Methods to control for unmeasured confounding in pharmacoepidemiology: an overview.

PubMed

Uddin, Md Jamal; Groenwold, Rolf H H; Ali, Mohammed Sanni; de Boer, Anthonius; Roes, Kit C B; Chowdhury, Muhammad A B; Klungel, Olaf H

2016-06-01

Background Unmeasured confounding is one of the principal problems in pharmacoepidemiologic studies. Several methods have been proposed to detect or control for unmeasured confounding either at the study design phase or the data analysis phase. Aim of the Review To provide an overview of commonly used methods to detect or control for unmeasured confounding and to provide recommendations for proper application in pharmacoepidemiology. Methods/Results Methods to control for unmeasured confounding in the design phase of a study are case only designs (e.g., case-crossover, case-time control, self-controlled case series) and the prior event rate ratio adjustment method. Methods that can be applied in the data analysis phase include, negative control method, perturbation variable method, instrumental variable methods, sensitivity analysis, and ecological analysis. A separate group of methods are those in which additional information on confounders is collected from a substudy. The latter group includes external adjustment, propensity score calibration, two-stage sampling, and multiple imputation. Conclusion As the performance and application of the methods to handle unmeasured confounding may differ across studies and across databases, we stress the importance of using both statistical evidence and substantial clinical knowledge for interpretation of the study results.

Oseltamivir use and severe abnormal behavior in Japanese children and adolescents with influenza: Is a self-controlled case series study applicable?

PubMed

Fukushima, Wakaba; Ozasa, Kotaro; Okumura, Akihisa; Mori, Masaaki; Hosoya, Mitsuaki; Nakano, Takashi; Tanabe, Takuya; Yamaguchi, Naoto; Suzuki, Hiroshi; Mori, Mitsuru; Hatayama, Hideaki; Ochiai, Hirotaka; Kondo, Kyoko; Ito, Kazuya; Ohfuji, Satoko; Nakamura, Yosikazu; Hirota, Yoshio

2017-08-24

Since the 1990s, self-controlled designs including self-controlled case series (SCCS) studies have been occasionally used in post-marketing evaluation of drug or vaccine safety. An SCCS study was tentatively applied to evaluate the relationship between oseltamivir use and abnormal behavior Type A (serious abnormal behavior potentially leading to an accident or harm to another person) in influenza patients. From the original prospective cohort study with approximately 10,000 Japanese children and adolescents with influenza (aged <18years), 28 subjects (mean age: 7.3years) who developed abnormal behavior Type A after the first visit to the collaborating hospitals/clinics were analyzed. We hypothesized four combination patterns of the effect period (i.e., the period that effect of oseltamivir on occurrence of abnormal behavior Type A is likely) and the control period. Mantel-Haenszel rate ratio (M-H RR) and its 95% confidence interval (CI) were calculated as the relative risk estimate. Among 28 subjects in the SCCS study, 24 subjects (86%) were administered oseltamivir and 4 subjects (14%) were not. Abnormal behavior Type A was more likely to occur in the effect period than the control period in every pattern (M-H RR: 1.90-29.1). We observed the highest estimate when the effect period was set between the initial intake of oseltamivir and T max (M-H RR: 29.1, 95% CI: 4.21-201). Abnormal behavior Type A was more likely to develop up to approximately 30 times during the period between the initial intake of oseltamivir and T max . However, this period overlapped with the early period of influenza where high fever was observed. Since useful approaches to control the influence of the natural disease course of influenza were not available in this study, we could not deny the possibility that abnormal behavior was induced by influenza itself. The SCCS study was not an optimal method to evaluate the relationship between oseltamivir use and abnormal behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

A case series of patients using medicinal marihuana for management of chronic pain under the Canadian Marihuana Medical Access Regulations.

PubMed

Lynch, Mary E; Young, Judee; Clark, Alexander J

2006-11-01

The Canadian Marihuana Medical Access Regulations (MMAR) program allows Health Canada to grant access to marihuana for medical use to those who are suffering from grave and debilitating illnesses. This is a report on a case series of 30 patients followed at a tertiary care pain management center in Nova Scotia who have used medicinal marihuana for 1-5 years under the MMAR program. Patients completed a follow-up questionnaire containing demographic and dosing information, a series of 11-point numerical symptom relief rating scales, a side effect checklist, and a subjective measure of improvement in function. Doses of marihuana ranged from less than 1 to 5g per day via the smoked or oral route of administration. Ninety-three percent of patients reported moderate or greater pain relief. Side effects were reported by 76% of patients, the most common of which were increased appetite and a sense of well-being, weight gain, and slowed thoughts. Limitations of the study include self-selection bias, small size, and lack of a control group. The need for further study using controlled trials is discussed along with an overview of the MMAR program.

A simulation study to compare three self-controlled case series approaches: correction for violation of assumption and evaluation of bias.

PubMed

Hua, Wei; Sun, Guoying; Dodd, Caitlin N; Romio, Silvana A; Whitaker, Heather J; Izurieta, Hector S; Black, Steven; Sturkenboom, Miriam C J M; Davis, Robert L; Deceuninck, Genevieve; Andrews, N J

2013-08-01

The assumption that the occurrence of outcome event must not alter subsequent exposure probability is critical for preserving the validity of the self-controlled case series (SCCS) method. This assumption is violated in scenarios in which the event constitutes a contraindication for exposure. In this simulation study, we compared the performance of the standard SCCS approach and two alternative approaches when the event-independent exposure assumption was violated. Using the 2009 H1N1 and seasonal influenza vaccines and Guillain-Barré syndrome as a model, we simulated a scenario in which an individual may encounter multiple unordered exposures and each exposure may be contraindicated by the occurrence of outcome event. The degree of contraindication was varied at 0%, 50%, and 100%. The first alternative approach used only cases occurring after exposure with follow-up time starting from exposure. The second used a pseudo-likelihood method. When the event-independent exposure assumption was satisfied, the standard SCCS approach produced nearly unbiased relative incidence estimates. When this assumption was partially or completely violated, two alternative SCCS approaches could be used. While the post-exposure cases only approach could handle only one exposure, the pseudo-likelihood approach was able to correct bias for both exposures. Violation of the event-independent exposure assumption leads to an overestimation of relative incidence which could be corrected by alternative SCCS approaches. In multiple exposure situations, the pseudo-likelihood approach is optimal; the post-exposure cases only approach is limited in handling a second exposure and may introduce additional bias, thus should be used with caution. Copyright © 2013 John Wiley & Sons, Ltd.

Diagnosis and treatment of impulse control disorders in patients with movement disorders.

PubMed

Mestre, Tiago A; Strafella, Antonio P; Thomsen, Teri; Voon, Valerie; Miyasaki, Janis

2013-05-01

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson's disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson's disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease has been developed specifically for Parkinson's disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine.

Risk of Guillain-Barré syndrome after 2010-2011 influenza vaccination.

PubMed

Galeotti, Francesca; Massari, Marco; D'Alessandro, Roberto; Beghi, Ettore; Chiò, Adriano; Logroscino, Giancarlo; Filippini, Graziella; Benedetti, Maria Donata; Pugliatti, Maura; Santuccio, Carmela; Raschetti, Roberto

2013-05-01

Influenza vaccination has been implicated in Guillain Barré Syndrome (GBS) although the evidence for this link is controversial. A case-control study was conducted between October 2010 and May 2011 in seven Italian Regions to explore the relation between influenza vaccination and GBS. The study included 176 GBS incident cases aged ≥18 years from 86 neurological centers. Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases. Each control was matched to a case by sex, age, Region and admission date. Two different analyses were conducted: a matched case-control analysis and a self-controlled case series analysis (SCCS). Case-control analysis included 140 cases matched to 308 controls. The adjusted matched odds ratio (OR) for GBS occurrence within 6 weeks after influenza vaccination was 3.8 (95 % CI: 1.3, 10.5). A much stronger association with gastrointestinal infections (OR = 23.8; 95 % CI 7.3, 77.6) and influenza-like illness or upper respiratory tract infections (OR = 11.5; 95 % CI 5.6, 23.5) was highlighted. The SCCS analysis included all 176 GBS cases. Influenza vaccination was associated with GBS, with a relative risk of 2.1 (95 % CI 1.1, 3.9). According to these results the attributable risk in adults ranges from two to five GBS cases per 1,000,000 vaccinations.

Parental bonding and vulnerability to adolescent suicide.

PubMed

Martin, G; Waite, S

1994-04-01

Part of a series of studies into early detection in adolescent suicide, this study investigated relationships between parenting style and suicidal thoughts, acts and depression. Students (mean age 15 years) from 4 randomly chosen high schools completed self-report questionnaires containing the Parental Bonding Instrument (PBI) and the Youth Self Report, which provided information about suicide ideation, deliberate self-harm and depression. Significant differences for mean scores on the PBI subscales were noted between cases and noncases of depression, suicidal thoughts and deliberate self-harm. Assignment by adolescents of their parents to the "affectionless control" quadrant of the PBI doubles the relative risk for suicidal thoughts, increases the relative risk for deliberate self-harm 3-fold and increases the relative risk for depression 5-fold. It seems that the PBI may play a role in identification of vulnerable adolescents; further, it both elucidates aspects of adolescent-parent interaction and points toward areas for intervention with at-risk adolescents. We recommend the use of the PBI in early detection studies of adolescent suicide.

Intussusception and Monovalent Rotavirus Vaccination in Singapore: Self-Controlled Case Series and Risk-Benefit Study.

PubMed

Yung, Chee-Fu; Chan, Siew Pang; Soh, Sally; Tan, Adriana; Thoon, Koh Cheng

2015-07-01

To investigate the association between monovalent human rotavirus vaccine (RV1) and intussusception among Asian infants and the impact of older age of vaccination. To perform risk-benefit analysis of RV1 vaccination programs in Singapore. We performed a self-controlled case series by extracting intussusception cases in infants aged <12 months from hospital databases (2005-2012) and with vaccination histories from a national immunization registry. Relative incidences were calculated by comparing incidence during defined risk periods after vaccination with times outside these periods. In the risk benefit analysis, we estimated excess intussusception hospitalization in relation to the number of infants vaccinated for hypothetical vaccination coverage scenarios. There were 86 infants hospitalized with intussusception; 20 cases had received at least 1 dose of RV1. Nearly all (19) had received their first dose at age >12 weeks old. The age-adjusted relative incidence of intussusception in the 1- to 7-day period post dose one was 8.36 (95% CI 2.42-28.96). Of all childhood hospitalizations because of rotavirus, 71% (570 cases) could be prevented with 90% vaccination coverage. There would be approximately 1 excess intussusception case per 65,000 infants vaccinated. Risk of intussusception increases about 8-fold during 1-7 days after receipt of first dose RV1 in infants of Chinese, Malay, and Indian ethnicity in Singapore, Asia. High vaccine coverage program in Singapore would be beneficial with only a low risk of excess intussusception. The relative risk of intussusception post-RV1 vaccination is not higher in Asia despite differences in background intussusception incidence compared with US and Australia, or older age of vaccination. Copyright © 2015 Elsevier Inc. All rights reserved.

Death following partner bereavement: A self-controlled case series analysis.

PubMed

King, Michael; Lodwick, Rebecca; Jones, Rebecca; Whitaker, Heather; Petersen, Irene

2017-01-01

There is mixed evidence that older people bereaved of a spouse or partner are at risk of adverse outcomes. The main difficulty is to take account of other explanatory factors. We tested for an association between a patient's death and the timing of any bereavement of a cohabitee. Self-controlled case series study in which each case serves as his or her own control and which thereby accounts for all fixed measurable and unmeasurable confounders. We used the Health Improvement Network (THIN) primary care database to identify patients who died aged 50-99 years during the period 2003 to 2014. We used the household identifier in the database to determine whether they had an opposite sex cohabitee at the start of the observation period. 38,773 men and 23,396 women who had died and who had a cohabitee at the start of the observation period, were identified and included in male and female cohorts respectively. A higher risk of death was found in the 24 months after the death of the cohabitee than in the time classified as unexposed. The greatest risk was during the first 3 months after the death of the cohabitee (age-adjusted incidence rate ratio [IRR] 1.63, 95% CI 1.45-1.83 in the male cohort, and IRR 1.70, 95% CI 1.52-1.90 in the female cohort). Risk of death in men or women was significantly higher after the death of a cohabitee and this was greatest in the first three months of bereavement. We need more evidence on the effectiveness of interventions to reduce this increased mortality.

Effectiveness and feasibility of Socratic feedback to increase awareness of deficits in patients with acquired brain injury: Four single-case experimental design (SCED) studies.

PubMed

Schrijnemaekers, Anne-Claire M C; Winkens, Ieke; Rasquin, Sascha M C; Verhaeg, Annette; Ponds, Rudolf W H M; van Heugten, Caroline M

2018-06-29

To investigate the effectiveness and feasibility of a Socratic feedback programme to improve awareness of deficits in patients with acquired brain injury (ABI). Rehabilitation centre. Four patients with ABI with awareness problems. A series of single-case experimental design studies with random intervention starting points (A-B + maintenance design). Rate of trainer-feedback and self-control behaviour on everyday tasks, patient competency rating scale (PCRS), self-regulating skills interview (SRSI), hospital anxiety and depression scale. All patients needed less trainer feedback, the change was significant in 3 out of 4. One patient increased in overt self-corrective behaviour. SRSI performance increased in all patients (medium to strong effect size), and PCRS performance increased in two patients (medium and strong effect size). Mood and anxiety levels were elevated in one patient at the beginning of the training and decreased to normal levels at the end of the training. The feasibility of the programme was scored 9 out of 10. The Socratic feedback method is a promising intervention for improving awareness of deficits in patients with ABI. Controlled studies with larger populations are needed to draw more solid conclusions about the effect of this method.

Towards a Definition of "Self-Neglect" in Psychiatric Patients: Descriptions of a Case Series.

PubMed

Lamkin, Joanna; Nguyen, Phuong T; Coverdale, John H; Gordon, Mollie R

2017-09-01

Self-neglect, although frequently studied in geriatric populations, has received only limited attention in psychiatric populations. To address this gap, we utilize a behavioral framework to present a set of case examples in order to illustrate the complex relationship between self-neglect behaviors and conditions and various psychiatric illness. Cases are discussed with respect to ascending severity of presentations of self-neglect in adult non-geriatric inpatient psychiatric populations. Self-neglect is conceptualized as a range of behaviors, as well as an overall condition that affects an individual's functioning in several major domains. The concept of self-neglect in non-geriatric psychiatric patients warrants additional study, including development of a formal definition, as well as evaluation of its associated manifestations and implications for treatment and prognosis.

Multi-Faceted Dimensions of Self-Concept and Personal Control: A Collection of Six Related Studies.

ERIC Educational Resources Information Center

Sherman, Lawrence W.; And Others

A series of six papers and an introduction which present the results and tentative analyses of studies investigating such constructs as self-esteem, perceptions of control, and competence are included in this document. These papers are: (1) "Multiple Dimensions of Locus of Control and Their Relationship To Standardized Achievement Scores in Fifth…

Examining the Practicum Experience to Increase Counseling Students' Self-Efficacy

ERIC Educational Resources Information Center

Ikonomopoulos, James; Vela, Javier Cavazos; Smith, Wayne D.; Dell'Aquila, Julia

2016-01-01

Counseling graduate students may begin practicum with low self-efficacy regarding their counseling abilities and skills. In the current study, we implemented a small-series (N = 11) single-case research design to assess the effectiveness of the practicum experience to increase counseling students' self-efficacy. Analysis of participants' scores on…

Diagnosis and treatment of impulse control disorders in patients with movement disorders

PubMed Central

Mestre, Tiago A.; Strafella, Antonio P.; Thomsen, Teri; Voon, Valerie

2013-01-01

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine. PMID:23634190

Risk of Stroke after Herpes Zoster - Evidence from a German Self-Controlled Case-Series Study.

PubMed

Schink, Tania; Behr, Sigrid; Thöne, Kathrin; Bricout, Hélène; Garbe, Edeltraut

2016-01-01

Herpes zoster (HZ) is caused by reactivation of the latent varicella-zoster virus (VZV). A severe complication of HZ is VZV vasculopathy which can result in ischemic or hemorrhagic stroke. The aims of our study were to assess the risk of stroke after the onset of HZ and to investigate the roles of stroke subtype, HZ location and the time interval between HZ onset and stroke. A self-controlled case-series study was performed on a cohort of patients with incident stroke recorded in the German Pharmacoepidemiological Research Database (GePaRD), which covers about 20 million persons throughout Germany. We estimated adjusted incidence rate ratios (IRR) by comparing the rate of stroke in risk periods (i.e., periods following HZ) with the rate of stroke in control periods (i.e., periods without HZ) in the same individuals, controlling for both time-invariant and major potentially time-variant confounders. The cohort included 124,462 stroke patients, of whom 6,035 (5%) had at least one HZ diagnosis identified in GePaRD either as main hospital discharge diagnosis or as HZ treated with antivirals. The risk of stroke was about 1.3 times higher in the risk periods 3 months after HZ onset, than in the control periods (IRR: 1.29; 95% confidence interval: 1.16-1.44). An elevated risk of similar magnitude was observed for ischemic and unspecified stroke, but a 1.5-fold higher risk was observed for hemorrhagic stroke. A slightly stronger effect on the risk of stroke was also observed during the 3 months after HZ ophthalmicus (HZO) onset (1.59; 1.10-2.32). The risk was highest 3 and 4 weeks after HZ onset and decreased thereafter. Our study corroborates an increased risk of stroke after HZ, which is highest 3 to 4 weeks after HZ onset. The results suggest that the risk is more pronounced after HZO and is numerically higher for hemorrhagic than for ischemic stroke.

What factors play a role in preventing self-immolation? Results from a case-control study in Iran

PubMed Central

Karim, Hosein; Schwebel, David C.; Bazargan-Hejazi, Shahrzad; Mohammadi, Reza; Choubsaz, Mansour; Heidari Zadie, Zahra; Ahmadi, Alireza

2015-01-01

Abstract: Background: To investigate factors related to prevention of self-immolation in west of Iran. Methods: In a case-control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional burn center (Imam Khomeini hospital in Kermanshah province, Iran) were compared with controls selected from the community and matched by sex, age, district-county of residence, and rural vs urban living environment. The following characteristics relevant to preventing self-immolation were collected from all cases and controls: main domestic fuel used in the household, awareness about complications of burn injuries, and use of counseling services. Results: Descriptive analyses revealed that kerosene was the main domestic fuel in the household for 83% of cases. Not surprisingly, the main means of self-immolation in 93% of the patients was kerosene, with other fuels such as petrol and domestic gas used in remaining cases. The majority of cases and controls were aware of the potential complications of burn injuries. Use of counseling services was more common in controls. Conclusions: All three aspects of preventing self-immolation – having kerosene and other fuels in the home, being aware of the complications of burn injuries, and using counseling services were present in both the cases and controls. This suggests a large portion of residents in rural Iran are potential self-immolation victims. Increasing preventive strategies may reduce risk of suicide by self-immolation. PMID:26081518

Chickenpox and Risk of Stroke: A Self-controlled Case Series Analysis

PubMed Central

Thomas, Sara L.; Minassian, Caroline; Ganesan, Vijeya; Langan, Sinéad M.; Smeeth, Liam

2014-01-01

Background. There is good evidence that respiratory and other infections that cause systemic inflammation can trigger strokes; however, the role of specific infections is unclear. Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk. Methods. We used anonymized electronic health records totaling >100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0–6 and 7–12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children. Results. Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0–6 months after chickenpox (summary IR = 4.07; 95% confidence interval [CI], 1.96–8.45; I2 = 0%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95% CI, 1.05–4.36; I2 = 51%). There was no significant increased risk of stroke in the 7–12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period. Conclusions. Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months. PMID:24092802

Chickenpox and risk of stroke: a self-controlled case series analysis.

PubMed

Thomas, Sara L; Minassian, Caroline; Ganesan, Vijeya; Langan, Sinéad M; Smeeth, Liam

2014-01-01

There is good evidence that respiratory and other infections that cause systemic inflammation can trigger strokes; however, the role of specific infections is unclear. Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk. We used anonymized electronic health records totaling >100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0-6 and 7-12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children. Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0-6 months after chickenpox (summary IR = 4.07; 95% confidence interval [CI], 1.96-8.45; I(2) = 0%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95% CI, 1.05-4.36; I(2) = 51%). There was no significant increased risk of stroke in the 7-12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period. Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months.

Nonpharmacological treatment of tics in Tourette syndrome adding videotape training to self-hypnosis.

PubMed

Lazarus, Jeffrey E; Klein, Susan K

2010-01-01

This case series examines the practicality of using a standardized method of training children in self-hypnosis (SH) methods to explore its efficiency and short-term efficacy in treating tics in patients with Tourette syndrome. The files of 37 children and adolescents with Tourette syndrome referred for SH training were reviewed, yielding 33 patients for analysis. As part of a protocol for SH training, all viewed a videotape series of a boy undergoing SH training for tic control. Improvement in tic control was abstracted from subjective patient report. Seventy-nine percent of the patients trained in this technique experienced short-term clinical response, defined as control over the average 6-week follow-up period. Of the responders, 46% achieved tic control with SH after only 2 sessions and 96% after 3 visits. One patient required 4 visits. Instruction in SH, aided by the use of videotape training, augments a protocol and probably shortens the time of training in this technique. If SH is made more accessible in this way, it will be a valuable addition to multi-disciplinary management of tic disorders in Tourette syndrome.

Self concepts, health locus of control and cognitive functioning associated with health-promoting lifestyles in schizophrenia.

PubMed

Chuang, Shu Ping; Wu, Jo Yung Wei; Wang, Chien Shu; Liu, Chia Hsuan; Pan, Li Hsiang

2016-10-01

The study aimed to investigate the relationship among self concepts, health locus of control, cognitive functioning and health-promoting lifestyles in patients diagnosed with schizophrenia. We examined health-promoting lifestyles through self-efficacy, self-esteem, health locus of control and neurocognitive factors. Fifty-six people with schizophrenia were enrolled in the study group. All subjects participated in the self-esteem (Rosenberg Self-Esteem Scale), self-efficacy (General Self-Efficacy Scale), health locus of control (The Multidimensional Health Locus of Control Scales), health-promoting lifestyles (Health Promotion Life-style Profile-II) and a series of neurocognitive measures. Stepwise regression analysis revealed that self-efficacy, internal health locus of control and attentional set-shifting accounted for 42% of the variance in total health-promoting lifestyles scores. Self-efficacy, self-esteem, internal and powerful others health locus of control and attentional set-shifting were significant predictors for domains of health-promoting lifestyles, respectively. Study findings can help mental health professionals maintain and improve health-promoting behaviors through a better understanding of self-esteem, self-efficacy, health locus of control and neurocognitive functioning among people with schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.

Clozapine in borderline personality disorder: a review of the evidence.

PubMed

Beri, Anand; Boydell, Jane

2014-05-01

Borderline personality disorder (BPD) is a serious mental disorder that is difficult to treat. Possible targets for pharmacotherapy include affective symptoms, cognitive disturbances, and impulsive, self-injurious behaviors. Although many of the medications tested for treatment of BPD have been demonstrated to be useful, no clear pharmacologic treatment has emerged. Clozapine is one of the medications that has been evaluated for the treatment of severe BPD. The aim of this review is to summarize the evidence examining the effectiveness of clozapine in the treatment of BPD. A comprehensive search of the health science databases PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Google Scholar was performed for studies describing the use of clozapine in the treatment of BPD. After the initial search, no randomized controlled trials evaluating the effectiveness of clozapine in BPD were identified. Therefore, case reports and case series were reviewed, with 12 articles selected for final review. This review suggests that clozapine may be a beneficial treatment option for BPD especially in controlling symptom severity, psychotic symptoms, impulsivity, self-mutilation, number of days on enhanced observation, use of restraint, and overall functioning.

Influenza vaccination and risk of stroke: Self-controlled case-series study.

PubMed

Asghar, Zahid; Coupland, Carol; Siriwardena, Niroshan

2015-10-05

Stroke may be triggered by respiratory infections, including influenza. Influenza vaccination could therefore reduce risk of stroke. Previous studies of this association have shown conflicting results. We aimed to investigate whether influenza vaccination was associated with reduced risk of stroke. We used a self-controlled case series design. The General Practice Research Database (GPRD) was used to extract records of patients aged 18 years or over recorded with stroke (fatal or non-fatal) from September 2001 to May 2009. Statistical modelling with conditional Poisson regression was employed to compute incidence rate ratios (IRR). The incidence rate of stroke in fixed time periods after influenza vaccination was compared with the incidence rate during a baseline period. There were 17,853 eligible individuals who received one or more influenza vaccinations and experienced a stroke during the observation period. The incidence of stroke was significantly reduced in the first 59 days following influenza vaccination compared with the baseline period. We found reductions of 55% (IRR 0.45; 95% CI 0.36-0.57) in the first 1-3 days after vaccination, 36% (0.64; 0.53-0.76) at 4-7 days, 30% (0.70; 0.61-0.79) at 8-14 days, 24% (0.76; 0.70-0.84) at 15-28 days and 17% (0.83; 0.77-0.89) at 29-59 days after vaccination. Early vaccination between 1 September and 15 November showed a greater reduction in IRR compared to later vaccination given after mid-November. Influenza vaccination is associated with a reduction in incidence of stroke. This study supports previous studies which have shown a beneficial association of influenza vaccination for stroke prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adverse Events following 12 and 18 Month Vaccinations: a Population-Based, Self-Controlled Case Series Analysis

PubMed Central

Wilson, Kumanan; Hawken, Steven; Kwong, Jeffrey C.; Deeks, Shelley; Crowcroft, Natasha S.; Van Walraven, Carl; Potter, Beth K.; Chakraborty, Pranesh; Keelan, Jennifer; Pluscauskas, Michael; Manuel, Doug

2011-01-01

Background Live vaccines have distinct safety profiles, potentially causing systemic reactions one to 2 weeks after administration. In the province of Ontario, Canada, live MMR vaccine is currently recommended at age 12 months and 18 months. Methods Using the self-controlled case series design we examined 271,495 12 month vaccinations and 184,312 18 month vaccinations to examine the relative incidence of the composite endpoint of emergency room visits or hospital admissions in consecutive one day intervals following vaccination. These were compared to a control period 20 to 28 days later. In a post-hoc analysis we examined the reasons for emergency room visits and the average acuity score at presentation for children during the at-risk period following the 12 month vaccine. Results Four to 12 days post 12 month vaccination, children had a 1.33 (1.29–1.38) increased relative incidence of the combined endpoint compared to the control period, or at least one event during the risk interval for every 168 children vaccinated. Ten to 12 days post 18 month vaccination, the relative incidence was 1.25 (95%, 1.17–1.33) which represented at least one excess event for every 730 children vaccinated. The primary reason for increased events was statistically significant elevations in emergency room visits following all vaccinations. There were non-significant increases in hospital admissions. There were an additional 20 febrile seizures for every 100,000 vaccinated at 12 months. Conclusions There are significantly elevated risks of primarily emergency room visits approximately one to two weeks following 12 and 18 month vaccination. Future studies should examine whether these events could be predicted or prevented. PMID:22174753

Self-limited coeliac-like enteropathy: a series of 18 cases highlighting another coeliac disease mimic.

PubMed

Brown, Ian S; Bettington, Andrew; Bettington, Mark; Rosty, Christophe

2016-01-01

To describe the clinical and pathological features of a series of patients with biopsy findings of a coeliac disease-like enteropathy in the setting of an acute illness. Eighteen cases of an abrupt-onset, self-limited illness with coeliac-like enteropathy (SLCE) were collected prospectively. Medication reaction, immune disorder, food allergy and parasitic infection were excluded. Coeliac disease was excluded by the transient nature of the illness and absence of tissue transglutaminase (TTG) elevation (nine of nine) or human leucocyte antigen (HLA)-DQ2/DQ8 haplotype (eight of nine). Clinical symptoms were recorded and histopathological findings in all gastrointestinal sites were quantified. Findings in the duodenum were compared to a coeliac disease control group. In 12 cases the clinical diagnosis was infective enteritis, probably viral in type. In six cases, a definite diagnosis was not established. Histological differences from coeliac disease included intra-epithelial neutrophil infiltration (P < 0.001), fewer intra-epithelial lymphocytes (P = 0.038) and uniform or crypt predominant intra-epithelial lymphocytosis in SCLE. One case displayed pan-gastrointestinal tract lymphocytosis. All resolved within 6 months. Histopathologists need to be aware that a coeliac disease-like enteropathy may occur in the setting of an acute gastrointestinal illness and resolve without sequelae. © 2015 John Wiley & Sons Ltd.

Desensitization of triggers and urge reprocessing for pathological gambling: a case series.

PubMed

Bae, Hwallip; Han, Changwoo; Kim, Daeho

2015-03-01

This case series introduces the desensitization of triggers and urge reprocessing (DeTUR), as a promising adjunctive therapy in addition to comprehensive treatment package for pathological gambling. This addiction protocol of eye movement desensitization and reprocessing was delivered to four male inpatients admitted to a 10-week inpatient program for pathological gambling. The therapist gave three 60-min weekly sessions of the DeTUR using bilateral stimulation (horizontal eye movements or alternative tactile stimuli) focusing on the hierarchy of triggering situations and the urge to initiate gambling behaviors. After treatment, self-reported gambling symptoms, depression, anxiety, and impulsiveness were all improved, and all the participants reported satisfaction with the therapy. They were followed up for 6 months and all maintained their abstinence from gambling and their symptomatic improvements. Given the efficiency (i.e., brevity and efficacy) of the treatment, a controlled study to confirm the effects of the DeTUR on pathological gambling would be justified.

Effects of extreme temperatures on cardiovascular emergency hospitalizations in a Mediterranean region: a self-controlled case series study.

PubMed

Ponjoan, Anna; Blanch, Jordi; Alves-Cabratosa, Lia; Martí-Lluch, Ruth; Comas-Cufí, Marc; Parramon, Dídac; Del Mar Garcia-Gil, María; Ramos, Rafel; Petersen, Irene

2017-04-04

Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health.

Traumatic Dental Injuries Prevalence and their Impact on Self-esteem among Adolescents in India: A Comparative Study.

PubMed

Goyal, Nikita; Singh, Simarpreet; Mathur, Anmol; Makkar, Diljot Kaur; Aggarwal, Vikram Pal; Sharma, Anshika; Kaur, Puneet

2017-08-01

Adolescents are mostly injured during sport activities, traffic accidents and some forms of violence which may lead to traumatic injuries. Traumatic injuries not only pose a health risk worldwide but are also regarded among serious social problems. Poor oral health has been related to poor social relationships that affect the ability to learn and grow which may lead to reduced self-esteem. This study was conducted to compare self-esteem of adolescents with and without anterior Traumatic Dental Injury (TDI). A population based comparative study was conducted among 10 to 17 years old adolescents from November 2014 to January 2016. The study sample comprised of 424 controls and 212 cases with 2:1 control-to-case ratio that were selected by four examiners along with a gold standard examiner. TDI was recorded using Ellis classification and self-esteem was recorded using Rosenberg's Self-Esteem Scale (RSES). For comparing self-esteem of cases and controls according to RSES questions, t-test is used. Odds ratio (OR) was utilized to assess and compare the self-esteem according to high and low esteem in cases and controls. Ellis Class I, Ellis Class II and Ellis Class III fractures were observed in 53.3%, 33.49% and 13.20% of cases, respectively. The maxillary arch was the most affected (72.48%) and on the hierarchy of causes, this study found that on most occasions dental injuries were caused by sports (40.09%). The total mean score of RSES in cases (23.16) and in controls (24.43) was also statistically significant (p<0.001). Improving oral health in schools may contribute considerably to increase the self-esteem of adolescents in a positive direction and help them in becoming socially competent adults.

Comparing the neural bases of self-referential processing in typically developing and 22q11.2 adolescents.

PubMed

Schneider, Maude; Debbané, Martin; Lagioia, Annalaura; Salomon, Roy; d'Argembeau, Arnaud; Eliez, Stephan

2012-04-01

The investigation of self-reflective processing during adolescence is relevant, as this period is characterized by deep reorganization of the self-concept. It may be the case that an atypical development of brain regions underlying self-reflective processing increases the risk for psychological disorders and impaired social functioning. In this study, we investigated the neural bases of self- and other-related processing in typically developing adolescents and youths with 22q11.2 deletion syndrome (22q11DS), a rare neurogenetic condition associated with difficulties in social interactions and increased risk for schizophrenia. The fMRI paradigm consisted in judging if a series of adjectives applied to the participant himself/herself (self), to his/her best friend or to a fictional character (Harry Potter). In control adolescents, we observed that self- and other-related processing elicited strong activation in cortical midline structures (CMS) when contrasted with a semantic baseline condition. 22q11DS exhibited hypoactivation in the CMS and the striatum during the processing of self-related information when compared to the control group. Finally, the hypoactivation in the anterior cingulate cortex was associated with the severity of prodromal positive symptoms of schizophrenia. The findings are discussed in a developmental framework and in light of their implication for the development of schizophrenia in this at-risk population. Copyright © 2011 Elsevier Ltd. All rights reserved.

A pragmatic investigation into the effects of massage therapy on the self efficacy of multiple sclerosis clients.

PubMed

Finch, Paul; Bessonnette, Susan

2014-01-01

This research was conducted to examine changes in self self-efficacy, (the perception/belief that one can competently cope with a challenging situation) in multiple sclerosis clients following a series of massage therapy treatments. This small practical trial investigated the effects of a pragmatic treatment protocol using a prospective randomized pretest posttest waitlist control design. Self-Efficacy scores were obtained before the first treatment, mid-treatment series, after the last treatment in the series, four weeks after the final treatment and again eight weeks after the final treatment had been received. The intervention involved a series of weekly one hour therapeutic massage treatments conducted over eight weeks and a subsequent eight week follow up period. All treatments were delivered by supervised student therapists in the final term of their two year massage therapy program. Self-Efficacy [SE] was the outcome for the study, measured using the Multiple Sclerosis Self-Efficacy survey [MSSE]. Descriptive statistics for SE scores were assessed and inferential analysis involved the testing of between group differences at each of the measurement points noted above. Statistically significant improvement in self-efficacy was noted between treatment (n = 8) and control (n = 7) groups at mid treatment series (t = 2.32; p < 0.02), post treatment series (t = 1.81; p < 0.05) and at four week follow up (t = 2.24; p < 0.02). At the eight week follow up self-efficacy scores had decreased and there was no statistically significant difference between groups (t = 0.87; p < 0.2). Study results support previous findings indicating that massage therapy increases the self-efficacy of clients with multiple sclerosis, potentially resulting in a better overall adjustment to the disease and an improvement in psycho-emotional state. The increase in self-efficacy after 4 weeks of treatment suggests that positive response occurs more rapidly that was previously demonstrated. The improvement in self-efficacy endured 4 weeks after the end of the treatment series, which suggests that massage therapy may have longer term effects on self-efficacy that were not previously noted. Lack of inter group difference at the eight week follow up reinforces the notion that on-going treatment is required in order to maintain the positive changes observed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Design considerations for case series models with exposure onset measurement error.

PubMed

Mohammed, Sandra M; Dalrymple, Lorien S; Sentürk, Damla; Nguyen, Danh V

2013-02-28

The case series model allows for estimation of the relative incidence of events, such as cardiovascular events, within a pre-specified time window after an exposure, such as an infection. The method requires only cases (individuals with events) and controls for all fixed/time-invariant confounders. The measurement error case series model extends the original case series model to handle imperfect data, where the timing of an infection (exposure) is not known precisely. In this work, we propose a method for power/sample size determination for the measurement error case series model. Extensive simulation studies are used to assess the accuracy of the proposed sample size formulas. We also examine the magnitude of the relative loss of power due to exposure onset measurement error, compared with the ideal situation where the time of exposure is measured precisely. To facilitate the design of case series studies, we provide publicly available web-based tools for determining power/sample size for both the measurement error case series model as well as the standard case series model. Copyright © 2012 John Wiley & Sons, Ltd.

A retrospective study of gastric dilatation and gastric dilatation and volvulus in working farm dogs in New Zealand.

PubMed

Hendriks, M M; Hill, K E; Cogger, N; Jones, B R; Cave, N J

2012-05-01

To present findings from a case series of gastric dilatation (GD) or gastric dilatation and volvulus (GDV) in working farm dogs in New Zealand that were examined at veterinary clinics, and to identify possible risk factors for GD or GDV in working farm dogs in New Zealand using a case-control study. This retrospective study included a case-series and a case-control study. The case series analysed information from 62 case records of GD or GDV in working farm dogs seen between August 2004 and September 2009 at 13 veterinary clinics throughout New Zealand. Cases were classified as GD or GDV if the diagnosis was confirmed by radiography, surgery or post-mortem examination. Details of history and treatment, as well as outcomes, were obtained for each case. For the case-control study, records of 41 working farm dogs with GD or GDV (cases) seen between April 2008 and April 2009, and 82 working farm dogs examined because of trauma over the same period and in the same 13 clinics (controls), were used to model the risk factors for GD or GDV. From the case-series study, 40/62 (65%) cases of GD or GDV that were examined and treated at the veterinary clinics returned to work. Of the 41 dogs where the gastric contents were recorded, 25 (61%) had predominantly food or bones in the stomach, and 26/27 dogs had a history of having eaten meat, bones or scavenged a carcass. The case-control study showed that the significant risk factors for GD or GDV, compared with control dogs presenting with trauma, were breed, age and season. The odds that a case of GD or GDV was a Huntaway, after adjusting for age and season, was 19 times higher than the odds a control was a Huntaway. Gender and bodyweight were not identified as risk factors. A high proportion of farm working dogs with GD or GDV were successfully treated by veterinarians. The risk of a case of GD or GDV being a Huntaway was significantly higher than for a dog presenting as a trauma case. However the influences of the season of the year, climatic factors and nutritional factors on the pathogenesis need to be identified before adequate preventative measures can be recommended.

Orthotic intervention incorporating the dart-thrower's motion as part of conservative management guidelines for treatment of scapholunate injury.

PubMed

Anderson, Hamish; Hoy, Greg

2016-01-01

Case series. This paper describes conservative guidelines for the management of scapho-lunate interosseous ligament (SLIL) injury including fabrication of an orthosis that restricts active wrist movement to the dart-throwers (DTM) plane. The dart throwers' orthosis (DTO) was designed as a response to biomechanical studies suggesting that restraining motion to the DTM would off-load a deficient SLIL. After six weeks of wearing the DTO, the 5 patients in this case series initiated an exercise program that incorporated wrist proprioceptive training and specific muscle strengthening. The DTO was designed to incorporate controlled movement in order to better integrate the secondary wrist stabilizers in wrists that had a deficient SLIL. The orthosis and the exercise program harnessed proprioceptive influences using active motion within the DTM plane, and stimulated mechanoreceptors so as to enhance stability. All patients demonstrated improvement in subjective and objective outcomes including self-reported pain and function. Orthotic intervention that controls motion within the DTM, combined with an appropriate proprioceptive rehabilitation program, may provide a viable conservative treatment option for patients with a similar clinical presentation. 4. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Chiropractic care and risk for acute lumbar disc herniation: a population-based self-controlled case series study.

PubMed

Hincapié, Cesar A; Tomlinson, George A; Côté, Pierre; Rampersaud, Y Raja; Jadad, Alejandro R; Cassidy, J David

2017-10-16

Chiropractic care is popular for low back pain, but may increase the risk for acute lumbar disc herniation (LDH). Low back pain is a common early (prodromal) symptom of LDH and commonly precedes LDH diagnosis. Our objective was to investigate the association between chiropractic care and acute LDH with early surgical intervention, and contrast this with the association between primary care physician (PCP) care and acute LDH with early surgery. Using a self-controlled case series design and population-based healthcare databases in Ontario, Canada, we investigated all adults with acute LDH requiring emergency department (ED) visit and early surgical intervention from April 1994 to December 2004. The relative incidence of acute LDH with early surgery in exposed periods after chiropractic visits relative to unexposed periods was estimated within individuals, and compared with the relative incidence of acute LDH with early surgery following PCP visits. 195 cases of acute LDH with early surgery (within 8 weeks) were identified in a population of more than 100 million person-years. Strong positive associations were found between acute LDH and both chiropractic and PCP visits. The risk for acute LDH with early surgery associated with chiropractic visits was no higher than the risk associated with PCP visits. Both chiropractic and primary medical care were associated with an increased risk for acute LDH requiring ED visit and early surgery. Our analysis suggests that patients with prodromal back pain from a developing disc herniation likely seek healthcare from both chiropractors and PCPs before full clinical expression of acute LDH. We found no evidence of excess risk for acute LDH with early surgery associated with chiropractic compared with primary medical care.

Bell’s palsy and influenza(H1N1)pdm09 containing vaccines: A self-controlled case series

PubMed Central

Wijnans, Leonoor; Weibel, Daniel; Sturkenboom, Miriam

2017-01-01

Background An association between AS03 adjuvanted pandemic influenza vaccine and the occurrence of Bell’s palsy was found in a population based cohort study in Stockholm, Sweden. To evaluate this association in a different population, we conducted a self-controlled case series in a primary health care database, THIN, in the United Kingdom. The aim of this study was to determine whether there was an increased risk of Bell’s palsy following vaccination with any influenza vaccine containing A/California/7/2009 (H1N1)-like viral strains. Secondly, we investigated whether risks were different following pandemic influenza A(H1N1)pdm09 vaccines and seasonal influenza vaccines containing the influenza A(H1N1)pdm09 strain. Methods The study population comprised all incident Bell’s palsy cases between 1 June 2009 and 30 June 2013 identified in THIN. We determined the relative incidence (RI) of Bell’s palsy during the 6 weeks following vaccination with either pandemic or seasonal influenza vaccine. All analyses were adjusted for seasonality and confounding variables. Results We found an incidence rate of Bell’s palsy of 38.7 per 100,000 person years. Both acute respiratory infection (ARI) consultations and pregnancy were found to be confounders. When adjusted for seasonality, ARI consultations and pregnancies, the RI during the 42 days after vaccination with an influenza vaccine was 0.85 (95% CI: 0.72–1.01). The RI was similar during the 42 days following seasonal vaccine (0.96, 95%CI: 0.82–1.13) or pandemic vaccine (0.73, 95%CI: 0.47–1.12). Conclusion We found no evidence for an increased incidence of Bell’s palsy following seasonal influenza vaccination overall, nor for monovalent pandemic influenza vaccine in 2009. PMID:28467420

Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases.

PubMed

Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart

2016-01-01

Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed.

Demographic risk factors of self-immolation: a case-control study.

PubMed

Ahmadi, Alireza; Mohammadi, Reza; Schwebel, David C; Khazaie, Habibolah; Yeganeh, Naser; Almasi, Afshin

2009-06-01

To investigate demographic risk factors for self-immolation patients. In a case-control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional Burn centre (Imam Khomeini hospital in Kermanshah province, Iran) were compared with 30 controls who were selected from the community and matched by gender, age, and living area. All cases and controls were reviewed for demographic variables, including: age, gender, living area, family size, marital status, bearing and number of children, Body Mass Index (BMI), birth order, employment state, educational status, early school drop-out, and parent/guardian employment status. Two variables emerged as related to risk of self-immolation. Being the first or last child in family birth order was associated with increased risk of self-immolation. Moreover, among the married participants, having children was associated with decreased risk of self-immolation. The comparisons of other variables were not statistically significant. In multivariate analyses, none of the variables predicted risk for self-immolation. This study suggests that being the first or last child of a family might be a risk factor for self-immolation. For married persons, having children might serve as a protective factor from self-immolation. Other variables such as family size, marital status, number of children, BMI, employment state, educational status, early school drop-out, and parent/guardian employment status did not play a role as individually protective or risk factors for self-immolation.

Parental Low Self-Control, Family Environments, and Juvenile Delinquency.

PubMed

Meldrum, Ryan C; Connolly, George M; Flexon, Jamie; Guerette, Rob T

2016-10-01

Research consistently finds that low self-control is significantly correlated with delinquency. Only recently, however, have researchers started to examine associations between parental low self-control, family environments, and child antisocial behavior. Adding to this emerging area of research, the current study examines associations between parental low self-control, aspects of the family environment, and officially recoded juvenile delinquency among a sample (N = 101) of juveniles processed through a juvenile justice assessment facility located in the Southeastern United States. Furthermore, it considers whether aspects of family environments, particularly family cohesion, family conflict, and parental efficacy, mediate the influence of parental low self-control on delinquency. The results of a series of analyses indicate that parental low self-control is correlated with various aspects of family environments and juvenile delinquency, and that the association between parental low self-control and juvenile delinquency is mediated by family environments. Supplementary analyses also suggest that the association between parental low self-control and the family environment may be reciprocal. © The Author(s) 2015.

Biomedical Informatics Approaches to Identifying Drug-Drug Interactions: Application to Insulin Secretagogues

PubMed Central

Han, Xu; Chiang, ChienWei; Leonard, Charles E.; Bilker, Warren B.; Brensinger, Colleen M.; Li, Lang; Hennessy, Sean

2017-01-01

Background Drug-drug interactions with insulin secretagogues are associated with increased risk of serious hypoglycemia in patients with type 2 diabetes. We aimed to systematically screen for drugs that interact with the five most commonly used secretagogues―glipizide, glyburide, glimepiride, repaglinide, and nateglinide―to cause serious hypoglycemia. Methods We screened 400 drugs frequently co-prescribed with the secretagogues as candidate interacting precipitants. We first predicted the drug–drug interaction potential based on the pharmacokinetics of each secretagogue–precipitant pair. We then performed pharmacoepidemiologic screening for each secretagogue of interest, and for metformin as a negative control, using an administrative claims database and the self-controlled case series design. The overall rate ratios (RRs) and those for four predefined risk periods were estimated using Poisson regression. The RRs were adjusted for multiple estimation using semi-Bayes method, and then adjusted for metformin results to distinguish native effects of the precipitant from a drug–drug interaction. Results We predicted 34 pharmacokinetic drug–drug interactions with the secretagogues, nine moderate and 25 weak. There were 140 and 61 secretagogue–precipitant pairs associated with increased rates of serious hypoglycemia before and after the metformin adjustment, respectively. The results from pharmacokinetic prediction correlated poorly with those from pharmacoepidemiologic screening. Conclusions The self-controlled case series design has the potential to be widely applicable to screening for drug–drug interactions that lead to adverse outcomes identifiable in healthcare databases. Coupling pharmacokinetic prediction with pharmacoepidemiologic screening did not notably improve the ability to identify drug–drug interactions in this case. PMID:28169935

Video game therapy for emotional regulation and impulsivity control in a series of treated cases with bulimia nervosa.

PubMed

Fagundo, Ana B; Santamaría, Juan J; Forcano, Laura; Giner-Bartolomé, Cristina; Jiménez-Murcia, Susana; Sánchez, Isabel; Granero, Roser; Ben-Moussa, Maher; Magnenat-Thalmann, Nadia; Konstantas, Dimitri; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Bults, Richard G A; Tarrega, Salomé; Menchón, José M; de la Torre, Rafael; Cardi, Valentina; Treasure, Janet; Fernández-Aranda, Fernando

2013-11-01

Although standard psychological treatments have been successful in treating several core features in eating disorders (ED), other characteristics such as emotional regulation or impulsivity appear to be more resistant to change. There is a growing body of evidence to support the efficacy of cognitive remediation for cognitive and emotional difficulties in ED. Playmancer/ Islands is a video game (VG) designed to specifically treat mental disorders, characterized by problems in impulse control. The objective of the game is to increase self-control over emotions, decision making and behaviours. The aim of this study is to describe the results from a consecutive series of nine bulimia nervosa patients who were treated with the VG in addition to cognitive behaviour therapy (CBT). The outcomes included clinical and psychopathological questionnaires, and physiological measures were obtained during the VG. Emotional regulation improved, heart rate variability increased, and respiratory rate and impulsivity measures reduced after the treatment. These findings suggest that VG training may enhance treatment for ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Using Educational Neuroscience and Psychology to Teach Science. Part 1: A Case Study Review of Cognitive Load Theory (CLT) and Cognitive Acceleration through Science Education (CASE)

ERIC Educational Resources Information Center

Jenkins, Rebecca Torrance

2017-01-01

This article is the first of a two-part series that explores science teachers' and their pupils' experiences of using different pedagogical approaches based on understandings of how brains learn. For this case-study research, nine science teachers were interviewed and four teachers self-selected to trial a pedagogical approach, new to them, from…

Behavioral Problems and Childhood Epilepsy: Parent vs Child Perspectives.

PubMed

Eom, Soyong; Caplan, Rochelle; Berg, Anne T

2016-12-01

To test whether the reported association between pediatric epilepsy and behavioral problems may be distorted by the use of parental proxy report instruments. Children in the Connecticut Study of Epilepsy were assessed 8-9 years after their epilepsy diagnosis (time-1) with the parent-proxy Child Behavior Check List (CBCL) (ages 6-18 years) or the Young Adult Self-Report (≥18 years of age). For children <18 years of age, parents also completed the Child Health Questionnaire, which contains scales for impact of child's illness on the parents. The same study subjects completed the Adult Self-Report 6-8 years later (time-2). Sibling controls were also tested. Case-control differences were examined for evidence suggesting more behavioral problems in cases with epilepsy than in controls based on proxy- vs self-report measures. At time-1, parent-proxy CBCL scores were significantly higher (worse) for cases than controls (n = 140 matched pairs). After adjustment for Child Health Questionnaire scales reflecting parent emotional and time impact, only 1 case-control difference on the CBCL remained significant. Self-reported Young Adult Self-Report scores did not differ between cases and controls (n = 42 pairs). At time-2, there were no significant self-reported case-control differences on the Adult Self-Report (n = 105 pairs). Parent-proxy behavior measures appear to be influenced by the emotional impact of epilepsy on parents. This may contribute to apparent associations between behavioral problems and childhood epilepsy. Self-report measures in older adolescents (>18 years of age) and young adults do not confirm parental perceptions. Evidence suggesting more behavioral problems in children with epilepsy should be interpreted in light of the source of information. Copyright © 2016 Elsevier Inc. All rights reserved.

Type 2 diabetes–related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature

PubMed Central

Bonner, Timethia; Foster, Margaret; Spears-Lanoix, Erica

2016-01-01

Introduction The purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions. Methods Medline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted. Results Thirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices. Conclusion Preventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations. PMID:26899439

Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature.

PubMed

Bonner, Timethia; Foster, Margaret; Spears-Lanoix, Erica

2016-01-01

The purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions. Medline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted. Thirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices. Preventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations.

[School Organization: Theory and Practice; Selected Readings on Grading, Nongrading, Multigrading, Self-Contained Classrooms, Departmentalization, Team Heterogeneous Grouping. Selected Bibliographies.] Rand McNally Education Series.

ERIC Educational Resources Information Center

Franklin, Marian Pope, Comp.

Over 400 journal articles, case studies, research reports, dissertations, and position papers are briefly described in a series of eight selected bibliographies related to school organization. The eight specific areas treated in the volume and the number of items listed for each include: nongraded elementary school organization, 96; nongraded…

Psychological Factors in Deliberate Self-Harm as Seen in an Urban African Population in Uganda: A Case-Control Study

ERIC Educational Resources Information Center

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2005-01-01

Psychological factors associated with deliberate self-harm (DSH) as seen in an African population in Uganda are described. A case-control study design was employed in which a Luganda version (predominant language in the study area) of the modified European Parasuicide Interview Schedule I (EPSIS I) was used to collect data. The controls were…

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk.

PubMed

Pettersson, David; Bottai, Matteo; Mathiesen, Tiit; Prochazka, Michaela; Feychting, Maria

2015-01-01

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

Benefits of group cognitive remediation therapy in anorexia nervosa: case series.

