta-blocker therapy. We evaluated an all-comer population of our dedicated CHF outpatient clinic between 2006 and 2010. For inclusion, individually optimized doses of guideline-recommended pharmacotherapy including beta-blockers had to be maintained for at least 3 months and routine follow-up performed at our outpatient CHF-clinic thereafter. Treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate were assessed. The outcome of patients who fulfilled select inclusion criteria of the SHIFT study (left-ventricular ejection fraction (LVEF) ≤35 %, sinus rhythm, NYHA II-IV) and were followed-up for at least 1 year was stratified according to resting heart rates: ≥75 versus <75 bpm and ≥70 versus <70 bpm. The composite primary endpoint was defined as all-cause death or hospital admission for worsening heart failure during 12-month follow-up. In total, 3,181 patients were assessed in regard to treatment dosages of beta-blockers, and demographic and clinical profiles including resting heart rate. Of the overall studied population, 443 patients fulfilled all inclusion criteria and entered outcome analysis. Median observation time of survivors was 27.5 months with 1,039.7 observation-years in total. Up-titration to at least half the evidence-based target dose of beta-blockers was achieved in 69 % and full up-titration in 29 % of these patients. Patients with increased heart rates were younger, more often male, exhibited a higher NYHA functional class and lower LVEF. The primary endpoint occurred in 21 % of patients in the ≥70 bpm group versus 9 % of patients in the group with heart rates <70�

Parental overprotection and heart-focused anxiety in adults with congenital heart disease.

PubMed

Ong, Lephuong; Nolan, Robert P; Irvine, Jane; Kovacs, Adrienne H

2011-09-01

The care of adult patients with congenital heart disease (CHD) is challenging from a mental health perspective, as these patients continue to face a variety of biopsychosocial issues that may impact emotional functioning. Despite these issues, there are limited data on the psychosocial functioning of adults with CHD, and there are no data on the impact of parental overprotection on heart-focused anxiety in this patient population. The aim of this study was to examine the relationships between patient recollections of parental overprotection and current heart-focused anxiety in adults with CHD. A cross-sectional sample of 190 adult patients with CHD (51% male; mean age = 32.28, SD = 11.86 years) completed validated measures of perceived parental overprotection (Parental Bonding Instrument) and heart-focused anxiety (Cardiac Anxiety Questionnaire). The results indicated that perceived parental overprotection (β = 0.19, p = 0.02) and heart defect complexity (β = 0.17, p = 0.03) were significantly related to heart-focused anxiety. Contrary to hypotheses, perceived parental overprotection did not vary as a function of heart defect complexity (F (2, 169) = 0.02, p = 0.98). Perceived parental overprotection and heart defect complexity are associated with heart-focused anxiety in adults with congenital heart disease. These results can inform the development of clinical interventions aimed at improving the psychosocial adjustment of this patient population.

Heart Failure

MedlinePlus

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

Defective support network: a major obstacle to coping for patients with heart failure: a qualitative study

PubMed Central

Shahrbabaki, Parvin Mangolian; Nouhi, Esmat; Kazemi, Majid; Ahmadi, Fazlollah

2016-01-01

Background Heart failure as a chronic disease poses many challenges for a patient in his or her everyday life. Support in various aspects of life positively affects coping strategies and influences the well-being and health outcomes of heart failure patients. Inadequate support may lead to a worsening of symptoms, increased hospital readmissions, psychological disorders, and a reduced quality of life. Objective This study explored obstacles to coping related to support for heart failure patients as viewed by the patients themselves and their family members and caregivers. Design This qualitative study was conducted using content analysis. The 20 Iranian participants included 11 patients with heart failure, three cardiologists, three nurses, and three family members of heart failure patients selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results During data analysis, ‘defective support network’ developed as the main theme along with four other categories of ‘inadequate family performance’, ‘inadequate support by the healthcare team’, ‘distorted societal social support’, and ‘inadequate welfare support’. Conclusion The findings of the current study can assist health authorities and planners in identifying the needs of patients with heart failure so as to focus and plan on facilitating their coping as much as possible by obviating the existing obstacles. PMID:27041539

Heart MRI

MedlinePlus

Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

Transformation Concepts for National Security in the 21st Century

DTIC Science & Technology

2002-09-01

The famous Confederate General Stonewall Jackson noted that To move swiftly, strike vigorously, and secure all the fruits of the victory is the ... secret of successful war. This observation is at the very heart of the current discussion and experimentation on how the transformed joint services of the

Forkhead box transcription factors in embryonic heart development and congenital heart disease.

PubMed

Zhu, Hong

2016-01-01

Embryonic heart development is a very complicated process regulated precisely by a network composed of many genes and signaling pathways in time and space. Forkhead box (Fox, FOX) proteins are a family of transcription factors characterized by the presence of an evolutionary conserved "forkhead"or "winged-helix" DNA-binding domain and able to organize temporal and spatial gene expression during development. They are involved in a wide variety of cellular processes, such as cell cycle progression, proliferation, differentiation, migration, metabolism and DNA damage response. An abundance of studies in model organisms and systems has established that Foxa2, Foxc1/c2, Foxh1 and Foxm1, Foxos and Foxps are important components of the signaling pathways that instruct cardiogenesis and embryonic heart development, playing paramount roles in heart development. The previous studies also have demonstrated that mutations in some of the forkhead box genes and the aberrant expression of forkhead box gene are heavily implicated in the congenital heart disease (CHD) of humans. This review primarily focuses on the current understanding of heart development regulated by forkhead box transcription factors and molecular genetic mechanisms by which forkhead box factors modulate heart development during embryogenesis and organogenesis. This review also summarizes human CHD related mutations in forkhead box genes as well as the abnormal expression of forkhead box gene, and discusses additional possible regulatory mechanisms of the forkhead box genes during embryonic heart development that warrant further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

Therapeutic patient education in heart failure: do studies provide sufficient information about the educational programme?

