Impact of obesity and body fat distribution on cardiovascular risk factors in Hong Kong Chinese.

PubMed

Thomas, G Neil; Ho, Sai-Yin; Lam, Karen S L; Janus, Edward D; Hedley, Anthony J; Lam, Tai Hing

2004-11-01

Body fat distribution has been reported to differentially contribute to the development of cardiovascular risk. We report the relative associations between general and central obesity and risk factors in 2893 Chinese subjects recruited from the Hong Kong population. Anthropometric parameters [waist circumference (WC) and BMI], surrogate measures of insulin resistance (fasting plasma glucose and insulin, oral glucose tolerance test, 2 hours glucose and insulin), fasting lipids (total, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) and systolic and diastolic blood pressure were measured. General obesity was classified as BMI > or =25.0 kg/m(2) and central obesity as a WC > or =80 or > or =90 cm in women and men, respectively. A total of 39.2% of the population was found to be obese. Obesity per se increased the levels of the risk factors, but central adiposity contributed to a greater extent to adverse high-density lipoprotein-cholesterol, triglyceride, and insulin resistance levels. There was a continuous relationship between increasing obesity, both general and central, and cardiovascular risk, with lowest risk associated with the lowest indices of obesity. In the 1759 nonobese subjects divided into quartiles of BMI or WC, the levels of the cardiovascular risk factors still significantly increased with increasing quartiles of adiposity. Central adiposity appears to contribute to a greater extent than general adiposity to the development of cardiovascular risk in this population. The relationship between obesity parameters and risk is a continuum, with risk factors significantly increasing even at levels usually considered nonobese. These observations support the proposed redefinition of overweight and obesity in Asian populations using lower cut-off points.

Eating Concerns in College Women across Sexual Orientation Identities

ERIC Educational Resources Information Center

Maloch, Janelle K.; Bieschke, Kathleen J.; McAleavey, Andrew A.; Locke, Benjamin D.

2013-01-01

This study found that treatment-seeking sexual minority college women evidenced serious eating concerns. Regardless of sexual orientation and compared with those with low levels of eating concerns, women with high levels of eating concerns evidenced increased depression, increased generalized anxiety, and a greater likelihood of experiencing…

[Influence of contractual medical association on inpatient service performance].

PubMed

Wu, Zhi-jun; Jian, Wei-yan

2015-06-18

To study the influence of contractual medical association on inpatient service performance. The data came from "Database of Inpatient Record" administered by Department of Medical Insurance. Using diagnosis related groups (DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference (DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index (CMI), the total weight, cost efficiency index and time efficiency index. After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had declined, and the cost efficiency index had increased. Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.

Unhappy doctors? A longitudinal study of life and job satisfaction among Norwegian doctors 1994 – 2002

PubMed Central

Nylenna, Magne; Gulbrandsen, Pål; Førde, Reidun; Aasland, Olaf G

2005-01-01

Background General opinion is that doctors are increasingly dissatisfied with their job, but few longitudinal studies exist. This study has been conducted to investigate a possible decline in professional and personal satisfaction among doctors by the turn of the century. Methods We have done a survey among a representative sample of 1 174 Norwegian doctors in 2002 (response rate 73 %) and compared the findings with answers to the same questions by (most of) the same doctors in 1994 and 2000. The main outcome measures were self reported levels of life satisfaction and job satisfaction according to the Job Satisfaction Scale (JSS). Results Most Norwegian doctors are happy. They reported an average life satisfaction of 5.21 in 1994 and 5.32 in 2002 on a scale from 1 (extremely dissatisfied) to 7 (extremely satisfied). Half of the respondents reported a very high level of general life satisfaction (a score of 6 or 7) while only one third said they would have reported this high level of satisfaction five years ago. The doctors thought that they had a higher level of job satisfaction than other comparable professional groups. The job satisfaction scale among the same doctors showed a significant increase from 1994 to 2002. Anaesthesiologists and internists reported a lower and psychiatrists and primary care doctors reported a higher level of job satisfaction than the average. Conclusion Norwegian doctors seem to have enjoyed an increasing level of life and job satisfaction rather than a decline over the last decade. This challenges the general impression of unhappy doctors as a general and worldwide phenomenon. PMID:15943859

Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction.

PubMed

Inverso, Gino; Dodson, Thomas B; Gonzalez, Martin L; Chuang, Sung-Kiang

2016-03-01

To examine the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction and determine whether any differences in complication risks exist between the 2 levels of sedation. We performed a prospective study of the Oral and Maxillofacial Surgery Outcomes System from January 2001 to December 2010. The primary predictor variable was the level of sedation, divided into 2 groups: moderate sedation versus deep sedation/general anesthesia. The primary outcome was the incidence of adverse complications resulting from the sedation level. Differences in the cohort characteristics were analyzed using the independent samples t test, χ(2) test, and analysis of variance, as appropriate. Multivariable logistic regression was used to measure the effect the level of sedation had on the adverse complication rate. Patients in the moderate sedation group had a complication rate of 0.5%, and patients in the deep sedation/general anesthesia group had a complication rate of 0.9%. Compared with moderate sedation, deep sedation/general anesthesia did not pose a significantly increased risk of adverse anesthesia complications (adjusted odds ratio 1.63, 95% confidence interval 0.95 to 2.81; P = .077). The results of our study have shown that the risk of adverse anesthesia complications is not increased when choosing between moderate and deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Increasing URM Undergraduate Student Success through Assessment-Driven Interventions: A Multiyear Study Using Freshman-Level General Biology as a Model System

ERIC Educational Resources Information Center

Carmichael, Mary C.; St. Clair, Candace; Edwards, Andrea M.; Barrett, Peter; McFerrin, Harris; Davenport, Ian; Awad, Mohamed; Kundu, Anup; Ireland, Shubha Kale

2016-01-01

Xavier University of Louisiana leads the nation in awarding BS degrees in the biological sciences to African-American students. In this multiyear study with ~5500 participants, data-driven interventions were adopted to improve student academic performance in a freshman-level general biology course. The three hour-long exams were common and…

The Impact of Students with Special Education Needs in the General Education Setting on Missouri's State Assessment

ERIC Educational Resources Information Center

Lent, Chad

2012-01-01

Schools and educators have been increasingly educating students with disabilities in the general education setting; while at the same time the level of accountability for making a positive outcome on high stakes assessments for all students has increased. As educators feel pressure for their students to perform well on state assessments and meet…

Cross-sectional population associations between detailed adiposity measures and C-reactive protein levels at age 6 years: the Generation R Study.

PubMed

Toemen, L; Gishti, O; Vogelezang, S; Gaillard, R; Hofman, A; Franco, O H; Felix, J F; Jaddoe, V W V

2015-07-01

High body mass index is associated with increased C-reactive protein levels in childhood and adulthood. Little is known about the associations of detailed adiposity measures with C-reactive protein levels in childhood. We examined the associations of general and abdominal adiposity measures with C-reactive protein levels at school age. To gain insight into the direction of causality, we used genetic risk scores based on known genetic variants in adults as proxies for child adiposity measures and C-reactive protein levels. Within a population-based cohort study among 4338 children at the median age of 6.2 years, we measured body mass index, fat mass percentage, android/gynoid fat mass ratio and preperitoneal abdominal fat mass. We also measured C-reactive protein blood levels and defined increased levels as ⩾3.0 mg l(-1). Single-nucleotide polymorphisms (SNPs) for the weighted genetic risk scores were extracted from large genome-wide association studies on adult body mass index, waist-hip ratio and C-reactive protein levels. All fat mass measures were associated with increased C-reactive protein levels, even after adjusting for multiple confounders. Fat mass percentage was most strongly associated with increased C-reactive protein levels (odds ratio 1.46 (95% confidence interval 1.30-1.65) per increase standard deviation scores in fat mass percentage). The association was independent of body mass index. The genetic risk score based on adult body mass index SNPs, but not adult waist-hip ratio SNPs, tended to be associated with increased C-reactive protein levels at school age. The genetic risk score based on adult C-reactive protein level SNPs was not associated with adiposity measures at school age. Our results suggest that higher general and abdominal fat mass may lead to increased C-reactive protein levels at school age. Further studies are needed to replicate these results and explore the causality and long-term consequences.

5 CFR 531.409 - Acceptable level of competence determinations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Acceptable level of competence... REGULATIONS PAY UNDER THE GENERAL SCHEDULE Within-Grade Increases § 531.409 Acceptable level of competence... delegated shall determine which employees are performing at an acceptable level of competence. (b) Basis for...

Serum uric acid level and cardiovascular risks in hemodialysis patients: an Algerian cohort study.

PubMed

Gouri, Adel; Dekaken, Aoulia; Bentorki, Ahmed Aimen; Touaref, Amel; Yakhlef, Amina; Kouicem, Nabila

2014-01-01

Elevated serum uric acid (SUA) was usually associated with an increased risk of cardiovascular events and mortality in the general population. However, there are few reports concerning the clinical impact and the pathogenic role of uric acid (UA) in hemodialysis (HD) patients. The aim of the study was to investigate the relationship between SUA and various cardiovascular (CV) risk factors in HD patients. This retrospective, observational cohort study includes 45 HD patients with a mean age of 51.26 +/- 15.21 years. The differences of the CV risk factors between the patients according to their SUA levels were investigated. Age, cardiovascular diseases (CVD), increased creatinine, fasting blood glucose (FBG), corrected calcium (cCa), phosphate (P), cCa x P product, and LDL cholesterol levels were associated with lower SUA levels, whereas a higher SUA level was associated with diabetes mellitus (DM), hypertension, and increased triglycerides level (p < 0.01). In multiple regression analysis, history of diabetes (beta = 0.360, p < 0.05), reduced corrected serum calcium (cCa) (beta = -1.456, p < 0.01), and phosphate (P) levels (beta = -1.752, p < 0.01) were predictive of an increased SUA concentration. Despite what has been demonstrated in the general population and DM patients, a lower SUA level in HD patients was associated with higher cardiovascular risk factors and high co-morbidity burden. Moreover, higher SUA concentrations may be cardioprotective in dialysis patients.

Serum uric acid level and cardiovascular risks in hemodialysis patients: an Algerian cohort study.

PubMed

Gouri, Adel; Dekaken, Aoulia; Bentorki, Ahmed Aimen; Touaref, Amel; Yekhlef, Amina; Sekkache, Fouzia; Kouicem, Nabila

2013-09-01

Elevated Serum Uric Acid (SUA) was usually associated with an increased risk of cardiovascular events and mortality in general population. However, there are few reports concerning the clinical impact and the pathogenic role of Uric Acid (UA) in Hemodialysis (HD) patients. The aim of the study was to investigate the relationship between SUA and various Cardiovascular (CV) risk factors in HD patients. This retrospective; observational cohort study includes 45 HD patients with a mean age of 51.26+/-15.21 years. The differences of the CV risk factors between the patients according to their SUA levels were investigated. Age, Cardiovascular Diseases (CVD), increased creatinine, Fasting Blood Glucose (FBG), Corrected Calcium (cCa), Phosphate (P), cCa x P product and LDL cholesterol levels were associated with lower SUA levels, whereas higher SUA level was associated with Diabetes Mellitus (DM), hypertension and increased triglycerides level (p<0.01). In multiple regression analysis, history of diabetes (beta= 0.360, p<0.05), reduced corrected serum calcium (cCa) (beta = -1.456, p<0.01) and Phosphate (P) levels (beta= -1.752, p<0.01) were predictive of an increased SUA concentration. Despite from what has been demonstrated in the general population and DM patients, a lower SUA level in HD patients was associated with higher cardiovascular risk factors and high co-morbidity burden. Moreover, higher SUA concentrations may be cardioprotective in dialysis patients.

Actionable Data Projects: Social Science and Service-Learning in General Education Courses

ERIC Educational Resources Information Center

Maloyed, Christie L.

2016-01-01

The use of service-learning pedagogies in general education courses is often limited to increasing volunteerism or civic literacy with problem-based or research-based projects reserved for upper level courses. This article examines the implementation of an "actionable data" service-learning project in an introductory, general studies…

Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

PubMed Central

2012-01-01

Background The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including Chlamydia trachomatis. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems. Methods Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed. Results Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England. Conclusions General practices can be important potential providers of chlamydia tests. With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men. PMID:22984897

Effects of dutasteride on lower urinary tract symptoms and general health in men with benign prostatic hypertroplasia and hypogonadism: a prospective study.

PubMed

Shigehara, Kazuyoshi; Koh, Eitetsu; Sakamoto, Jiro; Yaegashi, Hiroshi; Izumi, Koji; Ueno, Satoru; Kitagawa, Yasuhide; Maeda, Yuji; Kadono, Yoshifumi; Konaka, Hiroyuki; Mizokami, Atsushi; Nakashima, Takao; Namiki, Mikio

2014-03-01

We investigated the effects of the relative increase in testosterone by dutasteride administration in patients with benign prostatic hyperplasia and hypogonadism on urinary symptoms or androgen-responsive general health. Seventy-six patients were enrolled, and were taking 0.5 mg dutasteride daily for 52 weeks. Before and after treatment, all participants underwent blood test, and body mass index, prostate volume (PV), bone mineral density (BMD), post-voiding residual (PVR) volume, and muscle volume were measured. All patients responded to the questionnaires: International prostatic symptom score (IPSS), Overactive Bladder Symptom score (OABSS). Patients were divided into two groups according to the increase rate of total testosterone (TT): group A, ≥20% increase in TT level; group B, <20% increase or decrease. Baseline TT and free testosterone (FT) levels were significantly lower in group A than group B. Both groups showed marked improvement in PV and PVR. Group A showed significant improvement in IPSS and OABSS with a significant increase of FT level, whereas group B showed no significant change. Dutasteride treatment contributed to a significant increase in BMD in group A. Dutasteride treatment significantly improved urinary symptoms and BMD in patients with low baseline serum TT and FT levels.

Awake craniotomy induces fewer changes in the plasma amino acid profile than craniotomy under general anesthesia.

PubMed

Hol, Jaap W; Klimek, Markus; van der Heide-Mulder, Marieke; Stronks, Dirk; Vincent, Arnoud J; Klein, Jan; Zijlstra, Freek J; Fekkes, Durk

2009-04-01

In this prospective, observational, 2-armed study, we compared the plasma amino acid profiles of patients undergoing awake craniotomy to those undergoing craniotomy under general anesthesia. Both experimental groups were also compared with a healthy, age-matched and sex-matched reference group not undergoing surgery. It is our intention to investigate whether plasma amino acid levels provide information about physical and emotional stress, as well as pain during awake craniotomy versus craniotomy under general anesthesia. Both experimental groups received preoperative, perioperative, and postoperative dexamethasone. The plasma levels of 20 amino acids were determined preoperative, perioperative, and postoperatively in all groups and were correlated with subjective markers for pain, stress, and anxiety. In both craniotomy groups, preoperative levels of tryptophan and valine were significantly decreased whereas glutamate, alanine, and arginine were significantly increased relative to the reference group. Throughout time, tryptophan levels were significantly lower in the general anesthesia group versus the awake craniotomy group. The general anesthesia group had a significantly higher phenylalanine/tyrosine ratio, which may suggest higher oxidative stress, than the awake group throughout time. Between experimental groups, a significant increase in large neutral amino acids was found postoperatively in awake craniotomy patients, pain was also less and recovery was faster. A significant difference in mean hospitalization time was also found, with awake craniotomy patients leaving after 4.53+/-2.12 days and general anesthesia patients after 6.17+/-1.62 days; P=0.012. This study demonstrates that awake craniotomy is likely to be physically and emotionally less stressful than general anesthesia and that amino acid profiling holds promise for monitoring postoperative pain and recovery.

No cross-sectional evidence for an increased relation of cognitive and sensory abilities in old age.

PubMed

Ihle, Andreas; Oris, Michel; Fagot, Delphine; Kliegel, Matthias

2017-04-01

A key question in gerontological research concerns whether good functioning can be maintained in some cognitive abilities in old age, even if deficits occur in other cognitive or sensory abilities. Our goals were to investigate relations of cognitive and sensory abilities in old age, whether these relations differed in size across old age, and whether this was affected by general cognitive ability (processing speed), educational level, and/or general health status. Two thousand eight hundred and twelve older adults (aged 65-101, M = 77.9 years) from the Vivre-Leben-Vivere survey served as cross-sectional sample for the present study. We administered psychometric tests on processing speed (the speed of cognitive processing), cognitive flexibility (the ability to alternate between cognitive operations), and verbal abilities (vocabulary). In addition, we interviewed individuals on their hearing, eyesight, educational level, and general health status. We regressed sizes of relations between abilities (calculated within each 1-year age tranche) on mean age within the corresponding age tranche, with the number of participants within the corresponding age tranche as case weights. We observed a decrease in relations between processing speed and cognitive flexibility in old age that was particularly pronounced in individuals with high educational level (r = -.41). In contrast, we did not find differences in relations between other cognitive and sensory abilities across old age, which held for different levels of general cognitive ability, education, and general health status. Present data do not support the view of a generally increased relation of cognitive and sensory abilities in old age.

Associations between urinary phthalate metabolites and bisphenol A levels, and serum thyroid hormones among the Korean adult population - Korean National Environmental Health Survey (KoNEHS) 2012-2014.

PubMed

Park, Choonghee; Choi, Wookhee; Hwang, Moonyoung; Lee, Youngmee; Kim, Suejin; Yu, Seungdo; Lee, Inae; Paek, Domyung; Choi, Kyungho

2017-04-15

Phthalates and bisphenol A (BPA) have been used extensively in many consumer products, resulting in widespread exposure in the general population. Studies have suggested associations between exposure to phthalates and BPA, and serum thyroid hormone levels, but confirmation on larger human populations is warranted. Data obtained from nationally representative Korean adults (n=6003) recruited for the second round of the Korean National Environmental Health Survey (KoNEHS), 2012-2014, were employed. Three di-(2-ethylhexyl) phthalate (DEHP) metabolites, along with benzyl-butyl phthalate (BBzP) and di-butyl phthalate (DBP) metabolites, and BPA were measured in subjects' urine. Thyroxine (T4), total triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were measured in serum. The associations between urinary phthalates or BPA and thyroid hormone levels were determined. Urinary phthalate metabolites were generally associated with lowered total T4 or T3, or increased TSH levels in serum. Interquartile range (IQR) increases of mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) were associated with a 3.7% increase of TSH, and a 1.7% decrease of total T4 levels, respectively. When grouped by sex, urinary MEHHP levels were inversely associated with T4 only among males. Among females, mono-benzyl phthalate (MBzP) and mono-n-butyl phthalate (MnBP) levels were inversely associated with TSH and T3, respectively. In addition, negative association between BPA and TSH was observed. Several phthalates and BPA exposures were associated with altered circulatory thyroid hormone levels among general Korean adult population. Considering the importance of thyroid hormones, public health implications of such alteration warrant further studies. Copyright © 2017 Elsevier B.V. All rights reserved.

[The role of free-radical oхidation for patogenesis of chronic generalization periodontitis in elderly age patients].

PubMed

Pinelis, Y I; Malezhik, M S; Malezhik, L P

2017-01-01

In old aged patients with chronic generalized periodontitis and cardiovascular diseases the level lipoperoxidation increased and antioхidation protection decreased in saliva and blood. After the course of treatment myocardial ischemia and diseases chronic periodontal inflammation the level of lipoperoхidation was changed insignificant accompanied with decreased of TBK-active substance in saliva and blood. Change of nitric oхide after by treatment was depended it initial level before treatment and often had an opposite orientation.

Differences in DNA-damage in non-smoking men and women exposed to environmental tobacco smoke (ETS).

PubMed

Collier, Abby C; Dandge, Sachin D; Woodrow, James E; Pritsos, Chris A

2005-07-28

There is much data implicating environmental tobacco smoke (ETS) in the development and progression of disease, notably cancer, yet the mechanisms for this remain unclear. As ETS is both a pro-oxidant stressor and carcinogen, we investigated the relationship of ETS exposure to intracellular and serum levels of DNA-damage, both oxidative 8-hydroxy-2-deoxyguanosine (8OHdG) and general, in non-smokers from non-smoking households, occupationally exposed to ETS. General DNA-damage consisting of single and double strand breaks, alkali-labile sites and incomplete base-excision repair, increased significantly in a dose-dependent manner with ETS exposure in men (P=0.015, n=32, Pearson) but not women (P=0.736, n=17). Intracellular 8OHdG-DNA-damage and general DNA-damage were both greater in men than women (P=0.0005 and 0.016, respectively) but 8OHdG serum levels did not differ between the genders. Neither 8OHdG-DNA-damage nor serum levels correlated with increasing ETS exposure. This is the first study to demonstrate dose-dependent increases in DNA-damage from workplace ETS exposure. Perhaps most interesting was that despite equivalent ETS exposure, significantly greater DNA-damage occurred in men than women. These data may begin to provide a mechanistic rationale for the generally higher incidence of some diseases in males due to tobacco smoke and/or other genotoxic stressors.

Trend analysis and modelling of gender-specific age, period and birth cohort effects on alcohol abstention and consumption level for drinkers in Great Britain using the General Lifestyle Survey 1984-2009.

PubMed

Meng, Yang; Holmes, John; Hill-McManus, Daniel; Brennan, Alan; Meier, Petra Sylvia

2014-02-01

British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Great Britain 1984-2009. Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. © 2013 Society for the Study of Addiction.

Insulin resistance index (HOMA-IR) levels in a general adult population: curves percentile by gender and age. The EPIRCE study.

PubMed

Gayoso-Diz, Pilar; Otero-Gonzalez, Alfonso; Rodriguez-Alvarez, María Xosé; Gude, Francisco; Cadarso-Suarez, Carmen; García, Fernando; De Francisco, Angel

2011-10-01

To describe the distribution of HOMA-IR levels in a general nondiabetic population and its relationships with metabolic and lifestyles characteristics. Cross-sectional study. Data from 2246 nondiabetic adults in a random Spanish population sample, stratified by age and gender, were analyzed. Assessments included a structured interview, physical examination, and blood sampling. Generalized additive models (GAMs) were used to assess the effect of lifestyle habits and clinical and demographic measurements on HOMA-IR. Multivariate GAMs and quantile regression analyses of HOMA-IR were carried out separately in men and women. This study shows refined estimations of HOMA-IR levels by age, body mass index, and waist circumference in men and women. HOMA-IR levels were higher in men (2.06) than women (1.95) (P=0.047). In women, but not men, HOMA-IR and age showed a significant nonlinear association (P=0.006), with increased levels above fifty years of age. We estimated HOMA-IR curves percentile in men and women. Age- and gender-adjusted HOMA-IR levels are reported in a representative Spanish adult non-diabetic population. There are gender-specific differences, with increased levels in women over fifty years of age that may be related with changes in body fat distribution after menopause. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Effect of a Surgical Skills Course on Confidence Levels of Rural General Practitioners: An Observational Study.

PubMed

Byrd, Pippa; Ward, Olga; Hamdorf, Jeffrey

2016-10-01

Objective  To investigate the effect of a short surgical skills course on general practitioners' confidence levels to perform procedural skills. Design  Prospective observational study. Setting  The Clinical Evaluation and Training Centre, a practical skills-based educational facility, at The University of Western Australia. Participants  Medical practitioners who participated in these courses. Nurses, physiotherapists, and medical students were excluded. The response rate was 61% with 61 participants providing 788 responses for pre- and postcourse confidence levels regarding various surgical skills. Intervention  One- to two-day surgical skills courses consisting of presentations, demonstrations, and practical stations, facilitated by specialists. Main Outcome Measures  A two-page precourse and postcourse questionnaire was administered to medical practitioners on the day. Participants rated their confidence levels to perform skills addressed during the course on a 4-point Likert scale. Results  Of the 788 responses regarding confidence levels, 621 were rated as improved postcourse, 163 were rated as no change, and 4 were rated as lower postcourse. Seven of the courses showed a 25% median increase in confidence levels, and one course demonstrated a 50% median increase. All courses showed statistically significant results ( p  < 0.001). Conclusion  A short surgical skills course resulted in a statistically significant improvement in the confidence levels of rural general practitioners to perform these skills.

Effect of descriptive information and experience on automation reliance.

PubMed

Yuviler-Gavish, Nirit; Gopher, Daniel

2011-06-01

The present research addresses the issue of reliance on decision support systems for the long-term (DSSLT), which help users develop decision-making strategies and long-term planning. It is argued that providing information about a system's future performance in an experiential manner, as compared with a descriptive manner, encourages users to increase their reliance level. Establishing appropriate reliance on DSSLT is contingent on the system developer's ability to provide users with information about the system's future performance. A sequence of three studies contrasts the effect on automation reliance of providing descriptive information versus experience for DSSLT with two different positive expected values of recommendations. Study I demonstrated that when automation reliance was determined solely on the basis of description, it was relatively low, but it increased significantly when a decision was made after experience with 50 training simulations. Participants were able to learn to increase their automation reliance levels when they encountered the same type of recommendation again. Study 2 showed that the absence of preliminary descriptive information did not affect the automation reliance levels obtained after experience. Study 3 demonstrated that participants were able to generalize their learning about increasing reliance levels to new recommendations. Using experience rather than description to give users information about future performance in DSSLT can help increase automation reliance levels. Implications for designing DSSLT and decision support systems in general are discussed.

In Defense of P Values

PubMed Central

Verhulst, Brad

2016-01-01

P values have become the scapegoat for a wide variety of problems in science. P values are generally over-emphasized, often incorrectly applied, and in some cases even abused. However, alternative methods of hypothesis testing will likely fall victim to the same criticisms currently leveled at P values if more fundamental changes are not made in the research process. Increasing the general level of statistical literacy and enhancing training in statistical methods provide a potential avenue for identifying, correcting, and preventing erroneous conclusions from entering the academic literature and for improving the general quality of patient care. PMID:28366961

Theoretical foundations of spatially-variant mathematical morphology part ii: gray-level images.

PubMed

Bouaynaya, Nidhal; Schonfeld, Dan

2008-05-01

In this paper, we develop a spatially-variant (SV) mathematical morphology theory for gray-level signals and images in the Euclidean space. The proposed theory preserves the geometrical concept of the structuring function, which provides the foundation of classical morphology and is essential in signal and image processing applications. We define the basic SV gray-level morphological operators (i.e., SV gray-level erosion, dilation, opening, and closing) and investigate their properties. We demonstrate the ubiquity of SV gray-level morphological systems by deriving a kernel representation for a large class of systems, called V-systems, in terms of the basic SV graylevel morphological operators. A V-system is defined to be a gray-level operator, which is invariant under gray-level (vertical) translations. Particular attention is focused on the class of SV flat gray-level operators. The kernel representation for increasing V-systems is a generalization of Maragos' kernel representation for increasing and translation-invariant function-processing systems. A representation of V-systems in terms of their kernel elements is established for increasing and upper-semi-continuous V-systems. This representation unifies a large class of spatially-variant linear and non-linear systems under the same mathematical framework. Finally, simulation results show the potential power of the general theory of gray-level spatially-variant mathematical morphology in several image analysis and computer vision applications.

Production of a protein-rich extruded snack base using tapioca starch, sorghum flour and casein.

PubMed

Patel, Jiral R; Patel, Ashok A; Singh, Ashish K

2016-01-01

A protein-rich puffed snack was produced using a twin screw extruder and the effects of varying levels of tapioca starch (11 to 40 parts), rennet casein (6 to 20 parts) and sorghum flour (25 to 75 parts) on physico-chemical properties and sensory attributes of the product studied. An increasing level of sorghum flour resulted in a decreasing whiteness (Hunter L* value) of the snack. Although the starch also generally tended to make the product increasingly darker, both starch and casein showed redness parameter (a* value) was not significantly influenced by the ingredients levels, the yellow hue (b* value) generally declined with the increasing sorghum level. Tapioca starch significantly increased the expansion ratio and decreased the bulk density and hardness value of the snack, whereas the opposite effects seen in case of sorghum flour. While the water solubility index was enhanced by starch, water absorption index was appreciably improved by sorghum. Incorporation of casein (up to 25 %) improved the sensory color and texture scores, and so also the overall acceptability rating of the product. Sorghum flour had an adverse impact on all the sensory attributes whereas starch only on the color score. The casein or starch level had no perceivable effect on the product's flavor score. The response surface data enabled optimization of the snack-base formulation for the desired protein level or desired sensory characteristics.

[Job satisfaction among Norwegian doctors].

PubMed

Nylenna, Magne; Aasland, Olaf Gjerløw

2010-05-20

Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

Content Analysis: What Are They Talking About?

ERIC Educational Resources Information Center

Strijbos, Jan-Willem; Martens, Rob L.; Prins, Frans J.; Jochems, Wim M. G.

2006-01-01

Quantitative content analysis is increasingly used to surpass surface level analyses in computer-supported collaborative learning (e.g., counting messages), but critical reflection on accepted practice has generally not been reported. A review of CSCL conference proceedings revealed a general vagueness in definitions of units of analysis. In…

Flame Structure and Emissions of Strongly-Pulsed Turbulent Diffusion Flames with Swirl

NASA Astrophysics Data System (ADS)

Liao, Ying-Hao

This work studies the turbulent flame structure, the reaction-zone structure and the exhaust emissions of strongly-pulsed, non-premixed flames with co-flow swirl. The fuel injection is controlled by strongly-pulsing the fuel flow by a fast-response solenoid valve such that the fuel flow is completely shut off between pulses. This control strategy allows the fuel injection to be controlled over a wide range of operating conditions, allowing the flame structure to range from isolated fully-modulated puffs to interacting puffs to steady flames. The swirl level is controlled by varying the ratio of the volumetric flow rate of the tangential air to that of the axial air. For strongly-pulsed flames, both with and without swirl, the flame geometry is strongly impacted by the injection time. Flames appear to exhibit compact, puff-like structures for short injection times, while elongated flames, similar in behaviors to steady flames, occur for long injection times. The flames with swirl are found to be shorter for the same fuel injection conditions. The separation/interaction level between flame puffs in these flames is essentially governed by the jet-off time. The separation between flame puffs decreases as swirl is imposed, consistent with the decrease in flame puff celerity due to swirl. The decreased flame length and flame puff celerity are consistent with an increased rate of air entrainment due to swirl. The highest levels of CO emissions are generally found for compact, isolated flame puffs, consistent with the rapid quenching due to rapid dilution with excess air. The imposition of swirl generally results in a decrease in CO levels, suggesting more rapid and complete fuel/air mixing by imposing swirl in the co-flow stream. The levels of NO emissions for most cases are generally below the steady-flame value. The NO levels become comparable to the steady-flame value for sufficiently short jet-off time. The swirled co-flow air can, in some cases, increase the NO emissions. The elevated NO emissions are due to a longer combustion residence time due to the flow recirculation within the swirl-induced recirculation zone. The reaction zone structure, based on OH planar laser-induced fluorescence (PLIF) is broadly consistent with the observation of luminous flame structure for these types of flames. In many cases, the reaction zone exhibits discontinuities at the instantaneous flame tip in the early period of fuel injection. These discontinuities in the reaction zone likely result from the non-ignition of injected fuel, due to a relatively slower reaction rate in comparison with the mixing rate. The discontinuity in the OH zone is generally seen to diminish with increased swirl level. Statistics generated from the OH PLIF signals show that the reaction zone area generally increases with increased swirl level, consistent with a broader and more convoluted OH-zone structure for flames with swirl. The reaction zone area for swirled flames generally exhibits a higher degree of fluctuation, suggesting a relatively stronger impact of flow turbulence on the flame structure for flames with swirl.

High levels of confusion for cholesterol awareness campaigns.

PubMed

Hall, Danika V

2008-09-15

Earlier this year, two industry-sponsored advertising campaigns for cholesterol awareness that target the general public were launched in Australia. These campaigns aimed to alert the public to the risks associated with having high cholesterol and encouraged cholesterol testing for wider groups than those specified by the National Heart Foundation. General practitioners should be aware of the potential for the two campaigns to confuse the general public as to who should be tested, and where. The campaign sponsors (Unilever Australasia and Pfizer) each have the potential to benefit by increased market share for their products, and increased profits. These disease awareness campaigns are examples of what is increasingly being termed "condition branding" by pharmaceutical marketing experts.

Ground state destabilization from a positioned general base in the ketosteroid isomerase active site.

PubMed

Ruben, Eliza A; Schwans, Jason P; Sonnett, Matthew; Natarajan, Aditya; Gonzalez, Ana; Tsai, Yingssu; Herschlag, Daniel

2013-02-12

We compared the binding affinities of ground state analogues for bacterial ketosteroid isomerase (KSI) with a wild-type anionic Asp general base and with uncharged Asn and Ala in the general base position to provide a measure of potential ground state destabilization that could arise from the close juxtaposition of the anionic Asp and hydrophobic steroid in the reaction's Michaelis complex. The analogue binding affinity increased ~1 order of magnitude for the Asp38Asn mutation and ~2 orders of magnitude for the Asp38Ala mutation, relative to the affinity with Asp38, for KSI from two sources. The increased level of binding suggests that the abutment of a charged general base and a hydrophobic steroid is modestly destabilizing, relative to a standard state in water, and that this destabilization is relieved in the transition state and intermediate in which the charge on the general base has been neutralized because of proton abstraction. Stronger binding also arose from mutation of Pro39, the residue adjacent to the Asp general base, consistent with an ability of the Asp general base to now reorient to avoid the destabilizing interaction. Consistent with this model, the Pro mutants reduced or eliminated the increased level of binding upon replacement of Asp38 with Asn or Ala. These results, supported by additional structural observations, suggest that ground state destabilization from the negatively charged Asp38 general base provides a modest contribution to KSI catalysis. They also provide a clear illustration of the well-recognized concept that enzymes evolve for catalytic function and not, in general, to maximize ground state binding. This ground state destabilization mechanism may be common to the many enzymes with anionic side chains that deprotonate carbon acids.

Consequences of synergy between environmental carcinogens

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

Berenbaum, M.C.

1985-12-01

As it is generally impossible to determine dose-response relationships for carcinogens at the low concentrations in which they occur in the environment, risk-benefit considerations are by consensus based on the linear, no-threshold model, on the assumption that this represents the worst case. However, this assumption does not take into account the possibility of synergistic interactions between carcinogens. It is shown here that, as a result of such interactions, the dose-response curve for added risk due to any individual carcinogen will generally be steeper at lower doses than at higher doses, and consequently the risk at low environmental levels will bemore » higher than would be expected from a linear response. Moreover, this excess risk at low doses is shown to increase as the general level of environmental carcinogens rises and, independently of this effect, it may also increase with the number of carcinogens present.« less

Knowledge of family planning methods in Bangladesh, 1969-1979: trends and implications.

PubMed

Amin, R; Mariam, A G

1986-12-01

The changes in levels of knowledge about different contraceptive methods in Bangladesh between 1969-79 were assessed. 2 surveys provided the data: the 1969 National Impact Survey (NIS) of family planning and the 1979 Contraceptive Prevalence Survey (CPS) from Bangladesh. Both surveys were nationally representative and retrospective, containing detailed questions of pregnancy histories, socioeconomic background, family planning knowledge and attitude, and contraceptive practices. The sampling frames for both surveys consisted of all households in Bangladesh from which national probability samples of married women between the ages of 10-50 were selected and stratified by urban-rural residence. Unprompted data were analyzed. Apparently, the National Family Planning Program (NFPP) was successful in communicating general knowledge of family planning among the masses in Bangladesh. In terms of absolute level, the increase in general knowledge of family planning was from 46.3% in 1969 to 82.8% in 1979. With the exception of the oral contraceptive (OC), absolute increase in knowledge of specific family planning methods or a variety of methods was far less than that of general knowledge of family planning. Knowledge of condoms, female sterilization, and male sterilization increased between 1969-79, yet in terms of absolute levels these increases were far less than those of either general knowledge of family planning or knowledge of OCs. The percentages of couples reporting knowledge of the IUD, vaginal methods, rhythm, injection, or induced abortion either decreased or slightly increased between 1969-79. Nearly 40% of couples had knowledge of only 1 method; fewer couples knew of 2 or more methods. There were relative increases in the knowledge of OCs and female sterilization, an 8-fold increase in knowledge of the OC and a 6-fold increase in knowledge of female sterilization between 1969-79. Respondents from the urban areas or those who attended schools were more likely to know about different contraceptive methods. Despite government orders stipulating that each household be visited every month by a family planning worker, face-to-face contact with family planning extension workers continued to be very low. In view of poor field worker performance, the government has made various modifications in the NFPP operation aimed at strengthening information and service delivery programs, yet recent evidence shows their continuing ineffectiveness. The low levels of knowledge about different family planning methods and low level of contact between family planning workers and family planning target couples show that the NFPP, by failing to inform married couples of wider choice of methods, missed many potential new acceptors of family planning methods.

Choice-reaction time to visual motion with varied levels of simultaneous rotary motion

NASA Technical Reports Server (NTRS)

Clark, B.; Stewart, J. D.

1974-01-01

Twelve airline pilots were studied to determine the effects of whole-body rotation on choice-reaction time to the horizontal motion of a line on a cathode-ray tube. On each trial, one of five levels of visual acceleration and five corresponding proportions of rotary acceleration were presented simultaneously. Reaction time to the visual motion decreased with increasing levels of visual motion and increased with increasing proportions of rotary acceleration. The results conflict with general theories of facilitation during double stimulation but are consistent with neural-clock model of sensory interaction in choice-reaction time.

Incidence of elevated lipoprotein (a) levels in a large cohort of patients with cardiovascular disease.

PubMed

van Buuren, Frank; Horstkotte, Dieter; Knabbe, Cornelius; Hinse, Dennis; Mellwig, Klaus Peter

2017-03-01

Recently it has been demonstrated that elevated lipoprotein (a) (LPA) levels are associated with an increased risk of cardiovascular disease across multiple ethnic groups. However, there is only scanty data about the incidence of elevated LPA levels in different patient cohorts. As a consequence, we aimed to examine whether patients with elevated LPA levels might be seen more often in a cardiovascular center in comparison to the general population. We reviewed LPA concentrations of 52,898 consecutive patients who were admitted to our hospital between January 2004 and December 2014. We subdivided them into different groups according to their LPA levels. Data was compared to available information in medical literature. 26.4% of the patients had LPA levels >30 mg/dl which is in line with the data from literature. Mean level of LPA concentration in our study was twice as high in comparison to the general population (25.8% vs. 13.3%). 4.6% had LPA levels >98 mg/dl (general population <0.3%). In patients admitted to a cardiovascular center the proportion of LPA >30 mg/dl is comparable to the general population but mean levels over all are twice as high and the proportion of patients with LPA levels of >98 mg/dl is extremely higher.

Introducing Students to Psychological Research: General Psychology as a Laboratory Course

ERIC Educational Resources Information Center

Thieman, Thomas J.; Clary, E. Gil; Olson, Andrea M.; Dauner, Rachel C.; Ring, Erin E.

2009-01-01

For 6 years, we have offered an integrated weekly laboratory focusing on research methods as part of our general psychology course. Through self-report measures and controlled comparisons, we found that laboratory projects significantly increase students' knowledge and comfort level with scientific approaches and concepts, sustain interest in…

Promoting Student Learning in a Large General Chemistry Course

ERIC Educational Resources Information Center

Buchanan, Stacey A.; Reynolds, Melissa M.; Duersch, Brett S.; Lohr, Lawrence L.; Coppola, Brian P.; Zusho, Akane; Pintrich, Paul R.

2004-01-01

Based on recent reports in the science education literature, curricular modifications were made to one section of a freshman-level general chemistry course. Assessment results indicate that these modifications resulted in a more student-centered learning environment and increased student learning and satisfaction as compared to results from…

The role of physical fitness as risk indicator of increased low back pain intensity among people working with physically and mentally disabled persons: a 30-month prospective study.

PubMed

Strøyer, Jesper; Jensen, Lone Donbaek

2008-03-01

A prospective cohort study. To study if low level of physical fitness was associated with increased low back pain (LBP) intensity at 30-month follow-up. The evidence of low physical fitness as a risk factor for LBP is inconclusive due to contradictory results. Study participants were 327 employees (women = 271, men = 56) at institutions for physically and mentally disabled persons. Physical fitness was measured by tests of: back extension and flexion endurance, flexibility and balance; and by self-assessed aerobic fitness, muscle strength, endurance, flexibility and balance, using visual analogue scales. Low back pain, lifestyle parameters, and physical and psychosocial work factors were assessed by questionnaires at baseline and at follow-up. Outcome was defined as an increase above 2 steps in average LBP intensity during the previous year (0-10). Persons with low level back endurance showed an insignificantly higher risk of increased LBP intensity (OR = 2.4, P = 0.076), whereas persons with medium level back endurance were at significantly higher risk (OR = 2.7, P = 0.034) compared with those with high level back endurance. The general association between isometric back extension endurance and increased LBP intensity was insignificant (P = 0.067). Persons with medium level self-assessed aerobic fitness were at lower risk of increased LBP intensity compared with those with high level (OR = 0.37, P = 0.02), although the general association of aerobic fitness was insignificant (0.066). Performance-based back flexion endurance, flexibility, and balance; and self-assessed muscle strength, endurance, flexibility, and balance were not associated with increased LBP intensity. The significant association between medium level back extension endurance and increased LBP intensity supports the finding of other studies that particularly back extension endurance is an important physical fitness component in preventing LBP and that the subcomponents of physical fitness are related in different ways to LBP.

Are elderly dependency ratios associated with general population suicide rates?

PubMed

Shah, Ajit

2011-05-01

The elderly population size is increasing worldwide due to falling birth rates and increasing life expectancy. It has been hypothesized that as the elderly dependency ratio (the ratio of those over the age of 65 years to those under 65) increases, there will be fewer younger people available to care for older people and this, in turn, will increase the burden on younger carers with increased levels of psychiatric morbidity leading to an increase in general population suicide rates. A cross-national study examining the relationship between elderly dependency ratios and general population suicide rates was conducted using data from the World Health Organization and the United Nations websites. The main findings were of a significant and independent positive correlation between elderly dependency ratios and general population suicide rates in both genders. The contribution of cross-national differences in psychiatric morbidity in younger carers on general population suicide rates requires further study. The prevalence of psychiatric morbidity in younger carers of older people should be examined by: (i) cross-national studies using standardized measures of psychiatric morbidity that are education-free, culture-fair and language-fair; and (ii) within-country longitudinal studies with changing elderly dependency ratios over time.

An exploration of the relationship between fatigue and physical functioning in patients with end stage renal disease receiving haemodialysis.

PubMed

O'Sullivan, Dawn; McCarthy, Geraldine

2007-11-01

To measure fatigue and physical functioning in patients with end stage renal disease (ESRD) receiving haemodialysis and to investigate the relationships between fatigue and physical functioning. Fatigue and reduced physical functioning are among the most bothersome symptoms experienced by individuals receiving haemodialysis for ESRD. Research has shown that increasing activity levels has resulted in decreased fatigue levels and improved physical functioning in individuals with cancer. Establishing whether or not a relationship exists between both concepts in haemodialysis patients is a preliminary step in identifying potential fatigue reducing strategies necessary for improved wellbeing. A quantitative exploratory correlational design was used with 46 individuals completing the Multi-dimensional Fatigue Inventory, the Medical Outcomes Study Short-Form 36-item questionnaire and a Demographic Questionnaire. Results indicated fatigue was prevalent with highest scores achieved for physical fatigue; reduced activity and general fatigue. Substantial limitations in physical functioning were found. A significant moderate negative relationship between general fatigue and physical functioning indicated that, as physical functioning levels increased, fatigue levels decreased. A significant difference was also found between general fatigue scores for males and females. Significant relationships were found between overall physical functioning, older age and employment status. The research indicates the prevalence of fatigue and limitations in physical functioning in individuals with ESRD. However, as physical functioning increased fatigue decreased; a finding relevant to clinical nursing. Understanding the levels of fatigue and the value of exercise is of relevance to clinical practice thus assessment of fatigue and physical functioning ability in the clinical setting is necessary.

Neighbourhood safety and leisure-time physical activity among Dutch adults: a multilevel perspective.

PubMed

Kramer, Daniëlle; Maas, Jolanda; Wingen, Marleen; Kunst, Anton E

2013-01-28

Several neighbourhood elements have been found to be related to leisure-time walking and cycling. However, the association with neighbourhood safety remains unclear. This study aimed to assess the association of neighbourhood-level safety with leisure-time walking and cycling among Dutch adults. Data were derived from the national health survey (POLS) 2006-2009, with valid data on 20046 respondents residing in 2127 neighbourhoods. Multilevel logistic regression models were used to examine the association between neighbourhood-level safety (general safety and specific safety components: physical disorder, social disorder, crime-related fear, traffic safety) and residents' engagement in outdoor leisure-time walking and cycling for at least 30 minutes per week. An increase in neighbourhood safety (both general safety and each of the safety components) was significantly associated with an increase in leisure-time cycling participation. Associations were strongest for general safety and among older women. In the general population, neighbourhood safety was not significantly associated with leisure-time walking. However, among younger and older adult men and lower educated individuals, an increase in general safety was associated with a decrease in leisure-time walking participation. In the Netherlands, neighbourhood safety appears to be related to leisure-time cycling but not to walking. Leisure-time cycling may best be encouraged by improving different safety components at once, rather than focusing on one safety aspect such as traffic safety. Special attention is needed for older women.

Will there be a good general surgeon when you need one? (Part II) Solutions and taking back general surgery.

PubMed

Smith, Richard; Stain, Steven C; McFadden, David W; Finlayson, Samuel R G; Jones, Daniel B; Reid-Lombardo, K Marie

2014-07-01

Multiple reports have cited the looming shortage of physicians over the next decades related to increasing demand, an aging of the population, and a stagnant level in the production of new physicians. General surgery shares in this problem, and the specialty is "stressed" by a declining workforce related to increasing specialization that leaves gaps in emergency, trauma, and rural surgical care. The Society of Surgery of the Alimentary Tract (SSAT) Public Policy and Advocacy Committee sponsored panel discussions regarding the general surgery workforce shortage at the Digestive Disease Week 2012 and 2013 meetings. The 2012 panel focused on defining the problem. This is the summation of the series with the solutions to the general surgery workforce shortage as offered by the 2013 panel.

Association between hepatic steatosis and serum liver enzyme levels with atrial fibrillation in the general population: The Study of Health in Pomerania (SHIP).

PubMed

Markus, Marcello Ricardo Paulista; Meffert, Peter J; Baumeister, Sebastian Edgar; Lieb, Wolfgang; Siewert, Ulrike; Schipf, Sabine; Koch, Manja; Kors, Jan A; Felix, Stephan Burkhard; Dörr, Marcus; Targher, Giovanni; Völzke, Henry

2016-02-01

Hepatic steatosis (HS) affects up to 35% of adults in the general population. Atrial fibrillation (AF) is the most prevalent sustained arrhythmia and has a substantial impact on healthcare costs. We analyzed cross-sectional associations of HS and serum liver enzyme levels with prevalent AF in a general population sample. We analyzed data from 3090 women and men, aged 20-81 years, from the population-based Study of Health in Pomerania. HS was determined by ultrasonography. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltranspeptidase (GGT) were measured photometrically. AF was determined by automatic electrocardiographic analysis software. The prevalences of HS and AF were 30.3% and 1.49%, respectively. ALT, AST and GGT showed a positive linear association with the risk of prevalent AF, after multivariable adjustment. The adjusted odds ratios for AF per 1-standard deviation increment in log-transformed serum liver enzyme levels were 1.65 (95% confidence interval [CI]: 1.16 to 2.35; p = 0.006) for ALT, 1.47 (95%CI: 1.07 to 2.02; p = 0.017) for AST and 2.17 (95%CI: 1.64 to 2.87; p < 0.001) for GGT. In contrast, ultrasonographic HS was not associated with AF. Our findings indicate that moderately elevated serum liver enzymes, but not sonographic liver hyperechogenicity, were associated with increased AF prevalence in the general adult population. The hepatic release of increased levels of serum liver enzymes might be accompanied by higher levels of pro-inflammatory, pro-coagulant and pro-fibronogenic mediators that might lead to structural and electrical remodeling of the atrium resulting in the development and persistence of AF. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Warm Parenting Associated with Decreasing or Stable Child BMI during Treatment

PubMed Central

Jelalian, Elissa; Boutelle, Kerri; Dickstein, Susan; Seifer, Ronald; Wing, Rena

2016-01-01

Abstract Background: While authoritative parenting, which includes high levels of warmth and behavioral control, has been associated with lower risk of obesity, little is known about how general parenting impacts child weight loss during treatment. Our goal was to examine the relationship between several general parenting dimensions and ‘decreasing /stable’ child BMI during a 16-week family-based behavioral weight control program. Methods: Forty-four overweight parent-child dyads (child age 8 to 12 years) enrolled in the program. Families were videotaped at baseline eating dinner in their home. Using the General Parenting Observational Scale (GPOS), meals were coded for several general parenting dimensions. Primary outcome was percent of children whose BMI ‘decreased or stayed the same.’ Multivariable logistic regression was used to determine the relationship between general parenting and decreasing/stable child BMI. Results: Forty families (91%) completed the program. Children had a mean BMI change of −0.40 (SD 1.57), which corresponds to a −0.15 (SD 0.20) change in BMI z-score (BMI-Z); 75% of children had decreasing/stable BMI. In the unadjusted models, lower parent BMI, higher parent education, and higher levels of parental warmth were significantly associated with decreasing/stable child BMI. In the multivariable model, only higher level of warmth was associated with increased odds of decreasing/stable child BMI (OR = 1.28; 95% CI, 1.01, 1.62). Conclusions: Baseline parental warmth may influence a child's ability to lower/maintain BMI during a standard family-based behavioral weight control program. Efforts to increase parent displays of warmth and emotional support towards their overweight child may help to increase the likelihood of treatment success. PMID:26895374

Warm Parenting Associated with Decreasing or Stable Child BMI during Treatment.

PubMed

Rhee, Kyung E; Jelalian, Elissa; Boutelle, Kerri; Dickstein, Susan; Seifer, Ronald; Wing, Rena

2016-04-01

While authoritative parenting, which includes high levels of warmth and behavioral control, has been associated with lower risk of obesity, little is known about how general parenting impacts child weight loss during treatment. Our goal was to examine the relationship between several general parenting dimensions and 'decreasing /stable' child BMI during a 16-week family-based behavioral weight control program. Forty-four overweight parent-child dyads (child age 8 to 12 years) enrolled in the program. Families were videotaped at baseline eating dinner in their home. Using the General Parenting Observational Scale (GPOS), meals were coded for several general parenting dimensions. Primary outcome was percent of children whose BMI 'decreased or stayed the same.' Multivariable logistic regression was used to determine the relationship between general parenting and decreasing/stable child BMI. Forty families (91%) completed the program. Children had a mean BMI change of -0.40 (SD 1.57), which corresponds to a -0.15 (SD 0.20) change in BMI z-score (BMI-Z); 75% of children had decreasing/stable BMI. In the unadjusted models, lower parent BMI, higher parent education, and higher levels of parental warmth were significantly associated with decreasing/stable child BMI. In the multivariable model, only higher level of warmth was associated with increased odds of decreasing/stable child BMI (OR = 1.28; 95% CI, 1.01, 1.62). Baseline parental warmth may influence a child's ability to lower/maintain BMI during a standard family-based behavioral weight control program. Efforts to increase parent displays of warmth and emotional support towards their overweight child may help to increase the likelihood of treatment success.

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

Risk perception and level of knowledge of diseases transmitted by Aedes aegypti.

PubMed

Menchaca-Armenta, Imelda; Ocampo-Torres, Moisés; Hernández-Gómez, Arnulfo; Zamora-Cerritos, Karen

2018-03-08

Diseases caused by viruses such as dengue, chikungunya and zika are mosquito-borne diseases transmitted by Aedes aegypti. We performed a cross-sectional study of healthcare personnel and the general population using questionnaires to identify the level of knowledge, attitudes and practices, and risk perception for dengue, chikungunya and zika. A total of 248 questionnaires were applied, 63.3% to healthcare personnel and 36.7% to the general population. Of the healthcare personnel, 53% were men, and in the general population 74% were women. Nahuatl and Spanish were spoken by both, healthcare personnel (28%) and the general population (23%). The level of knowledge, attitudes and practices and risk perception of the population and personnel showed significant differences (p<0.05). Among healthcare personnel, nurses and vector operating staff had the lowest level of knowledge. On the other hand, the questions with the lowest scores were 1) symptoms of Zika in both groups, 2) circulating dengue serotypes in healthcare personnel and 3) symptoms of chikungunya in the general population. The results of this work allow us to identify information gaps in which knowledge, attitudes and practices, and risk perception need to be increased.

Public health care funding modifies the effect of out-of-pocket spending on maternal, infant, and child mortality.

PubMed

Noel, Jonathan K

2017-03-01

Increased out-of-pocket (OOP) health care spending has been associated with increased maternal, infant, and child mortality, but the effect of public health care spending on mortality has not been studied. I identified a statistically significant interaction between public health care expenditure and OOP health care spending for maternal, infant, and child mortality. Generally, increases in public expenditure coincide with decreased rates of mortality, regardless of OOP spending levels. Specifically, higher levels of public expenditure with moderate levels of OOP spending may result in the lowest mortality rates. Increased public health care spending may improve health outcomes better than efforts to reduce OOP expenditure alone.

Impacts of Groundwater Recharge from Rubber Dams on the Hydrogeological Environment in Luoyang Basin, China

PubMed Central

Dong, Shaogang; Liu, Baiwei; Liu, Huamin; Wang, Shidong; Wang, Lixin

2014-01-01

In the rubber dam's impact area, the groundwater total hardness (TH) has declined since 2000, ultimately dropping to 100–300 mg/L in 2012. pH levels have shown no obvious changes. NH4-N concentration in the groundwater remained stable from 2000 to 2006, but it increased from 2007 to 2012, with the largest increase up to 0.2 mg/L. NO3-N concentration in the groundwater generally declined in 2000–2006 and then increased from 2007; the largest increase was to 10 mg/L in 2012. Total dissolved solids (TDS) of the groundwater showed a general trend of decline from 2000 to 2009, but levels increased after 2010, especially along the south bank of the Luohe River where the largest increase recorded was approximately 100 mg/L. This study has shown that the increases in the concentrations of NH4-N and NO3-N were probably caused by changes in groundwater levels. Nitrates adsorbed by the silt clay of aeration zone appear to have entered the groundwater through physical and chemical reactions. TDS increased because of groundwater evaporation and some soluble ions entered the groundwater in the unsaturated zone. The distance of the contaminant to the surface of the aquifer became shorter due to the shallow depth of groundwater, resulting in the observed rise in pollutant concentrations more pronounced. PMID:25126593

The Influence of Oral Carbohydrate Solution Intake on Stress Response before Total Hip Replacement Surgery during Epidural and General Anaesthesia.

PubMed

Çeliksular, M Cem; Saraçoğlu, Ayten; Yentür, Ercüment

2016-06-01

The effects of oral carbohydrate solutions, ingested 2 h prior to operation, on stress response were studied in patients undergoing general or epidural anaesthesia. The study was performed on 80 ASA I-II adult patients undergoing elective total hip replacement, which were randomized to four groups (n=20). Group G patients undergoing general anaesthesia fasted for 8 h preoperatively; Group GN patients undergoing general anaesthesia drank oral carbohydrate solutions preoperatively; Group E patients undergoing epidural anaesthesia fasted for 8 h and Group EN patients undergoing epidural anaesthesia drank oral carbohydrate solutions preoperatively. Groups GN and EN drank 800 mL of 12.5% oral carbohydrate solution at 24:00 preoperatively and 400 mL 2 h before the operation. Blood samples were taken for measurements of glucose, insulin, cortisol and IL-6 levels. The effect of preoperative oral carbohydrate ingestion on blood glucose levels was not significant. Insulin levels 24 h prior to surgery were similar; however, insulin levels measured just before surgery were 2-3 times higher in groups GN and EN than in groups G and E. Insulin levels at the 24(th) postoperative hour in epidural groups were increased compared to those at basal levels, although general anaesthesia groups showed a decrease. From these measurements, only the change in Group EN was statistically significant (p<0.05). Plasma cortisol levels at the 2(nd) peroperative hour were higher in epidural groups than in general anaesthesia groups. Both anaesthesia techniques did not have an effect on IL-6 levels. We concluded that epidural anaesthesia suppressed stress response, although preoperative oral carbohydrate nutrition did not reveal a significant effect on surgical stress response.

Building a Cohesive Team: Increasing Communication and Understanding between Music Educators

ERIC Educational Resources Information Center

Brown, Linda C.

2009-01-01

Recently, the Music Educators National Conference (MENC) general music forum was abuzz with comments about teacher hierarchy. Many general music teachers expressed dismay at not always receiving the respect they deserve from colleagues teaching ensembles at the secondary level. In this article, the author talks about the importance of…

Reexamination of the Physiological Role of PykA in Escherichia coli Revealed that It Negatively Regulates the Intracellular ATP Levels under Anaerobic Conditions.

PubMed

Zhao, Chunhua; Lin, Zhao; Dong, Hongjun; Zhang, Yanping; Li, Yin

2017-06-01

Pyruvate kinase is one of the three rate-limiting glycolytic enzymes that catalyze the last step of glycolysis, conversion of phosphoenolpyruvate (PEP) into pyruvate, which is associated with ATP generation. Two isozymes of pyruvate kinase, PykF and PykA, are identified in Escherichia coli PykF is considered important, whereas PykA has a less-defined role. Prior studies inactivated the pykA gene to increase the level of its substrate, PEP, and thereby increased the yield of end products derived from PEP. We were surprised when we found a pykA ::Tn 5 mutant in a screen for increased yield of an end product derived from pyruvate ( n -butanol), suggesting that the role of PykA needs to be reexamined. We show that the pykA mutant exhibited elevated intracellular ATP levels, biomass concentrations, glucose consumption, and n -butanol production. We also discovered that the pykA mutant expresses higher levels of a presumed pyruvate transporter, YhjX, permitting the mutant to recapture and metabolize excreted pyruvate. Furthermore, we demonstrated that the nucleotide diphosphate kinase activity of PykA leads to negative regulation of the intracellular ATP levels. Taking the data together, we propose that inactivation of pykA can be considered a general strategy to enhance the production of pyruvate-derived metabolites under anaerobic conditions. IMPORTANCE This study showed that knocking out pykA significantly increased the intracellular ATP level and thus significantly increased the levels of glucose consumption, biomass formation, and pyruvate-derived product formation under anaerobic conditions. pykA was considered to be encoding a dispensable pyruvate kinase; here we show that pykA negatively regulates the anaerobic glycolysis rate through regulating the energy distribution. Thus, knocking out pykA can be used as a general strategy to increase the level of pyruvate-derived fermentative products. Copyright © 2017 American Society for Microbiology.

48 CFR 211.274-1 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... on the workforce through increased productivity and efficiency; and (e) Ensures item level traceability throughout lifecycle to strengthen supply chain integrity, enhance cyber security, and combat...

General practice funding underpins the persistence of the inverse care law: cross-sectional study in Scotland.

PubMed

McLean, Gary; Guthrie, Bruce; Mercer, Stewart W; Watt, Graham C M

2015-12-01

Universal access to health care, as provided in the NHS, does not ensure that patients' needs are met. To explore the relationships between multimorbidity, general practice funding, and workload by deprivation in a national healthcare system. Cross-sectional study using routine data from 956 general practices in Scotland. Estimated numbers of patients with multimorbidity, estimated numbers of consultations per 1000 patients, and payments to practices per patient are presented and analysed by deprivation decile at practice level. Levels of multimorbidity rose with practice deprivation. Practices in the most deprived decile had 38% more patients with multimorbidity compared with the least deprived (222.8 per 1000 patients versus 161.1; P<0.001) and over 120% more patients with combined mental-physical multimorbidity (113.0 per 1000 patients versus 51.5; P<0.001). Practices in the most deprived decile had 20% more consultations per annum compared with the least deprived (4616 versus 3846, P<0.001). There was no association between total practice funding and deprivation (Spearman ρ -0.09; P = 0.03). Although consultation rates increased with deprivation, the social gradients in multimorbidity were much steeper. There was no association between consultation rates and levels of funding. No evidence was found that general practice funding matches clinical need, as estimated by different definitions of multimorbidity. Consultation rates provide only a partial estimate of the work involved in addressing clinical needs and are poorly related to the prevalence of multimorbidity. In these circumstances, general practice is unlikely to mitigate health inequalities and may increase them. © British Journal of General Practice 2015.

Electromagnetic fields and the public: EMF standards and estimation of risk

NASA Astrophysics Data System (ADS)

Grigoriev, Yury

2010-04-01

Mobile communications are a relatively new and additional source of electromagnetic exposure for the population. Standard daily mobile-phone use is known to increase RF-EMF (radiofrequency electromagnetic field) exposure to the brains of users of all ages, whilst mobile-phone base stations, and base station units for cordless phones, can regularly increase the exposures of large numbers of the population to RF-EMF radiation in everyday life. The need to determine appropriate standards stipulating the maximum acceptable short-term and long-term RF-EMF levels encountered by the public, and set such levels as general guidelines, is of great importance in order to help preserve the general public's health and that of the next generation of humanity.

Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

PubMed Central

Yokoyama, Miyuki; Otaki, Yoichiro; Takahashi, Hiroki; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo; Shibata, Yoko; Daimon, Makoto; Kayama, Takamasa; Kubota, Isao

2016-01-01

Background. Early identification of high risk subjects for cardiovascular disease in health check-up is still unmet medical need. Cardiovascular disease is characterized by the superior increase in aspartate aminotransferase (AST) to alanine aminotransferase (ALT). However, the association of AST/ALT ratio with brain natriuretic peptide (BNP) levels and cardiovascular mortality remains unclear in the general population. Methods and Results. This longitudinal cohort study included 3,494 Japanese subjects who participated in a community-based health check-up, with a 10-year follow-up. The AST/ALT ratio increased with increasing BNP levels. And multivariate logistic analysis showed that the AST/ALT ratio was significantly associated with a high BNP (≥100 pg/mL). There were 250 all-cause deaths including 79 cardiovascular deaths. Multivariate Cox proportional hazard regression analysis revealed that a high AST/ALT ratio (>90 percentile) was an independent predictor of all-cause and cardiovascular mortality after adjustment for confounding factors. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in subjects with a high AST/ALT ratio than in those without. Conclusions. The AST/ALT ratio was associated with an increase in BNP and was predictive of cardiovascular mortality in a general population. Measuring the AST/ALT ratio during routine health check-ups may be a simple and cost-effective marker for cardiovascular mortality. PMID:27872510

Applying General Strain Theory to Examine Perceived Discrimination’s Indirect Relation to Mexican-Heritage Youth’s Alcohol, Cigarette, and Marijuana Use

PubMed Central

Cleveland, Michael J.; Hecht, Michael L.

2013-01-01

Latent growth curve modeling was used to test four hypotheses. First, this study hypothesized that acculturation-related variables (e.g., Mexican-heritage youth’s country of origin, time spent in the U.S., and language preference with family and friends) would be associated with initial levels of perceived discrimination. Guided by general strain theory (GST), this study then posed a second hypothesis: Initial levels of perceived discrimination would be indirectly related to initial levels of substance use through initial levels of acculturation stress. Third, this study hypothesized that changes in perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. As a fourth hypothesis, it was postulated that initial levels of perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. Mexican-heritage youth (N=1,106) from 29 schools in Phoenix, AZ completed surveys at six waves from 5th through 8th grades. In partial support of the first hypothesis, more time spent in the U.S. and speaking English with friends were associated with lower levels of perceived discrimination. The second hypothesis was not supported. Initial levels of perceived discrimination were positively associated with initial levels of acculturation stress; however, this association was not found between initial levels of acculturation stress and substance use. The third and fourth hypotheses were supported, which buttressed predictions derived from GST. Both initial levels and increases in perceived discrimination were indirectly related to increases in substance use through increases in acculturation stress. PMID:20490921

Recent Changes in Land Water Storage and its Contribution to Sea Level Variations

NASA Astrophysics Data System (ADS)

Wada, Yoshihide; Reager, John T.; Chao, Benjamin F.; Wang, Jida; Lo, Min-Hui; Song, Chunqiao; Li, Yuwen; Gardner, Alex S.

2017-01-01

Sea level rise is generally attributed to increased ocean heat content and increased rates glacier and ice melt. However, human transformations of Earth's surface have impacted water exchange between land, atmosphere, and ocean, ultimately affecting global sea level variations. Impoundment of water in reservoirs and artificial lakes has reduced the outflow of water to the sea, while river runoff has increased due to groundwater mining, wetland and endorheic lake storage losses, and deforestation. In addition, climate-driven changes in land water stores can have a large impact on global sea level variations over decadal timescales. Here, we review each component of negative and positive land water contribution separately in order to highlight and understand recent changes in land water contribution to sea level variations.

Recent Changes in Land Water Storage and Its Contribution to Sea Level Variations

NASA Technical Reports Server (NTRS)

Wada, Yoshihide; Reager, John T.; Chao, Benjamin F.; Wang, Jida; Lo, Min-Hui; Song, Chunqiao; Li, Yuwen; Gardner, Alex S.

2016-01-01

Sea level rise is generally attributed to increased ocean heat content and increased rates glacier and ice melt. However, human transformations of Earth's surface have impacted water exchange between land, atmosphere, and ocean, ultimately affecting global sea level variations. Impoundment of water in reservoirs and artificial lakes has reduced the outflow of water to the sea, while river runoff has increased due to groundwater mining, wetland and endorheic lake storage losses, and deforestation. In addition, climate-driven changes in land water stores can have a large impact on global sea level variations over decadal timescales. Here, we review each component of negative and positive land water contribution separately in order to highlight and understand recent changes in land water contribution to sea level variations.

Sickness absence among Finnish special and general education teachers.