PubMed

Tchanturia, Kate; Larsson, Emma; Brown, Amy

2016-03-01

Cognitive remediation therapy (CRT) is a treatment targeting cognitive difficulties in psychiatric disorders. CRT has been used with patients with severe anorexia nervosa (AN) in individual and group formats. Research of group CRT in AN is limited. Evaluation of a series of CRT groups delivered in inpatient and intensive daycare services was performed. Participants' self-reported cognitive flexibility and central coherence, as well as motivation to change were assessed pre- and post-group. Additionally, patients' evaluative feedback was collected after completion of the group. There was a significant improvement in the patients' self-reported cognitive flexibility and bigger picture thinking, as well as in their self-efficacy to change. The feedback questionnaires highlighted that patients found the sessions useful and reported confidence in using some of the skills and strategies they learnt in the group. In line with evidence from small-scale reports, this larger scale case series study indicates that group CRT leads to increased flexibility and bigger picture thinking, as well as improved confidence in the ability to change for participants. CRT in a group format seems to be a practical and helpful intervention for patients with AN in intensive treatment programmes.

Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study.

PubMed

Bressington, Daniel; Mui, Jolene; Hulbert, Sabina; Cheung, Eric; Bradford, Stephen; Gray, Richard

2014-02-27

People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP. ISRCTN12582470.

Testing self-regulation interventions to increase walking using factorial randomized N-of-1 trials.

PubMed

Sniehotta, Falko F; Presseau, Justin; Hobbs, Nicola; Araújo-Soares, Vera

2012-11-01

To investigate the suitability of N-of-1 randomized controlled trials (RCTs) as a means of testing the effectiveness of behavior change techniques based on self-regulation theory (goal setting and self-monitoring) for promoting walking in healthy adult volunteers. A series of N-of-1 RCTs in 10 normal and overweight adults ages 19-67 (M = 36.9 years). We randomly allocated 60 days within each individual to text message-prompted daily goal-setting and/or self-monitoring interventions in accordance with a 2 (step-count goal prompt vs. alternative goal prompt) × 2 (self-monitoring: open vs. blinded Omron-HJ-113-E pedometer) factorial design. Aggregated data were analyzed using random intercept multilevel models. Single cases were analyzed individually. The primary outcome was daily pedometer step counts over 60 days. Single-case analyses showed that 4 participants significantly increased walking: 2 on self-monitoring days and 2 on goal-setting days, compared with control days. Six participants did not benefit from the interventions. In aggregated analyses, mean step counts were higher on goal-setting days (8,499.9 vs. 7,956.3) and on self-monitoring days (8,630.3 vs. 7,825.9). Multilevel analyses showed a significant effect of the self-monitoring condition (p = .01), the goal-setting condition approached significance (p = .08), and there was a small linear increase in walking over time (p = .03). N-of-1 randomized trials are a suitable means to test behavioral interventions in individual participants.

Guillain-Barré Syndrome and Adjuvanted Pandemic Influenza A (H1N1) 2009 Vaccines: A Multinational Self-Controlled Case Series in Europe

PubMed Central

Dieleman, Jeanne P.; Olberg, Henning K.; de Vries, Corinne S.; Sammon, Cormac; Andrews, Nick; Svanström, Henrik; Mølgaard-Nielsen, Ditte; Hviid, Anders; Lapeyre-Mestre, Maryse; Sommet, Agnès; Saussier, Christel; Castot, Anne; Heijbel, Harald; Arnheim-Dahlström, Lisen; Sparen, Par; Mosseveld, Mees; Schuemie, Martijn; van der Maas, Nicoline; Jacobs, Bart C.; Leino, Tuija; Kilpi, Terhi; Storsaeter, Jann; Johansen, Kari; Kramarz, Piotr; Bonhoeffer, Jan; Sturkenboom, Miriam C. J. M.

2014-01-01

Background The risk of Guillain-Barré syndrome (GBS) following the United States' 1976 swine flu vaccination campaign in the USA led to enhanced active surveillance during the pandemic influenza (A(H1N1)pdm09) immunization campaign. This study aimed to estimate the risk of GBS following influenza A(H1N1)pdm09 vaccination. Methods A self-controlled case series (SCCS) analysis was performed in Denmark, Finland, France, Netherlands, Norway, Sweden, and the United Kingdom. Information was collected according to a common protocol and standardised procedures. Cases classified at levels 1–4a of the Brighton Collaboration case definition were included. The risk window was 42 days starting the day after vaccination. Conditional Poisson regression and pooled random effects models estimated adjusted relative incidences (RI). Pseudo likelihood and vaccinated-only methods addressed the potential contraindication for vaccination following GBS. Results Three hundred and three (303) GBS and Miller Fisher syndrome cases were included. Ninety-nine (99) were exposed to A(H1N1)pdm09 vaccination, which was most frequently adjuvanted (Pandemrix and Focetria). The unadjusted pooled RI for A(H1N1)pdm09 vaccination and GBS was 3.5 (95% Confidence Interval (CI): 2.2–5.5), based on all countries. This lowered to 2.0 (95% CI: 1.2–3.1) after adjustment for calendartime and to 1.9 (95% CI: 1.1–3.2) when we accounted for contra-indications. In a subset (Netherlands, Norway, and United Kingdom) we further adjusted for other confounders and there the RI decreased from 1.7 (adjusted for calendar month) to 1.4 (95% CI: 0.7–2.8), which is the main finding. Conclusion This study illustrates the potential of conducting European collaborative vaccine safety studies. The main, fully adjusted analysis, showed that the RI of GBS was not significantly elevated after influenza A(H1N1)pdm09 vaccination (RI = 1.4 (95% CI: 0.7–2.8). Based on the upper limits of the pooled estimate we can rule out with 95% certainty that the number of excess GBS cases after influenza A(H1N1)pdm09 vaccination would be more than 3 per million vaccinated. PMID:24404128

Pediatric and adolescent gynecology learned via a Web-based computerized case series.

PubMed

De Silva, Nirupama K; Dietrich, Jennifer E; Young, Amy E

2010-04-01

To increase resident knowledge in pediatric and adolescent gynecology via a Web-based self-tutorial. Prospective cohort involving 11 third- and fourth-year residents in a large university program. Residents were asked to complete a Web-based teaching series of cases involving common topics of pediatric and adolescent gynecology (PAG). A pretest and a posttest were completed to assess knowledge gained. Residents were asked to give feedback regarding improvements to the Web-based series for future case development. University-affiliated residency program in a major metropolitan area. Resident physicians in the Department of Obstetrics and Gynecology. Introduction of a Web-based teaching series to enhance resident education. Improvement of resident knowledge in PAG. All residents improved their knowledge in PAG after reviewing the series of cases. The pretest group mean score was 50%. The posttest group score was 69% (P < .05). All (100%) of participants said that this tool was an effective way to improve resident knowledge in PAG. A computer-based self-tutorial in pediatric and adolescent gynecology is a feasible and satisfactory teaching adjunct to PAG. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Effects due to induced azimuthal eddy currents in a self-exciting Faraday disk homopolar dynamo with a nonlinear series motor. I.. Two special cases

NASA Astrophysics Data System (ADS)

Hide, Raymond; Moroz, Irene M.

1999-10-01

The elucidation of the behaviour of physically realistic self-exciting Faraday-disk dynamos bears inter alia on attempts by theoretical geophysicists to interpret observations of geomagnetic polarity reversals. Hide [The nonlinear differential equations governing a hierarchy of self-exciting coupled Faraday-disk homopolar dynamos, Phys. Earth Planet. Interiors 103 (1997) 281-291; Nonlinear quenching of current fluctuations in a self-exciting homopolar dynamo, Nonlinear Processes in Geophysics 4 (1998) 201-205] has introduced a novel 4-mode set of nonlinear ordinary differential equations to describe such a dynamo in which a nonlinear electric motor is connected in series with the coil. The applied couple, α, driving the disk is steady and the Lorentz couple driving the motor is a quadratic function, x(1-ɛ)+ɛσx 2, of the dynamo-generated current x, with 0≤ɛ≤1. When there are no additional biasing effects due to background magnetic fields etc., the behaviour of the dynamo is determined by eight independent non-negative control parameters. These include ρ, proportional to the resistance of the disk to azimuthal eddy currents, and β, an inverse measure of the moment of inertia of the armature of the motor. When β=0 (the case when the motor is absent and ɛ and σ are redundant) and ρ -1≠0 , the 4-mode dynamo equations reduce to the 3-mode Lorenz equations, which can behave chaotically [E. Knobloch, Chaos in the segmented disc dynamo, Phys. Lett. A 82 (1981) 439-440]. When β≠0 but ρ -1=0 , the 4-mode set of equations reduces to a 3-mode dynamo [R. Hide (1997), see above], which can also behave chaotically when ɛ=0 [R. Hide, A.C. Skeldon, D.J. Acheson, A study of two novel self-exciting single-disk homopolar dynamos: theory, Proc. R. Soc. Lond. A 452 (1996) 1369-1395] but not when ɛ=1 [R. Hide (1998), see above]. In the latter case, however, all persistent fluctuations are completely quenched [R. Hide (1998), see above]. In this paper we investigate two limiting cases of ɛ=0 and ɛ=1 in the 4-mode dynamo when azimuthal eddy currents are allowed to flow i.e. cases when ρ -1=0 ; in a companion paper [I.M. Moroz, R. Hide, Effects due to induced azimuthal eddy currents in the Faraday disk self-exciting homopolar dynamo with a nonlinear series motor: II The general case, 1999, submitted] we extend the present analysis to the general case of 0≤ɛ≤1. When ɛ=0, chaotic behaviour occurs even more extensively in parameter space in the presence of azimuthal eddy currents than in their absence. When ɛ=1, the quenching of chaotic and all other non-steady dynamo action is no longer complete, for aperiodic solutions are found within limited regions of parameter space where β is very small and α is very large.

Dogmatism, Locus of Control, Perceived Counselor Self-Efficacy, and the Theoretical Orientation of Students in a Master's Level Counseling Practicum

ERIC Educational Resources Information Center

Benesh, Andrew Christopher

2017-01-01

Purpose: The purpose of this study was to fill a gap in the literature by examining the relationship between dogmatism, locus of control, counselor self-efficacy, and counselor theoretical orientation in a sample of master's level practicum students. Method: A total of 45 master's practicum students completed a series of four instruments, the DOG…

No increased risk of Guillain-Barré syndrome after human papilloma virus vaccine: A self-controlled case-series study in England.

PubMed

Andrews, Nick; Stowe, Julia; Miller, Elizabeth

2017-03-23

To investigate the risk of Guillain-Barré syndrome (GBS) after human papilloma virus (HPV) vaccine given to 12-18year old girls in England. Hospital Episode Statistics (HES) were searched using data to March 2016 to identify incident cases of GBS in female patients aged from 11 to 20years eligible to have received the HPV vaccine since its introduction as a 3 dose schedule in September 2008. Diagnosis was confirmed by the case's general practitioner (GP) who also provided HPV vaccination dates. The risk of admission within 3months (primary risk window) 6 and 12months of any dose was assessed using the self-controlled case-series (SCCS) method in vaccinated girls with age, season and time-period adjustment. The risk before and after the change in 2012 from bivalent vaccine to quadrivalent vaccine was also assessed. A total 244 episodes were initially identified which reduced to 101 episodes in 100 girls when just including cases where the GP could be contacted, at least one vaccine dose was given, and GBS was confirmed or classed as probable. Nine, 14 and 24GBS admissions occurred within 3, 6, 12months of a dose respectively. The relative incidence (RI) for the 3month risk period was 1.04 (95% confidence interval 0.47-2.28), for the 6month period 0.83 (0.41-1.69) and for the 12month period 1.10 (0.57-2.14). When restricting to 79 confirmed cases the RI in the 3month risk period was 1.26 (0.55-2.92) and the RI 1.61 (0.39-6.54) for quadrivalent vaccine compared to 0.84 (0.30-2.34) for bivalent. We found no evidence of an increased risk of GBS following HPV vaccination in England and, based on the upper end of the 95% CI for the RI and the number of HPV vaccine doses given in England, can exclude a risk of about 1 per million doses. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Employment as a welder and Parkinson disease among heavy equipment manufacturing workers.

PubMed

Marsh, Gary M; Gula, Mary Jean

2006-10-01

We investigated whether employment as a welder with potential exposure to manganese and other substances is associated with Parkinson disease (PD), parkinsonism or related neurological disorders, or accelerates the age of onset of PD. We selected cases and controls from 12,595 persons ever employed at three Caterpillar Inc. (CAT) plants between 1976 and 2004 with potential to make a medical insurance claim between 1998 and 2004. Cases had filed a claim for 1) PD, 2) "secondary parkinsonism", 3) "other degenerative diseases of the basal ganglia" or 4) "essential and other specific forms of tremor". Cases were grouped by claims: Group 1-claims 1 and 2 and Group 2-claims 1 to 4, and as study period incident (SPI) or prevalent. Each case was matched to two series of 10 controls each on date of case's first claim, year of birth, race and sex. Series I was also matched on plant. Odds ratios (OR) and 95% confidence intervals (CI) for the variable, "ever welder in any CAT plant" were: Group 1-SPI Cases: Series I (OR = .76, CI = .26-2.19), Series II (OR = .81, CI = .29-2.25); Group 1- Prevalent Cases: Series I (OR = .82, CI = .36-1.86), Series II (OR = .97, CI = .42-2.23); Group 2- SPI Cases: Series I (OR = 1.03, CI = .57-1.87), Series II (OR = 1.21, CI = .67-2.20) Group 2-Prevalent Cases: Series I (OR = 1.02, CI = .62-1.71), Series II (OR = .86, CI = .51-1.43). Our finding of no statistically significant associations for welding employment was maintained following adjustment for potential confounding and evaluation of possible effect modification. Employment as a welder did not accelerate the age of onset of PD. Our study supported the conclusion that employment as a welder is not associated with Parkinson disease, parkinsonism or a related neurological disorder.

Deconstructing the effect of self-directed study on episodic memory

PubMed Central

Markant, Douglas; DuBrow, Sarah; Davachi, Lila; Gureckis, Todd M.

2014-01-01

Self-directed learning is often associated with better long-term memory retention, however, the mechanisms that underlie this advantage remain poorly understood. This series of experiments was designed to “deconstruct” the notion of self-directed learning in order to better identify the factors most responsible for these improvements to memory. In particular, we isolate the memory advantage that comes from controlling the content of study episodes from the advantage that comes from controlling the timing of those episodes. Across four experiments, self-directed learning significantly enhanced recognition memory relative to passive observation. However, the advantage for self-directed learning was found to be present even under extremely minimal conditions of volitional control (simply pressing a button when ready to advance to the next item). Our results suggest that improvements to memory following self-directed encoding may be related to the ability to coordinate stimulus presentation with the learner’s current preparatory or attentional state, and highlight the need to consider the range of cognitive control processes involved in and influenced by self-directed study. PMID:24941938

The utility of the Kohlman Evaluation of Living Skills test is associated with substantiated cases of elder self-neglect.

PubMed

Pickens, Sabrina; Naik, Aanand D; Burnett, Jason; Kelly, P A; Gleason, Mary; Dyer, Carmel B

2007-03-01

Self-neglect is the most prevalent finding among cases reported to Adult Protective Services (APS) and is characterized by an inability to meet one's own basic needs. The Kohlman evaluation of living skills (KELS) has been validated in geriatric populations to assess performance with both instrumental and basic activities of daily living and as an assessment tool for the capacity to live independently; therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders. This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from APS as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender, and ZIP code. A geriatric nurse practitioner (NP)-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and mini-mental state examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls. The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p = .025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p = .013). Abnormal results using an in-home KELS test were significantly associated with substantiated cases of self-neglect. There is currently no gold-standard measure for identifying capacity with self-care behaviors among cases of self-neglect. As a result, self-neglect may remain unidentified in many clinical settings. The KELS provides clinicians with an objective measure of an individual's capacity and performance with everyday life-supporting tasks and thus, provides information that can help NPs identify elders at risk for self-neglect. These findings suggest that the KELS test has significant utility as part of a comprehensive geriatric assessment to aid clinicians in suspected cases of self-neglect.

Opioid Analgesics and the Risk of Serious Infections Among Patients With Rheumatoid Arthritis: A Self-Controlled Case Series Study.

PubMed

Wiese, Andrew D; Griffin, Marie R; Stein, C Michael; Mitchel, Edward F; Grijalva, Carlos G

2016-02-01

Animal studies and in vitro human studies suggest that certain opioid analgesics impair crucial immune functions. This study was undertaken to determine whether opioid use is associated with increased risk of serious infection in patients with rheumatoid arthritis (RA). We conducted a self-controlled case series analysis on a retrospective cohort of 13,796 patients with RA enrolled in Tennessee Medicaid in 1995-2009. Within-person comparisons of the risk of hospitalization for serious infection during periods of opioid use versus non-use were performed using conditional Poisson regression. Fixed confounders were accounted for by design; time-varying confounders included age and use of disease-modifying antirheumatic drugs, glucocorticoids, and proton-pump inhibitors. In additional analyses, risks associated with new opioid use, use of opioids known to have immunosuppressive properties, use of long-acting opioids, and different opioid dosages were assessed. Sensitivity analyses were performed to account for potential protopathic bias and confounding by indication. Among 1,790 patients with RA who had at least 1 hospitalization for serious infection, the adjusted incidence rate of serious infection was higher during periods of current opioid use compared to non-use, with an incidence rate ratio (IRR) of 1.39 (95% confidence interval [95% CI] 1.19-1.62). The incidence rate was also higher during periods of long-acting opioid use, immunosuppressive opioid use, and new opioid use compared to non-use (IRR 2.01 [95% CI 1.52-2.66], IRR 1.72 [95% CI 1.33-2.23], and IRR 2.38 [95% CI 1.65-3.42], respectively). Results of sensitivity analyses were consistent with the main findings. In within-person comparisons of patients with RA, opioid use was associated with an increased risk of hospitalization for serious infection. © 2016, American College of Rheumatology.

Advantages of the Multiple Case Series Approach to the Study of Cognitive Deficits in Autism Spectrum Disorder

ERIC Educational Resources Information Center

Towgood, Karren J.; Meuwese, Julia D. I.; Gilbert, Sam J.; Turner, Martha S.; Burgess, Paul W.

2009-01-01

In the neuropsychological case series approach, tasks are administered that tap different cognitive domains, and differences within rather than across individuals are the basis for theorising; each individual is effectively their own control. This approach is a mainstay of cognitive neuropsychology, and is particularly suited to the study of…

Innovative Power Wheelchair Control Interface: A Proof-of-Concept Study

PubMed Central

Romero, Sergio; Prather, Emily; Ramroop, Marisa; Slaibe, Emmy; Christensen, Matthew

2016-01-01

Some people without independent mobility are candidates for powered mobility but are unable to use a traditional power wheelchair joystick. This proof-of-concept study tested and further developed an innovative method of driving power wheelchairs for people whose impairments prevent them from operating commercial wheelchair controls. Our concept, Self-referenced Personal Orthotic Omni-purpose Control Interface (SPOOCI), is distinguished by referencing the control sensor not to the wheelchair frame but instead to the adjacent proximal lower-extremity segment via a custom-formed orthosis. Using a descriptive case-series design, we compared the pre–post functional power wheelchair driving skill data of 4 participants, measured by the Power Mobility Program, using descriptive analyses. The intervention consisted of standard-care power wheelchair training during 12 outpatient occupational or physical therapy sessions. All 4 participants who completed the 12-wk intervention improved their functional power wheelchair driving skills using SPOOCI, but only 3 were deemed safe to continue with power wheelchair driving. PMID:26943118

Promoting Creativity and Self-Efficacy of Elementary Students through a Collaborative Research Task in Mathematics: A Case Study

ERIC Educational Resources Information Center

Katz, Sara; Stupel, Moshe

2015-01-01

There is a consensus among mathematicians and mathematics educators that creativity plays an essential role in doing mathematics. Creative students are self-regulated students who take control over processes and experience high self-efficacy beliefs. The aim of this case study was to promote mathematical creativity and self-efficacy of elementary…

Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010-2016.

PubMed

Wright, Marc-Oliver; Allen-Bridson, Katherine; Hebden, Joan N

2017-06-01

The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance definitions are the most widely used criteria for health care-associated infection (HAI) surveillance. NHSN participants agree to conduct surveillance in accordance with the NHSN protocol and criteria. To assess the application of these standardized surveillance specifications and offer infection preventionists (IPs) opportunities for ongoing education, a series of case studies, with questions related to NHSN definitions and criteria were published. Beginning in 2010, case studies with multiple-choice questions based on standard surveillance criteria and protocols were written and published in the American Journal of Infection Control with a link to an online survey. Participants anonymously submitted their responses before receiving the correct answers. The 22 case studies had 7,950 respondents who provided 27,790 responses to 75 questions during the first 6 years. Correct responses were selected 62.5% of the time (17,376 out of 27,290), but ranged widely (16%-87%). In a subset analysis, 93% of participants self-identified as IPs (3,387 out of 3,640), 4.5% were public health professionals (163 out of 3,640), and 2.5% were physicians (90 out of 3,640). IPs responded correctly (62%) more often than physicians (55%) (P = .006). Among a cohort of voluntary participants, accurate application of surveillance criteria to case studies was suboptimal, highlighting the need for continuing education, competency development, and auditing. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Severe Propanil [N-(3,4-dichlorophenyl) propanamide] Pesticide Self-Poisoning

PubMed Central

Eddleston, Michael; Rajapakshe, Manjula; Roberts, Darren; Reginald, K; Sheriff, M H Rezvi; Dissanayake, Wasantha; Buckley, Nick

2007-01-01

Background propanil pesticide poisoning can produce methaemoglobinaemia, tissue hypoxia, and depression of CNS and respiratory system. It has been recorded only rarely worldwide and most current poison texts consider propanil to be of low toxicity. However, propanil self-poisoning is a significant clinical problem in parts of Sri Lanka and a not uncommon cause of death. Aim of study to report the clinical features and management of severe propanil poisoning. Patients and Methods we report a retrospective case series of patients who were treated in the intensive care unit (ICU) of and/or died in Anuradhapura General Hospital between 1998 and early 2002. Results sixteen patients were identified. Common manifestations of toxicity included confusion, reduced conscious level, cyanosis, and respiratory depression. Marked haemolysis was noted in several patients. Nine deaths occurred due to respiratory depression and cardiorespiratory arrest. Management was difficult given the lack of IV methylene blue, inability to measure methaemoglobin levels, and paucity of ICU beds. Conclusions this series indicates that propanil poisoning can be a severe form of self-poisoning, particularly in resource-poor settings. We have now initiated the establishment of a prospective series of propanil poisoned patients to further describe its clinical features, responsiveness to therapy, and case fatality rate. PMID:12507053

Occupational factors and pancreatic cancer.

PubMed Central

Norell, S; Ahlbom, A; Olin, R; Erwald, R; Jacobson, G; Lindberg-Navier, I; Wiechel, K L

1986-01-01

The relation between occupational factors and pancreatic cancer has been studied by two different approaches: a population based case-control study with two series of controls and a retrospective cohort study based on register data. With both approaches, some support was found for an association with occupational exposure to petroleum products. Associations were also indicated with exposure to paint thinner (case-control study) and work in painting and in paint and varnish factories (cohort study), for exposure to detergents, floor cleaning agents, or polish (case-control study) and with floor polishing or window cleaning (cohort study), and for exposure to refuse (case-control study) and work in refuse disposal plants (cohort study). PMID:3790458

Gravitational instability of slowly rotating isothermal spheres

NASA Astrophysics Data System (ADS)

Chavanis, P. H.

2002-12-01

We discuss the statistical mechanics of rotating self-gravitating systems by allowing properly for the conservation of angular momentum. We study analytically the case of slowly rotating isothermal spheres by expanding the solutions of the Boltzmann-Poisson equation in a series of Legendre polynomials, adapting the procedure introduced by Chandrasekhar (1933) for distorted polytropes. We show how the classical spiral of Lynden-Bell & Wood (1967) in the temperature-energy plane is deformed by rotation. We find that gravitational instability occurs sooner in the microcanonical ensemble and later in the canonical ensemble. According to standard turning point arguments, the onset of the collapse coincides with the minimum energy or minimum temperature state in the series of equilibria. Interestingly, it happens to be close to the point of maximum flattening. We generalize the singular isothermal solution to the case of a slowly rotating configuration. We also consider slowly rotating configurations of the self-gravitating Fermi gas at non-zero temperature.

Experimental study of transport of a dimer on a vertically oscillating plate

PubMed Central

Wang, Jiao; Liu, Caishan; Ma, Daolin

2014-01-01

It has recently been shown that a dimer, composed of two identical spheres rigidly connected by a rod, under harmonic vertical vibration can exhibit a self-ordered transport behaviour. In this case, the mass centre of the dimer will perform a circular orbit in the horizontal plane, or a straight line if confined between parallel walls. In order to validate the numerical discoveries, we experimentally investigate the temporal evolution of the dimer's motion in both two- and three-dimensional situations. A stereoscopic vision method with a pair of high-speed cameras is adopted to perform omnidirectional measurements. All the cases studied in our experiments are also simulated using an existing numerical model. The combined investigations detail the dimer's dynamics and clearly show that its transport behaviours originate from a series of combinations of different contact states. This series is critical to our understanding of the transport properties in the dimer's motion and related self-ordered phenomena in granular systems. PMID:25383029

A Weight-Loss Program Using Self-Control Techniques in a Correctional Facility: An Experimental Case Study

ERIC Educational Resources Information Center

Goldenberg, Edward E.; DeNinno, John

1977-01-01

Self-control techniques were taught to an obese 27-year-old black male to help modify overeating behavior. Self-reinforcement was utilized in addition to systematic isolation of chained eating behavior from associated stimulus situations. A physical exercise program was employed in conjunction with the self-control techniques. (Author)

ELECTRICAL AND ELECTRONIC INDUSTRIAL CONTROL, STATIC CONTROL SERIES. BASIC CONTROL FUNCTIONS, UNIT 9A.

ERIC Educational Resources Information Center

SUTTON, MACK C.

THIS SELF-INSTRUCTIONAL PROGRAMED TEXT IS FOR INDIVIDUAL STUDENT USE IN STUDYING STATIC CONTROL IN ELECTRICAL-ELECTRONIC PROGRAMS. IT WAS DEVELOPED BY AN INSTRUCTIONAL MATERIALS SPECIALIST AND ADVISERS AND HAS BEEN TESTED BY STUDENT USE. THE OBJECTIVE OF THE COURSE IS TO HELP THE ELECTRICAL-TECHNICIAN DEVELOP AN UNDERSTANDING OF STATIC CONTROL…

Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series

PubMed Central

Centeno, Christopher J; Pitts, John; Al-Sayegh, Hasan; Freeman, Michael D

2015-01-01

Introduction This was a prospective case series designed to investigate treatment for anterior cruciate ligament (ACL) tears using an injection of autologous bone marrow concentrate. Methods Consecutive adult patients presenting to a private outpatient interventional musculoskeletal and pain practice with knee pain, ACL laxity on exam, and magnetic resonance imaging (MRI) evidence of a grade 1, 2, or 3 ACL tears with less than 1 cm retraction were eligible for this study. Eligible patients were treated with an intraligamentous injection of autologous bone marrow concentrate, using fluoroscopic guidance. Pre- and postprocedural sagittal MRI images of the ACLs were analyzed using ImageJ software to objectively quantify changes between pre- and posttreatment scans. Five different types of measurement of ACL pixel intensity were examined as a proxy for ligament integrity. In addition pain visual analog scale (VAS) and Lower Extremity Functional Scale (LEFS) values were recorded at baseline and at 1 month, 3 months, 6 months, and annually postinjection. Objective outcomes measured were pre- to post-MRI measurement changes, as analyzed by the ImageJ software. Subjective outcomes measured were changes in the VAS and LEFS, and a self-rated percentage improvement. Results Seven of ten patients showed improvement in at least four of five objective measures of ACL integrity in their postprocedure MRIs. In the entire study group, the mean gray value, median, raw integrated density, and modal gray value all decreased toward low-signal ACLs (P=0.01, P=0.02, P=0.002, and P=0.08), indications of improved ligament integrity. Seven of ten patients responded to the self-rated metrics follow up. The mean VAS change was a decrease of 1.7 (P=0.25), the mean LEFS change was an increase of 23.3 (P=0.03), and mean reported improvement was 86.7%. Conclusion Based on this small case series, autologous bone marrow concentrate shows promise in the treatment of grade 1, 2, and possibly grade 3 ACL tears without retraction. Further investigation using a controlled study design is warranted. PMID:26261424

Does high flexion after total knee replacement really improve our patients' quality of life at a short-term follow-up? : a comparative case-control study with hyperflex PFC Sigma versus a Triathlon knee series.

PubMed

Mencière, Maxime L; Epinette, Jean-Alain; Gabrion, Antoine; Arnalsteen, Damien; Mertl, Patrice

2014-10-01

A full range of motion after total knee arthroplasty has become more and more requested by our patients, leading to novel designs of knee implants, the so-called "hyperflex" knees. The aim of the present study was to confirm whether or not hyperflexion of operated knees really improves the patients' quality of life. A retrospective comparative case-control study has been carried out to compare clinical results shown in two types of knee prosthesis, from two homogeneous paired groups of patients including 45 cases of a "hyperflex" model (RP-F), while the control group consisted of 43 cases of a "regular design" model (Triathlon) in terms of expected postoperative flexion. The hyperflex group demonstrated significant higher mean values of passive flexion at 119.9° in the RP-F group versus 111.1° in the Triathlon group. However, global results in the "regular" control group were significantly better than the "hyperflex" study group, in both IKS knee and functional scores at 84.4 points (RP-F) vs. 89.8 points (Triathlon), and 84.6 points (RP-F) vs. 89.5 points (Triathlon), respectively. Moreover, the self-administered KOOS questionnaire was significantly in favor of the control group, with 73.5 points in RP-F knees versus 86.0 points for Triathlon knees at global KOOS postoperative scores. The quality of life of operated patients after TKA obviously would be considered as the main priority, which was better obtained by a "regular design" in our study. Hence "high flexion" cannot be considered as an absolute target when choosing a model for total knee arthroplasty.

A critical assessment of the association between postnatal toxoplasmosis and epilepsy in immune-competent patients.

PubMed

Uzorka, J W; Arend, S M

2017-07-01

While postnatal toxoplasmosis in immune-competent patients is generally considered a self-limiting and mild illness, it has been associated with a variety of more severe clinical manifestations. The causal relation with some manifestations, e.g. myocarditis, has been microbiologically proven, but this is not unequivocally so for other reported associations, such as with epilepsy. We aimed to systematically assess causality between postnatal toxoplasmosis and epilepsy in immune-competent patients. A literature search was performed. The Bradford Hill criteria for causality were used to score selected articles for each component of causality. Using an arbitrary but defined scoring system, the maximal score was 15 points (13 for case reports). Of 704 articles, five case reports or series and five case-control studies were selected. The strongest evidence for a causal relation was provided by two case reports and one case-control study, with a maximal causality score of, respectively, 9/13, 10/13 and 10/15. The remaining studies had a median causality score of 7 (range 5-9). No selection bias was identified, but 6/10 studies contained potential confounders (it was unsure whether the infection was pre- or postnatal acquired, or immunodeficiency was not specifically excluded). Based on the evaluation of the available literature, although scanty and of limited quality, a causal relationship between postnatal toxoplasmosis and epilepsy seems possible. More definite proof requires further research, e.g. by performing Toxoplasma serology in all de novo epilepsy cases.

The risk of intussusception following monovalent rotavirus vaccination in England: A self-controlled case-series evaluation.

PubMed

Stowe, Julia; Andrews, Nick; Ladhani, Shamez; Miller, Elizabeth

2016-07-12

To investigate the risk of intussusception after monovalent rotavirus vaccine (RV1) given to infants aged 2 and 3 months in England. Hospital Episode Statistics (HES) were used to identify infants aged 48-183 days admitted between 11/03/2013 and 31/10/2014 with intussusception. Diagnosis was confirmed from medical records and HES procedure codes. Vaccination status was obtained from general practitioners. The risk of admission within 1-7 and 8-21 days of vaccination was analysed using the self-controlled case-series (SCCS) method with age effect adjustment by including historical data before RVI introduction in July 2013. A total of 119 cases were identified during the study period and intussusception confirmed in 95 of whom 39 were vaccinated 1-21 days before onset. An increased relative incidence (RI) in this period was found, 4.53 (95% confidence interval 2.34-8.58) and 2.60 (1.43-4.81) respectively after the 1st and 2nd doses with an attributable risk of 1.91 and 1.49 per 100,000 doses respectively. The peak risk was 1-7 days after the first dose, RI 13.81 (6.44-28.32), with an estimated 93% of the 15 cases being vaccine-attributable. Mean interval between onset and admission, and clinical features were similar between vaccine-associated and background cases. Despite intussusception being a contraindication to rotavirus vaccination, 10 infants received a further dose; none had a recurrence. The RIs in a meta-analysis combing our results with Australia, Mexico, Brazil and Singapore using RV1, a 2, 4 month schedule and SCCS gave pooled RI estimates of 2.35 (1.45-3.8) and 1.77 (1.29-2.43) in the 21 day period after the 1st and 2nd doses, respectively. The earlier age at the 2nd dose in England did not affect the risk. We estimate that the RVI programme causes around 21 intussusception admissions annually in England but, since it prevents around 25,000 gastro-intestinal infection admissions, its benefit/risk profile remains strongly positive. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Computer Aided Self-Instruction Training with Impulsive Deaf Students and Learning Disabled Students: A Study on Teaching Reflective Thought. Education and Technology Series.

ERIC Educational Resources Information Center

Campbell, Donald S.; And Others

Two studies examined the effectiveness of self-instruction training via a specially developed computer program to modify the impulsive problem-solving behavior of 16 deaf and 10 learning disabled (aphasic) adolescents attending two special residential schools in Canada. In the control condition, students learned the Apple LOGO computing language…

Test-retest of self-reported exposure to artificial tanning devices, self-tanning creams, and sun sensitivity showed consistency.

PubMed

Beane Freeman, Laura E; Dennis, Leslie K; Lynch, Charles F; Lowe, John B; Clarke, William R

2005-04-01

Exposure to ultraviolet radiation has consistently been linked to an increased risk of melanoma. Epidemiologic studies are susceptible to measurement error, which can distort the magnitude of observed effects. Although the reliability of self-report of many sun exposure factors has been previously described in several studies, self-report of use of artificial tanning devices and self-tanning creams has been less well characterized. A mailed survey was re-administered 2-4 weeks after completion of the initial survey to 76 randomly selected participants in a case-control study of melanoma. Cases and controls were individuals diagnosed in 1999 and 2000 who were ascertained from the Iowa Cancer Registry in 2002. We assessed the consistency of self-reported use of sunlamps and self-tanning creams, sun sensitivity, and history of sunburns. There was substantial reliability in reporting the use of sunlamps or self-tanning creams (cases: Kappa (kappa)=1.0 for both exposures; controls: kappa=0.71 and 0.87, respectively). kappa estimates of 0.62-0.78 were found for overall reliability of several sun sensitivity factors. Overall, the survey instrument demonstrated substantial reproducibility for factors related to the use of sunlamps or tanning beds, self-tanning creams, and sun sensitivity factors.

Bisphosphonates and risk of atrial fibrillation: a meta-analysis

PubMed Central

2010-01-01

Introduction Bisphosphonates are the most commonly used drugs for the prevention and treatment of osteoporosis. Although a recent FDA review of the results of clinical trials reported no clear link between bisphosphonates and serious or non-serious atrial fibrillation (AF), some epidemiologic studies have suggested an association between AF and bisphosphonates. Methods We conducted a meta-analysis of non-experimental studies to evaluate the risk of AF associated with bisphosphonates. Studies were identified by searching MEDLINE and EMBASE using a combination of the Medical Subject Headings and keywords. Our search was limited to English language articles. The pooled estimates of odds ratios (OR) as a measure of effect size were calculated using a random effects model. Results Seven eligible studies with 266,761 patients were identified: three cohort, three case-control, and one self-controlled case series. Bisphosphonate exposure was not associated with an increased risk of AF [pooled multivariate OR 1.04, 95% confidence interval (CI) 0.92-1.16] after adjusting for known risk factors. Moderate heterogeneity was noted (I-squared score = 62.8%). Stratified analyses by study design, cohort versus case-control studies, yielded similar results. Egger's and Begg's tests did not suggest an evidence of publication bias (P = 0.90, 1.00 respectively). No clear asymmetry was observed in the funnel plot analysis. Few studies compared risk between bisphosphonates or by dosing. Conclusions Our study did not find an association between bisphosphonate exposure and AF. This finding is consistent with the FDA's statement. PMID:20170505

What's in a Name? The Incorrect Use of Case Series as a Study Design Label in Studies Involving Dogs and Cats.

PubMed

Sargeant, J M; O'Connor, A M; Cullen, J N; Makielski, K M; Jones-Bitton, A

2017-07-01

Study design labels are used to identify relevant literature to address specific clinical and research questions and to aid in evaluating the evidentiary value of research. Evidence from the human healthcare literature indicates that the label "case series" may be used inconsistently and inappropriately. Our primary objective was to determine the proportion of studies in the canine and feline veterinary literature labeled as case series that actually corresponded to descriptive cohort studies, population-based cohort studies, or other study designs. Our secondary objective was to identify the proportion of case series in which potentially inappropriate inferential statements were made. Descriptive evaluation of published literature. One-hundred published studies (from 19 journals) labeled as case series. Studies were identified by a structured literature search, with random selection of 100 studies from the relevant citations. Two reviewers independently characterized each study, with disagreements resolved by consensus. Of the 100 studies, 16 were case series. The remaining studies were descriptive cohort studies (35), population-based cohort studies (36), or other observational or experimental study designs (13). Almost half (48.8%) of the case series or descriptive cohort studies, with no control group and no formal statistical analysis, included inferential statements about the efficacy of treatment or statistical significance of potential risk factors. Authors, peer-reviewers, and editors should carefully consider the design elements of a study to accurately identify and label the study design. Doing so will facilitate an understanding of the evidentiary value of the results. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Low-intensity LED therapy (658 nm) on burn healing: a series of cases.

PubMed

de Oliveira, Rauirys Alencar; Boson, Luara Lis Barbosa; Portela, Seísa Marina Martins; Filho, Antônio Luiz Martins Maia; de Oliveira Santiago, Denyberg

2018-05-01

The objective of this study was to evaluate the effects of LED on burns healing. Five patients with skin burns were submitted to photobiomodulation by LED, GaAsIP diode, (λ 658 nm) with 40 mW, 7 J/cm 2 on every other day. Biopsies of burned skin were performed and the healing process was photographed. Patients with bilateral burns were used as self-control, having one limb being irradiated and the contralateral limb irradiated with placebo. The burns treated with LED showed higher epithelization, with keratinocytes and fibroblasts proliferation, increased collagen synthesis, decreased pain, and pruritus. In conclusion, there was a faster clinical improvement in the irradiated limbs.

Exposure to community violence and self-harm in California: A multi-level, population-based, case-control study.

PubMed

Matthay, Ellicott C; Farkas, Kriszta; Skeem, Jennifer; Ahern, Jennifer

2018-06-07

Self-harm is a leading cause of morbidity and mortality. Exposure to community violence is an important and potentially modifiable feature of the social environment that may affect self-harm, but studies to date are limited in the samples and outcomes examined. We conducted a population-based, nested case-control study. Cases were all deaths and hospital visits due to self-harm in California, 2006-2013. We frequency-matched California resident population-based controls from the American Community Survey to cases on age, gender, race/ethnicity, and year of survey/injury. We assessed past-year community violence using deaths and hospital visits due to interpersonal violence in the community of residence. We estimated risk-difference parameters that were defined to avoid extrapolation and to capture associations between changes in the distribution of community violence and the population-level risk of self-harm. After adjustment for confounders, setting past-year community violence to the lowest monthly levels observed within each community over the study period was associated with a 30.1 (95% CI: 29.6 to 30.5) per 100,000 persons per year lower risk of nonfatal self-harm, but no difference in the risk of fatal self-harm. Associations for a parameter corresponding to a hypothetical violence prevention intervention targeting high-violence communities indicated a 5% decrease in self-harm at the population level. In sensitivity analyses, results were robust. This study strengthens evidence on the relationship between community violence and self-harm. Future research should investigate reasons for differential associations by age and gender and whether community violence prevention programs have meaningful impacts on self-harm.

Comparison of Six- and Eight-Session Cognitive Guided Self-Help for Bulimia Nervosa

ERIC Educational Resources Information Center

Furber, Gareth; Steele, Anna; Wade, Tracey D.

2004-01-01

A previous case-series evaluation of a six-session guided self-help (GSH) approach with 15 people with bulimia nervosa (BN) showed significant reductions across all measures, including binge eating, self-induced vomiting, weight concern, shape concern and dietary restraint. However, the reduction of binge eating and self-induced vomiting was…

Social and economic inequalities in fatal opioid and cocaine related overdoses in Luxembourg: a case-control study.

PubMed

Origer, Alain; Le Bihan, Etienne; Baumann, Michèle

2014-09-01

To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case-control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Being professionally active [OR=0.66 (95% CI 0.45-0.99)], reporting salary as main legal income source [OR=0.42 (95% CI 0.26-0.67)] and education attainment higher than primary school [OR=0.50 (95% CI 0.34-0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. Copyright © 2014 Elsevier B.V. All rights reserved.

An approach to checking case-crossover analyses based on equivalence with time-series methods.

PubMed

Lu, Yun; Symons, James Morel; Geyh, Alison S; Zeger, Scott L

2008-03-01

The case-crossover design has been increasingly applied to epidemiologic investigations of acute adverse health effects associated with ambient air pollution. The correspondence of the design to that of matched case-control studies makes it inferentially appealing for epidemiologic studies. Case-crossover analyses generally use conditional logistic regression modeling. This technique is equivalent to time-series log-linear regression models when there is a common exposure across individuals, as in air pollution studies. Previous methods for obtaining unbiased estimates for case-crossover analyses have assumed that time-varying risk factors are constant within reference windows. In this paper, we rely on the connection between case-crossover and time-series methods to illustrate model-checking procedures from log-linear model diagnostics for time-stratified case-crossover analyses. Additionally, we compare the relative performance of the time-stratified case-crossover approach to time-series methods under 3 simulated scenarios representing different temporal patterns of daily mortality associated with air pollution in Chicago, Illinois, during 1995 and 1996. Whenever a model-be it time-series or case-crossover-fails to account appropriately for fluctuations in time that confound the exposure, the effect estimate will be biased. It is therefore important to perform model-checking in time-stratified case-crossover analyses rather than assume the estimator is unbiased.

Investigating the Problem of Skill Generalization: Literature Review III.

ERIC Educational Resources Information Center

Haring, Norris

The third in a series of literature reviews, this monograph presents three articles on skill generalization among individuals with severe disabilities. Kathleen A. Liberty analyzes the results of 15 studies to determine how teaching self-control affected students' performance in training and generalization, "Behavior-Control of Stimulus Events to…

Empirical performance of the self-controlled case series design: lessons for developing a risk identification and analysis system.

PubMed

Suchard, Marc A; Zorych, Ivan; Simpson, Shawn E; Schuemie, Martijn J; Ryan, Patrick B; Madigan, David

2013-10-01

The self-controlled case series (SCCS) offers potential as an statistical method for risk identification involving medical products from large-scale observational healthcare data. However, analytic design choices remain in encoding the longitudinal health records into the SCCS framework and its risk identification performance across real-world databases is unknown. To evaluate the performance of SCCS and its design choices as a tool for risk identification in observational healthcare data. We examined the risk identification performance of SCCS across five design choices using 399 drug-health outcome pairs in five real observational databases (four administrative claims and one electronic health records). In these databases, the pairs involve 165 positive controls and 234 negative controls. We also consider several synthetic databases with known relative risks between drug-outcome pairs. We evaluate risk identification performance through estimating the area under the receiver-operator characteristics curve (AUC) and bias and coverage probability in the synthetic examples. The SCCS achieves strong predictive performance. Twelve of the twenty health outcome-database scenarios return AUCs >0.75 across all drugs. Including all adverse events instead of just the first per patient and applying a multivariate adjustment for concomitant drug use are the most important design choices. However, the SCCS as applied here returns relative risk point-estimates biased towards the null value of 1 with low coverage probability. The SCCS recently extended to apply a multivariate adjustment for concomitant drug use offers promise as a statistical tool for risk identification in large-scale observational healthcare databases. Poor estimator calibration dampens enthusiasm, but on-going work should correct this short-coming.

Relationship between Self-Control and Facebook Use: Case of CEIT Students

ERIC Educational Resources Information Center

Firat, Mehmet

2017-01-01

This is an explanatory mixed-method study that analyzes the relationship between the variables of students' self-control and Facebook usage. TIME's online Facebook calculator and the Brief Self-Control Scale are used for data collection. The research participants are 60 students in a department of computer education and instructional technology…

The Management of Independent Learning. Staff and Educational Development Series.

ERIC Educational Resources Information Center

Tait, Jo, Ed.; Knight, Peter, Ed.

The development of key competencies through higher education is of increasing interest in government, industry, and academics. The contributors to this collection of research analyses and case studies focus on the competencies associated with self-motivated autonomous lifelong learning. Examining a variety of issues from a British perspective, the…

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis.

PubMed

Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

2015-03-01

Between April and June, 2012, a reactive cholera vaccination campaign was done in Haiti with an oral inactivated bivalent whole-cell vaccine. We aimed to assess the effectiveness of the vaccine in a case-control study and to assess the likelihood of bias in that study in a bias-indicator study. Residents of Bocozel or Grand Saline who were eligible for the vaccination campaign (ie, age ≥12 months, not pregnant, and living in the region at the time of the vaccine campaign) were included. In the primary case-control study, cases had acute watery diarrhoea, sought treatment at one of three participating cholera treatment units, and had a stool sample positive for cholera by culture. For each case, four control individuals who did not seek treatment for acute watery diarrhoea were matched by location of residence, enrolment time (within 2 weeks of the case), and age (1-4 years, 5-15 years, and >15 years). Cases in the bias-indicator study were individuals with acute watery diarrhoea with a negative stool sample for cholera. Controls were selected in the same manner as in the primary case-control study. Trained staff used standard laboratory procedures to do rapid tests and stool cultures from study cases. Participants were interviewed to collect data on sociodemographic characteristics, risk factors for cholera, and self-reported vaccination. Data were analysed by conditional logistic regression, adjusting for matching factors. From Oct 24, 2012, to March 9, 2014, 114 eligible individuals presented with acute watery diarrhoea and were enrolled, 25 of whom were subsequently excluded. 47 participants were analysed as cases in the vaccine effectiveness case-control study and 42 as cases in the bias-indicator study. 33 (70%) of 47 cholera cases self-reported vaccination versus 167 (89%) of 188 controls (vaccine effectiveness 63%, 95% CI 8-85). 27 (57%) of 47 cases had certified vaccination versus 147 (78%) of 188 controls (vaccine effectiveness 58%, 13-80). Neither self-reported nor verified vaccination was significantly associated with non-cholera diarrhoea (vaccine effectiveness 18%, 95% CI -208 to 78 by self-report and -21%, -238 to 57 by verified vaccination). Bivalent whole-cell oral cholera vaccine effectively protected against cholera in Haiti from 4 months to 24 months after vaccination. Vaccination is an important component of efforts to control cholera epidemics. National Institutes of Health, Delivering Oral Vaccines Effectively project, and Department of Global Health and Social Medicine at Harvard Medical School. Copyright © 2015 Ivers et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study

PubMed Central

Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

2015-01-01

Background Between April and June 2012, a reactive cholera vaccination campaign was conducted in Haiti using an oral inactivated bivalent whole-cell vaccine (BivWC). Methods We conducted a case-control study to estimate field effectiveness of the vaccine. Cases had acute watery diarrhea, sought treatment at one of three participating cholera treatment units from October 24, 2012 through March 9, 2014, and had a stool sample positive for cholera by culture. For each case, four controls (individuals who did not seek treatment for acute watery diarrhea) were matched by location of residence, calendar time, and age. We also conducted a bias-indicator case-control study to assess the likelihood of bias in the vaccine effectiveness (VE) study. Findings During the study period, 114 eligible individuals presented with acute watery diarrhea and were enrolled. 47 were analyzed as cases in the VE case-control study and 42 as cases in the bias-indicator study. In multivariable analyses, VE was 63% [95% confidence interval (CI): 8%–85%] by self-reported vaccination and 58% [95% CI: 13%–80%] for verified vaccination. Neither self-reported nor verified vaccination was significantly associated with non-cholera diarrhea (VE: 18% [95% CI: −208%–−78%] by self-report and −21% [95%CI: −238%–57%] for verified vaccination). Interpretation BivWC oral cholera vaccine was effective in protecting against cholera in Haiti during the study period –from 4 through 24 months after vaccination. Vaccination is an important component of epidemic cholera control efforts. Funding National Institutes of Health, Delivering Oral Vaccines Effectively project, Department of Global Health and Social Medicine at Harvard Medical School. PMID:25701994

EFFECTS OF HOME-CARE TRAINING ON THE SELF-EFFICACY OF PATIENTS WITH BETA THALASSEMIA MAJOR

PubMed Central

Moghadam, Mahdieh Poodineh; Nourisancho, Hajar; Shahdadi, Hossein; Shahraki, Sohila; Azarkish, Batoul; Balouchi, Abbas

2016-01-01

Background: The self-efficacy of thalassemia patients is an important factor in creating behavioral changes in such patients. Home-care training reduces hospitalization duration as well as relevant costs and improves disease outcomes. This study was designed to assess the effect of home-care training on the self-efficacy of patients with beta thalassemia major. Methodology: This was a quasi-experimental, case-control, before and after intervention study conducted on 136 thalassemia cases from January 2014 to October 2015. Data was collected through Shere general self-efficacy questionnaire (SGSES). Home-care trainings were provided in the form of training courses with respect to the training needs of thalassemia major cases. Two (2) months after the end of training courses, SGSES questionnaire was filled again and the obtained data was analyzed by SPSS 21 as well as descriptive-inferential statistics (significance level=P≤0.05). Results: The results of this study revealed that the mean self-efficacy score of control group was 48.69±6.82 before intervention which increased to 46.69±6.81 after intervention. The mean self-efficacy score of case group was 44.58±5.23 before intervention which increased to 49.5±6.66 after intervention. The rise of self-efficacy score, after intervention, was significantly higher in the case group compared with the control group (P≤.001). Conclusion: According to results, home-care training can develop self-efficacy in thalassemia patients. In home-care training procedure patients play an active role. By providing home-care trainings, therefore, an effective step should be taken to promote the self-efficacy of the patients and to decrease associated problems. PMID:27999484

Traffic rule violations of private bus drivers and bus crashes in Sri Lanka: a case-control study.

PubMed

Jayatilleke, Achala Upendra; Poudel, Krishna C; Nakahara, Shinji; Dharmaratne, Samath D; Jayatilleke, Achini Chinthika; Jimba, Masamine

2010-06-01

To explore the association between self-reported traffic rule violations of private sector bus drivers and bus crashes in the Kandy district, Sri Lanka. We carried out a case-control study from August to September 2006. Cases were all the private bus drivers registered in the Kandy district and involved in crashes reported to the police between November 2005 and April 2006 (n = 63). We included two control groups: the private bus drivers working on the same routes of the cases (n = 90; matched controls) and the drivers selected randomly from the other routes of the district (n = 111; unmatched controls). We used a self-administered questionnaire to collect data on the self-reported traffic rule violations and analyzed the association between the self-reported traffic rule violations and crashes using logistic regression. The following variables showed significant associations with private bus crashes: illegal overtaking (matched controls, adjusted odds ratio [AOR] = 14.78, unmatched controls, AOR = 1.04), taking passengers outside the bus bays (matched controls, AOR = 3.96, unmatched controls, AOR = 2.29), and overloading (matched controls, AOR = 10.26, unmatched controls, AOR = 1.93). However, we did not observe an association between high-speed driving and bus crashes matched controls, AOR = 1.22, unmatched controls, AOR = 0.81. Traffic rule violations, such as illegal overtaking, overloading, and taking passengers outside the bus bays, are significant risk factors for private bus crashes in Sri Lanka.