PubMed

Albano, Maria Grazia; Jourdain, Patrick; De Andrade, Vincent; Domenke, Aukse; Desnos, Michel; d'Ivernois, Jean-François

2014-05-01

Therapeutic patient education programmes on heart failure have been widely proposed for many years for heart failure patients, but their efficiency remains questionable, partly because most articles lack a precise programme description, which makes comparative analysis of the studies difficult. To analyse the degree of precision in describing therapeutic patient education programmes in recent randomized controlled trials. Three major recent recommendations on therapeutic patient education in heart failure inspired us to compile a list of 23 relevant items that an 'ideal' description of a therapeutic patient education programme should contain. To discover the extent to which recent studies into therapeutic patient education in heart failure included these items, we analysed 19 randomized controlled trials among 448 articles published in this field from 2005 to 2012. The major elements required to describe a therapeutic patient education programme were present, but some other very important pieces of information were missing in most of the studies we analysed: the patient's educational needs, health literacy, projects, expectations regarding therapeutic patient education and psychosocial status; the educational methodology used; outcomes evaluation; and follow-up strategies. Research into how therapeutic patient education can help heart failure patients will be improved if more precise descriptions of patients, educational methodology and evaluation protocols are given by authors, ideally in a standardized format. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Heart Health: The Heart Truth Campaign 2009

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

Women's Heart Disease: Heart Disease Risk Factors

MedlinePlus

... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement

PubMed Central

Whincup, Peter H; Gilg, Julie A; Emberson, Jonathan R; Jarvis, Martin J; Feyerabend, Colin; Bryant, Andrew; Walker, Mary; Cook, Derek G

2004-01-01

Objective To examine the associations between a biomarker of overall passive exposure to tobacco smoke (serum cotinine concentration) and risk of coronary heart disease and stroke. Design Prospective population based study in general practice (the British regional heart study). Participants 4729 men in 18 towns who provided baseline blood samples (for cotinine assay) and a detailed smoking history in 1978-80. Main outcome measure Major coronary heart disease and stroke events (fatal and non-fatal) during 20 years of follow up. Results 2105 men who said they did not smoke and who had cotinine concentrations < 14.1 ng/ml were divided into four equal sized groups on the basis of cotinine concentrations. Relative hazards (95% confidence intervals) for coronary heart disease in the second (0.8-1.4 ng/ml), third (1.5-2.7 ng/ml), and fourth (2.8-14.0 ng/ml) quarters of cotinine concentration compared with the first (≥ 0.7 ng/ml) were 1.45 (1.01 to 2.08), 1.49 (1.03 to 2.14), and 1.57 (1.08 to 2.28), respectively, after adjustment for established risk factors for coronary heart disease. Hazard ratios (for cotinine 0.8-14.0 ν ≥ 0.7 ng/ml) were particularly increased during the first (3.73, 1.32 to 10.58) and second five year follow up periods (1.95, 1.09 to 3.48) compared with later periods. There was no consistent association between cotinine concentration and risk of stroke. Conclusion Studies based on reports of smoking in a partner alone seem to underestimate the risks of exposure to passive smoking. Further prospective studies relating biomarkers of passive smoking to risk of coronary heart disease are needed. PMID:15229131

Mitochondria and heart failure.

PubMed

Murray, Andrew J; Edwards, Lindsay M; Clarke, Kieran

2007-11-01

Energetic abnormalities in cardiac and skeletal muscle occur in heart failure and correlate with clinical symptoms and mortality. It is likely that the cellular mechanism leading to energetic failure involves mitochondrial dysfunction. Therefore, it is crucial to elucidate the causes of mitochondrial myopathy, in order to improve cardiac and skeletal muscle function, and hence quality of life, in heart failure patients. Recent studies identified several potential stresses that lead to mitochondrial dysfunction in heart failure. Chronically elevated plasma free fatty acid levels in heart failure are associated with decreased metabolic efficiency and cellular insulin resistance. Tissue hypoxia, resulting from low cardiac output and endothelial impairment, can lead to oxidative stress and mitochondrial DNA damage, which in turn causes dysfunction and loss of mitochondrial mass. Therapies aimed at protecting mitochondrial function have shown promise in patients and animal models with heart failure. Despite current therapies, which provide substantial benefit to patients, heart failure remains a relentlessly progressive disease, and new approaches to treatment are necessary. Novel pharmacological agents are needed that optimize substrate metabolism and maintain mitochondrial integrity, improve oxidative capacity in heart and skeletal muscle, and alleviate many of the clinical symptoms associated with heart failure.

Thromboprophylaxis for atrial arrhythmias in congenital heart disease: A multicenter study.