PubMed

Ervasti, J; Kivimäki, M; Pentti, J; Suominen, S; Vahtera, J; Virtanen, M

2011-10-01

Although teaching is considered a high-stress profession, research on stress-related outcomes among teachers, such as absence from work due to illness (i.e. sickness absence), remains scarce. It is possible that teachers are not a homogeneous group but include subgroups with particularly high risk of sickness absence, such as special education teachers. To examine differences in sickness absence rates between special and general education teachers in a large cohort of 2291 Finnish lower secondary school teachers. Register data on teachers' job titles, sociodemographic characteristics and sickness absence were obtained from 10 municipal employers' registers. Indices of sickness absence included rates of short-term (1-3 days) and long-term (>3 days) absence spells during 2003-05. With multi-level models adjusted for individual- and school-level covariates, we found that although the absolute level of sickness absence was higher among women than among men, male special education teachers were at a 1.36-fold (95% CI: 1.15-1.61) increased risk of short-term and a 1.33-fold (95% CI: 1.01-1.76) increased risk of long-term sickness absence compared with male teachers in general education. Among women, there were no differences in sickness absence between special and general education teachers. Compared to male teachers in general education, male teachers in special education appear to have an excess risk of absence from work due to illness. Future studies should examine the causes for this excess risk and determine the need for preventive interventions.

Association of psychological stress response of fatigue with white blood cell count in male daytime workers.

PubMed

Nishitani, Naoko; Sakakibara, Hisataka

2014-01-01

Relationships between work-related psychological and physical stress responses and counts of white blood cells (WBCs), neutrophils, and lymphocytes were investigated in 101 daytime workers. Counts of WBCs and neutrophils were positively associated with smoking and inversely correlated with high density lipoprotein (HDL)-cholesterol levels. Additionally, general fatigue score as measured by the profile of mood state was positively correlated with WBC and neutrophil counts whereas lymphocyte counts was not significantly associated with fatigue score. Multiple regression analysis showed that WBC count was significantly related to general fatigue, age, and HDL-cholesterol levels. Neutrophil count was significantly related to HDL-cholesterol levels and fatigue score. Among various psychological stress response variables, general fatigue may be a key determinant of low-grade inflammation as represented by increases of WBC and neutrophil counts.

Social health insurance and labor market outcomes: evidence from central and eastern Europe, and central Asia.

PubMed

Wagstaff, Adam; Moreno-Serra, Rodrigo

2009-01-01

The implications of social health insurance (SHI) for labor markets have featured prominently in recent debates over the merits of SHI and general revenue financing. It has been argued that by raising the nonwage component of labor costs, SHI reduces firms' demand for labor, lowers employment levels and net wages, and encourages self-employment and informal working arrangements. At the national level, SHI has been claimed to reduce a country's competitiveness in international markets and to discourage foreign direct investment (FDI). The transition from general revenue finance to SHI that occurred during the 1990s in many of the central and eastern European and central Asian countries provides a unique opportunity to investigate empirically these claims. We employ regression-based generalizations of difference-in-differences (DID) and instrumental variables (IV) on country-level panel data from 28 countries for the period 1990-2004. We find that, controlling for gross domestic product (GDP) per capita, SHI increases (gross) wages by 20%, reduces employment (as a share of the population) by 10%, and increases self-employment by 17%. However, we find no significant effects of SHI on unemployment (registered or self-reported), agricultural employment, a widely used measure of the size of the informal economy, or FDI. We do not claim that our results imply that SHI adoption everywhere must necessarily reduce employment and increase self-employment. Nonetheless, our results ought to serve as a warning to those contemplating shifting the financing of health care from general revenues to a SHI system.

The Impact of Attaining the Welsh Baccalaureate Advanced Diploma on Academic Performance in Bioscience Higher Education

ERIC Educational Resources Information Center

Yhnell, Emma; Wood, Heather; Baker, Mathew; Amici-Dargan, Sheila; Taylor, Chris; Randerson, Peter; Shore, Andrew

2016-01-01

Since the introduction of the Welsh Baccalaureate Advanced Diploma Qualification (WBQ) in 2003, an increasing number of students are applying to higher education institutions (HEIs) with this qualification. The advanced-level WBQ is regarded as equivalent to one General Certificate of Education A-Level (GCE A-Level). This study assesses the impact…

Adaptive Functioning and Behaviour Problems in Relation to Level of Education in Children and Adolescents with Intellectual Disability

ERIC Educational Resources Information Center

de Bildt, A.; Sytema, S.; Kraijer, D.; Sparrow, S.; Minderaa, R.

2005-01-01

Background: The interrelationship between adaptive functioning, behaviour problems and level of special education was studied in 186 children with IQs ranging from 61 to 70. The objective was to increase the insight into the contribution of adaptive functioning and general and autistic behaviour problems to the level of education in children with…

Examining the progression and consistency of thermal concepts: a cross-age study

NASA Astrophysics Data System (ADS)

Adadan, Emine; Yavuzkaya, Merve Nur

2018-03-01

This cross-sectional study examined how the progression and consistency of students' understanding of thermal concepts in everyday contexts changes across the grade levels. A total of 656 Turkish students from Grade 8 (age 13-14), Grade 10 (age 15-16), and the first year of college (age 19-20) participated in the study. The data were analysed using statistical procedures (descriptive and inferential). Findings indicated a substantial progression in the students' scientific understanding of thermal concepts across grade levels. In addition, the students' alternative conceptions about thermal concepts generally decreased in frequency across grade levels, but certain alternative conceptions were observed in every grade level to a similar extent. Even though the number of students who consistently used scientific ideas increased across grade levels, the number of students who consistently used non-scientific ideas decreased across grade levels. However, the number of students who used scientific and non-scientific ideas inconsistently generally increased as they progressed in the science curriculum. These findings can be associated with either fragmentation or alternative conceptions that result from the gradual enrichment processes students experience when they try to integrate scientific concepts into their conceptual frameworks.

Association between general self-efficacy level and use of dietary supplements in the group of American football players.

PubMed

Gacek, Maria

2016-01-01

Increased nutritional demands of athletes should be covered with a variable well-balanced diet, supported by dietary supplements stimulating synthesis of energy, development of muscle mass and strength, and improving physical capacity. The aim of this study was to analyze an association between the level of general self-efficacy and dietary supplement use among Polish athletes practicing American football on a competitive basis. The study included the group of 100 athletes (20-30 years of age, mean 24.27±2.76 years) who practiced American football on a competitive basis. The popularity of various dietary supplements was determined with an original survey, and the level of general self-efficacy with General Self-Efficacy Scale (GSES) by Schwarzer et al. Statistical analysis, conducted with Statistica 10.0 PL software, included intergroup comparisons with the Chi-square test. Isotonic drinks (74%), vitamin (65%) and mineral supplements (50%) and protein concentrates (53%) turned out to be the most popular ergogenic supplements among the American footballers. The group of less popular supplements included caffeine and/or guarana (44%), joint supporting supplements (40%), BCAA amino acids (39%), creatine (36%), carbohydrate concentrates (30%) and omega-3 fatty acids (30%). Analysis of a relationship between the popularity of ergogenic supplements and general self-efficacy showed that the athletes presenting with lower levels of this trait used multivitamin supplements significantly more often than did the persons characterized by lower self-efficacy levels (p<0.05). The popularity of some dietary supplements varied depending on the general self-efficacy level of the athletes; the popularity of vitamins was significantly higher among the sportsmen who presented with lower levels of this trait.

Comorbid subjective health complaints in patients with sciatica: a prospective study including comparison with the general population.

PubMed

Grøvle, Lars; Haugen, Anne J; Ihlebaek, Camilla M; Keller, Anne; Natvig, Bård; Brox, Jens I; Grotle, Margreth

2011-06-01

Chronic nonspecific low back pain is accompanied by high rates of comorbid mental and physical conditions. The aims of this study were to investigate if patients with specific back pain, that is, sciatica caused by lumbar herniation, report higher rates of subjective health complaints (SHCs) than the general population and if there is an association between change in sciatica symptoms and change in SHCs over a 12-month period. A multicenter cohort study of 466 sciatica patients was conducted with follow-up at 3 months and 1 year. Comorbid SHCs were measured by 27 items of the SHC inventory. Odds ratios (ORs) for each SHC were calculated with comparison to a general population sample (n=928) by logistic regression. The SHC number was calculated by summing all complaints present. At baseline, the ORs for reporting SHCs for the sciatica patients were significantly elevated in 15 of the 27 items with a mean (S.D.) SHC number of 7.5 (4.4), compared to 5.2 (4.4) in the general population (P<.01). Among those who during the 1-year follow-up period fully recovered from their sciatica, the SHC number was reduced to normal levels. Among those with persisting or worsening sciatica, the number increased to a level almost double that of the general population. Compared to the general population, the prevalence of subjective health complaints in sciatica is increased. During follow-up, the number of health complaints increased in patients with persisting or worsening sciatica. Copyright © 2010 Elsevier Inc. All rights reserved.

Review of Student Difficulties in Upper-Level Quantum Mechanics

ERIC Educational Resources Information Center

Singh, Chandralekha; Marshman, Emily

2015-01-01

Learning advanced physics, in general, is challenging not only due to the increased mathematical sophistication but also because one must continue to build on all of the prior knowledge acquired at the introductory and intermediate levels. In addition, learning quantum mechanics can be especially challenging because the paradigms of classical…

Uric acid is released in the brain during seizure activity and increases severity of seizures in a mouse model for acute limbic seizures.

PubMed

Thyrion, Lisa; Raedt, Robrecht; Portelli, Jeanelle; Van Loo, Pieter; Wadman, Wytse J; Glorieux, Griet; Lambrecht, Bart N; Janssens, Sophie; Vonck, Kristl; Boon, Paul

2016-03-01

Recent evidence points at an important role of endogenous cell-damage induced pro-inflammatory molecules in the generation of epileptic seizures. Uric acid, under the form of monosodium urate crystals, has shown to have pro-inflammatory properties in the body, but less is known about its role in seizure generation. This study aimed to unravel the contribution of uric acid to seizure generation in a mouse model for acute limbic seizures. We measured extracellular levels of uric acid in the brain and modulated them using complementary pharmacological and genetic tools. Local extracellular uric acid levels increased three to four times during acute limbic seizures and peaked between 50 and 100 min after kainic acid infusion. Manipulating uric acid levels through administration of allopurinol or knock-out of urate oxidase significantly altered the number of generalized seizures, decreasing and increasing them by a twofold respectively. Taken together, our results consistently show that uric acid is released during limbic seizures and suggest that uric acid facilitates seizure generalization. Copyright © 2016 Elsevier Inc. All rights reserved.

Cooperation in two-person evolutionary games with complex personality profiles.

PubMed

Płatkowski, Tadeusz

2010-10-21

We propose a theory of evolution of social systems which generalizes the standard proportional fitness rule of the evolutionary game theory. The formalism is applied to describe the dynamics of two-person one-shot population games. In particular it predicts the non-zero level of cooperation in the long run for the Prisoner's Dilemma games, the increase of the fraction of cooperators for general classes of the Snow-Drift game, and stable nonzero cooperation level for coordination games. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does outpatient physical therapy with the aim of improving health-related physical fitness influence the level of physical activity in patients with long-term musculoskeletal conditions?

PubMed

Holm, I; Tveter, A T; Moseng, T; Dagfinrud, H

2015-09-01

To evaluate any change in self-reported level of physical activity in patients receiving a general physical exercise programme in addition to disease-specific physiotherapy treatment. Pre-post-intervention study. Outpatient physiotherapy clinics. One hundred and ninety patients with long-term musculoskeletal conditions attending outpatient physiotherapy were recruited from seven physiotherapy clinics. Physiotherapy including disease-specific modalities and a general individually tailored exercise programme. Patients were evaluated at baseline and at the end of the programme. International Physical Activity Questionnaire short form (IPAQ-sf) and COOP WONCA functional assessment charts. Forty-two patients were excluded from the analysis because they did not complete the IPAQ-sf correctly or dropped out during the treatment period. There was a significant increase in the number of metabolic equivalent task (MET)-min/week for vigorous and moderate-intensity activities, walking and total physical activity. The number of exercise sessions per week increased from 1.8 [standard deviation (SD) 0.9] to 2.2 (SD 1.2) (P=0.001). The proportion of patients with a low level of physical activity decreased by 12%, and the proportion of the participants who did not/could not exercise decreased from 26% to 8%. The COOP WONCA charts showed significant improvements in the physical fitness, feelings, daily activities and social activities items. A significant increase was found in the number of MET-min/week for all activity levels. Therefore, a general physical exercise programme initiated by a physiotherapist led to a positive change in level of physical activity. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Are general surgeons able to accurately self-assess their level of technical skills?

PubMed

Rizan, C; Ansell, J; Tilston, T W; Warren, N; Torkington, J

2015-11-01

Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether self-assessment is an accurate form of technical skills appraisal in general surgery. The PubMed, MEDLINE(®), Embase(™) and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence. Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation). Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.

Positive End-Expiratory Pressure and Variable Ventilation in Lung-Healthy Rats under General Anesthesia

PubMed Central

Camilo, Luciana M.; Ávila, Mariana B.; Cruz, Luis Felipe S.; Ribeiro, Gabriel C. M.; Spieth, Peter M.; Reske, Andreas A.; Amato, Marcelo; Giannella-Neto, Antonio; Zin, Walter A.; Carvalho, Alysson R.

2014-01-01

Objectives Variable ventilation (VV) seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP) in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. Design Randomized experimental study. Setting Animal research facility. Subjects Forty-nine male Wistar rats (200–270 g). Interventions Animals were ventilated during 2 hours with protective low tidal volume (VT) in volume control ventilation (VCV) or VV and PEEP adjusted at the level of minimum respiratory system elastance (Ers), obtained during a decremental PEEP trial subsequent to a recruitment maneuver, and 2 cmH2O above or below of this level. Measurements and Main Results Ers, gas exchange and hemodynamic variables were measured. Cytokines were determined in lung homogenate and plasma samples and left lung was used for histologic analysis and diffuse alveolar damage scoring. A progressive time-dependent increase in Ers was observed independent on ventilatory mode or PEEP level. Despite of that, the rate of increase of Ers and lung tissue IL-1 beta concentration were significantly lower in VV than in VCV at the level of the PEEP of minimum Ers. A significant increase in lung tissue cytokines (IL-6, IL-1 beta, CINC-1 and TNF-alpha) as well as a ventral to dorsal and cranial to caudal reduction in aeration was observed in all ventilated rats with no significant differences among groups. Conclusions VV combined with PEEP adjusted at the level of the PEEP of minimal Ers seemed to better prevent anesthesia-induced atelectasis and might improve lung protection throughout general anesthesia. PMID:25383882

Changes in phytochemical and antioxidant activity of selected pepper cultivars (Capsicum species) as influenced by maturity.

PubMed

Howard, L R; Talcott, S T; Brenes, C H; Villalon, B

2000-05-01

The effect of fruit maturation on changes in carotenoids, flavonoids, total soluble reducing equivalents, phenolic acids, ascorbic acid, and antioxidant activity (AOX) in different pepper types (Capsicum annuum, Capsicum frutescens, and Capsicum chinese) was determined. Generally, the concentration of these chemical constituents increased as the peppers reached maturity. Peppers contained high levels of L-ascorbic acid and carotenoids at maturity, contributing 124-338% of the RDA for vitamin C and 0.33-336 RE/100 g of provitamin A activity, respectively. Levels of phenolic acids, capxanthin, and zeaxanthin generally increased during maturation, whereas the level of lutein declined. Flavonoid concentrations varied greatly among the pepper types analyzed and were negatively correlated to AOX under the conditions of the beta-carotene-linoleic assay. Model systems were used to aid in understanding the relationship between flavonoids and AOX. Significant increases in AOX were observed in pepper juice models in response to increasing dilution factors and the presence of EDTA, indicating a pro-oxidant effect due to metal ions in the system. In vitro models demonstrated that increasing levels of flavonoids in combination with constant levels of caffeic and ascorbic acid gave a resultant AOX that was either additive of the two compounds or competitive in their ability to scavenge peroxyl radicals. The model systems were in good agreement with the chemical composition of the pepper cultivars and reflected the interactions affecting AOX. More research is needed to understand the complex interactions that occur among various antioxidants present in pepper extracts.

2005 Mississippi Curriculum Framework: Secondary General Drafting. (Program CIP: 15.1301 - Drafting and Design Technology/Technician, General)

ERIC Educational Resources Information Center

Kirk, Karen; Ladner, Daryl; Lewis, Carroll; Moran, Sheryl; Schneider, Chester; Strickland, Ruth Ann; Welch, Amanda

2005-01-01

Secondary vocational-technical education programs in Mississippi are faced with many challenges resulting from sweeping educational reforms at the national and state levels. Schools and teachers are increasingly being held accountable for providing true learning activities to every student in the classroom. This accountability is measured through…

Is adenosine associated with sudden death in schizophrenia? A new framework linking the adenosine pathway to risk of sudden death.

PubMed

Gadelha, Ary; Zugman, André; Calzavara, Mariana Bendlin; de Mendonça Furtado, Remo Holanda; Scorza, Fulvio Alexandre; Bressan, Rodrigo Afonsecca

2018-01-01

Schizophrenia is associated with an increased mortality from cardiovascular disease. Relatively few studies have assessed the putative association of schizophrenia pathophysiology with sudden death. Low adenosine levels have been associated with schizophrenia. In cardiology, increased mortality among patients with congestive heart failure has been associated with genetic polymorphisms that potentially lead to lower adenosine levels. Thus, we hypothesize that adenosine could link schizophrenia and cardiovascular mortality, with decreased adenosine levels leading to increased vulnerability to hyperexcitability following hypoxic insults, increasing the odds of fatal arrhythmias. Low adenosine levels might also lead to a small increase in overall mortality rates and a major increase in the sudden death rate. This hypothesis paves the way for further investigation of the increased cardiac mortality associated with schizophrenia. Potentially, a better characterization of adenosine-related mechanisms of sudden death in schizophrenia could lead to new evidence of factors leading to sudden death in the general population. Copyright © 2017. Published by Elsevier Ltd.

Impact of acute care surgery to departmental productivity.

PubMed

Barnes, Stephen L; Cooper, Christopher J; Coughenour, Jeffrey P; MacIntyre, Allan D; Kessel, James W

2011-10-01

The face of trauma surgery is rapidly evolving with a paradigm shift toward acute care surgery (ACS). The formal development of ACS has been viewed by some general surgeons as a threat to their practice. We sought to evaluate the impact of a new division of ACS to both departmental productivity and provider satisfaction at a University Level I Trauma Center. Two-year retrospective analysis of annual work relative value unit (wRVU) productivity, operative volume, and FTEs before and after establishment of an ACS division at a University Level I trauma center. Provider satisfaction was measured using a 10-point scale. Analysis completed using Microsoft Excel with a p value less than 0.05 significant. The change to an ACS model resulted in a 94% increase in total wRVU production (78% evaluation and management, 122% operative; p<0.05) for ACS, whereas general surgery wRVU production increased 8% (-15% evaluation and management, 14% operative; p<0.05). Operative productivity was substantial after transition to ACS, with 129% and 44% increases (p<0.05) in operative and elective case load, respectively. Decline in overall general surgery operative volume was attributed to reduction in emergent cases. Establishment of the ACS model necessitated one additional FTE. Job satisfaction substantially improved with the ACS model while allowing general surgery a more focused practice. The ACS practice model significantly enhances provider productivity and job satisfaction when compared with trauma alone. Fears of a productivity impact to the nontrauma general surgeon were not realized.

Neighbourhood safety and leisure-time physical activity among Dutch adults: a multilevel perspective

PubMed Central

2013-01-01

Background Several neighbourhood elements have been found to be related to leisure-time walking and cycling. However, the association with neighbourhood safety remains unclear. This study aimed to assess the association of neighbourhood-level safety with leisure-time walking and cycling among Dutch adults. Methods Data were derived from the national health survey (POLS) 2006–2009, with valid data on 20046 respondents residing in 2127 neighbourhoods. Multilevel logistic regression models were used to examine the association between neighbourhood-level safety (general safety and specific safety components: physical disorder, social disorder, crime-related fear, traffic safety) and residents’ engagement in outdoor leisure-time walking and cycling for at least 30 minutes per week. Results An increase in neighbourhood safety (both general safety and each of the safety components) was significantly associated with an increase in leisure-time cycling participation. Associations were strongest for general safety and among older women. In the general population, neighbourhood safety was not significantly associated with leisure-time walking. However, among younger and older adult men and lower educated individuals, an increase in general safety was associated with a decrease in leisure-time walking participation. Conclusions In the Netherlands, neighbourhood safety appears to be related to leisure-time cycling but not to walking. Leisure-time cycling may best be encouraged by improving different safety components at once, rather than focusing on one safety aspect such as traffic safety. Special attention is needed for older women. PMID:23356476

SEL Ada reuse analysis and representations

NASA Technical Reports Server (NTRS)

Kester, Rush

1990-01-01

Overall, it was revealed that the pattern of Ada reuse has evolved from initial reuse of utility components into reuse of generalized application architectures. Utility components were both domain-independent utilities, such as queues and stacks, and domain-specific utilities, such as those that implement spacecraft orbit and attitude mathematical functions and physics or astronomical models. The level of reuse was significantly increased with the development of a generalized telemetry simulator architecture. The use of Ada generics significantly increased the level of verbatum reuse, which is due to the ability, using Ada generics, to parameterize the aspects of design that are configurable during reuse. A key factor in implementing generalized architectures was the ability to use generic subprogram parameters to tailor parts of the algorithm embedded within the architecture. The use of object oriented design (in which objects model real world entities) significantly improved the modularity for reuse. Encapsulating into packages the data and operations associated with common real world entities creates natural building blocks for reuse.

Effects of freshwater leaching on potential bioavailability of heavy metals in tidal flat soils.

PubMed

Li, Hui; Lu, Jun; Li, Qu-Sheng; He, Bao-Yan; Mei, Xiu-Qin; Yu, Dan-Ping; Xu, Zhi-Min; Guo, Shi-Hong; Chen, Hui-Jun

2016-02-01

Leaching experiments were conducted to investigate the effects of desalination levels and sediment depths on potential bioavailability of heavy metal (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) in tidal flat soils. The data showed that both the desalination levels (p < 0.001) and soil depths (p < 0.001) had significant effects on the concentrations of acid-volatile sulfide (AVS). AVS concentrations generally exhibited increasing trends with an increase in depth and decreasing trends with enhanced desalination levels. The desalination levels had significant (p < 0.05) effects on the concentrations of simultaneously extracted metal (SEM; Cd, Cr, Cu, Fe, Mn, Pb, and Zn). Moreover, the concentrations of SEM (Cd, Cr, Cu, Fe, Mn, Pb, and Zn) generally tended to decrease with an increase in the desalination level. The desalination treatment significantly reduced the ratios of SEM/AVS compared with control. However, the ratios of SEM/AVS increased with enhanced desalination levels in treatments. Results reveal that low desalination treatment is better for reducing toxicity to benthic organisms than high desalination treatment. Since these reclaimed tidal flats with low desalinisation are suitable for saline water aquaculture, transforming the present land use of reclaimed tidal flats from fresh water aquaculture into saline water aquaculture may reduce health risk of heavy metals remained in sediments. These results will also contribute to our understanding of the dynamic behavior of heavy metals in the reclamation of tidal flats during leaching and the role of the ratio of SEM/AVS predictions on assessing the ecological risks of reclaimed tidal flats.

Division of Behavioral Health

Science.gov Websites

that the most acute and chronic conditions require a corresponding increased level of services intervention to acute psychiatric care. Included are services for the general population (prevention &

[Gastric dynamics analysis of TEAS combined SNP induced general anesthesia when controlled hypotension dropped to 60% of the MAP baseline].

PubMed

Zhang, Le-Le; Fang, Jian-Qiao; Shao, Xiao; Lian, Lin-Li; Yu, Xiao-Jing; Dong, Zhen-Hua; Mo, Ya-Di

2015-01-01

To observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension. Eighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment. As for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group. EGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Study of the association of atmospheric temperature and relative humidity with bulk tank milk somatic cell count in dairy herds using Generalized additive mixed models.

PubMed

Testa, Francesco; Marano, Giuseppe; Ambrogi, Federico; Boracchi, Patrizia; Casula, Antonio; Biganzoli, Elia; Moroni, Paolo

2017-10-01

Elevated bulk tank milk somatic cell count (BMSCC) has a negative impact on milk production, milk quality, and animal health. Seasonal increases in herd level somatic cell count (SCC) are commonly associated with elevated environmental temperature and humidity. The Temperature Humidity Index (THI) has been developed to measure general environmental stress in dairy cattle; however, additional work is needed to determine a specific effect of the heat stress index on herd-level SCC. Generalized Additive Model methods were used for a flexible exploration of the relationships between daily temperature, relative humidity, and bulk milk somatic cell count. The data consist of BMSCC and meteorological recordings collected between March 2009 and October 2011 of 10 dairy farms. The results indicate that, an average increase of 0.16% of BMSCC is expected for an increase of 1°C degree of temperature. A complex relationship was found for relative humidity. For example, increase of 0.099%, 0.037% and 0.020% are expected in correspondence to an increase of relative humidity from 50% to 51%, 80% to 81%; and 90% to 91%, respectively. Using this model, it will be possible to provide evidence-based advice to dairy farmers for the use of THI control charts created on the basis of our statistical model. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavík, Iceland 2003-2009.

PubMed

Carlsen, Hanne Krage; Forsberg, Bertil; Meister, Kadri; Gíslason, Thorarinn; Oudin, Anna

2013-04-08

Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area. We constructed a time series of the daily number of adults who visited the emergency room, or were acutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 - 31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted for meteorological variables, day of week, and time trend with splines. Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR) change in average O3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly (70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10. We found an increase in daily emergency hospital visits associated with O3, indicating that low-level exposure may trigger cardiopulmonary events or stroke.

Perfluoroalkyl substances in older male anglers in Wisconsin.

PubMed

Christensen, Krista Y; Raymond, Michelle; Thompson, Brooke A; Anderson, Henry A

2016-05-01

Perfluoroalkyl substances (PFAS) are an emerging class of contaminants. Certain PFAS are regulated or voluntarily limited due to concern about environmental persistence and adverse health effects, including thyroid disease and to dyslipidemia. The major source of PFAS exposure in the general population is seafood. In this analysis we examine PFAS levels and their determinants, as well as associations between PFAS levels and self-reported health outcomes, in a group of older male anglers in Wisconsin with high fish consumption. A biomonitoring study of male anglers aged 50 and older living in Wisconsin collected detailed information on fish consumption, demographics and self-reported health outcomes, along with hair and blood samples for biomarker analysis. Sixteen different PFAS were extracted from serum samples. Regression models were used to identify factors (demographic characteristics and fish consumption habits) associated with PFAS biomarker levels in blood, as well as associations between PFAS and self-reported health outcomes, adjusting for potential confounders. Seven PFAS were detected in at least 30% of participants and were used in subsequent analyses (PFDA, PFHpS, PFHxS, PFNA, PFOA, PFOS, PFuDA). The PFAS with the highest levels were PFOS, followed by PFOA, PFHxS and PFNA (medians of 19.0, 2.5, 1.8 and 1.4ng/mL). In general, increasing age was associated with higher PFAS levels, while increasing BMI were associated with lower PFAS levels. Greater alcohol consumption was associated with higher levels of PFHpS, PFHxS and PFOA. Associations with smoking and employment did not show a consistent pattern. Associations between fish consumption and PFAS were generally weak, with the exception of notably higher PFDA and PFHpS with both other locally-caught fish, and restaurant-purchased fish. Regarding associations with health outcomes, PFuDA, PFNA and PFDA were all associated with increased risk of pre-diabetes and/or diabetes. PFHpS was associated with a significantly increased risk of high cholesterol; PFDA and PFuDA also showed notable, though non-significant associations. All PFAS evaluated were associated with lower risk of hypertension although the only significant odds ratio was that for PFNA. There were no associations between any of the PFAS examined and either coronary heart disease, or the grouped outcome of any cardiovascular condition. PFAS are emerging contaminants with widespread exposure, persistence, and potential for adverse health effects. In this study population, demographic patterns may reflect differences in exposure sources, or possibly differences in adsorption and metabolism. PFAS were associated mainly with endocrine related outcomes, with a general trend towards increased risk of glucose intolerance and high cholesterol. Continued research on the risks and benefits of fish consumption is important due to potential exposure to PFAS and noted associations with highly prevalent adverse health outcomes. Published by Elsevier Ltd.

Alterations in Oxygen Transport in Stored Canine Blood from Donors having Undergone Chronic Exercise.

DTIC Science & Technology

diphosphoglycerate and adenosine triphosphate levels . One group of units was drawn from sedentary animals. The other two groups were obtained from...in the 2,3 diphosphoglycerate levels were observed in units from Phase I with a greater increase noted in those from Phase II. Despite the general...decline of all levels during the long storage period, the exercise group consistently showed definite higher levels over the controls. Similarly, a

Job satisfaction in mainland China: comparing critical care nurses and general ward nurses.

PubMed

Zhang, Aihua; Tao, Hong; Ellenbecker, Carol Hall; Liu, Xiaohong

2013-08-01

To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China. Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown. A cross-sectional design was selected for this descriptive correlation study. Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010. Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job. Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse. © 2012 Blackwell Publishing Ltd.

The relationship between nurse staffing and failure to rescue: where does it matter most?

PubMed

Talsma, AkkeNeel; Jones, Katherine; Guo, Ying; Wilson, Deleise; Campbell, Darrell A

2014-09-01

This study further expands on the relationship between nurse staffing levels and patient outcomes, in particular, failure to rescue. Many studies are based on single-site hospitals or single-year data, thus limiting the generalizations of the findings. The purpose was to evaluate in a multisite multiyear study the relationship between unit-level nurse staffing and FTR mortality, for ICU and non-ICU patients. Using administrative and actual unit level nurse staffing data, we used AHRQ 2003 Patient Safety Indicator (2003) software and matched those with the patient's discharge month. Fixed effects multilevel logistic analyses were used to take into account the hierarchical structure of the database and patient clustering within units. We controlled for patient demographics, clinical conditions, and CCS categories. The majority (94%) of cases were discharged from general care units, ICUs reported higher nurse staffing levels based on patient complexity. Expired cases were 3 years older, male, and nonwhite. For general care discharges, the relationship between RN level HPPD approached significance (P = 0.07), suggesting increased odds of higher FTR mortality with higher staffing levels. We did not observe any of the expected associations between the nurse staffing variables and FTR for either general care unit or ICU discharges. The comprehensive risk adjustments provided adequate "leveling of the playing field" to evaluate the impact of unit-based nurse staffing levels on FTR mortality. Future studies should evaluate the influence of unit environment and patient risk.

General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China.

PubMed

Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu

2014-06-01

This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p < 0.001) and with job satisfaction (β = -0.35 and -0.34, respectively; p < 0.05). However, it did not modify the relationships between both experiencing and witnessing workplace violence with job initiative (p > 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

"Jeopardy" in Abnormal Psychology.

ERIC Educational Resources Information Center

Keutzer, Carolin S.

1993-01-01

Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

Groundwater-level trends in the U.S. glacial aquifer system, 1964-2013

USGS Publications Warehouse

Hodgkins, Glenn A.; Dudley, Robert W.; Nielsen, Martha G.; Renard, Benjamin; Qi, Sharon L.

2017-01-01

The glacial aquifer system in the United States is a major source of water supply but previous work on historical groundwater trends across the system is lacking. Trends in annual minimum, mean, and maximum groundwater levels for 205 monitoring wells were analyzed across three regions of the system (East, Central, West Central) for four time periods: 1964-2013, 1974-2013, 1984-2013, and 1994-2013. Trends were computed separately for wells in the glacial aquifer system with low potential for human influence on groundwater levels and ones with high potential influence from activities such as groundwater pumping. Generally there were more wells with significantly increasing groundwater levels (levels closer to ground surface) than wells with significantly decreasing levels. The highest numbers of significant increases for all four time periods were with annual minimum and/or mean levels. There were many more wells with significant increases from 1964 to 2013 than from more recent periods, consistent with low precipitation in the 1960s. Overall there were low numbers of wells with significantly decreasing trends regardless of time period considered; the highest number of these were generally for annual minimum groundwater levels at wells with likely human influence. There were substantial differences in the number of wells with significant groundwater-level trends over time, depending on whether the historical time series are assumed to be independent, have short-term persistence, or have long-term persistence. Mean annual groundwater levels have significant lag-one-year autocorrelation at 26.0% of wells in the East region, 65.4% of wells in the Central region, and 100% of wells in the West Central region. Annual precipitation across the glacial aquifer system, on the other hand, has significant autocorrelation at only 5.5% of stations, about the percentage expected due to chance.

Plant responses to increased inundation and salt exposure: interactive effects on tidal marsh productivity

EPA Science Inventory

Flooding and high salinity generally induce physiological stress in wetland vascular plants which may increase in intensity with sea-level rise (SLR). We tested the effects of these factors on seedling growth in a transplant experiment in a macrotidal estuary in the Pacific North...

The Role of International Research Collaboration in Enhancing Global Presence of an Institution

ERIC Educational Resources Information Center

Ao, Fiona Ka Wa

2012-01-01

In recent decades, higher education institutions have steadily increased their international involvement in response to globalization. High-level research is generally a key component in efforts to increase international visibility (Armstrong, 2007). International research collaborations are perceived to be an important way to enhance global…

Environmental effects on resistance gene expression in milk stage popcorn kernels and associations with mycotoxin production

USDA-ARS?s Scientific Manuscript database

Like other forms of maize, popcorn is subject to increased levels of contamination by a variety of different mycotoxins under stress conditions, although levels generally are less than dent maize under comparable stress. Gene array analysis was used to determine expression differences of disease res...

Effect of sonic boom asymmetry on subjective loudness

NASA Technical Reports Server (NTRS)

Leatherwood, Jack D.; Sullivan, Brenda M.

1992-01-01

The NASA Langley Research Center's sonic boom apparatus was used in an experimental study to quantify subjective loudness response to a wide range of asymmetrical N-wave sonic boom signatures. Results were used to assess the relative performance of several metrics as loudness estimators for asymmetrical signatures and to quantify in detail the effects on subjective loudness of varying both the degree and direction of signature loudness asymmetry. Findings of the study indicated that Perceived Level (Steven's Mark 7) and A-weighted sound exposure level were the best metrics for quantifying asymmetrical boom loudness. Asymmetrical signatures were generally rated as being less loud than symmetrical signatures of equivalent Perceived Level. The magnitude of the loudness reductions increased as the degree of boom asymmetry increased, and depended upon the direction of asymmetry. These loudness reductions were not accounted for by any of the metrics. Corrections were determined for use in adjusting calculated Perceived Level values to account for these reductions. It was also demonstrated that the subjects generally incorporated the loudness components of the complete signatures when making their subjective judgments.

Effects of 7.5% CO2 challenge in generalized anxiety disorder.

PubMed

Seddon, Kate; Morris, Kelly; Bailey, Jayne; Potokar, John; Rich, Ann; Wilson, Sue; Bettica, Paolo; Nutt, David J

2011-01-01

We have previously developed a putative model of generalized anxiety disorder in healthy volunteers using a 20-minute 7.5% carbon dioxide (CO(2)) inhalation challenge. The aim of this study was to validate the 7.5% CO(2) paradigm by assessing its effects in patients with generalized anxiety disorder in a test-retest design. Twelve medication-free generalized anxiety disorder patients attended our lab for two study days. On each study day placebo (compressed air) and 7.5% CO(2) mixture were randomly administered over 20 min, at least 30 min apart, in a single blind, randomized, placebo-controlled cross-over design. Subjective ratings, cardiovascular measures and cortisol levels were collected throughout. CO(2) challenge significantly increased ratings for anxiety and other subjective symptoms associated with generalized anxiety disorder, compared with air. It also significantly increased systolic blood pressure on day 2, indicating increased autonomic arousal. There was no change between the two test days in mean anxiety rating scores, and there also appeared to be a correlation for individual scores on a number of the subjective measures. In conclusion, 20 min of 7.5% CO(2) gas inhalation increases anxiety responses in patients with generalized anxiety disorder, and this is reliable over time.

Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents

PubMed Central

Marmorstein, Naomi R.

2015-01-01

This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents (N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms. PMID:27512337

Effects of Severe Mental Illness Education on MSW Student Attitudes About Schizophrenia

PubMed Central

Eack, Shaun M.; Newhill, Christina E.; Watson, Amy C.

2013-01-01

Social work students (n = 60) in a master’s-level course on severe mental illness participated in a quasi-experimental study examining the degree to which increased knowledge about and contact with individuals with schizophrenia during the course would impact their attitudes toward people with the disorder. Results revealed significant improvement in student knowledge and general attitudes after the course, and indicated that increased knowledge about schizophrenia was only related to general attitudinal improvement when accompanied by increased personal social contact. Implications for education on severe mental illnesses, and value and attitude development in social work education are discussed PMID:24465119

[Association between different types of obesity and cardiovascular risk factors in school-aged children].

PubMed

Liu, Junting; Zhao, Xiaoyuan; Cheng, Hong; Hou, Dongqing; Mi, Jie

2014-01-01

The aim of this paper was to analyze the association between different types of obesity and cardiovascular risk factors (CRFs)in school-aged children. 3508 children aged 6-18 years old including 2 054 non-obese and 1 454 obese children were chosen as the population under study, from Beijing Children and Adolescents Metabolic Syndrome Study. Demographic data was collected through questionnaires while height, weight, waist circumference, and blood pressure were measured through physical check-up. Fasting blood glucose and blood lipids were also tested. Children were divided into four groups:without obesity, with general obesity, with abdominal obesity and with combined obesity. CRFs including dyslipidemia, impaired fasting glucose (IFG), and hypertension were scored. Multiple linear regression and logistic regression analyses were performed to assess the association between different types of obesity and CRFs. From non-obese children, children under general-obesity, abdominal obesity and those with combined types of obesity, there appeared an increasing trend in the levels of blood pressure, blood glucose, and blood lipids, the prevalence dyslipidemia and hypertension (P < 0.001). There were no significant differences in the risks of IFG among four types of obesity. After controlling for age, sex, and puberty stage, when compared with non-obese children, those children with abdominal obesity or combined types of obesity had 1.54 and 2.51 times of risks to only one CRF, while generally obese children had similar risk of dyslipidemia. When compared to the non-obese ones, children with general obesity, abdominal obesity, or combined types of obesity showed 3.32, 2.21 and 7.42 times of risks to ≥ 2 CRFs and 3.10, 3.67 and 10.75 times of risks to ≥ 3 CRFs. The cluster of CRFs increased with the levels of obesity (P < 0.001). Levels and cluster of CRFs were increasing along with the levels of obesity in school-aged children in Beijing. Children with combined types of obesity had the highest risk of clustering CRFs, followed by those with abdominal obesity and general obesity.

General surgery in crisis--factors that impact on a career in general surgery.

PubMed

Kahn, D; Pillay, S; Veller, M G; Panieri, E; Westcott, M J R

2006-08-01

The Association of Surgeons of South Africa (ASSA), because of a concern about the decline in the number of applicants for registrar posts, undertook this study into the various factors that may influence the choice of surgery as career option. The study involved a combination of desk research and structured interviews with heads of departments, specialists, and registrars in general surgery. The reasons for choosing general surgery as a career included the immediately visible results of a surgeon's efforts and the practical and intellectual challenge of the specialty. General surgery continued to enjoy a high status in society. The greater focus on primary health care has affected facilities at tertiary and secondary institutions. General surgeons worked excessively long hours, which was associated with increased levels of stress and placed severe strains on family life. All respondents felt that their levels of remuneration were 'poor' in relation to other disciplines and professions. In this study we identified various factors that impacted either positively or negatively on the choice of general surgery as a career option.

Fresh pasta quality as affected by enrichment of nonstarch polysaccharides.

PubMed

Brennan, C S; Tudorica, C M

2007-11-01

Nonstarch polysaccharides (NSPs), both soluble and insoluble, were added to pasta doughs at levels of 2.5%, 5%, 7.5%, and 10% levels. The cooking and textural characteristics of the pastas were evaluated using a range of analytical techniques. Generally, NSP addition was found to increase the cooking losses, and reduce the protein and starch contents of the pasta. This effect was dependent on the level of NSP added and also the type (soluble or insoluble). Pasta firmness was generally reduced in relation to the level of NSP addition, although some gel-forming NSPs resulted in higher firmness values. Pasta stickiness, adhesiveness, and elasticity were also affected. The results indicate that careful selection of NSP addition is needed to ensure optimum textural and cooking characteristics in NSP enriched pasta products.

Evaluating the Effectiveness of the General Surgery Intern Boot Camp.

PubMed

Schoolfield, Clint S; Samra, Navdeep; Kim, Roger H; Shi, Runhua; Zhang, Wayne W; Tan, Tze-Woei

2016-03-01

The aim of our study is to evaluate the effectiveness of newly implemented general surgery intern boot camp. A 2-day didactic and skills-based intern boot camp was implemented before the start of clinical duties. Participants who did not attend all boot camp activities and had prior postgraduate training were excluded. A survey utilizing a 5-point Likert scale scoring system was used to assess the participants' confidence to perform intern-level tasks before and after the boot camp. Subgroup analyses were performed comparing changes in confidence among graduates from home institution versus others and general surgery versus other subspecialties. In the analysis, 21 participants over two years were included. Among them, 7 were graduates from home institution (4 general surgery, 3 subspecialty) and 14 were from other institutions (6 general surgery and 8 subspecialty). There were significant increases in overall confidence levels (pre = 2.79 vs post = 3.43, P < 0.001) after the boot camp. Additionally, there were improvements for all subcategories including medical knowledge (2.65 vs 3.36, P < 0.001), technical skill (3.02 vs 3.51, P < 0.001), interpersonal skills and communication (3.04 vs 3.53, P = 0.001), and practice-based learning (2.65 vs 3.41, P = 0.001). There was an improvement in confidence level for both home institution graduates (2.89 vs 3.53, P = 0.022) and other graduates (2.74 vs 3.34, P < 0.001). Similarly, participants from general surgery (2.78 vs 3.46, P = 0.001) and other specialties (2.74 vs 3.34, P < 0.001) reported significant improvement in confidence. General surgery intern boot camp before the start of official rotation is effective in improving confidence level in performing level-appropriate tasks of the incoming new interns.

Toward a Unified Knowledge-based Society for Sustainability -- Developing a Synthesis on the Methodological Level

Treesearch

Alec A. Schaerer

2006-01-01

The debates on development manifest an increasing concern for sustainability, but as yet little awareness of the hierarchy in the ideas through which humans contribute to the problem. This gap is widened by a widespread but nevertheless unnecessary acceptance of unreasonable elements such as paradoxes, or the general fragmentation in knowledge, or allegedly general...

Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients.

PubMed

Doerr, Johanna M; Fischer, Susanne; Nater, Urs M; Strahler, Jana

2017-02-01

Fatigue is a defining characteristic and one of the most debilitating features of fibromyalgia syndrome (FMS). The mechanisms underlying different dimensions of fatigue in FMS remain unclear. The aim of the current study was to test whether stress-related biological processes and physical activity modulate fatigue experience. Using an ambulatory assessment design, 26 female FMS patients reported general, mental, and physical fatigue levels at six time points per day for 14 consecutive days. Salivary cortisol and alpha-amylase were analyzed as markers of neuroendocrine functioning. Participants wore wrist actigraphs for the assessment of physical activity. Lower increases in cortisol after awakening predicted higher mean daily general and physical fatigue levels. Additionally, mean daily physical activity positively predicted next-day mean general fatigue. Levels of physical fatigue at a specific time point were positively associated with momentary cortisol levels. The increase in cortisol after awakening did not mediate the physical activity - fatigue relationship. There were no associations between alpha-amylase and fatigue. Our findings imply that both changes in hypothalamic-pituitary-adrenal axis activity and physical activity contribute to variance in fatigue in the daily lives of patients with FMS. This study helps to paint a clearer picture of the biological and behavioral underpinnings of fatigue in FMS and highlight the necessity of interdisciplinary treatment approaches targeting biological, behavioral and psychological aspects of FMS. Copyright © 2016 Elsevier Inc. All rights reserved.

IL-33 circulating serum levels are increased in patients with non-segmental generalized vitiligo.

PubMed

Vaccaro, Mario; Cicero, Francesca; Mannucci, Carmen; Calapai, Gioacchino; Spatari, Giovanna; Barbuzza, Olga; Cannavò, Serafinella P; Gangemi, Sebastiano

2016-09-01

IL-33 is a recently identified cytokine, encoded by the IL-33 gene, which is a member of the IL-1 family that drives the production of T-helper-2 (Th-2)-associated cytokines. Serum levels of IL-33 have been reported to be up-regulated in various T-helper (Th)-1/Th-17-mediated diseases, such as psoriasis, rheumatoid arthritis, and inflammatory bowel. To investigate whether cytokine imbalance plays a role in the pathogenesis of vitiligo, we performed a case-control association study by enzyme-linked immunosorbent assay of IL-33 in our patients. IL-33 serum levels were measured by a quantitative enzyme immunoassay technique in patients with non-segmental generalized vitiligo and compared with those of healthy controls. IL-33 serum levels in patients with vitiligo were significantly increased than those in healthy controls. There was a positive correlation of IL-33 serum levels with extension of vitiligo and disease activity. This study suggests a possible systemic role of IL-33 in the pathogenesis of vitiligo. Inhibiting IL-33 activity might be a novel therapeutic strategy in the treatment of autoimmune inflammatory disease, like vitiligo.

Meningococcal vaccination in primary care amongst adolescents in North West England: an ecological study investigating associations with general practice characteristics.

PubMed

Blagden, Sarah; Hungerford, Daniel; Limmer, Mark

2018-01-27

In 2015 the meningococcal ACWY (MenACWY) vaccination was introduced amongst adolescents in England following increased incidence and mortality associated with meningococcal group W. MenACWY vaccination uptake data for 17-18 years old and students delivered in primary care were obtained for 20 National Health Service clinical commissioning groups (CCGs) via the ImmForm vaccination system. Data on general practice characteristics, encompassing demographics and patient satisfaction variables, were extracted from the National General Practice Profiles resource. Univariable analysis of the associations between practice characteristics and vaccination was performed, followed by multivariable negative binomial regression. Data were utilized from 587 general practices, accounting for ~8% of all general practices in England. MenACWY vaccination uptake varied from 20.8% to 46.8% across the CCGs evaluated. Upon multivariable regression, vaccination uptake increased with increasing percentage of patients from ethnic minorities, increasing percentage of patients aged 15-24 years, increasing percentage of patients that would recommend their practice and total Quality and Outcomes Framework achievement for the practice. Conversely, vaccination uptake decreased with increasing deprivation. This study has identified several factors independently associated with MenACWY vaccination in primary care. These findings will enable a targeted approach to improve general practice-level vaccination uptake. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The atypical antipsychotic quetiapine increases both noradrenaline and dopamine release in the rat prefrontal cortex.

PubMed

Pira, Luigi; Mongeau, Raymond; Pani, Luca

2004-11-03

Quetiapine is a novel atypical antipsychotic drug with multi-receptorial affinity. Using in vivo microdialysis, we investigated if quetiapine modulates extracellular noradrenaline and dopamine in brain areas generally believed to be involved in the pathophysiology of schizophrenia and in the action of antipsychotic drugs. Quetiapine (5, 10 and 20 mg/kg, i.p.) increased levels of noradrenaline in both the prefrontal cortex and the caudate nucleus, while it increased dopamine levels mainly in the prefrontal cortex. It is argued that the marked increase of dopaminergic transmission in the prefrontal cortex induced by quetiapine might be relevant to its therapeutical action.

Early follicular phase hormone levels in relation to patterns of alcohol, tobacco, and coffee use.

PubMed

Lucero, J; Harlow, B L; Barbieri, R L; Sluss, P; Cramer, D W

2001-10-01

To examine the effects of alcohol, caffeine, and tobacco use on early follicular phase FSH, LH, E2, and sex hormone-binding globulin (SHBG). Cross-sectional study. Academic medical center. Four hundred ninety-eight women selected from the general population, ages 36-45, who were not currently pregnant, breast feeding, or using exogenous hormones. A general questionnaire assessing demography, anthropometry, and smoking habits and a standardized dietary questionnaire assessing food and beverage frequencies, including sources of alcohol and caffeine. FSH, LH, E2, and SHBG levels measured during the early follicular phase of the menstrual cycle. Significant associations observed in a univariate analysis included age > or =40 and current smoking associated with higher FSH; higher body mass index (BMI) associated with lower SHBG levels; and daily alcohol use, cholesterol consumption greater than the median, and coffee use >1 cup/d associated with higher E2 levels. In a multivariate model, total caffeine use was significantly associated with E2 levels after adjustment for age, BMI, total calories, current smoking, alcohol, cholesterol consumption, and day of sampling. Early follicular phase E2 increased from 28.2 pg/mL for women consuming < or =100 mg of caffeine to 45.2 pg/mL for women consuming > or =500 mg of caffeine per day, about a 70% increase. Coffee consumption and total caffeine use may increase early follicular phase E2 levels independent of related habits of alcohol or tobacco use.

Subseasonal to Seasonal Predictions of U.S. West Coast High Water Levels

NASA Astrophysics Data System (ADS)

Khouakhi, A.; Villarini, G.; Zhang, W.; Slater, L. J.

2017-12-01

Extreme sea levels pose a significant threat to coastal communities, ecosystems, and assets, as they are conducive to coastal flooding, coastal erosion and inland salt-water intrusion. As sea levels continue to rise, these sea level extremes - including occasional minor coastal flooding experienced during high tide (nuisance floods) - are of concern. Extreme sea levels are increasing at many locations around the globe and have been attributed largely to rising mean sea levels associated with intra-seasonal to interannual climate processes such as the El Niño-Southern Oscillation (ENSO). Here, intra-seasonal to seasonal probabilistic forecasts of high water levels are computed at the Toke Point tide gage station on the US west coast. We first identify the main climate drivers that are responsible for high water levels and examine their predictability using General Circulation Models (GCMs) from the North American Multi-Model Ensemble (NMME). These drivers are then used to develop a probabilistic framework for the seasonal forecasting of high water levels. We focus on the climate controls on the frequency of high water levels using the number of exceedances above the 99.5th percentile and above the nuisance flood level established by the National Weather Service. Our findings indicate good forecast skill at the shortest lead time, with the skill that decreases as we increase the lead time. In general, these models aptly capture the year-to-year variability in the observational records.

How applicable is the general adaptation syndrome to the unicellular Tetrahymena?

PubMed

Csaba, György; Pállinger, Eva

2009-01-01

Hormone receptors, hormones and signal transduction pathways characteristic of higher vertebrates can be observed also in the unicellular Tetrahymena. Previous work showed that stress conditions (starvation, high temperature, high salt concentration, formaldehyde or alcohol treatment) elevated the intracellular level of four hormones (ACTH, endorphin, serotonin and T(3)). Here, the effect of other stressors (CuSO4 poisoning, tryptophan hydroxylase inhibitor parachlorophenylalanine (PCPA) treatment) on the same and other hormones (epinephrine, insulin, histamine) was studied, using immunocytochemistry and flow cytometric analysis. It was found, that each effect increased the intracellular hormone contents, but some hormones (histamine, T(3)) were less reactive. Insulin--which is a life-saving factor for Tetrahymena--itself provoked elevation of hormone amounts in association with a stressor, further increased the level of hormones. It was concluded that the ancestor of Selye's General Adaptation Syndrome (GAS) can be found already at unicellular level, and this possibly has a life saving function. Copyright 2008 John Wiley & Sons, Ltd.

Serum levels of uric acid and diabetes mellitus influence survival after surgery for primary hyperparathyroidism: a prospective cohort study.

PubMed

Bergenfelz, Anders; Bladström, Anna; Their, Mark; Nordenström, Erik; Valdemarsson, Stig; Westerdahl, Johan

2007-07-01

Primary hyperparathyroidism (pHPT) is associated with an increased mortality attributable to cardiovascular disease (CVD), suggested to be alleviated by surgery. The exact mechanism of the beneficial influence of parathyroidectomy on survival is unknown. Furthermore, studies suggest that there is no increased mortality compared to the mortality rate in the general population during recent years. This study therefore investigated relative survival (RS), as well overall mortality associated with the clinical and biochemical variables in patients undergoing operation for sporadic pHPT. Furthermore, the influence of surgery on biochemical variables associated with pHPT was analyzed. A group of 323 patients with sporadic pHPT operated between September 1989 and July 2003 were followed from surgery over a 10-year period. The median and mean follow-up time was 69 and 70 months, respectively (range: 1-120 months). Relative survival (RS) was calculated, and the impact of clinical and biochemical variables on overall death were evaluated. Postoperatively, serum levels of triglycerides and uric acid decreased. Glucose levels and glomerular filtration rate remained unchanged. A decreased RS was evident during the latter part of the 10 year follow-up period. In the multivariate Cox-analysis, diabetes mellitus (hazard ratio [HR] = 2.8, 95%; confidence interval [CI] 1.2-6.7), and the combination of an increased level of serum uric acid and cardiovascular disease (CVD) (HR = 8.6, 95%; CI 1.5-49.7) was associated with a higher mortality. The increased risk of death was evident for patients with persistently increased levels of uric acid postoperatively (HR = 4.8, 95%; CI = 1.4-16.01). Patients undergoing operation for pHPT had a decreased RS during a 10-year follow-up compared to the general population. This decrease in RS is associated with diabetes mellitus and increased levels of uric acid pre-and postoperatively.

Generalized Drivers in the Mammalian Endangerment Process

PubMed Central

González-Suárez, Manuela; Revilla, Eloy

2014-01-01

An important challenge for conservation today is to understand the endangerment process and identify any generalized patterns in how threats occur and aggregate across taxa. Here we use a global database describing main current external threats in mammals to evaluate the prevalence of distinct threatening processes, primarily of anthropogenic origin, and to identify generalized drivers of extinction and their association with vulnerability status and intrinsic species' traits. We detect several primary threat combinations that are generally associated with distinct species. In particular, large and widely distributed mammals are affected by combinations of direct exploitation and threats associated with increasing landscape modification that go from logging to intense human land-use. Meanwhile, small, narrowly distributed species are affected by intensifying levels of landscape modification but are not directly exploited. In general more vulnerable species are affected by a greater number of threats, suggesting increased extinction risk is associated with the accumulation of external threats. Overall, our findings show that endangerment in mammals is strongly associated with increasing habitat loss and degradation caused by human land-use intensification. For large and widely distributed mammals there is the additional risk of being hunted. PMID:24587315

Ground-water levels in Huron County, Michigan, January 1996 through December 1996

USGS Publications Warehouse

Sweat, M.J.

1997-01-01

In 1990, the U.S. Geological Survey (USGS) completed a study of the hydrogeology of Huron County, Michigan (Sweat, 1991). In 1993, Huron County and the USGS entered into an agreement to continue collecting water levels at selected wells throughout Huron County. As part of the agreement, the USGS has provided training and instrumentation for County personnel to measure, on a quarterly basis, the depth to water below the land surface in selected wells. The agreement includes the operation of continuous water-level recorders installed on four wells in Bingham, Fairhaven, Grant and Lake Townships (fig. 1). County personnel make quarterly water-level measurements of 22 other wells. Once each year, County personnel are accompanied by USGS personnel who provide a quality assurance/quality control check of all measurements being made.Precipitation and the altitude of Lake Huron are good indicators of general climatic conditions and, therefore, provide an environmental context for ground-water levels in Huron County. Figure 2 shows the mean monthly water-level altitude of Lake Huron, averaged from measurements made by U.S. Army Corps of Engineers at two sites, and mean monthly precipitation as recorded in Huron County, for the period October 1988 through December 1996. In general, Lake Huron water levels in 1996 were about the same as they were from 1992-94 (NOAA, 1988-96). Precipitation was generally within the normal range, but was lower than 1993 or 1994. Rainfall during May, June, and July was, cumulatively, about 8.5 inches less in 1995 than in 1994.Hydrographs are presented for each of four wells with water-level recorders. Quarterly water-level measurements and range of water levels during 1996 for the other 22 wells are shown graphically and tabulated.In general, water levels in the glaciofluvial aquifer reflect seasonal variations, with maximum depths to water occurring in late summer and early fall and minimum depths to water occurring in late winter and early spring. In general, wells completed in the lower part of the Marshall aquifer continue to show an increase in water-level altitude from the original project period (1988-90); wells completed in the upper part of the Marshall aquifer showed little variation in water-level altitudes compared to previous years. Wells completed in the Saginaw aquifer continued to show higher water level altitudes in 1995, not only near the lake but also farther inland, while water-level altitudes in wells completed in the Coldwater confining unit showed a small increase from the original project period. Water-level altitudes were higher in the southwest and central parts of the County during 1995 than in the previous year, and water-level altitudes were for the most-part unchanged in the northwest, northeast, and southeast parts of the county during 1995. All wells with recorders had lower water levels in September 1995 than in 1993-94. Lower than average precipitation during May-August is the primary reason for lower levels.

Assessment of tolerant sunfish populations (Lepomis sp.) inhabiting selenium-laden coal ash effluents. 2. Tissue biochemistry evaluation.

PubMed

Lohner, T W; Reash, R J; Williams, M

2001-11-01

Sunfish were collected from a fly ash pond-receiving stream and an Ohio River reference site to assess biochemical responses to coal ash effluent exposure. Selenium levels in sunfish from the receiving stream were higher than toxic thresholds associated with adverse population effects and reproductive impairment. Tissue biochemistry was found to be indicative of metal exposure and effect, but varied widely. Liver glycogen was positively correlated with increased liver metal levels, indicating no adverse effect upon stored carbohydrate levels. Lipid levels decreased with increasing metals, indicating possible nutritional stress. Protein levels increased with increasing metal levels, possibly due to the synthesis of proteins to sequester the metals. ATPase, dUTPase, and alkaline phosphatase activity generally decreased with exposure to ash pond metals, but remained within normal physiological ranges. Fish condition factors and liver somatic indices were correlated with liver lipid levels, dUTPase activity, and gill ATPase and alkaline phosphatase activity. Exposure to coal ash effluents produced biochemical markers of exposure that were associated with fish condition indicators; however, the indices themselves were not significantly affected by effluent exposure.

Pronounced reversible hyperammonemic encephalopathy associated with combined valproate-topiramate therapy in a 7-year-old girl.

PubMed

Weise, Sebastian; Syrbe, Steffen; Preuss, Matthias; Bertsche, Astrid; Merkenschlager, Andreas; Bernhard, Matthias K

2015-01-01

Valproate is one of the most frequently used anticonvulsive drugs in children and adults. Valproate is a generally well tolerated medication. However, encephalopathy with or without hyperammonemia is one of its rare adverse events. We present a 7-year-old girl who suffered from epilepsy with generalized tonic-clonic seizures and absence epilepsy. She was initially treated with topiramate. Methylprednisolone pulse therapy and long-term therapy with valproate were initiated due to an increase of seizure frequency. At day 5 of therapy, a further increase of seizure frequency was observed followed by lethargy and somnolence. Liver enzymes remained within normal range, but ammonia serum levels increased to a maximum of 544 mmol/l. Discontinuing valproate and starting potassium-benzoate and sodium-phenylbutyrate improved the clinical condition and ammonia serum levels. Haemodialysis was not required. Cranial magnetic resonance imaging ruled out brain edema. The patient was further on successfully treated with a combination of both, topiramate and levetiracetam. Seizures did not recur and development was normal until now (3 years later). To the best of our knowledge, we observed the highest ammonia serum levels ever reported in valproate-induced hyperammonemia with a complete remission of the subsequent encephalopathy. Topiramate might increase the risk of valproate-induced encephalopathy by carbonic anhydrase inhibition.

How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan.

PubMed

Santus, Pierachille; Russo, Antonio; Madonini, Enzo; Allegra, Luigi; Blasi, Francesco; Centanni, Stefano; Miadonna, Antonio; Schiraldi, Gianfranco; Amaducci, Sandro

2012-10-18

Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0-2 and lag 3-5 in both single and multi-pollutant models, adjusted for daily weather variables. An increase in ozone (O(3)) levels at lag 3-5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0-2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO(2)), CO, nitrate dioxide (NO(2)), and particulate matter (PM(10) and PM(2.5)). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0-2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

The impact of later trading hours for Australian public houses (hotels) on levels of violence.

PubMed

Chikritzhs, Tanya; Stockwell, Tim

2002-09-01

To examine the impact of later trading hours for licensed hotels (Australian public houses are usually known as "hotels") in Perth, Western Australia, on levels of violent assault on or near these premises. Data on assault offenses reported to police between July 1, 1991, and June 30, 1997, were examined to identify those offenses that occurred on or close to hotels. During this period, 45 (24%) of the 188 hotels meeting study criteria were granted an extended trading permit for 1AM closing ("ETP hotels"), whereas the rest continued to close at midnight ("non-ETP hotels"). A time-series analysis employing linear regression was used to test whether there was a relationship between the introduction of extended trading and monthly rates of assaults associated with ETP hotels, while controlling for the general trend in assault rates among normally trading hotels. Possible confounders and other variables of interest (e.g., levels of alcohol purchases) were also examined. After controlling for the general trend in assaults occurring throughout Perth hotels, there was a significant increase in monthly assault rates for hotels with late trading following the introduction of extended trading permits. This relationship was largely accounted for by higher volumes of high alcohol content beer, wine and distilled spirits purchased by late trading hotels. Late trading was associated with both increased violence in and around Perth hotels and increased levels of alcohol consumption during the study period. It is suggested that greater numbers of patrons and increased levels of intoxication contributed to the observed increase in violence and that systematic planning and evaluation of late trading licenses is required.

Guidelines for computer security in general practice.

PubMed

Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

2007-01-01

As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making these guidelines relevant to local contexts should help maximise their uptake.

Gene expression of regulatory enzymes of glycolysis/gluconeogenesis in regenerating rat liver.

PubMed Central

Rosa, J L; Bartrons, R; Tauler, A

1992-01-01

Levels of mRNA for glucokinase, L-pyruvate kinase, fructose-1,6-bisphosphatase and phosphoenolpyruvate carboxykinase were analysed during liver regeneration. Levels of mRNA for glycolytic enzymes (glucokinase and L-pyruvate kinase) decreased rapidly after partial hepatectomy. Glucokinase mRNA increased at 16-24 h, returning to normal values after this time. L-pyruvate kinase mRNA recovered control levels at 168 h. In contrast, phosphoenolpyruvate carboxykinase mRNA increased rapidly after liver resection and remained high during the regenerative process. However, the levels of fructose-1,6-bisphosphatase mRNA were not modified significantly. These results correlate with the reported increased rate of gluconeogenesis and changes in enzyme levels after partial hepatectomy. The effect of stress on the mRNA levels was also studied. All enzymes showed variations in their mRNA levels after the surgical stress. In general, the differences were more pronounced in regenerating liver than in sham-operated animals, being practically normalized at 24 h. Images Fig. 2. Fig. 3. PMID:1329724

Ambivalent sexism: a tool for understanding and improving gender relations in organizations.

PubMed

Zakrisson, Ingrid; Anderzén, Marie; Lenell, Fredrik; Sandelin, Håkan

2012-02-01

This study tested predictions regarding ambivalent sexism, previously studied cross-culturally, here "within-culturally", between groups from different organizational settings. Based on three samples (334 adults in general, 744 industrial employees, and 189 high school students), completing a Swedish version of the Ambivalent Sexism Inventory (ASI), the results revealed that men scored higher on hostile and benevolent sexism than women, and high school students scored higher than both adult samples on both forms of sexism. The results generally confirmed the predictions; the gender gap in benevolent sexism decreased as a function of increasing levels of general sexism and the correlation between hostile and benevolent sexism decreased with higher levels of general sexism. In fact, the groups scoring highest on general sexism displayed significant negative correlations indicating a polarized ideology of women among these groups. Implications, both theoretical and practical, derived from these results are discussed. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Strategic Key Word Instruction: Increasing Fluency in Connected Expository Text

ERIC Educational Resources Information Center

Coulter, Gail; Lambert, Michael C.

2015-01-01

The effects of preteaching key words on fluency in connected text were examined with three third-grade general education participants. Researchers used a multiple base-line design (i.e., Baseline and Wordlist Intervention) and found that preteaching increased fluency in connected text written above the participant's instructional level of reading…

Primary laws and fine levels are associated with increases in seat belt use, 1997–2008 : traffic tech.

DOT National Transportation Integrated Search

2010-11-01

Increasing seat belt usage in the United States has proved to be a : slow and difficult task. It has taken about 30 years since NHTSA : conducted the first seat belt and child restraint workshops in : 1978 to reach 84% usage in 2009. In general, seat...

Can One Undergraduate Course Increase Cross-Cultural Competence?

ERIC Educational Resources Information Center

Spitzer, Lois

2015-01-01

The majority of students who took this general education undergraduate course in developing cross-cultural understanding at a state college in the northeastern United States reported that their level of cross-cultural competence and global awareness increased by the end of the course. The primary course objective was to help students better…

Mechanosensory based orienting behaviors in fluvial and lacustrine populations of mottled sculpin (Cottus bairdi)

Treesearch

Sheryl Coombs; Gary D. Grossman

2006-01-01

We compared prey-orienting and rheotactic behaviors in a fluvial (Coweeta Creek) and lacustrine (Lake Michigan) population of mottled sculpin. Blinded sculpin from both populations exhibited unconditioned, mechanosensory based rheotaxis to low velocity flows. Whereas Lake Michigan sculpin generally showed increasing levels of positive rheotaxis to increasing velocities...