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS--a case-control study in primary care.

PubMed

Grodzinsky, Ewa; Walter, Susanna; Viktorsson, Lisa; Carlsson, Ann-Kristin; Jones, Michael P; Faresjö, Åshild

2015-01-28

Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care. A case-control study in primary care setting among IBS patients meeting the ROME III criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any present or previous gastrointestinal complaints. The data were collected through self-reported questionnaires of psychosocial factors. IBS-patients reported significantly more negative self-esteem (p < 0.001), lower scores for positive self-esteem (p < 0.001), and lower sense of coherence (p < 0.001) than the controls. The IBS-cases were also less likely to report 'good' health status (p < 0.001) and less likely to report a positive belief in the future (p < 0.001). After controlling for relevant confounding factors in multiple regressions, the elevation in negative self-esteem among IBS patients remained statistically significant (p = 0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04). The more frequently reported negative self-esteem and inferior coping strategies among IBS patients found in this study suggest the possibility that psychological therapies might be helpful for these patients. However these data do not indicate the causal direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.

Life satisfaction and beliefs about self and the world in patients with psoriasis: a brief assessment.

PubMed

Solovan, Caius; Marcu, Mirona; Chiticariu, Elena

2014-01-01

Psoriasis is a chronic skin condition that can decrease the level of self-esteem, leading to self-devaluation, emotional distress, irrational beliefs and discomfort in everyday life. In this study, we aimed to provide a deeper understanding of lifestyle satisfaction and to identify the nature and magnitude of irrational beliefs in patients with psoriasis. A two-year case-control study was carried out between 2010 and 2012. The study enrolled 100 consecutive patients with psoriasis vulgaris, admitted to a dermatology clinic and 101 healthy volunteers with similar demographic characteristics, willing to subject themselves to the testing. A series of standardized questionnaires were used, including: The Anamnestic Questionnaire, The General Attitudes and Beliefs Scale - Short version, The Rosenberg Self-Esteem Scale, The Self-Efficacy Scale and The Unconditional Self-Acceptance Questionnaire. The tests revealed a strong correlation between the presence of the disease and the decrease of subject's satisfaction regarding: body satisfaction, sexual satisfaction, social satisfaction, family satisfaction, professional satisfaction and satisfaction concerning their own health condition; p<0.01. There were highly significant differences with a large effect regarding the level of irrational beliefs between the two groups of subjects (p<0.01; f > 0.35). The focus on psychological impacts of the disease provides important data for a holistic approach to patients with psoriasis. Effective cooperation between all the parties involved (physicians, family and social network) is necessary to improve the patient's psychological status.

Self-inflicted burns in patients with chronic combat-related post-traumatic stress disorder.

PubMed

Bras, Marijana; Loncar, Zoran; Boban, Maja; Gregurek, Rudolf; Brajković, Lovorka; Tomicić, Hrvoje; Muljacić, Ante; Micković, Vlatko; Kalenić, Barbara

2007-12-01

This study examined self-inflicted burns in case series of four patients with chronic combat-related post-traumatic stress disorder (PTSD). Those patients were hospitalized in the Burn Unit of the University Hospital of Traumatology in Zagreb because of severe burns and had a premorbid psychiatric history of PTSD. Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of these patients were collected. The authors have analyzed possible impacts of the sensationalistic way in which media present cases of self-inflicted burning that induce other, new cases of this suicide type, known in the literature as "Werther's syndrome". The importance of multidisciplinary approach in the treatment of burn patients is stressed with emphasis on the important role of liaison psychiatrist in treating these patients. It is necessary to educate media people to avoid sensational reporting on this kind of events. Continuous psychiatric treatment of vulnerable individuals could be useful in prevention of self-inflicted burns.

The Risk of Fractures Associated with Thiazolidinediones: A Self-controlled Case-Series Study

PubMed Central

Douglas, Ian J.; Evans, Stephen J.; Pocock, Stuart; Smeeth, Liam

2009-01-01

Background The results of clinical trials have suggested that the thiazolidinedione antidiabetic agents rosiglitazone and pioglitazone are associated with an increased risk of fractures, but such studies had limited power. The increased risk in these trials appeared to be limited to women and mainly involved fractures of the arm, wrist, hand, or foot: risk patterns that could not be readily explained. Our objective was to further investigate the risk of fracture associated with thiazolidinedione use. Methods and Findings The self-controlled case-series design was used to compare rates of fracture during thiazolidinedione exposed and unexposed periods and thus estimate within-person rate ratios. We used anonymised primary care data from the United Kingdom General Practice Research Database (GPRD). All patients aged 40 y or older with a recorded fracture and at least one prescription for a thiazolidinedione were included (n = 1,819). We found a within-person rate ratio of 1.43 (95% confidence interval [CI] 1.25–1.62) for fracture at any site comparing exposed with unexposed periods among patients prescribed any thiazolidinedione. This association was similar in men and women and in patients treated with either rosiglitazone or pioglitazone. The increased risk was also evident at a range of fracture sites, including hip, spine, arm, foot, wrist, or hand. The risk increased with increasing duration of thiazolidinedione exposure: rate ratio 2.00 (95% CI 1.48–2.70) for 4 y or more of exposure. Conclusion Within individuals who experience a fracture, fracture risk is increased during periods of exposure to thiazolidinediones (both rosiglitazone and pioglitazone) compared with unexposed periods. The increased risk is observed in both men and women and at a range of fracture sites. The risk also increases with longer duration of use. Please see later in the article for the Editors' Summary PMID:19787025

Difficult removal of fully covered self expandable metal stents (SEMS) for benign biliary strictures: the "SEMS in SEMS" technique.

PubMed

Tringali, Andrea; Blero, Daniel; Boškoski, Ivo; Familiari, Pietro; Perri, Vincenzo; Devière, Jacques; Costamagna, Guido

2014-06-01

Removal of biliary Fully Covered Self Expandable Metal Stents can fail due to stent migration and/or hyperplastic ingrowth/overgrowth. A case series of 5 patients with benign biliary strictures (2 post-cholecystectomy, 2 following liver transplantation and 1 related to chronic pancreatitis) is reported. The biliary stricture was treated by temporary insertion of Fully Covered Self Expandable Metal Stents. Stent removal failed due to proximal stent migration and/or overgrowth. Metal stent removal was attempted a few weeks after the insertion of another Fully Covered Metal Stent into the first one. The inner Fully Covered Self Expandable Metal Stent compressed the hyperplastic tissue, leading to the extraction of both the stents in all cases. Two complications were reported as a result of the attempt to stents removal (mild pancreatitis and self-limited haemobilia). In the present series, the "SEMS in SEMS" technique revealed to be effective when difficulties are encountered during Fully Covered Self Expandable Metal Stents removal. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Where There Is a Way, Is There a Will? The Effect of Future Choices on Self-Control

ERIC Educational Resources Information Center

Khan, Uzma; Dhar, Ravi

2007-01-01

Choices often involve self-control conflicts such that options that are immediately appealing are less desirable in the long run. In the current research, the authors examine how viewing such a choice as one of a series of similar future choices rather than as an isolated decision decreases the preference for items requiring self-control. The…

Cognitive functioning correlates of self-esteem and health locus of control in schizophrenia

PubMed Central

Wang, Chien-Shu; Wu, Jo Yung-Wei; Chang, Wei-Chung; Chuang, Shu-Ping

2013-01-01

Aim The study aimed to investigate the relationship among sociodemographic factors, neurocognitive factors, self-esteem, and health locus of control in patients diagnosed with schizophrenia. We examined the self-esteem, internal health locus of control, and external health locus of control through sociodemographic and neurocognitive factors. Methods Forty-six schizophrenic patients and 31 healthy residents from the community or hospital were recruited as the control group. All subjects participated in the self-esteem questionnaire, health locus of control questionnaire, and a series of neuropychological measures. Results Multiple regression analysis revealed that inhibition of attention and external health locus of control were predictors for self-esteem (r=−0.30, P<0.05; r=0.41, P<0.01); inhibition of attention and external health locus of control were contributors for internal health locus of control (r=−0.43, P<0.01; r=0.61, P<0.001); and education was related to external health locus of control (r=−0.31, P<0.05). Conclusion The current study integrated background characteristics and cognitive function to better understand the impact of self-esteem and health locus of control in schizophrenia. The findings indicated that inhibition of attention, external health locus of control, and education contributed to self-esteem, internal health locus of control and external health locus of control. However, the overall predicted variance accounted for by these predictors was small; thus, further research is necessary to examine imperative variables related with self-esteem and health locus of control in schizophrenia. PMID:24194641

Intussusception following rotavirus vaccination in the Valencia Region, Spain.

PubMed

Pérez-Vilar, Silvia; Díez-Domingo, Javier; Puig-Barberà, Joan; Gil-Prieto, Ruth; Romio, Silvana

2015-01-01

Studies have shown high intussusception rates in Spain. We performed a hospital-based retrospective observational study of the intussusception risk following rotavirus vaccinations among infants in Valencia, a region of Spain with an annual birth cohort of approximately 48,000 children, during 2007-2011, using a self-controlled case series design. We performed medical record review of all cases using Brighton Collaboration's case definition and assessed the positive predictive value (PPV) of the intussusception diagnosis code. Among 151 hospitalized cases discharged as intussusception, we confirmed 136 as Brighton Collaboration's Levels 1 or 2, resulting in a PPV of 93% (95% CI: 87%-96%). Three confirmed cases occurred within days 1-7 following the first rotavirus vaccination. The incidence rate ratio was 9.0 (95% CI: 0.9-86.5) (crude) and 4.7 (95% CI:0.3-74.1)(age adjusted). In this first study in Europe, the intussusception risk point estimate was comparable to other studies, although results were not statistically significant, maybe due to limited power. The high PPV found will facilitate implementation of a larger study without requiring medical record review. Our finding of very few vaccinated cases despite a thorough 5-year investigation in a country that, according to previous studies, may have a large background rate of intussusception is reassuring and should contribute to deliberations about the need to include rotavirus vaccines in the official Spanish calendars.

Workforce Development, Welfare Reform, and Child Well-Being. Working Paper 1

ERIC Educational Resources Information Center

National Forum on Early Childhood Program Evaluation, 2008

2008-01-01

This paper summarizes recent evidence from a series of evaluations of family self-sufficiency programs. These studies show that policies can be successful in achieving both positive economic benefits for parents (such as increased employment) and positive educational effects on their children. It need not be the case that increasing mothers' work…

Imagery rescripting as a stand-alone treatment for patients with social phobia: a case series.

PubMed

Frets, Petra G; Kevenaar, Ciska; van der Heiden, Colin

2014-03-01

The majority of patients with social phobia reports experiencing negative images, usually linked to memories of earlier aversive social experiences. Several studies have indicated that such negative self-imagery appears to have a causal role in maintaining social phobia, which suggests that interventions aimed at dealing with these images could be beneficial in the treatment of social phobia. One potentially powerful approach is imagery rescripting (IR), a clinical intervention that focuses on changing the meaning and impact of unpleasant memories. In the treatment of social phobia IR was only used as part of a broader cognitive-behavioral treatment package. However, we propose that IR alone might also be an effective treatment for this anxiety disorder. The present study reports an initial evaluation of the application of IR as a stand-alone treatment for six adult outpatients presenting with social phobia. A single case series using an A-B replication across patients design was employed. Following a no-treatment baseline period, IR was delivered weekly and patients were followed up for 3 and 6 months. For all patients, substantial reductions were obtained on all outcome measures at post-treatment, and gains were largely maintained at 6-months follow-up. The generalizability of the effects of IR for social phobia is limited by the small number of patients treated by only one therapist. The results of this preliminary case series suggest that IR as a stand alone treatment is an apparently effective intervention in the treatment of patients with social phobia, and indicate that controlled evaluation of its efficacy might be worthwhile. Copyright © 2013 Elsevier Ltd. All rights reserved.

Study design and hierarchy of evidence for surgical decision making.

PubMed

Sprague, Sheila; McKay, Paula; Thoma, Achilleas

2008-04-01

This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

Risk factors for acute pesticide poisoning in Sri Lanka.

PubMed

van der Hoek, Wim; Konradsen, Flemming

2005-06-01

This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self-poisoning. Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history of pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self-poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries.

Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review.

PubMed

Shi, Guanglin; Shen, Qin; Zhang, Caixin; Ma, Jun; Mohammed, Anaz; Zhao, Huan

2018-06-19

Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

Characterizations of Social-Based and Self-Based Contexts Associated with Students' Awareness, Evaluation, and Regulation of Their Thinking during Small-Group Mathematical Modeling

ERIC Educational Resources Information Center

Magiera, Marta T.; Zawojewski, Judith S.

2011-01-01

This exploratory study focused on characterizing problem-solving situations associated with spontaneous metacognitive activity. The results came from connected case studies of a group of 3 purposefully selected 9th-grade students working collaboratively on a series of 5 modeling problems. Students' descriptions of their own thinking during…

Evaluation of a Social Network Intervention for People with Mild to Borderline Intellectual Disabilities.

PubMed

van Asselt-Goverts, A E; Embregts, P J C M; Hendriks, A H C

2018-03-01

Little is known about the effectiveness of interventions aimed at enhancing the social networks of people with intellectual disabilities. This study explores the results of such an intervention. How did the clients with mild to borderline intellectual disabilities and their support workers evaluate the intervention? What did they learn from it? Were there any changes in network characteristics, satisfaction and wishes in relation to networks, participation, loneliness, self-determination or self-esteem? The evaluation of the intervention was explored from several perspectives (i.e. five clients, their six support workers and three trainers), using mixed methods (i.e. interviews and questionnaires). The intervention was positively evaluated by both clients and support workers. Moreover, the analysis revealed the vulnerability of clients and their networks but also the benefits experienced from the intervention, such as decreased loneliness, enhanced social networks, increased awareness, competence, autonomy and increased participation. The indicative level of evidence for the effectiveness of this intervention justifies a larger series of case studies or a larger control trial study. © 2016 John Wiley & Sons Ltd.

Self-Assessment Groups as a Means for Improving Teacher Behavior. A Research Project: Student Teachers at Wheaton College. (1968-1969).

ERIC Educational Resources Information Center

Cooperative Educational Research Lab., Inc., Northfield, IL.

A study was conducted to determine how participation in self-assessment seminars influences the attitudes, practices, and communication behavior of teachers. Two seminar groups of seven student teachers met for a series of 10 2-hour seminars during their senior student teaching. They were matched in a pretest-posttest design with control group…

DNAzyme-Based Logic Gate-Mediated DNA Self-Assembly.

PubMed

Zhang, Cheng; Yang, Jing; Jiang, Shuoxing; Liu, Yan; Yan, Hao

2016-01-13

Controlling DNA self-assembly processes using rationally designed logic gates is a major goal of DNA-based nanotechnology and programming. Such controls could facilitate the hierarchical engineering of complex nanopatterns responding to various molecular triggers or inputs. Here, we demonstrate the use of a series of DNAzyme-based logic gates to control DNA tile self-assembly onto a prescribed DNA origami frame. Logic systems such as "YES," "OR," "AND," and "logic switch" are implemented based on DNAzyme-mediated tile recognition with the DNA origami frame. DNAzyme is designed to play two roles: (1) as an intermediate messenger to motivate downstream reactions and (2) as a final trigger to report fluorescent signals, enabling information relay between the DNA origami-framed tile assembly and fluorescent signaling. The results of this study demonstrate the plausibility of DNAzyme-mediated hierarchical self-assembly and provide new tools for generating dynamic and responsive self-assembly systems.

Posterior approach and dislocation rate: a 213 total hip replacements case-control study comparing the dual mobility cup with a conventional 28-mm metal head/polyethylene prosthesis.

PubMed

Bouchet, R; Mercier, N; Saragaglia, D

2011-02-01

Dislocation is a frequent complication of total hip arthroplasties (THA) especially in older patients, especially when using a posterior approach. In these cases, dual mobility (DM) cups developed by Gilles Bousquet in 1975 can be indicated to reduce this complication risk. Dual mobility cups reduce the rate of dislocation in primary total hip arthroplasty using posterior approach in a single-surgeon series. Test this hypothesis in a controlled study to compare the rate of dislocation in primary total hip arthroplasties done in patients over 50 years old either with a dual mobility cup or a conventional metal-on-polyethylene 28-mm diameter head. Two consecutive series of primary total hip replacements were performed by a single surgeon using a posterolateral approach. The piriformis tendon was left intact. The DM series included 105 patients who underwent arthroplasty between January 2005 and June 2007 with a dual mobility cup (60 women and 45 men, mean age 76.6±5.65 years old [53-93]). The control series (S series) included 108 patients who underwent arthroplasty (56 women and 52 men, mean age 74.2±5.9 years old [53-87]) with a conventional 28-mm polyethylene cup between January 2003 and June 2005. All hip replacements included a 28-mm metal-polyethylene cup and a 12-14-mm Morse taper. Both groups were comparable for gender, diagnosis, body mass index, type of anesthesia and ASA score distribution. All patients included in this series had a minimum follow-up of 1 year. There were no dislocations in the DM series and five early dislocations (before the third month) in the S series for a rate of 4.63%. Although the rate of dislocation was higher in the S series (4.63% vs 0%), the difference was barely significant (P=0.0597). This study comparing the incidence of dislocations after THA with conventional or dual mobility cups, shows that even using a posterior approach and in older patients, dual mobility cups increase stability with no postoperative dislocations. Although results are barely significant, a larger series should confirm the benefit of this implant. In this series, morbidity was not increased with dual mobility cups. Level III: retrospective case-control study. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study.

PubMed Central

Jaakkola, Maritta S; Nordman, Henrik; Piipari, Ritva; Uitti, Jukka; Laitinen, Jukka; Karjalainen, Antti; Hahtola, Paula; Jaakkola, Jouni J K

2002-01-01

Previous cross-sectional and prevalent case-control studies have suggested increased risk of asthma in adults related to dampness problems and molds in homes. We conducted a population-based incident case-control study to assess the effects of indoor dampness problems and molds at work and at home on development of asthma in adults. We recruited systematically all new cases of asthma during a 2.5-year study period (1997-2000) and randomly selected controls from a source population consisting of adults 21-63 years old living in the Pirkanmaa Hospital district, South Finland. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma and the control series of 932 controls, after we excluded 76 (7.5%) controls with a history of asthma. In logistic regression analysis adjusting for confounders, the risk of asthma was related to the presence of visible mold and/or mold odor in the workplace (odds ratio, 1.54; 95% confidence interval, 1.01-2.32) but not to water damage or damp stains alone. We estimated the fraction of asthma attributable to workplace mold exposure to be 35.1% (95% confidence interval, 1.0-56.9%) among the exposed. Present results provide new evidence of the relation between workplace exposure to indoor molds and adult-onset asthma. PMID:12003761

Longitudinal patient-oriented outcomes in neuropathy

PubMed Central

Kerber, Kevin; Langa, Kenneth M.; Banerjee, Mousumi; Rodgers, Ann; McCammon, Ryan; Burke, James; Feldman, Eva

2015-01-01

Objective: To evaluate longitudinal patient-oriented outcomes in peripheral neuropathy over a 14-year time period including time before and after diagnosis. Methods: The 1996–2007 Health and Retirement Study (HRS)–Medicare Claims linked database identified incident peripheral neuropathy cases (ICD-9 codes) in patients ≥65 years. Using detailed demographic information from the HRS and Medicare claims, a propensity score method identified a matched control group without neuropathy. Patient-oriented outcomes, with an emphasis on self-reported falls, pain, and self-rated health (HRS interview), were determined before and after neuropathy diagnosis. Generalized estimating equations were used to assess differences in longitudinal outcomes between cases and controls. Results: We identified 953 peripheral neuropathy cases and 953 propensity-matched controls. The mean (SD) age was 77.4 (6.7) years for cases, 76.9 (6.6) years for controls, and 42.1% had diabetes. Differences were detected in falls 3.0 years before neuropathy diagnosis (case vs control; 32% vs 25%, p = 0.008), 5.0 years for pain (36% vs 27%, p = 0.002), and 5.0 years for good to excellent self-rated health (61% vs 74%, p < 0.0001). Over time, the proportion of fallers increased more rapidly in neuropathy cases compared to controls (p = 0.002), but no differences in pain (p = 0.08) or self-rated health (p = 0.9) were observed. Conclusions: In older persons, differences in falls, pain, and self-rated health can be detected 3–5 years prior to peripheral neuropathy diagnosis, but only falls deteriorates more rapidly over time in neuropathy cases compared to controls. Interventions to improve early peripheral neuropathy detection are needed, and future clinical trials should incorporate falls as a key patient-oriented outcome. PMID:26019191

A Microprocessor Development System for the ALTOS Series Microcomputers.

DTIC Science & Technology

1981-06-01

location, and 3) routines for online user self-help and system use instructions. The primary ccnsideration in the desin of the HOST control program was...TO LOWER CASE CPI ;rYNAMIC SET ITEMIZE JZ MAKEI CPI Vt" ;LYNAMIC SET TOTAL ONLY JZ MAKET CPI "e JNZ STACKIT ;RESTART TEST IF NOT E MEM55 LXI HMEMM...RESET STACK JMP MEM0I ;RESTART TEST MAKEI MVI All ;MAKE ITEMIZE STA MEMP CALL BSOUT RET MAKET MJI A,O ;MAKE TOTAL ONLY STA MEMP CALL BSOUT RET * LONE WITH

Self-Instructional Training with an Adolescent Schizophrenic.

ERIC Educational Resources Information Center

Gumaer, Jim; Headspeth, Tanya

1985-01-01

Presents a case study involving the use of self-instructional training with an adolescent schizophrenic boy. Changes initiated in his internal and external dialog with himself improved his self-control and task performance. (JAC)

Differentiation of African components of ancestry to stratify groups in a case-control study of a Brazilian urban population.

PubMed

Silbiger, Vivian N; Hirata, Mario H; Luchessi, Andre D; Genvigir, Fabiana D V; Cerda, Alvaro; Rodrigues, Alice C; Willrich, Maria A V; Arazi, Simone S; Dorea, Egidio L; Bernik, Marcia M S; Faludi, Andre A; Bertolami, Marcelo C; Santos, Carla; Carracedo, Angel; Salas, Antonio; Freire, Ana; Lareu, Maria Victoria; Phillips, Christopher; Porras-Hurtado, Liliana; Fondevila, Manuel; Hirata, Rosario D C

2012-06-01

Balancing the subject composition of case and control groups to create homogenous ancestries between each group is essential for medical association studies. We explored the applicability of single-tube 34-plex ancestry informative markers (AIM) single nucleotide polymorphisms (SNPs) to estimate the African Component of Ancestry (ACA) to design a future case-control association study of a Brazilian urban sample. One hundred eighty individuals (107 case group; 73 control group) self-described as white, brown-intermediate or black were selected. The proportions of the relative contribution of a variable number of ancestral population components were similar between case and control groups. Moreover, the case and control groups demonstrated similar distributions for ACA <0.25 and >0.50 categories. Notably a high number of outlier values (23 samples) were observed among individuals with ACA <0.25. These individuals presented a high probability of Native American and East Asian ancestral components; however, no individuals originally giving these self-described ancestries were observed in this study. The strategy proposed for the assessment of ancestry and adjustment of case and control groups for an association study is an important step for the proper construction of the study, particularly when subjects are taken from a complex urban population. This can be achieved using a straight forward multiplexed AIM-SNPs assay of highly discriminatory ancestry markers.

Use of Underarm Cosmetic Products in Relation to Risk of Breast Cancer: A Case-Control Study.

PubMed

Linhart, Caroline; Talasz, Heribert; Morandi, Evi M; Exley, Christopher; Lindner, Herbert H; Taucher, Susanne; Egle, Daniel; Hubalek, Michael; Concin, Nicole; Ulmer, Hanno

2017-07-01

Previous studies on breast cancer (BC), underarm cosmetic products (UCP) and aluminum salts have shown conflicting results. We conducted a 1:1 age-matched case-control study to investigate the risk for BC in relation to self-reported UCP application. Self-reported history of UCP use was compared between 209 female BC patients (cases) and 209 healthy controls. Aluminum concentration in breast tissue was measured in 100 cases and 52 controls. Multivariable conditional logistic regression analysis was performed to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for established BC risk factors. Use of UCP was significantly associated with risk of BC (p=0.036). The risk for BC increased by an OR of 3.88 (95% CI 1.03-14.66) in women who reported using UCP's several times daily starting at an age earlier than 30years. Aluminum in breast tissue was found in both cases and controls and was significantly associated to self-reported UCP use (p=0.009). Median (interquartile) aluminum concentrations were significantly higher (p=0.001) in cases than in controls (5.8, 2.3-12.9 versus 3.8, 2.5-5.8nmol/g). Frequent use of UCPs may lead to an accumulation of aluminum in breast tissue. More than daily use of UCPs at younger ages may increase the risk of BC. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Self-administered methoxyflurane for procedural analgesia: experience in a tertiary Australasian centre.

PubMed

Gaskell, A L; Jephcott, C G; Smithells, J R; Sleigh, J W

2016-04-01

Methoxyflurane, an agent formerly used as a volatile anaesthetic but that has strong analgesic properties, will soon become available again in the UK and Europe in the form of a small hand-held inhaler. We describe our experience in the use of inhaled methoxyflurane for procedural analgesia within a large tertiary hospital. In a small pilot crossover study of patients undergoing burns-dressing procedures, self-administered methoxyflurane inhalation was preferred to ketamine-midazolam patient-controlled analgesia by five of eight patients. Patient and proceduralist outcomes and satisfaction were recorded from a subsequent case series of 173 minor surgical and radiological procedures in 123 patients performed using inhaled methoxyflurane. The procedures included change of dressing, minor debridement, colonoscopy and incision-and-drainage of abscess. There was a 97% success rate of methoxyflurane analgesia to facilitate these procedures. Limitations of methoxyflurane include maximal daily and weekly doses, and uncertainty regarding its safety in patients with pre-existing renal disease. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

Talking Physics: Two Case Studies on Short Answers and Self-explanation in Learning Physics

NASA Astrophysics Data System (ADS)

Badeau, Ryan C.

This thesis explores two case studies into the use of short answers and self-explanation to improve student learning in physics. The first set of experiments focuses on the role of short answer questions in the context of computer-based instruction. Through a series of six experiments, we compare and evaluate the performance of computer-assessed short answer questions versus multiple choice for training conceptual topics in physics, controlling for feedback between the two formats. In addition to finding overall similar improvements on subsequent student performance and retention, we identify unique differences in how students interact with the treatments in terms of time spent on feedback and performance on follow-up short answer assessment. In addition, we identify interactions between the level of interactivity of the training, question format, and student attitudinal ratings of each respective training. The second case study focuses on the use of worked examples in the context of multi-concept physics problems - which we call "synthesis problems." For this part of the thesis, four experiments were designed to evaluate the effectiveness of two instructional methods employing worked examples on student performance with synthesis problems; these instructional techniques, analogical comparison and self-explanation, have previously been studied primarily in the context of single-concept problems. As such, the work presented here represents a novel focus on extending these two techniques to this class of more complicated physics problem. Across the four experiments, both self-explanation and certain kinds of analogical comparison of worked examples significantly improved student performance on a target synthesis problem, with distinct improvements in recognition of the relevant concepts. More specifically, analogical comparison significantly improved student performance when the comparisons were invoked between worked synthesis examples. In contrast, similar comparisons between corresponding pairs of worked single-concept examples did not significantly improve performance. On a more complicated synthesis problem, self-explanation was significantly more effective than analogical comparison, potentially due to differences in how successfully students encoded the full structure of the worked examples. Finally, we find that the two techniques can be combined for additional benefit, with the trade-off of slightly more time-on-task.

[Self-esteem, resilience, locus of control and suicide risk in nursing students].

PubMed

Montes-Hidalgo, Javier; Tomás-Sábado, Joaquín

2016-01-01

Assuming that suicide is the result of a series of factors acting cumulatively, the aim of this paper was to study the association of self-esteem, resilience and locus of control with the risk of suicidal behavior in a sample of nursing students. Observational, cross-sectional and correlational study with 186 nursing students who answered a questionnaire that contained, in addition to demographic data, the Spanish forms of Rosenberg self-esteem scale, the brief resilient coping scale, the Plutchik scale of suicide risk and the Rotter's internal-external locus of control scale. The scores of males and females are very similar on all scales except Locus of Control, where a significantly greater tendency of females attributed to external control. 6.4% of students have scores indicating suicide risk. Suicide risk scores correlated negatively and significantly with self-esteem and resilience and positively with locus of control. The multiple linear regression analysis identified self-esteem as the main variable related to suicide risk. The results suggest that students who have low self-esteem, have difficulty in adjusting to adverse situations and tend to the external attribution of the consequences of their actions may have an increased risk of suicidal behavior. Furthermore, the identification of self-esteem as the important factor involved in suicide risk can help in designing prevention programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Implications of weight-based stigma and self-bias on quality of life among individuals with Schizophrenia

PubMed Central

Barber, Jessica; Palmese, Laura; Reutenauer, Erin L.; Grilo, Carlos; Tek, Cenk

2011-01-01

Obesity has been associated with significant stigma and weight-related self-bias in community and clinical studies, but these issues have not been studied among individuals with schizophrenia. A consecutive series of 70 obese individuals with schizophrenia or schizoaffective disorder underwent assessment for perceptions of weight-based stigmatization, self-directed weight-bias, negative affect, medication compliance, and quality of life. Levels of weight-based stigmatization and self-bias were compared to levels reported for non-psychiatric overweight/obese samples. Weight measures were unrelated to stigma, self-bias, affect, and quality of life. Weight-based stigmatization was lower than published levels for non-psychiatric samples, whereas levels of weight-based self-bias did not differ. After controlling for negative affect, weight-based self-bias predicted an additional 11% of the variance in the quality of life measure. Individuals with schizophrenia and schizoaffective disorder reported weight-based self-bias to the same extent as non-psychiatric samples despite reporting less weight stigma. Weight-based self-bias was associated with poorer quality of life after controlling for negative affect. PMID:21716053

Case study: use of problem-based learning to develop students' technical and professional skills

NASA Astrophysics Data System (ADS)

Warnock, James N.; Mohammadi-Aragh, M. Jean

2016-03-01

Problem-based learning (PBL) is a pedagogy that has attracted attention for many biomedical engineering curricula. The aim of the current study was to address the research question, 'Does PBL enable students to develop desirable professional engineering skills?' The desirable skills identified were communication, teamwork, problem solving and self-directed learning. Forty-seven students enrolled in a biomedical materials course participated in the case study. Students worked in teams to complete a series of problems throughout the semester. The results showed that students made significant improvements in their problem-solving skills, written communication and self-directed learning. Students also demonstrated an ability to work in teams and communicate orally. In conclusion, this case study provides empirical evidence of the efficacy of PBL on student learning. We discuss findings from our study and provide observations of student performance and perceptions that could be useful for faculty and researchers interested in PBL for biomedical engineering education.

Developing a Growth Mindset through Outdoor Personal Development: Can an Intervention Underpinned by Psychology Increase the Impact of an Outdoor Learning Course for Young People?

ERIC Educational Resources Information Center

O'Brien, Kate; Lomas, Tim

2017-01-01

This study considers the impact of using a series of Mindset interventions during a five-day outdoor personal development (OPD) course. Self-efficacy, resilience and Mindset were measured pre course, post course and one month post course. It was hypothesised that both experimental and control groups would increase their self-efficacy and…

CBT for Medication Adherence and Depression (CBT-AD) in HIV-Infected Patients Receiving Methadone Maintenance Therapy

ERIC Educational Resources Information Center

Soroudi, Nafisseh; Perez, Giselle K.; Gonzalez, Jeffrey S.; Greer, Joseph A.; Pollack, Mark H.; Otto, Michael W.; Safren, Steven A.

2008-01-01

For individuals with HIV who are current or former injection drug users, depression is a common, distressing condition that can interfere with a critical self-care behavior--adherence to antiretroviral therapy. The present study describes the feasibility and outcome, in a case series approach, of cognitive behavioral therapy to improve adherence…

Self discipline and obesity in Bangkok school children.

PubMed

Sirikulchayanonta, Chutima; Ratanopas, Wasoontara; Temcharoen, Paradee; Srisorrachatr, Suwat

2011-03-10

Childhood obesity has become an important public health problem in Thailand. This study aimed to determine the relationship between self discipline and obesity in Bangkok school children. A case control study was conducted. 140 cases (obese children) and 140 controls (normal weight children) were randomly chosen from grades 4-6 students in 4 Bangkok public schools. Questionnaire responses regarding general characteristics and child self-discipline were obtained from children and their parents. Self discipline in eating habits, money management and time management were reported at significantly lower levels among the obese group (p < 0.05). After controlling all other variables, it was revealed that the ranking of factors associated with obesity by adjusted odds ratio (OR) were low self-discipline in managing expenses (3.1), poor home environment (3.0,), moderate self-discipline in time management (2.9), television viewing time ≥2 hours/day (2.6), an obese father (2.2), and an obese mother (1.9). It was recommended that parents and teachers participate in child self-discipline guidance, particularly with regard to eating habits, money management and time management in a supportive environment that both facilitates prevention of obesity and simultaneously develops a child's personal control.

Self discipline and obesity in Bangkok school children

PubMed Central

2011-01-01

Background Childhood obesity has become an important public health problem in Thailand. This study aimed to determine the relationship between self discipline and obesity in Bangkok school children. Methods A case control study was conducted. 140 cases (obese children) and 140 controls (normal weight children) were randomly chosen from grades 4-6 students in 4 Bangkok public schools. Questionnaire responses regarding general characteristics and child self-discipline were obtained from children and their parents. Results Self discipline in eating habits, money management and time management were reported at significantly lower levels among the obese group (p < 0.05). After controlling all other variables, it was revealed that the ranking of factors associated with obesity by adjusted odds ratio (OR) were low self-discipline in managing expenses (3.1), poor home environment (3.0,), moderate self-discipline in time management (2.9), television viewing time ≥2 hours/day (2.6), an obese father (2.2), and an obese mother (1.9). Conclusions It was recommended that parents and teachers participate in child self-discipline guidance, particularly with regard to eating habits, money management and time management in a supportive environment that both facilitates prevention of obesity and simultaneously develops a child's personal control. PMID:21392376

Effect of Self-regulation Training on Management of Type 2 Diabetes

PubMed Central

Tavakolizadeh, Jahanshir; Moghadas, Mehri; Ashraf, Hami

2014-01-01

Background: Diabetes is the most common metabolic disorder which is required to be taken under control. According to some studies, the impact of self-regulation on health has been considered as a monitoring strategy to achieve individual’s goals. Objectives: This study, which was performed in 2012, aimed at determining the consequences of self-regulation on controlling type 2 diabetes. Patients and Methods: In this double-blind clinical trial, 60 patients with type 2 diabetes - who were referred to Diabetes Clinic of Bisto-Dou Bahman Hospital in Gonabad, Iran - were divided randomly into case and control groups. Self-regulation questionnaire, nutritional information and physical activity checklists were completed by both groups once at the beginning and once at end of the training. Fasting blood sugar (FBS) of both groups were measured as well. Case group was trained for a month, whereas the control group received no special training. Data were analyzed by SPSS version 19 software, K-square and paired t-tests. Results: Comparing the case with the control group before and after the training showed that teaching patients self-regulatory strategies had significant impact on lowering blood sugar (-16.50 vs. -2.47, P < 0.001), observing dietary behaviors (5.97 vs. -0.87, P < 0.001) and increasing physical activities (6.2 vs. -0.73, P < 0.001) of the former group. Conclusions: Learning self-regulations has a role to play in controlling type 2 diabetes. Therefore, it is suggested to professionals in healthcare centers to educate patients about self-regulatory techniques and use them as auxiliary methods for keeping type 2 diabetes under control. PMID:24910800

Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis "prodromal" population.

PubMed

Nelson, Barnaby; Thompson, Andrew; Yung, Alison R

2012-11-01

Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to a disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. In this study, we investigated the presence of basic self-disturbance in an "ultra high risk" (UHR) for psychosis sample compared with a healthy control sample and whether it predicted transition to psychotic disorder. Forty-nine UHR patients and 52 matched healthy control participants were recruited to the study. Participants were assessed for basic self-disturbance using the Examination of Anomalous Self-Experience (EASE) instrument. UHR participants were followed for a mean of 569 days. Levels of self-disturbance were significantly higher in the UHR sample compared with the healthy control sample (P < .001). Cox regression indicated that total EASE score significantly predicted time to transition (P < .05) when other significant predictors were controlled for. Exploratory analyses indicated that basic self-disturbance scores were higher in schizophrenia spectrum cases, irrespective of transition to psychosis, than nonschizophrenia spectrum cases. The results indicate that identifying basic self-disturbance in the UHR population may provide a means of further "closing in" on individuals truly at high risk of psychotic disorder, particularly of schizophrenia spectrum disorders. This may be of practical value by reducing inclusion of "false positive" cases in UHR samples and of theoretical value by shedding light on core phenotypic features of schizophrenia spectrum pathology.

Alexithymia, impulsiveness, and psychopathology in nonsuicidal self-injured adolescents.

PubMed

Gatta, Michela; Dal Santo, Francesco; Rago, Alessio; Spoto, Andrea; Battistella, Pier Antonio

2016-01-01

Nonsuicidal self-injury (NSSI) is a multifaceted phenomenon and a major health issue among adolescents. A better understanding of self-injury comorbidities is crucial to improve our ability to assess, treat, and prevent NSSI. This study aimed at analyzing some of the psychobehavioral correlates of NSSI: psychological problems, alexithymia, impulsiveness, and sociorelational aspects. This was a case-control study. The clinical sample (n=33) included adolescents attending our unit for NSSI and other issues; the controls (n=79) were high-school students. Data were collected using six questionnaires: Youth Self-Report, Barratt's Impulsiveness Scale, Toronto Alexithymia Scale, Children's Depression Inventory, Symptom Checklist-90-R, and Child Behavior Checklist. Cases scored significantly higher in all questionnaires. Habitual self-injurers scored higher on impulsiveness and alexithymia. The gesture's repetition seems relevant to the global clinical picture: habitual self-injurers appear more likely to seek help from the sociosanitary services. We found a difference between the self-injurers' and their parents' awareness of the disorder. Habitual self-injurers show signs of having difficulty with assessing the consequences of their actions (nonplanning impulsiveness) and the inability to manage their feelings. Given the significantly higher scores found for cases than for controls on all the psychopathological scales, NSSI can be seen as a cross-category psychiatric disorder, supporting the Diagnostic and Statistical Manual of Mental Disorders decision to include it as a pathological entity in its own right.

Self-organization versus self-management: two sides of the same coin?

PubMed

Clancy, Thomas R

2009-03-01

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the eighth in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the author explores self-organization as it relates to self-management in complex social organizations.

Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland.

PubMed

Warren-Gash, Charlotte; Blackburn, Ruth; Whitaker, Heather; McMenamin, Jim; Hayward, Andrew C

2018-03-01

While acute respiratory tract infections can trigger cardiovascular events, the differential effect of specific organisms is unknown. This is important to guide vaccine policy.Using national infection surveillance data linked to the Scottish Morbidity Record, we identified adults with a first myocardial infarction or stroke from January 1, 2004 to December 31, 2014 and a record of laboratory-confirmed respiratory infection during this period. Using self-controlled case series analysis, we generated age- and season-adjusted incidence ratios (IRs) for myocardial infarction (n=1227) or stroke (n=762) after infections compared with baseline time.We found substantially increased myocardial infarction rates in the week after Streptococcus pneumoniae and influenza virus infection: adjusted IRs for days 1-3 were 5.98 (95% CI 2.47-14.4) and 9.80 (95% CI 2.37-40.5), respectively. Rates of stroke after infection were similarly high and remained elevated to 28 days: day 1-3 adjusted IRs 12.3 (95% CI 5.48-27.7) and 7.82 (95% CI 1.07-56.9) for S. pneumoniae and influenza virus, respectively. Although other respiratory viruses were associated with raised point estimates for both outcomes, only the day 4-7 estimate for stroke reached statistical significance.We showed a marked cardiovascular triggering effect of S. pneumoniae and influenza virus, which highlights the need for adequate pneumococcal and influenza vaccine uptake. Further research is needed into vascular effects of noninfluenza respiratory viruses. Copyright ©ERS 2018.

Efficiency of broadband terahertz rectennas based on self-switching nanodiodes

NASA Astrophysics Data System (ADS)

Briones, Edgar; Cortes-Mestizo, Irving E.; Briones, Joel; Droopad, Ravindranath; Espinosa-Vega, Leticia I.; Vilchis, Heber; Mendez-Garcia, Victor H.

2017-04-01

The authors investigate the efficiency of a series of broadband rectennas designed to harvest the free-propagating electromagnetic energy at terahertz frequencies. We analyze by simulations the case of self-complementary square- and Archimedean-spiral antennas coupled to L-shaped self-switching diodes (L-SSDs). First, the geometry (i.e., the width and length of the channel) of the L-SSD was optimized to obtain a remarkable diode-like I-V response. Subsequently, the optimized L-SSD geometry was coupled to both types of spiral antennas and their characteristic impedance was studied. Finally, the energy conversion efficiency was evaluated for both rectenna architectures.

Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

PubMed Central

Nyman, Samuel R.; Goodwin, Kelly; Kwasnicka, Dominika; Callaway, Andrew

2016-01-01

Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Main outcome measures: Walking was objectively measured using pedometers. Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity. PMID:26387689

Vocal fold self-disruption after phonotrauma on a lead actor: a case presentation.

PubMed

Behlau, Mara; Oliveira, Gisele; Pontes, Paulo

2009-11-01

It is well known that phonotraumatic events may produce laryngeal inflammation, vocal fold hemorrhage and different types of mass lesions. This study describes a vocal fold self-disruption that occurred on stage to a lead actor in the role of Richard III. The study design is as case presentation. A 43-year-old actor presented with a sudden voice loss that first occurred on stage after a series of presentations. He also had a cold-like condition that had not been treated. His past medical history included an average of ten cigarettes per day for ten years and a 10-year history of gastritis and stomach ulcer. Perceptual, acoustic, and laryngeal analyses were performed following pharmacological and voice therapy. Perceptual and acoustic analyses showed mild deviations whereas laryngeal visual examination revealed a complete right vocal fold detachment from the anterior commissure to the vocal process, with generalized hyperemia. A mild diffuse Reinke's edema was observed on the left vocal fold. Mild discomfort was present only during the first day of the acute period. Modified vocal rest was recommended and a series of vocal exercises were administered. The patient performed again 4 days later, after following a series of behavioral modification techniques that included casting guidelines during the subsequent 15 days. Healing was exceptional and his voice returned to normal. This unique case with an exceptional recovery emphasizes the etiological aspects of scar formation after phonotrauma. Positive contributing factors may include a good vocal technique and adequate training as well as the protective upregulated genes present in Reinke's edema.

Differences in child versus parent reports of the child's health-related quality of life in children with epilepsy and healthy siblings.

PubMed

Baca, Christine Bower; Vickrey, Barbara G; Hays, Ron D; Vassar, Stefanie D; Berg, Anne T

2010-01-01

Self versus proxy perspectives may produce different results that are important for clinical decision-making and for assessing outcomes in research studies. We examined differences in child versus parent report of the child's health-related quality of life (HRQOL) in a large prospective, community-based study of newly diagnosed childhood epilepsy that included children with epilepsy (case) and sibling controls. HRQOL was assessed 8 to 9 years after initial diagnosis of epilepsy in a subset of 143 case-control matched pairs using the Child Health Questionnaire (CHQ), a generic HRQOL measure with child (CHQ-CF87), and parent (CHQ-PF50) versions. There were no significant differences between self-reported case and sibling control HRQOL scores on 9 of 11 scales or 2 global items. Nevertheless, parent ratings were significantly better (higher HRQOL) for sibling controls compared with epilepsy cases on 10 of 12 scales, global behavior and general health items, and the physical and psychosocial summary scores (P≤0.05). Parent-child agreement was low for cases and controls (kappa 0.27-0.33) for three single-item questions with the same wording on parent and child versions. Parent ratings of the case's HRQOL were often significantly associated with 5-year remission status and current antiepileptic drug use, but the case's self-reported HRQOL scores were not. In contrast, current pharmacoresistance was often associated with the child and parent ratings of the child's HRQOL. Children with epilepsy report HRQOL that is comparable to that of sibling controls, while parents rate children with epilepsy as having lower HRQOL than sibling controls. Measuring outcomes in studies of this population should incorporate both perspectives. © 2010, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: Findings from ACTION-J study.

PubMed

Furuno, Taku; Nakagawa, Makiko; Hino, Kosuke; Yamada, Tomoki; Kawashima, Yoshitaka; Matsuoka, Yutaka; Shirakawa, Osamu; Ishizuka, Naoki; Yonemoto, Naohiro; Kawanishi, Chiaki; Hirayasu, Yoshio

2018-01-01

Self-harm is an important risk factor for subsequent suicide and repetition of self-harm, and a common cause of emergency department presentations. However, there still remains limited evidence on intervention in emergency department settings for individuals who self-harm. This multicentre, randomised controlled trial was conducted at 17 general hospitals in Japan. In total, 914 adult patients admitted to emergency departments for a suicide attempt and had a DSM-IV-TR axis I disorder were randomly assigned to two groups, to receive either assertive case management (intervention) or enhanced usual care (control). Assertive case management was introduced by the case manager during emergency department admissions for suicide attempts, and continued after discharge. Interventions were provided until the end of the study period (for at least 18 months and up to 5 years). The number of overall self-harm episodes per person-year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80-0.96, p=0.0031). Subgroup analysis showed a greater reduction of overall self-harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53-0.98, p=0.037). Patients younger than 20 years and patients who self-harmed but were not admitted to an emergency department were excluded. The present study showed that assertive case management following emergency admission for a suicide attempt reduced the incident rate of repeat overall self-harm. Copyright © 2017 Elsevier B.V. All rights reserved.

Association Between Psychotropic and Cardiovascular Iatrogenic Alerts and Risk of Hospitalizations in Elderly People Treated for Dementia: A Self-Controlled Case Series Study Based on the Matching of 2 French Health Insurance Databases.

PubMed

Zerah, Lorene; Boddaert, Jacques; Leperre-Desplanques, Armelle; Bonnet-Zamponi, Dominique; Verny, Marc; Deligne, Jean; Boelle, Pierre-Yves

2017-06-01

Elderly people are at risk of repeated hospitalizations, some of which may be drug related and preventable. In 2011, a group of French healthcare experts selected 5 iatrogenic alerts (IAs), based on criteria identified in a literature search and from their professional experience, to assess the appropriateness of medication in elderly patients. Our objective was to examine the association between hospitalizations and IAs in elderly patients treated for Alzheimer disease who are particularly sensitive to adverse drug events. A 2-year (January 1, 2011, to December 31, 2012) longitudinal national database study, with a study design similar to self-controlled case series, was performed to analyze data on drug prescriptions and hospitalization. IAs were defined as (1) long half-life benzodiazepine; (2) antipsychotic drugs in patients with Alzheimer disease; (3) co-prescription of 3 or more psychotropic drugs; (4) co-prescription of 2 or more diuretics; and (5) co-prescription of 4 or more antihypertensive drugs. Data were obtained by matching of 2 French National Health Insurance Databases. France. All affiliates, aged ≥75 years, receiving treatment for Alzheimer disease, alive on January 1, 2011 were included. We calculated the relative increase in the number of hospitalizations in patients with IAs. The analysis was performed over four 6-month periods. A total of 10,754 patients were included. During the periods with IAs, hospitalization rates increased by 0.36/year compared with 0.23/year in the periods without for the same patient, and the number of hospitalizations doubled [proportional fold change = 1.9, 95% confidence interval (1.8, 2.1)]. We estimated that 22% [95% confidence interval (20%, 23%)] of all hospitalizations were associated with IAs, 80% of which were due to psychotropic IAs. The IAs could be used as a simple and clinically relevant tool by prescribing physicians to assess the appropriateness of the prescription in elderly patients treated for Alzheimer disease. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Development of self-awareness after severe traumatic brain injury through participation in occupation-based rehabilitation: mixed-methods analysis of a case series.

PubMed

Doig, Emmah; Kuipers, Pim; Prescott, Sarah; Cornwell, Petrea; Fleming, Jennifer

2014-01-01

OBJECTIVE. We examined participation in goal planning and development of self-awareness for people with impaired self-awareness after traumatic brain injury. METHOD. We performed a mixed-methods study of 8 participants recently discharged from inpatient rehabilitation. Self-awareness was measured using discrepancy between self and significant other ratings on the Mayo-Portland Adaptability Index (MPAI-4) at four time points. We calculated effect size to evaluate the change in MPAI-4 discrepancy over time. RESULTS. Seven participants identified their own goals. We found a large reduction in mean MPAI-4 discrepancy (M = 8.57, SD = 6.59, N = 7, d = 1.08) in the first 6 wk and a further small reduction (M = 5.33, SD = 9.09, N = 6, d = 0.45) in the second 6 wk of intervention. Case data indicated that 7 participants demonstrated some growth in self-awareness. CONCLUSION. Engagement in occupation-based, goal-directed rehabilitation appeared to foster awareness of injury-related changes to varying extents. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Abuse and deliberate self-poisoning in women: a matched case-control study.

PubMed

Coll, X; Law, F; Tobías, A; Hawton, K; Tomàs, J

2001-10-01

Controlled studies have shown deliberate self-harm to be more common in abused populations, but no controlled studies have shown abuse to be more common in self-harming populations. This is the first controlled study to determine whether abuse experiences (sexual, physical, and psychological) occurred more commonly in women who take overdoses than in controls. The design was a matched (1:1) case-control study set in a district general hospital in England. The subjects were 36 women admitted following deliberate self-poisoning. They were matched with the next non-overdose admission to the same hospital on six variables (sex, age, ethnicity, social class, marital status, and geographical locality). The main outcome measures used were modified versions of standardized self-report questionnaires of sexual, physical, and psychological abuse, together with measures of parenting style and general psychopathology. Women who had taken an overdose were more likely (odds ratio 15.0, 95% confidence interval 2.0 to 113.6) to have been sexually abused, and somewhat more likely to have been psychologically (1.02, 1.00 to 1.05) but not physically abused. They also had higher measures of psychopathology (GHQ-30: 1.19, 1.07 to 1.31), were more likely to have been abused at a younger age, exposed to the "affectionless control" style of parenting by their mothers, and to have harmed themselves in other ways. The management of women presenting to hospital after self-poisoning should include assessment of abuse experiences, and instigation of appropriate treatment in those with significant sequelae of abuse.

Visual aided pacing in respiratory maneuvers

NASA Astrophysics Data System (ADS)

Rambaudi, L. R.; Rossi, E.; Mántaras, M. C.; Perrone, M. S.; Siri, L. Nicola

2007-11-01

A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

Effect of vaccinations on seizure risk and disease course in Dravet syndrome.