PubMed

Khairy, Paul; Aboulhosn, Jamil; Broberg, Craig S; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Levesque, Sylvie; Macle, Laurent; Marcotte, François; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Hamilton, Robert

2016-11-15

There is a paucity of data to guide decisions regarding thromboprophylaxis for atrial arrhythmias in congenital heart disease. A retrospective multicenter cohort study enrolled patients with documented sustained atrial arrhythmias and congenital heart disease from 12 North American centers to quantify thromboembolic and bleeding rates associated with antiplatelet and anticoagulation therapy, and explore associated factors. A blinded committee adjudicated all qualifying arrhythmias and outcomes. A total of 482 patients, 45.2% female, age 32.0±18.0years, were followed for 11.3±9.4years since the qualifying arrhythmia. Antiplatelet therapy was administered to 37.8%, anticoagulation to 54.4%, and neither to 7.9%. Congenital heart disease complexity was simple, moderate, and severe in 18.5%, 34.4%, and 47.1%, respectively. Freedom from thromboembolic events was 84.7±2.7% at 15years, with no difference between anticoagulation versus antiplatelet therapy (P=0.97). Congenital heart disease complexity was independently associated with thromboembolic events, with rates of 0.00%, 0.93%, and 1.95%/year in those with simple, moderate, and severe forms (P<0.001). CHADS 2 and CHA 2 DS 2 -VASc scores were not predictive of thromboembolic risk. Annualized bleeding rates with antiplatelet and anticoagulation therapy were 0.66% and 1.82% (P=0.039). In multivariable analyses, anticoagulation [hazard ratio (HR) 4.76, 95% CI (1.05-21.58), P=0.043] and HAS-BLED score [HR 3.15, 95% CI (1.02, 9.78), P=0.047] were independently associated with major bleeds. Current management of atrial arrhythmias in congenital heart disease is associated with a modest rate of thromboembolic events, which is predicted by disease complexity but not CHADS 2 /CHA 2 DS 2 -VASc scores. HAS-BLED score is applicable to the congenital population in predicting major bleeds. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pilot study of an Internet patient-physician communication tool for heart failure disease management.

PubMed

Wu, Robert C; Delgado, Diego; Costigan, Jeannine; Ross, Heather; MacIver, Jane

2006-01-01

Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. This pilot study evaluated the feasibility and patients' acceptability of using the Internet to communicate with patients with symptomatic heart failure. Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. Between 3 May 1999 and 1 November 2002, 62 patients (mean age 48.7 years) were enrolled. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3,386 entries out of all 5,098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient's entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3,386 comments to the Heart Function Clinic. Based on the content analysis of 100 patient entries, the following major categories of communication were identified: patient

Plasma microvesicle analysis identifies microRNA 129-5p as a biomarker of heart failure in univentricular heart disease.

PubMed

Ramachandran, Sweta; Lowenthal, Alexander; Ritner, Carissa; Lowenthal, Shiri; Bernstein, Harold S

2017-01-01

Biomarkers of heart failure in adults have been extensively studied. However, biomarkers to monitor the progression of heart failure in children with univentricular physiology are less well understood. We proposed that as mediators of diverse pathophysiology, miRNAs contained within circulating microvesicles could serve as biomarkers for the presence and progression of heart failure in univentricular patients. To test this, we studied the association of heart failure with elevations in specific miRNAs isolated from circulating microvesicles in a cohort of children with univentricular heart disease and heart failure. We conducted a single site cross-sectional observational study of 71 children aged 1 month-7 years with univentricular heart disease and heart failure. We demonstrated that levels of miR129-5p isolated from plasma microvesicles were inversely related to the degree of clinical heart failure as assessed by Ross score. We then showed that miR129-5p levels are downregulated in HL1 cells and human embryonic stem cell-derived cardiomyocytes exposed to oxidative stress. We demonstrated that bone morphogenetic protein receptor 2, which has been implicated in the development of pulmonary vascular disease, is a target of miR129-5p, and conversely regulated in response to oxidative stress in cell culture. Levels of miR129-5p were inversely related to the degree of clinical heart failure in patients with univentricular heart disease. This study demonstrates that miR129-5p is a sensitive and specific biomarker for heart failure in univentricular heart disease independent of ventricular morphology or stage of palliation. Further study is warranted to understand the targets affected by miR129-5p with the development of heart failure in patients with univentricular physiology.

Perceptions about eating experiences of low-literate older adults with heart disease: a qualitative study.

PubMed

Chen, Su-Hui; Shyu, Yea-Ing Lotus; Ko, Yu-Shien; Kung, Hsiu Ling; Shao, Jung-Hua

2016-04-01

To explore perceptions of low-literate older adults with heart disease about their eating experiences. Heart disease has been closely linked with nutrition, and nutritional status is poor in patients with limited education, but no studies have explored the eating experiences of low-literate adults with heart disease. Qualitative descriptive study. Data were collected in tape-recorded semi-structured interviews from March-June 2012. A convenience sample of 13 low-literate older adults with heart disease was recruited from a cardiovascular ward of a medical centre in northern Taiwan. Participants were recruited until findings reached saturation and data were analysed using qualitative content analysis. Analysis of participants' interview data on eating experiences identified three main categories: (1) eating-related hardships because of low literacy; (2) eating adjustments due to low literacy; and (3) misinformation about dietary modifications for heart disease. Because of their low literacy, these older adults had difficult life experiences, gained inappropriate or inadequate eating information and held a passive, fatalistic perspective about eating with heart disease. Healthcare practitioners caring for this population need to appreciate their unique eating challenges and respect their eating customs. Nurses could play a greater role in educating and supporting low-literate older adults in selecting appropriate foods and preparing meals. Strategies to help this population learn to select, prepare and cook their food should be easy and practical, using specific symbols, concrete signs and simple labels. © 2016 John Wiley & Sons Ltd.

Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation.

PubMed

Lord, P; Hansson, K; Kvart, C; Häggström, J

2010-04-01

The objective of the study was to examine the changes in vertebral heart scale, and left atrial and ventricular dimensions before and at onset of congestive heart failure in cavalier King Charles spaniels with mitral regurgitation. Records and radiographs from 24 cavalier King Charles spaniels with mitral regurgitation were used. Vertebral heart scale (24 dogs), and left atrial dimension and left ventricular end diastolic and end systolic diameters (18 dogs) and their rate of increase were measured at intervals over years to the onset of congestive heart failure. They were plotted against time to onset of congestive heart failure. Dimensions and rates of change of all parameters were highest at onset of congestive heart failure, the difference between observed and chance outcome being highly significant using a two-tailed chi-square test (P<0.001). The left heart chambers increase in size rapidly only in the last year before the onset of congestive heart failure. Increasing left ventricular end systolic dimension is suggestive of myocardial failure before the onset of congestive heart failure. Rate of increase of heart dimensions may be a useful indicator of impending congestive heart failure.

Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association.

PubMed

Doehner, Wolfram; Ural, Dilek; Haeusler, Karl Georg; Čelutkienė, Jelena; Bestetti, Reinaldo; Cavusoglu, Yuksel; Peña-Duque, Marco A; Glavas, Duska; Iacoviello, Massimo; Laufs, Ulrich; Alvear, Ricardo Marmol; Mbakwem, Amam; Piepoli, Massimo F; Rosen, Stuart D; Tsivgoulis, Georgios; Vitale, Cristiana; Yilmaz, M Birhan; Anker, Stefan D; Filippatos, Gerasimos; Seferovic, Petar; Coats, Andrew J S; Ruschitzka, Frank

2018-02-01

Heart failure (HF) is a complex clinical syndrome with multiple interactions between the failing myocardium and cerebral (dys-)functions. Bi-directional feedback interactions between the heart and the brain are inherent in the pathophysiology of HF: (i) the impaired cardiac function affects cerebral structure and functional capacity, and (ii) neuronal signals impact on the cardiovascular continuum. These interactions contribute to the symptomatic presentation of HF patients and affect many co-morbidities of HF. Moreover, neuro-cardiac feedback signals significantly promote aggravation and further progression of HF and are causal in the poor prognosis of HF. The diversity and complexity of heart and brain interactions make it difficult to develop a comprehensive overview. In this paper a systematic approach is proposed to develop a comprehensive atlas of related conditions, signals and disease mechanisms of the interactions between the heart and the brain in HF. The proposed taxonomy is based on pathophysiological principles. Impaired perfusion of the brain may represent one major category, with acute (cardio-embolic) or chronic (haemodynamic failure) low perfusion being sub-categories with mostly different consequences (i.e. ischaemic stroke or cognitive impairment, respectively). Further categories include impairment of higher cortical function (mood, cognition), of brain stem function (sympathetic over-activation, neuro-cardiac reflexes). Treatment-related interactions could be categorized as medical, interventional and device-related interactions. Also interactions due to specific diseases are categorized. A methodical approach to categorize the interdependency of heart and brain may help to integrate individual research areas into an overall picture. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Heart Rate Assessment Immediately after Birth.

PubMed

Phillipos, Emily; Solevåg, Anne Lee; Pichler, Gerhard; Aziz, Khalid; van Os, Sylvia; O'Reilly, Megan; Cheung, Po-Yin; Schmölzer, Georg M

2016-01-01

Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate. The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method. PubMed, EMBASE and Google Scholar were systematically searched using the following terms: 'infant', 'heart rate', 'monitoring', 'delivery room', 'resuscitation', 'stethoscope', 'auscultation', 'palpation', 'pulse oximetry', 'electrocardiogram', 'Doppler ultrasound', 'photoplethysmography' and 'wearable sensors'. Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion. Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use. © 2015 S. Karger AG, Basel.

Accuracy of Seattle Heart Failure Model and HeartMate II Risk Score in Non-Inotrope-Dependent Advanced Heart Failure Patients: Insights From the ROADMAP Study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients).

PubMed

Lanfear, David E; Levy, Wayne C; Stehlik, Josef; Estep, Jerry D; Rogers, Joseph G; Shah, Keyur B; Boyle, Andrew J; Chuang, Joyce; Farrar, David J; Starling, Randall C

2017-05-01

Timing of left ventricular assist device (LVAD) implantation in advanced heart failure patients not on inotropes is unclear. Relevant prediction models exist (SHFM [Seattle Heart Failure Model] and HMRS [HeartMate II Risk Score]), but use in this group is not established. ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) is a prospective, multicenter, nonrandomized study of 200 advanced heart failure patients not on inotropes who met indications for LVAD implantation, comparing the effectiveness of HeartMate II support versus optimal medical management. We compared SHFM-predicted versus observed survival (overall survival and LVAD-free survival) in the optimal medical management arm (n=103) and HMRS-predicted versus observed survival in all LVAD patients (n=111) using Cox modeling, receiver-operator characteristic (ROC) curves, and calibration plots. In the optimal medical management cohort, the SHFM was a significant predictor of survival (hazard ratio=2.98; P <0.001; ROC area under the curve=0.71; P <0.001) but not LVAD-free survival (hazard ratio=1.41; P =0.097; ROC area under the curve=0.56; P =0.314). SHFM showed adequate calibration for survival but overestimated LVAD-free survival. In the LVAD cohort, the HMRS had marginal discrimination at 3 (Cox P =0.23; ROC area under the curve=0.71; P =0.026) and 12 months (Cox P =0.036; ROC area under the curve=0.62; P =0.122), but calibration was poor, underestimating survival across time and risk subgroups. In non-inotrope-dependent advanced heart failure patients receiving optimal medical management, the SHFM was predictive of overall survival but underestimated the risk of clinical worsening and LVAD implantation. Among LVAD patients, the HMRS had marginal discrimination and underestimated survival post-LVAD implantation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01452802. © 2017 American Heart

Heart Failure and Frailty in the Community-Living Elderly Population: What the UFO Study Will Tell Us.