Levels of Stress among Secondary School Administrators and Its Implication in Education Management in Kenya

ERIC Educational Resources Information Center

Ngari, S. M.; Ndungu, A.; Mwonya, R.; Ngumi, O.; Mumiukha, C.; Chepchieng, M.; Kariuki, M.

2013-01-01

Stress significantly affects performance and service delivery of workers. Given the important role that education plays in the society, coupled with the dynamic nature of the education sector there has been an increased social pressure on the education system in general and school administrators in particular. This influences their levels of…

Effect of Personalized System of Instruction on Health-Related Fitness Knowledge and Class Time Physical Activity

ERIC Educational Resources Information Center

Prewitt, Steven L.; Hannon, James C.; Colquitt, Gavin; Brusseau, Timothy A.; Newton, Maria; Shaw, Janet

2015-01-01

In previous studies, researchers have identified a general low level of health-related fitness (HRF) knowledge among secondary students that can effect levels of physical activity (PA). An instructional strategy that may increase HRF knowledge without decreasing PA is the personalized system of instruction (PSI). Two classes from a private urban…

The global financial crisis and Australian general practice.

PubMed

McRae, Ian S; Paolucci, Francesco

2011-02-01

To explore the potential effects of the global financial crisis (GFC) on the market for general practitioner (GP) services in Australia. We estimate the impact of changes in unemployment rates on demand for GP services and the impact of lost asset values on GP retirement plans and work patterns. Combining these supply and demand effects, we estimate the potential effect of the GFC on the market for GP services under various scenarios. If deferral of retirement increases GP availability by 2%, and historic trends to reduce GP working hours are halved, at the current level of ~5.2% unemployment average fees would decline by $0.23 per GP consultation and volumes of GP services would rise by 2.53% with almost no change in average GP gross earnings over what would otherwise have occurred. With 8.5% unemployment, as initially predicted by Treasury, GP fees would increase by $0.91 and GP income by nearly 3%. The GFC is likely to increase activity in the GP market and potentially to reduce fee levels relative to the pre-GFC trends. Net effects on average GP incomes are likely to be small at current unemployment levels.

Beliefs about fact retrieval and inferential reasoning across the adult lifespan.

PubMed

Camp, C J; Pignatiello, M F

1988-01-01

This study deals with beliefs about question-answering processes involving "world knowledge" utilized by young, middle aged, and older adults. Questions intended to induce either fact retrieval or inferential reasoning were shown to younger (n = 37), middle aged (n = 37) and older (n = 37) adults in both a multiple choice and true/false format. Increasing age level was not related to decreased confidence in either fact retrieval or inferential reasoning. Global assessments about these question-answering processes involving "people in general" and self evaluations were taken from the same individuals. In contrast to personal confidence ratings, adults of all ages generally believed in declining fact retrieval abilities in old age. Inferential reasoning, however, often was believed to remain stable or even increase in ability level with increasing age. This was especially true in the assessments generated by older adults and in self evaluations. Thus, negative global beliefs about memory and aging may be present even when such global beliefs contradict item-specific judgments and personal beliefs about one's own cognition.

Population study of disease burden, management, and treatment of bipolar disorder in Sweden: a retrospective observational registry study.

PubMed

Carlborg, Andreas; Ferntoft, Lena; Thuresson, Marcus; Bodegard, Johan

2015-02-01

The aim of the study was to describe temporal changes in bipolar disorder during 20 years within the Swedish population and to investigate clinical and socioeconomic characteristics, drug treatment, and mortality among patients with bipolar disorder. We conducted a retrospective, nationwide registry study (the Swedish Population Register) that included all patients diagnosed with bipolar disorder (1991-2010) and linked individual data from the Swedish National Patient Register, the National Prescribed Drug Register, and the Population Register (NCT01455961). A cross-sectional cohort analysis was performed for years 2006 versus 2009. Data were analyzed using descriptive statistics. During the study period, the annual incidence of diagnosed bipolar disorder increased 3.5-fold, and patients were diagnosed at a younger age. Mortality among patients with bipolar disorder was twice that of the general population. Compared to an age-standardized population, 30% fewer patients with bipolar disorder were available for work. Among the 40% employed, 64% reported sick leave (46% >100 days/year). Despite similar education levels, disposable income was lower compared to the general population. The most commonly preceding psychiatric diagnoses were depressive or anxiety disorders. Comparing the data for 2006 and 2009 demonstrated similar somatic comorbidity burdens and socioeconomic levels. There was also a decrease in dispensed antipsychotic medications and lithium, while antiepileptic prescriptions increased slightly. Antidepressant dispenses remained virtually unchanged. In Sweden, the incidence and prevalence of diagnosed bipolar disorder have increased during the last 20 years. Compared to the general population, these patients had similar education levels, lower employment levels, less disposable income, more sick leave, and twice the mortality. A trend towards earlier diagnosis, more use of antidepressants, and less use of lithium was seen. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association of Heart-Type Fatty Acid-Binding Protein with Cardiovascular Risk Factors and All-Cause Mortality in the General Population: The Takahata Study

PubMed Central

Otaki, Yoichiro; Watanabe, Tetsu; Takahashi, Hiroki; Hirayama, Atushi; Narumi, Taro; Kadowaki, Shinpei; Honda, Yuki; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo; Shibata, Yoko; Fukao, Akira; Daimon, Makoto; Ueno, Yoshiyuki; Kato, Takeo; Kayama, Takamasa; Kubota, Isao

2014-01-01

Background Despite many recent advances in medicine, preventing the development of cardiovascular diseases remains a challenge. Heart-type fatty acid-binding protein (H-FABP) is a marker of ongoing myocardial damage and has been reported to be a useful indicator for future cardiovascular events. However, it remains to be determined whether H-FABP can predict all-cause and cardiovascular deaths in the general population. Methods and Results This longitudinal cohort study included 3,503 subjects who participated in a community-based health checkup with a 7-year follow-up. Serum H-FABP was measured in registered subjects. The results demonstrated that higher H-FABP levels were associated with increasing numbers of cardiovascular risk factors, including hypertension, diabetes mellitus, obesity, and metabolic syndrome. There were 158 deaths during the follow-up period, including 50 cardiovascular deaths. Deceased subjects had higher H-FABP levels compared to surviving subjects. Multivariate Cox proportional hazard regression analysis revealed that H-FABP is an independent predictor of all-cause and cardiovascular deaths after adjustments for confounding factors. Subjects were divided into four quartiles according to H-FABP level, and Kaplan-Meier analysis demonstrated that the highest H-FABP quartile was associated with the greatest risks for all-cause and cardiovascular deaths. Net reclassification index and integrated discrimination index were significantly increased by addition of H-FABP to cardiovascular risk factors. Conclusions H-FABP level was increased in association with greater numbers of cardiovascular risk factors and was an independent risk factor for all-cause and cardiovascular deaths. H-FABP could be a useful indicator for the early identification of high-risk subjects in the general population. PMID:24847804

An Unexpected Effect of Proton Pump Inhibitors: Elevation of the Cardiovascular Risk Factor ADMA

PubMed Central

Ghebremariam, Yohannes T.; LePendu, Paea; Lee, Jerry C.; Erlanson, Daniel A.; Slaviero, Anna; Shah, Nigam H.; Leiper, James; Cooke, John P.

2013-01-01

Background Proton pump inhibitors (PPIs) are gastric acid suppressing agents widely prescribed for the treatment of gastro-esophageal reflux disease (GERD). Recently, several studies in patients with acute coronary syndrome (ACS) have raised the concern that use of PPIs in these patients may increase their risk of major adverse cardiovascular events (MACE). The mechanism of this possible adverse effect is not known. Whether the general population might also be at risk has not been addressed. Methods and Results Plasma ADMA is an endogenous inhibitor of nitric oxide synthase (NOS). Elevated plasma ADMA is associated with increased risk for cardiovascular disease, likely due to its attenuation of the vasoprotective effects of endothelial NOS. We find that PPIs elevate plasma asymmetric dimethylarginine (ADMA) level and reduce nitric oxide (NO) levels and endothelium-dependent vasodilation in a murine model and ex vivo human tissues. PPIs increase ADMA because they bind to, and inhibit dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA. Conclusions We present a plausible biological mechanism to explain the association of PPIs with increased MACE in patients with unstable coronary syndromes. Of concern, this adverse mechanism is also likely to extend to the general population using PPIs. This finding compels additional clinical investigations and pharmacovigilance directed toward understanding the cardiovascular risk associated with use of the PPIs in the general population. PMID:23825361

Iron plaque formation and heavy metal uptake in Spartina alterniflora at different tidal levels and waterlogging conditions.

PubMed

Xu, Yan; Sun, Xiangli; Zhang, Qiqiong; Li, Xiuzhen; Yan, Zhongzheng

2018-05-30

Tidal flat elevation in the estuarine wetland determines the tidal flooding time and flooding frequency, which will inevitably affect the formation of iron plaque and accumulations of heavy metals (HMs) in wetland plants. The present study investigated the formation of iron plaque and HM's (copper, zinc, lead, and chromium) accumulation in S. alterniflora, a typical estuarine wetland species, at different tidal flat elevations (low, middle and high) in filed and at different time (3, 6, 9, 12 h per day) of waterlogging treatment in greenhouse conditions. Results showed that the accumulation of copper, zinc, lead, and chromium in S. alterniflora was proportional to the exchangeable fraction of these metals in the sediments, which generally increased with the increase of waterlogging time, whereas the formations of iron plaque in roots decreased with the increase of waterlogging time. Under field conditions, the uptake of copper and zinc in the different parts of the plants generally increased with the tidal levels despite the decrease in the metals' exchangeable fraction with increasing tidal levels. The formation of iron plaque was found to be highest in the middle tidal positions and significantly lower in low and high tidal positions. Longer waterlogging time increased the metals' accumulation but decreased the formation of iron plaque in S. alterniflora. The binding of metal ions on iron plaque helped impede the uptake and accumulation of copper and chromium in S. alterniflora. Copyright © 2018 Elsevier Inc. All rights reserved.

Socioeconomic status and the utilization of diagnostic imaging in an urban setting

PubMed Central

Demeter, Sandor; Reed, Martin; Lix, Lisa; MacWilliam, Leonard; Leslie, William D.

2005-01-01

Background In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been examined in Canada relative to surgical, cardiac and preventive health care services, no published studies have specifically explored the association between SES and diagnostic imaging. Methods We examined over 300 000 diagnostic imaging claims made in the Winnipeg Regional Health Authority between Apr. 1, 2001, and Mar. 31, 2002. Using patient postal codes, we assigned SES on the basis of average household incomes in Canada's 1996 census. Using multiple regression, we examined the association between income quintile, patient age group (≤16, 17–64, ≥ 65 years), patient morbidity level according to the Johns Hopkins University Adjusted Clinical Group method (high, moderate, low), and imaging modality (general radiology, vascular, computed tomography, magnetic resonance, and general and obstetric ultrasound). Results Relative rates (RR) of diagnostic imaging utilization (highest v. lowest income quintile) were significantly increased in pediatric and adult patient groups at all morbidity levels receiving general radiology (highest RR 2.47, 95% confidence interval [CI] 2.07–2.93); pediatric and adult patient groups at high and low morbidity levels and elderly patient groups at low morbidity levels receiving general ultrasound (highest RR 2.26, 95% CI 1.20–4.26); pediatric and adult patient groups at all morbidity levels and elderly patients at high and moderate morbidity levels receiving magnetic resonance imaging (highest RR 2.51, 95% CI 1.78– 3.52); and adult patient groups at all morbidity levels receiving computed tomography (highest RR 1.46, 95% CI 1.35– 1.59). A lower RR of diagnostic imaging utilization in the highest income quintile was found only among patients receiving obstetric ultrasound (RR 0.80, 95% CI 0.73–0.87). No significant associations were found among elderly patients receiving general radiology or computed tomography or adult patients receiving vascular imaging. Interpretation We found a pattern of increased diagnostic imaging utilization in patient groups with a higher SES. Further research is needed to better understand the nature of this finding and how it contributes to health outcomes. PMID:16275968

Noise reduction characteristics of general aviation type dual-pane windows

NASA Technical Reports Server (NTRS)

Grosveld, F.; Navaneethan, R.; Roskam, J.

1980-01-01

The noise reduction characteristics of general-aviation-type, dual-pane windows in various configurations have been experimentally investigated. The effects of inner and outer pane thickness, spacing between the panes, edge conditions, inclination of the inner pane and depressurization of the air in between the panes are presented. The space in between the two window panes is sealed airtight in all cases. Results show that increasing the mass of a 'floating' window pane does not increase the noise reduction below the fundamental resonance frequency. It is concluded that the concept of depressurization of the air between thin (1/8 in) Plexiglas panes and application of multiple-freedom edge conditions for the inner pane are promising to reduce noise levels in general aviation airplanes.

Increased flood risks in the Sacramento-San Joaquin Valleys, CA, under climate change

NASA Astrophysics Data System (ADS)

Das, T.; Hidalgo-Leon, H.; Dettinger, M.; Cayan, D.

2008-12-01

Natural calamities like floods cause immense damages to human society globally, and California is no exception. A simulation analysis of flood generation in the western Sierra Nevada of California was carried out on simulated by the Variable Infiltration Capacity (VIC) hydrologic model under prescribed changes in precipitation (+10 percent) and temperature (+3oC and +5oC) to evaluate likely changes in 3-day flood- frequency curves under climate change. An additional experiment was carried out where snow production was artificially turned off in VIC. All these experiments showed larger flood magnitudes from California's Northern Sierra Nevada (NSN) and Southern Sierra Nevada (SSN), but the changes (for floods larger than the historical 20-year floods) were significant (at 90 percent confidence level) only in the SSN for severe warming cases. Another analysis using downscaled daily precipitation and temperature projections from three General Circulation Models (CNRM CM3, GFDL CM2.1 and NCAR PCM1) and emission scenario A2 as input to VIC yielded a general increase in the 3-days annual maximum flows under climate change. The increases are significant (at 90 percent confidence level) in the SSN for the period 2051-2099 with all the three climate models analyzed. In the NSN the increases are significant only with the CNRM CM3 model. In general, the frequency of floods increases or stayed same under the projected future climates, and some of the projected floods were unprecedentedly large when compared to historical simulations.

Short-Term Particulate Air Pollution Exposure is Associated with Increased Severity of Respiratory and Quality of Life Symptoms in Patients with Fibrotic Sarcoidosis.

PubMed

Pirozzi, Cheryl S; Mendoza, Daniel L; Xu, Yizhe; Zhang, Yue; Scholand, Mary Beth; Baughman, Robert P

2018-05-26

This study aimed to determine if short-term exposure to particulate matter (PM 2.5 ) and ozone (O₃) is associated with increased symptoms or lung function decline in fibrotic sarcoidosis. Sixteen patients with fibrotic sarcoidosis complicated by frequent exacerbations completed pulmonary function testing and questionnaires every three months for one year. We compared 7-, 10-, and 14-day average levels of PM 2.5 and O₃ estimated at patient residences to spirometry (forced expiratory volume in 1 s (FEV1), to forced vital capacity (FVC), episodes of FEV1 decline > 10%) and questionnaire outcomes (Leicester cough questionnaire (LCQ), Saint George Respiratory Questionnaire (SGRQ), and King's Sarcoidosis Questionnaire (KSQ)) using generalized linear mixed effect models. PM 2.5 level averaged over 14 days was associated with lower KSQ general health status (score change -6.60 per interquartile range (IQR) PM 2.5 increase). PM 2.5 level averaged over 10 and 14 days was associated with lower KSQ lung specific health status (score change -6.93 and -6.91, respectively). PM 2.5 levels were not associated with FEV₁, FVC, episodes of FEV₁ decline > 10%, or respiratory symptoms measured by SGRQ or LCQ. Ozone exposure was not associated with any health outcomes. In this small cohort of patients with fibrotic sarcoidosis, PM 2.5 exposure was associated with increased severity of respiratory and quality of life symptoms.

Salivary matrix metalloproteinase (MMP-8) levels and gelatinase (MMP-9) activities in patients with type 2 diabetes mellitus.

PubMed

Collin, H L; Sorsa, T; Meurman, J H; Niskanen, L; Salo, T; Rönkä, H; Konttinen, Y T; Koivisto, A M; Uusitupa, M

2000-10-01

We studied the salivary levels and activities of the matrix metalloproteinases (MMP) -8 and -9 in 45 type 2 diabetic patients and 77 control subjects. The patients' mean glycosylated haemoglobin (HbA1c) was 8.7%, indicating an unsatisfactory metabolic control of the disease. The MMP levels were further related to the clinical and microbiological periodontal findings as well as to salivary flow rate and other factors. The salivary flow rate, albumin and amylase concentrations were similar in type 2 diabetic patients to those in the control group. The mean gingival and periodontal pocket indexes were higher in the diabetes group. The number of potential periodontopathogenic bacteria was lower, however, in the diabetic than in the control group. Zymography and immunoblotting revealed that the major MMPs in the type 2 diabetic patients' saliva were MMP-8 and MMP-9. Salivary MMP levels and activities in type 2 diabetic patients were in general similar to those in the control group. However, the correlation coefficients using multiple regression analysis revealed that gingival bleeding, pocket depths and HbA1c were associated with increased MMP-8 levels which, in turn, were negatively predicted by elevated plasma lipid peroxide levels in the diabetic group. Our data on salivary MMP-8 and -9 do not support the concept of generalized neutrophil dysfunction in unbalanced diabetes. Moreover, plasma lipid peroxidation levels reflecting the increased oxidative burden, which is generated mainly by triggered neutrophils, do not indicate neutrophil dysfunction due to diabetes, but may rather be related to the increased tissue damage in an uncontrolled disease. However. advanced periodontitis in type 2 diabetes seems to be related to elevated salivary MMP-8 levels which might be useful in monitoring periodontal disease in diabetes.

Age-dependent increase in ortho-tyrosine and methionine sulfoxide in human skin collagen is not accelerated in diabetes. Evidence against a generalized increase in oxidative stress in diabetes.

PubMed Central

Wells-Knecht, M C; Lyons, T J; McCance, D R; Thorpe, S R; Baynes, J W

1997-01-01

The glycoxidation products Nepsilon-(carboxymethyl)lysine and pentosidine increase in skin collagen with age and at an accelerated rate in diabetes. Their age-adjusted concentrations in skin collagen are correlated with the severity of diabetic complications. To determine the relative roles of increased glycation and/or oxidation in the accelerated formation of glycoxidation products in diabetes, we measured levels of amino acid oxidation products, distinct from glycoxidative modifications of amino acids, as independent indicators of oxidative stress and damage to collagen in aging and diabetes. We show that ortho-tyrosine and methionine sulfoxide are formed in concert with Nepsilon-(carboxymethyl)lysine and pentosidine during glycoxidation of collagen in vitro, and that they also increase with age in human skin collagen. The age-adjusted levels of these oxidized amino acids in collagen was the same in diabetic and nondiabetic subjects, arguing that diabetes per se does not cause an increase in oxidative stress or damage to extracellular matrix proteins. These results provide evidence for an age-dependent increase in oxidative damage to collagen and support previous conclusions that the increase in glycoxidation products in skin collagen in diabetes can be explained by the increase in glycemia alone, without invoking a generalized, diabetes-dependent increase in oxidative stress. PMID:9259583

Serum cholesterol levels of Seventh-day Adventists.

PubMed

Taylor, C B; Allen, E S; Mikkelson, B; Kang-Jey, H

1976-10-01

Serum cholesterol levels and dietary habits were surveyed in 27 male and 34 female Seventh-day Adventist. All subjects studied were lacto-ovo-vegetarians and a few consumed some meat products. Their serum cholesterol levels, significantly lower than those of the United States general population, showed no sex difference but increased with age and were higher in overweight males. Their levels, however, were much higher than those of true vegetarians which was most likely attributable to their consumption, even though to a limited acount, of dairy foods.

Sperm competition games: a general model for precopulatory male-male competition.

PubMed

Parker, Geoff A; Lessells, Catherine M; Simmons, Leigh W

2013-01-01

Reproductive males face a trade-off between expenditure on precopulatory male-male competition--increasing the number of females that they secure as mates--and sperm competition--increasing their fertilization success with those females. Previous sperm allocation models have focused on scramble competition in which males compete by searching for mates and the number of matings rises linearly with precopulatory expenditure. However, recent studies have emphasized contest competition involving precopulatory expenditure on armaments, where winning contests may be highly dependent on marginal increases in relative armament level. Here, we develop a general model of sperm allocation that allows us to examine the effect of all forms of precopulatory competition on sperm allocation patterns. The model predicts that sperm allocation decreases if either the "mate-competition loading,"a, or the number of males competing for each mating, M, increases. Other predictions remain unchanged from previous models: (i) expenditure per ejaculate should increase and then decrease, and (ii) total postcopulatory expenditure should increase, as the level of sperm competition increases. A negative correlation between a and M is biologically plausible, and may buffer deviations from the previous models. There is some support for our predictions from comparative analyses across dung beetle species and frog populations. © 2012 The Author(s). Evolution© 2012 The Society for the Study of Evolution.

Immunological Aging

EPA Science Inventory

Immunosenescence is associated with an increased incidence and severity of infections with common pathogens, neoplastic disease and autoimmunity. In general, aging is associated with a decline in function at the cellular level, rather than cell loss, although thymic atrophy and ...

Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

PubMed

Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

2015-01-01

In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Retirement intentions of general practitioners aged 45-65 years.

PubMed

Brett, Thomas D; Arnold-Reed, Diane E; Hince, Dana A; Wood, Ian K; Moorhead, Robert G

2009-07-20

To ascertain the retirement intentions of a cohort of Australian general practitioners. Postal questionnaire survey of members of four Divisions of General Practice in Western Australia, sent out November 2007 - January 2008. A sample of 178 GPs aged 45-65 years. Intention to work in general practice until retirement; reasons for retiring before age 65 years; factors that might encourage working beyond chosen retirement age; and perceived obstacles to working in general practice. 63% of GPs intended to work to at least age 65 years, with men more likely to retire early. Of 63 GPs intending to retire early, 46% gave pressure of work, exhaustion and burnout as reasons for early retirement. Better remuneration, better staffing levels and more general support were incentives to continue working for 46% of the 64 GPs who responded to the question about incentives, and more flexible working hours, part-time work and reduced workload for 41%. Of 169 participants, 65% gave increasing bureaucracy, poor job satisfaction and disillusionment with the medical system or Medicare as obstacles to working in general practice in Australia, whereas workforce shortage, increasing patient demands and diminishing lifestyle through overwork were obstacles named by 48%. Many GPs are planning to retire early, reflecting an emerging trend among professionals and society generally. Declining job satisfaction, falling workforce numbers, excessive workload and increasing bureaucracy were recurrent concerns of older WA GPs considering premature retirement.

Differential Neural Activity during Search of Specific and General Autobiographical Memories elicited by Musical Cues

PubMed Central

Ford, Jaclyn Hennessey; Addis, Donna Rose; Giovanello, Kelly S.

2011-01-01

Previous neuroimaging studies that have examined autobiographical memory specificity have utilized retrieval cues associated with prior searches of the event, potentially changing the retrieval processes being investigated. In the current study, musical cues were used to naturally elicit memories from multiple levels of specificity (i.e., lifetime period, general event, and event-specific). Sixteen young adults participated in a neuroimaging study in which they retrieved autobiographical memories associated with musical cues. These musical cues led to the retrieval of highly emotional memories that had low levels of prior retrieval. Retrieval of all autobiographical memory levels was associated with activity in regions in the autobiographical memory network, specifically the ventromedial prefrontal cortex, posterior cingulate, and right medial temporal lobe. Owing to the use of music, memories from varying levels of specificity were retrieved, allowing for comparison of event memory and abstract personal knowledge, as well as comparison of specific and general event memory. Dorsolateral and dorsomedial prefrontal regions were engaged during event retrieval relative to personal knowledge retrieval, and retrieval of specific event memories was associated with increased activity in the bilateral medial temporal lobe and dorsomedial prefrontal cortex relative to retrieval of general event memories. These results suggest that the initial search processes for memories of different specificity levels preferentially engage different components of the autobiographical memory network. The potential underlying causes of these neural differences are discussed. PMID:21600227

Job satisfaction among health care workers in Serbia.

PubMed

Korac, Vesna; Vasic, Milena; Krstic, Maja; Markovic, Roberta

2010-01-01

According to literature review there seems to be a general agreement that job satisfaction among doctors is declining. This study's objective was to identify job satisfaction levels and their causes among health care workers, employed at the public health institutions. A job satisfaction survey of health care workers was therefore carried out in 197 public health centers in the Republic of Serbia, 157 primary health care centers and 40 general hospitals, in 2008. A satisfaction questionnaire, containing 24 items was used to investigate job satisfaction. Respondents (23.259), working in primary health care, indicated an average job satisfaction level of 3.08 +/- 0.67 on a 5-point scale. Respondents (11.302), working in general hospitals, indicated a lower average job satisfaction level of 2.96 +/- 0.63. The reported level of satisfaction was the highest for their opportunities to use their abilities, cooperation with colleagues and fellow workers, and freedom to choose their own methods of work. Doctors, working in primary health care centers, reported higher level of job satisfaction than hospital doctors. Overall, job satisfaction of doctors and nurses is relatively low. Increased pay rate and more adequate equipment, as well as possibilities for education and career improvement, would enhance their job satisfaction.

Iron deficiency is associated with increased levels of blood cadmium in the Korean general population: Analysis of 2008-2009 Korean National Health and Nutrition Examination Survey data

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

Lee, Byung-Kook; Kim, Yangho, E-mail: yanghokm@nuri.net

Introduction: We present data from the Korean National Health and Nutrition Examination Survey 2008-2009 on the distribution of blood cadmium levels and their association with iron deficiency in a representative sample of the adult Korean population. Methods: Serum ferritin was categorized into three levels: low (serum ferritin <15.0 {mu}g/L), low normal (15.0-30.0 {mu}g/L for women and 15.0-50.0 for men), and normal ({>=}30.0 {mu}g/L for women and {>=}50.0 for men), and its association with blood cadmium level was assessed after adjustment for various demographic and lifestyle factors. Results: Geometric means of blood cadmium in the low serum ferritin group in women,more » men, and all participants were significantly higher than in the normal group. Additionally, multiple regression analysis after adjusting for various covariates showed that blood cadmium was significantly higher in the low-ferritin group in women, men, and all participants compared with the normal group. We also found an association between serum ferritin and blood cadmium among never-smoking participants. Discussion: We found, similar to other recent population-based studies, an association between iron deficiency and increased blood cadmium in men and women, independent of smoking status. The results of the present study show that iron deficiency is associated with increased levels of blood cadmium in the general population.« less

Type D personality is associated with social anxiety in the general population.

PubMed

Kupper, Nina; Denollet, Johan

2014-06-01

Research on the emotional processes associated with Type D personality is important for its further conceptualization. We examined the associations of Type D personality with social and general anxiety symptoms in a large community sample. The aim of the current study was to disentangle the associations of Type D personality and its components with social anxiety and general anxiety in a large sample from the general population. A random sample of 2,475 adults from the general population filled out questionnaires to assess Type D personality (DS-14), social anxiety (SIAS(10), SPS(11), BFNE-II), and general anxiety (HADS-A, GAD-7). Type D individuals were characterized by increased levels of both social and general anxiety. The social inhibition (SI) component of Type D personality was most strongly associated with social interaction anxiety (r = .63), while negative affectivity (NA) was strongly associated with general anxiety (GAD-7: r = .70; HADS-A: r = .66). Within social anxiety, SI was more strongly associated with facets of social interaction anxiety than with social phobia. Multiple regression analysis showed that the synergistic interaction of NA and SI was a predictor of social anxiety (SIAS(10): β = .32, p < .0005; SPS(11): β = .27, p < .0005; BFNE-II: β = .11, p = .007) independent of demographics and the scores on the individual Type D components. This interaction was not a significant predictor of general anxiety. Logistic regression using the dichotomous Type D classification demonstrated a 9.1-fold (95%CI, 7.0-11.8) increased odds of a score in the highest quartile of social interaction anxiety and a 7.6-fold (95%CI, 5.8-9.8) increased odds of high social phobia. Odds ratios for clinically relevant levels of general anxiety were 8.3 (95%CI, 5.5-12.5) for GAD-7 and 6.5 (95%CI, 3.4-12.6) for HADS-A. In the general population, Type D individuals were characterized by both social and general anxiety. The SI component of Type D is strongly associated with social interaction anxiety and the synergistic interaction of NA and SI was associated with high social anxiety, above and beyond the main NA and SI effects.

Mercury and selenium levels in lemon sharks (Negaprion brevirostris) in relation to a harmful red tide event.

PubMed

Nam, Dong-Ha; Adams, Douglas H; Reyier, Eric A; Basu, Niladri

2011-05-01

Tissue levels of mercury (Hg; total, organic) and selenium (Se) were assessed in juvenile lemon sharks (Negaprion brevirostris) from Florida nearshore waters collected during a harmful algal bloom (HAB, brevetoxin) event and compared with sharks not exposed to HABs. In all sharks studied, total Hg levels in the muscle were generally present in a molar excess over Se (which may protect against Hg toxicity) and mean muscle Hg levels (0.34 microg/g) exceed safe human consumption guidelines. While there was generally no difference in tissue Hg and Se levels following exposure of sharks to HABs, hepatic Hg levels were significantly lower (56% reduction) in the HAB-exposed sharks compared to controls. As Hg and HABs are globally increasing in scope and magnitude, further work is warranted to assess their interactions and biotic impacts within aquatic ecosystems, especially for a species such as the lemon shark that is classified as a near-threatened species by the International Union for the Conservation of Nature.

Joint projections of US East Coast sea level and storm surge

NASA Astrophysics Data System (ADS)

Little, Christopher M.; Horton, Radley M.; Kopp, Robert E.; Oppenheimer, Michael; Vecchi, Gabriel A.; Villarini, Gabriele

2015-12-01

Future coastal flood risk will be strongly influenced by sea-level rise (SLR) and changes in the frequency and intensity of tropical cyclones. These two factors are generally considered independently. Here, we assess twenty-first century changes in the coastal hazard for the US East Coast using a flood index (FI) that accounts for changes in flood duration and magnitude driven by SLR and changes in power dissipation index (PDI, an integrated measure of tropical cyclone intensity, frequency and duration). Sea-level rise and PDI are derived from representative concentration pathway (RCP) simulations of 15 atmosphere-ocean general circulation models (AOGCMs). By 2080-2099, projected changes in the FI relative to 1986-2005 are substantial and positively skewed: a 10th-90th percentile range 4-75 times higher for RCP 2.6 and 35-350 times higher for RCP 8.5. High-end FI projections are driven by three AOGCMs that project the largest increases in SLR, PDI and upper ocean temperatures. Changes in PDI are particularly influential if their intra-model correlation with SLR is included, increasing the RCP 8.5 90th percentile FI by a further 25%. Sea-level rise from other, possibly correlated, climate processes (for example, ice sheet and glacier mass changes) will further increase coastal flood risk and should be accounted for in comprehensive assessments.

Joint Projections of US East Coast Sea Level and Storm Surge

NASA Technical Reports Server (NTRS)

Little, Christopher M.; Horton, Radley M.; Kopp, Robert E.; Oppenheimer, Michael; Vecchi, Gabriel A.; Villarini, Gabriele

2015-01-01

Future coastal flood risk will be strongly influenced by sea-level rise (SLR) and changes in the frequency and intensity of tropical cyclones. These two factors are generally considered independently. Here, we assess twenty-first century changes in the coastal hazard for the US East Coast using a flood index (FI) that accounts for changes in flood duration and magnitude driven by SLR and changes in power dissipation index (PDI, an integrated measure of tropical cyclone intensity, frequency and duration). Sea-level rise and PDI are derived from representative concentration pathway (RCP) simulations of 15 atmosphere- ocean general circulation models (AOGCMs). By 2080-2099, projected changes in the FI relative to 1986-2005 are substantial and positively skewed: a 10th-90th percentile range 4-75 times higher for RCP 2.6 and 35-350 times higher for RCP 8.5. High-end Fl projections are driven by three AOGCMs that project the largest increases in SLR, PDI and upper ocean temperatures. Changes in PDI are particularly influential if their intra-model correlation with SLR is included, increasing the RCP 8.5 90th percentile FI by a further 25%. Sea-level rise from other, possibly correlated, climate processes (for example, ice sheet and glacier mass changes) will further increase coastal flood risk and should be accounted for in comprehensive assessments.

Potential effects of climate change on ground water in Lansing, Michigan

USGS Publications Warehouse

Croley, T.E.; Luukkonen, C.L.

2003-01-01

Computer simulations involving general circulation models, a hydrologic modeling system, and a ground water flow model indicate potential impacts of selected climate change projections on ground water levels in the Lansing, Michigan, area. General circulation models developed by the Canadian Climate Centre and the Hadley Centre generated meteorology estimates for 1961 through 1990 (as a reference condition) and for the 20 years centered on 2030 (as a changed climate condition). Using these meteorology estimates, the Great Lakes Environmental Research Laboratory's hydrologic modeling system produced corresponding period streamflow simulations. Ground water recharge was estimated from the streamflow simulations and from variables derived from the general circulation models. The U.S. Geological Survey developed a numerical ground water flow model of the Saginaw and glacial aquifers in the Tri-County region surrounding Lansing, Michigan. Model simulations, using the ground water recharge estimates, indicate changes in ground water levels. Within the Lansing area, simulated ground water levels in the Saginaw aquifer declined under the Canadian predictions and increased under the Hadley.

Personal Trust Increases Cooperation beyond General Trust

PubMed Central

Acedo-Carmona, Cristina; Gomila, Antoni

2014-01-01

In this paper we present a new methodology which, while allowing for anonymous interaction, it also makes possible to compare decisions of cooperating or defecting when playing games within a group, according to whether or not players personally trust each other. The design thus goes beyond standard approaches to the role of trust in fostering cooperation, which is restricted to general trust. It also allows considering the role of the topology of the social network involved may play in the level of cooperation found. The results of this work support the idea that personal trust promotes cooperation beyond the level of general trust. We also found that this effect carries over to the whole group, making it more cohesive, but that higher levels of cohesion rely on a particular topology. As a conclusion, we hypothesize that personal trust is a psychological mechanism evolved to make human social life possible in the small groups our ancestors lived in, and that this mechanism persists and plays a role in sustaining cooperation and social cohesion. PMID:25144539

The MCP-1, CCL-5 and SDF-1 chemokines as pro-inflammatory markers in generalized anxiety disorder and personality disorders.

PubMed

Ogłodek, Ewa A; Szota, Anna M; Just, Marek J; Moś, Danuta M; Araszkiewicz, Aleksander

2015-02-01

The co-occurrence of generalized anxiety disorder and personality disorders suggests the existence of association between the neurobiological predispositions leading to the development of these disorders and activation of cytokine system. Pro-inflammatory chemokines such as CCL-5/RANTES (regulated upon activation normal T cell expressed and secreted) and CXCL12/SDF-1 (stromal derived factor) play an important role in immune response. A total of 160 participants were enrolled in the study, 120 of whom comprised the study group (people with the dual diagnosis of personality disorder and generalized anxiety disorder). The mean age was 41.4 ± 3.5 years (range: 20-44 years). The control group consisted of 40 healthy individuals in the mean age of 40.8 ± 3.1 years (range: 20-43 years). A blood sample was collected from each participant and the plasma levels of the CCL-2/MCP-1 (monocyte chemoattractant protein-1), RANTES and SDF-1 chemokines were determined by ELISA. Increased levels of MCP-1 and SDF-1 were found both in women and in men versus the control group for all types of personality disorders. The levels of CCL-5 in men were significantly increased versus the control group and significantly higher in women than in men. Neither women nor men with avoidant or obsessive-compulsive personality disorder showed any significant differences in MCP-1 or SFD-1 levels. In subjects with borderline personality disorder, the levels of the study chemokines were higher in women than in men. Our study has shown the need for determination of proinflammatory interleukins which are considered as biomarkers of personality disorders and generalized anxiety disorders. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

The effect of solvent polarity on the accumulation of leachables from pharmaceutical product containers.

PubMed

Jenke, Dennis; Odufu, Alex; Poss, Mitchell

2006-02-01

Material/water equilibrium interaction constants (E(b)) were determined for 12 organic model solutes and a plastic material used in pharmaceutical product containers (non-PVC polyolefin). An excellent correlation was obtained between the measured interaction constants and the organic solute's octanol/water partition coefficient. The effect of solvent polarity on E(b) was assessed by examining the interaction between the plastic and selected model solutes in binary ethanol/water mixtures. In general, logE(b) could be linearily related to the polarity of the ethanol/water mixture. This information, coupled with the interaction model, was used to estimate the levels to which container leachables could accumulate in contacted solutions. Such estimates were made for six known leachables of the polyolefin material and compared to the leachable's measured accumulation levels in binary ethanol/water systems. In general, the accumulation level of the leachables increased with increasing solution polarity. For most of the leachables, the measured accumulation level was less than the calculated levels, suggesting that equilibrium was not achieved in the leaching portion of this study. This lack of equilibrium is attributable to the layered structure of the material studied, as such layering retards the migration of the leachables that are derived from the material's non-solution contact layers.

Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress.

PubMed

Cousins, Rosanna; Donnell, Christine

2012-04-01

Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored. To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice. In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice. Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay. Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.

Hypercalcitoninemia in infancy.

PubMed

Cannarozzi, D B; Canale, D D; Donabedian, R K

1976-02-02

Immunoreactive calcitonin (iCT) was measured in 19 infants with neonatal hypocalcemia. The infants had a variety of neonatal diseases and stresses. iCT levels were generally elevated to two to 20 times the adult values. Poor correlation existed between the infant age and the level of iCT or between iCT alone and the serum calcium. However, there was significant correlation between the serum calcium and the ratio of the iCT to infant age from conception, suggesting that both infant age and iCT levels in combination may be related to hypocalcemia. Also, it appears that a variety of neonatal stresses may be associated with increased sensitivity to the hypocalcemic effect of iCT, as well as increased levels of iCT.

Impact of monovalent cations on soil structure. Part I. Results of an Iranian soil

NASA Astrophysics Data System (ADS)

Farahani, Elham; Emami, Hojat; Keller, Thomas; Fotovat, Amir; Khorassani, Reza

2018-01-01

This study investigated the impact of monovalent cations on clay dispersion, aggregate stability, soil pore size distribution, and saturated hydraulic conductivity on agricultural soil in Iran. The soil was incubated with treatment solutions containing different concentrations (0-54.4 mmol l-1) of potassium and sodium cations. The treatment solutions included two levels of electrical conductivity (EC=3 or 6 dS m-1) and six K:Na ratios per electrical conductivity level. At both electrical conductivity levels, spontaneously dispersible clay increased with increasing K concentration, and with increasing K:Na ratio. A negative linear relationship between percentage of water-stable aggregates and spontaneously dispersible clay was observed. Clay dispersion generally reduced the mean pore size, presumably due to clogging of pores, resulting in increased water retention. At both electrical conductivity levels, hydraulic conductivity increased with increasing exchangeable potassium percentage at low exchangeable potassium percentage values, but decreased with further increases in exchangeable potassium percentage at higher exchangeable potassium percentage. This is in agreement with earlier studies, but seems in conflict with our data showing increasing spontaneously dispersible clay with increasing exchangeable potassium percentage. Our findings show that clay dispersion increased with increasing K concentration and increasing K:Na ratio, demonstrating that K can have negative impacts on soil structure.

Airborne asbestos in public buildings

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

Chesson, J.; Hatfield, J.; Schultz, B.

The U.S. Environmental Protection Agency sampled air in 49 government-owned buildings (six buildings with no asbestos-containing material, six buildings with asbestos-containing material in generally good condition, and 37 buildings with damaged asbestos-containing material). This is the most comprehensive study to date of airborne asbestos levels in U.S. public buildings during normal building activities. The air outside each building was also sampled. Air samples were analyzed by transmission electron microscopy using a direct transfer preparation technique. The results show an increasing trend in average airborne asbestos levels; outdoor levels are lowest and levels in buildings with damaged asbestos-containing material are highest.more » However, the measured levels and the differences between indoors and outdoors and between building categories are small in absolute magnitude. Comparable studies from Canada and the UK, although differing in their estimated concentrations, also conclude that while airborne asbestos levels may be elevated in buildings that contain asbestos, levels are generally low. This conclusion does not eliminate the possibility of higher airborne asbestos levels during maintenance or renovation that disturbs the asbestos-containing material.« less

Serum IL-18 level, clinical symptoms and IL-18-607A/C polymorphism among chronic patients with schizophrenia in a Chinese Han population.

PubMed

Zhang, Xiang Yang; Tan, Yun-Long; Chen, Da-Chun; Tan, Shu-Ping; Malouta, Michelle Z; Bernard, Jared D; Combs, Jessica L; Bhatti, Sarai; Davis, Michael C; Kosten, Thomas R; Soares, Jair C

2016-06-01

Literature suggests that alterations in the inflammatory and immune systems are involved in the pathogenesis of schizophrenia. Specifically, patients diagnosed with schizophrenia exhibit increased IL-18, a pleiotropic proinflammatory cytokine in type 1 T-helper (Th1) responses. The functional 607A/C promoter polymorphism of the IL-18 gene is also associated with the psychopathology of this disorder. However, no current study has explored its role in the clinical symptoms of schizophrenia as mediated through IL-18 levels. We recruited 772 inpatients with schizophrenia and 775 healthy controls in a Han Chinese population and genotyped the IL-18-607A/C polymorphism. Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Serum IL-18 levels were measured in 80 patients and 93 healthy controls. Our results showed that there were no significant differences in the distribution of the allele and genotype frequencies between the patients and controls. Both increased IL-18 serum level and the IL-18-607A/C polymorphism were positively associated with the PANSS general psychopathology subscore and the PANSS total score. Moreover, interaction of increased IL-18 serum level and the IL-18-607A/C polymorphism influenced the clinical psychopathological symptoms, indicating that association of IL-18 level with the PANSS general psychopathology subscale or the total scores was present only among patients carrying the C allele. We demonstrate an association between the IL-18-607A/C variant and clinical psychopathological symptoms in schizophrenia. Findings suggest that the association between higher IL-18 levels and clinical symptoms in schizophrenia is dependent on the IL-18-607A/C polymorphism. Copyright © 2016 Elsevier Ltd. All rights reserved.

Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia

PubMed Central

Klimek, Markus; Hol, Jaap W.; Wens, Stephan; Heijmans-Antonissen, Claudia; Niehof, Sjoerd; Vincent, Arnaud J.; Klein, Jan; Zijlstra, Freek J.

2009-01-01

Background. Surgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether those procedures cause different inflammatory responses. Methods. Twenty patients undergoing craniotomy under general anesthesia and 20 patients undergoing awake function-controlled craniotomy were included in this prospective, observational, two-armed study. Circulating levels of IL-6, IL-8, and IL-10 were determined pre-, peri-, and postoperatively in both patient groups. VAS scores for pain, anxiety, and stress were taken at four moments pre- and postoperatively to evaluate physical pain and mental duress. Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups. Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia. PMID:19536349

Job strain variations in relation to plasma testosterone fluctuations in working men--a longitudinal study.

PubMed

Theorell, T; Karasek, R A; Eneroth, P

1990-01-01

Job strain, a high level of psychological demands combined with a low level of decision latitude, has been hypothesized to induce mobilization of energy and inhibition of anabolism. In the present project this hypothesis was tested using four repeated observations every third month in a group of 44 men working in six widely different occupations. On each occasion scores of self-reported demands and decision latitude were calculated for every participant. An earlier report has shown that systolic blood pressure during work hours--an indicator of mobilization of energy--increased with increasing job strain (ratio between demands and decision latitude). Blood samples were drawn in the morning at the work site. For each man the plasma testosterone levels--representing the general level of anabolic activity--on the two occasions with the worst strain (ratio between demands and decision latitude) were compared with the plasma testosterone levels on the two occasions with the least strain. The results indicated that total plasma testosterone (but not free testosterone) levels increased when strain diminished in sedentary but not in physically demanding work. Subjects with a family history of hypertension showed a greater decrease in testosterone levels than others when job strain increased.

Women's Preference for Attractive Makeup Tracks Changes in Their Salivary Testosterone.

PubMed

Fisher, Claire I; Hahn, Amanda C; DeBruine, Lisa M; Jones, Benedict C

2015-12-01

Previous research suggests that women's motivation to appear attractive is increased around the time of ovulation. However, the specific hormonal correlates of within-woman changes in motivation to appear attractive have not been investigated. To address this issue, we used a longitudinal design and a data-driven visual preference task. We found that women's preference for attractive makeup increases when their salivary testosterone levels are high. The relationship between testosterone level and preference for attractive makeup was independent of estradiol level, progesterone level, and estradiol-to-progesterone ratio. These results suggest that testosterone may contribute to changes in women's motivation to wear attractive makeup and, potentially, their motivation to appear attractive in general. Our results are also consistent with recent models of the role of testosterone in social behavior, according to which testosterone increases the probability of behaviors that could function to support the acquisition of mates and competition for resources. © The Author(s) 2015.

Motivational "spill-over" during weight control: increased self-determination and exercise intrinsic motivation predict eating self-regulation.

PubMed

Mata, Jutta; Silva, Marlene N; Vieira, Paulo N; Carraça, Eliana V; Andrade, Ana M; Coutinho, Sílvia R; Sardinha, Luis B; Teixeira, Pedro J

2009-11-01

Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Secular trend: morphology and performance.

PubMed

Sedeaud, Adrien; Marc, Andy; Schipman, Julien; Schaal, Karine; Danial, Mario; Guillaume, Marion; Berthelot, Geoffroy; Toussaint, Jean-François

2014-01-01

In a context of morphological expansion of the general population, how do athletes follow such a pattern of anthropometric growth? Is there any relation to performance? Biometric data including mass, height, body mass index (BMI) and age were collected for 50,376 American athletes representing 249,336 annual performers playing in professional baseball, football, ice hockey and basketball. Distributions by mass in National Football League (NFL) players are described by periods. Field goals have been studied in relation to players' height in the National Basketball Association (NBA). Between 1871 and 2011, athletes from the four sports have increased significantly in mass, height and BMI, following a multi-exponential function series. Consequently, biometric differences between athletes and the general population are increasing gradually. Changes in the mass distribution within the NFL show the emergence of a biometrical specificity in relation to the field position. At the professional level, performance remains structured around precise biometric values. In the NBA, a height-attractor at 201.3 ± 6.3 cm for the best scorers is invariant, regardless of the level of play. These results suggest that laws of growth and biometrics drive high-level sport and organise performance around the specific constraint of each field position. Discrepancies between some mass and height developments question the (disproportionate) large mass increase (relative to the height increase) during the 1980s and 1990s.

Disparities in access to emergency general surgery care in the United States.

PubMed

Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

2018-02-01

As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

Veterans Affairs general surgery service: the last bastion of integrated specialty care.

PubMed

Poteet, Stephen; Tarpley, Margaret; Tarpley, John L; Pearson, A Scott

2011-11-01

In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients. Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to 2009 at the Nashville VA. Over a 5-year span general surgery residents spent an average of 5 months on the VA general surgery service, which includes a postgraduate year (PGY)-5, PGY-3, and 2 PGY-1 residents. Surgeries involved the following specialties: surgical oncology, endocrine, colorectal, hepatobiliary, transplant, gastrointestinal laparoscopy, and elective and emergency general surgery. The surgeries were categorized according to ACGME index requirements. A total of 2,956 surgeries were performed during the 5-year period from 2005 through 2009. Residents participated in an average of 246 surgeries during their experience at the VA; approximately 50 cases are completed during the chief year. On the VA surgery service alone, 100% of the ACGME requirement was met for the following categories: endocrine (8 cases); skin, soft tissue, and breast (33 cases); alimentary tract (78 cases); and abdominal (88 cases). Approximately 50% of the ACGME requirement was met for liver, pancreas, and basic laparoscopic categories. The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training programs. The increasing level of responsibility and simultaneous care of multiple specialty patients through the VA hospital systems offers a crucial experience for those pursuing a career in general surgery. Published by Elsevier Inc.

Evaluation of ozone, nitrogen dioxide, and carbon monoxide at nine sites in Saudi Arabia during 2007.

PubMed

Butenhoff, Christopher L; Khalil, M Aslam K; Porter, William C; Al-Sahafi, Mohammed Saleh; Almazroui, Mansour; Al-Khalaf, Abdulrahman

2015-07-01

This paper presents a one-year record of in situ air-quality data from nine sites throughout Saudi Arabia. The data set is composed of hourly measurements of ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO) at six of the largest cities in Saudi Arabia (Riyadh, Jeddah, Makkah, Yanbu, Dammam, Hafouf) and two remote locations in the mountainous southwestern region of Alsodah for the year 2007. The authors found that international O3 and CO standards were routinely exceeded throughout the year at many sites, and that exceedances increased during Ramadan (Sep. 12-Oct. 13), the Islamic month of fasting when much of normal daily activity is shifted to nighttime hours. In general NO2 and CO levels were higher in Saudi cities compared to U.S. cities of comparable population, while O3 levels were lower. There was a general trend for O3 and NO2 to be negatively correlated in Saudi cities in contrast to U.S. cities where the correlation is positive, suggesting that ozone chemistry in Saudi Arabia is limited by volatile organic compound emissions. This may be caused by low biogenic emissions from vegetation. Pollutant levels were lower at most Saudi sites during the four day Hajj period (Dec. 18-21) but higher in Makkah which receives millions of visitors during Hajj. The authors also found that ozone levels were elevated during the weekend (Thursday & Friday) relative to weekday levels despite lower NO2, a phenomenon known as the "weekend effect." As little air quality data is available from Saudi Arabia in the English-language literature, this data set fills a knowledge gap and improves understanding of air quality in an important but under-reported region of the world. Air quality measurements at nine sites in Saudi Arabia provide a detailed look at spatial and temporal patterns of ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). NO2 and CO levels increased in most cities during the fasting month of Ramadan, whereas O3 levels decreased. This led to an increased frequency of CO exceedances based on international standards. NO2 and CO also increased in Makkah during the Hajj pilgrimage. In general, NO2 and O3 levels were anticorrelated at most sites, suggesting that O3 chemistry is limited by volatile organic compound emissions throughout much of Saudi Arabia.

Medical Significance of Microorganisms in Spacecraft Environment

NASA Technical Reports Server (NTRS)

Pierson, Duane L.; Ott, C. Mark

2007-01-01

Microorganisms can spoil food supplies, contaminate drinking water, release noxious volatile compounds, initiate allergic responses, contaminate the environment, and cause infectious diseases. International acceptability limits have been established for bacterial and fungal contaminants in air and on surfaces, and environmental monitoring is conducted to ensure compliance. Allowable levels of microorganism in water and food have also been established. Environmental monitoring of the space shuttle, the Mir, and the ISS have allowed for some general conclusions. Generally, the bacteria found in air and on interior surfaces are largely of human origin such as Staphylococcus spp., Micrococcus spp. Common environmental genera such as Bacillus spp. are the most commonly isolated bacteria from all spacecraft. Yeast species associated with humans such as Candida spp. are commonly found. Aspergillus spp., Penicillium spp., and Cladosporium spp. are the most commonly isolated filamentous fungi. Microbial levels in the environment differ significantly depending upon humidity levels, condensate accumulation, and availability of carbon sources. However, human "normal flora" of bacteria and fungi can result in serious, life-threatening diseases if human immunity is compromised. Disease incidence is expected to increase as mission duration increases.

[Medical opinion leaders conflict of interests: effects of disclosures on the trust of the public and general practitioners].

PubMed

Chakroun, R; Milhabet, I

2011-08-01

Key medical opinion leaders influence the behaviors of physicians and patients. By law, they have to disclose their interests with pharmaceutical companies when they communicate in the media. Up to now, it appears that no study has explored the effect of opinion leaders' disclosures despite their potential impact on public health and economy. The study objective was to assess the effects of opinion leaders' disclosures of interest on the public and general practitioners' trust in opinion leader by comparison with the overall medical community. In an experimental setting, three opinion leader profiles were built that differed only by the disclosure of their interests (hidden vs. weak vs. strong interests). One of the three profiles was randomly assigned to the subjects of two groups: 67 students and 60 general practitioners. According to an Anova analysis, the main effects and interactions of the disclosure of interests, of the message recipients, and of the assessed targets on the level of trust were measured. The results show that the average level of trust expressed by general practitioners was lower than that expressed by the general public. The level of trust in the opinion leader was lower than that of the overall medical community. The level of trust of exposed subjects fell much lower with stronger disclosed interests. While the general public did not distinguish trust between opinion leaders and the overall medical community, practitioners showed a significantly lower level of trust in opinion leaders with increasingly strong levels of disclosed interests. These study results refute the assertion that public trust would be reduced by the disclosure of interests. They reinforce the importance of the "who judges who" and "which kind of disclosure impacts who ?" effects and draw attention to further research on the role of social interactions in both mass and group communications. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Variation in formulary adherence in general practice over time (2003-2007).

PubMed

van Dijk, Liset; de Jong, Judith D; Westert, Gert P; de Bakker, Dinny H

2011-12-01

To study trends and variation in adherence to the main national formulary for the 20 most prevalent health problems in Dutch general practice over a 5-year period (2003-07). Routine electronic medical records from a pool of 115 representative general practices were linked to the main national formulary. Analyses included over 2 million prescriptions for 246 391 patients. The outcome variable was whether or not the prescribed medication was congruent with recommendations in the national formulary. Trends and variation were analysed using three-level multilevel logistic regression analyses (general practice, patient, and prescription). The percentage of formulary adherent prescriptions for the 20 most prevalent health problems was 73-76% between 2003 and 2007. The percentage varied considerably between guidelines. Lowest adherence rates were found for acute bronchitis and acute upper respiratory infection. Interpractice variation was constant over time. General practice information networks are useful for monitoring general patterns of formulary on a year-to-year basis. Formulary adherence is stable over time but varies across diagnoses, patients and general practices. In the past decade, efforts have been made to increase the level of formulary adherent prescribing. These general efforts managed to stabilize (variation in) adherence in a field where many other initiatives (e.g. by pharmaceutical companies) are undertaken to influence prescribing behaviour.

The Association between genetic variations of CHI3L1, levels of the encoded glycoprotein YKL-40 and the lipid profile in a Danish population.

PubMed

Thomsen, Stine Brinkløv; Rathcke, Camilla Noelle; Skaaby, Tea; Linneberg, Allan; Vestergaard, Henrik

2012-01-01

The inflammatory biomarker YKL-40 seems to play a role in atherosclerosis and is elevated in patients with obesity, cardiovascular disease and type 2 diabetes. Single nucleotide polymorphisms (SNPs) of the YKL-40 encoding gene, CHI3L1, are associated with inter-individual YKL-40 levels. One study has described an association between a promoter polymorphism of CHI3L1 and levels of low density lipoprotein. The objective of this study was to evaluate the influence of YKL-40 on lipid parameters by determining the association between polymorphisms of CHI3L1, serum YKL-40 and levels of the differentiated lipid profile in a Danish general population. 12 SNPs of CHI3L1 were genotyped, and serum YKL-40 and parameters of the lipid profile were measured in 2,656 Danes. Lipid profile and genotypes were available in another Danish population (n = 6,784) for replication. Cholesterol and triglyceride levels increased with increasing YKL-40 quartile (both p<0.0001), and YKL-40 correlated with triglyceride levels (β = 0.15, p<0.0001). Low density lipoprotein levels increased slightly from the 1(st) to the 3(rd) quartile (p = 0.006). The highest YKL-40 quartile was associated with a greater risk of hypercholesterolemia compared to the lowest YKL-40 quartile (odds ratio 1.36, p = 0.009). Minor homozygosity of rs12123883 was associated with higher triglyceride levels (p = 0.022) and a higher prevalence of low high density lipoprotein (p = 0.012), but these associations could not be confirmed in the replication population. Serum YKL-40 correlates with triglyceride levels in a representative group of the general Danish population. No consistent associations between SNPs of CHI3L1 and lipid levels could be documented.

Developmental toxicity of perfluorononanoic acid in mice

EPA Science Inventory

Perfluorononanoic acid (PFNA) is a ubiquitous and persistent environmental contaminant. Although its levels in the environment and in humans are lower than those of perfluorooctane sulfonate(PFOS) or perfluorooctanoic acid (PFOA), a steady trend of increases in the general popula...

Attitudes among the general Austrian population towards neonatal euthanasia: a survey.

PubMed

Goldnagl, Lena; Freidl, Wolfgang; Stronegger, Willibald J

2014-10-07

The Groningen Protocol aims at providing guidance in end-of-life decision-making for severely impaired newborns. Since its publication in 2005 many bioethicists and health care professionals have written articles in response. However, only very little is known about the opinion among the general population on this subject. The aim of this study was to present the general attitude towards neonatal euthanasia (NE) among the Austrian population and the factors associated with the respondents' opinion. A cross-sectional study was conducted among the general Austrian population. Computer-assisted telephone interviews were performed with 1,000 interviewees aged 16 years and older. Binary logistic regression was performed in order to determine factors that are independently associated with the respondents' opinion about neonatal euthanasia. While 63.6% of the participants rejected the idea of neonatal euthanasia for severely impaired newborns, 36.4% opted either in favor or were undecided. Regression analysis has shown the respondents' educational level (p = 0.005) and experience in the care of terminally ill persons (p = 0.001) to be factors that are positively associated with the rejection of neonatal euthanasia, whereas a higher age was associated with a lower degree of rejection (p = 0.021). We found that the majority of the Austrian population rejects the idea of neonatal euthanasia for severely impaired newborns. However, given the increasing levels of rejection of NE among the younger generations and among people with a higher educational level, it cannot be precluded that the rejection rate might in future increase even further, rather than decrease.

Self-reported asthma and allergies in top athletes compared to the general population - results of the German part of the GA2LEN-Olympic study 2008

PubMed Central

2010-01-01

Background Prevalence of asthma and allergies in top athletes is high. However, most previous studies did not include a general population comparison group. We aimed to compare the prevalence of asthma, allergies and medical treatment in different groups of German top athletes to the general population. Methods Prior to the 2008 Summer Olympic Games, 291 German candidates for participation (65%) completed a questionnaire on respiratory and allergic symptoms. Results were compared to those of a general population study in Germany (n = 2425, response 68%). Furthermore, associations between types of sports and the self-reported outcomes were calculated. All models were adjusted for age, sex, level of education and smoking. Results Athletes reported significantly more doctors' diagnosed asthma (17% vs. 7%), more current use of asthma medication (10% vs. 4%) and allergic rhinitis (25% vs. 17%) compared to the general population. After adjustment, top athletes only had an increased Odds Ratio for doctor's diagnosed asthma (OR: 1.6; 95% CI 1.1-2.5). Compared to the general population, athletes in endurance sports had an increased OR for doctor's diagnosed asthma (2.4; 1.5-3.8) and current use of asthma medication (1.8; 1.0-3.4). In this group, current wheeze was increased when use of asthma medication was taken into account (1.8; 1.1-2.8). For other groups of athletes, no significantly increased ORs were observed. Conclusions Compared to the general population, an increased risk of asthma diagnosis and treatment was shown for athletes involved in endurance sports. This might be due to a better medical surveillance and treatment of these athletes. PMID:21118543

Soil biota in an ungrazed grassland: Response to annual grass (Bromus tectorum) invasion

USGS Publications Warehouse

Belnap, Jayne; Phillips, Susan L.

2001-01-01

Bromus tectorum is an exotic annual grass that currently dominates many western U.S. semi-arid ecosystems, and the effects of this grass on ecosystems in general, and soil biota specifically, are unknown. Bromus recently invaded two ungrazed and unburned perennial bunchgrass communities in southeastern Utah. This study compared the soil food-web structure of the two native grassland associations (Stipa [S] and Hilaria [H]), with and without the presence of Bromus. Perennial grass and total vascular-plant cover were higher in S than in H plots, while quantities of ground litter were similar. Distribution of live and dead plant material was highly clumped in S and fairly homogenous in H. Soil food-web structure was different between H and S, with lower trophic levels more abundant in H and higher trophic levels more abundant in S. In Bromus-invaded plots, the quantity of ground litter was 2.2 times higher in Hilaria–Bromus (HB) than in H plots, and 2.8 times higher in Stipa–Bromus (SB) than in S plots. Soil biota in HB generally responded to the Bromus invasion in an opposite manner than in SB, e.g., if a given component of the food web increased in one community, it generally decreased in the other. Active bacteria decreased in H vs. HB, while increasing in S vs. SB. Soil and live plant-infecting fungi were the exception, as they increased in both types of invaded plots relative to uninvaded plots. Dead-plant-infecting fungi decreased in H vs. HB and increased in S vs. SB. Most higher-trophic-level organisms increased in HB relative to H, while decreasing in SB relative to S. Given the mixed response to invasion, the structure of these soil food webs appears to be controlled by both plant inputs and internal dynamics between trophic levels. When compared to non-invaded sites, soil and soil food-web characterisitics of the newly invaded sites included: (1) lower species richness and lower absolute numbers of fungi and invertebrates; (2) greater abundance of active bacteria; (3) similar species of bacteria and fungi as those found in soils invaded over 50 yr ago; (4) higher levels of silt (thus greater fertility and soil water-holding capacity); and (5) a more continuous cover of living and dead plant material (thus facilitating germination of the large-seeded Bromus). These results illustrate that (1) soil food-web structure can vary widely within what would generally be considered one vegetation type (semi-arid grassland), depending on plant species composition within that type, and (2) addition of a common resource can evoke disparate responses from individual food-web compartments, depending on their original structure.

Risk of MS is not associated with exposure to crude oil, but increases with low level of education.

PubMed

Riise, Trond; Kirkeleit, Jorunn; Aarseth, Jan Harald; Farbu, Elisabeth; Midgard, Rune; Mygland, Åse; Eikeland, Randi; Mørland, Tore Jørgen; Telstad, Wenche; Førland, Per Tore; Myhr, Kjell-Morten

2011-07-01

Offshore workers in the Norwegian upstream petroleum industry are exposed to a number of chemicals such as organic solvents, mineral oils and other hydrocarbons, possibly contributing to an increased risk of multiple sclerosis (MS). To estimate the risk of MS in this population compared with the general working population in Norway, adjusting for education. Using the Norwegian Registry of Employers and Employees we included all 27,900 offshore workers registered from 1981 to 2003 and 366,805 referents from the general working population matched by gender, age and community of residence. The cohort was linked to the Norwegian MS Registry and the Norwegian Education Registry. There was no increased risk of MS among the offshore workers. We found a marked and linear inverse relationship between level of education and the risk of MS in the total study population, with a rate ratio of 0.48 (95% CI, 0.53 to 0.88) for workers with a graduate degree compared to workers with elementary school only. These findings do not support a major aetiological role of petroleum-based products, but rather point to smoking and other lifestyle factors related to the level of education as being important for the risk of MS.

[Epidemiologic situation in Ukraine, concerning malignant mesothelioma prevalence].

PubMed

Varivonchik, D V

2014-01-01

Malignant mesothelioma is an "indicator" tumor for evaluating public exposure to asbestos (mostly amphibolitic). Over 2001-2011 in Ukraine a total of 2645 cases of malignant mesothelioma was registered (annual number is 240.5 +/- 29.0 cases). 1 case of malignant mesothelioma per 457.4 tons of asbestos consumed by industry. Median annual levels of malignant mesothelioma morbidity in Ukraine (world standard): males--0.60; females--0.31 per 100,000 of general population. These levels are lower than worldwide (males--1.11; females--0.30) and Europaen WHO ones (males--1.53; female--0.37). Medians of malignant mesothelioma morbidity age are not different between males and females in Ukraine (males 59.5 +/- 13.2 years; females 62.6 +/- 13.1 years; p > 0.05). Most frequent location of malignant mesothelioma is on pleura (males 95.3%; females 89.8%). Now Ukraine is among the countries with low level (< 0.8 per 100,000 general population) and moderate (19.0-0.1% per year) increase of malignant mesothelioma morbidity in European WHO region. Up to 2025, the prognosis is of increased malignant mesothelioma morbidity in Ukraine to 0.97 [0.70-1.18] per 100,000 general population, and in European WHO region--to 2.68. Over 1992-2011, in Ukraine 3 cases of occupational malignant mesothelioma were diagnosed (2 cases of them were connected with occupational exposure to asbestos dust).

State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Colorado

ERIC Educational Resources Information Center

Center on Education Policy, 2010

2010-01-01

This paper profiles Colorado's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP (National Assessment of Educational Progress) increased in grades 4 and 8 in both reading and math. Average annual gains were generally larger on NAEP than…

State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Alabama

ERIC Educational Resources Information Center

Center on Education Policy, 2010

2010-01-01

This paper profiles Alabama's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP (National Assessment of Educational Progress) increased in grades 4 and 8 in both reading and math. Average annual gains were generally larger on the state…

State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Florida

ERIC Educational Resources Information Center

Center on Education Policy, 2010

2010-01-01

This paper profiles Florida's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP (National Assessment of Educational Progress) increased in grades 4 and 8 in both reading and math. Average annual gains were generally larger on the state…

State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Arizona

ERIC Educational Resources Information Center

Center on Education Policy, 2010

2010-01-01

This paper profiles Arizona's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP (National Assessment of Educational Progress) increased in grades 4 and 8 in both reading and math. Average annual gains were generally larger on the state…

What Preconceptions and Attitudes about Engineering Are Prevalent Amongst Upper Secondary School Pupils? An International Study

ERIC Educational Resources Information Center

Koycu, Ümit; de Vries, Marc J.

2016-01-01

In the Netherlands, as well as in many other countries, there is an increasing interest in implementing education about engineering as a part of general education at the upper secondary school level. In order to know what pupils at that level think about engineering, a study has been done to investigate their attitude towards and their concept of…

Mortality in Asia.