PubMed

Verbeek, Nienke E; van der Maas, Nicoline A T; Sonsma, Anja C M; Ippel, Elly; Vermeer-de Bondt, Patricia E; Hagebeuk, Eveline; Jansen, Floor E; Geesink, Huibert H; Braun, Kees P; de Louw, Anton; Augustijn, Paul B; Neuteboom, Rinze F; Schieving, Jolanda H; Stroink, Hans; Vermeulen, R Jeroen; Nicolai, Joost; Brouwer, Oebele F; van Kempen, Marjan; de Kovel, Carolien G F; Kemmeren, Jeanet M; Koeleman, Bobby P C; Knoers, Nine V; Lindhout, Dick; Gunning, W Boudewijn; Brilstra, Eva H

2015-08-18

To study the effect of vaccination-associated seizure onset on disease course and estimate the risk of subsequent seizures after infant pertussis combination and measles, mumps, and rubella (MMR) vaccinations in Dravet syndrome (DS). We retrospectively analyzed data from hospital medical files, child health clinics, and the vaccination register for children with DS and pathogenic SCN1A mutations. Seizures within 24 hours after infant whole-cell, acellular, or nonpertussis combination vaccination or within 5 to 12 days after MMR vaccination were defined as "vaccination-associated." Risks of vaccination-associated seizures for the different vaccines were analyzed in univariable and in multivariable logistic regression for pertussis combination vaccines and by a self-controlled case series analysis using parental seizure registries for MMR vaccines. Disease courses of children with and without vaccination-associated seizure onset were compared. Children who had DS (n = 77) with and without vaccination-associated seizure onset (21% and 79%, respectively) differed in age at first seizure (median 3.7 vs 6.1 months, p < 0.001) but not in age at first nonvaccination-associated seizure, age at first report of developmental delay, or cognitive outcome. The risk of subsequent vaccination-associated seizures was significantly lower for acellular pertussis (9%; odds ratio 0.18, 95% confidence interval [CI] 0.05-0.71) and nonpertussis (8%; odds ratio 0.11, 95% CI 0.02-0.59) than whole-cell pertussis (37%; reference) vaccines. Self-controlled case series analysis showed an increased incidence rate ratio of seizures of 2.3 (95% CI 1.5-3.4) within the risk period of 5 to 12 days following MMR vaccination. Our results suggest that vaccination-associated earlier seizure onset does not alter disease course in DS, while the risk of subsequent vaccination-associated seizures is probably vaccine-specific. © 2015 American Academy of Neurology.

Association of Bariatric Surgery With Risk of Infectious Diseases: A Self-Controlled Case Series Analysis.

PubMed

Goto, Tadahiro; Hirayama, Atsushi; Faridi, Mohammad Kamal; Camargo, Carlos A; Hasegawa, Kohei

2017-10-15

Although emerging data demonstrate that obesity is a risk factor for infectious diseases, no study has investigated the relationship of bariatric surgery with the risk of infectious diseases among obese adults. We conducted a self-controlled case series analysis using data from the State Emergency Department Database and State Inpatient Database of 3 US states (California, Florida, and Nebraska) from 2005 through 2011. We included obese adults who underwent bariatric surgery as an instrument of weight reduction. Primary outcomes were emergency department (ED) visit or hospitalization for skin and soft-tissue infection (SSTI), respiratory infection, intra-abdominal infection, or urinary tract infection (UTI). Among 56277 obese adults who underwent bariatric surgery, compared to presurgery months 13-24 as the reference period, the risk of ED visit or hospitalization in the 0- to 12-month postsurgery period decreased significantly for SSTI (aOR, 0.85 [95% confidence interval {CI}, .76-.95]) and respiratory infection (aOR, 0.82 [95% CI, .75-.90]) and remained significantly low in the 13- to 24-month postsurgery period (aORs, 0.77 [95% CI, .68-.86] and 0.75 [95% CI, .68-.82], respectively). By contrast, the risk increased significantly in the 0- to 12-month postsurgery period for intra-abdominal infection (aOR, 2.09 [95% CI, 1.78-2.46]) and UTI (aOR, 1.93 [95% CI, 1.74-2.15]) and remained high in the 13- to 24-month postsurgery period (aORs, 1.29 [95% CI, 1.09-1.54] and 1.31 [95% CI, 1.17-1.47], respectively). We found a divergent risk pattern in the risk of 4 common infectious diseases after bariatric surgery. The risk of SSTI and respiratory infection decreased after bariatric surgery whereas that of intra-abdominal infection and UTI increased. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Neural basis of distorted self-face recognition in social anxiety disorder.

PubMed

Kim, Min-Kyeong; Yoon, Hyung-Jun; Shin, Yu-Bin; Lee, Seung-Koo; Kim, Jae-Jin

2016-01-01

The observer perspective causes patients with social anxiety disorder (SAD) to excessively inspect their performance and appearance. This study aimed to investigate the neural basis of distorted self-face recognition in non-social situations in patients with SAD. Twenty patients with SAD and 20 age- and gender-matched healthy controls participated in this fMRI study. Data were acquired while participants performed a Composite Face Evaluation Task, during which they had to press a button indicating how much they liked a series of self-faces, attractively transformed self-faces, and attractive others' faces. Patients had a tendency to show more favorable responses to the self-face and unfavorable responses to the others' faces compared with controls, but the two groups' responses to the attractively transformed self-faces did not differ. Significant group differences in regional activity were observed in the middle frontal and supramarginal gyri in the self-face condition (patients < controls); the inferior frontal gyrus in the attractively transformed self-face condition (patients > controls); and the middle frontal, supramarginal, and angular gyri in the attractive others' face condition (patients > controls). Most fronto-parietal activities during observation of the self-face were negatively correlated with preference scores in patients but not in controls. Patients with SAD have a positive point of view of their own face and experience self-relevance for the attractively transformed self-faces. This distorted cognition may be based on dysfunctions in the frontal and inferior parietal regions. The abnormal engagement of the fronto-parietal attentional network during processing face stimuli in non-social situations may be linked to distorted self-recognition in SAD.

Influence of characteristics of time series on short-term forecasting error parameter changes in real time

NASA Astrophysics Data System (ADS)

Klevtsov, S. I.

2018-05-01

The impact of physical factors, such as temperature and others, leads to a change in the parameters of the technical object. Monitoring the change of parameters is necessary to prevent a dangerous situation. The control is carried out in real time. To predict the change in the parameter, a time series is used in this paper. Forecasting allows one to determine the possibility of a dangerous change in a parameter before the moment when this change occurs. The control system in this case has more time to prevent a dangerous situation. A simple time series was chosen. In this case, the algorithm is simple. The algorithm is executed in the microprocessor module in the background. The efficiency of using the time series is affected by its characteristics, which must be adjusted. In the work, the influence of these characteristics on the error of prediction of the controlled parameter was studied. This takes into account the behavior of the parameter. The values of the forecast lag are determined. The results of the research, in the case of their use, will improve the efficiency of monitoring the technical object during its operation.

Postural control and balance self-efficacy in women with fibromyalgia: are there differences?

PubMed

Muto, L H A; Sauer, J F; Yuan, S L K; Sousa, A; Mango, P C; Marques, A P

2015-04-01

Fibromyalgia (FM) is a rheumatic disease characterized by chronic widespread pain and symptoms such as fatigue, sleep disturbances, cognitive difficulties, and depression. Postural instability is a debilitating disorder increasingly recognized as part of FM. To assess and compare postural control and balance self-efficacy in women with and without FM and verify the association of these variables with pain, symptom severity, and strength. Case-control study Physiotherapeutic Clinical Research and Electromyography Laboratory Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Case-control study of 117 women ranging from age 35 to 60 years. Of these, 67 had FM. Posture control was assessed with the modified clinical test of sensory interaction on balance with patients in forceplates, balance self-efficacy with the Activities-specific Balance Confidence Scale, pain severity with the Visual Analog Scale, tender point pain threshold with digital algometry, symptom severity with the fibromyalgia impact questionnaire, and lower limb strength with a dynamometer. Individuals with FM had impaired postural control showing increased speed of oscillation of the center of gravity (P=0.004) and decreased balance self-efficacy (P<0.001). They had moderate to excellent correlations of balance self-efficacy with pain (r=0.7, P<0.01), muscle strength (r=0.52, P<0.01), and symptom severity (r=0.78, P<0.10) compared with the control group. Correlation of postural control with the same variables was weak. Patients with FM have impaired postural control and low balance self-efficacy that are associated with pain, muscle strength, and symptom severity. Postural control and balance self-efficacy needs to be assessed in patients with FM and the treatment goals should be the improvement of postural control and balance self-efficacy.

Stability Improvement of High-Pressure-Ratio Turbocharger Centrifugal Compressor by Asymmetrical Flow Control-Part II: Nonaxisymmetrical Self-Recirculation Casing Treatment.

PubMed

Zheng, Xinqian; Zhang, Yangjun; Yang, Mingyang; Bamba, Takahiro; Tamaki, Hideaki

2013-03-01

This is part II of a two-part paper involving the development of an asymmetrical flow control method to widen the operating range of a turbocharger centrifugal compressor with high-pressure ratio. A nonaxisymmetrical self-recirculation casing treatment (SRCT) as an instance of asymmetrical flow control method is presented. Experimental and numerical methods were used to investigate the impact of nonaxisymmetrical SRCT on the surge point of the centrifugal compressor. First, the influence of the geometry of a symmetric SRCT on the compressor performance was studied by means of numerical simulation. The key parameter of the SRCT was found to be the distance from the main blade leading edge to the rear groove (S r ). Next, several arrangements of a nonaxisymmetrical SRCT were designed, based on flow analysis presented in part I. Then, a series of experiments were carried out to analyze the influence of nonaxisymmetrical SRCT on the compressor performance. Results show that the nonaxisymmetrical SRCT has a certain influence on the performance and has a larger potential for stability improvement than the traditional symmetric SRCT. For the investigated SRCT, the surge flow rate of the compressor with the nonaxisymmetrical SRCTs is about 10% lower than that of the compressor with symmetric SRCT. The largest surge margin (smallest surge flow rate) can be obtained when the phase of the largest S r is coincident with the phase of the minimum static pressure in the vicinity of the leading edge of the splitter blades.

Validity of Self-reported Sleep Bruxism among Myofascial Temporomandibular Disorder Patients and Controls

PubMed Central

Raphael, Karen G.; Janal, Malvin N.; Sirois, David A.; Dubrovsky, Boris; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

2015-01-01

Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of orofacial problems, including temporomandibular disorders (TMD). Since laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n=124) and a demographically matched control group without TMD (n=46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. PMID:26010126

Irritable Bowel Syndrome and Complementary Health Practices: What the Science Says

MedlinePlus

... controlled trials on various herbal preparations; however, the methodological quality of most of these studies is poor. ... if improperly manufactured. A 2012 systematic review of case reports and case series concluded that using certain ...

Methodology Series Module 2: Case-control Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

High School Students Are a Target Group for Fight against Self-Medication with Antimalarial Drugs: A Pilot Study in University of Kinshasa, Democratic Republic of Congo.

PubMed

Kabongo Kamitalu, Ramsès; Aloni, Michel Ntetani

2016-01-01

Aim. To assess the self-medication against malaria infection in population of Congolese students in Kinshasa, Democratic Republic of Congo (DRC). Methods. A cross-sectional study was carried out in University of Kinshasa, Kinshasa, Democratic Republic of Congo. Medical records of all students with malaria admitted to Centre de Santé Universitaire of University of Kinshasa from January 1, 2008, to April 30, 2008, were reviewed retrospectively. Results. The median age of the patients was 25.4 years (range: from 18 to 36 years). The majority of them were male (67.9%). Artemisinin-based combination treatments (ACTs) was the most used self-prescribed antimalarial drugs. However, self-medication was associated with the ingestion of quinine in 19.9% of cases. No case of ingestion of artesunate/artemether in monotherapy was found. All the medicines taken were registered in DRC. In this series, self-prescribed antimalarial was very irrational in terms of dose and duration of treatment. Conclusion. This paper highlights self-medication by a group who should be aware of malaria treatment protocols. The level of self-prescribing quinine is relatively high among students and is disturbing for a molecule reserved for severe disease in Congolese health care policy in management of malaria.

Sensitivity of self-reported opioid use in case-control studies: Healthy individuals versus hospitalized patients.

PubMed

Rashidian, Hamideh; Hadji, Maryam; Marzban, Maryam; Gholipour, Mahin; Rahimi-Movaghar, Afarin; Kamangar, Farin; Malekzadeh, Reza; Weiderpass, Elisabete; Rezaianzadeh, Abbas; Moradi, Abdolvahab; Babhadi-Ashar, Nima; Ghiasvand, Reza; Khavari-Daneshvar, Hossein; Haghdoost, Ali Akbar; Zendehdel, Kazem

2017-01-01

Several case-control studies have shown associations between the risk of different cancers and self-reported opium use. Inquiring into relatively sensitive issues, such as the history of drug use, is usually prone to information bias. However, in order to justify the findings of these types of studies, we have to quantify the level of such a negative bias. In current study, we aimed to evaluate sensitivity of self-reported opioid use and suggest suitable types of control groups for case-control studies on opioid use and the risk of cancer. In order to compare the validity of the self-reported opioid use, we cross-validated the response of two groups of subjects 1) 178 hospitalized patients and 2) 186 healthy individuals with the results of their tests using urine rapid drug screen (URDS) and thin layer chromatography (TLC). The questioners were asked by trained interviewers to maximize the validity of responses; healthy individuals were selected from the companions of patients in hospitals. Self-reported regular opioid use was 36.5% in hospitalized patients 19.3% in healthy individuals (p-value> 0.001).The reported frequencies of opioid use in the past 72 hours were 21.4% and 11.8% in hospitalized patients and healthy individuals respectively. Comparing their responses with the results of urine tests showed a sensitivity of 77% and 69% among hospitalized patients and healthy individuals for self-reports (p-value = 0.4). Having corrected based on the mentioned sensitivities; the frequency of opioid regular use was 47% and 28% in hospitalized patients and healthy individuals, respectively. Regular opioid use among hospitalized patients was significantly higher than in healthy individuals (p-value> 0.001). Our findings showed that the level of opioid use under-reporting in hospitalized patients and healthy individuals was considerable but comparable. In addition, the frequency of regular opioid use among hospitalized patients was significantly higher than that in the general population. Altogether, it seems that, without corrections for these differences and biases, the results of many studies including case-control studies on opioid use might distort findings substantially.

Sensitivity of self-reported opioid use in case-control studies: Healthy individuals versus hospitalized patients

PubMed Central

Rashidian, Hamideh; Hadji, Maryam; Marzban, Maryam; Gholipour, Mahin; Rahimi-Movaghar, Afarin; Kamangar, Farin; Malekzadeh, Reza; Weiderpass, Elisabete; Rezaianzadeh, Abbas; Moradi, Abdolvahab; Babhadi-Ashar, Nima; Ghiasvand, Reza; Khavari-Daneshvar, Hossein; Haghdoost, Ali Akbar; Zendehdel, Kazem

2017-01-01

Background Several case-control studies have shown associations between the risk of different cancers and self-reported opium use. Inquiring into relatively sensitive issues, such as the history of drug use, is usually prone to information bias. However, in order to justify the findings of these types of studies, we have to quantify the level of such a negative bias. In current study, we aimed to evaluate sensitivity of self-reported opioid use and suggest suitable types of control groups for case-control studies on opioid use and the risk of cancer. Methods In order to compare the validity of the self-reported opioid use, we cross-validated the response of two groups of subjects 1) 178 hospitalized patients and 2) 186 healthy individuals with the results of their tests using urine rapid drug screen (URDS) and thin layer chromatography (TLC). The questioners were asked by trained interviewers to maximize the validity of responses; healthy individuals were selected from the companions of patients in hospitals. Results Self-reported regular opioid use was 36.5% in hospitalized patients 19.3% in healthy individuals (p-value> 0.001).The reported frequencies of opioid use in the past 72 hours were 21.4% and 11.8% in hospitalized patients and healthy individuals respectively. Comparing their responses with the results of urine tests showed a sensitivity of 77% and 69% among hospitalized patients and healthy individuals for self-reports (p-value = 0.4). Having corrected based on the mentioned sensitivities; the frequency of opioid regular use was 47% and 28% in hospitalized patients and healthy individuals, respectively. Regular opioid use among hospitalized patients was significantly higher than in healthy individuals (p-value> 0.001). Conclusion Our findings showed that the level of opioid use under-reporting in hospitalized patients and healthy individuals was considerable but comparable. In addition, the frequency of regular opioid use among hospitalized patients was significantly higher than that in the general population. Altogether, it seems that, without corrections for these differences and biases, the results of many studies including case-control studies on opioid use might distort findings substantially. PMID:28854228

Does cataract surgery alleviate poverty? Evidence from a multi-centre intervention study conducted in Kenya, the Philippines and Bangladesh.

PubMed

Kuper, Hannah; Polack, Sarah; Mathenge, Wanjiku; Eusebio, Cristina; Wadud, Zakia; Rashid, Mamunur; Foster, Allen

2010-11-09

Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure--PCE, asset ownership and self-rated wealth) were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity<6/24 in the better eye) and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls), of which 263 cases had undergone cataract surgery ("operated cases"). At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus £35 p = 0.02, Bangladesh: $16 vs $24 p = 0.004, Philippines: $24 vs 32 p = 0.0007), assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus £36 p = 0.49, Bangladesh: $23 vs $23 p = 0.20, Philippines: $45 vs $36 p = 0.68). There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline. This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate poverty and achieve the Millennium Development Goals.

Genetic variants in a haplotype block spanning IDE are significantly associated with plasma Abeta42 levels and risk for Alzheimer disease.

PubMed

Ertekin-Taner, Nilüfer; Allen, Mariet; Fadale, Daniel; Scanlin, Leah; Younkin, Linda; Petersen, Ronald C; Graff-Radford, Neill; Younkin, Steven G

2004-04-01

Risk for late onset Alzheimer disease (LOAD) and plasma amyloid beta levels (Abeta42; encoded by APP), an intermediate phenotype for LOAD, show linkage to chromosome 10q. Several strong candidate genes (VR22, PLAU, IDE) lie within the 1-lod support interval for linkage. Others have independently identified haplotypes in the chromosome 10q region harboring IDE that show highly significant association with intermediate AD phenotypes and with risk for AD. To pursue these associations, we analyzed the same haplotypes for association with plasma Abeta42 in 24 extended LOAD families and for association with LOAD in two independent case-control series. One series (MCR, 188 age-matched case-control pairs) did not show association (p=0.64) with the six haplotypes in the 276-kb region spanning three genes (IDE, KNSL1, and HHEX) previously shown to associate with LOAD. The other series (MCJ, 109 age-matched case-control pairs) showed significant (p=0.003) association with these haplotypes. In the MCJ series, the H4 (odds ratio [OR]=5.1, p=0.003) and H2(H7) haplotypes (OR=0.60, p=0.04) had the same effects previously reported. In this series, the H8 haplotype (OR=2.7, p=0.098) also had an effect similar as in one previous case control series but not in others. In the extended families, the H8 haplotype was associated with significantly elevated plasma Abeta42 (p=0.02). In addition, the H5(H10) haplotype, which is associated with reduced risk for AD in the other study is associated with reduced plasma Abeta42 (p=0.007) in our family series. These results provide strong evidence for pathogenic variant(s) in the 276-kb region harboring IDE that influence intermediate AD phenotypes and risk for AD. Copyright 2004 Wiley-Liss, Inc.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients.

PubMed

Sidorov, Alexey; Mayur, Prashanth

2017-02-01

The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

A longitudinal study of self-control at the transition to secondary school: Considering the role of pubertal status and parenting.

PubMed

Ng-Knight, Terry; Shelton, Katherine H; Riglin, Lucy; McManus, I C; Frederickson, Norah; Rice, Frances

2016-07-01

Higher self-control in children and adolescents is associated with a range of positive outcomes in adulthood. However, little is known about the naturalistic development of self-control during early adolescence and the factors that affect this. We examined the role of puberty and parenting style as theoretically important influences on stability and change in self-control. A longitudinal (3 waves), multiple-informant dataset of children entering early adolescence (M = 11 years) was used to explore longitudinal change in self-control using latent growth curve modelling. Children's self-control declined during the one-year study period and declines were associated with children's behavioural and social functioning. Associations with self-control were found for pubertal status and parental warmth and hostility, but not for parental discipline. The findings suggest that during early adolescence, when children make the transition to secondary school, self-control declines. This is particularly the case for those experiencing puberty earlier than their peers. Parent warmth influences the trajectory of self-control during this period. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Case studies in pathophysiology: The development and evaluation of an interactive online learning environment to develop higher order thinking and argumentation

NASA Astrophysics Data System (ADS)

Titterington, Lynda C.

2007-12-01

This study presents a framework for examining the effects of higher order thinking on the achievement of allied health students enrolled in a pathophysiology course. A series of clinical case studies was developed and published in an enriched online environment that guided students through the process of developing a solution and supporting it through data analysis and interpretation. The series of case study modules scaffolded argumentation through question prompts. The modules began with a simple, direct problem and they became progressively more complex throughout the quarter. A control group was assigned a pencil-and-paper case study based upon recall. The case studies were scored for content accuracy and evidence of higher order thinking skills. Higher order thinking was measured using a rubric based upon the Toulmin argumentation pattern. The results indicated implementing a case study of either online or traditional format was associated with significant gains in achievement. The Web-enhanced case studies were associated with modest gains in knowledge acquisition. The argumentation scores across the series followed two trends: directed case studies were associated with higher levels of argumentation than ill-structured case studies, and there appeared to be an inverse relationship between the students' argumentation and content scores. The protocols developed for this study can serve as a template for a larger, extended investigation into student learning in the online environment.

Identification and replication of the interplay of four genetic high-risk variants for urinary bladder cancer

PubMed Central

Selinski, Silvia; Blaszkewicz, Meinolf; Ickstadt, Katja; Gerullis, Holger; Otto, Thomas; Roth, Emanuel; Volkert, Frank; Ovsiannikov, Daniel; Moormann, Oliver; Banfi, Gergely; Nyirady, Peter; Vermeulen, Sita H; Garcia-Closas, Montserrat; Figueroa, Jonine D; Johnson, Alison; Karagas, Margaret R; Kogevinas, Manolis; Malats, Nuria; Schwenn, Molly; Silverman, Debra T; Koutros, Stella; Rothman, Nathaniel; Kiemeney, Lambertus A; Hengstler, Jan G; Golka, Klaus

2017-01-01

Abstract Little is known whether genetic variants identified in genome-wide association studies interact to increase bladder cancer risk. Recently, we identified two- and three-variant combinations associated with a particular increase of bladder cancer risk in a urinary bladder cancer case–control series (Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), 1501 cases, 1565 controls). In an independent case–control series (Nijmegen Bladder Cancer Study, NBCS, 1468 cases, 1720 controls) we confirmed these two- and three-variant combinations. Pooled analysis of the two studies as discovery group (IfADo-NBCS) resulted in sufficient statistical power to test up to four-variant combinations by a logistic regression approach. The New England and Spanish Bladder Cancer Studies (2080 cases and 2167 controls) were used as a replication series. Twelve previously identified risk variants were considered. The strongest four-variant combination was obtained in never smokers. The combination of rs1014971[AA] near apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like 3A (APOBEC3A) and chromobox homolog 6 (CBX6), solute carrier family 1s4 (urea transporter), member 1 (Kidd blood group) (SLC14A1) exon single nucleotide polymorphism (SNP) rs1058396[AG, GG], UDP glucuronosyltransferase 1 family, polypeptide A complex locus (UGT1A) intron SNP rs11892031[AA] and rs8102137[CC, CT] near cyclin E1 (CCNE1) resulted in an unadjusted odds ratio (OR) of 2.59 (95% CI = 1.93–3.47; P = 1.87 × 10−10), while the individual variant ORs ranged only between 1.11 and 1.30. The combination replicated in the New England and Spanish Bladder Cancer Studies (ORunadjusted = 1.60, 95% CI = 1.10–2.33; P = 0.013). The four-variant combination is relatively frequent, with 25% in never smoking cases and 11% in never smoking controls (total study group: 19% cases, 14% controls). In conclusion, we show that four high-risk variants can statistically interact to confer increased bladder cancer risk particularly in never smokers. PMID:29028944

Bridging glycated hemoglobin with quality of life and health state; a randomized case-control study among type 2 diabetes patients.

PubMed

Gillani, Syed Wasif; Ansari, Irfan Altaf; Zaghloul, Hisham A; Abdul, Mohi Iqbal Mohammad; Sulaiman, Syed Azhar Syed; Baig, Mirza R

2018-01-01

The aim of this study was to explore the predictors of QOL and health state and examine the relationship with glycemic control among type 2 diabetes mellitus (T2DM) patients. A randomized cross-sectional case-control study was conducted among n = 600 T2DM patients of Malaysia. Study population was distributed into three groups as: controls: patients with HbA1c ≤ 7 (n = 199), cases arm 1: with HbA1c 7-7.9 (n = 204) and cases arm 2 (n = 197): with HbA1c ≥ 8 consecutively last 3 times. Participants with diabetes history > 10 years exhibits higher mean QOL score among all the three groups. In contrast mean health status score significantly ( p  < 0.001) reduced with the exposure duration of diabetes both within and intergroup assessment that participants with poor glycemic control (arm 2) had significantly higher mean QOL score with knowledge and self-care dimensions as compared to others, however mean health state scores were significantly ( p  < 0.001) lower in all assessment dimensions as compared to controls. The F test of significance showed that demographic and clinical parameters were strong predictors of QOL, whereas self-care activities, comorbidities, ability of positive management and BMI were significant predictors to health state for consistent glycemic control (controls) as compared to poor glycemic control (arm 2) participants. This study suggested that poor glycemic index reported low self-care behavior, increase barriers to daily living activities and poor ability to manage diabetes positively, which cause poor QOL and decrease health state.

Quantifying direct effects of social determinants of health on glycemic control in adults with type 2 diabetes.

PubMed

Walker, Rebekah J; Gebregziabher, Mulugeta; Martin-Harris, Bonnie; Egede, Leonard E

2015-02-01

The aim of this study was to investigate if self-care is the pathway through which social determinants of health impact diabetes outcomes by analyzing the direct and indirect effects of socioeconomic and psychosocial factors on self-care and glycemic control. Six hundred fifteen adults were recruited from two primary care clinics in the southeastern United States. A series of confirmatory factor analyses identified the latent factors underlying social status, psychosocial determinants (psychological distress, self-efficacy, and social support), and self-care (diet, exercise, foot care, glucose testing, and medication adherence). Structured equation modeling investigated the relationship among social determinants, self-care and glycemic control. Latent variables were created for diabetes self-care, psychological distress, self-efficacy, social support, and social status. The final model [χ(2)(275)=450.07, P<0.001, R(2)=99, root mean square error of approximation=0.03, comparative fit index=0.98] showed lower psychological distress (r=-0.13, P=0.012), higher social support (r=0.14, P=0.01), and higher self-efficacy (r=0.47, P<0.001) were significantly related to diabetes self-care. Lower psychological distress (r=0.10, P=0.03), lower social support (r=0.10, P=0.02), and higher self-efficacy (r=-0.37, P<0.001) were significantly related to lower glycemic control. When social determinants of health variables were included in the model, self-care was no longer significantly associated with glycemic control (r=0.01, P=0.83). This study suggests a direct relationship between psychosocial determinants of health and glycemic control. Although associated with self-care, the relationship between social determinants of health and glycemic control is not mediated by self-care. Development of interventions should take psychosocial factors into account as independent influences on diabetes outcomes, rather than as indirect influences via self-care behavior.

Feeling of control of an action after supra and subliminal haptic distortions.

PubMed

Weibel, Sébastien; Poncelet, Patrick Eric; Delevoye-Turrell, Yvonne; Capobianco, Antonio; Dufour, André; Brochard, Renaud; Ott, Laurent; Giersch, Anne

2015-09-01

Here we question the mechanisms underlying the emergence of the feeling of control that can be modulated even when the feeling of being the author of one's own action is intact. With a haptic robot, participants made series of vertical pointing actions on a virtual surface, which was sometimes postponed by a small temporal delay (15 or 65 ms). Subjects then evaluated their subjective feeling of control. Results showed that after temporal distortions, the hand-trajectories were adapted effectively but that the feeling of control decreased significantly. This was observed even in the case of subliminal distortions for which subjects did not consciously detect the presence of a distortion. Our findings suggest that both supraliminal and subliminal temporal distortions that occur within a healthy perceptual-motor system impact the conscious experience of the feeling of control of self-initiated motor actions. Copyright © 2015 Elsevier Inc. All rights reserved.

Statistical robustness of machine-learning estimates for characterizing a groundwater-surface water system, Southland, New Zealand

NASA Astrophysics Data System (ADS)

Friedel, M. J.; Daughney, C.

2016-12-01

The development of a successful surface-groundwater management strategy depends on the quality of data provided for analysis. This study evaluates the statistical robustness when using a modified self-organizing map (MSOM) technique to estimate missing values for three hypersurface models: synoptic groundwater-surface water hydrochemistry, time-series of groundwater-surface water hydrochemistry, and mixed-survey (combination of groundwater-surface water hydrochemistry and lithologies) hydrostratigraphic unit data. These models of increasing complexity are developed and validated based on observations from the Southland region of New Zealand. In each case, the estimation method is sufficiently robust to cope with groundwater-surface water hydrochemistry vagaries due to sample size and extreme data insufficiency, even when >80% of the data are missing. The estimation of surface water hydrochemistry time series values enabled the evaluation of seasonal variation, and the imputation of lithologies facilitated the evaluation of hydrostratigraphic controls on groundwater-surface water interaction. The robust statistical results for groundwater-surface water models of increasing data complexity provide justification to apply the MSOM technique in other regions of New Zealand and abroad.

Investigating the Co-Occurrence of Self-Mutilation and Suicide Attempts among Opioid-Dependent Individuals

ERIC Educational Resources Information Center

Maloney, Elizabeth; Degenhardt, Louisa; Darke, Shane; Nelson, Elliot C.

2010-01-01

The prevalence and risk factors associated with self-mutilation among opioid dependent cases and controls were determined, and the co-occurrence of self-mutilation and attempted suicide was examined. The prevalence of self-mutilation among cases and controls did not differ significantly (25% vs. 23%, respectively), with gender differences…

Occurrence of Multiple Sclerosis After Drug Exposure: Insights From Evidence Mapping.

PubMed

Antonazzo, Ippazio Cosimo; Raschi, Emanuel; Vignatelli, Luca; Baldin, Elisa; Riise, Trond; D'Alessandro, Roberto; De Ponti, Fabrizio; Poluzzi, Elisabetta

2017-09-01

The role of drugs in the occurrence of multiple sclerosis (MS) is perceived to be insufficiently investigated. The aim of this study was to map and assess the evidence on MS occurrence after drug exposure, in order to identify possible signals of causal association. A search strategy was performed in MEDLINE and Embase as of July 2016; references consistent with the aim of the study were analysed to extract relevant measures of causal association between drugs and MS. The Newcastle-Ottawa Scale and appropriate guidelines from the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) were used to assess the quality of included studies. After screening 832 articles, 58 were selected (of which 14 were found by checking the reference lists of reviews): 30 case reports and case series, 24 longitudinal studies and four randomized controlled trials. Seven longitudinal studies had good (at least 7 out of 9) quality scores, whereas case reports/case series presented several limitations. Half of included articles focused on immunomodulatory drugs (etanercept, infliximab and adalimumab), especially in case reports/series, suggesting an association with MS occurrence. Contraceptives and antibacterials were investigated in some population-based studies, without definite results. A heterogeneous pharmacological profile of identified classes emerged. Low strength of evidence and conflicting results highlighted the difficulties in addressing the possible contribution of drugs in MS occurrence. Methodological advances are needed, especially to control the confounding role of underlying disease for specific drug classes.

Do serum BDNF levels vary in self-harm behavior among adolescents and are they correlated with traumatic experiences?

PubMed

Kavurma, Canem; Varol Tas, Fatma; Serim Demirgoren, Burcu; Demirci, Ferhat; Akan, Pınar; Eyuboglu, Damla; Guvenir, Taner

2017-12-01

The aim of this study was to compare serum brain-derived neurotrophic factor (BDNF) levels between adolescents that harm themselves, those that receive psychiatric treatment but do not harm themselves, healthy adolescents, and childhood traumas and to investigate the relationship between traumatic experiences and serum BDNF levels. The cases were divided into two groups of 40 adolescents exhibiting self-harm behavior (self-harm/diagnosed group) and 30 adolescents receiving psychiatric treatment but not exhibiting self-harm behaviors (non self-harm/diagnosed group). The control group (healthy control group) consisted of 35 healthy adolescents with no psychiatric disorders or self-harm behaviors. The adolescents were asked to fill in the Inventory of Statements About Self Injury (ISAS) and Childhood Trauma Questionnaire (CTQ). For BDNF measurement, blood samples were taken from the cases and controls. The serum BDNF level of self-harming adolescents who used the self-cutting method was significantly lower than that of other groups, and serum BDNF levels decreased with the increase in the emotional neglect and abuse severity of self-harming adolescents during childhood. In our study, serum BDNF levels decreased with the increase in emotional abuse in self-harming adolescents. This finding may indicate that neuroplasticity can be affected by a negative emotional environment during the early period. Copyright © 2017 Elsevier B.V. All rights reserved.

Self-Care Guide for the Heart Failure Patient

MedlinePlus

... Bridging Disciplines Circulation at Major Meetings Special Themed Issues Global Impact of the 2017 ACC/AHA Hypertension Guidelines Circulation Supplements Cardiovascular Case Series ECG Challenge Hospitals of History Brigham and ...

Chicano Educational Achievement: Comparing Escuela Tlatelolco, a Chicanocentric School, and a Public High School. Latino Communities: Emerging Voices--Political, Social, Cultural, and Legal Issues--A Garland Series.

ERIC Educational Resources Information Center

McKissack, Elena Aragon de

Building on the theorem that a positive self-identity is fundamental to completion of an education, a study was conducted to learn how schools with differing backgrounds affected the ethnic identity of students. Two schools in Denver (Colorado) were selected for this case study. "Broderick High School" is a large public school whose…

Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls.

PubMed

Raphael, K G; Janal, M N; Sirois, D A; Dubrovsky, B; Klausner, J J; Krieger, A C; Lavigne, G J

2015-10-01

Sleep bruxism (SB), primarily involving rhythmic grinding of the teeth during sleep, has been advanced as a causal or maintenance factor for a variety of oro-facial problems, including temporomandibular disorders (TMD). As laboratory polysomnographic (PSG) assessment is extremely expensive and time-consuming, most research testing this belief has relied on patient self-report of SB. The current case-control study examined the accuracy of those self-reports relative to laboratory-based PSG assessment of SB in a large sample of women suffering from chronic myofascial TMD (n = 124) and a demographically matched control group without TMD (n = 46). A clinical research coordinator administered a structured questionnaire to assess self-reported SB. Participants then spent two consecutive nights in a sleep laboratory. Audiovisual and electromyographic data from the second night were scored to assess whether participants met criteria for the presence of 2 or more (2+) rhythmic masticatory muscle activity episodes accompanied by grinding sounds, moderate SB, or severe SB, using previously validated research scoring standards. Contingency tables were constructed to assess positive and negative predictive values, sensitivity and specificity, and 95% confidence intervals surrounding the point estimates. Results showed that self-report significantly predicted 2+ grinding sounds during sleep for TMD cases. However, self-reported SB failed to significantly predict the presence or absence of either moderate or severe SB as assessed by PSG, for both cases and controls. These data show that self-report of tooth grinding awareness is highly unlikely to be a valid indicator of true SB. Studies relying on self-report to assess SB must be viewed with extreme caution. © 2015 John Wiley & Sons Ltd.

A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities

PubMed Central

Chow, Susan Ka Yee; Wong, Frances Kam Yuet

2014-01-01

Aim To examine the effects of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. Background The most significant chronic conditions today involve diseases of the cardiovascular, respiratory, endocrine and renal systems. Previous studies have suggested that a nurse-led case management approach using either telephone follow-ups or home visits was able to improve clinical and patient outcomes for patients having a single, chronic disease, while the effects for older patients having at least two long-term conditions are unknown. A self-help programme using motivation and empowerment approaches is the framework of care in the study. Design Randomized controlled trial. Method The study was conducted from 2010–2012. Older patients having at least two chronic diseases were included for analysis. The participants were randomized into three arms: two study groups and one control group. Data were collected at baseline and at 4 and 12 weeks later. Results Two hundred and eighty-one patients completed the study. The interventions demonstrated significant differences in hospital readmission rates within 84 days post discharge. The two intervention groups had lower readmission rates than the control group. Patients in the two study arms had significantly better self-rated health and self-efficacy. There was significant difference between the groups in the physical composite score, but no significant difference in mental component score in SF-36 scale. Conclusion The postdischarge interventions led by the nurse case managers on self-management of disease using the empowerment approach were able to provide effective clinical and patient outcomes for older patients having co-morbidities. PMID:24617755

Finding Limit Cycles in self-excited oscillators with infinite-series damping functions

NASA Astrophysics Data System (ADS)

Das, Debapriya; Banerjee, Dhruba; Bhattacharjee, Jayanta K.

2015-03-01

In this paper we present a simple method for finding the location of limit cycles of self excited oscillators whose damping functions can be represented by some infinite convergent series. We have used standard results of first-order perturbation theory to arrive at amplitude equations. The approach has been kept pedagogic by first working out the cases of finite polynomials using elementary algebra. Then the method has been extended to various infinite polynomials, where the fixed points of the corresponding amplitude equations cannot be found out. Hopf bifurcations for systems with nonlinear powers in velocities have also been discussed.

Methodology Series Module 2: Case-control Studies

PubMed Central

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design.

PubMed

Franke, Molly F; Jerome, J Gregory; Matias, Wilfredo R; Ternier, Ralph; Hilaire, Isabelle J; Harris, Jason B; Ivers, Louise C

2017-10-13

Case-control studies to quantify oral cholera vaccine effectiveness (VE) often rely on neighbors without diarrhea as community controls. Test-negative controls can be easily recruited and may minimize bias due to differential health-seeking behavior and recall. We compared VE estimates derived from community and test-negative controls and conducted bias-indicator analyses to assess potential bias with community controls. From October 2012 through November 2016, patients with acute watery diarrhea were recruited from cholera treatment centers in rural Haiti. Cholera cases had a positive stool culture. Non-cholera diarrhea cases (test-negative controls and non-cholera diarrhea cases for bias-indicator analyses) had a negative culture and rapid test. Up to four community controls were matched to diarrhea cases by age group, time, and neighborhood. Primary analyses included 181 cholera cases, 157 non-cholera diarrhea cases, 716 VE community controls and 625 bias-indicator community controls. VE for self-reported vaccination with two doses was consistent across the two control groups, with statistically significant VE estimates ranging from 72 to 74%. Sensitivity analyses revealed similar, though somewhat attenuated estimates for self-reported two dose VE. Bias-indicator estimates were consistently less than one, with VE estimates ranging from 19 to 43%, some of which were statistically significant. OCV estimates from case-control analyses using community and test-negative controls were similar. While bias-indicator analyses suggested possible over-estimation of VE estimates using community controls, test-negative analyses suggested this bias, if present, was minimal. Test-negative controls can be a valid low-cost and time-efficient alternative to community controls for OCV effectiveness estimation and may be especially relevant in emergency situations. Copyright © 2017. Published by Elsevier Ltd.

Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case-control study.

PubMed

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael; Pearson, Melissa; Gunnell, David; Hawton, Keith; Jayamanne, Shaluka; Pabasara, Chathurani; Jayathilaka, Tharidu; Dissanayaka, Kalpani; Rajapaksha, Sandamali; Thilakarathna, Prasanna; Agampodi, Suneth

2015-05-20

Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300,000 people annually. Around 15-20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm. This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case-control group approach. Four interviewer-administered data collection tools will be used for this study: a semistructured questionnaire, Beck Suicidal Intent Scale (SIS), Clinical Interview Schedule-Sinhalese version (CIS-Sn) and Alcohol Use Disorders Identification Test (AUDIT). Each case (expected n=33) will be compared with two groups of individuals: (1) those who have self-poisoned using pesticides from the home, home garden or farmland and (2) those who bought pesticides from the same shops as the above cases, but not did not self-poison. Logistic regression models will be used to identify risk factors of purchasing pesticides for self-poisoning from shops. The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results will be disseminated in scientific peer-reviewed articles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nonlinear time-series-based adaptive control applications

NASA Technical Reports Server (NTRS)

Mohler, R. R.; Rajkumar, V.; Zakrzewski, R. R.

1991-01-01

A control design methodology based on a nonlinear time-series reference model is presented. It is indicated by highly nonlinear simulations that such designs successfully stabilize troublesome aircraft maneuvers undergoing large changes in angle of attack as well as large electric power transients due to line faults. In both applications, the nonlinear controller was significantly better than the corresponding linear adaptive controller. For the electric power network, a flexible AC transmission system with series capacitor power feedback control is studied. A bilinear autoregressive moving average reference model is identified from system data, and the feedback control is manipulated according to a desired reference state. The control is optimized according to a predictive one-step quadratic performance index. A similar algorithm is derived for control of rapid changes in aircraft angle of attack over a normally unstable flight regime. In the latter case, however, a generalization of a bilinear time-series model reference includes quadratic and cubic terms in angle of attack.

Healthy control subjects are poorly defined in case-control studies of irritable bowel syndrome

PubMed Central

Ghorbani, Shireen; Nejad, Amir; Law, David; Chua, Kathleen S.; Amichai, Meridythe M.; Pimentel, Mark

2015-01-01

Background Case-control studies are vital for understanding the pathophysiology of gastrointestinal disease. While the definition of disease is clear, the definition of healthy control is not. This is particularly relevant for functional bowel diseases such as irritable bowel syndrome (IBS). In this study, a systematic review formed the basis for a prospective study evaluating the effectiveness of commonly used techniques for defining healthy controls in IBS. Methods A systematic review of the literature was conducted to identify case-control studies involving functional gastrointestinal disorders. “Lack of Rome criteria”, self-description as “healthy” and the bowel disease questionnaire (BDQ) were common methods for identifying healthy controls. These 3 methods were then applied to a cohort of 53 non-patient subjects to determine their validity compared to objective outcome measures (7-day stool diary). Results “Lack of Rome criteria” and “healthy” self-description were the most common methods for identifying healthy control subjects, but many studies failed to describe the methods used. In the prospective study, more subjects were identified as non-healthy using the BDQ than using either lack of Rome criteria (P=0.01) or “healthy” self-description (P=0.026). Furthermore, stool diaries identified several subjects with abnormal stool form and/or frequency which were not identified using lack of Rome criteria or the “healthy” question. Comparisons revealed no agreement (κ) between the different methods for defining healthy controls. Conclusions The definitions of healthy controls in studies of functional bowel diseases such as IBS are inconsistent. Since functional symptoms are common, a strict definition of “normal” is needed in this area of research. PMID:25609236

T-cell receptor excision circle levels and safety of paediatric immunization: A population-based self-controlled case series analysis.

PubMed

Wilson, Kumanan; Duque, Daniel Rodriguez; Murphy, Malia Sq; Hawken, Steven; Pham-Huy, Anne; Kwong, Jeffrey; Deeks, Shelley L; Potter, Beth K; Crowcroft, Natasha S; Bulman, Dennis E; Chakraborty, Pranesh; Little, Julian

2018-02-08

T-cell receptor excision circle levels are a surrogate marker of T-cell production and immune system function. We sought to determine whether non-pathological levels of infant T-cell receptor excision circles were associated with adverse events following immunization. A self-controlled case series design was applied on a sample of 231,693 children who completed newborn screening for severe combined immunodeficiency in Ontario, Canada between August 2013 and December 2015. Exposures included routinely administered pediatric vaccines up to 15 months of age. Main outcomes were combined health services utilization for recognized adverse events following immunization. 1,406,981 vaccination events were included in the final dataset. 103,007 children received the Pneu-C-13 or Men-C-C vaccine and 97,998 received the MMR vaccine at 12 months of age. 67,725 children received the varicella immunization at 15 months. Our analysis identified no association between newborn T-cell receptor excision circle levels and subsequent health services utilization events following DTa-IPV-Hib, Pneu-C-13, and Men-C-C vaccinations at 2-month (RI 0.94[95%CI 0.87-1.02]), 4-month (RI 0.82[95%CI 0.75-0.9]), 6-month (RI 0.63[95%CI 0.57-0.7]) and 12-month (RI 0.49[95%CI 0.44-0.55]). We also found no trends in health services utilization following MMR (RI 1.43[95%1.34-1.52]) or varicella (RI 1.14[95%CI 1.05-1.23]) vaccination. Our findings provide further support for the safety of pediatric vaccinations.

Emergence and Disappearance of a Virulent Clone of Haemophilus influenzae Biogroup aegyptius, Cause of Brazilian Purpuric Fever

PubMed Central

Harrison, Lee H.; Simonsen, Vera; Waldman, Eliseu A.

2008-01-01

Summary: In 1984, children presented to the emergency department of a hospital in the small town of Promissão, São Paulo State, Brazil, with an acute febrile illness that rapidly progressed to death. Local clinicians and public health officials recognized that these children had an unusual illness, which led to outbreak investigations conducted by Brazilian health officials in collaboration with the U.S. Centers for Disease Control and Prevention. The studies that followed are an excellent example of the coordinated and parallel studies that are used to investigate outbreaks of a new disease, which became known as Brazilian purpuric fever (BPF). In the first outbreak investigation, a case-control study confirmed an association between BPF and antecedent conjunctivitis but the etiology of the disease could not be determined. In a subsequent outbreak, children with BPF were found to have bacteremia caused by Haemophilus influenzae biogroup aegyptius (H. aegyptius), an organism previously known mainly to cause self-limited purulent conjunctivitis. Molecular characterization of blood and other isolates demonstrated the clonal nature of the H. aegyptius strains that caused BPF, which were genetically distant from the diverse strains that cause only conjunctivitis. This led to an intense effort to identify the factors causing the unusual invasiveness of the BPF clone, which has yet to definitively identify the virulence factor or factors involved. After a series of outbreaks and sporadic cases through 1993, no additional cases of BPF have been reported. PMID:18854482

Risk of hospitalisation with fever following MenB vaccination: self-controlled case series analysis.

PubMed

Murdoch, Heather; Wallace, Lynn; Bishop, Jennifer; Robertson, Chris; Claire Cameron, J

2017-10-01

To investigate a possible association between fever admissions and 4 component Meningococcal B (4CMenB). 4CMenB is given at 8 and 16 weeks in the first year of life. Self-controlled case series using linked routinely collected healthcare data, where the risk period was the 3 days immediately following receipt of a vaccine dose. Children aged under 1 year in Scotland preintroduction and postintroduction of 4CMenB vaccine (pre-September 2014 to August 2015 and post-September 2015 to June 2016). Hospitalisations for fever attributable to 4CMenB vaccine. The postintroduction model showed an increased risk in the 3 days after dose 1 (relative incidence (RI), 10.78; 95% CI: 8.31 to 14.00) and dose 3 (RI, 9.80; 95% CI: 7.10 to 13.62), with a smaller increased risk after dose 2 (RI, 2.20; 95% CI: 1.27 to 3.82). The magnitude of these effects was greater than in the preintroduction model. The attributable fractions were 90.7%, 54.8% and 89.7%, equating to 162, 14 and 84 vaccine attributable cases per 100 000 doses, respectively.This is equivalent to 102 extra hospitalisations in Scotland annually, based on a birth cohort of 55 100 and extrapolated to 1430 across the UK based on a birth cohort of 777 165. There is an increased risk of hospital admission with fever within 3 days of the routine childhood immunisations at 8 and 16 weeks following introduction of 4CMenB vaccine. The results indicate that further understanding of the current use of prophylactic paracetamol is needed. Communication to parents and health professionals may also need to be re-examined, and guidance on the use of prophylactic paracetamol reinforced. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

PubMed

Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

2017-08-01

This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p < 0.01) and self-efficacy to perform various culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

Artificial Epigenetic Networks: Automatic Decomposition of Dynamical Control Tasks Using Topological Self-Modification.

PubMed

Turner, Alexander P; Caves, Leo S D; Stepney, Susan; Tyrrell, Andy M; Lones, Michael A

2017-01-01

This paper describes the artificial epigenetic network, a recurrent connectionist architecture that is able to dynamically modify its topology in order to automatically decompose and solve dynamical problems. The approach is motivated by the behavior of gene regulatory networks, particularly the epigenetic process of chromatin remodeling that leads to topological change and which underlies the differentiation of cells within complex biological organisms. We expected this approach to be useful in situations where there is a need to switch between different dynamical behaviors, and do so in a sensitive and robust manner in the absence of a priori information about problem structure. This hypothesis was tested using a series of dynamical control tasks, each requiring solutions that could express different dynamical behaviors at different stages within the task. In each case, the addition of topological self-modification was shown to improve the performance and robustness of controllers. We believe this is due to the ability of topological changes to stabilize attractors, promoting stability within a dynamical regime while allowing rapid switching between different regimes. Post hoc analysis of the controllers also demonstrated how the partitioning of the networks could provide new insights into problem structure.

A new adaptive self-tuning Fourier coefficients algorithm for periodic torque ripple minimization in permanent magnet synchronous motors (PMSM).

PubMed

Gómez-Espinosa, Alfonso; Hernández-Guzmán, Víctor M; Bandala-Sánchez, Manuel; Jiménez-Hernández, Hugo; Rivas-Araiza, Edgar A; Rodríguez-Reséndiz, Juvenal; Herrera-Ruíz, Gilberto

2013-03-19

A New Adaptive Self-Tuning Fourier Coefficients Algorithm for Periodic Torque Ripple Minimization in Permanent Magnet Synchronous Motors (PMSM) Torque ripple occurs in Permanent Magnet Synchronous Motors (PMSMs) due to the non-sinusoidal flux density distribution around the air-gap and variable magnetic reluctance of the air-gap due to the stator slots distribution. These torque ripples change periodically with rotor position and are apparent as speed variations, which degrade the PMSM drive performance, particularly at low speeds, because of low inertial filtering. In this paper, a new self-tuning algorithm is developed for determining the Fourier Series Controller coefficients with the aim of reducing the torque ripple in a PMSM, thus allowing for a smoother operation. This algorithm adjusts the controller parameters based on the component's harmonic distortion in time domain of the compensation signal. Experimental evaluation is performed on a DSP-controlled PMSM evaluation platform. Test results obtained validate the effectiveness of the proposed self-tuning algorithm, with the Fourier series expansion scheme, in reducing the torque ripple.

Control of OSA During Automatic Positive Airway Pressure Titration in a Clinical Case Series: Predictors and Accuracy of Device Download Data

PubMed Central

Huang, Hsin-Chia Carol; Hillman, David R.; McArdle, Nigel

2012-01-01

Study Objectives: To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Design: Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Setting: Tertiary sleep clinic. Participants: There were 190 consecutive patients with OSA referred for APAP titration. Measurements and Results: There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI < 10, or at least 50% reduction in AHI if diagnostic AHI < 15/hr) during APAP titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square < 0.001). Conclusion: In a clinical sample control of OSA during APAP titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices. Citation: Huang HCC; Hillman DR; McArdle N. Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data. SLEEP 2012;35(9):1277–1283. PMID:22942506

[Mes differ by positioning: empirical testing of decentralized dynamics of the self].

PubMed

Mizokami, Shinichi

2013-10-01

The present study empirically tested the conceptualization of the decentralized dynamics of the self proposed by Hermans & Kempen (1993), which they developed theoretically and from clinical cases, not from large samples of empirical data. They posited that worldviews and images of the self could vary by positioning even in the same individual, and denied that the ego was an omniscient entity that knew and controlled all aspects of the self (centralized ego). Study 1 tested their conceptualization empirically with 47 university students in an experimental group and 17 as a control group. The results showed that the scores on the Rosenberg's self-esteem scale and images of the Mes in the experimental group significantly varied by positioning, but those in the control group did not. Similar results were found in Study 2 with a sample of 120 university students. These results empirically supported the conceptualization of the decentralized dynamics of the self.

Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis.

PubMed

Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa; Shannon, Carol; Singh, Siddharth

2018-02-01

Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation. We searched multiple electronic databases and conference proceedings. We calculated pooled rates (and 95% confidence intervals [CI]) of technical success and stent migration using a random effects model. We identified 14 studies (212 patients) describing covered esophageal SEMS placement with endoscopic suture fixation. When reported, SEMS indications included leak/fistula (n = 75), stricture (n = 65), perforation (n = 10), and achalasia (n = 4). The pooled technical success rate was 96.7% (95% CI 92.3-98.6), without heterogeneity (I 2  = 0%). We identified 29 SEMS migrations at rate of 15.9% (95% CI 11.4-21.6), without heterogeneity (I 2  = 0%). Publication bias was observed, and using the trim-and-fill method, a more conservative estimate for stent migration was 17.0%. Suture-related adverse events were estimated to occur in 3.7% (95% CI 1.6-8.2) of cases. Endoscopic suture fixation of covered esophageal SEMS appears to reduce stent migration when compared to published rates of non-anchored SEMS. However, SEMS migration still occurs in approximately 1 out of 6 cases despite excellent immediate technical success and low risk of suture-related adverse events.