PubMed

Fung, Erik; Hui, Elsie; Yang, Xiaobo; Lui, Leong T; Cheng, King F; Li, Qi; Fan, Yiting; Sahota, Daljit S; Ma, Bosco H M; Lee, Jenny S W; Lee, Alex P W; Woo, Jean

2018-01-01

Heart failure and frailty are clinical syndromes that present with overlapping phenotypic characteristics. Importantly, their co-presence is associated with increased mortality and morbidity. While mechanical and electrical device therapies for heart failure are vital for select patients with advanced stage disease, the majority of patients and especially those with undiagnosed heart failure would benefit from early disease detection and prompt initiation of guideline-directed medical therapies. In this article, we review the problematic interactions between heart failure and frailty, introduce a focused cardiac screening program for community-living elderly initiated by a mobile communication device app leading to the Undiagnosed heart Failure in frail Older individuals (UFO) study, and discuss how the knowledge of pre-frailty and frailty status could be exploited for the detection of previously undiagnosed heart failure or advanced cardiac disease. The widespread use of mobile devices coupled with increasing availability of novel, effective medical and minimally invasive therapies have incentivized new approaches to heart failure case finding and disease management.

Heart Failure and Frailty in the Community-Living Elderly Population: What the UFO Study Will Tell Us

PubMed Central

Fung, Erik; Hui, Elsie; Yang, Xiaobo; Lui, Leong T.; Cheng, King F.; Li, Qi; Fan, Yiting; Sahota, Daljit S.; Ma, Bosco H. M.; Lee, Jenny S. W.; Lee, Alex P. W.; Woo, Jean

2018-01-01

Heart failure and frailty are clinical syndromes that present with overlapping phenotypic characteristics. Importantly, their co-presence is associated with increased mortality and morbidity. While mechanical and electrical device therapies for heart failure are vital for select patients with advanced stage disease, the majority of patients and especially those with undiagnosed heart failure would benefit from early disease detection and prompt initiation of guideline-directed medical therapies. In this article, we review the problematic interactions between heart failure and frailty, introduce a focused cardiac screening program for community-living elderly initiated by a mobile communication device app leading to the Undiagnosed heart Failure in frail Older individuals (UFO) study, and discuss how the knowledge of pre-frailty and frailty status could be exploited for the detection of previously undiagnosed heart failure or advanced cardiac disease. The widespread use of mobile devices coupled with increasing availability of novel, effective medical and minimally invasive therapies have incentivized new approaches to heart failure case finding and disease management. PMID:29740330

Incidental histopathological findings in hearts of control beagle dogs in toxicity studies.

PubMed

Bodié, Karen; Decker, Joshua H

2014-08-01

In preclinical studies of pharmaceutical agents, the beagle dog is a commonly used model for the detection of cardiotoxicity. Incidental findings, postmortem changes, and artifacts must be distinguished histopathologically from test item-related findings in the heart. In this retrospective analysis, cardiac sections from 88 control beagles (41 male, 47 female; ages 5-18 months) in preclinical studies were examined histopathologically. The most common finding was thickening of the tunica media of intramural coronary arteries, most likely a postmortem change. The second most common finding was the presence of vacuoles within Purkinje fibers. Dilated lymphatic and blood vessels at the insertion of chordae tendineae were noted more commonly in males than in females and were considered a normal anatomic feature. Mesothelial-lined papillary fronds along the epicardial surface of the atria were present in several dogs, as were small infiltrates of inflammatory cells usually within the myocardium. In summary, control beagles' hearts frequently have incidental findings that must be differentiated from test item-related pathologic changes. Historical control data can be useful for the interpretation of incidental and test item-related findings in the beagle heart. © 2013 by The Author(s).

Reduced intrinsic heart rate is associated with reduced arrhythmic susceptibility in guinea-pig heart.

PubMed

Osadchii, Oleg E

2014-12-01

In the clinical setting, patients with slower resting heart rate are less prone to cardiovascular death compared with those with elevated heart rate. However, electrophysiological adaptations associated with reduced cardiac rhythm have not been thoroughly explored. In this study, relationships between intrinsic heart rate and arrhythmic susceptibility were examined by assessments of action potential duration (APD) rate adaptation and inducibility of repolarization alternans in sinoatrial node (SAN)-driven and atrioventricular (AV)-blocked guinea-pig hearts perfused with Langendorff apparatus. Electrocardiograms, epicardial monophasic action potentials, and effective refractory periods (ERP) were assessed in normokalemic and hypokalemic conditions. Slower basal heart rate in AV-blocked hearts was associated with prolonged ventricular repolarization during spontaneous beating, and with attenuated APD shortening at increased cardiac activation rates during dynamic pacing, when compared with SAN-driven hearts. During hypokalemic perfusion, the inducibility of repolarization alternans and tachyarrhythmia by rapid pacing was found to be lower in AV-blocked hearts. This difference was ascribed to prolonged ERP in the setting of reduced basal heart rate, which prevented ventricular capture at critically short pacing intervals required to induce arrhythmia. Reduced basal heart rate is associated with electrophysiological changes that prevent electrical instability upon an abrupt cardiac acceleration.