PubMed

1981-01-01

Although the general trend in mortality between 1950 and 1975 in South and East Asia has been downward, there is considerable country-to-country variation in the rate of decline. In countries where combined economic, social, and political circumstances resulted in controlling the disease spectrum (e.g., China, Malaysia, Sri Lanka), mortality levels declined to those seen in low-mortality countries. In most of the large countries of the region however, mortality declined at a slower rate, even slowing down considerably in the 1970's while the death rates remained high (e.g., India, Bangladesh, Thailand, Philippines); this slowing down of mortality level is attributed essentially to the poverty-stricken masses of society which were not able to take advantage of social, technological, and health-promoting behavioral changes conducive to mortality decline. Infant mortality levels, although declining since 1950, followed the same dismal pattern of the general mortality level. The rate varies from less than 10/1000 live births (Japan) to more than 140/1000 (Bangladesh, Laos, Nepal). Generally, rural areas exhibited higher infant mortality than urban areas. The level of child mortality declines with increases in the mother's educational level in Bangladesh, India, Indonesia, Sri Lanka, and Thailand. The largest decline in child mortality occurs when at least 1 parent has secondary education. The premature retardation of mortality decline is caused by several factors: economic development, nutrition and food supply, provision and adequacy of health services, and demographic trends. The outlook for the year 2000 for most of Asia's countries will depend heavily on significant population increases. In most countries, particularly in South Asia, population is expected to increase by 75%, much of it in rural areas and among poorer socioeconomic groups. In view of this, Asia's health planners and policymakers will have to develop health policies which will strike a balance between costs and returns of curative vs. preventive strategies. Health services will have to continue dealing with infectious diseases and will have to be redistributed geographically. Investments in health programs will produce clear economic benefits and returns for society.

Update on subclinical hyperthyroidism.

PubMed

Donangelo, Ines; Braunstein, Glenn D

2011-04-15

Subclinical hyperthyroidism is defined by low or undetectable serum thyroid-stimulating hormone levels, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (as in Graves disease or toxic nodular goiter), administration of thyroid hormone for treatment of malignant thyroid disease, or unintentional excessive thyroid hormone therapy. The rate of progression to overt hyperthyroidism is higher in persons who have suppressed thyroid-stimulating hormone levels compared with those who have low but detectable levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation in older adults, and with decreased bone mineral density in postmenopausal women; however, the effectiveness of treatment in preventing these conditions is unknown. There is lesser-quality evidence suggesting an association between subclinical hyperthyroidism and other cardiovascular effects, including increased heart rate and left ventricular mass, and increased bone turnover markers. Possible associations between subclinical hyperthyroidism and quality of life parameters, cognition, and increased mortality rates are controversial. Prospective randomized controlled trials are needed to address the effects of early treatment on potential morbidities to help determine whether screening should be recommended in the asymptomatic general population.

The METIS project for generalist ultrasonography.

PubMed

Bono, F; Campanini, A

2007-12-01

Reorganization of the community healthcare system and the growing presence of group practices in the field of general medicine have increased the demands placed on primary-care medicine, in terms of the skills required and the level of responsibility. Satisfying the need for rapid, effective primary-care solutions to the health problems of citizens is easier thanks to technological and medical advances that provide high level equipment at costs within the reach of general practitioners (GPs). In the near future, trained GPs equipped with appropriate diagnostic scanners will be able to handle up to 40% of the requests of ultrasound examinations of each primary-care group (each PCG includes approximately 15,000-20,000 citizens). The Italian Federation of General Practitioners (Federazione Italiana dei Medici di Medicina Generale - FIMMG) and its Scientific Society, METIS, have organized national courses for those GPs who wish to become generalist ultrasonographers, in a joint effort with the two most important Italian scientific societies of imaging, the Italian Society of Ultrasonology in Medicine and Biology and the Italian Society of Medical Radiology.

Inactivation of klotho function induces hyperphosphatemia even in presence of high serum fibroblast growth factor 23 levels in a genetically engineered hypophosphatemic (Hyp) mouse model.

PubMed

Nakatani, Teruyo; Ohnishi, Mutsuko; Razzaque, M Shawkat

2009-11-01

Hyp mice possess a mutation that inactivates the phosphate-regulating gene, which is homologous to the endopeptidases of the X-chromosome (PHEX). The mutation is associated with severe hypophosphatemia due to excessive urinary phosphate wasting. Such urinary phosphate wasting in Hyp mice is associated with an increased serum accumulation of fibroblast growth factor (FGF) 23. We wanted to determine the biological significance of increased serum FGF23 levels and concomitant hypophosphatemia in Hyp mice and to evaluate whether FGF23 activity could be modified by manipulating klotho (a cofactor of FGF23 signaling). We generated Hyp and klotho double-mutant mice (Hyp/klotho(-/-)). Severe hypophosphatemia of Hyp mice was reversed to hyperphosphatemia in Hyp/klotho(-/-) double mutants, despite the fact that the double mutants showed significantly increased serum levels of FGF23. Hyperphosphatemia in Hyp/klotho(-/-) mice was associated with increased renal expression of sodium/phosphate cotransporter 2a (NaPi2a) protein. Exogenous injection of bioactive parathyroid hormone 1-34 down-regulated renal expression of NaPi2a and consequently reduced serum levels of phosphate in Hyp/klotho(-/-) mice. Moreover, in contrast to the Hyp mice, the Hyp/klotho(-/-) mice showed significantly higher serum levels of 1,25-dihydroxyvitamin D and developed extensive calcification in soft tissues and vascular walls. Furthermore, compared with the Hyp mice, Hyp/klotho(-/-) mice were smaller in size, showed features of generalized tissue atrophy, and generally died by 15-20 wk of age. Our in vivo studies provide genetic evidence for a pathological role of increased FGF23 activities in regulating abnormal phosphate homeostasis in Hyp mice. Moreover, these results suggest that even when serum levels of FGF23 are significantly high, in the absence of klotho, FGF23 is unable to regulate systemic phosphate homeostasis. Our in vivo observations have significant clinical implications in diseases associated with increased FGF23 activity and suggest that the functions of FGF23 can be therapeutically modulated by manipulating the effects of klotho.

Illinois Community College Board FY 2006 Adult Education and Family Literacy Report to the Governor and General Assembly

ERIC Educational Resources Information Center

Illinois Community College Board, 2007

2007-01-01

Economic and demographic changes are dramatically increasing the need for adult education, basic literacy, and English-as-a-Second Language (ESL) programs. Millions of Illinois residents lack the level of literacy skills needed to obtain good jobs, perform well on the job, and function well in an increasingly complex society. Addressing the scope…

Illinois Community College Board FY 2005 Adult Education and Family Literacy Report to the Governor and General Assembly

ERIC Educational Resources Information Center

Illinois Community College Board, 2006

2006-01-01

Economic and demographic changes are dramatically increasing the need for adult education, basic literacy, and English-as-a-Second Language (ESL) programs. Millions of Illinois residents lack the level of literacy skills needed to obtain good jobs, perform well on the job, and function well in an increasingly complex society. Addressing the scope…

Association of stress and depression with chronic facial pain: A case-control study based on the Northern Finland 1966 Birth Cohort.

PubMed

Nevalainen, Netta; Lähdesmäki, Raija; Mäki, Pirjo; Ek, Ellen; Taanila, Anja; Pesonen, Paula; Sipilä, Kirsi

2017-05-01

The aim was to study the association between stress level and chronic facial pain, while controlling for the effect of depression on this association, during a three-year follow-up in a general population-based birth cohort. In the general population-based Northern Finland 1966 Birth Cohort, information about stress level, depression and facial pain were collected using questionnaires at the age of 31 years. Stress level was measured using the Work Ability Index. Depression was assessed using the 13-item depression subscale in the Hopkins Symptom Checklist-25. Three years later, a subsample of 52 subjects (42 women) with chronic facial pain and 52 pain-free controls (42 women) was formed. Of the subjects having high stress level at baseline, 73.3% had chronic facial pain, and 26.7% were pain-free three years later. The univariate logistic regression analysis showed that high stress level at 31 years increased the risk for chronic facial pain (crude OR 6.1, 95%, CI 1.3-28.7) three years later. When including depression in a multivariate model, depression associated statistically significantly with chronic facial pain (adjusted OR 2.5, 95%, CI 1.0-5.8), whereas stress level did not (adjusted OR 2.3, 95%, CI 0.6-8.4). High stress level is connected with increased risk for chronic facial pain. This association seems to mediate through depression.

Refractory orthostatic hypotension in a patient with a spinal cord injury: Treatment with droxidopa.

PubMed

Canosa-Hermida, Eva; Mondelo-García, Cristina; Ferreiro-Velasco, María Elena; Salvador-de la Barrera, Sebastián; Montoto-Marqués, Antonio; Rodríguez-Sotillo, Antonio; Vizoso-Hermida, José Ramón

2018-01-01

Orthostatic hypotension (OH) is a common complication in patients with a spinal cord injury, mainly affecting complete injuries above neurological level T6. It is generally more severe during the acute phase but can remain symptomatic for several years. A 65-year-old male with a grade ASIA A post-traumatic cervical spinal cord injury, at neurological level C4, presenting with symptomatic refractory OH. Increased blood pressure (BP) levels and an overall clinical improvement was observed after administering an increasing dose of droxidopa. Treatment was started at a dose of 100 mg twice daily (bid), one to be taken upon rising in the morning and another one in the afternoon, at least three hours before bedtime. According to the patient's symptomatic response, each individual dose was increased by 100 mg at 48-hour intervals. Both increased mean BP levels and a subjective symptomatic improvement were evidenced at a dose of 300 mg bid. Treatment with droxidopa increases BP levels and improves symptoms related to refractory OH using all physical and pharmacological measures available. It could therefore constitute an effective alternative treatment for OH in patients with a spinal cord injury.

Efficacy of Flaxseed Flour as Bind Enhancing Agent on the Quality of Extended Restructured Mutton Chops

PubMed Central

Sharma, Heena; Sharma, Brahma Deo; Mendiratta, S. K.; Talukder, Suman; Ramasamy, Giriprasad

2014-01-01

Consumers have become very conscious about their nutrition and well being due to changes in their socio-economic lifestyle and rapid urbanization. Therefore, development of technology for production of low cost and functional meat products is urgently required. One such approach is innovative restructuring technology in which binding of meat pieces still remains the main challenge and extension of product is generally associated with poor binding and texture. Thus, the present study was envisaged as an attempt to solve this problem by the incorporation of flaxseed flour (FF) as bind enhancing agent. The FF was used at three different levels viz., 0.5%, 1%, and 1.5% to replace lean meat in pre-standardized restructured mutton chops formulation. The products were subjected to analysis for physico-chemical, sensory and textural properties. Cooking yield, moisture percentage and fat percentage increased with increase in the level of incorporation of FF, however, protein percent and pH decreased with increase in the level of incorporation. Shear force value of product incorporated with 1.5% FF was significantly higher (p<0.01) than control and product containing 0.5% FF level. Among the sensory attributes, product with 1% flaxseed flour showed significantly higher values (p<0.05) for general appearance, binding, texture and overall acceptability. Hardness showed significant increasing (p<0.01) values with increasing levels of incorporation of flaxseed flour, however all other parameters of texture profile analysis showed a decreasing trend. On the basis of sensory scores and physico-chemical properties, the optimum incorporation level of FF was adjudged as 1%. Products incorporated with optimum level of flaxseed flour (1%) were also assessed for water activity and microbiological quality during the storage period of 15 days. It was found that the extended restructured product could be safely stored under refrigeration (4°C±1°C) in low density polyethylene (LDPE) pouches for 15 days without marked deterioration in sensory and microbiological quality. Thus, it was concluded that flaxseed flour can be used as a good bind enhancing agent in extended restructured meat products at an economic cost. PMID:25049949

High-throughput and rapid quantification of lipids by nanoflow UPLC-ESI-MS/MS: application to the hepatic lipids of rabbits with nonalcoholic fatty liver disease.

PubMed

Byeon, Seul Kee; Lee, Jong Cheol; Chung, Bong Chul; Seo, Hong Seog; Moon, Myeong Hee

2016-07-01

A rapid and high-throughput quantification method (approximately 300 lipids within 20 min) was established using nanoflow ultrahigh-pressure liquid chromatography-tandem mass spectrometry (nUPLC-ESI-MS/MS) with selective reaction monitoring (SRM) and applied to the quantitative profiling of the hepatic lipids of rabbits with different metabolic conditions that stimulate the development of nonalcoholic fatty liver disease (NAFLD). Among the metabolic conditions of rabbits in this study [inflammation (I), high-cholesterol diet (HC), and high-cholesterol diet combined with inflammation (HCI)], significant perturbation in hepatic lipidome (>3-fold and p < 0.01) was observed in the HC and HCI groups, while no single lipid showed a significant change in group I. In addition, this study revealed a dramatic increase (>2-fold) in relatively high-abundant monohexosylceramides (MHCs), sphingomyelins (SMs), and triacylglycerols (TGs) in both the HC and HCI groups, especially in MHCs as all 11 MHCs increased by larger than 3- to 12-fold. As the levels of the relatively high-abundant lipids in the above classes increased, the total lipidome level of each class increased significantly by approximately 2-fold to 5-fold. Other classes of lipids also generally increased, which was likely induced by the increase in mitogenic and nonapoptotic MHCs and SMs, as they promote cell proliferation. On the other hand, a slight decrease in the level of apoptotic ceramides (Cers) was observed, which agreed with the general increase in total lipid level. As distinct changes in hepatic lipidome were observed from HC groups, this suggests that HC or HCI is highly associated with NAFLD but not inflammation alone itself. Graphical Abstract Schematic of lipidomic analysis from hepatic tissue using nanoflow LC-ESI-MS/MS and nUPLC-ESI-MS/MS.

Modulation of spinal reflexes by sexual films of increasing intensity.

PubMed

Both, Stephanie; Boxtel, Geert; Stekelenburg, Jeroen; Everaerd, Walter; Laan, Ellen

2005-11-01

Sexual arousal can be viewed as an emotional state generating sex-specific autonomic and general somatic motor system responses that prepare for sexual action. In the present study modulation of spinal tendious (T) reflexes by sexual films of varying intensity was investigated. T reflexes were expected to increase as a function of increased film intensity. Through use of a between-subjects design, participants were exposed to three erotic films of low, moderate, and high intensity or to three films of moderate intensity. Self-report and genital data confirmed the induction of increasing versus stable levels of sexual arousal. Exposure to the films of increasing intensity resulted in increasing T reflexes. The results indicate that T reflex modulation is sensitive to varying levels of sexual arousal and may be of use in research on behavioral mechanisms underlying appetitive motivation.

Robust Brain Hyperglycemia during General Anesthesia: Relationships with Metabolic Brain Inhibition and Vasodilation

PubMed Central

Bola, R. Aaron; Kiyatkin, Eugene A.

2016-01-01

Glucose is the main energetic substrate for the metabolic activity of brain cells and its proper delivery into the extracellular space is essential for maintaining normal neural functions. Under physiological conditions, glucose continuously enters the extracellular space from arterial blood via gradient-dependent facilitated diffusion governed by the GLUT-1 transporters. Due to this gradient-dependent mechanism, glucose levels rise in the brain after consumption of glucose-containing foods and drinks. Glucose entry is also accelerated due to local neuronal activation and neuro-vascular coupling, resulting in transient hyperglycemia to prevent any metabolic deficit. Here, we explored another mechanism that is activated during general anesthesia and results in significant brain hyperglycemia. By using enzyme-based glucose biosensors we demonstrate that glucose levels in the nucleus accumbens (NAc) strongly increase after iv injection of Equthesin, a mixture of chloral hydrate and sodium pentobarbital, which is often used for general anesthesia in rats. By combining electrochemical recordings with brain, muscle, and skin temperature monitoring, we show that the gradual increase in brain glucose occurring during the development of general anesthesia tightly correlate with decreases in brain-muscle temperature differentials, suggesting that this rise in glucose is related to metabolic inhibition. While the decreased consumption of glucose by brain cells could contribute to the development of hyperglycemia, an exceptionally strong positive correlation (r = 0.99) between glucose rise and increases in skin-muscle temperature differentials was also found, suggesting the strong vasodilation of cerebral vessels as the primary mechanism for accelerated entry of glucose into brain tissue. Our present data could explain drastic differences in basal glucose levels found in awake and anesthetized animal preparations. They also suggest that glucose entry into brain tissue could be strongly modulated by pharmacological drugs via drug-induced changes in metabolic activity and the tone of cerebral vessels. PMID:26913008

Symptom load and general function among patients with erythema migrans: a prospective study with a 1-year follow-up after antibiotic treatment in Norwegian general practice.

PubMed

Eliassen, Knut Eirik; Hjetland, Reidar; Reiso, Harald; Lindbæk, Morten; Tschudi-Madsen, Hedda

2017-03-01

Promptly treated erythema migrans (EM) has good prognosis. However, some patients report persistent symptoms. Do patients with EM have more symptoms than the general population? We describe individual symptoms and general function in EM-patients at time of diagnosis and one year after treatment. Prospective study with 1-year follow up after treatment. Questionnaires included a modified version of the Subjective Health Complaints Inventory, comprising three additional Lyme borreliosis (LB) related symptoms. General function was assessed using a five-point scale modified from the COOP/WONCA charts. Norwegian general practice. A total of 188 patients were included in a randomized controlled trial comparing three antibiotic regimens for EM, of whom 139 had complete data for this study. Individual symptoms, symptom load and general function. Mild symptoms were common, reported by 84.9% at baseline and by 85.6% at follow-up. At baseline, patients reported a mean of 5.4 symptoms, compared with 6.2 after one year. Severely bothersome symptoms and severely impaired general function were rare. Tiredness was the most reported symptom both at baseline and at follow-up. Palsy (other than facial) was the least reported symptom, but the only one with a significant increase. However, this was not associated to the EM. The symptom load was comparable to that reported in the general population. We found an increase in symptom load at follow-up that did not significantly affect general function. Monitoring patients' symptom loads prior to treatment reduce the probability of attributing follow-up symptoms to LB. Key points Erythema migrans has a good prognosis.Patients treated for erythema migrans have a slight increase in symptom load one year after treatment. This increase does not affect general function. The levels of subjective health complaints in patients treated for erythema migrans are comparable to the background population.

Response of lactate metabolism in brain glucosensing areas of rainbow trout (Oncorhynchus mykiss) to changes in glucose levels.

PubMed

Otero-Rodiño, Cristina; Librán-Pérez, Marta; Velasco, Cristina; Álvarez-Otero, Rosa; López-Patiño, Marcos A; Míguez, Jesús M; Soengas, José L

2015-12-01

There is no evidence in fish brain demonstrating the existence of changes in lactate metabolism in response to alterations in glucose levels. We induced in rainbow trout through intraperitoneal (IP) treatments, hypoglycaemic or hyperglycaemic changes to assess the response of parameters involved in lactate metabolism in glucosensing areas like hypothalamus and hindbrain. To distinguish those effects from those induced by peripheral changes in the levels of metabolites or hormones, we also carried out intracerebroventricular (ICV) treatments with 2-deoxy-D-glucose (2-DG, a non-metabolizable glucose analogue thus inducing local glucopenia) or glucose. Finally, we also incubated hypothalamus and hindbrain in vitro in the presence of increased glucose concentrations. The changes in glucose availability were in general correlated to changes in the amount of lactate in both areas. However, when we assessed in these areas the response of parameters related to lactate metabolism, the results obtained were contradictory. The increase in glucose levels did not produce in general the expected changes in those pathways with only a minor increase in their capacity of lactate production. The decrease in glucose levels was, however, more clearly related to a decreased capacity of the pathways involved in the production and use of lactate, and this was especially evident after ICV treatment with 2-DG in both areas. In conclusion, the present results while addressing the existence of changes in lactate metabolism after inducing changes in glucose levels in brain glucosensing areas only partially support the possible existence of an astrocyte-neuron lactate shuttle in hypothalamus and hindbrain of rainbow trout relating glucose availability to lactate production and use.

Prescription patterns of analgesics in the last 3 months of life: a retrospective analysis of 10202 lung cancer patients

PubMed Central

Gao, W; Gulliford, M; Higginson, I J

2011-01-01

Background: To describe the prescription patterns of analgesics during the last 3 months of life in lung cancer and to determine the associated factors. Methods: Data on lung cancer patients (N=10 202) who died during 2000–2008 were extracted from the General Practice Research Database (GPRD). This database records prescriptions of patients received from UK general practices (GP), but not those from non-GP routes. Prescription prevalences were estimated. The associated factors were investigated using log-binomial regression. Results: The overall prescription prevalences were 50.4% (95% confidence interval (CI): 49.4–51.4%) for level 1 (e.g., paracetamol), 34.1% (95% CI: 33.2–35.0%) for level 2 (weak opioids), and 55.5 % (95% CI: 54.5–56.4%) for level 3 analgesics (strong opioids). Prescription prevalence of analgesics of all levels showed an increasing trend over the period 2000–2008 (annual increases range: 1.1–1.5%) but a decreasing trend with age (average decrease per group range: −5.8 to −1.8%). Patients in the older age groups were less likely to be prescribed level 3 analgesics than those in the younger age groups (PR‘90+' vs ‘<50'=0.55 (95% CI: 0.45–0.67); PR‘80−89' vs ‘<50'=0.73 (95% CI: 0.66–0.79); PR‘70−79' vs ‘<50'=0.84 (95% CI: 0.77–0.90)). Conclusion: Analgesics have been increasingly prescribed in lung cancer. However, analgesics, especially at level 3, were relatively under-prescribed to people older than 70 years, warranting further investigation. PMID:21540860

Multi-investigator collaboration in orthopaedic surgery research compared to other medical fields.

PubMed

Brophy, Robert H; Smith, Matthew V; Latterman, Christian; Jones, Morgan H; Reinke, Emily K; Flanigan, David C; Wright, Rick W; Wolf, Brian R

2012-10-01

An increasing emphasis has been placed across health care on evidence-based medicine with higher level studies, such as randomized trials and prospective cohort studies. Historically, clinical research in orthopaedic surgery has been dominated by studies with low patient numbers from a limited number of surgeons. The purpose of this study was to test our hypothesis that orthopaedics has fewer multi-center collaborative studies as compared to other medical disciplines. We chose three leading journals from general medicine, a leading journal from the surgical subspecialties of obstetrics and gynecology, ophthalmology and otolaryngology, and three leading journals from orthopaedic surgery based on highest impact factor. We compared the percentage of collaborative studies and the number of contributing institutions and authors in original research manuscripts published in 2009 between general medical, surgical subspecialty and orthopaedic surgery journals. A significantly higher percentage of manuscripts resulted from multicenter collaborative efforts in the general medical literature (p < 0.000001) and the other surgical subspecialty literature (p < 0.000001) compared to the orthopaedic surgery literature. Manuscripts published in the general medical journals came from more institutions (p < 0.0001) and had significantly more authors (p < 0.000001) than those published in the orthopaedic surgery journals. There is an opportunity to stimulate greater multicenter collaborative research, which correlates with increased patient numbers, a higher level of evidence and more generalizable findings, in the orthopaedic surgery community. These efforts can be supported through increased funding, surgeon participation, and appropriate expansion of authorship for multicenter studies in orthopaedic journals. Copyright © 2012 Orthopaedic Research Society.

Chronic pain and health care spending: an analysis of longitudinal data from the Medical Expenditure Panel Survey.

PubMed

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

2015-06-01

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

Mechanism of the Antimicrobial Action of Pyrithione: Effects on Membrane Transport, ATP Levels, and Protein Synthesis

PubMed Central

Chandler, Carol J.; Segel, Irwin H.

1978-01-01

Pyrithione is a general inhibitor of membrane transport processes in fungi. A brief preincubation of Penicillium mycelia with pyrithione resulted in a marked decrease in the activities of a variety of independently regulated transport systems, including those for inorganic sulfate, inorganic phosphate, methylamine (actually, the NH4+ permease), choline-O-sulfate, glucose, l-methionine (a specific system), and several hydrophobic l-α-amino acids (the general amino acid permease). The degree of inhibition at any fixed pyrithione concentration and exposure time increased as the pH of the incubation medium was decreased. This result strongly suggests that the active species is the un-ionized molecule and that pyrithione acts by collapsing a transmembrane ΔpH driving force. The degree of transport inhibition caused by a given concentration of pyrithione increased with increasing time of exposure to the inhibitor. However, exposure time and pyrithione concentration were not reciprocally related. At “low” pyrithione concentrations, transport inhibition plateaued at some finite value. This observation suggests that the fungi can detoxify low levels of the inhibitor. The concentration of pyrithione required for a given degree of growth inhibition increased as the experimental mycelial density increased. This phenomenon was consistent with the suggestion that the fungi are capable of inactivating pyrithione. PMID:28693

Examining the "evolution of increased competitive ability" hypothesis in response to parasites and pathogens in the invasive paper wasp Polistes dominula

NASA Astrophysics Data System (ADS)

Manfredini, Fabio; Grozinger, Christina M.; Beani, Laura

2013-03-01

Successful invaders often become established in new ranges by outcompeting native species. The "evolution of increased competitive ability" hypothesis predicts that invasive species are subjected to less predation and parasitization than sympatric native species, and thus can allocate resources from defence and immunity to growth and fecundity, thereby achieving higher fitness. In this study, we examined whether American invasive Polistes dominula paper wasps have reduced immunocompetence. To explore this scenario, we tested their susceptibility towards parasites and pathogens at both the individual (immune defence) and colony levels, i.e. hygienic behaviour (removal of diseased individuals by nestmates). First, we examined the response to the specific coevolved parasite Xenos vesparum (lost after invasion) in terms of individual host susceptibility and hygienic behaviour. Second, we explored the response against general pathogens by quantifying the bacterial clearance in individual wasps after a challenge with Escherichia coli and hygienic behaviour after a challenge with the fungus Beauveria bassiana. Our results show that American invasive P. dominula have a higher response against X. vesparum at the colony level, but at the individual level their susceptibility is not significantly different from conspecifics of the native range. On the other hand, invasive P. dominula display lower response after a challenge with general pathogens at both the individual and colony levels. While supporting the hypothesis of a reduction of immunocompetence towards general pathogens in invasive species, these findings also suggest that the response against coevolved parasites might follow different evolutionary pathways which are not always easily predictable.

Examining the "evolution of increased competitive ability" hypothesis in response to parasites and pathogens in the invasive paper wasp Polistes dominula.

PubMed

Manfredini, Fabio; Beani, Laura; Grozinger, Christina M

2013-03-01

Successful invaders often become established in new ranges by outcompeting native species. The "evolution of increased competitive ability" hypothesis predicts that invasive species are subjected to less predation and parasitization than sympatric native species, and thus can allocate resources from defence and immunity to growth and fecundity, thereby achieving higher fitness. In this study, we examined whether American invasive Polistes dominula paper wasps have reduced immunocompetence. To explore this scenario, we tested their susceptibility towards parasites and pathogens at both the individual (immune defence) and colony levels, i.e. hygienic behaviour (removal of diseased individuals by nestmates). First, we examined the response to the specific coevolved parasite Xenos vesparum (lost after invasion) in terms of individual host susceptibility and hygienic behaviour. Second, we explored the response against general pathogens by quantifying the bacterial clearance in individual wasps after a challenge with Escherichia coli and hygienic behaviour after a challenge with the fungus Beauveria bassiana. Our results show that American invasive P. dominula have a higher response against X. vesparum at the colony level, but at the individual level their susceptibility is not significantly different from conspecifics of the native range. On the other hand, invasive P. dominula display lower response after a challenge with general pathogens at both the individual and colony levels. While supporting the hypothesis of a reduction of immunocompetence towards general pathogens in invasive species, these findings also suggest that the response against coevolved parasites might follow different evolutionary pathways which are not always easily predictable.

Stabilization of Large Generalized Lotka-Volterra Foodwebs By Evolutionary Feedback

NASA Astrophysics Data System (ADS)

Ackland, G. J.; Gallagher, I. D.

2004-10-01

Conventional ecological models show that complexity destabilizes foodwebs, suggesting that foodwebs should have neither large numbers of species nor a large number of interactions. However, in nature the opposite appears to be the case. Here we show that if the interactions between species are allowed to evolve within a generalized Lotka-Volterra model such stabilizing feedbacks and weak interactions emerge automatically. Moreover, we show that trophic levels also emerge spontaneously from the evolutionary approach, and the efficiency of the unperturbed ecosystem increases with time. The key to stability in large foodwebs appears to arise not from complexity perse but from evolution at the level of the ecosystem which favors stabilizing (negative) feedbacks.

Stabilization of large generalized Lotka-Volterra foodwebs by evolutionary feedback.

PubMed

Ackland, G J; Gallagher, I D

2004-10-08

Conventional ecological models show that complexity destabilizes foodwebs, suggesting that foodwebs should have neither large numbers of species nor a large number of interactions. However, in nature the opposite appears to be the case. Here we show that if the interactions between species are allowed to evolve within a generalized Lotka-Volterra model such stabilizing feedbacks and weak interactions emerge automatically. Moreover, we show that trophic levels also emerge spontaneously from the evolutionary approach, and the efficiency of the unperturbed ecosystem increases with time. The key to stability in large foodwebs appears to arise not from complexity per se but from evolution at the level of the ecosystem which favors stabilizing (negative) feedbacks.

A general framework for a collaborative water quality knowledge and information network.

PubMed

Dalcanale, Fernanda; Fontane, Darrell; Csapo, Jorge

2011-03-01

Increasing knowledge about the environment has brought about a better understanding of the complexity of the issues, and more information publicly available has resulted into a steady shift from centralized decision making to increasing levels of participatory processes. The management of that information, in turn, is becoming more complex. One of the ways to deal with the complexity is the development of tools that would allow all players, including managers, researchers, educators, stakeholders and the civil society, to be able to contribute to the information system, in any level they are inclined to do so. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements.

A General Framework for a Collaborative Water Quality Knowledge and Information Network

NASA Astrophysics Data System (ADS)

Dalcanale, Fernanda; Fontane, Darrell; Csapo, Jorge

2011-03-01

Increasing knowledge about the environment has brought about a better understanding of the complexity of the issues, and more information publicly available has resulted into a steady shift from centralized decision making to increasing levels of participatory processes. The management of that information, in turn, is becoming more complex. One of the ways to deal with the complexity is the development of tools that would allow all players, including managers, researchers, educators, stakeholders and the civil society, to be able to contribute to the information system, in any level they are inclined to do so. In this project, a search for the available technology for collaboration, methods of community filtering, and community-based review was performed and the possible implementation of these tools to create a general framework for a collaborative "Water Quality Knowledge and Information Network" was evaluated. The main goals of the network are to advance water quality education and knowledge; encourage distribution and access to data; provide networking opportunities; allow public perceptions and concerns to be collected; promote exchange of ideas; and, give general, open, and free access to information. A reference implementation was made available online and received positive feedback from the community, which also suggested some possible improvements.

Correlates of Leisure Time Physical Inactivity in a Scandinavian Population: A Basis for Interventions.

PubMed

Bonn, Stephanie E; Alfredsson, Lars; Saevarsdottir, Saedis; Schelin, Maria E C

2016-11-01

Effective interventions are needed to increase physical activity in the general population. To target interventions, we need knowledge of insufficiently active groups in society. This study aims to identify demographic and health-related correlates of leisure-time physical inactivity in a general Scandinavian population. Study participants comprised 5734 control subjects, age 18 to 70 years, from 2 ongoing Swedish case-control studies. Participants self-reported their leisure-time physical activity level. The odds of being physically inactive were calculated using logistic regression. A total of 42% of participants were classified as physically inactive during leisure time. A lower prevalence of inactivity was associated with middle age, higher education, having previous experience of sports participation, following a low glycemic index/Mediterranean diet and having a light physical workload. A high prevalence of inactivity was associated with greater age, high body mass index, smoking, never drinking alcohol, having children, having a weak social network or lower levels of emotional support, and a low vegetable intake. Several factors were associated with leisure-time physical inactivity. Directing interventions to target groups defined by specific factors associated with physical inactivity could be an efficient way to increase activity and improve health in the general population.

Increased plastic litter cover affects the foraging activity of the sandy intertidal gastropod Nassarius pullus.

PubMed

Aloy, Alexander B; Vallejo, Benjamin M; Juinio-Meñez, Marie Antonette

2011-08-01

This study analyzed the foraging behavior of the gastropod Nassarius pullus on garbage-impacted sandy shores of Talim Bay, Batangas, Philippines. The effect of different levels of plastic garbage cover on foraging efficiency was investigated. Controlled in situ baiting experiments were conducted to quantify aspects of foraging behavior as affected by the levels of plastic litter cover in the foraging area. The results of the study indicated that the gastropod's efficiency in locating and in moving towards a food item generally decreased as the level of plastic cover increased. Prolonged food searching time and increased self-burial in sand were highly correlated with increased plastic cover. The accuracy of orientation towards the actual position of the bait decreased significantly when the amount of plastic cover increased to 50%. These results are consistent with the significant decreases in the abundance of the gastropod observed during periods of deposition of large amounts of plastic and other debris on the shore. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dietary fish oil stimulates hepatic low density lipoprotein transport in the rat.

PubMed Central

Ventura, M A; Woollett, L A; Spady, D K

1989-01-01

These studies were undertaken to examine the effect of fish oil, safflower oil, and hydrogenated coconut oil on the major processes that determine the concentration of low density lipoprotein (LDL) in plasma, i.e., the rate of LDL production and the rates of receptor-dependent and receptor-independent LDL uptake in the various organs of the body. When fed at the 20% level, fish oil reduced plasma LDL-cholesterol levels by 38% primarily by increasing LDL receptor activity in the liver. Dietary safflower oil also increased hepatic LDL receptor activity; however, since the rate of LDL production also increased, plasma LDL-cholesterol levels remained essentially unchanged. Hydrogenated coconut oil had no effect on LDL receptor activity but increased the rate of LDL-cholesterol production causing plasma LDL-cholesterol levels to increase 46%. Dietary fish oil had no effect on the receptor-dependent transport of asialofetuin by the liver, suggesting that the effect of fish oil on hepatic LDL receptor activity was specific and not due to a generalized alteration in the physical properties of hepatic membranes. Finally, dietary fish oil increased hepatic cholesteryl ester levels and suppressed hepatic cholesterol synthesis rates, suggesting that the up-regulation of hepatic LDL receptor activity in these animals was not simply a response to diminished cholesterol availability in the liver. PMID:2760200

Characteristics of surface ozone and nitrogen oxides at urban, suburban and rural sites in Ningbo, China

NASA Astrophysics Data System (ADS)

Tong, Lei; Zhang, Huiling; Yu, Jie; He, Mengmeng; Xu, Nengbin; Zhang, Jingjing; Qian, Feizhong; Feng, Jiayong; Xiao, Hang

2017-05-01

Surface ozone (O3) is a harmful air pollutant that has attracted growing concern in China. In this study, the mixing ratios of O3 and nitrogen oxides (NOx) at three different sites (urban, suburban and rural) of Ningbo were continuously measured to investigate the spatiotemporal characteristics of O3 and its relationships with environmental variables. The diurnal O3 variations were characterized by afternoon maxima (38.7-53.1 ppb on annual average) and early morning minima (11.7-26.2 ppb) at all the three sites. Two seasonal peaks of O3 were observed in spring (April or May) and autumn (October) with minima being observed in winter (December). NOx levels showed generally opposite variations to that of O3 with diurnal and seasonal maxima occurring in morning/evening rush-hours and in winter, respectively. As to the inter-annual variations of air pollutants, generally decreasing and increasing trends were observed in NO and O3 levels, respectively, from 2012 to 2015 at both urban and suburban sites. O3 levels were positively correlated with temperature but negatively correlated with relative humidity and NOx levels. Significant differences in O3 levels were observed for different wind speeds and wind directions (p < 0.001). O3 levels varied non-linearly with wind speed ranges with an increasing trend within 4 m/s. Higher mixing ratio of O3 was observed for wind blowing from the sea, which indicates that the coastal air mass might carry more O3. A decreasing trend in O3 levels was observed from weekdays to weekends at all the three sites. As to the spatial variation, higher levels of O3 were observed at the suburban and rural sites where less O3 was depleted by NO titration. In contrast, the urban site exhibited lower O3 but higher NOx levels due to the influence of traffic emissions. Larger amplitudes of diurnal and monthly O3 variations were observed at the suburban site than those at the urban and rural sites. In general, the O3 levels at the non-urban sites were more affected by the background transport, while both the local and regional contributions played roles in urban O3 variations. The annual average O3 mixing ratios (22.7-37.7 ppb) in Ningbo were generally similar to those of other regions around the world. However, the recommended air quality standards for O3 were often exceeded during warm seasons, which could be a potential threat to both local population and plant growth.

[A PhD completed. Periodontitis, diabetes mellitus, cardiovascular disease: a Bermuda triangle].

PubMed

Teeuw, W J

2017-10-01

The relationship among periodontitis, diabetes mellitus and atherosclerotic cardiovascular disease is complex and can be thought of as a Bermuda triangle. A relationship has been demonstrated between periodontitis, a worsening in the condition of the vascular system and an increased total level of inflammatory markers. Patients with severe periodontitis also show raised levels of glycosylated haemoglobin. This means that severe periodontitis can be an early indication of diabetes mellitus. Periodontal treatment generally promotes improved blood sugar regulation in diabetes patients, an improved condition of the vascular system and a decrease in the total levels of inflammation. Factors such as genetics, lifestyle and the presence of other chronic co-morbidities contribute to the complexity of this relationship. For the treatment of severe periodontitis, interdisciplinary cooperation among dentists, general practitioners and internists is therefore recommended.

Google Trends as a Resource for Informing Plastic Surgery Marketing Decisions.

PubMed

Ward, Brittany; Ward, Max; Paskhover, Boris

2018-04-01

Celebrities have long influenced the medical decisions of the general population. By analyzing Google search data using Google Trends, we measured the impact of highly publicized plastic surgery-related events on the interest level of the general population in specific search terms. Additionally, we investigated seasonal and geographic trends around interest in rhinoplasties, which is information that physicians and small surgical centers can use to optimize marketing decisions. Google Trends was used to access search data histories for three separate areas of interest: Kylie Jenner and lip fillers, Joan Rivers and plastic surgery, and rhinoplasty, which were then analyzed using two-tailed, two-sample equal variance t-tests. The average interest level in fillers increased by 30.31 points after Kylie Jenner announced that she received Juvéderm lip injections. The interest level in plastic surgery was decreased by 21.3% the month after Joan Rivers' death. Between January 2004 and May 2017, the average interest level for rhinoplasty was significantly different in January/December (67.91 ± 20.68) and June/July (70.12 ± 18.89) from the remaining calendar months (63.58 ± 19.67). Los Angeles, New York City, and Miami showed consistently high interest levels throughout the time period, while Tulsa, OK, showed a major interest increase between 2015 to 2016 of 65 points. A noticeable impact was observed in both celebrity cases on search term volume, and a seasonal effect is apparent for rhinoplasty searches. As many surgeons already employ aggressive Internet marketing strategies, understanding and utilizing these trends could help optimize their investments, increase social engagement, and increase practice awareness by potential patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Factoring the brain signatures of anesthesia concentration and level of arousal across individuals.

PubMed

Barttfeld, Pablo; Bekinschtein, Tristan A; Salles, Alejo; Stamatakis, Emmanuel A; Adapa, Ram; Menon, David K; Sigman, Mariano

2015-01-01

Combining resting-state functional magnetic resonance imaging (fMRI) connectivity and behavioral analysis during sedation, we factored out general effects of the anesthetic drug propofol and a specific index of conscious report, participants' level of responsiveness. The factorial analysis shows that increasing concentration of propofol in blood specifically decreases the connectivity strength of fronto-parietal cortical loops. In contrast, loss of responsiveness is indexed by a functional disconnection between the thalamus and the frontal cortex, balanced by an increase in connectivity strength of the thalamus to the occipital and temporal regions of the cortex.

Factoring the brain signatures of anesthesia concentration and level of arousal across individuals

PubMed Central

Barttfeld, Pablo; Bekinschtein, Tristan A.; Salles, Alejo; Stamatakis, Emmanuel A.; Adapa, Ram; Menon, David K.; Sigman, Mariano

2015-01-01

Combining resting-state functional magnetic resonance imaging (fMRI) connectivity and behavioral analysis during sedation, we factored out general effects of the anesthetic drug propofol and a specific index of conscious report, participants’ level of responsiveness. The factorial analysis shows that increasing concentration of propofol in blood specifically decreases the connectivity strength of fronto-parietal cortical loops. In contrast, loss of responsiveness is indexed by a functional disconnection between the thalamus and the frontal cortex, balanced by an increase in connectivity strength of the thalamus to the occipital and temporal regions of the cortex. PMID:26509121

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

Schroeder, Alex

Motor fuel taxes were established to finance our nation’s transportation infrastructure, yet evolving economic, political, and technological influences are constraining this ability. At the federal level, the Highway Trust Fund (HTF), which is primarily funded by motor fuel taxes, has become increasingly dependent on general fund contributions and short-term reauthorizations to prevent insolvency. As a result, there are discussions at both the federal and state levels in which stakeholders are examining the future of motor fuel excise taxes as well as the role of electric and alternative fuel vehicles in that future. On July 1, 2015, six states increased theirmore » motor fuel tax rates.« less

Psychophysiological measures of cognitive workload in laboratory and flight

NASA Technical Reports Server (NTRS)

Wilson, Glenn F.; Badeau, Albert

1993-01-01

Psychophysiological data have been recorded during different levels of cognitive workload in laboratory and flight settings. Cardiac, eye blink, and brain data have shown meaningful changes as a function of the levels of mental workload. Increased cognitive workload is generally associated with increased heart rates, decreased blink rates and eye closures, and decreased evoked potential amplitudes. However, comparisons of laboratory and flight data show that direct transference of laboratory findings to the flight environment is not possible in many cases. While the laboratory data are valuable, a data base from flight is required so that 'real world' data can be properly interpreted.

Identification of Risk Factors for Nephrotoxicity in Patients Receiving Extended-Duration, High-Trough Vancomycin Therapy

PubMed Central

Contreiras, Claire; Legal, Michael; Lau, Tim T Y; Thalakada, Rosanne; Shalansky, Stephen; Ensom, Mary H H

2014-01-01

Background: In the past, impurities in vancomycin formulations were thought to contribute to nephrotoxicity. In contrast, when current, purer formulations are dosed at conventional trough levels (i.e., 5–15 mg/L), the incidence of nephrotoxicity is relatively low. Recent guidelines have recommended targeting higher vancomycin trough levels in treatment of complicated methicillin-resistant Staphylococcus aureus infections. Dosing based on these higher trough levels may be associated with nephrotoxicity, so the potential risk factors for vancomycin-associated nephrotoxicity require clearer definition. Objectives: To determine the occurrence of nephrotoxicity in patients receiving more than 7 days of vancomycin therapy with high trough levels (15–20 mg/L) and to identify and evaluate specific risk factors related to development of vancomycin-associated nephrotoxicity (i.e., serum creatinine ≥ 44.2 μmol/L or increase ≥ 50% [i.e., ≥ 26.2 μmol/L] from baseline on 2 consecutive days). Methods: Health care records were reviewed for patients seen at 2 major teaching hospitals between January 2008 and March 2011. Patients who had attained high trough levels of vancomycin were screened for eligibility. Patients with unstable renal function, those undergoing hemodialysis, and those for whom dosage and/or sampling times were unclear were excluded. Univariate and multivariate analyses were performed to identify risk factors associated with nephrotoxicity. Univariate variables with p < 0.1 were included in the logistic regression model. Results: Of the 176 patients with high trough levels included in the analysis, 24 (14%) experienced nephrotoxicity. In univariate analysis, admission to a general medicine unit (the setting of care for 16 [67%] of the 24 patients with nephrotoxicity) and extended duration of vancomycin treatment were identified as risk factors for nephrotoxicity (p < 0.1). Other risk factors included gastrointestinal comorbidity (p = 0.056), malignancy (p = 0.044), and febrile neutropenia (p = 0.032). Multivariate analysis identified treatment on general medicine units and treatment courses longer than 7 days as independent predictors of vancomycin-associated nephrotoxicity. Conclusion: Patients being treated on general medicine units and those receiving vancomycin for more than 7 days had an increased likelihood of experiencing nephrotoxicity. The increased risk for patients on general medicine units is likely multifactorial. The relationship between treatment duration and risk of nephrotoxicity appeared to be linear. When using extended-duration, high-trough vancomycin therapy, clinicians should be vigilant in monitoring for nephrotoxicity. PMID:24799722

Effect of ultrasound on some chemical and microbiological properties of sour cherry juice by response surface methodology.

PubMed

Türken, Tuğba; Erge, Hande S

2017-09-01

In this study, it is aimed to determine effect of ultrasonication on some chemical and microbiological properties of sour cherry juice by response surface methodology, since ultrasound is known as an alternative method for thermal food processing. Sour cherry juice was sonicated at varying amplitude levels (50, 75, 100%); moderate temperatures (20, 30, 40 ℃); and treatment times of 2, 6, 10 min at a constant frequency of 20 kHz. Different ultrasonication amplitudes, temperatures, and times had no significant effect on pH,°Bx, and titratable acidity. A significant increase in total monomeric anthocyanins was observed as the amplitude level and temperature increased (p < 0.01). An increase in the total phenolics was also obtained as the temperature increased (p < 0.05). The effect of amplitude level on antioxidant capacity of sour cherry juice was also found significant (p < 0.05). Color parameters (L*, a*, b*, C, h) generally increased by increasing temperature, amplitude level, and treatment time. It was determined that Escherichia coli O157:H7 significantly affected by temperature and treatment time (p < 0.05).

[The internationalization of the nursing profession in Taiwan].

PubMed

Chuang, Hsiao-Ling; Wang, Cheng-Ching; Kuo, Pi-Chao

2011-06-01

Globalization, nursing manpower migration, and the multinational nature of the medical industry have increased the level of internationalization in Taiwan's nursing profession. In nursing practice, competencies for the general nursing list (Taiwan version) and ICNP (International Classification for Nursing Practice) have been clinically tested and revised. In academic nursing, significant effort is invested toward achieving the three general objectives of internationalized teaching, internationalized campuses, and international academic exchanges. We should further test and revise Taiwan's competencies for the general nursing list, and the ICNP should be continually tested and revised. Additionally, nursing personnel should strengthen foreign language competencies, appreciate different nursing practice cultures, participate in international exchange activities, and place increasing emphasis on international cooperation in research and nursing education accreditation. Such should further enhance and strengthen international cooperation, which should further encourage internationalization in the domestic nursing profession.

[Urban noise pollution].

PubMed

Chouard, C H

2001-07-01

Noise is responsible for cochlear and general damages. Hearing loss and tinnitus greatly depend on sound intensity and duration. Short-duration sound of sufficient intensity (gunshot or explosion) will not be described because they are not currently encountered in our normal urban environment. Sound levels of less than 75 d (A) are unlikely to cause permanent hearing loss, while sound levels of about 85 d (A) with exposures of 8 h per day will produce permanent hearing loss after many years. Popular and largely amplified music is today one of the most dangerous causes of noise induced hearing loss. The intensity of noises (airport, highway) responsible for stress and general consequences (cardiovascular) is generally lower. Individual noise sensibility depends on several factors. Strategies to prevent damage from sound exposure should include the use of individual hearing protection devices, education programs beginning with school-age children, consumer guidance, increased product noise labelling, and hearing conservation programs for occupational settings.

The Hiroshima/Nagasaki Survivor Studies: Discrepancies Between Results and General Perception

PubMed Central

2016-01-01

The explosion of atom bombs over the cities of Hiroshima and Nagasaki in August 1945 resulted in very high casualties, both immediate and delayed but also left a large number of survivors who had been exposed to radiation, at levels that could be fairly precisely ascertained. Extensive follow-up of a large cohort of survivors (120,000) and of their offspring (77,000) was initiated in 1947 and continues to this day. In essence, survivors having received 1 Gy irradiation (∼1000 mSV) have a significantly elevated rate of cancer (42% increase) but a limited decrease of longevity (∼1 year), while their offspring show no increased frequency of abnormalities and, so far, no detectable elevation of the mutation rate. Current acceptable exposure levels for the general population and for workers in the nuclear industry have largely been derived from these studies, which have been reported in more than 100 publications. Yet the general public, and indeed most scientists, are unaware of these data: it is widely believed that irradiated survivors suffered a very high cancer burden and dramatically shortened life span, and that their progeny were affected by elevated mutation rates and frequent abnormalities. In this article, I summarize the results and discuss possible reasons for this very striking discrepancy between the facts and general beliefs about this situation. PMID:27516613

20 CFR 627.201 - Waivers.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., promote coordination of JTPA programs with other human resource programs, or substantially improve the job...' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR GENERAL PROVISIONS GOVERNING PROGRAMS... services to the hard to serve, increase the level of basic and occupational skills training provided by the...

Hostile Attributional Bias, Negative Emotional Responding, and Aggression in Adults: Moderating Effects of Gender and Impulsivity

PubMed Central

Chen, Pan; Coccaro, Emil F.; Jacobson, Kristen C.

2012-01-01

The current study examined the main effects of hostile attributional bias (HAB) and negative emotional responding on a variety of aggressive behaviors in adults, including general aggression, physical aggression, relational aggression, and verbal aggression. Effects of both externalizing (anger) and internalizing (embarrassment/upset) negative emotions were considered. In addition, the moderating roles of gender and impulsivity on the effects of HAB and negative emotional responding were explored. Multilevel models were fitted to data from 2,749 adult twins aged 20–55 from the PennTwins cohort. HAB was positively associated with all four forms of aggression. There was also a significant interaction between impulsivity and HAB for general aggression. Specifically, the relationship between HAB and general aggression was only significant for individuals with average or above-average levels of impulsivity. Negative emotional responding was also found to predict all measures of aggression, although in different ways. Anger was positively associated with all forms of aggression, whereas embarrassment/upset predicted decreased levels of general, physical, and verbal aggression but increased levels of relational aggression. The associations between negative emotional responding and aggression were generally stronger for males than females. The current study provides evidence for the utility of HAB and negative emotional responding as predictors of adult aggression and further suggests that gender and impulsivity may moderate their links with aggression. PMID:24833604

Hostile attributional bias, negative emotional responding, and aggression in adults: moderating effects of gender and impulsivity.

PubMed

Chen, Pan; Coccaro, Emil F; Jacobson, Kristen C

2012-01-01

The current study examined the main effects of hostile attributional bias (HAB) and negative emotional responding on a variety of aggressive behaviors in adults, including general aggression, physical aggression, relational aggression, and verbal aggression. Effects of both externalizing (anger) and internalizing (embarrassment/upset) negative emotions were considered. In addition, the moderating roles of gender and impulsivity on the effects of HAB and negative emotional responding were explored. Multilevel models were fitted to data from 2,749 adult twins aged 20-55 from the PennTwins cohort. HAB was positively associated with all four forms of aggression. There was also a significant interaction between impulsivity and HAB for general aggression. Specifically, the relationship between HAB and general aggression was only significant for individuals with average or above-average levels of impulsivity. Negative emotional responding was also found to predict all measures of aggression, although in different ways. Anger was positively associated with all forms of aggression, whereas embarrassment/upset predicted decreased levels of general, physical, and verbal aggression but increased levels of relational aggression. The associations between negative emotional responding and aggression were generally stronger for males than females. The current study provides evidence for the utility of HAB and negative emotional responding as predictors of adult aggression and further suggests that gender and impulsivity may moderate their links with aggression. © 2011 Wiley Periodicals, Inc.

Adaptive functioning and behaviour problems in relation to level of education in children and adolescents with intellectual disability.

PubMed

de Bildt, A; Sytema, S; Kraijer, D; Sparrow, S; Minderaa, R

2005-09-01

The interrelationship between adaptive functioning, behaviour problems and level of special education was studied in 186 children with IQs ranging from 61 to 70. The objective was to increase the insight into the contribution of adaptive functioning and general and autistic behaviour problems to the level of education in children with intellectual disability (ID). Children from two levels of special education in the Netherlands were compared with respect to adaptive functioning [Vineland Adaptive Behavior Scales (VABS)], general behaviour problems [Child Behavior Checklist (CBCL)] and autistic behaviour problems [Autism Behavior Checklist (ABC)]. The effect of behaviour problems on adaptive functioning, and the causal relationships between behaviour problems, adaptive functioning and level of education were investigated. Children in schools for mild learning problems had higher VABS scores, and lower CBCL and ABC scores. The ABC had a significant effect on the total age equivalent of the VABS in schools for severe learning problems, the CBCL in schools for mild learning problems. A direct effect of the ABC and CBCL total scores on the VABS age equivalent was found, together with a direct effect of the VABS age equivalent on level of education and therefore an indirect effect of ABC and CBCL on level of education. In the children with the highest level of mild ID, adaptive functioning seems to be the most important factor that directly influences the level of education that a child attends. Autistic and general behaviour problems directly influence the level of adaptive functioning. Especially, autistic problems seem to have such a restrictive effect on the level of adaptive functioning that children do not reach the level of education that would be expected based on IQ. Clinical implications are discussed.

Low-serum GTA-446 anti-inflammatory fatty acid levels as a new risk factor for colon cancer.

PubMed

Ritchie, Shawn A; Tonita, Jon; Alvi, Riaz; Lehotay, Denis; Elshoni, Hoda; Myat, Su-; McHattie, James; Goodenowe, Dayan B

2013-01-15

Gastrointestinal tract acid-446 (GTA-446) is a long-chain polyunsaturated fatty acid present in the serum. A reduction of GTA-446 levels in colorectal cancer (CRC) patients has been reported previously. Our study compared GTA-446 levels in subjects diagnosed with CRC at the time of colonoscopy to the general population. Serum samples and pathology data were collected from 4,923 representative subjects undergoing colonoscopy and from 964 subjects from the general population. Serum GTA-446 levels were determined using a triple-quadrupole tandem mass spectrometry method. A low-serum GTA-446 level was based on the bottom tenth percentile of subjects with low risk based on age (40-49 years old) in the general population. Eighty-six percent of newly diagnosed CRC subjects (87% for stages 0-II and 85% for stages III-IV) showed low-serum GTA-446 levels. A significant increase in the CRC incidence rate with age was observed in subjects with low GTA-446 levels (p = 0.019), but not in subjects with normal levels (p = 0.86). The relative risk of CRC given a low GTA-446 level was the highest for subjects under age 50 (10.1, 95% confidence interval [C.I.] = 6.4-16.4 in the reference population, and 7.7, 95% C.I. = 4.4-14.1 in the colonoscopy population, both p < 0.0001), and declined with age thereafter. The CRC incidence rate in subjects undergoing colonoscopy with low GTA-446 levels was over six times higher than for subjects with normal GTA-446 levels and twice that of subjects with gastrointestinal symptoms. The results show that a low-serum GTA-446 level is a significant risk factor for CRC, and a sensitive predictor of early-stage disease. Copyright © 2012 UICC.

Physiological and genotypic responses of central hardwood species to allelochemicals, other stresses, and their interactions

Treesearch

J. W. Van Sambeek; John E. Preece; Nadia E. Navarrete; George Rink

1996-01-01

In response to increasing carbon dioxide levels, most general circulation models (GCMs) predict increasing temperatures and decreasing precipitation for the central hardwood region of the United States. Plants in this region will need to adapt to these changes as well as to other stress agents if they are to germinate, grow, and reproduce. For the last five years, our...

Comparing the Differences in Access to Professional Development for General Education and Special Education Teachers and the Subsequent Impact on Instructional Practice

ERIC Educational Resources Information Center

Slater, Lori L.

2017-01-01

The demands on schools, teachers, and students continue to increase as greater accountability measures are put into place at all levels. For teachers to meet these increased demands, it is important that they be provided opportunities to improve and enhance their content knowledge and pedagogy. One way to ensure the provision of these…

Responses of Wheat Yield, Macro- and Micro-Nutrients, and Heavy Metals in Soil and Wheat following the Application of Manure Compost on the North China Plain.

PubMed

Wang, Fan; Wang, Zhaohui; Kou, Changlin; Ma, Zhenghua; Zhao, Dong

2016-01-01

The recycling of livestock manure in cropping systems is considered to enhance soil fertility and crop productivity. However, there have been no systematic long-term studies of the effects of manure application on soil and crop macro- and micro-nutrients, heavy metals, and crop yields in China, despite their great importance for sustainable crop production and food safety. Thus, we conducted field experiments in a typical cereal crop production area of the North China Plain to investigate the effects of compost manure application rates on wheat yield, as well as on the macro-/micro-nutrients and heavy metals contents of soil and wheat. We found that compost application increased the soil total N and the available K, Fe, Zn, and Mn concentrations, whereas the available P in soil was not affected, and the available Cu decreased. In general, compost application had no significant effects on the grain yield, biomass, and harvest index of winter wheat. However, during 2012 and 2013, the N concentration decreased by 9% and 18% in straw, and by 16% and 12% in grain, respectively. With compost application, the straw P concentration only increased in 2012 but the grain P generally increased, while the straw K concentration tended to decrease and the grain K concentration increased in 2013. Compost application generally increased the Fe and Zn concentrations in straw and grain, whereas the Cu and Mn concentrations decreased significantly compared with the control. The heavy metal concentrations increased at some compost application rates, but they were still within the safe range. The balances of the macro-and micro-nutrients indicated that the removal of nutrients by wheat was compensated for by the addition of compost, whereas the level of N decreased without the application of compost. The daily intake levels of micronutrients via the consumption of wheat grain were still lower than the recommended levels when sheep manure compost was applied, except for that of Mn.

Responses of Wheat Yield, Macro- and Micro-Nutrients, and Heavy Metals in Soil and Wheat following the Application of Manure Compost on the North China Plain

PubMed Central

Wang, Fan; Wang, Zhaohui; Kou, Changlin; Ma, Zhenghua; Zhao, Dong

2016-01-01

The recycling of livestock manure in cropping systems is considered to enhance soil fertility and crop productivity. However, there have been no systematic long-term studies of the effects of manure application on soil and crop macro- and micro-nutrients, heavy metals, and crop yields in China, despite their great importance for sustainable crop production and food safety. Thus, we conducted field experiments in a typical cereal crop production area of the North China Plain to investigate the effects of compost manure application rates on wheat yield, as well as on the macro-/micro-nutrients and heavy metals contents of soil and wheat. We found that compost application increased the soil total N and the available K, Fe, Zn, and Mn concentrations, whereas the available P in soil was not affected, and the available Cu decreased. In general, compost application had no significant effects on the grain yield, biomass, and harvest index of winter wheat. However, during 2012 and 2013, the N concentration decreased by 9% and 18% in straw, and by 16% and 12% in grain, respectively. With compost application, the straw P concentration only increased in 2012 but the grain P generally increased, while the straw K concentration tended to decrease and the grain K concentration increased in 2013. Compost application generally increased the Fe and Zn concentrations in straw and grain, whereas the Cu and Mn concentrations decreased significantly compared with the control. The heavy metal concentrations increased at some compost application rates, but they were still within the safe range. The balances of the macro-and micro-nutrients indicated that the removal of nutrients by wheat was compensated for by the addition of compost, whereas the level of N decreased without the application of compost. The daily intake levels of micronutrients via the consumption of wheat grain were still lower than the recommended levels when sheep manure compost was applied, except for that of Mn. PMID:26771517

Inactivation of klotho function induces hyperphosphatemia even in presence of high serum fibroblast growth factor 23 levels in a genetically engineered hypophosphatemic (Hyp) mouse model

PubMed Central

Nakatani, Teruyo; Ohnishi, Mutsuko; Razzaque, M. Shawkat

2009-01-01

Hyp mice possess a mutation that inactivates the phosphate-regulating gene, which is homologous to the endopeptidases of the X-chromosome (PHEX). The mutation is associated with severe hypophosphatemia due to excessive urinary phosphate wasting. Such urinary phosphate wasting in Hyp mice is associated with an increased serum accumulation of fibroblast growth factor (FGF) 23. We wanted to determine the biological significance of increased serum FGF23 levels and concomitant hypophosphatemia in Hyp mice and to evaluate whether FGF23 activity could be modified by manipulating klotho (a cofactor of FGF23 signaling). We generated Hyp and klotho double-mutant mice (Hyp/klotho−/−). Severe hypophosphatemia of Hyp mice was reversed to hyperphosphatemia in Hyp/klotho−/− double mutants, despite the fact that the double mutants showed significantly increased serum levels of FGF23. Hyperphosphatemia in Hyp/klotho−/− mice was associated with increased renal expression of sodium/phosphate cotransporter 2a (NaPi2a) protein. Exogenous injection of bioactive parathyroid hormone 1-34 down-regulated renal expression of NaPi2a and consequently reduced serum levels of phosphate in Hyp/klotho−/− mice. Moreover, in contrast to the Hyp mice, the Hyp/klotho−/− mice showed significantly higher serum levels of 1,25-dihydroxyvitamin D and developed extensive calcification in soft tissues and vascular walls. Furthermore, compared with the Hyp mice, Hyp/klotho−/− mice were smaller in size, showed features of generalized tissue atrophy, and generally died by 15–20 wk of age. Our in vivo studies provide genetic evidence for a pathological role of increased FGF23 activities in regulating abnormal phosphate homeostasis in Hyp mice. Moreover, these results suggest that even when serum levels of FGF23 are significantly high, in the absence of klotho, FGF23 is unable to regulate systemic phosphate homeostasis. Our in vivo observations have significant clinical implications in diseases associated with increased FGF23 activity and suggest that the functions of FGF23 can be therapeutically modulated by manipulating the effects of klotho.—Nakatani, Y., Ohnishi, M., Razzaque, M. S. Inactivation of klotho function induces hyperphosphatemia even in presence of high serum fibroblast growth factor 23 levels in a genetically engineered hypophosphatemic (Hyp) mouse model. PMID:19584304

Levels of organization in biology: on the nature and nomenclature of ecology's fourth level.

PubMed

Lidicker, William Z

2008-02-01

Viewing the universe as being composed of hierarchically arranged systems is widely accepted as a useful model of reality. In ecology, three levels of organization are generally recognized: organisms, populations, and communities (biocoenoses). For half a century increasing numbers of ecologists have concluded that recognition of a fourth level would facilitate increased understanding of ecological phenomena. Sometimes the word "ecosystem" is used for this level, but this is arguably inappropriate. Since 1986, I and others have argued that the term "landscape" would be a suitable term for a level of organization defined as an ecological system containing more than one community type. However, "landscape" and "landscape level" continue to be used extensively by ecologists in the popular sense of a large expanse of space. I therefore now propose that the term "ecoscape" be used instead for this fourth level of organization. A clearly defined fourth level for ecology would focus attention on the emergent properties of this level, and maintain the spatial and temporal scale-free nature inherent in this hierarchy of organizational levels for living entities.

Where have all the doctors gone? (2). Intraurban trends: changes in the geographic distribution of general practitioners in Auckland, 1980-7.

PubMed

Barnett, J R

1991-08-14

During the 1980s the Auckland metropolitan area increased its share of all general practitioners in New Zealand at a much faster rate than its share of the population, resulting in a high level of availability by 1987. In the light of such trends, neoclassical theory would predict a diffusion of general practitioners into areas with fewer doctors where there is less competition for patients. Data for 1980-7, however, indicates that for every FTE general practitioner who located in doctor poor areas of the city, 1.87 general practitioners continued to open practices in areas already well provided for. Or, for every extra consultation that took place in low income suburbs, 1.51 extra consultations occurred in more affluent localities. These results do not provide strong support for a market led diffusion of doctors into areas of need and any gains in increased equity appear to have been achieved at the expense of considerable inefficiency given the likely presence of induced demand.

Neither the internist nor the Internet: use of and trust in health information sources by people with schizophrenia.

PubMed

Maguire, Paul A; Reay, Rebecca E; Looi, Jeffrey C L; Cubis, Jeff; Byrne, Gerard J; Raphael, Beverley

2011-06-01

The aim of this study was to explore health information sources accessed by people with schizophrenia and the level of trust invested in them. A cross-sectional survey was performed comparing the responses of 71 adults with schizophrenia (recruited from both community and inpatient settings) with 238 general practice attendees on their use of television, radio, the Internet, newspapers, magazines, family and friends, and doctor to obtain information on health matters, and their levels of trust in these sources. People with schizophrenia most commonly reported using a doctor, family and friends, and television to obtain information on health matters. However, compared with general practice attendees, they gained less health information from doctors and the Internet, and had less trust in doctors. Within-group analysis revealed that in people with schizophrenia: living alone increased the likelihood of obtaining health information from television; a higher level of education increased the odds of trusting the Internet as a health information source; a higher estimated household income was associated with an increased likelihood of trusting newspapers; and women with schizophrenia were considerably more likely than men with schizophrenia to trust family and friends as providers of health information. For both groups, there were significant positive correlations between the amount of health information obtained from a given information source and the level of trust invested in it. There are significant differences in the reported utilization and trust of health information sources between people with schizophrenia and attendees at general practice settings. Those with schizophrenia are less likely to trust and obtain information from a doctor, and less likely to access the Internet. Further research is required to explore this disparity. This is critical given the high rates of comorbid physical illness and reduced longevity in people suffering from schizophrenia.

Proteomic profiling of the antifungal drug response of Aspergillus fumigatus to voriconazole.