A longitudinal test of the demand-control model using specific job demands and specific job control.

PubMed

de Jonge, Jan; van Vegchel, Natasja; Shimazu, Akihito; Schaufeli, Wilmar; Dormann, Christian

2010-06-01

Supportive studies of the demand-control (DC) model were more likely to measure specific demands combined with a corresponding aspect of control. A longitudinal test of Karasek's (Adm Sci Q. 24:285-308, 1) job strain hypothesis including specific measures of job demands and job control, and both self-report and objectively recorded well-being. Job strain hypothesis was tested among 267 health care employees from a two-wave Dutch panel survey with a 2-year time lag. Significant demand/control interactions were found for mental and emotional demands, but not for physical demands. The association between job demands and job satisfaction was positive in case of high job control, whereas this association was negative in case of low job control. In addition, the relation between job demands and psychosomatic health symptoms/sickness absence was negative in case of high job control and positive in case of low control. Longitudinal support was found for the core assumption of the DC model with specific measures of job demands and job control as well as self-report and objectively recorded well-being.

The clinical application of teaching people about pain.

PubMed

Louw, Adriaan; Zimney, Kory; O'Hotto, Christine; Hilton, Sandra

2016-07-01

Teaching people about the neurobiology and neurophysiology of their pain experience has a therapeutic effect and has been referred to as pain neuroscience education (PNE). Various high-quality randomized controlled trials and systematic reviews have shown increasing efficacy of PNE decreasing pain, disability, pain catastrophization, movement restrictions, and healthcare utilization. Research studies, however, by virtue of their design, are very controlled environments and, therefore, in contrast to the ever-increasing evidence for PNE, little is known about the clinical application of this emerging therapy. In contrast, case studies, case series, and expert opinion and perspectives by authorities in the world of pain science provide clinicians with a glimpse into potential "real" clinical application of PNE in the face of the ever-increasing chronic pain epidemic. By taking the material from the randomized controlled trials, systematic reviews, case series, case studies, and expert opinion, this article aims to provide a proposed layout of the clinical application of PNE. The article systematically discusses key elements of PNE including examination, educational content, and delivery methods, merging of PNE with movement, goal setting, and progression. This perspectives article concludes with a call for research into the clinical application of PNE.

Health on impulse: when low self-control promotes healthy food choices.

PubMed

Salmon, Stefanie J; Fennis, Bob M; de Ridder, Denise T D; Adriaanse, Marieke A; de Vet, Emely

2014-02-01

Food choices are often made mindlessly, when individuals are not able or willing to exert self-control. Under low self-control, individuals have difficulties to resist palatable but unhealthy food products. In contrast to previous research aiming to foster healthy choices by promoting high self-control, this study exploits situations of low self-control, by strategically using the tendency under these conditions to rely on heuristics (simple decision rules) as quick guides to action. More specifically, the authors associated healthy food products with the social proof heuristic (i.e., normative cues that convey majority endorsement for those products). One hundred seventy-seven students (119 men), with an average age of 20.47 years (SD = 2.25) participated in the experiment. This study used a 2 (low vs. high self-control) × 2 (social proof vs. no heuristic) × 2 (trade-off vs. control choice) design, with the latter as within-subjects factor. The dependent variable was the number of healthy food choices in a food-choice task. In line with previous studies, people made fewer healthy food choices under low self-control. However, this negative effect of low self-control on food choice was reversed when the healthy option was associated with the social proof heuristic. In that case, people made more healthy choices under conditions of low self-control. Low self-control may be even more beneficial for healthy food choices than high self-control in the presence of a heuristic. Exploiting situations of low self-control is a new and promising method to promote health on impulse. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Major Depressive Disorder and Impulsive Reactivity to Emotion: Toward a Dual Process View of Depression

PubMed Central

Carver, Charles S.; Johnson, Sheri L.; Joormann, Jutta

2012-01-01

Objective Dual process theories of behavior have been used to suggest that vulnerability to depression involves elevated reactivity to emotions. This study tests that idea, examining self-reported reactivity. Design 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). Methods 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 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. Results 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. Conclusions Reflexive reactivity to emotions characterizes depression, in addition to some externalizing problems, and it may deserve study as a potential transdiagnostic feature. PMID:23865405

Therapeutic effects of saireito (chai-ling-tang), a traditional Japanese herbal medicine, on lymphedema caused by radiotherapy: a case series study.

PubMed

Nagai, Aiko; Shibamoto, Yuta; Ogawa, Keiko

2013-01-01

Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT) is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50%) showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: Case-matched patient reported outcomes.

PubMed

Kelsall, Jennett E; McCulley, Stephen J; Brock, Lisa; Akerlund, Malin T E; Macmillan, R Douglas

2017-10-01

Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size and controlling for radiotherapy; body image scale (BIS) scores of psychosocial function and patient reported outcome measures (PROMs) for breast appearance and return to function were analysed. A total of 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age and tumour size (all p < 0.001). Overall, BIS score (p = 0.002), self-rated breast appearance, return to work and function (all p < 0.001) significantly favoured OBCS. Case-matched women with larger breasts treated by OBCS reported better BIS scores (mean 3.30 vs. 5.37, p = 0.011) and self-rated breast appearance score (p < 0.001) than MxIR, whereas no significant difference was observed for smaller breasts. BIS and appearance favoured OBCS, regardless of whether radiotherapy would have been avoided if treated by MxIR. OBCS offers suitable women the option to avoid MxIR while providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy, apart from those women with smaller breasts for whom the results are comparable. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Autoantibodies against voltage-gated potassium channel and glutamic acid decarboxylase in psychosis: A systematic review, meta-analysis, and case series.

PubMed

Grain, Rosemary; Lally, John; Stubbs, Brendon; Malik, Steffi; LeMince, Anne; Nicholson, Timothy R; Murray, Robin M; Gaughran, Fiona

2017-10-01

Antibodies to the voltage-gated potassium channel (VGKC) complex and glutamic acid decarboxylase (GAD) have been reported in some cases of psychosis. We conducted the first systematic review and meta-analysis to investigate their prevalence in people with psychosis and report a case series of VGKC-complex antibodies in refractory psychosis. Only five studies presenting prevalence rates of VGKC seropositivity in psychosis were identified, in addition to our case series, with an overall prevalence of 1.5% (25/1720) compared to 0.7% in healthy controls (12/1753). Meta-analysis established that the pooled prevalence of GAD65 autoantibodies was 5.8% (95% confidence interval [CI]: 2.0-15.6%; I 2  = 91%; nine studies) in psychotic disorders, with a prevalence of 4.6% (95%CI: 1.2-15.9%; nine studies; I 2  = 89%) and 6.2% (95%CI: 1.2-27.0%; two studies; I 2  = 69%) in schizophrenia and bipolar disorder, respectively. People with psychosis were more likely to have GAD65 antibodies than controls (odds ratio [OR], 2.24; 95%CI: 1.28-3.92%; P = 0.005; eight studies; I 2  = 0%). Among 21 participants with treatment-resistant psychosis, none had VGKC antibodies. The prevalence of VGKC antibodies is low in psychosis. Our preliminary meta-analysis suggests that GAD autoantibodies are more common in people with psychosis than in controls, although few studies accounted for the possibility of co-existing type 1 diabetes mellitus and the clinical significance of reported GAD titers remains unclear. The paucity of studies reporting thresholds for defining GAD abnormality and rates of comorbid type 1 diabetes mellitus precludes interpretations regarding the influence of GAD antibodies on the development of psychotic disorders and may have led to an overestimate of the prevalence of GAD. Our case series fails to support the hypothesis that VGKC antibodies are linked to treatment resistance in psychosis, but the literature to date is remarkably sparse. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

The regulatory function of self-conscious emotion: insights from patients with orbitofrontal damage.

PubMed

Beer, Jennifer S; Heerey, Erin A; Keltner, Dacher; Scabini, Donatella; Knight, Robert T

2003-10-01

Although once considered disruptive, self-conscious emotions are now theorized to be fundamentally involved in the regulation of social behavior. The present study examined the social regulation function of self-conscious emotions by comparing healthy participants with a neuropsychological population--patients with orbitofrontal lesions--characterized by selective regulatory deficits. Orbitofrontal patients and healthy controls participated in a series of tasks designed to assess their social regulation and self-conscious emotions. Another task assessed the ability to infer others' emotional states, an appraisal process involved in self-conscious emotion. Consistent with the theory that self-conscious emotions are important for regulating social behavior, the findings show that deficient behavioral regulation is associated with inappropriate self-conscious emotions that reinforce maladaptive behavior. Additionally, deficient behavioral regulation is associated with impairments in interpreting the self-conscious emotions of others.

Neonatal medical exposures and characteristics of low birth weight hepatoblastoma cases: a report from the Children's Oncology Group.

PubMed

Turcotte, Lucie M; Georgieff, Michael K; Ross, Julie A; Feusner, James H; Tomlinson, Gail E; Malogolowkin, Marcio H; Krailo, Mark D; Miller, Nicole; Fonstad, Rachel; Spector, Logan G

2014-11-01

Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case-control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Incident hepatoblastoma cases who were born <2,500 g (N = 60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N = 51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Case-control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. This study presents the largest case series of hepatoblastoma in <2,500 g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology. © 2014 Wiley Periodicals, Inc.

Acute Cardiovascular Events after Herpes Zoster: A Self-Controlled Case Series Analysis in Vaccinated and Unvaccinated Older Residents of the United States.

PubMed

Minassian, Caroline; Thomas, Sara L; Smeeth, Liam; Douglas, Ian; Brauer, Ruth; Langan, Sinéad M

2015-12-01

Herpes zoster is common and can have serious consequences. Additionally, emerging data suggest an increased risk of acute cardiovascular events following herpes zoster. However, to our knowledge, existing association studies compare outcomes between individuals and are therefore vulnerable to between-person confounding. In this study, we used a within-person study design to quantify any short-term increased risk of acute cardiovascular events (stroke and myocardial infarction [MI]) after zoster and to assess whether zoster vaccination modifies this association. The self-controlled case series method was used to estimate rates of stroke and acute MI in defined periods after herpes zoster compared to other time periods, within individuals. Participants were fully eligible Medicare beneficiaries aged ≥ 65 y with a herpes zoster diagnosis and either an ischemic stroke (n = 42,954) or MI (n = 24,237) between 1 January 2006 and 31 December 2011. Age-adjusted incidence ratios (IRs) for stroke and MI during predefined periods up to 12 mo after zoster relative to unexposed time periods were calculated using conditional Poisson regression. We observed a marked increase in the rate of acute cardiovascular events in the first week after zoster diagnosis: a 2.4-fold increased ischemic stroke rate (IR 2.37, 95% CI 2.17-2.59) and a 1.7-fold increased MI rate (IR 1.68, 95% CI 1.47-1.92), followed by a gradual resolution over 6 mo. Zoster vaccination did not appear to modify the association with MI (interaction p-value = 0.44). We also found no evidence for a difference in the IR for ischemic stroke between vaccinated (IR 1.14, 95% CI 0.75-1.74) and unvaccinated (IR 1.78, 95% CI 1.68-1.88) individuals during the first 4 wk after zoster diagnosis (interaction p-value = 0.28). The relatively few vaccinated individuals limited the study's power to assess the role of vaccination. Stroke and MI rates are transiently increased after exposure to herpes zoster. We found no evidence for a role of zoster vaccination in these associations. These findings enhance our understanding of the temporality and magnitude of the association between zoster and acute cardiovascular events.

Hereditary sensory and autosomal peripheral neuropathy-type IV: case series and review of literature.

PubMed

Ashwin, D P; Chandan, G D; Jasleen, Handa Kaur; Rajkumar, G C; Rudresh, K B; Prashanth, R

2015-06-01

Hereditary sensory and autonomic neuropathy (HSAN) IV is a rare autosomal recessive disorder which is characterized by a decrease in the number of myelinated and non-myelinated nerve fibers of peripheral nerves which causes diminished or absent pain sensation leading to increase in self-mutilative habits. A retrospective study of eight cases ranging from age group of 4 to 17 years for oral and digital signs and symptoms is presented. All the patients showed congenital insensitivity to pain and anhidrosis. Oral self-mutilations, such as autoextraction of teeth and severe bite injuries (with resultant scarring) of the finger tips and oral soft tissues (tongue, lip, and buccal mucosa) were found in most patients. Our study suggests that early diagnosis and specific treatment plan are important for prevention of characteristic of the oral as well as digital trauma associated with this disorder.

Low testosterone in non-responsive coeliac disease: A case series, case-control study with comparisons to the National Health and Nutrition Examination Survey.

PubMed

Kurada, Satya; Veeraraghavan, Gopal; Kaswala, Dharmesh; Hansen, Josh; Cohen, David; Kelly, Ciaran; Leffler, Daniel

2016-10-01

Adults with coeliac disease (CD) often report persistent fatigue, even when CD appears well controlled for unknown reasons. To evaluate common indications for testosterone panel (TP) testing and prevalence of low testosterone (T) in CD. In our case series, we determined common indications for checking TP in CD. Next, we conducted a case-control study to compare TP in CD vs. healthy controls (HC). We compared mean total T (TT), free T (FT) based on serologic, histologic disease activity. Finally, we assessed TT in tissue transglutaminase (tTG)+ vs. tTG- subjects and CD vs. HC obtained from the National Health and Nutrition Examination Survey (NHANES). 53 coeliac males had TP tested. Common indications included osteoporosis and fatigue. Low FT was observed in 7/13 men with osteoporosis and 5/6 with fatigue. In our case-control study (n=26 each), there was no difference in mean TT or FT between CD vs. HC, tTG+ vs tTG- or Marsh 0 vs. Marsh 3 groups. NHANES data showed no difference in mean TT between tTG+ vs tTG- (n=16 each) or CD vs. HC subjects (n=5 each). Low T occurs in CD patients at a similar rate as the general population. Common presentations of low T may mimic non-responsive CD symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

A Case-Control Study to Assess the Relationship between Poverty and Visual Impairment from Cataract in Kenya, the Philippines, and Bangladesh

PubMed Central

Kuper, Hannah; Polack, Sarah; Eusebio, Cristina; Mathenge, Wanjiku; Wadud, Zakia; Foster, Allen

2008-01-01

Background The link between poverty and health is central to the Millennium Development Goals (MDGs). Poverty can be both a cause and consequence of poor health, but there are few epidemiological studies exploring this complex relationship. The aim of this study was to examine the association between visual impairment from cataract and poverty in adults in Kenya, Bangladesh, and the Philippines. Methods and Findings A population-based case–control study was conducted in three countries during 2005–2006. Cases were persons aged 50 y or older and visually impaired due to cataract (visual acuity < 6/24 in the better eye). Controls were persons age- and sex-matched to the case participants with normal vision selected from the same cluster. Household expenditure was assessed through the collection of detailed consumption data, and asset ownership and self-rated wealth were also measured. In total, 596 cases and 535 controls were included in these analyses (Kenya 142 cases, 75 controls; Bangladesh 216 cases, 279 controls; Philippines 238 cases, 180 controls). Case participants were more likely to be in the lowest quartile of per capita expenditure (PCE) compared to controls in Kenya (odds ratio = 2.3, 95% confidence interval 0.9–5.5), Bangladesh (1.9, 1.1–3.2), and the Philippines (3.1, 1.7–5.7), and there was significant dose–response relationship across quartiles of PCE. These associations persisted after adjustment for self-rated health and social support indicators. A similar pattern was observed for the relationship between cataract visual impairment with asset ownership and self-rated wealth. There was no consistent pattern of association between PCE and level of visual impairment due to cataract, sex, or age among the three countries. Conclusions Our data show that people with visual impairment due to cataract were poorer than those with normal sight in all three low-income countries studied. The MDGs are committed to the eradication of extreme poverty and provision of health care to poor people, and this study highlights the need for increased provision of cataract surgery to poor people, as they are particularly vulnerable to visual impairment from cataract. PMID:19090614

Multidisciplinary care considerations for gender nonconforming adolescents with eating disorders: A case series.

PubMed

Donaldson, Abigail A; Hall, Allison; Neukirch, Jodie; Kasper, Vania; Simones, Shannon; Gagnon, Sherry; Reich, Steven; Forcier, Michelle

2018-05-01

Gender nonconforming youth are at risk for body dissatisfaction and disordered eating. Currently, only a small body of literature addresses this high-risk group. The five cases in this series highlight important themes for this patient population from an interdisciplinary perspective. Identified themes include increased risk for self-harm/suicide, complex psychiatric, and medical implications of delay to treatment for either gender dysphoria or disordered eating, and the importance of collaborative management to maximize care and facilitate healthy development to adulthood. The purpose of this case series is to expand the interdisciplinary discussion regarding the breadth of presentation and management considerations for gender nonconforming adolescents with disordered eating. An interdisciplinary approach to care might enhance access to comprehensive, collaborative treatment for disordered eating, and gender dysphoria in this unique population. © 2018 Wiley Periodicals, Inc.

Self-rated health: patterns in the journeys of patients with multi-morbidity and frailty.

PubMed

Martin, Carmel Mary

2014-12-01

Self-rated health (SRH) is a single measure predictor of hospital utilization and health outcomes in epidemiological studies. There have been few studies of SRH in patient journeys in clinical settings. Reduced resilience to stressors, reflected by SRH, exposes older people (complex systems) to the risk of hospitalization. It is proposed that SRH reflects rather than predicts deteriorations and hospital use; with low SRH autocorrelation in time series. The aim was to investigate SRH fluctuations in regular outbound telephone calls (average biweekly) to patients by Care Guides. Descriptive case study using quantitative autoregressive techniques and qualitative case analysis on SRH time series. Fourteen participants were randomly selected from the Patient Journey Record System (PaJR) database. The PaJR database recorded 198 consecutively sampled older multi-morbid patients journeys in three primary care settings. Analysis consisted of triangulation of SRH (0 very poor - 6 excellent) patterns from three analyses: SRH graduations associations with service utilization; time series modelling (autocorrelation, and step ahead forecast); and qualitative categorization of deteriorations. Fourteen patients reported mean SRH 2.84 (poor-fair) in 818 calls over 13 ± 6.4 months of follow-up. In 24% calls, SRH was poor-fair and significantly associated with hospital use. SRH autocorrelation was low in 14 time series (-0.11 to 0.26) with little difference (χ(2)  = 6.46, P = 0.91) among them. Fluctuations between better and worse health were very common and poor health was associated with hospital use. It is not clear why some patients continued on a downward trajectory, whereas others who destabilized appeared to completely recover, and even improved over time. SRH reflects an individual's complex health trajectory, but as a single measure does not predict when and how deteriorations will occur in this study. Individual patients appear to behave as complex adaptive systems. The dynamics of SRH and its influences in destabilizations warrant further research. © 2014 John Wiley & Sons, Ltd.

Clinical Research Methodology 2: Observational Clinical Research.

PubMed

Sessler, Daniel I; Imrey, Peter B

2015-10-01

Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

Safety of Ultrasound-Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists.

PubMed

Shariat-Madar, Bahbak; Chun, Robert H; Sulman, Cecille G; Conley, Stephen F

2016-05-01

To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea. Case series with chart review. Children's Hospital of Wisconsin. A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement. There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement. Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Wandering in both mind and body: individual differences in mind wandering and inattention predict fidgeting.

PubMed

Carriere, Jonathan S A; Seli, Paul; Smilek, Daniel

2013-03-01

Anecdotal reports suggest that during periods of inattention or mind wandering, people tend to experience increased fidgeting. In four studies, we examined whether individual differences in the tendency to be inattentive and to mind wander in everyday life are related to the tendency to make spontaneous and involuntary movements (i.e., to fidget). To do so, we developed self-report measures of spontaneous and deliberate mind wandering, as well as a self-report scale to index fidgeting. In addition, we used several existing self-report measures of inattentiveness, attentional control, and memory failures. Across our studies, a series of multiple regression analyses indicated that fidgeting was uniquely predicted by inattentiveness and spontaneous mind wandering but not by other related factors, including deliberate mind wandering, attentional control, and memory failures. As a result, we suggest that only spontaneously wandering thoughts are related to a wandering body.

Poetic Signs of Third Place: A Case Study of Student-Driven Imitation in a Shelter for Young Homeless People in Copenhagen

ERIC Educational Resources Information Center

Matthiesen, Christina

2014-01-01

During a series of writing workshops at a shelter for young homeless people in Copenhagen, I examined to what extent the literary practice of student-driven imitation with its emphasis on self-governance and a dialogical approach can engage marginalized learners in reading and writing. I found that student-driven imitation had the potential to…

Molecular basis of quantitative structure-properties relationships (QSPR): a quantum similarity approach.

PubMed

Ponec, R; Amat, L; Carbó-Dorca, R

1999-05-01

Since the dawn of quantitative structure-properties relationships (QSPR), empirical parameters related to structural, electronic and hydrophobic molecular properties have been used as molecular descriptors to determine such relationships. Among all these parameters, Hammett sigma constants and the logarithm of the octanol-water partition coefficient, log P, have been massively employed in QSPR studies. In the present paper, a new molecular descriptor, based on quantum similarity measures (QSM), is proposed as a general substitute of these empirical parameters. This work continues previous analyses related to the use of QSM to QSPR, introducing molecular quantum self-similarity measures (MQS-SM) as a single working parameter in some cases. The use of MQS-SM as a molecular descriptor is first confirmed from the correlation with the aforementioned empirical parameters. The Hammett equation has been examined using MQS-SM for a series of substituted carboxylic acids. Then, for a series of aliphatic alcohols and acetic acid esters, log P values have been correlated with the self-similarity measure between density functions in water and octanol of a given molecule. And finally, some examples and applications of MQS-SM to determine QSAR are presented. In all studied cases MQS-SM appeared to be excellent molecular descriptors usable in general QSPR applications of chemical interest.

Molecular basis of quantitative structure-properties relationships (QSPR): A quantum similarity approach

NASA Astrophysics Data System (ADS)

Ponec, Robert; Amat, Lluís; Carbó-dorca, Ramon

1999-05-01

Since the dawn of quantitative structure-properties relationships (QSPR), empirical parameters related to structural, electronic and hydrophobic molecular properties have been used as molecular descriptors to determine such relationships. Among all these parameters, Hammett σ constants and the logarithm of the octanol- water partition coefficient, log P, have been massively employed in QSPR studies. In the present paper, a new molecular descriptor, based on quantum similarity measures (QSM), is proposed as a general substitute of these empirical parameters. This work continues previous analyses related to the use of QSM to QSPR, introducing molecular quantum self-similarity measures (MQS-SM) as a single working parameter in some cases. The use of MQS-SM as a molecular descriptor is first confirmed from the correlation with the aforementioned empirical parameters. The Hammett equation has been examined using MQS-SM for a series of substituted carboxylic acids. Then, for a series of aliphatic alcohols and acetic acid esters, log P values have been correlated with the self-similarity measure between density functions in water and octanol of a given molecule. And finally, some examples and applications of MQS-SM to determine QSAR are presented. In all studied cases MQS-SM appeared to be excellent molecular descriptors usable in general QSPR applications of chemical interest.

Sativex Associated With Behavioral-Relapse Prevention Strategy as Treatment for Cannabis Dependence: A Case Series.

PubMed

Trigo, Jose M; Soliman, Alexandra; Staios, Gregory; Quilty, Lena; Fischer, Benedikt; George, Tony P; Rehm, Jürgen; Selby, Peter; Barnes, Allan J; Huestis, Marilyn A; Le Foll, Bernard

2016-01-01

Cannabis is the most commonly used illicit drug; a substantial minority of users develop dependence. The current lack of pharmacological treatments for cannabis dependence warrants the use of novel approaches and further investigation of promising pharmacotherapy. In this case series, we assessed the use of self-titrated dosages of Sativex (1:1, Δ-tetrahydrocannabinol [THC]/cannabidiol [CBD] combination) and motivational enhancement therapy and cognitive behavioral therapy (MET/CBT) for the treatment of cannabis dependence among 5 treatment-seeking community-recruited cannabis-dependent subjects. Participants underwent a 3-month open-label self-titration phase with Sativex (up to 113.4 of THC/105 mg of CBD) and weekly MET/CBT, with a 3-month follow-up. Sativex was well-tolerated by all participants (average dosage 77.5 THC/71.7 mg CBD). The combination of Sativex and MET/CBT reduced the amount of cannabis use and progressively reduced craving and withdrawal scores. THC/CBD metabolite concentration indicated reduced cannabis use and compliance with medication. In summary, this pilot study found that with Sativex in combination with MET/CBT reduced cannabis use while preventing increases in craving and withdrawal in the 4 participants completing the study. Further systematic exploration of Sativex as a pharmacological treatment option for cannabis dependence should be performed.

Curvilinear approach to an intersection and visual detection of a collision.

PubMed

Berthelon, C; Mestre, D

1993-09-01

Visual motion perception plays a fundamental role in vehicle control. Recent studies have shown that the pattern of optical flow resulting from the observer's self-motion through a stable environment is used by the observer to accurately control his or her movements. However, little is known about the perception of another vehicle during self-motion--for instance, when a car driver approaches an intersection with traffic. In a series of experiments using visual simulations of car driving, we show that observers are able to detect the presence of a moving object during self-motion. However, the perception of the other car's trajectory appears to be strongly dependent on environmental factors, such as the presence of a road sign near the intersection or the shape of the road. These results suggest that local and global visual factors determine the perception of a car's trajectory during self-motion.

Directed self-assembly of diblock copolymers in cylindrical confinement: effect of underfilling and air-polymer interactions on configurations

NASA Astrophysics Data System (ADS)

Carpenter, Corinne L.; Delaney, Kris T.; Laachi, Nabil; Fredrickson, Glenn H.

2015-03-01

Directed self-assembly (DSA) of block copolymers has attracted attention for its use as a simple, cost- effective patterning tool for creating vertical interconnect access (VIA) channels in nanoelectronic devices.1, 2 This technique supplements existing lithographic technologies to allow for the creation of high-resolution cylindrical holes whose diameter and placement can be precisely controlled. In this study, we use self-consistent field theory (SCFT) simulations to investigate the equilibrium configurations of under-filled DSA systems with air-polymer interactions. We report on a series of SCFT simulations of our three species (PMMA-b-PS diblock and air) model in cylindrical confinement to explore the role of template diameter, under-fill fraction (i.e. volume fraction of air), air-polymer surface interaction and polymer-side wall/substrate interactions on equilibrium morphologies in an under-filled template with a free top surface. We identify parameters and system configurations where a meniscus appears and explore cases with PMMA-attractive, PS-attractive, and all-neutral walls to understand the effects of wall properties on meniscus geometry and DSA morphology. An important outcome is an understanding of the parameters that control the contact angle of the meniscus with the wall, as it is one of the simplest quantitative measures of the meniscus shape. Ultimately, we seek to identify DSA formulations, templates, and surface treatments with predictable central cylinder diameter and a shallow contact angle, as these factors would facilitate broad process windows and ease of manufacturing.

Pretreatment serum concentrations of 25-hydroxyvitamin D and breast cancer prognostic characteristics: a case-control and a case-series study.

PubMed

Yao, Song; Sucheston, Lara E; Millen, Amy E; Johnson, Candace S; Trump, Donald L; Nesline, Mary K; Davis, Warren; Hong, Chi-Chen; McCann, Susan E; Hwang, Helena; Kulkarni, Swati; Edge, Stephen B; O'Connor, Tracey L; Ambrosone, Christine B

2011-02-28

Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity. In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses. In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant vitamin D supplementation for reducing breast cancer risk, particularly those with poor prognostic characteristics among premenopausal women.

Pretreatment Serum Concentrations of 25-Hydroxyvitamin D and Breast Cancer Prognostic Characteristics: A Case-Control and a Case-Series Study

PubMed Central

Yao, Song; Sucheston, Lara E.; Millen, Amy E.; Johnson, Candace S.; Trump, Donald L.; Nesline, Mary K.; Davis, Warren; Hong, Chi-Chen; McCann, Susan E.; Hwang, Helena; Kulkarni, Swati; Edge, Stephen B.; O'Connor, Tracey L.; Ambrosone, Christine B.

2011-01-01

Background Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity. Methods and Findings In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08–0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22–0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses. Conclusion In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant vitamin D supplementation for reducing breast cancer risk, particularly those with poor prognostic characteristics among premenopausal women. PMID:21386992

Case, Teacher and School Characteristics Influencing Teachers' Detection and Reporting of Child Physical Abuse and Neglect: Results from an Australian Survey

ERIC Educational Resources Information Center

Walsh, Kerryann; Bridgstock, Ruth; Farrell, Ann; Rassafiani, Mehdi; Schweitzer, Robert

2008-01-01

Objective: To identify the influence of multiple case, teacher and school characteristics on Australian primary school teachers' propensity to detect and report child physical abuse and neglect using vignettes as short hypothetical cases. Methods: A sample of 254 teachers completed a self-report questionnaire. They responded to a series of 32…

Evaluation of the impact on human salmonellosis of control measures targeted to Salmonella Enteritidis and Typhimurium in poultry breeding using time-series analysis and intervention models in France.

PubMed

Poirier, E; Watier, L; Espie, E; Weill, F-X; De Valk, H; Desenclos, J-C

2008-09-01

In France, salmonellosis is the main cause of foodborne bacterial infection with serotypes Enteritis (SE) and Typhimurium (ST) accounting for 70% of all cases. French authorities implemented a national control programme targeting SE and ST in poultry and eggs from October 1998 onwards. A 33% decrease in salmonellosis has been observed since implementation. We designed an evaluation of the impact of this control programme on SE and ST human infections in France. Using monthly Salmonella human isolate reports to the National Reference Centre we defined two intervention series (SE and ST) and one control series comprising serotypes not know to be associated with poultry or eggs. The series, from 1992 to 2003, were analysed using autoregressive moving average models (ARMA). To test the hypothesis of a reduction of SE and ST human cases >0 after the programme started and to estimate its size, we introduced an intervention model to the ARMA modelling. In contrast to the control series, we found an annual reduction of 555 (95% CI 148-964) SE and of 492 (95% CI 0-1092) ST human infections, representing respectively a 21% and 18% decrease. For SE, the decrease occurred sharply after implementation while for ST, it followed a progressive decrease that started early in 1998. Our study, suggests a true relation between the Salmonella control programme and the subsequent decrease observed for the two targeted serotypes. For ST, however, the decrease prior to the intervention may also reflect control measures implemented earlier by the cattle and milk industry.

A New Adaptive Self-Tuning Fourier Coefficients Algorithm for Periodic Torque Ripple Minimization in Permanent Magnet Synchronous Motors (PMSM)

PubMed Central

Gómez-Espinosa, Alfonso; Hernández-Guzmán, Víctor M.; Bandala-Sánchez, Manuel; Jiménez-Hernández, Hugo; Rivas-Araiza, Edgar A.; Rodríguez-Reséndiz, Juvenal; Herrera-Ruíz, Gilberto

2013-01-01

Torque ripple occurs in Permanent Magnet Synchronous Motors (PMSMs) due to the non-sinusoidal flux density distribution around the air-gap and variable magnetic reluctance of the air-gap due to the stator slots distribution. These torque ripples change periodically with rotor position and are apparent as speed variations, which degrade the PMSM drive performance, particularly at low speeds, because of low inertial filtering. In this paper, a new self-tuning algorithm is developed for determining the Fourier Series Controller coefficients with the aim of reducing the torque ripple in a PMSM, thus allowing for a smoother operation. This algorithm adjusts the controller parameters based on the component's harmonic distortion in time domain of the compensation signal. Experimental evaluation is performed on a DSP-controlled PMSM evaluation platform. Test results obtained validate the effectiveness of the proposed self-tuning algorithm, with the Fourier series expansion scheme, in reducing the torque ripple. PMID:23519345

Effectiveness of self-management promotion educational program among diabetic patients based on health belief model

PubMed Central

Jalilian, Farzad; Motlagh, Fazel Zinat; Solhi, Mahnaz; Gharibnavaz, Hasan

2014-01-01

Introduction: Diabetes is a chronic disease; it can cause serious complications. Diabetes self-management is essential for prevention of disease complications. This study was conducted to evaluate self-management promotion educational program intervention efficiency among diabetic patients in Iran and health belief model (HBM) was applied as a theoretical framework. Materials and Methods: Overall, 120 Type 2 diabetic patients referred to rural health centers in Gachsaran, Iran participated in this study as randomly divided into intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to promotion self-management among diabetic patients. Cross-tabulation and t-test by using SPSS statistical package, version 16 was used for the statistical analysis. Results: Mean age was 55.07 years (SD = 9.94, range: 30-70). Our result shows significant improvements in average response for susceptibility, severity, benefit and self-management among intervention group. Additionally, after intervention, average response of the barrier to self-management was decreased among intervention group. Conclusion: Our result showed education program based on HBM was improve of self-management and seems implementing these programs can be effective in the and prevention of diabetes complications. PMID:24741654

Improving the quality of cognitive behaviour therapy case conceptualization: the role of self-practice/self-reflection.

PubMed

Haarhoff, Beverly; Gibson, Kerry; Flett, Ross

2011-05-01

CBT case conceptualization is considered to be a key competency. Prior to the publication in 2009 of Kuyken, Padesky and Dudley's book, little has been documented concerning methods for training conceptualization skills and the conceptualization process is usually perceived as predominantly an intellectual process. In this paper, the Declarative-Procedural-Reflective model of therapist skill acquisition provides a route to understanding how different kinds of knowledge systems can be integrated to enhance therapist skill acquisition. Sixteen recent graduates of a postgraduate diploma in cognitive behaviour therapy worked independently through a self-practice/self-reflection workbook designed to lead them through a series of CBT interventions commonly used to elicit the information required for a CBT conceptualization. The participants' self-reflections were thematically analyzed and uncovered the following inter-related themes: increased theoretical understanding of the CBT model, self-awareness, empathy, conceptualization of the therapeutic relationship, and adaptation of clinical interventions and practice. A tentative conclusion reached, based on the self-reflections of the participants, was that targeted self-practice/self-reflection enhanced case conceptualization skill by consolidating the Declarative, Procedural and Reflective systems important in therapist skill acquisition. © British Association for Behavioural and Cognitive Psychotherapies 2011

Generalized Riemann hypothesis and stochastic time series

NASA Astrophysics Data System (ADS)

Mussardo, Giuseppe; LeClair, André

2018-06-01

Using the Dirichlet theorem on the equidistribution of residue classes modulo q and the Lemke Oliver–Soundararajan conjecture on the distribution of pairs of residues on consecutive primes, we show that the domain of convergence of the infinite product of Dirichlet L-functions of non-principal characters can be extended from down to , without encountering any zeros before reaching this critical line. The possibility of doing so can be traced back to a universal diffusive random walk behavior of a series C N over the primes which underlies the convergence of the infinite product of the Dirichlet functions. The series C N presents several aspects in common with stochastic time series and its control requires to address a problem similar to the single Brownian trajectory problem in statistical mechanics. In the case of the Dirichlet functions of non principal characters, we show that this problem can be solved in terms of a self-averaging procedure based on an ensemble of block variables computed on extended intervals of primes. Those intervals, called inertial intervals, ensure the ergodicity and stationarity of the time series underlying the quantity C N . The infinity of primes also ensures the absence of rare events which would have been responsible for a different scaling behavior than the universal law of the random walks.

New controller for functional electrical stimulation systems.

PubMed

Fisekovic, N; Popovic, D B

2001-07-01

A novel, self-contained controller for functional electrical stimulation systems has been designed. The development was motivated by the need to have a general purpose, easy to use controller capable of stimulating many muscle groups, thus restoring complex motor functions (e.g. standing, walking, reaching, and grasping). The designed controller can regulate the frequency, pulse duration, and charge balance on up to 16 channels, and execute pre-programmed and sensory-driven control operations. The controller supports up to eight analog and six digital sensors, and comprises a memory block for including history of the sensory data (time series). Five independent timers provide the basis for the multi-modal and multi-level control of movement. The PC compatible interface is realised via an IR serial communication channel. The PC based software is user friendly and fully menu driven. This paper also presents a case study where the controller was implemented to restore walking in a paraplegic subject. The assistive system comprised the novel controller, the power and output stages of an eight-channel FES system (IEEE Trans Rehabil Eng, TRE-2 (1994) 234), ankle-foot orthoses, and a rolling walker. Stimulation was applied with surface electrodes positioned over the motoneurons that innervate muscles responsible for the hip and knee flexion and extension. The sensory system included goniometers at knee and hip joints, force-sensing resistors built in the shoe insoles, and digital accelerometers at the hips. A rule-based control algorithm was generated following a two-step procedure: (1) simulation and (2) machine learning as described in earlier studies (IEEE Trans Rehab Eng, TRE-7 (1999) 69). The paraplegic subject walked faster, and with less physiological effort, when automatic control was applied as compared to hand-control. This case study, as well as a previous one for assisting grasping (The design and testing of a new programmable electronic stimulator. N. Fisekovic, MS thesis. University of Belgrade, Belgrade, 2000) indicate that the novel control unit is effectively applicable to FES systems.

Boys' serotonin transporter genotype affects maternal behavior through self-control: a case of evocative gene-environment correlation.

PubMed

Pener-Tessler, Roni; Avinun, Reut; Uzefovsky, Florina; Edelman, Shany; Ebstein, Richard P; Knafo, Ariel

2013-02-01

Self-control, involving processes such as delaying gratification, concentrating, planning, following instructions, and adapting emotions and behavior to situational requirements and social norms, may have a profound impact on children's adjustment. The importance of self-control suggests that parents are likely to modify their parenting based on children's ability for self-control. We study the effect of children's self-control, a trait partially molded by genetics, on their mothers' parenting, a process of evocative gene-environment correlation. Israeli 3.5-year-old twins (N = 320) participated in a lab session in which their mothers' parenting was observed. DNA was available from most children (N = 228). Mothers described children's self-control in a questionnaire. Boys were lower in self-control and received less positive parenting from their mothers, in comparison with girls. For boys, and not for girls, the serotonin transporter linked polymorphic region gene predicted mothers' levels of positive parenting, an effect mediated by boys' self-control. The implications of this evocative gene-environment correlation and the observed sex differences are discussed.

Head-shaking nystagmus predicts greater disability in unilateral peripheral vestibulopathy.

PubMed

Angeli, Simon I; Velandia, Sandra; Snapp, Hillary

2011-01-01

The objective of this study was to determine the association of the bedside test of head-shaking nystagmus (HSN) with patients' self-perceived dizziness handicap as well as this test's sensitivity and specificity in unilateral peripheral vestibular hypofunction. A retrospective case-control study was performed. The study was held at an academic, tertiary referral center. Fifty-three adult patients with unilateral peripheral hypofunction defined by the caloric test of the videonystagmography with documented bedside HSN and who had completed questionnaires of self-perceived dizziness handicap were included. The sensitivity and specificity of the bedside HSN in patients and 10 healthy controls in diagnosing unilateral vestibular hypofunction defined by videonystagmographic caloric testing and by abnormal gain and symmetry of the vestibular-ocular reflex by rotary chair testing were determined. Scores of the screening test of the Dizziness Handicap Index and Functional Level Scale questionnaires were taken. When using the caloric irrigation test as the reference standard for unilateral vestibular hypofunction, the sensitivity, specificity, and positive predictive value of the bedside HSN were 31%, 96%, and 97%, respectively. When comparing with results of rotational chair testing (vestibular-ocular reflex gain and symmetry), the sensitivity of the HSN test increases to 71%. Patients with positive bedside HSN had higher scores (greater self-perceived dizziness handicap) of the Dizziness Handicap Index (P = .049) and higher (worse) scores of the Functional Level Scale (P = .0377) than those with negative bedside HSN (Wilcoxon rank test). Greater perceived handicap was correlated with a positive bedside HSN in patients with unilateral peripheral vestibulopathy. The HSN has sufficient sensitivity to be used as screening test of uncompensated vestibulopathy in this series. However, a negative HSN alone does not rule out the diagnosis of peripheral vestibular dysfunction. Copyright © 2011 Elsevier Inc. All rights reserved.

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

PubMed

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Framework for Small-Scale Experiments in Software Engineering: Guidance and Control Software Project: Software Engineering Case Study

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.

1998-01-01

Software is becoming increasingly significant in today's critical avionics systems. To achieve safe, reliable software, government regulatory agencies such as the Federal Aviation Administration (FAA) and the Department of Defense mandate the use of certain software development methods. However, little scientific evidence exists to show a correlation between software development methods and product quality. Given this lack of evidence, a series of experiments has been conducted to understand why and how software fails. The Guidance and Control Software (GCS) project is the latest in this series. The GCS project is a case study of the Requirements and Technical Concepts for Aviation RTCA/DO-178B guidelines, Software Considerations in Airborne Systems and Equipment Certification. All civil transport airframe and equipment vendors are expected to comply with these guidelines in building systems to be certified by the FAA for use in commercial aircraft. For the case study, two implementations of a guidance and control application were developed to comply with the DO-178B guidelines for Level A (critical) software. The development included the requirements, design, coding, verification, configuration management, and quality assurance processes. This paper discusses the details of the GCS project and presents the results of the case study.

From early attachment to engagement with learning in school: the role of self-regulation and persistence.

PubMed

Drake, Kim; Belsky, Jay; Fearon, R M Pasco

2014-05-01

This article presents theoretical arguments and supporting empirical evidence suggesting that attachment experiences in early life may be important in the later development of self-regulation and conscientious behavior. Analyses of data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (NICHD Early Child Care Research Network, 2005; N = 1,149) were conducted to test the association between attachment, measured at 15 and 36 months, and 3 measures of self-regulation (social self-control rated by teachers, task persistence as measured by observers in a series of lab tasks, and a continuous performance test) between Grades 1 and 5. Mediational analyses were also conducted to test whether self-regulation mediates the effect of attachment on children's engagement with learning in the classroom, as measured by direct observation. The results confirmed the hypothesis that attachment would be related to later self-regulation, but only for social self-control, and attentional impulsivity, not task persistence. Furthermore, social self-control at Grade 1 mediated the effect of attachment (at both 15 and 36 months) on school engagement at Grade 5, even when Grade 1 school engagement was statistically controlled. The discussion focuses on the potential importance of early attachment experiences for the development and maintenance of conscientiousness across the lifespan. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Effectiveness of rotavirus pentavalent vaccine under a universal immunization programme in Israel, 2011-2015: a case-control study.

PubMed

Muhsen, K; Anis, E; Rubinstein, U; Kassem, E; Goren, S; Shulman, L M; Ephros, M; Cohen, D

2018-01-01

The use of rotavirus pentavalent vaccine (RotaTeq ® ) as a sole vaccine within rotavirus universal immunization programmes remains limited. We examined the effectiveness of RotaTeq in preventing rotavirus gastroenteritis (RVGE) hospitalization in Israel, after the introduction of universal immunization against the disease. A test-negative case-control study included age-eligible children for universal RotaTeq immunization (aged 2-59 months, born in 2011-2015). Cases (n = 98) were patients who tested positive for rotavirus by immunochromatography; those who tested negative (n = 628) comprised the control group. Information on rotavirus immunization history was obtained through linkage with a national immunization registry. Vaccination status was compared between cases and controls, adjusted odds ratios (aORs) were obtained from logistic regression models, and vaccine effectiveness calculated as (1 - aOR)*100. Immunization with RotaTeq was less frequent in RVGE cases (73.5%) than in controls (90.1%), p < 0.001; this association persisted after controlling for potential confounders. Effectiveness of the complete vaccine series was estimated at 77% (95% confidence interval (CI): 49-90) in children aged 6-59 months, and 86% (95% CI: 65-94) in children aged 6-23 months; whereas for the incomplete series, the respective estimates were 72% (95% CI: 28-89) and 75% (95% CI: 30-91). Vaccine effectiveness was estimated at 79% (95% CI: 45-92) against G1P[8]-associated RVGE hospitalizations and 69% (95% CI: 11-89) against other genotype-RVGE hospitalizations. High effectiveness of RotaTeq as the sole rotavirus vaccine in a universal immunization programme was demonstrated in a high-income country. Although partial vaccination conferred protection, completing the vaccine series is warranted to maximize the benefit. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study.

PubMed

Morgan, C; Kirkbride, J; Hutchinson, G; Craig, T; Morgan, K; Dazzan, P; Boydell, J; Doody, G A; Jones, P B; Murray, R M; Leff, J; Fearon, P

2008-12-01

Numerous studies have reported high rates of psychosis in the Black Caribbean population in the UK. Recent speculation about the reasons for these high rates has focused on social factors. However, there have been few empirical studies. We sought to compare the prevalence of specific indicators of social disadvantage and isolation, and variations by ethnicity, in subjects with a first episode of psychosis and a series of healthy controls. All cases with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK and a series of community controls were recruited over a 3-year period. Data relating to clinical and social variables were collected from cases and controls. On all indicators, cases were more socially disadvantaged and isolated than controls, after controlling for potential confounders. These associations held when the sample was restricted to those with an affective diagnosis and to those with a short prodrome and short duration of untreated psychosis. There was a clear linear relationship between concentrated disadvantage and odds of psychosis. Similar patterns were evident in the two main ethnic groups, White British and Black Caribbean. However, indicators of social disadvantage and isolation were more common in Black Caribbean subjects than White British subjects. We found strong associations between indicators of disadvantage and psychosis. If these variables index exposure to factors that increase risk of psychosis, their greater prevalence in the Black Caribbean population may contribute to the reported high rates of psychosis in this population.

Control of cell nucleus shapes via micropillar patterns.

PubMed

Pan, Zhen; Yan, Ce; Peng, Rong; Zhao, Yingchun; He, Yao; Ding, Jiandong

2012-02-01

We herein report a material technique to control the shapes of cell nuclei by the design of the microtopography of substrates to which the cells adhere. Poly(D,L-lactide-co-glycolide) (PLGA) micropillars or micropits of a series of height or depth were fabricated, and some surprising self deformation of the nuclei of bone marrow stromal cells (BMSCs) was found in the case of micropillars with a sufficient height. Despite severe nucleus deformation, BMSCs kept the ability of proliferation and differentiation. We further demonstrated that the shapes of cell nuclei could be regulated by the appropriate micropillar patterns. Besides circular and elliptoid shapes, some unusual nucleus shapes of BMSCs have been achieved, such as square, cross, dumbbell, and asymmetric sphere-protrusion. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

A Pilot Study on the Efficacy of Volunteer Mentorship for Young Adults With Self-Harm Behaviors Using a Quasi-Experimental Design.

PubMed

Law, Yik-Wa; Yip, Paul S F; Lai, Carmen C S; Kwok, Chi Leung; Wong, Paul W C; Liu, Kwong-Sun; Ng, Pauline W L; Liao, Carmen W M; Wong, Tai-Wai

2016-11-01

Studies have shown that postdischarge care for self-harm patients is effective in reducing repeated suicidal behaviors. Little is known about whether volunteer support can help reduce self-harm repetition and improve psychosocial well-being. This study investigated the efficacy of volunteer support in preventing repetition of self-harm. This study used a quasi-experimental design by assigning self-harm patients admitted to the emergency departments to an intervention group with volunteer support and treatment as usual (TAU) for 9 months and to a control group of TAU. Outcome measures include repetition of self-harm, suicidal ideation, hopelessness, and level of depressive and anxiety symptoms. A total of 74 cases were recruited (38 participants; 36 controls). There were no significant differences in age, gender, and clinical condition between the two groups at the baseline. The intervention group showed significant improvements in hopelessness and depressive symptoms. However, the number of cases of suicide ideation and of repetition of self-harm episodes was similar for both groups at the postintervention period. Postdischarge care provided by volunteers showed significant improvement in hopelessness and depression. Volunteers have been commonly involved in suicide prevention services. Further research using rigorous methods is recommended for improving service quality in the long term.

Legal Rights, Local Wrongs: When Community Control Collides with Educational Equity. SUNY Series, Restructuring and School Change.

ERIC Educational Resources Information Center

Welner, Kevin G.

This book challenges fundamental assumptions about the opportunities for equity-minded educational reform, using data from case studies of districts nationwide and their experiences with court-ordered detracking. The case studies show how white, upper middle class parents exercised a disproportionate amount of power in local school policy making…

Management, leadership, and user control in self-advocacy: an english case study.

PubMed

Tilley, Elizabeth

2013-12-01

This paper presents findings from a qualitative research project on an English self-advocacy organization. In light of recent political and economic developments that have threatened the sustainability of a number of self-advocacy groups for people with intellectual disability, I seek to explore how one particular organization managed to survive and grow. In particular, the paper explores themes of management, leadership, and user control, linking these to external perceptions about self-advocacy organizations. The organization in my study developed an "interdependent" governance model based on key organizational roles for nondisabled advisors and self-advocates, which proved popular with external funders. Despite the organization's notable achievements, its success raises questions for the wider self-advocacy movement, notably how leadership capacity can be developed among self-advocates.

Management, Leadership, and User Control in Self-Advocacy: An English Case Study

ERIC Educational Resources Information Center

Tilley, Elizabeth

2013-01-01

This paper presents findings from a qualitative research project on an English self-advocacy organization. In light of recent political and economic developments that have threatened the sustainability of a number of self-advocacy groups for people with intellectual disability, I seek to explore how one particular organization managed to survive…

Literacy, Self-esteem and Locus of Control

ERIC Educational Resources Information Center

Galbraith, Alison; Alexander, Joy

2005-01-01

In this article, Alison Galbraith and Joy Alexander use case studies of a group of primary school pupils to examine the efficacy of an integrated, eclectic approach to the teaching of literacy, including whether constructs such as self-concept and self-esteem have a bearing on academic achievement. Circle Time activities, interactive teaching…

Neonatal Medical Exposures and Characteristics of Low Birth Weight Hepatoblastoma Cases: A Report From the Children's Oncology Group

PubMed Central

Turcotte, Lucie M.; Georgieff, Michael K.; Ross, Julie A.; Feusner, James H.; Tomlinson, Gail E.; Malogolowkin, Marcio H.; Krailo, Mark D.; Miller, Nicole; Fonstad, Rachel; Spector, Logan G.

2015-01-01

Background Hepatoblastoma is a malignancy of young children. Low birth weight is associated with significantly increased risk of hepatoblastoma and neonatal medical exposures are hypothesized as contributors. This study represents the largest case–control study of hepatoblastoma to date and aimed to define the role of neonatal exposures in hepatoblastoma risk among low birth weight children. Procedure Incident hepatoblastoma cases who were born <2,500 g (N = 60), diagnosed between 2000 and 2008, were identified through the Children's Oncology Group. Controls were recruited through state birth registries (N = 51). Neonatal medical exposures were abstracted from medical records. Subjects from the Vermont Oxford Network were used for further comparisons, as were existing reports on neonatal medical exposures. Results Case–control comparisons were hindered by poor matching within birth weight strata. Cases were smaller and received more aggressive neonatal treatment compared to controls, and reflected high correlation levels between birth weight and treatments. Similar difficulty was encountered when comparing cases to Vermont Oxford Network subjects; cases were smaller and required more aggressive neonatal therapy. Furthermore, it appears hepatoblastoma cases were exposed to a greater number of diagnostic X-rays than in case series previously reported in the neonatal literature. Conclusions This study presents the largest case series of hepatoblastoma in <2,500 g birth weight infants with accompanying neonatal medical exposure data. Findings confirm that birth weight is highly correlated with exposure intensity, and neonatal exposures are themselves highly correlated, which hampers the identification of a causal exposure among hepatoblastoma cases. Experimental models or genetic susceptibility testing may be more revealing of etiology. PMID:25044669

ERAP1 variants are associated with ankylosing spondylitis in East Asian population: a new Chinese case-control study and meta-analysis of published series.