Heart Attack

MedlinePlus

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

Retrospective study of the effect of remifentanil use during labor on fetal heart rate patterns.

PubMed

Boterenbrood, Danne; Wassen, Martine M; Visser, Gerard H A; Nijhuis, Jan G

2018-01-01

To investigate possible associations between remifentanil and the appearance of sinusoidal heart rate patterns in fetuses, and neonatal outcomes. The present retrospective cohort study included data from patients at over 37 weeks of singleton or multiple pregnancies attending Zuyderland Medical Center, Sittard, the Netherlands, in labor between June 1, and August 31, 2015. Patient data were stratified by whether remifentanil was administered during delivery (remifentanil group) or not (control group), and fetal heart rate tracings were reviewed to identify sinusoidal heart rate patterns. The neonatal outcomes compared were 5-minute Apgar scores and umbilical artery pH. There were 119 patients included in the study; 60 in the remifentanil group and 59 in the control group. Tracings from 20 (33%) patients in the remifentanil group exhibited a sinusoidal heart rate pattern after remifentanil administration, compared with 5 (8%) patients in the control group (P=0.001). The median time before the onset of sinusoidal patterns after remifentanil administration was 12 minutes. No adverse neonatal outcomes were recorded in either group. Remifentanil use during labor was associated with the occurrence of sinusoidal heart rate patterns in the fetus; this was not associated with adverse neonatal outcomes. © 2017 International Federation of Gynecology and Obstetrics.

Serum Bicarbonate Is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis.

PubMed

Kendrick, Jessica B; Zelnick, Leila; Chonchol, Michel B; Siscovick, David; Hoofnagle, Andrew N; Ix, Joachim H; Sarnak, Mark; Shlipak, Michael G; Kestenbaum, Bryan; de Boer, Ian H

2017-01-01

Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. We performed a cohort study of 6,229 adult participants from the Multi-Ethnic Study of Atherosclerosis, a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: (1) subclinical CVD (left ventricular mass [LVM] and aortic pulse pressure [PP] measured at baseline), (2) incident atherosclerotic cardiovascular events (CVE; composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), and (3) incident heart failure. During a median (interquartile range) follow-up of 8.5 (7.7-8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 g greater LVM (95% CI 0.5-5.0) and 1.0 mm Hg higher aortic PP (95% CI 0.4-2.0) compared to bicarbonate 23-24 mEq/L. Each 1 mEq/L of bicarbonate increase was associated with a 13% higher risk of incident heart failure (hazards ratio 1.13, 95% CI 1.01-2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure. © 2016 S. Karger AG, Basel.

Nurses' decision making in heart failure management based on heart failure certification status.

PubMed

Albert, Nancy M; Bena, James F; Buxbaum, Denise; Martensen, Linda; Morrison, Shannon L; Prasun, Marilyn A; Stamp, Kelly D

Research findings on the value of nurse certification were based on subjective perceptions or biased by correlations of certification status and global clinical factors. In heart failure, the value of certification is unknown. Examine the value of certification based nurses' decision-making. Cross-sectional study of nurses who completed heart failure clinical vignettes that reflected decision-making in clinical heart failure scenarios. Statistical tests included multivariable linear, logistic and proportional odds logistic regression models. Of nurses (N = 605), 29.1% were heart failure certified, 35.0% were certified in another specialty/job role and 35.9% were not certified. In multivariable modeling, nurses certified in heart failure (versus not heart failure certified) had higher clinical vignette scores (p = 0.002), reflecting higher evidence-based decision making; nurses with another specialty/role certification (versus no certification) did not (p = 0.62). Heart failure certification, but not in other specialty/job roles was associated with decisions that reflected delivery of high-quality care. Copyright © 2018 Elsevier Inc. All rights reserved.

Role of ivabradine and heart rate lowering in chronic heart failure: guideline update.

PubMed

Chow, Sheryl L; Page, Robert Lee; Depre, Christophe

2018-06-14

This review summarizes the current management of heart failure (HF) in patients with reduced ejection fraction and the potential role of heart rate lowering agents in select populations, as recommended in the updated guidelines. Areas covered: PubMed was searched for studies that evaluated the role of heart rate lowering or ivabradine in HF management. Expert commentary: Targeting heart rate may offer benefit when added to renin-angiotensin aldosterone antagonists, and beta-blockers. Ivabradine is a heart rate lowering agent that acts on the funny current (I f ) in the sinoatrial node, thereby reducing heart rate without directly affecting cardiac contraction and relaxation. Clinical data from a phase 3 trial demonstrated that ivabradine reduced the composite endpoint of cardiovascular death or hospital admission for worsening systolic HF, while maintaining an acceptable safety profile in patients receiving standard of care therapy. These data, in addition to more recently published guidelines, suggest ivabradine as a promising new treatment option for lowering heart rate after optimizing standard therapy in select patients with chronic HF.

Ideal Cardiovascular Health and Incident Cardiovascular Events

PubMed Central

Ommerborn, Mark J.; Blackshear, Chad T.; Hickson, DeMarc A.; Griswold, Michael E.; Kwatra, Japneet; Djousse, Luc; Clark, Cheryl R.