PubMed

Amarsaikhan, Nansalmaa; Albrecht-Eckardt, Daniela; Sasse, Christoph; Braus, Gerhard H; Ogel, Zumrut B; Kniemeyer, Olaf

2017-10-01

Antifungal resistance is an emerging problem and one of the reasons for treatment failure of invasive aspergillosis (IA). Voriconazole has become a standard therapeutic for the treatment of this often fatal infection. We studied the differentially expressed proteins as a response of Aspergillus fumigatus to voriconazole by employing the two-dimensional difference gel electrophoresis (DIGE) technique. Due to addition of drug, a total of 135 differentially synthesized proteins were identified by MALDI-TOF/TOF-mass spectrometry. In particular, the level of proteins involved in the general stress response and cell detoxification increased prominently. In contrast, cell metabolism and energy proteins were down-regulated, which suggests the cellular effort to maintain balance in energy utilization while trying to combat the cellular stress exerted by the drug. We detected several so-far uncharacterized proteins which may play a role in stress response and drug metabolism and which could be future targets for antifungal treatment. A mutant strain, which is deleted in the cross-pathway control gene cpcA, was treated with voriconazole to investigate the contribution of the general control of amino acid biosynthesis to drug resistance. We compared the mutant strain's protein expression profile with the wild-type strain. The absence of CpcA led to an increased resistance to voriconazole and a reduced activation of some general stress response proteins, while the transcript level of the triazole target gene erg11A (cyp51A) remained unchanged. In contrast, the sensitivity of strain ΔcpcA to terbinafine and amphotericin B was slightly increased. These findings imply a role of CpcA in the cellular stress response to azole drugs at the post transcriptional level. Copyright © 2017 Elsevier GmbH. All rights reserved.

Excited-state quantum phase transitions in systems with two degrees of freedom: Level density, level dynamics, thermal properties

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

Stránský, Pavel; Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, 04510, México, D.F.; Macek, Michal

2014-06-15

Quantum systems with a finite number of freedom degrees f develop robust singularities in the energy spectrum of excited states as the system’s size increases to infinity. We analyze the general form of these singularities for low f, particularly f=2, clarifying the relation to classical stationary points of the corresponding potential. Signatures in the smoothed energy dependence of the quantum state density and in the flow of energy levels with an arbitrary control parameter are described along with the relevant thermodynamical consequences. The general analysis is illustrated with specific examples of excited-state singularities accompanying the first-order quantum phase transition. --more » Highlights: •ESQPTs found in infinite-size limit of systems with low numbers of freedom degrees f. •ESQPTs related to non-analytical evolutions of classical phase–space properties. •ESQPT signatures analyzed for general f, particularly f=2, extending known case f=1. •ESQPT signatures identified in smoothened density and flow of energy spectrum. •ESQPTs shown to induce a new type of thermodynamic anomalies.« less

Predicting the synergy of multiple stress effects

NASA Astrophysics Data System (ADS)

Liess, Matthias; Foit, Kaarina; Knillmann, Saskia; Schäfer, Ralf B.; Liess, Hans-Dieter

2016-09-01

Toxicants and other, non-chemical environmental stressors contribute to the global biodiversity crisis. Examples include the loss of bees and the reduction of aquatic biodiversity. Although non-compliance with regulations might be contributing, the widespread existence of these impacts suggests that for example the current approach of pesticide risk assessment fails to protect biodiversity when multiple stressors concurrently affect organisms. To quantify such multiple stress effects, we analysed all applicable aquatic studies and found that the presence of environmental stressors increases individual sensitivity to toxicants (pesticides, trace metals) by a factor of up to 100. To predict this dependence, we developed the “Stress Addition Model” (SAM). With the SAM, we assume that each individual has a general stress capacity towards all types of specific stress that should not be exhausted. Experimental stress levels are transferred into general stress levels of the SAM using the stress-related mortality as a common link. These general stress levels of independent stressors are additive, with the sum determining the total stress exerted on a population. With this approach, we provide a tool that quantitatively predicts the highly synergistic direct effects of independent stressor combinations.

Level of Satisfaction of Older Persons with Their General Practitioner and Practice: Role of Complexity of Health Problems

PubMed Central

Poot, Antonius J.; den Elzen, Wendy P. J.; Blom, Jeanet W.; Gussekloo, Jacobijn

2014-01-01

Background Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP) and practice. Methods and Findings This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons) study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social). For 2664 randomly chosen respondents (median age 82 years; 68% female) information was collected on level of satisfaction (satisfied, neutral, dissatisfied) with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (p<0.001). Per additional health domain with problems, the risk of being dissatisfied increased 1.7 times (95% CI 1.4–2.14; p<0.001). This was independent of age, gender, and demographic and clinical parameters (adjusted OR 1.4, 95% CI 1.1–1.8; p = 0.021). Conclusion In older persons, dissatisfaction with general practice is strongly correlated with rising complexity of health problems, independent of age, demographic and clinical parameters. It remains unclear whether complexity of health problems is a patient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to investigate the causal associations between care organization, patient characteristics, indicators of quality, and patient perceptions. PMID:24710557

Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

PubMed

Poot, Antonius J; den Elzen, Wendy P J; Blom, Jeanet W; Gussekloo, Jacobijn

2014-01-01

Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP) and practice. This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons) study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social). For 2664 randomly chosen respondents (median age 82 years; 68% female) information was collected on level of satisfaction (satisfied, neutral, dissatisfied) with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (p<0.001). Per additional health domain with problems, the risk of being dissatisfied increased 1.7 times (95% CI 1.4-2.14; p<0.001). This was independent of age, gender, and demographic and clinical parameters (adjusted OR 1.4, 95% CI 1.1-1.8; p = 0.021). In older persons, dissatisfaction with general practice is strongly correlated with rising complexity of health problems, independent of age, demographic and clinical parameters. It remains unclear whether complexity of health problems is a patient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to investigate the causal associations between care organization, patient characteristics, indicators of quality, and patient perceptions.

Reducing Lake Erie's Harmful Algal Blooms: Projection and Adoption of Management Plans

NASA Astrophysics Data System (ADS)

Martin, J.; Aloysius, N.; Howard, G.; Kalcic, M. M.; Wilson, R. S.; Scavia, D.; Roe, B.

2016-12-01

In early 2016, the United States and Canada formally agreed to reduce phosphorus inputs to Lake Erie by 40% to reduce the severity of annual Harmful Algal Blooms (HABs). These blooms have become more severe, with record events occurring in 2011 and 2015, and have compromised public safety, shut down drinking water supplies, and negatively impacted the economy of the western Lake Erie basin. Now, key questions revolve around the ability to reach the 40% reduction, required management changes, and resources to support these changes. This presentation will highlight interdisciplinary research to compare the amount and types of practices needed for this reduction to the current and projected levels of adoption. Economic resources to support these management changes are also compared with the financial support from the general public to improve Lake Erie water quality. Multiple models of the Maumee watershed identified management plans and adoption rates needed to reach the reduction targets. For example, one successful scenario estimated necessary adoption rates of 50% for subsurface application of fertilizer on row crops, 58% for cover crops, and 78% for buffer strips. Current adoption is below these levels, but future projections based on farmer surveys shows these levels are possible. Public support is necessary to generate the funding to support cost sharing and other programs aimed at increasing adoption of recommended practices. Comparing results from willingness-to-pay surveys of the general public with the estimated need for these management plans shows a gap in resources to support these levels of adoption. In general, these results show that accelerated adoption of management plans is needed compared to past adoption rates, but that these rates are possible based on likely adoption rates. Projected support from the general public indicates it will be challenging to fund these rates of adoption, especially during climate changes that may require even greater adoption. To partially address this challenge, accelerated rates of adoption may be achieved through voluntary means by increasing the perceived efficacy of the practices.

A multilevel analysis of trimethoprim and ciprofloxacin prescribing and resistance of uropathogenic Escherichia coli in general practice.

PubMed

Vellinga, Akke; Murphy, Andrew W; Hanahoe, Belinda; Bennett, Kathleen; Cormican, Martin

2010-07-01

A retrospective analysis of databases was performed to describe trimethoprim and ciprofloxacin prescribing and resistance in Escherichia coli within general practices in the West of Ireland from 2004 to 2008. Antimicrobial susceptibility testing was performed by disc diffusion methods according to the CLSI methods and criteria on significant E. coli isolates (colony count >10(5) cfu/mL) from urine samples submitted from general practice. Data were collected over a 4.5 year period and aggregated at practice level. Data on antimicrobial prescribing of practices were obtained from the national Irish prescribing database, which accounts for approximately 70% of all medicines prescribed in primary care. A multilevel model (MLwiN) was fitted with trimethoprim/ciprofloxacin resistance rates as outcome and practice prescribing as predictor. Practice and individual routinely collected variables were controlled for in the model. Seventy-two general practices sent between 13 and 720 (median 155) samples that turned out to be E. coli positive. Prescribing at practice level was significantly correlated with the probability of antimicrobial-resistant E. coli with an odds ratio of 1.02 [95% confidence interval (CI) 1.01-1.04] for every additional prescription of trimethoprim per 1000 patients per month in the practice and 1.08 (1.04-1.11) for ciprofloxacin. Age was a significant risk factor in both models. Higher variation between practices was found for ciprofloxacin as well as a yearly increase in resistance. Comparing a 'mean' practice with 1 prescription per month with one with 10 prescriptions per month showed an increase in predicted probability of a resistant E. coli for the 'mean' patient from 23.9% to 27.5% for trimethoprim and from 3.0% to 5.5% for ciprofloxacin. A higher level of antimicrobial prescribing in a practice is associated with a higher probability of a resistant E. coli for the patient. The variation in antimicrobial resistance levels between practices was relatively higher for ciprofloxacin than for trimethoprim.

Posttraumatic stress in aging World War II survivors after a fireworks disaster: a controlled prospective study.

PubMed

Bramsen, Inge; van der Ploeg, Henk M; Boers, Maarten

2006-04-01

Little is known about the effects of cumulative trauma and whether traumatized individuals are more vulnerable. In 2000, a fireworks disaster created the possibility to examine this issue among World War II survivors who were part of an ongoing longitudinal study. Between 1998 and 2000 posttraumatic stress increased in disaster exposed respondents as opposed to the control group. War-related reexperiencing and avoidance also increased. The strongest increase occurred in disaster-exposed respondents who had low levels of wartime stress and a slight decrease occurred in those who had high wartime exposure. This unique controlled observation suggests that disasters do increase the levels of posttraumatic stress, and that reactivation of previous traumatic events generally occurs. However, the vulnerability hypothesis was not supported.

Just-in-Time Teaching Exercises to Engage Students in an Introductory-Level Dinosaur Course

NASA Astrophysics Data System (ADS)

Guertin, Laura A.; Zappe, Sarah E.; Kim, Heeyoung

2007-12-01

The Just-in-Time Teaching (JiTT) technique allows students to be engaged in course material outside of the classroom by answering web-based questions. The responses are summarized and presented to students in class with a follow-up active learning exercise. College students enrolled in an introductory-level general education geoscience course were surveyed over a two-semester period on their engagement level during lecture and perceived learning of course content. Data show that students are able to reflect on their prior knowledge and construct new knowledge with weekly graded JiTT exercises. Despite increasing and competing pressures outside of the classroom, students reported increased learning and engagement in a course with required weekly assignments.

Sucrose accelerates flower opening and delays senescence through a hormonal effect in cut lily flowers.

PubMed

Arrom, Laia; Munné-Bosch, Sergi

2012-06-01

Sugars are generally used to extend the vase life of cut flowers. Such beneficial effects have been associated with an improvement of water relations and an increase in available energy for respiration by floral tissues. In this study we aimed at evaluating to what extent (i) endogenous levels of sugars in outer and inner tepals, androecium and gynoecium are altered during opening and senescence of lily flowers; (ii) sugar levels increase in various floral tissues after sucrose addition to the vase solution; and (iii) sucrose addition alters the hormonal balance of floral tissues. Results showed that endogenous glucose levels increased during flower opening and decreased during senescence in all floral organs, while sucrose levels increased in outer and inner tepals and the androecium during senescence. Sucrose treatment accelerated flower opening, and delayed senescence, but did not affect tepal abscission. Such effects appeared to be exerted through a specific increase in the endogenous levels of sucrose in the gynoecium and of glucose in all floral tissues. The hormonal balance was altered in the gynoecium as well as in other floral tissues. Aside from cytokinin and auxin increases in the gynoecium; cytokinins, gibberellins, abscisic acid and salicylic acid levels increased in the androecium, while abscisic acid decreased in outer tepals. It is concluded that sucrose addition to the vase solution exerts an effect on flower opening and senescence by, among other factors, altering the hormonal balance of several floral tissues. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

PubMed

Kunst, Anton E; Bos, Vivian; Lahelma, Eero; Bartley, Mel; Lissau, Inge; Regidor, Enrique; Mielck, Andreas; Cardano, Mario; Dalstra, Jetty A A; Geurts, José J M; Helmert, Uwe; Lennartsson, Carin; Ramm, Jorun; Spadea, Teresa; Stronegger, Willibald J; Mackenbach, Johan P

2005-04-01

Changes over time in inequalities in self-reported health are studied for increasingly more countries, but a comprehensive overview encompassing several countries is still lacking. The general aim of this article is to determine whether inequalities in self-assessed health in 10 European countries showed a general tendency either to increase or to decrease between the 1980s and the 1990s and whether trends varied among countries. Data were obtained from nationally representative interview surveys held in Finland, Sweden, Norway, Denmark, England, The Netherlands, West Germany, Austria, Italy, and Spain. The proportion of respondents with self-assessed health less than 'good' was measured in relation to educational level and income level. Inequalities were measured by means of age-standardized prevalence rates and odds ratios (ORs). Socioeconomic inequalities in self-assessed health showed a high degree of stability in European countries. For all countries together, the ORs comparing low with high educational levels remained stable for men (2.61 in the 1980s and 2.54 in the 1990s) but increased slightly for women (from 2.48 to 2.70). The ORs comparing extreme income quintiles increased from 3.13 to 3.37 for men and from 2.43 to 2.86 for women. Increases could be demonstrated most clearly for Italian and Spanish men and women, and for Dutch women, whereas inequalities in health in the Nordic countries showed no tendency to increase. The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

Serum lipocalin-2 levels are increased in patients with psoriasis.

PubMed

Kamata, M; Tada, Y; Tatsuta, A; Kawashima, T; Shibata, S; Mitsui, H; Asano, Y; Sugaya, M; Kadono, T; Kanda, N; Watanabe, S; Sato, S

2012-04-01

The protein lipocalin (LCN)-2 is known to be related to insulin resistance, obesity and atherosclerotic diseases. Psoriasis is an inflammatory skin disease related to metabolic syndrome. The aim of this study was to examine the relationship between serum LCN2 levels and indicators for metabolic syndrome and inflammatory cytokine levels in patients with psoriasis. Serum LCN2 levels were measured in patients with psoriasis, atopic dermatitis (AD) or bullous pemphigoid (BP), and compared with those of healthy controls. Serum LCN2 levels were also compared with several indicators for metabolic syndrome, and with serum levels of interleukin (IL)-6 and tumour necrosis factor (TNF)-α, two markers of inflammation. Serum LCN2 levels in patients with psoriasis were significantly higher than those of healthy controls, but there was no significant correlation between serum LCN2 and body mass index. Serum LCN2 levels also correlated with serum IL-6 and TNF-α levels in patients with psoriasis. Serum LCN2 levels are a general indicator for increased inflammation in the patients with psoriasis. © The Author(s). CED © 2012 British Association of Dermatologists.

[The course of inpatient rehabilitation in gastrointestinal and metabolic diseases under increasing integration of behavior and experience].

PubMed

Gutschmidt, S; Hänisch, S; Würthner, K

1993-08-01

Starting out from the thesis that behaviour and felt experience, i.e., the patient's "subjective world", have considerable influence on chronic diseases and their consequences in the gastrointestinal field, a "basic course documentation"-based comparison has been carried out of the courses of 4-week in-patient rehabilitation programmes designed to increasingly incorporate interventions directed at this area; the study population had consisted of two groups of patients (n = 688 each) without any significant differences concerning age and sex distribution admitted during the summer terms of 1990 (Group A) and 1991 (Group B), respectively. This documentation (in DBASE IV format) compiles (anonymized) patient data at an "objective" level on the one hand, i.e. basic data (such as diagnoses, age, sex), results obtained by the Edinburgh Rehabilitation Status Scale (ERSS), risk behaviour, and scope of interventions both in the organ-medical and physical therapy fields and in the area of "instruction, motivation, support, group work, and creativity" (designed to achieve integration of behaviour and felt experience); on the other hand, at "subjective level", it comprises the patient's own judgements relative to the treatment regimen and its environment, with subsequent correlational analysis of the data obtained (using the SPSSPC statistical package). As had been expected, correlations have on the one hand been stated at the "objective" level between an increased share of more "serious" conditions (ICD) in 1990 as compared to 1991 and higher ERSS scores (i.e., increased impact of disease consequences), greater organ-medical care intensity, and frequency of incapacity for work; on the other hand, at "subjective" level, strong linkages were found among the item ratings for general sense of improvement, specific and general therapy, as well as so-called "therapeutic environment". When the two levels are linked, the sense of improvement, as expected, is found to correlate negatively with the ERSS, but positively with the scope of the interventions designed to foster integration of behaviour and felt experience. The judgements given for quality of care provided relative to the patient's self-reported primary disorder and for general medical care correlate positively both with the scope of diagnostic/therapeutic organ-medical interventions and integration-focussed ones, which, at least from the patient's perspective, hence exercise an ascertainable, essential effect in the therapeutic setting of in-patient rehabilitation in gastrointestinal and metabolic diseases.

Managing the Changing Nature of Distance and Open Education at Institutional Level.

ERIC Educational Resources Information Center

King, Bruce

2001-01-01

Discusses changes that distance and open learning are facing, partly because the context of higher education generally is being transformed. Topics include globalization; massification; increasing government intervention; technological developments; resistance from teachers; individualization; institutional change; and the need for management…

Increase in sickness absence with psychiatric diagnosis in Norway: a general population-based epidemiologic study of age, gender and regional distribution

PubMed Central

Hensing, Gunnel; Andersson, Lena; Brage, Sören

2006-01-01

Background The aim of this study was to assess the incidence of sickness absence with psychiatric diagnoses from 1994–2000, and the distribution across gender, age groups, diagnostic groups and regions in a general population. Methods The population at risk was defined as all individuals aged 16–66 years who were entitled to sickness benefits in 1994, 1996, 1998 and 2000 (n = 2,282,761 in 2000). All individuals with a full-time disability pension were excluded. The study included approximately 77% of the Norwegian population aged 16–66 years. For each year, the study base started on 1 January and ended on 31 December. Individuals that were sick-listed for more than 14/16 consecutive days with a psychiatric diagnosis on their medical certificate were selected as cases. Included in this study were data for Norway, the capital city Oslo and five regions in the southeast of the country. Results Sickness absence with psychiatric diagnoses increased in all age groups, in women and men, and in all regions. At the national level, the cumulative incidence increased in women from 1.7% in 1994 to 4.6% in 2000, and in men from 0.8% in 1994 to 2.2% in 2000. The highest cumulative incidence was found in middle-aged women and men (30–59 years). Women had a higher incidence than men in all stratification groups. The cumulative incidences in 2000 varied between 4.6% to 5.6% in women in the different regions, and for men the corresponding figures were 2.1% to 3.2%. Throughout the four years studied, women in Oslo had more than twice as high incidence levels of sickness absence with alcohol and drug diagnoses as the country as a whole. There were some differences between regions in sickness absence with specific psychiatric diagnoses, but they were small and most comparisons were non-significant. Conclusion Sickness absence with psychiatric diagnoses increased between 1994 and 2000 in Norway. The increase was highest in the middle-aged, and in women. Few regional differences were found. That the increase pervaded all stratification groups supports general explanations of the increase, such as changes in attitudes to psychiatric disorders in both patients and doctors, and increased mental distress probably associated with societal changes at a more structural level. PMID:16923198

Assessing cutoff values for increased exercise blood pressure to predict incident hypertension in a general population.

PubMed

Lorbeer, Roberto; Ittermann, Till; Völzke, Henry; Gläser, Sven; Ewert, Ralf; Felix, Stephan B; Dörr, Marcus

2015-07-01

Cutoff values for increased exercise blood pressure (BP) are not established in hypertension guidelines. The aim of the study was to assess optimal cutoff values for increased exercise BP to predict incident hypertension. Data of 661 normotensive participants (386 women) aged 25-77 years from the Study of Health in Pomerania (SHIP-1) with a 5-year follow-up were used. Exercise BP was measured at a submaximal level of 100 W and at maximum level of a symptom-limited cycle ergometry test. Cutoff values for increased exercise BP were defined at the maximum sum of sensitivity and specificity for the prediction of incident hypertension. The area under the receiver-operating characteristic curve (AUC) and net reclassification index (NRI) were calculated to investigate whether increased exercise BP adds predictive value for incident hypertension beyond established cardiovascular risk factors. In men, values of 160  mmHg (100  W level; AUC = 0.7837; NRI = 0.534, P < 0.001) and 210  mmHg (maximum level; AUC = 0.7677; NRI = 0.340, P = 0.003) were detected as optimal cutoff values for the definition of increased exercise SBP. A value of 190  mmHg (AUC = 0.8347; NRI = 0.519, P < 0.001) showed relevance for the definition of increased exercise SBP in women at the maximum level. According to our analyses, 190 and 210  mmHg are clinically relevant cutoff values for increased exercise SBP at the maximum exercise level of cycle ergometry test for women and men, respectively. In addition, for men, our analyses provided a cutoff value of 160  mmHg for increased exercise SBP at the 100  W level.

The psychiatric nurse specialist: a valuable asset in the general hospital.

PubMed

Fife, B; Lemler, S

1983-04-01

In summary, what are the ways in which the psychiatric/mental clinical specialist contributes to cost-effectiveness, the professional growth of nursing staff, and quality patient care in the general hospital setting? All services of the psychiatric/mental health clinical specialist are ultimately directed toward increasing the effectiveness with which staff can deliver care. This goal is accomplished by helping staff nurses maximize their knowledge, by providing needed educational opportunities, by promoting the use of a holistic model of care, and by helping staff cope with their own stress. In our experience, high quality care that meets the physiological, psychological, and sociological needs of patients decreases the length of the hospital stay, prevents repeated hospitalizations, and minimizes the development of psychosocial problems secondary to the illness. With the necessary support and cooperation from administration, this clinical specialist role reduces health care costs, promotes a higher level of functioning in patients and their families, and increases the level of job satisfaction for the staff who provide direct bedside care.

Is the knowledge and attitude of physicians in Nigeria adequate for the diagnosis and management of obstructive sleep apnea?

PubMed

Ozoh, Obianuju B; Ojo, Oluwadamilola O; Iwuala, Sandra O; Akinkugbe, Ayesha O; Desalu, Olufemi O; Okubadejo, Njideka U

2017-05-01

The knowledge and attitude of doctors in Nigeria towards obstructive sleep apnea is not known. We evaluated the level of knowledge and attitude regarding OSA among resident doctors in Internal Medicine and general practitioners in Nigeria. A cross-sectional survey among doctors during continuing medical education programs was conducted. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) questionnaire was used to obtain information. Two hundred seventy-three doctors (235 resident doctors and 38 general practitioners) participated in the study. The mean knowledge score was 10.7 ± 2.6 (out of a maximum possible of 18) for all participants corresponding to 59 ± 14.4 % knowledge. There was no significant difference in the mean score of resident doctors (10.8 ± 2.5) compared to general practitioners (10.0 ± 2.8), (t = 2.6, p = 0.10). Over 70 % of the participants wrongly responded that uvuloplasty was an effective treatment and less than 40 % correctly answered that continuous positive airway pressure treatment was first line for severe obstructive sleep apnea. The mean score on the attitude segment was 3.4 ± 0.6 (maximum possible score of 5) for all participants and 3.4 ± 0.6 and 3.3 ± 0.5, respectively, for the residents and the general practitioners (p = 0.47). Increasing age was negatively associated with level of knowledge, while increasing number of years in medical practice and higher level of residency training was positively associated with higher knowledge scores. The knowledge of obstructive sleep apnea among resident doctors and general practitioners in Nigeria is inadequate. There is need to improve training on sleep disorders in Nigeria both at continuing medical education programs and during residency training.

[Effect of Seasonal Temperature Increasing on Nitrogen Mineralization in Soil of the Water Level Fluctuating Zone of Three Gorge Tributary During the Dry Period].

PubMed

Lin, Jun-jie; Zhang, Shuai; Liu, Dan; Zhou, Bin; Xiao, Xiao-jun; Ma, Hui-yan; Yu, Zhi-guo

2016-02-15

To reveal the effect of seasonal temperature increasing on nitrogen mineralization in soil of the water level fluctuating soil zone of three gorge reservoir areas in the Yangtze river tributary during the dry period, surface soils were collected from the water level fluctuating zone of Pengxi river crossing two hydrological sections, i.e., upstream and downstream and three water level altitudes, 155 m (low), 165 m (middle) and 175 m (high). We incubated the soil at 25 degrees C and 35 degrees C to determine the transformation rates of nitrogen in soil of Pengxi river basin during the dry period. The result showed that TN and NO3- -N contents in the soil of upstream section and higher (175 m) altitude of water level were higher than those in downstream and low (165 m) altitude of water level, whereas the pattern for NH4+ -N was different, with higher NH4+ -N contents in downstream and low water level. The inorganic nitrogen was dominated by NO3- -N, which accounted for up to 57.4%-84.7% of inorganic nitrogen. Generally, soil ammoniation, nitration and net N mineralization increased with the rising water level altitude and stream sections (P < 0.05). In summary, nitration and net N mineralization significantly increased with increasing temperature, (P < 0.05), while ammoniation showed no difference (P > 0.05).

Cationic boranes for the complexation of fluoride ions in water below the 4 ppm maximum contaminant level.

PubMed

Kim, Youngmin; Gabbaï, François P

2009-03-11

In search of a molecular receptor that could bind fluoride ions in water below the maximum contaminant level of 4 ppm set by the Environmental Protection Agency (EPA), we have investigated the water stability and fluoride binding properties of a series of phosphonium boranes of general formula [p-(Mes(2)B)C(6)H(4)(PPh(2)R)](+) with R = Me ([1](+)), Et ([2](+)), n-Pr ([3](+)), and Ph ([4](+)). These phosphonium boranes are water stable and react reversibly with water to form the corresponding zwitterionic hydroxide complexes of general formula p-(Mes(2)(HO)B)C(6)H(4)(PPh(2)R). They also react with fluoride ions to form the corresponding zwitterionic fluoride complexes of general formula p-(Mes(2)(F)B)C(6)H(4)(PPh(2)R). Spectrophotometric acid-base titrations carried out in H(2)O/MeOH (9:1 vol.) afford pK(R+) values of 7.3(+/-0.07) for [1](+), 6.92(+/-0.1) for [2](+), 6.59(+/-0.08) for [3](+), and 6.08(+/-0.09) for [4](+), thereby indicating that the Lewis acidity of the cationic boranes increases in following order: [1](+) < [2](+) < [3](+) < [4](+). In agreement with this observation, fluoride titration experiments in H(2)O/MeOH (9:1 vol.) show that the fluoride binding constants (K = 840(+/-50) M(-1) for [1](+), 2500(+/-200) M(-1) for [2](+), 4000(+/-300) M(-1) for [3](+), and 10 500(+/-1000) M(-1) for [4](+)) increase in the same order. These results show that the Lewis acidity of the cationic boranes increases with their hydrophobicity. The resulting Lewis acidity increase is substantial and exceeds 1 order of magnitude on going from [1](+) to [4](+). In turn, [4](+) is sufficiently fluorophilic to bind fluoride ions below the EPA contaminant level in pure water. These results indicate that phosphonium boranes related to [4](+) could be used as molecular recognition units in chemosensors for drinking water analysis.

Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999).

PubMed

Cohen, Joachim; Marcoux, Isabelle; Bilsen, Johan; Deboosere, Patrick; van der Wal, Gerrit; Deliens, Luc

2006-12-01

We wanted to examine how the acceptance of euthanasia among the general public in Western Europe has changed in the last decades, and we wanted to look for possible explanations. We analysed data from the European Values Surveys, held in 1981, 1990, and 1999-2000 in 12 West European countries. In each country, representative samples of the general public were interviewed using the same structured questionnaire in all countries. Euthanasia was explained in the questionnaires as 'terminating the life of the incurably sick'. A total of 46 199 respondents participated in the surveys. A significant increase in acceptance of euthanasia could be observed in all countries except (West) Germany. While the average increase in euthanasia acceptance was 22%, the increase was particularly obvious in Belgium, Italy, Spain, and Sweden. Although changes in several characteristics of respondents, such as decrease in religious beliefs, rising belief in the right to self-determination, and (to a lesser extent) rise in levels of education, were associated with growing acceptance of euthanasia, they could only partly explain the increase of euthanasia acceptance over the years. An increase of euthanasia acceptance among the general public took place over the last two decades in almost all West European countries, possibly indicating a growing support for personal autonomy regarding medical end-of-life decisions. If this trend continues, it is likely to increase the public and political debate about the (legal) regulation of euthanasia under certain conditions of careful medical practice in several West European countries.

The effects of rhodium on the renal function of female Wistar rats.

PubMed

Iavicoli, Ivo; Leso, Veruscka; Fontana, Luca; Marinaccio, Alessandro; Bergamaschi, Antonio; Calabrese, Edward J

2014-06-01

In recent years, the increased use of rhodium (Rh) as an active catalyst material in modern three-way automobile catalytic converters has led to a parallel rise in environmental levels of this metal. In spite of this, the literature contains few studies of the effects of Rh on human health. The aim of this study is to assess the effects of Rh on the renal function of female Wistar rats. Our findings show that sub-acute exposure to six increasing concentrations, ranging from 0.001 to 1 mg L(-1), of Rh (III) chloride hydrate in drinking water does not induce alterations in urinary albumin levels, while, at concentrations from 0.1 to 1 mg L(-1), a significant rise in urinary levels of Retinol Binding Protein is evident and an increasing trend in urinary β2-microglobulin, which becomes significant at 1 mg L(-1), is observed. These results therefore demonstrate a nephrotoxic action of Rh at tubular level in a wide range of doses. Interestingly, because of the recent increase in environmental Rh levels, these findings may have relevant implications both for occupationally exposed subjects and for the general population, especially children. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of an uncontrolled fire and the subsequent fire fight on the chemical composition of landfill leachate.

PubMed

Oygard, Joar Karsten; Måge, Amund; Gjengedal, Elin; Svane, Tore

2005-01-01

Landfill leachates sampled during and after an accidental landfill fire were analysed and the levels of selected metals and chemical compounds compared to those occurring in the leachate under normal conditions. The fire at the landfill site was put out by excavation and cooling by use of water. The investigation during the fire and fire fight revealed a moderate increase in the level of nitrogen and also in pH and conductivity. Heavy metals and COD in the leachate showed considerably increased levels. In general, the determined variables appeared to normalise within one week after the fire was extinguished. It can be concluded that landfill fires extinguished by excavation may lead to elevated leachate levels of especially COD and heavy metals, but that this is only a short-term effect.

Myoclonic epilepsy with ragged-red fibers without increased lactate levels.

PubMed

Kimura, Shigemi; Ozasa, Shiro; Nakamura, Kyoko; Nomura, Keiko; Kosuge, Hirofumi

2009-07-01

Myoclonic epilepsy associated with ragged-red fibers is one of the mitochondrial encephalomyopathies. Pathogenic mitochondrial DNA mutations have been identified in the mitochondrial transfer RNA (tRNA)(Lys) at positions 8344 and 8356. Characteristics of myoclonic epilepsy associated with ragged-red fibers include myoclonic epilepsy, generalized epilepsy, hearing loss, exercise intolerance, lactic acidosis, and ragged-red fibers. The elevated lactate level is one of the most important symptoms needed to make a diagnosis of mitochondrial encephalomyopathy. In the present case, however, myoclonic epilepsy was associated with ragged-red fibers but without increased lactate levels. Therefore, myoclonic epilepsy associated with ragged-red fibers should be suspected in a patient who has myoclonic epilepsy that is difficult to control with antiepileptic medications and who has other symptoms of mitochondrial disease, such as mental retardation, even if the patient's lactate level is normal.

Genetic mouse models of brain ageing and Alzheimer's disease.

PubMed

Bilkei-Gorzo, Andras

2014-05-01

Progression of brain ageing is influenced by a complex interaction of genetic and environmental factors. Analysis of genetically modified animals with uniform genetic backgrounds in a standardised, controlled environment enables the dissection of critical determinants of brain ageing on a molecular level. Human and animal studies suggest that increased load of damaged macromolecules, efficacy of DNA maintenance, mitochondrial activity, and cellular stress defences are critical determinants of brain ageing. Surprisingly, mouse lines with genetic impairment of anti-oxidative capacity generally did not show enhanced cognitive ageing but rather an increased sensitivity to oxidative challenge. Mouse lines with impaired mitochondrial activity had critically short life spans or severe and rapidly progressing neurodegeneration. Strains with impaired clearance in damaged macromolecules or defects in the regulation of cellular stress defences showed alterations in the onset and progression of cognitive decline. Importantly, reduced insulin/insulin-like growth factor signalling generally increased life span but impaired cognitive functions revealing a complex interaction between ageing of the brain and of the body. Brain ageing is accompanied by an increased risk of developing Alzheimer's disease. Transgenic mouse models expressing high levels of mutant human amyloid precursor protein showed a number of symptoms and pathophysiological processes typical for early phase of Alzheimer's disease. Generally, therapeutic strategies effective against Alzheimer's disease in humans were also active in the Tg2576, APP23, APP/PS1 and 5xFAD lines, but a large number of false positive findings were also reported. The 3xtg AD model likely has the highest face and construct validity but further studies are needed. Copyright © 2013 Elsevier Inc. All rights reserved.

National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

PubMed

Checkland, Kath

2004-11-01

This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

Daily micro-breaks and job performance: General work engagement as a cross-level moderator.

PubMed

Kim, Sooyeol; Park, YoungAh; Headrick, Lucille

2018-03-29

Despite the growing research on work recovery and its well-being outcomes, surprisingly little attention has been paid to at-work recovery and its job performance outcomes. The current study extends the work recovery literature by examining day-level relationships between prototypical microbreaks and job performance as mediated by state positive affect. Furthermore, general work engagement is tested as a cross-level moderator weakening the indirect effects of microbreaks on job performance via positive affect. Using multisource experience sampling method, the authors collected two daily surveys from 71 call center employees and obtained objective records of daily sales performance for two consecutive weeks (n = 632). Multilevel path analysis results showed that relaxation, socialization, and cognitive microbreaks were related to increased positive affect at work which, in turn, predicted greater sales performance. However, breaks for nutrition-intake (having snacks and drinks) did not show significant effects. Importantly, microbreaks had significant indirect effects on job performance via positive affect only for workers who had lower general work engagement, whereas the indirect effects did not exist for workers who had higher general work engagement. Furthermore, Bayesian multilevel analyses confirmed the results. Theoretical and practical implications, limitations, and future research directions are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Incorporating Data Link Messaging into a Multi-function Display for General Aviation Aircraft

NASA Technical Reports Server (NTRS)

Adams, Catherine A.; Murdoch, Jennifer L.

2006-01-01

One objective of the Small Aircraft Transportation System (SATS) Project is to increase the capacity and utilization of small non-towered, non-radar equipped airports by transferring traffic management activities to an automated system and separation responsibilities to general aviation (GA) pilots. This paper describes the development of a research multi-function display (MFD) to support the interaction between pilots and an automated Airport Management Module (AMM). Preliminary results of simulation and flight tests indicate that adding the responsibility of monitoring other traffic for self-separation does not increase pilots subjective workload levels. Pilots preferred using the enhanced MFD to execute flight procedures, reporting improved situation awareness over conventional instrument flight rules (IFR) procedures.

History of ground-water pumpage and water-level decline in the Black Creek and upper Cape Fear aquifers of the central coastal plain of North Carolina

USGS Publications Warehouse

Winner, M.D.; Lyke, W.L.

1986-01-01

Historical ground-water withdrawals and a general water-level decline in the Black Creek and upper Cape Fear aquifers of the central Coastal Plain of North Carolina are documented. Total municipal and industrial pumpage from these aquifers has increased from approximately 120,000 gal/day (gpd) in 1910 to >21 million gpd in 1980. Major pumpage, > 10,000 gpd, began around 1900. Since that time, per capita water use in the central Coastal Plain area has ranged from 17 to 172 gpd/person. The higher values partially represent the increasing availability and use of modern conveniences since the World War II era. The range of per capita water use can be subdivided according to general water-use and population characteristics for both urban and rural areas. The pumpage of ground water from the Black Creek and upper Cape Fear aquifers has created water-level declines from 0.5 to 4.9 ft/year since 1900. Approximately a third of the study area has experienced a decline > 50 ft up to the period 1979-1981, with 148 ft being the maximum.

Municipal water supplies in Lee County, Florida, 1974

USGS Publications Warehouse

O'Donnell, T. H.

1977-01-01

In 1974 the total pumpage for Lee County, Fla., municipal supplies reached 5,700 Mgal (million gallons annually), an increase of 54 percent over 1970 levels. Pumpage from individual sources included: Caloosahatchee River, 1,312 Mgal; water-table aquifer, 2,171 Mgal; the water-bearing zone in the Tamiami Formation, 340 Mgal; the water-bearing zone in the upper part of the Hawthorn Formation, 1,399 Mgal; the saline water zones in the lower part of the Hawthorn Formation and the Suwannee Limestone, 483 Mgal. Among the various sources, the water-table aquifer showed the greatest increase in municipal pumpage over 1970 levels (60 percent) while the saline zones in the lower part of the Hawthorn Formation and Suwannee Limestone showed the least (40 percent). Intensive pumpage from the water bearing zone in the upper part of the Hawthorn Formation has caused a progressive decline in water levels in wells tapping that zone. The quality of fresh ground water in areas unaffected by intrusion of saline water, generally meets all the recommended limits of the Environmental Protection Agency. The chemical treatment processes utilized by water plants in the county are generally effective in producing finished water that meets EPA preliminary drinking water standards. (Woodard-USGS)

Assessment of DNA damage in a group of professional dancers during a 10-month dancing season.

PubMed

Esteves, Filipa; Teixeira, Eduardo; Amorim, Tânia; Costa, Carla; Pereira, Cristiana; Fraga, Sónia; De Andrade, Vanessa Moraes; Teixeira, João Paulo; Costa, Solange

2017-01-01

Despite the numerous health benefits of physical activity, some studies reported that increased intensity and duration may induce oxidative stress in several cellular components including DNA. The aim of this study was to assess the level of basal DNA damage as well as oxidative DNA damage in a group of professional dancers before and after a 10-month dancing season. A group of individuals from general population was also assessed as a control. The alkaline version of the comet assay was the method selected to measure both basal DNA damage and oxidative stress, since this method quantifies both endpoints. In order to measure oxidative stress, the comet assay was coupled with a lesion-specific endonuclease (formamidopyrimidine glycosylase) to detect oxidized purines. The levels of oxidative DNA damage in dancers were significantly increased after the dancing season. Pre-season levels of oxidative DNA damage were lower in dancers than those obtained from the general population, suggesting an adaptation of antioxidant system in dancers. Results of the present biomonitoring study indicate the need for more effective measures to protect ballet dancers from potentially occupational health risks related to regular intensive physical exercise.

A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.

PubMed

Vannoy, Steven D; Mauer, Barbara; Kern, John; Girn, Kamaljeet; Ingoglia, Charles; Campbell, Jeannie; Galbreath, Laura; Unützer, Jürgen

2011-07-01

Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.

Tests of general relativity using pulsars

NASA Technical Reports Server (NTRS)

Reichley, P. E.

1971-01-01

The arrival times of the pulses from each pulsar are measured by a cesium clock. The observations are all made at a frequency of 2388 MHz (12.5 cm wavelength) on a 26 m dish antenna. The effect of interstellar charged particles is a random one that increases the noise level on the arrival time measurements. The variation in clock rate is shown consisting of two effects: the time dilation effect of special relativity and the red shift effect of general relativity.

Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness.

PubMed

Protheroe, Joanne; Estacio, Emee Vida; Saidy-Khan, Sirandou

2015-03-01

Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. PILs were assessed for readability (Flesch Reading Ease and Flesch-Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as 'systems navigation' (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices. © British Journal of General Practice 2015.

Carboxyhaemoglobin levels and their determinants in older British men.

PubMed

Whincup, Peter; Papacosta, Olia; Lennon, Lucy; Haines, Andrew

2006-07-18

Although there has been concern about the levels of carbon monoxide exposure, particularly among older people, little is known about COHb levels and their determinants in the general population. We examined these issues in a study of older British men. Cross-sectional study of 4252 men aged 60-79 years selected from one socially representative general practice in each of 24 British towns and who attended for examination between 1998 and 2000. Blood samples were measured for COHb and information on social, household and individual factors assessed by questionnaire. Analyses were based on 3603 men measured in or close to (< 10 miles) their place of residence. The COHb distribution was positively skewed. Geometric mean COHb level was 0.46% and the median 0.50%; 9.2% of men had a COHb level of 2.5% or more and 0.1% of subjects had a level of 7.5% or more. Factors which were independently related to mean COHb level included season (highest in autumn and winter), region (highest in Northern England), gas cooking (slight increase) and central heating (slight decrease) and active smoking, the strongest determinant. Mean COHb levels were more than ten times greater in men smoking more than 20 cigarettes a day (3.29%) compared with non-smokers (0.32%); almost all subjects with COHb levels of 2.5% and above were smokers (93%). Pipe and cigar smoking was associated with more modest increases in COHb level. Passive cigarette smoking exposure had no independent association with COHb after adjustment for other factors. Active smoking accounted for 41% of variance in COHb level and all factors together for 47%. An appreciable proportion of men have COHb levels of 2.5% or more at which symptomatic effects may occur, though very high levels are uncommon. The results confirm that smoking (particularly cigarette smoking) is the dominant influence on COHb levels.

Environmental consequences of Pollution and its Impact on earth's surface climate Using Geospatial Technology

NASA Astrophysics Data System (ADS)

Kumar, Amit

2016-07-01

Modern transportation is an indispensable ingredient for development, allowing the pressure group of labor, supplies and goods, and enabling general public to access key resources and services. Climate change is a most important threat to sustainable development in any developing or developed country. Urban air pollution is on the rise, due to rapid economic and inhabitants growth and an increase in motorization. Modern transport is fundamental for improvement, allowing the movement of goods and enabling general public to access key resources and services. Travel today is relatively faster and people across the world are travelling more than ever before. Its stipulate regarding forecast is an indispensable part of transportation development in order to evaluate future needs of an urban area. Over increasing traffic concentration posed continued threat to ambient air quality and responsible for producing agents of physical condition hazards. Geospatial technology provides the smartest approach to resolve these inconvenience as it can cover a large area in a fraction of time. The research work focuses on the recognition of traffic intensities with increasing of SO2, NO2 and noise level considered at particular traffic sites in the Varanasi, Uttar Pradesh, India. SO2, NO2 and Noise levels recorded in the city, are much higher than the permissible level and are likely to causes associated health and psychological illnesses to nearby inhabitant.

Environmental consequences of Pollution and its Impact on climate Using Geospatial Technology

NASA Astrophysics Data System (ADS)

Kumar, Amit; Vandana, Vandana

2016-07-01

Modern transportation is an indispensable ingredient for development, allowing the pressure group of labor, supplies and goods, and enabling general public to access key resources and services. Climate change is a most important threat to sustainable development in any developing or developed country. Urban air pollution is on the rise, due to rapid economic and inhabitants growth and an increase in motorization. Modern transport is fundamental for improvement, allowing the movement of goods and enabling general public to access key resources and services. Travel today is relatively faster and people across the world are travelling more than ever before. Its stipulate regarding forecast is an indispensable part of transportation development in order to evaluate future needs of an urban area. Over increasing traffic concentration posed continued threat to ambient air quality and responsible for producing agents of physical condition hazards. Geospatial technology provides the smartest approach to resolve these inconvenience as it can cover a large area in a fraction of time. The research work focuses on the recognition of traffic intensities with increasing of SO2, NO2 and noise level considered at particular traffic sites in the Varanasi, Uttar Pradesh, India. SO2, NO2 and Noise levels recorded in the city, are much higher than the permissible level and are likely to causes associated health and psychological illnesses to nearby inhabitant. Keywords: Population growth; Traffic; Transportation

Deterioration and modification of the biosphere leading to irreversible climatic change of the global ecosystem

NASA Technical Reports Server (NTRS)

1975-01-01

The level, intensity, nature and impact of man's activities upon weather and climatic changes are explored. It is shown that industrialization leads to increased CO2 levels, atmospheric dust content and land surfaces changes. This in turn causes global climatic interactions which results in a general cooling trend. Global cooperation is advocated to stem environmental degradation and weather pattern interruption by the use of corrective mechanisms.

Psychological Distress among Victimized Women on Probation and Parole: A Latent Class Analysis

PubMed Central

Golder, Seana; Engstrom, Malitta; Hall, Martin T.; Higgins, George; Logan, TK

2015-01-01

Latent class analysis was used to identify subgroups of victimized women (N=406) on probation and parole differentiated by levels of general psychological distress. The nine primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified three classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented. PMID:25915692

State-of-the-art research on electromagnetic information security

NASA Astrophysics Data System (ADS)

Hayashi, Yu-ichi

2016-07-01

As information security is becoming increasingly significant, security at the hardware level is as important as in networks and applications. In recent years, instrumentation has become cheaper and more precise, computation has become faster, and capacities have increased. With these advancements, the threat of advanced attacks that were considerably difficult to carry out previously has increased not only in military and diplomatic fields but also in general-purpose manufactured devices. This paper focuses on the problem of the security limitations concerning electromagnetic waves (electromagnetic information security) that has rendered attack detection particularly difficult at the hardware level. In addition to reviewing the mechanisms of these information leaks and countermeasures, this paper also presents the latest research trends and standards.

A physiologic-based approach to the evaluation of a patient with hyperkalemia.

PubMed

Palmer, Biff F

2010-08-01

Hyperkalemia generally is attributable to cell shifts or abnormal renal potassium excretion. Cell shifts account for transient increases in serum potassium levels, whereas sustained hyperkalemia generally is caused by decreased renal potassium excretion. Impaired renal potassium excretion can be caused by a primary decrease in distal sodium delivery, a primary decrease in mineralocorticoid level or activity, or abnormal cortical collecting duct function. Excessive potassium intake is an infrequent cause of hyperkalemia by itself, but can worsen the severity of hyperkalemia when renal excretion is impaired. Before concluding that a cell shift or renal defect in potassium excretion is present, pseudohyperkalemia should be excluded. Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Predation and nutrients drive population declines in breeding waders.

PubMed

Møller, Anders Pape; Thorup, Ole; Laursen, Karsten

2018-04-20

Allee effects are defined as a decline in per capita fitness at low population density. We hypothesized that predation reduces population size of breeding waders and thereby the efficiency of predator deterrence, while total nitrogen through its effects on primary and secondary productivity increases population size. Therefore, nest predation could have negative consequences for population size because nest failure generally results in breeding dispersal and hence reduced local population density. To test these predictions, we recorded nest predation in five species of waders for 4,745 nests during 1987-2015 at the nature reserve Tipperne, Denmark. Predation rates were generally negatively related to conspecific and heterospecific population density, but positively related to overall population density of the entire wader community. Nest predation and population density were related to ground water level, management (grazing and mowing), and nutrients. High nest predation with a time lag of one year resulted in low overall breeding population density, while high nutrient levels resulted in higher population density. These two factors accounted for 86% of the variance in population size, presumably due to effects of nest predation on emigration, while nutrient levels increased the level of vegetation cover and the abundance of food in the surrounding brackish water. These findings are consistent with the hypothesis that predation may reduce population density through negative density dependence, while total nitrogen at adjacent shallow water may increase population size. Nest predation rates were reduced by high ground water level in March, grazing by cattle and mowing that affected access to and susceptibility of nests to predators. These effects can be managed to benefit breeding waders. © 2018 by the Ecological Society of America.

Mono-2-ethylhexyl phthalate associated with insulin resistance and lower testosterone levels in a young population.

PubMed

Chen, Szu-Ying; Hwang, Jing-Shiang; Sung, Fung-Chang; Lin, Chien-Yu; Hsieh, Chia-Jung; Chen, Pau-Chung; Su, Ta-Chen

2017-06-01

Phthalates are commonly used as plasticizers and are reported to associate with testicular dysfunction or insulin resistance in different studies, but the concurrent relationship between phthalate exposure, testosterone levels, and insulin resistance in the young population is not well understood. We recruited 786 subjects aged 12-30 years from a population-based sample of Taiwanese adolescents and young adults from 2006 to 2008. Generalized additive models were used to evaluate glucose homeostasis and testicular function in relation to seven urinary phthalate metabolites among adolescents (aged 12-20) and young adults (aged 20-30) in Taiwan. We observed a trend toward a decrease in male testosterone and an increase in urinary mono-2-ethylhexyl phthalate (MEHP) levels across four quartiles of homeostasis model assessment of insulin resistance (HOMA-IR). After adjusting for potential covariates, generalized additive models further showed that log-transformed insulin and HOMA-IR were raised by 0.055 [95% confidence interval (CI), 0.027-0.082] and 0.056 (95% CI, 0.027-0.084), respectively, with a one-unit increase in log-transformed MEHP in young adults. In male adults (aged 22-30), the log-testosterone levels were reduced by 0.018 (95% CI, 0.001-0.036), with a one-unit of increase in log-transformed MEHP. Such relationships were not observed in adolescents. In conclusion, this study demonstrated age-related associations of urinary MEHP metabolites with impaired metabolic homeostasis of glucose that were only observed in young adults. In addition, MEHP exposure was concurrently associated with lower testosterone levels in young, male adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clearly written, easily comprehended? The readability of websites providing information on epilepsy.

PubMed

Brigo, Francesco; Otte, Willem M; Igwe, Stanley C; Tezzon, Frediano; Nardone, Raffaele

2015-03-01

There is a general need for high-quality, easily accessible, and comprehensive health-care information on epilepsy to better inform the general population about this highly stigmatized neurological disorder. The aim of this study was to evaluate the health literacy level of eight popular English-written websites that provide information on epilepsy in quantitative terms of readability. Educational epilepsy material on these websites, including 41 Wikipedia articles, were analyzed for their overall level of readability and the corresponding academic grade level needed to comprehend the published texts on the first reading. The Flesch Reading Ease (FRE) was used to assess ease of comprehension while the Gunning Fog Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Automated Readability Index, and Simple Measure of Gobbledygook scales estimated the corresponding academic grade level needed for comprehension. The average readability of websites yielded results indicative of a difficult-to-fairly-difficult readability level (FRE results: 44.0±8.2), with text readability corresponding to an 11th academic grade level (11.3±1.9). The average FRE score of the Wikipedia articles was indicative of a difficult readability level (25.6±9.5), with the other readability scales yielding results corresponding to a 14th grade level (14.3±1.7). Popular websites providing information on epilepsy, including Wikipedia, often demonstrate a low level of readability. This can be ameliorated by increasing access to clear and concise online information on epilepsy and health in general. Short "basic" summaries targeted to patients and nonmedical users should be added to articles published in specialist websites and Wikipedia to ease readability. Copyright © 2014 Elsevier Inc. All rights reserved.

Post-surgical rehabilitative approach to fragility fractures.

PubMed

Gimigliano, F; Iolascon, G; Riccio, I; Frizzi, L; Gimigliano, R

2013-10-01

Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. The most frequent sites of fragility fractures are the hip, the distal radius, the spine, the proximal humerus, and the ankle. In most cases, a surgical approach with subsequent rehabilitative treatment is required. The general aims of rehabilitation are to increase functioning and improve patients' activities, participation level, and quality of life.

Radiation safety.

PubMed

Skinner, Sarah

2013-06-01

Diagnostic radiology procedures, such as computed tomography (CT) and X-ray, are an increasing source of ionising radiation exposure to our community. Exposure to ionising radiation is associated with increased risk of malignancy, proportional to the level of exposure. Every diagnostic test using ionising radiation needs to be justified by clinical need. General practitioners need a working knowledge of radiation safety so they can adequately inform their patients of the risks and benefits of diagnostic imaging procedures.

Reputation management promotes strategic adjustment of service quality in cleaner wrasse.

PubMed

Binning, Sandra A; Rey, Olivia; Wismer, Sharon; Triki, Zegni; Glauser, Gaétan; Soares, Marta C; Bshary, Redouan

2017-08-21

Adjusting one's behaviour in response to eavesdropping bystanders is considered a sophisticated social strategy, yet the underlying mechanisms are not well studied. Cleaner wrasse, Labroides dimidiatus, cooperate by eating ectoparasites off "client" fishes, or cheat (i.e. bite) and eat client mucus. Image scoring by bystander clients generally causes cleaners from socially-complex (i.e. high cleaner and client abundance; high client species richness) habitats to increase levels of cooperation. However, some individuals may periodically provide tactile stimulation to small resident clients, which attract bystanders close that are bitten, a form of tactical deception. Cortisol injection can reproduce this pattern. Here, we tested whether cleaners from socially-complex versus simple habitats respond differently to cortisol injections in terms of their cleaning interactions with clients. We found that only cleaners from the socially-complex habitat respond to cortisol injection with strategies functioning as tactical deception: i.e. increased tactile stimulation to small clients and increased cheating of large clients relative to small ones. At the socially-simple site, where reputation management is less important, cortisol-treated fish increased their overall levels of cheating, especially of small clients. Thus, strategic adjustments to cooperative behaviour and tactical deception are likely context-dependent, forming part of general reputation management abilities in cleaner wrasse.

Multi-Model Assessment of the Factors Driving Stratospheric Ozone Evolution Over the 21st Century

NASA Technical Reports Server (NTRS)

Oman, L. D.; Plummer, D. A.; Waugh, D. W.; Austin, J.; Scinocca, J.; Douglass, A. R.; Salawitch, R. J.; Canty, T.; Akiyoshi, H.; Bekki, S.;

Modeling Caspian Sea water level oscillations under different scenarios of increasing atmospheric carbon dioxide concentrations.

PubMed

Roshan, Gholamreza; Moghbel, Masumeh; Grab, Stefan

2012-12-12

The rapid rise of Caspian Sea water level (about 2.25 meters since 1978) has caused much concern to all five surrounding countries, primarily because flooding has destroyed or damaged buildings and other engineering structures, roads, beaches and farm lands in the coastal zone. Given that climate, and more specifically climate change, is a primary factor influencing oscillations in Caspian Sea water levels, the effect of different climate change scenarios on future Caspian Sea levels was simulated. Variations in environmental parameters such as temperature, precipitation, evaporation, atmospheric carbon dioxide and water level oscillations of the Caspian sea and surrounding regions, are considered for both past (1951-2006) and future (2025-2100) time frames. The output of the UKHADGEM general circulation model and five alternative scenarios including A1CAI, BIASF, BIMES WRE450 and WRE750 were extracted using the MAGICC SCENGEN Model software (version 5.3). The results suggest that the mean temperature of the Caspian Sea region (Bandar-E-Anzali monitoring site) has increased by ca. 0.17°C per decade under the impacts of atmospheric carbon dioxide changes (r=0.21). The Caspian Sea water level has increased by ca. +36cm per decade (r=0.82) between the years 1951-2006. Mean results from all modeled scenarios indicate that the temperature will increase by ca. 3.64°C and precipitation will decrease by ca. 10% (182 mm) over the Caspian Sea, whilst in the Volga river basin, temperatures are projected to increase by ca. 4.78°C and precipitation increase by ca. 12% (58 mm) by the year 2100. Finally, statistical modeling of the Caspian Sea water levels project future water level increases of between 86 cm and 163 cm by the years 2075 and 2100, respectively.

Modeling Caspian Sea water level oscillations under different scenarios of increasing atmospheric carbon dioxide concentrations

PubMed Central

2012-01-01

The rapid rise of Caspian Sea water level (about 2.25 meters since 1978) has caused much concern to all five surrounding countries, primarily because flooding has destroyed or damaged buildings and other engineering structures, roads, beaches and farm lands in the coastal zone. Given that climate, and more specifically climate change, is a primary factor influencing oscillations in Caspian Sea water levels, the effect of different climate change scenarios on future Caspian Sea levels was simulated. Variations in environmental parameters such as temperature, precipitation, evaporation, atmospheric carbon dioxide and water level oscillations of the Caspian sea and surrounding regions, are considered for both past (1951-2006) and future (2025-2100) time frames. The output of the UKHADGEM general circulation model and five alternative scenarios including A1CAI, BIASF, BIMES WRE450 and WRE750 were extracted using the MAGICC SCENGEN Model software (version 5.3). The results suggest that the mean temperature of the Caspian Sea region (Bandar-E-Anzali monitoring site) has increased by ca. 0.17°C per decade under the impacts of atmospheric carbon dioxide changes (r=0.21). The Caspian Sea water level has increased by ca. +36cm per decade (r=0.82) between the years 1951-2006. Mean results from all modeled scenarios indicate that the temperature will increase by ca. 3.64°C and precipitation will decrease by ca. 10% (182 mm) over the Caspian Sea, whilst in the Volga river basin, temperatures are projected to increase by ca. 4.78°C and precipitation increase by ca. 12% (58 mm) by the year 2100. Finally, statistical modeling of the Caspian Sea water levels project future water level increases of between 86 cm and 163 cm by the years 2075 and 2100, respectively. PMID:23369617

Analogical transfer as guided by an abstraction process: the case of learning by doing in text editing.

PubMed

Sander, E; Richard, J F

1997-11-01

The authors proposed that not only are the first attempts to solve a problem made by analogy but also that progress in learning can be guided by referring to more abstract knowledge, which affords new possibilities. Two experiments investigated this view in a situation of learning how to use a text editor. Experiments 1A to 1C identified the knowledge associated with 3 domains hypothesized as sources of transfer at increasing levels of abstraction (typewriting, writing in general, manipulating objects). Experiment 2 tested whether participants first use their knowledge about typewriting, then about writing in general, and then about manipulating objects. The data showed that the order of acquisition of text editor functions appeared to be strongly related to this hierarchy, supporting the idea that part of learning consists of discovering properties of objects by accessing increasingly general domains.

[Robotic general surgery: where do we stand in 2013?].

PubMed

Buchs, Nicolas C; Pugin, François; Ris, Frédéric; Jung, Minoa; Hagen, Monika E; Volonté, Francesco; Azagury, Dan; Morel, Philippe

2013-06-19

While the number of publications concerning robotic surgery is increasing, the level of evidence remains to be improved. The safety of robotic approach has been largely demonstrated, even for complex procedures. Yet, the objective advantages of this technology are still lacking in several fields, notably in comparison to laparoscopy. On the other hand, the development of robotic surgery is on its way, as the enthusiasm of the public and the surgical community can testify. Still, clear clinical indications remain to be determined in the field of general surgery. The study aim is to review the current literature on robotic general surgery and to give the reader an overview in 2013.

Interactive Taste Tests Enhance Student Learning

ERIC Educational Resources Information Center

Soh, Michael; Roth-Johnson, Elizabeth A.; Levis-Fitzgerald, Marc; Rowat, Amy

2015-01-01

If we could effectively engage students in general science curricula and lead them to recognize the everyday relevance of scientific concepts, we would significantly strengthen the understanding of science among our nation's future workforce. This article shows that increased levels of student cognition can be achieved through interactive taste…

Veterinary dentistry: a clinician's viewpoint.

PubMed

Baxter, Colin

2013-06-01

This is a clinician's view of the current state of veterinary dentistry at the level of the general practitioner across the different species. An indication of the work done and the hazards commonly encountered are covered. To increase awareness within the dental profession of the current state of veterinary dentistry.

Comparability of [0-Level] GCE Grades in 1968 and 1973.

ERIC Educational Resources Information Center

Backhouse, John K.

1978-01-01

Willmott's comparison of General Certificate of Education (GCE) scores in 1968 and 1973 is reexamined. The trend toward an increasing percentage of students who pass is confirmed, but estimates of standard errors indicate that subtest differences may be attributed to the sampling plan. (CP)

RANKED SET SAMPLING FOR ECOLOGICAL RESEARCH: ACCOUNTING FOR THE TOTAL COSTS OF SAMPLING

EPA Science Inventory

Researchers aim to design environmental studies that optimize precision and allow for generalization of results, while keeping the costs of associated field and laboratory work at a reasonable level. Ranked set sampling is one method to potentially increase precision and reduce ...

The Full Spectrum of Community Support

ERIC Educational Resources Information Center

Pawlowski, Brett; Meeder, Hans K.

2012-01-01

Career and technical education (CTE) programs generally attract a deeper level of involvement with the business community, given their shared interest in workforce preparedness. There are significant opportunities to increase the depth and scope of business and community engagement, which can lead to more resources, better operations and improved…

Commercialism in Schools. ERIC Digest.

ERIC Educational Resources Information Center

Larson, Kirstin

Businesses are increasingly making inroads into the classroom, particularly in underfunded schools. The dramatic rise in commercial activities in schools has sparked intense public debate, triggering a U.S. General Accounting Office (GAO) report and various regulatory attempts at district, state, and federal levels. This digest offers an overview…

Exploring the Unknown

ERIC Educational Resources Information Center

Pallant, Amy; Pryputniewicz, Sarah; Lee, Hee-Sun

2012-01-01

Scientists, and science in general, move from the unknown to increasing levels of certainty. Teaching students about science means encouraging them to embrace and investigate the unknown, make reliable scientific claims, justify those claims with evidence, and evaluate the quality of the evidence. In all areas of science--and especially in…

High pressure processing and its application to the challenge of virus-contaminated foods

USDA-ARS?s Scientific Manuscript database

High pressure processing (HPP) is an increasingly popular non-thermal food processing technology. Study of HPP’s potential to inactivate foodborne viruses has defined general pressure levels required to inactivate hepatitis A virus, norovirus surrogates, and human norovirus itself within foods such...

International Students and Mental Health

ERIC Educational Resources Information Center

Forbes-Mewett, Helen; Sawyer, Anne-Maree

2016-01-01

Since the early 2000s, reports of increased rates of mental ill health among young people worldwide have received much attention. Several studies indicate a greater incidence of mental health problems among tertiary students, compared with the general population, and higher levels of anxiety, in particular, among international students compared…

Trust increases euthanasia acceptance: a multilevel analysis using the European Values Study.

PubMed

Köneke, Vanessa

2014-12-20

This study tests how various kinds of trust impact attitudes toward euthanasia among the general public. The indication that trust might have an impact on euthanasia attitudes is based on the slippery slope argument, which asserts that allowing euthanasia might lead to abuses and involuntary deaths. Adopting this argument usually leads to less positive attitudes towards euthanasia. Tying in with this, it is assumed here that greater trust diminishes such slippery slope fears, and thereby increases euthanasia acceptance. The effects of various trust indicators on euthanasia acceptance were tested using multilevel analysis, and data from the European Values Study 2008 (N = 49,114, 44 countries). More precisely, the influence of people's general levels of trust in other people, and their confidence in the health care system, were measured--both at the individual and at the country level. Confidence in the state and the press were accounted for as well, since both institutions might monitor and safeguard euthanasia practices. It was shown that the level of trust in a country was strongly positively linked to euthanasia attitudes, both for general trust and for confidence in health care. In addition, within countries, people who perceived their fellow citizens as trustworthy, and who had confidence in the press, were more supportive of euthanasia than their less trusting counterparts. The pattern was, however, not true for confidence in the state and for confidence in the health care system at the individual level. Notably, all confirmative effects held, even when other variables such as religiosity, education, and values regarding autonomy were controlled for. Trust seems to be a noteworthy construct to explain differences in attitudes towards euthanasia, especially when drawing cross-country comparisons. Therefore, it should be added to the existing literature on correlates of euthanasia attitudes.

Interpreting the g loadings of intelligence test composite scores in light of Spearman's law of diminishing returns.

PubMed

Reynolds, Matthew R

2013-03-01

The linear loadings of intelligence test composite scores on a general factor (g) have been investigated recently in factor analytic studies. Spearman's law of diminishing returns (SLODR), however, implies that the g loadings of test scores likely decrease in magnitude as g increases, or they are nonlinear. The purpose of this study was to (a) investigate whether the g loadings of composite scores from the Differential Ability Scales (2nd ed.) (DAS-II, C. D. Elliott, 2007a, Differential Ability Scales (2nd ed.). San Antonio, TX: Pearson) were nonlinear and (b) if they were nonlinear, to compare them with linear g loadings to demonstrate how SLODR alters the interpretation of these loadings. Linear and nonlinear confirmatory factor analysis (CFA) models were used to model Nonverbal Reasoning, Verbal Ability, Visual Spatial Ability, Working Memory, and Processing Speed composite scores in four age groups (5-6, 7-8, 9-13, and 14-17) from the DAS-II norming sample. The nonlinear CFA models provided better fit to the data than did the linear models. In support of SLODR, estimates obtained from the nonlinear CFAs indicated that g loadings decreased as g level increased. The nonlinear portion for the nonverbal reasoning loading, however, was not statistically significant across the age groups. Knowledge of general ability level informs composite score interpretation because g is less likely to produce differences, or is measured less, in those scores at higher g levels. One implication is that it may be more important to examine the pattern of specific abilities at higher general ability levels. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Advanced laparoscopic bariatric surgery Is safe in general surgery training.

PubMed

Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

2017-05-01

Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

Seasonal variations of anti-/apoptotic and antioxidant proteins in the heart and gastrocnemius muscle of the water frog Pelophylax ridibundus.