PubMed

Chen, C; Zhang, X

2015-06-01

Endoplasmic reticulum aminopeptidase 1 (ERAP1) has been confirmed to be associated with ankylosing spondylitis (AS) in Caucasian. However, whether they are associated with AS in East Asian population remains unidentified. We investigated this relationship by a new Chinese case-control study and a meta-analysis of published series. 368 cases and 460 controls were recruited in the Chinese case-control study. Genotyping was completed using the chip-based matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Allelic associations were analysed using contingency tables. In the meta-analysis, up to 2748 cases and 2774 controls from seven different studies and the new Chinese study were combined using Review Manager software version 5.1.1. Mantel-Haenszel or Inverse Variance test was used to calculate fixed or random-effects pooled ORs. In the new Chinese study, strong association with AS was observed for marker rs10050860, rs27434 and rs1065407 at P value of <0.001. Moderate association was observed for rs30187 at P value of <0.01, while no association was observed for rs27044 (P = 0.37) and rs2287987 (P = 0.23). The meta-analysis showed that rs27037 and rs30187 were strongly associated with AS (P < 0.00001). Significant association was also observed for rs27434 (P = 0.001). No association was shown for rs27044 (P = 0.70). We concluded that ERAP1 variants are associated with AS in East Asian population, indicating a common pathogenic mechanism for AS in East Asians and Caucasians. © 2015 John Wiley & Sons Ltd.

The nonlinear differential equations governing a hierarchy of self-exciting coupled Faraday-disk homopolar dynamos

NASA Astrophysics Data System (ADS)

Hide, Raymond

1997-02-01

This paper discusses the derivation of the autonomous sets of dimensionless nonlinear ordinary differential equations (ODE's) that govern the behaviour of a hierarchy of related electro-mechanical self-exciting Faraday-disk homopolar dynamo systems driven by steady mechanical couples. Each system comprises N interacting units which could be arranged in a ring or lattice. Within each unit and connected in parallel or in series with the coil are electric motors driven into motion by the dynamo, all having linear characteristics, so that nonlinearity arises entirely through the coupling between components. By introducing simple extra terms into the equations it is possible to represent biasing effects arising from impressed electromotive forces due to thermoelectric or chemical processes and from the presence of ambient magnetic fields. Dissipation in the system is due not only to ohmic heating but also to mechanical friction in the disk and the motors, with the latter agency, no matter how weak, playing an unexpectedly crucial rôle in the production of régimes of chaotic behaviour. This has already been demonstrated in recent work on a case of a single unit incorporating just one series motor, which is governed by a novel autonomous set of nonlinear ODE's with three time-dependent variables and four control parameters. It will be of mathematical as well as geophysical and astrophysical interest to investigate systematically phase and amplitude locking and other types of behaviour in the more complicated cases that arise when N > 1, which can typically involve up to 6 N dependent variables and 19 N-5 control parameters. Even the simplest members of the hierarchy, with N as low as 1, 2 or 3, could prove useful as physically-realistic low-dimensional models in theoretical studies of fluctuating stellar and planetary magnetic fields. Geomagnetic polarity reversals could be affected by the presence of the Earth's solid metallic inner core, driven like an electric motor by currents generated by self-exciting magnetohydrodynamic (MHD) dynamo action involving motional induction associated with buoyancy-driven flow in the liquid metallic outer core. The study of biased disk dynamos could bear on the theory of the magnetic fields of natural systems where a significant background field is present (e.g., Galilean satellites of Jupiter) or when the action of motional induction is modified by electromotive forces produced by other mechanisms, such as thermoelectric processes, as in certain stars.

Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing

PubMed Central

Li, Mian; Xu, Changqing; Yao, Wenguo; Mahan, Clare M.; Kang, Han K.; Sandbrink, Friedhelm; Zhai, Ping; Karasik, Pamela A.

2014-01-01

To determine if objective evidence of autonomic dysfunction exists from a group of Gulf War veterans with self-reported post-exertional fatigue, we evaluated 16 Gulf War ill veterans and 12 Gulf War controls. Participants of the ill group had self- reported, unexplained chronic post-exertional fatigue and the illness symptoms had persisted for years until the current clinical study. The controls had no self-reported post-exertional fatigue either at the time of initial survey nor at the time of the current study. We intended to identify clinical autonomic disorders using autonomic and neurophysiologic testing in the clinical context. We compared the autonomic measures between the 2 groups on cardiovascular function at both baseline and head-up tilt, and sudomotor function. We identified 1 participant with orthostatic hypotension, 1 posture orthostatic tachycardia syndrome, 2 distal small fiber neuropathy, and 1 length dependent distal neuropathy affecting both large and small fiber in the ill group; whereas none of above definable diagnoses was noted in the controls. The ill group had a significantly higher baseline heart rate compared to controls. Compound autonomic scoring scale showed a significant higher score (95% CI of mean: 1.72–2.67) among ill group compared to controls (0.58–1.59). We conclude that objective autonomic testing is necessary for the evaluation of self-reported, unexplained post-exertional fatigue among some Gulf War veterans with multi-symptom illnesses. Our observation that ill veterans with self-reported post-exertional fatigue had objective autonomic measures that were worse than controls warrants validation in a larger clinical series. PMID:24431987

Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study

PubMed Central

Weerasinghe, Manjula; Konradsen, Flemming; Eddleston, Michael; Pearson, Melissa; Gunnell, David; Hawton, Keith; Jayamanne, Shaluka; Pabasara, Chathurani; Jayathilaka, Tharidu; Dissanayaka, Kalpani; Rajapaksha, Sandamali; Thilakarathna, Prasanna; Agampodi, Suneth

2015-01-01

Introduction Pesticide self-poisoning is one of the most frequently used methods of suicide worldwide, killing over 300 000 people annually. Around 15–20% of pesticide self-poisonings occur soon after the person has bought the pesticide from a shop. We aim to determine the characteristics of individuals who purchase pesticides directly from shops and how they differ from individuals who access pesticides from other sources such as home, home garden or farmland. This information will help inform possible vendor/shop-based intervention strategies aimed at reducing access to pesticides used for self-harm. Methods and analysis This study will investigate risk factors associated with purchasing pesticides for acts of self-poisoning from pesticide shops, including cases identified over a 9-month period using a population-based case–control group approach. Four interviewer-administered data collection tools will be used for this study: a semistructured questionnaire, Beck Suicidal Intent Scale (SIS), Clinical Interview Schedule—Sinhalese version (CIS-Sn) and Alcohol Use Disorders Identification Test (AUDIT). Each case (expected n=33) will be compared with two groups of individuals: (1) those who have self-poisoned using pesticides from the home, home garden or farmland and (2) those who bought pesticides from the same shops as the above cases, but not did not self-poison. Logistic regression models will be used to identify risk factors of purchasing pesticides for self-poisoning from shops. Ethics and dissemination The study has received ethical approval from the Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka. A sensitive data collection technique will be used and ethical issues will be considered throughout the study. Results will be disseminated in scientific peer-reviewed articles. PMID:25995242

Acute Cardiovascular Events after Herpes Zoster: A Self-Controlled Case Series Analysis in Vaccinated and Unvaccinated Older Residents of the United States

PubMed Central

Minassian, Caroline; Thomas, Sara L.; Smeeth, Liam; Douglas, Ian; Brauer, Ruth; Langan, Sinéad M.

2015-01-01

Background Herpes zoster is common and can have serious consequences. Additionally, emerging data suggest an increased risk of acute cardiovascular events following herpes zoster. However, to our knowledge, existing association studies compare outcomes between individuals and are therefore vulnerable to between-person confounding. In this study, we used a within-person study design to quantify any short-term increased risk of acute cardiovascular events (stroke and myocardial infarction [MI]) after zoster and to assess whether zoster vaccination modifies this association. Methods and Findings The self-controlled case series method was used to estimate rates of stroke and acute MI in defined periods after herpes zoster compared to other time periods, within individuals. Participants were fully eligible Medicare beneficiaries aged ≥65 y with a herpes zoster diagnosis and either an ischemic stroke (n = 42,954) or MI (n = 24,237) between 1 January 2006 and 31 December 2011. Age-adjusted incidence ratios (IRs) for stroke and MI during predefined periods up to 12 mo after zoster relative to unexposed time periods were calculated using conditional Poisson regression. We observed a marked increase in the rate of acute cardiovascular events in the first week after zoster diagnosis: a 2.4-fold increased ischemic stroke rate (IR 2.37, 95% CI 2.17–2.59) and a 1.7-fold increased MI rate (IR 1.68, 95% CI 1.47–1.92), followed by a gradual resolution over 6 mo. Zoster vaccination did not appear to modify the association with MI (interaction p-value = 0.44). We also found no evidence for a difference in the IR for ischemic stroke between vaccinated (IR 1.14, 95% CI 0.75–1.74) and unvaccinated (IR 1.78, 95% CI 1.68–1.88) individuals during the first 4 wk after zoster diagnosis (interaction p-value = 0.28). The relatively few vaccinated individuals limited the study’s power to assess the role of vaccination. Conclusions Stroke and MI rates are transiently increased after exposure to herpes zoster. We found no evidence for a role of zoster vaccination in these associations. These findings enhance our understanding of the temporality and magnitude of the association between zoster and acute cardiovascular events. PMID:26671338

Study of placenta of children born with congenital malformations.

PubMed

Stoll, Claude; Alembik, Yves; Dott, Béatrice; Roth, Marie-Paule

2003-01-01

The malformations in this study were observed in a series of 279,642 consecutive births of known outcome registered in our Registry of congenital anomalies. For each case, more than 50 factors included in the registration forms were studied. One of the factors studied was the placenta. For each malformed child, a control was chosen. Cases with maternal known factors impairing placenta function, i.e. vasculopathy and diabetes, were excluded. In each category of malformations studied, the malformed children were divided into isolated and non-isolated (multiple malformed) cases. The weight of placenta of isolated cases was not lower than the weight of placenta of the controls. In contrast, the weight of placenta of the cases with non-isolated malformations was lower than the weight of placenta of the controls and of the isolated cases, for all categories of malformations but gastroschisis and omphalocele. The mean weights at birth of the cases with multiple malformations were also lower than those of the controls. The human placenta discounts a principal functional part, the maternal blood in the intervillous space. Congenital malformations may interact with this function.

An accurate algorithm to calculate the Hurst exponent of self-similar processes

NASA Astrophysics Data System (ADS)

Fernández-Martínez, M.; Sánchez-Granero, M. A.; Trinidad Segovia, J. E.; Román-Sánchez, I. M.

2014-06-01

In this paper, we introduce a new approach which generalizes the GM2 algorithm (introduced in Sánchez-Granero et al. (2008) [52]) as well as fractal dimension algorithms (FD1, FD2 and FD3) (first appeared in Sánchez-Granero et al. (2012) [51]), providing an accurate algorithm to calculate the Hurst exponent of self-similar processes. We prove that this algorithm performs properly in the case of short time series when fractional Brownian motions and Lévy stable motions are considered. We conclude the paper with a dynamic study of the Hurst exponent evolution in the S&P500 index stocks.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: a case study in endemic districts of Bhutan.

PubMed

Wangdi, Kinley; Singhasivanon, Pratap; Silawan, Tassanee; Lawpoolsri, Saranath; White, Nicholas J; Kaewkungwal, Jaranit

2010-09-03

Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan.

A Longitudinal Test of the Demand–Control Model Using Specific Job Demands and Specific Job Control

PubMed Central

van Vegchel, Natasja; Shimazu, Akihito; Schaufeli, Wilmar; Dormann, Christian

2010-01-01

Background Supportive studies of the demand–control (DC) model were more likely to measure specific demands combined with a corresponding aspect of control. Purpose A longitudinal test of Karasek’s (Adm Sci Q. 24:285–308, 1) job strain hypothesis including specific measures of job demands and job control, and both self-report and objectively recorded well-being. Method Job strain hypothesis was tested among 267 health care employees from a two-wave Dutch panel survey with a 2-year time lag. Results Significant demand/control interactions were found for mental and emotional demands, but not for physical demands. The association between job demands and job satisfaction was positive in case of high job control, whereas this association was negative in case of low job control. In addition, the relation between job demands and psychosomatic health symptoms/sickness absence was negative in case of high job control and positive in case of low control. Conclusion Longitudinal support was found for the core assumption of the DC model with specific measures of job demands and job control as well as self-report and objectively recorded well-being. PMID:20195810

Influence of Mass Media on Judgments of Physical Attractiveness: The People's Case Against Farrah Fawcett.

ERIC Educational Resources Information Center

Kenrick, Douglas T.; Gutierres, Sara

The way the attractiveness of an average female is rated can be significantly changed by exposing the rater to media females, even for very short periods. In one study, subjects were exposed either to a series of advertisements containing female faces or to a control series of average females. Subsequent ratings of a target female's attractiveness…

Interchangeability of counts of cases and hours of cases for quantifying a hospital's change in workload among four-week periods of 1 year.

PubMed

Dexter, Franklin; Epstein, Richard H; Ledolter, Johannes; Wanderer, Jonathan P

2018-05-16

Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics). Observational cohort study. Large teaching hospital. 35 years of annual anesthesia caseload data. Annual data were used without regard to where or when in the year each case was performed, thereby matching public use files. Changes in caseload or hours among four-week periods were examined within individual year-long periods using 159 consecutive four-week periods from the same hospital. Series of 12 four-week periods of the hours of cases performed on workdays lacked trend or correlation among periods for 49 of 50 series and followed normal distributions for 50 of 50 series. These criteria also were satisfied for 50 of 50 series based on counts of cases. The Pearson r = 0.999 between hours of anesthetics and cases. For purposes of time series analysis of total workload at a hospital within 1-year, hours of cases and counts of cases are interchangeable. Simple control chart methods of detecting sudden changes in workload or caseload, based simply on the sample mean and standard deviation from the preceding year, are appropriate. Copyright © 2018 Elsevier Inc. All rights reserved.

The neurovascular complexity index as a potential indicator of traumatic brain injury severity: A case-series study.

PubMed

Howard, Jeffrey T; Janak, Jud C; Bukhman, Vladislav; Robertson, Claudia; Frolov, Iurii; Nawn, Corinne D; Schiller, Alicia M; Convertino, Victor A

2017-07-01

Multimodal monitoring of brain physiology following a traumatic brain injury (TBI) shows promise as a strategy to improve management and outcomes of TBI patients within civilian and military trauma. Valid and reliable measures of different aspects of brain physiology following a TBI could prove critical to accurately capturing these changes. Using a case-series design with a control subject group comparison, we evaluated a new proprietary algorithm called the Neurovascular Complexity Index (NCI) using transcranial Doppler to noninvasively obtain measures of cerebral blood flow variability. Baseline NCI data from 169 control subjects were compared with 12 patients with moderate to severe TBI. Patients with TBI exhibited significantly greater mean and variability in NCI scores compared with control subjects (F = 195.48; p < 0.001). The mean absolute deviation (MAD) of NCI scores increased significantly and in a monotonic fashion with severity of injury, where control subjects exhibited a small MAD of 0.44, patients with moderate TBI had a higher MAD of 4.20, and patients with severe TBI had an MAD of 6.51 (p < 0.001). Advancement in multimodal monitoring of TBI patients is important in reducing the potential risk of secondary injury. This study reports results indicating that a new noninvasive quantifiable assessment of TBI based on a noninvasive measure of cerebral blood flow variability shows potential for continuous monitoring and early identification of brain-injured patients, deployable in far-forward military environments, to better inform individualized management. Case series, level IV.

Time-series modeling of long-term weight self-monitoring data.

PubMed

Helander, Elina; Pavel, Misha; Jimison, Holly; Korhonen, Ilkka

2015-08-01

Long-term self-monitoring of weight is beneficial for weight maintenance, especially after weight loss. Connected weight scales accumulate time series information over long term and hence enable time series analysis of the data. The analysis can reveal individual patterns, provide more sensitive detection of significant weight trends, and enable more accurate and timely prediction of weight outcomes. However, long term self-weighing data has several challenges which complicate the analysis. Especially, irregular sampling, missing data, and existence of periodic (e.g. diurnal and weekly) patterns are common. In this study, we apply time series modeling approach on daily weight time series from two individuals and describe information that can be extracted from this kind of data. We study the properties of weight time series data, missing data and its link to individuals behavior, periodic patterns and weight series segmentation. Being able to understand behavior through weight data and give relevant feedback is desired to lead to positive intervention on health behaviors.

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.

A SIX-WEEK SUPERVISED EXERCISE AND EDUCATIONAL INTERVENTION AFTER TOTAL HIP ARTHROPLASTY: A CASE SERIES

PubMed Central

Madara, Kathleen; Zeni, Joseph A

2017-01-01

Background and Purpose Most rehabilitation interventions after total hip arthroplasty (THA) are not designed to return patients to high-levels of physical activity and, thus, low levels of physical activity and residual weakness are common. The purpose of this case series was to describe the feasibility and preliminary efficacy of an exercise and education intervention for patients after THA who have already completed formal outpatient physical therapy. Study Design Case series Case Description Two participants underwent unilateral THA seven (case A) or eight (case B) months prior to the intervention. Individuals participated in 18 treatment sessions that included progressive aerobic and strengthening exercises and meetings with a health coach. Change in function, strength, and self-reported physical activity were measured. Outcomes 12 months after surgery were compared to a historical cohort of patients after THA. Outcome There were no adverse events during the intervention. At the end of the intervention, hip and knee strength on the surgical side increased approximately 30% compared to baseline in both cases. Activity level, and recreational performance, including walking up stairs and hiking uphill (case A), and running and golfing (case B), improved by the end of the intervention. Most changes were maintained at follow-up, although hip strength for case B decreased 27% after discharge from the intervention. Outcomes for both cases exceeded historical averages for patients 12 months after THA, with the exception of strength in case B. Discussion The exercise intervention was well tolerated and without negative effects in two participants. Both participants increased their ability to complete demanding recreational and sports-related activities, physical activity, and demonstrated improved hip abductor and knee extensor strength. Further research is needed to evaluate the implementation and effectiveness of similar interventions after THA. Level of Evidence Level 4 PMID:28515981

Mental health promotion of Iranian university students: the effect of self-esteem and health locus of control.

PubMed

Moshki, M; Amiri, M; Khosravan, S

2012-10-01

The purpose of this study was to investigate the effect of self-esteem and health control belief on promoting students' mental health. In so doing, 144 students from two medical universities in the north-east of Iran were recruited into study. They were pair-matched and randomly assigned to case and control groups. The data were collected through Goldberg's General Health Questionnaire-28, Multidimensional Health Locus of Control and Rosenberg's Self-Esteem Scales. The results showed that there were significant differences between the groups before and after the intervention. The external components of health locus of control (chance and powerful others) showed a significant decrease but the internal health locus of control and self-esteem revealed a significant increase after the intervention (P < 0.0001). Moreover, the students' mental health had a significant increase after 3 months of intervention (P < 0.0001). The findings emphasize that the programme can improve the health locus of control beliefs, self-esteem and mental health promotion of the students. This will require additional monitoring and uninterrupted attempts to be effective. © 2011 Blackwell Publishing.

Uterine Tonus Assessment by Midwives versus Patient self-assessment in the active management of the third stage of labor (UTAMP): study protocol for a randomized controlled trial.

PubMed

Browne, Joyce L; Damale, Nelson K R; Raams, Tessa M; Van der Linden, Eva L; Maya, Ernest T; Doe, Roseline; Rijken, Marcus J; Adanu, Richard; Grobbee, Diederick E; Franx, Arie; Klipstein-Grobusch, Kerstin

2015-12-18

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and accounts for one third of maternal deaths in low-income and middle-income countries. PPH can be prevented by active management of the third stage of labor (AMTSL), a series of steps recommended by the World Health Organization to be performed by skilled birth attendants (SBAs). Task shifting in the AMTSL step of uterotonic drugs administration to community health workers, traditional birth attendants and self-administration has been investigated as a strategy to increase access to quality obstetric care considering persistent SBA and facility-based delivery shortages. The aim of this study is to assess task shifting in the final step of AMTSL and compare uterine tonus assessment by a SBA to self-assessment. The study is an individual-level two-arm non-inferiority randomized controlled trial (RCT). A total of 800 women will be recruited in Korle Bu Teaching Hospital in Accra, Ghana. Adult women in labor at term with an expected vaginal delivery who received antenatal instructions for self-assessment of uterine tonus will be eligible for inclusion. Women with an increased risk for PPH will be excluded. Women will be randomized to uterine tone assessment by a skilled birth attendant (midwife) or uterine tone self-assessment (with the safety back-up of a midwife present in case of PPH or uterine atony). Postpartum blood loss will be measured through weighing of disposable mats. The main study endpoints are PPH (≥500 ml blood loss), severe PPH (≥1000 ml blood loss), mean blood loss, and routine maternal and neonatal outcomes. Participants and caregivers will not be blinded given the nature of the intervention. A reduction of PPH-related maternal mortality requires full implementation of AMTSL. Task shifting of uterine tone assessment may contribute to increased AMTSL implementation in (clinical) settings where SBAs capacity is constrained. Clinicaltrials.gov: NCT02223806 , registration August 2014. PACTR201402000736158 , registration July 2014. University of Ghana, Medical School Ethical and Protocol Review Committee: MS-Et/M.8-P4.1/2014-2015.

Better cancer biomarker discovery through better study design.

PubMed

Rundle, Andrew; Ahsan, Habibul; Vineis, Paolo

2012-12-01

High-throughput laboratory technologies coupled with sophisticated bioinformatics algorithms have tremendous potential for discovering novel biomarkers, or profiles of biomarkers, that could serve as predictors of disease risk, response to treatment or prognosis. We discuss methodological issues in wedding high-throughput approaches for biomarker discovery with the case-control study designs typically used in biomarker discovery studies, especially focusing on nested case-control designs. We review principles for nested case-control study design in relation to biomarker discovery studies and describe how the efficiency of biomarker discovery can be effected by study design choices. We develop a simulated prostate cancer cohort data set and a series of biomarker discovery case-control studies nested within the cohort to illustrate how study design choices can influence biomarker discovery process. Common elements of nested case-control design, incidence density sampling and matching of controls to cases are not typically factored correctly into biomarker discovery analyses, inducing bias in the discovery process. We illustrate how incidence density sampling and matching of controls to cases reduce the apparent specificity of truly valid biomarkers 'discovered' in a nested case-control study. We also propose and demonstrate a new case-control matching protocol, we call 'antimatching', that improves the efficiency of biomarker discovery studies. For a valid, but as yet undiscovered, biomarker(s) disjunctions between correctly designed epidemiologic studies and the practice of biomarker discovery reduce the likelihood that true biomarker(s) will be discovered and increases the false-positive discovery rate. © 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.

Integration of the Reconfigurable Self-Healing eDNA Architecture in an Embedded System

NASA Technical Reports Server (NTRS)

Boesen, Michael Reibel; Keymeulen, Didier; Madsen, Jan; Lu, Thomas; Chao, Tien-Hsin

2011-01-01

In this work we describe the first real world case study for the self-healing eDNA (electronic DNA) architecture by implementing the control and data processing of a Fourier Transform Spectrometer (FTS) on an eDNA prototype. For this purpose the eDNA prototype has been ported from a Xilinx Virtex 5 FPGA to an embedded system consisting of a PowerPC and a Xilinx Virtex 5 FPGA. The FTS instrument features a novel liquid crystal waveguide, which consequently eliminates all moving parts from the instrument. The addition of the eDNA architecture to do the control and data processing has resulted in a highly fault-tolerant FTS instrument. The case study has shown that the early stage prototype of the autonomous self-healing eDNA architecture is expensive in terms of execution time.

A study of school adjustment, self-concept, self-esteem, general wellbeing and parent child relationship in Juvenile Idiopathic Arthritis.

PubMed

Yadav, Anita; Yadav, T P

2013-03-01

To assess school adjustment, self-concept, self-esteem, general wellbeing and parent-child relationship in children with Juvenile Idiopathic Arthritis (JIA)and to study the correlation of these parameters with chronicity of disease, number of active joints, laboratory parameters of disease activity and JIA subtypes. A total of 64 children (32 cases and 32 controls) were recruited for analysis. Self report questionnaires which included PGI General Wellbeing Measure, Adjustment Inventory for School Students, Parent Child Relationship Scale, Self Esteem Inventory and Self Concept Questionnaires were used to assess all the enrolled subjects. Cases had significantly lower general physical well being (p < 0.001), self- esteem (p = 0.039), social self-concept (p = 0.023) and poorer social (p = 0.002), educational (p = 0.002) and overall (p = 0.006) adjustment as compared to controls. Both parents of cases were significantly more demanding (p = 0.028, p = 0.004)and mothers were over protective (p = 0.009) and pampering with object rewards (p = 0.02). PGI wellbeing score (p = 0.042, p = 0.019) and self concept (p = 0.002, for social SCQ p = 0.030) correlated well with number of active joints and ESR. As the disease duration increased, fathers tended to neglect their children (p = 0.043) and with persistent disease activity (reflected by CRP positivity) even resorted to punishment (p = 0.022) or remained indifferent (p = 0.048). JIA significantly hampers the child's self-esteem, self-concept, adjustment in school, general wellbeing and evokes disturbed parent-child relationship.

Child Maltreatment, Subsequent Non-Suicidal Self-Injury and the Mediating Roles of Dissociation, Alexithymia and Self-Blame

ERIC Educational Resources Information Center

Swannell, Sarah; Martin, Graham; Page, Andrew; Hasking, Penelope; Hazell, Philip; Taylor, Anne; Protani, Melinda

2012-01-01

Objective: Although child maltreatment is associated with later non-suicidal self-injury (NSSI), the mechanism through which it might lead to NSSI is not well understood. The current retrospective case-control study examined associations between child maltreatment and later NSSI, and investigated the mediating roles of dissociation, alexithymia,…

The Use of Milrinone in Patients with Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage: A Systematic Review.

PubMed

Lannes, Marcelo; Zeiler, Frederick; Guichon, Céline; Teitelbaum, Jeanne

2017-03-01

The purpose of this article is to provide a systematic review of the evidence supporting the use of milrinone for the management of delayed cerebral ischemia (DCI) following subarachnoid hemorrhage (SAH). Primary outcomes were functional neurological status and the incidence of cerebral infarction. Search strategies adapted to the different databases were developed by a professional librarian. Medline, EMBASE, the Cochrane Library database, Web of Science, SCOPUS, BIOSIS, Global Health, Health Star, Open SIGLE, Google Scholar and the New York Academy of Medicine Gray Literature were searched as well as clinical trials databases and the proceedings of several scientific meetings. Quality of the evidence for these outcomes across studies was adjudicated using the GRADE Working Group criteria. The search resulted in 284 citations after elimination of duplicates. Of those 9 conference proceedings and 15 studies met inclusion criteria and consisted of case reports, case series and two comparative studies: one non-randomized study with physiological outcomes only and a case series with historical controls. There was considerable variation in dosing and in co-interventions and no case control or randomized controlled studies were found. There is currently only very low quality evidence to support the use of milrinone to improve important outcomes in patients with delayed cerebral ischemia secondary to subarachnoid hemorrhage. Further research is needed to clarify the value and risks of this medication in patients with SAH.

Evaluation of the impact on human salmonellosis of control measures targeted to Salmonella Enteritidis and Typhimurium in poultry breeding using time-series analysis and intervention models in France

PubMed Central

POIRIER, E.; WATIER, L.; ESPIE, E.; WEILL, F.-X.; VALK, H. DE; DESENCLOS, J.-C.

2008-01-01

SUMMARY In France, salmonellosis is the main cause of foodborne bacterial infection with serotypes Enteritis (SE) and Typhimurium (ST) accounting for 70% of all cases. French authorities implemented a national control programme targeting SE and ST in poultry and eggs from October 1998 onwards. A 33% decrease in salmonellosis has been observed since implementation. We designed an evaluation of the impact of this control programme on SE and ST human infections in France. Using monthly Salmonella human isolate reports to the National Reference Centre we defined two intervention series (SE and ST) and one control series comprising serotypes not know to be associated with poultry or eggs. The series, from 1992 to 2003, were analysed using autoregressive moving average models (ARMA). To test the hypothesis of a reduction of SE and ST human cases >0 after the programme started and to estimate its size, we introduced an intervention model to the ARMA modelling. In contrast to the control series, we found an annual reduction of 555 (95% CI 148–964) SE and of 492 (95% CI 0–1092) ST human infections, representing respectively a 21% and 18% decrease. For SE, the decrease occurred sharply after implementation while for ST, it followed a progressive decrease that started early in 1998. Our study, suggests a true relation between the Salmonella control programme and the subsequent decrease observed for the two targeted serotypes. For ST, however, the decrease prior to the intervention may also reflect control measures implemented earlier by the cattle and milk industry. PMID:18047748

Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?

PubMed

Wen, Frances K; Millar, James; Oberst-Walsh, Linda; Nashelsky, Joan

2018-02-01

No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).

Acute Idiopathic Scrotal Edema: Systematic Literature Review.

PubMed

Santi, Maristella; Lava, Sebastiano A G; Simonetti, Giacomo D; Bianchetti, Mario G; Milani, Gregorio P

2018-06-01

 Existing information on acute idiopathic scrotal edema relies on small case series and textbooks.  We searched reports with no date limits on acute idiopathic scrotal edema.  Thirty-seven studies were included. Sixteen case series addressed the prevalence of acute idiopathic scrotal edema among males with acute scrotum: among 3,403 cases, the diagnosis of acute idiopathic scrotal edema was made in 413 cases (12%). Twenty-four reports addressed history, findings, management, and course of acute idiopathic scrotal edema in 311 patients. The patients mostly ranged in age from 5 to 8 years, presented with acute scrotal redness and swelling, associated or not with mild pain. Ninety percent or more of the cases developed in patients without atopic diathesis and were not preceded by inguinoscrotal surgery, acute febrile illnesses, or trauma. They were afebrile; in good general condition; and presented without pruritus, nausea or vomiting, or abdominal pain. The lesions were bilateral in two-thirds and unilateral in one-third of the cases. The condition resolved spontaneously within 2 to 3 days without sequelae. Approximately 10% of the cases experienced a recurrence.  Acute idiopathic scrotal edema is a self-limiting condition that accounts for ≥ 10% of cases of acute scrotum in children and adolescents. Georg Thieme Verlag KG Stuttgart · New York.

Differences between blood donors and a population sample: implications for case-control studies.

PubMed

Golding, Jean; Northstone, Kate; Miller, Laura L; Davey Smith, George; Pembrey, Marcus

2013-08-01

Selecting appropriate controls for studies of genetic variation in case series is important. The two major candidates involve the use of blood donors or a random sample of the population. We compare and contrast the two different populations of controls for studies of genetic variation using data from parents enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). In addition we compute different biases using a series of hypothetical assumptions. The study subjects who had been blood donors differed markedly from the general population in social, health-related, anthropometric, and personality-related variables. Using theoretical examples, we show that blood donors are a poor control group for non-genetic studies of diseases related to environmentally, behaviourally, or socially patterned exposures. However, we show that if blood donors are used as controls in genetic studies, these factors are unlikely to make a major difference in detecting true associations with relatively rare disorders (cumulative incidence through life of <10%). Nevertheless, for more common disorders, the reduction in accuracy resulting from the inclusion in any control population of individuals who have or will develop the disease in question can create a greater bias than can socially patterned factors. Information about the medical history of a control and the parents of the control (as a proxy for whether the control will develop the disease) is more important with regard to the choice of controls than whether the controls are a random population sample or blood donors.

Psychosocial Characteristics and Social Networks of Suicidal Prisoners: Towards a Model of Suicidal Behaviour in Detention

PubMed Central

Rivlin, Adrienne; Hawton, Keith; Marzano, Lisa; Fazel, Seena

2013-01-01

Prisoners are at increased risk of suicide. Investigation of both individual and environmental risk factors may assist in developing suicide prevention policies for prisoners and other high-risk populations. We conducted a matched case-control interview study with 60 male prisoners who had made near-lethal suicide attempts in prison (cases) and 60 male prisoners who had not (controls). We compared levels of depression, hopelessness, self-esteem, impulsivity, aggression, hostility, childhood abuse, life events (including events occurring in prison), social support, and social networks in univariate and multivariate models. A range of psychosocial factors was associated with near-lethal self-harm in prisoners. Compared with controls, cases reported higher levels of depression, hopelessness, impulsivity, and aggression, and lower levels of self-esteem and social support (all p values <0.001). Adverse life events and criminal history factors were also associated with near-lethal self-harm, especially having a prior prison spell and having been bullied in prison, both of which remained significant in multivariate analyses. The findings support a model of suicidal behaviour in prisoners that incorporates imported vulnerability factors, clinical factors, and prison experiences, and underscores their interaction. Strategies to reduce self-harm and suicide in prisoners should include attention to such factors. PMID:23922671

The Impact of Self-Regulatory Skills Training for Reducing in School Suspension Placement: A Case Study

ERIC Educational Resources Information Center

Schilling-Dickey, Gwen

2013-01-01

Researchers have been looking for solutions to disciplinary problems within the school setting. Many studies have been conducted to assess the impact of a variety of intervention strategies with research indicating that strategies involving self-regulatory control of behavioral responses can benefit students. Additionally, positive behavioral…

For Parents' Sake: A Survival Kit for Parents and Kids. Volume II: Tips for Parents.

ERIC Educational Resources Information Center

Butchee, Brenda, Ed.; And Others

Developed by the Oklahoma State Department of Health, this booklet is the second in a series that provides tips that parents can use to help their children grow. The booklet is divided into three sections. The first section, "Getting Along as a Person," discusses a child's self-esteem, self-concept, and self-control, and suggests ways for parents…

Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders.

PubMed

Marklund, Susanna; Wänman, Anders

2010-09-01

To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

Effects of a Family-based Diabetes Intervention on Behavioral and Biological Outcomes for Mexican American Adults.

PubMed

McEwen, Marylyn Morris; Pasvogel, Alice; Murdaugh, Carolyn; Hepworth, Joseph

2017-06-01

Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.

The association between social relationships and self-harm: a case–control study in Taiwan

PubMed Central

2013-01-01

Background Although suicide has been postulated as a result of social breakdown, relatively little attention has been paid to the association between social relationships and non-fatal self-harm. We sought to investigate the extent to which social factors correlate with self-harm in this case–control study. Methods The primary outcome was self-harm with hospital presentation. Cases of self-harm from the Emergency Department in a general hospital in Northern Taiwan were recruited, and individually age-and-gender-matched control participants were recruited from non-psychiatric outpatient clinics at the same hospital. The Close Persons Questionnaire was administered and its social support and social network subscales were used to measure social relationships in the 12 months prior to the interview. Other covariates, comprising sociodemographic factors, major life events, physical and mental health, were adjusted in conditional logistic regression models. Results A total of 124 case–control pairs were recruited. The mean (standard deviation) age of the case group was 34.7 (12.8) years and 80.6% were female. Higher social isolation score remained significantly associated with self-harm after adjustment (adjusted odds ratio per standard deviation increase 2.92, 95% confidence interval 1.44-5.95) and household size was negatively associated with the outcome (adjusted odds ratio per unit increase 0.54, 95% CI 0.32-0.94). Conclusions More limited social networks were associated with self-harm after adjustment for potential confounders. Enhancing social structure and effective networking of people with self-harm to community resources may be important for self-harm management in Asian societies and elsewhere. PMID:23531045

The Safety of Physically Disabled Drivers

PubMed Central

Ysander, Lars

1966-01-01

Four hundred and ninety-four disabled drivers, the majority with loss of function in the legs usually as the result of poliomyelitis or amputations, have been studied with respect to the frequency of traffic accidents and serious traffic offences during a 10-year period. Traffic accidents which may have been caused by their disability occurred in only three (0·6%) of the total number of drivers investigated. In all three cases the driver had loss of function in the right leg. A comparison was made between the investigation series and a control series identical as regards sex, age, and licence-holding period but with a shorter exposure to traffic than the investigation series. The frequency of traffic accidents amounted to 7·1% in both series, and the frequency of serious traffic offences was 12·2% in the investigation series and 14·8% in the control series. Disabled drivers are not an increased hazard in traffic. The compensatory technical modifications to the vehicle which are generally adopted appeared to be adequate. However, there was a relatively increased frequency of accidents among drivers with loss of function in the right leg or right arm. An improvement of the technical modifications applied in these cases might result in a further reduction of the road-safety risks. PMID:4223486

The effect of group play therapy on social-emotional skills in pre-school children.

PubMed

Chinekesh, Ahdieh; Kamalian, Mehrnoush; Eltemasi, Masoumeh; Chinekesh, Shirin; Alavi, Manijeh

2013-12-24

Childhood is important and critical period in human life. The foundation of ego is shaped in childhood. Play therapy is one of the successful strategies to help children with inner conflicts problems. This method of psychotherapy is base on the normal learning processes of children, provides solutions to relieve feelings of stress, and expands self-expression. Group play therapy can enhance the self-awareness, self- regulation, social communication, empathy and adoptability in children. Present study investigated the effects of play therapy on relational and emotional skills of pre-school children. For this purpose, the total numbers of 372 pre-school children were randomly selected, and divided into two equal groups (case and control). In next step, the BUSSE-SR methodology was used for evaluation and comparison of self-awareness, self-regulation, social interaction, empathy, adoptability, and control groups. Pre-test were performed for both groups and case group was involved in-group play therapy. According to the results of post-test, correlation of variables between case-control groups was examined by multivariate analysis of covariance. Frequency of boys and girls in our sample were 51.3 and 48.7 percent, respectively. The mean age of children was 5.1±0.6 year. According to the results of present study, play therapy significantly enhanced the social-emotional skills (P< 0.001). Our findings are consistent with the results of previous studies in other nations with different environmental and cultural properties. In conclusion, it seems that play therapy can be used in pre-school centers to help children learn problem-solving skills and communicate with others.

Association between human herpesvirus infections and dementia or mild cognitive impairment: a systematic review protocol.

PubMed

Warren-Gash, Charlotte; Forbes, Harriet; Breuer, Judith; Hayward, Andrew C; Mavrodaris, Angelique; Ridha, Basil H; Rossor, Martin; Thomas, Sara L; Smeeth, Liam

2017-06-23

Persisting neurotropic viruses are proposed to increase the risk of dementia, but evidence of association from robust, adequately powered population studies is lacking. This is essential to inform clinical trials of targeted preventive interventions. We will carry out a comprehensive systematic review of published and grey literature of the association between infection with, reactivation of, vaccination against or treatment of any of the eight human herpesviruses and dementia or mild cognitive impairment. We will search the Cochrane Library, Embase, Global Health, Medline, PsycINFO, Scopus, Web of Science, clinical trials registers, the New York Academy of Medicine Grey Literature Report, Electronic Theses Online Service through the British Library and the ISI Conference Proceedings Citation Index for randomised controlled trials, cohort, caseâ€"control, case crossover or self-controlled case series studies reported in any language up to January 2017. Titles, abstracts and full-text screening will be conducted by two researchers independently. Data will be extracted systematically from eligible studies using a piloted template. We will assess risk of bias of individual studies in line with the Cochrane Collaboration tool. We will conduct a narrative synthesis, grouping studies by exposure and outcome definitions, and will describe any differences by population subgroups and dementia subtypes. We will consider performing meta-analyses if there are adequate numbers of sufficiently homogeneous studies. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development and Evaluations criteria. As this is a review of existing studies, no ethical approval is required. Results will be disseminated through a peer-reviewed publication and at national and international conferences. We anticipate the review will clarify the current extent and quality of evidence for a link between herpesviruses and dementia, identify gaps and inform the direction of future research. CRD42017054684. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Alexithymia, impulsiveness, and psychopathology in nonsuicidal self-injured adolescents

PubMed Central

Gatta, Michela; Dal Santo, Francesco; Rago, Alessio; Spoto, Andrea; Battistella, Pier Antonio

2016-01-01

Introduction Nonsuicidal self-injury (NSSI) is a multifaceted phenomenon and a major health issue among adolescents. A better understanding of self-injury comorbidities is crucial to improve our ability to assess, treat, and prevent NSSI. Purpose This study aimed at analyzing some of the psychobehavioral correlates of NSSI: psychological problems, alexithymia, impulsiveness, and sociorelational aspects. Patients and methods This was a case–control study. The clinical sample (n=33) included adolescents attending our unit for NSSI and other issues; the controls (n=79) were high-school students. Data were collected using six questionnaires: Youth Self-Report, Barratt’s Impulsiveness Scale, Toronto Alexithymia Scale, Children’s Depression Inventory, Symptom Checklist-90-R, and Child Behavior Checklist. Results Cases scored significantly higher in all questionnaires. Habitual self-injurers scored higher on impulsiveness and alexithymia. The gesture’s repetition seems relevant to the global clinical picture: habitual self-injurers appear more likely to seek help from the sociosanitary services. We found a difference between the self-injurers’ and their parents’ awareness of the disorder. Conclusion Habitual self-injurers show signs of having difficulty with assessing the consequences of their actions (nonplanning impulsiveness) and the inability to manage their feelings. Given the significantly higher scores found for cases than for controls on all the psychopathological scales, NSSI can be seen as a cross-category psychiatric disorder, supporting the Diagnostic and Statistical Manual of Mental Disorders decision to include it as a pathological entity in its own right. PMID:27672324

Hyperbaric oxygen therapy in the treatment of osteonecrosis of the femoral head: a review of the current literature.

PubMed

Uzun, Gunalp; Mutluoglu, Mesut; Ersen, Omer; Yildiz, Senol

2016-01-01

To review the current literature on the use of hyperbaric oxygen (HBO₂) therapy in the treatment of osteonecrosis of the femoral head (ONFH). We searched PubMed, Directory of Open Access Journals (DOAJ), EMBASE, Web of Science, Academic Search Complete, CINAHL and MEDLINE through April 2015. We hand-searched relevant textbooks, conference proceedings and the reference lists of review articles and clinical studies Randomized controlled trials (RCT) and observational studies (cohort study, case-control study, case series) that reported the outcome of patients who received HBO₂therapy for ONFH were included. Only English-language articles were included. Study quality was not used as an exclusion criterion. Two authors independently assessed trials for inclusion, extracted data and presented to other authors. Disagreements were resolved by consensus. We identified eight clinical studies; two randomized controlled trials (RCTs); one historically controlled study; and five case series. The majority of the studies were small-scale, heterogeneous and methodologically weak. In four of the studies HBO₂therapy was combined with other treatment modalities, making it impossible to draw firm conclusions on the specific effects of HBO₂therapy. Hip survivorship in studies wherein HBO₂therapy was used alone was 95.5% in Steinberg Stage I lesions, 89% in Steinberg Stage II lesions and 100% in Ficat Stage II lesions. There is a room for HBO₂therapy in the management ONFH. Further RCTs, however, are required to better elucidate the role of HBO₂therapy in the treatment of ONFH.

New Perspectives for the Evaluation of Training Sessions in Self-Regulated Learning: Time-Series Analyses of Diary Data

ERIC Educational Resources Information Center

Schmitz, Bernhard; Wiese, Bettina S.

2006-01-01

The present study combines a standardized diary approach with time-series analysis methods to investigate the process of self-regulated learning. Based on a process-focused adaptation of Zimmerman's (2000) learning model, an intervention (consisting of four weekly training sessions) to increase self-regulated learning was developed. The diaries…

Deliberate self-harm as seen in Kampala, Uganda - a case-control study.

PubMed

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2004-04-01

A study to investigate deliberate self-harm (DSH) in an African context was undertaken in Uganda. A case-control study in which 100 cases of DSH and 300 controls matched on age and sex were recruited from three general hospitals in Kampala and subjected to a structured interview using a modified version of the European Parasuicide Study Interview Schedule I. Among the cases, 63% were males, with a male to female ratio of 1.7:1 and a peak age range of 20-24 years. Higher educational attainment, higher socio-economic class and poor housing were significantly associated with DSH. District of current residence, district of birth, religion, ethnicity, marital status, number of children, current living arrangement, area of usual residence, employment status of respondent and partner were not significantly associated with DSH. Pesticides and medications, mainly antimalarials and diazepam, were the main methods of DSH used. The most commonly reported psychiatric disorders were adjustment disorder, acute stress reactions and depression. DSH in Uganda appears to predominantly afflict the young. Disturbed interpersonal relationships, poverty and loneliness were important factors in the immediate precipitation of this behaviour. The fact that pesticide poisoning is still the predominantly used method in DSH in this area calls for a review of the legislation that controls the sale and availability of these agricultural chemicals.

Sedentary work and the risk of breast cancer in premenopausal and postmenopausal women: a pooled analysis of two case-control studies.

PubMed

Boyle, Terry; Fritschi, Lin; Kobayashi, Lindsay C; Heyworth, Jane S; Lee, Derrick G; Si, Si; Aronson, Kristan J; Spinelli, John J

2016-11-01

There is limited research on the association between sedentary behaviour and breast cancer risk, particularly whether sedentary behaviour is differentially associated with premenopausal and postmenopausal breast cancer. We pooled data from 2 case-control studies from Australia and Canada to investigate this association. This pooled analysis included 1762 incident breast cancer cases and 2532 controls. Participants in both studies completed a lifetime occupational history and self-rated occupational physical activity level. A job-exposure matrix (JEM) was also applied to job titles to assess sedentary work. Logistic regression analyses (6 pooled and 12 study-specific) were conducted to estimate associations between both self-reported and JEM-assessed sedentary work and breast cancer risk among premenopausal and postmenopausal women. No association was observed in the 6 pooled analyses, and 10 of the study-specific analyses also showed null results. 2 study-specific analyses provided inconsistent and contradictory results, with 1 showing statistically significant increased risk of breast cancer for self-reported sedentary work among premenopausal women cancer in the Canadian study, and the other a non-significant inverse association between JEM-assessed sedentary work and breast cancer risk among postmenopausal women in the Australian study. While a suggestion of increased risk was seen for premenopausal women in the Canadian study when using the self-reported measure, overall this pooled study does not provide evidence that sedentary work is associated with breast cancer risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations.

PubMed

Boels, D; Landreau, A; Bruneau, C; Garnier, R; Pulce, C; Labadie, M; de Haro, L; Harry, P

2014-07-01

Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. This paper reports a French shiitake dermatitis case series. The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.

The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases.

PubMed

Yates, Gregory; Bass, Christopher

2017-10-01

Little is known about the perpetrators of medical child abuse (MCA) which is often described as "Munchausen's syndrome by proxy" or "factitious disorder imposed on another". The demographic and clinical characteristics of these abusers have yet to be described in a sufficiently large sample. We aimed to address this issue through a systematic review of case reports and series in the professional literature. A systematic search for case reports and series published since 1965 was undertaken using MEDLINE, Web of Science and EMBASE. 4100 database records were screened. A supplementary search was then conducted using GoogleScholar and reference lists of eligible studies. Our search yielded a total sample of 796 perpetrators: 309 from case reports and 487 from case series. Information extracted included demographic and clinical characteristics, in addition to methods of abuse and case outcomes. Nearly all abusers were female (97.6%) and the victim's mother (95.6%). Most were married (75.8%). Mean caretaker age at the child's presentation was 27.6 years. Perpetrators were frequently reported to be in healthcare-related professions (45.6%), to have had obstetric complications (23.5%), or to have histories of childhood maltreatment (30%). The most common psychiatric diagnoses recorded were factitious disorder imposed on self (30.9%), personality disorder (18.6%), and depression (14.2%). From the largest analysis of MCA perpetrators to date, we provide several clinical recommendations. In particular, we urge clinicians to consider mothers with a personal history of childhood maltreatment, obstetric complications, and/or factitious disorder at heightened risk for MCA. Longitudinal studies are required to establish the true prognostic value of these factors as our method may have been vulnerable to publication bias. Copyright © 2017. Published by Elsevier Ltd.

Implementation of training programs in self-regulated learning strategies in Moodle format: results of a experience in higher education.

PubMed

Núñez, José Carlos; Cerezo, Rebeca; Bernardo, Ana; Rosário, Pedro; Valle, Antonio; Fernández, Estrella; Suárez, Natalia

2011-04-01

This paper tests the efficacy of an intervention program in virtual format intended to train studying and self-regulation strategies in university students. The aim of this intervention is to promote a series of strategies which allow students to manage their learning processes in a more proficient and autonomous way. The program has been developed in Moodle format and hosted by the Virtual Campus of the University of Oviedo. The present study had a semi-experimental design, included an experimental group (n=167) and a control one (n=206), and used pretest and posttest measures (self-regulated learning strategies' declarative knowledge, self-regulated learning macro-strategy planning-execution-assessment, self-regulated learning strategies on text, surface and deep learning approaches, and academic achievement). Data suggest that the students enrolled in the training program, comparing with students in the control group, showed a significant improvement in their declarative knowledge, general and on text use of learning strategies, increased their deep approach to learning, decreased their use of a surface approach and, in what concerns to academic achievement, statistically significant differences have been found in favour of the experimental group.

Self-Injurious Behaviour in Cornelia De Lange Syndrome: 1. Prevalence and Phenomenology

ERIC Educational Resources Information Center

Oliver, C.; Sloneem, J.; Hall, S.; Arron, K.

2009-01-01

Background: Self-injurious behaviour is frequently identified as part of the behavioural phenotype of Cornelia de Lange syndrome (CdLS). We conducted a case-control study of the prevalence and phenomenology of self-injurious behaviour (SIB) in CdLS. Methods: A total of 54 participants with CdLS were compared with 46 individuals who were comparable…

Development and External Validation of a Melanoma Risk Prediction Model Based on Self-assessed Risk Factors.

PubMed

Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov; Veierod, Marit B; Barrett, Jennifer H; Davies, John R; Bishop, D Timothy; Whiteman, David C; Olsen, Catherine M; Hopper, John L; Mann, Graham J; Cust, Anne E; McGeechan, Kevin

2016-08-01

Identifying individuals at high risk of melanoma can optimize primary and secondary prevention strategies. To develop and externally validate a risk prediction model for incident first-primary cutaneous melanoma using self-assessed risk factors. We used unconditional logistic regression to develop a multivariable risk prediction model. Relative risk estimates from the model were combined with Australian melanoma incidence and competing mortality rates to obtain absolute risk estimates. A risk prediction model was developed using the Australian Melanoma Family Study (629 cases and 535 controls) and externally validated using 4 independent population-based studies: the Western Australia Melanoma Study (511 case-control pairs), Leeds Melanoma Case-Control Study (960 cases and 513 controls), Epigene-QSkin Study (44 544, of which 766 with melanoma), and Swedish Women's Lifestyle and Health Cohort Study (49 259 women, of which 273 had melanoma). We validated model performance internally and externally by assessing discrimination using the area under the receiver operating curve (AUC). Additionally, using the Swedish Women's Lifestyle and Health Cohort Study, we assessed model calibration and clinical usefulness. The risk prediction model included hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and lifetime sunbed use. On internal validation, the AUC was 0.70 (95% CI, 0.67-0.73). On external validation, the AUC was 0.66 (95% CI, 0.63-0.69) in the Western Australia Melanoma Study, 0.67 (95% CI, 0.65-0.70) in the Leeds Melanoma Case-Control Study, 0.64 (95% CI, 0.62-0.66) in the Epigene-QSkin Study, and 0.63 (95% CI, 0.60-0.67) in the Swedish Women's Lifestyle and Health Cohort Study. Model calibration showed close agreement between predicted and observed numbers of incident melanomas across all deciles of predicted risk. In the external validation setting, there was higher net benefit when using the risk prediction model to classify individuals as high risk compared with classifying all individuals as high risk. The melanoma risk prediction model performs well and may be useful in prevention interventions reliant on a risk assessment using self-assessed risk factors.