2016-01-01

Introduction The epidemiology of American Heart Association ideal cardiovascular health (CVH) metrics has not been fully examined in African Americans. This study examines associations of CVH metrics with incident cardiovascular disease (CVD) in the Jackson Heart Study, a longitudinal cohort study of CVD in African Americans. Methods Jackson Heart Study participants without CVD (N=4,702) were followed prospectively between 2000 and 2011. Incidence rates and Cox proportional hazard ratios estimated risks for incident CVD (myocardial infarction, stroke, cardiac procedures, and CVD mortality) associated with seven CVH metrics by sex. Analyses were performed in 2015. Results Participants were followed for a median 8.3 years; none had ideal health on all seven CVH metrics. The prevalence of ideal health was low for nutrition, physical activity, BMI, and blood pressure metrics. The age-adjusted CVD incidence rate (IR) per 1,000 person years was highest for individuals with the least ideal health metrics: zero to one (IR=12.5, 95% CI=9.7, 16.1), two (IR=8.2, 95% CI=6.5, 10.4), three (IR=5.7, 95% CI=4.2, 7.6), and four or more (IR=3.4, 95% CI=2.0, 5.9). Adjusting for covariates, individuals with four or more ideal CVH metrics had lower risks of incident CVD compared with those with zero or one ideal CVH metric (hazard ratio, 0.29; 95% CI=0.17, 0.52; p<0.001). Conclusions African Americans with more ideal CVH metrics have lower risks of incident CVD. Comprehensive preventive behavioral and clinical supports should be intensified to improve CVD risk for African Americans with few ideal CVH metrics. PMID:27539974

Maintenance steroid use at 30 days post-transplant and outcomes of pediatric heart transplantation: A propensity matched analysis of the Pediatric Heart Transplant Study database.

PubMed

Auerbach, Scott R; Kukreja, Manisha; Gilbert, Deborah; Bastardi, Heather; Feingold, Brian; Knecht, Kenneth; Kaufman, Beth D; Brown, Robert N; Miyamoto, Shelley D

2015-08-01

Maintenance steroid (MS) use in pediatric heart transplantation is variable. The purpose of this study was to evaluate the impact of MS use on graft outcomes. All patients <18 years old in the Pediatric Heart Transplant Study database at the time of first heart transplant between 1993 and 2011 who survived ≥30 days post-transplant and were from centers with a protocolized approach to MS use were included (N = 2,178). Patients were grouped by MS use at 30 days post-transplant as MS+ or MS- (no MS use). Propensity score analysis was used to generate matched groups of MS+ and MS- patients based on pre-transplant and peri-transplant factors. Kaplan-Meier survival analysis was used to compare freedom from graft loss, graft loss secondary to rejection, rejection, rejection with severe hemodynamic compromise (RSHC), malignancy, and infection between groups. Of patients, 1,393 (64%) were MS+ and 785 (36%) were MS-. There were 315 MS- patients who had propensity matched MS+ controls. Kaplan-Meier estimates showed no difference in graft loss (p = 0.9) or graft loss secondary to rejection (p = 0.09). At 1 year post-transplant, there was no difference in freedom from rejection (p = 0.15) or malignancy (p = 0.07), but there was lower freedom from RSHC and infection in the MS- group (p = 0.05 and p = 0.02, respectively). MS use at 30 days post-transplant was not associated with enhanced graft survival after pediatric heart transplant. MS- patients had a higher incidence of RSHC and infection. These risks should be taken into consideration when determining MS use for pediatric recipients of heart transplants. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Chronic heart failure in Japan: implications of the CHART studies.

PubMed

Shiba, Nobuyuki; Shimokawa, Hiroaki

2008-01-01

The prognosis of patients with chronic heart failure (CHF) still remains poor, despite the recent advances in medical and surgical treatment. Furthermore, CHF is a major public health problem in most industrialized countries where the elderly population is rapidly increasing. Although the prevalence and mortality of CHF used to be relatively low in Japan, the disorder has been markedly increasing due to the rapid aging of the society and the Westernization of lifestyle that facilitates the development of coronary artery disease. The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 study was one of the largest cohorts in Japan. The study has clarified the characteristics and prognosis of Japanese patients with CHF, demonstrating that their prognosis was similarly poor compared with those in Western countries. However, we still need evidence for the prevention and treatment of CHF based on the large cohort studies or randomized treatment trials in the Japanese population. Since the strategy for CHF management is now changing from treatment to prevention, a larger-size prospective cohort, called the CHART-2 study, has been initiated to evaluate the risk factors of CHF in Japan. This review summarizes the current status of CHF studies in Japan and discusses their future perspectives.

Commercial aircraft engine emissions characterization of in-use aircraft at Hartsfield-Jackson Atlanta International Airport.

PubMed

Herndon, Scott C; Jayne, John T; Lobo, Prem; Onasch, Timothy B; Fleming, Gregg; Hagen, Donald E; Whitefield, Philip D; Miake-Lye, Richard C

2008-03-15

The emissions from in-use commercial aircraft engines have been analyzed for selected gas-phase species and particulate characteristics using continuous extractive sampling 1-2 min downwind from operational taxi- and runways at Hartsfield-Jackson Atlanta International Airport. Using the aircraft tail numbers, 376 plumes were associated with specific engine models. In general, for takeoff plumes, the measured NOx emission index is lower (approximately 18%) than that predicted by engine certification data corrected for ambient conditions. These results are an in-service observation of the practice of "reduced thrust takeoff". The CO emission index observed in ground idle plumes was greater (up to 100%) than predicted by engine certification data for the 7% thrust condition. Significant differences are observed in the emissions of black carbon and particle number among different engine models/technologies. The presence of a mode at approximately 65 nm (mobility diameter) associated with takeoff plumes and a smaller mode at approximately 25 nm associated with idle plumes has been observed. An anticorrelation between particle mass loading and particle number concentration is observed.