PubMed

Feidantsis, Konstantinos; Anestis, Andreas; Michaelidis, Basile

2013-10-01

In the present work we investigated the seasonal variations of apoptotic and antioxidant proteins in the heart and gastrocnemius muscle of the amphibian Pelophylax ridibundus. Particularly processes studied included the evaluation of hypoxia through the levels of transcriptional factor Hif-1α, of apoptosis through the determination of Bcl-2 and Bax, ubiquitin conjugates levels and the antioxidant defense through the determination of the activity of enzymes such as superoxide dismutase, catalase and glutathione peroxidase. Due to a general metabolic depression during overwintering, levels of the above mentioned proteins and enzymes are generally retained at low levels of expression and activity in the examined tissues of P. ridibundus. On the other hand recovery from overwintering induces oxidative stress, followed by increased levels of the specific proteins and enzymes. A milder up-regulation of antioxidant enzymes during overwintering probably prepares P. ridibundus for oxidative stress during arousal. The seasonal activation of these mechanisms seems to protect this species from these unfavourable conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

Patterns and drivers of daily bed-level dynamics on two tidal flats with contrasting wave exposure.

PubMed

Hu, Zhan; Yao, Peng; van der Wal, Daphne; Bouma, Tjeerd J

2017-08-02

Short-term bed-level dynamics has been identified as one of the main factors affecting biota establishment or retreat on tidal flats. However, due to a lack of proper instruments and intensive labour involved, the pattern and drivers of daily bed-level dynamics are largely unexplored in a spatiotemporal context. In this study, 12 newly-developed automatic bed-level sensors were deployed for nearly 15 months on two tidal flats with contrasting wave exposure, proving an unique dataset of daily bed-level changes and hydrodynamic forcing. By analysing the data, we show that (1) a general steepening trend exists on both tidal flats, even with contrasting wave exposure and different bed sediment grain size; (2) daily morphodynamics level increases towards the sea; (3) tidal forcing sets the general morphological evolution pattern at both sites; (4) wave forcing induces short-term bed-level fluctuations at the wave-exposed site, but similar effect is not seen at the sheltered site with smaller waves; (5) storms provoke aggravated erosion, but the impact is conditioned by tidal levels. This study provides insights in the pattern and drivers of daily intertidal bed-level dynamics, thereby setting a template for future high-resolution field monitoring programmes and inviting in-depth morphodynamic modelling for improved understanding and predictive capability.

Relationship between estimated glomerular filtration rate, albuminuria, and oxidant status in the Japanese population

PubMed Central

2013-01-01

Background In the general population, reported levels of oxidative stress and antioxidant potential seem to vary. The aim of this study was to investigate the levels of oxidant status markers in relation to estimated glomerular filtration rate (eGFR) and albuminuria in Japanese population. Methods Data were analyzed from 8335 individuals who underwent a general health screening test. For the estimation of albuminuria, urinary albumin-to-creatinine ratio (UAER) was calculated. Oxidant status was determined by assessing derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP). Results After adjusting for age, high blood pressure, depressor agent use, CRP, smoking status, multivariate logistic regression analysis showed that the lowest eGFR quartile was associated negatively with the top d-ROM quartile in men (odds ratio 0.78 [95% CI 0.62-0.98, P = 0.034]) and the highest UAER was associated with the top d-ROM in men (odds ratio 1.68) [95% CI 1.35-2.10, P < 0.001]. In addition, both the first eGFR quartile and the fourth UAER quartile showed significant positive association with low BAP levels in men, but not in women. Conclusions Among men who underwent general health screening, lower eGFR and increased albuminuria was negatively and positively, respectively, associated with higher oxidative stress levels, whereas both conditions were positively associated with lower antioxidant potential levels. PMID:24016221

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

Wong, Melissa; Bolovan-Fritts, Cynthia; Dar, Roy D.

Signal transduction circuits have long been known to differentiate between signals by amplifying inputs to different levels. Here, we describe a novel transcriptional circuitry that dynamically converts greater input levels into faster rates, without increasing the final equilibrium level (i.e. a rate amplifier). We utilize time-lapse microscopy to study human herpesvirus (cytomegalovirus) infection of live cells in real time. Strikingly, our results show that transcriptional activators accelerate viral gene expression in single cells without amplifying the steady-state levels of gene products in these cells. Experiment and modeling show that rate amplification operates by dynamically manipulating the traditional gain-bandwidth feedback relationshipmore » from electrical circuit theory to convert greater input levels into faster rates, and is driven by highly self-cooperative transcriptional feedback encoded by the virus s essential transactivator, IE2. This transcriptional rate-amplifier provides a significant fitness advantage for the virus and for minimal synthetic circuits. In general, rate-amplifiers may provide a mechanism for signal-transduction circuits to respond quickly to external signals without increasing steady-state levels of potentially cytotoxic molecules.« less

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

PubMed Central

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

2015-01-01

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

Communication and general concern criterion prior to activation of the rapid response team: a grounded theory.

PubMed

Martland, Jarrad; Chamberlain, Diane; Hutton, Alison; Smigielski, Michael

2016-11-01

Objective Patients commonly show signs and symptoms of deterioration for hours or days before cardiorespiratory arrest. Rapid response teams (RRT) were created to improve recognition and response to patient deterioration in these situations. Activation criteria include vital signs or 'general concern' by a clinician or family member. The general concern criterion for RRT activation accounts for nearly one-third of all RRT activity, and although it is well established that communication deficits between staff can contribute to poorer outcomes for patients, there is little evidence pertaining to communication and its effects on the general concern RRT activation. Thus, the aim of the present study was to develop a substantive grounded theory related to the communication process between clinicians that preceded the activation of an RRT when general concern criterion was used. Methods Qualitative grounded theory involved collection of three types of data details namely personal notes from participants in focus groups with white board notes from discussions and audio recordings of the focus groups sessions. Focus groups were conducted with participants exploring issues associated with clinician communication and how it related to the activation of an RRT using the general concern criterion. Results The three main phases of coding (i.e. open, axial and selective coding) analysis identified 322 separate open codes. The strongest theme contributed to a theory of ineffective communication and decreased psychological safety, namely that 'In the absence of effective communication there is a subsequent increase in anxiety, fear or concern that can be directly attributed to the activation of an RRT using the 'general concern' criterion'. The RRT filled cultural and process deficiencies in the compliance with an escalation protocol. Issues such as 'not for resuscitation documentation' and 'inability to establish communication with and between medical or nursing personnel' rated highly and contributed to the debate. Conclusions This study highlighted that in the surveillance and management of the deteriorating patient and in the absence of effective communication there is a subsequent increase in anxiety, fear or concern that can be directly attributed to the activation of an RRT for the 'general concern' calling criteria. What is known about the topic? Deficiencies in collaboration and communication between healthcare professionals (HCPs) increase the stress and anxiety of healthcare staff and correspond to poorer outcomes for patients. The RRT can be activated as a 'general concern RRT' without observation of physiological derangements if staff are concerned about a patient's condition, allowing for assistance from a skilled critical care team at the patient's bedside. There are limited data on how poor communication affects the frequency of activation of general concern RRTs. What does this paper add? This study shows that poor communication between health professionals increases staff levels of anxiety and concern. In addition, the RRT system is being used to fill deficiencies in many other hospital processes, including end-of-life discussions. The deficiencies in hospital processes contribute to poor communication and increased levels of concern with this study demonstrating a direct link between a clinician's level of anxiety/concern and the 'general concern' activation category for the RRT system. What are the implications for practitioners? The present study highlights the importance of effective communication strategies between HCPs to improve patient safety and quality of care. The study also highlights the expanding role of the RRT in hospitals, which has implications for hospital policy makers with regard to future funding and resource allocation. Finally, many of the concerns raised in the present study by the focus groups have been addressed by recent measures introduced through the Australian Commission on Safety and Quality in Health Care (e.g. rapid detection and response observation charts and Introduction, Situation, Background, Assessment and Recommendation [ISBAR] style of communication) with these measures supported by the findings of the present study.

Groundwater conditions in Georgia, 2012–14

USGS Publications Warehouse

Peck, Michael F.; Painter, Jaime A.

2016-12-07

The U.S. Geological Survey collects groundwater data and conducts studies to monitor hydrologic conditions, better define groundwater resources, and address problems related to water supply, water use, and water quality. In Georgia, water levels were monitored continuously at 181 wells during calendar year 2012, 185 wells during calendar year 2013, and at 171 wells during calendar year 2014. Because of missing data or short periods of record (less than 3 years) for several of these wells, a total of 164 wells are discussed in this report. These wells include 17 in the surficial aquifer system, 18 in the Brunswick aquifer system and equivalent sediments, 68 in the Upper Floridan aquifer, 15 in the Lower Floridan aquifer and underlying units, 10 in the Claiborne aquifer, 1 in the Gordon aquifer, 11 in the Clayton aquifer, 16 in the Cretaceous aquifer system, 2 in Paleozoic-rock aquifers, and 6 in crystalline-rock aquifers. Data from the well network indicate that water levels generally rose during the 2012 through 2014 calendar-year period, with water levels rising in 151 wells, declining in 12, and remained about the same in 1. Water levels declined over the long-term period of record at 94 wells, increased at 60 wells, and remained relatively constant at 10 wells.In addition to continuous water-level data, periodic water-level measurements were collected and used to construct potentiometric-surface maps for the Upper Floridan aquifer in the following areas in Georgia: the Brunswick-Glynn County area during August 2012 and October 2014 and in the Albany-Dougherty County area during November 2012 and November 2014. Periodic water-level measurements were also collected and used to construct potentiometric surface maps for the Cretaceous aquifer system in the Augusta-Richmond County area during August 2012 and July 2014. In general, water levels in these areas were higher during 2014 than during 2012; however, the configuration of the potetiometric surface in each of the areas showed little change.In the Brunswick area, maps showing chloride concentration of water in the Upper Floridan aquifer (constructed using data collected from 25 wells during August 2012 and from 32 wells during October 2014) indicate that chloride concentrations remained above the U.S. Environmental Protection Agency's secondary drinking-water standard in an approximately 2-square-mile area. During calendar years 2012 through 2014, chloride concentrations generally increased in over 90 percent of the wells sampled with a maximum increase of 410 milligrams per liter in a well located in the north-central part of the Brunswick area.

Trauma care in Scotland: effect of rurality on ambulance travel times and level of destination healthcare facility.

PubMed

Yeap, E E; Morrison, J J; Apodaca, A N; Egan, G; Jansen, J O

2014-06-01

The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for trauma patients in Scotland. We used a retrospective analysis of pre-hospital data routinely collected by the Scottish Ambulance Service from 2009-2010. Incident locations were categorised by rurality, using the Scottish urban/rural classification. The level of destination healthcare facility was coded as either a teaching hospital, large general hospital, general hospital, or other type of facility. A total of 64,377 incidents met the inclusion criteria. The majority of incidents occurred in urban areas, which mostly resulted in admission to teaching hospitals. Incidents from other areas resulted in admission to a lower-level facility. The majority of incidents originating in very remote small towns and very remote rural areas were treated in a general hospital. Median call-out times and travel times increased with the degree of rurality, although with some exceptions. Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.

The Effects of Pathological Gaming on Aggressive Behavior

PubMed Central

Valkenburg, Patti M.; Peter, Jochen

2010-01-01

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this purpose, we conducted a two-wave panel study among 851 Dutch adolescents (49% female) of which 540 played games (30% female). Our analyses indicated that higher levels of pathological gaming predicted an increase in time spent playing games 6 months later. Time spent playing violent games specifically, and not just games per se, increased physical aggression. Furthermore, higher levels of pathological gaming, regardless of violent content, predicted an increase in physical aggression among boys. That this effect only applies to boys does not diminish its importance, because adolescent boys are generally the heaviest players of violent games and most susceptible to pathological involvement. PMID:20549320

The effects of pathological gaming on aggressive behavior.

PubMed

Lemmens, Jeroen S; Valkenburg, Patti M; Peter, Jochen

2011-01-01

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this purpose, we conducted a two-wave panel study among 851 Dutch adolescents (49% female) of which 540 played games (30% female). Our analyses indicated that higher levels of pathological gaming predicted an increase in time spent playing games 6 months later. Time spent playing violent games specifically, and not just games per se, increased physical aggression. Furthermore, higher levels of pathological gaming, regardless of violent content, predicted an increase in physical aggression among boys. That this effect only applies to boys does not diminish its importance, because adolescent boys are generally the heaviest players of violent games and most susceptible to pathological involvement.

Dose-response relationship between urinary polycyclic aromatic hydrocarbons metabolites and urinary 8-hydroxy-2'-deoxyguanosine in a Chinese general population.

PubMed

Sun, Huizhen; Hou, Jian; Zhou, Yun; Yang, Yuqing; Cheng, Juan; Xu, Tian; Xiao, Lili; Chen, Weihong; Yuan, Jing

2017-05-01

Association of exposure to polycyclic aromatic hydrocarbons (PAHs) with increased urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) formation has been reported in occupational population and children. However, studies on the association between them in general population are limited. A total of 1864 eligible subjects from the baseline Wuhan participants of the Wuhan-Zhuhai Cohort Study (n = 3053) were included in this study, after excluding individuals with certain disease and missing data on urinary monohydroxy PAHs (OH-PAHs) and 8-OHdG levels. Urinary monohydroxy PAHs and 8-OHdG levels were measured by gas chromatography-mass spectrometry and high performance liquid chromatography-electrochemical detection, respectively. Association of urinary OH-PAHs with urinary 8-OHdG was analyzed by multiple linear regression analysis. We found a dose-dependent relationship between urinary PAHs metabolites and urinary 8-OHdG (p < 0.05 for all). Furthermore, more evidence for the association of total concentrations of urinary OH-PAHs with 8-OHdG levels were observed in individuals with normal body mass index or central obesity (p < 0.01 for all). There was a dose-dependent relationship between urinary OH-PAHs levels and urinary 8-OHdG levels among a general Chinese population. Exposure to background PAHs may have a greater influence on urinary 8-OHdG levels in individuals with central obesity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Urinary Angiotensinogen Excretion Level Is Associated With Elevated Blood Pressure in the Normotensive General Population.

PubMed

Sato, Emiko; Wang, An Yi; Satoh, Michihiro; Nishikiori, Yoko; Oba-Yabana, Ikuko; Yoshida, Mai; Sato, Hiroshi; Ito, Sadayoshi; Hida, Wataru; Mori, Takefumi

2018-05-07

Inflammation, intrarenal renin-angiotensin system (RAS) activation, oxidative stress, and carbonyl stress have been postulated to play a fundamental role in controlling blood pressure. However, little is known about the association among renal RAS activation, carbonyl stress, and blood pressure elevation. We evaluated the relationship between blood pressure elevation and either renal RAS activity or carbonyl stress in the general population (N = 355) in Japan. To minimize the effect of antihypertensive drug therapy, we divided participants into 3 groups (normotensive, hypertensive-with-non-medication, and hypertensive-with-medication). Intrarenal RAS activity and carbonyl stress were indicated by the urinary angiotensinogen (AGT) and carbonyl compound excretion levels, respectively. The urinary AGT and carbonyl compound excretion levels were significantly associated with blood pressure. Using a stepwise multiple regression analysis, we found that the urinary AGT excretion levels were strongly associated with blood pressure elevation, compared with inflammation, oxidative stress, and carbonyl stress markers, in all groups. Urinary carbonyl compound excretion was significantly associated with blood pressure in only the hypertensive-without-medication group. Furthermore, blood pressure was significantly increased in these participants, and both the urinary AGT and carbonyl compound levels were high. The urinary AGT excretion levels were strongly associated with elevated blood pressure in normotensive people, and inappropriate renal RAS activity and carbonyl stress independently contributed to the development of hypertension. These findings suggest that RAS activation, particularly renal RAS activation exert a fundamental role in the pathogenesis of hypertension in the general population.

Assessing impacts of oil-shale development on the Piceance Basin mule deer herd

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

White, G.C.; Garrott, R.A.

Development of energy resources on big game ranges generally negatively impacts these important wildlife resources. Although habitat disturbance is generally important, this impact is overshadowed by the negative impacts due to an increasing human population in the area. Increased human activities particularly stress animals during winter periods when inadequate nutrition levels may have already severely impacted the population. Increased road traffic and poaching causes additional deaths, which a decline in survival rates expected, or at least changes in the cause of mortality. This paper describes the experimental design to monitor and mitigate the impact of oil shale development in northwesternmore » Colorado on the Piceance Basin mule deer herd. Biotelemetry techniques are used to measure changes through time in movements, habitat utilization, and survival rates between control and treatment areas. 2 figures.« less

Potential effects of sea-level rise on the depth to saturated sediments of the Sagamore and Monomoy flow lenses on Cape Cod, Massachusetts

USGS Publications Warehouse

Walter, Donald A.; McCobb, Timothy D.; Masterson, John P.; Fienen, Michael N.

2016-05-25

In 2014, the U.S. Geological Survey, in cooperation with the Association to Preserve Cape Cod, the Cape Cod Commission, and the Massachusetts Environmental Trust, began an evaluation of the potential effects of sea-level rise on water table altitudes and depths to water on central and western Cape Cod, Massachusetts. Increases in atmospheric and oceanic temperatures arising, in part, from the release of greenhouse gases likely will result in higher sea levels globally. Increasing water table altitudes in shallow, unconfined coastal aquifer systems could adversely affect infrastructure—roads, utilities, basements, and septic systems—particularly in low-lying urbanized areas. The Sagamore and Monomoy flow lenses on Cape Cod are the largest and most populous of the six flow lenses that comprise the region’s aquifer system, the Cape Cod glacial aquifer. The potential effects of sea-level rise on water table altitude and depths to water were evaluated by use of numerical models of the region. The Sagamore and Monomoy flow lenses have a number of large surface water drainages that receive a substantial amount of groundwater discharge, 47 and 29 percent of the total, respectively. The median increase in the simulated water table altitude following a 6-foot sea-level rise across both flow lenses was 2.11 feet, or 35 percent when expressed as a percentage of the total sea-level rise. The response is nearly the same as the sea-level rise (6 feet) in some coastal areas and less than 0.1 foot near some large inland streams. Median water table responses differ substantially between the Sagamore and Monomoy flow lenses—at 29 and 49 percent, respectively—because larger surface water discharge on the Sagamore flow lens results in increased dampening of the water table response than in the Monomoy flow lens. Surface waters dampen water table altitude increases because streams are fixed-altitude boundaries that cause hydraulic gradients and streamflow to increase as sea-level rises, partially fixing the local water table altitude.The region has a generally thick vadose zone with a mean of about 38 feet; areas with depths to water of 5 feet or less, as estimated from light detection and ranging (lidar) data from 2011 and simulated water table altitudes, currently [2011] occur over about 24.9 square miles, or about 8.4 percent of the total land area of the Sagamore and Monomoy flow lenses, generally in low-lying coastal areas and inland near ponds and streams. Excluding potentially submerged areas, an additional 4.5, 9.8, and 15.9 square miles would have shallow depths to water (5 feet or less) for projected sea-level rises of 2, 4, and 6 feet above levels in 2011. The additional areas with shallow depths to water generally occur in the same areas as the areas with current [2011] depths to water of 5 feet or less: low-lying coastal areas and near inland surface water features. Additional areas with shallow depths to water for the largest sea-level rise prediction (6 feet) account for about 5.7 percent of the total land area, excluding areas likely to be inundated by seawater. The numerous surface water drainages will dampen the response of the water table to sea-level rise. This dampening, combined with the region’s thick vadose zone, likely will mitigate the potential for groundwater inundation in most areas. The potential does exist for groundwater inundation in some areas, but the effects of sea-level rise on depths to water and infrastructure likely will not be substantial on a regional level.

Time course of saliva and serum melatonin levels after ingestion of melatonin.

PubMed

Shirakawa, S; Tsuchiya, S; Tsutsumi, Y; Kotorii, T; Uchimura, N; Sakamoto, T; Yamada, S

1998-04-01

Salival and serum melatonin levels after melatonin ingestion were measured by gas chromatography-mass spectrometry. Ingestion of 3 mg melatonin caused a marked increase in serum melatonin (3561+/-1201 pg/mL) within 20 min, followed by a gradual decrease, but the level still remained higher than the basal level at 240 min after the ingestion. The saliva melatonin 60 min after the ingestion showed the highest level (1177+/-403 pg/mL) which was one-third of the plasma level. The saliva melatonin level was highly correlated with the serum level throughout the experimental period (r=0.82, P=0.0001). These data indicate that the measurement of saliva melatonin level may be a suitable indicator for the melatonin secretion into general circulation.

Dynamical generalized Hurst exponent as a tool to monitor unstable periods in financial time series

NASA Astrophysics Data System (ADS)

Morales, Raffaello; Di Matteo, T.; Gramatica, Ruggero; Aste, Tomaso

2012-06-01

We investigate the use of the Hurst exponent, dynamically computed over a weighted moving time-window, to evaluate the level of stability/instability of financial firms. Financial firms bailed-out as a consequence of the 2007-2008 credit crisis show a neat increase with time of the generalized Hurst exponent in the period preceding the unfolding of the crisis. Conversely, firms belonging to other market sectors, which suffered the least throughout the crisis, show opposite behaviors. We find that the multifractality of the bailed-out firms increase at the crisis suggesting that the multi fractal properties of the time series are changing. These findings suggest the possibility of using the scaling behavior as a tool to track the level of stability of a firm. In this paper, we introduce a method to compute the generalized Hurst exponent which assigns larger weights to more recent events with respect to older ones. In this way large fluctuations in the remote past are less likely to influence the recent past. We also investigate the scaling associated with the tails of the log-returns distributions and compare this scaling with the scaling associated with the Hurst exponent, observing that the processes underlying the price dynamics of these firms are truly multi-scaling.

Inhibitory effect of vasopressin receptor antagonist OPC-31260 on experimental brain oedema induced by global cerebral ischaemia.

PubMed

Molnár, A H; Varga, C; Berkó, A; Rojik, I; Párducz, A; László, F; László, F A

2008-03-01

The effects of the non-peptide vasopressin V(2) receptor antagonist 5-dimethylamino-1-[4-(2-methylbenzoylamino)benzoyl]-2,3,4,5-tetrahydro-1H-benzazepine hydrochloride (OPC-31260) on the cerebral oedema induced by general cerebral hypoxia were studied in rats. The general cerebral hypoxia was produced by bilateral common carotid ligation in Sprague-Dawley rats of the CFY strain. By 6 h after the ligation, half of the rats had died, but the survival rate was significantly higher following OPC-31260 administration. Electron microscopic examinations revealed typical ischaemic changes after the carotid ligation. The carotid ligation increased the brain contents of water and Na(+) and enhanced the plasma vasopressin level. The increased brain water and Na(+) accumulation was prevented by OPC-31260 administration, but the plasma vasopressin level was further enhanced by OPC-31260. These results demonstrate the important role of vasopressin in the development of the disturbances in brain water and electrolyte balance in response to general cerebral hypoxia. The carotid ligation-induced cerebral oedema was significantly reduced following oral OPC-31260 administration. The protective mechanism exerted by OPC-31260 stems from its influence on the renal vasopressin V(2) receptors. These observations might suggest an effective approach to the treatment of global hypoxia-induced cerebral oedema in humans.

Prevalence of burnout among Irish general practitioners: a cross-sectional study.

PubMed

O'Dea, B; O'Connor, P; Lydon, S; Murphy, A W

2017-05-01

Burnout constitutes a significant problem among physicians which impacts negatively upon both the doctor and their patients. Previous research has indicated that burnout is prevalent among primary care physicians in other European countries and North America. However, there is a paucity of research assessing burnout among Irish general practitioners and examining predictive factors. To report the findings of a survey of burnout among Irish general practitioners, and assess variables related to burnout in this population. An online, anonymous questionnaire was distributed to general practitioners working in the Republic of Ireland. In total, 683 general practitioners (27.3 % of practising Irish general practitioners) completed the survey. Of these, 52.7 % reported high levels of emotional exhaustion, 31.6 % scored high on depersonalisation and 16.3 % presented with low levels of personal accomplishment. In total, 6.6 % presented with all three symptoms, fulfilling the criteria for burnout. Emotional exhaustion was higher among this sample than that reported in European and UK studies of burnout in general practitioners. Personal accomplishment was, however, higher in this sample than in other studies. Multiple regression analyses revealed that younger age, non-principal status role, and male gender were related to increased risk of burnout symptoms. The symptoms of burnout appear prevalent among Irish general practitioners. This is likely to have a detrimental impact both upon the individual general practitioners and the patients that they serve. Research investigating the factors contributing to burnout in this population, and evaluating interventions to improve general practitioner well-being, is, therefore, essential.

Career satisfaction among general surgeons in Canada: a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.

PubMed

Ahmed, Najma; Conn, Lesley Gotlib; Chiu, Mary; Korabi, Bochra; Qureshi, Adnan; Nathens, Avery B; Kitto, Simon

2012-11-01

To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery. Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice. Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care. Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.

Indirect medical education and disproportionate share adjustments to Medicare inpatient payment rates.

PubMed

Nguyen, Nguyen Xuan; Sheingold, Steven H

2011-11-04

The indirect medical education (IME) and disproportionate share hospital (DSH) adjustments to Medicare's prospective payment rates for inpatient services are generally intended to compensate hospitals for patient care costs related to teaching activities and care of low income populations. These adjustments were originally established based on the statistical relationships between IME and DSH and hospital costs. Due to a variety of policy considerations, the legislated levels of these adjustments may have deviated over time from these "empirically justified levels," or simply, "empirical levels." In this paper, we estimate the empirical levels of IME and DSH using 2006 hospital data and 2009 Medicare final payment rules. Our analyses suggest that the empirical level for IME would be much smaller than under current law-about one-third to one-half. Our analyses also support the DSH adjustment prescribed by the Affordable Care Act of 2010 (ACA)--about one-quarter of the pre-ACA level. For IME, the estimates imply an increase in costs of 1.88% for each 10% increase in teaching intensity. For DSH, the estimates imply that costs would rise by 0.52% for each 10% increase in the low-income patient share for large urban hospitals. Public Domain.

Plasma glycoprotein V levels in the general population: normal distribution, associated parameters and implications for clinical studies.

PubMed

Aleil, Boris; Meyer, Nicolas; Wolff, Valérie; Kientz, Daniel; Wiesel, Marie-Louise; Gachet, Christian; Cazenave, Jean-Pierre; Lanza, François

2006-10-01

Soluble glycoprotein V (sGPV) is a new plasma marker of thrombosis released from the platelet surface by thrombin. sGPV levels are increased in patients with atherothrombotic diseases, but the determinants of sGPV levels are unknown in the general population. Identification of these potential confounding factors is needed for correct design and analysis of clinical studies on cardiovascular diseases. The aim of this study was to determine the normal range of plasma values and the factors controlling sGPV levels in a population of normal individuals. Three hundred blood donors were recruited at the Etablissement Français du Sang-Alsace for the measurement of plasma levels of sGPV, platelet factor 4 (PF4), thrombin-antithrombin complexes (TAT) and D-dimers. The plasma level of sGPV was (median [interquartile range]) 27.5 [23.5-34.4] microg/l and displayed a Gaussian distribution. sGPV had a lower interindividual coefficient of variation (33%) than PF4 (176%), TAT (87%) or D-dimers (82%). sGPV levels were independent of age and sex but sensitive to red cell (r = 0.412; p < 0.0001) and platelet counts (r = 0.267; p = 0.001), total cholesterol (r = -0.313; p < 0.0001), food intake (r = 0.184; p = 0.0014) and smoking (r = -0.154; p = 0.039). Contrary to PF4 and TAT, sGPV did not differ between venous and arterial blood samples of 12 healthy individuals. Red cell and platelet counts, total cholesterol, current smoking and recent food intake are important determinants of sGPV levels and must be taken into account in clinical studies using sGPV as a thrombosis marker. Normal distribution of sGPV levels in the general population supports its use in clinical applications.

Cyclic fluctuations of water level as a basis for determining aquifer transmissibility

USGS Publications Warehouse

Ferris, John G.

1952-01-01

In coastal areas, wells near bodies of tidal water frequently exhibit sinusoidal fluctuations of water level, in response to periodic changes of tidewater stage.  Inland, the regulation of a surface reservoir often produces correlative changes of ground-water stage in wells adjacent either to the reservoir or to its attendant stream.  As the stage of the surface water rises, the head upon the subaqueous outcrop of the aquifer increases and thereby either increases the rate of inflow to the aquifer or reduces the rate of outflow therefrom.  The increase in recharge or reduction in discharge results in a general recovery of water level in the aquifer. On the subsequent falling stage this pattern is reversed.  When the stage of the surface body fluctuates as a simple harmonic motion a train of sinusoidal waves is propagated shoreward through the sub-outcrop of the aquifer.  With increasing distance from the sub-outcrop, the amplitude of the transmitted wave decreases and the time lag of a given maximum or minimum increases.

A hydrologic and archeologic study of climate change in Al Ain, United Arab Emirates

NASA Astrophysics Data System (ADS)

Jorgensen, Donald G.; Yasin al-Tikiriti, Walid

2003-01-01

Aridity trends established for Al Ain, United Arab Emirates, for the past 4500 years correlate with the trends of increased well depths and declining groundwater levels. Depth of wells found at archeologic sites at Hili near Al Ain were correlated to groundwater levels. Trends of declining groundwater levels were related to trends of increasing aridity (climate change). The increasing aridity had a pronounced affect on man's development in Al Ain area as well. For example, nonirrigation farming could not be successfully sustained at the end of the Bronze Age. This thwarted the economic development until the falaj (a water conveyance structure) was introduced in the Iron Age. The aridity trends in Al Ain correspond to contemporaneous aridity trends noted in Mesopotamia and the Dead Sea area, as well as the Middle East, Mediterranean, and northern Africa, in general. Other global climatic changes that are contemporaneous with climate change at Al Ain have been noted. The increased aridity (desertification) trends at Al Ain are contemporaneous with increased atmospheric CO 2 trends as reported by Indermuhle et al. [Nature (398) 121].

Association between serum ferritin and hemoglobin levels and bone health in Korean adolescents

PubMed Central

Jung, Dong-Wook; Park, Joo-Hyun; Kim, Do-Hoon; Choi, Moonyoung; Kim, Shinhye; Kim, Hyonchong; Seul, Da-eun; Park, Soo Gyeong; Jung, Jin-Hyung; Han, Kyungdo; Park, Young-Gyu

2017-01-01

Abstract It is important to identify risk factors for low bone mass at a young age. An influence of iron store on bone health in the general population has been reported but has not been studied in adolescents. This study aimed to investigate the relationship between hemoglobin and serum ferritin levels and bone mineral content (BMC) in South Korean adolescents. This study was based on data collected during the 2009to 2010 Korea National Health and Nutrition Examination Survey. We included 1321 participants aged 10 to 18 years. BMC was measured at the femur and lumbar spine using dual-energy x-ray absorptiometry, and hemoglobin and serum ferritin levels were examined. In boys, hemoglobin and serum ferritin levels were positively associated with BMC of the total femur and lumbar spine after adjusting for confounders, and hemoglobin levels significantly increased as BMC increased at all sites (P for trend = .001 for total femur, .01 for femur neck, and <.001 for lumbar spine). Likewise, serum ferritin levels showed increasing trends according to increasing BMC of the total femur and lumbar spine in boys (P for trend = .04 for total femur; and <.001 for lumbar spine). However, these associations were not observed in girls. This study suggests a positive relationship between serum ferritin and hemoglobin levels and BMC in South Korean adolescent boys. PMID:29390554

Non-Linear Interactions Determine the Impact of Sea-Level Rise on Estuarine Benthic Biodiversity and Ecosystem Processes

PubMed Central

Yamanaka, Tsuyuko; Raffaelli, David; White, Piran C. L.

2013-01-01

Sea-level rise induced by climate change may have significant impacts on the ecosystem functions and ecosystem services provided by intertidal sediment ecosystems. Accelerated sea-level rise is expected to lead to steeper beach slopes, coarser particle sizes and increased wave exposure, with consequent impacts on intertidal ecosystems. We examined the relationships between abundance, biomass, and community metabolism of benthic fauna with beach slope, particle size and exposure, using samples across a range of conditions from three different locations in the UK, to determine the significance of sediment particle size beach slope and wave exposure in affecting benthic fauna and ecosystem function in different ecological contexts. Our results show that abundance, biomass and oxygen consumption of intertidal macrofauna and meiofauna are affected significantly by interactions among sediment particle size, beach slope and wave exposure. For macrofauna on less sloping beaches, the effect of these physical constraints is mediated by the local context, although for meiofauna and for macrofauna on intermediate and steeper beaches, the effects of physical constraints dominate. Steeper beach slopes, coarser particle sizes and increased wave exposure generally result in decreases in abundance, biomass and oxygen consumption, but these relationships are complex and non-linear. Sea-level rise is likely to lead to changes in ecosystem structure with generally negative impacts on ecosystem functions and ecosystem services. However, the impacts of sea-level rise will also be affected by local ecological context, especially for less sloping beaches. PMID:23861863

Non-linear interactions determine the impact of sea-level rise on estuarine benthic biodiversity and ecosystem processes.

PubMed

Yamanaka, Tsuyuko; Raffaelli, David; White, Piran C L

2013-01-01

Sea-level rise induced by climate change may have significant impacts on the ecosystem functions and ecosystem services provided by intertidal sediment ecosystems. Accelerated sea-level rise is expected to lead to steeper beach slopes, coarser particle sizes and increased wave exposure, with consequent impacts on intertidal ecosystems. We examined the relationships between abundance, biomass, and community metabolism of benthic fauna with beach slope, particle size and exposure, using samples across a range of conditions from three different locations in the UK, to determine the significance of sediment particle size beach slope and wave exposure in affecting benthic fauna and ecosystem function in different ecological contexts. Our results show that abundance, biomass and oxygen consumption of intertidal macrofauna and meiofauna are affected significantly by interactions among sediment particle size, beach slope and wave exposure. For macrofauna on less sloping beaches, the effect of these physical constraints is mediated by the local context, although for meiofauna and for macrofauna on intermediate and steeper beaches, the effects of physical constraints dominate. Steeper beach slopes, coarser particle sizes and increased wave exposure generally result in decreases in abundance, biomass and oxygen consumption, but these relationships are complex and non-linear. Sea-level rise is likely to lead to changes in ecosystem structure with generally negative impacts on ecosystem functions and ecosystem services. However, the impacts of sea-level rise will also be affected by local ecological context, especially for less sloping beaches.

Cheques and challenges: business performance in New Zealand general practice.

PubMed

Greatbanks, Richard; Doolan-Noble, Fiona; McKenna, Alex

2017-09-01

INTRODUCTION New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors. AIM To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice. METHODS For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data. RESULTS All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand. DISCUSSION As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of 'super practices' based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.

The Resident-Run Minor Surgery Clinic: A Pilot Study to Safely Increase Operative Autonomy.

PubMed

Wojcik, Brandon M; Fong, Zhi Ven; Patel, Madhukar S; Chang, David C; Petrusa, Emil; Mullen, John T; Phitayakorn, Roy

General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program. Single institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort. Massachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program. Ten third-year general surgery residents. Overall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing increased operative autonomy as the greatest strength. Implementation of a resident-run minor surgery clinic is a safe and effective method to increase trainee operative autonomy. The rotation is well suited for mid-level residents, as it provides an opportunity for realistic self-evaluation and focused learning that may enhance their operative experience during senior level rotations. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Urinary 2,5-hexanedione excretion in cryptogenic polyneuropathy compared to the general Swedish population

PubMed Central

2013-01-01

Background 2,5-hexanedione (2,5-HD) is the main neurotoxic metabolite of methyl-n-butyl ketone (MBK) and n-hexane, and known to cause polyneuropathy. The aim of our study was to compare the urinary levels of 2,5-HD between cases with cryptogenic polyneuropathy and the general Swedish population, and to elucidate the role of certain external factors. Methods Morning urine samples were collected from 114 cases with cryptogenic polyneuropathy (77 men and 37 women) and 227 referents (110 men and 117 women) randomly selected from the population registry. None had any current occupational exposure to n-hexane or MBK. The urine samples were analysed by a gas chromatographic method based on acidic hydrolysis. Results Cases had statistically higher urinary levels of 2,5-HD (0.48 mg/L) than the general population (0.41 mg/L) and men higher excretion than women (0.48 mg/L and 0.38 mg/L, respectively). There was no difference in 2,5-HD levels between current smokers and non-smokers. Occupational exposure to xylene, alcohol consumption and ever exposed to general anaesthesia were associated with lower excretion in men while for occupational exposure to nitrous oxide in women higher excretion was seen. Higher excretion of 2,5 HD was inversely related to increasing age. Conclusions Significantly higher levels of urinary 2,5-HD were seen in men and cryptogenic polyneuropathy cases seemingly unexposed to n-hexane. Hypothetically, this might be due to either differences in metabolic patterns or some concealed exposure. The difference in means between cases and the general population is small and can therefore not allow any firm conclusions of the causality, however. PMID:23898939

Learning about Genetic Inheritance through Technology-Enhanced Instruction

ERIC Educational Resources Information Center

Williams, Michelle; Merritt, Joi; Opperman, Amanda; Porter, Jakob; Erlenbeck, Kyle

2012-01-01

Genetics is an increasingly important topic in today's society, and one that permeates people's lives on many levels. Students, teachers, and the general public alike are constantly exposed to this topic through popular television shows such as "CSI: Crime Scene Investigation," political issues like voting on stem-cell research, and the…

Athletics and Students with Disabilities: What Principals Should Know

ERIC Educational Resources Information Center

Losinski, Mickey; Katsiyannis, Antonis; Yell, Mitchell L.

2014-01-01

Public concern over the general health of children in the United States has risen during recent years due to dramatic decreases in physical activity levels and increases in obesity and other health-related issues. This article examines the participation of students with disabilities in extracurricular activities, particularly athletic activities,…

Examining Willingness to Attack Critical Infrastructure Online and Offline

ERIC Educational Resources Information Center

Holt, Thomas J.; Kilger, Max

2012-01-01

The continuing adoption of technologies by the general public coupled with the expanding reliance of critical infrastructures connected through the Internet has created unique opportunities for attacks by civilians and nation-states alike. Although governments are increasingly focusing on policies to deter nation-state level attacks, it is unclear…

The Impact of Positive Behavior Interventions & Supports (PBIS) on Student Behavior and Academic Achievement

ERIC Educational Resources Information Center

Norton, Linda Clark

2009-01-01

Over the past decade, policymakers have enforced increasingly greater accountability demands for student achievement and zero tolerance policies. Legislators have outlined proficient measures for student achievement which includes students enrolled in general and special education classes and all ethnicities and socioeconomic levels. Schools…

The Return of the Sun. Editorial.

ERIC Educational Resources Information Center

Vogl, Robert; Vogl, Sonia

1994-01-01

Editorializes briefly upon general progress in solar energy with a focus on electricity generated by a range of solar technologies. Suggests a major educational effort is essential to increase public's awareness of benefits and limitations of solar electricity. Briefly describes a multidisciplinary solar energy education kit for grade levels from…

GED Revision Opens Path to Higher Ed.

ERIC Educational Resources Information Center

Gewertz, Catherine

2011-01-01

The General Educational Development program, or GED, is undergoing the biggest revamping in its 69-year history, driven by mounting recognition that young adults' future success depends on getting more than a high-school-level education. Potent forces have converged to stoke the GED's redesign. A labor market that increasingly seeks some…

10 CFR 60.131 - General design criteria for the geologic repository operations area.

Code of Federal Regulations, 2012 CFR

2012-01-01

... operating systems, including alarm systems, important to safety. (g) Inspection, testing, and maintenance... radioactivity areas; and (6) A radiation alarm system to warn of significant increases in radiation levels... system shall be designed with provisions for calibration and for testing its operability. (b) Protection...

10 CFR 60.131 - General design criteria for the geologic repository operations area.

Code of Federal Regulations, 2014 CFR

2014-01-01

... operating systems, including alarm systems, important to safety. (g) Inspection, testing, and maintenance... radioactivity areas; and (6) A radiation alarm system to warn of significant increases in radiation levels... system shall be designed with provisions for calibration and for testing its operability. (b) Protection...

10 CFR 60.131 - General design criteria for the geologic repository operations area.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operating systems, including alarm systems, important to safety. (g) Inspection, testing, and maintenance... radioactivity areas; and (6) A radiation alarm system to warn of significant increases in radiation levels... system shall be designed with provisions for calibration and for testing its operability. (b) Protection...

10 CFR 60.131 - General design criteria for the geologic repository operations area.

Code of Federal Regulations, 2013 CFR

2013-01-01

... operating systems, including alarm systems, important to safety. (g) Inspection, testing, and maintenance... radioactivity areas; and (6) A radiation alarm system to warn of significant increases in radiation levels... system shall be designed with provisions for calibration and for testing its operability. (b) Protection...

2007 Mississippi Curriculum Framework: Secondary Agriscience. (Program CIP: 01.0000 - Agriculture, General)

ERIC Educational Resources Information Center

Cantrell, Steve; Conway, Scott; Jack, Linda; Stuckey, Dan

2007-01-01

Secondary vocational-technical education programs in Mississippi are faced with many challenges resulting from sweeping educational reforms at the national and state levels. Schools and teachers are increasingly being held accountable for providing true learning activities to every student in the classroom. This accountability is measured through…

The Effect of General Objectives Defined by Behavioral Objectives on Achievement in a College Zoology Course.

ERIC Educational Resources Information Center

Rushin, John W.; Baller, William

1981-01-01

Tests the effect of developmental level objectives on student achievement and efficiency in a zoology course. These objectives were found to have no significant effect on achievement, but they did significantly increase student efficiency in learning the content material of the module. (Author)

What Would You Tell Professor Wundt?

ERIC Educational Resources Information Center

Cronan-Hillix, W. A.; And Others

1990-01-01

Reports on a study that measured some of the less accessible changes in student attitudes toward the quality of instruction. Students in three history of psychology classes were given a "semiprojective" pretest and posttest. Concludes that student responses increased in level of abstraction, concentrating more on philosophical and general issues.…

STUDYING ALBUMIN FRACTIONS OF THE BLOOD BY THE ELECTROPHORESIS METHOD OF CHRONIC MOUTH DISEASES,

DTIC Science & Technology

Conclusions: The examined patients showed an increase in globulin content and reduction in albumina . This displacement becomes more pronounced in... albumina fractions improved, histamine level decreased, general condition improved. This allows to continue with the perfection of basic therapy of the named illnesses. (Author)

Teaching home safety and survival skills to latch-key children: a comparison of two manuals and methods.

PubMed Central

Peterson, L

1984-01-01

I evaluated the influence of two training manuals on latch-key children's acquisition of home safety and survival skills. The widely used, discussion-oriented "Prepared for Today" manual was compared with a behaviorally oriented "Safe at Home" manual. Data were scored by response criteria developed by experts and by parents' and experts' ratings of children's spontaneous answers. With both methods of scoring, three behaviorally trained children demonstrated clear and abrupt increases in skill following training in each of seven trained modules, and these increases largely persisted in real world generalization probes and at 5-month follow-up. Smaller and less stable increases in skill were found in the three discussion-trained children across the seven modules; lower skill levels were also seen in real world generalization probes and at follow-up. Neither group of children demonstrated skill increases in home safety areas that were not explicitly trained. Both training methods produced small decreases in children's self-report of general anxiety and anxiety concerning home safety. Results are discussed in terms of their implications for cost-effective training of latch-key children. PMID:6511698

Assessment of vital exhaustion and identification of subjects at increased risk of myocardial infarction in general practice.

PubMed

Schuitemaker, G E; Dinant, G J; van der Pol, G A; Appels, A

2004-01-01

Vital exhaustion, a state characterized by unusual fatigue, loss of energy, increased irritability, and feelings of demoralization, is one of the cardiovascular risk factors. The authors investigated whether vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice. In this prospective cohort study, vital exhaustion was assessed with the Maastricht Interview on Vital Exhaustion. Other cardiovascular risk factors established were age, gender, systolic and diastolic blood pressure, total cholesterol, body mass index, smoking habits, cardiovascular disease, and diabetes mellitus. A Cox regression analysis was used. The subjects were adults (41-66 years) in an average Dutch village population. Outcome measures were fatal and nonfatal myocardial infarction. At the univariate level, vital exhaustion doubled the risk of myocardial infarction. The effect of exhaustion was confounded by gender; women had higher exhaustion scores and a lower incidence of myocardial infarction. With control for gender, age, systolic blood pressure, total cholesterol, smoking habits, self-reported cardiovascular disease, and diabetes mellitus, vital exhaustion almost tripled the risk of myocardial infarction. Assessment of vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice.

The learner's perspective in GP teaching practices with multi-level learners: a qualitative study.

PubMed

Thomson, Jennifer S; Anderson, Katrina; Haesler, Emily; Barnard, Amanda; Glasgow, Nicholas

2014-03-19

Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used.A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners' perspective.Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed "GP consultant teacher"). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers.

The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

PubMed Central

2014-01-01

Background Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. Methods A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. Results 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used. A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners’ perspective. Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed “GP consultant teacher”). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Conclusions Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers. PMID:24645670

Exploration into Uric and Cardiovascular Disease: Uric Acid Right for heArt Health (URRAH) Project, A Study Protocol for a Retrospective Observational Study.

PubMed

Desideri, Giovambattista; Virdis, Agostino; Casiglia, Edoardo; Borghi, Claudio

2018-06-01

The relevance of cardiovascular role played by levels of serum uric acid is dramatically growing, especially as cardiovascular risk factor potentially able to exert either a direct deleterious impact or a synergic effect with other cardiovascular risk factors. At the present time, it still remains undefined the threshold level of serum uric acid able to contribute to the cardiovascular risk. Indeed, the available epidemiological case studies are not homogeneous, and some preliminary data suggest that the so-called "cardiovascular threshold limit" may substantially differ from that identified as a cut-off able to trigger the acute gout attack. In such scenario, there is the necessity to clarify and quantify this threshold value, to insert it in the stratification of risk algorithm scores and, in turn, to adopt proper prevention and correction strategies. The clarification of the relationship between circulating levels of uric acid and cardio-nephro-metabolic disorders in a broad sample representative of general population is critical to identify the threshold value of serum uric acid better discriminating the increased risk associated with uric acid. The Uric acid Right for heArt Health (URRAH) project has been designed to define, as primary objective, the level of uricemia above which the independent risk of cardiovascular disease may increase in a significantly manner in a general Italian population.

Towards Implementation of a Generalized Architecture for High-Level Quantum Programming Language

NASA Astrophysics Data System (ADS)

Ameen, El-Mahdy M.; Ali, Hesham A.; Salem, Mofreh M.; Badawy, Mahmoud

2017-08-01

This paper investigates a novel architecture to the problem of quantum computer programming. A generalized architecture for a high-level quantum programming language has been proposed. Therefore, the programming evolution from the complicated quantum-based programming to the high-level quantum independent programming will be achieved. The proposed architecture receives the high-level source code and, automatically transforms it into the equivalent quantum representation. This architecture involves two layers which are the programmer layer and the compilation layer. These layers have been implemented in the state of the art of three main stages; pre-classification, classification, and post-classification stages respectively. The basic building block of each stage has been divided into subsequent phases. Each phase has been implemented to perform the required transformations from one representation to another. A verification process was exposed using a case study to investigate the ability of the compiler to perform all transformation processes. Experimental results showed that the efficacy of the proposed compiler achieves a correspondence correlation coefficient about R ≈ 1 between outputs and the targets. Also, an obvious achievement has been utilized with respect to the consumed time in the optimization process compared to other techniques. In the online optimization process, the consumed time has increased exponentially against the amount of accuracy needed. However, in the proposed offline optimization process has increased gradually.

BolA inhibits cell elongation and regulates MreB expression levels.

PubMed

Freire, Patrick; Moreira, Ricardo Neves; Arraiano, Cecília Maria

2009-02-06

The morphogene bolA is a general stress response gene in Escherichia coli that induces a round morphology when overexpressed. Results presented in this report show that increased BolA levels can inhibit cell elongation mechanisms. MreB polymerization is crucial for the bacterial cell cytoskeleton, and this protein is essential for the maintenance of a cellular rod shape. In this report, we demonstrate that bolA overexpression affects the architecture of MreB filaments. An increase in BolA leads to a significant reduction in MreB protein levels and mreB transcripts. BolA affects the mreBCD operon in vivo at the level of transcription. Furthermore, our results show that BolA is a new transcriptional repressor of MreB. The alterations in cell morphology induced by bolA seem to be mediated by a complex pathway that integrates PBP5, PBP6, MreB, and probably other regulators of cell morphology/elongation.

Implications of new data on lead toxicity for managing and preventing exposure.

PubMed Central

Silbergeld, E K

1990-01-01

Recent advances in research on low-level lead poisoning point to the need to increase efforts to prevent exposure. Current biomedical consensus accepts that blood lead levels as low as 5 to 15 mcg/dL are risky to fetuses, young children, and adults. Lead at low dose is associated with increased blood pressure in adults, and chronic exposure has been associated in cohort studies with kidney disease and cancer. Data on lead toxicokinetics also points to the hazards of low-level, chronic exposure, since the lead that is accumulated over time in bone can be released at a relatively rapid rate during pregnancy and menopause. Sources that contribute to current lead exposure of the general population include unabated lead-based paint and contaminated soils, as well as lower level but pervasive sources in drinking water, food, and consumer products. PMID:2088754

1-hydroxypyrene as a biomarker of occupational exposure to polycyclic aromatic hydrocarbons (PAH) in boilermakers.

PubMed

Mukherjee, Sutapa; Rodrigues, Ema; Weker, Robert; Palmer, Lyle J; Christiani, David C

2002-12-01

A repeated measures short-term prospective study was performed in boilermakers to determine occupational polycyclic aromatic hydrocarbon (PAH) exposure using the biomarker, 1-hydroxypyrene (1-OHP). Two work sites were studied; an apprentice school (metal fume exposure) and a boiler overhaul (residual oil fly ash [ROFA] and metal fume exposure). Pre- and postshift urine samples (n = 241; 41 male subjects) were analyzed for cotinine and 1-OHP. Descriptive statistics and generalized estimating equations were calculated. At the apprentice school cross-shift 1-OHP levels did not significantly differ. At the overhaul 1-OHP levels increased during the week in smokers and nonsmokers; in nonsmokers the 1-OHP level increased significantly postshift compared to preshift. In conclusion this study suggests that boilermakers exposed to occupational particulates are exposed to PAH. The urinary 1-OHP level may be a useful biomarker of PAH exposure in boilermakers exposed to ROFA, particularly in nonsmokers.

Implications of new data on lead toxicity for managing and preventing exposure

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

Silbergeld, E.K.

1990-11-01

Recent advances in research on low-level lead poisoning point to the need to increase efforts to prevent exposure. Current biomedical consensus accepts that blood lead levels as low as 5 to 15 mcg/dL are risky to fetuses, young children, and adults. Lead at low dose is associated with increased blood pressure in adults, and chronic exposure has been associated in cohort studies with kidney disease and cancer. Data on lead toxicokinetics also points to the hazards of low-level, chronic exposure, since the lead that is accumulated over time in bone can be released at a relatively rapid rate during pregnancymore » and menopause. Sources that contribute to current lead exposure of the general population include unabated lead-based paint and contaminated soils, as well as lower level but pervasive sources in drinking water, food, and consumer products.« less

Noiseonomics: the relationship between ambient noise levels in the sea and global economic trends.

PubMed

Frisk, George V

2012-01-01

In recent years, the topic of noise in the sea and its effects on marine mammals has attracted considerable attention from both the scientific community and the general public. Since marine mammals rely heavily on acoustics as a primary means of communicating, navigating, and foraging in the ocean, any change in their acoustic environment may have an impact on their behavior. Specifically, a growing body of literature suggests that low-frequency, ambient noise levels in the open ocean increased approximately 3.3 dB per decade during the period 1950-2007. Here we show that this increase can be attributed primarily to commercial shipping activity, which in turn, can be linked to global economic growth. As a corollary, we conclude that ambient noise levels can be directly related to global economic conditions. We provide experimental evidence supporting this theory and discuss its implications for predicting future noise levels based on global economic trends.

Developmental kinesiology: three levels of motor control in the assessment and treatment of the motor system.

PubMed

Kobesova, Alena; Kolar, Pavel

2014-01-01

Three levels of sensorimotor control within the central nervous system (CNS) can be distinguished. During the neonatal stage, general movements and primitive reflexes are controlled at the spinal and brain stem levels. Analysis of the newborn's spontaneous general movements and the assessment of primitive reflexes is crucial in the screening and early recognition of a risk for abnormal development. Following the newborn period, the subcortical level of the CNS motor control emerges and matures mainly during the first year of life. This allows for basic trunk stabilization, a prerequisite for any phasic movement and for the locomotor function of the extremities. At the subcortical level, orofacial muscles and afferent information are automatically integrated within postural-locomotor patterns. Finally, the cortical (the highest) level of motor control increasingly becomes activated. Cortical control is important for the individual qualities and characteristics of movement. It also allows for isolated segmental movement and relaxation. A child with impaired cortical motor control may be diagnosed with developmental dyspraxia or developmental coordination disorder. Human ontogenetic models, i.e., developmental motor patterns, can be used in both the diagnosis and treatment of locomotor system dysfunction. Copyright © 2013 Elsevier Ltd. All rights reserved.

Higher weight, lower education: a longitudinal association between adolescents' body mass index and their subsequent educational achievement level?

PubMed

Larsen, Junilla K; Kleinjan, Marloes; Engels, Rutger C M E; Fisher, Jennifer O; Hermans, Roel C J

2014-12-01

The purpose of this study was to examine the association between adolescents' body mass index (BMI) z-scores and their subsequent level of schooling, extending previous longitudinal research by using objectively measured weight and height data. A longitudinal study with 3 study waves (1-year intervals) involving 1248 Dutch adolescents (49% girls; mean age = 13.7 years) at schools providing different educational levels was used to determine adolescents who moved and did not move to a lower educational level in the first year, or in the second year, and to examine whether this movement could be predicted by BMI z-scores (zBMI), after controlling for a large range of potential confounding factors. A total of 1164 Dutch adolescents continued in the same level of education, whereas 84 adolescents moved to a lower educational level (43 moved in the first and 41 in the second year). A higher zBMI significantly increased the risk of a general transition to a lower educational level, and of a transition in the first year, but not in the second year, after controlling for potential demographic, behavioral, and psychological confounds. Findings suggest that a higher zBMI during adolescence immediately lowers educational achievement level during general secondary education. © 2014, American School Health Association.

Liquid level controller

DOEpatents

Mangus, J.D.; Redding, A.H.

1975-07-15

A system for maintaining two distinct sodium levels within the shell of a heat exchanger having a plurality of J-shaped modular tube bundles each enclosed in a separate shell which extends from a common base portion. A lower liquid level is maintained in the base portion and an upper liquid level is maintained in the shell enwrapping the long stem of the J-shaped tube bundles by utilizing standpipes with a notch at the lower end which decreases in open area the distance from the end of the stand pipe increases and a supply of inert gas fed at a constant rate to produce liquid levels, which will remain generally constant as the flow of liquid through the vessel varies. (auth)

[Psycho-emotional state of workers engaged into chlorine and soda production through electrolysis with mercury-pool cathode].

PubMed

Alieva, R Kh; Shiralieva, R K; Khalilova, S A

2012-01-01

Workers engaged into the studied production are exposed to occupational factors complex as vapor, gas and aerosol mixture. Metallic mercury vapors and its compounds exceed MAC over 10 times in this mixture, noise level at the enterprise is 10 dB over the maximal allowable level, general vibration is 8 dB over the MAL, the occupational hazards also include unfavorable microclimate, work hardiness and intensity. Psychoemotional state of the workers demonstrate significantly disordered emotions and will, premorbid personality changes, lower memory and attention level, indisposition and mood changes, increased reactive and personal anxiety, decreased performance level. Informative parameter in occupational examination of workers is memory and attention level evaluation.

Food Security (CSL Issue Paper, Volume 14-09, September 2009)

DTIC Science & Technology

2009-09-01

Security Analyst in the Operations and Gaming Division of CSL. Cadet Jason Delousa is a senior at the United State Military Academy. This paper is...cotton, oil palm, beef, dairy, poultry and fisheries products as strategic commodities at the continental level.”32 Sustainability of these cash...Increased incomes, such as in Asia, generally lead to higher consumption of meat and hence, increased demand for cereal as livestock feed. (Source

Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

PubMed Central

Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

2015-01-01

Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from <1.0% of clinical teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve this. PMID:26009536

A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

PubMed

Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

2017-03-01

To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers. © 2016 John Wiley & Sons Ltd.

Promoting sugar-free medicines: evaluation of a multi-faceted intervention.

PubMed

Weeks, Julie C; Dutt, Amalin; Robinson, Peter G

2003-12-01

To evaluate an intervention to increase the proportion of medicines prescribed as sugar-free formulations by general practitioners. Natural experiment. Interventions were set in Camden and Islington Health Authority with comparator data within that and adjacent health authorities. General medical practices. Two interventions were employed. A prescribing incentive scheme that used the proportion of medicines prescribed as sugar-free formulations as a quality marker for general practitioners and a publicity campaign for health care workers and members of the public. The proportions of amoxycillin mixture and all paracetamol liquid preparations that were prescribed in sugar-free formulations. Sugar-free prescribing in the practices participating in the incentive scheme increased from 27% to 45% whereas non-participating practices showed a decrease from 20% to 14%. The proportion of prescriptions for sugar-free formulations increased by approximately one half across the entire health authority so that after two years Camden and Islington had the highest level of prescribing of sugar-free paracetamol and amoxycillin in London. These data provide compelling evidence of the effectiveness of the prescribing incentive scheme whereas the publicity campaign did not change prescribing behaviour.

[Feasibility of consultation - liaison psychiatry in a large general hospital: quantitative description of services and personnel expenditure].

PubMed

Windhager, Elmar; Thaler, Katharina; Selberis-Vahl, Wilia Vasiliki; Friedl-Wörgetter, Petra; Windhager, Isabella; Zauner, Katharina

2015-01-01

The integration of psychiatric departments in general hospitals lead to an increasing demand of psychiatric consultation, which often overstrains personnel resources of short staffed psychiatric services. To provide consulting service, as it is demanded by guidelines, a multidisciplinary consulting team could be a possible solution. A retrospective descriptive analysis of all consultations made by the psychosocial consultation and liaison service at the general hospital Wels-Grieskirchen in the years 2012 and 2013. There was an increase in referrals overall of 22 % from 2012 to 2013. The largest increase was observed in the group of psychiatrists, who carried out 33.1 % of all consultations. Most consultations, 39.5 %, were done by the group of clinical psychologists, partly substituting medical attendance. Taking together both occupational groups, the expected number of consultations of at least 3 % of all admissions could be achieved. A multidisciplinary consulting team consisting of psychiatrists, psychologists, psychosomatic physicians and social workers staffed with 5.11-6.79 full-time personnel is able to provide psychosocial consultation service at a quantitative level required by international guidelines.

Clinical Utility of Acetylcholine Receptor Antibody Testing in Ocular Myasthenia Gravis.

PubMed

Peeler, Crandall E; De Lott, Lindsey B; Nagia, Lina; Lemos, Joao; Eggenberger, Eric R; Cornblath, Wayne T

2015-10-01

The sensitivity of acetylcholine receptor (AChR) antibody testing is thought to be lower in ocular myasthenia gravis (OMG) compared with generalized disease, although estimates in small-scale studies vary. There is little information in the literature about the implications of AChR antibody levels and progression from OMG to generalized myasthenia gravis. To test the hypothesis that serum AChR antibody testing is more sensitive in OMG than previously reported and to examine the association between AChR antibody levels and progression from OMG to generalized myasthenia gravis. A retrospective, observational cohort study was conducted of 223 patients (mean [SD] age, 59.2 [16.4] years; 139 [62.3%] male) diagnosed with OMG between July 1, 1986, and May 31, 2013, at 2 large, academic medical centers. Baseline characteristics, OMG symptoms, results of AChR antibody testing, and progression time to generalized myasthenia gravis (if this occurred) were recorded for each patient. Multiple logistic regression was used to measure the association between all clinical variables and antibody result. Kaplan-Meier survival analysis was performed to examine time to generalization. Among the 223 participants, AChR antibody testing results were positive in 158 participants (70.9%). In an adjusted model, increased age at diagnosis (odds ratio [OR], 1.03; 95% CI, 1.01-1.04; P = .007) and progression to generalized myasthenia gravis (OR, 2.92; 95% CI, 1.18-7.26; P = .02) were significantly associated with positive antibody test results. Women were less likely to have a positive antibody test result (OR, 0.36; 95% CI, 0.19-0.68; P = .002). Patients who developed symptoms of generalized myasthenia gravis had a significantly higher mean (SD) antibody level than those who did not develop symptoms of generalized myasthenia gravis (12.7 [16.5] nmol/L vs 4.2 [7.9] nmol/L; P = .002). We demonstrate a higher sensitivity of AChR antibody testing than previously reported in the largest cohort of patients with OMG available to date. Older age, male sex, and progression to generalized myasthenia gravis were significantly associated with a positive antibody test result. In addition, to our knowledge, this is the first report of an association between high AChR antibody levels and progression from OMG to generalized disease.

JAK2V617F somatic mutation in the general population: myeloproliferative neoplasm development and progression rate

PubMed Central

Nielsen, Camilla; Bojesen, Stig E.; Nordestgaard, Børge G.; Kofoed, Klaus F.; Birgens, Henrik S.

2014-01-01

Clinical significance of the JAK2V617F mutation in patients with a myeloproliferative neoplasm has been the target of intensive research in recent years. However, there is considerably uncertainty about prognosis in JAK2V617F positive individuals without overt signs of myeloproliferative disease. In this study, we tested the hypothesis that increased JAK2V617F somatic mutation burden is associated with myeloproliferative neoplasm progression rate in the general population. Among 49,488 individuals from the Copenhagen General Population Study, 63 (0.1%) tested positive for the JAK2V617F mutation in the time period 2003–2008. Of these, 48 were available for re-examination in 2012. Level of JAK2V617F mutation burden was associated with myeloproliferative neoplasm progression rate, consistent with a biological continuum of increasing JAK2V617F mutation burden across increasing severity of myeloproliferative neoplasm from no disease (n=8 at re-examination) through essential thrombocythemia (n=20) and polycythemia vera (n=13) to primary myelofibrosis (n=7). Among those diagnosed with a myeloproliferative neoplasm only at re-examination in 2012, in the preceding years JAK2V617F mutation burden increased by 0.55% per year, erythrocyte volume fraction increased by 1.19% per year, and erythrocyte mean corpuscular volume increased by 1.25% per year, while there was no change in platelet count or erythropoietin levels. Furthermore, we established a JAK2V617F mutation burden cut-off point of 2% indicative of disease versus no disease; however, individuals with a mutation burden below 2% may suffer from a latent form of myeloproliferative disease revealed by a slightly larger spleen and/or slightly higher lactic acid dehydrogenase concentration compared to controls. Of all 63 JAK2V617F positive individuals, 48 were eventually diagnosed with a myeloproliferative neoplasm. PMID:24907356

Status of ground-water levels and storage volume in the Equus Beds aquifer near Wichita, Kansas, January 2000-January 2003

USGS Publications Warehouse

Hansen, Cristi V.; Aucott, Walter R.

2004-01-01

The Equus Beds aquifer northwest of Wichita, Kansas, was developed to supply water to Wichita residents and for irrigation in south-central Kansas beginning on September 1, 1940. Ground-water pumping for city and agricultural use from the aquifer caused water levels to decline in a large part of the area. Irrigation pumpage in the area increased substantially during the 1970s and 1980s and accelerated water-level declines. A period of water-level rises associated with greater-than-average precipitation and decreased city pumpage from the study area began in 1993. An important factor in the decreased city pumpage was increased use of Cheney Reservoir as a water-supply source by the city of Wichita; as a result, city pumpage from the Equus Beds aquifer during 1993-2002 went from being greater than one-half to slightly less than one-third of Wichita's water usage. Since 1995, the city also has been investigating the use of artificial recharge in the study area to meet future water-supply needs and to protect the aquifer from the intrusion of saltwater from natural and human-related sources to the west. During January 2003, the direction of ground-water flow in the Equus Beds aquifer in the area was generally from west to east similar to predevelopment of the aquifer. The maximum water-level decline since 1940 for the period January 2000 to January 2003 was 29.54 feet in July 2002 at well 3 in the northern part of the area. Cumulative water-level changes from January 2000 to January 2003 typically were less than 4 feet with rises of less than 4 feet common in the central part of the area; however, declines of more than 4 feet occurred in the northwestern and southern parts of the area. The recovery of water levels and aquifer storage volumes from record low levels in October 1992 generally continued to April 2000. The recovery of about 182,000 acre-feet of storage volume in the area from October 1992 to April 2000 represents about a 64-percent recovery of the storage depletion that occurred from August 1940 to October 1992. About 47 percent of this recovery was lost from April 2000 to October 2002 when storage volume in the area decreased by about 86,000 acre-feet. Major contributors to the decreases in water levels and storage volumes were reduced recharge associated with precipitation that was less than in the preceding 5 years and increased irrigation pumpage. The loss of storage probably would have been larger if the continued decrease in city pumpage, which is closely associated with the water-level rises in the central part of the study area, and increased city use of water from Cheney Reservoir had not occurred. The effect of artificial recharge on water levels and storage volume probably was masked by the generally larger decreases in city pumpage in the area.

Are the frail destined to fail? Frailty index as predictor of surgical morbidity and mortality in the elderly.

PubMed

Farhat, Joseph S; Velanovich, Vic; Falvo, Anthony J; Horst, H Mathilda; Swartz, Andrew; Patton, Joe H; Rubinfeld, Ilan S

2012-06-01

America's aging population has led to an increase in the number of elderly patients necessitating emergency general surgery. Previous studies have demonstrated that increased frailty is a predictor of outcomes in medicine and surgical patients. We hypothesized that use of a modification of the Canadian Study of Health and Aging Frailty Index would be a predictor of morbidity and mortality in patients older than 60 years undergoing emergency general surgery. Data were obtained from the National Surgical Quality Improvement Program Participant Use Files database in compliance with the National Surgical Quality Improvement Program Data Use Agreement. We selected all emergency cases in patients older than 60 years performed by general surgeons from 2005 to 2009. The effect of increasing frailty on multiple outcomes including wound infection, wound occurrence, any infection, any occurrence, and mortality was then evaluated. Total sample size was 35,334 patients. As the modified frailty index increased, associated increases occurred in wound infection, wound occurrence, any infection, any occurrence, and mortality. Logistic regression of multiple variables demonstrated that the frailty index was associated with increased mortality with an odds ratio of 11.70 (p < 0.001). Frailty index is an important predictive variable in emergency general surgery patients older than 60 years. The modified frailty index can be used to evaluate risk of both morbidity and mortality in these patients. Frailty index will be a valuable preoperative risk assessment tool for the acute care surgeon. Prognostic study, level II. Copyright © 2012 by Lippincott Williams & Wilkins

Increased sexual desire with exogenous testosterone administration in men with obstructive sleep apnea: a randomized placebo-controlled study.

PubMed

Melehan, K L; Hoyos, C M; Yee, B J; Wong, K K; Buchanan, P R; Grunstein, R R; Liu, P Y

2016-01-01

Testosterone (T) deficiency, sexual dysfunction, obesity and obstructive sleep apnea (OSA) are common and often coexist. T prescriptions have increased worldwide during the last decade, including to those with undiagnosed or untreated OSA. The effect of T administration on sexual function, neurocognitive performance and quality of life in these men is poorly defined. The aim of this study was to examine the impact of T administration on sexual function, quality of life and neurocognitive performance in obese men with OSA. We also secondarily examined whether baseline T might modify the effects of T treatment by dichotomizing on baseline T levels pre-specified at 8, 11 and 13 nmol/L. This was a randomized placebo-controlled study in which 67 obese men with OSA (mean age 49 ± 1.3 years) were randomized to receive intramuscular injections of either 1000 mg T undecanoate or placebo at baseline, week 6 and week 12. All participants were concurrently enrolled in a weight loss program. General and sleep-related quality of life, neurocognitive performance and subjective sexual function were assessed before and 6, 12 and 18 weeks after therapy. T compared to placebo increased sexual desire (p = 0.004) in all men, irrespective of baseline T levels. There were no differences in erectile function, frequency of sexual attempts, orgasmic ability, general or sleep-related quality of life or neurocognitive function (all p = NS). In those with baseline T levels below 8 nmol/L, T increased vitality (p = 0.004), and reduced reports of feeling down (p = 0.002) and nervousness (p = 0.03). Our findings show that 18 weeks of T therapy increased sexual desire in obese men with OSA independently of baseline T levels whereas improvements in quality of life were evident only in those with T levels below 8 nmol/L. These small improvements would need to be balanced against potentially more serious adverse effects of T therapy on breathing. © 2015 American Society of Andrology and European Academy of Andrology.

Fluorochemicals used in food packaging inhibit male sex hormone synthesis

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

Rosenmai, A.K., E-mail: akjro@food.dtu.dk; Nielsen, F.K.; Pedersen, M.

Polyfluoroalkyl phosphate surfactants (PAPS) are widely used in food contact materials (FCMs) of paper and board and have recently been detected in 57% of investigated materials. Human exposure occurs as PAPS have been measured in blood; however knowledge is lacking on the toxicology of PAPS. The aim of this study was to elucidate the effects of six fluorochemicals on sex hormone synthesis and androgen receptor (AR) activation in vitro. Four PAPS and two metabolites, perfluorooctanoic acid (PFOA) and 8:2 fluorotelomer alcohol (8:2 FTOH) were tested. Hormone profiles, including eight steroid hormones, generally showed that 8:2 diPAPS, 8:2 monoPAPS and 8:2more » FTOH led to decreases in androgens (testosterone, dehydroepiandrosterone, and androstenedione) in the H295R steroidogenesis assay. Decreases were observed for progesterone and 17-OH-progesterone as well. These observations indicated that a step prior to progestagen and androgen synthesis had been affected. Gene expression analysis of StAR, Bzrp, CYP11A, CYP17, CYP21 and CYP19 mRNA showed a decrease in Bzrp mRNA levels for 8:2 monoPAPS and 8:2 FTOH indicating interference with cholesterol transport to the inner mitochondria. Cortisol, estrone and 17β-estradiol levels were in several cases increased with exposure. In accordance with these data CYP19 gene expression increased with 8:2 diPAPS, 8:2 monoPAPS and 8:2 FTOH exposures indicating that this is a contributing factor to the decreased androgen and the increased estrogen levels. Overall, these results demonstrate that fluorochemicals present in food packaging materials and their metabolites can affect steroidogenesis through decreased Bzrp and increased CYP19 gene expression leading to lower androgen and higher estrogen levels. -- Highlights: ► Fluorochemicals found in 57% of paper and board food packaging were tested. ► Collectively six fluorochemicals were tested for antiandrogenic potential in vitro. ► Three out of six tested fluorochemicals inhibited synthesis of male sex hormones. ► Generally, levels of estrogens and cortisol stayed unaffected or increased. ► The effect on steroid synthesis was specific on gene expression of Bzrp and CYP19.« less

The geographic distribution and economic value of climate change-related ozone health impacts in the United States in 2030.

PubMed

Fann, Neal; Nolte, Christopher G; Dolwick, Patrick; Spero, Tanya L; Brown, Amanda Curry; Phillips, Sharon; Anenberg, Susan

2015-05-01

In this United States-focused analysis we use outputs from two general circulation models (GCMs) driven by different greenhouse gas forcing scenarios as inputs to regional climate and chemical transport models to investigate potential changes in near-term U.S. air quality due to climate change. We conduct multiyear simulations to account for interannual variability and characterize the near-term influence of a changing climate on tropospheric ozone-related health impacts near the year 2030, which is a policy-relevant time frame that is subject to fewer uncertainties than other approaches employed in the literature. We adopt a 2030 emissions inventory that accounts for fully implementing anthropogenic emissions controls required by federal, state, and/or local policies, which is projected to strongly influence future ozone levels. We quantify a comprehensive suite of ozone-related mortality and morbidity impacts including emergency department visits, hospital admissions, acute respiratory symptoms, and lost school days, and estimate the economic value of these impacts. Both GCMs project average daily maximum temperature to increase by 1-4°C and 1-5 ppb increases in daily 8-hr maximum ozone at 2030, though each climate scenario produces ozone levels that vary greatly over space and time. We estimate tens to thousands of additional ozone-related premature deaths and illnesses per year for these two scenarios and calculate an economic burden of these health outcomes of hundreds of millions to tens of billions of U.S. dollars (2010$). Near-term changes to the climate have the potential to greatly affect ground-level ozone. Using a 2030 emission inventory with regional climate fields downscaled from two general circulation models, we project mean temperature increases of 1 to 4°C and climate-driven mean daily 8-hr maximum ozone increases of 1-5 ppb, though each climate scenario produces ozone levels that vary significantly over space and time. These increased ozone levels are estimated to result in tens to thousands of ozone-related premature deaths and illnesses per year and an economic burden of hundreds of millions to tens of billions of U.S. dollars (2010$).

Association of telomere length with general cognitive trajectories: a meta-analysis of four prospective cohort studies.

PubMed

Zhan, Yiqiang; Clements, Mark S; Roberts, Rosebud O; Vassilaki, Maria; Druliner, Brooke R; Boardman, Lisa A; Petersen, Ronald C; Reynolds, Chandra A; Pedersen, Nancy L; Hägg, Sara

2018-06-02

To investigate the association of telomere length (TL) with trajectories of general cognitive abilities, we used data on 5955 participants from the Sex Differences in Health and Aging Study and the Swedish Adoption/Twin Study of Aging in Sweden, and the Mayo Clinic Study of Aging, and the Health and Retirement Study in the United States. TL was measured at baseline, while general cognitive ability was assessed repeatedly up to 7 occasions. Latent growth curve models were used to examine the associations. One standard deviation increase of TL was associated with 0.021 unit increase (95% confidence interval [CI]: 0.001, 0.042) of standardized mean general cognitive ability. After controlling for sex, the point estimate remained similar (0.019) with a wider CI (95% CI: -0.002, 0.039). The association was attenuated with adjustment for educational attainment (0.009, 95% CI: -0.009, 0.028). No strong evidence was observed for the association of TL and decline in general cognitive ability. Longer TL was associated with higher general cognitive ability levels in the age-adjusted models but not in the models including all covariates, nor with cognitive decline. Copyright © 2018 Elsevier Inc. All rights reserved.

Irish nursing students' changing levels of assertiveness during their pre-registration programme.

PubMed

Begley, Cecily M; Glacken, Michèle

2004-10-01

Stress and bullying have been found to be common problems in a number of studies of Irish nursing and midwifery. Victims of bullying need high levels of assertiveness to enable them to withstand the stress of victimization. It was deemed important to measure nursing students' level of assertiveness prior to, and near completion of, their pre-registration education programme. Aim. To ascertain nursing students' perceived levels of assertiveness prior to, and nearing the completion of, their three-year pre-registration programme. Ethical approval was given. The students commencing general nurse education programmes in two schools in Southern Ireland agreed to take part (n=72). A questionnaire adapted from a number of assertiveness scales, and tested for validity and reliability in this population, was used to collect data. In general, students' reported assertiveness levels rose as they approached completion of their three-year education programme. The resource constrained health service of the 21st century requires nurses who are assertive to meet the needs of its users. Nursing students' assertiveness skills could be augmented through concentrated efforts from nurse educationalists and clinicians to reduce the communication theory practice gap in nurse education today. To address the multi-dimensional nature of assertiveness, strategies to increase assertiveness should operate at the individual, interface and organisational level. The students in this study reported an increase in levels of assertiveness as they approached completion of their three-year education programme. To function as effective, safe practitioners registered nurses need to be assertive, therefore education in assertiveness should be an integral part of their preparation. The precise composition and mode of delivery of this education requires exploration and evaluation.

Ultrasound visual feedback treatment and practice variability for residual speech sound errors

PubMed Central

Preston, Jonathan L.; McCabe, Patricia; Rivera-Campos, Ahmed; Whittle, Jessica L.; Landry, Erik; Maas, Edwin

2014-01-01

Purpose The goals were to (1) test the efficacy of a motor-learning based treatment that includes ultrasound visual feedback for individuals with residual speech sound errors, and (2) explore whether the addition of prosodic cueing facilitates speech sound learning. Method A multiple baseline single subject design was used, replicated across 8 participants. For each participant, one sound context was treated with ultrasound plus prosodic cueing for 7 sessions, and another sound context was treated with ultrasound but without prosodic cueing for 7 sessions. Sessions included ultrasound visual feedback as well as non-ultrasound treatment. Word-level probes assessing untreated words were used to evaluate retention and generalization. Results For most participants, increases in accuracy of target sound contexts at the word level were observed with the treatment program regardless of whether prosodic cueing was included. Generalization between onset singletons and clusters was observed, as well as generalization to sentence-level accuracy. There was evidence of retention during post-treatment probes, including at a two-month follow-up. Conclusions A motor-based treatment program that includes ultrasound visual feedback can facilitate learning of speech sounds in individuals with residual speech sound errors. PMID:25087938

Herbicide cycling has diverse effects on evolution of resistance in Chlamydomonas reinhardtii

PubMed Central

Lagator, Mato; Vogwill, Tom; Colegrave, Nick; Neve, Paul

2013-01-01

Cycling pesticides has been proposed as a means of retarding the evolution of resistance, but its efficacy has rarely been empirically tested. We evolved populations of Chlamydomonas reinhardtii in the presence of three herbicides: atrazine, glyphosate and carbetamide. Populations were exposed to a weekly, biweekly and triweekly cycling between all three pairwise combinations of herbicides and continuously to each of the three herbicides. We explored the impacts of herbicide cycling on the rate of resistance evolution, the level of resistance selected, the cost of resistance and the degree of generality (cross-resistance) observed. Herbicide cycling resulted in a diversity of outcomes: preventing evolution of resistance for some combinations of herbicides, having no impacts for others and increasing rates of resistance evolution in some instances. Weekly cycling of atrazine and carbetamide resulted in selection of a generalist population. This population had a higher level of resistance, and this generalist resistance was associated with a cost. The level of resistance selected did not vary amongst other regimes. Costs of resistance were generally highest when cycling was more frequent. Our data suggest that the effects of herbicide cycling on the evolution of resistance may be more complex and less favourable than generally assumed. PMID:23467494

Review of 2,4-dichlorophenoxyacetic acid (2,4-D) biomonitoring and epidemiology.

PubMed

Burns, Carol J; Swaen, Gerard M H

2012-10-01

A qualitative review of the epidemiological literature on the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) and health after 2001 is presented. In order to compare the exposure of the general population, bystanders and occupational groups, their urinary levels were also reviewed. In the general population, 2,4-D exposure is at or near the level of detection (LOD). Among individuals with indirect exposure, i.e. bystanders, the urinary 2,4-D levels were also very low except in individuals with opportunity for direct contact with the herbicide. Occupational exposure, where exposure was highest, was positively correlated with behaviors related to the mixing, loading and applying process and use of personal protection. Information from biomonitoring studies increases our understanding of the validity of the exposure estimates used in epidemiology studies. The 2,4-D epidemiology literature after 2001 is broad and includes studies of cancer, reproductive toxicity, genotoxicity, and neurotoxicity. In general, a few publications have reported statistically significant associations. However, most lack precision and the results are not replicated in other independent studies. In the context of biomonitoring, the epidemiology data give no convincing or consistent evidence for any chronic adverse effect of 2,4-D in humans.

Review of 2,4-dichlorophenoxyacetic acid (2,4-D) biomonitoring and epidemiology

PubMed Central

Burns, Carol J.; Swaen, Gerard M. H.

2012-01-01

A qualitative review of the epidemiological literature on the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) and health after 2001 is presented. In order to compare the exposure of the general population, bystanders and occupational groups, their urinary levels were also reviewed. In the general population, 2,4-D exposure is at or near the level of detection (LOD). Among individuals with indirect exposure, i.e. bystanders, the urinary 2,4-D levels were also very low except in individuals with opportunity for direct contact with the herbicide. Occupational exposure, where exposure was highest, was positively correlated with behaviors related to the mixing, loading and applying process and use of personal protection. Information from biomonitoring studies increases our understanding of the validity of the exposure estimates used in epidemiology studies. The 2,4-D epidemiology literature after 2001 is broad and includes studies of cancer, reproductive toxicity, genotoxicity, and neurotoxicity. In general, a few publications have reported statistically significant associations. However, most lack precision and the results are not replicated in other independent studies. In the context of biomonitoring, the epidemiology data give no convincing or consistent evidence for any chronic adverse effect of 2,4-D in humans. PMID:22876750

Dopamine and temporal attention: An attentional blink study in Parkinson's disease patients on and off medication.

PubMed

Slagter, H A; van Wouwe, N C; Kanoff, K; Grasman, R P P P; Claassen, D O; van den Wildenberg, W P M; Wylie, S A

2016-10-01

The current study aimed to shed more light on the role of dopamine in temporal attention. To this end, we pharmacologically manipulated dopamine levels in a large sample of Parkinson's disease patients (n=63) while they performed an attentional blink (AB) task in which they had to identify two targets (T1 and T2) presented in close temporal proximity among distractors. We specifically examined 1) differences in the magnitude of the AB between unmedicated Parkinson patients, who have depleted levels of striatal dopamine, and healthy controls, and 2) effects of two dopaminergic medications (l-DOPA and dopamine agonists) on the AB in the Parkinson patients at the group level and as a function of individual baseline performance. In line with the notion that relatively low levels of striatal dopamine may impair target detection in general, Parkinson patients OFF medications displayed overall poor target perception compared to healthy controls. Moreover, as predicted, effects of dopaminergic medication on AB performance critically depended on individual baseline AB size, although this effect was only observed for l-DOPA. l-DOPA generally decreased the size of the AB in patients with a large baseline AB (i.e., OFF medications), while l-DOPA generally increased the AB in patients with a small baseline AB. These findings may support a role for dopamine in the AB and temporal attention, more generally and corroborate the notion that there is an optimum dopamine level for cognitive function. They also emphasize the need for more studies that examine the separate effects of DA agonists and l-DOPA on cognitive functioning. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Beneficial Effects of Group-Based Exercises on Fall Risk Profile and Physical Activity Persist One-Year Post-Intervention in Older Women with Low Bone Mass: Follow-up After Withdrawal of Exercise

PubMed Central

Liu-Ambrose, Teresa YL; Khan, Karim M; Eng, Janice J; Gillies, Graham L; Lord, Stephen R; McKay, Heather A

2012-01-01

OBJECTIVE To determine whether exercise-induced reductions in fall risk are maintained in older women one year following the cessation of three types of interventions – resistance training, agility training, and general stretching. DESIGN One-year observational study. PARTICIPANTS 98 women aged 75–85 years with low bone mass. MEASUREMENTS Primary outcome measure was fall risk as measured by the Physiological Profile Assessment tool. Secondary outcome measures were current physical activity level as assessed by the Physical Activity Scale for the Elderly and formal exercise participation as assessed by interview. RESULTS At the end of the follow-up, the fall risk among former participants of all three exercise programs was maintained (i.e., still reduced) from trial completion. Mean fall risk value at the end of follow-up was 43.3% reduced compared with the mean baseline value among former participants of the Resistance Training group, 40.1% reduced in the Agility Training group, and 37.4% reduced in the general Stretching group. Physical activity levels were also maintained from trial completion. Specifically, there was a 3.8% increase in physical activity from baseline for the Resistance Training group, a 29.2% increase for the Agility Training group, and 37.7% increase for the general Stretching group. CONCLUSION After three types of group-based exercise programs, benefits are sustained for at least 12 months without further formal exercise intervention. Thus, these six-month exercise interventions appeared to act as a catalyst for increasing physical activity with resultant reductions in fall risk profile that were maintained for at least 18 months among older women with low bone mass. PMID:16181178

Water-quality conditions at selected landfills in Mecklenburg County, North Carolina, 1986-92

USGS Publications Warehouse

Ferrell, G.M.; Smith, D.G.

1995-01-01

Water-quality conditions at five municipal landfills in Mecklenburg County, North Carolina, were studied during 1986-92. Analytical results of water samples from monitoring wells and streams at and near the landfills were used to evaluate effects of leachate on surface and ground water. Ground-water levels at monitoring wells were used to determine directions of ground-water flow at the landfills. Data from previous studies were used for analysis of temporal trends in selected water-quality properties and chemical constituents. Effects of leachate, such as large biochemical- and chemical-oxygen demands, generally were evident in small streams originating within the landfills, whereas effects of leachate generally were not evident in most of the larger streams. In larger streams, surface-water quality upstream and downstream from most of the landfills was similar. However, the chemical quality of water in Irwin Creek appears to have been affected by the Statesville Road landfill. Concentrations of several constituents indicative of leachate were larger in samples collected from Irwin Creek downstream from the Statesville Road landfill than in samples collected from Irwin Creek upstream from the landfill. The effect of leachate on ground-water quality generally was largest in water from wells adjacent to waste-disposal cells. Concentrations of most constituents considered indicative of leachate generally were smaller with increasing distance from waste-disposal cells. Water samples from offsite wells generally indicated no effect or very small effects of leachate. Action levels designated by the Mecklenburg County Engineering Department and maximum contaminant levels established by the U.S. Environmental Protection Agency were exceeded in some samples from the landfills. Ground-water samples exceeded action levels and maximum contaminant levels more commonly than surface-water samples. Iron and manganese were the constituents that most commonly exceeded action levels in water samples from the landfills. Synthetic organic compounds were detected more commonly and in larger concentrations in ground-water samples than in surface-water samples. Concentrations of synthetic organic compounds detected in water samples from monitoring sites at the landfills generally were much less than maximum contaminant levels. However, concentrations of some chlorinated organic compounds exceeded maximum contaminant levels in samples from several monitoring wells at the Harrisburg Road and York Road landfills. Trend analysis indicated statistically significant temporal changes in concentrations of selected water-quality constituents and properties at some of the monitoring sites. Trends detected for the Holbrooks Road and Statesville Road landfills generally indicated an improvement in water quality and a decrease in effects of leachate at most monitoring sites at these landfills from 1979 to 1992. Water-quality trends detected for monitoring sites at the Harrisburg Road and York Road landfills, the largest landfills in the study, differed in magnitude and direction. Upward trends generally were detected for sites near recently closed waste-disposal cells, whereas downward trends generally were detected for sites near older waste-disposal cells. Temporal trends in water quality generally reflected changes in degradation processes associated with the aging of landfill wastes.

Posttraumatic stress in immigrants from Central America and Mexico.

PubMed

Cervantes, R C; Salgado de Snyder, V N; Padilla, A M

1989-06-01

International migration has been associated with increased levels of psychological disturbance, particularly among refugees who have fled from war or political unrest. This study examined self-reported symptoms of depression, anxiety, somatization, generalized distress, and posttraumatic stress disorder (PTSD) in a community sample of 258 immigrants from Central America and Mexico and 329 native-born Mexican Americans and Anglo Americans. Immigrants were found to have higher levels of generalized distress than native-born Americans. Fifty-two percent of Central American immigrants who migrated as a result of war or political unrest reported symptoms consistent with a diagnosis of PTSD, compared with 49 percent of Central Americans who migrated for other reasons and 25 percent of Mexican immigrants. The authors call for more research to document the psychosocial aspects of migration.

Sibling Caregivers of People With Intellectual and Developmental Disabilities: Sociodemographic Characteristics and Material Hardship Prevalence.

PubMed

Sonik, Rajan A; Parish, Susan L; Rosenthal, Eliana S

2016-10-01

In growing numbers, people with intellectual and developmental disabilities are outliving their parents, or at least their parents' ability to care for them. Consequently, adult siblings without intellectual and developmental disabilities are increasingly taking on primary caregiving responsibilities. However, adult siblings have received little study generally, and sibling caregivers have received even less. We used nationally representative data from the Survey of Income and Program Participation (SIPP) to describe the social characteristics and material hardship levels of sibling caregivers, in comparison to the general working age adult population. This study finds moderate material hardship to be pervasive among sibling caregivers, though extreme levels of hardship are possibly being abated somewhat through public benefit programs. Implications for greater service needs are discussed.

Regulating anxiety with extrasynaptic inhibition

PubMed Central

Botta, Paolo; Demmou, Lynda; Kasugai, Yu; Markovic, Milica; Xu, Chun; Fadok, Jonathan P.; Lu, Tingjia; Poe, Michael M.; Xu, Li; Cook, James M.; Rudolph, Uwe; Sah, Pankaj; Ferraguti, Francesco; Lüthi, Andreas

2015-01-01

Aversive experiences can lead to complex behavioral adaptations including increased levels of anxiety and fear generalization. The neuronal mechanisms underlying such maladaptive behavioral changes, however, are poorly understood. Here, using a combination of behavioral, physiological and optogenetic approaches in mouse, we identify a specific subpopulation of central amygdala neurons expressing protein kinase C δ (PKCδ) as key elements of the neuronal circuitry controlling anxiety. Moreover, we show that aversive experiences induce anxiety and fear generalization by regulating the activity of PKCδ+ neurons via extrasynaptic inhibition mediated by α5 subunit-containing GABAA receptors. Our findings reveal that the neuronal circuits that mediate fear and anxiety overlap at the level of defined subpopulations of central amygdala neurons and demonstrate that persistent changes in the excitability of a single cell type can orchestrate complex behavioral changes. PMID:26322928

Occupational wellbeing--management of injured workers with psychosocial barriers.

PubMed

Cotton, Peter

2006-12-01

Although most injured workers return to work with minimal intervention, approximately 20% show levels of distress and disability beyond that expected for the injury. The level of morale in a workplace seems to play a major role in this. Workers who experience positive emotions leading to increased morale are more likely to be resilient following injury. It is important for general practitioners to recognise the nonclinical factors that exert a significant influence over employee wellbeing and return to work outcomes. Some management strategies are presented. General practitioners who work collaboratively with all major stakeholders, who identify and manage psychosocial barriers early, who take an active role in promoting positive expectations, and who focus on the immediate problem rather than its industrial associations will achieve better outcomes for their injured patients.

Towards generalizing co-evolutionary dynamics of socio-hydrology: Theoretical frameworks of cultural evolution and robustness-fragility tradeoff

NASA Astrophysics Data System (ADS)

Oh, W. S.; Yu, D. J.; Davis, T.; Hillis, V.; Waring, T. M.

2017-12-01

One ongoing challenge to socio-hydrology is the problem of generalization: to what extent do common human-water co-evolutions exist across distinct cases and what are underlying mechanisms of these co-evolutions. This problem stems in part from a lack of unifying theories in socio-hydrology, which hinders the explanation and generalization of results between cases in different regions. Theories help an analyst to make assumptions that are necessary to diagnose a specific phenomenon, to explain the general mechanisms of causation, and, thus, to predict future outcomes. To help address the issue, this study introduces two theories that are increasingly used in the fields of sustainability science and social-ecological systems research: robustness-fragility tradeoff (RFTO) and cultural multi-level selection (CMLS). We apply each of these theories to two distinct cases (water management issues in southwest Bangladesh and the Kissimmee River Basin, Florida) and interpret the phenomena of the levee and adaptation effects. CMLS and RFTO focus on complementary aspects of socio-hydrological phenomena. The theory of RFTO, which is mostly about inherent tradeoffs associated with infrastructure improvements, explains how efforts to increase system robustness can generate hidden endogenous risks. CMLS theory, rooted in the broader theory of cultural evolution, concerns how human cultural dynamics can act as an endogenous driver of system change across multiple levels of social organizations. Using the applied examples, we demonstrate that these two theories can provide an effective way to study social-hydrological systems and to overcome the generalization problem. Our work shows that multiple theories can be synthesized to give a richer understanding of diverse socio-hydrological patterns.

Teachers' generalized use of delay as a stimulus control procedure to increase language use in handicapped children.

PubMed Central

Halle, J W; Baer, D M; Spradlin, J E

1981-01-01

In Experiment 1, classroom teachers were taught to delay their offers of help in naturally occurring situations, and thereby to provide additional opportunities for language use by six moderately retarded language-delayed children. The teachers introduced this delay technique in a multiple-baseline design across the six children. As delays were used, child verbal initiations increased. Follow-up assessment showed that teachers were maintaining greater than baseline levels of the delay technique after 10 weeks. Experiment 2 replicated the findings of Experiment 1, and included a more thorough maintenance assessment, while focusing on teachers' generalization of the delay technique. Teachers were found to generalize their use of delay to 56% of their monitored untaught opportunities. The two experiments show that (a) the delay technique is quick to teach and simple to implement, (b) delays do provide opportunities for children to initiate, (c) teachers can generalize their use of delay to novel self-selected situations, and (d) teachers can maintain their use of delays over time. PMID:6460019

Physical Activity- and Alcohol-dependent Association Between Air Pollution Exposure and Elevated Liver Enzyme Levels: An Elderly Panel Study.

PubMed

Kim, Kyoung-Nam; Lee, Hyemi; Kim, Jin Hee; Jung, Kweon; Lim, Youn-Hee; Hong, Yun-Chul

2015-05-01

The deleterious effects of air pollution on various health outcomes have been demonstrated. However, few studies have examined the effects of air pollution on liver enzyme levels. Blood samples were drawn up to three times between 2008 and 2010 from 545 elderly individuals who regularly visited a community welfare center in Seoul, Korea. Data regarding ambient air pollutants (particulate matter ≤2.5 μm [PM2.5], nitrogen dioxide [NO2], ozone [O3], carbon monoxide, and sulfur dioxide) from monitoring stations were used to estimate air pollution exposure. The effects of the air pollutants on the concentrations of three liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and γ-glutamyltranspeptidase [γ-GTP)]) were evaluated using generalized additive and linear mixed models. Interquartile range increases in the concentrations of the pollutants showed significant associations of PM2.5 with AST (3.0% increase, p=0.0052), ALT (3.2% increase, p=0.0313), and γ-GTP (5.0% increase, p=0.0051) levels; NO2 with AST (3.5% increase, p=0.0060) and ALT (3.8% increase, p=0.0179) levels; and O3 with γ-GTP (5.3% increase, p=0.0324) levels. Significant modification of these effects by exercise and alcohol consumption was found (p for interaction <0.05). The effects of air pollutants were greater in non-exercisers and heavy drinkers. Short-term exposure to air pollutants such as PM2.5, NO2, and O3 is associated with increased liver enzyme levels in the elderly. These adverse effects can be reduced by exercising regularly and abstinence from alcohol.

An experimental test of noise-dependent voice amplitude regulation in Cope's grey treefrog (Hyla chrysoscelis).

PubMed

Love, Elliot K; Bee, Mark A

2010-09-01

One strategy for coping with the constraints on acoustic signal reception posed by ambient noise is to signal louder as noise levels increase. Termed the 'Lombard effect', this reflexive behaviour is widespread among birds and mammals and occurs with a diversity of signal types, leading to the hypothesis that voice amplitude regulation represents a general vertebrate mechanism for coping with environmental noise. Support for this evolutionary hypothesis, however, remains limited due to a lack of studies in taxa other than birds and mammals. Here, we report the results of an experimental test of the hypothesis that male grey treefrogs increase the amplitude of their advertisement calls in response to increasing levels of chorus-shaped noise. We recorded spontaneously produced calls in quiet and in the presence of noise broadcast at sound pressure levels ranging between 40 dB and 70 dB. While increasing noise levels induced predictable changes in call duration and rate, males did not regulate call amplitude. These results do not support the hypothesis that voice amplitude regulation is a generic vertebrate mechanism for coping with noise. We discuss the possibility that intense sexual selection and high levels of competition for mates in choruses place some frogs under strong selection to call consistently as loudly as possible.

Environmental mercury in China: a review.

PubMed

Lin, Yan; Vogt, Rolf; Larssen, Thorjorn

2012-11-01

Mercury is a global pollutant that can be transported over long distances and can bioaccumulate. Currently, China is the country that contributes most to atmospheric Hg emissions and has the greatest intentional (industrial) use of Hg. Mercury in the Chinese environment is generally elevated, particularly in air and water bodies. Remote areas in China also show elevated Hg levels in air and water bodies compared to other rural regions in the world. Large river estuaries are often heavily affected by upstream industrial sources. Mercury is also elevated in sediments, a direct result of contamination in river systems. Regardless of the few heavily polluted sites, the urban environment in Chinese cities is comparable to that of other megacities in terms of Hg pollution, considering the size and rapid development of Chinese cities. Studies on Hg in fish showed generally low levels of contamination resulting from low bioaccumulation of Hg in the mostly short food chains. Mercury in rice has recently received increased research interest; elevated concentrations have been reported from rice grown in contaminated areas and may pose a threat to people dependent on such locally grown food. For the general population, Hg exposure from rice is, however, small. In addition, Hg hair concentration in the Chinese population showed generally low levels of exposure to Hg, except for people with special occupational exposure. Copyright © 2012 SETAC.

Physicochemical Properties of Flaxseed Fortified Extruded Bean Snack.

PubMed

Vadukapuram, Naveen; Hall, Clifford; Tulbek, Mehmet; Niehaus, Mary

2014-01-01

Milled flaxseed was incorporated (0-20%) into a combination of bean-corn flours and extruded in a twin screw extruder using corn curl method. Physicochemical parameters such as water activity, color, expansion ratio, bulk density, lipid content, and peroxide values of extruded snack were analyzed. Scanning electron micrographs were taken. Peroxide values and propanal contents were measured over four months of storage. Rancidity scores of extruded snack were measured using a trained panel. As expected, omega-3 fatty acids and bulk density increased with increasing flaxseed fortification levels. Extrudates with more flaxseed had decreased lightness values and expansion ratios. However, only the 15 and 20% flaxseed containing extrudates had expansion ratios that were significantly (P ≤ 0.05) different from the control. In general, no significant difference (P > 0.05) in water activity values was observed in the flaxseed fortified extrudates, except in the navy-corn based extrudates. Peroxide values increased with increased flaxseed levels and over a storage period. However, propanal values did not change significantly in the 5-10% flaxseed fortified extrudates but increased in extrudates with higher levels of flaxseed. Rancidity scores were correlated with peroxide values and did not increase significantly during storage under nitrogen flushed conditions.

Physicochemical Properties of Flaxseed Fortified Extruded Bean Snack

PubMed Central

Vadukapuram, Naveen; Hall, Clifford

2014-01-01

Milled flaxseed was incorporated (0–20%) into a combination of bean-corn flours and extruded in a twin screw extruder using corn curl method. Physicochemical parameters such as water activity, color, expansion ratio, bulk density, lipid content, and peroxide values of extruded snack were analyzed. Scanning electron micrographs were taken. Peroxide values and propanal contents were measured over four months of storage. Rancidity scores of extruded snack were measured using a trained panel. As expected, omega-3 fatty acids and bulk density increased with increasing flaxseed fortification levels. Extrudates with more flaxseed had decreased lightness values and expansion ratios. However, only the 15 and 20% flaxseed containing extrudates had expansion ratios that were significantly (P ≤ 0.05) different from the control. In general, no significant difference (P > 0.05) in water activity values was observed in the flaxseed fortified extrudates, except in the navy-corn based extrudates. Peroxide values increased with increased flaxseed levels and over a storage period. However, propanal values did not change significantly in the 5–10% flaxseed fortified extrudates but increased in extrudates with higher levels of flaxseed. Rancidity scores were correlated with peroxide values and did not increase significantly during storage under nitrogen flushed conditions. PMID:26904633

Myopia and Exposure to Organophosphate and Pyrethroid Pesticides in the General United States Population.

PubMed

Migneron-Foisy, Vincent; Bouchard, Maryse F; Freeman, Ellen E; Saint-Amour, Dave

2017-09-01

Previous research suggests that exposure to pesticides might be associated with human myopia, although data were obtained only from highly exposed individuals. The present study aimed to assess whether exposure to organophosphates and pyrethroids in the United States general population was associated with the prevalence of myopia. Data were obtained from the National Health and Nutrition Examination Survey (NHANES, years 1999-2008). One-spot urine samples were used to estimate the concentration of several pesticide metabolites. Exposure data and equivalent spherical refraction errors were available for 5147 and 2911 individuals for organophosphates and pyrethroids, respectively. Multiple logistic regression models were used to assess the relation between log10-transformed urinary levels of pesticide metabolites and the risk of moderate (≤-1 and >-5 diopters [D]) and high myopia (≤-5 D) in adolescents (12- to 19-years old) and young adults (20- to 40-years old). Models were adjusted for sex, age, ethnicity, diabetes, creatinine, cadmium and lead concentrations, and income in both age groups, but also for education level and cigarette and alcohol consumption in the adult group. No association between organophosphates or pyrethroid metabolites and myopia was observed. However, after adjusting for education level and cigarette and alcohol consumption, a statistically significant decreased risk of high myopia in those with a 10-fold increase of dialkyl phosphate metabolites was found in adults but only in men (P < 0.05). Our results suggest that exposure to organophosphates or pyrethroids do not increase the risk of myopia in the United States general population.

Reviews of the environmental effects of pollutants: IV. Cadmium

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

Hammons, A.S.; Huff, J.E.; Braunstein, H.M.

This report is a comprehensive, multidisciplinary review of the health and environmental effects of cadmium and specific cadmium derivatives. More than 500 references are cited. The cadmium body burden in animals and humans results mainly from the diet. In the United States, the normal intake of cadmium for adult humans is estimated at about 50 ..mu..g per day. Tobacco smoke is a significant additional source of cadmium exposure. The kidneys and liver together contain about 50% of the total cadmium body burden. Acute cadmium poisoning is primarily an occupational problem, generally from inhalation of cadmium fumes or dusts. In themore » general population, incidents of acute poisoning by inhaled or ingested cadmium or its compounds are relatively rare. The kidney is the primary target organ for toxicity from prolonged low-level exposure to cadmium. No causal relationship has been established between cadmium exposure and human cancer, although a possible link between cadmium and prostate cancer has been indicated. Cadmium has been shown to be teratogenic in rats, hamsters, and mice, but no such effects have been proven in humans. Cadmium has been reported to increase the frequency of chromosomal aberrations in cultured Chinese hamster ovary cells and in human peripheral leukocytes. The major concern about environmental cadmium is the potential effects on the general population. There is no substantial evidence of hazard from current levels of cadmium in air, water, or food. However, because cadmium is a cumulative poison and because present intake provides a relatively small safety margin, there are adequate reasons for concern over possible future increases in background levels.« less

Same-level fall injuries in US workplaces by age group, gender, and industry.

PubMed

Scott, Kenneth A; Fisher, Gwenith G; Barón, Anna E; Tompa, Emile; Stallones, Lorann; DiGuiseppi, Carolyn

2018-02-01

As the workforce ages, occupational injuries from falls on the same level will increase. Some industries may be more affected than others. We conducted a cross-sectional study using data from the Bureau of Labor Statistics to estimate same-level fall injury incidence rates by age group, gender, and industry for four sectors: 1) healthcare and social assistance; 2) manufacturing; 3) retail; and 4) transportation and warehousing. We calculated rate ratios and rate differences by age group and gender. Same-level fall injury incidence rates increase with age in all four sectors. However, patterns of rate ratios and rate differences vary by age group, gender, and industry. Younger workers, men, and manufacturing workers generally have lower rates. Variation in incidence rates suggests there are unrealized opportunities to prevent same-level fall injuries. Interventions should be evaluated for their effectiveness at reducing injuries, avoiding gender- or age-discrimination and improving work ability. © 2017 Wiley Periodicals, Inc.

Intelligence Failure in Korea: Major General Charles A. Willoughby’s Role in the United Nations Command’s Defeat in November 1950

DTIC Science & Technology

2009-06-12

the USSR is prepared to accept increased risk of starting a general war with the West.‖ 19 This statement further advances the argument that...decision, if any, is beyond the purview of collective intelligence: it is a decision for war , on the highest level.‖ 93 This report followed with...In the introduction for his chapter on the Sino-Japanese War , Willoughby described a ―Conflict of Empire,‖ in which Japan is perilously exposed to

The healthy diver: A cross-sectional survey to evaluate the health status of recreational scuba diver members of Divers Alert Network (DAN).

PubMed

Ranapurwala, Shabbar I; Kucera, Kristen L; Denoble, Petar J

2018-01-01

Scuba diver fitness is paramount to confront environmental stressors of diving. However, the diving population is aging and the increasing prevalence of diseases may be a concern for diver fitness. The purpose of this study is to assess the demographics, lifestyle factors, disease prevalence, and healthcare access and utilization of Divers Alert Network (DAN) members and compare them with those from the general population. DAN membership health survey (DMHS) was administered online in 2011 to DAN members in the United States (US). Health status of DMHS respondents was compared with the general US population data from the Center for Disease Control and Prevention's Behavioral Risk Factor Surveillance System using two-sided student's t-tests and Mantel-Haenszel chi-square tests. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with healthcare utilization among the DMHS participants. Compared to the general US population, the DMHS population had lower prevalence of asthma, heart attack, angina, stroke, diabetes, hypertension, hypercholesterolemia, and disabilities (p<0.01); more heavy alcohol drinkers, and fewer smokers (p<0.01); and greater access and utilization (routine checkup) of healthcare (p<0.01). Healthcare utilization in males was lower than among females. Increasing age and increase in the number of chronic illnesses were associated with increased healthcare utilization. DAN members are healthier than the general US population. DAN members also have better access to healthcare and utilize healthcare for preventive purposes more often than the general population. DAN members appear to have a better fitness level than their non-diving peers.

Low-serum GTA-446 anti-inflammatory fatty acid levels as a new risk factor for colon cancer

PubMed Central

Ritchie, Shawn A; Tonita, Jon; Alvi, Riaz; Lehotay, Denis; Elshoni, Hoda; Myat, Su-; McHattie, James; Goodenowe, Dayan B

2013-01-01

Gastrointestinal tract acid-446 (GTA-446) is a long-chain polyunsaturated fatty acid present in the serum. A reduction of GTA-446 levels in colorectal cancer (CRC) patients has been reported previously. Our study compared GTA-446 levels in subjects diagnosed with CRC at the time of colonoscopy to the general population. Serum samples and pathology data were collected from 4,923 representative subjects undergoing colonoscopy and from 964 subjects from the general population. Serum GTA-446 levels were determined using a triple-quadrupole tandem mass spectrometry method. A low-serum GTA-446 level was based on the bottom tenth percentile of subjects with low risk based on age (40–49 years old) in the general population. Eighty-six percent of newly diagnosed CRC subjects (87% for stages 0–II and 85% for stages III–IV) showed low-serum GTA-446 levels. A significant increase in the CRC incidence rate with age was observed in subjects with low GTA-446 levels (p = 0.019), but not in subjects with normal levels (p = 0.86). The relative risk of CRC given a low GTA-446 level was the highest for subjects under age 50 (10.1, 95% confidence interval [C.I.] = 6.4–16.4 in the reference population, and 7.7, 95% C.I. = 4.4–14.1 in the colonoscopy population, both p < 0.0001), and declined with age thereafter. The CRC incidence rate in subjects undergoing colonoscopy with low GTA-446 levels was over six times higher than for subjects with normal GTA-446 levels and twice that of subjects with gastrointestinal symptoms. The results show that a low-serum GTA-446 level is a significant risk factor for CRC, and a sensitive predictor of early-stage disease. PMID:22696299

Groundwater conditions in Georgia, 2015–16

USGS Publications Warehouse

Gordon, Debbie W.; Painter, Jaime A.

2018-02-21

The U.S. Geological Survey collects groundwater data and conducts studies to monitor hydrologic conditions, define groundwater resources, and address problems related to water supply, water use, and water quality. In Georgia, water levels were monitored continuously at 157 wells during calendar years 2015 and 2016. Because of missing data or short periods of record (less than 5 years) for several of these wells, data for 147 wells are presented in this report. These wells include 15 in the surficial aquifer system, 18 in the Brunswick aquifer system and equivalent sediments, 59 in the Upper Floridan aquifer, 13 in the Lower Floridan aquifer and underlying units, 9 in the Claiborne aquifer, 1 in the Gordon aquifer, 8 in the Clayton aquifer, 16 in the Cretaceous aquifer system, 2 in Paleozoic-rock aquifers, and 6 in crystalline-rock aquifers. Data from the well network indicate that water levels generally rose during the 10-year period from 2007 through 2016, with water levels rising in 105 wells and declining in 31 wells; insufficient data prevented determination of a 10-year trend in 11 wells. Water levels declined over the long-term period of record at 80 wells, increased at 62 wells, and remained relatively constant at 5 wells.In addition to continuous water-level data, periodic water-level data were collected and used to construct potentiometric-surface maps for the Upper Floridan aquifer in the Brunswick–Glynn County area during October 2015 and October 2016 and in the Albany–Dougherty County area during December 2015 and November and December 2016. Periodic water-level measurements were also collected and used to construct potentiometric-surface maps for the Cretaceous aquifer system in the Augusta–Richmond County area during July 2015 and June 2016. In general, water levels in the Upper Floridan aquifer were higher during 2015 than during 2016 in the Brunswick–Glynn County and Albany–Dougherty County areas due to higher precipitation during 2015. Water levels were lower, however, during 2015 than during 2016 in the Cretaceous aquifer system in the Augusta–Richmond County area.In the Brunswick area, maps showing the chloride concentration of water in the Upper Floridan aquifer constructed using data collected from 33 wells during October 2015 and from 30 wells during October 2016 indicate that chloride concentrations remained above the U.S. Environmental Protection Agency’s secondary drinking-water standard in an approximately 2-square-mile area. During calendar years 2015–16, chloride concentrations generally were similar to those measured during 2012–14; however, some wells did show an increase in chloride concentration, likely due to increases in pumping.

Entry-level dietitians' salaries and benefits: comparisons with those of other selected health care professionals.

PubMed

Loushine, S K; Vaden, A G

1985-10-01

Data on salaries and fringe benefits of entry-level hospital dietitians were provided by surveys sent to personnel administrators in seven Midwestern states. In September 1982, the annual mean salary offered to dietitians awaiting registration was +16,472, whereas that for entry-level registered dietitians (R.D.s) was +17,250. In the smallest hospitals, annual mean salaries for R.D.s were lowest; non-metropolitan salaries were 2.8% lower than the metropolitan salaries. The salaries of entry-level R.D.s increased 54% from 1977 to 1982, while the Consumer Price Index (CPl), North Central, increased 59.7%. Salaries for selected entry-level health professionals ranked in decreasing order as follows: pharmacist, physical therapist, occupational therapist, social worker, staff nurse, dietitian, medical technologist, and respiratory therapist. Nationally, the entry-level dietitian's mean annual salary was +630 higher than that of the Midwestern dietitian. The increase in the national CPl from 1977 to 1982 was 57%, while the increase in the dietitian's salary was 48%. Leave time generally included 12 sick days, 2 weeks' vacation, 6 holidays, and 3 personal days per year. Employers contribute various amounts to life, health, and dental insurance costs. Discounts often were permitted on various hospital services. More than 80% of the hospitals surveyed provided some reimbursement for continuing education, and 74% permitted educational leaves of absence.

Graphics Processing Unit Assisted Thermographic Compositing

NASA Technical Reports Server (NTRS)

Ragasa, Scott; Russell, Samuel S.

2012-01-01

Objective Develop a software application utilizing high performance computing techniques, including general purpose graphics processing units (GPGPUs), for the analysis and visualization of large thermographic data sets. Over the past several years, an increasing effort among scientists and engineers to utilize graphics processing units (GPUs) in a more general purpose fashion is allowing for previously unobtainable levels of computation by individual workstations. As data sets grow, the methods to work them grow at an equal, and often greater, pace. Certain common computations can take advantage of the massively parallel and optimized hardware constructs of the GPU which yield significant increases in performance. These common computations have high degrees of data parallelism, that is, they are the same computation applied to a large set of data where the result does not depend on other data elements. Image processing is one area were GPUs are being used to greatly increase the performance of certain analysis and visualization techniques.

Metabolic changes in rat striatum following convulsive seizures.

PubMed

Darbin, Olivier; Risso, Jean Jacque; Carre, Emily; Lonjon, Michel; Naritoku, Dean K

2005-07-19

Generalized convulsive seizures increase glucose utilization within the brain but their impact on metabolism is not well known. The striatum receives excitatory input from widespread sources in the brain and could potentially reflect energy depletion in the brain resulting from generalized seizures. We utilized multiprobe microdialysis in freely moving rats subjected to maximal electroshock to simultaneously measure glucose, lactate, and pyruvate levels in the interstitial space within striatum and in peripheral subcutaneous tissue. A brief convulsive seizure was associated with marked changes in striatal and peripheral metabolism during the post-ictal state that lasted up to 1 h. There were significant central and peripheral elevations of glucose, pyruvate, and lactate, reflecting increased glucose metabolism. Interestingly, the lactate-to-pyruvate ratio increased significantly in the periphery but remained unchanged in the striatum. Thus, there appears to be brain mechanisms that maintain adequate energy sources and prevent anaerobic shift during the post-ictal state.

Facial Recognition of Happiness Is Impaired in Musicians with High Music Performance Anxiety.

PubMed

Sabino, Alini Daniéli Viana; Camargo, Cristielli M; Chagas, Marcos Hortes N; Osório, Flávia L

2018-01-01

Music performance anxiety (MPA) can be defined as a lasting and intense apprehension connected with musical performance in public. Studies suggest that MPA can be regarded as a subtype of social anxiety. Since individuals with social anxiety have deficits in the recognition of facial emotion, we hypothesized that musicians with high levels of MPA would share similar impairments. The aim of this study was to compare parameters of facial emotion recognition (FER) between musicians with high and low MPA. 150 amateur and professional musicians with different musical backgrounds were assessed in respect to their level of MPA and completed a dynamic FER task. The outcomes investigated were accuracy, response time, emotional intensity, and response bias. Musicians with high MPA were less accurate in the recognition of happiness ( p  = 0.04; d  = 0.34), had increased response bias toward fear ( p  = 0.03), and increased response time to facial emotions as a whole ( p  = 0.02; d  = 0.39). Musicians with high MPA displayed FER deficits that were independent of general anxiety levels and possibly of general cognitive capacity. These deficits may favor the maintenance and exacerbation of experiences of anxiety during public performance, since cues of approval, satisfaction, and encouragement are not adequately recognized.

Pricing and reimbursement of drugs in Denmark.

PubMed

Møller Pedersen, K

2003-01-01

The Danish health care system is decentralized and tax financed. Reimbursable drugs are financed by the national health insurance, which despite its official name, is a tax-funded system for paying for drugs,practicing physicians outside hospitals, dentists, etc. Most issues related to pricing and reimbursement of drugs are placed centrally, however, with the Danish Medicines Agency, and in contrast to most of the health care system reimbursement is thoroughly grounded in legislation. Pricing in principle is free. In the 1990s a number of agreements between industry and government in practice introduced regulated price competition. Generic substitution at the pharmacy level and the agreements between government and industry have led to a decline in the overall price level for drugs from 1995 and onwards. The still increasing drug expenditures hence must be attributed to increasing volume and the introduction of new drugs. Reimbursement is divided into two: general reimbursement meaning unconditional reimbursement for a given drug or single reimbursement based on an application from the patient's physician on behalf of individual patients. The criteria for granting general reimbursement are relatively clear. Economic evaluations on a voluntary basis can be used to support documentation of a reasonable relationship between price and therapeutic effects. Reimbursement is calculated on the basis of an average European price level.

Sex, race, and age distributions of mean aortic wall thickness in a multiethnic population-based sample.

PubMed

Rosero, Eric B; Peshock, Ronald M; Khera, Amit; Clagett, Patrick; Lo, Hao; Timaran, Carlos H

2011-04-01

Reference values and age-related changes of the wall thickness of the abdominal aorta have not been described in the general population. We characterized age-, race-, and gender-specific distributions, and yearly rates of change of mean aortic wall thickness (MAWT), and associations between MAWT and cardiovascular risk factors in a multi-ethnic population-based probability sample. Magnetic resonance imaging measurements of MAWT were performed on 2466 free-living white, black, and Hispanic adult subjects. MAWT race/ethnicity- and gender-specific percentile values across age were estimated using regression analyses. MAWT was greater in men than in women and increased linearly with age in all the groups and across all the percentiles. Hispanic women had the thinnest and black men the thickest aortas. Black men had the highest and white women the lowest age-related MAWT increase. Age, gender, ethnicity, smoking status, systolic blood pressure, low-density lipoprotein-cholesterol levels, high-density lipoprotein-cholesterol levels, and fasting glucose levels were independent predictors of MAWT. Age, gender, and racial/ethnic differences in MAWT distributions exist in the general population. Such differences should be considered in future investigations assessing aortic atherosclerosis and the effects of anti-atherosclerotic therapies. Published by Mosby, Inc.

Ferrate treatment for removing chromium from high-level radioactive tank waste.

PubMed

Sylvester, P; Rutherford, L A; Gonzalez-Martin, A; Kim, J; Rapko, B M; Lumetta, G J

2001-01-01

A method has been developed for removing chromium from alkaline high-level radioactive tank waste. Removing chromium from these wastes is critical in reducing the volume of waste requiring expensive immobilization and deep geologic disposition. The method developed is based on the oxidation of insoluble chromium(III) compounds to soluble chromate using ferrate. This method could be generally applicable to removing chromium from chromium-contaminated solids, when coupled with a subsequent reduction of the separated chromate back to chromium(III). The tests conducted with a simulated Hanford tank sludge indicate that the chromium removal with ferrate is more efficient at 5 M NaOH than at 3 M NaOH. Chromium removal increases with increasing Fe(VI)/Cr(II) molar ratio, but the chromium removal tends to level out for Fe(VI)/ Cr(III) greaterthan 10. Increasingtemperature leadsto better chromium removal, but higher temperatures also led to more rapid ferrate decomposition. Tests with radioactive Hanford tank waste generally confirmed the simulant results. In all cases examined, ferrate enhanced the chromium removal, with a typical removal of around 60-70% of the total chromium present in the washed sludge solids. The ferrate leachate solutions did not contain significant concentrations of transuranic elements, so these solutions could be disposed as low-activity waste.

The effect of lossy image compression on image classification

NASA Technical Reports Server (NTRS)

Paola, Justin D.; Schowengerdt, Robert A.

1995-01-01

We have classified four different images, under various levels of JPEG compression, using the following classification algorithms: minimum-distance, maximum-likelihood, and neural network. The training site accuracy and percent difference from the original classification were tabulated for each image compression level, with maximum-likelihood showing the poorest results. In general, as compression ratio increased, the classification retained its overall appearance, but much of the pixel-to-pixel detail was eliminated. We also examined the effect of compression on spatial pattern detection using a neural network.

Investigation of the beta-damascenone level in fresh and aged commercial beers.

PubMed

Chevance, Fabienne; Guyot-Declerck, Christine; Dupont, Jérôme; Collin, Sonia

2002-06-19

This study investigated the increase of beta-damascenone content during aging in a variety of commercial Belgian beers. Quantities detected in fresh beers were generally low (from 6 ng/g to 25 ng/g). After 5 days at 40 degrees C, the level increased (to as much as 210 ng/g) in most of the beers studied, according to the type of beer. Further experiments showed that wort initially contains large quantities of beta-damascenone (450 ng/g), but that degradation of the compound during fermentation accounts for the low concentrations observed in fresh beers. Production during beer aging can be partially explained by acid hydrolysis of glycosides.

An unusual case of generalized severe gingival enlargement during pregnancy.

PubMed

McIntosh, Crystal L; Kolhatkar, Shilpa; Winkler, James R; Ojha, Junu; Bhola, Monish

2010-01-01

Increased hormone levels that are present during puberty and pregnancy are associated with localized or generalized gingival enlargement. This article reviews the gingival alterations that can occur during pregnancy and describes a case of generalized severe gingival enlargement associated with pregnancy and its management. A 36-year-old woman had severe bilateral gingival enlargement of short duration. The patient denied taking any medications. The laboratory report revealed no systemic abnormalities; however, the report disclosed that she was pregnant. Surgical therapy for the gingival enlargement included gingivectomy and gingivoplasty of all quadrants, which reduced the size of the enlarged gingiva. Postoperative visits demonstrated uneventful healing, with no recurrence seen at the one-year follow-up appointment. It appears that the English literature includes only one other case report that discusses generalized gingival enlargement during pregnancy. Pregnancy-related gingival enlargement should be included as a differential diagnosis in women who have non-drug-induced generalized gingival enlargement.

Premium growth and its effect on employer-sponsored insurance.

PubMed

Vistnes, Jessica; Selden, Thomas

2011-03-01

We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers' health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.

Childhood drinking and depressive symptom level predict harmful personality change

PubMed Central

Riley, Elizabeth N.; Smith, Gregory T.

2016-01-01

Personality traits in children predict numerous life outcomes. Although traits are generally stable, if there is personality change in youth, it could affect subsequent behavior in important ways. We found that the trait of urgency, the tendency to act impulsively when highly emotional, increases for some youth in early adolescence. This increase can be predicted from the behavior of young children: alcohol consumption and depressive symptom level in elementary school children (5th grade) predicted increases in urgency 18 months later. Urgency, in turn, predicted increases in a wide range of maladaptive behaviors another 30 months later, at the end of the first year of high school. The mechanism by which early drinking behavior and depressive symptoms predict personality is not yet clear and merits future research; notably, the findings are consistent with mechanisms proposed by personality change theory and urgency theory. PMID:28392979

Trends in cigarette smoking among adults with HIV compared with the general adult population, United States - 2009-2014.

PubMed

Frazier, Emma L; Sutton, Madeline Y; Brooks, John T; Shouse, R Luke; Weiser, John

2018-06-01

Smoking increases HIV-related and non-HIV-related morbidity and mortality for persons with HIV infection. We estimated changes in cigarette smoking among adults with HIV and adults in the general U.S. population from 2009 to 2014 to inform HIV smoking cessation programs. Among HIV-positive adults, rates of current smoking declined from 37.6% (confidence interval [CI]: 34.7-40.6) in 2009 to 33.6% (CI: 29.8-37.8) in 2014. Current smoking among U.S. adults declined from 20.6% (CI: 19.9-21.3) in 2009 to 16.8% (CI: 16.2-17.4) in 2014. HIV-positive adults in care were significantly more likely to be current smokers compared with the general U.S. population; they were also less likely to quit smoking. For both HIV-positive adults in care and the general population, disparities were noted by racial/ethnic, educational level, and poverty-level subgroups. For most years, non-Hispanic blacks, those with less than high school education, and those living below poverty level were more likely to be current smokers and less likely to quit smoking compared with non-Hispanic whites, those with greater than high school education, and those living above poverty level, respectively. To decrease smoking-related causes of illness and death and to decrease HIV-related disparities, smoking cessation interventions are vital as part of routine care with HIV-positive persons. Clinicians who care for HIV-positive persons who smoke should utilize opportunities to discuss and implement smoking cessation strategies during routine clinical visits. Published by Elsevier Inc.

Comparing shame in clinical and nonclinical populations: Preliminary findings.

PubMed

Dyer, Kevin F W; Dorahy, Martin J; Corry, Mary; Black, Rebecca; Matheson, Laura; Coles, Holly; Curran, David; Seager, Lenaire; Middleton, Warwick

2017-03-01

To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt. A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of "withdrawal," "attack self," "attack other," and "avoidance," and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride. The DID group exhibited significantly higher levels of "attack self," "withdrawal," and "avoidance" relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the "withdrawal" coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. "Attack self" emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas "withdrawal" was the sole predictor of state shame in the DID group. DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The effect of high total ammonia concentration on the survival of channel catfish experimentally infected with Flavobacterium columnare

USDA-ARS?s Scientific Manuscript database

Although it is generally accepted that elevated ammonia levels in the water increase mortalities of Flavobacterium columnare infected fish, recent observation at our laboratory indicated otherwise. Two trials were conducted to determine the effect of a single immersion flush treatment of total ammo...

2005 Mississippi Curriculum Framework: Secondary Cosmetology. (Program CIP: 12.0401 - Cosmetology/Cosmetologist, General)

ERIC Educational Resources Information Center

Buchanon, Rouser; Farmer, Helen

2005-01-01

Secondary vocational-technical education programs in Mississippi are faced with many challenges resulting from sweeping educational reforms at the national and state levels. Schools and teachers are increasingly being held accountable for providing true learning activities to every student in the classroom. This accountability is measured through…

The Minimum Wage, Restaurant Prices, and Labor Market Structure

ERIC Educational Resources Information Center

Aaronson, Daniel; French, Eric; MacDonald, James

2008-01-01

Using store-level and aggregated Consumer Price Index data, we show that restaurant prices rise in response to minimum wage increases under several sources of identifying variation. We introduce a general model of employment determination that implies minimum wage hikes cause prices to rise in competitive labor markets but potentially fall in…

Family Stress and Organization following Parental Divorce or Death.

ERIC Educational Resources Information Center

Felner, Robert D.; And Others

1980-01-01

Examined whether children of separation/divorce experience more associated family disorganization and stress than those from homes broken by parental death or from intact families. Findings indicated that divorce and not the more general case of family dissolution, is significantly related to increased levels of family stressors for the child.…

Effects of Ritalin on Academic Achievement from First to Fifth Grade.

ERIC Educational Resources Information Center

Frankenberger, William; Cannon, Christie

1999-01-01

A study involving 13 subjects (ages 9 to 11) identified with attention-deficit/hyperactivity disorder and placed on Ritalin between first and second grade, found cognitive and achievement scores were lower before medication, dosage levels tended to increase over time, and few of the children in general-education classes received supplementary…

Effective Practices for Online Delivery of Quantitative Business Courses

ERIC Educational Resources Information Center

Lam, Helen; Khare, Anshuman

2010-01-01

Online delivery of university-level courses has grown exponentially in the last decade and is increasingly being recognised as a viable and effective alternative to face-to-face classroom teaching. Many scholars have already written about the benefits and best practices of online teaching in general. However, not many studies have paid specific…

Human Biology, High School Science Course Guide.

ERIC Educational Resources Information Center

Donovan, Edward P.; Prickitt, Ralph

A course in human biology was developed to increase course options for students of all abilities and interest levels who successfully completed 1 year of high school science. Major topic areas of the course include: general plan of the human body; causes, cures, and prevention of diseases; human body chemistry; structure and function of cells,…

The American Community College: From Access to Success

ERIC Educational Resources Information Center

Boggs, George R.

2011-01-01

The focus on educational attainment has taken on a renewed sense of national urgency. It is now commonly accepted that educational achievement is correlated with higher individual lifetime earnings and a better quality of life. Increasing the general level of education is also seen as important for the well-being of society and the economic…

Advertising, Desire, and the Unified Field: A Metaphysical Perspective on Advertising.

ERIC Educational Resources Information Center

Wesson, David A.

Suggesting that ills said to be perpetrated by advertising are really attributes of a unified field of consciousness, this paper discusses the concept that advertising creates desire. The generally undisputed notion that advertising helps to create specific desires is distinguished from the criticism that advertising increases the level and…

Increasing Asian International College Students' Physical Activity Behavior: A Review of the Youth Physical Activity Promotion Model

ERIC Educational Resources Information Center

Yan, Zi; Cardinal, Bradley J.

2013-01-01

Asian students attending American colleges and universities report relatively low levels of physical activity participation, which may hinder their ability to realize their full human potential (i.e., cognitively, physically, socially). This paper reviewed the possible reasons underlying their generally inactive lifestyle, addressed the importance…

10 CFR 60.131 - General design criteria for the geologic repository operations area.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., systems, and components important to safety shall be designed to withstand dynamic effects such as missile... radioactivity areas; and (6) A radiation alarm system to warn of significant increases in radiation levels... system shall be designed with provisions for calibration and for testing its operability. (b) Protection...

2005 Mississippi Curriculum Framework: Secondary Horticulture. (Program CIP: 01.0601 - Applied Horticulture/Horticultural Operations, General)

ERIC Educational Resources Information Center

Research and Curriculum Unit, 2005

2005-01-01

Secondary vocational-technical education programs in Mississippi are faced with many challenges resulting from sweeping educational reforms at the national and state levels. Schools and teachers are increasingly being held accountable for providing true learning activities to every student in the classroom. This accountability is measured through…

The Manitoba Schools' Physical Fitness Survey (1976-77).

ERIC Educational Resources Information Center

Manitoba Dept. of Education, Winnipeg.

An abundance of research relative to physical fitness and, more generally, physical education of school children, has surfaced during the past few years. Negative aspects of health and physical fitness are increasing year by year, and further evidence suggests that academic performance is negatively affected by low levels of fitness. A survey was…

Succinate-based preparation alleviates manifestations of the climacteric syndrome in women.

PubMed

Peskov, A B; Maevskii, E I; Uchitel', M L; Sakharova, N Yu; Vize-Khripunova, M A

2005-09-01

Clinical placebo-controlled study of Enerlit-Clima (bioactive succinate-based food additive) a showed positive effect of the preparation on general clinical and psychoemotional manifestations of the climacteric syndrome. A trend to an increase in estradiol level in early pathological climacteric and normalization of the endometrial status were observed.

2005 Mississippi Curriculum Framework: Secondary Building Trades. (Program CIP: 46.0000 - Construction Trades, General)

ERIC Educational Resources Information Center

Jernigan, Jarvis; Manning, Phillip; Matkins, Billy

2005-01-01

Secondary vocational-technical education programs in Mississippi are faced with many challenges resulting from sweeping educational reforms at the national and state levels. Schools and teachers are increasingly being held accountable for providing true learning activities to every student in the classroom. This accountability is measured through…

Astro 101 Students' Perceptions of Science: Results from the "Thinking about Science Survey Instrument"

ERIC Educational Resources Information Center

Wallace, Colin S.; Prather, Edward E.; Mendelsohn, Benjamin M.

2013-01-01

What are the underlying worldviews and beliefs about the role of science in society held by students enrolled in a college-level, general education, introductory astronomy course (Astro 101)--and are those beliefs affected by active engagement instruction shown to significantly increase students' conceptual knowledge and reasoning abilities…

Interactions between dietary n-3 fatty acids and genetic variants and risk of disease

USDA-ARS?s Scientific Manuscript database

Nutritional genomics has undergone rapid development and the concept is now very popular with the general public. Therefore, there is increasing demand for knowledge on adapting dietary composition to the genome. Our aim has been to undertake a systematic review so as to find out the level of eviden...

The Socio-Political Significance of Changes to the Vocational Education System in Germany

ERIC Educational Resources Information Center

Kupfer, Antonia

2010-01-01

This paper explores the effects on social inequality in Germany of ongoing changes to the employment system and, thus, vocational education. Results based on an examination of the literature indicate that students from increasingly middle-class backgrounds with higher levels of general, rather than vocational, educational attainment are winning…

Just Breathe: The Effects of Emotional Dysregulation and Test Anxiety on GPA

ERIC Educational Resources Information Center

Hartman, Samantha D.; Wasieleski, David T.; Whatley, Mark A.

2017-01-01

College is considered to be one of the most evaluative and stressful times during a student's academic career. A student's inability to regulate emotions may be correlated with an increased level of test anxiety. Previous research has indicated significant relationships between emotional dysregulation and generalized anxiety disorders (e.g.,…

Changes in Social Support over Time in a Faith-Based Physical Activity Intervention

ERIC Educational Resources Information Center

Story, Chandra R.; Knutson, Douglas; Brown, Jameisha B.; Spears-Laniox, Erica; Harvey, Idethia Shevon; Gizlice, Ziya; Whitt-Glover, Melicia C.

2017-01-01

African-American women report higher levels of chronic conditions and church attendance relative to the overall US population. Therefore, efforts have increased over the past decade to design church-based health promotion programs. The present study compared changes in religiosity, religious social support and general social support across time…

Hidden Rules, Secret Agendas: Challenges Facing Contemporary Women Doctoral Students.