KRAS mutations in blood circulating cell-free DNA: a pancreatic cancer case-control

PubMed Central

Le Calvez-Kelm, Florence; Foll, Matthieu; Wozniak, Magdalena B.; Delhomme, Tiffany M.; Durand, Geoffroy; Chopard, Priscilia; Pertesi, Maroulio; Fabianova, Eleonora; Adamcakova, Zora; Holcatova, Ivana; Foretova, Lenka; Janout, Vladimir; Vallee, Maxime P.; Rinaldi, Sabina; Brennan, Paul; McKay, James D.; Byrnes, Graham B.; Scelo, Ghislaine

2016-01-01

The utility of KRAS mutations in plasma circulating cell-free DNA (cfDNA) samples as non-invasive biomarkers for the detection of pancreatic cancer has never been evaluated in a large case-control series. We applied a KRAS amplicon-based deep sequencing strategy combined with analytical pipeline specifically designed for the detection of low-abundance mutations to screen plasma samples of 437 pancreatic cancer cases, 141 chronic pancreatitis subjects, and 394 healthy controls. We detected mutations in 21.1% (N=92) of cases, of whom 82 (89.1%) carried at least one mutation at hotspot codons 12, 13 or 61, with mutant allelic fractions from 0.08% to 79%. Advanced stages were associated with an increased proportion of detection, with KRAS cfDNA mutations detected in 10.3%, 17,5% and 33.3% of cases with local, regional and systemic stages, respectively. We also detected KRAS cfDNA mutations in 3.7% (N=14) of healthy controls and in 4.3% (N=6) of subjects with chronic pancreatitis, but at significantly lower allelic fractions than in cases. Combining cfDNA KRAS mutations and CA19-9 plasma levels on a limited set of case-control samples did not improve the overall performance of the biomarkers as compared to CA19-9 alone. Whether the limited sensitivity and specificity observed in our series of KRAS mutations in plasma cfDNA as biomarkers for pancreatic cancer detection are attributable to methodological limitations or to the biology of cfDNA should be further assessed in large case-control series. PMID:27705932

The epidemiology of injury in hang-gliding and paragliding.

PubMed

Rekand, Tiina

2012-01-01

Para- and hang-gliding are modern air sports that developed in the 20th century. Performers should possess technical skills and manage certified equipment for successful flight. Injuries may happen during the take-off, flight and landing. PubMed was searched using the search terms 'paragliding' and/or 'hang-gliding'. The reference lists of articles identified in the search strategy were also searched for relevant articles. The most common injuries are fractures, dislocations or sprains in the extremities, followed by spinal and head traumas. Multiple injuries after accidents are common. Collision with electrical wires may cause burn injuries. Fatal outcomes are caused by brain injuries, spinal cord injuries at the cervical level or aorta rupture. Accidents happen because of risk-taking behavior, lack of education or use of self-modified equipment. Observational studies have suggested the need for protection of the head, trunk and lower extremities. The measures proposed are often based on conclusions of observational studies and not proven through randomized studies. Better education along with focusing on possible risk factors will probably diminish the risks of hang- and paragliding. Large denominator-based case series, case-control and population-based studies are needed for assessment of the risks of hang- and paragliding. Copyright © 2012 S. Karger AG, Basel.

The effect of group bibliotherapy on the self-esteem of female students living in dormitory.

PubMed

Salimi, Sepideh; Zare-Farashbandi, Firoozeh; Papi, Ahmad; Samouei, Rahele; Hassanzadeh, Akbar

2014-01-01

Bibliotherapy is a supplement, simple, inexpensive and readily available method to treat the diseases that is performed with cooperation of librarians and psychologists or doctors. The aim of this study is the investigation of group bibliotherapy's effect on the self-esteem of the female students of Isfahan University of Medical Sciences Living in Dormitory in 2012. The present study is an interventional semi-experimental study with pre test and post test and control group. The statistical population of study consisted of 32 female students who reside in Isfahan University of Medical Sciences dormitories which control and case groups and the students were divided randomly between these two groups. Data was collected by Cooper Smith Self-esteem questionnaire scale (Cronbach's alpha: 0.85). Two groups were examined by the questionnaire in pre test. Case group received group bibliotherapy for 2 month (8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups were assessed in post test after 1 month. Descriptive statistics (means and frequencies distribution) and inferential statistics (independent t- test, paired t- test and mann whitney) were used and data was analyzed by SPSS20 software. The findings showed that group bibliotherapy had positive and significant effect on general, family, professional and total self esteem of female students living in dormitories, but it had no effect on their social self esteem. Group bibliotherapy can increase female students' self-esteem levels. On the other hand, conducting these studies not only can improve mental health of people, but can also improve their reading habits.

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

PubMed Central

2009-01-01

Introduction Perioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published. Case presentations A series of four consecutive patients who developed acute lower-limb myoclonus following spinal or epidural anaesthesia are described. The case series occurred at three different hospitals and involved four anaesthetists over a 3-year period. Two Caucasian men, aged 90-years-old and 67-years-old, manifested unilateral myoclonus. Two Caucasian women, aged 64-years-old and 53-years-old, developed bilateral myoclonus. Myoclonus was self-limiting in one patient, treated with further regional anaesthesia in one patient and treated with intravenous midazolam in two patients. The overall outcome was good in all patients, with no recurrence or sequelae in any of the patients. Conclusion This case series emphasizes that spinal myoclonus following regional anaesthesia is rare, has diverse pathophysiology and can have diverse presentations. The treatment of perioperative spinal myoclonus should be directed at the aetiology. Anaesthetists and perioperative practitioners who are unfamiliar with this rare complication should be reassured that it may be treated successfully with midazolam. PMID:19830168

Involvement of the renin-angiotensin system in the progression of severe hand-foot-and-mouth disease.

PubMed

Zhang, Chao; Chen, Shuaiyin; Zhou, Guangyuan; Jin, Yuefei; Zhang, Rongguang; Yang, Haiyan; Xi, Yuanlin; Ren, Jingchao; Duan, Guangcai

2018-01-01

Hand-foot-and-mouth disease (HFMD) is generally considered as a mild exanthematous disease to infants and young children worldwide. HFMD cases are usually mild and self-limiting but for few cases leads to complicated severe clinical outcomes, and even death. Previous studies have indicated that serum Ang II levels in patients with H7N9 infection were related to the severity of infection. However, the mechanisms underlying the pathogenesis of severe HFMD remain unclear. This study was undertaken to clarify the role of the renin-angiotensin system (RAS) in the progression of severe HFMD. In the present study, 162 children including HFMD patients and healthy controls were recruited. The data was analyzed by time-series fashion. Concentrations of angiotensin II (Ang II) and noradrenaline (NA) in serum of patients were measured with ELISA. We established a mouse model for enterovirus 71 (EV71) infection and determined concentrations of Ang II, NA in tissue lysates at 3, 5 and 7 days post infection (dpi). The concentrations of Ang II and NA in serum of the HFMD patients with mild or severe symptoms were significantly higher than that in healthy controls. Additionally, the concentrations of Ang II and NA in serum of severe cases were significantly higher than those mild cases and the increased concentrations of Ang II and NA showed the same time trend during the progression of HFMD in the severe cases. Furthermore, the concentrations of Ang II and NA in target organs of EV71-infected mice including brains, skeletal muscle, and lungs were increased with the progression of EV71 infection in mice. Histopathological alterations were observed in the brains, skeletal muscle and lungs of EV71-infected mice. Our study suggested that activation of the RAS is implicated in the pathogenesis of severe HFMD.

Risk of Guillain–Barré syndrome following pandemic influenza A(H1N1) 2009 vaccination in Germany†

PubMed Central

Prestel, Jürgen; Volkers, Peter; Mentzer, Dirk; Lehmann, Helmar C; Hartung, Hans-Peter; Keller-Stanislawski, Brigitte

2014-01-01

Purpose A prospective, epidemiologic study was conducted to assess whether the 2009 pandemic influenza A(H1N1) vaccination in Germany almost exclusively using an AS03-adjuvanted vaccine (Pandemrix) impacts the risk of Guillain–Barré syndrome (GBS) and its variant Fisher syndrome (FS). Methods Potential cases of GBS/FS were reported by 351 participating hospitals throughout Germany. The self-controlled case series methodology was applied to all GBS/FS cases fulfilling the Brighton Collaboration (BC) case definition (levels 1–3 of diagnostic certainty) with symptom onset between 1 November 2009 and 30 September 2010 reported until end of December 2010. Results Out of 676 GBS/FS reports, in 30 cases, GBS/FS (BC levels 1–3) occurred within 150 days following influenza A(H1N1) vaccination. The relative incidence of GBS/FS within the primary risk period (days 5–42 post-vaccination) compared with the control period (days 43–150 post-vaccination) was 4.65 (95%CI [2.17, 9.98]). Similar results were found when stratifying for infections within 3 weeks prior to onset of GBS/FS and when excluding cases with additional seasonal influenza vaccination. The overall result of temporally adjusted analyses supported the primary finding of an increased relative incidence of GBS/FS following influenza A(H1N1) vaccination. Conclusions The results indicate an increased risk of GBS/FS in temporal association with pandemic influenza A(H1N1) vaccination in Germany. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd. PMID:24817531

Exchangeability in the case-crossover design

PubMed Central

Mittleman, Murray A; Mostofsky, Elizabeth

2014-01-01

In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

Schizophrenia and Deliberate Self-Harm: A Systematic Review of Risk Factors

ERIC Educational Resources Information Center

Haw, Camilla; Hawton, Keith; Sutton, Lesley; Sinclair, Julia; Deeks, Jonathan

2005-01-01

Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were…

Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series.

PubMed

Rådman, Lisa; Gunnarsson, Lars-Gunnar; Nilsagård, Ylva; Nilsson, Tohr

2016-12-01

Symptoms described in previous studies indicate that electrical injury can cause longstanding injuries to the neurosensory nerves. The aim of the present case series was to objectively assess the profile of neurosensory dysfunction in electricians in relation to high voltage or low voltage electrical injury and the "no-let-go phenomenon". Twenty-three Swedish male electricians exposed to electrical injury were studied by using a battery of clinical instruments, including quantitative sensory testing (QST). The clinical test followed a predetermined order of assessments: thermal perceptions thresholds, vibration perception thresholds, tactile gnosis (the Shape and Texture Identification test), manual dexterity (Purdue Pegboard Test), and grip strength. In addition, pain was studied by means of a questionnaire, and a colour chart was used for estimation of white fingers. The main findings in the present case series were reduced thermal perceptions thresholds, where half of the group showed abnormal values for warm thermal perception and/or cold thermal perception. Also, the tactile gnosis and manual dexterity were reduced. High voltage injury was associated with more reduced sensibility compared to those with low voltage. Neurosensory injury can be objectively assessed after an electrical injury by using QST with thermal perception thresholds. The findings are consistent with injuries to small nerve fibres. In the clinical setting thermal perception threshold is therefore recommended, in addition to tests of tactile gnosis and manual dexterity (Purdue Pegboard). Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

[Changes in the diagnosis and therapeutic management of hepatic trauma. A retrospective study comparing 2 series of cases in different (1997-1984 vs. 2001-2008)].

PubMed

Sánchez-Bueno, Francisco; Fernández-Carrión, Jezabel; Torres Salmerón, Gloria; García Pérez, Rocío; Ramírez Romero, Pablo; Fuster Quiñonero, Matilde; Parrilla, Pascual

2011-01-01

We present a series of 146 cases of hepatic trauma (HT) treated in our hospital over a period of 8 yearsm (2001-2008), and comparing it with a previous series of 92 cases (1977-1984). The mean age in the current series was 28.6 years and the majority were male. The closed traumas were mainly penetrating, with the most frequent cause being road traffic accidents. The American Association for the Surgery of Trauma (AAST) classification was used to evaluate the grade of the hepatic injury. Associated abdominal and /or extra-abdominal injuries were seen in 79.5% of the patients, with the most frequent being chest trauma, compared to bone fractures in the previous series. The most common associated intra-abdominal injury was the spleen in both series. The most used diagnostic technique in the current series was abdominal CT. Simple peritoneal puncture and lavage (PLP) were the most used examinations used in the previous series. Non-surgical treatment (NST) was given in 98 cases and the surgery was indicated in the remaining 48. In the previous series, 97.8% of patients were operated on. In the current series, on the 15 patients with severe liver injuries, 5 right hepatectomies, 2 segmentectomies and 6 packing compressions were performed, with the remaining two dying during surgery due to hepatic avulsion. The overall mortality was 3.4%, being 1% in the NST group and 8.3% in the surgical patients. In the previous series, the overall mortality was 29.3%. The key factor for using NST is to control haemodynamic stability, leaving surgical treatment for haemodynamically unstable patients. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

Long-range dependence in earthquake-moment release and implications for earthquake occurrence probability.

PubMed

Barani, Simone; Mascandola, Claudia; Riccomagno, Eva; Spallarossa, Daniele; Albarello, Dario; Ferretti, Gabriele; Scafidi, Davide; Augliera, Paolo; Massa, Marco

2018-03-28

Since the beginning of the 1980s, when Mandelbrot observed that earthquakes occur on 'fractal' self-similar sets, many studies have investigated the dynamical mechanisms that lead to self-similarities in the earthquake process. Interpreting seismicity as a self-similar process is undoubtedly convenient to bypass the physical complexities related to the actual process. Self-similar processes are indeed invariant under suitable scaling of space and time. In this study, we show that long-range dependence is an inherent feature of the seismic process, and is universal. Examination of series of cumulative seismic moment both in Italy and worldwide through Hurst's rescaled range analysis shows that seismicity is a memory process with a Hurst exponent H ≈ 0.87. We observe that H is substantially space- and time-invariant, except in cases of catalog incompleteness. This has implications for earthquake forecasting. Hence, we have developed a probability model for earthquake occurrence that allows for long-range dependence in the seismic process. Unlike the Poisson model, dependent events are allowed. This model can be easily transferred to other disciplines that deal with self-similar processes.

Diet and the risk of breast cancer in a case-control study: does the threat of disease have an influence on recall bias?

PubMed

Männistö, S; Pietinen, P; Virtanen, M; Kataja, V; Uusitupa, M

1999-05-01

It has been suggested that recall bias may explain the discrepant results between case-control and cohort studies on diet and the risk of breast cancer. Two control groups were used for this case-control study of 25 to 75-year-old breast cancer cases (n = 310). The first group consisted of population controls drawn from the Finnish National Population Register (n = 454). The second group consisted of women who were referred to the same examinations as were the cases because of clinical suspicion of breast disease but who were later diagnosed as healthy (referral controls; n = 506). Because the diagnosis was unknown at the time of interview, it was possible to assess by comparing the two control groups whether the self-reporting of diet changed under the threat of disease. Dietary habits were examined using a validated, self-administered food-frequency questionnaire. Premenopausal women misreported their consumption of liquid milk products, tea, and sugar. Reporting bias was also associated with the intake of fat and vitamins. Postmenopausal women misreported consumption of milk products. When recall bias was taken into consideration, milk was associated with increased risk of premenopausal breast cancer, whereas high consumption of poultry or high intake of monounsaturated fatty acids, n-3 fatty acids, n-6 fatty acids, and vitamin E were related to lower risk. The study suggested that oil, milk, cheese, coffee and beta-carotene may act as protective factors in postmenopausal women, whereas butter and cream may be risk factors for breast cancer. In summary, it is possible that some food items may be overreported or underreported under the threat of disease in health-conscious population. However, most of the results in this study were not modified by recall bias.

Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation.

PubMed

Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J

2016-12-01

Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.

The effect of gun control laws on hospital admissions for children in the United States.

PubMed

Tashiro, Jun; Lane, Rebecca S; Blass, Lawrence W; Perez, Eduardo A; Sola, Juan E

2016-10-01

Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearms-related injury admissions. Kids' Inpatient Database (1997-2012) was searched for accidental (E922), self-inflicted (E955), assault (E965), legal intervention-related (E970), or undetermined circumstance (E985) firearm injuries. Patients were younger than 20 years and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score-matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws. Overall, 38,424 cases were identified, with an overall mortality of 7%. Firearm injuries were most commonly assault (64%), followed by accidental (25%), undetermined circumstance (7%), or self-inflicted (3%). A small minority involved military-grade weapons (0.2%). Most cases occurred in lenient gun control states (48%), followed by strict (47%) and neutral (6%).On 1:1 propensity score-matched analysis, in-hospital mortality by case was higher in lenient (7.5%) versus strict (6.5%) states, p = 0.013. Lenient states had a proportionally higher rate of accidental (31%) and self-inflicted injury (4%) versus strict states (17% and 1.6%, respectively), p < 0.001. Assault-related injuries were proportionally lower in lenient (54%) versus strict (75%) states, p < 0.001. Military-grade weapons were more common in lenient (0.4%) versus strict (0.1%) states, p = 0.001. These findings highlight the importance of legislative measures and their role in injury prevention, as firearm injuries are entirely avoidable mechanisms of injury. Lenient gun control contributes not only to worse outcomes per case, but also to a more significant and detrimental impact on public health. Epidemiologic study, level III.

Detecting At-Risk Alzheimer's Disease Cases.

PubMed

Fladby, Tormod; Pålhaugen, Lene; Selnes, Per; Waterloo, Knut; Bråthen, Geir; Hessen, Erik; Almdahl, Ina Selseth; Arntzen, Kjell-Arne; Auning, Eirik; Eliassen, Carl Fredrik; Espenes, Ragna; Grambaite, Ramune; Grøntvedt, Gøril Rolfseng; Johansen, Krisztina Kunszt; Johnsen, Stein Harald; Kalheim, Lisa Flem; Kirsebom, Bjørn-Eivind; Müller, Kai Ivar; Nakling, Arne Exner; Rongve, Arvid; Sando, Sigrid Botne; Siafarikas, Nikias; Stav, Ane Løvli; Tecelao, Sandra; Timon, Santiago; Bekkelund, Svein Ivar; Aarsland, Dag

2017-01-01

While APOEɛ4 is the major genetic risk factor for Alzheimer's disease (AD), amyloid dysmetabolism is an initial or early event predicting clinical disease and is an important focus for secondary intervention trials. To improve identification of cases with increased AD risk, we evaluated recruitment procedures using pathological CSF concentrations of Aβ42 (pAβ) and APOEɛ4 as risk markers in a multi-center study in Norway. In total, 490 subjects aged 40-80 y were included after response to advertisements and media coverage or memory clinics referrals. Controls (n = 164) were classified as normal controls without first-degree relatives with dementia (NC), normal controls with first-degree relatives with dementia (NCFD), or controls scoring below norms on cognitive screening. Patients (n = 301) were classified as subjective cognitive decline or mild cognitive impairment. Subjects underwent a clinical and cognitive examination and MRI according to standardized protocols. Core biomarkers in CSF from 411 and APOE genotype from 445 subjects were obtained. Cases (both self-referrals (n = 180) and memory clinics referrals (n = 87)) had increased fractions of pAβ and APOEɛ4 frequency compared to NC. Also, NCFD had higher APOEɛ4 frequencies without increased fraction of pAβ compared to NC, and cases recruited from memory clinics had higher fractions of pAβ and APOEɛ4 frequency than self-referred. This study shows that memory clinic referrals are pAβ enriched, whereas self-referred and NCFD cases more frequently are pAβ negative but at risk (APOEɛ4 positive), suitable for primary intervention.

Development of temporal modelling for forecasting and prediction of malaria infections using time-series and ARIMAX analyses: A case study in endemic districts of Bhutan

PubMed Central

2010-01-01

Background Malaria still remains a public health problem in some districts of Bhutan despite marked reduction of cases in last few years. To strengthen the country's prevention and control measures, this study was carried out to develop forecasting and prediction models of malaria incidence in the endemic districts of Bhutan using time series and ARIMAX. Methods This study was carried out retrospectively using the monthly reported malaria cases from the health centres to Vector-borne Disease Control Programme (VDCP) and the meteorological data from Meteorological Unit, Department of Energy, Ministry of Economic Affairs. Time series analysis was performed on monthly malaria cases, from 1994 to 2008, in seven malaria endemic districts. The time series models derived from a multiplicative seasonal autoregressive integrated moving average (ARIMA) was deployed to identify the best model using data from 1994 to 2006. The best-fit model was selected for each individual district and for the overall endemic area was developed and the monthly cases from January to December 2009 and 2010 were forecasted. In developing the prediction model, the monthly reported malaria cases and the meteorological factors from 1996 to 2008 of the seven districts were analysed. The method of ARIMAX modelling was employed to determine predictors of malaria of the subsequent month. Results It was found that the ARIMA (p, d, q) (P, D, Q)s model (p and P representing the auto regressive and seasonal autoregressive; d and D representing the non-seasonal differences and seasonal differencing; and q and Q the moving average parameters and seasonal moving average parameters, respectively and s representing the length of the seasonal period) for the overall endemic districts was (2,1,1)(0,1,1)12; the modelling data from each district revealed two most common ARIMA models including (2,1,1)(0,1,1)12 and (1,1,1)(0,1,1)12. The forecasted monthly malaria cases from January to December 2009 and 2010 varied from 15 to 82 cases in 2009 and 67 to 149 cases in 2010, where population in 2009 was 285,375 and the expected population of 2010 to be 289,085. The ARIMAX model of monthly cases and climatic factors showed considerable variations among the different districts. In general, the mean maximum temperature lagged at one month was a strong positive predictor of an increased malaria cases for four districts. The monthly number of cases of the previous month was also a significant predictor in one district, whereas no variable could predict malaria cases for two districts. Conclusions The ARIMA models of time-series analysis were useful in forecasting the number of cases in the endemic areas of Bhutan. There was no consistency in the predictors of malaria cases when using ARIMAX model with selected lag times and climatic predictors. The ARIMA forecasting models could be employed for planning and managing malaria prevention and control programme in Bhutan. PMID:20813066

Research subject privacy protection in otolaryngology.

PubMed

Noone, Michael C; Walters, K Christian; Gillespie, M Boyd

2004-03-01

Health Insurance Portability and Accountability Act regulations, which took effect on April 14, 2003, placed new constraints on the use of protected health information for research purposes. To review practices of research subject privacy protection in otolaryngology in order to determine steps necessary to achieve compliance with Health Insurance Portability and Accountability Act regulations. Literature review. Articles appearing in 2001 in 3 widely circulated otolaryngology journals were classified according to study design. The "Methods" section of each article was reviewed to determine whether the informed consent and institutional review board processes were clearly documented. Descriptive studies involving case reports and case series were more common than observational studies that include a control group (66% vs 11%). Few case series documented the consent process (18%) and institutional review board process (19%). Observational designs demonstrated better documentation of the consent process (P<.001) and the institutional review board exemption and approval process (P<.001). Methods used to protect subject privacy are not commonly documented in case series in otolaryngology. More attention needs to be given to research subject privacy concerns in the otolaryngology literature in order to comply with Health Insurance Portability and Accountability Act regulations.

Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases

PubMed Central

Mahesh, Seema; Mallappa, Mahesh; Tsintzas, Dionysios; Vithoulkas, George

2017-01-01

Case series Patient: — Final Diagnosis: — Symptoms: Skin lesions Medication: — Clinical Procedure: — Specialty: Dermatology Objective: Unusual or unexpected effect of treatment Background: Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress. Case Reports: A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment. Conclusions: In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area. PMID:29196612

A general regression framework for a secondary outcome in case-control studies.

PubMed

Tchetgen Tchetgen, Eric J

2014-01-01

Modern case-control studies typically involve the collection of data on a large number of outcomes, often at considerable logistical and monetary expense. These data are of potentially great value to subsequent researchers, who, although not necessarily concerned with the disease that defined the case series in the original study, may want to use the available information for a regression analysis involving a secondary outcome. Because cases and controls are selected with unequal probability, regression analysis involving a secondary outcome generally must acknowledge the sampling design. In this paper, the author presents a new framework for the analysis of secondary outcomes in case-control studies. The approach is based on a careful re-parameterization of the conditional model for the secondary outcome given the case-control outcome and regression covariates, in terms of (a) the population regression of interest of the secondary outcome given covariates and (b) the population regression of the case-control outcome on covariates. The error distribution for the secondary outcome given covariates and case-control status is otherwise unrestricted. For a continuous outcome, the approach sometimes reduces to extending model (a) by including a residual of (b) as a covariate. However, the framework is general in the sense that models (a) and (b) can take any functional form, and the methodology allows for an identity, log or logit link function for model (a).

Case Series in Cognitive Neuropsychology: Promise, Perils and Proper Perspective

PubMed Central

Rapp, Brenda

2012-01-01

Schwartz & Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on “Case Series in Cognitive Neuropsychology” there are six commentaries on Schwartz and Dell (2010) as well as a response to the six commentaries by Dell and Schwartz. In this paper, I provide a brief summary of the key points made in Schwartz and Dell (2010) and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single case approaches, raising some cautionary notes for case series studies and situating both case series and single case approaches within the larger context of theory development in the cognitive sciences. PMID:22746685

Self-Assembly and Responsiveness of Polypeptide-Based Star and Triblock Copolymers

NASA Astrophysics Data System (ADS)

Savin, Daniel

This study involves the bottom-up design and tunability of responsive, peptide-based block polymers. The self-assembly of amphiphilic block polymers is dictated primarily by the balance between the hydrophobic core volume and the hydrophilic corona. In these studies, amphiphilic triblock and star copolymers containing poly(lysine) (PK), poly(leucine) (PL) and poly(glutamic acid) (PE) were synthesized and their solution properties studied using dynamic light scattering, circular dichroism spectroscopy and transmission electron microscopy. The peptide block in these structures can serve to introduce pH responsiveness (in the case of PK and PE), or can facilitate the formation of elongated or kinetically-trapped structures (in the case of PL.) This talk will present some recent studies in solution morphology transitions that occur in these materials under varying solution conditions. As the topological complexity of the polymers increases from diblock to linear triblock or star polymers, the solution morphology and response becomes much more complex. We present a systematic series of structures, with increasing complexity, that have applications as passive and active delivery vehicles, hydrogels, and responsive viscosity modifiers. NSF CHE-1539347.

Genome-wide association study in discordant sibships identifies multiple inherited susceptibility alleles linked to lung cancer.

PubMed

Galvan, Antonella; Falvella, Felicia S; Frullanti, Elisa; Spinola, Monica; Incarbone, Matteo; Nosotti, Mario; Santambrogio, Luigi; Conti, Barbara; Pastorino, Ugo; Gonzalez-Neira, Anna; Dragani, Tommaso A

2010-03-01

We analyzed a series of young (median age = 52 years) non-smoker lung cancer patients and their unaffected siblings as controls, using a genome-wide 620 901 single-nucleotide polymorphism (SNP) array analysis and a case-control DNA pooling approach. We identified 82 putatively associated SNPs that were retested by individual genotyping followed by use of the sib transmission disequilibrium test, pointing to 36 SNPs associated with lung cancer risk in the discordant sibs series. Analysis of these 36 SNPs in a polygenic model characterized by additive and interchangeable effects of rare alleles revealed a highly statistically significant dosage-dependent association between risk allele carrier status and proportion of cancer cases. Replication of the same 36 SNPs in a population-based series confirmed the association with lung cancer for three SNPs, suggesting that phenocopies and genetic heterogeneity can play a major role in the complex genetics of lung cancer risk in the general population.

Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data.

PubMed

Huang, Hsin-Chia Carol; Hillman, David R; McArdle, Nigel

2012-09-01

To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Tertiary sleep clinic. There were 190 consecutive patients with OSA referred for APAP titration. There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI < 10, or at least 50% reduction in AHI if diagnostic AHI < 15/hr) during APAP titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square < 0.001). In a clinical sample control of OSA during APAP titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices.

Psychological disorders and oral lichen planus: matched case-control study and literature review.

PubMed

Pippi, R; Romeo, U; Santoro, M; Del Vecchio, A; Scully, C; Petti, S

2016-04-01

Oral lichen planus (OLP) may be linked to psychological disorders. This study investigated psychological factors associated with OLP. A case-control study with incident OLP case patients and age-gender-socio-economic status-matched controls, recruited from among relatives, accompanying persons, and departmental staff, investigated psychological traits using the Psychological General Well-Being Index-Short form. Common factor analysis was used to generate a set of psychological dimensions. The association between these dimensions and OLP adjusted for confounders (education, number of lifetime sexual partners, drinking-smoking) and interactions was assessed through conditional logistic regression and odds ratios (OR) were estimated. A total of 67 case-control pairs were recruited. Psychological dimensions generated were: dimension-1 (anxiety, low vitality), dimension-2 (negative well-being, low vitality), dimension-3 (depressed mood, low self-control). The ORs for OLP were, dimension-1, 1.0 (95% confidence interval -95CI, 0.3-2.6); dimension-2, 0.5 (95CI, 0.2-1.2); dimension-3, 4.8 (95CI, 1.8-12.9). Dimension-3 was highly associated with mild, but not associated with severe, OLP. Literature searching provided 21 studies, with anxiety and depression principally associated with OLP. Depressed mood and low self-control were highly associated with OLP, particularly the reticular-papular forms. These traits could have a causative role in OLP development-progression, but further investigations are necessary. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The validity of tooth grinding measures: etiology of pain dysfunction syndrome revisited.

PubMed

Marbach, J J; Raphael, K G; Dohrenwend, B P; Lennon, M C

1990-03-01

The current study explores the proposition that a treating clinician's etiologic model influences patients' reports of tooth grinding, the validity of, and subsequent research findings relying on these measures. The investigation compares self-reports of tooth grinding and related clinical variables for 151 cases of temporomandibular pain and dysfunction syndrome (TMPDS) treated by a clinician who does not explicitly support the grinding theory of the etiology of TMPDS, and 139 healthy controls. Cases were no more likely than well controls to report ever-grinding, but were actually significantly less likely than well controls to report current grinding. They were also significantly more likely to report that a dentist had told them they ground. Findings suggest that studies using self-report, clinician-report of tooth grinding (or both) are methodologically inadequate for addressing the relationship between tooth grinding and TMPDS.

Laryngospasm during emergency department ketamine sedation: a case-control study.

PubMed

Green, Steven M; Roback, Mark G; Krauss, Baruch

2010-11-01

The objective of this study was to assess predictors of emergency department (ED) ketamine-associated laryngospasm using case-control techniques. We performed a matched case-control analysis of a sample of 8282 ED ketamine sedations (including 22 occurrences of laryngospasm) assembled from 32 prior published series. We sequentially studied the association of each of 7 clinical variables with laryngospasm by assigning 4 controls to each case while matching for the remaining 6 variables. We then used univariate statistics and conditional logistic regression to analyze the matched sets. We found no statistical association of age, dose, oropharyngeal procedure, underlying physical illness, route, or coadministered anticholinergics with laryngospasm. Coadministered benzodiazepines showed a borderline association in the multivariate but not univariate analysis that was considered anomalous. This case-control analysis of the largest available sample of ED ketamine-associated laryngospasm did not demonstrate evidence of association with age, dose, or other clinical factors. Such laryngospasm seems to be idiosyncratic, and accordingly, clinicians administering ketamine must be prepared for its rapid identification and management. Given no evidence that they decrease the risk of laryngospasm, coadministered anticholinergics seem unnecessary.

An updated review of case-control studies of lung cancer and indoor radon-Is indoor radon the risk factor for lung cancer?

PubMed

Sheen, Seungsoo; Lee, Keu Sung; Chung, Wou Young; Nam, Saeil; Kang, Dae Ryong

2016-01-01

Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon ((222)Rn) is a natural gas produced from radium ((226)Ra) in the decay series of uranium ((238)U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers. Case-control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case-control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose-response relationship between indoor radon and lung cancer risk. Further refined case-control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case-control studies.

Self-reported smoking habits and serum cotinine levels in women with placental abruption.

PubMed

Tikkanen, Minna; Surcel, Heljä-Marja; Bloigu, Aini; Nuutila, Mika; Ylikorkala, Olavi; Hiilesmaa, Vilho; Paavonen, Jorma

2010-12-01

smoking is an important risk factor for placental abruption with strong dose-dependency. Pregnant smokers often underreport tobacco use which can be objectively assessed by measuring serum cotinine levels. We examined the accuracy between self-reported smoking habits and early pregnancy serum cotinine levels in women with or without placental abruption. retrospective case-control study. university Hospital. a total of 175 women with placental abruption and 370 control women. serum samples collected during the first trimester were analyzed for serum cotinine levels. Cotinine concentration over 15 ng/ml was considered as the cutoff indicating active smoking. Smoking habits of the women and their partners were recorded at the same visit. placental abruption. of the cases of women with placental abruption, 27.4% reported smoking compared with 14.3% of the controls (p < 0.001). Based on serum cotinine levels, 30.3% of the case women and 17.6% of the control women were considered smokers (p = 0.003). Serum cotinine levels among smokers were higher in the abruption group than in the control group (median 229.5 ng/ml (interquartile range 169.8-418.1) vs. 153.5 ng/ml (56.6-241.4), p = 0.002). Self-reported number of cigarettes smoked daily correlated well with the cotinine levels (r = 0.68, p < 0.001). Of the women reporting as nonsmokers, approximately 7% were considered smokers based on cotinine testing. pregnant women with subsequent placental abruption are heavier smokers than pregnant control women. Self-reported smoking habits correlate well with serum cotinine levels in Finland. Therefore, self-reported smoking can be considered as a risk marker for placental abruption.

Educating neonatal nurses in Brazil: a before-and-after study with interrupted time series analysis.

PubMed

Gilbert, Clare; Darlow, Brian; Zin, Andrea; Sivasubramaniam, Selvaraj; Shah, Shaheen; Gianini, Nicole; Beecroft, Gina; Lopes Moreira, Maria Elisabeth

2014-01-01

Preterm birth contributes significantly to infant mortality and morbidity, including blindness from retinopathy of prematurity (ROP). Access to intensive neonatal care is expanding in many countries, but care is not always optimal, one factor being that nursing is often by inadequately trained nurse assistants. The aim of this study was to evaluate whether an educational package for nurses improves a range of outcomes including survival rates and severe ROP in 5 neonatal units in Rio de Janeiro, Brazil. The study design included an uncontrolled before-and-after study in 5 units, with interrupted time series analysis. Participatory approaches were used to develop a self-administered educational package for control of pain, oxygenation, infection, nutrition, and temperature and to improve supportive care ('POINTS of Care'). Educational materials and DVD clips were developed and training skills of nurse tutors were enhanced. There were two 1-year periods of data collection before and after a 3-month period of self-administration of the education package. Overall, 74% of 401 nurses and nurse assistants were trained. A total of 679 and 563 infants were included in the pre- and post-training periods, respectively. Despite improvement in knowledge and nursing practices, such as the delivery and monitoring of oxygen, there was no change in survival (pre-training 80%, post-training 78.2%), severe ROP (1.6 vs. 2.8%), sepsis (11.3 vs. 12.3 cases per 1,000 infant days) or other outcomes. Outcomes worsened over the pre-intervention period but the change to an improvement after the intervention was not statistically significant. During the study period many trained staff left the units, but few were replaced. Future studies need to focus on barriers to implementation, team building, leadership and governance, as well as the acquisition of knowledge and skills. © 2014 S. Karger AG, Basel.

Empirical performance of the calibrated self-controlled cohort analysis within temporal pattern discovery: lessons for developing a risk identification and analysis system.

PubMed

Norén, G Niklas; Bergvall, Tomas; Ryan, Patrick B; Juhlin, Kristina; Schuemie, Martijn J; Madigan, David

2013-10-01

Observational healthcare data offer the potential to identify adverse drug reactions that may be missed by spontaneous reporting. The self-controlled cohort analysis within the Temporal Pattern Discovery framework compares the observed-to-expected ratio of medical outcomes during post-exposure surveillance periods with those during a set of distinct pre-exposure control periods in the same patients. It utilizes an external control group to account for systematic differences between the different time periods, thus combining within- and between-patient confounder adjustment in a single measure. To evaluate the performance of the calibrated self-controlled cohort analysis within Temporal Pattern Discovery as a tool for risk identification in observational healthcare data. Different implementations of the calibrated self-controlled cohort analysis were applied to 399 drug-outcome pairs (165 positive and 234 negative test cases across 4 health outcomes of interest) in 5 real observational databases (four with administrative claims and one with electronic health records). Performance was evaluated on real data through sensitivity/specificity, the area under receiver operator characteristics curve (AUC), and bias. The calibrated self-controlled cohort analysis achieved good predictive accuracy across the outcomes and databases under study. The optimal design based on this reference set uses a 360 days surveillance period and a single control period 180 days prior to new prescriptions. It achieved an average AUC of 0.75 and AUC >0.70 in all but one scenario. A design with three separate control periods performed better for the electronic health records database and for acute renal failure across all data sets. The estimates for negative test cases were generally unbiased, but a minor negative bias of up to 0.2 on the RR-scale was observed with the configurations using multiple control periods, for acute liver injury and upper gastrointestinal bleeding. The calibrated self-controlled cohort analysis within Temporal Pattern Discovery shows promise as a tool for risk identification; it performs well at discriminating positive from negative test cases. The optimal parameter configuration may vary with the data set and medical outcome of interest.

Improvement of nonsuicidal self-injury following treatment with antipsychotics possessing strong D1 antagonistic activity: evidence from a report of three cases.

PubMed

Wollweber, Bastian; Keck, Martin E; Schmidt, Ulrike

2015-08-01

There is no drug treatment for nonsuicidal self-injury (NSSI), a highly prevalent and burdensome symptom of several psychiatric diseases like posttraumatic stress disorder (PTSD), personality disorders, and major depression (MD). Here, we present a retrospective series of three patients demonstrating a persistent remission in MD-associated NSSI in response to treatment with antipsychotics possessing marked D1 receptor antagonistic activity. To the best of the authors' knowledge, the case series presented is only the second clinical paper suggesting a role for D1 antagonists in NSSI drug therapy. Together with previously published data from rodent models, the findings suggest a role for D1 antagonists in NSSI drug therapy and hence for the D1 receptor in NSSI pathogenesis. This conclusion is limited by the facts that the patients presented here received polypharmacy and that the D1 receptor antagonistic antipsychotics suggested here as effective 'anti-auto-aggressants' do not address D1 receptors only but multiple neurotransmitter receptors/systems.

Algebra: Level II, Unit 8, Lesson 1; Powers and Roots: Lesson 2; Geometry: Lesson 3; Number Series: Lesson 4. Advanced General Education Program. A High School Self-Study Program.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Job Corps.

This self-study program for high-school level contains lessons on: Algebra, Powers and Roots, Geometry, and Number Series. Each of the lessons concludes with a Mastery Test to be completed by the student. (DB)

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

PubMed

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

Testing the feasibility of a knowledge translation intervention designed to improve chiropractic care for adults with neck pain disorders: study protocol for a pilot cluster-randomized controlled trial.

PubMed

Dhopte, Prakash; Ahmed, Sara; Mayo, Nancy; French, Simon; Quon, Jeffrey A; Bussières, André

2016-01-01

Neck pain in adults is common and a leading cause of physical disability. Recently, a guideline was developed for the management of non-specific neck pain (NSNP) with an aim to improve the quality of the delivery of chiropractic care. One key guideline recommendation is to undertake multimodal care for patients with NSNP. The aim of this pilot study is to determine the feasibility of implementing a multifaceted knowledge translation intervention by promoting the use of multimodal care by chiropractors managing patients with NSNP. The design is a cluster-randomized controlled pilot and feasibility trial. Chiropractors in private practice in Canada will be approached to participate in the study. Thirty consenting chiropractors will be randomized to receive either a theory-based educational intervention in the experimental group or simply a printed copy of the guideline in the control group. Each chiropractor will recruit five neck pain patients (a total of 150 patients) into the study. Development of the multifaceted intervention was informed by the results of a related qualitative study based on the Theoretical Domains Framework and consists of a series of three webinars, two online case scenarios, a self-management video on Brief Action Planning, and a printed copy of the practice guideline. Primary feasibility outcomes for both chiropractors and patients include rates of (1) recruitment, (2) retention, and (3) adherence to the intervention. A checklist of proxy measures embedded within patient encounter forms will be used to assess chiropractors' compliance with guideline recommendations (e.g. exercise and self-care prescriptions) at study onset and at 3 months. Secondary outcomes include scores of behavioural constructs (level of knowledge and self-efficacy) for recommended multimodal care. Clinical outcomes include pain intensity and neck pain-specific disability. Analyses from this study will focus on generating point estimates and corresponding 95 % confidence intervals for parameters of a priori interest (recruitment, retention, adherence, pain intensity, Neck Disability Index). Results of this study will inform the design of a larger cluster-randomized controlled trial aimed at evaluating the effectiveness of the theory-based tailored intervention and increasing the use of multimodal care by chiropractors managing patients with NSNP. https://clinicaltrials.gov/, NCT02483091.

Effects of a blended learning module on self-reported learning performances in baccalaureate nursing students.

PubMed

Hsu, Li-Ling; Hsieh, Suh-Ing

2011-11-01

This article is a report of a quasi-experimental study of the effects of blended modules on nursing students' learning of ethics course content. There is yet to be an empirically supported mix of strategies on which a working blended learning model can be built for nursing education. This was a two-group pretest and post-test quasi-experimental study in 2008 involving a total of 233 students. Two of the five clusters were designated the experimental group to experience a blended learning model, and the rest were designated the control group to be given classroom lectures only. The Case Analysis Attitude Scale, Case Analysis Self-Evaluation Scale, Blended Learning Satisfaction Scale, and Metacognition Scale were used in pretests and post-tests for the students to rate their own performance. In this study, the experimental group did not register significantly higher mean scores on the Case Analysis Attitude Scale at post-test and higher mean ranks on the Case Analysis Self-Evaluation Scale, the Blended Learning Satisfaction Scale, and the Metacognition Scale at post-test than the control group. Moreover, the experimental group registered significant progress in the mean ranks on the Case Analysis Self-Evaluation Scale and the Metacognition Scale from pretest to post-test. No between-subjects effects of four scales at post-test were found. Newly developed course modules, be it blended learning or a combination of traditional and innovative components, should be tested repeatedly for effectiveness and popularity for the purpose of facilitating the ultimate creation of a most effective course module for nursing education. © 2011 Blackwell Publishing Ltd.

Investigating the Role of Mitochondrial Haplogroups in Genetic Predisposition to Meningococcal Disease

PubMed Central

Salas, Antonio; Fachal, Laura; Marcos-Alonso, Sonia; Vega, Ana; Martinón-Torres, Federico

2009-01-01

Background and Aims Meningococcal disease remains one of the most important infectious causes of death in industrialized countries. The highly diverse clinical presentation and prognosis of Neisseria meningitidis infections are the result of complex host genetics and environmental interactions. We investigated whether mitochondrial genetic background contributes to meningococcal disease (MD) susceptibility. Methodology/Principal Findings Prospective controlled study was performed through a national research network on MD that includes 41 Spanish hospitals. Cases were 307 paediatric patients with confirmed MD, representing the largest series of MD patients analysed to date. Two independent sets of ethnicity-matched control samples (CG1 [N = 917]), and CG2 [N = 616]) were used for comparison. Cases and controls underwent mtDNA haplotyping of a selected set of 25 mtDNA SNPs (mtSNPs), some of them defining major European branches of the mtDNA phylogeny. In addition, 34 ancestry informative markers (AIMs) were genotyped in cases and CG2 in order to monitor potential hidden population stratification. Samples of known African, Native American and European ancestry (N = 711) were used as classification sets for the determination of ancestral membership of our MD patients. A total of 39 individuals were eliminated from the main statistical analyses (including fourteen gypsies) on the basis of either non-Spanish self-reported ancestry or the results of AIMs indicating a European membership lower than 95%. Association analysis of the remaining 268 cases against CG1 suggested an overrepresentation of the synonym mtSNP G11719A variant (Pearson's chi-square test; adjusted P-value = 0.0188; OR [95% CI] = 1.63 [1.22–2.18]). When cases were compared with CG2, the positive association could not be replicated. No positive association has been observed between haplogroup (hg) status of cases and CG1/CG2 and hg status of cases and several clinical variants. Conclusions We did not find evidence of association between mtSNPs and mtDNA hgs with MD after carefully monitoring the confounding effect of population sub-structure. MtDNA variability is particularly stratified in human populations owing to its low effective population size in comparison with autosomal markers and therefore, special care should be taken in the interpretation of seeming signals of positive associations in mtDNA case-control association studies. PMID:20019817

A numerical investigation of the impact of surface topology on laminar boundary layers

NASA Astrophysics Data System (ADS)

Beratlis, Nikolaos; Squires, Kyle; Balaras, Elias

2015-11-01

Surface topology, such as dimples or trip wires, has been utilized in the past for passive separation control over bluff bodies. The majority of the work, however, has focused on the indirect effects on the drag and lift forces, while the details of the impact on the boundary layer evolution are not well understood. Here we report a series of DNS of flow over a single row of spherical and hexagonal dimples, as well as, circular grooves. The Reynolds number and the thickness of the incoming laminar boundary layer is carefully controlled. In all cases transition to turbulence downstream of the elements comes with reorientation of the spanwise vorticity into hairpin like vortices. Although qualitatively the transition mechanism amongst different dimples and grooves is similar, important quantitative differences exist: two-dimensional geometries such as the groove, are more stable than three-dimensional geometries. In addition, it was found that the cavity geometry controls the initial thickness of the boundary layer and practically results in a shift of the virtual origin of the turbulent boundary layer. Important differences in the momentum transport downstream of the dimples exist, but in all cases the boundary layer evolves in a self-similar manner.

Dependency and self-criticism in post-partum depression and anxiety: a case control study.

PubMed

Vliegen, Nicole; Luyten, Patrick

2009-01-01

This study investigates the role of self-criticism and dependency in inpatient post-partum depressed women (n = 55) and non-depressed controls (n = 37) as well as the relationship between both personality dimensions and severity of depression and anxiety. As expected, mothers with post-partum depression showed not only increased levels of depression but also anxiety compared with non-depressed mothers. Furthermore, they had significantly higher levels of self-criticism, but not of dependency. In the post-partum depressed mothers, both personality dimensions were positively associated with severity of depression. However, in non-depressed mothers, self-criticism was positively associated with depression, while there was an inverse relationship between dependency and severity of depression. In both samples, self-criticism, but not dependency, was related to state anxiety. The cross-sectional nature of this study limits the ability to draw causal conclusions. The study was based on self-report and conducted in relatively small samples.

The Effect of Group Play Therapy on Social-Emotional Skills in Pre-School Children

PubMed Central

Chinekesh, Ahdieh; Kamalian, Mehrnoush; Eltemasi, Masoumeh; Chinekesh, Shirin; Alavi, Manijeh

2014-01-01

Background: Childhood is important and critical period in human life. The foundation of ego is shaped in childhood. Play therapy is one of the successful strategies to help children with inner conflicts problems. This method of psychotherapy is base on the normal learning processes of children, provides solutions to relieve feelings of stress, and expands self-expression. Group play therapy can enhance the self-awareness, self- regulation, social communication, empathy and adoptability in children. Methods: Present study investigated the effects of play therapy on relational and emotional skills of pre-school children. For this purpose, the total numbers of 372 pre-school children were randomly selected, and divided into two equal groups (case and control). In next step, the BUSSE-SR methodology was used for evaluation and comparison of self-awareness, self-regulation, social interaction, empathy, adoptability, and control groups. Pre-test were performed for both groups and case group was involved in-group play therapy. According to the results of post-test, correlation of variables between case-control groups was examined by multivariate analysis of covariance. Results: Frequency of boys and girls in our sample were 51.3 and 48.7 percent, respectively. The mean age of children was 5.1±0.6 year. According to the results of present study, play therapy significantly enhanced the social-emotional skills (P< 0.001). Our findings are consistent with the results of previous studies in other nations with different environmental and cultural properties. In conclusion, it seems that play therapy can be used in pre-school centers to help children learn problem-solving skills and communicate with others. PMID:24576376

Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series.

PubMed

Martínez-Lavín, Manuel; Amezcua-Guerra, Luis

2017-10-01

This article critically reviews HPV vaccine serious adverse events described in pre-licensure randomized trials and in post-marketing case series. HPV vaccine randomized trials were identified in PubMed. Safety data were extracted. Post-marketing case series describing HPV immunization adverse events were reviewed. Most HPV vaccine randomized trials did not use inert placebo in the control group. Two of the largest randomized trials found significantly more severe adverse events in the tested HPV vaccine arm of the study. Compared to 2871 women receiving aluminum placebo, the group of 2881 women injected with the bivalent HPV vaccine had more deaths on follow-up (14 vs. 3, p = 0.012). Compared to 7078 girls injected with the 4-valent HPV vaccine, 7071 girls receiving the 9-valent dose had more serious systemic adverse events (3.3 vs. 2.6%, p = 0.01). For the 9-valent dose, our calculated number needed to seriously harm is 140 (95% CI, 79–653) [DOSAGE ERROR CORRECTED] . The number needed to vaccinate is 1757 (95% CI, 131 to infinity). Practically, none of the serious adverse events occurring in any arm of both studies were judged to be vaccine-related. Pre-clinical trials, post-marketing case series, and the global drug adverse reaction database (VigiBase) describe similar post-HPV immunization symptom clusters. Two of the largest randomized HPV vaccine trials unveiled more severe adverse events in the tested HPV vaccine arm of the study. Nine-valent HPV vaccine has a worrisome number needed to vaccinate/number needed to harm quotient. Pre-clinical trials and post-marketing case series describe similar post-HPV immunization symptoms.

Creating a New Future in West River. A Series of Case Studies by Teachers, Principals, Superintendents and an Outside Observer of the South Dakota Rural Schools and Community Development Projects.

ERIC Educational Resources Information Center

Cole, R.; And Others

Many rural communities share these complaints: (1) an exodus of the best and brightest young people; (2) a changing and ambivalent self-concept about the identity and the future of the community; and (3) a scarcity of good jobs to act as the mortar that bonds the other elements together. The South Dakota Rural Schools and Community Development…

[Spurious pity--lethal consequences: how helpers turn into offenders].

PubMed

Beine, Karl H

2014-07-01

This study gives a general view of 40 cases of killing series by members of staff in health care professions in hospitals and homes. The main issue of the analyses are the nine killing series in the German language area. For the investigation legal documents concerning specific characteristics of victims, site of crime and offenders were evaluated. The respective fields of work were investigated concerning the working climate, the position of the offenders in their working group, conflicts in the work place and the handling of the first intern hints to suspective behaviour. It is derives from the case-by-case analyses if there are any preliminary warnings and if there are any commonalities with regard to the victims, the offenders and the respective fields of activity. Personal sensitivities, working conditions and permanent confrontation with human sufferings can be interlaced with each other in that way that the superficial motivation to help is abysmally reversed. In this repect a term of compassion, which confounds real sympathy and self-pity, is essential. © Georg Thieme Verlag KG Stuttgart · New York.

Dermatoglyphics in kidney diseases: a review.

PubMed

Wijerathne, Buddhika T B; Meier, Robert J; Salgado, Sujatha S; Agampodi, Suneth B

2016-01-01

Kidney diseases are becoming a major cause of global burden with high mortality and morbidity. The origins of most kidney diseases are known, but for some the exact aetiology is not yet understood. Dermatoglyphics is the scientific study of epidermal ridge patterns and it has been used as a non-invasive diagnostic tool to detect or predict different medical conditions that have foetal origin. However, there have been a limited number of studies that have evaluated a dermatoglyphic relationship in different kidney diseases. The aim of this review was to systematically identify, review and appraise available literature that evaluated an association of different dermatoglyphic variables with kidney diseases. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The PubMed(®) (Medline), POPLINE, Cochrane Library and Trip Database and grey literature sources such as OpenGrey, Google Scholar, and Google were searched to earliest date to 17 April 2014. Of the 36 relevant publications, 15 were included in the review. Of these studies, there are five case reports, seven case series and three comparative studies. Possible association of dermatoglyphics with Wilms tumor (WT) had been evaluated in two comparative studies and one case series that found fewer whorls and a lower mean total ridge count (TRC). Another study evaluated adult polycystic kidney disease (APCD) type III that revealed lower TRC means in all cases. All other case series and case reports describe dermatoglyphics in various kidney disease such as acro-renal-ocular syndrome, potter syndrome, kabuki makeup syndrome, neurofaciodigitorenal syndrome, syndactyly type V, ring chromosome 13 syndrome, trisomy 13 syndrome and sirenomelia. It is evident that whorl pattern frequency and TRC have been used widely to investigate the uncertainty related to the origin of several kidney diseases such as WT and APCD type III. However, small sample sizes, possibly methodological issues, and discrepancy in the make up between cases and control groups limits interpretation of any significant findings. Future studies with proper protocol, adequate cases, and control groups may provide stronger evidence to resolve uncertainty related to the aetiology of kidney diseases.