Congenital heart defects and extracardiac malformations.

PubMed

Rosa, Rosana Cardoso M; Rosa, Rafael Fabiano M; Zen, Paulo Ricardo G; Paskulin, Giorgio Adriano

2013-06-01

To review the association between congenital heart defects and extracardiac malformations. Scientific articles were searched in the Medline, Lilacs, and SciELO databases, using the descriptors "congenital heart disease," "congenital heart defects," "congenital cardiac malformations," "extracardiac defects," and "extracardiac malformations." All case series that specifically explored the association between congenital heart defects and extracardiac malformations were included. Congenital heart diseases are responsible for about 40% of birth defects, being one of the most common and severe malformations. Extracardiac malformations are observed in 7 to 50% of the patients with congenital heart disease, bringing a greater risk of comorbidity and mortality and increasing the risks related to heart surgery. Different studies have attempted to assess the presence of extracardiac abnormalities in patients with congenital heart disease. Among the changes described, those of the urinary tract are more often reported. However, no study has evaluated all patients in the same way. Extracardiac abnormalities are frequent among patients with congenital heart disease, and patients with these alterations may present an increased risk of morbimortality. Therefore, some authors have been discussing the importance and cost-effectiveness of screening these children for other malformations by complementary exams.

Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study).

PubMed

Mendes, Fernanda de Souza Nogueira Sardinha; Sousa, Andréa Silvestre; Souza, Fernando Cesar de Castro Cesar; Pinto, Vivian Liane Mattos; Silva, Paula Simplicio; Saraiva, Roberto Magalhães; Xavier, Sergio Salles; Veloso, Henrique Horta; Holanda, Marcelo Teixeira; Costa, Andréa Rodrigues; Carneiro, Fernanda Martins; Silva, Gilberto Marcelo Sperandio; Borges, Juliana Pereira; Tibirica, Eduardo; Pinheiro, Roberta Olmo; Lara, Flávio Alves; Hasslocher-Moreno, Alejandro Marcel; Brasil, Pedro Emmanuel Alvarenga Americano; Mediano, Mauro Felippe Felix

2016-09-02

The effects of exercise training on Chagas heart disease are still unclear. This study aimed to evaluate the effect of exercise training over functional capacity, cardiac function, quality of life, and biomarkers in Chagas heart disease. The PEACH study is a superiority randomized clinical trial which will include subjects who meet the following criteria: Chagas heart disease with a left ventricular ejection fraction below 45 % with or without heart failure symptoms; clinical stability in the last 3 months; adherence to clinical treatment; and age above 18 years. The exclusion criteria are: pregnancy; neuromuscular limitations; smoking; evidence of non-chagasic heart disease; systemic conditions that limit exercise practice or cardiopulmonary exercise test; unavailability to attend the center three times a week during the intervention period; and practitioners of regular exercise. The intervention group will perform an exercise training intervention three times per week during 6 months and will be compared to the control group without exercise. Both groups will undergo the same monthly pharmaceutical and nutritional counseling as well as standard medical treatment according to the Brazilian consensus on Chagas disease. The primary outcome is functional capacity based on peak exercise oxygen consumption during cardiopulmonary exercise testing. Secondary outcomes are: cardiac function; body composition; muscle respiratory strength; microvascular reactivity; cardiac rhythm abnormalities; autonomic function; biochemical; oxidative stress and inflammatory biomarkers; and quality of life. Subjects will be evaluated at baseline, and at 3 and 6 months after randomization. Thirty patients will be randomly assigned into exercise or control groups at a ratio of 1:1. Findings of the present study will be useful to determine if physical exercise programs should be included as an important additional therapy in the treatment of patients with Chagas heart disease. Clinical

Heart Transplantation

MedlinePlus

A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

Heart Diseases

MedlinePlus

... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

Early menopause predicts future coronary heart disease and stroke: the Multi-Ethnic Study of Atherosclerosis.

PubMed

Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

2012-10-01

Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if self-reported early menopause (menopause at an age <46 y) identifies women as at risk for future coronary heart disease or stroke. The study population came from the Multi-Ethnic Study of Atherosclerosis, a longitudinal, ethnically diverse cohort study of US men and women aged 45 to 84 years enrolled in 2000-2002 and followed up until 2008. The association between a personal history of early menopause (either natural menopause or surgical removal of ovaries at an age <46 y) and future coronary heart disease and stroke was assessed in 2,509 women (ages 45-84 y; 987 white, 331 Chinese, 641 black, and 550 Hispanic) from the Multi-ethnic Study Atherosclerosis who were free of cardiovascular disease at baseline. Of 2,509 women, 693 (28%) reported either surgical or natural early menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank P = 0.008 and P = 0.0158). In models adjusted for age, race/ethnicity, Multi-ethnic Study Atherosclerosis site, and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (hazard ratio, 2.08; 95% CI, 1.17-3.70; and hazard ratio, 2.19; 95% CI, 1.11-4.32, respectively). Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors.