Developmental Factors Associated with the Formation of the Antisocial Personality: A Literature Review.

ERIC Educational Resources Information Center

Cannon, Kent Wesley

Research on factors which contribute to the development of antisocial personality disorder is reviewed. Methodological issues are critiqued, including major assessment instruments and frequently used research designs. Factors which current research indicates might lead to the continuation of antisocial behavior from childhood into adulthood are…

Study of groundwater arsenic pollution in Lanyang Plain using multivariate statistical analysis

NASA Astrophysics Data System (ADS)

chan, S.

2013-12-01

The study area, Lanyang Plain in the eastern Taiwan, has highly developed agriculture and aquaculture, which consume over 70% of the water supplies. Groundwater is frequently considered as an alternative water source. However, the serious arsenic pollution of groundwater in Lanyan Plain should be well studied to ensure the safety of groundwater usage. In this study, 39 groundwater samples were collected. The results of hydrochemistry demonstrate two major trends in Piper diagram. The major trend with most of groundwater samples is determined with water type between Ca+Mg-HCO3 and Na+K-HCO3. This can be explained with cation exchange reaction. The minor trend is obviously corresponding to seawater intrusion, which has water type of Na+K-Cl, because the localities of these samples are all in the coastal area. The multivariate statistical analysis on hydrochemical data was conducted for further exploration on the mechanism of arsenic contamination. Two major factors can be extracted with factor analysis. The major factor includes Ca, Mg and Sr while the minor factor includes Na, K and As. This reconfirms that cation exchange reaction mainly control the groundwater hydrochemistry in the study area. It is worth to note that arsenic is positively related to Na and K. The result of cluster analysis shows that groundwater samples with high arsenic concentration can be grouped into that with high Na, K and HCO3. This supports that cation exchange would enhance the release of arsenic and exclude the effect of seawater intrusion. In other words, the water-rock reaction time is key to obtain higher arsenic content. In general, the major source of arsenic in sediments include exchangeable, reducible and oxidizable phases, which are adsorbed ions, Fe-Mn oxides and organic matters/pyrite, respectively. However, the results of factor analysis do not show apparent correlation between arsenic and Fe/Mn. This may exclude Fe-Mn oxides as a major source of arsenic. The other sources will be evaluated by more trace elements, such as rare earth elements.

Two Major Medicinal Honeys Have Different Mechanisms of Bactericidal Activity

PubMed Central

Kwakman, Paulus H. S.; te Velde, Anje A.; de Boer, Leonie; Vandenbroucke-Grauls, Christina M. J. E.; Zaat, Sebastian A. J.

2011-01-01

Honey is increasingly valued for its antibacterial activity, but knowledge regarding the mechanism of action is still incomplete. We assessed the bactericidal activity and mechanism of action of Revamil® source (RS) honey and manuka honey, the sources of two major medical-grade honeys. RS honey killed Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa within 2 hours, whereas manuka honey had such rapid activity only against B. subtilis. After 24 hours of incubation, both honeys killed all tested bacteria, including methicillin-resistant Staphylococcus aureus, but manuka honey retained activity up to higher dilutions than RS honey. Bee defensin-1 and H2O2 were the major factors involved in rapid bactericidal activity of RS honey. These factors were absent in manuka honey, but this honey contained 44-fold higher concentrations of methylglyoxal than RS honey. Methylglyoxal was a major bactericidal factor in manuka honey, but after neutralization of this compound manuka honey retained bactericidal activity due to several unknown factors. RS and manuka honey have highly distinct compositions of bactericidal factors, resulting in large differences in bactericidal activity. PMID:21394213

Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China

PubMed Central

Li, Haisheng; Yao, Zhihui; Tan, Jianglin; Zhou, Junyi; Li, Yi; Wu, Jun; Luo, Gaoxing

2017-01-01

Burns are a major cause of injury worldwide. We investigated the epidemiology and outcomes of burn patients in a major burn center in southwest China between 2011 and 2015 to provide guidance for burn prevention. Of the 6,325 included burn patients, 66.8% were male and 34.7% were 0 ~ 6 years old. The incidence of burns peaked in autumn. Scald was the most common cause of burns, which was predominant in patients aged 0 ~ 6 years. The mean total body surface area (TBSA) of burns was 13.4%, and patients with burns ≤10% TBSA comprised 64.1% of all cases. Patients with full-thickness burns accounted for 40.1% of all patients and 81.0% of operated patients; these burns were primarily caused by flame (34.8%), scald (21.0%), and electricity (20.4%). Fifty-six deaths occurred (mortality 0.9%), and risk factors included full-thickness burns, larger TBSA and older age. The median length of stay was 17 days, and major risk factors included more operations, better outcomes and larger TBSA. Our data showed that closer attention should be paid to children under 6 years old, males, incidents in autumn and scald burns to prevent burn injuries. Furthermore, individualized burn prevention and treatment measures based on related risk factors should be adopted. PMID:28383066

The association between major depressive disorder in childhood and risk factors for cardiovascular disease in adolescence.

PubMed

Rottenberg, Jonathan; Yaroslavsky, Ilya; Carney, Robert M; Freedland, Kenneth E; George, Charles J; Baji, Ildikó; Dochnal, Roberta; Gádoros, Júlia; Halas, Kitti; Kapornai, Krisztina; Kiss, Eniko; Osváth, Viola; Varga, Hedvig; Vetró, Agnes; Kovacs, Maria

2014-02-01

Depression in adults is associated with risk factors for cardiovascular disease (CVD). It is unclear, however, when the association between clinical depression and cardiac risk factors develops or how early in life this association can be detected. In an ongoing study of pediatric depression, we compared CVD risk factors including smoking, obesity, physical activity level, sedentary behavior, and parental history of CVD across three samples of adolescents: probands with established histories of childhood-onset major depressive disorder (n = 210), never-depressed siblings of probands (n = 195), and controls with no history of any major psychiatric disorder (n = 161). When assessed during adolescence, 85% of the probands were not in a major depressive episode. Nevertheless, at that assessment, probands had a higher prevalence of regular smoking (odds ratio [OR] = 12.54, 95% confidence interval [CI] = 4.36-36.12) and were less physically active than controls (OR = 0.59, CI = 0.43-0.81) and siblings (OR = 0.70, CI = 0.52-0.94) and had a higher rate of obesity than did controls (OR = 3.67, CI = 1.42-9.52). Parents of probands reported high rates of CVD (significantly higher than did parents of controls), including myocardial infarction and CVD-related hospitalization (ORs = 1.62-4.36, CIs = 1.03-15.40). Differences in CVD risk factors between probands and controls were independent of parental CVD. Major depression in childhood is associated with an unfavorable CVD risk profile in adolescence, and risks for pediatric depression and CVD may coincide in families. Effective prevention and treatment of childhood depression may be a means to reduce the incidence of adult CVD.

The Association between Major Depressive Disorder in Childhood and Risk Factors for Cardiovascular Disease in Adolescence

PubMed Central

Rottenberg, Jonathan; Yaroslavsky, Ilya; Carney, Robert M.; Freedland, Kenneth E.; George, Charles J.; Baji, Ildikó; Dochnal, Roberta; Gádoros, Júlia; Halas, Kitti; Kapornai, Krisztina; Kiss, Enikő; Osváth, Viola; Varga, Hedvig; Vetró, Ágnes; Kovacs, Maria

2014-01-01

Objective Depression in adults is associated with risk factors for cardiovascular disease (CVD). It is unclear, however, when the association between clinical depression and cardiac risk factors develops, or how early in life this association can be detected. Methods In an ongoing study of pediatric depression, we compared CVD risk factors, including smoking, obesity, physical activity level, sedentary behavior, and parental history of CVD, across three samples of adolescents: probands with established histories of childhood-onset major depressive disorder (MDD; N=210), never-depressed siblings of probands (N=195), and controls with no history of any major psychiatric disorder (N=161). Results When assessed during adolescence, 85% of the probands were not in a major depressive episode. Nevertheless, at that assessment, probands had a higher prevalence of regular smoking ([odds ratio [OR] 12.54, 95% confidence interval [CI] = 4.36–36.12) and were less physically active than controls (OR .59, CI = .43–.81) and siblings (OR .70, CI = .52–.94), and had a higher rate of obesity than did controls (OR 3.67, CI = 1.42–9.52). Parents of probands reported high rates of CVD (significantly higher than did parents of controls), including myocardial infarction and CVD-related hospitalization (ORs 1.62–4.36; CIs = 1.03–15.40). Differences in CVD risk factors between probands and controls were independent of parental CVD. Conclusions Major depression in childhood is associated with an unfavorable CVD risk profile in adolescence, and risks for pediatric depression and CVD may coincide in families. Effective prevention and treatment of childhood depression may be a means to reduce the incidence of adult CVD. PMID:24470130

Emerging growth factor receptor antagonists for the treatment of renal cell carcinoma.

PubMed

Zahoor, Haris; Rini, Brian I

2016-12-01

The landscape of systemic treatment for metastatic renal cell carcinoma (RCC) has dramatically changed with the introduction of targeted agents including vascular endothelial growth factor (VEGF) inhibitors. Recently, multiple new agents including growth factor receptor antagonists and a checkpoint inhibitor were approved for the treatment of refractory metastatic RCC based on encouraging benefit shown in clinical trials. Areas covered: The background and biological rationale of existing treatment options including a brief discussion of clinical trials which led to their approval, is presented. This is followed by reviewing the limitations of these therapeutic options, medical need to develop new treatments and major goals of ongoing research. We then discuss two recently approved growth factor receptor antagonists i.e. cabozantinib and lenvatinib, and a recently approved checkpoint inhibitor, nivolumab, and issues pertaining to drug development, and future directions in treatment of metastatic RCC. Expert opinion: Recently approved growth factor receptor antagonists have shown encouraging survival benefit but associated drug toxicity is a major issue. Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, has similarly shown survival benefit and is well tolerated. With multiple options now available in this patient population, the right sequence of these agents remains to be determined.

The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study.

PubMed

Przedlacki, J; Buczyńska-Chyl, J; Koźmiński, P; Niemczyk, E; Wojtaszek, E; Gieglis, E; Żebrowski, P; Podgórzak, A; Wściślak, J; Wieliczko, M; Matuszkiewicz-Rowińska, J

2018-05-01

We assessed the FRAX® method in 718 hemodialyzed patients in estimating increased risk of bone major and hip fractures. Over two prospective years, statistical analysis showed that FRAX® enables a better assessment of bone major fracture risk in these patients than any of its components and other risk factors considered in the analysis. Despite the generally increased risk of bone fractures among patients with end-stage renal disease, no prediction models for identifying individuals at particular risk have been developed to date. The goal of this prospective, multicenter observational study was to assess the usefulness of the FRAX® method in comparison to all its elements considered separately, selected factors associated with renal disease and the history of falls, in estimating increased risk of low-energy major bone and hip fractures in patients undergoing chronic hemodialysis. The study included a total of 1068 hemodialysis patients, who were followed for 2 years, and finally, 718 of them were analyzed. The risk analysis included the Polish version of the FRAX® calculator (without bone mineral density), dialysis vintage, mineral metabolism disorders (serum calcium, phosphate, and parathyroid hormone), and the number of falls during the last year before the study. Over 2 years, low-energy 30 major bone fractures were diagnosed and 13 of hip fractures among them. Area under the curve for FRAX® was 0.76 (95% CI 0.69-0.84) for major fractures and 0.70 (95% CI 0.563-0.832) for hip fractures. The AUC for major bone fractures was significantly higher than for all elements of the FRAX® calculator. In logistic regression analysis FRAX® was the strongest independent risk factor of assessment of the major bone fracture risk. FRAX® enables a better assessment of major bone fracture risk in ESRD patients undergoing hemodialysis than any of its components and other risk factors considered in the analysis.

Anal Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Anal cancer is often curable with treatment. Major prognostic factors are site, size, and nodal status. Treatments include radiation therapy, chemotherapy, and surgery. Get detailed information for anal cancer risk factors, classification, staging, prognosis, and treatment in this summary for clinicians.

Premarital Predictors of Marital Quality and Stability.

ERIC Educational Resources Information Center

Larson, Jeffry H.; Holman, Thomas B.

1994-01-01

Reviews research on premarital factors associated with later marital quality and stability in first marriages. Three major categories of factors are described, including background and context, individual traits and behaviors, and couple interactional processes. Both cross-sectional and longitudinal research are summarized. Recommendations for…

Bronchoscopy-Derived Correlates of Lung Injury Following Inhalational Injuries: A Prospective Obervational Study

EPA Science Inventory

Acute lung injury (ALI) is a major factor determining morbidity following burns and inhalational injury. In experimental models, factors potentially contributing to ALI risk include inhalation of toxins directly causing cell damage; inflammation; and infection. However, few studi...

Alcoholism among Psychologists: A Review of the Literature.

ERIC Educational Resources Information Center

French, Rebecca J.

Alcoholism, a major health problem currently being addressed by other professions, has unique features, manifestations, and ramifications for psychologists. Salient aspects of alcoholism in psychology include etiological and motivational factors, characteristic behaviors, and specific risk factors in the work environment of psychologists.…

Risk factors of recipient site infection in head and neck cancer patients undergoing pectoralis major myocutaneous flap reconstruction.

PubMed

Wang, Chao-Hsien; Wong, Yong-Kie; Wang, Ching-Ping; Wang, Chen-Chi; Jiang, Rong-San; Lai, Chih-Sheng; Liu, Shih-An

2015-11-01

The aim of this study was to investigate the factors associated with infection at the recipient site of pectoralis major myocutaneous flap (PMMF) of head and neck cancer patients. We retrospectively reviewed head and neck cancer patients who underwent PMMF reconstruction and identified those with recipient site infection. Variables of patients with and without infection were compared and associated factors were investigated by logistic regression model. A total of 478 patients were included in the final analysis and 183 patients (38.3%) developed recipient site infection. Lower margin of skin island, concurrent tracheotomy, diabetes mellitus, mandibular plate reconstruction, prior radiation, and peri-operative blood transfusion were independent factors associated with recipient site infection of PMMF. Skin island of PMMF beyond the eighth intercostal space markedly increased the risk of recipient site infection after major head and neck cancer surgery. Recognition of relevant factors associated with infection may help surgeons to identify those at risk.

Sex similarities and differences in risk factors for recurrence of major depression.

PubMed

van Loo, Hanna M; Aggen, Steven H; Gardner, Charles O; Kendler, Kenneth S

2017-11-27

Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

Etiology and Prevention of Esophageal Cancer

PubMed Central

Yang, Chung S.; Chen, Xiaoxin; Tu, Shuiping

2016-01-01

Background Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. Recently, great progress has been made in research on the etiology and prevention of EC. Summary The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. Dietary parameters, including dietary carcinogens and insufficiency of micronutrients, could also be important risk factors in certain areas. A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. With improvements in diet and drinking water in developing countries, the incidence of ESCC decreased. However, in economically well-developed countries, the incidence of esophageal adenocarcinoma (EAC) has markedly increased in the past 40 years. The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). In certain areas of China, the occurrence of GCA is closely related to ESCC. Susceptibility genes for EC are starting to be discovered, and this may help to identify high-risk groups that have more need for preventive measures. Mitigation of the risk factors, early detection and treatment of precancerous lesions are effective approaches for prevention. Smoking cessation, avoidance of excessive alcohol, meat and caloric consumption, increasing physical activity and frequent consumption of vegetables and fruits are prudent lifestyle modifications for the prevention of EC as well as other diseases. Key Message The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes. Practical Implications A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC. PMID:27722152

How Much Gender Disparity Exists in Salary? A Profile of Graduates of a Major Public University.

ERIC Educational Resources Information Center

Dutt, Diya

1997-01-01

A study of University of Illinois 1976 graduates (n=2,306) in 1977, 1981, 1986, and 1991 examined changes in salary patterns for all degree levels and majors. Results suggest women earn less than men in first full-time jobs, and gaps widen with time. Possible factors include women's breaks in full-time employment, and differences in majors,…

Effects of Curriculum and Nonacademic Factors on Undergraduate Electronic Engineering Program Retention

NASA Astrophysics Data System (ADS)

Sulaiman, Munir

Science, technology, engineering, and mathematics (STEM) programs in higher education institutions, particularly engineering programs, face challenges related to recruitment, retention, and graduation rates. The purpose of this study was to determine whether there are significant relationships among students' major preference, academic skills, nonacademic characteristics and perceptions, and retention to year 2 among students in electronic engineering, other STEM, and non STEM majors. The academic skills considered were study habits, intellectual interest, verbal and writing confidence, and academic assistance. The non-academic factors included academic support, family support, financial support, and student social integration into the campus environment. Tinto's theory of retention served as the theoretical framework. The research design was quantitative with a general linear method of analysis using responses to the College Student Inventory (CSI) survey as secondary data to determine the relationships among the independent variables (major and academic and non-academic factors) and dependent variable (retention). Participants were 3,575 first year undergraduate full-time students from three entering classes, 2012 to 2014. Findings suggested that student major and non-academic factors had no effect on student retention, but student study habits and seeking academic assistance were predictors of retention in each of the three groups of majors: engineering, other STEM majors, and nonSTEM majors. Strategies to help increase undergraduate students' study skills and help seeking behaviors may contribute to positive social change at HBCU institutions.

Investigating Student Motivation and Performance in Electrical Engineering and Its Subdisciplines

ERIC Educational Resources Information Center

Foley, Justin M.; Daly, Shanna; Lenaway, Catherine; Phillips, Jamie

2016-01-01

Factors influencing choice of major in electrical engineering and later curricular and professional choices are investigated. Studies include both quantitative and qualitative analyses via student transcripts, surveys, and focus groups. Student motivation for choosing an electrical engineering major and later subdiscipline in the field is…

Moving beyond GPA: Alternative Measures of Success and Predictive Factors in Honors Programs

ERIC Educational Resources Information Center

Mould, Tom; DeLoach, Stephen B.

2017-01-01

While studies of predictive factors for success in honors have been increasingly creative and expansive on what these factors might include, they have rarely challenged the dominant, virtually monolithic definitions of success. The majority of studies measure success either by collegiate grade point averages (GPAs) or retention rates in honors,…

A REVIEW OF EPIDEMIOOGICAL STUDIES ON DRINKING WATER HARDNESS AND CARDIOVASCULAR DISEASES

EPA Science Inventory

Major risk factors do not entirely explain the worldwide variability of morbidity and mortality due to

cardiovascular disease. Several environmental factors, including the hardness of drinking water may

affect cardiovascular disease risks. We conducted a qualitative...

Higher incidence of nasopharyngeal carcinoma in some regions in the world confers for interplay between genetic factors and external stimuli.

PubMed

Roy Chattopadhyay, Nabanita; Das, Piyanki; Chatterjee, Koustav; Choudhuri, Tathagata

2017-01-01

Nasopharyngeal carcinoma (NPC) is a rare variety of head and neck cancers. The risk factors include three major causes: genetic factors, viral infection, and environmental and dietary factors. The types of NPC show strong ethnic and geographic variations. The keratinizing and non-keratinizing types are prevalent in the lower incidence regions like North America and Europe; whereas the undifferentiated type is mostly found in the regions with higher incidences like China, North Africa, Arctic, and Nagaland of North-East India. These suggest a possible major role of the internal genetic factors for generation and promotion of this disease. Viral infections might accelerate the process of carcinogenesis by helping in cellular proliferation and loss of apoptosis. Diet and other environmental factors promote these neoplastic processes and further progression of the disease occurs.

Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents.

PubMed

O'dea, Jennifer A

2003-04-01

The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

Expedited Permanency Planning: Evaluation of the Kentucky Adoptions Opportunities Project.

ERIC Educational Resources Information Center

Martin, Mavin H.; Barbee, Anita P.; Antle, Becky F.; Sar, Bibhuti

2002-01-01

Presents evaluation findings of a 3-year Kentucky Adoptions Opportunities Project. Notes that a majority of children had one or both parents coping with multiple risk factors including mental illness, substance abuse, mental retardation, or family violence. Discusses major barriers to permanency, as well as policy and practice implications in the…

Systematic review of factors affecting pharmaceutical expenditures.

PubMed

Mousnad, Mohamed Awad; Shafie, Asrul Akmal; Ibrahim, Mohamed Izham

2014-06-01

To systematically identify the main factors contributing to the increase in pharmaceutical expenditures. A systematic search of published studies was conducted utilising major widely used electronic databases using the search terms 'factors,' 'financing,' 'pharmaceutical,' and 'expenditures.' To be included, the studies needed to: (1) measure at least one of the following outcomes: total growth in pharmaceutical expenditures, price growth or quantity growth; (2) mention a clear method for analysing the impact of factors affecting the increases in drug expenditures; (3) be written in English. Nonprimary articles that were published only as an abstract, a review, a commentary or a letter were excluded. From a total of 2039 studies, only 25 were included in the full review. The main determinant categories that were identified in the review were factors related to price, utilisation, therapeutic choice, demand and health care system. The major cost drivers were found to be changes in drug quantities and therapies as well as new drugs. It is important for policymakers to understand pharmaceutical spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography.

PubMed

Sato, N; Kenjo, A; Kimura, T; Okada, R; Ishigame, T; Kofunato, Y; Shimura, T; Abe, K; Ohira, H; Marubashi, S

2018-04-23

Liver fibrosis is a risk factor for hepatectomy but cannot be determined accurately before hepatectomy because diagnostic procedures are too invasive. Magnetic resonance elastography (MRE) can determine liver stiffness (LS), a surrogate marker for assessing liver fibrosis, non-invasively. The aim of this study was to investigate whether the LS value determined by MRE is predictive of major complications after hepatectomy. This prospective study enrolled consecutive patients who underwent hepatic resection between April 2013 and August 2016. LS values were measured by imaging shear waves by MRE in the liver before hepatectomy. The primary endpoint was major complications, defined as Clavien-Dindo grade IIIa or above. Logistic regression analysis identified independent predictive factors, from which a logistic model to estimate the probability of major complications was constructed. A total of 96 patients were included in the study. Major complications were observed in 15 patients (16 per cent). Multivariable logistic analysis confirmed that higher LS value (P = 0·021) and serum albumin level (P = 0·009) were independent predictive factors for major complications after hepatectomy. Receiver operating characteristic (ROC) analysis showed that the best LS cut-off value was 4·3 kPa for detecting major complications, comparable to liver fibrosis grade F4, with a sensitivity of 80 per cent and specificity of 82 per cent. A logistic model using the LS value and serum albumin level to estimate the probability of major complications was constructed; the area under the ROC curve for predicting major complications was 0·84. The LS value determined by MRE in patients undergoing hepatectomy was an independent predictive factor for major complications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

Teacher Governance Factors and Social Cohesion: Insights from Pakistan

ERIC Educational Resources Information Center

Halai, Anjum; Durrani, Naureen

2016-01-01

This paper explores teacher governance factors, particularly recruitment and deployment of teachers, in relation to inequalities and social cohesion. Pakistan introduced major reforms in education in the post 9/11 context of escalating conflict. These include a merit and needs-based policy on teacher recruitment to eliminate corruption in…

Solid State Lasers from an Efficiency Perspective

NASA Technical Reports Server (NTRS)

Barnes, Norman P.

2007-01-01

Solid state lasers have remained a vibrant area of research because several major innovations expanded their capability. Major innovations are presented with emphasis focused on the laser efficiency. A product of efficiencies approach is developed and applied to describe laser performance. Efficiency factors are presented in closed form where practical and energy transfer effects are included where needed. In turn, efficiency factors are used to estimate threshold and slope efficiency, allowing a facile estimate of performance. Spectroscopic, thermal, and mechanical data are provided for common solid state laser materials.

Extravehicular activities guidelines and design criteria

NASA Technical Reports Server (NTRS)

Brown, N. E.; Dashner, T. R.; Hayes, B. C.

1973-01-01

A listing of astronaut EVA support systems and equipment, and the physical, operational, and performance characteristics of each major system are presented. An overview of the major ground based support operations necessary in the development and verification of orbital EVA systems is included. The performance and biomedical characteristics of man in the orbital EV environment are discussed. Major factors affecting astronaut EV work performance are identified and delineated as they relate to EV support systems design. Data concerning the medical and physiological aspects of spaceflight on man are included. The document concludes with an extensive bibliography, and a series of appendices which expand on some of the information presented in the main body.

Psychological Factors and Cardiac Risk And Impact of Exercise Training Programs—A Review of Ochsner Studies

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Artham, Surya M.; Gilliland, Yvonne

2007-01-01

Although under-emphasized, substantial evidence indicates that psychological distress, especially depression, hostility, and anxiety, are risk factors for coronary heart disease (CHD) and affect recovery following major coronary heart disease events. We review several major studies from Ochsner Medical Center demonstrating the high prevalence of psychological distress in CHD patients and the marked benefits that occur following formal cardiac rehabilitation and exercise training programs. These benefits include reductions in psychological stress, improvements in CHD risk factors that accompany high stress, and reduced all-cause mortality. These data support the benefits of exercise training and increased levels of fitness to improve psychological stress and subsequent prognosis. PMID:21603539

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

PubMed

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

2017-01-01

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

NASA and Me

NASA Technical Reports Server (NTRS)

Wong, Douglas T.

2010-01-01

Topics in this student project report include: biography, NASA history and structure, overview of Johnson Space Center facilities and major projects, and an overview of the Usability Testing and Analysis Facility (UTAF). The UTAF section slides include space habitat evaluations with mockups, crew space vehicle evaluations, and human factors research.

Physical Education in New England Schools and Academies from 1789 to 1860: Concepts and Practices.

ERIC Educational Resources Information Center

Albertson, Roxanne M.

This study traces the major programs and factors which contributed to the development of physical education in New England schools and academies between 1789 and 1860. First, the major types of physical exercise programs and the schools in which these programs operated are presented. Types of exercise programs identified include military training…

Pinguecula

MedlinePlus

... exposure and eye irritation may be factors. Arc-welding is a major job-related risk. Symptoms A ... include: Keeping the eye well lubricated Wearing good quality sunglasses Avoiding eye irritants Images Eye anatomy References ...

Role of Matricellular Proteins in Disorders of the Central Nervous System.

PubMed

Jayakumar, A R; Apeksha, A; Norenberg, M D

2017-03-01

Matricellular proteins (MCPs) are actively expressed non-structural proteins present in the extracellular matrix, which rapidly turnover and possess regulatory roles, as well as mediate cell-cell interactions. MCPs characteristically contain binding sites for other extracellular proteins, cell surface receptors, growth factors, cytokines and proteases, that provide structural support for surrounding cells. MCPs are present in most organs, including brain, and play a major role in cell-cell interactions and tissue repair. Among the MCPs found in brain include thrombospondin-1/2, secreted protein acidic and rich in cysteine family (SPARC), including Hevin/SC1, Tenascin C and CYR61/Connective Tissue Growth Factor/Nov family of proteins, glypicans, galectins, plasminogen activator inhibitor (PAI-1), autotaxin, fibulin and perisostin. This review summarizes the potential role of MCPs in the pathogenesis of major neurological disorders, including Alzheimer's disease, amyotrophic lateral sclerosis, ischemia, trauma, hepatic encephalopathy, Down's syndrome, autism, multiple sclerosis, brain neoplasms, Parkinson's disease and epilepsy. Potential therapeutic opportunities of MCP's for these disorders are also considered in this review.

Physicians' Migration: Perceptions of Pakistani Medical Students.

PubMed

Hossain, Nazli; Shah, Nusrat; Shah, Tahira; Lateef, Sidra Binte

2016-08-01

To study the perceptions of medical students about factors responsible for physicians'migration. Cross-sectional survey. Dow Medical College and Civil Hospital, Karachi, from April to May 2015. Aself-administered structured questionnaire was used including demographic details, attitudes about push and pull factors of migration, and reasons for migrating or not migrating abroad. Final year students and interns were included. Likert scale from 1 to 4 (1=strongly disagree to 4=strongly agree) was used to assess attitudes. Data was analyzed by SPSS version 16. Atotal of 240 medical students, mostly females (n=181, 75%) (60% final year and 40% interns), participated in the study. Majority wished to go abroad (n=127; 54%) with United States being the favourite destination (n=80; 66.1%) and internal medicine fields being the preferred choice for specialization (n=126; 54%). The major pull factors were better quality of postgraduate education abroad (n=110; 48.2%) and economic prospects (80; 35.2%); while the push factors were a weak healthcare system (n=219; 94.3%), inadequate salary structure (n=205; 88.3%), insecurity (n=219; 93.9%) and increasing religious intolerance in Pakistan (n=183; 78.5%). This survey highlights the continuing trend of physician migration from Pakistan owing to an interplay of various push and pull factors. Majority of our medical students wish to migrate, mainly due to low salaries, poor job structure, and insecurity. Urgent interventions are required to reverse this trend of medical brain-drain.

Expiratory Flow Limitation as a Risk Factor for Pulmonary Complications After Major Abdominal Surgery.

PubMed

Spadaro, Savino; Caramori, Gaetano; Rizzuto, Chiara; Mojoli, Francesco; Zani, Gianluca; Ragazzi, Riccardo; Valpiani, Giorgia; Dalla Corte, Francesca; Marangoni, Elisabetta; Volta, Carlo Alberto

2017-02-01

Postoperative pulmonary complications are major causes of postoperative morbidity and mortality. Although several risk factors have been associated with postoperative pulmonary complications, they are not consistent between studies and, even in those studies in which these factors were identified, the predictive power is low. We hypothesized that postoperative pulmonary complications would correlate with the presence of intraoperative expiratory flow limitation. Candidates for this prospective observational study were patients undergoing general anesthesia for major abdominal surgery. Preoperative data collection included age, body mass index, American Society of Anesthesiologists class, smoking and dyspnea history, and room air PO2. Expiratory flow limitation was assessed intraoperatively using the positive end-expiratory pressure test. Postoperative data collection included the incidence of postoperative pulmonary complications. Of the 330 patients we enrolled, 31% exhibited expiratory flow limitation. On univariate analysis, patients with expiratory flow limitation were more likely to have postoperative pneumonia (5% vs 0%, P < .001) and acute respiratory failure (11% vs 1%, P < .001) and a longer length of hospital stay (7 vs 9 days, P < .01). Multivariate analysis identified that expiratory flow limitation increased the risk of developing postoperative pulmonary complications by >50% (risk ratio, 2.7; 95% confidence interval, 1.7-4.2). Age and Medical Research Council dyspnea score were also significant multivariate risk factors for pulmonary complications. Our results show that intraoperative expiratory flow limitation correlates with that of postoperative pulmonary complication after major abdominal surgery. Further work is needed to better understand the relevance of expiratory flow limitation on postoperative pulmonary outcomes.

The Effects of Teacher Perceptions of Administrative Support, School Climate, and Academic Success in Urban Schools

ERIC Educational Resources Information Center

Robinson, Lakishia N.

2015-01-01

Teacher turnover refers to major changes in teachers' assignments from one school year to the next. Past research has given an overview of several factors of teacher turnover. These factors include the school environment, teacher collaborative efforts, administrative support, school climate, location, salary, classroom management, academic…

Beyond Introductory Programming: Success Factors for Advanced Programming

ERIC Educational Resources Information Center

Hoskey, Arthur; Maurino, Paula San Millan

2011-01-01

Numerous studies document high drop-out and failure rates for students in computer programming classes. Studies show that even when some students pass programming classes, they still do not know how to program. Many factors have been considered to explain this problem including gender, age, prior programming experience, major, math background,…

Preterm Birth: An Overview of Risk Factors and Obstetrical Management

ERIC Educational Resources Information Center

Stewart, Amanda; Graham, Ernest

2010-01-01

Preterm birth is the leading cause of neonatal mortality and a major public health concern. Risk factors for preterm birth include a history of preterm birth, short cervix, infection, short interpregnancy interval, smoking, and African-American race. The use of progesterone therapy to treat mothers at risk for preterm delivery is becoming more…

Cervical Cancer, A Major Killer of Hispanic Women: Implications for Health Education.

ERIC Educational Resources Information Center

Morris, Donna LeBlanc; And Others

1989-01-01

This article outlines the incidence and etiology of cervical cancer among Hispanic women, discusses screening and treatment, and identifies factors that may contribute to high incidence and death rate. Factors include Hispanics' utilization of health services, culturally based attitudes, and the role of Hispanic men. Implications for health…

Selection and Use of General-Purpose Programming Languages--Overview. Volume 1.

ERIC Educational Resources Information Center

Cugini, John V.

This study presents a review of selection factors for the seven major general-purpose programming languages: Ada, BASIC, C, COBOL, FORTRAN, PASCAL, and PL/I. The factors covered include not only the logical operations within each language, but also the advantages and disadvantages stemming from the current computing environment, e.g., software…

Identification of Personality Differences among Various Swimming Ability Groups by Sex. Final Report. CORD Project.

ERIC Educational Resources Information Center

Davis, Michael G.; Stewart, Charles W.

This study investigates 16 personality factors and their relevance to the swimming proficiency of physical education students at Wisconsin State University-River Falls. Two instruments, a swimming skills test and the Cattell Sixteen Personality Factor Questionnaire, were utilized. The major hypotheses tested include: (1) there is no difference…

Risk factors for postoperative complications in robotic general surgery.

PubMed

Fantola, Giovanni; Brunaud, Laurent; Nguyen-Thi, Phi-Linh; Germain, Adeline; Ayav, Ahmet; Bresler, Laurent

2017-03-01

The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2-2.4)], hematocrit value <38 [OR 1.6; 95 % CI (1.1-2.2)], previous abdominal surgery [OR 1.5; 95 % CI (1-2)], advanced dissection [OR 5.8; 95 % CI (3.1-10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7-3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9-9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3-8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.

Patient adherence to tuberculosis treatment: a systematic review of qualitative research.

PubMed

Munro, Salla A; Lewin, Simon A; Smith, Helen J; Engel, Mark E; Fretheim, Atle; Volmink, Jimmy

2007-07-24

Tuberculosis (TB) is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence. We searched 19 electronic databases (1966-February 2005) for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms "Tuberculosis AND (adherence OR compliance OR concordance)". We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the themes across all studies produced a line-of-argument synthesis describing how four major factors interact to affect adherence to TB treatment: structural factors, including poverty and gender discrimination; the social context; health service factors; and personal factors. The findings of this study are limited by the quality and foci of the included studies. Adherence to the long course of TB treatment is a complex, dynamic phenomenon with a wide range of factors impacting on treatment-taking behaviour. Patients' adherence to their medication regimens was influenced by the interaction of a number of these factors. The findings of our review could help inform the development of patient-centred interventions and of interventions to address structural barriers to treatment adherence.

Increased red blood cell transfusions are associated with worsening outcomes in pediatric heart transplant patients.

PubMed

Howard-Quijano, Kimberly; Schwarzenberger, Johanna C; Scovotti, Jennifer C; Alejos, Alexandra; Ngo, Jason; Gornbein, Jeffrey; Mahajan, Aman

2013-06-01

Red blood cell (RBC) transfusions are associated with increased morbidity. Children receiving heart transplants constitute a unique group of patients due to their risk factors. Although previous studies in nontransplant patients have focused primarily on the effects of postoperative blood transfusions, a significant exposure to blood occurs during the intraoperative period, and a larger percentage of heart transplant patients require intraoperative blood transfusions when compared with general cardiac surgery patients. We investigated the relationship between clinical outcomes and the amount of blood transfused both during and after heart transplantation. We hypothesized that larger amounts of RBC transfusions are associated with worsening clinical outcomes in pediatric heart transplant patients. A database comprising 108 pediatric patients undergoing heart transplantation from 2004 to 2010 was queried. Preoperative and postoperative clinical risk factors, including the amount of blood transfused intraoperatively and 48 hours postoperatively, were analyzed. The outcome measures were length of hospital stay, duration of tracheal intubation, inotrope score, and major adverse events. Bivariate and multivariate analyses were performed to control for simultaneous risk factors and determine outcomes in which the amount of blood transfused was an independent risk factor. Ninety-four patients with complete datasets were included in the final analysis. Eighty-eight percent received RBC transfusions, with a median transfusion amount of 38.7 mL/kg. A multivariate analysis correcting for 8 covariate risk factors, including the Index for Mortality Prediction After Cardiac Transplantation, age, weight, United Network for Organ Sharing status, warm and cold ischemia time, repeat sternotomy, and pretransplant hematocrit, showed RBC transfusions were independently associated with increased length of intensive care unit stay (means ratio = 1.34; 95% confidence interval, 1.03-1.76; P = 0.03), and increased inotrope score in the first postoperative 24 hour (mean ratio = 1.26; 95% confidence interval, 1.04-1.52; P = 0.04). Patients suffering major adverse events received significantly larger median amounts of blood RBC transfusions (P = 0.002). Transfusions >60 mL/kg were also associated with increased risk of major adverse events (accuracy 76%) including postoperative sepsis, extracorporeal membrane oxygenation, open chest, dialysis, and graft failure. The majority of pediatric patients undergoing orthotropic heart transplantation receive RBC transfusions, with the largest amount transfused in the operating room. Escalating amounts of RBC transfusions are independently associated with increased length of intensive care unit stay, inotrope scores, and major adverse events. Since heart allografts are a limited resource, improvement in the blood transfusion and conservation practices can enhance clinical outcomes in pediatric heart transplant patients.

Factors associated with quality of life and caregiver strain amongst frail older adults referred to a community rehabilitation service: implications for service delivery.

PubMed

Comans, Tracy A; Currin, Michelle L; Brauer, Sandra G; Haines, Terry P

2011-01-01

To identify factors contributing to reduced quality of life and increased caregiver strain in an older population referred to a community rehabilitation team and to recommend service delivery models. Analytical cross-sectional study arising from baseline assessments from 107 subjects drawn from a randomised controlled trial of community rehabilitation service delivery models. A community rehabilitation team based in Brisbane, Queensland, Australia. Primary outcome variables include quality of life (EQ-5D & VAS) and Carer Strain Index. Predictor variables include participation in functional activities, history of falls, number of medications, number of co-morbidities, depression, environmental hazards, physical function and nutrition. Association between variables assessed using linear regression. Major factors contributing to reduced quality of life were having reduced participation in daily activities, depression, and having poor vision. Having poor nutrition and no longer driving also contributed to poor quality of life. The major factor contributing to increased caregiver strain was reduced participation in daily activities by the older person. Community rehabilitation services working with older populations must adopt models of care that screen for and address a wide range of factors that contribute to poor quality of life and caregiver strain.

Stress, stress reduction and hypercholesterolemia in African Americans: a review.

PubMed

Calderon, R; Schneider, R H; Alexander, C N; Myers, H F; Nidich, S I; Haney, C

1999-01-01

Psychological stress may directly contribute to the disproportionately high rates of coronary heart disease morbidity and mortality and its etiologic risk factors in African Americans. Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events. The mechanisms by which stress contributes to alterations in lipid levels are not fully known, but various pathways (ie, hormonal, dietary, etc) have been implicated. Traditional methods for reducing blood serum lipids include diet, drugs or both. These methods have been criticized because of issues of compliance, side effects, and cost. Because of these limitations, nondrug behavioral methods are recommended by the National Cholesterol Education Program as the first line of prevention and treatment for hypercholesterolemia and other risk factors. Research shows that CHD morbidity and mortality and major risk factors may be modifiable by behavioral intervention. Specifically, the Transcendental Meditation technique, an effective antidote to stress, reduces levels of major CHD risk factors including hypercholesterolemia, as well as blood pressure and smoking. Using an effective stress reduction approach for prevention and treatment of CHD and its risk factors in African Americans may prove to be a valuable asset for this underserved population.

Factors Influencing Professional Help-Seeking for Suicidality.

PubMed

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

2018-05-01

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

Rediscovering the wound haematoma as a site of haemostasis during major arterial haemorrhage

PubMed Central

White, N.J.; Mehic, E.; Wang, X.; Chien, D.; Lim, E.; St. John, A.E.; Stern, S.A.; Mourad, P.D.; Rieger, M.; Fries, D.; Martinowitz, U.

2015-01-01

Background Treatments for major internal bleeding after injury include permissive hypotension to decrease the rate of blood loss, intravenous infusion of plasma or clotting factors to improve clot formation, and rapid surgical haemostasis or arterial embolization to control bleeding vessels. Yet, little is known regarding major internal arterial haemostasis, or how these commonly-used treatments might influence haemostasis. Objectives (1) Use a swine model of femoral artery bleeding to understand the perivascular haemostatic response to contained arterial haemorrhage. (2) Directly confirm the association between hemodynamics and bleeding velocity. (3) Observe the feasibility of delivering an activated clotting factor directly to internal sites of bleeding using a simplified angiographic approach. Methods Ultrasound was used to measure bleeding velocity and in vivo clot formation by elastography in a swine model of contained femoral artery bleeding with fluid resuscitation. A swine model of internal pelvic and axillary artery haemorrhage was also used to demonstrate feasibility of local delivery of an activated clotting factor. Results In this model, clots formed slowly within the peri-wound hematoma , but eventually containing the bleeding. Central hemodynamics correlated positively with bleeding velocity. Infusion of recombinant human activated Factor VII into the injured artery nearby the site of major internal haemorrhage in the pelvis and axillae was feasible. Conclusions We rediscover that clot formation within the peri-wound haematoma is an integral component of haemostasis and a feasible target for treatment of major internal bleeding using activated clotting factors delivered using a simplified angiographic approach. PMID:26414624

Body Image, Media, and Eating Disorders

ERIC Educational Resources Information Center

Derenne, Jennifer L.; Beresin, Eugene V.

2006-01-01

Objective: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The…

Angiogenic therapy for cardiac repair based on protein delivery systems.

PubMed

Formiga, F R; Tamayo, E; Simón-Yarza, T; Pelacho, B; Prósper, F; Blanco-Prieto, M J

2012-05-01

Cardiovascular diseases remain the first cause of morbidity and mortality in the developed countries and are a major problem not only in the western nations but also in developing countries. Current standard approaches for treating patients with ischemic heart disease include angioplasty or bypass surgery. However, a large number of patients cannot be treated using these procedures. Novel curative approaches under investigation include gene, cell, and protein therapy. This review focuses on potential growth factors for cardiac repair. The role of these growth factors in the angiogenic process and the therapeutic implications are reviewed. Issues including aspects of growth factor delivery are presented in relation to protein stability, dosage, routes, and safety matters. Finally, different approaches for controlled growth factor delivery are discussed as novel protein delivery platforms for cardiac regeneration.

Marketing environment dynamics and implications for pricing strategies: the case of home health care.

PubMed

Ponsford, B J; Barlow, D

1999-01-01

This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

Diabetes mellitus and stroke: A clinical update

PubMed Central

Tun, Nyo Nyo; Arunagirinathan, Ganesan; Munshi, Sunil K; Pappachan, Joseph M

2017-01-01

Cardiovascular disease including stroke is a major complication that tremendously increases the morbidity and mortality in patients with diabetes mellitus (DM). DM poses about four times higher risk for stroke. Cardiometabolic risk factors including obesity, hypertension, and dyslipidaemia often co-exist in patients with DM that add on to stroke risk. Because of the strong association between DM and other stroke risk factors, physicians and diabetologists managing patients should have thorough understanding of these risk factors and management. This review is an evidence-based approach to the epidemiological aspects, pathophysiology, diagnostic work up and management algorithms for patients with diabetes and stroke. PMID:28694925

Comparative Effectiveness of Minimally Invasive Surgery and Conventional Approaches to Major or Challenging Hepatectomy

PubMed Central

Thornblade, Lucas W; Shi, Xu; Ruiz, Alex; Flum, David R; Park, James O

2017-01-01

Background The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. Study Design Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014. We assessed serious morbidity or mortality (SMM, including organ-space infection and organ failure). Secondary outcomes included transfusion, bile leak, liver failure, reoperation or intervention, and 30-day readmission. We also measured factors considered to make resection more challenging (large tumors, cirrhosis, ≥3 concurrent resections, prior neoadjuvant chemotherapy, or morbid obesity). Results 2819 patients underwent hepatectomy (age 58±14 years, 53% female; 25% MIS). After adjusting for clinical and operative factors, the odds of SMM (OR=0.57, 95%CI: 0.34–0.96, p=0.03) and reoperation or intervention (OR=0.52 (0.29–0.93), p=0.03) were significantly lower for patients undergoing MIS compared with open. In the MH group (n=1,015; 13% MIS), there was no difference in the odds of SMM after MIS (OR=0.37, (0.13–1.11), p=0.08) however MIS MH met criteria for non-inferiority. There were no differences in liver-specific complications or readmission between the groups. Odds of SMM were significantly lower following MIS among patients who had received neoadjuvant chemotherapy (OR 0.33 (0.15–0.70), p=0.004). Conclusion In this large study of minimally invasive major hepatectomy, we demonstrate safety outcomes that are equivalent or superior to conventional open surgery. While the decision to offer MIS may be influenced by factors not included in this evaluation, (e.g. surgeon experience and other patient factors), these findings support its current use in major hepatectomies. PMID:28163089

Associations of Childhood Trauma, Trauma in Adulthood and Previous-Year Stress with Psychopathology in Patients with Major Depression and Borderline Personality Disorder

ERIC Educational Resources Information Center

Wingenfeld, Katja; Schaffrath, Camille; Rullkoetter, Nina; Mensebach, Christoph; Schlosser, Nicole; Beblo, Thomas; Driessen, Martin; Meyer, Bjorn

2011-01-01

Posttraumatic stress disorder (PTSD) is an important possible outcome of exposure to traumatic events that occur in childhood. However, early traumatic experiences are also an important risk factor for several other mental disorders, such as borderline personality disorder and major depressive disorder. Furthermore, chronic stress, including daily…

The impact and control of major southern forest diseases

Treesearch

A. Dan Wilson; Theodor D. Leininger; William J. Otrosina; L. David Dwinell; Nathan M. Schiff

2004-01-01

A variety of forest health issues, concerns, and events have rapidly changed southern forests and plantations in the past two decades. These factors have strongly impacted the ways we manage forest pests in the Southern United States. This trend will no doubt continue to shape forest pest management in the future. The major issues and events of concern include changing...

76 FR 21393 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

76 FR 25367 - Agency Information Collection Activities: Proposed Collection, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition.... Capital and startup costs include, among other items, computers and software you purchase to prepare for...

76 FR 5192 - BOEMRE Information Collection Activity: 1010-0170-Coastal Impact Assistance Program (CIAP...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... disclose this information, you should comment and provide your total capital and startup cost components or... use to estimate major cost factors, including system and technology acquisition, expected useful life... startup costs include, among other items, computers and software you purchase to prepare for collecting...

What's on the Horizon? Trends Impacting Higher Education.

ERIC Educational Resources Information Center

Corey, Del; And Others

Major national trends and their effects on the future of education are examined. Demographic events that affected schools include the postwar baby boom and the migration from the Northeast to the sunbelt region. Factors affecting the college curriculum include: (1) enrollment projections, (2) decline in literacy, (3) decline in mathematics and…

Evaluating the appropriate level of service for Michigan rest areas and welcome centers considering safety and economic factors : executive summary.

DOT National Transportation Integrated Search

2012-04-30

The Michigan Department of Transportation (MDOT) currently operates and maintains : 81 rest areas, including 14 welcome centers, along freeways and other major roadways. Public : rest areas in Michigan serve a broad range of travelers, including vaca...

Sexually Transmitted Diseases and Infertility

PubMed Central

TSEVAT, Danielle G.; WIESENFELD, Harold C.; Parks, Caitlin; PEIPERT, Jeffrey F.

2016-01-01

Female infertility, including tubal factor infertility, is a major public health concern worldwide. Most cases of tubal factor infertility are attributable to untreated sexually transmitted diseases that ascend along the reproductive tract and are capable of causing tubal inflammation, damage, and scarring. Evidence has consistently demonstrated the effects of Chlamydia trachomatis and Neisseria gonorrhoeae as pathogenic bacteria involved in reproductive tract morbidities including tubal factor infertility and pelvic inflammatory disease. There is limited evidence in the medical literature that other sexually transmitted organisms, including Mycoplasma genitalium, Trichomonas vaginalis, and other microorganisms within the vaginal microbiome may be important factors involved in the pathology of infertility. Further investigation into the vaginal microbiome and other potential pathogens is necessary in order to identify preventable causes of tubal factor infertility. Improved clinical screening and prevention of ascending infection may provide a solution to the persistent burden of infertility. PMID:28007229

[Epidemiology of osteoporosis].

PubMed

Grazio, Simeon

2006-01-01

Osteoporosis represents a major and increasing public health problem with the aging of population. Major clinical consequences and economic burden of the disease are fractures. Many risk factors are associated with the fractures including low bone mass, hormonal disorders, personal and family history of fractures, low body weight, use of certain drugs (e.g. glucocorticoids), cigarette smoking, elevated intake of alchohol, low physical activity, insufficient level of vitamin D and low intake of calcium. This epidemiological review describes frequency, importance of risk factors and impact of osteoporosis and osteoporotic fractures. Objective measures of bone mineral density along with clinical assessment of risk factors can help identify patients who will benefit from prevention and intervention efforts and eventually reduce the morbidity and mortality associated with osteoporosis-related fractures.

Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: Attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study.

PubMed

Chao, Tze-Fan; Lip, Gregory Y H; Lin, Yenn-Jiang; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Tuan, Ta-Chuan; Liao, Jo-Nan; Chung, Fa-Po; Chen, Tzeng-Ji; Chen, Shih-Ann

2018-03-01

While modifiable bleeding risks should be addressed in all patients with atrial fibrillation (AF), use of a bleeding risk score enables clinicians to 'flag up' those at risk of bleeding for more regular patient contact reviews. We compared a risk assessment strategy for major bleeding and intracranial hemorrhage (ICH) based on modifiable bleeding risk factors (referred to as a 'MBR factors' score) against established bleeding risk stratification scores (HEMORR 2 HAGES, HAS-BLED, ATRIA, ORBIT). A nationwide cohort study of 40,450 AF patients who received warfarin for stroke prevention was performed. The clinical endpoints included ICH and major bleeding. Bleeding scores were compared using receiver operating characteristic (ROC) curves (areas under the ROC curves [AUCs], or c-index) and the net reclassification index (NRI). During a follow up of 4.60±3.62years, 1581 (3.91%) patients sustained ICH and 6889 (17.03%) patients sustained major bleeding events. All tested bleeding risk scores at baseline were higher in those sustaining major bleeds. When compared to no ICH, patients sustaining ICH had higher baseline HEMORR 2 HAGES (p=0.003), HAS-BLED (p<0.001) and MBR factors score (p=0.013) but not ATRIA and ORBIT scores. When HAS-BLED was compared to other bleeding scores, c-indexes were significantly higher compared to MBR factors (p<0.001) and ORBIT (p=0.05) scores for major bleeding. C-indexes for the MBR factors score was significantly lower compared to all other scores (De long test, all p<0.001). When NRI was performed, HAS-BLED outperformed all other bleeding risk scores for major bleeding (all p<0.001). C-indexes for ATRIA and ORBIT scores suggested no significant prediction for ICH. All contemporary bleeding risk scores had modest predictive value for predicting major bleeding but the best predictive value and NRI was found for the HAS-BLED score. Simply depending on modifiable bleeding risk factors had suboptimal predictive value for the prediction of major bleeding in AF patients, when compared to the HAS-BLED score. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Defining the genetic connection linking amyotrophic lateral sclerosis (ALS) with frontotemporal dementia (FTD).

PubMed

Lattante, Serena; Ciura, Sorana; Rouleau, Guy A; Kabashi, Edor

2015-05-01

Several genetic causes have been recently described for neurological diseases, increasing our knowledge of the common pathological mechanisms involved in these disorders. Mutation analysis has shown common causative factors for two major neurodegenerative disorders, ALS and FTD. Shared pathological and genetic markers as well as common neurological signs between these diseases have given rise to the notion of an ALS/FTD spectrum. This overlap among genetic factors causing ALS/FTD and the coincidence of mutated alleles (including causative, risk and modifier variants) have given rise to the notion of an oligogenic model of disease. In this review we summarize major advances in the elucidation of novel genetic factors in these diseases which have led to a better understanding of the common pathogenic factors leading to neurodegeneration. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intending to Stay: Images of Scientists, Attitudes Toward Women, and Gender as Influences on Persistence among Science and Engineering Majors

NASA Astrophysics Data System (ADS)

Wyer, Mary

Contemporary research on gender and persistence in undergraduate education in science and engineering has routinely focused on why students leave their majors rather than asking why students stay. This study compared three common ways of measuring persistence-commitment to major, degree aspirations, and commitment to a science or engineering career-and emphasized factors that would encourage students to persist, including positive images of scientists and engineers, positive attitudes toward gender equity in science and engineering, and positive classroom experiences. A survey was administered in classrooms to a total of 285 female and male students enrolled in two required courses for majors. The results indicate that the different measures of persistence were sensitive to different influences but that students' gender did not interact with their images, attitudes, and experiences in predicted ways. The study concludes that an individual student's gender may be a more important factor in explaining why some female students leave their science and engineering majors than in explaining why others stay.

Preventing School Violence: What Schools Can Do. Hot Topics Series.

ERIC Educational Resources Information Center

Bosworth, Kris, Ed.

This collection of papers provide a range of data on dealing with violence in the schools and communities, focusing on risk factors and correlates of youth violence, how violence affects young people, and how schools can help students avoid violence. The papers include: "Youth Violence in the United States: Major Trends, Risk Factors, and…

Revitalizing Higher Education in Bangladesh: Insights from Alumni and Policy Prescriptions

ERIC Educational Resources Information Center

Andaleeb, Syed Saad

2003-01-01

Higher education in Bangladesh must become more responsive to the needs of a major constituency: its students. How this might be accomplished is examined in this study using a nine-factor model to explain the satisfaction of alumni with their education. These factors include teacher quality, method and content, peer quality, facilities and…

Accident hazard evaluation and control decisions on forested recreation sites

Treesearch

Lee A. Paine

1971-01-01

Accident hazard associated with trees on recreation sites is inherently concerned with probabilities. The major factors include the probabilities of mechanical failure and of target impact if failure occurs, the damage potential of the failure, and the target value. Hazard may be evaluated as the product of these factors; i.e., expected loss during the current...

Needs Assessment in STEM Disciplines: Reliability, Validity and Factor Structure of the Student Support Needs Scale (SSNS)

ERIC Educational Resources Information Center

Hardy, Precious; Aruguete, Mara

2014-01-01

Retention is a major problem in most colleges and universities. High dropout rates, especially in the STEM disciplines (science, technology, engineering and mathematics), have proved intractable despite the offering of supplemental instruction. A broad model of support systems that includes psychological factors is needed to address retention in…

Beyond the Disease Model: Reframing the Etiology of Alcoholism from a Spiritual Perspective

ERIC Educational Resources Information Center

Bliss, Donna Leigh

2009-01-01

The disease model of alcoholism, which has gained prominence since the mid-20th century as the major etiological model of alcoholism, suffers from several limitations including its overemphasis on biological factors at the expense of other psychosocial factors, in addition to its lack of consistency with a holistic, social work…

Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis.

PubMed

Jin, Shangyi; Li, Mengtao; Fang, Yongfei; Li, Qin; Liu, Ju; Duan, Xinwang; Liu, Yi; Wu, Rui; Shi, Xiaofei; Wang, Yongfu; Jiang, Zhenyu; Wang, Yanhong; Yu, Chen; Wang, Qian; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng

2017-11-15

Rheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities. Baseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses. A total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0-2.5%); fragility fracture, 1.7% (95% CI 1.5-1.9%); malignancy, 0.6% (95% CI 0.5-0.7%); overall major comorbidities, 4.2% (95% CI 3.9-4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities. Patients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

Factors influencing physicians' choice of workplace: systematic review of drivers of attrition and policy interventions to address them.

PubMed

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-12-01

The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians' choice of workplace, and policy interventions for retaining physicians in the public sector. Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Nineteen articles met the inclusion criteria. Six major themes that affected physicians' choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. While factors affecting physicians' choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross-country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

PubMed Central

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-01-01

Objectives The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector. Methods Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Results Nineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. Conclusion While factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector. PMID:27648254

Management of Major Vascular Injury During Endoscopic Endonasal Skull Base Surgery.

PubMed

Gardner, Paul A; Snyderman, Carl H; Fernandez-Miranda, Juan C; Jankowitz, Brian T

2016-06-01

A major vascular injury is the most feared complication of endoscopic sinus and skull base surgery. Risk factors for vascular injury are discussed, and an algorithm for management of a major vascular injury is presented. A team of surgeons (otolaryngology and neurosurgery) is important for identification and control of a major vascular injury applying basic principles of vascular control. A variety of techniques can be used to control a major injury, including coagulation, a muscle patch, sacrifice of the artery, and angiographic stenting. Immediate and close angiographic follow-up is critical to prevent and manage subsequent complications of vascular injury. Copyright © 2016 Elsevier Inc. All rights reserved.

WORKING ENVIRONMENT AND JOB SATISFACTION AMONG HEALTH PROFESSIONAL WORKING AT A TERTIARY CARE HOSPITAL OF PAKISTAN.

PubMed

Aziz, Imrana; Kumar, Ramesh; Rathore, Anita; Lal, Manohr

2015-01-01

Work environment is believed to be a major factor for better performance of human resource for health in any organization. This study concentrated on multiple factors involved in job satisfaction was appraised to critique their efficient significance in calculation of the health professional liking. Factors included job matched with workers' skills/experience, incentives, supervision, administrator support; convenient work load, training, appreciation, low pay and job protection were major contributors in job satisfaction. A mix method study was done in 2014; an initial descriptive cross sectional survey was done followed by qualitative approach. Eighteen in-depth interviews with health care providers were conducted after taking written consent. Nodes, sub-nodes and final themes were generated during qualitative data analysis. Main findings and themes were, generated after making the nodes and sub-nodes from the most frequent responses. These themes were; absence of work pressure, work place safety, social support, learning opportunities, and employee influence on conditions and recognition individual or team efforts. Work environment is a major contributing factor towards job satisfaction among the health workers.

The Association Between Major Depressive Disorder and Outcomes in Older Veterans Hospitalized With Pneumonia.

PubMed

DeWaters, Ami L; Chansard, Matthieu; Anzueto, Antonio; Pugh, Mary Jo; Mortensen, Eric M

2018-01-01

Major depressive disorder ("depression") has been identified as an independent risk factor for mortality for many comorbid conditions, including heart failure, cancer and stroke. Major depressive disorder has also been linked to immune suppression by generating a chronic inflammatory state. However, the association between major depression and pneumonia has not been examined. The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in Veterans hospitalized with pneumonia. We conducted a retrospective national study using administrative data of patients hospitalized at any Veterans Administration acute care hospital. We included patients ≥65 years old hospitalized with pneumonia from 2002-2012. Depressed patients were further analyzed based on whether they were receiving medications to treat depression. We used generalized linear mixed effect models to examine the association of depression with the outcomes of interest after controlling for potential confounders. Patients with depression had a significantly higher 90-day mortality (odds ratio 1.12, 95% confidence interval 1.07-1.17) compared to patients without depression. Patients with untreated depression had a significantly higher 30-day (1.11, 1.04-1.20) and 90-day (1.20, 1.13-1.28) mortality, as well as significantly higher intensive care unit admission rates (1.12, 1.03-1.21), compared to patients with treated depression. For older veterans hospitalized with pneumonia, a concurrent diagnosis of major depressive disorder, and especially untreated depression, was associated with higher mortality. This highlights that untreated major depressive disorder is an independent risk factor for mortality for patients with pneumonia. Published by Elsevier Inc.

Brain-derived neurotrophic factor signaling and subgenual anterior cingulate cortex dysfunction in major depressive disorder.

PubMed

Tripp, Adam; Oh, Hyunjung; Guilloux, Jean-Philippe; Martinowich, Keri; Lewis, David A; Sibille, Etienne

2012-11-01

The subgenual anterior cingulate cortex is implicated in the pathology and treatment response of major depressive disorder. Low levels of brain-derived neurotrophic factor (BDNF) and reduced markers for GABA function, including in the amygdala, are reported in major depression, but their contribution to subgenual anterior cingulate cortex dysfunction is not known. Using polymerase chain reaction, we first assessed the degree to which BDNF controls mRNA expression (defined as BDNF dependency) of 15 genes relating to GABA and neuropeptide functions in the cingulate cortex of mice with reduced BDNF function (BDNF-heterozygous [Bdnf(+/-)] mice and BDNF exon-IV knockout [Bdnf(KIV)] mice). Gene expression was then quantified in the subgenual anterior cingulate cortex of 51 postmortem subjects with major depressive disorder and comparison subjects (total subjects, N=102; 49% were women) and compared with previous amygdala results. Based on the results in Bdnf(+/-) and Bdnf(KIV) mice, genes were sorted into high, intermediate, and no BDNF dependency sets. In postmortem human subjects with major depression, BDNF receptor (TRKB) expression, but not BDNF, was reduced. Postmortem depressed subjects exhibited down-regulation in genes with high and intermediate BDNF dependency, including markers of dendritic targeting interneurons (SST, NPY, and CORT) and a GABA synthesizing enzyme (GAD2). Changes extended to BDNF-independent genes (PVALB and GAD1). Changes were greater in men (potentially because of low baseline expression in women), displayed notable differences from prior amygdala results, and were not explained by demographic or clinical factors other than sex. These parallel human/mouse analyses provide direct (low TRKB) and indirect (low expression of BDNF-dependent genes) evidence in support of decreased BDNF signaling in the subgenual anterior cingulate cortex in individuals with major depressive disorder, implicate dendritic targeting GABA neurons and GABA synthesis, and, together, suggest a common BDNF-/GABA-related pathology in major depression with sex- and brain region-specific features.

Serum urate and the risk of major coronary heart disease events.

PubMed Central

Wannamethee, S. G.; Shaper, A. G.; Whincup, P. H.

1997-01-01

OBJECTIVE: To examine the relation between serum urate and the risk of major coronary heart disease events. DESIGN: A prospective study of a male cohort. SETTING: One general practice in each of 24 British towns. SUBJECTS: 7688 men aged 40-59 years at screening. MAIN OUTCOME MEASURES: Fatal and non-fatal coronary heart disease events. RESULTS: There were 1085 major coronary heart disease events during the average follow up period of 16.8 years. Serum urate was significantly associated with a wide range of cardiovascular risk factors including body mass index, alcohol intake, antihypertensive treatment, pre-existing coronary heart disease, serum triglycerides, cholesterol, and diastolic blood pressure. There was a significant positive association between serum urate and risk of coronary heart disease after adjustment for lifestyle factors and disease indicators. This relation was attenuated to non-significance upon additional adjustment for diastolic blood pressure and serum total cholesterol: cholesterol appeared to be the critical factor in attenuating this relation. When the association between serum urate and risk of coronary heart disease was examined by presence and grade of pre-existing coronary heart disease, a positive association was seen only in men with previous definite myocardial infarction, even after full adjustment (P = 0.07). CONCLUSIONS: The relation between serum urate and the risk of coronary heart disease depends heavily upon the presence of pre-existing myocardial infarction and widespread underlying atherosclerosis as well as the clustering of risk factors. Thus serum urate is not a truly independent risk factor for coronary heart disease. Raised serum urate appears to be an integral part of the cluster of risk factors associated with the insulin resistance syndrome that include obesity, raised serum triglycerides, and serum cholesterol. PMID:9326988

An annotated bibliography of eastern redcedar.

Treesearch

Thomas L. Schmidt; Ronald J. Piva

1995-01-01

Presents a listing of 719 citations related to eastern redcedar through September 1994. Major eastern redcedar subject headings include: physiology, nursery propagation, regeneration / planting, pests, weather-related factors, control, products, wildlife relationship, and ecological relationships.

Major bleeding in patients with atrial fibrillation receiving apixaban or warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes.

PubMed

Hylek, Elaine M; Held, Claes; Alexander, John H; Lopes, Renato D; De Caterina, Raffaele; Wojdyla, Daniel M; Huber, Kurt; Jansky, Petr; Steg, Philippe Gabriel; Hanna, Michael; Thomas, Laine; Wallentin, Lars; Granger, Christopher B

2014-05-27

This study sought to characterize major bleeding on the basis of the components of the major bleeding definition, to explore major bleeding by location, to define 30-day mortality after a major bleeding event, and to identify factors associated with major bleeding. Apixaban was shown to reduce the risk of major hemorrhage among patients with atrial fibrillation in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. All patients who received at least 1 dose of a study drug were included. Major bleeding was defined according to the criteria of the International Society on Thrombosis and Haemostasis. Factors associated with major hemorrhage were identified using a multivariable Cox model. The on-treatment safety population included 18,140 patients. The rate of major hemorrhage among patients in the apixaban group was 2.13% per year compared with 3.09% per year in the warfarin group (hazard ratio [HR] 0.69, 95% confidence interval [CI]: 0.60 to 0.80; p < 0.001). Compared with warfarin, major extracranial hemorrhage associated with apixaban led to reduced hospitalization, medical or surgical intervention, transfusion, or change in antithrombotic therapy. Major hemorrhage followed by mortality within 30 days occurred half as often in apixaban-treated patients than in those receiving warfarin (HR 0.50, 95% CI: 0.33 to 0.74; p < 0.001). Older age, prior hemorrhage, prior stroke or transient ischemic attack, diabetes, lower creatinine clearance, decreased hematocrit, aspirin therapy, and nonsteroidal anti-inflammatory drugs were independently associated with an increased risk. Apixaban, compared with warfarin, was associated with fewer intracranial hemorrhages, less adverse consequences following extracranial hemorrhage, and a 50% reduction in fatal consequences at 30 days in cases of major hemorrhage. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Multiple sex partner behavior in female undergraduate students in China: a multi-campus survey.

PubMed

Yan, Hong; Chen, Weiqi; Wu, Haocheng; Bi, Yongyi; Zhang, Miaoxuan; Li, Shiyue; Braun, Kathryn L

2009-08-22

China is realizing increases in women engaged in premarital sex and multiple sex partner behavior. Our aim was to examine prevalence and determinants of multiple sex partner behavior among female undergraduates in China. Anonymously completed questionnaires were received from 4,769 unmarried female undergraduates, recruited using randomized cluster sampling by type of university and students' major and grade. Items captured demographic, family, peer and work influence, and student factors (major, academic performance, and sex-related knowledge and attitudes). To examine risk factors for sexual behaviors, we used multi-level logistic regression, yielding odds ratios (OR) and 95% confidence intervals (95% CI). Of 4,769 female students, 863 (18.10%) reported ever having sexual intercourse, and 5.31% reported having multiple sex partners (29.32% of all women having sexual intercourse). Several demographic, family, peer and work influences, and student factors (including major, performance, knowledge, and attitude toward sex) were risk factors for ever having sex. However, risk factors for multiple sex partners only included working in a place of entertainment, having current close friends that were living with boyfriends, poor academic performance, and positive attitudes toward multiple partners. These women also were more likely to practice masturbation, start having sex at a younger age, have sex with married men and/or men not their "boyfriends" at first coitus, and not use condoms consistently. A small but important subset of Chinese female undergraduates is engaged in unprotected sex with multiple sex partners. Interventions need to target at risk women, stressing the importance of consistent condom use.

Multiple sex partner behavior in female undergraduate students in China: A multi-campus survey

PubMed Central

Yan, Hong; Chen, Weiqi; Wu, Haocheng; Bi, Yongyi; Zhang, Miaoxuan; Li, Shiyue; Braun, Kathryn L

2009-01-01

Background China is realizing increases in women engaged in premarital sex and multiple sex partner behavior. Our aim was to examine prevalence and determinants of multiple sex partner behavior among female undergraduates in China. Methods Anonymously completed questionnaires were received from 4,769 unmarried female undergraduates, recruited using randomized cluster sampling by type of university and students' major and grade. Items captured demographic, family, peer and work influence, and student factors (major, academic performance, and sex-related knowledge and attitudes). To examine risk factors for sexual behaviors, we used multi-level logistic regression, yielding odds ratios (OR) and 95% confidence intervals (95% CI). Results Of 4,769 female students, 863 (18.10%) reported ever having sexual intercourse, and 5.31% reported having multiple sex partners (29.32% of all women having sexual intercourse). Several demographic, family, peer and work influences, and student factors (including major, performance, knowledge, and attitude toward sex) were risk factors for ever having sex. However, risk factors for multiple sex partners only included working in a place of entertainment, having current close friends that were living with boyfriends, poor academic performance, and positive attitudes toward multiple partners. These women also were more likely to practice masturbation, start having sex at a younger age, have sex with married men and/or men not their "boyfriends" at first coitus, and not use condoms consistently. Conclusion A small but important subset of Chinese female undergraduates is engaged in unprotected sex with multiple sex partners. Interventions need to target at risk women, stressing the importance of consistent condom use. PMID:19698132

Nutrients in groundwaters of the conterminous United States, 1992-1995

USGS Publications Warehouse

Nolan, B.T.; Stoner, J.D.

2000-01-01

Results of a national water quality assessment indicate that nitrate is detected in 71% of groundwater samples, more than 13 times as often as ammonia, nitrite, organic nitrogen, and orthophosphate, based on a common detection threshold of 0.2 mg/L. Shallow groundwater (typically 5 m deep or less) beneath agricultural land has the highest median nitrate concentration (3.4 mg/L), followed by shallow groundwater beneath urban land (1.6 mg/L) and deeper groundwater in major aquifers (0.48 mg/L). Nitrate exceeds the maximum contaminant level, 10 mg/L as nitrogen, in more than 15% of groundwater samples from 4 of 33 major aquifers commonly used as a source of drinking water. Nitrate concentration in groundwater is variable and depends on interactions among several factors, including nitrogen loading, soil type, aquifer permeability, recharge rate, and climate. For a given nitrogen loading, factors that generally increase nitrate concentration in groundwater include well-drained soils, fractured bedrock, and irrigation. Factors that mitigate nitrate contamination of groundwater include poorly drained soils, greater depth to groundwater, artificial drainage systems, intervening layers of unfractured bedrock, a low rate of groundwater recharge, and anaerobic conditions in aquifers.

The performance environment of the England youth soccer teams.

PubMed

Pain, Matthew A; Harwood, Chris

2007-10-01

In the present study, we examined the performance environment of the England youth soccer teams. Using a semi-structured protocol with a prospective sample, national coaches (n = 6), sport scientists (n = 3), and players (n = 4) were interviewed directly following international tournaments about the factors that positively and negatively influenced performance. Qualitative content analysis revealed the following factors as major positive influences on performance: adhering to a consistent tournament strategy, player understanding, strong team cohesion, organized entertainment activities, detailed knowledge of opposition, an effective physical rest/recovery strategy, and previous tournament experience. Major factors perceived to have negatively influenced performance included: over-coaching, player boredom, player anxiety, physical superiority of the opposition, physical fatigue over the tournament, problems sleeping, and lack of information on the opposition. Eight overall dimensions emerged to describe the performance environment: planning and organization, physical environment, tactical factors, development and performance philosophy, psychological factors, physical factors, social factors, and coaching. The findings support recent work that suggests the performance environment is multifaceted, with performance being contingent upon a broad range of interacting factors that go beyond the traditional psychosocial and physical domains.

Characterization of heavy-metal-contaminated sediment by using unsupervised multivariate techniques and health risk assessment.

PubMed

Wang, Yeuh-Bin; Liu, Chen-Wuing; Wang, Sheng-Wei

2015-03-01

This study characterized the sediment quality of the severely contaminated Erjen River in Taiwan by using multivariate analysis methods-including factor analysis (FA), self-organizing maps (SOMs), and positive matrix factorization (PMF)-and health risk assessment. The SOMs classified the dataset with similar heavy-metal-contaminated sediment into five groups. FA extracted three major factors-traditional electroplating and metal-surface processing factor, nontraditional heavy-metal-industry factor, and natural geological factor-which accounted for 80.8% of the variance. The SOMs and FA revealed the heavy-metal-contaminated-sediment hotspots in the middle and upper reaches of the major tributary in the dry season. The hazardous index value for health risk via ingestion was 0.302. PMF further qualified the source apportionment, indicating that traditional electroplating and metal-surface-processing industries comprised 47% of the health risk posed by heavy-metal-contaminated sediment. Contaminants discharged from traditional electroplating and metal-surface-processing industries in the middle and upper reaches of the major tributary must be eliminated first to improve the sediment quality in Erjen River. The proposed assessment framework for heavy-metal-contaminated sediment can be applied to contaminated-sediment river sites in other regions. Copyright © 2014 Elsevier Inc. All rights reserved.

Rediscovering the wound hematoma as a site of hemostasis during major arterial hemorrhage.

PubMed

White, N J; Mehic, E; Wang, X; Chien, D; Lim, E; St John, A E; Stern, S A; Mourad, P D; Rieger, M; Fries, D; Martinowitz, U

2015-12-01

Treatments for major internal bleeding after injury include permissive hypotension to decrease the rate of blood loss, intravenous infusion of plasma or clotting factors to improve clot formation, and rapid surgical hemostasis or arterial embolization to control bleeding vessels. Yet, little is known regarding major internal arterial hemostasis, or how these commonly used treatments might influence hemostasis. (i) To use a swine model of femoral artery bleeding to understand the perivascular hemostatic response to contained arterial hemorrhage. (ii) To directly confirm the association between hemodynamics and bleeding velocity. (iii) To observe the feasibility of delivering an activated clotting factor directly to internal sites of bleeding using a simplified angiographic approach. Ultrasound was used to measure bleeding velocity and in vivo clot formation by elastography in a swine model of contained femoral artery bleeding with fluid resuscitation. A swine model of internal pelvic and axillary artery hemorrhage was also used to demonstrate the feasibility of local delivery of an activated clotting factor. In this model, clots formed slowly within the peri-wound hematoma, but eventually contained the bleeding. Central hemodynamics correlated positively with bleeding velocity. Infusion of recombinant human activated factor VII into the injured artery near the site of major internal hemorrhage in the pelvis and axillae was feasible. We rediscovered that clot formation within the peri-wound hematoma is an integral component of hemostasis and a feasible target for the treatment of major internal bleeding using activated clotting factors delivered using a simplified angiographic approach. © 2015 International Society on Thrombosis and Haemostasis.

Stress and coping in Australian nurses: a systematic review.

PubMed

Lim, J; Bogossian, F; Ahern, K

2010-03-01

To identify factors that contribute to stress in Australian nurses, consider the coping strategies they use and examine the effects of stressors on nurses' health and well-being. Stress is a major concern in the nursing profession with work overload, nurse shortages and high turnover rates as the common stressors. Although nursing stress has been studied extensively, there is a lack of clarity on the nursing situation in Australia. A systematic review of the current literature was conducted on stress and coping strategies within the Australian nursing population. Stressors included work overload, role conflicts and experiences of aggression. Coping strategies included seeking support, problem solving and self-control. The majority of the studies reported detrimental effects on nurses' physical and mental well-being with little consideration given to the spillover effects of nursing work stress to their family and social relationships. Recommendations included factoring in personal and work stresses, promoting the use of effective coping strategies and maintaining supportive social relationships.

Barrett’s Esophagus: Frequency and Prediction of Dysplasia and Cancer

PubMed Central

Falk, Gary W.

2015-01-01

The incidence of esophageal adenocarcinoma is continuing to increase at an alarming rate in the Western world today. Barrett’s esophagus is a clearly recognized risk factor for the development of esophageal adenocarcinoma, but the overwhelming majority of patients with Barrett’s esophagus will never develop esophageal cancer. A number of endoscopic, histologic and epidemiologic risk factors identify Barrett’s esophagus patients at increased risk for progression to high-grade dysplasia and esophageal adenocarcinoma. Endoscopic factors include segment length, mucosal abnormalities as seemingly trivial as esophagitis and the 12 to 6 o’clock hemisphere of the esophagus. Both intestinal metaplasia and low grade dysplasia, the latter only if confirmed by a pathologist with expertise in Barrett’s esophagus pathologic interpretation are the histologic risk factors for progression. Epidemiologic risk factors include aging, male gender, obesity, and smoking. Factors that may protect against the development of adenocarcinoma include a diet rich in fruits and vegetables, and the use of proton pump inhibitors, aspirin/NSAIDs and statins. PMID:25743461

Barrett's oesophagus: frequency and prediction of dysplasia and cancer.

PubMed

Falk, Gary W

2015-02-01

The incidence of oesophageal adenocarcinoma is continuing to increase at an alarming rate in the Western world today. Barrett's oesophagus is a clearly recognized risk factor for the development of oesophageal adenocarcinoma, but the overwhelming majority of patients with Barrett's oesophagus will never develop oesophageal cancer. A number of endoscopic, histologic and epidemiologic risk factors identify Barrett's oesophagus patients at increased risk for progression to high-grade dysplasia and oesophageal adenocarcinoma. Endoscopic factors include segment length, mucosal abnormalities as seemingly trivial as oesophagitis and the 12 to 6 o'clock hemisphere of the oesophagus. Both intestinal metaplasia and low grade dysplasia, the latter only if confirmed by a pathologist with expertise in Barrett's oesophagus pathologic interpretation are the histologic risk factors for progression. Epidemiologic risk factors include ageing, male gender, obesity, and smoking. Factors that may protect against the development of adenocarcinoma include a diet rich in fruits and vegetables, and the use of proton pump inhibitors, aspirin/NSAIDs and statins. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stroke in Saudi children. Epidemiology, clinical features and risk factors.

PubMed

Salih, Mustafa A; Abdel-Gader, Abdel-Galil M; Al-Jarallah, Ahmed A; Kentab, Amal Y; Alorainy, Ibrahim A; Hassan, Hamdy H; Bahakim, Hassan M; Kurbaan, Khadija M; Zahraa, Jihad N; Al-Nasser, Mohammed N; Nasir, Ali A; Khoja, Waleed A; Kabiraj, Mohammad M

2006-03-01

To describe the epidemiology and clinical features of stroke in a prospective and retrospective cohort of Saudi children and ascertain the causes, pathogenesis, and risk factors. The Retrospective Study Group (RSG) included children with stroke who were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the period July 1992 to February 2001. The Prospective Study Group (PSG) included those seen between February 2001 and March 2003. During the combined study periods of 10 years and 7 months, 117 children (61 males and 56 females, aged one month-12 years) were evaluated; the majority (89%) of these were Saudis. The calculated annual hospital frequency rate of stroke was 27.1/100,000 of the pediatric (1 month-12 years) population. The mean age at onset of the initial stroke in the 104 Saudi children was 27.1 months (SD = 39.3 months) and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). Large-vessel infarcts (LVI, 51.9%) were more common than small-vessel lacunar lesions (SVLL, 19.2%). Five patients (4.8%) had combined LVI and SVLL. Intracranial hemorrhage was less common (18.2%), whereas sinovenous thrombosis was diagnosed in 6 (5.8%) patients. A major risk factor was identified in 94 of 104 (89.4%) Saudi children. Significantly more hematologic disorders and coagulopathies were identified in the PSG compared to the RSG (p=0.001), reflecting a better yield following introduction of more comprehensive hematologic and coagulation laboratory tests during the prospective study period. Hematologic disorders were the most common risk factor (46.2%), presumed perinatal ischemic cerebral injury was a risk factor in 23 children (22.1%) and infectious and inflammatory disorders of the circulatory system in 18 (17.3%). Congenital and genetic cerebrovascular anomalies were the underlying cause in 7 patients (6.7%) and cardiac diseases in 6 (5.8%). Six patients (5.8%) had moyamoya syndrome, which was associated with another disease in all of them. Inherited metabolic disorders (3.8%) included 3 children with Leigh syndrome and a 29-month-old girl with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes. Systemic vascular disease was a risk factor in 3 children (2.9%) including 2 who had hypernatremic dehydration; and post-traumatic arterial dissection was causative in 3 cases (2.9%). Several patients had multiple risk factors, whereas no risk factor could be identified in 11 (10.6%). Due to the high prevalence and importance of multiple risk factors, a comprehensive investigation, including hematologic, neuroimaging and metabolic studies should be considered in every child with stroke.

Un Corazón Saludable: factors influencing outcomes of an exercise program designed to impact cardiac and metabolic risks among urban Latinas.

PubMed

Harralson, Tina L; Emig, Julie Cousler; Polansky, Marcia; Walker, Renee E; Cruz, Joanna Otero; Garcia-Leeds, Claudia

2007-12-01

A high prevalence of physical inactivity, metabolic risk factors, and depression place Latinas in peril of developing cardiovascular disease. "Un Corazón Saludable: A Healthy Heart" was developed to engage urban Latinas in physical activity and increase awareness of cardiac and metabolic risk factors. Two hundred and twenty-five Latinas enrolled in the program that included salsa aerobics and culturally sensitive health education modules. Cardiac and metabolic risk factors measured in this study were body mass index (BMI), waist-to-hip ratio, abdominal obesity, and blood pressure. Psychosocial risk factors measured included depressive symptoms and perceived social support. Fifty-two percent of the enrollees completed the program. Results indicated decreases in BMI, abdominal obesity, and symptoms of depression among Latinas who completed the program. Those who did not complete the program were younger, had greater depressive symptomatology, reported poorer social support, and they tended to be caregivers and U.S. born. Focus groups of program participants ascertained that caregiving and family obligations were major barriers to exercise while social support was a major facilitator of exercise. This research indicates that programs developed to recognize and address cultural barriers can impact physical and psychosocial risk factors among urban Latinas who are able to attend. Program retention may improve if future exercise programs conducted through community-base organizations offered support to Latinas regarding issues that interfere with self-care and health promotion. Future programs should consider including mental health and social service case management as part of comprehensive exercise/educational programs.

Cosmetic Liposuction: Preoperative Risk Factors, Major Complication Rates, and Safety of Combined Procedures.

PubMed

Kaoutzanis, Christodoulos; Gupta, Varun; Winocour, Julian; Layliev, John; Ramirez, Roberto; Grotting, James C; Higdon, Kent

2017-06-01

Liposuction is among the most commonly performed aesthetic procedures, and is being performed increasingly as an adjunct to other procedures. To report the incidence and risk factors of significant complications after liposuction, and to determine whether adding liposuction to other cosmetic surgical procedures impacts the complication risk. A prospective cohort of patients who underwent liposuction between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major complications requiring emergency room visit, hospital admission, or reoperation within 30 days of the operation. Univariate and multivariate analysis evaluated risk factors including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, and combined procedures. Of the 31,010 liposuction procedures, only 11,490 (37.1%) were performed as a solitary procedure. Liposuction alone had a major complication rate of 0.7% with hematoma (0.15%), pulmonary complications (0.1%), infection (0.1%), and confirmed venous thromboembolism (VTE) (0.06%) being the most common. Independent predictors of major complications included combined procedures (Relative Risk (RR) 4.81), age (RR 1.01), BMI (RR 1.05), and procedures performed in hospitals (RR 1.36). When examining specifically other aesthetic procedures performed alone or with liposuction, combined procedures had a higher risk of confirmed VTE (RR 5.65), pulmonary complications (RR 2.72), and infection (RR 2.41), but paradoxically lower hematoma risk (RR 0.77) than solitary procedures. Liposuction performed alone is a safe procedure with a low risk of major complications. Combined procedures, especially on obese or older individuals, can significantly increase complication rates. The impact of liposuction on the risk of hematoma in combined procedures needs further investigation. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Examining the latent structure mechanisms for comorbid posttraumatic stress disorder and major depressive disorder.

PubMed

Hurlocker, Margo C; Vidaurri, Desirae N; Cuccurullo, Lisa-Ann J; Maieritsch, Kelly; Franklin, C Laurel

2018-03-15

Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD. Therefore, we compared the factor structures of the Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5) PTSD and MDD and examined the mediating role of the PTSD NACM and Hyperarousal factors on the relationship between MDD and PTSD symptom severity. Participants included 598 trauma-exposed veterans (M age = 48.39, 89% male) who completed symptom self-report measures of DSM-5 PTSD and MDD. Confirmatory factor analyses indicated an adequate-fitting four-factor DSM-5 PTSD model and two-factor MDD model. Compared to other PTSD factors, the PTSD NACM factor had the strongest relationship with the MDD Affective factor, and the PTSD NACM and Hyperarousal factors had the strongest association with the MDD Somatic factor. Further, the PTSD NACM factor explained the relationship between MDD factors and PTSD symptom severity. More Affective and Somatic depression was related to more NACM symptoms, which in turn were related to increased severity of PTSD. Limitations include the reliance on self-report measures and the use of a treatment-seeking, trauma-exposed veteran sample which may not generalize to other populations. Implications concerning the shared somatic complaints and psychological distress in the comorbidity of PTSD and MDD are discussed. Published by Elsevier B.V.

Die Virus-induzierten Lebererkrankungen des Menschen

NASA Astrophysics Data System (ADS)

Eisenburg, J.

1982-12-01

Although many viral agents may be associated with inflammatory hepatic changes, the vast majority of clinically important viral hepatitis is caused by hepatitis A, hepatitis B and the non A, non B agents. Infection of the liver of man by these hepatotropic agents is still a major public health problem in all parts of the world and constitutes a major hazard of the transfusion of blood and plasma derivatives. The magnitude of this hepatitis problem is not only documented by the about 200 million carriers of the hepatitis-B virus throughout the world, many of them asymptomatic, but also by the fact, that hepatitis B and non A, non B may progress to chronic liver disease, including cirrhosis and probably primary liver cancer. Potentially important pathogenetic determinants include viral factors such as subtype, dosage and mode of transmission and host factors such as age, sex, preexisting liver disease, coexisting non-liver disease (diabetes etc.), genetics and immune response to viral or autoantigens. As the virus itself seems not directly cytopathic, the diversity of lesions has been attributed to variation in the capacity of the host's response.

Proposal of a new staging system for intrahepatic cholangiocarcinoma: Analysis of surgical patients from a nationwide survey of the Liver Cancer Study Group of Japan.

PubMed

Sakamoto, Yoshihiro; Kokudo, Norihiro; Matsuyama, Yutaka; Sakamoto, Michiie; Izumi, Namiki; Kadoya, Masumi; Kaneko, Shuichi; Ku, Yonson; Kudo, Masatoshi; Takayama, Tadatoshi; Nakashima, Osamu

2016-01-01

In the current American Joint Committee on Cancer/International Union Against Cancer staging system (seventh edition) for intrahepatic cholangiocarcinoma (ICC), tumor size was excluded, and periductal invasion was added as a new tumor classification-defining factor. The objective of the current report was to propose a new staging system for ICC that would be better for stratifying the survival of patients based on data from the nationwide Liver Cancer Study Group of Japan database. Of 756 patients who underwent surgical resection for ICC between 2000 and 2005, multivariate analyses of the clinicopathologic factors of 419 patients who had complete data sets were performed to elucidate relevant factors for inclusion in a new tumor classification and staging system. Overall survival data were best stratified using a cutoff value of 2 cm using a minimal P value approach to discriminate patient survival. The 5-year survival rate of 15 patients who had ICC measuring ≤ 2 cm in greatest dimension without lymph node metastasis or vascular invasion was 100%, and this cohort was defined as T1. Multivariate analysis of prognostic factors for 267 patients with lymph node-negative and metastasis-negative (N0M0) disease indicated that the number of tumors, the presence arterial invasion, and the presence major biliary invasion were independent and significant prognostic factors. The proposed new system, which included tumor number, tumor size, arterial invasion, and major biliary invasion for tumor classification, provided good stratification of overall patient survival according to disease stage. Macroscopic periductal invasion was associated with major biliary invasion and an inferior prognosis. The proposed new staging system, which includes a tumor cutoff size of 2 cm and major biliary invasion, may be useful for assigning patients to surgery. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.

PubMed

Bruins Slot, Karsten M H; Berge, Eivind

2013-08-08

Anticoagulant treatment with vitamin K antagonists (VKAs) is aimed at preventing thromboembolic complications and has been the therapy of choice for most people with non-valvular atrial fibrillation (AF) for many decades. A new class of anticoagulants, the factor Xa inhibitors, appear to have several pharmacological and practical advantages over VKAs. To assess the effectiveness and safety of treatment with factor Xa inhibitors versus VKAs for the prevention of cerebral or systemic embolic events in people with AF. We searched the trials registers of the Cochrane Stroke Group and the Cochrane Heart Group (June 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10), MEDLINE (1950 to April 2013) and EMBASE (1980 to April 2013). In an effort to identify further published, unpublished and ongoing trials we searched trials registers and Google Scholar (July 2012). We also screened reference lists and contacted pharmaceutical companies, authors and sponsors of relevant published trials. Randomised controlled trials that directly compared the effects of long-term treatment (more than four weeks) with factor Xa inhibitors and VKAs for the prevention of cerebral and systemic embolism in patients with AF. We included patients with and without a previous stroke or TIA. The primary efficacy outcome was the composite endpoint of all strokes and other systemic embolic events. Two authors independently assessed trial quality and the risk of bias, and extracted data. We calculated a weighted estimate of the typical treatment effect across trials using the odds ratio (OR) with 95% confidence interval (CI) by means of a fixed-effect model. However, in the case of moderate or high heterogeneity of treatment effects, we used a random-effects model to compare the overall treatment effects and performed a pre-specified sensitivity analysis excluding any fully open-label studies. We included data from 42,084 participants randomised into 10 trials. All participants had a confirmed diagnosis of AF (or atrial flutter) and were deemed by the randomising physician to be eligible for long-term anticoagulant treatment with a VKA (warfarin) with a target International Normalised Ratio (INR) of 2.0 to 3.0 in most patients. The included trials directly compared dose-adjusted warfarin with either apixaban, betrixaban, darexaban, edoxaban, idraparinux or rivaroxaban. Four trials were double-masked, five partially-masked (that is different doses of factor Xa inhibitor administered double-masked and warfarin administered open-label) and one was open-label. Median duration of follow-up ranged from 12 weeks to 1.9 years.The composite primary efficacy endpoint of all strokes (both ischaemic and haemorrhagic) and non-central nervous systemic embolic events was reported in nine of the included studies (40,777 participants). Treatment with a factor Xa inhibitor significantly decreased the number of strokes and systemic embolic events compared with dose-adjusted warfarin (OR 0.81, 95% CI 0.72 to 0.91). We also analysed both components of this composite endpoint separately: treatment with a factor Xa inhibitor significantly decreased both the number of ischaemic and haemorrhagic strokes (OR 0.78, 95% CI 0.69 to 0.89) and the number of systemic embolic events (OR 0.53, 95% CI 0.32 to 0.87).All of the included studies (42,078 participants) reported the number of major bleedings. Treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.89, 95% CI 0.81 to 0.98). There was, however, statistically significant and high heterogeneity (I² = 81%) and an analysis using a random-effects model did not show a statistically significant decrease in the number of major bleedings (OR 0.92, 95% CI 0.63 to 1.34). The pre-specified sensitivity analysis excluding open-label studies showed that treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.84, 95% CI 0.76 to 0.92) but moderate heterogeneity was still observed (I² = 65%). A similar sensitivity analysis using a random-effects model did not show a statistically significant decrease in the number of major bleedings in patients treated with factor Xa inhibitors (OR 0.78, 95% CI 0.57 to 1.05). Part of the observed heterogeneity can thus be explained by the increased risk of major bleedings in the factor Xa treatment arm in the single included open-label study, which studied idraparinux. Other heterogeneity might be explained by differences in baseline bleeding risks in the two largest trials of apixaban and rivaroxaban that we included in this review.Data on intracranial haemorrhages (ICHs) were reported in eight studies (39,638 participants). Treatment with a factor Xa inhibitor significantly reduced the risk of ICH compared with warfarin (OR 0.56, 95% CI 0.45 to 0.70). Again, we observed statistically significant heterogeneity (I² = 60%). The pre-specified sensitivity analysis excluding the open-label study showed that treatment with a factor Xa inhibitor significantly reduced the number of ICHs compared with warfarin (OR 0.51, 95% CI 0.41 to 0.64), without any sign of statistical heterogeneity (I² = 0%).The number of patients who died from any cause was reported in six studies (38,924 participants). Treatment with a factor Xa inhibitor significantly reduced the number of all-cause deaths compared with warfarin (OR 0.88, 95% 0.81 to 0.97). Factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in patients with AF. Factor Xa inhibitors also seem to reduce the number of major bleedings and ICHs compared with warfarin, though the evidence for a reduction of major bleedings is somewhat less robust. There is currently no conclusive evidence to determine which factor Xa inhibitor is more effective and safer for long-term anticoagulant treatment of patients with AF as head-to-head studies of the different factor Xa inhibitors have not yet been performed.

Survey of piloting factors in V/STOL aircraft with implications for flight control system design

NASA Technical Reports Server (NTRS)

Ringland, R. F.; Craig, S. J.

1977-01-01

Flight control system design factors involved for pilot workload relief are identified. Major contributors to pilot workload include configuration management and control and aircraft stability and response qualities. A digital fly by wire stability augmentation, configuration management, and configuration control system is suggested for reduction of pilot workload during takeoff, hovering, and approach.

Cultural Factors Related to Smoking in San Francisco's Irish Bars

ERIC Educational Resources Information Center

Satterlund, Travis D.; Antin, Tamar M. J.; Lee, Juliet P.; Moore, Roland S.

2009-01-01

California's Smoke-Free Workplace Act was extended to include bars in 1998. While the majority of bars in the state have become smoke free, in many bars patrons and staff continue to smoke despite the law. The authors present findings from a study which assessed cultural factors related to continued smoking in bars in the city of San Francisco. In…

Seasonality of Suicidal Behavior

PubMed Central

Woo, Jong-Min; Okusaga, Olaoluwa; Postolache, Teodor T.

2012-01-01

A seasonal suicide peak in spring is highly replicated, but its specific cause is unknown. We reviewed the literature on suicide risk factors which can be associated with seasonal variation of suicide rates, assessing published articles from 1979 to 2011. Such risk factors include environmental determinants, including physical, chemical, and biological factors. We also summarized the influence of potential demographic and clinical characteristics such as age, gender, month of birth, socioeconomic status, methods of prior suicide attempt, and comorbid psychiatric and medical diseases. Comprehensive evaluation of risk factors which could be linked to the seasonal variation in suicide is important, not only to identify the major driving force for the seasonality of suicide, but also could lead to better suicide prevention in general. PMID:22470308

Shared Risk Factors in Cardiovascular Disease and Cancer.

PubMed

Koene, Ryan J; Prizment, Anna E; Blaes, Anne; Konety, Suma H

2016-03-15

Cardiovascular disease (CVD) and cancer are the 2 leading causes of death worldwide. Although commonly thought of as 2 separate disease entities, CVD and cancer possess various similarities and possible interactions, including a number of similar risk factors (eg, obesity, diabetes mellitus), suggesting a shared biology for which there is emerging evidence. Although chronic inflammation is an indispensable feature of the pathogenesis and progression of both CVD and cancer, additional mechanisms can be found at their intersection. Therapeutic advances, despite improving longevity, have increased the overlap between these diseases, with millions of cancer survivors now at risk of developing CVD. Cardiac risk factors have a major impact on subsequent treatment-related cardiotoxicity. In this review, we explore the risk factors common to both CVD and cancer, highlighting the major epidemiological studies and potential biological mechanisms that account for them. © 2016 American Heart Association, Inc.

Development of the major trauma case review tool.

PubMed

Curtis, Kate; Mitchell, Rebecca; McCarthy, Amy; Wilson, Kellie; Van, Connie; Kennedy, Belinda; Tall, Gary; Holland, Andrew; Foster, Kim; Dickinson, Stuart; Stelfox, Henry T

2017-02-28

As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.

Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study.

PubMed

Klijs, Bart; Kibele, Eva U B; Ellwardt, Lea; Zuidersma, Marij; Stolk, Ronald P; Wittek, Rafael P M; Mendes de Leon, Carlos M; Smidt, Nynke

2016-08-11

Previous studies are inconclusive on whether poor socioeconomic conditions in the neighborhood are associated with major depressive disorder. Furthermore, conceptual models that relate neighborhood conditions to depressive disorder have not been evaluated using empirical data. In this study, we investigated whether neighborhood income is associated with major depressive episodes. We evaluated three conceptual models. Conceptual model 1: The association between neighborhood income and major depressive episodes is explained by diseases, lifestyle factors, stress and social participation. Conceptual model 2: A low individual income relative to the mean income in the neighborhood is associated with major depressive episodes. Conceptual model 3: A high income of the neighborhood buffers the effect of a low individual income on major depressive disorder. We used adult baseline data from the LifeLines Cohort Study (N = 71,058) linked with data on the participants' neighborhoods from Statistics Netherlands. The current presence of a major depressive episode was assessed using the MINI neuropsychiatric interview. The association between neighborhood income and major depressive episodes was assessed using a mixed effect logistic regression model adjusted for age, sex, marital status, education and individual (equalized) income. This regression model was sequentially adjusted for lifestyle factors, chronic diseases, stress, and social participation to evaluate conceptual model 1. To evaluate conceptual models 2 and 3, an interaction term for neighborhood income*individual income was included. Multivariate regression analysis showed that a low neighborhood income is associated with major depressive episodes (OR (95 % CI): 0.82 (0.73;0.93)). Adjustment for diseases, lifestyle factors, stress, and social participation attenuated this association (ORs (95 % CI): 0.90 (0.79;1.01)). Low individual income was also associated with major depressive episodes (OR (95 % CI): 0.72 (0.68;0.76)). The interaction of individual income*neighborhood income on major depressive episodes was not significant (p = 0.173). Living in a low-income neighborhood is associated with major depressive episodes. Our results suggest that this association is partly explained by chronic diseases, lifestyle factors, stress and poor social participation, and thereby partly confirm conceptual model 1. Our results do not support conceptual model 2 and 3.

Central obesity, hypertension and coronary artery disease: The seed and soil hypothesis

PubMed Central

Dwivedi, Shridhar; Aggarwal, Amitesh

2011-01-01

Coronary artery disease (CAD) is a multifactorial disease wherein hereditary and environmental factors play a major role. Our hypothesis is that an individual’s genetic profile functions as soil while various environmental factors such as physical inactivity, smoking, stress, etc. act as seeds in the etiopathogenesis of CAD. Much of the information regarding genetic and environmental factors can be determined in a pedigree chart by taking a history of the index patient, including details of major risk factors such as age, sex, smoking, hypertension, diabetes, coronary artery disease and stroke in the family. Preparing such a chart is a cost-effective way of initiating primary preventive measures in patients in a developing economy. The advantage of a detailed pedigree chart is to provide a snapshot view of the evident and underlying risk factors in the family as a whole, and not to merely study conventional risk factors. It elucidates the hidden stressors and hereditary factors responsible for cardiovascular disease in the family. We report herein an illustrative pedigree chart which exemplifies our above hypothesis. PMID:21286217

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.

PubMed

Bruins Slot, Karsten Mh; Berge, Eivind

2018-03-06

Factor Xa inhibitors and vitamin K antagonists (VKAs) are now recommended in treatment guidelines for preventing stroke and systemic embolic events in people with atrial fibrillation (AF). This is an update of a Cochrane review previously published in 2013. To assess the effectiveness and safety of treatment with factor Xa inhibitors versus VKAs for preventing cerebral or systemic embolic events in people with AF. We searched the trials registers of the Cochrane Stroke Group and the Cochrane Heart Group (September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (August 2017), MEDLINE (1950 to April 2017), and Embase (1980 to April 2017). We also contacted pharmaceutical companies, authors and sponsors of relevant published trials. We used outcome data from marketing authorisation applications of apixaban, edoxaban and rivaroxaban that were submitted to regulatory authorities in Europe and the USA. We included randomised controlled trials (RCTs) that directly compared the effects of long-term treatment (lasting more than four weeks) with factor Xa inhibitors versus VKAs for preventing cerebral and systemic embolism in people with AF. The primary efficacy outcome was the composite endpoint of all strokes and systemic embolic events. Two review authors independently extracted data, and assessed the quality of the trials and the risk of bias. We calculated a weighted estimate of the typical treatment effect across trials using the odds ratio (OR) with 95% confidence interval (CI) by means of a fixed-effect model. In case of moderate or high heterogeneity of treatment effects, we used a random-effects model to compare the overall treatment effects. We also performed a pre-specified sensitivity analysis excluding any open-label studies. We included data from 67,688 participants randomised into 13 RCTs. The included trials directly compared dose-adjusted warfarin with either apixaban, betrixaban, darexaban, edoxaban, idraparinux, idrabiotaparinux, or rivaroxaban. The majority of the included data (approximately 90%) was from apixaban, edoxaban, and rivaroxaban.The composite primary efficacy endpoint of all strokes (both ischaemic and haemorrhagic) and non-central nervous systemic embolic events was reported in all of the included studies. Treatment with a factor Xa inhibitor significantly decreased the number of strokes and systemic embolic events compared with dose-adjusted warfarin in participants with AF (OR 0.89, 95% CI 0.82 to 0.97; 13 studies; 67,477 participants; high-quality evidence).Treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.78, 95% CI 0.73 to 0.84; 13 studies; 67,396 participants; moderate-quality evidence). There was, however, statistically significant and high heterogeneity (I 2 = 83%). When we repeated this analysis using a random-effects model, it did not show a statistically significant decrease in the number of major bleedings (OR 0.88, 95% CI 0.66 to 1.17). A pre-specified sensitivity analysis excluding all open-label studies showed that treatment with a factor Xa inhibitor significantly reduced the number of major bleedings compared with warfarin (OR 0.75, 95% CI 0.69 to 0.81), but high heterogeneity was also observed in this analysis (I 2 = 72%). The same sensitivity analysis using a random-effects model also showed a statistically significant decrease in the number of major bleedings in participants treated with factor Xa inhibitors (OR 0.76, 95% CI 0.60 to 0.96).Treatment with a factor Xa inhibitor significantly reduced the risk of intracranial haemorrhages (ICHs) compared with warfarin (OR 0.50, 95% CI 0.42 to 0.59; 12 studies; 66,259 participants; high-quality evidence). We observed moderate, but statistically significant heterogeneity (I 2 = 55%). The pre-specified sensitivity analysis excluding open-label studies showed that treatment with a factor Xa inhibitor significantly reduced the number of ICHs compared with warfarin (OR 0.47, 95% CI 0.40 to 0.56), with low, non-statistically significant heterogeneity (I 2 = 27%).Treatment with a factor Xa inhibitor also significantly reduced the number of all-cause deaths compared with warfarin (OR 0.89, 95% 0.83 to 0.95; 10 studies; 65,624 participants; moderate-quality evidence). Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with AF. The absolute effect of factor Xa inhibitors compared with warfarin treatment was, however, rather small. Factor Xa inhibitors also reduced the number of ICHs, all-cause deaths and major bleedings compared with warfarin, although the evidence for a reduction in the latter is less robust.

Efficacy of Chinese herbal medicine for stroke modifiable risk factors: a systematic review.

PubMed

Peng, Wenbo; Lauche, Romy; Ferguson, Caleb; Frawley, Jane; Adams, Jon; Sibbritt, David

2017-01-01

The vast majority of stroke burden is attributable to its modifiable risk factors. This paper aimed to systematically summarise the evidence of Chinese herbal medicine (CHM) interventions on stroke modifiable risk factors for stroke prevention. A literature search was conducted via the MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database from 1996 to 2016. Randomised controlled trials or cross-over studies were included. Risk of bias was assessed according to the Cochrane Risk of Bias tool. A total of 46 trials (6895 participants) were identified regarding the use of CHM interventions in the management of stroke risk factors, including 12 trials for hypertension, 10 trials for diabetes, eight trials for hyperlipidemia, seven trials for impaired glucose tolerance, three trials for obesity, and six trials for combined risk factors. Amongst the included trials with diverse study design, an intervention of CHM as a supplement to biomedicine and/or a lifestyle intervention was found to be more effective in lowering blood pressure, decreasing blood glucose level, helping impaired glucose tolerance reverse to normal, and/or reducing body weight compared to CHM monotherapy. While no trial reported deaths amongst the CHM groups, some papers do report moderate adverse effects associated with CHM use. However, the findings of such beneficial effects of CHM should be interpreted with caution due to the heterogeneous set of complex CHM studied, the various control interventions employed, the use of different participants' inclusion criteria, and low methodological quality across the published studies. The risk of bias of trials identified was largely unclear in the domains of selection bias and detection bias across the included studies. This study showed substantial evidence of varied CHM interventions improving the stroke modifiable risk factors. More rigorous research examining the use of CHM products for sole or multiple major stroke risk factors are warranted.

Anal Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Anal cancer treatment options include radiation therapy, chemotherapy, and/or surgery. Major prognostic factors are site, size, and nodal status. Get detailed information about newly diagnosed and recurrent anal cancer and treatment in this summary for clinicians.

Handbook of legumes of world economic importance

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

Duke, J.A.

1981-01-01

Treatments by 65 contributing authors are presented for some 150 species of Leguminosae (including major tree and shrub species) with information on: uses, folk medicine, chemistry, 'germplasm'; ecology; cultivation/harvesting/yields; and biotic factors affecting the species.

Amazonian freshwater habitats experiencing environmental and socioeconomic threats affecting subsistence fisheries.

PubMed

Alho, Cleber J R; Reis, Roberto E; Aquino, Pedro P U

2015-09-01

Matching the trend seen among the major large rivers of the globe, the Amazon River and its tributaries are facing aquatic ecosystem disruption that is affecting freshwater habitats and their associated biodiversity, including trends for decline in fishery resources. The Amazon's aquatic ecosystems, linked natural resources, and human communities that depend on them are increasingly at risk from a number of identified threats, including expansion of agriculture; cattle pastures; infrastructure such as hydroelectric dams, logging, mining; and overfishing. The forest, which regulates the hydrological pulse, guaranteeing the distribution of rainfall and stabilizing seasonal flooding, has been affected by deforestation. Flooding dynamics of the Amazon Rivers are a major factor in regulating the intensity and timing of aquatic organisms. This study's objective was to identify threats to the integrity of freshwater ecosystems, and to seek instruments for conservation and sustainable use, taking principally fish diversity and fisheries as factors for analysis.

[The psychological analysis of patients with tinnitus].

PubMed

Cai, Qing; Li, Jun; Tao, Zezhang; Huang, Zhiwu; Ma, Zhelan; Cao, Yongmao

2004-04-01

To investigate the psychological factor of tinnitus and assess the possible influenced aspects. To inspect the 95 cases with tinnitus by SCL-90, the 9 items were divided to 10 factors and compared to the Chinese normalizations. There were significant difference between 4 factors including: somatization, depression, anxiety, compel symptom and normalization (P<0.05). There were correlation between the emotion, age and educational level and psychological dysfunction of tinnitus. Psychoprophylaxis is the important factors to tinnitus, and the major influenced aspects are age, educational level and emotional stability.

Genetics of Dementia

PubMed Central

Paulson, Henry L.; Igo, Indu

2012-01-01

Genetic factors are now recognized to play an important role in most age-related dementias. While other factors, including aging itself, contribute to dementia, in this review we focus on the role of specific disease-causing genes and genetic factors in the most common age-related dementias. We review each dementia within the context of a genes/environment continuum, with varying levels of genetic versus environmental influence. All major classes of dementia will be discussed but greatest attention will be given to the most common dementia, Alzheimer’s disease, for which several new genetic factors were recently identified. PMID:22266883

Determinants of Mental Disorders in Syrian Refugees in Turkey Versus Internally Displaced Persons in Syria.

PubMed

Tekeli-Yesil, Sidika; Isik, Esra; Unal, Yesim; Aljomaa Almossa, Fuad; Konsuk Unlu, Hande; Aker, Ahmet Tamer

2018-07-01

To compare frequencies of some mental health disorders between Syrian refugees living in Turkey and internally displaced persons in Syria, and to identify factors associated with posttraumatic stress disorder and major depressive disorder. We carried out a field survey in May 2017 among 540 internally displaced persons in Syria and refugees in Turkey. The study revealed that mental disorders were highly prevalent in both populations. Major depressive disorder was more frequent among refugees in Turkey than among internally displaced persons in Syria; other mental disorders, including posttraumatic stress disorder, were more prevalent in the latter than in the former. Posttraumatic stress disorder was also associated with postmigration factors. Major depressive disorder was more likely among refugees in Turkey. In addition, the likelihood of major depressive disorder was predicted by stopping somewhere else before resettlement in the current location. The resettlement locus and the context and type of displacement seem to be important determinants of mental health disorders, with postmigration factors being stronger predictors of conflict-related mental health. Internally displaced persons may benefit more from trauma-focused approaches, whereas refugees may derive greater benefit from psychosocial approaches.

Key issues in application of composites to transport aircraft

NASA Technical Reports Server (NTRS)

Stone, M.

1978-01-01

The application of composite materials to transport aircraft was identified and reviewed including the major contributing disciplines of design, manufacturing, and processing. Factors considered include: crashworthiness considerations (structural integrity, postcrash fires, and structural fusing), electrical/avionics subsystems integration, lightning, and P-static protection design; manufacturing development, evaluation, selection, and refining of tooling and curing procedures; and major joint design considerations. Development of the DC-10 rudder, DC-10 vertical stabilizer, and the DC-9 wing study project was reviewed. The Federal Aviation Administration interface and the effect on component design of compliance with Federal Aviation Regulation 25 Composite Guidelines are discussed.

Room to Live: the sizing of Lunar and Martian Habitats

NASA Technical Reports Server (NTRS)

McGregor, Walter L.

2006-01-01

In order for man to return to space or extra terrestrial bodies for long duration missions it is important that adequate habitat volume be defined early to avoid costly delays and redesign. To properly define a habitat volume two major factors need to be considered. The first factor is the free or open space. This is the space that allows the crew room to move about the habitat. This space will vary based on crew size and length of the mission. The second major factor is the stowage space required for equipment and supplies. This includes both fixed volumes and consumables. Fixed volumes include items such as tools, communication equipment, Advanced Life Support (ALS) equipment, and support equipment. Consumables include items like filters, food, water and oxygen. This space is also dependent on crew size and mission length. A review of past missions into alien environments, such as deep sea habitats as well as space based habitats will be used to validate the assumption made in this paper. Once these key factors are defined trades must be run to optimize the overall volume of a habitat. This includes trades of disposable vs. reusable for items such as clothing, dishes, and water. Another factor to consider is the availability of in situ resources to aid in the construction of the habitat structure as well as re-supply of consumable items. A review of past missions into alien environments, such as deep sea habitats as well as space based habitats will be used to validate the assumption made in this paper. The result is a habitat sizing tool to provide a first order estimate of habitat volumes for extended mission to the surface of the moon and Mars.

Hepatitis C Among Clients of Health Care for the Homeless Primary Care Clinics

PubMed Central

Strehlow, Aaron J; Robertson, Marjorie J.; Zerger, Suzanne; Rongey, Catherine; Arangua, Lisa; Farrell, Ed; O’Sullivan, Adele; Gelberg, Lillian

2013-01-01

Objectives To describe the prevalence, distribution and risk factors for hepatitis C virus (HCV) infection among homeless adults using eight Health Care for the Homeless (HCH) clinics nationally. Methods Data were collected for 387 participants through blood draws, structured interviews, chart reviews. Results Overall prevalence of HCV-antibody positivity was 31.0%, including 70.0% among injection drug users and 15.5% among reported non-injectors. Much HCV infection was “hidden” as the majority (53.3%) of HCV-antibody positive participants was unaware of their status. Independent risk factors for HCV among the total sample included injection drug use, prison and tattoos; among injectors, risk factors included prison and ≥ 3 years of injection drug use; and among reported non-injectors, risk factors included tattoos and prison. Conclusion These HCH clinics serve high concentrations of HCV-infected injectors, making these and similar clinics priority intervention sites for aggressive screening, education, testing, and treatment for HCV and other blood-borne diseases. PMID:22643626

Evaluation of Risk Factors for Severe Pneumonia in Children: The Pneumonia Etiology Research for Child Health Study

PubMed Central

Deloria-Knoll, Maria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Moïsi, Jennifer C.; Johnson, Hope L.; Murdoch, David R.; O’Brien, Katherine L.; Levine, Orin S.; Scott, J. Anthony G.

2012-01-01

As a case-control study of etiology, the Pneumonia Etiology Research for Child Health (PERCH) project also provides an opportunity to assess the risk factors for severe pneumonia in hospitalized children at 7 sites. We identified relevant risk factors by literature review and iterative expert consultation. Decisions for inclusion in PERCH were based on comparability to published data, analytic plans, data collection costs and logistic feasibility, including interviewer time and subject fatigue. We aimed to standardize questions at all sites, but significant variation in the economic, cultural, and geographic characteristics of sites made it difficult to obtain this objective. Despite these challenges, the depth of the evaluation of multiple risk factors across the breadth of the PERCH sites should furnish new and valuable information about the major risk factors for childhood severe and very severe pneumonia, including risk factors for pneumonia caused by specific etiologies, in developing countries. PMID:22403226

Evaluation of risk factors for severe pneumonia in children: the Pneumonia Etiology Research for Child Health study.

PubMed

Wonodi, Chizoba B; Deloria-Knoll, Maria; Feikin, Daniel R; DeLuca, Andrea N; Driscoll, Amanda J; Moïsi, Jennifer C; Johnson, Hope L; Murdoch, David R; O'Brien, Katherine L; Levine, Orin S; Scott, J Anthony G

2012-04-01

As a case-control study of etiology, the Pneumonia Etiology Research for Child Health (PERCH) project also provides an opportunity to assess the risk factors for severe pneumonia in hospitalized children at 7 sites. We identified relevant risk factors by literature review and iterative expert consultation. Decisions for inclusion in PERCH were based on comparability to published data, analytic plans, data collection costs and logistic feasibility, including interviewer time and subject fatigue. We aimed to standardize questions at all sites, but significant variation in the economic, cultural, and geographic characteristics of sites made it difficult to obtain this objective. Despite these challenges, the depth of the evaluation of multiple risk factors across the breadth of the PERCH sites should furnish new and valuable information about the major risk factors for childhood severe and very severe pneumonia, including risk factors for pneumonia caused by specific etiologies, in developing countries.

Low-factor consumption for major surgery in haemophilia B with long-acting recombinant glycoPEGylated factor IX.

PubMed

Escobar, M A; Tehranchi, R; Karim, F A; Caliskan, U; Chowdary, P; Colberg, T; Giangrande, P; Giermasz, A; Mancuso, M E; Serban, M; Tsay, W; Mahlangu, J N

2017-01-01

Surgery in patients with haemophilia B carries a high risk of excessive bleeding and requires adequate haemostatic control until wound healing. Nonacog beta pegol, a long-acting recombinant glycoPEGylated factor IX (FIX), was used in the perioperative management of patients undergoing major surgery. To evaluate the efficacy and safety of nonacog beta pegol in patients with haemophilia B who undergo major surgery. This was an open-label, multicentre, non-controlled surgery trial aimed at assessing peri- and postoperative efficacy and safety of nonacog beta pegol in 13 previously treated patients with haemophilia B. All patients received a preoperative nonacog beta pegol bolus injection of 80 IU kg -1 . Postoperatively, the patients received fixed nonacog beta pegol doses of 40 IU kg -1 , repeated at the investigator's discretion. Safety assessments included monitoring of immunogenicity and adverse events. Intraoperative haemostatic effect was rated 'excellent' or 'good' in all 13 cases. Apart from the preoperative injection, none of the patients needed additional doses of nonacog beta pegol on the day of surgery. The median number of postoperative doses of nonacog beta pegol was 2.0 from days 1 to 6 and 1.5 from days 7 to 13. No unexpected intra- or postoperative complications were observed including deaths or thromboembolic events. No patients developed inhibitors. These results indicated that nonacog beta pegol was safe and effective in the perioperative setting, allowing major surgical interventions in patients with haemophilia B with minimal peri- and postoperative concentrate consumption and infrequent injections as reported with standard FIX products. © 2016 John Wiley & Sons Ltd.

Healthy and unhealthy dependence: implications for major depression.

PubMed

Schulte, Fiona S; Mongrain, Myriam; Flora, David B

2008-09-01

To examine the contribution of varying levels of dependency to Axis I and Axis II disorders, and to the recurrence of major depression in a graduate student sample diagnosed with a history of the disorder. At Time 1, participants were interviewed to confirm a current or past episode of major depression along with the presence of Axis II and other current or past Axis I disorders. Various measures of dependency were administered including the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976), the 3-Vector Dependency Inventory (3VDI; Pincus & Gurtman, 1995), and the Personal Style Inventory (PSI; Robins et al., 1994). Participants were interviewed 20 months later to determine the recurrence of a depressive episode. A factor analysis conducted on scale scores for each dependency measure resulted in three factors labelled 'unhealthy', 'intermediate', and 'healthy' dependence. Controlling for history of major depression, structural equation modelling found 'unhealthy' dependence to be the only predictor of recurrences of major depression and Axis II disorders, while 'healthy' dependence was related to fewer depressive symptoms. These results have important implications for the conceptualization of the dependency construct.

Mycobacterium Xenopi Found Incidentally on MRI of the Cervical Spine

DTIC Science & Technology

2010-01-01

been demonstrated to infect immunocompetent individuals.2 These individuals usually have some chronic health disorder as a risk factor for infection...The major associated risk factor is COPD; others include diabetes mellitus, alcoholism, and cancer. Actual cases present with symptoms...xenopi lung abscess in an immunocompetent man without pre-existing lung pathology. Scandinavian Journal of Infectious Diseases. 2005 August 8. 5 [No

Colorectal cancer--applying a gender lens.