ERIC Educational Resources Information Center

Smith, Bobbi

Studies indicate that, although enrollment and degree production by women doctoral students have increased, fewer women than men complete doctorates and women generally take longer than men to finish, in spite of the fact that women demonstrate equal if not superior performance levels on virtually every objective measure. Women who complete the…

Personality at midlife: stability, intrinsic maturation, and response to life events.

PubMed

Costa, P T; Herbst, J H; McCrae, R R; Siegler, I C

2000-12-01

Although developmental theories and popular accounts suggest that midlife is a time of turmoil and change, longitudinal studies of personality traits have generally found stability of rank order and little or no change in mean levels. Using data from 2,274 men and women in their 40s retested after 6 to 9 years, the present study examined two hypotheses: (a) that retest correlations should be no higher than about .60 and (b) that there should be small decreases in Neuroticism, Extraversion, and Openness, and small increases in Agreeableness and Conscientiousness. The study also explored the effects of recalled life events on subsequent personality scores. Results did not support the first hypothesis; uncorrected retest correlations uniformly exceeded .60. This was true for all personality traits, including facets of Agreeableness and Conscientiousness not previously included in longitudinal studies. The hypothesized decreases in Neuroticism, Extraversion, and Openness were found, but Conscientiousness showed a small decrease instead of the predicted increase. Life events in general showed very little influence on the levels of personality traits, although some effects were seen for changes in job and marital status that warrant further research.

Two-dimensional converging-diverging rippled nozzles at transonic speeds. [performed in the Langley 16-Foot Transonic Tunnel

NASA Technical Reports Server (NTRS)

Carlson, John R.; Asbury, Scott C.

1994-01-01

An experimental investigation was performed in the Langley 16-Foot Transonic tunnel to determine the effects of external and internal flap rippling on the aerodynamics of a nonaxisymmetric nozzle. Data were obtained at several Mach numbers from static conditions to 1.2 over a range of nozzle pressure ratios. Nozzles with chordal boattail angles of 10, 20, and 30 degrees, with and without surface rippling, were tested. No effect on discharge coefficient due to surface rippling was observed. Internal thrust losses due to surface rippling were measured and attributed to a combination of additional internal skin friction and shock losses. External nozzle drag for the baseline configurations were generally less than that for the rippled configurations at all free-stream Mach numbers tested. The difference between the baseline and rippled nozzle drag levels generally increased with increasing boat tail angle. The thrust-minus-drag level for each rippled nozzle configuration was less than the equivalent baseline configuration for each Mach number at the design nozzle pressure ratio.

Type 2 diabetes is associated with an increased prevalence of respiratory symptoms as compared to the general population.

PubMed

De Santi, F; Zoppini, G; Locatelli, F; Finocchio, E; Cappa, V; Dauriz, M; Verlato, G

2017-07-17

To estimate the prevalence of respiratory symptoms in individuals with type 2 diabetes, as compared to the general population. Between 2007 and 2010 the screening questionnaire of GEIRD (Gene Environment Interactions in Respiratory Diseases) study was administered to two samples of Verona general population, aged respectively 45-64 years and 65-84 years, and to a convenience sample of individuals with type 2 diabetes, consequently recruited at the local Diabetes Centre. Ninety-four and 165 people with type 2 diabetes, aged respectively 45-64 and 65-84 years, were compared with 676 and 591 subjects in the same age range from the general population. The influence of type 2 diabetes on respiratory symptoms was evaluated by logistic regression models, controlling for sex, age (45-54, 55-64, 65-74, 75-84 years), education level, smoking habits and heavy vehicle traffic exposure and adjusting standard errors of ORs for intra-sample correlation. Compared to the general population, dyspnoea limiting walking pace on level ground (grade 2 dyspnoea) was more frequently reported by people with type 2 diabetes, irrespective of age (p < 0.001), while self-reported chronic cough/phlegm was more common in those aged 45-64 years (p = 0.02). These results were confirmed by multivariable analysis: compared to their counterparts from the general population, people with type 2 diabetes aged 45-54 years showed an increased risk of reporting grade 2 dyspnoea (OR = 3.92, 95% CI 3.28-4.68) or chronic cough/phlegm (OR = 1.69, 1.60-1.78). Similar figures held significant at older ages (75-84 years), although partially blunted (dyspnoea: OR = 1.79, 1.68-1.91; chough/phlegm: OR = 1.09, 1.03-1.16). As such, the interaction between age class and type 2 diabetes was significant for both respiratory disorders. The proportion of self-reported dyspnoea among individuals with type 2 diabetes significantly increased across incremental body-mass index (BMI), from 15.4 to 25.4% and further to 41.3% respectively in normoweight, overweight and obese patients (p = 0.048). People with type 2 diabetes more frequently reported grade 2 dyspnoea and chronic cough/phlegm than the general population of the same age, although presenting similar smoking habits. Diabetes appears to anticipate the lung ageing process, recorded in the general population. The increased occurrence of dyspnoea at incremental BMI among individuals with type 2 diabetes may reflect both cardiovascular and respiratory impairment in this high-risk patient population.

Statement of Roger B. Andewelt, Deputy Assistant Attorney General, Antitrust Division, before the Subcommittee on Monopolies and Commercial Law Committee on the Judiciary, House of Representatives, concerning H.R. 557, Intellectual Property Licensing Legislation.

ERIC Educational Resources Information Center

Andewelt, Roger B.

The recent increased awareness of the importance to our economy of innovation and the development of new technologies has been coupled with the crafting of new legislation to increase the level of intellectual property protection available to innovators. Because one of the key methods of encouraging the efficient use of intellectual property is…

Elevated basal serum tryptase identifies a multisystem disorder associated with increased TPSAB1 copy number.

PubMed

Lyons, Jonathan J; Yu, Xiaomin; Hughes, Jason D; Le, Quang T; Jamil, Ali; Bai, Yun; Ho, Nancy; Zhao, Ming; Liu, Yihui; O'Connell, Michael P; Trivedi, Neil N; Nelson, Celeste; DiMaggio, Thomas; Jones, Nina; Matthews, Helen; Lewis, Katie L; Oler, Andrew J; Carlson, Ryan J; Arkwright, Peter D; Hong, Celine; Agama, Sherene; Wilson, Todd M; Tucker, Sofie; Zhang, Yu; McElwee, Joshua J; Pao, Maryland; Glover, Sarah C; Rothenberg, Marc E; Hohman, Robert J; Stone, Kelly D; Caughey, George H; Heller, Theo; Metcalfe, Dean D; Biesecker, Leslie G; Schwartz, Lawrence B; Milner, Joshua D

2016-12-01

Elevated basal serum tryptase levels are present in 4-6% of the general population, but the cause and relevance of such increases are unknown. Previously, we described subjects with dominantly inherited elevated basal serum tryptase levels associated with multisystem complaints including cutaneous flushing and pruritus, dysautonomia, functional gastrointestinal symptoms, chronic pain, and connective tissue abnormalities, including joint hypermobility. Here we report the identification of germline duplications and triplications in the TPSAB1 gene encoding α-tryptase that segregate with inherited increases in basal serum tryptase levels in 35 families presenting with associated multisystem complaints. Individuals harboring alleles encoding three copies of α-tryptase had higher basal serum levels of tryptase and were more symptomatic than those with alleles encoding two copies, suggesting a gene-dose effect. Further, we found in two additional cohorts (172 individuals) that elevated basal serum tryptase levels were exclusively associated with duplication of α-tryptase-encoding sequence in TPSAB1, and affected individuals reported symptom complexes seen in our initial familial cohort. Thus, our findings link duplications in TPSAB1 with irritable bowel syndrome, cutaneous complaints, connective tissue abnormalities, and dysautonomia.

An ecological analysis of pertussis disease in Minnesota, 2009-2013.

PubMed

Iroh Tam, P Y; Menk, J S; Hughes, J; Kulasingam, S L

2016-03-01

The increase in pertussis cases in Minnesota in the last decade has been mainly attributed to the switch from whole cell to acellular pertussis [as part of the diphtheria, tetanus and acellular pertussis vaccine (DTaP)]. It is unclear, however, to what degree community-level risk factors also contribute. Understanding these factors can help inform public health policy-makers about where else to target resources. We performed an ecological analysis within Minnesota to identify risk factors at the county level using a Bayesian Poisson generalized linear areal model to account for spatial dependence. Univariate analyses suggested an association between increased pertussis rates at the county level and white maternal ethnicity, being US born, urban counties and average household size. In the multivariable analysis, the rate of pertussis was 1·79 times greater for urban vs. rural counties and 4·75 times greater for counties with a one-person larger average household size. Pertussis rates in counties with higher (i.e. 4+DTaP) receipt in children were 0·97 times lower. Examining county-level factors associated with varying levels of pertussis may help identify those counties that would most benefit from targeted interventions and increased resource allocation.

Psychological and Biological Validation of a Novel Digital Social Peer Evaluation Experiment (digi-SPEE).

PubMed

Menne-Lothmann, Claudia; Decoster, Jeroen; van Winkel, Ruud; Collip, Dina; Rutten, Bart P F; Delespaul, Philippe; De Hert, Marc; Derom, Catherine; Thiery, Evert; Jacobs, Nele; van Os, Jim; Wichers, Marieke

2017-03-01

Negative social evaluation is associated with psychopathology. Given the frequency of evaluation through increasingly prevalent virtual social networks, increased understanding of the effects of this social evaluation is urgently required. A new digital social peer evaluation experiment (digi-SPEE) was developed to mimic everyday online social interactions between peers. Participants received mildly negative feedback on their appearance, intelligence, and congeniality. Two hundred and forty-one young people [58.9% female, aged 18.9 years (15 to 34)] from an ongoing novel general population twin study participated in this study. Positive affect (PA), negative affect (NA), implicit self-esteem, and cortisol were assessed before and after exposure to the social evaluation experiment. The social evaluation experiment decreased PA (B=-5.25, p<.001) and implicit self-esteem (B=-.19; p<.001), whereas it increased NA (B=5.99; p<.001) and cortisol levels (B=.07; p<.001). Females (PA: B=-7.62; p<.001; NA: B=8.28; p<.001) and participants with higher levels of general psychological distress (PA: B=-.04, p=.035; NA: B=.06; p=.028) showed stronger affective responses. Stressor-induced cortisol increase was stronger in adolescents under the age of 18 than in participants 18 years and older (B=-.06, p=.002). The digi-SPEE represents a social evaluation stressor that elicits biological and implicit and explicit mental changes that are relevant to mechanisms of psychopathology.

Equatorial Winds on Saturn and the Stratospheric Oscillation

NASA Technical Reports Server (NTRS)

Li, Liming; Jian, Xun; Ingersoll, Andrew P.; DelGenio, Anthony D.; Porco, Carolyn C.; West, Robert A.; Vasavada, Ashwin R.; Ewald, Shawn P.; Conrath, Barney J.; Gierasch, Peter J.;

Subsidence of Puna, Hawaii inferred from sulfur content of drilled lava flows

USGS Publications Warehouse

Moore, J.G.; Thomas, D.M.

1988-01-01

Sulfur was analyzed in more than 200 lava samples from five drill holes located on the east rift zone of Kilauea volcano on the island of Hawaii. The sulfur content is a gage of whether lava was erupted subaerially (low sulfur) or erupted subaqueously (high sulfur). Despite considerable variation, sulfur is generally low (less than 0.025%) in the upper part of the holes, begins to increase at a depth of 250-320 m below sea level, and generally reaches a high level (greater than 0.1%) indicative of steady submarine eruption at 330-450 m below sea level. Assuming that the island is subsiding at 2.4 mm/yr, an analysis of these data indicates that part of the variation in sulfur concentration results from past eustatic oscillation of sea level, and that the volcano (at the drill hole site) finally emerged for the last time about 98 ka. The long-term average rate of lava accumulation is roughly 4.4 mm/yr, and upward growth of the volcano at the drill hole area is about 2 mm/yr in excess of subsidence. ?? 1988.

Child welfare caseworkers as service brokers for youth in foster care: findings from project focus.

PubMed

Dorsey, Shannon; Kerns, Suzanne E U; Trupin, Eric W; Conover, Kate L; Berliner, Lucy

2012-02-01

Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of "brokers" or "gateway providers" of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.

County-level job automation risk and health: Evidence from the United States.

PubMed

Patel, Pankaj C; Devaraj, Srikant; Hicks, Michael J; Wornell, Emily J

2018-04-01

Previous studies have observed a positive association between automation risk and employment loss. Based on the job insecurity-health risk hypothesis, greater exposure to automation risk could also be negatively associated with health outcomes. The main objective of this paper is to investigate the county-level association between prevalence of workers in jobs exposed to automation risk and general, physical, and mental health outcomes. As a preliminary assessment of the job insecurity-health risk hypothesis (automation risk → job insecurity → poorer health), a structural equation model was used based on individual-level data in the two cross-sectional waves (2012 and 2014) of General Social Survey (GSS). Next, using county-level data from County Health Rankings 2017, American Community Survey (ACS) 2015, and Statistics of US Businesses 2014, Two Stage Least Squares (2SLS) regression models were fitted to predict county-level health outcomes. Using the 2012 and 2014 waves of the GSS, employees in occupational classes at higher risk of automation reported more job insecurity, that, in turn, was associated with poorer health. The 2SLS estimates show that a 10% increase in automation risk at county-level is associated with 2.38, 0.8, and 0.6 percentage point lower general, physical, and mental health, respectively. Evidence suggests that exposure to automation risk may be negatively associated with health outcomes, plausibly through perceptions of poorer job security. More research is needed on interventions aimed at mitigating negative influence of automation risk on health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Management of unmanned moving sensors through human decision layers: a bi-level optimization process with calls to costly sub-processes

NASA Astrophysics Data System (ADS)

Dambreville, Frédéric

2013-10-01

While there is a variety of approaches and algorithms for optimizing the mission of an unmanned moving sensor, there are much less works which deal with the implementation of several sensors within a human organization. In this case, the management of the sensors is done through at least one human decision layer, and the sensors management as a whole arises as a bi-level optimization process. In this work, the following hypotheses are considered as realistic: Sensor handlers of first level plans their sensors by means of elaborated algorithmic tools based on accurate modelling of the environment; Higher level plans the handled sensors according to a global observation mission and on the basis of an approximated model of the environment and of the first level sub-processes. This problem is formalized very generally as the maximization of an unknown function, defined a priori by sampling a known random function (law of model error). In such case, each actual evaluation of the function increases the knowledge about the function, and subsequently the efficiency of the maximization. The issue is to optimize the sequence of value to be evaluated, in regards to the evaluation costs. There is here a fundamental link with the domain of experiment design. Jones, Schonlau and Welch proposed a general method, the Efficient Global Optimization (EGO), for solving this problem in the case of additive functional Gaussian law. In our work, a generalization of the EGO is proposed, based on a rare event simulation approach. It is applied to the aforementioned bi-level sensor planning.

Lead exposure in a tank demolition crew: implications for the new OSHA construction lead standard.

PubMed

Waller, K; Osorio, A M; Jones, J

1994-11-01

The Federal Occupational Safety and Health Administration (OSHA) has recently extended the basic health and safety provisions of the OSHA lead standard for general industry to workers in the construction industry. In this report we describe a tank demolition worksite that midway through the project strengthened its lead exposure control activities to a level that approximated the current lead standard. Of 12 tested ironworkers and laborers who worked at the site before the change, zinc protoporphyrin levels increased and seven developed blood lead levels (BLL) > 50 micrograms/dL. After the change these workers' BLLs declined. Six workers hired after the change did not experience increases in zinc protoporphyrin and none developed BLL > 25 micrograms/dL. The experience at this worksite demonstrates the usefulness and feasibility of implementing the current lead standard in construction settings.

A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

PubMed

Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

2015-01-01

There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and established. The data enabled a framework to be constructed to map rural general practice activity with respect to activity characteristic of an academic general practice. The framework offers guidance to practices seeking to transition towards becoming a mature academic practice. The framework also offers guidance to educational institutions and funding bodies to support the development of academic activity in rural general practices. The strengths and limitations of the study design are outlined.

Declining operative experience for junior level residents: Is this an unintended consequence of minimally invasive surgery?

PubMed Central

Mullen, Matthew G.; Salerno, Elise P.; Michaels, Alex D.; Hedrick, Traci L.; Sohn, Min-Woong; Smith, Philip W.; Schirmer, Bruce D.; Friel, Charles M.

2016-01-01

Introduction Our group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve. Methods A sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The ACS NSQIP Participant Use Files were queried for these procedures between 2005–2012. Cases were stratified by participating resident post-graduate year (PGY) with ‘junior resident’ defined as PGY1–3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time. Results 185,335 cases were included in the study. For three of the operations we considered, the prevalence of laparoscopic surgery increased from 2005–2012 (all p<0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p=0.119). Junior resident participation decreased by 4.5%/year (p<0.001) for laparoscopic procedures and by 6.2%/year (p<0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior level residents decreased for appendectomy by 2.6%/year (p<0.001) and cholecystectomy by 6.1%/year (p<0.001), whereas it was unchanged for inguinal herniorrhaphy (p=0.75) and increased for partial colectomy by 3.9%/year (p=0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/year (p<0.001), cholecystectomy by 4.1%/year (p<0.002), inguinal herniorrhaphy by 10%/year (p<0.001) and partial colectomy by 2.9%/year (p<0.004). Conclusions Along with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education. PMID:27066854

Screening for Albuminuria Identifies Individuals at Increased Renal Risk

PubMed Central

van der Velde, Marije; Halbesma, Nynke; de Charro, Frank T.; Bakker, Stephan J.L.; de Zeeuw, Dick; de Jong, Paul E.; Gansevoort, Ronald T.

2009-01-01

It is unknown whether screening for albuminuria in the general population identifies individuals at increased risk for renal replacement therapy (RRT) or accelerated loss of renal function. Here, in a general population-based cohort of 40,854 individuals aged 28 to 75 yr, we collected a first morning void for measurement of urinary albumin. In a subset of 6879 individuals, we measured 24-h urinary albumin excretion and estimated GFR at baseline and during 6 yr of follow-up. Linkage with the national RRT registry identified 45 individuals who started RRT during 9 yr of follow-up. The quantity of albuminuria was associated with increased renal risk: the higher the level of albuminuria, the higher the risk of need for renal replacement therapy and the more rapid renal function decline. A urinary albumin concentration of ≥20 mg/L identified individuals who started RRT during follow-up with 58% sensitivity and 92% specificity. Of the identified individuals, 39% were previously unknown to have impaired renal function, and 50% were not being medically treated. Restricting screening to high-risk groups (e.g., known hypertension, diabetes, cardiovascular disease [CVD], older age) reduced the sensitivity of the test only marginally but failed to identify 45% of individuals with micro- and macroalbuminuria. In conclusion, individuals with elevated levels of urinary albumin are at increased risk for RRT and accelerated loss of renal function. Screening for albuminuria identifies patients at increased risk for progressive renal disease, 40 to 50% of whom were previously undiagnosed or untreated. PMID:19211710

Effects of a 2009 Illinois Alcohol Tax Increase on Fatal Motor Vehicle Crashes.

PubMed

Wagenaar, Alexander C; Livingston, Melvin D; Staras, Stephanie S

2015-09-01

We examined the effects of a 2009 increase in alcohol taxes in Illinois on alcohol-related fatal motor vehicle crashes. We used an interrupted time-series design, with intrastate and cross-state comparisons and measurement derived from driver alcohol test results, for 104 months before and 28 months after enactment. Our analyses used autoregressive moving average and generalized linear mixed Poisson models. We examined both population-wide effects and stratifications by alcohol level, age, gender, and race. Fatal alcohol-related motor vehicle crashes declined 9.9 per month after the tax increase, a 26% reduction. The effect was similar for alcohol-impaired drivers with positive alcohol levels lower than 0.15 grams per deciliter (-22%) and drivers with very high alcohol levels of 0.15 or more (-25%). Drivers younger than 30 years showed larger declines (-37%) than those aged 30 years and older (-23%), but gender and race stratifications did not significantly differ. Increases in alcohol excise taxes, such as the 2009 Illinois act, could save thousands of lives yearly across the United States as part of a comprehensive strategy to reduce alcohol-impaired driving.

Experimental demonstration of the importance of competition under disturbance.

PubMed

Violle, Cyrille; Pu, Zhichao; Jiang, Lin

2010-07-20

Ecologists have long recognized the roles of competition and disturbance in shaping ecological communities, and the combinatorial effects of these two factors have been the subject of substantial ecological research. Nevertheless, it is still unclear whether competition remains as an important structuring force in habitats strongly influenced by disturbance. The conventional belief remains that the importance of competition decreases with increasing disturbance, but limited theory suggests otherwise. Using protist communities established in laboratory microcosms, we demonstrate that disturbance does not diminish the importance of competition. Interspecific competition significantly increased rates of species extinction over a broad disturbance gradient, and increasing disturbance intensities increased, rather than decreased, the tempo of competitive exclusion. This community-level pattern is linked to the species-level pattern that interspecific competition led to most frequent extinctions of each species at the highest level of disturbance that the species can tolerate. Consequently, despite a strong tradeoff between competitive ability and disturbance tolerance across the competing species, species diversity generally declined with disturbance. The consistent structuring role of competition throughout the disturbance gradient underscores the need to understand competitive interactions and their consequences even in highly disturbed habitats.

Competitive helping increases with the size of biological markets and invades defection.

PubMed

Barclay, Pat

2011-07-21

Cooperation between unrelated individuals remains a puzzle in evolutionary biology. Recent work indicates that partner choice can select for high levels of helping. More generally, helping can be seen as but one strategy used to compete for partners within a broader biological market, yet giving within such markets has received little mathematical investigation. In the present model, individuals help others to attract attention from them and thus receive a larger share of any help actively or passively provided by those others. The evolutionarily stable level of helping increases with the size of the biological market and the degree of partner choice. Furthermore, if individuals passively produce some no-cost help to partners, competitive helping can then invade populations of non-helpers because helpers directly benefit from increasing their access to potential partners. This framework of competitive helping demonstrates how high helping can be achieved and why different populations may differ in helping levels. Copyright © 2011 Elsevier Ltd. All rights reserved.

Vertical variation of ice particle size in convective cloud tops.

PubMed

van Diedenhoven, Bastiaan; Fridlind, Ann M; Cairns, Brian; Ackerman, Andrew S; Yorks, John E

2016-05-16

A novel technique is used to estimate derivatives of ice effective radius with respect to height near convective cloud tops ( dr e / dz ) from airborne shortwave reflectance measurements and lidar. Values of dr e / dz are about -6 μ m/km for cloud tops below the homogeneous freezing level, increasing to near 0 μ m/km above the estimated level of neutral buoyancy. Retrieved dr e / dz compares well with previously documented remote sensing and in situ estimates. Effective radii decrease with increasing cloud top height, while cloud top extinction increases. This is consistent with weaker size sorting in high, dense cloud tops above the level of neutral buoyancy where fewer large particles are present, and with stronger size sorting in lower cloud tops that are less dense. The results also confirm that cloud-top trends of effective radius can generally be used as surrogates for trends with height within convective cloud tops. These results provide valuable observational targets for model evaluation.

Vertical Variation of Ice Particle Size in Convective Cloud Tops

NASA Technical Reports Server (NTRS)

Van Diedenhoven, Bastiaan; Fridlind, Ann M.; Cairns, Brian; Ackerman, Andrew S.; Yorks, John E.

2016-01-01

A novel technique is used to estimate derivatives of ice effective radius with respect to height near convective cloud tops (dr(sub e)/dz) from airborne shortwave reflectance measurements and lidar. Values of dr(sub e)/dz are about -6 micrometer/km for cloud tops below the homogeneous freezing level, increasing to near 0 micrometer/km above the estimated level of neutral buoyancy. Retrieved dr(sub e)/dz compares well with previously documented remote sensing and in situ estimates. Effective radii decrease with increasing cloud top height, while cloud top extinction increases. This is consistent with weaker size sorting in high, dense cloud tops above the level of neutral buoyancy where fewer large particles are present and with stronger size sorting in lower cloud tops that are less dense. The results also confirm that cloud top trends of effective radius can generally be used as surrogates for trends with height within convective cloud tops. These results provide valuable observational targets for model evaluation.

The Influence of Social Modeling, Gender, and Empathy on Treatment Side Effects.

PubMed

Faasse, Kate; Parkes, Bryony; Kearney, James; Petrie, Keith J

2018-05-31

Social modeling has the capacity to shape treatment outcomes, including side effects. This study investigated the influence of social modeling of treatment side effects, gender, and participant empathy, on side effects of a placebo treatment. Ninety-six participants (48 females) completed a study purportedly investigating the influence of modafinil (actually placebo) on alertness and fatigue. The participants were randomly seated with a male or female confederate and saw this confederate report experiencing side effects or no side effects. Participant empathy was assessed at baseline. Changes in modeled and general symptoms, and misattribution of symptoms, were assessed during the session and at 24-hr follow-up. During the experimental session, seeing side effect modeling significantly increased modeled symptoms (p = .023, d = 0.56) but not general or misattributed symptoms. Regardless of modeling condition, female participants seated with a female model reported significantly more general symptoms during the session. However, response to social modeling did not differ significantly by model or participant gender. At follow-up, the effect of social modeling of side effects had generalized to other symptoms, resulting in significantly higher rates of modeled symptoms (p = .023, d = 0.48), general symptoms (p = .013, d = 0.49), and misattributed symptoms (p = .022, d = 0.50). The experience of modeled symptoms in response to social modeling was predicted by participants' levels of baseline empathy. Social modeling of symptoms can increase the side effects following treatment, and this effect appears to generalize to a broader range of symptoms and symptom misattribution over time. Higher baseline empathy seems to increase response to social modeling.

The impact of monetary incentives on general fertility rates in Western Australia.

PubMed

Langridge, Amanda T; Nassar, Natasha; Li, Jianghong; Jacoby, Peter; Stanley, Fiona J

2012-04-01

There has been widespread international concern about declining fertility rates and the long-term negative consequences particularly for industrialised countries with ageing populations. In an attempt to boost fertility rates, the Australian Government introduced a maternity payment known as the Baby Bonus. However, major concerns have been raised that such monetary incentives would attract teenagers and socially disadvantaged groups. Population-level data and generalised linear models were used to examine general fertility rates between 1995 and 2006 by socioeconomic group, maternal age group, Aboriginality and location in Western Australia prior to and following the introduction of the Baby Bonus in July 2004. After a steady decline in general fertility rates between 1995 and 2004, rates increased significantly from 52.2 births per 1000 women, aged between 15 and 49 years, in 2004 to 58.6 births per 1000 women in 2006. While there was an overall increase in general fertility rates after adjusting for maternal socio-demographic characteristics, there were no significant differences among maternal age groups (p=0.98), between Aboriginal and non-Aboriginal women(p=0.80), maternal residential locations (p=0.98) or socioeconomic groups (p=0.68). The greatest increase in births were among women residing in the highest socioeconomic areas who had the lowest general fertility rate in 2004 (21.5 births per 1000 women) but the highest in 2006 (38.1 births per 1000 women). Findings suggest that for countries with similar social, economic and political climates to Australia, a monetary incentive may provide a satisfactory solution to declining general fertility rates.

Work-related violence, lifestyle, and health among special education teachers working in Finnish basic education.

PubMed

Ervasti, Jenni; Kivimäki, Mika; Pentti, Jaana; Salmi, Venla; Suominen, Sakari; Vahtera, Jussi; Virtanen, Marianna

2012-07-01

Studies have reported higher levels of absenteeism due to illness among special education teachers compared to other teachers, but it is not known which factors might contribute to this difference. We examined whether health, health behaviors, and exposure to violence at work differed between special education and general education teachers in Finnish basic education. Survey data from 5760 general and special education teachers were analyzed with multilevel logistic models adjusted for individual- and school-level confounding factors. No difference was found between the health behaviors of general and special education teachers. The differences in physical and mental health between the two groups were also relatively small. With regard to work-related violence, however, male special education teachers were 3 times more likely to be exposed to mental abuse, and 5 times more likely to be exposed to physical violence when compared to their male colleagues in general education. Although female special educators were also at an increased risk of mental abuse and physical violence compared to their female general teacher colleagues, their odds ratios for such an encounter were smaller (2- and 3-fold, respectively) than those of male special education teachers. The school-level variance of physical violence toward teachers was large, which indicates that while most schools have little physical violence toward teachers, schools do exist in which teachers' exposure to violence is common. These findings suggest that special education teachers may benefit from training for handling violent situations and interventions to prevent violence at schools. © 2012, American School Health Association.

Association between serum ferritin and hemoglobin levels and bone health in Korean adolescents: A nationwide population-based study.

PubMed

Jung, Dong-Wook; Park, Joo-Hyun; Kim, Do-Hoon; Choi, Moonyoung; Kim, Shinhye; Kim, Hyonchong; Seul, Da-Eun; Park, Soo Gyeong; Jung, Jin-Hyung; Han, Kyungdo; Park, Young-Gyu

2017-12-01

It is important to identify risk factors for low bone mass at a young age. An influence of iron store on bone health in the general population has been reported but has not been studied in adolescents. This study aimed to investigate the relationship between hemoglobin and serum ferritin levels and bone mineral content (BMC) in South Korean adolescents.This study was based on data collected during the 2009to 2010 Korea National Health and Nutrition Examination Survey. We included 1321 participants aged 10 to 18 years. BMC was measured at the femur and lumbar spine using dual-energy x-ray absorptiometry, and hemoglobin and serum ferritin levels were examined.In boys, hemoglobin and serum ferritin levels were positively associated with BMC of the total femur and lumbar spine after adjusting for confounders, and hemoglobin levels significantly increased as BMC increased at all sites (P for trend = .001 for total femur, .01 for femur neck, and <.001 for lumbar spine). Likewise, serum ferritin levels showed increasing trends according to increasing BMC of the total femur and lumbar spine in boys (P for trend = .04 for total femur; and <.001 for lumbar spine). However, these associations were not observed in girls.This study suggests a positive relationship between serum ferritin and hemoglobin levels and BMC in South Korean adolescent boys. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men.

PubMed

Kenny, Anne M; Biskup, Bradley; Robbins, Bertha; Marcella, Glenn; Burleson, Joseph A

2003-12-01

To study the effects of vitamin D supplementation in healthier populations of men. : Randomized, controlled trial. General clinical research center. Sixty-five healthy, community-dwelling men (mean age+/-standard deviation=76+/-4, range 65-87). Cholecalciferol (1,000 IU/d) or placebo supplementation for 6 months; all received 500 mg supplemental calcium. Upper and lower extremity muscle strength and power, physical performance and activity, health perception, calcium and vitamin D intake, and biochemical assessment, including 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and ionized calcium levels. The levels of 25OHD increased and PTH decreased in the cholecalciferol group, whereas there were no significant changes in the control group (P<.001). Baseline 25OHD levels correlated with baseline single-leg stance time and physical activity score. Baseline PTH levels correlated with baseline 8-foot walk time and physical activity score. No significant difference in strength, power, physical performance, or health perception was found between groups. The 25OHD or PTH levels correlated with physical activity and physical performance in older, community-dwelling men with normal 25OHD status. Vitamin D supplementation increased 25OHD levels and decreased PTH levels but did not increase muscle strength or improve physical performance or health perception in this group of healthy, older men. Further investigations of the effects of vitamin D supplementation should focus on individuals with low levels of vitamin D.

The temporal evolution of conceptual object representations revealed through models of behavior, semantics and deep neural networks.

PubMed

Bankson, B B; Hebart, M N; Groen, I I A; Baker, C I

2018-05-17

Visual object representations are commonly thought to emerge rapidly, yet it has remained unclear to what extent early brain responses reflect purely low-level visual features of these objects and how strongly those features contribute to later categorical or conceptual representations. Here, we aimed to estimate a lower temporal bound for the emergence of conceptual representations by defining two criteria that characterize such representations: 1) conceptual object representations should generalize across different exemplars of the same object, and 2) these representations should reflect high-level behavioral judgments. To test these criteria, we compared magnetoencephalography (MEG) recordings between two groups of participants (n = 16 per group) exposed to different exemplar images of the same object concepts. Further, we disentangled low-level from high-level MEG responses by estimating the unique and shared contribution of models of behavioral judgments, semantics, and different layers of deep neural networks of visual object processing. We find that 1) both generalization across exemplars as well as generalization of object-related signals across time increase after 150 ms, peaking around 230 ms; 2) representations specific to behavioral judgments emerged rapidly, peaking around 160 ms. Collectively, these results suggest a lower bound for the emergence of conceptual object representations around 150 ms following stimulus onset. Copyright © 2018 Elsevier Inc. All rights reserved.

Endocrine and metabolic characteristics in polycystic ovary syndrome.

PubMed

Glintborg, Dorte

2016-04-01

Hirsutism affects 5-25% women, and the condition is most often caused by polycystic ovary syndrome (PCOS). The initial evaluation of hirsute patients should include a thorough medical history, clinical evaluation, and standardized blood samples to diagnose the 5% hirsute patients with rare endocrine disorders. The majority of these examinations can be performed by the patient's general practitioner. PCOS is a diagnosis of exclusion and is a multiorgan disease affecting most endocrine organs including ovaries, adrenals, pituitary, fat cells, and endocrine pancreas. The manifestations of PCOS are diverse, and up to 50% patients are normal weight. In most cases, however, the severity of symptoms can be related to abdominal obesity. Increased inflammation in PCOS can be measured as decreased adiponectin levels and increased levels of adipokines, chemokines, and interleukins. In the present thesis the use of these inflammatory markers is reviewed, but more data including hard end points are needed to determine which of these markers that should be introduced to the daily clinic. Abdominal obesity and insulin resistance stimulates ovarian and adrenal androgen production, whereas SHBG levels are decreased. Increased testosterone levels may further increase abdominal obesity and inflammation, therefore describing PCOS as a vicious cycle. Abdominal obesity and increased activation of the inflammatory system is seen in both normal weight and obese PCOS patients leading to an increased risk of dyslipidemia, diabetes, and possibly cardiovascular disease. Patients diagnosed with PCOS therefore should be screened for elements in the metabolic syndrome including weight, waist, blood pressure, HbA1c, and lipid status. Our data supported that prolactin and HbA1c levels could be markers of cardiovascular risk and should be confirmed by prospective studies. PCOS is a life-long condition and treatment modalities involve lifestyle modification, insulin sensitizers such as metformin, or inhibition of testosterone levels with OCP. Treatment with pioglitazone supported that increased insulin sensitivity in PCOS is associated with improved inflammatory and cardiovascular risk markers. Our data supported that one year's metformin treatment was associated with a minor but significant weight loss in patients with PCOS irrespective of BMI at study inclusion. Treatment with OCP improved sex-hormone levels, but was associated with minor weight gain. Based on the study results, clinicians should consider the combined treatment with metformin and OCP also in normal weight patients with PCOS. The challenge in the future is to ensure sufficient evaluation and treatment of patients with hirsutism and PCOS and to determine which subgroups of patients should be treated by their general practitioner and which patients should be referred for hospital and/or gynecological evaluation and treatment. Furthermore more data are needed to determine the optimal follow-up program regarding metabolic risk in different subgroups of patients with PCOS.

Temporal Trends in Exposure to Organophosphate Flame Retardants in the United States

PubMed Central

2017-01-01

During the past decade, use of organophosphate compounds as flame retardants and plasticizers has increased. Numerous studies investigating biomarkers (i.e., urinary metabolites) demonstrate ubiquitous human exposure and suggest that human exposure may be increasing. To formally assess temporal trends, we combined data from 14 U.S. epidemiologic studies for which our laboratory group previously assessed exposure to two commonly used organophosphate compounds, tris(1,3-dichloro-2-propyl) phosphate (TDCIPP) and triphenyl phosphate (TPHP). Using individual-level data and samples collected between 2002 and 2015, we assessed temporal and seasonal trends in urinary bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) and diphenyl phosphate (DPHP), the metabolites of TDCIPP and TPHP, respectively. Data suggest that BDCIPP concentrations have increased dramatically since 2002. Samples collected in 2014 and 2015 had BDCIPP concentrations that were more than 15 times higher than those collected in 2002 and 2003 (10β = 16.5; 95% confidence interval from 9.64 to 28.3). Our results also demonstrate significant increases in DPHP levels; however, increases were much smaller than for BDCIPP. Additionally, results suggest that exposure varies seasonally, with significantly higher levels of exposure in summer for both TDCIPP and TPHP. Given these increases, more research is needed to determine whether the levels of exposure experienced by the general population are related to adverse health outcomes. PMID:28317001

Association between organophosphate pesticides exposure and thyroid hormones in floriculture workers

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

Lacasana, Marina, E-mail: marina.lacasana.easp@juntadeandalucia.e; CIBER de Epidemiologia y Salud Publica; Lopez-Flores, Inmaculada

The ability of organophosphate pesticides to disturb thyroid gland function has been demonstrated by experimental studies on animal, but evidence of such effects on human remains scarce. The aim of this study was to assess the association between exposure to organophosphate compounds and serum levels of thyroid hormones in floriculture workers. A longitudinal study was conducted on 136 male subjects from the State of Mexico and Morelos, Mexico, occupationally exposed to organophosphate pesticides, during agricultural periods of high (rainy season) and low (dry season) levels of pesticide application. Using a structured questionnaire, a survey was carried out on sociodemographic characteristics,more » anthropometry, clinical history, alcohol and tobacco consumption, residential chemical exposure, and occupational history. Urine and blood samples were taken the day after pesticide application to determine urine dialkylphosphate (DAP) levels, serum levels of TSH, total T{sub 3}, total T{sub 4}, serum PON1 activity, and serum p,p'-DEE levels. The analysis of the association between DAP levels and thyroid hormonal profile was carried out using multivariate generalized estimating equation (GEE) models. Our results showed an increase in both TSH and T{sub 4} hormones in serum associated with a increase in total dimethylphosphate levels (SIGMADMP) in urine (p-trend < 0.001) and a decrease in total T{sub 3} serum levels with an increase of SIGMADMP levels in the urine (p-trend = 0.053). These results suggest that exposure to organophosphate pesticides may be responsible of increasing TSH and T{sub 4} serum hormone levels and decreasing T{sub 3} serum hormone levels, therefore supporting the hypothesis that organophosphate pesticides act as endocrine disruptors in humans.« less

Is “Football for All” Safe for All? Cross-Sectional Study of Disparities as Determinants of 1-Year Injury Prevalence in Youth Football Programs

PubMed Central

Dahlström, Örjan; Backe, Stefan; Ekberg, Joakim; Janson, Staffan; Timpka, Toomas

2012-01-01

Background Football (soccer) is endorsed as a health-promoting physical activity worldwide. When football programs are introduced as part of general health promotion programs, equal access and limitation of pre-participation disparities with regard to injury risk are important. The aim of this study was to explore if disparity with regard to parents’ educational level, player body mass index (BMI), and self-reported health are determinants of football injury in community-based football programs, separately or in interaction with age or gender. Methodology/Principal Findings Four community football clubs with 1230 youth players agreed to participate in the cross-sectional study during the 2006 season. The study constructs (parents’ educational level, player BMI, and self-reported health) were operationalized into questionnaire items. The 1-year prevalence of football injury was defined as the primary outcome measure. Data were collected via a postal survey and analyzed using a series of hierarchical statistical computations investigating associations with the primary outcome measure and interactions between the study variables. The survey was returned by 827 (67.2%) youth players. The 1-year injury prevalence increased with age. For youths with parents with higher formal education, boys reported more injuries and girls reported fewer injuries than expected; for youths with lower educated parents there was a tendency towards the opposite pattern. Youths reporting injuries had higher standardized BMI compared with youths not reporting injuries. Children not reporting full health were slightly overrepresented among those reporting injuries and underrepresented for those reporting no injury. Conclusion Pre-participation disparities in terms of parents’ educational level, through interaction with gender, BMI, and self-reported general health are associated with increased injury risk in community-based youth football. When introduced as a general health promotion, football associations should adjust community-based youth programs to accommodate children and adolescents with increased pre-participation injury risk. PMID:22928035

Is "football for all" safe for all? Cross-sectional study of disparities as determinants of 1-year injury prevalence in youth football programs.

PubMed

Dahlström, Örjan; Backe, Stefan; Ekberg, Joakim; Janson, Staffan; Timpka, Toomas

2012-01-01

Football (soccer) is endorsed as a health-promoting physical activity worldwide. When football programs are introduced as part of general health promotion programs, equal access and limitation of pre-participation disparities with regard to injury risk are important. The aim of this study was to explore if disparity with regard to parents' educational level, player body mass index (BMI), and self-reported health are determinants of football injury in community-based football programs, separately or in interaction with age or gender. Four community football clubs with 1230 youth players agreed to participate in the cross-sectional study during the 2006 season. The study constructs (parents' educational level, player BMI, and self-reported health) were operationalized into questionnaire items. The 1-year prevalence of football injury was defined as the primary outcome measure. Data were collected via a postal survey and analyzed using a series of hierarchical statistical computations investigating associations with the primary outcome measure and interactions between the study variables. The survey was returned by 827 (67.2%) youth players. The 1-year injury prevalence increased with age. For youths with parents with higher formal education, boys reported more injuries and girls reported fewer injuries than expected; for youths with lower educated parents there was a tendency towards the opposite pattern. Youths reporting injuries had higher standardized BMI compared with youths not reporting injuries. Children not reporting full health were slightly overrepresented among those reporting injuries and underrepresented for those reporting no injury. Pre-participation disparities in terms of parents' educational level, through interaction with gender, BMI, and self-reported general health are associated with increased injury risk in community-based youth football. When introduced as a general health promotion, football associations should adjust community-based youth programs to accommodate children and adolescents with increased pre-participation injury risk.

Sex-specific effects of dietary fatty acids on saliva cortisol and social behavior in guinea pigs under different social environmental conditions.

PubMed

Nemeth, Matthias; Millesi, Eva; Puehringer-Sturmayr, Verena; Kaplan, Arthur; Wagner, Karl-Heinz; Quint, Ruth; Wallner, Bernard

2016-01-01

Unbalanced dietary intakes of saturated (SFAs) and polyunsaturated (PUFAs) fatty acids can profoundly influence the hypothalamic-pituitary-adrenal (HPA)-axis and glucocorticoid secretions in relation to behavioral performances. The beneficial effects of higher dietary PUFA intakes and PUFA:SFA ratios may also affect social interactions and social-living per se, where adequate physiological and behavioral responses are essential to cope with unstable social environmental conditions. Effects of diets high in PUFAs or SFAs and a control diet were investigated in male and female guinea pigs after 60 days of supplementation. Plasma fatty acid patterns served as an indicator of the general fatty acid status. HPA-axis activities, determined by measuring saliva cortisol concentrations, social behaviors, and hierarchy ranks were analyzed during group housing of established single-sexed groups and during challenging social confrontations with unfamiliar individuals of the other groups. The plasma PUFA:SFA ratio was highest in PUFA supplemented animals, with female levels significantly exceeding males, and lowest in SFA animals. SFA males and females showed increased saliva cortisol levels and decreased aggressiveness during group housing, while sociopositive behaviors were lowest in PUFA males. Males generally showed higher cortisol increases in response to the challenging social confrontations with unfamiliar individuals than females. While increasing cortisol concentrations were detected in control and PUFA animals, no such effect was found in SFA animals. During social confrontations, PUFA males showed higher levels of agonistic and sociopositive behaviors and also gained higher dominance ranks among males, which was not detected for females. While SFAs seemingly impaired cortisol responses and social behaviors, PUFAs enabled adequate behavioral responses in male individuals under stressful new social environmental conditions. This sex-specific effect was possibly related to a general sex difference in the n-3 PUFA bioavailability and cortisol responses, which may indicate that males are more susceptible to changing environmental conditions, and shows how dietary fatty acids can shape social systems.

Salivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort study.

PubMed

Giltay, Erik J; Enter, Dorien; Zitman, Frans G; Penninx, Brenda W J H; van Pelt, Johannes; Spinhoven, Phillip; Roelofs, Karin

2012-03-01

Low circulating levels of testosterone have been associated with major depression, but there is more limited evidence for differences in patients with anxiety disorders. The use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants is associated with sexual side effects, warranting testing for interactions with testosterone. Data are from 722 male and 1380 female participants of The Netherlands Study of Depression and Anxiety (NESDA), who were recruited from the community, general practice care, and specialized mental health care. Depressive and anxiety diagnoses were assessed using the DSM-IV Composite International Diagnostic Interview. To smooth the episodic secretion, the four morning saliva samples per participant and the two evening samples were pooled before testosterone analysis. Morning median testosterone levels were 25.2 pg/ml in men and 16.2 pg/ml in women, with lower evening levels of 18.2 and 14.1 pg/ml, respectively. Significant determinants of testosterone levels were sex, age, time of the day, use of contraceptives, and smoking status. Female patients with a current (1-month) depressive disorder (effect size 0.29; P=0.002), generalized anxiety disorder (0.25; P=0.01), social phobia (0.30; P<0.001), and agoraphobia without panic disorder (0.30; P=0.02) had lower salivary testosterone levels than female controls. Higher testosterone levels were found in male and female participants using SSRIs than in non-users (effect size 0.26; P<0.001). Salivary testosterone levels are lower in female patients with a depressive disorder, generalized anxiety disorder, social phobia, and agoraphobia as compared to female controls. SSRIs may increase salivary testosterone in men and women. Copyright © 2011 Elsevier Inc. All rights reserved.

Multimodel Assessment of the Factors Driving Stratospheric Ozone Evolution over the 21st Century

NASA Technical Reports Server (NTRS)

Oman, L. D.; Plummer, D. A.; Waugh, D. W.; Austin, J.; Scinocca, J. F.; Douglass, A. R.; Salawitch, R. J.; Canty, T.; Akiyoshi, H.; Bekki, S.;

General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels

PubMed Central

Kishikawa, Jun-ichi; Inoue, Yuki; Fujikawa, Makoto; Nishimura, Kenji; Nakanishi, Atsuko; Tanabe, Tsutomu; Imamura, Hiromi

2018-01-01

General anesthetics are indispensable for effective clinical care. Although, the mechanism of action of general anesthetics remains controversial, lipid bilayers and proteins have been discussed as their targets. In this study, we focused on the relationship between cellular ATP levels and general anesthetics. The ATP levels of nematodes and cultured mammalian cells were decreased by exposure to three general anesthetics: isoflurane, pentobarbital, and 1-phenoxy-2-propanol. Furthermore, these general anesthetics abolished mitochondrial membrane potential, resulting in the inhibition of mitochondrial ATP synthesis. These results suggest that the observed decrease of cellular ATP level is a common phenomenon of general anesthetics. PMID:29298324

Prevalence and treatment of cancer pain in Italian oncological wards centres: a cross-sectional survey.

PubMed

Mercadante, Sebastiano; Roila, Fausto; Berretto, Oscar; Labianca, Roberto; Casilini, Stefania

2008-11-01

The aim of this national cross-sectional survey was to draw information on pain prevalence and intensity from a large sample of patients who were admitted to oncologic centres for different reasons and to evaluate the pain treatment and possible influencing factors. A total of 2,655 patients completed the study. Nine hundred and one patients (34%) reported pain. Higher pain levels were observed in inpatients, in the presence of bone metastases, and with low levels of Eastern Cooperative Oncology Group status. The number of patients receiving strong opioids increased with the highest levels of pain. However, a significant part of patients with moderate-severe pain were not receiving appropriate medication, patients being predominantly administered non-opioid drugs. General practitioners' attitudes did not negatively influence the opioid prescription. The results of this survey indicate a need for continuing educational and informative program in pain management for oncologists and more generally for any physician dealing with cancer patients.

Relationship Power, Sexual Decision Making, and HIV Risk Among Midlife and Older Women.

PubMed

Altschuler, Joanne; Rhee, Siyon

2015-01-01

The number of midlife and older women with HIV/AIDS is high and increasing, especially among women of color. This article addresses these demographic realities by reporting on findings about self-esteem, relationship power, and HIV risk from a pilot study of midlife and older women. A purposive sample (N = 110) of ethnically, economically, and educationally diverse women 40 years and older from the Greater Los Angeles Area was surveyed to determine their levels of self-esteem, general relationship power, sexual decision-making power, safer sex behaviors, and HIV knowledge. Women with higher levels of self-esteem exercised greater power in their relationships with their partner. Women with higher levels of general relationship power and self-esteem tend to exercise greater power in sexual decision making, such as having sex and choosing sexual acts. Income and sexual decision-making power were statistically significant in predicting the use of condoms. Implications and recommendations for future HIV/AIDS research and intervention targeting midlife and older women are presented.

Why psychopathy matters: Implications for public health and violence prevention✩

PubMed Central

Reidy, Dennis E.; Kearns, Megan C.; DeGue, Sarah; Lilienfeld, Scott O.; Massetti, Greta; Kiehl, Kent A.

2018-01-01

Psychopathy is an early-appearing risk factor for severe and chronic violence. The violence largely attributable to psychopathy constitutes a substantial portion of the societal burden to the public health and criminal justice systems, and thus necessitates significant attention from prevention experts. Yet, despite a vast base of research in psychology and criminology, the public health approach to violence has generally neglected to consider this key variable. Fundamentally, the public health approach to violence prevention is focused on achieving change at the population level to provide the most benefit to the maximum number of people. Increasing attention to the individual-level factor of psychopathy in public health could improve our ability to reduce violence at the community and societal levels. We conclude that the research literature on psychopathy points to a pressing need for a broad-based public health approach with a focus on primary prevention. Further, we consider how measuring psychopathy in public health research may benefit violence prevention, and ultimately society, in general. PMID:29593448

Languages, communication potential and generalized trust in Sub-Saharan Africa: evidence based on the Afrobarometer Survey.

PubMed

Buzasi, Katalin

2015-01-01

The goal of this study is to investigate whether speaking other than home languages in Sub-Saharan Africa promotes generalized trust. Based on various psychological and economic theories, a simple model is provided to illustrate how languages might shape trust through various channels. Relying on data from the Afrobarometer Project, which provides information on home and additional languages, the Index of Communication Potential (ICP) is introduced to capture the linguistic situation in the 20 sample countries. The ICP, which can be computed at any desired level of aggregation, refers to the probability that an individual can communicate with a randomly selected person in the society based on common languages. The estimated two-level hierarchical models show that, however, individual level communication potential does not seem to impact trust formation, but living in an area with higher average communication potential increases the chance of exhibiting higher trust toward unknown people. Copyright © 2014 Elsevier Inc. All rights reserved.

Social network cohesion in school classes promotes prosocial behavior

PubMed Central

Crone, Eveline A.; Meuwese, Rosa; Güroğlu, Berna

2018-01-01

Adolescence is a key period of social development at the end of which individuals are expected to take on adult social roles. The school class, as the most salient peer group, becomes the prime environment that impacts social development during adolescence. Using social network analyses, we investigated how individual and group level features are related to prosocial behavior and social capital (generalized trust). We mapped the social networks within 22 classrooms of adolescents aged between 12 and 18 years (N = 611), and collected data on social behaviors towards peers. Our results indicate that individuals with high centrality show both higher levels of prosocial behavior and relational aggression. Importantly, greater social cohesion in the classroom was associated with (1) reduced levels of antisocial behavior towards peers and (2) increased generalized trust. These results provide novel insights in the relationship between social structure and social behavior, and stress the importance of the school environment in the development of not only intellectual but also social capital. PMID:29617405

Social network cohesion in school classes promotes prosocial behavior.

PubMed

van den Bos, Wouter; Crone, Eveline A; Meuwese, Rosa; Güroğlu, Berna

2018-01-01

Adolescence is a key period of social development at the end of which individuals are expected to take on adult social roles. The school class, as the most salient peer group, becomes the prime environment that impacts social development during adolescence. Using social network analyses, we investigated how individual and group level features are related to prosocial behavior and social capital (generalized trust). We mapped the social networks within 22 classrooms of adolescents aged between 12 and 18 years (N = 611), and collected data on social behaviors towards peers. Our results indicate that individuals with high centrality show both higher levels of prosocial behavior and relational aggression. Importantly, greater social cohesion in the classroom was associated with (1) reduced levels of antisocial behavior towards peers and (2) increased generalized trust. These results provide novel insights in the relationship between social structure and social behavior, and stress the importance of the school environment in the development of not only intellectual but also social capital.

Dimethyl sulfoxide-caused changes in pro- and anti-angiogenic factor levels could contribute to an anti-angiogenic response in HeLa cells.

PubMed

Şimşek, Ece; Aydemir, Esra Arslan; İmir, Nilüfer; Koçak, Orhan; Kuruoğlu, Aykut; Fışkın, Kayahan

2015-10-01

Dimethyl sulfoxide (DMSO) is widely used in biological research as a general solvent. While it has been previously demonstrated that DMSO possesses a wide range of pharmacological effects, there is no published work regarding the effects of DMSO on pro-angiogenic factor levels. This study was designed to investigate the possible effects of DMSO on the levels of three pro-angiogenic factors released from HeLa cells in vitro. Cells were treated with two different and previously determined concentrations of DMSO. The cytotoxic effects of DMSO concentrations on HeLa cells were determined via MTT. Survival rates of DMSO-treated cells were determined by Invitrogen live/dead viability/cytotoxicity kit and trypan blue exclusion assay. Changes in the pro-angiogenic levels in media were evaluated by Cayman's Substance P Enzyme Immunoassay ELISA kit. Vascular endothelial growth factor ELISA kit and interferon gamma ELISA kit for substance P, VEGF and IFNγ respectively. Changes in substance P levels were corrected by standard western blotting. Changes in VEGF and IFNγ levels were corrected both by western blot and real time PCR. Treatment with 1.4 μM DMSO caused a time-dependent inhibition of cell proliferation at 24, 48 and 72 h. 1.4 μM DMSO caused a significant reduction in VEGF levels at 72 h of incubation and sharp increases in IFNγ levels at both 48 and 72 h of incubation. According to real time PCR analyses, DMSO (1.4 μM) exhibited an inhibitory effect on VEGF but acted as an augmenter of IFNγ release on HeLa cells in vitro. This is the first report showing that the general solvent DMSO suppressed HeLa cell proliferation, decreased the levels of two pro-angiogenic factors (substance P and VEGF) and increased the release of an anti-angiogenic factor IFNγ in vitro. Copyright © 2015 Elsevier Ltd. All rights reserved.

Firm productivity, pollution, and output: theory and empirical evidence from China.

PubMed

Tang, Erzi; Zhang, Jingjing; Haider, Zulfiqar

2015-11-01

Using a theoretical model, this paper argues that as firm productivity increases, there is a decrease in firm-level pollution intensity. However, as productivity increases, firms tend to increase their aggregate output, which requires the use of additional resources that increase pollution. Hence, an increase in productivity results in two opposing effects where increased productivity may in fact increase pollution created by a firm. We describe the joint effect of these two mechanisms on pollution emissions as the "productivity dilemma" of pollution emission. Based on firm-level data from China, we also empirically test this productivity dilemma hypothesis. Our empirical results suggest that, in general, firm productivity has a positive and statistically significant impact on pollution emission in China. However, the impact of productivity on pollution becomes negative when we control for increases in firm output. The empirical evidence also confirms the positive influence of productivity on output, which suggests that the main determinant of pollution is the firm's output. The empirical results provide evidence of the existence of, what we describe as, the productivity dilemma of pollution emission.

On the importance of considering heterogeneity in witnesses' competence levels when reconstructing crimes from multiple witness testimonies.

PubMed

Waubert de Puiseau, Berenike; Greving, Sven; Aßfalg, André; Musch, Jochen

2017-09-01

Aggregating information across multiple testimonies may improve crime reconstructions. However, different aggregation methods are available, and research on which method is best suited for aggregating multiple observations is lacking. Furthermore, little is known about how variance in the accuracy of individual testimonies impacts the performance of competing aggregation procedures. We investigated the superiority of aggregation-based crime reconstructions involving multiple individual testimonies and whether this superiority varied as a function of the number of witnesses and the degree of heterogeneity in witnesses' ability to accurately report their observations. Moreover, we examined whether heterogeneity in competence levels differentially affected the relative accuracy of two aggregation procedures: a simple majority rule, which ignores individual differences, and the more complex general Condorcet model (Romney et al., Am Anthropol 88(2):313-338, 1986; Batchelder and Romney, Psychometrika 53(1):71-92, 1988), which takes into account differences in competence between individuals. 121 participants viewed a simulated crime and subsequently answered 128 true/false questions about the crime. We experimentally generated groups of witnesses with homogeneous or heterogeneous competences. Both the majority rule and the general Condorcet model provided more accurate reconstructions of the observed crime than individual testimonies. The superiority of aggregated crime reconstructions involving multiple individual testimonies increased with an increasing number of witnesses. Crime reconstructions were most accurate when competences were heterogeneous and aggregation was based on the general Condorcet model. We argue that a formal aggregation should be considered more often when eyewitness testimonies have to be assessed and that the general Condorcet model provides a good framework for such aggregations.

A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across the first three semesters of veterinary school.

PubMed

Reisbig, Allison M J; Danielson, Jared A; Wu, Tsui-Feng; Hafen, McArthur; Krienert, Ashley; Girard, Destiny; Garlock, Jessica

2012-01-01

This study builds on previous research on predictors of depression and anxiety in veterinary medical students and reports data on three veterinary cohorts from two universities through their first three semesters of study. Across all three semesters, 49%, 65%, and 69% of the participants reported depression levels at or above the clinical cut-off, suggesting a remarkably high percentage of students experiencing significant levels of depression symptoms. Further, this study investigated the relationship between common stressors experienced by veterinary students and mental health, general health, and academic performance. A factor analysis revealed four factors among stressors common to veterinary students: academic stress, transitional stress, family-health stress, and relationship stress. The results indicated that both academic stress and transitional stress had a robust impact on veterinary medical students' well-being during their first three semesters of study. As well, academic stress negatively impacted students in the areas of depression and anxiety symptoms, life satisfaction, general health, perception of academic performance, and grade point average (GPA). Transitional stress predicted increased depression and anxiety symptoms and decreased life satisfaction. This study helped to further illuminate the magnitude of the problem of depression and anxiety symptoms in veterinary medical students and identified factors most predictive of poor outcomes in the areas of mental health, general health, and academic performance. The discussion provides recommendations for considering structural changes to veterinary educational curricula to reduce the magnitude of academic stressors. Concurrently, recommendations are suggested for mental health interventions to help increase students' resistance to environmental stressors.

Hydrogeology and water quality of the Shell Valley Aquifer, Rolette County, North Dakota

USGS Publications Warehouse

Strobel, M.L.

1997-01-01

The Shell Valley aquifer is the sole source of water for the city of Belcourt and the primary source of water for most of the Turtle Mountain Indian Reservation. The Turtle Mountain Band of Chippewa Indians is concerned about the quantity and quality of water in the Shell Valley aquifer, which underlies about 56 square miles in central Rolette County and has an average saturated thickness of about 35 feet. Water levels across most of the Shell Valley aquifer fluctuate with variations in precipitation but generally are stable. Withdrawals from the north well field decreased slightly during 1976-95, but withdrawals from the south well field increased during 1983-95. Water levels in the south well field declined as withdrawals increased. The average decline during the last 8 years was about 1.75 feet per year. The water level has reached the well screen in at least one of the production wells. Most of the water in the aquifer is a bicarbonate type and has dissolved-solids concentrations ranging from 479 to 1,510 milligrams per liter. None of the samples analyzed had detectable concentrations of pesticides, but hydrocarbons were detected in both ground- and surfacewater samples. Polycyclic aromatic hydrocarbons (PAH) were the most frequently detected hydrocarbons. Benzene, toluene, ethylbenzene, and xylene (BTEX), polychlorinated biphenyls (PCB), and pentachlorophenol (PCP) also were detected.Generally, the Shell Valley aquifer is an adequate source of water for current needs, but evaluation of withdrawals in relation to a knowledge of aquifer hydrology would be important in quantifying sustainable water supplies. Water quality in the aquifer generally is good; the Turtle Mountain Band of Chippewa Indians filters the water to reduce concentrations of dissolved constituents. Hydrocarbons, although present in the aquifer, have not been quantified and may not pose a general health risk. Further analysis of the quantity and distribution of the hydrocarbons would be useful to understand their sources and implications for water use.

Geochemical monitoring for potential environmental impacts of geologic sequestration of CO2

USGS Publications Warehouse

Kharaka, Yousif K.; Cole, David R.; Thordsen, James J.; Gans, Kathleen D.; Thomas, Randal B.

2013-01-01

Carbon dioxide sequestration is now considered an important component of the portfolio of options for reducing greenhouse gas emissions to stabilize their atmospheric levels at values that would limit global temperature increases to the target of 2 °C by the end of the century (Pacala and Socolow 2004; IPCC 2005, 2007; Benson and Cook 2005; Benson and Cole 2008; IEA 2012; Romanak et al. 2013). Increased anthropogenic emissions of CO2 have raised its atmospheric concentrations from about 280 ppmv during pre-industrial times to ~400 ppmv today, and based on several defined scenarios, CO2 concentrations are projected to increase to values as high as 1100 ppmv by 2100 (White et al. 2003; IPCC 2005, 2007; EIA 2012; Global CCS Institute 2012). An atmospheric CO2 concentration of 450 ppmv is generally the accepted level that is needed to limit global temperature increases to the target of 2 °C by the end of the century. This temperature limit likely would moderate the adverse effects related to climate change that could include sea-level rise from the melting of alpine glaciers and continental ice sheets and from the ocean warming; increased frequency and intensity of wildfires, floods, droughts, and tropical storms; and changes in the amount, timing, and distribution of rain, snow, and runoff (IPCC 2007; Sundquist et al. 2009; IEA 2012). Rising atmospheric CO2 concentrations are also increasing the amount of CO2 dissolved in ocean water lowering its pH from 8.1 to 8.0, with potentially disruptive effects on coral reefs, plankton and marine ecosystems (Adams and Caldeira 2008; Schrag 2009; Sundquist et al. 2009). Sedimentary basins in general and deep saline aquifers in particular are being investigated as possible repositories for the large volumes of anthropogenic CO2 that must be sequestered to mitigate global warming and related climate changes (Hitchon 1996; Benson and Cole 2008; Verma and Warwick 2011).

Longevity of animals under reactive oxygen species stress and disease susceptibility due to global warming.

PubMed

Paital, Biswaranjan; Panda, Sumana Kumari; Hati, Akshaya Kumar; Mohanty, Bobllina; Mohapatra, Manoj Kumar; Kanungo, Shyama; Chainy, Gagan Bihari Nityananda

2016-02-26

The world is projected to experience an approximate doubling of atmospheric CO2 concentration in the next decades. Rise in atmospheric CO2 level as one of the most important reasons is expected to contribute to raise the mean global temperature 1.4 °C-5.8 °C by that time. A survey from 128 countries speculates that global warming is primarily due to increase in atmospheric CO2 level that is produced mainly by anthropogenic activities. Exposure of animals to high environmental temperatures is mostly accompanied by unwanted acceleration of certain biochemical pathways in their cells. One of such examples is augmentation in generation of reactive oxygen species (ROS) and subsequent increase in oxidation of lipids, proteins and nucleic acids by ROS. Increase in oxidation of biomolecules leads to a state called as oxidative stress (OS). Finally, the increase in OS condition induces abnormality in physiology of animals under elevated temperature. Exposure of animals to rise in habitat temperature is found to boost the metabolism of animals and a very strong and positive correlation exists between metabolism and levels of ROS and OS. Continuous induction of OS is negatively correlated with survivability and longevity and positively correlated with ageing in animals. Thus, it can be predicted that continuous exposure of animals to acute or gradual rise in habitat temperature due to global warming may induce OS, reduced survivability and longevity in animals in general and poikilotherms in particular. A positive correlation between metabolism and temperature in general and altered O2 consumption at elevated temperature in particular could also increase the risk of experiencing OS in homeotherms. Effects of global warming on longevity of animals through increased risk of protein misfolding and disease susceptibility due to OS as the cause or effects or both also cannot be ignored. Therefore, understanding the physiological impacts of global warming in relation to longevity of animals will become very crucial challenge to biologists of the present millennium.

Tax policy, adult binge drinking, and youth alcohol consumption in the United States.

PubMed

Xuan, Ziming; Nelson, Toben F; Heeren, Timothy; Blanchette, Jason; Nelson, David E; Gruenewald, Paul; Naimi, Timothy S

2013-10-01

Prior research attributed youth alcohol consumption to the attitudes and drinking patterns among adults. Yet at a population level, few have examined the relationship between state-level adult binge drinking prevalence and youth drinking behaviors, or whether tax policy plays a role in this relationship. We analyzed 6 biennial surveys (1999 to 2009) of individual-level youth alcohol use and related behaviors from state-based Youth Risk Behavior Surveys and corresponding years of state-level adult binge drinking prevalence from the Behavioral Risk Factor Surveillance System. We employed logistic regression with generalized estimating equations method to assess the extent to which state adult binge drinking predicted individual-level youth drinking outcomes and examined the role of alcohol taxes in that relationship. Population-aggregate analyses based on 194 state-year strata showed a positive correlation between state adult binge drinking and youth binge drinking (Pearson r = 0.40, p < 0.01). For individual-level youth drinking outcomes, a 5 percentage point increase in binge drinking prevalence among adults was associated with a 12% relative increase in the odds of alcohol use (adjusted OR = 1.12, 95% CI: 1.08, 1.16). Taxes were strongly inversely related with adult and youth drinking measures, and the effect of tax on youth drinking was attenuated after controlling for adult binge drinking. Both tax and adult binge drinking are strong predictors of youth drinking. Tax may affect youth drinking through its effect on adult alcohol consumption. Implementing effective alcohol policies to reduce excessive drinking in the general population is an important strategy to reduce youth drinking. Copyright © 2013 by the Research Society on Alcoholism.