PubMed

Oberoi, Devesh V; Jiwa, Moyez; McManus, Alexandra; Hodder, Rupert

2014-01-01

Colorectal cancer (CRC) is a major global health problem with survival varying according to stage at diagnosis. The incidence of CRC is much higher in patients with lower bowel symptoms. The symptoms are non-specific and are commonly experienced in the general population. Biological and environmental factors account for the high incidence and poor prognosis of CRC in men. To review the behavioural factors influencing patient delay in seeking help for lower bowel symptoms using a gender lens. An extensive literature search was performed using various databases including Medline, PubMed, CINAHL Plus, EMBASE and PsycINFO (1993-2013). Various search terms including rectal bleeding, prevalence, colorectal cancer, consultation, help-seeking, gender differences and men were used. A systematic methodology including systematic data extraction and narrative synthesis was applied. Thirty-two studies were included in the review. All studies except four were quantitative. Although there is some evidence that men delay more compared with women, there has not been any major improvement in the help-seeking behaviour for such symptoms over the past two decades. Several behavioural and demographic factors were associated with low rates of help-seeking. There are limited studies focusing on men's help-seeking behaviour for lower bowel symptoms. To facilitate timely help-seeking in men, it is important to understand their patterns of helpseeking for such symptoms. Further research to understand men's help-seeking behaviour is warranted.

iDriving (Intelligent Driving)

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

Malikopoulos, Andreas

2012-09-17

iDriving identifies the driving style factors that have a major impact on fuel economy. An optimization framework is used with the aim of optimizing a driving style with respect to these driving factors. A set of polynomial metamodels is constructed to reflect the responses produced in fuel economy by changing the driving factors. The optimization framework is used to develop a real-time feedback system, including visual instructions, to enable drivers to alter their driving styles in responses to actual driving conditions to improve fuel efficiency.

Key factors associated with postoperative complications in patients undergoing colorectal surgery.

PubMed

Manilich, E; Vogel, J D; Kiran, R P; Church, J M; Seyidova-Khoshknabi, Dilara; Remzi, F H

2013-01-01

Surgical outcomes are determined by complex interactions among a variety of factors including patient characteristics, diagnosis, and type of procedure. The aim of this study was to prioritize the effect and relative importance of the surgeon (in terms of identity of a surgeon and surgeon volume), patient characteristics, and the intraoperative details on complications of colorectal surgery including readmission, reoperation, sepsis, anastomotic leak, small-bowel obstruction, surgical site infection, abscess, need for transfusion, and portal and deep vein thrombosis. This study uses a novel classification methodology to measure the influence of various risk factors on postoperative complications in a large outcomes database. Using prospectively collected information from the departmental outcomes database from 2010 to 2011, we examined the records of 3552 patients who underwent colorectal surgery. Instead of traditional statistical methods, we used a family of 7000 bootstrap classification models to examine and quantify the impact of various factors on the most common serious surgical complications. For each complication, an ensemble of multivariate classification models was designed to determine the relative importance of potential factors that may influence outcomes of surgery. This is a new technique for analyzing outcomes data that produces more accurate results and a more reliable ranking of study variables in order of their importance in producing complications. Patients who underwent colorectal surgery in 2010 and 2011 were included. This study was conducted at a tertiary referral department at a major medical center. Postoperative complications were the primary outcomes measured. Factors sorted themselves into 2 groups: a highly important group (operative time, BMI, age, identity of the surgeon, type of surgery) and a group of low importance (sex, comorbidity, laparoscopy, and emergency). ASA score and diagnosis were of intermediate importance. The outcomes most influenced by variations in the highly important factors included readmission, transfusion, surgical site infection, and abscesses. This study was limited by the use of data from a single tertiary referral department at a major medical center. Body mass index, operative time, and the surgeon who performed the operation are the 3 most important factors influencing readmission rates, rates of transfusions, and surgical site infection. Identification of these contributing factors can help minimize complications.

Managing Depression during the Menopausal Transition

ERIC Educational Resources Information Center

Pearson, Quinn M.

2010-01-01

The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…

Working with Men Who Batter.

ERIC Educational Resources Information Center

Edleson, Jeffrey L.

1984-01-01

Examines factors associated with wife abuse and describes major components of a small group program designed to help men who batter. These include self-observation, cognitive restructuring, interpersonal skills training, relaxation training, and establishing a small group environment for intervention. (JAC)

Epistemologies and scientific reasoning skills among undergraduate science students

NASA Astrophysics Data System (ADS)

Mollohan, Katherine N.

Non-cognitive factors such as students' attitudes and beliefs toward a subject and their proficiency in scientific reasoning are important aspects of learning within science disciplines. Both factors have been studied in relation to science education in various discplines. This dissertation presents three studies that investigate student epistemologies and scientific reasoning in the domain of biology education. The first study investigated students' epistemic viewpoints in two introductory biology courses, one for science majors and one for non-science majors. This quantitative investigation revealed that the majors exhibited a negative shift in their attitudes and beliefs about biology and learning biology during a semester of introductory instruction. However, the non-science majors did not exhibit a similar shift. If fact, the non-science majors improved in their attitudes and beliefs during a semester of instruction, though not significantly so. The second study expands epistemological research to a population that has often been left out of this work, that is, intermediate-level biology majors. Quantitative and qualitative data was collected to reveal that junior and senior ranked students for the most part were able to characterize their views about biology and learning biology, and were able to associate factors with their epistemic improvement. Finally, the third study expands epistemology research further to determine if scientific reasoning and student attitudes and beliefs about learning science (specifically biology) are related. After a description of how various science and engineering majors compare in their scientific reasoning skills, this study indicated that among intermediate level biology majors there is no relationship between scientific reasoning skills and epistemologies, nor is there a relationship with other educational factors, including the number of courses taken during an undergraduate career, cumulative GPA, and standardized test scores (ACT). Taken together, the results of these studies can inform science education, particularly discipline-based education research in biology.

Factors influencing the pattern of self-medication in an adult Nigerian population.

PubMed

Afolabi, A O

2008-09-01

Despite the growing research interest in self-medication, little information has been available about its major determinants especially in developing countries. This informed the conduct of this study to determine the major factors that influence the pattern of self medication in a population of market women in Ifako-Ijaiye area of Lagos, Nigeria. Interviewer administered pretested semistructured questionnaire was used to collect data from 205 market women selected by multistage sampling technique. The patent medicine dealers were the commonest source of information on medications (31.4%) and where they were obtained (52.2%). The exceptions were the educated (62.5%) respondents who obtained theirs from hospitals and pharmacies. Trade and generic names (61.1%) were common means of drug recognition especially among the educated respondents (P<.05). Education of the respondents was the major factor influencing the practice of self-medication though the pattern was descriptively associated with the marital status and educational level of the respondents (P<.05). Benefits of the practice includes in the order: curing of ailments (58.0%), saving time and money (32.0%) and independence of care (7.0%). Literacy and public health education were the major factors influencing the pattern of self-medication among market women. Recommendations on the role of education of market women, patent medicine dealers and the importance of community pharmacy were suggested.

Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes.

PubMed

Miller, F W; Chen, W; O'Hanlon, T P; Cooper, R G; Vencovsky, J; Rider, L G; Danko, K; Wedderburn, L R; Lundberg, I E; Pachman, L M; Reed, A M; Ytterberg, S R; Padyukov, L; Selva-O'Callaghan, A; Radstake, T R; Isenberg, D A; Chinoy, H; Ollier, W E R; Scheet, P; Peng, B; Lee, A; Byun, J; Lamb, J A; Gregersen, P K; Amos, C I

2015-10-01

Autoimmune muscle diseases (myositis) comprise a group of complex phenotypes influenced by genetic and environmental factors. To identify genetic risk factors in patients of European ancestry, we conducted a genome-wide association study (GWAS) of the major myositis phenotypes in a total of 1710 cases, which included 705 adult dermatomyositis, 473 juvenile dermatomyositis, 532 polymyositis and 202 adult dermatomyositis, juvenile dermatomyositis or polymyositis patients with anti-histidyl-tRNA synthetase (anti-Jo-1) autoantibodies, and compared them with 4724 controls. Single-nucleotide polymorphisms showing strong associations (P<5×10(-8)) in GWAS were identified in the major histocompatibility complex (MHC) region for all myositis phenotypes together, as well as for the four clinical and autoantibody phenotypes studied separately. Imputation and regression analyses found that alleles comprising the human leukocyte antigen (HLA) 8.1 ancestral haplotype (AH8.1) defined essentially all the genetic risk in the phenotypes studied. Although the HLA DRB1*03:01 allele showed slightly stronger associations with adult and juvenile dermatomyositis, and HLA B*08:01 with polymyositis and anti-Jo-1 autoantibody-positive myositis, multiple alleles of AH8.1 were required for the full risk effects. Our findings establish that alleles of the AH8.1 comprise the primary genetic risk factors associated with the major myositis phenotypes in geographically diverse Caucasian populations.

Genome-wide Association Study Identifies HLA 8.1 Ancestral Haplotype Alleles as Major Genetic Risk Factors for Myositis Phenotypes

PubMed Central

Miller, Frederick W.; Chen, Wei; O’Hanlon, Terrance P.; Cooper, Robert G.; Vencovsky, Jiri; Rider, Lisa G.; Danko, Katalin; Wedderburn, Lucy R.; Lundberg, Ingrid E.; Pachman, Lauren M.; Reed, Ann M.; Ytterberg, Steven R.; Padyukov, Leonid; Selva-O’Callaghan, Albert; Radstake, Timothy R.; Isenberg, David A.; Chinoy, Hector; Ollier, William E.R.; Scheet, Paul; Peng, Bo; Lee, Annette; Byun, Jinyoung; Lamb, Janine A.; Gregersen, Peter K.; Amos, Christopher I.

2016-01-01

Autoimmune muscle diseases (myositis) comprise a group of complex phenotypes influenced by genetic and environmental factors. To identify genetic risk factors in patients of European ancestry, we conducted a genome-wide association study (GWAS) of the major myositis phenotypes in a total of 1710 cases, which included 705 adult dermatomyositis; 473 juvenile dermatomyositis; 532 polymyositis; and 202 adult dermatomyositis, juvenile dermatomyositis or polymyositis patients with anti-histidyl tRNA synthetase (anti-Jo-1) autoantibodies, and compared them with 4724 controls. Single-nucleotide polymorphisms showing strong associations (P < 5 × 10−8) in GWAS were identified in the major histocompatibility complex (MHC) region for all myositis phenotypes together, as well as for the four clinical and autoantibody phenotypes studied separately. Imputation and regression analyses found that alleles comprising the human leukocyte antigen (HLA) 8.1 ancestral haplotype (AH8.1) defined essentially all the genetic risk in the phenotypes studied. Although the HLA DRB1*03:01 allele showed slightly stronger associations with adult and juvenile dermatomyositis, and HLA B*08:01 with polymyositis and anti-Jo-1 autoantibody-positive myositis, multiple alleles of AH8.1 were required for the full risk effects. Our findings establish that alleles of the AH8.1haplotype comprise the primary genetic risk factors associated with the major myositis phenotypes in geographically diverse Caucasian populations. PMID:26291516

Factors influencing wound dehiscence.

PubMed

Riou, J P; Cohen, J R; Johnson, H

1992-03-01

Thirty-one abdominal fascial wound dehiscences occurred in 2,761 patients undergoing major abdominal surgery during a 5-year period (1%). Twenty-two specific local and systemic risk factors were analyzed and compared with the risk factors of a control group of 38 patients undergoing similar procedures without dehiscence. Through multivariate analysis, each factor was assessed as an independent statistical variable. Significant factors (p less than 0.05) were found to include age over 65, wound infection, pulmonary disease, hemodynamic instability, and ostomies in the incision. Additional systemic risk factors that were found to be significant included hypoproteinemia, systemic infection, obesity, uremia, hyperalimentation, malignancy, ascites, steroid use, and hypertension. Risk factors not found to be important independent variables included sex, type of incision, type of closure, foreign body in the wound, anemia, jaundice, and diabetes. When dehiscence and control groups were combined, 30% of patients with at least five significant risk factors developed dehiscence, and all the patients with more than eight risk factors developed a wound dehiscence. There was an overall mortality of 29%, which was directly related to the number of significant risk factors. The co-existence of 9 risk factors portended death in one third of the patients, and all the patients with more than 10 risk factors died.

Testing the dimensional structure of DSM-5 posttraumatic stress disorder symptoms in a nonclinical trauma-exposed adolescent sample.

PubMed

Liu, Liyong; Wang, Li; Cao, Chengqi; Qing, Yulan; Armour, Cherie

2016-02-01

The current study investigated the underlying dimensionality of DSM-5 posttraumatic stress disorder (PTSD) symptoms in a trauma-exposed Chinese adolescent sample using a confirmatory factor analytic (CFA) alternative model approach. The sample consisted of 559 students (242 females and 314 males) ranging in age from 12 to 18 years (M = 15.8, SD = 1.3). Participants completed the PTSD Checklist for DSM-5, the Major Depression Disorder and Panic Disorder subscales of the Revised Children's Anxiety and Depression Scale, and the Aggressive Behavior subscale of the Youth Self-Report. Confirmatory factor analytic results indicated that a seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal factors emerged as the best-fitting model. Further analyses showed that the external measures of psychopathological variables including major depressive disorder, panic disorder, and aggressive behavior were differentially associated with the resultant factors. These findings support and extend previous findings for the newly refined seven-factor hybrid model, and carry clinical and research implications for trauma-related psychopathology. © 2015 Association for Child and Adolescent Mental Health.

Student perceptions of secondary science: A performance technology application

NASA Astrophysics Data System (ADS)

Small, Belinda Rusnak

The primary purpose of this study was to identify influences blocking or promoting science performance from the lived K-12 classroom experience. Human Performance Technology protocols were used to understand factors promoting or hindering science performance. The goal was to gain information from the individual students' perspective to enhance opportunities for stakeholders to improve the current state of performance in science education. Individual perspectives of 10 secondary science students were examined using grounded theory protocols. Findings include students' science learning behaviors are influenced by two major themes, environmental supports and individual learning behaviors. The three environmental support factors identified include the methods students receive instruction, students' opportunities to access informal help apart from formal instruction, and students' feelings of teacher likability. Additionally, findings include three major factors causing individual learners to generate knowledge in science. Factors reported include personalizing information to transform data into knowledge, customizing learning opportunities to maximize peak performance, and tapping motivational opportunities to persevere through complex concepts. The emergent theory postulated is that if a performance problem exists in an educational setting, then integrating student perspectives into the cause analysis opens opportunity to align interventions for influencing student performance outcomes. An adapted version of Gilbert's Behavioral Engineering Model is presented as an organizational tool to display the findings. The boundaries of this Performance Technology application do not extend to the identification, selection, design, or implementation of solutions to improved science performance. However, as stakeholders begin to understand learner perspectives then aligned decisions may be created to support learners of science in a direct, cost effective manner.

Prenatal risk factors for Tourette Syndrome: a systematic review.

PubMed

Chao, Ting-Kuang; Hu, Jing; Pringsheim, Tamara

2014-01-30

Tourette Syndrome (TS) appears to be an inherited disorder, although genetic abnormalities have been identified in less than 1% of patients, and the mode of inheritance is uncertain. Many studies have investigated environmental factors that might contribute to the onset and severity of tics and associated comorbidities such as obsessive compulsive disorder (OCD) and attention deficit hyperactive disorder (ADHD). A systematic review and qualitative analysis were performed to provide a broad view of the association between pre- and perinatal factors and TS. The Medline, Embase and PsycINFO databases were searched using terms specific to Tourette's syndrome and keywords such as "pregnancy", "prenatal", "perinatal", "birth" and "neonatal". Studies were limited to studies on human subjects published in English or French through October 2012. 22 studies were included. Studies were of limited methodological quality, with most samples derived from specialty clinics, and most exposures ascertained retrospectively. The majority of the results for demographic factors of parents, including age, education, socioeconomic status, and marital status, revealed no significant association with the onset of TS, or the presence of comorbidity. Many factors were reported to be significantly associated with the onset of TS, the presence of comorbidity and symptom severity, but the most consistently reported factors were maternal smoking and low birth weight. There are few studies evaluating the relationship between pre and perinatal events and TS, and existing studies have major limitations, including the use of clinic rather than epidemiologically derived samples, retrospective data collection on pre and perinatal events and multiple hypothesis testing without appropriate statistical correction. The mechanism by which prenatal and perinatal adversities could lead to TS onset or symptom severity is unknown, but may be related to changes in the dopaminergic system as a result of early brain injury.

Non-small cell lung cancer: current treatment and future advances

PubMed Central

Zappa, Cecilia

2016-01-01

Lung cancer has a poor prognosis; over half of people diagnosed with lung cancer die within one year of diagnosis and the 5-year survival is less than 18%. Non-small cell lung cancer (NSCLC) accounts for the majority of all lung cancer cases. Risk factors for developing NSCLC have been identified, with cigarette smoking being a major factor along with other environmental and genetic risk factors. Depending on the staging of lung cancer, patients are eligible for certain treatments ranging from surgery to radiation to chemotherapy as well as targeted therapy. With the advancement of genetics and biomarkers testing, specific mutations have been identified to better target treatment for individual patients. This review discusses current treatments including surgery, chemotherapy, radiotherapy, and immunotherapy as well as how biomarker testing has helped improve survival in patients with NSCLC. PMID:27413711

Molecular epidemiology of tuberculosis in foreign-born persons living in San Francisco.

PubMed

Suwanpimolkul, Gompol; Jarlsberg, Leah G; Grinsdale, Jennifer A; Osmond, Dennis; Kawamura, L Masae; Hopewell, Philip C; Kato-Maeda, Midori

2013-05-01

In San Francisco, 70% of the tuberculosis cases occur among foreign-born persons, mainly from China, the Philippines, and Mexico. We postulate that there are differences in the characteristics and risk factors for tuberculosis among these populations. To determine the clinical, epidemiological and microbiological characteristics of tuberculosis caused by recent infection and rapid evolution in the major groups of foreign-born and the U.S.-born populations. We analyzed data from a 20-year prospective community-based study of the molecular epidemiology of tuberculosis in San Francisco. We included all culture-positive tuberculosis cases in the City during the study period. We calculated and compared incidence rates, clinical and microbiological characteristics, and risk factors for being a secondary case between the various foreign-born and U.S.-born tuberculosis populations. Between 1991 and 2010, there were 4,058 new cases of tuberculosis, of which 1,226 (30%) were U.S.-born and 2,832 (70%) were foreign-born. A total of 3,278 (81%) were culture positive, of which 2,419 (74%) had complete data for analysis. The incidence rate, including the incidence rate of tuberculosis due to recent infection and rapid evolution, decreased significantly in the U.S.-born and the major foreign-born populations. The clinical and microbiological characteristics and the risk factors for tuberculosis due to recent infection differed among the groups. There are differences in the characteristics and the risk factors for tuberculosis due to recent transmission among the major foreign-born and U.S.-born populations in San Francisco. These differences should be considered for the design of targeted tuberculosis control interventions.

Community Stakeholders' Perceptions of Major Factors Influencing Childhood Obesity, the Feasibility of Programs Addressing Childhood Obesity, and Persisting Gaps.

PubMed

Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Blaine, Rachel E; Land, Thomas; Davison, Kirsten K

2016-04-01

Prior research has identified numerous factors contributing to increased rates of childhood obesity. However, few studies have focused explicitly on the experience of community stakeholders in low-income communities. This study sought to capture the perspectives of these on-the-ground experts regarding major factors contributing to childhood obesity as well as gaps in current prevention and control efforts. We conducted semi-structured interviews with 39 stakeholders from different community sectors (e.g., healthcare providers, childcare providers, teachers). Data were drawn from the Massachusetts Childhood Obesity Research Demonstration project, a multi-level, multi-sector intervention designed to reduce childhood obesity being implemented in two low-income communities in Massachusetts. Interviews were conducted at baseline, transcribed, coded using grounded theory approach, and analyzed in NVivo 10.0. The vast majority of stakeholders had recently participated in obesity prevention strategies, and nearly all of them identified gaps in prevention efforts either within their organizations or in the broader community. In addition to factors previously identified in the literature, several themes emerged including the need to change policies to increase physical activity during school, offer healthier snacks in schools and afterschool programs, and increase communication and collaboration within the community in prevention efforts. Community stakeholders can impact the success of interventions by bridging the gap between science and lived experience. The results of this study can guide future research by highlighting the importance of including stakeholders' frontline experiences with target populations, and using information on identified gaps to augment intervention planning efforts.

Gender Differences in Attitudes Toward Science and Technology Among Majors

NASA Astrophysics Data System (ADS)

Gokhale, Anu A.; Rabe-Hemp, Cara; Woeste, Lori; Machina, Kenton

2015-08-01

In the USA, women have consistently been proportionally underrepresented in science and technology (S&T). In these disciplines, as students move from high schools to colleges to graduate programs, qualified women drop out at higher rates than do men, resulting in a striking loss of talented students. Attitude toward a discipline is one of the major factors in students' choice of majors. As a result, attitudes toward S&T are issues with longstanding attention and interest in education research. Retention of female students in S&T majors remains a major concern. The purpose of the study was to investigate attitudes toward S&T including attitudes toward female participation in S&T, among S&T majors, and examine differences by gender and class standing. Such an investigation would provide deeper insights to help devise strategies to retain women in S&T majors.

Assessing Stream Channel Stability at Bridges in Physiographic Regions

DOT National Transportation Integrated Search

2006-07-01

The objective of this study was to expand and improve a rapid channel stability assessment method developed previously by Johnson et al. to include additional factors, such as major physiographic units across the United States, a greater range of ban...

Bone Growth, Mechanical Stimulus and IGF-I

DTIC Science & Technology

2005-10-01

children, stress fractures in military recruits, and osteoporotic fractures in elderly women. Insulin-like growth factor-I (IGF-I), a major regulator...subjects completed the intervention arm of the study and returned for the short-term post-intervention appointment, which included anthropometrie

42 CFR 405.505 - Determination of locality.

Code of Federal Regulations, 2011 CFR

2011-10-01

... population density, economic level, and other major factors affecting charges for services. Carriers... State (including the District of Columbia, a territory, or a Commonwealth), a political or economic... to economic and other characteristics. Where people tend to gravitate toward certain population...

42 CFR 405.505 - Determination of locality.

Code of Federal Regulations, 2010 CFR

2010-10-01

... population density, economic level, and other major factors affecting charges for services. Carriers... State (including the District of Columbia, a territory, or a Commonwealth), a political or economic... to economic and other characteristics. Where people tend to gravitate toward certain population...

Jiangsu Four Cancers Study: a large case-control study of lung, liver, stomach, and esophageal cancers in Jiangsu Province, China.

PubMed

Zhao, Jin-Kou; Wu, Ming; Kim, Claire H; Jin, Zi-Yi; Zhou, Jin-Yi; Han, Ren-Qiang; Yang, Jie; Zhang, Xiao-Feng; Wang, Xu-Shan; Liu, Ai-Ming; Gu, Xiaoping; Su, Ming; Hu, Xu; Sun, Zheng; Li, Gang; Li, Liming; Mu, Lina; Zhang, Zuo-Feng

2017-07-01

Cancer is a major public health burden both globally and in China. The most common cancer-related deaths in China are attributable to cancers of the lung, liver, stomach, and esophagus. Previous epidemiologic studies on cancer in China have often been limited by small sample sizes, inconsistent measurements, and lack of precise and accurate data. The Jiangsu Four Cancers (JFC) Study is a population-based case-control study carried out in an effort to obtain consistent and high-quality data to investigate the life style, behavioral, environmental, and genetic factors associated with the four major cancers in China. The aim of this paper is to describe the overall design of the JFC Study and report selected findings on the major risk factors for cancers. Epidemiologic data were collected from 2003 to 2010 through in-person interviews using a structured questionnaire and blood samples were drawn. Unconditional logistic regression was used to estimate the associations of putative risk factors with risks of cancers of the lung, liver, stomach, and esophagus. The study included 2871 lung cancer cases, 2018 liver cancer cases, 2969 esophageal cancer cases, 2216 stomach cancer cases, and 8019 community controls. Low educational level, low income level, tobacco smoking, alcohol drinking, and family history of cancer were confirmed as risk factors for these major cancers. The JFC Study is one of the largest case-control studies of cancers in the Chinese population and will serve as a rich resource for future research on the four major cancers in China.

Delaware's Occupational-Vocational Education Model: Establishment and Implementation of a K-12 Career Guidance and Job Placement Program.

ERIC Educational Resources Information Center

Delaware State Board for Vocational Education, Milford.

Career Guidance and job placement are integral elements of the career education concept. Career decision making, a major component, includes learning about self, the world of work, and the interrelationship of these factors. The total professional staff, including a placement coordinator, should be involved in a team approach to serve all…

Applying airline safety practices to medication administration.

PubMed

Pape, Theresa M

2003-04-01

Medication administration errors (MAE) continue as major problems for health care institutions, nurses, and patients. However, MAEs are often the result of system failures leading to patient injury, increased hospital costs, and blaming. Costs include those related to increased hospital length of stay and legal expenses. Contributing factors include distractions, lack of focus, poor communication, and failure to follow standard protocols during medication administration.

Psychosocial work environment and mental health: Job-strain and effort-reward imbalance models in a context of major organizational changes.

PubMed

Niedhammer, Isabelle; Chastang, Jean-François; David, Simone; Barouhiel, Lina; Barrandon, Guy

2006-01-01

This study explored the association between the two job-stress models, job-strain and effort-reward imbalance, and mental health outcomes in a working population exposed to major organizational changes. The cross-sectional study was based on 680 subjects, 504 men and 176 women. Psychosocial factors at work included: psychological demands, decision latitude, social support, effort, reward, and overcommitment. Mental health outcomes were depressive symptoms (CES-D) and psychiatric disorders (GHQ-12). Job strain, low decision latitude, effort-reward imbalance, and low reward (especially job instability) were found to be associated with depressive symptoms and/or psychiatric disorders among men. Overcommitment at work was a risk factor for both men and women. Social support at work played a role to reduce depressive symptoms for women. These findings emphasize the deleterious effects of psychosocial work environment on mental health during major organizational changes.

Consensus Report of the European Federation of Conservative Dentistry: Erosive tooth wear – diagnosis and management.

PubMed

Carvalho, Thiago S; Colon, Pierre; Ganss, Carolina; Huysmans, Marie-Charlotte; Lussi, Adrian; Schlueter, Nadine; Schmalz, Gottfried; Shellis, Peter R; Björg Tveit, Anne; Wiegand, Annette

2016-01-01

Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the predisposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETWaims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.

Diesel exhaust particles induce the over expression of tumor necrosis factor-alpha (TNF-alpha) gene in alvelor machrophage and failed to induce apoptosis through activation of nuclear factor-kappaB (NF-kappaB)

EPA Science Inventory

Exposure to particulate matter (PM2.5-10), including diesel exhaust particles (DEP) has been reported to induce lung injury and exacerbation of asthma and chronic obstructive pulmonary disease. Alveolar macrophages play a major role in the lung's response to inhaled particles and...

[Spinal subarachnoid haematoma after spinal anaesthesia: case report].

PubMed

Vidal, Marion; Strzelecki, Antoine; Houadec, Mireille; Krikken, Isabelle Ranz; Danielli, Antoine; Souza Neto, Edmundo Pereira de

2016-01-01

Subarachnoid haematoma after spinal anaesthesia is known to be very rare. In the majority of these cases, spinal anaesthesia was difficult to perform and/or unsuccessful; other risk factors included antiplatelet or anticoagulation therapy, and direct spinal cord trauma. We report a case of subarachnoid haematoma after spinal anaesthesia in a young patient without risk factors. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Spinal subarachnoid haematoma after spinal anaesthesia: case report.

PubMed

Vidal, Marion; Strzelecki, Antoine; Houadec, Mireille; Krikken, Isabelle Ranz; Danielli, Antoine; Souza Neto, Edmundo Pereira de

2016-01-01

Subarachnoid haematoma after spinal anaesthesia is known to be very rare. In the majority of these cases, spinal anaesthesia was difficult to perform and/or unsuccessful; other risk factors included antiplatelet or anticoagulation therapy, and direct spinal cord trauma. We report a case of subarachnoid haematoma after spinal anaesthesia in a young patient without risk factors. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Evaluation of Factors Influencing Accuracy of Principal Procedure Coding Based on ICD-9-CM: An Iranian Study

PubMed Central

Farzandipour, Mehrdad; Sheikhtaheri, Abbas

2009-01-01

To evaluate the accuracy of procedural coding and the factors that influence it, 246 records were randomly selected from four teaching hospitals in Kashan, Iran. “Recodes” were assigned blindly and then compared to the original codes. Furthermore, the coders' professional behaviors were carefully observed during the coding process. Coding errors were classified as major or minor. The relations between coding accuracy and possible effective factors were analyzed by χ2 or Fisher exact tests as well as the odds ratio (OR) and the 95 percent confidence interval for the OR. The results showed that using a tabular index for rechecking codes reduces errors (83 percent vs. 72 percent accuracy). Further, more thorough documentation by the clinician positively affected coding accuracy, though this relation was not significant. Readability of records decreased errors overall (p = .003), including major ones (p = .012). Moreover, records with no abbreviations had fewer major errors (p = .021). In conclusion, not using abbreviations, ensuring more readable documentation, and paying more attention to available information increased coding accuracy and the quality of procedure databases. PMID:19471647

Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study.

PubMed

Forman, M R; Berendest, H W; Lewando-Hundt, G; Sarov, B; Naggan, L

1991-04-01

Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty-six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Caesarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high-risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.

ABA signaling in stress-response and seed development.

PubMed

Nakashima, Kazuo; Yamaguchi-Shinozaki, Kazuko

2013-07-01

KEY MESSAGE : We review the recent progress on ABA signaling, especially ABA signaling for ABA-dependent gene expression, including the AREB/ABF regulon, SnRK2 protein kinase, 2C-type protein phosphatases and ABA receptors. Drought negatively impacts plant growth and the productivity of crops. Drought causes osmotic stress to organisms, and the osmotic stress causes dehydration in plant cells. Abscisic acid (ABA) is produced under osmotic stress conditions, and it plays an important role in the stress response and tolerance of plants. ABA regulates many genes under osmotic stress conditions. It also regulates gene expression during seed development and germination. The ABA-responsive element (ABRE) is the major cis-element for ABA-responsive gene expression. ABRE-binding protein (AREB)/ABRE-binding factor (ABF) transcription factors (TFs) regulate ABRE-dependent gene expression. Other TFs are also involved in ABA-responsive gene expression. SNF1-related protein kinases 2 are the key regulators of ABA signaling including the AREB/ABF regulon. Recently, ABA receptors and group A 2C-type protein phosphatases were shown to govern the ABA signaling pathway. Moreover, recent studies have suggested that there are interactions between the major ABA signaling pathway and other signaling factors in stress-response and seed development. The control of the expression of ABA signaling factors may improve tolerance to environmental stresses.

Evaluation of Diabetes Mellitus as a Risk Factor for Major Complications in Patients Undergoing Aesthetic Surgery.

PubMed

Bamba, Ravinder; Gupta, Varun; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2016-05-01

Diabetes mellitus has been linked with a variety of perioperative adverse events across surgical disciplines. There is a paucity of studies systematically examining risk factors, including diabetes, and complications of aesthetic surgical procedures. The purpose of this study was to compare incidence and type of complications between diabetic and non-diabetic patients undergoing various aesthetic surgical procedures, to identify specific procedures where diabetes significantly increases risk of complications, and to study diabetes as an independent risk factor for major complications following aesthetic surgery. A prospective cohort of 129,007 patients who enrolled into the CosmetAssure insurance program and underwent cosmetic surgical procedures between May 2008 and May 2013 were reviewed. Diabetes was evaluated as risk factor for major complications, requiring hospital admission, emergency room visit, or a reoperation within 30 days after surgery. Multivariate regression analysis was performed controlling for the effects of age, smoking, obesity, gender, type of procedures, and surgical facility. Overall, 2506 patients (1.9%) had a major complication. Diabetics had significantly more complications compared to non-diabetics (3.1% vs 1.9%, P < 0.01). In univariate analysis, infectious (1.1% vs 0.5%, P < 0.01) and pulmonary (0.3% vs 0.1%, P < 0.01) complications were significantly higher among diabetics. Notably, diabetics had higher risks of complication in body cases (4.3% vs 2.6%, P < 0.01) and specifically abdominoplasty (6.1% vs 3.0%, P < 0.01). In multivariate analysis, diabetes was found to be an independent risk factor of any complication (relative risk 1.31, P = 0.03) and infection (relative risk 1.70, P < 0.01). Diabetes is an independent risk factor of major complications, particularly infection, after aesthetic surgical procedures. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Synergistic interactions of blood-borne immune cells, fibroblasts and extracellular matrix drive repair in an in vitro peri-implant wound healing model

NASA Astrophysics Data System (ADS)

Burkhardt, Melanie A.; Waser, Jasmin; Milleret, Vincent; Gerber, Isabel; Emmert, Maximilian Y.; Foolen, Jasper; Hoerstrup, Simon P.; Schlottig, Falko; Vogel, Viola

2016-02-01

Low correlations of cell culture data with clinical outcomes pose major medical challenges with costly consequences. While the majority of biomaterials are tested using in vitro cell monocultures, the importance of synergistic interactions between different cell types on paracrine signalling has recently been highlighted. In this proof-of-concept study, we asked whether the first contact of surfaces with whole human blood could steer the tissue healing response. This hypothesis was tested using alkali-treatment of rough titanium (Ti) surfaces since they have clinically been shown to improve early implant integration and stability, yet blood-free in vitro cell cultures poorly correlated with in vivo tissue healing. We show that alkali-treatment, compared to native Ti surfaces, increased blood clot thickness, including platelet adhesion. Strikingly, blood clots with entrapped blood cells in synergistic interactions with fibroblasts, but not fibroblasts alone, upregulated the secretion of major factors associated with fast healing. This includes matrix metalloproteinases (MMPs) to break down extracellular matrix and the growth factor VEGF, known for its angiogenic potential. Consequently, in vitro test platforms, which consider whole blood-implant interactions, might be superior in predicting wound healing in response to biomaterial properties.

The contribution of human agricultural activities to increasing evapotranspiration is significantly greater than climate change effect over Heihe agricultural region.

PubMed

Zou, Minzhong; Niu, Jun; Kang, Shaozhong; Li, Xiaolin; Lu, Hongna

2017-08-18

Evapotranspiration (ET) is a major component linking the water, energy, and carbon cycles. Understanding changes in ET and the relative contribution rates of human activity and of climate change at the basin scale is important for sound water resources management. In this study, changes in ET in the Heihe agricultural region in northwest China during 1984-2014 were examined using remotely-sensed ET data with the Soil and Water Assessment Tool (SWAT). Correlation analysis identified the dominant factors that influence change in ET per unit area and those that influence change in total ET. Factor analysis identified the relative contribution rates of the dominant factors in each case. The results show that human activity, which includes factors for agronomy and irrigation, and climate change, including factors for precipitation and relative humidity, both contribute to increases in ET per unit area at rates of 60.93% and 28.01%, respectively. Human activity, including the same factors, and climate change, including factors for relative humidity and wind speed, contribute to increases in total ET at rates of 53.86% and 35.68%, respectively. Overall, in the Heihe agricultural region, the contribution of human agricultural activities to increased ET was significantly greater than that of climate change.

Reducing symptoms of major depressive disorder through a systematic training of general emotion regulation skills: protocol of a randomized controlled trial.

PubMed

Ehret, Anna M; Kowalsky, Judith; Rief, Winfried; Hiller, Wolfgang; Berking, Matthias

2014-01-27

Major Depressive Disorder is one of the most challenging mental health problems of our time. Although effective psychotherapeutic treatments are available, many patients fail to demonstrate clinically significant improvements. Difficulties in emotion regulation have been identified as putative risk and maintaining factors for Major Depressive Disorder. Systematically enhancing adaptive emotion regulation skills should thus help reduce depressive symptom severity. However, at this point, no study has systematically evaluated effects of increasing adaptive emotion regulation skills application on symptoms of Major Depressive Disorder. In the intended study, we aim to evaluate stand-alone effects of a group-based training explicitly and exclusively targeting general emotion regulation skills on depressive symptom severity and assess whether this training augments the outcome of subsequent individual cognitive behavioral therapy for depression. In the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids. If findings should support the hypothesis that enhancing regulation skills reduces symptom severity in Major Depressive Disorder, systematic emotion regulation skills training can enhance the efficacy and efficiency of current treatments for this severe and highly prevalent disorder. This study is registered with ClinicalTrials.gov, number NCT01330485.

Voluntary and involuntary driving cessation in later life.

PubMed

Choi, Moon; Mezuk, Briana; Rebok, George W

2012-01-01

This study explores the decision-making process of driving cessation in later life, with a focus on voluntariness. The sample included 83 former drivers from the Baltimore Epidemiologic Catchment Area Study. A majority of participants (83%) reportedly stopped driving by their own decision. However, many voluntary driving retirees reported external factors such as financial difficulty, anxiety about driving, or lack of access to a car as main reasons for driving cessation. These findings imply that distinction between voluntary and involuntary driving cessation is ambiguous and that factors beyond health status, including financial strain, play a role in the transition to non-driving.

Leininger's model for discoveries at The Farm and midwifery services to the Amish.

PubMed

Finn, J

1995-01-01

This paper is a descriptive report and analysis of a transcultural nurse's experiences immersed in a hippie subculture at The Farm near Summertown, Tennessee. This subcultural group initially was established over 20 years ago as a community with a unique worldview which included pacifistic, vegetarian, and collective values and beliefs. This community prefers health care provided by their own community members who serve as generic care providers and also as folk midwives for home births. Leininger's (1991) Theory of Culture Care Diversity and Universality and her Sunrise Model provided the framework for discovering and understanding this unique subcultural group. The major components of Leininger's Sunrise Model including worldview, cultural values, and lifeways were used in the analysis. The important social structure factors discovered included environmental context, technological factors, religious and philosophical factors, political and legal factors, economic factors, and educational factors. The Farm community's culture care expressions, patterns and practices for health and well being were discovered including generic and folk systems of care. The farm midwives provide primary care and home birthing care to a nearby Old Order Amish community. The Amish culture and health care seeking patterns are discussed including their selective use of generic, folk, and professional care systems. The discoveries that resulted from the application of Leininger's Sunrise Model are presented including implications for transcultural nurse caregiving.

Short- and long-term major cardiovascular adverse events in carotid artery interventions: a nationwide population-based cohort study in Taiwan.

PubMed

Tsai, Ming-Lung; Mao, Chun-Tai; Chen, Dong-Yi; Hsieh, I-Chang; Wen, Ming-Shien; Chen, Tien-Hsing

2015-01-01

Carotid artery stenosis is one of the leading causes of ischemic stroke. Carotid artery stenting has become well-established as an effective treatment option for carotid artery stenosis. For this study, we aimed to determine the efficacy and safety of carotid stenting in a population-based large cohort of patients by analyzing the Taiwan National Healthcare Insurance (NHI) database. 2,849 patients who received carotid artery stents in the NHI database from 2004 to 2010 were identified. We analyzed the risk factors of outcomes including major adverse cardiovascular events including death, acute myocardial infarction, and cerebral vascular accidents at 30 days, 1 year, and overall period and further evaluated cause of death after carotid artery stenting. The periprocedural stroke rate was 2.7% and the recurrent stroke rate for the overall follow-up period was 20.3%. Male, diabetes mellitus, and heart failure were significant risk factors for overall recurrent stroke (Hazard Ratio (HR) = 1.35, p = 0.006; HR = 1.23, p = 0.014; HR = 1.61, p < 0.001, respectively). The periprocedural acute myocardial infarction rate was 0.3%. Age and Diabetes mellitus were the significant factors to predict periprocedural myocardial infarction (HR = 3.06, p = 0.019; HR = 1.68, p < 0.001, respectively). Periprocedural and overall mortality rates were 1.9% and 17.3%, respectively. The most significant periprocedural mortality risk factor was acute renal failure. Age, diabetes mellitus, acute or chronic renal failure, heart failure, liver disease, and malignancy were factors correlated to the overall period mortality. Periprocedural acute renal failure significantly increased the mortality rate and the number of major adverse cardiovascular events, and the predict power persisted more than one year after the procedure. Age and diabetes mellitus were significant risk factors to predict acute myocardial infarction after carotid artery stenting.

A systems biology perspective on the role of WRKY transcription factors in drought responses in plants.

PubMed

Tripathi, Prateek; Rabara, Roel C; Rushton, Paul J

2014-02-01

Drought is one of the major challenges affecting crop productivity and yield. However, water stress responses are notoriously multigenic and quantitative with strong environmental effects on phenotypes. It is also clear that water stress often does not occur alone under field conditions but rather in conjunction with other abiotic stresses such as high temperature and high light intensities. A multidisciplinary approach with successful integration of a whole range of -omics technologies will not only define the system, but also provide new gene targets for both transgenic approaches and marker-assisted selection. Transcription factors are major players in water stress signaling and some constitute major hubs in the signaling webs. The main transcription factors in this network include MYB, bHLH, bZIP, ERF, NAC, and WRKY transcription factors. The role of WRKY transcription factors in abiotic stress signaling networks is just becoming apparent and systems biology approaches are starting to define their places in the signaling network. Using systems biology approaches, there are now many transcriptomic analyses and promoter analyses that concern WRKY transcription factors. In addition, reports on nuclear proteomics have identified WRKY proteins that are up-regulated at the protein level by water stress. Interactomics has started to identify different classes of WRKY-interacting proteins. What are often lacking are connections between metabolomics, WRKY transcription factors, promoters, biosynthetic pathways, fluxes and downstream responses. As more levels of the system are characterized, a more detailed understanding of the roles of WRKY transcription factors in drought responses in crops will be obtained.

Heat Shock Proteins in Association with Heat Tolerance in Grasses

PubMed Central

Xu, Yan; Zhan, Chenyang; Huang, Bingru

2011-01-01

The grass family Poaceae includes annual species cultivated as major grain crops and perennial species cultivated as forage or turf grasses. Heat stress is a primary factor limiting growth and productivity of cool-season grass species and is becoming a more significant problem in the context of global warming. Plants have developed various mechanisms in heat-stress adaptation, including changes in protein metabolism such as the induction of heat shock proteins (HSPs). This paper summarizes the structure and function of major HSPs, recent research progress on the association of HSPs with grass tolerance to heat stress, and incorporation of HSPs in heat-tolerant grass breeding. PMID:22084689

Risk Factors as Major Determinants of Resilience: A Replication Study.

PubMed

Eshel, Yohanan; Kimhi, Shaul; Lahad, Mooli; Leykin, Dmitry; Goroshit, Marina

2018-03-16

The present study was conducted in the context of current concerns about replication in psychological research. It claims that risk factors should be regarded as an integral part of the definition of individual resilience, which should be defined in terms of the balance between individual strength or protective factors, and individual vulnerability or risk factors (IND-SVR). Five independent samples, including 3457 Israeli participants, were employed to determine the effects of resilience promoting and resilience suppressing variables on the IND-SVR index of resilience, and on its two components: recovery from adversity, and distress symptoms. Five path analyses were employed for determining the role of distress symptoms as a measure of psychological resilience, as compared to other indices of this resilience. Results indicated the major role of risk factors (distress symptoms) as an integral component of resilience. This role was generally replicated in the five investigated samples. Risk factors are legitimate, valid, and useful parts of the definition of psychological resilience. Resilience research has shifted away from studying individual risk factors to investigating the process through which individuals overcome the hardships they experience. The present data seem to suggest that this shift should be reexamined.

Objectively Measured Sedentary Time and Cardiovascular Risk Factor Control in US Hispanics/Latinos With Diabetes Mellitus: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

PubMed

Wang, Xueyin; Strizich, Garrett; Hua, Simin; Sotres-Alvarez, Daniela; Buelna, Christina; Gallo, Linda C; Gellman, Marc D; Mossavar-Rahmani, Yasmin; O'Brien, Matthew J; Stoutenberg, Mark; Wang, Tao; Avilés-Santa, M Larissa; Kaplan, Robert C; Qi, Qibin

2017-05-25

Cardiovascular disease (CVD) risk factor control is a cornerstone of diabetes mellitus management. Little is known about relationships of objectively measured sedentary time and physical activity with major CVD risk factor control in individuals with diabetes mellitus. We examined associations of objectively measured sedentary time and moderate-to-vigorous physical activity with reaching major CVD risk factor control goals among US Hispanic/Latino adults with diabetes mellitus. This cross-sectional analysis included 1699 participants with diabetes mellitus from the Hispanic Community Health Study/Study of Latinos (2008-2011). Logistic regression models were used to estimate the odds ratios (ORs) of meeting the following 5 major CVD risk factor control goals: hemoglobin A 1c <7.0%; systolic/diastolic blood pressure <140/80 mm Hg; triglycerides <150 mg/dL; low-density lipoprotein cholesterol <100 mg/dL; and high-density lipoprotein cholesterol >40/50 mg/dL for men/women. After adjustment for covariates including moderate-to-vigorous physical activity, less sedentary time was associated with increased odds of reaching hemoglobin A 1c (OR=1.76 [95% CI: 1.10, 2.82]) and triglyceride control goals (OR=2.16 [1.36, 3.46]), and reaching ≥3 CVD risk factor control goals (OR=2.08 [1.34, 3.23]) (all ORs for comparisons of extreme tertiles of sedentary time). Moderate-to-vigorous physical activity was not associated with reaching any CVD risk factor control goals. Substituting 60-min/day of sedentary time with light-intensity physical activity was associated with increased odds of reaching hemoglobin A 1c (OR=1.18 [1.04, 1.35]), high-density lipoprotein cholesterol (OR=1.17 [1.04, 1.32]), and triglyceride (OR=1.20 [1.05, 1.36]) control goals. Among US Hispanic/Latino adults with diabetes mellitus, less sedentary time, but not moderate-to-vigorous physical activity, was associated with improved CVD risk factor control, specifically in reaching hemoglobin A 1c and triglyceride control goals. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Mechanisms and assessment of water eutrophication*

PubMed Central

Yang, Xiao-e; Wu, Xiang; Hao, Hu-lin; He, Zhen-li

2008-01-01

Water eutrophication has become a worldwide environmental problem in recent years, and understanding the mechanisms of water eutrophication will help for prevention and remediation of water eutrophication. In this paper, recent advances in current status and major mechanisms of water eutrophication, assessment and evaluation criteria, and the influencing factors were reviewed. Water eutrophication in lakes, reservoirs, estuaries and rivers is widespread all over the world and the severity is increasing, especially in the developing countries like China. The assessment of water eutrophication has been advanced from simple individual parameters like total phosphorus, total nitrogen, etc., to comprehensive indexes like total nutrient status index. The major influencing factors on water eutrophication include nutrient enrichment, hydrodynamics, environmental factors such as temperature, salinity, carbon dioxide, element balance, etc., and microbial and biodiversity. The occurrence of water eutrophication is actually a complex function of all the possible influencing factors. The mechanisms of algal blooming are not fully understood and need to be further investigated. PMID:18357622

Microbiology and risk factors associated with war-related wound infections in the Middle East.

PubMed

Sahli, Z T; Bizri, A R; Abu-Sittah, G S

2016-10-01

The Middle East region is plagued with repeated armed conflicts that affect both civilians and soldiers. Injuries sustained during war are common and frequently associated with multiple life-threatening complications. Wound infections are major consequences of these war injuries. The microbiology of war-related wound infections is variable with predominance of Gram-negative bacteria in later stages. The emergence of antimicrobial resistance among isolates affecting war-related wound injuries is a serious problem with major regional and global implications. Factors responsible for the increase in multidrug-resistant pathogens include timing and type of surgical management, wide use of antimicrobial drugs, and the presence of metallic or organic fragments in the wound. Nosocomial transmission is the most important factor in the spread of multidrug-resistant pathogens. Wound management of war-related injuries merits a multidisciplinary approach. This review aims to describe the microbiology of war-related wound infections and factors affecting their incidence from conflict areas in Iraq, Syria, Israel, and Lebanon.

In Vitro Cerebrovascular Modeling in the 21st Century: Current and Prospective Technologies

PubMed Central

Palmiotti, Christopher A.; Prasad, Shikha; Naik, Pooja; Abul, Kaisar MD; Sajja, Ravi K.; Achyuta, Anilkumar H.; Cucullo, Luca

2014-01-01

The blood-brain barrier (BBB) maintains the brain homeostasis and dynamically responds to events associated with systemic and/or rheological impairments (e.g., inflammation, ischemia) including the exposure to harmful xenobiotics. Thus, understanding the BBB physiology is crucial for the resolution of major central nervous system CNS) disorders challenging both health care providers and the pharmaceutical industry. These challenges include drug delivery to the brain, neurological disorders, toxicological studies, and biodefense. Studies aimed at advancing our understanding of CNS diseases and promoting the development of more effective therapeutics are primarily performed in laboratory animals. However, there are major hindering factors inherent to in vivo studies such as cost, limited throughput and translational significance to humans. These factors promoted the development of alternative in vitro strategies for studying the physiology and pathophysiology of the BBB in relation to brain disorders as well as screening tools to aid in the development of novel CNS drugs. Herein, we provide a detailed review including pros and cons of current and prospective technologies for modelling the BBB in vitro including ex situ, cell based and computational (in silico) models. A special section is dedicated to microfluidic systems including micro-BBB, BBB-on-a-chip, Neurovascular Unit-on-a-Chip and Synthetic Microvasculature Blood-Brain Barrier. PMID:25098812

In vitro cerebrovascular modeling in the 21st century: current and prospective technologies.

PubMed

Palmiotti, Christopher A; Prasad, Shikha; Naik, Pooja; Abul, Kaisar M D; Sajja, Ravi K; Achyuta, Anilkumar H; Cucullo, Luca

2014-12-01

The blood-brain barrier (BBB) maintains the brain homeostasis and dynamically responds to events associated with systemic and/or rheological impairments (e.g., inflammation, ischemia) including the exposure to harmful xenobiotics. Thus, understanding the BBB physiology is crucial for the resolution of major central nervous system CNS) disorders challenging both health care providers and the pharmaceutical industry. These challenges include drug delivery to the brain, neurological disorders, toxicological studies, and biodefense. Studies aimed at advancing our understanding of CNS diseases and promoting the development of more effective therapeutics are primarily performed in laboratory animals. However, there are major hindering factors inherent to in vivo studies such as cost, limited throughput and translational significance to humans. These factors promoted the development of alternative in vitro strategies for studying the physiology and pathophysiology of the BBB in relation to brain disorders as well as screening tools to aid in the development of novel CNS drugs. Herein, we provide a detailed review including pros and cons of current and prospective technologies for modelling the BBB in vitro including ex situ, cell based and computational (in silico) models. A special section is dedicated to microfluidic systems including micro-BBB, BBB-on-a-chip, Neurovascular Unit-on-a-Chip and Synthetic Microvasculature Blood-brain Barrier.

Diet Modification for Hyperlipidemia

PubMed Central

Mann, Heather D.; Piotrowski, Pamela

1992-01-01

Hyperlipidemia is a major risk factor associated with cardiovascular disease. Dietary modification is effective in achieving and maintaining improved serum lipid levels. Nutritional care provided by a dietitian includes individual dietary and lifestyle assessment, formulating an appropriate dietary regimen, education, and follow-up assessments. PMID:21221406

Use Technology

ERIC Educational Resources Information Center

Teo, Timothy

2013-01-01

Technology acceptance is posited to be influenced by a variety of factors, including individual differences, social influences, beliefs, attitudes and situational influences (Agarwal, 2000; Teo, 2009a). A majority of the conceptualisations of technology acceptance have drawn on theories and models from social psychology, notably the theory of…

Research in Intelligent Automata (Phase I)

DTIC Science & Technology

1964-04-29

results , major practical problems will not be overlooked, costs of real solutions may be assessed, and the operating models can also serve a major purpose...demonstration(s). In any case , the total cost of the equipments in these categories should be held to only a small fraction of the cost of all of the...number of factors , including ( I) Storage capaci ty required (2) Response time required (3) Current avai labi Ii ty and cost of associa ti ve

Patching the Leaky STEM Pipeline: Identifying Institutional Factors That Influence a STEM Qualified Female Undergraduate s Choice of Institution

NASA Astrophysics Data System (ADS)

Hurlock, Ashley J.

Despite increased female participation in the workforce and females earning more undergraduate degrees than men over the past decade, women are still awarded fewer undergraduate degrees than men and hold less than 25% of jobs in the areas of science, technology, engineering and math, or STEM (Beede, et al., 2011). Research shows that females may be leaking from the STEM pipeline because they are not choosing to attend institutions that fulfill their interdisciplinary and non-academic interests or have learning environments that are supportive of their needs. The purpose of this quantitative, cross-sectional survey study, conducted at one non-research intensive university, was to identify institutional factors most pertinent to the decision to attend a non-research intensive university by a "STEM qualified" female undergraduate student. 23 of 45 factors were reported as positively influencing their decision regardless of major. The top six factors for both groups were: average class size, campus environment, a visit to campus, university population size, and major/department offered. The seven factors ranked statistically significantly different between STEM and non-STEM majors were undergraduate research opportunities, faculty reputation, graduate/professional school admission, academic support/tutoring, graduate program available, intramural sports, and off-campus housing. Only two of 17 factors negatively influenced STEM majors who were accepted to a research intensive university: the research intensive university's size and average class sizes were undesirable compared to their current institution. STEM qualified females weighed the importance of non-academic factors as high, or higher, than critical academic factors. STEM qualified females are also choosing to attend the non-research intensive university for a variety of reasons and not simply because another institution did not offer certain academic factors. Future studies should expanded to include other non-research intensive universities, research intensive universities, and high schools in order to further understand the impact that certain factors have on female choice of institution. The authors strongly feel that if institutions which provide a more supportive environment for female undergraduates create successful recruitment initiatives, their female students may be more likely to persist as STEM majors. This could potentially patch one of the substantial leaks in the STEM pipeline for women.

Unemployment in the United States After Traumatic Brain Injury for Working-Age Individuals: Prevalence and Associated Factors 2 Years Postinjury

PubMed Central

Cuthbert, Jeffrey P.; Harrison-Felix, Cynthia; Corrigan, John D.; Bell, Jeneita M.; Haarbauer-Krupa, Juliet K.; Miller, A. Cate

2017-01-01

Objective To estimate the prevalence of unemployment and part-time employment in the United States for working-age individuals completing rehabilitation for a primary diagnosis of traumatic brain injury (TBI) between 2001 and 2010. Design Secondary data analysis. Setting Acute inpatient rehabilitation facilities. Participants Patients aged 16 to 60 years at injury who completed inpatient rehabilitation for TBI between 2001 and 2010. Main Outcome Measures Unemployment; Part-time employment. Results The prevalence of unemployment for persons in the selected cohort was 60.4% at 2-year postinjury. Prevalence of unemployment at 2-year postinjury was significantly associated with the majority of categories of age group, race, gender, marital status, primary inpatient rehabilitation payment source, education, preinjury vocational status, length of stay, and Disability Rating Scale. The direction of association for the majority of these variables complement previous research in this area, with only Hispanic ethnicity and the FIM Cognitive subscale demonstrating disparate findings. For those employed at 2-year postinjury, the prevalence of part-time employment was 35.0%. The model of prevalence for part-time employment at 2-year postinjury was less robust, with significant relationships with some categorical components of age group, gender, marital status, primary payment source, preinjury vocational status, and Disability Rating Scale. Conclusions The prevalence of unemployment for patients completing inpatient rehabilitation for TBI was substantial (60.4%). The majority of factors found to associate with 2 years’ unemployment were complementary of previously published research; however, these were often smaller in magnitude than previous reports. The prevalence of part-time employment was also an issue for this cohort and included 35.0% of all employed individuals. In regard to the determination of factors associated with part-time employment, additional analyses that include more fine-grained factors associated with employment, including physical and psychosocial functioning, are recommended. PMID:25955703

Conceptions of Memorizing and Understanding in Learning, and Self-Efficacy Held by University Biology Majors

NASA Astrophysics Data System (ADS)

Lin, Tzu-Chiang; Liang, Jyh-Chong; Tsai, Chin-Chung

2015-02-01

This study aims to explore Taiwanese university students' conceptions of learning biology as memorizing or as understanding, and their self-efficacy. To this end, two questionnaires were utilized to survey 293 Taiwanese university students with biology-related majors. A questionnaire for measuring students' conceptions of memorizing and understanding was validated through an exploratory factor analysis of participants' responses. As for the questionnaire regarding the students' biology learning self-efficacy (BLSE), an exploratory factor analysis revealed a total of four factors including higher-order cognitive skills (BLSE-HC), everyday application (BLSE-EA), science communication (BLSE-SC), and practical works (BLSE-PW). The results of the cluster analysis according to the participants' conceptions of learning biology indicated that students in the two major clusters either viewed learning biology as understanding or possessed mixed-conceptions of memorizing and understanding. The students in the third cluster mainly focused on memorizing in their learning while the students in the fourth cluster showed less agreement with both conceptions of memorizing and understanding. This study further revealed that the conception of learning as understanding was positively associated with the BLSE of university students with biology-related majors. However, the conception of learning as memorizing may foster students' BLSE only when such a notion co-exists with the conception of learning with understanding.

A case-control study of diet and gastric cancer in northern Italy.

PubMed

La Vecchia, C; Negri, E; Decarli, A; D'Avanzo, B; Franceschi, S

1987-10-15

Dietary factors in the aetiology of stomach cancer were investigated using data from a case-control study conducted in Northern Italy on 206 histologically confirmed carcinomas and 474 control subjects in hospital for acute, non-digestive conditions, unrelated to any of the potential risk factors for gastric cancer. Dietary histories concerned the frequency of consumption per week of 29 selected food items (including the major sources of starches, proteins, fats, fibres, vitamins A and C, nitrates and nitrites in the Italian diet) and subjective scores for condiments and salt intake. Pasta and rice (the major sources of starch), polenta (a porridge made of maize) and ham were positively related with gastric cancer risk, whereas green vegetables and fresh fruit as a whole (and specifically citrus fruit) and selected fibre-rich aliments (such as whole-grain bread or pasta) showed protective effects on gastric cancer risk. Allowance for major identified potential distorting factors (chiefly indicators of socio-economic status) reduced the positive association with pasta or rice consumption, but did not appreciably modify any of the other risk estimates. When a single logistic model was fitted including all food items significant in univariate analysis, the 3 items remaining statistically significant were green vegetables (relative risk, RR = 0.27 for upper vs. lower tertile), polenta (RR = 2.32) and ham (RR = 1.60). Indices of beta-carotene and ascorbate intake were negatively and strongly related with gastric cancer risk, but the association with these micronutrients was no longer evident after simultaneous allowance for various food items. An approximately 7-fold difference in risk was found between extreme quintiles of a scale measuring major positive and negative associations.

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

PubMed

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

2009-10-01

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

Complement factor H in host defense and immune evasion.

PubMed

Parente, Raffaella; Clark, Simon J; Inforzato, Antonio; Day, Anthony J

2017-05-01

Complement is the major humoral component of the innate immune system. It recognizes pathogen- and damage-associated molecular patterns, and initiates the immune response in coordination with innate and adaptive immunity. When activated, the complement system unleashes powerful cytotoxic and inflammatory mechanisms, and thus its tight control is crucial to prevent damage to host tissues and allow restoration of immune homeostasis. Factor H is the major soluble inhibitor of complement, where its binding to self markers (i.e., particular glycan structures) prevents complement activation and amplification on host surfaces. Not surprisingly, mutations and polymorphisms that affect recognition of self by factor H are associated with diseases of complement dysregulation, such as age-related macular degeneration and atypical haemolytic uremic syndrome. In addition, pathogens (i.e., non-self) and cancer cells (i.e., altered-self) can hijack factor H to evade the immune response. Here we review recent (and not so recent) literature on the structure and function of factor H, including the emerging roles of this protein in the pathophysiology of infectious diseases and cancer.

Factors influencing acceptance of technology for aging in place: a systematic review.

PubMed

Peek, Sebastiaan T M; Wouters, Eveline J M; van Hoof, Joost; Luijkx, Katrien G; Boeije, Hennie R; Vrijhoef, Hubertus J M

2014-04-01

To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage. A systematic review of mixed studies. Seven major scientific databases (including MEDLINE, Scopus and CINAHL) were searched. Inclusion criteria were as follows: (1) original and peer-reviewed research, (2) qualitative, quantitative or mixed methods research, (3) research in which participants are community-dwelling older adults aged 60 years or older, and (4) research aimed at investigating factors that influence the intention to use or the actual use of electronic technology for aging in place. Three researchers each read the articles and extracted factors. Sixteen out of 2841 articles were included. Most articles investigated acceptance of technology that enhances safety or provides social interaction. The majority of data was based on qualitative research investigating factors in the pre-implementation stage. Acceptance in this stage is influenced by 27 factors, divided into six themes: concerns regarding technology (e.g., high cost, privacy implications and usability factors); expected benefits of technology (e.g., increased safety and perceived usefulness); need for technology (e.g., perceived need and subjective health status); alternatives to technology (e.g., help by family or spouse), social influence (e.g., influence of family, friends and professional caregivers); and characteristics of older adults (e.g., desire to age in place). When comparing these results to qualitative results on post-implementation acceptance, our analysis showed that some factors are persistent while new factors also emerge. Quantitative results showed that a small number of variables have a significant influence in the pre-implementation stage. Fourteen out of the sixteen included articles did not use an existing technology acceptance framework or model. Acceptance of technology in the pre-implementation stage is influenced by multiple factors. However, post-implementation research on technology acceptance by community-dwelling older adults is scarce and most of the factors in this review have not been tested by using quantitative methods. Further research is needed to determine if and how the factors in this review are interrelated, and how they relate to existing models of technology acceptance. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam.

PubMed

Kruse, Alexandra Y; Phuong, Cam N; Ho, Binh T T; Stensballe, Lone G; Pedersen, Freddy K; Greisen, Gorm

2014-02-01

Neonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates. We prospectively studied all neonatal deaths and expected deaths (discharged alive after withdrawal of life-sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12-month period in 2009-2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important and potentially avoidable risk factors during the hospital stay. Among 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60/71) of the neonates with a relatively good prognosis: recognition or response to danger signs, internal transfers, nosocomial infections, sepsis management, access to usual equipment/staff, and family perception. Among 302 neonatal deaths/expected deaths, the major causes were congenital malformations, prematurity and severe infections. Six important and potentially avoidable risk factors could be addressed in the subgroup with relatively good admission prognosis, without implementing new technology or major organisational changes. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Latino adults' health insurance coverage: an examination of Mexican and Puerto Rican subgroup differences.

PubMed

Vitullo, Margaret Weigers; Taylor, Amy K

2002-11-01

Lack of health insurance is a serious problem in the United States. Using data from the 1996 Medical Expenditure Panel Survey, this paper examines how insurance varies between black, white, and Latino adults. Because Latino subgroups are not homogeneous, the paper also compares the factors associated with health insurance status for Mexican and Puerto Rican adults. Results indicate that access to private health insurance for Latino adults was more closely associated with workplace characteristics than employment itself. Time lived in the United States was a major factor associated with being uninsured for Mexican adults, while language barriers were a major factor limiting Puerto Rican individuals' access to private health insurance. The paper suggests two approaches for decreasing uninsurance among Latino adults: (1) strengthening the link between employment and private health insurance and (2) addressing disparities in access to public coverage for racial and ethnic groups, including recent immigrants.

Introducing systems change in the schools: the case of school luncheons and vending machines.

PubMed

Suarez-Balcazar, Yolanda; Redmond, Ladonna; Kouba, Joanne; Hellwig, Maureen; Davis, Rochelle; Martinez, Louise I; Jones, Lara

2007-06-01

A major public health crisis facing America's society is the increase in child and youth obesity, which has seen a fourfold increase in the last four decades. Major concerns include what children eat for school lunch and what other foods are available in schools. This paper illustrates efforts towards systems change in the luncheon program and food vending machines in the Chicago Public Schools. We discuss the different factors that lead to such changes using the framework of the social ecological model and the soft systems methodology, and we analyze how the resulting innovation was implemented and evaluated. First, we present a theoretical perspective to explain factors that influence children's eating patterns from a systems approach. Second, we discuss the antecedent factors that lead to systems change. Finally, we examine challenges to systems change, such as resistance to change, different stakeholder priorities, lack of resources, institutional bureaucracy, and unrealistic funder expectations.

Following up patients with depression after hospital discharge: a mixed methods approach

PubMed Central

2011-01-01

Background A medication information intervention was delivered to patients with a major depressive episode prior to psychiatric hospital discharge. Methods The objective of this study was to explore how patients evolved after hospital discharge and to identify factors influencing this evolution. Using a quasi-experimental longitudinal design, the quantitative analysis measured clinical (using the Hospital Anxiety and Depression Scale, the somatic dimension of the Symptom Checklist 90 and recording the number of readmissions) and humanistic (using the Quality of Life Enjoyment and Satisfaction Questionnaire) outcomes of patients via telephone contacts up to one year following discharge. The qualitative analysis was based on the researcher diary, consisting of reports on the telephone outcome assessment of patients with major depression (n = 99). All reports were analyzed using the thematic framework approach. Results The change in the participants' health status was as diverse as it was at hospital discharge. Participants reported on remissions; changes in mood; relapses; and re-admissions (one third of patients). Quantitative data on group level showed low anxiety, depression and somatic scores over time. Three groups of contributing factors were identified: process, individual and environmental factors. Process factors included self caring process, medical care after discharge, resumption of work and managing daily life. Individual factors were symptom control, medication and personality. Environmental factors were material and social environment. Each of them could ameliorate, deteriorate or be neutral to the patient's health state. A mix of factors was observed in individual patients. Conclusions After hospital discharge, participants with a major depressive episode evolved in many different ways. Process, individual and environmental factors may influence the participant's health status following hospital discharge. Each of the factors could be positive, neutral or negative for the patient. PMID:22074732

Team-Based Learning in US Colleges and Schools of Pharmacy

PubMed Central

Copeland, Jeffrey; Franks, Andrea S.; Karimi, Reza; McCollum, Marianne; Riese, David J.; Lin, Anne Y.F.

2013-01-01

Objective. To characterize the use of team-based learning (TBL) in US colleges and schools of pharmacy, including factors that may affect implementation and perceptions of faculty members regarding the impact of TBL on educational outcomes. Methods. Respondents identified factors that inhibit or enable TBL use and its impact on student learning. Results were stratified by type of institution (public/private), class size, and TBL experience. Results. Sixty-nine of 100 faculty members (69%) representing 43 (86%) institutions responded. Major factors considered to enable TBL implementation included a single campus and student and administration buy-in. Inhibiting factors included distant campuses, faculty resistance, and lack of training. Compared with traditional lectures, TBL is perceived to enhance student engagement, improve students’ preparation for class, and promote achievement of course outcomes. In addition, TBL is perceived to be more effective than lectures at fostering learning in all 6 domains of Bloom’s Taxonomy. Conclusions. Despite potential implementation challenges, faculty members perceive that TBL improves student engagement and learning. PMID:23966718

Factors affecting bleeding risk during anticoagulant therapy in patients with atrial fibrillation: observations from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study.

PubMed

DiMarco, John P; Flaker, Gregory; Waldo, Albert L; Corley, Scott D; Greene, H Leon; Safford, Robert E; Rosenfeld, Lynda E; Mitrani, Gladys; Nemeth, Margit

2005-04-01

Stroke and systemic thromboembolism are serious problems for patients with atrial fibrillation (AF), but their incidence can be substantially reduced by appropriate anticoagulation. Bleeding is the major complication of anticoagulant treatment, and the relative risks for bleeding vs stroke must be considered when starting anticoagulation. The AFFIRM trial included patients with AF and at least one risk factor for stroke, randomly assigning them to either a rate-control or rhythm-control strategy. All patients were initially treated with warfarin. The incidence of protocol-defined major and minor bleeding was documented during follow-up. Variables associated with bleeding were determined using a Cox proportional hazards model, using baseline and time-dependent covariates. The 4060 patients in the AFFIRM trial were followed for an average of 3.5 years. Major bleeding occurred in 260 patients, an annual incidence of approximately 2% per year, with no significant difference between the rate-control and rhythm-control groups. Increased age, heart failure, hepatic or renal disease, diabetes, first AF episode, warfarin use, and aspirin use were significantly associated with major bleeding. Minor bleeding was common in both treatment arms, with 738 patients reporting this problem in one or more visits. Bleeding is a significant problem that complicates management of patients with AF. Risk factors for bleeding can be identified, and knowledge of these risk factors can be used to plan therapy.

An acceptable role for computers in the aircraft design process

NASA Technical Reports Server (NTRS)

Gregory, T. J.; Roberts, L.

1980-01-01

Some of the reasons why the computerization trend is not wholly accepted are explored for two typical cases: computer use in the technical specialties and computer use in aircraft synthesis. The factors that limit acceptance are traced in part, to the large resources needed to understand the details of computer programs, the inability to include measured data as input to many of the theoretical programs, and the presentation of final results without supporting intermediate answers. Other factors are due solely to technical issues such as limited detail in aircraft synthesis and major simplifying assumptions in the technical specialties. These factors and others can be influenced by the technical specialist and aircraft designer. Some of these factors may become less significant as the computerization process evolves, but some issues, such as understanding large integrated systems, may remain issues in the future. Suggestions for improved acceptance include publishing computer programs so that they may be reviewed, edited, and read. Other mechanisms include extensive modularization of programs and ways to include measured information as part of the input to theoretical approaches.

Risk Factors for Lung Cancer in Iowa Women: Implications for Prevention

PubMed Central

Neuberger, John S.; Mahnken, Jonathan D.; Mayo, Matthew S.; Field, R. William

2007-01-01

Background Multiple risk factors possibly associated with lung cancer were examined as part of a large-scale residential radon case-control study conducted in Iowa between 1994 and 1997. We were particularly interested in stratifying risk factors by smoking status. Relatively little risk factor information is available for Midwestern rural women. Methods Four hundred thirteen female lung cancer cases and 614 controls aged 40-84, who were residents of their current home for at least 20 years, were included. Risk factors examined included cigarette smoking, passive smoking, occupation, chemical exposure, previous lung disease, family history of cancer, and urban residence. Multiple logistic regression analysis was conducted after adjusting for age, education, and cumulative radon exposure. Results As expected, active cigarette smoking was the major risk factor for lung cancer. While cessation of smoking was significantly associated with a reduced risk for lung cancer, the risk remained significantly elevated for 25 years. Among all cases, asbestos exposure was a significant risk. Among ex-smokers, pack-year history predominated as the major risk. Among never smokers, a family history of kidney or bladder cancer were significant risk factors (OR= 7.34, 95% CI = 1.91 - 28.18; and 5.02, 95% CI = 1.64-15.39, respectively), as was a history of previous lung disease (OR=2.28, 95% CI=1.24-4.18) and asbestos exposure. No statistically significant increase in lung cancer risk was found for occupation or urban residence. Conclusions Smoking prevention activities are urgently needed in rural areas of the United States. Relatives of individuals with smoking-related cancers are potentially at increased risk. Genetic risk factors should be more fully investigated in never smokers. PMID:16581199

Medical hypothesis: xenoestrogens as preventable causes of breast cancer.

PubMed Central

Davis, D L; Bradlow, H L; Wolff, M; Woodruff, T; Hoel, D G; Anton-Culver, H

1993-01-01

Changes in documented risk factors for breast cancer and rates of screening cannot completely explain recent increases in incidence or mortality. Established risk factors for breast cancer, including genetics, account for at best 30% of cases. Most of these risk factors can be linked to total lifetime exposure to bioavailable estrogens. Experimental evidence reveals that compounds such as some chlorinated organics, polycyclic aromatic hydrocarbons (PAHs), triazine herbicides, and pharmaceuticals affect estrogen production and metabolism and thus function as xenoestrogens. Many of these xenoestrogenic compounds also experimentally induce mammary carcinogenesis. Recent epidemiologic studies have found that breast fat and serum lipids of women with breast cancer contain significantly elevated levels of some chlorinated organics compared with noncancer controls. As the proportion of inherited breast cancer in the population is small, most breast cancers are due to acquired mutations. Thus, the induction of breast cancer in the majority of cases stems from interactions between host factors, including genetics and environmental carcinogens. We hypothesize that substances such as xenoestrogens increase the risk of breast cancer by mechanisms which include interaction with breast-cancer susceptibility genes. A series of major epidemiologic studies need to be developed to evaluate this hypothesis, including studies of estrogen metabolism, the role of specific xenoestrogenic substances in breast cancer, and relevant genetic-environmental interactions. In addition, experimental studies are needed to evaluate biologic markers of suspect xenoestrogens and biologic markers of host susceptibility and identify pathways of estrogenicity that affect the development of breast cancer. If xenoestrogens do play a role in breast cancer, reductions in exposure will provide an opportunity for primary prevention of this growing disease.(ABSTRACT TRUNCATED AT 250 WORDS) Images p372-a Figure 1. PMID:8119245

Struvite scale formation and control.

PubMed

Parsons, S A; Doyle, J D

2004-01-01

Struvite scale formation is a major operational issue at both conventional and biological nutrient removal wastewater treatment plants. Factors affecting the formation of struvite scales were investigated including supersaturation, pH and pipe material and roughness. A range of control methods have been investigated including low fouling materials, pH control, inhibitor and chemical dosing. Control methods exist to reduce scale formation although each has its advantages and disadvantages.

Perinatal mortality in caribou from the Porcupine herd, Alaska

USGS Publications Warehouse

Roffe, T.J.

1993-01-01

During the 1989 caribou (Rangifer tarandus) calving season on the Arctic National Wildlife Refuge, Alaska (USA), 61 calf carcasses were examined for cause of death and associated pathology. Dead calves were located by low-level aerial searches with two fixed-wing aircraft and a helicopter over high density calving areas between the Hulahula and Aichilik rivers. Primary diagnoses included emaciation (39%), malnutrition (8%), stillbirth (21%), trauma (16%), other primary causes (7%), and undetermined causes (8%). Twenty calves had contributory renal tubular degeneration. The findings indicate that factors contributing to nutritional deprivation in calves were the major cause of neonatal mortality; however, factors affecting stillbirth, abortion, or the urogenital system may have major effects on neonatal caribou and warrant further investigation.

Perinatal mortality in caribou from the Porcupine herd, Alaska.

PubMed

Roffe, T J

1993-04-01

During the 1989 caribou (Rangifer tarandus) calving season on the Arctic National Wildlife Refuge, Alaska (USA), 61 calf carcasses were examined for cause of death and associated pathology. Dead calves were located by low-level aerial searches with two fixed-wing aircraft and a helicopter over high density calving areas between the Hulahula and Aichilik rivers. Primary diagnoses included emaciation (39%), malnutrition (8%), stillbirth (21%), trauma (16%), other primary causes (7%), and undetermined causes (8%). Twenty calves had contributory renal tubular degeneration. The findings indicate that factors contributing to nutritional deprivation in calves were the major cause of neonatal mortality; however, factors affecting stillbirth, abortion, or the urogenital system may have major effects on neonatal caribou and warrant further investigation.

Changing (Almost) Everything and Keeping (Almost) Everyone Happy.

ERIC Educational Resources Information Center

Stewart, Craig A.; Grover, Douglas; Vernon, R. David

1998-01-01

In 1994, the information technology organization at Indiana University, Bloomington, undertook a major computing technology conversion that affected 40,000 people. The project is described, and factors contributing to its success are discussed, including system architecture, marketing and customer communications, and migration of information…

Microbial and metabolic signatures of necrotizing enterocolitis in formula-fed piglets

USDA-ARS?s Scientific Manuscript database

Major risk factors for necrotizing enterocolitis (NEC) include premature birth, formula feeding, and microbial colonization of the gastrointestinal tract. We previously showed that feeding formula composed of lactose vs corn syrup solids protects against NEC in preterm pigs, however the microbial an...

Making Training Dollars Count: Distance Education and the Certified Public Manager Program.

ERIC Educational Resources Information Center

Vogelsang-Coombs, Vera

1999-01-01

Presents three accountability relationships for assessing the appropriateness of using distance education in the Certified Public Manager (CPM) program educational accountability, financial accountability, and organizational accountability. Identifies factors inhibiting investment in distance education, including the necessity for a major modal…

Heat Effects on Living Plants

Treesearch

Robert C. Hare

1961-01-01

This review of knowledge concerning the effects of high temperatures on plants was undertaken in preparation for research aimed at determining how forest fires affect physiological processes in woody species. Major subjects discussed include morphological and physiological responses to high temperatures, external and internal factors governing these responses,...

Some Problems Affecting Higher Education in Mexico.

ERIC Educational Resources Information Center

Arredondo, Victor A.

Major problems of higher education in Mexico are addressed in the context of the country's developmental stages, socioeconomic conditions, and demographics. Important factors in modern Mexican history include: population growth, public and private investment to stimulate socioeconomic activities in different regions of the country, and financial…

Educational Reform Agenda and Partnerships.

ERIC Educational Resources Information Center

Corrigan, Dean C.; Mobley, William H.

Major factors contributing to the crisis in United States education are summarized, including poverty, changes in the American family, child abuse, changes in the ethnic composition of schools, increasing global competition, decline in traditional student performance measures, crisis in mathematics and science, shortages of teachers, shift in the…

The Formation of Trihalomethanes.

ERIC Educational Resources Information Center

Trussell, R. Rhodes; Umphres, Mark D.

1978-01-01

Reviewed are a number of factors important in the formation of trihalomethanes (THM) including the nature of aquatic humus and the influences of preozonation, bromide, pH, and chlorine. A brief investigation is also conducted into the kinetics of the THM reaction. Several major research needs are represented. (CS)

42 CFR 405.505 - Determination of locality.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subdivision of a State, or a group of States. It should include a cross section of the population with respect to economic and other characteristics. Where people tend to gravitate toward certain population... population density, economic level, and other major factors affecting charges for services. Carriers...

42 CFR 405.505 - Determination of locality.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subdivision of a State, or a group of States. It should include a cross section of the population with respect to economic and other characteristics. Where people tend to gravitate toward certain population... population density, economic level, and other major factors affecting charges for services. Carriers...

42 CFR 405.505 - Determination of locality.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subdivision of a State, or a group of States. It should include a cross section of the population with respect to economic and other characteristics. Where people tend to gravitate toward certain population... population density, economic level, and other major factors affecting charges for services. Carriers...

The Impact of Neuroimmune Alterations in Autism Spectrum Disorder

PubMed Central

Gottfried, Carmem; Bambini-Junior, Victorio; Francis, Fiona; Riesgo, Rudimar; Savino, Wilson

2015-01-01

Autism spectrum disorder (ASD) involves a complex interplay of both genetic and environmental risk factors, with immune alterations and synaptic connection deficiency in early life. In the past decade, studies of ASD have substantially increased, in both humans and animal models. Immunological imbalance (including autoimmunity) has been proposed as a major etiological component in ASD, taking into account increased levels of pro-inflammatory cytokines observed in postmortem brain from patients, as well as autoantibody production. Also, epidemiological studies have established a correlation of ASD with family history of autoimmune diseases; associations with major histocompatibility complex haplotypes and abnormal levels of immunological markers in the blood. Moreover, the use of animal models to study ASD is providing increasing information on the relationship between the immune system and the pathophysiology of ASD. Herein, we will discuss the accumulating literature for ASD, giving special attention to the relevant aspects of factors that may be related to the neuroimmune interface in the development of ASD, including changes in neuroplasticity. PMID:26441683

Use of Risk Assessment Tool for Inpatient Traumatic Intracranial Hemorrhage after Falls in Acute Care Hospital Setting

PubMed Central

Toyabe, Shin-ichi

2012-01-01

Severe injuries such as intracranial hemorrhage (ICH) are the most serious problem after falls in hospital, but they have not been considered in risk assessment scores for falls. We tried to determine the risk factors for ICH after falls in 20,320 inpatients (696,364 patient-days) aged from 40 to 90 years who were admitted to a tertiary-care university hospital. Possible risk factors including STRATIFY risk score for falls and FRAX™ risk score for fractures were analyzed by univariate and multivariate analyses. Fallers accounted for 3.2% of the patients, and 5.0% of the fallers suffered major injuries, including peripheral bone fracture (59.6%) and ICH (23.4%). In addition to STRATIFY, FRAX™ was significantly associated not only with bone fractures but also ICH. Concomitant use of risk score for falls and risk score for fractures might be useful for the prediction of major injuries such as ICH after falls. PMID:22980233

Leachate generation from landfill in a semi-arid climate: A qualitative and quantitative study from Sousse, Tunisia.

PubMed

Frikha, Youssef; Fellner, Johann; Zairi, Moncef

2017-09-01

Despite initiatives for enhanced recycling and waste utilization, landfill still represents the dominant disposal path for municipal solid waste (MSW). The environmental impacts of landfills depend on several factors, including waste composition, technical barriers, landfill operation and climatic conditions. A profound evaluation of all factors and their impact is necessary in order to evaluate the environmental hazards emanating from landfills. The present paper investigates a sanitary landfill located in a semi-arid climate (Tunisia) and highlights major differences in quantitative and qualitative leachate characteristics compared to landfills situated in moderate climates. Besides the qualitative analysis of leachate samples, a quantitative analysis including the simulation of leachate generation (using the HELP model) has been conducted. The results of the analysis indicate a high load of salts (Cl, Na, inorganic nitrogen) in the leachate compared to other landfills. Furthermore the simulations with HELP model highlight that a major part of the leachate generated originates form the water content of waste.

Independent risk factors of 30-day outcomes in 1264 patients with peptic ulcer bleeding in the USA - large ulcers do worse

PubMed Central

Camus, Marine; Jensen, Dennis M.; Kovacs, Thomas O.; Jensen, Mary Ellen; Markovic, Daniela; Gornbein, Jeffrey

2016-01-01

Background Predictors of worse outcomes (rebleeding, surgery and death) of peptic ulcer bleeding (PUB’s) are essential indicators because of significant morbidity and mortality. rates of PUB’s. However those have been rarely infrequently reported since changes in medical therapy (proton poump inhibitors-PPI) and application of newer endoscopic hemostasis. Aim Our purposes were to determine: 1) independent risk factors of 30-day rebleeding, surgery, and death and 2) whether ulcer size is an independent predictor of major outcomes in patients with severe PUB’s after successful endoscopic hemostasis and treatment with optimal medical (high dose IV PPI) vs. prior treatment (high dose IV histamine 2 antagonists – H2RA’s). Methods A large prospectively followed population of patients hospitalized with severe PUB’s between 1993 and 2011 at two US tertiary care academic medical centers, stratified by stigmata of recent hemorrhage (SRH) was studied. Using multivariable logistic regression analyses, independent risk factors of each outcome (rebleeding, surgery, and death) up to 30 days were analyzed. Effects of medical treatment (H2RA patients 1993–2005 vs. PPI’s 2006–2011) were also analysed. Results 1264 patients were included. For ulcers ≥10mm, the odds of 30-day rebleeding increased 6% per each 10% increase in ulcer size (OR 1.06, 95%CI 1.02–1.10, p=0.0053). Other risk factors of 30-day rebleeding were major SRH, inpatient start of bleeding, and prior GI bleeding. Major SRH and ulcer size ≥10 mm were predictors of 30-day surgery. Risk factors of 30-day death were major SRH, inpatient bleeding, any initial platelet transfusion or fresh frozen plasma transfusion ≥2 units. Among patients with major SRH and outpatient start of bleeding, larger ulcer size was also a risk factor for death (OR 1.08 per 10% increase in ulcer size, 95%CI 1.02–1.14, p=0.0095). Ulcer size was a significant independent variable for both time periods. Conclusions Ulcer size is a risk factor and should be carefully recorded at initial endoscopy to improve patient triage and management. PMID:27000531

An exploration of the perceived factors that affect the learning and transfer of skills taught to student midwives.

PubMed

Longworth, Mary K

2013-08-01

the aim of this study was to examine the attitudes of student midwives towards skills training and practise. The objectives were to explore the factors in the skills laboratory environment and in clinical practice which affect how successfully student midwives transfer into clinical practice the various skills they have learnt in preparation for an Objective Structured Clinical Examination. a review of the background literature revealed that there were many variables related to successful transfer of skills in general but there appeared to be a gap around perceived factors affecting transfer of skills of student midwives. a mixed methods design was conducted using both questionnaires and semi-structured interviews between June and August 2010. questionnaires were administered to all midwifery students at one university in Wales. These were later followed by semi-structured interviews for 6 student midwives who were purposively selected from all year groups. the results from the questionnaires revealed that a majority of students had positive attitudes to educators and mentors and to their skills acquisition experience in the skills laboratory and to the available opportunities to practise in clinical practice. Although students believed in the transferability of skills from the laboratory setting to clinical practice, a majority thought that clinical practice provided them with a better opportunity to learn clinical skills. The semi-structured interviews demonstrated that facilitating factors in the skills laboratory included having adequate instruction as well as having a designated space. Hindering factors included unrealistic models and equipment. In clinical practice, facilitating factors included having the opportunities to practise skills and support and feedback from the mentor. Hindering factors included deficits in the student-mentor relationship. this study highlighted that midwifery students must be adequately prepared to carry out clinical skills competently and effectively. Educators and mentors must provide adequate support and feedback to promote transfer of knowledge and skills into the workplace to optimise high standards of care for women and their babies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Molecular Epidemiology of Tuberculosis in Foreign-Born Persons Living in San Francisco

PubMed Central

Suwanpimolkul, Gompol; Jarlsberg, Leah G.; Grinsdale, Jennifer A.; Osmond, Dennis; Kawamura, L. Masae; Hopewell, Philip C.

2013-01-01

Rationale: In San Francisco, 70% of the tuberculosis cases occur among foreign-born persons, mainly from China, the Philippines, and Mexico. We postulate that there are differences in the characteristics and risk factors for tuberculosis among these populations. Objectives: To determine the clinical, epidemiological and microbiological characteristics of tuberculosis caused by recent infection and rapid evolution in the major groups of foreign-born and the U.S.-born populations. Methods: We analyzed data from a 20-year prospective community-based study of the molecular epidemiology of tuberculosis in San Francisco. We included all culture-positive tuberculosis cases in the City during the study period. Measurements and Main Results: We calculated and compared incidence rates, clinical and microbiological characteristics, and risk factors for being a secondary case between the various foreign-born and U.S.-born tuberculosis populations. Between 1991 and 2010, there were 4,058 new cases of tuberculosis, of which 1,226 (30%) were U.S.-born and 2,832 (70%) were foreign-born. A total of 3,278 (81%) were culture positive, of which 2,419 (74%) had complete data for analysis. The incidence rate, including the incidence rate of tuberculosis due to recent infection and rapid evolution, decreased significantly in the U.S.-born and the major foreign-born populations. The clinical and microbiological characteristics and the risk factors for tuberculosis due to recent infection differed among the groups. Conclusions: There are differences in the characteristics and the risk factors for tuberculosis due to recent transmission among the major foreign-born and U.S.-born populations in San Francisco. These differences should be considered for the design of targeted tuberculosis control interventions. PMID:23471470

Revisiting the utility of technical performance scores following tetralogy of Fallot repair.

PubMed

Lodin, Daud; Mavrothalassitis, Orestes; Haberer, Kim; Sunderji, Sherzana; Quek, Ruben G W; Peyvandi, Shabnam; Moon-Grady, Anita; Karamlou, Tara

2017-08-01

Although an important quality metric, current technical performance scores may not be generalizable and may omit operative factors that influence outcomes. We examined factors not included in current technical performance scores that may contribute to increased postoperative length of stay, major complications, and cost after primary repair of tetralogy of Fallot. This is a retrospective single site study of patients younger than age 2 years with tetralogy of Fallot undergoing complete repair between 2007 and 2015. Medical record data and discharge echocardiograms were reviewed to ascertain component and composite technical performance scores. Primary outcomes included postoperative length of stay, major complications, and total hospital costs. Multivariable logistic and linear regression identified determinants of each outcome. Patient population (n = 115) had a median postoperative length of stay of 8 days (interquartile range, 6-10 days), and a median total cost of $71,147. Major complications occurred in 33 patients (29%) with 1 death. Technical performance scores assigned were optimum in 28 patients (25%), adequate in 59 patients (52%), and inadequate in 26 patients (23%). Neither technical performance score components nor composite scores were associated with increased postoperative length of stay. Optimum or adequate repairs versus inadequate had equal risk of a complication (P = .79), and equivalent mean total cost ($100,000 vs $187,000; P = .25). Longer cardiopulmonary bypass time per 1-minute increase (P < .01) was associated with longer postoperative length of stay and reintervention (P = .02). The need to return to bypass also increased total cost (P < .01). Current tetralogy of Fallot technical performance scores were not associated with selected outcomes in our postoperative population. Although returning to bypass and bypass length are not included as components in the current score, these are important factors influencing complications and resource use in our population. Revisions anticipated from a prospective trial should consider including these variables. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Understanding Interpersonal Function in Psychiatric Illness Through Multiplayer Economic Games

PubMed Central

2014-01-01

Interpersonal factors play significant roles in the onset, maintenance, and remission of psychiatric conditions. In the current major diagnostic classification systems for psychiatric disorders, some conditions are defined by the presence of impairments in social interaction or maintaining interpersonal relationships; these include autism, social phobia, and the personality disorders. Other psychopathologies confer significant difficulties in the social domain, including major depression, posttraumatic stress disorder, and psychotic disorders. Still other mental health conditions, including substance abuse and eating disorders, seem to be exacerbated or triggered in part by the influence of social peers. For each of these and other psychiatric conditions, the extent and quality of social support is a strong determinant of outcome such that high social support predicts symptom improvement and remission. Despite the central role of interpersonal factors in psychiatric illness, the neurobiology of social impairments remains largely unexplored, in part due to difficulties eliciting and quantifying interpersonal processes in a parametric manner. Recent advances in functional neuroimaging, combined with multiplayer exchange games drawn from behavioral economics, and computational/quantitative approaches more generally, provide a fitting paradigm within which to study interpersonal function and dysfunction in psychiatric conditions. In this review, we outline the importance of interpersonal factors in psychiatric illness and discuss ways in which neuroeconomics provides a tractable framework within which to examine the neurobiology of social dysfunction. PMID:22579510

Dietary Factors in the Etiology of Parkinson's Disease

PubMed Central

Agim, Zeynep S.; Cannon, Jason R.

2015-01-01

Parkinson's disease (PD) is the second most common neurodegenerative disorder. The majority of cases do not arise from purely genetic factors, implicating an important role of environmental factors in disease pathogenesis. Well-established environmental toxins important in PD include pesticides, herbicides, and heavy metals. However, many toxicants linked to PD and used in animal models are rarely encountered. In this context, other factors such as dietary components may represent daily exposures and have gained attention as disease modifiers. Several in vitro, in vivo, and human epidemiological studies have found a variety of dietary factors that modify PD risk. Here, we critically review findings on association between dietary factors, including vitamins, flavonoids, calorie intake, caffeine, alcohol, and metals consumed via food and fatty acids and PD. We have also discussed key data on heterocyclic amines that are produced in high-temperature cooked meat, which is a new emerging field in the assessment of dietary factors in neurological diseases. While more research is clearly needed, significant evidence exists that specific dietary factors can modify PD risk. PMID:25688361

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

Dourson, M.L.

The quantitative procedures associated with noncancer risk assessment include reference dose (RfD), benchmark dose, and severity modeling. The RfD, which is part of the EPA risk assessment guidelines, is an estimation of a level that is likely to be without any health risk to sensitive individuals. The RfD requires two major judgments: the first is choice of a critical effect(s) and its No Observed Adverse Effect Level (NOAEL); the second judgment is choice of an uncertainty factor. This paper discusses major assumptions and limitations of the RfD model.

Uncertainty assessment of source attribution of PM(2.5) and its water-soluble organic carbon content using different biomass burning tracers in positive matrix factorization analysis--a case study in Beijing, China.

PubMed

Tao, Jun; Zhang, Leiming; Zhang, Renjian; Wu, Yunfei; Zhang, Zhisheng; Zhang, Xiaoling; Tang, Yixi; Cao, Junji; Zhang, Yuanhang

2016-02-01

Daily PM2.5 samples were collected at an urban site in Beijing during four one-month periods in 2009-2010, with each period in a different season. Samples were subject to chemical analysis for various chemical components including major water-soluble ions, organic carbon (OC) and water-soluble organic carbon (WSOC), element carbon (EC), trace elements, anhydrosugar levoglucosan (LG), and mannosan (MN). Three sets of source profiles of PM2.5 were first identified through positive matrix factorization (PMF) analysis using single or combined biomass tracers - non-sea salt potassium (nss-K(+)), LG, and a combination of nss-K(+) and LG. The six major source factors of PM2.5 included secondary inorganic aerosol, industrial pollution, soil dust, biomass burning, traffic emission, and coal burning, which were estimated to contribute 31±37%, 39±28%, 14±14%, 7±7%, 5±6%, and 4±8%, respectively, to PM2.5 mass if using the nss-K(+) source profiles, 22±19%, 29±17%, 20±20%, 13±13%, 12±10%, and 4±6%, respectively, if using the LG source profiles, and 21±17%, 31±18%, 19±19%, 11±12%, 14±11%, and 4±6%, respectively, if using the combined nss-K(+) and LG source profiles. The uncertainties in the estimation of biomass burning contributions to WSOC due to the different choices of biomass burning tracers were around 3% annually and up to 24% seasonally in terms of absolute percentage contributions, or on a factor of 1.7 annually and up to a factor of 3.3 seasonally in terms of the actual concentrations. The uncertainty from the major source (e.g. industrial pollution) was on a factor of 1.9 annually and up to a factor of 2.5 seasonally in the estimated WSOC concentrations. Copyright © 2015 Elsevier B.V. All rights reserved.

Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder.

PubMed

Haapakoski, Rita; Mathieu, Julia; Ebmeier, Klaus P; Alenius, Harri; Kivimäki, Mika

2015-10-01

Cumulative meta-analyses are used to evaluate the extent to which further studies are needed to confirm or refute a hypothesis. We used this approach to assess observational evidence on systemic inflammation in individuals with major depressive disorder. We identified 58 studies of four common inflammatory markers in a literature search of PubMed, Embase and PsychInfo databases in May 2014. Pooled data from the earliest eight studies already showed an association between interleukin-6 concentrations and major depression; 23 more recent studies confirmed this finding (d=0.54, p<0.0001). A significant association between C-reactive protein levels and major depression was noted after 14 studies and this did not change after addition of six more studies (d=0.47, p<0.0001). For these two inflammatory markers, there was moderate heterogeneity in study-specific estimates, subgroup differences were small, and publication bias appeared to be an unlikely explanation for the findings. Sensitivity analyses including only high-quality studies and subjects free of antidepressant medication further verified the associations. While there was a link between tumour necrosis factor-α levels and major depression (d=0.40, p=0.002), the cumulative effect remained uncertain due to the extensive heterogeneity in study-specific estimates and inconsistencies between subgroups. No evidence was found for the association between interleukin-1β levels and major depression (d=-0.05, p=0.86). In conclusion, this cumulative meta-analysis confirmed higher mean levels of interleukin-6 and C-reactive protein in patients with major depression compared to non-depressed controls. No consistent association between tumour necrosis factor-α, interleukin-1β and major depression was observed. Future studies should clarify the specific immune mechanisms involved as well as continue testing anti-inflammatory therapies in patients suffering from major depression. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder

PubMed Central

Haapakoski, Rita; Mathieu, Julia; Ebmeier, Klaus P.; Alenius, Harri; Kivimäki, Mika

2015-01-01

Cumulative meta-analyses are used to evaluate the extent to which further studies are needed to confirm or refute a hypothesis. We used this approach to assess observational evidence on systemic inflammation in individuals with major depressive disorder. We identified 58 studies of four common inflammatory markers in a literature search of PubMed, Embase and PsychInfo databases in May 2014. Pooled data from the earliest eight studies already showed an association between interleukin-6 concentrations and major depression; 23 more recent studies confirmed this finding (d = 0.54, p < 0.0001). A significant association between C-reactive protein levels and major depression was noted after 14 studies and this did not change after addition of six more studies (d = 0.47, p < 0.0001). For these two inflammatory markers, there was moderate heterogeneity in study-specific estimates, subgroup differences were small, and publication bias appeared to be an unlikely explanation for the findings. Sensitivity analyses including only high-quality studies and subjects free of antidepressant medication further verified the associations. While there was a link between tumour necrosis factor-α levels and major depression (d = 0.40, p = 0.002), the cumulative effect remained uncertain due to the extensive heterogeneity in study-specific estimates and inconsistencies between subgroups. No evidence was found for the association between interleukin-1β levels and major depression (d = −0.05, p = 0.86). In conclusion, this cumulative meta-analysis confirmed higher mean levels of interleukin-6 and C-reactive protein in patients with major depression compared to non-depressed controls. No consistent association between tumour necrosis factor-α, interleukin-1β and major depression was observed. Future studies should clarify the specific immune mechanisms involved as well as continue testing anti-inflammatory therapies in patients suffering from major depression. PMID:26065825

Risk factors for first time incidence sciatica: a systematic review.

PubMed

Cook, Chad E; Taylor, Jeffrey; Wright, Alexis; Milosavljevic, Steven; Goode, Adam; Whitford, Maureen

2014-06-01

Characteristically, sciatica involves radiating leg pain that follows a dermatomal pattern along the distribution of the sciatic nerve. To our knowledge, there are no studies that have investigated risk factors associated with first time incidence sciatica. The purpose of the systematic review was to identify the longitudinal risk factors associated with first time incidence sciatica and to report incidence rates for the condition. For the purposes of this review, first time incidence sciatica was defined as either of the following: 1) no prior history of sciatica or 2) transition from a pain-free state to sciatica. Studies included subjects of any age from longitudinal, observational, cohort designs. The study was a systematic review. Eight of the 239 articles identified by electronic search strategies met the inclusion criteria. Risk factors and their respective effect estimates were reported using descriptive analysis and the preferred reporting items for systematic reviews and meta-analyses guidelines. Modifiable risk factors included smoking, obesity, occupational factors and health status. Non-modifiable factors included age, gender and social class. Incidence rates varied among the included studies, in part reflecting the variability in the operationalized definition of sciatica but ranged from <1% to 37%. A majority of the identified risk factors associated with first time sciatica are modifiable, suggesting the potential benefits of primary prevention. In addition, those risk factors are also associated with unhealthy lifestyles, which may function concomitantly toward the development of sciatica. Sciatica as a diagnosis is inconsistently defined among studies. © 2013 John Wiley & Sons, Ltd.

Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear--diagnosis and management.

PubMed

Carvalho, T S; Colon, P; Ganss, C; Huysmans, M C; Lussi, A; Schlueter, N; Schmalz, G; Shellis, R P; Tveit, A B; Wiegand, A

2015-09-01

Due to an increased focus on erosive tooth wear (ETW), the European Federation of Conservative Dentistry (EFCD) considered ETW as a relevant topic for generating this consensus report. This report is based on a compilation of the scientific literature, an expert conference, and the approval by the General Assembly of EFCD. ETW is a chemical-mechanical process resulting in a cumulative loss of hard dental tissue not caused by bacteria, and it is characterized by loss of the natural surface morphology and contour of the teeth. A suitable index for classification of ETW is the basic erosive wear examination (BEWE). Regarding the etiology, patient-related factors include the pre-disposition to erosion, reflux, vomiting, drinking and eating habits, as well as medications and dietary supplements. Nutritional factors relate to the composition of foods and beverages, e.g., with low pH and high buffer capacity (major risk factors), and calcium concentration (major protective factor). Occupational factors are exposition of workers to acidic liquids or vapors. Preventive management of ETW aims at reducing or stopping the progression of the lesions. Restorative management aims at reducing symptoms of pain and dentine hypersensitivity, or to restore esthetic and function, but it should only be used in conjunction with preventive strategies. Effective management of ETW includes screening for early signs of ETW and evaluating all etiological factors. ETW is a clinical condition, which calls for the increased attention of the dental community and is a challenge for the cooperation with other medical specialities.

Views of Health System Experts on Macro Factors of Induced Demand

PubMed Central

Khorasani, Elahe; Keyvanara, Mahmoud; Karimi, Saeed; Jazi, Marzie Jafarian

2014-01-01

Background: The probability and severity of effects of induced demand are because of the interaction between a range of factors that can affect physicians and patients behavior. It is also affected by the laws of the markets and organizational arrangements for medical services. This article studies major factors that affect the phenomenon of induced demand with the use of experts’ experiences of the Isfahan University of Medical Sciences. Methods: The research is applied a qualitative method. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard and had to be experienced and were known as experts. Purposive sampling was done for data saturation. Seventeen people were interviewed and criteria such as data “reliability of information” and stability were considered. The anonymity of the interviewees was preserved. The data are transcribed, categorized and then used the thematic analysis. Results: In this study, thematic analysis was conducted, and 77 sub-themes and 3 themes were extracted respectively. The three main themes include infrastructural factors, social factors, and organizational structural factors affecting induced demand. Each of these also has some sub-themes. Conclusions: Results of this research present a framework for analyzing the major causes of induced demand. The causes identified here include complexity of medicine, information mismatch between service providers and consumers, clinical uncertainty, false beliefs, advertisements, insufficient supervision, scarcity of clinical guidelines, weakness of education system, and ignorance of medical ethics. These findings help policymakers to investigate the induced demand phenomenon clear-sighted. PMID:25400888

Risk factors for amyotrophic lateral sclerosis

PubMed Central

Ingre, Caroline; Roos, Per M; Piehl, Fredrik; Kamel, Freya; Fang, Fang

2015-01-01

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2–5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS. PMID:25709501

Estimating the effect of fermentation yeast on distillers grains protein

USDA-ARS?s Scientific Manuscript database

Distillers dried grains with solubles (DDGS) is the key co-product of bio-ethanol production from grains. Major factors affecting its quality and market values include protein quantity (concentration) and quality (amino acid composition). Yet, the effect of fermentation yeast on DDGS quality has no...

Microfilm Permanence and Archival Quality

ERIC Educational Resources Information Center

Avedon, Don M.

1972-01-01

The facts about microfilm permanence and archival quality are presented in simple terms. The major factors, including the film base material, the film emulsion, processing, and storage conditions are reviewed. The designations on the edge of the film are explained and a list of refernces provided. (14 references) (Author)

The Feminization of Poverty.

ERIC Educational Resources Information Center

Garza, Janet K. Weir

After the introduction defined poverty and the feminization of poverty, this paper cited U.S. Census data that includes earnings, family status, and education attained which were posited as major factors for the economic condition of women. The first section on earnings presented female-dominated occupations, such as secretaries, teachers,…

A Virtual Embedded Microcontroller Laboratory for Undergraduate Education: Development and Evaluation

ERIC Educational Resources Information Center

Richardson, Jeffrey J.; Adamo-Villani, Nicoletta

2010-01-01

Laboratory instruction is a major component of the engineering and technology undergraduate curricula. Traditional laboratory instruction is hampered by several factors including limited access to resources by students and high laboratory maintenance cost. A photorealistic 3D computer-simulated laboratory for undergraduate instruction in…

Irrigation waters as a source of pathogenic microorganisms in produce: a review

USDA-ARS?s Scientific Manuscript database

There is increasing evidence that consumption of raw fresh produce is a major factor contributing to human gastrointestinal illness. A wide variety of pathogens contribute to food-borne illnesses, including bacteria (e.g., Salmonella, pathogenic E. coli), protozoa (e.g., Cryptosporidium, Giardia), ...

The Educational and Instructional Responsibilities of Employers

ERIC Educational Resources Information Center

Suchy, Stanislaw

1977-01-01

Discusses the responsibilities of employers in Poland toward the continuing education of their employers. Major topics included are responsibilities of firms based on socioeconomic needs, main features of worker education within firms, continuing education programs for workers, and factors determining the development of the firms' educational and…

Fire and birds in maritime Pacific Northwest

Treesearch

Mark H. Huff; Nathaniel E. Seavy; John D. Alexander; C. John Ralph

2005-01-01

Resource managers face the challenge of understanding how numerous factors, including fire and fire suppression, influence habitat composition and animal communities. We summarize information on fire effects on major vegetation types and bird/fire relations within the maritime Pacific Northwest, and pose management related questions and research considerations....

Medical tourists: who goes and what motivates them?

PubMed

Gan, Lydia L; Frederick, James R

2013-01-01

This study relates consumers' attitudes toward medical tourism to a number of consumer characteristics, such as age, education, income, and insurance status. Principal components analysis of the attitudes of 289 consumers from various communities of North Carolina resulted in three attitude-related factors: economic, treatment-related, and travel-related. Major findings include: (a) the uninsured and low-income consumers are more sensitive to economic factors than the insured and the middle-income consumers; (b) the 51- to 64-year-olds are less motivated by economic factors than young adults; (c) surprisingly, the better one's health, the more one is motivated by treatment-related factors.

Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases.

PubMed

Difede, Joann; Cukor, Judith; Lee, Francis; Yurt, Roger

2009-12-01

Common and pernicious adult psychiatric disorders consequent to burn injury include post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and new-onset substance abuse disorder. Diagnosing and treating these disorders is complicated by the complex psychosocial issues associated with burns including grief, pain, role impairment, disfigurement, dysfunction, stigma, as well as financial and legal issues. Additionally, pre-morbid psychiatric and neurological illnesses are risk factors for burns, adding to the challenge of diagnosis and treatment. This article will focus on the diagnosis and treatment of PTSD and MDD consequent to burn trauma, as these are the major psychiatric outcomes, addressing the attendant psychosocial problems as threads in this post-trauma tapestry.

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

PubMed

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

2013-07-02

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

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

PubMed

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

1999-08-01

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

Solid Tumor Second Primary Neoplasms: Who is at Risk, What Can We Do?

PubMed Central

Oeffinger, Kevin C.; Baxi, Shrujal S.; Friedman, Danielle Novetsky; Moskowitz, Chaya S.

2014-01-01

Eighteen percent of incident malignancies in the U.S. are a second (or subsequent) cancer. Second primary neoplasms (SPN), particularly solid tumors, are a major cause of mortality and serious morbidity among cancer survivors successfully cured of their first cancer. Multiple etiologies may lead to a cancer survivor subsequently being diagnosed with an SPN, including radiotherapy for the first cancer, unhealthy lifestyle behaviors, germline and somatic mutations, aging, or an interaction between any of these factors. In this article, we discuss these factors and synthesize this information for use in clinical practice, including preventive strategies and screening recommendations for SPNs. PMID:24331190

Cervical cancer awareness and risk factors among female university students.

PubMed

Buga, G A

1998-07-01

Population cervical screening programmes are necessary for meaningfully reducing cervical cancer morbidity and mortality. Because of the high incidence of cervical cancer in South Africa, the need for a national screening programme has become evident. The success of such a programme will depend on, among others, the level of cervical cancer awareness among the target population, and their willingness to utilise cytological services and to comply with treatment and follow up protocols. We conducted a survey among female university students, as an elite group of women, to determine their level of cervical cancer awareness and the prevalence of the major risk factors for cervical cancer among them, their rate of utilisation of existing Pap smear services, and their attitudes to Pap smears in general. The majority of respondents were young, single (93.0%) and sexually active (86.9%,) having initiated sexual activity at a mean age of 17.27 +/- 2.18 years. There was a high prevalence of the major risk factors for cervical cancer among the respondents, and these included initiation of coitus before 18 years (53.3%), multiple sexual partners (73.6%), male partner with other partners (37.7%), and previous history of sexually transmitted diseases (42.2%) and vulval warts (4.7%). Their overall knowledge of cervical cancer was poor, although the majority of respondents were able to identify the major risk factors from a given list. This level of awareness of cervical cancer risk factors, however, did not translate into appreciation of personal risk of cervical cancer, safer sex practices or utilisation of Pap smear services. In conclusion, this elite group of women is at a high risk of cervical cancer and would benefit from cervical screening programmes. This would have to be coupled with measures to increase the level of awareness and knowledge of cervical cancer and its prevention.

[Working environment and educational environment are two sides of the same coin].

PubMed

Kannegaard, Pia Nimann; Holm, Ellen Astrid

2014-01-20

Educational environment is of major importance for job satisfaction and it consists of several components including curriculum and values of the organization. Educational climate is the environment, as the individual physicians perceive it. Motivation is important for job satisfaction as well as for learning. Autonomy, responsibility, supervision, feedback are all important factors influencing motivation and learning. These factors must be supported through appropriate organization of work in hospital departments and in general practice.

Determinants of HMO success: the case of Complete Health.

PubMed

Widra, L S; Fottler, M D

1992-01-01

The health maintenance organization (HMO) industry has experienced a variety of difficulties and criticisms in recent years. Various hybrid models have been proposed to alleviate these problems. This article presents an in-depth case study of factors associated with the success of one such hybrid: an individual practice association (IPA)-model HMO affiliated with an academic health center. The major success factors identified include the plan design/structure, the strategic orientation/practices, and the stakeholder management orientation practices.

[Risk factors for Pseudomonas aeruginosa infections, resistant to carbapenem].

PubMed

Ghibu, Laura; Miftode, Egidia; Teodor, Andra; Bejan, Codrina; Dorobăţ, Carmen Mihaela

2010-01-01

Since their introduction in clinical practice,carbapenems have been among the most powerful antibiotics for treating serious infections cased by Gram-negative nosocomial pathogens, including Pseudomonas aeruginosa. The emergence of betalactamases with carbapenem-hydrolyzing activity is of major clinical concern. Pseudomonas aeruginosa is a leading cause of nosocomial infection. Risk factors for colonization with carbapenems-resistant Pseudomonas in hospital are: history of P. aeruginosa infection or colonization within the previous year, (length of hospital stay, being bedridden or in the ICU, mechanical ventilation, malignant disease, and history of chronic obstructive pulmonary disease have all been identified as independent risk factors for MDR P. aeruginosa infection. Long-term-care facilities are also reservoirs of resistant bacteria. Risk factors for colonization of LTCF residents with resistant bacteria included age > 86 years, antibiotic treatment in the previous 3 months, indwelling devices, chronic obstructive pulmonary disease, physical disability, and the particular LTCF unit.

Retinopathy of prematurity: the need for prevention

PubMed Central

Liegl, Raffael; Hellström, Ann; Smith, Lois EH

2016-01-01

More than 450,000 babies are born prematurely in the USA every year. The improved survival of even the most vulnerable low body weight preterm infants has, despite improving health outcomes, led to the resurgence in preterm complications including one of the major causes for blindness in children, retinopathy of prematurity (ROP). The current mainstay in ROP therapy is laser photocoagulation and the injection of vascular endothelial growth factor (VEGF) antibodies in the late stages of the disease after the onset of neovascularization. Both are proven options for ophthalmologists to treat the severe forms of late ROP. However, laser photocoagulation destroys major parts of the retina, and the injection of VEGF antibodies, although rather simple to administer, may cause a systemic suppression of normal vascularization, which has not been studied in sufficient depth. However, the use of neither VEGF antibody nor laser treatment prevents ROP, which should be the long-term goal. It should be possible to prevent ROP by more closely mimicking the intrauterine environment after preterm birth. Such preventive measures include preventing the toxic postbirth influences (eg, oxygen excess) as well as providing the missing intrauterine factors (eg, insulin growth factor 1) and are likely to also reduce other complications of premature birth as well as ROP. This review is meant to summarize the current knowledge on the prevention of ROP with a particular emphasize on the use of insulin growth factor 1 supplementation. PMID:28539804

Insulin-like growth factor-1: a possible marker for emotional and cognitive disturbances, and treatment effectiveness in major depressive disorder.

PubMed

Levada, Oleg A; Troyan, Alexandra S

2017-01-01

Depression and cognitive dysfunction share a common neuropathological platform. Abnormal neural plasticity in the frontolimbic circuits has been linked to changes in the expression of neurotrophic factors, including IGF-1. These changes may result in clinical abnormalities observed over the course of major depressive disorder (MDD), including cognitive dysfunction. The present review aimed to summarize evidence regarding abnormalities of peripheral IGF-1 in MDD patients and assess a marker and predictive role of the neurotrophin for emotional and cognitive disturbances, and treatment effectiveness. A literature search of the PubMed database was conducted for studies, in which peripheral IGF-1 levels were evaluated. Our analysis revealed four main findings: (1) IGF-1 levels in MDD patients mismatch across the studies, which may arise from various factors, e.g., age, gender, the course of the disease, presence of cognitive impairment, ongoing therapy, or general health conditions; (2) the initial peripheral IGF-1 levels may predict the occurrence of depression in future; (3) peripheral IGF-1 levels may reflect cognitive dysfunction, although the data is limited; (4) it is difficult to evaluate the influence of treatment on IGF-1 levels as there is discrepancy of this growth factor among the studies at baseline, although most of them showed a decrease in IGF-1 levels after treatment.

Overweight and its associated risk factors among urban school adolescents in Nepal: a cross-sectional study

PubMed Central

Baral, Kedar Prasad; Pradhan, Bandana; Poudyal, Amod Kumar

2016-01-01

Objectives The prevalence of non-communicable diseases is increasing in Nepal. Overweight and obesity are the major risk factors of many non-communicable diseases. Adolescence is a critical phase for development of overweight and obesity. Risk factors associated with overweight and obesity are not well understood in Nepal. The objective of the study was to identify the factors associated with overweight and obesity among adolescent students. Setting A cross-sectional descriptive study was carried out on higher secondary school students in the Lalitpur sub-metropolitan city, Nepal. Participants A random sample of 360 students aged 16–19 years from eight schools was included in the study. Results The prevalence of overweight among adolescent students was 12.2% (95% CI 8.9 to 15.5). Factors associated with being overweight included being male (adjusted OR (AOR) 2.64, 95% CI 1.18 to 4.88), studying in private school (AOR 2.10, 95% CI 1.03 to 4.28), high socioeconomic status family (AOR 4.77, 95% CI 1.36 to 16.72), watching television for more than 2 h per day (AOR 8.86, 95% CI 3.90 to 20.11), and consuming fruit four times or less per week (AOR 3.13, 95% CI 1.39 to 7.01). There was no statistically significant association between adolescent overweight and age, ethnicity, mother's education level, mother's occupation, number of siblings or family type. Conclusions Socioeconomic status, watching television for a longer time and consuming less fruit are major risk factors for overweight among adolescents in Nepal. Interventions are needed to increase awareness about the risk factors of adolescent overweight and obesity to decrease prevalence of overweight-associated non-communicable diseases. PMID:27207624

Genetic and Epigenetic Biomarkers for Recurrent Prostate Cancer After Radiotherapy

DTIC Science & Technology

2014-05-01

complications from surgery as well as risks associated with anesthesia. Moreover, this therapy includes a low risk of urinary incontinence . Major...another type of RT, involves placing radioactive sources into the prostate tissue. Disadvantages of this treatment include the risk of acute urinary ...Molecular mechanisms and clinical applications of angiogenesis. Nature, 2011. 473(7347): p. 298-307. 6. Yao, J.L., et al., Tissue factor and VEGF

Thermal and energy battery management optimization in electric vehicles using Pontryagin's maximum principle

NASA Astrophysics Data System (ADS)

Bauer, Sebastian; Suchaneck, Andre; Puente León, Fernando

2014-01-01

Depending on the actual battery temperature, electrical power demands in general have a varying impact on the life span of a battery. As electrical energy provided by the battery is needed to temper it, the question arises at which temperature which amount of energy optimally should be utilized for tempering. Therefore, the objective function that has to be optimized contains both the goal to maximize life expectancy and to minimize the amount of energy used for obtaining the first goal. In this paper, Pontryagin's maximum principle is used to derive a causal control strategy from such an objective function. The derivation of the causal strategy includes the determination of major factors that rule the optimal solution calculated with the maximum principle. The optimization is calculated offline on a desktop computer for all possible vehicle parameters and major factors. For the practical implementation in the vehicle, it is sufficient to have the values of the major factors determined only roughly in advance and the offline calculation results available. This feature sidesteps the drawback of several optimization strategies that require the exact knowledge of the future power demand. The resulting strategy's application is not limited to batteries in electric vehicles.

Chromosomal Abnormalities Are Major Prognostic Factors in Elderly Patients With Multiple Myeloma: The Intergroupe Francophone du Myélome Experience

PubMed Central

Avet-Loiseau, Hervé; Hulin, Cyrille; Campion, Loic; Rodon, Philippe; Marit, Gerald; Attal, Michel; Royer, Bruno; Dib, Mamoun; Voillat, Laurent; Bouscary, Didier; Caillot, Denis; Wetterwald, Marc; Pegourie, Brigitte; Lepeu, Gerard; Corront, Bernadette; Karlin, Lionel; Stoppa, Anne-Marie; Fuzibet, Jean-Gabriel; Delbrel, Xavier; Guilhot, Francois; Kolb, Brigitte; Decaux, Olivier; Lamy, Thierry; Garderet, Laurent; Allangba, Olivier; Lifermann, Francois; Anglaret, Bruno; Moreau, Philippe; Harousseau, Jean-Luc; Facon, Thierry

2013-01-01

Purpose Chromosomal abnormalities, especially t(4;14) and del(17p), are major prognostic factors in patients with multiple myeloma (MM). However, this has been especially demonstrated in patients age < 66 years treated with intensive approaches. The goal of this study was to address this issue in elderly patients treated with conventional-dose chemotherapy. Patients and Methods To answer this important question, we retrospectively analyzed a series of 1,890 patients (median age, 72 years; range, 66 to 94 years), including 1,095 with updated data on treatment modalities and survival. Results This large study first showed that the incidence of t(4;14) was not uniform over age, with a marked decrease in the oldest patients. Second, it showed that both t(4;14) and del(17p) retained their prognostic value in elderly patients treated with melphalan and prednisone–based chemotherapy. Conclusion t(4;14) and del(17p) are major prognostic factors in elderly patients with MM, both for progression-free and overall survival, indicating that these two abnormalities should be investigated at diagnosis of MM, regardless of age. PMID:23796999

Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression

PubMed Central

Luby, Joan L.; Gaffrey, Michael S.; Tillman, Rebecca; April, Laura M.; Belden, Andy C.

2014-01-01

Background Preschool-onset depression, a developmentally adapted form of depression arising between the ages of 3–6, has demonstrated numerous features of validity including characteristic alterations in stress reactivity and brain function. Notably, this validated syndrome with multiple clinical markers is characterized by sub-threshold DSM Major Depressive Disorder criteria, raising questions about its clinical significance. To clarify the utility and public health significance of the preschool-onset depression construct, diagnostic outcomes of this group at school age and adolescence were investigated. Methods We investigated the likelihood of meeting full DSM Major Depressive Disorder criteria in later childhood (i.e., ≥ age 6) as a function of preschool depression, other preschool Axis I disorders, maternal depression, parenting non-support and traumatic life events in a longitudinal prospective study of preschool children. Results Preschool-onset depression emerged as a robust predictor of DSM-5 Major Depressive Disorder in later childhood even after accounting for the effect of maternal depression and other risk factors. Preschool-onset conduct disorder also predicted DSM-5 Major Depressive Disorder in later childhood, but this association was partially mediated by maternal non-support, reducing the effect of preschool conduct disorder in predicting DSM depression by 21%. Discussion Study findings provide evidence that this preschool depressive syndrome is a robust risk factor for meeting full DSM criteria for Major Depressive Disorder in later childhood over and above other established risk factors. Preschool conduct disorder also predicted Major Depressive Disorder but was mediated by maternal non-support. Findings suggest that attention to preschool depression and conduct disorder in addition to maternal depression and exposure to trauma should now become an important factor for identification of young children at highest risk for later MDD who should be targeted for early interventions. PMID:24700355

Factors affecting perioperative mortality and wound-related complications following major lower extremity amputations.

PubMed

Stone, Patrick A; Flaherty, Sarah K; Aburahma, Ali F; Hass, Stephen M; Jackson, J Michelle; Hayes, J David; Hofeldt, Matthew J; Hager, Casey S; Elmore, Michael S

2006-03-01

Major lower extremity amputations continue to be associated with significant morbidity and mortality, yet few recent large series have evaluated factors associated with perioperative mortality and wound complications. The purpose of this study was to examine factors affecting perioperative mortality and wound-related complications following major lower extremity amputation. A retrospective review was conducted of all adult patients who underwent nontraumatic major lower extremity amputations over a 5-year period at a single tertiary-care center in southern West Virginia. Demographic and clinical data, perioperative data, and outcomes were collected and analyzed to identify any relationship with perioperative mortality, as well as wound complications and early revisions (within 90 days) to a more proximal level. Variables were examined using chi-squared, two-tailed t-tests, and logistic regression. Three hundred eighty patients (61% male) underwent 412 major lower extremity amputations during 1999-2003. The initial level of amputation included 230 below-knee (BKA), 149 above-knee (AKA), and one hip disarticulation. Perioperative mortality was 15.5% (n = 59). From a regression model, age, albumin level, AKA, and lack of a previous coronary artery bypass graft (CABG) were independently related to mortality. Patients who did not have a previous CABG were nearly three times more likely to die than those who did (p = 0.038). Overall early wound complications were noted in 13.4% (n = 51). Four factors were independently related to experiencing a 90-day wound complication: BKA, community (rather than care facility) living, type of anesthesia, and preoperative hematocrit >30%. Major lower extremity amputation in patients with peripheral vascular disease continues to be associated with considerable perioperative morbidity and mortality. Even though the surgical procedure itself may not be challenging from a technical standpoint, underlying medical conditions put this group at high risk for perioperative death. Wound-healing problems are frequently encountered and must be minimized to facilitate early mobilization and hospital discharge.

A putative model of overeating and obesity based on brain-derived neurotrophic factor: direct and indirect effects.

PubMed

Ooi, Cara L; Kennedy, James L; Levitan, Robert D

2012-08-01

Increased food intake is a major contributor to the obesity epidemic in all age groups. Elucidating brain systems that drive overeating and that might serve as targets for novel prevention and treatment interventions is thus a high priority for obesity research. The authors consider 2 major pathways by which decreased activity of brain-derived neurotrophic factor (BDNF) may confer vulnerability to overeating and weight gain in an obesogenic environment. The first "direct" pathway focuses on the specific role of BDNF as a mediator of food intake control at brain areas rich in BDNF receptors, including the hypothalamus and hindbrain. It is proposed that low BDNF activity limited to this direct pathway may best explain overeating and obesity outside the context of major neuropsychiatric disturbance. A second "indirect" pathway considers the broad neurotrophic effects of BDNF on key monoamine systems that mediate mood dysregulation, impulsivity, and executive dysfunction as well as feeding behavior per se. Disruption in this pathway may best explain overeating and obesity in the context of various neuropsychiatric disturbances including mood disorders, attention-deficit disorder, and/or binge eating disorders. An integrative model that considers these potential roles of BDNF in promoting obesity is presented. The implications of this model for the early prevention and treatment of obesity are also considered.

Immunoevasive Aspergillus virulence factors.

PubMed

Chotirmall, Sanjay H; Mirkovic, Bojana; Lavelle, Gillian M; McElvaney, Noel G

2014-12-01

Individuals with structural lung disease or defective immunity are predisposed to Aspergillus-associated disease. Manifestations range from allergic to cavitary or angio-invasive syndromes. Despite daily spore inhalation, immunocompetence facilitates clearance through initiation of innate and adaptive host responses. These include mechanical barriers, phagocyte activation, antimicrobial peptide release and pattern recognition receptor activation. Adaptive responses include Th1 and Th2 approaches. Understanding Aspergillus virulence mechanisms remains critical to the development of effective research and treatment strategies to counteract the fungi. Major virulence factors relate to fungal structure, protease release and allergens; however, mechanisms utilized to evade immune recognition continue to be important in establishing infection. These include the fungal rodlet layer, dihydroxynaphthalene-melanin, detoxifying systems for reactive oxygen species and toxin release. One major immunoevasive toxin, gliotoxin, plays a key role in mediating Aspergillus-associated colonization in the context of cystic fibrosis. Here, it down-regulates vitamin D receptor expression which following itraconazole therapy is rescued concurrent with decreased Th2 cytokine (IL-5 and IL-13) concentrations in the CF airway. This review focuses on the interaction between Aspergillus pathogenic mechanisms, host immune responses and the immunoevasive strategies employed by the organism during disease states such as that observed in cystic fibrosis.

Climate Change and the Neglected Tropical Diseases.

PubMed

Booth, Mark

2018-01-01

Climate change is expected to impact across every domain of society, including health. The majority of the world's population is susceptible to pathological, infectious disease whose life cycles are sensitive to environmental factors across different physical phases including air, water and soil. Nearly all so-called neglected tropical diseases (NTDs) fall into this category, meaning that future geographic patterns of transmission of dozens of infections are likely to be affected by climate change over the short (seasonal), medium (annual) and long (decadal) term. This review offers an introduction into the terms and processes deployed in modelling climate change and reviews the state of the art in terms of research into how climate change may affect future transmission of NTDs. The 34 infections included in this chapter are drawn from the WHO NTD list and the WHO blueprint list of priority diseases. For the majority of infections, some evidence is available of which environmental factors contribute to the population biology of parasites, vectors and zoonotic hosts. There is a general paucity of published research on the potential effects of decadal climate change, with some exceptions, mainly in vector-borne diseases. © 2018 Elsevier Ltd All rights reserved.

Reflections on curative health care in Nicaragua.

PubMed Central

Slater, R G

1989-01-01

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID:2705603

A Tune in “A Minor” Can “B Major”: A Review of Epidemiology, Illness Course, and Public Health Implications of Subthreshold Depression in Older Adults

PubMed Central

Meeks, Thomas; Vahia, Ipsit; Lavretsky, Helen; Kulkarni, Ganesh; Jeste, Dilip

2010-01-01

BACKGROUND With emphasis on dimensional aspects of psychopathology in development of the upcoming DSM-V, we systematically review data on epidemiology, illness course, risk factors for, and consequences of late-life depressive syndromes not meeting DSM-IV-TR criteria for major depression or dysthymia. We termed these syndromes subthreshold depression, including minor depression and subsyndromal depression. METHODS We searched PubMed (1980–Jan 2010) using the terms: subsyndromal depression, subthreshold depression, and minor depression in combination with elderly, geriatric, older adult, and late-life. Data were extracted from 181 studies of late-life subthreshold depression. RESULTS In older adults subthreshold depression was generally at least 2–3 times more prevalent (median community point prevalence 9.8%) than major depression. Prevalence of subthreshold depression was lower in community settings versus primary care and highest in long-term care settings. Approximately 8–10% of older persons with subthreshold depression developed major depression per year. The course of late-life subthreshold depression was more favorable than that of late-life major depression, but far from benign, with a median remission rate to non-depressed status of only 27% after ≥1 year. Prominent risk factors included female gender, medical burden, disability, and low social support; consequences included increased disability, greater healthcare utilization, and increased suicidal ideation. LIMITATIONS Heterogeneity of the data, especially related to definitions of subthreshold depression limit our ability to conduct meta-analysis. CONCLUSIONS The high prevalence and associated adverse health outcomes of late-life subthreshold depression indicate the major public health significance of this condition and suggest a need for further research on its neurobiology and treatment. Such efforts could potentially lead to prevention of considerable morbidity for the growing number of older adults. PMID:20926139

Proceedings of the Eighth Annual Software Engineering Workshop

NASA Technical Reports Server (NTRS)

1983-01-01

The four major topics of discussion included: the NASA Software Engineering Laboratory, software testing, human factors in software engineering and software quality assessment. As in the past years, there were 12 position papers presented (3 for each topic) followed by questions and very heavy participation by the general audience.

Assessing Faculty Publication Productivity: Issues of Equity. ERIC Digest.

ERIC Educational Resources Information Center

Creamer, Elizabeth G.

This digest summarizes a report of a study of the research literature on faculty publication productivity, with special emphasis on gender as a factor in publishing productivity. Major issues addressed by the report include: (1) the existence of significant gender and race differences in publishing productivity, with women and minorities…

ASSESSING EXPOSURE IN EPIDEMIOLOGIC STUDIES TO DISINFECTION BY-PRODUCTS IN DRINKING WATER: REPORT FROM AN INTERNATIONAL WORKSHOP

EPA Science Inventory

The inability to accurately assess exposure has been one of the major shortcomings of epidemiologic studies of disinfection by-products (DBPs) in drinking water. A number of contributing factors include: (1) limited information on the identity, occurrence, toxicity and pharmacok...

Educative Conditions for Prosocial Value Development during College

ERIC Educational Resources Information Center

Horn, Aaron S.

2013-01-01

Several facets of the undergraduate experience have been linked with the importance students assign to prosocial values (e.g., helping people in need), including academic major, exposure to social and cultural diversity, community service, and a prosocial institutional ethos. However, these factors have not been examined within a single framework…

Genetic Variations of Physiological Responses Following Heat Stress in Laying Hens

USDA-ARS?s Scientific Manuscript database

Heat stress (HS), also known as hyperthermia, is a major problem experienced by poultry during high-temperature conditions. The ability to manage the detrimental effects of HS can be attributed to many factors, including genetics. The objective of the present study was to determine the variation of ...

One Speaker, Two Languages. Cross-Disciplinary Perspectives on Code-Switching.

ERIC Educational Resources Information Center

Milroy, Lesley, Ed.; Muysken, Pieter, Ed.

Fifteen articles review code-switching in the four major areas: policy implications in specific institutional and community settings; perspectives of social theory of code-switching as a form of speech behavior in particular social contexts; the grammatical analysis of code-switching, including factors that constrain switching even within a…

24 CFR 901.105 - Computing assessment score.

Code of Federal Regulations, 2010 CFR

2010-04-01

... substantial rehabilitation within the past ten years are not eligible to be included in the calculation of... past ten years and are eligible for an adjusted score for the physical condition factor. (6) PHAs shall... ten years old that require major capital investment in order to meet local codes or minimum HQS...

Modeling hygroelastic properties of genetically modified aspen

Treesearch

Laszlo Horvath; Perry Peralta; Ilona Peszlen; Levente Csoka; Balazs Horvath; Joseph Jakes

2012-01-01

Numerical and three-dimensional finite element models were developed to improve understanding of major factors affecting hygroelastic wood properties. Effects of chemical composition, microfibril angle, crystallinity, structure of microfibrils, moisture content, and hydrophilicity of the cell wall were included in the model. Wood from wild-type and decreased-lignin...

One-world chemistry and systems thinking

NASA Astrophysics Data System (ADS)

Matlin, Stephen A.; Mehta, Goverdhan; Hopf, Henning; Krief, Alain

2016-05-01

The practice and overarching mission of chemistry need a major overhaul in order to be fit for purpose in the twenty-first century and beyond. The concept of 'one-world' chemistry takes a systems approach that brings together many factors, including ethics and sustainability, that are critical to the future role of chemistry.

Aging and Motor Skill: A Research Frontier.

ERIC Educational Resources Information Center

Lersten, Ken

This report reviews research which characterizes the motor skill capacity of older persons, 50 years of age and beyond. Research dealing with sensory-motor systems, memory, and practice factors receives major attention. Suggestions for future research include the following: (a) social psychological parameters which contribute to motor learning and…

Common Sense Planning for a Computer, or, What's It Worth to You?

ERIC Educational Resources Information Center

Crawford, Walt

1984-01-01

Suggests factors to be considered in planning for the purchase of a microcomputer, including budgets, benefits, costs, and decisions. Major uses of a personal computer are described--word processing, financial analysis, file and database management, programming and computer literacy, education, entertainment, and thrill of high technology. (EJS)

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

Helping Students Cope with Test Anxiety. ERIC Digest.

ERIC Educational Resources Information Center

Harris, Henry L.; Coy, Doris R.

One of the most threatening events that causes anxiety in students today is testing. When students develop an extreme fear of performing poorly on an examination, they experience test anxiety. Test anxiety is a major factor contributing to a variety of negative outcomes including psychological distress, academic underachievement, academic failure,…

Significance of Literature in Foreign Language Teaching

ERIC Educational Resources Information Center

Babaee, Ruzbeh; Yahya, Wan Roselezam Bt Wan

2014-01-01

This research aims to consider literature as a significant tool for teaching fundamental language skills including speaking, listening, reading and writing. Reasons for the use of literature in language classrooms and major factors for choosing appropriate kinds of literary texts in such classes should be highlighted in order to make readers aware…

Introduction

Treesearch

Jeanne C. Chambers; Nora Devoe; Angela Evenden

2008-01-01

The Great Basin is considered to be one of the most endangered ecoregions in the United States (Noss and others 1995, Wisdom and others 2005). The population is expanding at the highest rate in the nation, and major sociological and ecological changes are occurring across the region. These changes can be attributed to numerous interacting factors including urbanization...

Factor Structure of the B-Scan 360: A Measure of Corporate Psychopathy

ERIC Educational Resources Information Center

Mathieu, Cynthia; Hare, Robert D.; Jones, Daniel N.; Babiak, Paul; Neumann, Craig S.

2013-01-01

Psychopathy is a clinical construct defined by a cluster of personality traits and behaviors, including grandiosity, egocentricity, deceptiveness, shallow emotions, lack of empathy or remorse, irresponsibility, impulsivity, and a tendency to ignore or violate social norms. The majority of empirical research on psychopathy involves forensic…

Reflections on a Seminal Force in International Accounting

ERIC Educational Resources Information Center

Cascini, Karen T.

2007-01-01

Accounting is a manifestation of several important environmental factors within a country, including economic, educational and political, and, as such, is evolutionary in accordance with those changing social structures. Because of the major impact that international accounting has had on countries' internal accounting systems, it is important to…

Timing and Methodology of Application of Azoxystrobin to Control Rhizoctonia Solani in Sugarbeet

USDA-ARS?s Scientific Manuscript database

Rhizoctonia solani AG 2-2 is the causal agent of Rhizoctonia root and crown rot of sugar beet (Beta vulgaris) in North Dakota and Minnesota. This disease is a major limiting factor to sugar beet production. Management strategies currently include using partially resistant cultivars and fungicides. ...

Are Homeschoolers Prepared for College Calculus?

ERIC Educational Resources Information Center

Wilkens, Christian P.; Wade, Carol H.; Sonnert, Gerhard; Sadler, Philip M.

2015-01-01

Homeschooling in the United States has grown considerably over the past several decades. This article presents findings from the Factors Influencing College Success in Mathematics (FICSMath) survey, a national study of 10,492 students enrolled in tertiary calculus, including 190 students who reported homeschooling for a majority of their high…

Do Kenyan Set Book Novel Kidagaa Kimemwozea Advance Environmental Education?

ERIC Educational Resources Information Center

Magothe, Stephen Njangiru

2016-01-01

Environmental protection is a sensitive issue in the world today. Erratic weather changes have been witnessed in many parts world including Kenya. Indeed, scholars and critics have argued that human beings are a major contributing factor to destruction of nature through industrialization, farming activities, transport, deforestation, wildlife…

Organic greenhouse soil media + supplemental fertilizer = better organic tomato transplants

USDA-ARS?s Scientific Manuscript database

Consumer perceptions that organic food tastes better and is healthier are two major factors driving the increasing demand for organically produced crops in the U.S. All components entering into the organic crop production system must be approved for organic use, including seed, soil media, and fert...

A State of the Art Review of Soviet Research in Cognitive Psychology.

ERIC Educational Resources Information Center

Wertsch, James V.

This paper outlines the theoretical foundations of Soviet psychology, analyzes major themes based on these foundations, and identifies relevance of Soviet psychological research for American investigators. Basic social and political factors that influence Soviet research include centralization of all scientific and academic endeavors and…

Gender and Career Paths

ERIC Educational Resources Information Center

Leatherwood, Laura; Williams, Mitch

2008-01-01

Although women lead several major universities, including Harvard, the number of women leading the more than 1100 community colleges is not a record in which women--or the community college--can take pride. The current study examines factors affecting the advancement of women to the presidency in the North Carolina Community College System…

The Feasibility of Establishing Satellite Campuses for Georgia State University.

ERIC Educational Resources Information Center

Strickland, Wayne G.

Georgia State University, one of the southeast's major urban universities, is considering new methods of delivering its educational services. This report addresses the concept of satellite campuses for Georgia State University by examining those factors affecting their development. Topics included are: the market potential for educational services…

Investigation of the Factors That Influence Undergraduate Student Chemistry Course Selection

ERIC Educational Resources Information Center

Hinds, Elsa M.; Shultz, Ginger V.

2018-01-01

The introductory chemistry sequence is a common pathway for undergraduates pursuing science, technology, engineering, and math (STEM) and prehealth careers. Student's academic decision-making has far-reaching consequences for their trajectory, including persistence in the major and ultimate career choice. This phenomenon was studied using a survey…

Prenatal risk factors for Tourette Syndrome: a systematic review

PubMed Central

2014-01-01

Background Tourette Syndrome (TS) appears to be an inherited disorder, although genetic abnormalities have been identified in less than 1% of patients, and the mode of inheritance is uncertain. Many studies have investigated environmental factors that might contribute to the onset and severity of tics and associated comorbidities such as obsessive compulsive disorder (OCD) and attention deficit hyperactive disorder (ADHD). A systematic review and qualitative analysis were performed to provide a broad view of the association between pre- and perinatal factors and TS. Methods The Medline, Embase and PsycINFO databases were searched using terms specific to Tourette’s syndrome and keywords such as “pregnancy”, “prenatal”, “perinatal”, “birth” and “neonatal”. Studies were limited to studies on human subjects published in English or French through October 2012. Results 22 studies were included. Studies were of limited methodological quality, with most samples derived from specialty clinics, and most exposures ascertained retrospectively. The majority of the results for demographic factors of parents, including age, education, socioeconomic status, and marital status, revealed no significant association with the onset of TS, or the presence of comorbidity. Many factors were reported to be significantly associated with the onset of TS, the presence of comorbidity and symptom severity, but the most consistently reported factors were maternal smoking and low birth weight. Conclusions There are few studies evaluating the relationship between pre and perinatal events and TS, and existing studies have major limitations, including the use of clinic rather than epidemiologically derived samples, retrospective data collection on pre and perinatal events and multiple hypothesis testing without appropriate statistical correction. The mechanism by which prenatal and perinatal adversities could lead to TS onset or symptom severity is unknown, but may be related to changes in the dopaminergic system as a result of early brain injury. PMID:24479407

Delay of insulin initiation in patients with type 2 diabetes mellitus inadequately controlled with oral hypoglycemic agents (analysis of patient- and physician-related factors): A prospective observational DIPP-FACTOR study in Korea.

PubMed

Kim, Sin Gon; Kim, Nam Hoon; Ku, Bon Jeong; Shon, Ho Sang; Kim, Doo Man; Park, Tae Sun; Kim, Yong-Seong; Kim, In Joo; Choi, Dong Seop

2017-05-01

To assess the time to initiation of insulin therapy, and concurrently investigate both patient- and physician-related factors associated with delaying insulin therapy in Korean patients with type 2 diabetes uncontrolled by oral hypoglycemic agents (OHAs). This prospective, observational disease registry study was carried out across 69 centers in Korea. Type 2 diabetes patients who had received two or more OHAs within the past 5 years, had a glycated hemoglobin ≥8% in the past 6 months and had not received insulin were included. Data recorded on data collection forms during a 12-month period were analyzed. Of 2168 patients enrolled, 1959 were evaluated and classified as the insulin-initiated or insulin-delayed group. Insulin was prescribed for just 20% of the patients during a 1-year follow-up period, and less than half (44.5%) of the patients who were taking two OHAs started insulin after 6 years. Patient-related factors for delay in insulin initiation included older age, shorter duration of diabetes and lower glycated hemoglobin. Physician-related factors included age (~50 to <60 years), sex (women) and number (<1000) of patients consulted per month. Patient refusal (33.6%) and physicians' concerns of patient non-compliance (26.5%) were the major physician-reported reasons for delaying insulin therapy. Inconvenience of insulin therapy (51.6%) and fear of injection (48.2%) were the major reasons for patient refusal. Insulin initiation is delayed in patients with type 2 diabetes uncontrolled by two or more OHAs in Korea. Patient- and physician-related factors associated with this delay need to be addressed for better diabetes management. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

The growth receptors and their role in wound healing.

PubMed

Rolfe, Kerstin J; Grobbelaar, Adriaan O

2010-11-01

Abnormal wound healing is a major problem in healthcare today, with both scarring and chronic wounds affecting large numbers of individuals worldwide. Wound healing is a complex process involving several variables, including growth factors and their receptors. Chronic wounds fail to complete the wound healing process, while scarring is considered to be an overzealous wound healing process. Growth factor receptors and their ligands are being investigated to assess their potential in the development of therapeutic strategies to improve wound healing. This review discusses potential therapeutics for manipulating growth factors and their corresponding receptors for the treatment of abnormal wound healing.

Cardiovascular diseases and risk factors among Chinese immigrants.

PubMed

Gong, Zhizhong; Zhao, Dong

2016-04-01

The aim of this study is to identify the prevalence of cardiovascular disease (CVD) and major CVD risk factors, including diabetes, hypertension, dyslipidemia, obesity and smoking among Chinese immigrants by a systematic review of studies from various countries. PubMed and the China National Knowledge Infrastructure databases were searched for studies of the prevalence of major CVDs and risk factors, and of CVD mortality among Chinese immigrants. The search identified 386 papers, 16 of which met the inclusion criteria for this review. In mainland China, there is a pattern of high stroke prevalence but low coronary heart disease (CHD) prevalence. Among Chinese immigrants, there is a much lower prevalence and mortality of stroke, but a higher prevalence and mortality of CHD, even though these are lower than the rates in immigrants of other ethnicities in the host country. The prevalence of CVD risk factors is also markedly different in immigrants. Compared with mainland Chinese, Chinese immigrants have a higher prevalence of diabetes and hypertension, higher serum cholesterol, poorer dietary patterns, and higher prevalence of obesity and smoking. Thus, the epidemiological pattern of CVD among Chinese immigrants changes compared with resident mainland Chinese. The less healthy environmental factor after immigration may be a major trigger in the adverse CVD status of Chinese immigrants. It is important for policy-makers to pay more attention to specific minority immigrant groups, and to implement more effective preventive measures to improve the health of immigrant populations.

Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006.

PubMed

Rastam, Samer; Al Ali, Radwan; Maziak, Wasim; Mzayek, Fawaz; Fouad, Fouad M; O'Flaherty, Martin; Capewell, Simon

2012-09-09

Despite advances made in treating coronary heart disease (CHD), mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81%) of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD.

The Compelling and Persistent Problem of Bipolar Disorder Disguised as Major Depression Disorder: An Integrative Review [Formula: see text].

PubMed

Stiles, Brandie M; Fish, Anne F; Vandermause, Roxanne; Malik, Azfar M

2018-06-01

Up to 40% of patients with bipolar disorder are misdiagnosed, usually with major depression disorder. The purpose was to describe the current state of the science of the misdiagnosis of bipolar disorder, with the ultimate goal of improving psychiatric diagnostic workups including screening. An integrative review was conducted using standard criteria for evaluating research articles. Forty-nine articles met the eligibility criteria. Articles explored patient-related and health care provider-related factors contributing to the misdiagnosis of bipolar disorder as well as consequences of misdiagnosis. Clinically oriented, reliable, and valid screening tools for bipolar disorder also were reviewed. Awareness of multiple, challenging patient-related factors and more comprehensive assessment and screening by health care providers may reduce misdiagnosis.

Cancer control programs in East Asia: evidence from the international literature.

PubMed

Moore, Malcolm A

2014-07-01

Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East. Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.

Childhood obesity: a review of increased risk for physical and psychological comorbidities.

PubMed

Pulgarón, Elizabeth R

2013-01-01

Worldwide estimates of childhood overweight and obesity are as high as 43 million, and rates continue to increase each year. Researchers have taken interest in the childhood obesity epidemic and the impact of this condition across health domains. The consequences of childhood and adolescent obesity are extensive, including both medical and psychosocial comorbidities. The purpose of this review was to consolidate and highlight the recent literature on the comorbidities associated with childhood obesity, both nationally and internationally. PubMed and PsychINFO searches were conducted on childhood obesity and comorbidities. The initial search of the terms obesity and comorbidity yielded >5000 published articles. Limits were set to include studies on children and adolescents that were published in peer-reviewed journals from 2002 to 2012. These limits narrowed the search to 938. Review of those articles resulted in 79 that are included in this review. The major medical comorbidities associated with childhood obesity in the current literature are metabolic risk factors, asthma, and dental health issues. Major psychological comorbidities include internalizing and externalizing disorders, attention-deficit hyperactivity disorder, and sleep problems. The high prevalence rates of childhood obesity have resulted in extensive research in this area. Limitations to the current childhood obesity literature include differential definitions of weight status and cut-off levels for metabolic risk factors across studies. Additionally, some results are based on self-report of diagnoses rather than chart reviews or physician diagnosis. Even so, there is substantial support for metabolic risk factors, internalizing disorders, attention-deficit hyperactivity disorder, and decreased health-related quality of life as comorbidities to obesity in childhood. Additional investigations on other diseases and conditions that might be associated with childhood obesity are warranted and intervention research in this area is critical. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Purification and characterization of an abnormal factor IX (Christmas factor) molecule. Factor IX Chapel Hill.

PubMed Central

Chung, K S; Madar, D A; Goldsmith, J C; Kingdon, H S; Roberts, H R

1978-01-01

Human Factor IX (Christmas factor) was isolated from the plasma of a patient with mild hemophilia B. The patient's plasma contained 5% Factor IX clotting activity but 100% Factor IX antigenic activity as determined by immunological assays, which included inhibitor neutralization and a radioimmunoassay for Factor IX. This abnormal Factor IX is called Factor IX Chapel Hill (Factor IXCH). Both normal Factor IX and Factor IXCH have tyrosine as the NH2-terminal amino acid. The two proteins have a similar molecular weight, a similar amino acid analysis, the same number of gamma-carboxyglutamic acid residues (10 gamma-carboxyglutamic acid residues), and a similar carbohydrate content. Both exist as a single-chain glycoprotein in plasma. The major difference between normal Factor IX and Factor IXCH is that the latter exhibits delayed activation to Factor IXa in the presence of Factor XIa and Ca2+. Thus, Factor IXCH differs from other previously described abnormal Factor IX molecules. Images PMID:711853

African American ethnicity as a risk factor for respiratory complications following adenotonsillectomy.

PubMed

Horwood, Linda; Nguyen, Lily H P; Brown, Karen; Paci, Philippe; Constantin, Evelyn

2013-02-01

To evaluate whether African American ethnicity is a risk factor for major respiratory complications following adenotonsillectomy (T&A). Retrospective cohort study. A Canadian tertiary care center. PATIENTS Children aged 0 to 18 years who underwent T&A at our institution from 2002 to 2006 with planned or unplanned postoperative admissions. We evaluated the association between ethnicity and our main outcome measure, major perioperative respiratory complications of T&A. Parental report of ethnicity was available for 23% of our cohort. At our institution, African American children undergo a routine preoperative sickle cell test (TestSC). Data on TestSC were included for all children. We established that having a TestSC was an accurate proxy for African American ethnicity (sensitivity, 96%; specificity, 93%; positive predictive value, 77%; negative predictive value, 99%). Seventy-four of 594 children experienced major respiratory complications (12.5%). Compared with children who did not have major respiratory complications, those who did had a TestSC (P = .01), were 2 years or younger (P < .001) and had lower weight-for-age z scores (P = .04), moderate to severe obstructive sleep apnea (P = .003), and comorbidities (P < .001). When controlling for these variables in a multivariate analysis, children of African American ethnicity (TestSC used as a proxy) were at higher risk of having major perioperative respiratory complications (adjusted odds ratio, 1.82 [95% CI 1.05-3.14]) (P = .003). Children of African American ethnicity (TestSC used as a proxy) are nearly twice as likely to experience major respiratory complications related to T&A. Ethnicity may be an additional independent risk factor for clinicians to consider when planning for T&A.

Tubal factor infertility in Benin City, Nigeria - sociodemographics of patients and aetiopathogenic factors.

PubMed

Umeora, O U J; Mbazor, J O; Okpere, E E

2007-04-01

In Africa, infertility constitutes a major gynaecological complaint and causes enormous socio-psychological stress to the patients. This study examined retrospective data at the University of Benin Teaching Hospital, Benin City, Nigeria, over a 5-year period to determine the factors associated with tubal infertility. Tubal infertility was confirmed in 13.5% of the 1181 new cases of infertility over the study period. The mean age of the patients was 33.2+/-9.5 years. Over 65% were nulliparous and all socioeconomic classes were affected. Major associated factors included infections such as post-abortal sepsis, puerperal sepsis and pelvic inflammatory disease (PID). Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID. Infertility is largely preventable. Attention should be focused on reducing the incidence of unsafe abortion and its consequences, providing clean and safe delivery as well as reducing the incidence of and ensuring proper treatment of any cases of PID.

The Psycho-cardiac Coupling, Myocardial Remodeling, and Neuroendocrine Factor Levels: The Psychosomatics of Major Depressive Disorder.

PubMed

Syeda, Javeria N; Rutkofsky, Ian H; Muhammad, Adnan S; Balla Abdalla, Tarig H; Saghir, Zahid

2018-04-11

The association of major depressive disorder (MDD) with myocardial infarction (MI) and vice versa is not unknown. Depression, along with many other systemic factors like atherosclerosis, obesity, diabetes and vascular dysfunction, contributes to the development of adverse cardiac events in the future and, has always been a topic of interest in the fields of cardiology and psychosomatics. We wrote this review article to elaborate this relationship in detail. This article suggests that the individuals with type D personality who already had cardiovascular disease had undergone more serious myocardial damage. In addition, we elucidated the effects of depression on sympathetic activity and remodeling of myocardium after MI. The alterations in the neuroendocrine factors, which included the changes in levels of Serotonin (5-HT), Norepinephrine and Corticosterone, also geared towards the changes associated with depression-induced myocardial injury. However, we need more studies in the near future to further dig into this association process. Therefore, we recommend more research to explore the relationship of psychological factors and adverse cardiac outcomes.

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

PubMed Central

Salamonson, Y.; Descallar, J.; Davidson, P. M.

2015-01-01

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants' perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle. PMID:26380277

Differentiating suicide ideators from attempters: violence--a research note.

PubMed

Stack, Steven

2014-02-01

Which factors distinguish suicide attempters from suicide ideators is a relatively neglected question in suicidology. Data from the 2001 Youth Risk Behavior Survey, encompassing 1,439 youth suicide ideators and 1,097 attempters, was used to explore which factors best differentiate suicide attempters from ideators, with a focus on violence involvement. Measures of violence include the contexts of fights, dating, and weapons carrying. Controls were incorporated for psychiatric disorders, risky sexual behavior, school integration, and demographics. Controlling for the other variables, violence differentiated attempts from ideation: fighting (OR = 2.18) and weapon carrying (OR = 1.13). Psychiatric factors that predicted attempts over ideation included major depression (OR = 1.86), use of cocaine (OR = 2.34), and having a suicide plan (OR = 2.69), while demographic factors included gender, age, residence in the Midwest, and Hispanic, African American, or Asian ethnicity. A supplementary analysis (N = 11,546) determined that violence also helped to differentiate suicide ideators from nonsuicidal youth. Four factors (including violence involvement, eating disorders, and gender consistently) differentiated both between suicide attempts and ideation, and also between suicide ideators and nonsuicidal youth. The link between violence involvement and suicidality is interpreted in terms of the capability for suicide from the interpersonal theory of suicide. © 2013 The American Association of Suicidology.

Parental smoking and other risk factors for wheezing bronchitis in children.

PubMed

Rylander, E; Pershagen, G; Eriksson, M; Nordvall, L

1993-09-01

A population-based case-control study was performed to investigate etiologic factors for wheezing bronchitis and asthma in children up to four years of age. A total of 199 children hospitalized for the first time with these diagnoses at a major hospital in Stockholm in 1986-1988 constituted the cases, 351 children from the catchment area of the hospital were used as controls. Information on known and suspected risk factors was obtained through home interviews with a parent. Parental smoking was associated with a relative risk of 1.8 (95% confidence interval 1.3-2.6) corresponding to a population attributable proportion of 27%. The strongest association was seen for maternal smoking and children below 18 months of age. Other major risk factors included atopic heredity, recurrent upper respiratory tract infections and breast-feeding less than 3 months, which appeared to interact multiplicatively with parental smoking. The environmental factors had a stronger influence in the youngest age group, and the overall attributable proportion associated with parental smoking, short breast-feeding period and exposure to pets in the household was 43%. It is clear that successful primary prevention could dramatically reduce the incidence of wheezing bronchitis in children.

Role of Helicobacter pylori in gastric cancer: Updates

PubMed Central

Khatoon, Jahanarah; Rai, Ravi Prakash; Prasad, Kashi Nath

2016-01-01

Helicobacter pylori (H. pylori) infection is highly prevalent in human, affecting nearly half of the world’s population; however, infection remains asymptomatic in majority of population. During its co-existence with humans, H. pylori has evolved various strategies to maintain a mild gastritis and limit the immune response of host. On the other side, presence of H. pylori is also associated with increased risk for the development of various gastric pathologies including gastric cancer (GC). A complex combination of host genetics, environmental agents, and bacterial virulence factors are considered to determine the susceptibility as well as the severity of outcome in a subset of individuals. GC is one of the most common cancers and considered as the third most common cause of cancer related death worldwide. Many studies had proved H. pylori as an important risk factor in the development of non-cardia GC. Although both H. pylori infection and GC are showing decreasing trends in the developed world, they still remain a major threat to human population in the developing countries. The current review attempts to highlight recent progress in the field of research on H. pylori induced GC and aims to provide brief insight into H. pylori pathogenesis, the role of major virulence factors of H. pylori that modulates the host environment and transform the normal gastric epithelium to neoplastic one. This review also emphasizes on the mechanistic understanding of how colonization and various virulence attributes of H. pylori as well as the host innate and adaptive immune responses modulate the diverse signaling pathways that leads to different disease outcomes including GC. PMID:26909129

Major depressive disorder with religious struggle and completed suicide after hair transplantation.

PubMed

Ceylan, Mehmet Emin; Önen Ünsalver, Barış; Evrensel, Alper

2017-01-01

Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have been reported for breast augmentation patients. Difficulty adapting to the new image, unfulfilled psychological needs expected to be met by the surgery, side effects of the surgery like tissue swelling or bruising, uncontrolled pain, presence of body dysmorphic disorder and previous history of mood disorder may be some of the risk factors for post-surgical depression. Here, we present a case without prior psychiatric history who developed major depressive disorder after hair transplantation and died of suicide. He started experiencing religious struggle related to his decision about the hair transplant which he interpreted as acting against God's will. While religious involvement has been reported to be a protective factor against depression, spiritual struggle, which includes religious guilt, has been described as an important risk factor for depression, hopelessness and suicidality which might explain the severity of depression in our patient. This case highlights the importance of a detailed psychiatric evaluation and exploration of religious concerns of any patient before any type of aesthetic surgery. Major depressive disorder is a treatable condition; however, mild depression can go unnoticed. Religious belief and related religious practices affect an individual's personal health attitudes; therefore, we think that every physician is needed to explore the religious concerns of any patient during any medical examination or surgical procedure. Relevant religious authorities should be consulted when necessary.

Awareness of risk factors for cancer among Omani adults--a community based study.

PubMed

Al-Azri, Mohammed; Al-Rasbi, Khadija; Al-Hinai, Mustafa; Davidson, Robin; Al-Maniri, Abdullah

2014-01-01

Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI>25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (p<0.0005), passive smoking (p= 0.007), excessive drinking of alcohol (p<0.0005), eating less fruit and vegetables (p= 0.001) and infection with HPV (p<0.0005). The majority of respondents in this study in Oman were not aware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.

Acute Kidney Injury After Major Surgery: A Retrospective Analysis of Veterans Health Administration Data

PubMed Central

Grams, Morgan E.; Sang, Yingying; Coresh, Josef; Ballew, Shoshana; Matsushita, Kunihiro; Molnar, Miklos Z.; Szabo, Zoltan; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P.

2015-01-01

Background Few trials of acute kidney injury (AKI) prevention after surgery have been conducted and most observational studies focus on AKI following cardiac surgery. The frequency of, risk factors for, and outcomes after AKI following other types of major surgery have not been well characterized, and may present additional opportunities for trials in AKI. Study Design Observational cohort study. Setting & Participants 3.6 million US veterans followed up from 2004-2011 for the receipt of major surgery (cardiac; general; ear, nose, and throat [ENT], thoracic, vascular, urologic, orthopedic) and post-operative outcomes. Factors Demographics, health characteristics, and type of surgery. Outcomes Post-operative AKI defined by the KDIGO creatinine criteria, post-operative length of stay, end-stage renal disease (ESRD), and mortality. Results Post-operative AKI occurred in 11.8% of the 161,185 major surgery hospitalizations (stage 1, 76%; stage 2, 15%, stage 3 [without dialysis], 7%; AKI requiring dialysis, 2%). Cardiac surgery had the highest post-operative AKI risk (relative risk [RR], 1.22; 95% CI, 1.17-1.27), followed by general (reference), thoracic (RR, 0.92; 95% CI, 0.87-0.98), orthopedic (RR, 0.70; 95% CI, 0.67-0.73), vascular (RR, 0.68; 95% CI, 0.64-0.71), urologic (RR, 0.65; 95% CI, 0.61-0.69), and ENT (RR, 0.32; 95% CI, 0.28-0.37) surgery. Risk factors for post-operative AKI included older age, African-American race, hypertension, diabetes mellitus, and, when eGFR < 90 ml/min/1.73 m2, lower eGFR. Participants with post-operative AKI had longer length of stay (15.8 vs. 8.6 days) and higher rates of 30-day hospital readmission (21% vs. 13%), 1-year ESRD (0.94% vs. 0.05%) and mortality (19% vs. 8%), with similar associations by type of surgery and more severe stage of AKI relating to poorer outcomes. Limitations Urine output was not available to classify AKI; cohort included mostly men. Conclusions AKI was common after major surgery, with similar risk factor and outcome associations across surgery type. These results can inform the design of clinical trials in post-operative AKI to the non-cardiac surgery setting. PMID:26337133

Hip fractures are risky business: an analysis of the NSQIP data.

PubMed

Sathiyakumar, Vasanth; Greenberg, Sarah E; Molina, Cesar S; Thakore, Rachel V; Obremskey, William T; Sethi, Manish K

2015-04-01

Hip fractures are one of the most common types of orthopaedic injury with high rates of morbidity. Currently, no study has compared risk factors and adverse events following the different types of hip fracture surgeries. The purpose of this paper is to investigate the major and minor adverse events and risk factors for complication development associated with five common surgeries for the treatment of hip fractures using the NSQIP database. Using the ACS-NSQIP database, complications for five forms of hip surgeries were selected and categorized into major and minor adverse events. Demographics and clinical variables were collected and an unadjusted bivariate logistic regression analyses was performed to determine significant risk factors for adverse events. Five multivariate regressions were run for each surgery as well as a combined regression analysis. A total of 9640 patients undergoing surgery for hip fracture were identified with an adverse events rate of 25.2% (n=2433). Open reduction and internal fixation of a femoral neck fracture had the greatest percentage of all major events (16.6%) and total adverse events (27.4%), whereas partial hip hemiarthroplasty had the greatest percentage of all minor events (11.6%). Mortality was the most common major adverse event (44.9-50.6%). For minor complications, urinary tract infections were the most common minor adverse event (52.7-62.6%). Significant risk factors for development of any adverse event included age, BMI, gender, race, active smoking status, history of COPD, history of CHF, ASA score, dyspnoea, and functional status, with various combinations of these factors significantly affecting complication development for the individual surgeries. Hip fractures are associated with significantly high numbers of adverse events. The type of surgery affects the type of complications developed and also has an effect on what risk factors significantly predict the development of a complication. Concerted efforts from orthopaedists should be made to identify higher risk patients and prevent the most common adverse events that occur postoperatively. Copyright © 2014 Elsevier Ltd. All rights reserved.

Industrial production of clotting factors: Challenges of expression, and choice of host cells.

PubMed

Kumar, Sampath R

2015-07-01

The development of recombinant forms of blood coagulation factors as safer alternatives to plasma derived factors marked a major advance in the treatment of common coagulation disorders. These are complex proteins, mostly enzymes or co-enzymes, involving multiple post-translational modifications, and therefore are difficult to express. This article reviews the nature of the expression challenges for the industrial production of these factors, vis-à-vis the translational and post-translational bottlenecks, as well as the choice of host cell lines for high-fidelity production. For achieving high productivities of vitamin K dependent proteins, which include factors II (prothrombin), VII, IX and X, and protein C, host cell limitation of γ-glutamyl carboxylation is a major bottleneck. Despite progress in addressing this, involvement of yet unidentified protein(s) impedes a complete cell engineering solution. Human factor VIII expresses at very low levels due to limitations at several steps in the protein secretion pathway. Protein and cell engineering, vector improvement and alternate host cells promise improvement in the productivity. Production of Von Willebrand factor is constrained by its large size, complex structure, and the need for extensive glycosylation and disulfide-bonded oligomerization. All the licensed therapeutic factors are produced in CHO, BHK or HEK293 cells. While HEK293 is a recent adoption, BHK cells appear to be disfavored. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Critical factors for the return-to-work process among people with affective disorders: Voices from two vocational approaches.

PubMed

Porter, Susann; Lexén, Annika; Johansson, Suzanne; Bejerholm, Ulrika

2018-05-22

Depression is among the major causes of disability with a negative impact on both daily life and work performance. Whilst depression is the primary cause of sick-leave and unemployment in today's workplace there is a lack of knowledge of the needs of individuals with depression regarding their return-to-work (RTW) process. To explore which factors are of critical importance for people suffering from depression and who also are unemployed in their RTW-process and to explore the impact of two vocational approaches on the service users' experiences. The study included participants in two vocational rehabilitation approaches; Individual Enabling and Support (IES) and Traditional Vocational Rehabilitation (TVR). Qualitative methods were applied to explore critical factors in the RTW-process. Individuals with affective disorders including depression and bipolar disorder were included.RESULTSThree themes emerged as critical factors; Experiencing hope and power, Professionals' positive attitudes, beliefs and behaviours, and Employing a holistic perspective and integrating health and vocational service.CONCLUSIONThis study has demonstrated critical factors for the return-to-work process as experienced by persons with depression. To experience hope and power, to meet professionals that believe "you can work", who use a person-centred and holistic service approach, are such factors necessary for gaining a real job. In particular, professionals in TVR need to embrace this understanding since their services were not experienced as including these elements.

Risk of early surgery for Crohn's disease: implications for early treatment strategies.

PubMed

Sands, Bruce E; Arsenault, Joanne E; Rosen, Michael J; Alsahli, Mazen; Bailen, Laurence; Banks, Peter; Bensen, Steven; Bousvaros, Athos; Cave, David; Cooley, Jeffrey S; Cooper, Herbert L; Edwards, Susan T; Farrell, Richard J; Griffin, Michael J; Hay, David W; John, Alex; Lidofsky, Sheldon; Olans, Lori B; Peppercorn, Mark A; Rothstein, Richard I; Roy, Michael A; Saletta, Michael J; Shah, Samir A; Warner, Andrew S; Wolf, Jacqueline L; Vecchio, James; Winter, Harland S; Zawacki, John K

2003-12-01

In this study we aimed to define the rate of early surgery for Crohn's disease and to identify risk factors associated with early surgery as a basis for subsequent studies of early intervention in Crohn's disease. We assembled a retrospective cohort of patients with Crohn's disease diagnosed between 1991 and 1997 and followed for at least 3 yr, who were identified in 16 community and referral-based practices in New England. Chart review was performed for each patient. Details of baseline demographic and disease features were recorded. Surgical history including date of surgery, indication, and procedure were also noted. Risk factors for early surgery (defined as major surgery for Crohn's disease within 3 yr of diagnosis, exclusive of major surgery at time of diagnosis) were identified by univariate analysis. Multiple logistic regression was used to identify independent risk factors. Of 345 eligible patients, 69 (20.1%) required surgery within 3 yr of diagnosis, excluding the 14 patients (4.1%) who had major surgery at the time of diagnosis. Overall, the interval between diagnosis and surgery was short; one half of all patients who required surgery underwent operation within 6 months of diagnosis. Risk factors identified by univariate analysis as significantly associated with early surgery included the following: smoking; disease of small bowel without colonic involvement; nausea and vomiting or abdominal pain on presentation; neutrophil count; and steroid use in the first 6 months. Disease localized to the colon only, blood in the stool, use of 5-aminosalicylate, and lymphocyte count were inversely associated with risk of early surgery. Logistic regression confirmed independent associations with smoking as a positive risk factor and involvement of colon without small bowel as a negative risk factor for early surgery. The rate of surgery is high in the first 3 yr after diagnosis of Crohn's disease, particularly in the first 6 months. These results suggest that improved risk stratification and potent therapies with rapid onset of action are needed to modify the natural history of Crohn's disease.

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

PubMed

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

2017-04-01

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

Nutrient dynamics as indicators of karst processes: Comparison of the Chalk aquifer (Normandy, France) and the Edwards aquifer (Texas, U.S.A.)

USGS Publications Warehouse

Mahler, B.J.; Valdes, D.; Musgrove, M.; Massei, N.

2008-01-01

Karst aquifers display a range of geologic and geomorphic characteristics in a wide range of climatic and land-use settings; identification of transport dynamics representative of karst aquifers in general could help advance our understanding of these complex systems. To this end, nutrient, turbidity, and major ion dynamics in response to storms were compared at multiple sites in two karst aquifers with contrasting characteristics and settings: the Chalk aquifer (Eure Department, Normandy, France) and the Barton Springs segment of the Edwards Aquifer (Texas, U.S.A.). The Chalk aquifer is typified by high matrix porosity, thick surficial deposits (up to 30??m thick), and agricultural land use; the Barton Springs segment is typified by low matrix porosity, outcropping limestone, and urban land use. Following one to three storms, from 5 to 16 samples from springs and wells were analyzed for major ions, and specific conductance and turbidity were monitored continuously. Comparison of the chemographs indicated some generalized responses, including an increase in turbidity and potassium concentrations and a decrease in major ion and nitrate concentrations with infiltrating storm runoff. Factor analysis of major ions and turbidity revealed strikingly similar behavior of the chemical variables for the two aquifers: The first two factors, explaining more than 75% of the variability, illustrate that dynamics of most major ions (including nitrate) are opposed to those of turbidity and of potassium. The results demonstrate that potassium and nitrate are effective tracers of infiltrating storm runoff and resident ground water, respectively, and the similar results for these two highly contrasting aquifers suggest that the dynamics identified might be applicable to karst systems in general. ?? 2008 Elsevier B.V. All rights reserved.

Nutrient dynamics as indicators of karst processes: comparison of the Chalk aquifer (Normandy, France) and the Edwards aquifer (Texas, U.S.A.).

PubMed

Mahler, B J; Valdes, D; Musgrove, M; Massei, N

2008-05-26

Karst aquifers display a range of geologic and geomorphic characteristics in a wide range of climatic and land-use settings; identification of transport dynamics representative of karst aquifers in general could help advance our understanding of these complex systems. To this end, nutrient, turbidity, and major ion dynamics in response to storms were compared at multiple sites in two karst aquifers with contrasting characteristics and settings: the Chalk aquifer (Eure Department, Normandy, France) and the Barton Springs segment of the Edwards Aquifer (Texas, U.S.A.). The Chalk aquifer is typified by high matrix porosity, thick surficial deposits (up to 30 m thick), and agricultural land use; the Barton Springs segment is typified by low matrix porosity, outcropping limestone, and urban land use. Following one to three storms, from 5 to 16 samples from springs and wells were analyzed for major ions, and specific conductance and turbidity were monitored continuously. Comparison of the chemographs indicated some generalized responses, including an increase in turbidity and potassium concentrations and a decrease in major ion and nitrate concentrations with infiltrating storm runoff. Factor analysis of major ions and turbidity revealed strikingly similar behavior of the chemical variables for the two aquifers: The first two factors, explaining more than 75% of the variability, illustrate that dynamics of most major ions (including nitrate) are opposed to those of turbidity and of potassium. The results demonstrate that potassium and nitrate are effective tracers of infiltrating storm runoff and resident ground water, respectively, and the similar results for these two highly contrasting aquifers suggest that the dynamics identified might be applicable to karst systems in general.

Goblet Cells of the Conjunctiva: A Review of Recent Findings

PubMed Central

Gipson, Ilene K

2016-01-01

Goblet cells within the conjunctival epithelium are specialized cells that secrete mucins onto the surface of the eye. Recent research has demonstrated new characteristics of the cells, including factors influencing their differentiation, their gene products and their functions at the ocular surface. The following review summarizes the newly discovered aspects of the role of Spdef, a member of the Ets transcription factor family in conjunctival goblet cell differentiation, the newly discovered goblet cell products including claudin2, the Wnt inhibitor Frzb, and the transmembrane mucin Muc16. The current concepts of conjunctival goblet cell function, including debris removal and immune surveillance are reviewed, as are changes in the goblet cell population in ocular surface diseases. Major remaining questions regarding conjunctival cell biology are discussed. PMID:27091323

Meta-analysis identifies six new susceptibility loci for atrial fibrillation

PubMed Central

Ellinor, Patrick T; Lunetta, Kathryn L; Albert, Christine M; Glazer, Nicole L; Ritchie, Marylyn D; Smith, Albert V; Arking, Dan E; Müller-Nurasyid, Martina; Krijthe, Bouwe P; Lubitz, Steven A; Bis, Joshua C; Chung, Mina K; Dörr, Marcus; Ozaki, Kouichi; Roberts, Jason D; Smith, J Gustav; Pfeufer, Arne; Sinner, Moritz F; Lohman, Kurt; Ding, Jingzhong; Smith, Nicholas L; Smith, Jonathan D; Rienstra, Michiel; Rice, Kenneth M; Van Wagoner, David R; Magnani, Jared W; Wakili, Reza; Clauss, Sebastian; Rotter, Jerome I; Steinbeck, Gerhard; Launer, Lenore J; Davies, Robert W; Borkovich, Matthew; Harris, Tamara B; Lin, Honghuang; Völker, Uwe; Völzke, Henry; Milan, David J; Hofman, Albert; Boerwinkle, Eric; Chen, Lin Y; Soliman, Elsayed Z; Voight, Benjamin F; Li, Guo; Chakravarti, Aravinda; Kubo, Michiaki; Tedrow, Usha B; Rose, Lynda M; Ridker, Paul M; Conen, David; Tsunoda, Tatsuhiko; Furukawa, Tetsushi; Sotoodehnia, Nona; Xu, Siyan; Kamatani, Naoyuki; Levy, Daniel; Nakamura, Yusuke; Parvez, Babar; Mahida, Saagar; Furie, Karen L; Rosand, Jonathan; Muhammad, Raafia; Psaty, Bruce M; Meitinger, Thomas; Perz, Siegfried; Wichmann, H-Erich; Witteman, Jacqueline C M; Kao, W H Linda; Kathiresan, Sekar; Roden, Dan M; Uitterlinden, Andre G; Rivadeneira, Fernando; McKnight, Barbara; Sjögren, Marketa; Newman, Anne B; Liu, Yongmei; Gollob, Michael H; Melander, Olle; Tanaka, Toshihiro; Ch Stricker, Bruno H; Felix, Stephan B; Alonso, Alvaro; Darbar, Dawood; Barnard, John; Chasman, Daniel I; Heckbert, Susan R; Benjamin, Emelia J; Gudnason, Vilmundur; Kääb, Stefan

2012-01-01

Atrial fibrillation is a highly prevalent arrhythmia and a major risk factor for stroke, heart failure and death1. We conducted a genome-wide association study (GWAS) in individuals of European ancestry, including 6,707 with and 52,426 without atrial fibrillation. Six new atrial fibrillation susceptibility loci were identified and replicated in an additional sample of individuals of European ancestry, including 5,381 subjects with and 1 0,030 subjects without atrial fibrillation (P < 5 × 10−8). Four of the loci identified in Europeans were further replicated in silico in a GWAS of Japanese individuals, including 843 individuals with and 3,350 individuals without atrial fibrillation. The identified loci implicate candidate genes that encode transcription factors related to cardiopulmonary development, cardiac-expressed ion channels and cell signaling molecules. PMID:22544366

Balance between transmitted HLA preadapted and nonassociated polymorphisms is a major determinant of HIV-1 disease progression.

PubMed

Mónaco, Daniela C; Dilernia, Dario A; Fiore-Gartland, Andrew; Yu, Tianwei; Prince, Jessica L; Dennis, Kristine K; Qin, Kai; Schaefer, Malinda; Claiborne, Daniel T; Kilembe, William; Tang, Jianming; Price, Matt A; Farmer, Paul; Gilmour, Jill; Bansal, Anju; Allen, Susan; Goepfert, Paul; Hunter, Eric

2016-09-19

HIV-1 adapts to a new host through mutations that facilitate immune escape. Here, we evaluate the impact on viral control and disease progression of transmitted polymorphisms that were either preadapted to or nonassociated with the new host's HLA. In a cohort of 169 Zambian heterosexual transmission pairs, we found that almost one-third of possible HLA-linked target sites in the transmitted virus Gag protein are already adapted, and that this transmitted preadaptation significantly reduced early immune recognition of epitopes. Transmitted preadapted and nonassociated polymorphisms showed opposing effects on set-point VL and the balance between the two was significantly associated with higher set-point VLs in a multivariable model including other risk factors. Transmitted preadaptation was also significantly associated with faster CD4 decline (<350 cells/µl) and this association was stronger after accounting for nonassociated polymorphisms, which were linked with slower CD4 decline. Overall, the relative ratio of the two classes of polymorphisms was found to be the major determinant of CD4 decline in a multivariable model including other risk factors. This study reveals that, even before an immune response is mounted in the new host, the balance of these opposing factors can significantly influence the outcome of HIV-1 infection. © 2016 Mónaco et al.

Crystal structure of the zymogen form of the group A Streptococcus virulence factor SpeB: an integrin-binding cysteine protease.

PubMed

Kagawa, T F; Cooney, J C; Baker, H M; McSweeney, S; Liu, M; Gubba, S; Musser, J M; Baker, E N

2000-02-29

Pathogenic bacteria secrete protein toxins that weaken or disable their host, and thereby act as virulence factors. We have determined the crystal structure of streptococcal pyrogenic exotoxin B (SpeB), a cysteine protease that is a major virulence factor of the human pathogen Streptococcus pyogenes and participates in invasive disease episodes, including necrotizing fasciitis. The structure, determined for the 40-kDa precursor form of SpeB at 1.6-A resolution, reveals that the protein is a distant homologue of the papain superfamily that includes the mammalian cathepsins B, K, L, and S. Despite negligible sequence identity, the protease portion has the canonical papain fold, albeit with major loop insertions and deletions. The catalytic site differs from most other cysteine proteases in that it lacks the Asn residue of the Cys-His-Asn triad. The prosegment has a unique fold and inactivation mechanism that involves displacement of the catalytically essential His residue by a loop inserted into the active site. The structure also reveals the surface location of an integrin-binding Arg-Gly-Asp (RGD) motif that is a feature unique to SpeB among cysteine proteases and is linked to the pathogenesis of the most invasive strains of S. pyogenes.

The Pattern of Road Traffic Crashes in South East Iran

PubMed Central

Rad, Mahdieh; Martiniuk, Alexandra LC.; Ansari-Moghaddam, Alireza; Mohammadi, Mahdi; Rashedi, Fariborz; Ghasemi, Ardavan

2016-01-01

Background: In the present study, the epidemiologic aspects of road traffic crashes in South East of Iran are described. Methods: This cross-sectional study included the profile of 2398 motor vehicle crashes recorded in the police office in one Year in South East of Iran. Data collected included: demographics, the type of crash, type of involved vehicle, location of crash and factors contributing to the crash. Descriptive statistics were used for data analysis. Results: Collisions with other vehicles or objects contributed the highest proportion (62.4%) of motor vehicle crashes. Human factors including careless driving, violating traffic laws, speeding, and sleep deprivation/fatigue were the most important causal factors accounting for 90% of road crashes. Data shows that 41% of drivers were not using a seat belt at the time of crash. One- third of the crashes resulted in injury (25%) or death (5%). Conclusions: Reckless driving such as speeding and violation of traffic laws are major risk factors for crashes in the South East of Iran. This highlights the need for education along with traffic law enforcement to reduce motor vehicle crashes in future. PMID:27157159

The Pattern of Road Traffic Crashes in South East Iran.

PubMed

Rad, Mahdieh; Martiniuk, Alexandra Lc; Ansari-Moghaddam, Alireza; Mohammadi, Mahdi; Rashedi, Fariborz; Ghasemi, Ardavan

2016-09-01

In the present study, the epidemiologic aspects of road traffic crashes in South East of Iran are described. This cross-sectional study included the profile of 2398 motor vehicle crashes recorded in the police office in one Year in South East of Iran. Data collected included: demographics, the type of crash, type of involved vehicle, location of crash and factors contributing to the crash. Descriptive statistics were used for data analysis. Collisions with other vehicles or objects contributed the highest proportion (62.4%) of motor vehicle crashes. Human factors including careless driving, violating traffic laws, speeding, and sleep deprivation/fatigue were the most important causal factors accounting for 90% of road crashes. Data shows that 41% of drivers were not using a seat belt at the time of crash. One- third of the crashes resulted in injury (25%) or death (5%). Reckless driving such as speeding and violation of traffic laws are major risk factors for crashes in the South East of Iran. This highlights the need for education along with traffic law enforcement to reduce motor vehicle crashes in future.

The Use of Major Risk Factors for Computer-Based Distinction of Diabetic Patients with Ischemic Stroke and Without Stroke

DTIC Science & Technology

2001-10-25

THE USE of MAJOR RISK FACTORS for COMPUTER-BASED DISTINCTION of DIABETIC PATIENTS with ISCHEMIC STROKE and WITHOUT STROKE Sibel Oge Merey1...highlighting the major risk factors of diabetic patients with non-embolic stroke and without stroke by performing dependency analysis and decision making...of Major Risk Factors for Computer-Based Distinction of Diabetic Patients with Ischemic Stroke and Without Stroke Contract Number Grant Number

Evoluton of the Tharsis Region of Mars

NASA Astrophysics Data System (ADS)

Anderson, R. C.; Dohm, J. M.; Maruyama, S.

2015-12-01

The evolution of the Tharsis region includes at least five major stages of Tharsis-related activity, which includes the formation of igneous plateaus, canyon and fault systems, volcanoes, and centers of magmatic-driven tectonism. This activity drove major environmental changes that were recorded in the walls of Valles Marineris, the circum-Chryse outflow channel system, the northern plains, and impact basins such as Argyre, among many other Martian features and landscapes. Environmental change included flooding and associated formation of lakes and oceans in basins such as the prominent northern plains and impact basins such as Argyre. This Tharsis-driven activity also included the formation of glaciers in the southern hemisphere and other landscape features (e.g., alluvial fans, periglacial landforms, gelifluction features including mass wasting, fluvial channels) indicative of an active landscape. At this conference, we will present the details of the evolution of Tharsis, as well as discuss contributing factors to its origin, estimated beginning development, and explanations for its longevity.

Impact of Environmental Factors on the Regulation of Cyanotoxin Production

PubMed Central

Boopathi, Thangavelu; Ki, Jang-Seu

2014-01-01

Cyanobacteria are capable of thriving in almost all environments. Recent changes in climatic conditions due to increased human activities favor the occurrence and severity of harmful cyanobacterial bloom all over the world. Knowledge of the regulation of cyanotoxins by the various environmental factors is essential for effective management of toxic cyanobacterial bloom. In recent years, progress in the field of molecular mechanisms involved in cyanotoxin production has paved the way for assessing the role of various factors on the cyanotoxin production. In this review, we present an overview of the influence of various environmental factors on the production of major group of cyanotoxins, including microcystins, nodularin, cylindrospermopsin, anatoxins and saxitoxins. PMID:24967641

General distress is more important than PTSD's cognition and mood alterations factor in accounting for PTSD and depression's comorbidity.

PubMed

Byllesby, Brianna M; Elhai, Jon D; Tamburrino, Marijo; Fine, Thomas H; Cohen, Gregory; Sampson, Laura; Shirley, Edwin; Chan, Philip K; Liberzon, Israel; Galea, Sandro; Calabrese, Joseph R

2017-03-15

Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are highly comorbid and exhibit strong correlations with each other at both the symptom level and latent factor level. Various theories have attempted to explain this relationship. Results have been inconsistent regarding whether PTSD's negative alterations in cognition and mood factor (NACM) is significantly more related to depression, in contrast to other factors of PTSD. Confirmatory factor analysis was used to attempt to address the relationships between PTSD and MDD in a large sample of trauma-exposed combat veterans from the Ohio National Guard as part of a larger longitudinal study. Confirmatory factor analysis was used to test a bifactor model of PTSD symptoms, testing relations between PTSD's factors and a latent depressive factor. After partitioning out the common variance into the bifactor, we found that in contrast to other PTSD factors, PTSD's NACM factor was not significantly more related to depression. Instead, only the general bifactor predicted depressive symptoms. The limitations of the present study include the following: the specific measures of PTSD and MDD used were based on self-report, and the sample consisted of non-clinical, non-treatment seeking veterans. The present study suggests that the high rate of comorbidity between posttraumatic stress disorder (PTSD) and major depressive disorder is more related to underlying general distress or negative affectivity than the symptom categories of the PTSD diagnostic criteria. Copyright © 2017 Elsevier B.V. All rights reserved.

Public relations effectiveness in public health institutions.

PubMed

Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

2005-01-01

This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients.

PubMed

Kaoutzanis, Christodoulos; Winocour, Julian; Gupta, Varun; Ganesh Kumar, Nishant; Sarosiek, Konrad; Wormer, Blair; Tokin, Christopher; Grotting, James C; Higdon, K Kye

2017-10-16

Postoperative hematomas are one of the most frequent complications following aesthetic surgery. Identifying risk factors for hematoma has been limited by underpowered studies from single institution experiences. To examine the incidence and identify independent risk factors for postoperative hematomas following cosmetic surgery utilizing a prospective, multicenter database. A prospectively enrolled cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major hematomas requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis was used to identify potential risk factors for hematomas including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures. Of 129,007 patients, 1180 (0.91%) had a major hematoma. Mean age (42.0 ± 13.0 years vs 40.9 ± 13.9 years, P < 0.01) and BMI (24.5 ± 5.0 kg/m2 vs 24.3 ± 4.6 kg/m2, P < 0.01) were higher in patients with hematomas. Males suffered more hematomas than females (1.4% vs 0.9%, P < 0.01). Hematoma rates were higher in patients undergoing combined procedures compared to single procedures (1.1% vs 0.8%, P < 0.01), and breast procedures compared to body/extremity or face procedures (1.0% vs 0.8% vs 0.7%, P < 0.01). On multivariate analysis, independent predictors of hematoma included age (Relative Risk [RR] 1.01), male gender (RR 1.98), the procedure being performed in a hospital setting rather than an office-based setting (RR 1.68), combined procedures (RR 1.35), and breast procedures rather than the body/extremity and face procedures (RR 1.81). Major hematoma is the most common complication following aesthetic surgery. Male patients and those undergoing breast or combined procedures have a significantly higher risk of developing hematomas. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

The Thai anesthesia incident monitoring study (Thai AIMS): an analysis of perioperative myocardial ischemia/infarction.

PubMed

Ngamprasertwong, Pornswan; Kositanurit, Inthiporn; Yokanit, Preechayuth; Wattanavinit, Rhuthai; Atichat, Sunida; Lapisatepun, Worawut

2008-11-01

To analyze the clinical course, outcome, contributing factors and factors minimizing the incidents of perioperative myocardial ischemia or infarction (PMI) from Thai AIMS study. The present study was a prospective multicenter study. Data was collected from 51 hospitals in Thailand during a six-month period. The participating anesthesia provider completed the standardized incident report form of the Thai AIMS as soon as they found the PMI incident. Each incident was reviewed by three peer reviewers for clinical courses, contributing factors, outcome and minimizing factors of PMI. From the Thai AIMS incident report, the authors found 25 suspected PMI cases which was 0.9% of the 2,669 incidents reported in the present study. Most of the PMI occurred in elective cases (84%) and orthopedic procedures (56%). The majority of PMI was reported from the patients undergoing general anesthesia (72%). Suspected PMI occurred mostly during operations (56%). New ST-T segment change was detected in 92% of these patients. The most common immediate outcome of PMI was major physiological change (88%). The most common management effect of PMI was unplanned ICU admission (64%); the others were prolonged ventilatory support (12%) and prolonged hospital stay (16%). Four patients (16%) died after the suspected PMI. Most of the events occurred spontaneously and were unpreventable (80%). Patient factors (100%), anesthesia factors (72%), surgical factors (32%) and system factors (8%) were all judged as a precipitating factor for PMI. Human factors were the most common contributing factors which included poor preoperative evaluation, inexperience and improper decision. The three most common factors minimizing the adverse incidents included prior experienced, high awareness and experienced assistance. The recommended corrective strategies were guideline practice, quality assurance activity, improvement of supervision and additional training. Perioperative myocardial ischemia/infarction was infrequent but may be lethal. Patient factors were the most common precipitating cause. The morbidity and mortality could be reduced by high quality preoperative evaluation and preparation, early detection and appropriate treatment. Guideline practice, quality assurance activity, improvement of supervision and additional training were suggested corrective strategies.

The current state of play on the molecular genetics of depression.

PubMed

Cohen-Woods, S; Craig, I W; McGuffin, P

2013-04-01

It has been well established that both genes and non-shared environment contribute substantially to the underlying aetiology of major depressive disorder (MDD). A comprehensive overview of genetic research in MDD is presented. Method Papers were retrieved from PubMed up to December 2011, using many keywords including: depression, major depressive disorder, genetics, rare variants, gene-environment, whole genome, epigenetics, and specific candidate genes and variants. These were combined in a variety of permutations. Linkage studies have yielded some promising chromosomal regions in MDD. However, there is a continued lack of consistency in association studies, in both candidate gene and genome-wide association studies (GWAS). Numerous factors may account for variable results including the use of different diagnostic approaches, small samples in early studies, population stratification, epigenetic phenomena, copy number variation (CNV), rare variation, and phenotypic and allelic heterogeneity. The conflicting results are also probably, in part, a consequence of environmental factors not being considered or controlled for. Each research group has to identify what issues their sample may best address. We suggest that, where possible, more emphasis should be placed on the environment in molecular behavioural genetics to identify individuals at environmental high risk in addition to genetic high risk. Sequencing should be used to identify rare and alternative variation that may act as a risk factor, and a systems biology approach including gene-gene interactions and pathway analyses would be advantageous. GWAS may require even larger samples with reliably defined (sub)phenotypes.

Attitudes and expectations regarding exercise in the hospital of hospitalized older adults: a qualitative study.

PubMed

So, Cynthia; Pierluissi, Edgar

2012-04-01

To describe expectations of, and perceived motivators and barriers to, in-hospital exercise of hospitalized older adults. Qualitative study using the framework theory. Public hospital general medical wards. Twenty-eight English- or Spanish-speaking inpatients aged 65 to 103. Semistructured interviews were conducted at the bedside. Questions explored attitudes and expectations regarding in-hospital exercise. Interviews were tape recorded and transcribed, and content analysis was performed to identify major themes. For most participants (71%), exercise in the hospital meant walking. Only 29% of participants expected to be exercising in the hospital, although three-quarters perceived it to be appropriate. Major themes included motivating factors and barriers to in-hospital exercise. Motivating factors included avoiding the negative effects of prolonged bed rest, promoting a sense of well-being, promoting functional recovery, and being asked to exercise. Barriers included symptoms related to one's illness, institutional barriers, and fear of injury. Most respondents (85%) felt that if the physician suggested exercise, it would influence their decision to do so, yet few (27%) reported that they had spoken to their physician about exercise. Hospitalized older adults have positive perceptions about in-hospital exercise, although they must overcome significant barriers to do so. Medical professionals have a strong influence over the exercise behavior of elderly adults in the hospital yet infrequently address the issue. Incorporating motivating factors and removing barriers may increase the effectiveness of in-hospital exercise programs. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

[Risk factors associated with dystocic delivery].

PubMed

Romero Gutiérrez, Gustavo; Ríos López, Juan Carlos; Cortés Salim, Patricia; Ponce Ponce de León, Ana Lilia

2007-09-01

the dystocic delivery is a frequent complication and its perinatal repercussions vary from minor lesions to severe brain damage. It has been reported diverse factors associated with this medical complication. to identify the risk factors with significant association with dystocic delivery. a case-control study was carried out. There were included 750 patients, divided into 250 women with dystocic deliveries (cases) and 500 women with eutocic deliveries (controls). Demographic and clinical variables were registered. The statistical analysis was performed with percentages, arithmetic media, standard deviation, Student t test, chi2 and logistic regression analysis. An alpha value was set at 0.05. the factors with statistical significance were: advanced age (p < 0.001), major patient's height (p < 0.001), major new born's weight (p = 0.009), lower parity (p < 0.001), and prolonged duration of labor (p = 0.04). Other variables such as number of pregnancies, previous cesarean sections, spontaneous abortions, weight of the patient, weight earned during pregnancy, number of medical appointments during antenatal care, previous dystocic delivery, and premature rupture of the membranes, were not significant. there are clinical and demographic risk factors associated with dystocic delivery. To identify this risk factors during the antenatal care could diminish the frequency of dystocic deliveries and therefore to avoid the associated maternal-fetal complications.

Fibroblast Growth Factors and Vascular Endothelial Growth Factor Promote Cardiac Reprogramming under Defined Conditions

PubMed Central

Yamakawa, Hiroyuki; Muraoka, Naoto; Miyamoto, Kazutaka; Sadahiro, Taketaro; Isomi, Mari; Haginiwa, Sho; Kojima, Hidenori; Umei, Tomohiko; Akiyama, Mizuha; Kuishi, Yuki; Kurokawa, Junko; Furukawa, Tetsushi; Fukuda, Keiichi; Ieda, Masaki

2015-01-01

Summary Fibroblasts can be directly reprogrammed into cardiomyocyte-like cells (iCMs) by overexpression of cardiac transcription factors, including Gata4, Mef2c, and Tbx5; however, this process is inefficient under serum-based culture conditions, in which conversion of partially reprogrammed cells into fully reprogrammed functional iCMs has been a major hurdle. Here, we report that a combination of fibroblast growth factor (FGF) 2, FGF10, and vascular endothelial growth factor (VEGF), termed FFV, promoted cardiac reprogramming under defined serum-free conditions, increasing spontaneously beating iCMs by 100-fold compared with those under conventional serum-based conditions. Mechanistically, FFV activated multiple cardiac transcriptional regulators and converted partially reprogrammed cells into functional iCMs through the p38 mitogen-activated protein kinase and phosphoinositol 3-kinase/AKT pathways. Moreover, FFV enabled cardiac reprogramming with only Mef2c and Tbx5 through the induction of cardiac reprogramming factors, including Gata4. Thus, defined culture conditions promoted the quality of cardiac reprogramming, and this finding provides new insight into the mechanism of cardiac reprogramming. PMID:26626177

Biological determinants of depression following bereavement.

PubMed

Assareh, Amelia A; Sharpley, Christopher F; McFarlane, James R; Sachdev, Perminder S

2015-02-01

There is considerable variability among people in their response to bereavement. While most people adapt well to bereavement, some develop exaggerated and/or pathological responses and may meet criteria for a major depressive episode. Many studies have investigated the effect of psychosocial factors on bereavement outcome but biological factors have not received much attention, hence the focus of this paper. The biological factors studied to date in relation to bereavement outcomes include genetic polymorphisms, neuroendocrine factors, and immunologic/inflammatory markers. In addition, animal studies have shown the alterations of brain neurotransmitters as well as changes in the plasma levels of the neurotrophic growth factors under the influence of peer loss. Recent studies have also investigated the biological basis of stress resilience, and have found a few genetic polymorphisms and potential biomarkers as protective factors in the face of adversity. Longitudinal studies that include data collection prior to, and also after, bereavement and which chart both biological and psychological measures are needed to develop profiles for the prediction of response to bereavement and personalised interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

PubMed

Price, Matthew; van Stolk-Cooke, Katherine

2015-11-01

Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Late-life factors associated with healthy aging in older men.

PubMed

Bell, Christina L; Chen, Randi; Masaki, Kamal; Yee, Priscilla; He, Qimei; Grove, John; Donlon, Timothy; Curb, J David; Willcox, D Craig; Poon, Leonard W; Willcox, Bradley J

2014-05-01

To identify potentially modifiable late-life biological, lifestyle, and sociodemographic factors associated with overall and healthy survival to age 85. Prospective longitudinal cohort study with 21 years of follow-up (1991-2012). Hawaii Lifespan Study. American men of Japanese ancestry (mean age 75.7, range 71-82) without baseline major clinical morbidity and functional impairments (N = 1,292). Overall survival and healthy survival (free from six major chronic diseases and without physical or cognitive impairment) to age 85. Factors were measured at late-life baseline examinations (1991-1993). Of 1,292 participants, 1,000 (77%) survived to 85 (34% healthy) and 309 (24%) to 95 (<1% healthy). Late-life factors associated with survival and healthy survival included biological (body mass index, ankle-brachial index, cognitive score, blood pressure, inflammatory markers), lifestyle (smoking, alcohol use, physical activity), and sociodemographic factors (education, marital status). Cumulative late-life baseline risk factor models demonstrated that age-standardized (at 70) probability of survival to 95 ranged from 27% (no factors) to 7% (≥ 5 factors); probability of survival to 100 ranged from 4% (no factors) to 0.1% (≥ 5 factors). Age-standardized (at 70) probability of healthy survival to 90 ranged from 4% (no factors) to 0.01% (≥ 5 factors). There were nine healthy survivors at 95 and one healthy survivor at 100. Several potentially modifiable risk factors in men in late life (mean age 75.7) were associated with markedly greater probability of subsequent healthy survival and longevity. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Epidemiology of venous thromboembolism

PubMed Central

Heit, John A.

2015-01-01

Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and—in women—pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing. PMID:26076949

Epidemiology of venous thromboembolism.

PubMed

Heit, John A

2015-08-01

Thrombosis can affect any venous circulation. Venous thromboembolism (VTE) includes deep-vein thrombosis of the leg or pelvis, and its complication, pulmonary embolism. VTE is a fairly common disease, particularly in older age, and is associated with reduced survival, substantial health-care costs, and a high rate of recurrence. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors. Major risk factors for incident VTE include hospitalization for surgery or acute illness, active cancer, neurological disease with leg paresis, nursing-home confinement, trauma or fracture, superficial vein thrombosis, and-in women-pregnancy and puerperium, oral contraception, and hormone therapy. Although independent risk factors for incident VTE and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be fairly constant, or even increasing.

Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, and Prevention

PubMed Central

Karimi, Parisa; Islami, Farhad; Anandasabapathy, Sharmila; Freedman, Neal D.; Kamangar, Farin

2014-01-01

Less than a century ago, gastric cancer (GC) was the most common cancer in the United States and perhaps throughout the world. Despite its worldwide decline in incidence over the past century, GC remains a major killer across the globe. This article reviews the epidemiology, screening, and prevention of gastric cancer. We first discuss the descriptive epidemiology of GC, including its incidence, survival, and mortality, including trends over time. Next, we characterize the risk factors for gastric cancer, both environmental and genetic. Serological markers and histological precursor lesions of GC and early detection of GC of using these markers is reviewed. Finally, we discuss prevention strategies and provide suggestions for further research. PMID:24618998

Malunited fracture of the body and condyle of the mandible : A Case Report.

PubMed

Yeluri, Ramakrishna; Baliga, Sudhindra; Munshi, Autar Krishen

2010-07-01

Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, developing tooth buds and growth issues. One major factor is the inherent instability of the occlusion in the mixed deciduous-permanent tooth phase. This case report documents a child in mixed dentition period with a complication arising due to direct fixation of the fractured mandible.

Musculoskeletal pain symptoms among allied health professions' students: Prevalence rates and associated factors.

PubMed

Almhdawi, Khader A; Mathiowetz, Virgil; Al-Hourani, Zeid; Khader, Yousef; Kanaan, Saddam F; Alhasan, Mustafa

2017-11-06

Very few articles, comprehensively, investigated musculoskeletal pain symptoms (MPS) among wide variety of allied health professions (AHP) students. This study aimed to investigate the prevalence of MPS and their associated factors among different AHP majors' students. A cross-sectional design was conducted. A sample of AHP students from nine majors (n= 838, Mean age = 21.3 years) completed a validated structured self-administrated questionnaires including Nordic Musculoskeletal Questionnaire, Depression Anxiety Stress Scale (DASS 21), and specific questions regarding demographics and life style. MPS prevalence rate were compared between males and females and between majors. Logistic regression was conducted to identify predictors of MPS. MPS in neck, lower back, and shoulder 12-month were the most prevalent (67.1%, and 61.4%, 58.8% respectively). MPS prevalence was significantly higher in females and statistically different among majors. MPS were significantly associated with increased clinical training load, mental stress symptoms, and smartphone average use time. MPS in AHP students are prevalent and statistically higher among females. Students are advised to adhere to different conservative precautions and follow prevention programs. Future studies are needed to assess actual mechanisms causing MPS among AHP students and designing effective prevention programs specific to AHP students.

Pathogenic mechanisms of pancreatitis

PubMed Central

Manohar, Murli; Verma, Alok Kumar; Venkateshaiah, Sathisha Upparahalli; Sanders, Nathan L; Mishra, Anil

2017-01-01

Pancreatitis is inflammation of pancreas and caused by a number of factors including pancreatic duct obstruction, alcoholism, and mutation in the cationic trypsinogen gene. Pancreatitis is represented as acute pancreatitis with acute inflammatory responses and; chronic pancreatitis characterized by marked stroma formation with a high number of infiltrating granulocytes (such as neutrophils, eosinophils), monocytes, macrophages and pancreatic stellate cells (PSCs). These inflammatory cells are known to play a central role in initiating and promoting inflammation including pancreatic fibrosis, i.e., a major risk factor for pancreatic cancer. A number of inflammatory cytokines are known to involve in promoting pancreatic pathogenesis that lead pancreatic fibrosis. Pancreatic fibrosis is a dynamic phenomenon that requires an intricate network of several autocrine and paracrine signaling pathways. In this review, we have provided the details of various cytokines and molecular mechanistic pathways (i.e., Transforming growth factor-β/SMAD, mitogen-activated protein kinases, Rho kinase, Janus kinase/signal transducers and activators, and phosphatidylinositol 3 kinase) that have a critical role in the activation of PSCs to promote chronic pancreatitis and trigger the phenomenon of pancreatic fibrogenesis. In this review of literature, we discuss the involvement of several pro-inflammatory and anti-inflammatory cytokines, such as in interleukin (IL)-1, IL-1β, IL-6, IL-8 IL-10, IL-18, IL-33 and tumor necrosis factor-α, in the pathogenesis of disease. Our review also highlights the significance of several experimental animal models that have an important role in dissecting the mechanistic pathways operating in the development of chronic pancreatitis, including pancreatic fibrosis. Additionally, we provided several intermediary molecules that are involved in major signaling pathways that might provide target molecules for future therapeutic treatment strategies for pancreatic pathogenesis. PMID:28217371

Parental Involvement and Children's Readiness for School in China

ERIC Educational Resources Information Center

Lau, Eva Y. H.; Li, Hui; Rao, Nirmala

2011-01-01

Background: The remarkable academic advancement of Asian students in cross-national studies has been attributed to numerous factors, including the value placed on education by Chinese parents. However, there is a dearth of research on how exactly Chinese parents are involved in children's early learning. Purpose: This study has two major research…

Predicting how altering propagule pressure changes establishment rates of biological invaders across species pools

Treesearch

Eckehard G. Brockerhoff; Mark Kimberley; Andrew M. Liebhold; Robert A. Haack; Joseph F. Cavey

2014-01-01

Biological invasions resulting from international trade can cause major environmental and economic impacts. Propagule pressure is perhaps the most important factor influencing establishment, although actual arrival rates of species are rarely recorded. Furthermore, the pool of potential invaders includes many species that vary in their arrival rate and establishment...

The Religious Aspects of Diasporic Experience of Muslims in Europe within the Crisis of Multiculturalism

ERIC Educational Resources Information Center

Habti, Driss

2014-01-01

The literature on migration has largely covered concepts of diaspora, such as transnationalism, immigration and religious-ethnic minorities. These concepts that concern related factors of social transformation, mainly with reference to Islam in Europe, have been investigated with respect to religion. Major research questions include whether, and…

Sex, Income, and Achievement: Reward-Dualism in Academia.

ERIC Educational Resources Information Center

Fox, Mary Frank

A report is presented on an analysis of sex factors in academic income variation as determined by achieved, ascribed, and university location characteristics. The study group consisted of 5450 individuals at a major midwestern university as of June 1971. The subjects included 4541 men and 908 women research assistants and associates, deans and…

Proceedings of the symposium on the ecology, management, and utilization of California oaks, June 26-28

Treesearch

Timothy R. Plumb

1980-01-01

The symposium, held at Scripps College in Southern California, addressed most aspects of California's vast oak resource. Papers represented four major subject categories: ecological relationships, silviculture and management, damage factors, and products. Both scientific and applied information was presented, including original material not published previously....

An Exploratory Study of Undergraduate College Students' Perceptions and Attitudes toward Foreign Accented Faculty

ERIC Educational Resources Information Center

Kavas, Aysel; Kavas, Alican

2008-01-01

The findings of an exploratory survey related to students' perceptions of factors, including accent and pronunciation, influencing their learning were presented. Data were collected from students through a self-administered questionnaire at one Southeastern University. A big majority (82.4%) of the respondents indicated that instructors'…

A Preliminary Qualitative Evaluation of the Virginia Gold Quality Improvement Program

ERIC Educational Resources Information Center

Craver, Gerald A.; Burkett, Amy K.

2012-01-01

Certified nursing assistants (CNAs) perform an important role in the long-term care system because they provide the majority of paid care to nursing facility residents. Unfortunately, annual CNA turnover often exceeds 100 percent nationally. Many factors account for this, including stressful working conditions, low pay, and limited benefits. The…

International Dimensions in American Education: Evaluative Criteria for Precollegiate Programs.

ERIC Educational Resources Information Center

Slouka, Z. J.; Slouka, O.

The purposes of the project described in this document are to identify and evaluate factors which encourage a global perspective in students in grades K-12. The document is presented in three major sections. Section one introduces the scope of the study, discusses objectives, and describes evaluation methods, including reviewing written materials,…

Ten power mega-trends for the 1990`s

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

Zimmer, M.J.

1995-12-01

Changes in the power generation industry have accelerated, with the progress of new legislation, globalization, financing and technology leading the way. Major trends shaping the future of the industry this decade include: fuels; niche markets; utility generation; financing; retail service; transmission; geographic regions; repowering; international developments; and regulation. These factors are discussed briefly.

Convergence on Cooperation: The Driving Factors in U.S. and Russian Cooperation on Belarus

DTIC Science & Technology

2005-09-01

result, Belarus became the major production center for military electronics , including the control systems for the S-300 missile system and the Su...is seen “as an engine for such reintegration and Russification.” 125 John Erickson notes that in the rhetoric of Russian realists, Belarus plays a

Wife Battering: A Multi-Faceted Approach to Etiology.

ERIC Educational Resources Information Center

Deitz, Marian B.

A review of the literature was conducted relevant to the history of wife battering, the incidence of such abuse in the United States, and difficulties in the definition of domestic violence. Major attempts to explain wife battering found in the literature included a focus on: (1) personality factors of the individuals involved (the ontogenic…

Evolving Impressions: Undergraduate Perceptions of Graduate Teaching Assistants and Faculty Members over a Semester

ERIC Educational Resources Information Center

Kendall, K. Denise; Schussler, Elisabeth E.

2013-01-01

Undergraduate experiences in lower-division science courses are important factors in student retention in science majors. These courses often include a lecture taught by faculty, supplemented by smaller sections, such as discussions and laboratories, taught by graduate teaching assistants (GTAs). Given that portions of these courses are taught by…

Oak Ridge National Laboratory Institutional Plan, FY 1995--FY 2000

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

Not Available

1994-11-01

This report discusses the institutional plan for Oak Ridge National Laboratory for the next five years (1995-2000). Included in this report are the: laboratory director`s statement; laboratory mission, vision, and core competencies; laboratory plan; major laboratory initiatives; scientific and technical programs; critical success factors; summaries of other plans; and resource projections.

Predictors of Post-Secondary Academic Outcomes among Local-Born, Immigrant, and International Students in Canada: A Retrospective Analysis

ERIC Educational Resources Information Center

de Silva, Tricia L.; Zakzanis, Konstantine; Henderson, Joanna; Ravindran, Arun V.

2017-01-01

Poor academic performance and dropout are major concerns at post-secondary institutions. Influences include sociodemographic, psychosocial, and academic functioning factors. Canadian literature is limited, and little published data directly compare academic outcomes between local-born, immigrant, and international students. We conducted a…

High levels of avenanthramides in oat-based diet further suppress high fat diet-induced atherosclerosis in Ldlr-/- mice

USDA-ARS?s Scientific Manuscript database

Background: The consumption of oats reduces plasma cholesterol, a major risk factor for heart disease. Oats, in addition to cholesterol lowering properties through its beta-glucan content, are a good source of several antioxidants including Avenanthramides (Avns), a unique group of polyphenols prese...

Eye Movements Reveal Readers' Lexical Quality and Reading Experience

ERIC Educational Resources Information Center

Taylor, Jessica Nelson; Perfetti, Charles A.

2016-01-01

Two experiments demonstrate that individual differences among normal adult readers, including lexical quality, are expressed in silent reading at the word level. In the first of two studies we identified major dimensions of variability among college readers and among words using factor analysis. We then examined the effects of these dimensions of…

Incidence Rate and Results of the Surgical Treatment of Pectoralis Major Tendon Ruptures in Active-Duty Military Personnel.

PubMed

Balazs, George C; Brelin, Alaina M; Donohue, Michael A; Dworak, Theodora C; Rue, John-Paul H; Giuliani, Jeffrey R; Dickens, Jonathan F

2016-07-01

Pectoralis major tendon ruptures are commonly described as rare injuries affecting men between 20 and 40 years of age, with generally excellent results after surgical repair. However, this perception is based on a relatively small number of case series and prospective studies in the orthopaedic literature. To determine the incidence of pectoralis major tendon ruptures in the active-duty military population and the demographic risk factors for a rupture and to describe the outcomes of surgical treatment. Case control study; Level of evidence, 3. We utilized the Military Health System Data Repository (MDR) to identify all active-duty military personnel surgically treated for a pectoralis major tendon rupture between January 2012 and December 2014. Electronic medical records were searched for patients' demographic information, injury characteristics, and postoperative complications and outcomes. Risk factors for a rupture were calculated using Poisson regression, based on population counts obtained from the MDR. Risk factors for a postoperative complication, the need for revision surgery, and the inability to continue with active duty were determined using univariate analysis and multivariate logistic regression. A total of 291 patients met inclusion criteria. The mean patient age was 30.5 years, all patients were male, and the median follow-up period was 18 months. The incidence of injuries was 60 per 100,000 person-years over the study period. Risk factors for a rupture included service in the Army, junior officer or junior enlisted rank, and age between 25 and 34 years. White race and surgery occurring >6 weeks after injury were significant risk factors for a postoperative complication. Among the 214 patients with a minimum of 12 months' clinical follow-up, 95.3% were able to return to military duty. Junior officer/enlisted status was a significant risk factor for failure to return to military duty. Among military personnel, Army soldiers and junior officer/enlisted rank were at highest risk of pectoralis major tendon ruptures, and junior personnel were at highest risk of being unable to return to duty after surgical treatment. Although increasing time from injury to surgery was not a risk factor for treatment failure or inability to return to duty, it did significantly increase the risk of a postoperative complication. © 2016 The Author(s).

Self-harm and suicide in adolescents.

PubMed

Hawton, Keith; Saunders, Kate E A; O'Connor, Rory C

2012-06-23

Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Pathophysiology of transfusional iron overload: contrasting patterns in thalassemia major and sickle cell disease.

PubMed

Porter, John B

2009-01-01

The pathophysiological consequences of transfusional iron overload largely reflect the pattern of excess iron distribution and include cardiomyopathy, endocrinopathy, cirrhosis, and hepatocellular carcinoma. Since the introduction of desferrioxamine (DFO) in the late 1970s, these complications have fallen substantially but approximately half of the chelated adult patients with thalassemia major (TM) still show evidence of increased myocardial iron loading by MRI. An understanding of the factors that determine the propensity to extrahepatic iron distribution may be a key to minimizing the pathophysiological consequences of transfusional iron overload. Transfused patients with sickle cell disease (SCD) appear less likely to develop these extrahepatic complications, possibly because plasma nontransferrin-bound iron (NTBI) levels are typically lower than in TM patients at matched levels of iron loading. Other mechanisms that may reduce the extrahepatic iron distribution in SCD include raised plasma hepcidin due to chronic inflammation, lower growth differentiation factor 15 (GDF15) levels because of less ineffective erythropoiesis (IE), and induction of heme oxygenase (HO1) by intravascular hemolysis. Further understanding of these mechanisms may help in designing strategies to decrease extrahepatic iron distribution in TM.

Health world views of post-Soviet citizens.

PubMed

Abbott, Pamela A; Turmov, Sergei; Wallace, Claire

2006-01-01

The collapse of the Soviet Union has had an adverse impact on the lives of the peoples of Russia and Ukraine. This paper reports on qualitative case studies including interviews, focus groups and children's essays from Russia and Ukraine, on the topics of everyday understanding of health and the factors influencing it. The majority report poor health and difficult material circumstances. Their understandings of health and illness are multifactorial and include emotional as well as descriptive elements. Whilst the most frequently cited definition of health is of people with/without health problems, it is evident that health is seen positively, as more than the absence of debilitating illness. There is a strong emphasis on individual responsibility for health and evidence that people are thought to have a moral responsibility to strive to be healthy. However, there is also a strong awareness that the major factors which cause ill health are beyond their control. The findings provide additional support for the health lifestyles theory that has been developed to provide a sociological understanding of the mortality crisis in the former Soviet Union.

Modeling the influence of LASIK surgery on optical properties of the human eye

NASA Astrophysics Data System (ADS)

Szul-Pietrzak, Elżbieta; Hachoł, Andrzej; Cieślak, Krzysztof; Drożdż, Ryszard; Podbielska, Halina

2011-11-01

The aim was to model the influence of LASIK surgery on the optical parameters of the human eye and to ascertain which factors besides the central corneal radius of curvature and central thickness play the major role in postsurgical refractive change. Ten patients were included in the study. Pre- and postsurgical measurements included standard refraction, anterior corneal curvature and pachymetry. The optical model used in the analysis was based on the Le Grand and El Hage schematic eye, modified by the measured individual parameters of corneal geometry. A substantial difference between eye refractive error measured after LASIK and estimated from the eye model was observed. In three patients, full correction of the refractive error was achieved. However, analysis of the visual quality in terms of spot diagrams and optical transfer functions of the eye optical system revealed some differences in these measurements. This suggests that other factors besides corneal geometry may play a major role in postsurgical refraction. In this paper we investigated whether the biomechanical properties of the eyeball and changes in intraocular pressure could account for the observed discrepancies.

Members of the Dof transcription factor family in Triticum aestivum are associated with light-mediated gene regulation.

PubMed

Shaw, Lindsay M; McIntyre, C Lynne; Gresshoff, Peter M; Xue, Gang-Ping

2009-11-01

DNA binding with One Finger (Dof) protein is a plant-specific transcription factor implicated in the regulation of many important plant-specific processes, including photosynthesis and carbohydrate metabolism. This study has identified 31 Dof genes (TaDof) in bread wheat through extensive analysis of current nucleotide databases. Phylogenetic analysis suggests that the TaDof family can be divided into four clades. Expression analysis of the TaDof family across all major organs using quantitative RT-PCR and searches of the wheat genome array database revealed that the majority of TaDof members were predominately expressed in vegetative organs. A large number of TaDof members were down-regulated by drought and/or were responsive to the light and dark cycle. Further expression analysis revealed that light up-regulated TaDof members were highly correlated in expression with a number of genes that are involved in photosynthesis or sucrose transport. These data suggest that the TaDof family may have an important role in light-mediated gene regulation, including involvement in the photosynthetic process.

The experience of return to work in individuals with traumatic brain injury (TBI): A qualitative study.

PubMed

Libeson, Lauren; Downing, Marina; Ross, Pamela; Ponsford, Jennie

2018-05-10

Traumatic Brain Injury (TBI) is a leading cause of disability in young people, with return to work (RTW) a major goal of recovery. This qualitative study aimed to understand the RTW experience of individuals with TBI who received comprehensive vocational rehabilitation, and to identify facilitating and limiting factors in the RTW process. Semi-structured interviews were conducted with 15 individuals (mean age = 47.33 years) approximately 4.5 years post-injury, of whom 14 had moderate to severe TBI. Twelve individuals had successfully returned to work. Thematic analysis of transcribed interviews identified three key factors affecting RTW: client, work and rehabilitation factors. Across these factors, 12 themes reported to be critical to the success or failure of the RTW programme were identified. Client themes included social support, cognitive difficulties and motivation, with RTW too early associated with unfavourable outcomes. Work themes included work modifications, employer support and financial incentives. Rehabilitation themes included the RTW programme, the role of the vocational occupational therapist and work preparation. These key factors were reported to have impacted the RTW outcome, comprising three further themes: work satisfaction, future vocational outlook, and quality of life. Consideration of these factors can inform vocational rehabilitation programmes, potentially improving employment outcomes following TBI.

Clinical risk factors for the development of tardive dyskinesia.

PubMed

Solmi, Marco; Pigato, Giorgio; Kane, John M; Correll, Christoph U

2018-06-15

Tardive dyskinesia (TD) is a severe condition that can affect almost 1 out of 4 patients on current or previous antipsychotic treatment, including both first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). While two novel vesicular monoamine transporter inhibitors, deutetrabenazine and valbenazine, have shown acute efficacy for TD, the majority of patients do not remit, and TD appears to recur once treatment is withdrawn. Hence, prevention of TD remains a crucial goal. We provide a clinically oriented overview of risk factors for TD, dividing them into patient-, illness- and treatment-related variables, as well as nonmodifiable and modifiable factors. Unmodifiable patient-related and illness-related risk factors for TD include older age, female sex, white and African descent, longer illness duration, intellectual disability and brain damage, negative symptoms in schizophrenia, mood disorders, cognitive symptoms in mood disorders, and gene polymorphisms involving antipsychotic metabolism and dopamine functioning. Modifiable comorbidity-related and treatment-related factors include diabetes, smoking, and alcohol and substance abuse, FGA vs SGA treatment, higher cumulative and current antipsychotic dose or antipsychotic plasma levels, early parkinsonian side effects, anticholinergic co-treatment, akathisia, and emergent dyskinesia. Clinicians using dopamine antagonists need to consider risk factors for TD to minimize TD and its consequences. Copyright © 2018 Elsevier B.V. All rights reserved.

Overcoming sleep disordered breathing and ensuring sufficient good sleep time for a healthy life expectancy

PubMed Central

CHIN, Kazuo

2017-01-01

Recent advances in basic and clinical medicine have resulted in major improvements in human health. Currently sleep has been considered an essential factor in maintaining and promoting a healthy life expectancy. Sleep disorders include more than 60 diseases. Sleep disordered breathings (SDB) have 17 disorders, including sleep apnea. SDB usually induces hypoxemia and hypercapnia, which would have significant effects on cells, organs, and the whole body. We have investigated SDB for nearly 35 years. We found that SDB has significant associations with humoral factors, including coagulation systems, the body’s protective factors against diseases, and metabolic and organ diseases. Currently we have been giving attention to the associations among SDB, short sleep duration, and obesity. In addition, SDB is important not only in the home but under critical care such as in the perioperative stage. In this review, I would like to describe several aspects of SDB in relation to systemic diseases and overall health based mainly on our published reports. PMID:29021511

A Genome-Wide Association Study of the Human Metabolome in a Community-Based Cohort

PubMed Central

Rhee, Eugene P.; Ho, Jennifer E.; Chen, Ming-Huei; Shen, Dongxiao; Cheng, Susan; Larson, Martin G.; Ghorbani, Anahita; Shi, Xu; Helenius, Iiro T.; O’Donnell, Christopher J.; Souza, Amanda L.; Deik, Amy; Pierce, Kerry A.; Bullock, Kevin; Walford, Geoffrey A.; Vasan, Ramachandran S.; Florez, Jose C.; Clish, Clary; Yeh, J.-R. Joanna; Wang, Thomas J.; Gerszten, Robert E.

2014-01-01

SUMMARY Because metabolites are hypothesized to play key roles as markers and effectors of cardio-metabolic diseases, recent studies have sought to annotate the genetic determinants of circulating metabolite levels. We report a genome-wide association study (GWAS) of 217 plasma metabolites, including >100 not measured in prior GWAS, in 2,076 participants of the Framingham Heart Study. For the majority of analytes, we find that estimated heritability explains >20% of inter-individual variation, and that variation attributable to heritable factors is greater than that attributable to clinical factors. Further, we identify 31 genetic loci associated with plasma metabolites, including 23 that have not previously been reported. Importantly, we include GWAS results for all surveyed metabolites, and demonstrate how this information highlights a role for AGXT2 in cholesterol ester and triacylglycerol metabolism. Thus, our study outlines the relative contributions of inherited and clinical factors on the plasma metabolome and provides a resource for metabolism research. PMID:23823483

Rates and risk factors for prolonged opioid use after major surgery: population based cohort study

PubMed Central

Soneji, Neilesh; Ko, Dennis T; Yun, Lingsong; Wijeysundera, Duminda N

2014-01-01

Objective To describe rates and risk factors for prolonged postoperative use of opioids in patients who had not previously used opioids and undergoing major elective surgery. Design Population based retrospective cohort study. Setting Acute care hospitals in Ontario, Canada, between 1 April 2003 and 31 March 2010. Participants 39 140 opioid naïve patients aged 66 years or older who had major elective surgery, including cardiac, intrathoracic, intra-abdominal, and pelvic procedures. Main outcome measure Prolonged opioid use after discharge, as defined by ongoing outpatient prescriptions for opioids for more than 90 days after surgery. Results Of the 39 140 patients in the entire cohort, 49.2% (n=19 256) were discharged from hospital with an opioid prescription, and 3.1% (n=1229) continued to receive opioids for more than 90 days after surgery. Following risk adjustment with multivariable logistic regression modelling, patient related factors associated with significantly higher risks of prolonged opioid use included younger age, lower household income, specific comorbidities (diabetes, heart failure, pulmonary disease), and use of specific drugs preoperatively (benzodiazepines, selective serotonin reuptake inhibitors, angiotensin converting enzyme inhibitors). The type of surgical procedure was also highly associated with prolonged opioid use. Compared with open radical prostatectomies, both open and minimally invasive thoracic procedures were associated with significantly higher risks (odds ratio 2.58, 95% confidence interval 2.03 to 3.28 and 1.95 1.36 to 2.78, respectively). Conversely, open and minimally invasive major gynaecological procedures were associated with significantly lower risks (0.73, 0.55 to 0.98 and 0.45, 0.33 to 0.62, respectively). Conclusions Approximately 3% of previously opioid naïve patients continued to use opioids for more than 90 days after major elective surgery. Specific patient and surgical characteristics were associated with the development of prolonged postoperative use of opioids. Our findings can help better inform understanding about the long term risks of opioid treatment for acute postoperative pain and define patient subgroups that warrant interventions to prevent progression to prolonged postoperative opioid use. PMID:24519537

Associations between psychosocial work factors and provider mental well-being in emergency departments: A systematic review.

PubMed

Schneider, Anna; Weigl, Matthias

2018-01-01

Emergency departments (ED) are complex and dynamic work environments with various psychosocial work stressors that increase risks for providers' well-being. Yet, no systematic review is available which synthesizes the current research base as well as quantitatively aggregates data on associations between ED work factors and provider well-being outcomes. We aimed at synthesizing the current research base on quantitative associations between psychosocial work factors (classified into patient-/ task-related, organizational, and social factors) and mental well-being of ED providers (classified into positive well-being outcomes, affective symptoms and negative psychological functioning, cognitive-behavioural outcomes, and psychosomatic health complaints). A systematic literature search in eight databases was conducted in December 2017. Original studies were extracted following a stepwise procedure and predefined inclusion criteria. A standardized assessment of methodological quality and risk of bias was conducted for each study with the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. In addition to a systematic compilation of included studies, frequency and strength of quantitative associations were synthesized by means of harvest plots. Subgroup analyses for ED physicians and nurses were conducted. N = 1956 records were retrieved. After removal of duplicates, 1473 records were screened for titles and abstracts. 199 studies were eligible for full-text review. Finally, 39 original studies were included whereof 37 reported cross-sectional surveys. Concerning the methodological quality of included studies, the majority was evaluated as weak to moderate with considerable risk of bias. Most frequently surveyed provider outcomes were affective symptoms (e.g., burnout) and positive well-being outcomes (e.g., job satisfaction). 367 univariate associations and 370 multivariate associations were extracted with the majority being weak to moderate. Strong associations were mostly reported for social and organizational work factors. To the best of our knowledge, this review is the first to provide a quantitative summary of the research base on associations of psychosocial ED work factors and provider well-being. Conclusive results reveal that peer support, well-designed organizational structures, and employee reward systems balance the negative impact of adverse work factors on ED providers' well-being. This review identifies avenues for future research in this field including methodological advances by using quasi-experimental and prospective designs, representative samples, and adequate confounder control. Protocol registration number: PROSPERO 2016 CRD42016037220.

Behavior Risk Factors Among Russian University Students Majoring in Medicine, Education, and Exercise Science.

PubMed

Anischenko, Aleksander; Gurevich, Konstantin; Arhangelskaya, Anna; Klenov, Michael; Burdukova, Ekaterina; Ogarev, Valrii; Ignatov, Nikolay; Osadchenko, Irina

2016-09-14

To analyze the prevalence of select behavioral risk factors among Russian university students majoring in medicine, education, and exercise science. A total of 834 students from five Federal universities located in four federal regions of Russia were included in the study. The purposive sample included future doctors, school teachers, and fitness trainers. Students were asked specifically about smoking, level of physical activity, and food preferences. To calculate body mass indices (BMIs), waist, hip, weight, and height were also measured. Smoking rates, level of activity, and nutritional habits were significantly different by age, but BMI was not. Smoking rates and BMI were significantly different by gender, but level of activity and nutritional habits were not. Like the differences found by age, smoking rates, level of activity, and nutritional habits were significantly different by ethnicity, but BMI was not. There were significant difference across all behavioral health risk factors by region. The results show significantly higher levels of physical inactivity, consumption of unhealthy foods, and high BMIs among medical students compared with future teachers and wellness instructors (p < .05). In the same time, the smoking levels are the highest among future teachers. The highest prevalence of smoking was found to be associated with gender (for females living Moscow and for males in rural regions), and Russian ethnic group. Tailored programs to prevent common health behavior risk factors among future medical doctors are urgently needed in the Russian Federation. © The Author(s) 2016.

[The Common Risk Factor Approach - An Integrated Population- and Evidence-Based Approach for Reducing Social Inequalities in Oral Health].

PubMed

Heilmann, A; Sheiham, A; Watt, R G; Jordan, R A

2016-10-01

Worldwide, non-communicable diseases including dental caries and periodontal diseases, remain a major public health problem. Moreover, there is a social gradient in health across society that runs from the top to the bottom in a linear, stepwise fashion. Health promoting behaviours become more difficult to sustain further down the social ladder. Oral health inequalities also exist in Germany. Earlier explanations of social inequalities have mainly focused on individual lifestyle factors, ignoring the broader social determinants of health and disease. Until recently, the dominant approaches to general health promotion focused on actions to reduce specific diseases, separating oral health from general health. An alternative approach is the common risk factor approach (CRFA) where risk factors common to a number of major chronic diseases, including diseases of the mouth and teeth, are tackled. The CRFA focuses on the common underlying determinants of health to improve the overall health of populations, thereby reducing social inequalities. The main implication of the CRFA for oral health policies is to work in partnership with a range of other sectors and disciplines. Oral health issues need to be integrated with recommendations to promote general health. Improvements in oral health and a reduction in oral health inequalities are more likely by working in partnership across sectors and disciplines using strategies that focus upstream on the underlying determinants of oral diseases. © Georg Thieme Verlag KG Stuttgart · New York.

Inflammatory bowel disease: pathogenesis.

PubMed

Zhang, Yi-Zhen; Li, Yong-Yu

2014-01-07

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation. It has been a worldwide health-care problem with a continually increasing incidence. It is thought that IBD results from an aberrant and continuing immune response to the microbes in the gut, catalyzed by the genetic susceptibility of the individual. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the genetic, environmental or microbial factors and the immune responses. Of the four components of IBD pathogenesis, most rapid progress has been made in the genetic study of gut inflammation. The latest internationally collaborative studies have ascertained 163 susceptibility gene loci for IBD. The genes implicated in childhood-onset and adult-onset IBD overlap, suggesting similar genetic predispositions. However, the fact that genetic factors account for only a portion of overall disease variance indicates that microbial and environmental factors may interact with genetic elements in the pathogenesis of IBD. Meanwhile, the adaptive immune response has been classically considered to play a major role in the pathogenesis of IBD, as new studies in immunology and genetics have clarified that the innate immune response maintains the same importance in inducing gut inflammation. Recent progress in understanding IBD pathogenesis sheds lights on relevant disease mechanisms, including the innate and adaptive immunity, and the interactions between genetic factors and microbial and environmental cues. In this review, we provide an update on the major advances that have occurred in above areas.

Childhood trauma and neighborhood-level crime interact in predicting adult posttraumatic stress and major depression symptoms.

PubMed

Lowe, Sarah R; Quinn, James W; Richards, Catherine A; Pothen, John; Rundle, Andrew; Galea, Sandro; Ressler, Kerry J; Koenen, Karestan C; Bradley, Bekh

2016-01-01

Previous research has identified several individual-level factors that modify the risk of childhood trauma on adult psychiatric symptoms, including symptoms of major depression (MD) and posttraumatic stress (PTS). Neighborhood-level factors also influence the impact of individual-level exposures on adult psychopathology. However, no prior studies to our knowledge have explored cross-level interactions between childhood trauma and neighborhood-level factors on MD and PTS symptoms. The purpose of this study was therefore to explore cross-level interactions between a neighborhood-level factor - neighborhood-level crime - and childhood trauma on MD and PTS symptoms. Participants in this study (N=3192) were recruited from a large public hospital, and completed self-report inventories of childhood trauma and MD and PTS symptoms. Participant addresses were mapped onto 2010 census tracts, and data on crime within each tract were collected. Multilevel models found a significant cross-level interaction between childhood trauma and neighborhood crime on MD symptoms, such that the influence of high levels of childhood trauma on MD symptoms was enhanced for participants living in high-crime neighborhoods. Supplementary analyses found variation in the strength of cross-level interaction terms by types of childhood trauma and crime, with the strongest associations including emotional neglect paired with personal and property crime. The results provide preliminary support for interventions that help childhood trauma survivors find housing in less vulnerable neighborhoods and build skills to cope with neighborhood crime. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Morgan, K.T.; Monticello, T.M.

The nasal passages of laboratory animals and man are complex, and lesions induced in the delicate nasal lining by inhaled air pollutants vary considerably in location and nature. The distribution of nasal lesions is generally a consequence of regional deposition of the inhaled material, local tissue susceptibility, or a combination of these factors. Nasal uptake and regional deposition are are influenced by numerous factors including the physical and chemical properties of the inhaled material, such as water solubility and reactivity; airborne concentration and length of exposure; the presence of other air contaminants such as particulate matter; nasal metabolism, and bloodmore » and mucus flow. For certain highly water-soluble or reactive gases, nasal airflow patterns play a major role in determining lesion distribution. Studies of nasal airflow in rats and monkeys, using casting and molding techniques combined with a water-dye model, indicate that nasal airflow patterns are responsible for characteristic differences in the distribution of nasal lesions induced by formaldehyde in these species. Local tissue susceptibility is also a complex issue that may be a consequence of many factors, including physiologic and metabolic characteristics of the diverse cell populations that comprise each of the major epithelial types lining the airways. Identification of the principal factors that influence the distribution and nature of nasal lesions is important when attempting the difficult process of determining potential human risks using data derived from laboratory animals. Toxicologic pathologists can contribute to this process by carefully identifying the site and nature of nasal lesions induced by inhaled materials. 61 references.« less

The transcriptional regulatory network in the drought response and its crosstalk in abiotic stress responses including drought, cold, and heat.

PubMed

Nakashima, Kazuo; Yamaguchi-Shinozaki, Kazuko; Shinozaki, Kazuo

2014-01-01

Drought negatively impacts plant growth and the productivity of crops around the world. Understanding the molecular mechanisms in the drought response is important for improvement of drought tolerance using molecular techniques. In plants, abscisic acid (ABA) is accumulated under osmotic stress conditions caused by drought, and has a key role in stress responses and tolerance. Comprehensive molecular analyses have shown that ABA regulates the expression of many genes under osmotic stress conditions, and the ABA-responsive element (ABRE) is the major cis-element for ABA-responsive gene expression. Transcription factors (TFs) are master regulators of gene expression. ABRE-binding protein and ABRE-binding factor TFs control gene expression in an ABA-dependent manner. SNF1-related protein kinases 2, group A 2C-type protein phosphatases, and ABA receptors were shown to control the ABA signaling pathway. ABA-independent signaling pathways such as dehydration-responsive element-binding protein TFs and NAC TFs are also involved in stress responses including drought, heat, and cold. Recent studies have suggested that there are interactions between the major ABA signaling pathway and other signaling factors in stress responses. The important roles of these TFs in crosstalk among abiotic stress responses will be discussed. Control of ABA or stress signaling factor expression can improve tolerance to environmental stresses. Recent studies using crops have shown that stress-specific overexpression of TFs improves drought tolerance and grain yield compared with controls in the field.

Epidemiology of Diabetes Mellitus in the United Arab Emirates.

PubMed

Razzak, Hira Abdul; Harbi, Alya; Shelpai, Wael; Qawas, Ahmad

2017-09-20

Background/ Objective: Diabetes mellitus is a non-communicable disease which has become a major global public health issue. This systematic review summarized epidemiological studies related to the prevalence, risk factors, complications, incidence, knowledge, attitude and practices of Diabetes Mellitus (DM) among Arab population in the United Arab Emirates (UAE). PubMed, Scopus databases, Science direct, Wiley online library, and other local journals were searched to identify relevant literature using appropriate keywords to retrieve studies conducted in the UAE. Search limits were restricted to studies in English language, between 2007 and 2016, and on UAE population (both citizens and expatriates). Electronic database search yielded 24 studies about the prevalence, incidence, complications, risk factors, knowledge, attitudes and practices of diabetes, including cross sectional studies (n =18), population-based survey (n = 1), retrospective cohort studies (n = 3), qualitative (n=1), and randomized controlled trial (n = 1). Countrywide prevalence estimates of Diabetes Mellitus were reported to be high. The major determinants of Diabetes Mellitus involved hypertension, physical inactivity, sedentary lifestyle, and unhealthy diet. Even though past evidences have promulgated the role of numerous causative factors, the epidemiological implications of some of the risk factors including family history, educational level, and the use of alcohol remains elusive. This systematic review signifies epidemiology of Diabetes Mellitus in the United Arab Emirates and suggests that extra efforts are needed for preventive and curative strategies in order to decrease the burden of this non-communicable disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Intact stable isotope labeled plasma proteins from the SILAC-labeled HepG2 secretome.

PubMed

Mangrum, John B; Martin, Erika J; Brophy, Donald F; Hawkridge, Adam M

2015-09-01

The plasma proteome remains an attractive biospecimen for MS-based biomarker discovery studies. The success of these efforts relies on the continued development of quantitative MS-based proteomics approaches. Herein we report the use of the SILAC-labeled HepG2 secretome as a source for stable isotope labeled plasma proteins for quantitative LC-MS/MS measurements. The HepG2 liver cancer cell line secretes the major plasma proteins including serum albumin, apolipoproteins, protease inhibitors, coagulation factors, and transporters that represent some of the most abundant proteins in plasma. The SILAC-labeled HepG2 secretome was collected, spiked into human plasma (1:1 total protein), and then processed for LC-MS/MS analysis. A total of 62 and 56 plasma proteins were quantified (heavy:light (H/L) peptide pairs) from undepleted and depleted (serum albumin and IgG), respectively, with log2 H/L = ± 6. Major plasma proteins quantified included albumin, apolipoproteins (e.g., APOA1, APOA2, APOA4, APOB, APOC3, APOE, APOH, and APOM), protease inhibitors (e.g., A2M and SERPINs), coagulation factors (e.g., Factor V, Factor X, fibrinogen), and transport proteins (e.g., TTR). The average log2 H/L values for shared plasma proteins in both undepleted and depleted plasma samples were 0.43 and 0.44, respectively. This work further expands the SILAC strategy into MS-based biomarker discovery of clinical biospecimens. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Childhood Trauma and Neighborhood-Level Crime Interact in Predicting Adult Posttraumatic Stress and Major Depression Symptoms

PubMed Central

Lowe, Sarah R.; Quinn, James W.; Richards, Catherine A.; Pothen, John; Rundle, Andrew; Galea, Sandro; Ressler, Kerry J.; Koenen, Karestan C.; Bradley, Bekh

2015-01-01

Previous research has identified several individual-level factors that modify the risk of childhood trauma on adult psychiatric symptoms, including symptoms of major depression (MD) and posttraumatic stress (PTS). Neighborhood-level factors also influence the impact of individual-level exposures on adult psychopathology. However, no prior studies to our knowledge have explored cross-level interactions between childhood trauma and neighborhood-level factors on MD and PTS symptoms. The purpose of this study was therefore to explore cross-level interactions between a neighborhood-level factor – neighborhood-level crime – and childhood trauma on MD and PTS symptoms. Participants in this study (N = 3,192) were recruited from a large public hospital, and completed self-report inventories of childhood trauma and MD and PTS symptoms. Participant addresses were mapped onto 2010 census tracts, and data on crime within each tract was collected. Multilevel models found a significant cross-level interaction between childhood trauma and neighborhood crime on MD symptoms, such that the influence of high levels of childhood trauma on MD symptoms was enhanced for participants living in high-crime neighborhoods. Supplementary analyses found variation in the strength of cross-level interaction terms by types of childhood trauma and crime, with the strongest associations including emotional neglect paired with personal and property crime. The results provide preliminary support for interventions that help childhood trauma survivors find housing in less vulnerable neighborhoods and build skills to cope with neighborhood crime. PMID:26499372

A Concept Mapping Study of Physicians' Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa

PubMed Central

Iwelunmor, Juliet; Blackstone, Sarah; Gyamfi, Joyce; Airhihenbuwa, Collins; Plange-Rhule, Jacob; Tayo, Bamidele; Adanu, Richard; Ogedegbe, Gbenga

2015-01-01

Hypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians' perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management. PMID:26550488

Appetite Loss and Neurocognitive Deficits in Late-Life Depression

PubMed Central

Potter, Guy G.; McQuoid, Douglas R.; Steffens, David C.

2015-01-01

Objectives Examine association of appetite loss symptoms to neurocognitive performance in late-life depression (LLD). Methods Cross-sectional data from individuals aged 60+ with Major Depressive Disorder (N =322). Participants received clinical assessment of depression and neuropsychological testing. Factor analysis was used to characterize depression symptom factors, and composite scales were developed for episodic memory, psychomotor executive functions, verbal fluency, and working memory span. Results Factor analysis produced a five-factor solution: (1) Anhedonia/Sadness, (2) Suicidality/Guilt, (3) Appetite/Weight Loss, (4) Sleep Disturbance, and (5) Anxiety/Tension. In separate multivariate models for each neurocognitive domain and including all 5 depression factors, higher appetite-loss-related symptoms were associated with lower performance in episodic memory, psychomotor executive functions, and verbal fluency; results were significant with covariates of age, education, race, sex, age of depression onset, and illness burden. No other depression factors were associated with neurocognitive performance in these models. In an additional set of models, the Appetite factor mediated the association between global depression severity and neurocognitive performance. Discussion A factor of appetite and weight loss symptoms in LLD was uniquely associated with neurocognitive performance, in contrast to lack of association among other depression symptom factors. Conclusion Cognitive deficits are a major adverse outcome of LLD, and prominent appetite loss during acute depression may be a marker for these deficits, independent of overall depression severity. Research is needed to understand the mechanisms that may explain this association, and how it is related to the cognitive and symptomatic course of LLD. PMID:25315155

Recombinant activated factor VII in the treatment of bleeds and for the prevention of surgery-related bleeding in congenital haemophilia with inhibitors.

PubMed

Santagostino, Elena; Escobar, Miguel; Ozelo, Margareth; Solimeno, Luigi; Arkhammar, Per; Lee, Hye Youn; Rosu, Gabriela; Giangrande, Paul

2015-06-01

The availability of recombinant activated factor VII (rFVIIa, eptacog alfa activated) has greatly advanced the care of patients with haemophilia A or B who have developed inhibitors against the infused replacement factor. Recombinant FVIIa is licensed for the on-demand treatment of bleeding episodes and the prevention of bleeding in surgery or invasive procedures in patients with congenital haemophilia with inhibitors. This article attempts to review in detail the extensive evidence of rFVIIa in congenital haemophilia patients with inhibitors. Patients with acute bleeding episodes are best treated on demand at home, to achieve the short- and long-term benefits of rapid bleed control. Key prospective studies have shown that rFVIIa achieves consistently high efficacy rates in the management of acute (including joint) bleeds in inhibitor patients in the home treatment setting. Substantial post-approval data from key registries also support the on-demand efficacy profile of rFVIIa established by the prospective clinical trials. The availability of rFVIIa has allowed major surgery to become a reality for inhibitor patients. Studies in key surgery, including orthopaedic procedures, have found that rFVIIa provides consistently high efficacy rates. Importantly, the wealth of data does not raise any unexpected safety concerns surrounding rFVIIa use; this is likely because rFVIIa is a recombinant product with a localised mechanism of action at the site of vascular injury. In summary, rFVIIa is established as an effective and well-tolerated first-line treatment for on-demand bleeding control and bleed prevention during minor and major (including elective orthopaedic) surgery in inhibitor patients. Use of rFVIIa has been a major step towards narrowing the gap in outcomes between inhibitor patients and non-inhibitor patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factor analysis of submicron particle size distributions near a major United States-Canada trade bridge.

PubMed

Ogulei, David; Hopke, Philip K; Ferro, Andrea R; Jaques, Peter A

2007-02-01

A factor analytic model has been applied to resolve and apportion particles based on submicron particle size distributions downwind of a United States-Canada bridge in Buffalo, NY. The sites chosen for this study were located at gradually increasing distances downwind of the bridge complex. Seven independent factors were resolved, including four factors that were common to all of the five sites considered. The common factors were generally characterized by the existence of two or more number and surface area modes. The seven factors resolved were identified as follows: fresh tail-pipe diesel exhaust, local/street diesel traffic, aged/evolved diesel particles, spark-ignition gasoline emissions, background urban emissions, heavy-duty diesel agglomerates, and secondary/transported material. Submicron (<0.5 microm) and ultrafine (<0.1 microm) particle emissions downwind of the bridge were dominated by commercial diesel truck emissions. Thus, this study obtained size distinction between fresh versus aged vehicle exhaust and spark-ignition versus diesel emissions based on the measured high time-resolution particle number concentrations. Because this study mainly used particles <300 nm in diameter, some sources that would usually exhibit number modes >100 nm were not resolved. Also, the resolved profiles suggested that the major number mode for fresh tailpipe diesel exhaust might exist below the detection limit of the spectrometer used. The average particle number contributions from the resolved factors were highest closest to the bridge.

Factors Affecting Lactoferrin Concentration in Human Milk: How Much Do We Know?

PubMed Central

Villavicencio, Aasith; Rueda, Maria S.; Turin, Christie G.; Ochoa, Theresa J.

2017-01-01

Lactoferrin (LF) is a breast milk glycoprotein with antimicrobial and anti-inflammatory effects. Its beneficial properties in infants, especially in those born preterm, are currently being studied in clinical trials. However, the maternal and nursing infant factors that may affect the concentration of LF in breast milk are still not clear. We conducted a systematic review to investigate the factors that may affect LF concentration. We used a 2-step approach to identify the eligible studies according to inclusion/exclusion criteria and to determine which studies would be considered. We included 70 qualified articles from 29 countries with publication dates ranging from 1976 to 2015. We described the correlation between LF concentration in breast milk and lactation stage; 10 maternal factors, such as race, parity, among others; and 2 infant factors, infections and prematurity. Colostrum has the highest LF levels, but they decrease with days postpartum. No other factor has been consistently associated with LF concentration. A major limitation of the majority of the published studies is the small sample size and the different methods used to measure LF concentration. Therefore, there is a need for large, multicenter studies with standardized study design, sample collection, and LF measurement methods to identify clinically significant factors associated with LF expression in breast milk, which will help promote exclusive breastfeeding in preterm infants. PMID:28075610

Complications after surgery for lumbar stenosis in a veteran population.

PubMed

Deyo, Richard A; Hickam, David; Duckart, Jonathan P; Piedra, Mark

2013-09-01

Secondary analysis of the prospectively collected Veterans Affairs National Surgical Quality Improvement Program database. Determine rates of major medical complications, wound complications, and mortality among patients undergoing surgery for lumbar stenosis and examine risk factors for these complications. Surgery for spinal stenosis is concentrated among older adults, in whom complications are more frequent than among middle-aged patients. Many studies have focused on infections or device complications, but fewer studies have focused on major cardiopulmonary complications, using prospectively collected data. We identified patients who underwent surgery for a primary diagnosis of lumbar stenosis between 1998 and 2009 from the Veterans Affairs National Surgical Quality Improvement Program database. We created a composite of major medical complications, including acute myocardial infarction, stroke, pulmonary embolism, pneumonia, systemic sepsis, coma, and cardiac arrest. Among 12,154 eligible patients, major medical complications occurred in 2.1%, wound complications in 3.2%, and 90-day mortality in 0.6%. Major medical complications, but not wound complications, were strongly associated with age. American Society of Anesthesiologists (ASA) class was a strong predictor of complications. Insulin use, long-term corticosteroid use, and preoperative functional status were also significant predictors. Fusion procedures were associated with higher complication rates than with decompression alone. In logistic regressions, ASA class and age were the strongest predictors of major medical complications (odds ratio for ASA class 4 vs. class 1 or 2: 2.97; 95% confidence interval, 1.68-5.25; P = 0.0002). After adjustment for comorbidity, age, and functional status, fusion procedures remained associated with higher medical complication rates than were decompressions alone (odds ratio = 2.85; 95% confidence interval, 2.14-3.78; P < 0.0001). ASA class, age, type of surgery, insulin or corticosteroid use, and functional status were independent risk factors for major medical complications. These factors may help in selecting patients and planning procedures, improving patient safety.

Predicting Major Bleeding in Ischemic Stroke Patients With Atrial Fibrillation.

PubMed

Hilkens, Nina A; Algra, Ale; Greving, Jacoba P

2017-11-01

Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy). We assessed performance of HEMORR 2 HAGES (hepatic or renal disease, ethanol abuse, malignancy, older age, reduced platelet count or function, hypertension [uncontrolled], anemia, genetic factors, excessive fall risk, and stroke), Shireman, HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and ORBIT scores (older age, reduced haemoglobin/haematocrit/history of anaemia, bleeding history, insufficient kidney function, and treatment with antiplatelet) with C statistics and calibration plots. Net benefit of oral anticoagulants was explored by comparing risk reduction in ischemic stroke with risk increase in major bleedings on warfarin. During 6922 person-years of follow-up, 266 patients experienced a major bleed (3.8 per 100 person-years). C statistics ranged from 0.62 (Shireman) to 0.67 (ATRIA). Calibration was poor for ATRIA and moderate for other models. The reduction in recurrent ischemic strokes on warfarin was larger than the increase in major bleeding risk, irrespective of bleeding risk category. Performance of prediction models for major bleeding in patients with cerebral ischemia and atrial fibrillation is modest but comparable with performance in patients with only atrial fibrillation. Bleeding risk scores cannot guide treatment decisions for oral anticoagulants but may still be useful to identify modifiable risk factors for bleeding. Clinical usefulness may be best for ORBIT, which is based on a limited number of easily obtainable variables and showed reasonable performance. © 2017 American Heart Association, Inc.

Lessons Learned: Newly Hired Nurses' Perspectives on Transition Into Practice.

PubMed

Ziebert, Carolyn; Klingbeil, Carol; Schmitt, Catherine A; Stonek, Alice V; Totka, Joan P; Stelter, Ashley; Schiffman, Rachel F

2016-01-01

This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes.

Nervous System Infections and the Global Traveler.

PubMed

Reid, Savina; Thompson, Haley; Thakur, Kiran T

2018-04-01

Neurological complications of infectious diseases are associated with high rates of morbidity and mortality. It is imperative that neurologists be up-to-date on current developments including typical and atypical presentations of neurological infections in travelers, diagnostic and treatment recommendations, and emerging pathogen resistance patterns to avoid fatal outcomes and long-term sequelae. This article will address concepts of emerging and reemerging infectious diseases, and will provide updates on the neurological manifestations of select emerging and reemerging infections, including Ebola virus, bacterial meningitis, enterovirus 71, Zika virus, cerebral malaria, and Japanese encephalitis. Emerging and reemerging neurotropic infectious diseases, including Zika virus, have recently been major global health threats. Factors contributing to the emergence of infectious diseases include closer contact with zoonoses, population growth in cities, globalization, environmental changes, and the rise in antibiotic resistance. Serotype replacement of bacterial meningitis, the possibility of viral persistence in the central nervous system in Ebola virus, antibiotic resistance of malaria, and the evolution of neurovirulent strains of Zika virus display some of the developing challenges that accompany various neurotropic infectious diseases. Neurologists should be aware of the factors contributing to the emergence and reemergence of neurotropic infectious diseases. As emerging and reemerging neurotropic infectious continue to be a major global health security threat, clinicians should be aware of the risks to travelers and current guidelines on prevention and management. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Multicenter retrospective analysis of cardiovascular risk factors affecting long-term outcome of de novo cardiac transplant recipients.

PubMed

Kobashigawa, Jon A; Starling, Randall C; Mehra, Mandeep R; Kormos, Robert L; Bhat, Geetha; Barr, Mark L; Sigouin, Chris S; Kolesar, June; Fitzsimmons, William

2006-09-01

Previous risk factor studies in cardiac transplant patients have analyzed pre-transplant risk factors as they relate to outcomes. This study is the first in-depth multicenter assessment of ongoing post-transplant risk factors in heart transplant patients and their impact on 5-year outcomes. We reviewed 280 heart transplant patients who survived > 1 year for the impact of post-transplant risk factors (hyperlipidemia, hypertension, diabetes, body mass index [BMI] and renal dysfunction: 8 to 18 possible measurements over 5 years) on outcomes, including death, cardiac allograft vasculopathy (CAV) and non-fatal major adverse cardiac events (NF-MACE). Upon multivariate Cox regression analysis, significant findings were high total-cholesterol for NF-MACE (relative risk [RR] = 4.34, confidence interval [CI] 1.35 to 13.98, p = 0.01), presence of diabetes for NF-MACE (RR = 3.96, CI 1.24 to 12.65, p = 0.02) and high serum creatinine for graft death (RR = 1.59, CI 1.35 to 1.87, p < 0.001). No covariates were found to be significant for CAV. Other significant risk factors by univariate Cox regression models with time-dependent covariates included BMI > or = 33 for graft death. Post-transplant risk factors of hypercholesterolemia and diabetes are associated with NF-MACE, whereas high serum creatinine and BMI > or = 33 are associated with graft death. Risk factor modification, including direct therapy to minimize risk factors, should be considered.

Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery.

PubMed

Lai, Hou-Chuan; Chan, Shun-Ming; Lu, Chueng-He; Wong, Chih-Shung; Cherng, Chen-Hwan; Wu, Zhi-Fu

2017-02-01

Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011. The various time intervals including waiting for anesthesia time, anesthesia time, surgical time, extubation time, exit from OR after extubation, total OR time, and postanesthetic care unit (PACU) stay time and percentage of prolonged extubation (≥15 minutes) were compared between these 2 anesthetic techniques.We included data from 343 patients, with 159 patients receiving TIVA and 184 patients receiving DES. The only significant difference is extubation time, TIVA was faster than the DES group (8.5 ± 3.8 vs 9.4 ± 3.7 minutes; P = 0.04). The factors contributed to prolonged extubation were age, gender, body mass index, DES anesthesia, and anesthesia time.In our hospital, propofol-based TIVA by target-controlled infusion provides faster emergence compared with DES anesthesia; however, it did not improve OR efficiency in open major abdominal surgery. Older, male gender, higher body mass index, DES anesthesia, and lengthy anesthesia time were factors that contribute to extubation time.

Association between total serum cholesterol and suicide attempts in subjects with major depressive disorder: Exploring the role of clinical and biochemical confounding factors.

PubMed

Bartoli, Francesco; Crocamo, Cristina; Dakanalis, Antonios; Riboldi, Ilaria; Miotto, Alessio; Brosio, Enrico; Clerici, Massimo; Carrà, Giuseppe

2017-04-01

We tested whether serum total cholesterol levels might be associated with recent suicide attempts in subjects with major depressive disorder, after controlling for relevant individual characteristics. We conducted a comparative cross-sectional study including consecutive inpatients with major depressive disorder. We differentiated subjects admitted for a recent serious (violent or non-violent) suicide attempt and those without such recent history. Total cholesterol was measured from fasting blood tests. At univariate analyses, suicide attempters had levels of total cholesterol (174.0±45.7mg/dL) lower than non-attempters (193.9±42.6mg/dL) (p=0.004). This was confirmed among both violent (174.1±46.2mg/dL) and non-violent (173.8±46.1mg/dL) suicide attempters (p=0.035 and 0.016, respectively). However, logistic regression analyses, sequentially including demographic, clinical (comorbid alcohol and personality disorders), and biochemical factors, did not show any association between serum cholesterol and recent suicide attempts (p=0.172). Similar findings were observed in multinomial logistic regression analyses, for both violent (p=0.512) and non-violent (p=0.157) suicide attempts. Our findings do not support the hypothesis that serum cholesterol and suicide attempts are associated among subjects with major depressive disorder. The identification of valid and accessible biological markers of suicidal behaviors still represents a challenge for future research. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Teamwork in high-risk environments analogous to space

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.

1990-01-01

Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

Thermal expansion of composites: Methods and results. [large space structures

NASA Technical Reports Server (NTRS)

Bowles, D. E.; Tenney, D. R.

1981-01-01

The factors controlling the dimensional stability of various components of large space structures were investigated. Cyclic, thermal and mechanical loading were identified as the primary controlling factors of the dimensional stability of cables. For organic matrix composites, such as graphite-epoxy, it was found that these factors include moisture desorption in the space environment, thermal expansion as the structure moves from the sunlight to shadow in its orbit, mechanical loading, and microyielding of the material caused by microcracking of the matrix material. The major focus was placed on the thermal expansion of composites and in particular the development and testing of a method for its measurement.

Treatment outcomes, quality of life, and impact of hemophilia on young adults (aged 18-30 years) with hemophilia.

PubMed

Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L

2015-12-01

The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood. © 2015 Wiley Periodicals, Inc.

Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence

PubMed Central

Adam, Emma K.; Doane, Leah D.; Zinbarg, Richard E.; Mineka, Susan; Craske, Michelle G.; Griffith, James W.

2010-01-01

Levels of the stress-sensitive hormone cortisol increase dramatically in the first 30-40 minutes after waking, an effect known as the cortisol awakening response (CAR). There is considerable cross-sectional evidence that psychosocial stress is associated with an increased CAR, and the CAR has been found to be altered in the presence of stress-related diseases, including Major Depressive Disorder (MDD). To date, no prospective longitudinal studies have examined whether individual differences in the CAR serve as a premorbid risk factor for MDD. In a sample of 230 late adolescents, clinical diagnoses of MDD were predicted from the CAR as well as other indicators of basal cortisol functioning gathered one year earlier, including: waking cortisol levels, bedtime cortisol levels, the size of the CAR, average cortisol, and the slope of the diurnal cortisol rhythm across the waking day. Age and gender, health and health behaviors, baseline neuroticism, exposure to stressful life events and past episodes of mood and anxiety disorders were included as covariates, to help ensure effects are attributable to the CAR rather than related variables. A higher baseline CAR was associated with a significantly increased risk of developing MDD by follow-up, even when excluding individuals with baseline MDD. No other baseline cortisol measures were significant prospective predictors of MDD. In summary, the CAR is a significant prospective risk factor for the development of MDD in young adults, providing some support for the possibility that a heightened CAR may play a role in the etiology of Major Depressive Disorder. PMID:20079576

Predictors of electrocardiographic abnormalities in type 1 Diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

PubMed

O'Neal, Wesley T; Lee, Kristine E; Soliman, Elsayed Z; Klein, Ronald; Klein, Barbara E K

2017-03-01

To determine the incidence and determinants of developing abnormalities on the 12-lead electrocardiogram (ECG) in persons with type 1 diabetes. We evaluated the distribution of ECG abnormalities and risk factors for developing new abnormalities in 266 (mean age = 44 years ± 9.0; 50 % female) people with type 1 diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. This analysis included participants with complete ECG data from study visit 5 (2000-2001) and follow-up ECGs from study visit 7 (2012-2014). ECG abnormalities were classified as major and minor according to Minnesota Code Classification. At baseline, 94 (35 %) participants had at least one ECG abnormality, including 13 major ECG abnormalities. At follow-up, 117 (44 %) participants developed at least one new ECG abnormality, including 35 new major ECG abnormalities. In a multivariable logistic regression model, older age (per 5-year increase: OR = 1.31, 95 % CI = 1.08, 1.60) was associated with the development of at least one new ECG abnormality, while serum HDL cholesterol (per 10-unit increase: OR = 0.98, 95 % CI = 0.96, 1.00) was protective against developing new ECG abnormalities. The development of new ECG abnormalities is common in type 1 diabetes. Older age and HDL cholesterol are independent risk factors for developing new ECG abnormalities. Further research is needed to determine whether routine ECG screening is indicated in people with type 1 diabetes to identify those with underlying subclinical coronary heart disease.

Specialty satisfaction, positive psychological capital, and nursing professional values in nursing students: A cross-sectional survey.

PubMed

Woo, Chung Hee; Park, Ju Young

2017-10-01

Ideally, college majors should be chosen to achieve self-realization and correspond to self-concept. However, some students select a major based on extrinsic factors, rather than aptitude or interests, because of a lack of employment opportunities. If they have negative college experiences with an unsatisfactory major, they might not engage fully in their occupation following graduation. This study aimed to identify factors affecting specialty satisfaction in preclinical practice nursing-college students. A cross-sectional descriptive survey. A nonprobability convenience sample of 312 nursing-college students at colleges in Deajeon City, South Korea. The survey questionnaire was distributed to those who agreed to participate. Freshmen and sophomore nursing students (n=312). Participants were 312 students at colleges in Deajeon City. A structured questionnaire was used to collect data, which were analyzed using SPSS/WIN. Positive psychological capital and nursing professional values were positively correlated with specialty satisfaction. Significant predictors for specialty satisfaction included hope and optimism (as components of positive psychological capital), the roles of nursing service and originality of nursing (as nursing professional values), and aptitude/interests and job value (as motives for selecting a major). The findings suggested that nursing students' specialty satisfaction was partially linked to positive psychological capital and professional values. Therefore, the promotion of positive factors should be useful in enhancing specialty satisfaction in preclinical-practice nursing-college students. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intelligent data analysis to interpret major risk factors for diabetic patients with and without ischemic stroke in a small population

PubMed Central

Gürgen, Fikret; Gürgen, Nurgül

2003-01-01

This study proposes an intelligent data analysis approach to investigate and interpret the distinctive factors of diabetes mellitus patients with and without ischemic (non-embolic type) stroke in a small population. The database consists of a total of 16 features collected from 44 diabetic patients. Features include age, gender, duration of diabetes, cholesterol, high density lipoprotein, triglyceride levels, neuropathy, nephropathy, retinopathy, peripheral vascular disease, myocardial infarction rate, glucose level, medication and blood pressure. Metric and non-metric features are distinguished. First, the mean and covariance of the data are estimated and the correlated components are observed. Second, major components are extracted by principal component analysis. Finally, as common examples of local and global classification approach, a k-nearest neighbor and a high-degree polynomial classifier such as multilayer perceptron are employed for classification with all the components and major components case. Macrovascular changes emerged as the principal distinctive factors of ischemic-stroke in diabetes mellitus. Microvascular changes were generally ineffective discriminators. Recommendations were made according to the rules of evidence-based medicine. Briefly, this case study, based on a small population, supports theories of stroke in diabetes mellitus patients and also concludes that the use of intelligent data analysis improves personalized preventive intervention. PMID:12685939

Infrequent Loss of Luminal Differentiation in Ductal Breast Cancer Metastasis

PubMed Central

Calvo, Julia; Sánchez-Cid, Lourdes; Muñoz, Montserrat; Lozano, Juan José; Thomson, Timothy M.; Fernández, Pedro L.

2013-01-01

Lymph node involvement is a major prognostic variable in breast cancer. Whether the molecular mechanisms that drive breast cancer cells to colonize lymph nodes are shared with their capacity to form distant metastases is yet to be established. In a transcriptomic survey aimed at identifying molecular factors associated with lymph node involvement of ductal breast cancer, we found that luminal differentiation, assessed by the expression of estrogen receptor (ER) and/or progesterone receptor (PR) and GATA3, was only infrequently lost in node-positive primary tumors and in matched lymph node metastases. The transcription factor GATA3 critically determines luminal lineage specification of mammary epithelium and is widely considered a tumor and metastasis suppressor in breast cancer. Strong expression of GATA3 and ER in a majority of primary node-positive ductal breast cancer was corroborated by quantitative RT-PCR and immunohistochemistry in the initial sample set, and by immunohistochemistry in an additional set from 167 patients diagnosed of node-negative and –positive primary infiltrating ductal breast cancer, including 102 samples from loco-regional lymph node metastases matched to their primary tumors, as well as 37 distant metastases. These observations suggest that loss of luminal differentiation is not a major factor driving the ability of breast cancer cells to colonize regional lymph nodes. PMID:24205108

Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy.

PubMed

Haskell, William L

2003-01-01

Over the past half century scientific data support the strong relationship between the way a person or population lives and their risk for developing or dying from cardiovascular disease (CVD). While heredity can be a major factor for some people, their personal health habits and environmental/cultural exposure are more important factors. CVD is a multifactor process that is contributed to by a variety of biological and behavioral characteristics of the person including a number of well-established and emerging risk factors. Not smoking, being physically active, eating a heart healthy diet, staying reasonably lean, and avoiding major stress and depression are the major components of an effective CVD prevention program. For people at high risk of CVD, medications frequently need to be added to a healthy lifestyle to minimize their risk of a heart attack or stroke, particularly in persons with conditions such as hypertension, hypercholesterolemia, or hyperglycemia. Maintaining an effective CVD prevention program in technologically advanced societies cannot be achieved by many high-risk persons without effective and sustained support from a well-organized health care system. Nurse-provided or nurse-coordinated care management programs using an integrated or multifactor approach have been highly effective in reducing CVD morbidity and mortality of high-risk persons.

Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity ('SNAP') health risk factors.

PubMed

Noble, Natasha; Paul, Christine; Turon, Heidi; Oldmeadow, Christopher

2015-12-01

There is a growing body of literature examining the clustering of health risk behaviours, but little consensus about which risk factors can be expected to cluster for which sub groups of people. This systematic review aimed to examine the international literature on the clustering of smoking, poor nutrition, excess alcohol and physical inactivity (SNAP) health behaviours among adults, including associated socio-demographic variables. A literature search was conducted in May 2014. Studies examining at least two SNAP risk factors, and using a cluster or factor analysis technique, or comparing observed to expected prevalence of risk factor combinations, were included. Fifty-six relevant studies were identified. A majority of studies (81%) reported a 'healthy' cluster characterised by the absence of any SNAP risk factors. More than half of the studies reported a clustering of alcohol with smoking, and half reported clustering of all four SNAP risk factors. The methodological quality of included studies was generally weak to moderate. Males and those with greater social disadvantage showed riskier patterns of behaviours; younger age was less clearly associated with riskier behaviours. Clustering patterns reported here reinforce the need for health promotion interventions to target multiple behaviours, and for such efforts to be specifically designed and accessible for males and those who are socially disadvantaged. Copyright © 2015 Elsevier Inc. All rights reserved.

[Pathogenic factors of vibrios with special emphasis on Vibrio vulnificus].

PubMed

Shinoda, Sumio

2005-07-01

Bacteria of the genus Vibrio are normal habitants of the aquatic environment and play roles for biocontrole of aquatic ecosystem, but some species are believed to be human pathogens. These species can be classified into two groups according to the types of diseases they cause: the gastrointestinal infections and the extraintestinal infections. The pathogenic species produce various pathogenic factors including enterotoxin, hemolysin, cytotoxin, protease, siderophore, adhesive factor, and hemagglutinin. We studied various pathogenic factors of vibrios with special emphasis on protease and hemolysin of V. vulnificus. V. vulnificus is now recognized as being among the most rapidly fatal of human pathogens, although the infection is appeared in patients having underlying disease(s) such as liver dysfunction, alcoholic cirrhosis or haemochromatosis. V. vulnificus protease (VVP) is thought to be a major toxic factor causing skin damage in the patients having septicemia. VVP is a metalloprotease and degrades a number of biologically important proteins including elastin, fibrinogen, and plasma proteinase inhibitors of complement components. VVP causes skin damages through activation of the Factor XII-plasma kallikrein-kinin cascade and/or exocytotic histamine release from mast cells, and a haemorrhagic lesion through digestion of the vascular basement membrane. Thus, the protease is the most probable candidate for tissue damage and bacterial invasion during an infection. Pathogenic roles and functional mechanism of other factors including hemolysins of V. vulnificus and V. mimicus are also shown in this review article.

Evidence for cost-effectiveness of lifestyle primary preventions for cardiovascular disease in the Asia-Pacific Region: a systematic review.

PubMed

Sutton, Lainie; Karan, Anup; Mahal, Ajay

2014-11-19

Countries of the Asia Pacific region account for a major share of the global burden of disease due to cardiovascular disease (CVD) and this burden is rising over time. Modifiable behavioural risk factors for CVD are considered a key target for reduction in incidence but their effectiveness and cost-effectiveness tend to depend on country context. However, no systematic assessment of cost-effectiveness of interventions addressing behavioural risk factors in the region exists. A systematic review of the published literature on cost-effectiveness of interventions targeting modifiable behavioural risk factors for CVD was undertaken. Inclusion criteria were (a) countries in Asia and the Pacific, (b) studies that had conducted economic evaluations of interventions (c) published papers in major economic and public health databases and (d) a comprehensive list of search words to identify appropriate articles. All authors independently examined the final list of articles relating to methodology and findings. Under our inclusion criteria a total of 28 studies, with baseline years ranging from 1990 to 2012, were included in the review, 19 conducted in high-income countries of the region. Reviewed studies assessed cost-effectiveness of interventions for tobacco control, alcohol reduction, salt intake control, physical activity and dietary interventions. The majority of cost-effectiveness analyses were simulation analyses mostly relying on developed country data, and only 6 studies used effectiveness data from RCTs in the region. Other than for Australia, no direct conclusions could be drawn about cost-effectiveness of interventions targeting behavioural risk factors due to the small number of studies, interventions that varied widely in design, and varied methods for measurement of costs associated with interventions. Good quality cost-effectiveness information on interventions targeting behavioural interventions for the Asia-Pacific region remains a major gap in the literature.

Suicidal Behaviour in Mood Disorders—Who, When, and Why?

PubMed Central

Isometsä, Erkki

2014-01-01

Objective: About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. Method: The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Results: Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Conclusion: Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts. PMID:24881160

Suicidal behaviour in mood disorders--who, when, and why?

PubMed

Isometsä, Erkki

2014-03-01

About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions. The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed. Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive-aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention. Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.

Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006

PubMed Central

2012-01-01

Background Despite advances made in treating coronary heart disease (CHD), mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. Methods The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Results Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81%) of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Conclusion Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD. PMID:22958443

Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study.

PubMed

Pappas, Dimitrios A; Nyberg, Fredrik; Kremer, Joel M; Lampl, Kathy; Reed, George W; Horne, Laura; Ho, Meilien; Onofrei, Alina; Malaviya, Anand N; Rillo, Oscar L; Radominski, Sebastiao C; Gal, Janos; Gibofsky, Allan; Popkova, Tatiana V; Laurindo, Leda; Kerzberg, Eduardo M; Zahora, Roman; Pons-Estel, Bernado A; Curtis, Jeffrey R; Furst, Daniel E; Greenberg, Jeffrey D

2018-04-25

To compare the prevalence of cardiovascular disease (CVD) and major CVD risk factors among rheumatoid arthritis (RA) patients enrolled in a large US and multinational registry. We compared CVD and CVD risk factor prevalence from 11 countries enrolled in the CORRONA US and CORRONA International registries; patients from the 10 ex-US participating countries were grouped by region (Eastern Europe, Latin America, and India). Unadjusted summary data were presented for demographics and disease characteristics; comparisons for prevalence of CVD risk factors and CVD were age/gender standardized to the age/gender distribution of the US enrolled patients. Overall, 25,987 patients were included in this analysis. Compared to patients from the ex-US regions, US participants had longer disease duration and lower disease activity, yet were more likely to receive a biologic agent. Additionally, CORRONA US participants had the highest body mass index (BMI). Enrolled patients in India had the lowest BMI, were more rarely smokers, and had a low prevalence of hyperlipidemia, hypertension, and prior CVD compared to the US and other ex-US regions. Participants from Eastern Europe had a higher prevalence of hypertension and hyperlipidemia and highest prevalence of all manifestations of CVD. Differences in the prevalence of both CVD and major CVD risk factors were observed across the four regions investigated. Observed differences may be influenced by variations in both non-modifiable/modifiable characteristics of patient populations, and may contribute to heterogeneity on the observed safety of investigational and approved therapies in studies involving RA patients from different origins.

Host-regulated Hepatitis B Virus Capsid Assembly in a Mammalian Cell-free System.

PubMed

Liu, Kuancheng; Hu, Jianming

2018-04-20

The hepatitis B virus (HBV) is an important global human pathogen and represents a major cause of hepatitis, liver cirrhosis and liver cancer. The HBV capsid is composed of multiple copies of a single viral protein, the capsid or core protein (HBc), plays multiple roles in the viral life cycle, and has emerged recently as a major target for developing antiviral therapies against HBV infection. Although several systems have been developed to study HBV capsid assembly, including heterologous overexpression systems like bacteria and insect cells, in vitro assembly using purified protein, and mammalian cell culture systems, the requirement for non-physiological concentrations of HBc and salts and the difficulty in manipulating host regulators of assembly presents major limitations for detailed studies on capsid assembly under physiologically relevant conditions. We have recently developed a mammalian cell-free system based on the rabbit reticulocyte lysate (RRL), in which HBc is expressed at physiological concentrations and assembles into capsids under near-physiological conditions. This system has already revealed HBc assembly requirements that are not anticipated based on previous assembly systems. Furthermore, capsid assembly in this system is regulated by endogenous host factors that can be readily manipulated. Here we present a detailed protocol for this cell-free capsid assembly system, including an illustration on how to manipulate host factors that regulate assembly.

Voices of South Asian women: immigration and mental health.

PubMed

Ahmad, Farah; Shik, Angela; Vanza, Reena; Cheung, Angela M; George, Usha; Stewart, Donna E

2004-01-01

This qualitative research aimed to elicit experiences and beliefs of recent South Asian immigrant women about their major health concerns after immigration. Four focus groups were conducted with 24 Hindi-speaking women who had lived less than five years in Canada. The audiotaped data were transcribed, translated, and analyzed by identification of themes and subcategories. Mental health (MH) emerged as an overarching health concern with three major themes i.e. appraisal of the mental burden (extent and general susceptibility), stress-inducing factors, and coping strategies. Many participants agreed that MH did not become a concern to them until after immigration. Women discussed their compromised MH using verbal and symptomatic expressions. The stress-inducing factors identified by participants included loss of social support, economic uncertainties, downward social mobility, mechanistic lifestyle, barriers in accessing health services, and climatic and food changes. Women's major coping strategies included increased efforts to socialize, use of preventative health practices and self-awareness. Although participant women discussed a number of ways to deal with post-immigration stressors, the women's perceived compromised mental health reflects the inadequacy of their coping strategies and the available resources. Despite access to healthcare providers, women failed to identify healthcare encounters as opportunities to seek help and discuss their mental health concerns. Health and social care programs need to actively address the compromised mental health perceived by the studied group.

Major depressive disorder and impulsive reactivity to emotion: toward a dual-process view of depression.

PubMed

Carver, Charles S; Johnson, Sheri L; Joormann, Jutta

2013-09-01

Dual-process theories of behaviour have been used to suggest that vulnerability to depression involves elevated reactivity to emotions. This study tests that idea, examining self-reported reactivity. Comparison between persons with at least one lifetime episode of major depressive disorder (lifetime MDD) and those without this diagnosis, controlling for symptoms of alcohol use (a potential externalizing confound) and current symptoms of depression (a potential state-dependent confound). Undergraduates (N = 120) completed a clinical interview to diagnose lifetime MDD and a series of self-reports bearing on diverse aspects of self-control, including reactivity to emotion. Thirty-four people were diagnosed with lifetime MDD; 86 did not meet criteria for MDD. The groups were then compared on three factors underlying the scales assessing self-control. The MDD group had higher scores than controls on the two factors that reflect impulsive reactivity to diverse emotions, including emotions that are positive in valence. These effects were not explained by associations with either externalizing symptoms or current depressive symptoms. Reflexive reactivity to emotions characterizes depression, in addition to some externalizing problems, and it may deserve study as a potential trans-diagnostic feature. Reflexive reactivity to emotions characterizes persons diagnosed with major depressive disorder. Findings suggest desirability of focusing treatment partly on management of reflexive reactions to emotions. Measures were self-reports, rather than behavioural responses to emotions. © 2013 The British Psychological Society.

Risk Factors Associated With Language in Autism Spectrum Disorder: Clues to Underlying Mechanisms.

PubMed

Tager-Flusberg, Helen

2016-02-01

Identifying risk factors associated with neurodevelopmental disorders is an important line of research, as it will lead to earlier identification of children who could benefit from interventions that support optimal developmental outcomes. The primary goal of this review was to summarize research on risk factors associated with autism spectrum disorder (ASD). The review focused on studies of infants who have older siblings with ASD, with particular emphasis on risk factors associated with language impairment that affects the majority of children with ASD. Findings from this body of work were compared to the literature on specific language impairment. A wide range of risk factors has been found for ASD, including demographic (e.g., male, family history), behavioral (e.g., gesture, motor) and neural risk markers (e.g., atypical lateralization for speech and reduced functional connectivity). Environmental factors, such as caregiver interaction, have not been found to predict language outcomes. Many of the risk markers for ASD are also found in studies of risk for specific language impairment, including demographic, behavioral, and neural factors. There are significant gaps in the literature and limitations in the current research that preclude direct cross-syndrome comparisons. Future research directions are outlined that could address these limitations.

Diabetes and cardiovascular disease interventions by community pharmacists: a systematic review.

PubMed

Evans, Charity D; Watson, Erin; Eurich, Dean T; Taylor, Jeff G; Yakiwchuk, Erin M; Shevchuk, Yvonne M; Remillard, Alfred; Blackburn, David

2011-05-01

To systematically review and assess the quality of studies evaluating community pharmacist interventions for preventing or managing diabetes or cardiovascular disease (CVD) and/or their major risk factors. A comprehensive literature search was performed using MEDLINE (1950-February 2011), EMBASE (1980-February 2011), International Pharmaceutical Abstracts (1970-February 2011), Cumulative Index to Nursing and Allied Health Literature (1982-June 2007), and Cochrane Central Register of Controlled Trials (1898-February 2011). Search terms included: community pharmacy(ies), community pharmacist(s), cardiovascular, diabetes, and intervention. The grey literature was searched using the ProQuest Dissertations and Theses, Theses Canada, and OAlster databases. Articles published in English or French with all study designs were considered for the review. Studies were included if they contained interventions designed to reduce the incidence, risk, or mortality of CVD or diabetes; affect clinical indicators of CVD or diabetes mellitus (including hypertension, dyslipidemia, or hemoglobin A(1c)); and/or improve adherence to treatment strategies. Only studies involving interventions carried out primarily by pharmacists in community pharmacy settings were included. Study quality was assessed using a checklist validated for both randomized and nonrandomized studies. A total of 4142 studies were initially identified, with 40 meeting our inclusion criteria. Eleven studies were randomized controlled trials, 4 were cluster randomized trials, and 2 studies had randomized before-after designs. The remaining studies were controlled before-after (n = 2), cohort (n = 4), and uncontrolled before-after (n = 17) designs. Interventions focused on diabetes (n = 12), hypertension (n = 9), medication adherence (n = 9), lipids (n = 5), evidence-based medication initiation or optimization (n = 3), risk factor prediction scores (n = 1), and body mass index (n = 1). All studies contained interventions focused at the patient level and the majority of studies (34/40) involved interventions directed at both the physician and patient. No specific intervention emerged as superior, and study quality was generally poor, making it difficult to determine the true effect of the interventions. Poor study quality, time-intensive interventions, and unproven clinical significance warrant the need for further high-quality studies of community pharmacist interventions for preventing or managing diabetes or CVD and/or their major risk factors.

The Internalizing and Externalizing Structure of Psychiatric Comorbidity in Combat Veterans

PubMed Central

Miller, Mark W.; Fogler, Jason M.; Wolf, Erika J.; Kaloupek, Danny G.; Keane, Terence M.

2013-01-01

This study examined the latent structure of psychiatric disorders in a sample with a high prevalence of PTSD. A series of confirmatory factor analyses tested competing models for the covariation between SCID diagnoses among 1,325 Vietnam veterans. The best fitting solution was a three-factor model that included two correlated internalizing factors: anxious-misery, defined by PTSD and major depression, and fear, defined by panic disorder/agoraphobia and obsessive-compulsive disorder. The third factor, externalizing, was defined by antisocial personality disorder, alcohol abuse/dependence, and drug abuse/dependence. Both substance-related disorders also showed significant, albeit smaller, cross-loadings on the anxious-misery factor. These findings shed new light on the structure of psychiatric comorbidity in a treatment-seeking sample characterized by high rates of PTSD. PMID:18302181

Factors associated with dropout in a group weight-loss programme: a longitudinal investigation.

PubMed

Yackobovitch-Gavan, M; Steinberg, D M; Endevelt, R; Benyamini, Y

2015-02-01

Attrition is a major limitation of most weight management intervention programmes. The present study aimed to conduct an extensive investigation of personal, sociodemographic and treatment-related factors associated with attrition at different stages of a 10-week group weight-loss programme. The present study is part of a longitudinal, clinical intervention study comparing three conditions in a 10-week group programme: Control, Behavioural Intentions and Implementation Intentions. The study included 587 participants with a mean (SD) age of 46 (11) years (range 18-78 years) and a mean (SD) body mass index (BMI) of 31.9 (5.5) kg m(-2), with 90% being female. To characterise dropout in each week separately, as well as overall dropout (dropout until week 9, the median time of dropout), we tested several logistic regression models, including multiple imputations to cope with missing data. The results of the different dropout models consistently showed that a smaller reduction in BMI in the first 2 weeks of the programme was the strongest predictor of dropout. Dropout in the tenth and last week differed from the earlier weeks both in the relatively high dropout rate (56% of total dropout) and in that, in contrast to earlier weeks, the week 10 model included the reduction in BMI during the last 2 weeks before dropout but did not include the reduction in BMI at the initiation of the intervention. Weight-loss in the beginning of the programme is a crucial independent determinant of dropout in each week except the last one. This finding is important because it suggests a simple assessment for a major dropout risk factor in adult weight-loss intervention programmes. © 2014 The British Dietetic Association Ltd.

A study on the epidemiological characteristics and infectious forecast model of malaria at Guangzhou Airport among Chinese returnees from Africa.

PubMed

Wu, Hui-Ming; Fang, Zhi-Qiang; Zhao, Dang; Chen, Yan-Ling; Liu, Chuan-Ge; Liang, Xi

2017-07-04

Cross-border malaria transmission in China is a major component of Chinese imported malaria cases. Such cases mostly are travellers returning from malaria endemic countries in Africa. By investigating malaria infectious status among Chinese worker in Africa, this study analysed the malaria risk factors, in order to establish infectious forecast model. Chinese returnees data from Africa were collected at Guangzhou Baiyun International Airport, Guangzhou, China between August 2015 and March 2016 and were included in the cross-sectional and retrospective survey. A total of 1492 respondents were included in the study with the majority consisting of junior middle school educated male. Most of them are manual and technical workers hired by companies, with average of 37.04 years of age. Overall malaria incidence rate of the population was 8.98% (134/1492), and there were no significant differences regarding age, gender, occupation, or team. Forecast model was developed on the basis of malaria risk factors including working country, local ecological environment type, work duration and intensity of mosquito bite prevention. The survey suggested that malaria incidence was high among Chinese travellers who had worked in Africa countries of heavy malaria burden. Further research on the frequency and severity of clinical episodes among Chinese travellers having worked in Africa is needed.

Increasing global burden of cardiovascular disease in general populations and patients with schizophrenia.

PubMed

Hennekens, Charles H

2007-01-01

Cardiovascular disease (CVD), which includes coronary heart, cerebrovascular, and peripheral vascular disease, is the leading cause of death in the United States and most developed countries, accounting for about 50% of all deaths. The major risk factors include obesity and its consequences, dyslipidemia, hypertension, insulin resistance leading to diabetes, and cigarette smoking. In developing countries, CVD will become the leading cause of death due to alarming increases in obesity, sedentary lifestyles, cigarette smoking, and improvements in prevention and treatment of malnutrition and infection. Compared with nonschizophrenics, patients with schizophrenia have a 20% shorter life expectancy (i.e., from 76 to 61 years). In general populations, about 1% die from suicide compared with about 10% among patients with schizophrenia (relative risk = 10). For CVD, the corresponding figures are 50% and about 75% (relative risk = 1.5). In patients with schizophrenia, however, CVD occurs more frequently and accounts for more premature deaths than suicide. Patients with schizophrenia have alarmingly higher rates of obesity, dyslipidemia, hypertension, diabetes, and cigarette smoking than nonschizophrenic individuals in the general population. Compounding these data, patients with schizophrenia have less access to medical care, consume less medical care, and are less compliant. Primary prevention strategies should include the choice of antipsychotic drug regimens that do not adversely affect the major risk factors for CVD.

A rapid method to visualize von willebrand factor multimers by using agarose gel electrophoresis, immunolocalization and luminographic detection.

PubMed

Krizek, D R; Rick, M E

2000-03-15

A highly sensitive and rapid clinical method for the visualization of the multimeric structure of von Willebrand Factor in plasma and platelets is described. The method utilizes submerged horizontal agarose gel electrophoresis, followed by transfer of the von Willebrand Factor onto a polyvinylidine fluoride membrane, and immunolocalization and luminographic visualization of the von Willebrand Factor multimeric pattern. This method distinguishes type 1 from types 2A and 2B von Willebrand disease, allowing timely evaluation and classification of von Willebrand Factor in patient plasma. It also allows visualization of the unusually high molecular weight multimers present in platelets. There are several major advantages to this method including rapid processing, simplicity of gel preparation, high sensitivity to low concentrations of von Willebrand Factor, and elimination of radioactivity.

Nongenetic risk factors for holoprosencephaly: An updated review of the epidemiologic literature.

PubMed

Summers, April D; Reefhuis, Jennita; Taliano, Joanna; Rasmussen, Sonja A

2018-05-15

Holoprosencephaly (HPE) is a major structural birth defect of the brain that occurs in approximately 1 in 10,000 live births. Although some genetic causes of HPE are known, a substantial proportion of cases have an unknown etiology. Due to the low birth prevalence and rarity of exposure to many potential risk factors for HPE, few epidemiologic studies have had sufficient sample size to examine risk factors. A 2010 review of the literature identified several risk factors that had been consistently identified as occurring more frequently among cases of HPE, including maternal diabetes, twinning, and a predominance of females, while also identifying a number of potential risk factors that had been less widely studied. In this article, we summarize a systematic literature review conducted to update the evidence for nongenetic risk factors for HPE. © 2018 Wiley Periodicals, Inc.

Polycystic ovary syndrome: a major unrecognized cardiovascular risk factor in women.

PubMed

Alexander, Carolyn J; Tangchitnob, Edward P; Lepor, Norman E

2009-01-01

The prevalence of polycystic ovary syndrome (PCOS) is estimated to be nearly 10% among reproductive-age women. PCOS may represent the largest underappreciated segment of the female population at risk of cardiovascular disease. Clinicians providing care to women of childbearing age must recognize the presenting clues, including irregular menses, hirsutism, alopecia, hyperandrogenemia, and obesity. The pathophysiology of PCOS is complex, involving the hypothalamus-pituitary-ovarian axis, ovarian theca cell hyperplasia, hyperinsulinemia, and a multitude of other cytokine- and adipocyte-driven factors. Cardiac risk factors associated with PCOS have public health implications and should drive early screening and intervention measures. There are no consensus guidelines regarding screening for cardiovascular disease in patients with PCOS. Fasting lipid profiles and glucose examinations should be performed regularly. Carotid intimal medial thickness examinations should begin at age 30 years, and coronary calcium screening should begin at age 45 years. Treatment of the associated cardiovascular risk factors, including insulin resistance, hypertension, and dyslipidemia, should be incorporated into the routine PCOS patient wellness care program.

Polycystic ovary syndrome: a major unrecognized cardiovascular risk factor in women.

PubMed

Alexander, Carolyn J; Tangchitnob, Edward P; Lepor, Norman E

2009-01-01

The prevalence of polycystic ovary syndrome (PCOS) is estimated to be nearly 10% among reproductive age women. PCOS may represent the largest underappreciated segment of the female population at risk of cardiovascular disease. Clinicians providing care to women of childbearing age must recognize the presenting clues, including irregular menses, hirsutism, alopecia, hyperandrogenemia, and obesity. The pathophysiology of PCOS is complex, involving the hypothalamus-pituitary-ovarian axis, ovarian theca cell hyperplasia, hyperinsulinemia, and a multitude of other cytokine- and adipocyte-driven factors. Cardiac risk factors associated with PCOS have public health implications and should drive early screening and intervention measures. There are no consensus guidelines regarding screening for cardiovascular disease in patients with PCOS. Fasting lipid profiles and glucose examinations should be performed regularly. Carotid intimal medial thickness examinations should begin at age 30 years, and coronary calcium screening should begin at age 45 years. Treatment of the associated cardiovascular risk factors, including insulin resistance, hypertension, and dyslipidemia, should be incorporated into the routine PCOS patient wellness care program.

Cardiovascular safety of biologic therapies for the treatment of RA.

PubMed

Greenberg, Jeffrey D; Furer, Victoria; Farkouh, Michael E

2011-11-15

Cardiovascular disease represents a major source of extra-articular comorbidity in patients with rheumatoid arthritis (RA). A combination of traditional cardiovascular risk factors and RA-related factors accounts for the excess risk in RA. Among RA-related factors, chronic systemic inflammation has been implicated in the pathogenesis and progression of atherosclerosis. A growing body of evidence--mainly derived from observational databases and registries--suggests that specific RA therapies, including methotrexate and anti-TNF biologic agents, can reduce the risk of future cardiovascular events in patients with RA. The cardiovascular profile of other biologic therapies for the treatment of RA has not been adequately studied, including of investigational drugs that improve systemic inflammation but alter traditional cardiovascular risk factors. In the absence of large clinical trials adequately powered to detect differences in cardiovascular events between biologic drugs in RA, deriving firm conclusions on cardiovascular safety is challenging. Nevertheless, observational research using large registries has emerged as a promising approach to study the cardiovascular risk of emerging RA biologic therapies.

Factors Associated with Mental Health Service Utilization among Korean American Immigrants

PubMed Central

Park, So-Youn; Cho, Sunhee; Park, Yeddi; Bernstein, Kunsook S.; Shin, Jinah K.

2014-01-01

This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. PMID:23417654

Factors Influencing Postoperative Complications in Reconstructive Microsurgery for Head and Neck Cancer.

PubMed

Lo, Shih-Lun; Yen, Yu-Hsiu; Lee, Pi-Jung; Liu, Chih-Ho Charles; Pu, Chi-Ming

2017-04-01

The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed. Major complications included flap failure and life-threatening events. Minor complications were defined as requiring only routine wound care or conservative treatments. To evaluate group differences, the χ 2 test was applied for categorical variables and the Mann-Whitney U test was used for continuous variables. In total, 158 patients (145 men [91.8%], 13 women [8.2%]) were included in this study. The mean age of the study population was 52.4 years (range, 34 to 84 yr). The mean body mass index (BMI) was 23.71 kg/m 2 . Most patients (93.7%) had a history of cigarette smoking. Some patients had diabetes (20.3%) and hypertension (31.6%). The percentage of patients who underwent radiotherapy before surgery was 19.6%. The percentage whose flap required a salvage operation was 8.9%. The success rate of the microvascular surgeries was 95.6%. The major complication rate was 6.3% and the minor complication rate was 27.8%. No surgical mortality was noted. In these patients, poor nutrition status, indicated by low BMI and low albumin level, was associated with a greater tendency to develop postoperative complications. Patients who had diabetes or who had received radiotherapy before surgery had a high risk for major complications. A large skin paddle seemed to be an influencing factor for minor complications, such as wound dehiscence and superficial loss of flaps. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Epidemiology of lung tumors].

PubMed

Ott, S; Geiser, T

2012-07-01

Approximately one out of 500 chest radiographs shows the incidental finding of a solitary pulmonary nodule and almost one half of these pulmonary lesions are caused by a tumor. Unfortunately, only 2% to 5% of all lung tumors are of benign origin, e. g. lipoma, fibroma, hamartoma, and chondroma, and the majority are malignant neoplasms, most commonly primary lung cancer followed by metastases of extrapulmonary primary carcinomas. Thus, a careful diagnostic work up of solitary pulmonary nodules, including histological diagnosis, is mandatory for an adequate management and treatment of patients with pulmonary lesions. Despite all recent improvements of treatment modalities, lung cancer continues to be a major cause of morbidity and mortality among malignant diseases worldwide. The prognosis of affected patients is still very poor and a 5-years survival rate of only 14% makes lung cancer the number one cause of death due to cancer in Switzerland. Active and passive tobacco smoking are by far the best known risk factor for the development of lung cancer, but there are severe other probably less known factors that may increase the individual risk for malignant neoplasms of the lung. These risk factors include e. g. exposure to natural ionic radiation, consisting of terrestrial radiation and indoor radiation caused by radon gas, exposure to respirable dust and Diesel engine emissions, asbestos, and polycyclic aromatic hydrocarbons. In the majority of cases, the latency between exposure and development of cancer is years to decades and the person concerned was occupationally exposed. Therefore, a detailed evaluation of a patient's medical and occupational history is needed. Due to its poor prognosis, prevention and early diagnosis of lung cancer is crucial to improve our patients' outcome. Good knowledge of epidemiology and aetiology of pulmonary tumors is the key to preventive measures and identification of individuals at increased risk for lung cancer. An overview will be provided on the epidemiology of lung tumors and predominantly preventable risk factors for lung cancer.

Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: Systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE)

PubMed Central

Peñalvo, Jose L.; Khatibzadeh, Shahab; Singh, Gitanjali M.; Rao, Mayuree; Fahimi, Saman; Powles, John; Mozaffarian, Dariush

2017-01-01

Background Dietary habits are major contributors to coronary heart disease, stroke, and diabetes. However, comprehensive evaluation of etiologic effects of dietary factors on cardiometabolic outcomes, their quantitative effects, and corresponding optimal intakes are not well-established. Objective To systematically review the evidence for effects of dietary factors on cardiometabolic diseases, including comprehensively assess evidence for causality; estimate magnitudes of etiologic effects; evaluate heterogeneity and potential for bias in these etiologic effects; and determine optimal population intake levels. Methods We utilized Bradford-Hill criteria to assess probable or convincing evidence for causal effects of multiple diet-cardiometabolic disease relationships. Etiologic effects were quantified from published or de novo meta-analyses of prospective studies or randomized clinical trials, incorporating standardized units, dose-response estimates, and heterogeneity by age and other characteristics. Potential for bias was assessed in validity analyses. Optimal intakes were determined by levels associated with lowest disease risk. Results We identified 10 foods and 7 nutrients with evidence for causal cardiometabolic effects, including protective effects of fruits, vegetables, beans/legumes, nuts/seeds, whole grains, fish, yogurt, fiber, seafood omega-3s, polyunsaturated fats, and potassium; and harms of unprocessed red meats, processed meats, sugar-sweetened beverages, glycemic load, trans-fats, and sodium. Proportional etiologic effects declined with age, but did not generally vary by sex. Established optimal population intakes were generally consistent with observed national intakes and major dietary guidelines. In validity analyses, the identified effects of individual dietary components were similar to quantified effects of dietary patterns on cardiovascular risk factors and hard endpoints. Conclusions These novel findings provide a comprehensive summary of causal evidence, quantitative etiologic effects, heterogeneity, and optimal intakes of major dietary factors for cardiometabolic diseases, informing disease impact estimation and policy planning and priorities. PMID:28448503

Analyzing Recent Coronary Heart Disease Mortality Trends in Tunisia between 1997 and 2009

PubMed Central

Saidi, Olfa; Ben Mansour, Nadia; O’Flaherty, Martin; Capewell, Simon; Critchley, Julia A.; Romdhane, Habiba Ben

2013-01-01

Background In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing. Objective To explain recent CHD trends in Tunisia between 1997 and 2009. Methods Data Sources: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys. Analysis Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity). Results CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (−0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75). Conclusions Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive. PMID:23658808

Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation.

PubMed

Amsters, Delena; Schuurs, Sarita; Pershouse, Kiley; Power, Bettina; Harestad, Yvonne; Kendall, Melissa; Kuipers, Pim

2016-01-01

Interpersonal interactions and relationships can influence an individual's perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.

Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation

PubMed Central

Schuurs, Sarita; Power, Bettina; Harestad, Yvonne; Kuipers, Pim

2016-01-01

Interpersonal interactions and relationships can influence an individual's perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI. PMID:28127471

An outbreak of carbon monoxide poisoning after a major ice storm in Maine.

PubMed

Daley, W R; Smith, A; Paz-Argandona, E; Malilay, J; McGeehin, M

2000-01-01

Unintentional carbon monoxide (CO) exposure kills over 500 people in the U.S. annually. Outbreaks of CO poisoning have occurred after winter storms. The objective of this study was to describe clinical features and identify important risk factors of a CO poisoning outbreak occurring after a major ice storm. The study design included a case series of CO poisoning patients, a telephone survey of the general community, and a case-controlled study of households using specific CO sources. The setting was the primary service area of four hospital emergency departments located in the heavily storm-impacted interior region of Maine. Participants included all patients with a laboratory-confirmed diagnosis of CO poisoning during the 2 weeks after the storm onset, and a population-based comparison group of 522 households selected by random digit dialing. There were 100 cases identified, involving 42 common-source exposure incidents, most of them during the first week. Though classic CO symptoms of headache, dizziness, and nausea predominated, 9 patients presented with chest pain and 10 were asymptomatic. One patient died and 5 were transferred for hyperbaric oxygen therapy. Gasoline-powered electric generators were a CO source in 30 incidents, kerosene heaters in 8, and propane heaters in 4. In the community, 31.4% of households used a generator after the ice storm. The strongest risk factor for poisoning was locating a generator in a basement or an attached structure such as a garage. Cases of CO poisoning with various presentations can be expected in the early aftermath of a severe ice storm. Generators are a major CO source and generator location an important risk factor for such disasters.

Acute kidney injury post-major orthopaedic surgery: A single-Centre case-control study.

PubMed

Ying, Tracey; Chan, Samantha; Lane, Stephen; Somerville, Christine

2018-02-01

To identify risk factors for acute kidney injury following major orthopaedic surgery. We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use. We reviewed the patients' history of cardiovascular disease, chronic liver disease, hypertension and diabetes mellitus along with presence of sepsis and obesity. Associations of hypothetical risk factors were estimated using conditional logistic regression. We identified 164 cases of AKI in an elderly cohort (median age = 73 years). Controlling for baseline comorbidities, both diuretic and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use were found to be associated with a twofold risk of acute kidney injury (diuretic - OR 2.06 95% CI:1.30-3.26, P < 0.005, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use OR 2.09 95% CI:1.31-3.32, P < 0.005). A dose-effect model accounting for perioperative nonsteroidal anti-inflammatory drug administration demonstrated a linear relationship between the number of times these drugs were given and postoperative acute kidney injury risk (OR 1.35 95% CI:1.05-1.73, P = 0.02). We identified perioperative diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to be significantly associated with postoperative AKI. Further prospective studies are required to confirm this. © 2016 Asian Pacific Society of Nephrology.

Investigation of structural factors of safety for the space shuttle

NASA Technical Reports Server (NTRS)

1972-01-01

A study was made of the factors governing the structural design of the fully reusable space shuttle booster to establish a rational approach to select optimum structural factors of safety. The study included trade studies of structural factors of safety versus booster service life, weight, cost, and reliability. Similar trade studies can be made on other vehicles using the procedures developed. The major structural components of a selected baseline booster were studied in depth, each being examined to determine the fatigue life, safe-life, and fail-safe capabilities of the baseline design. Each component was further examined to determine its reliability and safety requirements, and the change of structural weight with factors of safety. The apparent factors of safety resulting from fatigue, safe-life, proof test, and fail-safe requirements were identified. The feasibility of reduced factors of safety for design loads such as engine thrust, which are well defined, was examined.

Genetic susceptibility to Grave's disease.

PubMed

Li, Hong; Chen, Qiuying

2013-06-01

The variety of clinical presentations of eye changes in patients with Graves' disease (GD) suggests that complex interactions between genetic, environmental, endogenous and local factors influence the severity of Graves' ophthalmopathy (GO). It is thought that the development of GO might be influenced by genetic factors and environmental factors, such as cigarette smoking. At present, however, the role of genetic factors in the development of GO is not known. On the basis of studies with candidate genes and other genetic approaches, several susceptibility loci in GO have been proposed, including immunological genes, human leukocyte antigen (HLA), cytotoxic T-lymphocyte antigen-4 (CTLA-4), regulatory T-cell genes and thyroid-specific genes. This review gives a brief overview of the current range of major susceptibility genes found for GD.

Animal models of aging research: implications for human aging and age-related diseases.

PubMed

Mitchell, Sarah J; Scheibye-Knudsen, Morten; Longo, Dan L; de Cabo, Rafael

2015-01-01

Aging is characterized by an increasing morbidity and functional decline that eventually results in the death of an organism. Aging is the largest risk factor for numerous human diseases, and understanding the aging process may thereby facilitate the development of new treatments for age-associated diseases. The use of humans in aging research is complicated by many factors, including ethical issues; environmental and social factors; and perhaps most importantly, their long natural life span. Although cellular models of human disease provide valuable mechanistic information, they are limited in that they may not replicate the in vivo biology. Almost all organisms age, and thus animal models can be useful for studying aging. Herein, we review some of the major models currently used in aging research and discuss their benefits and pitfalls, including interventions known to extend life span and health span. Finally, we conclude by discussing the future of animal models in aging research.

Factors influencing post abortion outcomes among high-risk patients in Zimbabwe.

PubMed

Mudokwenuy-Rawdon, C; Ehlers, V J; Bezuidenhout, M C

2005-11-01

Post abortion complications remain one of the major causes of mortality among women of child bearing age in Zimbabwe. Based on this problem, factors associated with mortalities due to abortion were investigated with the aim of improving post abortion outcomes for Zimbabwe's women, and possibly also for women of other African countries. Cases and controls were selected from 4895 post abortion records to conduct a retrospective case-control study. Significant risk factors identified for reducing mortalities due to post abortion complications included the administration of oxytocic drugs and evacuation of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. Women who died (cases) from post abortion complications apparently received better reported quantitative care than controls. Recommendations based on this research report include improved education of health care workers and enhanced in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe.

PAX3-FOXO1: Zooming in on an "undruggable" target.

PubMed

Wachtel, Marco; Schäfer, Beat W

2018-06-01

Driver oncogenes are prime targets for therapy in tumors many of which, including leukemias and sarcomas, express recurrent fusion transcription factors. One specific example for such a cancer type is alveolar rhabdomyosarcoma, which is associated in the majority of cases with the fusion protein PAX3-FOXO1. Since fusion transcription factors are challenging targets for development of small molecule inhibitors, indirect inhibitory strategies for this type of oncogenes represent a more promising approach. One can envision strategies at different molecular levels including upstream modifiers and activators, epigenetic and transcriptional co-regulators, and downstream effector targets. In this review, we will discuss the current knowledge regarding potential therapeutic targets that might contribute to indirect interference with PAX3-FOXO1 activity in alveolar rhabdomyosarcoma at the different molecular levels and extrapolate these findings to fusion transcription factors in general. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Constitutional Epi/Genetic Conditions: Genetic, Epigenetic, and Environmental Factors

PubMed Central

Schenkel, Laila C.; Rodenhiser, David; Siu, Victoria; McCready, Elizabeth; Ainsworth, Peter; Sadikovic, Bekim

2016-01-01

There are more than 4,000 phenotypes for which the molecular basis is at least partly known. Though defects in primary DNA structure constitute a major cause of these disorders, epigenetic disruption is emerging as an important alternative mechanism in the etiology of a broad range of congenital and developmental conditions. These include epigenetic defects caused by either localized (in cis) genetic alterations or more distant (in trans) genetic events but can also include environmental effects. Emerging evidence suggests interplay between genetic and environmental factors in the epigenetic etiology of several constitutional “epi/genetic” conditions. This review summarizes our broadening understanding of how epigenetics contributes to pediatric disease by exploring different classes of epigenomic disorders. It further challenges the simplistic dogma of “DNA encodes RNA encodes protein” to best understand the spectrum of factors that can influence genetic traits in a pediatric population. PMID:28180025

Diel activity patterns of major species of adult mosquitoes and ULV spraying impacts in St. John's County, Florida

USDA-ARS?s Scientific Manuscript database

Knowledge of daily activity patterns in adult mosquitoes can be used to determine the best time to apply adulticides for mosquito control. Many factors influence these activity patterns, including migration, hormonal cycles in the mosquito, hunger, and the need to lay eggs. In this study, FL scien...

Implications of Therapist Effects for the Design and Analysis of Comparative Studies of Psychotherapies.

ERIC Educational Resources Information Center

Crits-Christoph, Paul; Mintz, Jim

1991-01-01

Presents reasons therapist should be included as random design factor in nested analysis of (co)variance (AN[C]OVA) design used in psychotherapy research. Reviews studies which indicate majority of investigators ignore issue of effects from incorrect specification of ANOVA design. Presents reanalysis of data from 10 psychotherapy outcome studies…

Revisiting a Cognitive Framework for Test Design: Applications for a Computerized Perceptual Speed Test.

ERIC Educational Resources Information Center

Alderton, David L.

This paper highlights the need for a systematic, content aware, and theoretically-based approach to test design. The cognitive components approach is endorsed, and is applied to the development of a computerized perceptual speed test. Psychometric literature is reviewed and shows that: every major multi-factor theory includes a clerical/perceptual…

Rapid discovery of SNPs differentiating hatchery steelhead trout from ESA-listed wild steelhead trout using a 57K SNP array

USDA-ARS?s Scientific Manuscript database

Natural-origin steelhead in the Pacific Northwest USA are threatened by a number of factors including habitat destruction, disease, decline in marine survival and a potential erosion of genetic viability due to introgression from hatchery strains. The major goal of this study was to use a recently ...

A Cardiovascular Risk Reduction Program for American Indians with Metabolic Syndrome: The Balance Study

ERIC Educational Resources Information Center

Lee, Elisa T.; Jobe, Jared B.; Yeh, Jeunliang; Ali, Tauqeer; Rhoades, Everett R.; Knehans, Allen W.; Willis, Diane J.; Johnson, Melanie R.; Zhang, Ying; Poolaw, Bryce; Rogers, Billy

2012-01-01

The Balance Study is a randomized controlled trial designed to reduce cardiovascular disease (CVD) risk in 200 American Indian (AI) participants with metabolic syndrome who reside in southwestern Oklahoma. Major risk factors targeted include weight, diet, and physical activity. Participants are assigned randomly to one of two groups, a guided or a…

The Synthesis of 2-acetyl-1,4-naphthoquinone: A Multi-step Synthesis.

ERIC Educational Resources Information Center

Green, Ivan R.

1982-01-01

Outlines 2 procedures for synthesizing 2-acetyl-1,4-naphthoquinone to compare relative merits of the two pathways. The major objective of the exercise is to demonstrate that certain factors should be considered when selecting a pathway for synthesis including availability of starting materials, cost of reagents, number of steps involved,…

A survey of Black Connecticut High School Graduates Attending Out-of State Colleges and Universities

ERIC Educational Resources Information Center

Lyons, James E.

1974-01-01

It was found that a strong desire to leave the state of Connecticut was a major force in black students attending out of state colleges and universities. Other contributory factors included the Connecticut schools lengthy admissions evaluations, the structure of some compensatory education programs, a non-competitive financial aid program and the…

Racial Bullying and Victimization in Canadian School-Aged Children: Individual and School Level Effects

ERIC Educational Resources Information Center

Larochette, Anne-Claire; Murphy, Ashley Nicole; Craig, Wendy M.

2010-01-01

Numerous individual factors, including race, have been identified to date that may place children at risk for bullying involvement. The importance of the school's environment on bullying behaviours has also been highlighted, as the majority of bullying occurs at school. The variables associated with racial bullying and victimization, however, have…

75 FR 23303 - Chlorinated Isocyanurates From China and Spain

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... output of the Domestic Like Product constitutes a major proportion of the total domestic production of... Commission conducts under Title VII of the Act, or in internal audits and investigations relating to the... various factors specified in section 752(a) of the Act (19 U.S.C. 1675a(a)) including the likely volume of...

The human factor: Biomedicine in the manned space program to 1980

NASA Technical Reports Server (NTRS)

Pitts, J. A.

1985-01-01

The purpose of this publication is to provide NASA personnel, NASA managers, and the biomedical and historical research communities a well-documented, historical summary of the content and organization of NASA's biomedical programs from Project Mercury up to the Shuttle program. The publication includes not only a major narrative portion, but appendixes and reference notes.

The Influence of the Intermediary System of Cognition on Vocabulary Acquisition for Chinese English-Majors

ERIC Educational Resources Information Center

Luo, Yanyan

2009-01-01

In the article, the author tries to find out the main factors that affect the subject's vocabulary acquisition by an investigation. It is concluded that vocabulary acquisition models and strategies are something external, what really works upon vocabulary acquisition is the intermediary system of cognition including the knowledge structure and…

Creating a Realistic IT Vision: The Roles and Responsibilities of a Chief Information Officer.

ERIC Educational Resources Information Center

Penrod, James I.

2003-01-01

Discusses the crucial position of the chief information officer (CIO) at higher education institutions and reviews the six major stages of information technology (IT) planning. Includes fundamental elements related to an IT vision; roles of the CIO; the six-stage planning model for a realistic IT vision; and factors for success. (AEF)

Adolescent Diet and Time Use Clusters and Associations with Overweight and Obesity and Socioeconomic Position

ERIC Educational Resources Information Center

Ferrar, Katia; Golley, Rebecca

2015-01-01

Risk factors for adolescent overweight and obesity include low levels of physical activity, high levels of sedentary behavior, low fruit and vegetable intake, and low socioeconomic position (SEP). To date, the vast majority of research investigating associations between lifestyle behaviors and weight status analyze dietary and time use factors…

Exploration of Healthy Eating Education and Consumption of Various Foods of College Students in a Small Liberal Arts College

ERIC Educational Resources Information Center

Miller, Patricia Bederman; Anthony, Dorothy; Yarrish, Karen K.

2013-01-01

Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer (World Health Organization, 2011; National Institutes of Health, 1998). Children with high BMI often become obese adults (Serdula, Ivery, Coates, Freedman, Williamson, & Byers, 1993). According to the World…

"Are All Beliefs Equal?" Investigating the Nature and Determinants of Parental Attitudinal Beliefs towards Educational Inclusion

ERIC Educational Resources Information Center

Sosu, Edward M.; Rydzewska, Ewelina

2017-01-01

This study explores the nature of parental attitudinal beliefs towards educational inclusion and the factors that determine these beliefs. Participants were drawn from the Growing Up in Scotland Survey (N = 2200). Results indicate that majority of parents held positive generalised belief towards including children with additional support needs…

English Proficiency and Admission and Graduation of Post-Secondary Students at a Puerto Rican University

ERIC Educational Resources Information Center

Alea, Jamie

2009-01-01

This dissertation has examined English proficiency as a mediating social factor within the occupational structure of Puerto Rico. It included an analysis of the educational records of 641 students majoring in industrial engineering, nursing, education and finance of the University of Puerto Rico, Mayaguez from 1998-2000. The investigation…

Demographic Correlates of Constant Condom Use among Sex Workers in Tangail, Dhaka, Bangladesh

ERIC Educational Resources Information Center

Eva, Nilufar Akter; Munakata, Tsunetsugu; Onuoha, Francis N.

2007-01-01

Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n…

A Review of the Short Life of the U.S. Open University

ERIC Educational Resources Information Center

Krenelka, Lynette M.

2009-01-01

This article presents the findings of a single case study of the United States Open University (USOU), including factors affecting its demise and success. Interviews were conducted with administrators, board members, associate faculty, and staff who played a major role in the planning and operation of the USOU, and pertinent documents were…

Factors Influencing Student Prerequisite Preparation for and Subsequent Performance in College Chemistry Two: A Statistical Investigation

ERIC Educational Resources Information Center

Easter, David C.

2010-01-01

For students entering Chemistry Two following a Chemistry One course, an assessment exam was given and the results were evaluated in combination with other variables to develop a predictive model that forecasts student achievement in the course. Variables considered in the analysis included student major, GPA, classification (student standing:…

Mothers Who Formula Feed: Their Practices, Support Needs and Factors Influencing Their Infant Feeding Decision

ERIC Educational Resources Information Center

Tarrant, Roslyn C.; Sheridan-Pereira, Margaret; McCarthy, Roberta A.; Younger, Katherine M.; Kearney, John M.

2013-01-01

The majority of mothers in Ireland provide formula milk to their infants during the initial weeks postpartum; however, data are lacking on their formula feeding practices and support needs. This prospective Dublin-based observational study, which included 450 eligible mother-term infant pairs recruited and followed up to six months postpartum,…

Private Supplementary Tutoring: Comparative Perspectives on Patterns and Implications

ERIC Educational Resources Information Center

Bray, Mark

2006-01-01

Private supplementary tutoring has long been a major phenomenon in parts of East Asia, including Japan, Hong Kong, South Korea and Taiwan. In recent times it has grown dramatically in other parts of Asia and in Africa, Europe and North America. The factors underlying the growth of private tutoring vary, but in all settings it has major…

Regional patterns of major nonnative invasive plants and associated factors in upper Midwest forests

Treesearch

Zhaofei Fan; W. Keith Moser; Mark H. Hansen; Mark D. Nelson

2013-01-01

Nonnative invasive plants (IPs) are rapidly spreading into natural ecosystems (e.g., forests and grasslands). Potential threats of IP invasion into natural ecosystems include biodiversity loss, structural and environmental change, habitat degradation, and economic losses. The Upper Midwest of the United States encompasses the states of Illinois, Indiana, Iowa, Michigan...

Implications of Demographic Change for the Design of Retirement Programs.

ERIC Educational Resources Information Center

Biggs, John H.

1994-01-01

The influences that demographic changes may have on the design of private pension plans in the twenty-first century are examined. Major demographic factors to be considered include the aging of the population, declining mortality rate, potential for an even lower mortality rate, improved health for all ages and especially for older workers, and…

Leptin, Insulin, and Cinnamon Polyphenols Attenuate Glial Swelling and Mitochondrial Dysfunction in Ischemic Injury

USDA-ARS?s Scientific Manuscript database

Obesity is a major risk factor for stroke, and tissue injury following a stroke may be more severe in the obese. A key feature of obesity is increased serum levels of obesity-related hormones including leptin and insulin, indicating a state of resistance to these hormones. Insulin resistance is gen...

New monoclonal antibodies against a novel subtype of Shiga toxin 1 produced by Enterobacter cloacae and their use in analysis of human serum

USDA-ARS?s Scientific Manuscript database

Shiga toxin (Stx) is a major virulence factor for several bacterial pathogens that cause potentially fatal illness, including Escherichia coli and Shigella spp. The continual emergence of new subtypes of Stxs presents challenges in clinical diagnosis of infections caused by Shiga toxin-producing org...

Effect of urbanization on the structure and functional traits of remnant subtropical evergreen broad-leaved forests in South China

Treesearch

Liujing Huang; Hongfeng Chen; Hai Ren; Jun Wang; Qinfeng Guo

2013-01-01

We investigated the effects of major environmental drivers associated with urbanization on species diversity and plant functional traits (PFTs) in the remnant subtropical evergreen broad-leaved forests in Metropolitan Guangzhou (Guangdong, China). Twenty environmental factors including topography, light, and soil properties were used to quantify the effects of...

Direct oral anticoagulant use in patients with thrombophilia, antiphospholipid syndrome or venous thrombosis of unusual sites: A narrative review.

PubMed

Bertoletti, Laurent; Benhamou, Ygal; Béjot, Yannick; Marechaux, Sylvestre; Cheggour, Saida; Aleil, Boris; Lellouche, Nicolas; Dillinger, Jean-Guillaume; Delluc, Aurélien

2018-07-01

Direct oral anticoagulants (DOACs) are indicated in the treatment and prevention of venous thromboembolism (VTE). However, the use of DOACs in unusual VTE, including cerebral venous thrombosis (CVT) and splanchnic venous thrombosis (SVT), and in patients with biological thrombophilia including minor thrombophilia (Factor V Leiden and prothrombin G20210A), major innate thrombophilia (protein C and S deficiency, and antithrombin) and major acquired thrombophilia (antiphospholipid syndrome [APS]), remains controversial due to the paucity of available data. There are some reports of DOACs use in the initial treatment or long-term maintenance of patients with either CVT or SVT, but their efficacy remains unclear. The efficacy of DOACs may be suitable in patients with biological minor or major thrombophilia. The use of DOACs for the long-term maintenance of patients with APS is more contentious. Randomized clinical trials, which are currently underway, should offer definitive insight into the efficacy and safety profiles of DOACs in these patient populations. Copyright © 2018. Published by Elsevier Ltd.

The fate of human remains in a maritime context and feasibility for forensic humanitarian action to assist in their recovery and identification.

PubMed

Ellingham, Sarah Theresa Dorothea; Perich, Pierre; Tidball-Binz, Morris

2017-10-01

The number of annual maritime fatalities reported in the Mediterranean has more than doubled in the last two years, a phenomenon closely linked to the increase of migrants attempting to reach Europe via the Mediterranean. The majority of victims reportedly never gets recovered, which in part relates to the fact that the mechanisms and interaction of factors affecting marine taphonomy are still largely not understood. These factors include intrinsic factors such as whether the individual was alive or dead at the time of submergence, the individual's stature and clothing, as well as extrinsic factors such including ambient temperature, currents, water depth, salinity and oxygen levels. This paper provides a compilation of the current literature on factors influencing marine taphonomy, recovery and identification procedures for submerged remains, and discusses the implications for the retrieval and identification of maritime mass fatalities as part of the humanitarian response, specifically humanitarian forensic action, to the consequences of the current migration phenomenon. Copyright © 2017. Published by Elsevier B.V.

The incidence and risk factors of meningitis after major craniotomy in China: a retrospective cohort study.

PubMed

Chen, Chen; Zhang, Bingyan; Yu, Shenglei; Sun, Feng; Ruan, Qiaoling; Zhang, Wenhong; Shao, Lingyun; Chen, Shu

2014-01-01

Meningitis after neurosurgery can result in severe morbidity and high mortality. Incidence varies among regions and limited data are focused on meningitis after major craniotomy. This retrospective cohort study aimed to determine the incidence, risk factors and microbiological spectrum of postcraniotomy meningitis in a large clinical center of Neurosurgery in China. Patients who underwent neurosurgeries at the Department of Neurosurgery in Huashan Hospital, the largest neurosurgery center in Asia and the Pacific, between 1st January and 31st December, 2008 were selected. Individuals with only shunts, burr holes, stereotactic surgery, transsphenoidal or spinal surgery were excluded. The complete medical records of each case were reviewed, and data on risk factors were extracted and evaluated for meningitis. A total of 65 meningitides were identified among 755 cases in the study, with an incidence of 8.60%. The risk of meningitis was increased by the presence of diabetes mellitus (odds ratio [OR], 6.27; P = 0.009), the use of external ventricular drainage (OR, 4.30; P = 0.003) and the use of lumbar drainage (OR, 17.23; P<0.001). The isolated microorganisms included Acinetobacter baumannii, Enterococcus sp, Streptococcus intermedius and Klebsiella pneumonia. Meningitis remains an important source of morbidity and mortality after major craniotomy. Diabetic patients or those with cerebral spinal fluid shunts carry significant high risk of infection. Thus, identification of the risk factors as soon as possible will help physicians to improve patient care.

The Incidence and Risk Factors of Meningitis after Major Craniotomy in China: A Retrospective Cohort Study

PubMed Central

Yu, Shenglei; Sun, Feng; Ruan, Qiaoling; Zhang, Wenhong; Shao, Lingyun; Chen, Shu

2014-01-01

Background Meningitis after neurosurgery can result in severe morbidity and high mortality. Incidence varies among regions and limited data are focused on meningitis after major craniotomy. Aim This retrospective cohort study aimed to determine the incidence, risk factors and microbiological spectrum of postcraniotomy meningitis in a large clinical center of Neurosurgery in China. Methods Patients who underwent neurosurgeries at the Department of Neurosurgery in Huashan Hospital, the largest neurosurgery center in Asia and the Pacific, between 1stJanuary and 31st December, 2008 were selected. Individuals with only shunts, burr holes, stereotactic surgery, transsphenoidal or spinal surgery were excluded. The complete medical records of each case were reviewed, and data on risk factors were extracted and evaluated for meningitis. Results A total of 65 meningitides were identified among 755 cases in the study, with an incidence of 8.60%. The risk of meningitis was increased by the presence of diabetes mellitus (odds ratio [OR], 6.27; P = 0.009), the use of external ventricular drainage (OR, 4.30; P = 0.003) and the use of lumbar drainage (OR, 17.23; P<0.001). The isolated microorganisms included Acinetobacter baumannii, Enterococcus sp, Streptococcus intermedius and Klebsiella pneumonia. Conclusions Meningitis remains an important source of morbidity and mortality after major craniotomy. Diabetic patients or those with cerebral spinal fluid shunts carry significant high risk of infection. Thus, identification of the risk factors as soon as possible will help physicians to improve patient care. PMID:25003204

Variations in hospitals costs for surgical procedures: inefficient care or sick patients?

PubMed

Gani, Faiz; Hundt, John; Daniel, Michael; Efron, Jonathan E; Makary, Martin A; Pawlik, Timothy M

2017-01-01

Reducing unwanted variations has been identified as an avenue for cost containment. We sought to characterize variations in hospital costs after major surgery and quantitate the variability attributable to the patient, procedure, and provider. A total of 22,559 patients undergoing major surgical procedure at a tertiary-care center between 2009 and 2013 were identified. Hierarchical linear regression analysis was performed to calculate risk-adjusted fixed, variable and total costs. The median cost of surgery was $23,845 (interquartile ranges, 13,353 to 43,083). Factors associated with increased costs included insurance status (Medicare vs private; coefficient: 14,934; 95% CI = 12,445.7 to 17,422.5, P < .001), preoperative comorbidity (Charlson Comorbidity Index = 1; coefficient: 10,793; 95% CI = 8,412.7 to 13,174.2; Charlson Comorbidity Index ≥2; coefficient: 24,468; 95% CI = 22,552.7 to 26,383.6; both P < .001) and the development of a postoperative complication (coefficient: 58,624.1; 95% CI = 56,683.6 to 60,564.7; P < .001). Eighty-six percent of total variability was explained by patient-related factors, whereas 8% of the total variation was attributed to surgeon practices and 6% due to factors at the level of surgical specialty. Although inpatient costs varied markedly between procedures and providers, the majority of variation in costs was due to patient-level factors and should be targeted by future cost containment strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

Monogenic Disorders of Adrenal Steroidogenesis.

PubMed

Baranowski, Elizabeth S; Arlt, Wiebke; Idkowiak, Jan

2018-06-06

Disorders of adrenal steroidogenesis comprise autosomal recessive conditions affecting steroidogenic enzymes of the adrenal cortex. Those are located within the 3 major branches of the steroidogenic machinery involved in the production of mineralocorticoids, glucocorticoids, and androgens. This mini review describes the principles of adrenal steroidogenesis, including the newly appreciated 11-oxygenated androgen pathway. This is followed by a description of pathophysiology, biochemistry, and clinical implications of steroidogenic disorders, including mutations affecting cholesterol import and steroid synthesis, the latter comprising both mutations affecting steroidogenic enzymes and co-factors required for efficient catalysis. A good understanding of adrenal steroidogenic pathways and their regulation is crucial as the basis for sound management of these disorders, which in the majority present in early childhood. © 2018 The Author(s) Published by S. Karger AG, Basel.

Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients.

PubMed

Brunault, Paul; Champagne, Anne-Laure; Huguet, Grégoire; Suzanne, Isabelle; Senon, Jean-Louis; Body, Gilles; Rusch, Emmanuel; Magnin, Guillaume; Voyer, Mélanie; Réveillère, Christian; Camus, Vincent

2016-05-01

Our aim was to identify risk factors for lower quality of life (QOL) in non-metastatic breast cancer patients. Our study included 120 patients from the University Hospital Centers of Tours and Poitiers. This cross-sectional study was conducted 7 months after patients' breast cancer diagnosis and assessed QOL (Quality of Life Questionnaire Core 30 = QLQ-C30), socio-demographic characteristics, coping strategies (Brief-COPE), physiological and biological variables (e.g., initial tumor severity and types of treatment received), the existence of major depressive disorder (Mini International Neuropsychiatric Interview), and pain severity (Questionnaire de Douleur Saint Antoine). We assessed personality disorders 3 months after diagnosis (Vragenlijst voor Kenmerken van de Persoonlijkheid questionnaire). We used multiple linear regression models to determine which factors were associated with physical, emotional, and global QOL. Lower physical QOL was associated with major depressive disorder, younger age, a more severe initial tumor stage, and the use of the behavioral disengagement coping. Lower emotional QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, and lower use of acceptance coping strategies. Lower global QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, lower use of positive reframing coping strategies, and an absence of hormone therapy. Lower QOL scores were more strongly associated with variables related to the individual's premorbid psychological characteristics and the manner in which this individual copes with the cancer (e.g., depression, personality, and coping) than to cancer-related variables (e.g., treatment types and cancer severity). Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Factors influencing infant/child mortality in Bangladesh: implication for family planning programs and policies.

PubMed

Miah, M M

1993-01-01

"This study examined a host of socio-economic and demographic factors (including their interactions) that determine infant/child mortality of married women at the different parity levels in Bangladesh [using data from] a multivariate analysis of the 1975-76 Bangladesh Fertility Survey.... The major hypothesis of this research is that the higher the level of fertility of a married woman, the higher will be her experience of infant/child mortality. However, a woman's family planning practice may interact with fertility and affect the total infant/child deaths...." excerpt

Factors influencing aircraft ground handling performance

NASA Technical Reports Server (NTRS)

Yager, T. J.

1983-01-01

Problems associated with aircraft ground handling operations on wet runways are discussed and major factors which influence tire/runway braking and cornering traction capability are identified including runway characteristics, tire hydroplaning, brake system anomalies, and pilot inputs. Research results from tests with instrumented ground vehicles and aircraft, and aircraft wet runway accident investigation are summarized to indicate the effects of different aircraft, tire, and runway parameters. Several promising means are described for improving tire/runway water drainage capability, brake system efficiency, and pilot training to help optimize aircraft traction performance on wet runways.

Impact of revascularization and factors associated with limb salvage in patients with diabetic foot.

PubMed

Hinojosa, Carlos A; Boyer-Duck, Estefanía; Anaya-Ayala, Javier E; Núñez-Salgado, Ana E; Laparra-Escareno, Hugo; Lizola, René

2018-01-01

Diabetic foot is a common cause of hospitalization. To examine the impact of revascularization on lower limb salvage. Retrospective study of diabetic patients with foot ulcers. The extent of tissue loss was assessed according to the PEDIS and Wagner classifications, and revascularization indications and techniques were evaluated. Factors involved with major amputation and limb salvage were assessed with Fisher's and chi-square tests. A total of 307 patients with a mean age of 61 years were included in the study; 198 (64%) were males; 53 (17%) underwent limb revascularization, 26 (8%) with endovascular techniques and 27 (9%) with open surgery; 27 belonged to PEDIS grade 3 (51%) and 21 (41%) to Wagner's classification grade 4; 52% of revascularized patients required major amputation versus 25% of those without revascularization. Comorbidities, demographic variables, complications and mortality showed no differences when patients who required major amputation were compared with those who didn't. Despite revascularization, the limb was preserved in less than 50% of patients. Early referral to vascular surgery and appropriate patient-selection criteria might increase limb salvage. Copyright: © 2018 SecretarÍa de Salud.

Cellular and molecular mechanisms of alcohol-induced osteopenia.

PubMed

Luo, Zhenhua; Liu, Yao; Liu, Yitong; Chen, Hui; Shi, Songtao; Liu, Yi

2017-12-01

Alcoholic beverages are widely consumed, resulting in a staggering economic cost in different social and cultural settings. Types of alcohol consumption vary from light occasional to heavy, binge drinking, and chronic alcohol abuse at all ages. In general, heavy alcohol consumption is widely recognized as a major epidemiological risk factor for chronic diseases and is detrimental to many organs and tissues, including bones. Indeed, recent findings demonstrate that alcohol has a dose-dependent toxic effect in promoting imbalanced bone remodeling. This imbalance eventually results in osteopenia, an established risk factor for osteoporosis. Decreased bone mass and strength are major hallmarks of osteopenia, which is predominantly attributed not only to inhibition of bone synthesis but also to increased bone resorption through direct and indirect pathways. In this review, we present knowledge to elucidate the epidemiology, potential pathogenesis, and major molecular mechanisms and cellular effects that underlie alcoholism-induced bone loss in osteopenia. Novel therapeutic targets for correcting alcohol-induced osteopenia are also reviewed, such as modulation of proinflammatory cytokines and Wnt and mTOR signaling and the application of new drugs.

Diffraction analysis of sidelobe characteristics of optical elements with ripple error

NASA Astrophysics Data System (ADS)

Zhao, Lei; Luo, Yupeng; Bai, Jian; Zhou, Xiangdong; Du, Juan; Liu, Qun; Luo, Yujie

2018-03-01

The ripple errors of the lens lead to optical damage in high energy laser system. The analysis of sidelobe on the focal plane, caused by ripple error, provides a reference to evaluate the error and the imaging quality. In this paper, we analyze the diffraction characteristics of sidelobe of optical elements with ripple errors. First, we analyze the characteristics of ripple error and build relationship between ripple error and sidelobe. The sidelobe results from the diffraction of ripple errors. The ripple error tends to be periodic due to fabrication method on the optical surface. The simulated experiments are carried out based on angular spectrum method by characterizing ripple error as rotationally symmetric periodic structures. The influence of two major parameter of ripple including spatial frequency and peak-to-valley value to sidelobe is discussed. The results indicate that spatial frequency and peak-to-valley value both impact sidelobe at the image plane. The peak-tovalley value is the major factor to affect the energy proportion of the sidelobe. The spatial frequency is the major factor to affect the distribution of the sidelobe at the image plane.

Factors That Matter to Low-Income and Racial/Ethnic Minority Mothers When Choosing a Pediatric Practice: a Mixed Methods Analysis.

PubMed

Goff, Sarah L; Mazor, Kathleen M; Guhn-Knight, Haley; Budway, Yara Youssef; Murphy, Lorna; White, Katharine O; Lagu, Tara; Pekow, Penelope S; Priya, Aruna; Lindenauer, Peter K

2017-12-01

Pediatric practices' scores on healthcare quality measures are increasingly available to the public. However, patients from low-income and racial/ethnic minority populations rarely use these data. We sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice. As part of a randomized trial to overcome barriers to using quality data, we recruited women from a prenatal clinic serving an underserved population. Women reported how much 12 factors mattered when they chose a pediatric practice (5-point Likert scale), what other factors mattered to them, and which factors mattered the most. We assessed whether factor importance varied with selected participant characteristics and qualitatively analyzed the "other" factors named. Participants' (n = 367) median age was 23 years, and they were largely Hispanic (60.4%), white (21.2%), or black (16.9%). Insurance acceptance "mattered a lot" to the highest percentage of women (93.2%), while online information about what other parents think of a practice "mattered a lot" to the fewest (7.4%). Major themes from our qualitative analysis of "other" factors that mattered included physicians' interpersonal skills and pediatrician-specific traits. Factors related to access "mattered the most" to the majority of women. Pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics. Aligning both the content and delivery of publicly reported quality data with women's interests may increase use of pediatric quality data. Clinicaltrials.gov NCT01784575.

Source apportionment of particulate matter and trace gases near a major refinery near the Houston Ship Channel

NASA Astrophysics Data System (ADS)

Wallace, Henry W.; Sanchez, Nancy P.; Flynn, James H.; Erickson, Mathew H.; Lefer, Barry L.; Griffin, Robert J.

2018-01-01

From February 7 to 27, 2015, a mobile air quality laboratory was deployed to a location proximate to a major refinery, the Port of Houston, and several neighborhoods to conduct measurements of atmospheric trace gases and particulate matter. Two statistical models were utilized to apportion the sources of pollution impacting this site and the denizens of the nearby neighborhoods. Positive matrix factorization (PMF) was performed on the organic signal of the aerosol mass spectra, resulting in five factors totaling an average of 4.1 μg/m3 of the organic aerosol: hydrocarbon-like (0.67 μg/m3), cooking (0.35 μg/m3) biomass burning (1.14 μg/m3), low-volatility oxidized (1.15 μg/m3), and semi-volatile oxidized (0.78 μg/m3). Principal component analysis was performed on daytime and nighttime data, including concentrations from PMF output, of other PM1 components, and of trace gases. This generated five daytime and five nighttime factors that explained 74.5% and 73.0% of the variance, respectively. The most important factors impacting this site were from mobile source exhaust and petrochemical aromatic compound emissions. Together these two factors also constitute most of the observed carcinogens.

Source apportionment of PM2.5 at urban and suburban areas of the Pearl River Delta region, south China - With emphasis on ship emissions.

PubMed

Tao, Jun; Zhang, Leiming; Cao, Junji; Zhong, Liuju; Chen, Dongsheng; Yang, Yihong; Chen, Duohong; Chen, Laiguo; Zhang, Zhisheng; Wu, Yunfei; Xia, Yunjie; Ye, Siqi; Zhang, Renjian

2017-01-01

Daily PM 2.5 samples were collected at an urban site in Guangzhou in 2014 and at a suburban site in Zhuhai in 2014-2015. Samples were subject to chemical analysis for various chemical components including organic carbon (OC), element carbon (EC), major water-soluble inorganic ions, and trace elements. The annual average PM 2.5 mass concentration was 48±22μgm -3 and 45±25μgm -3 in Guangzhou and Zhuhai, respectively, with the highest seasonal average concentration in winter and the lowest in summer at both sites. Regional transport of pollutants accompanied with different air mass origins arriving at the two sites and pollution sources in between the two cities caused larger seasonal variations in Zhuhai (>a factor of 3.5) than in Guangzhou (17% of PM 2.5 mass concentrations. Copyright © 2016 Elsevier B.V. All rights reserved.

Impact of major depressive disorder, distinct subtypes, and symptom severity on lifestyle in the BiDirect Study.

PubMed

Rahe, Corinna; Khil, Laura; Wellmann, Jürgen; Baune, Bernhard T; Arolt, Volker; Berger, Klaus

2016-11-30

The aim of this study was to examine associations of major depressive disorder (MDD), its distinct subtypes, and symptom severity with the individual lifestyle factors smoking, diet quality, physical activity, and body mass index as well as with a combined lifestyle index measuring the co-occurrence of these lifestyle factors. A sample of 823 patients with MDD and 597 non-depressed controls was examined. The psychiatric assessment was based on a clinical interview including the Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale. Each lifestyle factor was scored as either healthy or unhealthy, and the number of unhealthy lifestyle factors was added up in a combined lifestyle index. Cross-sectional analyses were performed using alternating logistic regression and ordinal logistic regression, adjusted for socio-demographic characteristics. After adjustment, MDD was significantly associated with smoking, low physical activity, and overweight. Likewise, MDD was significantly related to the overall lifestyle index. When stratifying for subtypes, all subtypes showed higher odds for an overall unhealthier lifestyle than controls, but the associations with the individual lifestyle factors were partly different. Symptom severity was associated with the lifestyle index in a dose-response manner. In conclusion, patients with MDD represent an important target group for lifestyle interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Analysis of Complaints from Patients During Mechanical Ventilation After Cardiac Surgery: A Retrospective Study.

PubMed

Wang, Yi; Li, Hua; Zou, Honglin; Li, Yaxiong

2015-08-01

This study analyzed major complaints from patients during mechanical ventilation after cardiac surgery and identified the most common complaints to reduce adverse psychologic responses. Retrospective. A single tertiary university hospital. Patients with heart disease who were on mechanical ventilation after cardiac surgery (N = 800). The major complaints of the patients during mechanical ventilation after cardiac surgery were analyzed. Patients' comfort was evaluated using a visual analog scale, and the factors affecting comfort were analyzed. The average visual analog scale score in all patients was 5.8±2.0, and most patients presented moderate discomfort. The factors affecting comfort included dry mouth, thirst, tracheal intubation, aspiration of sputum, communication barriers, limited mobility, fear/anxiety, patient-ventilator dyssynchrony, and poor environmental conditions. Of these factors, 8 were independent predictors of the visual analog scale score. Patients considered mechanical ventilation to be the worst part of their hospitalization. The study identified 8 independent factors causing discomfort in patients during mechanical ventilation after cardiac surgery. Clinicians should take appropriate measures and implement nursing interventions to reduce suffering, physical and psychologic trauma, and adverse psychologic responses and to promote recovery. Copyright © 2015 Elsevier Inc. All rights reserved.

Burden of Noncommunicable Diseases and National Strategies to Control Them in Korea

PubMed Central

2013-01-01

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea. PMID:23946873

Voltage Controller

NASA Technical Reports Server (NTRS)

1997-01-01

Power Efficiency Corporation, specifically formed to manufacture and develop products from NASA technology, has a license to a three-phase power factor controller originally developed by Frank Nola, an engineer at Marshall Space Flight Center. Power Efficiency and two major distributors, Performance Control and Edison Power Technologies, use the electronic control boards to assemble three different motor controllers: Power Commander, Performance Controller, and Energy Master. The company Power Factor Controller reduces excessive energy waste in AC induction motors. It is used in industries and applications where motors operate under variable loads, including elevators and escalators, machine tools, intake and exhaust fans, oil wells, conveyors, pumps, die casting, and compressors. Customer lists include companies such as May Department Stores, Caesars Atlantic City, Ford Motors, and American Axle.

Infectious Diseases Associated With Organized Sports and Outbreak Control.

PubMed

Davies, H Dele; Jackson, Mary Anne; Rice, Stephen G

2017-10-01

Participation in organized sports has a variety of health benefits but also has the potential to expose the athlete to a variety of infectious diseases, some of which may produce outbreaks. Major risk factors for infection include skin-to-skin contact with athletes who have active skin infections, environmental exposures and physical trauma, and sharing of equipment and contact with contaminated fomites. Close contact that is intrinsic to team sports and psychosocial factors associated with adolescence are additional risks. Minimizing risk requires leadership by the organized sports community (including the athlete's primary care provider) and depends on outlining key hygiene behaviors, recognition, diagnosis, and treatment of common sports-related infections, and the implementation of preventive interventions. Copyright © 2017 by the American Academy of Pediatrics.

Carbon Nanotubes in Biomedical Applications: Factors, Mechanisms, and Remedies of Toxicity.

PubMed

Alshehri, Reem; Ilyas, Asad Muhammad; Hasan, Anwarul; Arnaout, Adnan; Ahmed, Farid; Memic, Adnan

2016-09-22

Carbon nanotubes (CNTs) represent one of the most studied allotropes of carbon. The unique physicochemical properties of CNTs make them among prime candidates for numerous applications in biomedical fields including drug delivery, gene therapy, biosensors, and tissue engineering applications. However, toxicity of CNTs has been a major concern for their use in biomedical applications. In this review, we present an overview of carbon nanotubes in biomedical applications; we particularly focus on various factors and mechanisms affecting their toxicity. We have discussed various parameters including the size, length, agglomeration, and impurities of CNTs that may cause oxidative stress, which is often the main mechanism of CNTs' toxicity. Other toxic pathways are also examined, and possible ways to overcome these challenges have been discussed.

The eye in sleep apnea syndrome.

PubMed

Abdal, Helen; Pizzimenti, Joseph J; Purvis, Cheryl C

2006-03-01

Sleep apnea syndrome (SAS) is a disease characterized by recurrent complete or partial upper airway obstructions during sleep. The majority of patients with SAS demonstrate this obstruction either at the nasopharynx or the oropharynx. Risk factors for SAS include obesity, male gender, upper airway abnormalities, alcohol use, snoring, and neck girth of more than 17 in. in men or 16 in. in women. Reported ophthalmic findings in patients with SAS include floppy eyelid syndrome (FES), glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION).

Ballistic intercept missions to Comet Encke

NASA Technical Reports Server (NTRS)

Mumma, M. (Compiler)

1975-01-01

The optimum ballistic intercept of a spacecraft with the comet Encke is determined. The following factors are considered in the analysis: energy requirements, encounter conditions, targeting error, comet activity, spacecraft engineering requirements and restraints, communications, and scientific return of the mission. A baseline model is formulated which includes the basic elements necessary to estimate the scientific return for the different missions considered. Tradeoffs which have major impact on the cost and/or scientific return of a ballistic mission to comet Encke are identified and discussed. Recommendations are included.

Unmanned Aircraft System / Remotely Piloted Aircraft (UAS/RPA) Human Factors and Human Systems Integration Research Workshop Held in Dayton, Ohio on November 8-9, 2011

DTIC Science & Technology

2012-05-25

station design . These issues include: poor ergonomics ; varying data input methods; multiple inputs required to implement a single command; lack of...facing the UAS/RPA discipline. Major discussion topics included: UAS operator selection, training, control station design , manpower and scheduling...Break 1400 – 1430: Naval UAS Training  LCDR Brent Olde 1430 – 1500: Control Station Design Issues  Melissa Walwanis 1500 – 1600: Tour of NAMRU-D

Risk Factors for Bartonella species Infection in Blood Donors from Southeast Brazil.

PubMed

Diniz, Pedro Paulo Vissotto de Paiva; Velho, Paulo Eduardo Neves Ferreira; Pitassi, Luiza Helena Urso; Drummond, Marina Rovani; Lania, Bruno Grosselli; Barjas-Castro, Maria Lourdes; Sowy, Stanley; Breitschwerdt, Edward B; Scorpio, Diana Gerardi

2016-03-01

Bacteria from the genus Bartonella are emerging blood-borne bacteria, capable of causing long-lasting infection in marine and terrestrial mammals, including humans. Bartonella are generally well adapted to their main host, causing persistent infection without clinical manifestation. However, these organisms may cause severe disease in natural or accidental hosts. In humans, Bartonella species have been detected from sick patients presented with diverse disease manifestations, including cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, polyarthritis, or granulomatous inflammatory disease. However, with the advances in diagnostic methods, subclinical bloodstream infection in humans has been reported, with the potential for transmission through blood transfusion been recently investigated by our group. The objective of this study was to determine the risk factors associated with Bartonella species infection in asymptomatic blood donors presented at a major blood bank in Southeastern Brazil. Five hundred blood donors were randomly enrolled and tested for Bartonella species infection by specialized blood cultured coupled with high-sensitive PCR assays. Epidemiological questionnaires were designed to cover major potential risk factors, such as age, gender, ethnicity, contact with companion animals, livestock, or wild animals, bites from insects or animal, economical status, among other factors. Based on multivariate logistic regression, bloodstream infection with B. henselae or B. clarridgeiae was associated with cat contact (adjusted OR: 3.4, 95% CI: 1.1-9.6) or history of tick bite (adjusted OR: 3.7, 95% CI: 1.3-13.4). These risk factors should be considered during donor screening, as bacteremia by these Bartonella species may not be detected by traditional laboratory screening methods, and it may be transmitted by blood transfusion.

Exploring community gardens in a health disparate population: findings from a mixed methods pilot study.

PubMed

Zoellner, Jamie; Zanko, Ashley; Price, Bryan; Bonner, Jennifer; Hill, Jennie L

2012-01-01

Despite recommendations, there have been few efforts to apply the community-based participatory research (CBPR) approach in the development, implementation, and evaluation of community gardens. As guided by the CBPR approach and grounded in a social-ecological model and behavioral theory, the purpose of this mixed methods study was to understand opinions and interests in developing and implementing a community garden and to understand factors impacting fruit, vegetable, and gardening behaviors. Community and academic members collaborated to develop and execute this study. The qualitative phase- targeting regional key informants-was designed to elicit perceived benefits and challenges of community gardens at the environmental, community, and individual levels. The quantitative phase targeted low resourced youth and parents and included a variety of validated theory-based questionnaires to understand factors impacting fruit, vegetable, and gardening behaviors. Major benefits of community gardens that emerged from the 10 qualitative interviews included increasing community cohesion and improving nutrition and physical activity factors. The quantitative phase included 87 youth and 67 parents. Across 16 items for fruits and vegetables, the average willingness to try was 1.32 (standard deviation [SD] = 0.40) on a 2-point scale. The majority of youth indicated they would work in a garden (n = 59; 68%) and eat food grown in their garden (n = 71; 82%). Among parents, gardening attitude, belief, and self-efficacy scores were all above average; however, gardening intentions were neutral. This research illustrates the successful partnering a community-academic team and has provided the partnership with a clearer lens to conceptualize and launch future regional community garden efforts.

Barriers associated with the treatment of hepatitis C virus infection among illicit drug users.

PubMed

Grebely, Jason; Genoway, Krista A; Raffa, Jesse D; Dhadwal, Gurbir; Rajan, Tasleem; Showler, Grey; Kalousek, Kate; Duncan, Fiona; Tyndall, Mark W; Fraser, Chris; Conway, Brian; Fischer, Benedikt

2008-01-11

Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment. We evaluated barriers to initiating HCV treatment -- including general treatment willingness -- and factors associated with these among HCV infected illicit drug users. Participants were recruited via convenience sampling from two community clinics in Canada. Individuals age >18 years with a history of illicit drug use completed interviewer-administered surveys. Those reporting positive HCV testing underwent additional questioning on willingness, uptake and barriers to treatment for HCV. Of 188 HCV positive illicit drug users, 16% (n=30) had received treatment for HCV. Factors associated with a decreased treatment uptake included current heroin use and HIV/HCV co-infection. Among those not having received therapy, 77% (117/153) indicated a willingness to receive HCV treatment. Factors associated with treatment willingness included not being infected with HIV, having not recently used drugs by injection and having reported physical health problems. Among those not having sought HCV treatment (n=107), the major reasons for not doing so were: lack of information about HCV or knowledge that treatment was available (23%), the absence of symptoms (20%) and the perceived side effects of treatment (14%). Among illicit drug users attending inner city clinics, we have observed a low uptake of HCV treatment, but a high willingness to receive therapy. An increased focus on improving education about the long-term consequences of HCV and the availability of effective treatment are important components for expanding HCV treatment among illicit drug users.

Bio-psycho-social factors affecting sexual self-concept: A systematic review.

PubMed

Potki, Robabeh; Ziaei, Tayebe; Faramarzi, Mahbobeh; Moosazadeh, Mahmood; Shahhosseini, Zohreh

2017-09-01

Nowadays, it is believed that mental and emotional aspects of sexual well-being are the important aspects of sexual health. Sexual self-concept is a major component of sexual health and the core of sexuality. It is defined as the cognitive perspective concerning the sexual aspects of 'self' and refers to the individual's self-perception as a sexual creature. The aim of this study was to assess the different factors affecting sexual self-concept. English electronic databases including PubMed, Scopus, Web of Science and Google Scholar as well as two Iranian databases including Scientific Information Database and Iranmedex were searched for English and Persian-language articles published between 1996 and 2016. Of 281 retrieved articles, 37 articles were finally included for writing this review article. Factors affecting sexual self-concept were categorized to biological, psychological and social factors. In the category of biological factors, age gender, marital status, race, disability and sexual transmitted infections are described. In the psychological category, the impact of body image, sexual abuse in childhood and mental health history are present. Lastly, in the social category, the roles of parents, peers and the media are discussed. As the development of sexual self-concept is influenced by multiple events in individuals' lives, to promotion of sexual self-concept, an integrated implementation of health policies is recommended.

Local Anesthetic-Induced Neurotoxicity

PubMed Central

Verlinde, Mark; Hollmann, Markus W.; Stevens, Markus F.; Hermanns, Henning; Werdehausen, Robert; Lirk, Philipp

2016-01-01

This review summarizes current knowledge concerning incidence, risk factors, and mechanisms of perioperative nerve injury, with focus on local anesthetic-induced neurotoxicity. Perioperative nerve injury is a complex phenomenon and can be caused by a number of clinical factors. Anesthetic risk factors for perioperative nerve injury include regional block technique, patient risk factors, and local anesthetic-induced neurotoxicity. Surgery can lead to nerve damage by use of tourniquets or by direct mechanical stress on nerves, such as traction, transection, compression, contusion, ischemia, and stretching. Current literature suggests that the majority of perioperative nerve injuries are unrelated to regional anesthesia. Besides the blockade of sodium channels which is responsible for the anesthetic effect, systemic local anesthetics can have a positive influence on the inflammatory response and the hemostatic system in the perioperative period. However, next to these beneficial effects, local anesthetics exhibit time and dose-dependent toxicity to a variety of tissues, including nerves. There is equivocal experimental evidence that the toxicity varies among local anesthetics. Even though the precise order of events during local anesthetic-induced neurotoxicity is not clear, possible cellular mechanisms have been identified. These include the intrinsic caspase-pathway, PI3K-pathway, and MAPK-pathways. Further research will need to determine whether these pathways are non-specifically activated by local anesthetics, or whether there is a single common precipitating factor. PMID:26959012

Local Anesthetic-Induced Neurotoxicity.

PubMed

Verlinde, Mark; Hollmann, Markus W; Stevens, Markus F; Hermanns, Henning; Werdehausen, Robert; Lirk, Philipp

2016-03-04

This review summarizes current knowledge concerning incidence, risk factors, and mechanisms of perioperative nerve injury, with focus on local anesthetic-induced neurotoxicity. Perioperative nerve injury is a complex phenomenon and can be caused by a number of clinical factors. Anesthetic risk factors for perioperative nerve injury include regional block technique, patient risk factors, and local anesthetic-induced neurotoxicity. Surgery can lead to nerve damage by use of tourniquets or by direct mechanical stress on nerves, such as traction, transection, compression, contusion, ischemia, and stretching. Current literature suggests that the majority of perioperative nerve injuries are unrelated to regional anesthesia. Besides the blockade of sodium channels which is responsible for the anesthetic effect, systemic local anesthetics can have a positive influence on the inflammatory response and the hemostatic system in the perioperative period. However, next to these beneficial effects, local anesthetics exhibit time and dose-dependent toxicity to a variety of tissues, including nerves. There is equivocal experimental evidence that the toxicity varies among local anesthetics. Even though the precise order of events during local anesthetic-induced neurotoxicity is not clear, possible cellular mechanisms have been identified. These include the intrinsic caspase-pathway, PI3K-pathway, and MAPK-pathways. Further research will need to determine whether these pathways are non-specifically activated by local anesthetics, or whether there is a single common precipitating factor.

Student and high-school characteristics related to completing a science, technology, engineering or mathematics (STEM) major in college

NASA Astrophysics Data System (ADS)

LeBeau, Brandon; Harwell, Michael; Monson, Debra; Dupuis, Danielle; Medhanie, Amanuel; Post, Thomas R.

2012-04-01

Background: The importance of increasing the number of US college students completing degrees in science, technology, engineering or mathematics (STEM) has prompted calls for research to provide a better understanding of factors related to student participation in these majors, including the impact of a student's high-school mathematics curriculum. Purpose: This study examines the relationship between various student and high-school characteristics and completion of a STEM major in college. Of specific interest is the influence of a student's high-school mathematics curriculum on the completion of a STEM major in college. Sample: The sample consisted of approximately 3500 students from 229 high schools. Students were predominantly Caucasian (80%), with slightly more males than females (52% vs 48%). Design and method: A quasi-experimental design with archival data was used for students who enrolled in, and graduated from, a post-secondary institution in the upper Midwest. To be included in the sample, students needed to have completed at least three years of high-school mathematics. A generalized linear mixed model was used with students nested within high schools. The data were cross-sectional. Results: High-school predictors were not found to have a significant impact on the completion of a STEM major. Significant student-level predictors included ACT mathematics score, gender and high-school mathematics GPA. Conclusions: The results provide evidence that on average students are equally prepared for the rigorous mathematics coursework regardless of the high-school mathematics curriculum they completed.

Highlighting Uncertainty and Recommendations for Improvement of Black Carbon Biomass Fuel-Based Emission Inventories in the Indo-Gangetic Plain Region.

PubMed

Soneja, Sutyajeet I; Tielsch, James M; Khatry, Subarna K; Curriero, Frank C; Breysse, Patrick N

2016-03-01

Black carbon (BC) is a major contributor to hydrological cycle change and glacial retreat within the Indo-Gangetic Plain (IGP) and surrounding region. However, significant variability exists for estimates of BC regional concentration. Existing inventories within the IGP suffer from limited representation of rural sources, reliance on idealized point source estimates (e.g., utilization of emission factors or fuel-use estimates for cooking along with demographic information), and difficulty in distinguishing sources. Inventory development utilizes two approaches, termed top down and bottom up, which rely on various sources including transport models, emission factors, and remote sensing applications. Large discrepancies exist for BC source attribution throughout the IGP depending on the approach utilized. Cooking with biomass fuels, a major contributor to BC production has great source apportionment variability. Areas requiring attention tied to research of cookstove and biomass fuel use that have been recognized to improve emission inventory estimates include emission factors, particulate matter speciation, and better quantification of regional/economic sectors. However, limited attention has been given towards understanding ambient small-scale spatial variation of BC between cooking and non-cooking periods in low-resource environments. Understanding the indoor to outdoor relationship of BC emissions due to cooking at a local level is a top priority to improve emission inventories as many health and climate applications rely upon utilization of accurate emission inventories.

Towards understanding the epidemiology of Neisseria meningitidis in the African meningitis belt: a multi-disciplinary overview.

PubMed

Agier, Lydiane; Martiny, Nadège; Thiongane, Oumy; Mueller, Judith E; Paireau, Juliette; Watkins, Eleanor R; Irving, Tom J; Koutangni, Thibaut; Broutin, Hélène

2017-01-01

Neisseria meningitidis is the major cause of seasonal meningitis epidemics in the African meningitis belt. In the changing context of a reduction in incidence of serogroup A and an increase in incidence of serogroups W and C and of Streptococcus pneumoniae, a better understanding of the determinants driving the disease transmission dynamics remains crucial to improving bacterial meningitis control. The literature was searched to provide a multi-disciplinary overview of the determinants of meningitis transmission dynamics in the African meningitis belt. Seasonal hyperendemicity is likely predominantly caused by increased invasion rates, sporadic localized epidemics by increased transmission rates, and larger pluri-annual epidemic waves by changing population immunity. Carriage likely involves competition for colonization and cross-immunity. The duration of immunity likely depends on the acquisition type. Major risk factors include dust and low humidity, and presumably human contact rates and co-infections; social studies highlighted environmental and dietary factors, with supernatural explanations. Efforts should focus on implementing multi-country, longitudinal seroprevalence and epidemiological studies, validating immune markers of protection, and improving surveillance, including more systematic molecular characterizations of the bacteria. Integrating climate and social factors into disease control strategies represents a high priority for optimizing the public health response and anticipating the geographic evolution of the African meningitis belt. Copyright © 2016. Published by Elsevier Ltd.

Managing comorbidities in COPD

PubMed Central

Hillas, Georgios; Perlikos, Fotis; Tsiligianni, Ioanna; Tzanakis, Nikolaos

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Age and smoking are common risk factors for COPD and other illnesses, often leading COPD patients to demonstrate multiple coexisting comorbidities. COPD exacerbations and comorbidities contribute to the overall severity in individual patients. Clinical trials investigating the treatment of COPD routinely exclude patients with multiple comorbidities or advanced age. Clinical practice guidelines for a specific disease do not usually address comorbidities in their recommendations. However, the management and the medical intervention in COPD patients with comorbidities need a holistic approach that is not clearly established worldwide. This holistic approach should include the specific burden of each comorbidity in the COPD severity classification scale. Further, the pharmacological and nonpharmacological management should also include optimal interventions and risk factor modifications simultaneously for all diseases. All health care specialists in COPD management need to work together with professionals specialized in the management of the other major chronic diseases in order to provide a multidisciplinary approach to COPD patients with multiple diseases. In this review, we focus on the major comorbidities that affect COPD patients. We present an overview of the problems faced, the reasons and risk factors for the most commonly encountered comorbidities, and the burden on health care costs. We also provide a rationale for approaching the therapeutic options of the COPD patient afflicted by comorbidity. PMID:25609943

[Social-psychological factors contributing to male juvenile delinquency].

PubMed

Wei, Hong-Ping; Yang, Fang-Ru

2011-11-01

To study the major social-psychological factors contributing to male juvenile delinquency. One hundred and thirty-seven cases of male juvenile delinquents (delinquent group) and 145 aged-matched male students (control group) were enrolled in this case-control study. A questionnaire survey was conducted using the Adolescent Self-Rating Life Events Check List, the Coping Style Questionnaire, the Family Environment Scale-Chinese version, and the Social Support Rating Scale. The monovariate analysis showed that the total score and the scores of some factors of negative life events, the scores of immature coping styles and family conflicts, and the proportion of broken families in the delinquent group were significantly higher than those in the control group. In contrast, the scores of educational levels, study stress factor in the negative life events, mature coping styles, family environments and social supports were significantly lower in the delinquent group than those in the control group. The multivariate factors analysis showed that 7 variables were enrolled into the discriminatory equations, including negative life events (interpersonal relationship and healthy adaptation), self-condemn styles, family conflicts, subjective supports, objective supports, and utilization of social supports. The total accuracy of this equation was 92.2%. Negative life events in the interpersonal relationship and healthy adaptation, self-condemn styles, family conflicts, and weak social support system may be major social-psychological factors contributing to male juvenile delinquency.

Diabetes knowledge of nurses providing community care for diabetes patients in Auckland, New Zealand.

PubMed

Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert

2014-10-01

To quantify and compare knowledge of diabetes including risk factors for diabetes-related complications among the three main groups of primary health care nurses. In a cross-sectional survey of practice, district and specialist nurses (n=1091) in Auckland, New Zealand, 31% were randomly sampled to complete a self-administered questionnaire and telephone interview, designed to ascertain nurses' knowledge of diabetes and best practice, in 2006-2008. All 287 nurses (response rate 86%) completed the telephone interview and 284 the self-administered questionnaire. Major risk factors identified by nurses were excess body weight for type 2 diabetes (96%) and elevated plasma glucose levels or glycosylated haemoglobin (86%) for diabetes-related complications. In contrast, major cardiovascular risk factors were less well identified, particularly smoking, although by more specialist nurses (43%) than practice (14%) and district (12%) nurses (p=0.0005). Cardiovascular complications, particularly stroke, were less well known than microvascular complications, and by significantly fewer practice (13%) and district (8%) nurses than specialist nurses (36%, p=0.002). In general, nurses had better knowledge of overweight as a risk factor for type 2 diabetes mellitus and elevated plasma glucose levels as a risk factor for diabetes-related complications compared with knowledge of cardiovascular risk factors, particularly smoking. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.