Exploring the Effectiveness of a Virtual Learning Methodology in Occupational Therapy Education

ERIC Educational Resources Information Center

Bebeau, Deborah

2016-01-01

This quantitative, randomly controlled study sought to find relationships between occupational therapy students' participation in a virtual situated-case scenario (VSCS) and enhanced perceived self-efficacy as well as academic performance when compared to participation in a text-based case study. To determine effects of participation in a virtual…

Amino Acid Chirality and Ferrocene Conformation Guided Self-Assembly and Gelation of Ferrocene-Peptide Conjugates.

PubMed

Adhikari, Bimalendu; Singh, Charanpreet; Shah, Afzal; Lough, Alan J; Kraatz, Heinz-Bernhard

2015-08-03

The self-assembly and gelation behavior of a series of mono- and disubstituted ferrocene (Fc)-peptide conjugates as a function of ferrocene conformation and amino acid chirality are described. The results reveal that ferrocene-peptide conjugates self-assemble into organogels by controlling the conformation of the central ferrocene core, through inter- versus intramolecular hydrogen bonding in the attached peptide chain(s). The chirality controlled assembling studies showed that two monosubstituted Fc conjugates FcCO-LFLFLA-OMe and FcCO-LFLFDA-OMe form gels with nanofibrillar network structures, whereas the other two diastereomers FcCO-DFLFLA-OMe and FcCO-LFDFLA-OMe exclusively produced straight nanorods and non-interconnected small fibers, respectively. This suggests the potential tuning of gelation behavior and nanoscale morphology by altering the chirality of constituted amino acids. The current study confirms the profound effect of diastereomerism and no influence of enantiomers on gelation. Correspondingly, the diastereomeric and enantiomeric Fc[CO-FFA-OMe]2 were constructed for the study of chirality-organized structures. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Assessing adherence in the CAPRISA 004 tenofovir gel HIV prevention trial: results of a nested case-control study.

PubMed

MacQueen, Kathleen M; Weaver, Mark A; van Loggerenberg, Francois; Succop, Stacey; Majola, Nelisle; Taylor, Doug; Karim, Quarraisha Abdool; Karim, Salim Abdool

2014-05-01

Adherence undeniably impacts product effectiveness in microbicide trials, but the connection has proven challenging to quantify using routinely collected behavioral data. We explored this relationship using a nested case-control study in the CAPRISA 004 Tenofovir (TFV) gel HIV prevention trial. Detailed 3-month recall data on sex events, condom and gel use were collected from 72 incident cases and 205 uninfected controls. We then assessed how the relationship between self-reported adherence and HIV acquisition differed between the TFV and placebo gel groups, an interaction effect that should exist if effectiveness increases with adherence. The CAPRISA 004 trial determined that randomization to TFV gel was associated with a significant reduction in risk of HIV acquisition. In our nested case-control study, however, we did not observe a meaningful decrease in the relative odds of infection-TFV versus placebo-as self-reported adherence increased. To the contrary, exploratory sub-group analysis of the case-control data identified greater evidence for a protective effect of TFV gel among participants reporting less than 80 % adherence to the protocol-defined regimen (odds ratio (OR) 0.30; 95 % CI 0.11-0.78) than among those reporting ≥ 80 % adherence (Odds Ratio 0.81; 95 % CI 0.34-1.92). The small number of cases may have inhibited our ability to detect the hypothesized interaction between adherence and effectiveness. Nonetheless, our results re-emphasize the challenges faced by investigators when adherence may be miss-measured, miss-reported, or confounded with the risk of HIV.

Self-organizing sensing and actuation for automatic control

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

Cheng, George Shu-Xing

A Self-Organizing Process Control Architecture is introduced with a Sensing Layer, Control Layer, Actuation Layer, Process Layer, as well as Self-Organizing Sensors (SOS) and Self-Organizing Actuators (SOA). A Self-Organizing Sensor for a process variable with one or multiple input variables is disclosed. An artificial neural network (ANN) based dynamic modeling mechanism as part of the Self-Organizing Sensor is described. As a case example, a Self-Organizing Soft-Sensor for CFB Boiler Bed Height is presented. Also provided is a method to develop a Self-Organizing Sensor.

Modified directly observed treatment for tuberculosis versus self-administered therapy: an observational study in rural Greece.

PubMed

Charokopos, N; Tsiros, G; Foka, A; Voila, P; Chrysanthopoulos, K; Spiliopoulou, I; Jelastopulu, E

2013-01-01

Directly Observed Treatment (DOT) is the key element of DOTS (directly observed treatment, short course), part of the internationally recommended control strategy for tuberculosis (TB). The evaluation of DOT has not been widely evaluated in rural areas in developed settings. The aim of this pilot study was to evaluate a modified DOT program (MDOT) by a general practitioner (GP) in a rural area of southwest Greece, where there is substantial underreporting of TB cases. Thirteen new TB cases with 30 close contacts were compared with 41 past-treated TB subjects (controls) with 111 close contacts in this observational, case-control study. Home visits by a GP were conducted and comparison of various data (laboratory findings, treatment outcomes, questionnaire-based parameters, on-site recorded conditions) was performed in both newly detected pulmonary TB cases and previously treated TB cases managed without DOT intervention. MDOT by GP implementation revealed that 11 cases (84.6%) were successfully treated, one (7.7%) case died, and one (7.7%) was lost to follow up. None of the close contacts of new TB cases was infected with active TB, while 6.3% of previously-treated TB subjects were infected with active TB and had to receive a complete anti-TB regimen. Chemoprophylaxis was administered to 13.3% of close contacts of new cases; whereas 12.6% of close contacts of previously-treated patients received chemoprophylaxis. This pilot study revealed that a GP is able to implement a program based on DOT resulting in high treatment adherence and prevention of TB compared with the conventional self-administration of treatment.

[The protective efficacy of BCG against leprosy in São Paulo, Brazil].

PubMed

Lombardi, C; Pedrazzani, E S; Pedrazzani, J C; Ferreira Filho, P; Zicker, F

1995-11-01

The protection against leprosy conferred by BCG vaccination was evaluated in a case-control study. Selected for the study were 97 patients under 16 years of age who had been diagnosed with leprosy (cases) and 385 healthy persons (controls), who were matched according to sex, age, place of residence, and type of contact (intra- or extradomicilliary). The cases were selected from a register of active cases as well as a series of new leprosy patients treated in 50 centers in the city of São Paulo, Brasil. To estimate the protective effect of BCG, the prevalences of BCG scars among cases and controls were compared. The presence of one or more scars was associated with a protective efficacy of 90% (95% confidence interval: 78%-96%). Stratified analysis by age group, sex, socioeconomic level, and clinical form of leprosy did not reveal any important differences in the protection conferred by the vaccine. The significance of these findings and the appropriateness of using BCG in leprosy control programs is discussed.

Which is guilty in self-induced penile fractures: marital status, culture or geographic region? A case series and literature review.

PubMed

Al Ansari, A; Talib, R A; Shamsodini, A; Hayati, A; Canguven, O; Al Naimi, A

2013-01-01

Penile fracture is a well-recognized and relatively uncommon clinical entity. It was previously reported that the incidence of penile fracture varies according to various geographic regions. In order to determine whether marital status or culture other than geographic region is involved in the etiology of penile fracture in our country, the charts of 122 men diagnosed with penile fracture were retrospectively reviewed. Detailed history including cause, symptoms, country of origin and a single-question self-report of erectile dysfunction was used for all cases. Diagnosis of our cases was mainly based on history and physical examination and ultrasonography. Immediate or delayed surgical repair of penile fracture included a degloving circumferential, and an additional direct incision, if the site of the tear could not be reached via degloving, was performed. The patients were evaluated after 1 week and 1, 3, and 6 months follow-up by penile examination, recording complications, and with a single-question self-report questionnaire after 3 and 6 months. The most common cause of penile fracture was manual bending of the erected penis in 66 out of 122 (54.1%) of our study patients. In our study, we believe that the prime causes of bending the penis are single status and culture, which are influencing factors irrespective of the geographic distribution.

Application of real-time machine learning to myoelectric prosthesis control: A case series in adaptive switching.

PubMed

Edwards, Ann L; Dawson, Michael R; Hebert, Jacqueline S; Sherstan, Craig; Sutton, Richard S; Chan, K Ming; Pilarski, Patrick M

2016-10-01

Myoelectric prostheses currently used by amputees can be difficult to control. Machine learning, and in particular learned predictions about user intent, could help to reduce the time and cognitive load required by amputees while operating their prosthetic device. The goal of this study was to compare two switching-based methods of controlling a myoelectric arm: non-adaptive (or conventional) control and adaptive control (involving real-time prediction learning). Case series study. We compared non-adaptive and adaptive control in two different experiments. In the first, one amputee and one non-amputee subject controlled a robotic arm to perform a simple task; in the second, three able-bodied subjects controlled a robotic arm to perform a more complex task. For both tasks, we calculated the mean time and total number of switches between robotic arm functions over three trials. Adaptive control significantly decreased the number of switches and total switching time for both tasks compared with the conventional control method. Real-time prediction learning was successfully used to improve the control interface of a myoelectric robotic arm during uninterrupted use by an amputee subject and able-bodied subjects. Adaptive control using real-time prediction learning has the potential to help decrease both the time and the cognitive load required by amputees in real-world functional situations when using myoelectric prostheses. © The International Society for Prosthetics and Orthotics 2015.

MetaRNA-Seq: An Interactive Tool to Browse and Annotate Metadata from RNA-Seq Studies.

PubMed

Kumar, Pankaj; Halama, Anna; Hayat, Shahina; Billing, Anja M; Gupta, Manish; Yousri, Noha A; Smith, Gregory M; Suhre, Karsten

2015-01-01

The number of RNA-Seq studies has grown in recent years. The design of RNA-Seq studies varies from very simple (e.g., two-condition case-control) to very complicated (e.g., time series involving multiple samples at each time point with separate drug treatments). Most of these publically available RNA-Seq studies are deposited in NCBI databases, but their metadata are scattered throughout four different databases: Sequence Read Archive (SRA), Biosample, Bioprojects, and Gene Expression Omnibus (GEO). Although the NCBI web interface is able to provide all of the metadata information, it often requires significant effort to retrieve study- or project-level information by traversing through multiple hyperlinks and going to another page. Moreover, project- and study-level metadata lack manual or automatic curation by categories, such as disease type, time series, case-control, or replicate type, which are vital to comprehending any RNA-Seq study. Here we describe "MetaRNA-Seq," a new tool for interactively browsing, searching, and annotating RNA-Seq metadata with the capability of semiautomatic curation at the study level.

Evaluating performance of risk identification methods through a large-scale simulation of observational data.

PubMed

Ryan, Patrick B; Schuemie, Martijn J

2013-10-01

There has been only limited evaluation of statistical methods for identifying safety risks of drug exposure in observational healthcare data. Simulations can support empirical evaluation, but have not been shown to adequately model the real-world phenomena that challenge observational analyses. To design and evaluate a probabilistic framework (OSIM2) for generating simulated observational healthcare data, and to use this data for evaluating the performance of methods in identifying associations between drug exposure and health outcomes of interest. Seven observational designs, including case-control, cohort, self-controlled case series, and self-controlled cohort design were applied to 399 drug-outcome scenarios in 6 simulated datasets with no effect and injected relative risks of 1.25, 1.5, 2, 4, and 10, respectively. Longitudinal data for 10 million simulated patients were generated using a model derived from an administrative claims database, with associated demographics, periods of drug exposure derived from pharmacy dispensings, and medical conditions derived from diagnoses on medical claims. Simulation validation was performed through descriptive comparison with real source data. Method performance was evaluated using Area Under ROC Curve (AUC), bias, and mean squared error. OSIM2 replicates prevalence and types of confounding observed in real claims data. When simulated data are injected with relative risks (RR) ≥ 2, all designs have good predictive accuracy (AUC > 0.90), but when RR < 2, no methods achieve 100 % predictions. Each method exhibits a different bias profile, which changes with the effect size. OSIM2 can support methodological research. Results from simulation suggest method operating characteristics are far from nominal properties.

How to Make Nothing Out of Something: Analyses of the Impact of Study Sampling and Statistical Interpretation in Misleading Meta-Analytic Conclusions

PubMed Central

Cunningham, Michael R.; Baumeister, Roy F.

2016-01-01

The limited resource model states that self-control is governed by a relatively finite set of inner resources on which people draw when exerting willpower. Once self-control resources have been used up or depleted, they are less available for other self-control tasks, leading to a decrement in subsequent self-control success. The depletion effect has been studied for over 20 years, tested or extended in more than 600 studies, and supported in an independent meta-analysis (Hagger et al., 2010). Meta-analyses are supposed to reduce bias in literature reviews. Carter et al.’s (2015) meta-analysis, by contrast, included a series of questionable decisions involving sampling, methods, and data analysis. We provide quantitative analyses of key sampling issues: exclusion of many of the best depletion studies based on idiosyncratic criteria and the emphasis on mini meta-analyses with low statistical power as opposed to the overall depletion effect. We discuss two key methodological issues: failure to code for research quality, and the quantitative impact of weak studies by novice researchers. We discuss two key data analysis issues: questionable interpretation of the results of trim and fill and Funnel Plot Asymmetry test procedures, and the use and misinterpretation of the untested Precision Effect Test and Precision Effect Estimate with Standard Error (PEESE) procedures. Despite these serious problems, the Carter et al. (2015) meta-analysis results actually indicate that there is a real depletion effect – contrary to their title. PMID:27826272

The effect of group bibliotherapy on the self-esteem of female students living in dormitory

PubMed Central

Salimi, Sepideh; Zare-Farashbandi, Firoozeh; Papi, Ahmad; Samouei, Rahele; Hassanzadeh, Akbar

2014-01-01

Introduction: Bibliotherapy is a supplement, simple, inexpensive and readily available method to treat the diseases that is performed with cooperation of librarians and psychologists or doctors. The aim of this study is the investigation of group bibliotherapy's effect on the self-esteem of the female students of Isfahan University of Medical Sciences Living in Dormitory in 2012. Materials and Methods: The present study is an interventional semi-experimental study with pre test and post test and control group. The statistical population of study consisted of 32 female students who reside in Isfahan University of Medical Sciences dormitories which control and case groups and the students were divided randomly between these two groups. Data was collected by Cooper Smith Self-esteem questionnaire scale (Cronbach's alpha: 0.85). Two groups were examined by the questionnaire in pre test. Case group received group bibliotherapy for 2 month (8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups were assessed in post test after 1 month. Descriptive statistics (means and frequencies distribution) and inferential statistics (independent t- test, paired t- test and mann whitney) were used and data was analyzed by SPSS20 software. Results: The findings showed that group bibliotherapy had positive and significant effect on general, family, professional and total self esteem of female students living in dormitories, but it had no effect on their social self esteem. Conclusion: Group bibliotherapy can increase female students’ self-esteem levels. On the other hand, conducting these studies not only can improve mental health of people, but can also improve their reading habits. PMID:25250355

A systematic review of psychological interventions for adult and pediatric patients with vocal cord dysfunction.

PubMed

Guglani, Loveleen; Atkinson, Sarah; Hosanagar, Avinash; Guglani, Lokesh

2014-01-01

Vocal cord dysfunction (VCD) or paradoxical vocal-fold motion (PVFM) is a functional disorder of the vocal cords that requires multidisciplinary treatment. Besides relaxation techniques, the use of psychological interventions can help treat the underlying psychological co-morbidities. There is currently no literature that examines the effectiveness of psychological interventions for VCD/PVFM. To review the evidence for psychological interventions used for the treatment of patients with VCD/PVFM. We searched electronic databases for English medical literature using Pubmed (Medline), PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Registry of Controlled Trials, and Clinicaltrials.gov. The date range for our search is from June 1964 to June 2014. We included studies that reported the use of psychological interventions in both adults and children diagnosed with VCD/PVFM. We included randomized controlled trials, case-control studies, retrospective chart reviews, prospective case series, and individual case reports. Most reported studies are small case series or individual case reports that have described the use of interventions such as psychotherapy, behavioral therapy, use of anti-anxiety and anti-depressant medications, and hypnotherapy in conjunction with breathing exercises taught by speech therapists for symptomatic relief. Among the various psychological interventions that have been reported, there is no data regarding effectiveness and/or superiority of one approach over another in either adult or pediatric patients. Psychological interventions have a role to play in the management of adult and pediatric patients with VCD/PVFM. Future prospective studies using uniform approaches for treatment of associated psychopathology may help address this question.

Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study.

PubMed

Browne, J L; Nefs, G; Pouwer, F; Speight, J

2015-01-01

Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults ( ≥ 40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). Participants in the case group had higher depression scores (Cohen's d = 0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V = 0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V = 0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V = 0.15). Our results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults and more so than for older adults. Young adults with Type 2 diabetes may require more intensive psychological and self-care support than their older counterparts. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Comparing U.S. Army suicide cases to a control sample: initial data and methodological lessons.

PubMed

Alexander, Cynthia L; Reger, Mark A; Smolenski, Derek J; Fullerton, Nicole R

2014-10-01

Identification of risk and protective factors for suicide is a priority for the United States military, especially in light of the recent steady increase in military suicide rates. The Department of Defense Suicide Event Report contains comprehensive data on suicides for active duty military personnel, but no analogous control data is available to permit identification of factors that differentially determine suicide risk. This proof-of-concept study was conducted to determine the feasibility of collecting such control data. The study employed a prospective case-control design in which control cases were randomly selected from a large Army installation at a rate of four control participants for every qualifying Army suicide. Although 111 Army suicides were confirmed during the study period, just 27 control soldiers completed the study. Despite the small control sample, preliminary analyses comparing suicide cases to controls identified several factors more frequently reported for suicide cases, including recent failed intimate relationships, outpatient mental health history, mood disorder diagnosis, substance abuse history, and prior self-injury. No deployment-related risk factors were found. These data are consistent with existing literature and form a foundation for larger control studies. Methodological lessons learned regarding study design and recruitment are discussed to inform future studies. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Fibrinolytic agents in the management of posthemorrhagic hydrocephalus in preterm infants: the evidence.

PubMed

Haines, S J; Lapointe, M

1999-05-01

The objective of this study was to review current literature on the management of posthemorrhagic hydrocephalus in preterm infants with intraventricular administration of fibrinolytic agents; to this end a literature search was carried out electronically. The keywords used were "intraventricular hemorrhage" or "posthemorrhagic hydrocephalus" in combination with "fibrinolytic agent," "urokinase," "streptokinase," or "recombinant tissue plasminogen activator" and "intraventricular administration"; the search covered the years 1966-1998 and was restricted to English language papers and human subjects. It was supplemented by a search through the reference lists of the articles identified. Articles dealing with intracerebral hemorrhage or hematoma, intraventricular hemorrhage in adults, nontherapeutic issues and laboratory research were excluded. The articles included are summarized in evidence and evaluation tables. Five scientific publications evaluating the use of a fibrinolytic agent to manage posthemorrhagic hydrocephalus were retrieved. In the studies described in these reports, a total of 62 neonates received streptokinase, urokinase or r-tPA intraventricularly. No two of the regimens were identical in the drug used, method of administration and duration of therapy. The time before therapy was started ranged from 2 to 35 days after the ictus. Among the case series reported, three were small series with a total of 38 neonates. One other case series of 18 neonates compared the treatment group with an historical control group. All case series showed that endoventricular fibrinolytic therapy was practical. The proportion of cases in which shunt placement was performed ranged from 11% to 100%. Only one small prospective, randomized, controlled study was identified. That study was too small to allow useful conclusions. Overall, 3 cases of secondary intraventricular hemorrhage were reported. However, it was not possible to determine with certainty whether these episodes were related to the drug therapy itself. The reports suffer from inadequate study design, lack of descriptive information and short follow-up period. There is insufficient evidence to justify the claim that fibrinolytic agents administered intraventricularly in posthemorrhagic hydrocephalus are safe and effective. More evidence is needed to prove or disprove the effectiveness and safety of this form of therapy.

Self-regulated learning strategies used in surgical clerkship and the relationship with clinical achievement.

PubMed

Turan, Sevgi; Konan, Ali

2012-01-01

Self-regulated learning indicates students' skills in controlling their own learning. Self-regulated learning, which a context-specific process, emphasizes autonomy and control. Students gain more autonomy with respect to learning in the clinical years. Examining the self-regulated learning skills of students in this period will provide important clues about the level at which students are ready to use these skills in real-life conditions. The self-regulated learning strategies used by medical students in surgical clerkship were investigated in this study and their relation with clinical achievement was analyzed. The study was conducted during the surgery clerkship of medical students. The participation rate was 94% (309 students). Motivated Strategies for Learning Questionnaire (MSLQ), a case-based examination, Objective Structured Clinical Examination (OSCE), and tutor evaluations for assessing achievement were used. The relationship between the Motivated Strategies for Learning Questionnaire scores of the students and clinical achievement was analyzed with multilinear regression analysis. The findings showed that students use self-regulated learning skills at medium levels during their surgery clerkship. A relationship between these skills and OSCE scores and tutor evaluations was determined. OSCE scores of the students were observed to increase in conjunction with increased self-efficacy levels. However, as students' beliefs regarding control over learning increased, OSCE scores decreased. No significant relationship was defined between self-regulated learning skills and case-based examination scores. We observed that a greater self-efficacy for learning resulted in higher OSCE scores. Conversely, students who believe that learning is a result of their own effort had lower OSCE scores. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effect of case management on glycemic control and behavioral outcomes for chinese people with type 2 diabetes: A 2-year study.

PubMed

Yuan, Xiaodan; Wang, Fengmei; Fish, Anne Folta; Xue, Cunyi; Chen, Tao; Liu, Chao; Lou, Qingqing

2016-08-01

To examine the effect of case management on glycemic control and behavioral outcomes in adults with Type 2 diabetes in China. Participants were randomly assigned to a 1-year case management (CM) group (n=60) or control group (n=60). Monthly case management visits included identifying individuals' diabetes-related problems, setting goals, planning self-care, and evaluating progress. During a 1-year follow-up, all participants attended visits every 3 months without intervention. In the CM vs. the control group, HbA1c was reduced at 6 months compared to baseline (P=0.034), with trends at 12 and 24 months, and empowerment ability improved (P<0.05). Also in the CM vs. controls, total self-care behaviors, the frequency of exercise, blood glucose testing, and foot care were higher (P<0.001) at 12 months, and the percentage of individuals with HbA1c ≤7.0% was higher (P=0.035) at 24 months. The case management intervention in China was effective at 6 months and, based on trends in HbA1c at 12 and 24 months and results for behavioral outcomes, the intervention shows promise and warrants more research. A case management approach can enhance behavior change and glycemic control in Chinese with diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Forecasting dengue hemorrhagic fever cases using ARIMA model: a case study in Asahan district

NASA Astrophysics Data System (ADS)

Siregar, Fazidah A.; Makmur, Tri; Saprin, S.

2018-01-01

Time series analysis had been increasingly used to forecast the number of dengue hemorrhagic fever in many studies. Since no vaccine exist and poor public health infrastructure, predicting the occurrence of dengue hemorrhagic fever (DHF) is crucial. This study was conducted to determine trend and forecasting the occurrence of DHF in Asahan district, North Sumatera Province. Monthly reported dengue cases for the years 2012-2016 were obtained from the district health offices. A time series analysis was conducted by Autoregressive integrated moving average (ARIMA) modeling to forecast the occurrence of DHF. The results demonstrated that the reported DHF cases showed a seasonal variation. The SARIMA (1,0,0)(0,1,1)12 model was the best model and adequate for the data. The SARIMA model for DHF is necessary and could applied to predict the incidence of DHF in Asahan district and assist with design public health maesures to prevent and control the diseases.

Control of a free-flying robot manipulator system

NASA Technical Reports Server (NTRS)

Alexander, H.

1986-01-01

The development of and test control strategies for self-contained, autonomous free flying space robots are discussed. Such a robot would perform operations in space similar to those currently handled by astronauts during extravehicular activity (EVA). Use of robots should reduce the expense and danger attending EVA both by providing assistance to astronauts and in many cases by eliminating altogether the need for human EVA, thus greatly enhancing the scope and flexibility of space assembly and repair activities. The focus of the work is to develop and carry out a program of research with a series of physical Satellite Robot Simulator Vehicles (SRSV's), two-dimensionally freely mobile laboratory models of autonomous free-flying space robots such as might perform extravehicular functions associated with operation of a space station or repair of orbiting satellites. It is planned, in a later phase, to extend the research to three dimensions by carrying out experiments in the Space Shuttle cargo bay.

Lower omega-3 fatty acids are associated with the presence of anti-cyclic citrullinated peptide autoantibodies in a population at risk for future rheumatoid arthritis: a nested case-control study

PubMed Central

Gan, Ryan W.; Young, Kendra A.; Zerbe, Gary O.; Demoruelle, M. Kristen; Weisman, Michael H.; Buckner, Jane H.; Gregersen, Peter K.; Mikuls, Ted R.; O’Dell, James R.; Keating, Richard M.; Clare-Salzler, Michael J.; Deane, Kevin D.; Holers, V. Michael

2016-01-01

Objective. The aim of this study was to investigate omega-3 fatty acid (FA) supplement use and omega-3 FAs in erythrocyte membranes [omega-3 FA % in erythrocyte membranes (RBC)] and their association with anti-CCP autoantibodies in a population without RA, but who are at genetic risk for RA. Methods. The multicentre Studies of the Etiology of RA (SERA) cohort includes RA-free subjects who are first-degree relatives of RA probands or are enriched with the HLA-DR4 allele. In a nested case-control study, 30 SERA cases were identified who were anti-CCP2 antibody positive. We further identified 47 autoantibody negative controls, frequency matched to cases on age at study visit, sex, race and study site. Anti-CCP2 status, self-reported omega-3 FA supplement use and omega-3 FA % in RBCs were obtained from a single visit. Results. Anti-CCP2 positive cases were less likely than controls to report omega-3 FA supplement use (odds ratio: 0.14; 95% CI 0.03, 0.68). In addition, the likelihood of anti-CCP2 positivity was inversely associated with total omega-3 FA % in RBCs (odds ratio: 0.47; 95% CI 0.24, 0.92, for a s.d. increase). Conclusion. The inverse association between anti-CCP2 positivity and self-reported omega-3 FA supplement use and omega-3 FA % in RBCs suggests that omega-3 FAs may protect against the development of RA-related autoimmunity in pre-clinical RA. PMID:26370400

Self-assembling electroactive hydrogels for flexible display technology

NASA Astrophysics Data System (ADS)

Jones, Scott L.; Hou Wong, Kok; Thordarson, Pall; Ladouceur, François

2010-12-01

We have assessed the potential of self-assembling hydrogels for use in conformal displays. The self-assembling process can be used to alter the transparency of the material to all visible light due to scattering by fibres. The reversible transition is shown to be of low energy by differential scanning calorimetry. For use in technology it is imperative that this transition is controlled electrically. We have thus synthesized novel self-assembling hydrogelator molecules which contain an electroactive group. The well-known redox couple of anthraquinone/anthrahydroquinone has been used as the hydrophobic component for a series of small molecule gelators. They are further functionalized with peptide combinations of L-phenylalanine and glycine to provide the hydrophilic group to complete 'head-tail' models of self-assembling gels. The gelation and electroactive characteristics of the series were assessed. Cyclic voltammetry shows the reversible redox cycle to be only superficially altered by functionalization. Additionally, spectroelectrochemical measurements show a reversible transparency and colour change induced by the redox process.

Research on stalking: what do we know and where do we go?

PubMed

Davis, K E; Frieze, I H

2000-01-01

Findings of the article in this two-volume series on stalking are reviewed. Building on the findings of the National Violence Against Women Survey (Tjaden & Thoennes, 1998), this series of studies adds to the literature in defining and measuring stalking behaviors. Repeated stalking victimization is reported by up to 62% of young adults, although frequencies depend on the sample and the precise definition used. Self-definitions of stalking victimization may be quite different from legal definitions. Although the majority of legally defined stalkers (where victim fear is a key component) are men stalking women, studies utilizing other definitions find many more women as stalkers, with no significant gender differences in many studies. In many cases, it does appear that stalking is one part of a larger pattern of relationship physical and psychological abuse. Data on emotional reactions and coping strategies of victims are also reviewed, along with findings on characteristics of stalkers.

Sleep bruxism and myofascial temporomandibular disorders

PubMed Central

Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

2015-01-01

Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

Risk of Guillain-Barré syndrome after exposure to pandemic influenza A(H1N1)pdm09 vaccination or infection: a Norwegian population-based cohort study.

PubMed

Ghaderi, Sara; Gunnes, Nina; Bakken, Inger Johanne; Magnus, Per; Trogstad, Lill; Håberg, Siri Eldevik

2016-01-01

Vaccinations and infections are possible triggers of Guillain-Barré syndrome (GBS). However, studies on GBS after vaccinations during the influenza A(H1N1)pmd09 pandemic in 2009, show inconsistent results. Only few studies have addressed the role of influenza infection. We used information from national health data-bases with information on the total Norwegian population (N = 4,832,211). Cox regression analyses with time-varying covariates and self-controlled case series was applied. The risk of being hospitalized with GBS during the pandemic period, within 42 days after an influenza diagnosis or pandemic vaccination was estimated. There were 490 GBS cases during 2009-2012 of which 410 cases occurred after October 1, 2009 of which 46 new cases occurred during the peak period of the influenza pandemic. An influenza diagnosis was registered for 2.47% of the population and the vaccination coverage was 39.25%. The incidence rate ratio of GBS during the pandemic peak relative to other periods was 1.46 [95% confidence interval (CI) 1.08-1.98]. The adjusted hazard ratio (HR) of GBS within 42 days after a diagnosis of pandemic influenza was 4.89 (95% CI 1.17-20.36). After pandemic vaccination the adjusted HR was 1.11 (95% CI 0.51-2.43). Our results indicated that there was a significantly increased risk of GBS during the pandemic season and after pandemic influenza infection. However, vaccination did not increase the risk of GBS. The small number of GBS cases in this study warrants caution in the interpretation of the findings.

Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study.

PubMed

Ramírez-Moreno, J M; Muñoz Vega, P; Espada, S; Bartolomé Alberca, S; Aguirre, J; Peral, D

2017-12-22

Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Mutations in the pancreatic secretory enzymes CPA1 and CPB1 are associated with pancreatic cancer.

PubMed

Tamura, Koji; Yu, Jun; Hata, Tatsuo; Suenaga, Masaya; Shindo, Koji; Abe, Toshiya; MacGregor-Das, Anne; Borges, Michael; Wolfgang, Christopher L; Weiss, Matthew J; He, Jin; Canto, Marcia Irene; Petersen, Gloria M; Gallinger, Steven; Syngal, Sapna; Brand, Randall E; Rustgi, Anil; Olson, Sara H; Stoffel, Elena; Cote, Michele L; Zogopoulos, George; Potash, James B; Goes, Fernando S; McCombie, Richard W; Zandi, Peter P; Pirooznia, Mehdi; Kramer, Melissa; Parla, Jennifer; Eshleman, James R; Roberts, Nicholas J; Hruban, Ralph H; Klein, Alison Patricia; Goggins, Michael

2018-05-01

To evaluate whether germline variants in genes encoding pancreatic secretory enzymes contribute to pancreatic cancer susceptibility, we sequenced the coding regions of CPB1 and other genes encoding pancreatic secretory enzymes and known pancreatitis susceptibility genes ( PRSS1 , CPA1 , CTRC , and SPINK1 ) in a hospital series of pancreatic cancer cases and controls. Variants in CPB1 , CPA1 (encoding carboxypeptidase B1 and A1), and CTRC were evaluated in a second set of cases with familial pancreatic cancer and controls. More deleterious CPB1 variants, defined as having impaired protein secretion and induction of endoplasmic reticulum (ER) stress in transfected HEK 293T cells, were found in the hospital series of pancreatic cancer cases (5/986, 0.5%) than in controls (0/1,045, P = 0.027). Among familial pancreatic cancer cases, ER stress-inducing CPB1 variants were found in 4 of 593 (0.67%) vs. 0 of 967 additional controls ( P = 0.020), with a combined prevalence in pancreatic cancer cases of 9/1,579 vs. 0/2,012 controls ( P < 0.01). More ER stress-inducing CPA1 variants were also found in the combined set of hospital and familial cases with pancreatic cancer than in controls [7/1,546 vs. 1/2,012; P = 0.025; odds ratio, 9.36 (95% CI, 1.15-76.02)]. Overall, 16 (1%) of 1,579 pancreatic cancer cases had an ER stress-inducing CPA1 or CPB1 variant, compared with 1 of 2,068 controls ( P < 0.00001). No other candidate genes had statistically significant differences in variant prevalence between cases and controls. Our study indicates ER stress-inducing variants in CPB1 and CPA1 are associated with pancreatic cancer susceptibility and implicate ER stress in pancreatic acinar cells in pancreatic cancer development.

Using Polarized Spectroscopy to Investigate Order in Thin-Films of Ionic Self-Assembled Materials Based on Azo-Dyes

PubMed Central

Ahmad, Mariam; Andersen, Frederik; Brend Bech, Ári; Bendixen, H. Krestian L.; Nawrocki, Patrick R.; Bloch, Anders J.; Bora, Ilkay; Bukhari, Tahreem A.; Bærentsen, Nicolai V.; Carstensen, Jens; Chima, Smeeah; Colberg, Helene; Dahm, Rasmus T.; Daniels, Joshua A.; Dinckan, Nermin; El Idrissi, Mohamed; Erlandsen, Ricci; Førster, Marc; Ghauri, Yasmin; Gold, Mikkel; Hansen, Andreas; Hansen, Kenn; Helmsøe-Zinck, Mathias; Henriksen, Mathias; Hoffmann, Sophus V.; Hyllested, Louise O. H.; Jensen, Casper; Kallenbach, Amalie S.; Kaur, Kirandip; Khan, Suheb R.; Kjær, Emil T. S.; Kristiansen, Bjørn; Langvad, Sylvester; Lund, Philip M.; Munk, Chastine F.; Møller, Theis; Nehme, Ola M. Z.; Nejrup, Mathilde Rove; Nexø, Louise; Nielsen, Simon Skødt Holm; Niemeier, Nicolai; Nikolajsen, Lasse V.; Nøhr, Peter C. T.; Skaarup Ovesen, Jacob; Paustian, Lucas; Pedersen, Adam S.; Petersen, Mathias K.; Poulsen, Camilla M.; Praeger-Jahnsen, Louis; Qureshi, L. Sonia; Schiermacher, Louise S.; Simris, Martin B.; Smith, Gorm; Smith, Heidi N.; Sonne, Alexander K.; Zenulovic, Marko R.; Winther Sørensen, Alma; Vogt, Emil; Væring, Andreas; Westermann, Jonas; Özcan, Sevin B.

2018-01-01

Three series of ionic self-assembled materials based on anionic azo-dyes and cationic benzalkonium surfactants were synthesized and thin films were prepared by spin-casting. These thin films appear isotropic when investigated with polarized optical microscopy, although they are highly anisotropic. Here, three series of homologous materials were studied to rationalize this observation. Investigating thin films of ordered molecular materials relies to a large extent on advanced experimental methods and large research infrastructure. A statement that in particular is true for thin films with nanoscopic order, where X-ray reflectometry, X-ray and neutron scattering, electron microscopy and atom force microscopy (AFM) has to be used to elucidate film morphology and the underlying molecular structure. Here, the thin films were investigated using AFM, optical microscopy and polarized absorption spectroscopy. It was shown that by using numerical method for treating the polarized absorption spectroscopy data, the molecular structure can be elucidated. Further, it was shown that polarized optical spectroscopy is a general tool that allows determination of the molecular order in thin films. Finally, it was found that full control of thermal history and rigorous control of the ionic self-assembly conditions are required to reproducibly make these materials of high nanoscopic order. Similarly, the conditions for spin-casting are shown to be determining for the overall thin film morphology, while molecular order is maintained. PMID:29462883

Using Polarized Spectroscopy to Investigate Order in Thin-Films of Ionic Self-Assembled Materials Based on Azo-Dyes.

PubMed

Kühnel, Miguel R Carro-Temboury Martin; Ahmad, Mariam; Andersen, Frederik; Bech, Ári Brend; Bendixen, H Krestian L; Nawrocki, Patrick R; Bloch, Anders J; Bora, Ilkay; Bukhari, Tahreem A; Bærentsen, Nicolai V; Carstensen, Jens; Chima, Smeeah; Colberg, Helene; Dahm, Rasmus T; Daniels, Joshua A; Dinckan, Nermin; Idrissi, Mohamed El; Erlandsen, Ricci; Førster, Marc; Ghauri, Yasmin; Gold, Mikkel; Hansen, Andreas; Hansen, Kenn; Helmsøe-Zinck, Mathias; Henriksen, Mathias; Hoffmann, Sophus V; Hyllested, Louise O H; Jensen, Casper; Kallenbach, Amalie S; Kaur, Kirandip; Khan, Suheb R; Kjær, Emil T S; Kristiansen, Bjørn; Langvad, Sylvester; Lund, Philip M; Munk, Chastine F; Møller, Theis; Nehme, Ola M Z; Nejrup, Mathilde Rove; Nexø, Louise; Nielsen, Simon Skødt Holm; Niemeier, Nicolai; Nikolajsen, Lasse V; Nøhr, Peter C T; Orlowski, Dominik B; Overgaard, Marc; Ovesen, Jacob Skaarup; Paustian, Lucas; Pedersen, Adam S; Petersen, Mathias K; Poulsen, Camilla M; Praeger-Jahnsen, Louis; Qureshi, L Sonia; Ree, Nicolai; Schiermacher, Louise S; Simris, Martin B; Smith, Gorm; Smith, Heidi N; Sonne, Alexander K; Zenulovic, Marko R; Sørensen, Alma Winther; Sørensen, Karina; Vogt, Emil; Væring, Andreas; Westermann, Jonas; Özcan, Sevin B; Sørensen, Thomas Just

2018-02-15

Three series of ionic self-assembled materials based on anionic azo-dyes and cationic benzalkonium surfactants were synthesized and thin films were prepared by spin-casting. These thin films appear isotropic when investigated with polarized optical microscopy, although they are highly anisotropic. Here, three series of homologous materials were studied to rationalize this observation. Investigating thin films of ordered molecular materials relies to a large extent on advanced experimental methods and large research infrastructure. A statement that in particular is true for thin films with nanoscopic order, where X-ray reflectometry, X-ray and neutron scattering, electron microscopy and atom force microscopy (AFM) has to be used to elucidate film morphology and the underlying molecular structure. Here, the thin films were investigated using AFM, optical microscopy and polarized absorption spectroscopy. It was shown that by using numerical method for treating the polarized absorption spectroscopy data, the molecular structure can be elucidated. Further, it was shown that polarized optical spectroscopy is a general tool that allows determination of the molecular order in thin films. Finally, it was found that full control of thermal history and rigorous control of the ionic self-assembly conditions are required to reproducibly make these materials of high nanoscopic order. Similarly, the conditions for spin-casting are shown to be determining for the overall thin film morphology, while molecular order is maintained.

The effect of nabilone on neuropsychological functions related to driving ability: an extended case series.

PubMed

Kurzthaler, Ilsemarie; Bodner, Thomas; Kemmler, Georg; Entner, Tanja; Wissel, Joerg; Berger, Thomas; Fleischhacker, W Wolfgang

2005-06-01

The primary goal of this prospective extended case series was to obtain the first data about the potential influence of nabilone intake on driving ability related neuropsychological functions. Six patients were investigated within a placebo controlled, double-blind crossover study of this synthetic cannabinoid (2 mg/day) in patients with multiple sclerosis and spasticity associated pain. Five neuropsychological functions (reaction time, working memory, divided attention, psychomotor speed and mental flexibility) were assessed. No indication was found of a deterioration of any of the five investigated neuropsychological functions during the 4-week treatment period with nabilone. Copyright 2005 John Wiley & Sons, Ltd.

75 FR 67799 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... strike, an out-of-the-money option. However, if a $0.50 strike series had been available, the investor would have been able to control 5,000 shares by purchasing 50 exercisable in-the-money $0.50 strike call... the time was $1, an in-the-money option. If a $0.50 strike series had been available, the investor...

Is adherence to weight monitoring or weight-based diuretic self-adjustment associated with fewer heart failure-related emergency department visits or hospitalizations?

PubMed

Jones, Christine D; Holmes, George M; Dewalt, Darren A; Erman, Brian; Broucksou, Kimberly; Hawk, Victoria; Cene, Crystal W; Wu, Jia-Rong; Pignone, Michael

2012-07-01

Heart failure (HF) self-care interventions can improve outcomes, but less than optimal adherence may limit their effectiveness. We evaluated if adherence to weight monitoring and diuretic self-adjustment was associated with HF-related emergency department (ED) visits or hospitalizations. We performed a case-control analysis nested in a HF self-care randomized trial. Participants received HF self-care training, including weight monitoring and diuretic self-adjustment, which they were to record in a diary. We defined case time periods as HF-related ED visits or hospitalizations in the 7 preceding days; control time periods were defined as 7-day periods free of ED visits and hospitalizations. We used logistic regression to compare weight monitoring and diuretic self-adjustment adherence in case and control time periods, adjusted for demographic and clinical covariates. Among 303 participants, we identified 81 HF-related ED visits or hospitalizations (cases) in 54 patients over 1 year of follow-up. Weight monitoring adherence (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.23-0.76) and diuretic self-adjustment adherence (OR 0.44, 95% CI 0.19-0.98) were both associated with lower adjusted odds of HF-related ED visits or hospitalizations. Adherence to weight monitoring and diuretic self-adjustment was associated with lower odds of HF-related ED visits or hospitalizations. Adherence to these activities may reduce HF-related morbidity. Copyright © 2012 Elsevier Inc. All rights reserved.

Association of bariatric surgery with risk of acute care use for hypertension-related disease in obese adults: population-based self-controlled case series study.

PubMed

Shimada, Yuichi J; Tsugawa, Yusuke; Iso, Hiroyasu; Brown, David F M; Hasegawa, Kohei

2017-08-23

Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension. We performed a self-controlled case series study of obese patients with hypertension who underwent bariatric surgery using population-based ED and inpatient databases that recorded every bariatric surgery, ED visit, and hospitalization in three states (California, Florida, and Nebraska) from 2005 to 2011. The primary outcome was acute care use for hypertension-related disease. We used conditional logistic regression to compare each patient's risk of the outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. We identified 980 obese patients with hypertension who underwent bariatric surgery. The median age was 48 years (interquartile range, 40-56 years), 74% were female, and 55% were non-Hispanic white. During the reference period, 17.8% (95% confidence interval [CI], 15.4-20.2%) had a primary outcome event. The risk remained unchanged in the subsequent 12-month pre-surgery period (18.2% [95% CI, 15.7-20.6%]; adjusted odds ratio [aOR] 1.02 [95% CI, 0.83-1.27]; P = 0.83). In the first 12-month period after bariatric surgery, the risk significantly decreased (10.5% [8.6-12.4%]; aOR 0.58 [95% CI, 0.45-0.74]; P < 0.0001). Similarly, the risk remained significantly reduced in the 13-24 months after bariatric surgery (12.9% [95% CI, 10.8-15.0%]; aOR 0.71 [95% CI, 0.57-0.90]; P = 0.005). By contrast, there was no significant reduction in the risk among obese patients who underwent non-bariatric surgery (i.e., cholecystectomy, hysterectomy, spinal fusion, or mastectomy). In this population-based study of obese adults with hypertension, we found that the risk of acute care use for hypertension-related disease decreased by 40% after bariatric surgery. The data provide the best evidence on the effectiveness of substantial weight loss on hypertension-related morbidities, underscoring the importance of discussing options for weight reduction when treating obese patients with hypertension.

The effect of Think Pair Share (TPS) using scientific approach on students’ self-confidence and mathematical problem-solving

NASA Astrophysics Data System (ADS)

Rifa’i, A.; Lestari, H. P.

2018-03-01

This study was designed to know the effects of Think Pair Share using Scientific Approach on students' self-confidence and mathematical problem-solving. Quasi-experimental with pre-test post-test non-equivalent group method was used as a basis for design this study. Self-confidence questionnaire and problem-solving test have been used for measurement of the two variables. Two classes of the first grade in religious senior high school (MAN) in Indonesia were randomly selected for this study. Teaching sequence and series from mathematics book at control group in the traditional way and at experiment group has been in TPS using scientific approach learning method. For data analysis regarding students’ problem-solving skill and self-confidence, One-Sample t-Test, Independent Sample t-Test, and Multivariate of Variance (MANOVA) were used. The results showed that (1) TPS using a scientific approach and traditional learning had positive effects (2) TPS using scientific approach learning in comparative with traditional learning had a more significant effect on students’ self-confidence and problem-solving skill.

A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events

PubMed Central

Erskine, Nathaniel; Tran, Hoang; Levin, Leonard; Ulbricht, Christine; Fingeroth, Joyce; Kiefe, Catarina; Singh, Sonal

2017-01-01

Background Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events. Methods/Results Systematic searches of PubMed (MEDLINE), SCOPUS (Embase) and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on the occurrence of the examined events were abstracted. Odds ratios and their accompanying confidence intervals were estimated using random and fixed effects models with statistical heterogeneity estimated with the I2 statistic. Twelve studies examining 7.9 million patients up to 28 years after the onset of herpes zoster met our pre-defined eligibility criteria. Random and fixed effects meta-analyses showed that herpes zoster, type unspecified, and herpes zoster ophthalmicus were associated with a significantly increased risk of cerebrovascular events, without any evidence of statistical heterogeneity. Our meta-analysis also found a significantly increased risk of cardiac events associated with herpes zoster, type unspecified. Conclusions Our results are consistent with the accumulating body of evidence that herpes zoster and herpes zoster ophthalmicus are significantly associated with cerebrovascular and cardiovascular events. PMID:28749981

A systematic review and meta-analysis on herpes zoster and the risk of cardiac and cerebrovascular events.

PubMed

Erskine, Nathaniel; Tran, Hoang; Levin, Leonard; Ulbricht, Christine; Fingeroth, Joyce; Kiefe, Catarina; Goldberg, Robert J; Singh, Sonal

2017-01-01

Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events. Systematic searches of PubMed (MEDLINE), SCOPUS (Embase) and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on the occurrence of the examined events were abstracted. Odds ratios and their accompanying confidence intervals were estimated using random and fixed effects models with statistical heterogeneity estimated with the I2 statistic. Twelve studies examining 7.9 million patients up to 28 years after the onset of herpes zoster met our pre-defined eligibility criteria. Random and fixed effects meta-analyses showed that herpes zoster, type unspecified, and herpes zoster ophthalmicus were associated with a significantly increased risk of cerebrovascular events, without any evidence of statistical heterogeneity. Our meta-analysis also found a significantly increased risk of cardiac events associated with herpes zoster, type unspecified. Our results are consistent with the accumulating body of evidence that herpes zoster and herpes zoster ophthalmicus are significantly associated with cerebrovascular and cardiovascular events.

Case-control study on uveal melanoma (RIFA): rational and design

PubMed Central

Schmidt-Pokrzywniak, Andrea; Jöckel, Karl-Heinz; Bornfeld, Norbert; Stang, Andreas

2004-01-01

Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study) that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups), except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding. PMID:15318944

Associations of daily pediatric asthma emergency department visits with air pollution in Newark, NJ: utilizing time-series and case-crossover study designs.

PubMed

Gleason, Jessie A; Fagliano, Jerald A

2015-10-01

Asthma is one of the most common chronic diseases affecting children. This study assesses the associations of ozone and fine particulate matter (PM2.5) with pediatric emergency department visits in the urban environment of Newark, NJ. Two study designs were utilized and evaluated for usability. We obtained daily emergency department visits among children aged 3-17 years with a primary diagnosis of asthma during April to September for 2004-2007. Both a time-stratified case-crossover study design with bi-directional control sampling and a time-series study design were utilized. Lagged effects (1-d through 5-d lag, 3-d average, and 5-d average) of ozone and PM2.5 were explored and a dose-response analysis comparing the bottom 5th percentile of 3-d average lag ozone with each 5 percentile increase was performed. Associations of interquartile range increase in same-day ozone were similar between the time-series and case-crossover study designs (RR = 1.08, 95% CI 1.04-1.12) and (OR = 1.10, 95% CI 1.06-1.14), respectively. Similar associations were seen for 1-day lag and 3-day average lag ozone levels. PM2.5 was not associated with the outcome in either study design. Dose-response assessment indicated a statistically significant and increasing association around 50-55 ppb consistent for both study designs. Ozone was statistically positively associated with pediatric asthma ED visits in Newark, NJ. Our results were generally comparable across the time-series and case-crossover study designs, indicating both are useful to assess local air pollution impacts.

Gate-controlled current and inelastic electron tunneling spectrum of benzene: a self-consistent study.

PubMed

Liang, Y Y; Chen, H; Mizuseki, H; Kawazoe, Y

2011-04-14

We use density functional theory based nonequilibrium Green's function to self-consistently study the current through the 1,4-benzenedithiol (BDT). The elastic and inelastic tunneling properties through this Au-BDT-Au molecular junction are simulated, respectively. For the elastic tunneling case, it is found that the current through the tilted molecule can be modulated effectively by the external gate field, which is perpendicular to the phenyl ring. The gate voltage amplification comes from the modulation of the interaction between the electrodes and the molecules in the junctions. For the inelastic case, the electron tunneling scattered by the molecular vibrational modes is considered within the self-consistent Born approximation scheme, and the inelastic electron tunneling spectrum is calculated.

Analyzing Short Message Services Application Effect on Diabetic Patients' Self-caring.

PubMed

Naghibi, Seyed Abolhassan; Moosazadeh, Mahmood; Zhyanifard, Akram; Jafari Makrani, Zoreh; Yazdani Cherati, Jamshid

2015-01-01

Diabetes is the most prevalent metabolic disease with a growing spread rate in word wide. Short message service (SMS) is of the most common public communication networks, which have brought about a broad spectrum of applications like social, cultural and service products in the late decade. The objective of this research is, the investigate of using SMS on diabetes patients self-caring. In an interventional study, 228 diabetes patients have been selected from a community charity. With using of random sampling method, they were divided into two groups of 114 subjects as the control and case. The case group was sent messages reminding them about sports, caring foot, taking insulin and oral tablet for 4 weeks via mobile phone. After 4 weeks, a posttest questionnaire was completed. The data analysis was performed using a descriptive statistic, Chi-square, independent t-test, and paired t-test. There are not significant differences between case and control groups before intervention by studied dependent variables (P > 0.05). Performance score mean of taking care of foot, sport and taking oral tablet and insulin in case group before intervention were 29.90, 10, 11.16 and 3.75 respectively and after intervention were 20.11, 41.36, 13.09 and 4.90, respectively. Furthermore, the performance scores mean difference after intervention, taking care of foot (P < 0.001), sport (P < 0.001), taking oral tablet (P = 0.020) was meaningful in case and control groups. Regarding the study results on using cell phone, to utilize virtual training methods is recommended as an appropriate procedure for different health care, self-caring and follow-up training plans for various groups in society, especially diabetic and chronic patients.

The BBaRTS Healthy Teeth Behaviour Change Programme for preventing dental caries in primary school children: study protocol for a cluster randomised controlled trial.

PubMed

Pine, Cynthia; Adair, Pauline; Robinson, Louise; Burnside, Girvan; Moynihan, Paula; Wade, William; Kistler, James; Curnow, Morag; Henderson, Mary

2016-02-20

Oral health behaviours such as establishing twice-daily toothbrushing and sugar control intake need parental self-efficacy (PSE) to prevent the development of childhood dental caries. A previous study has shown that behaviour change techniques (BCTs) delivered via a storybook can improve parental self-efficacy to undertake twice-daily toothbrushing. to determine whether an intervention (BBaRTS, Bedtime Brush and Read Together to Sleep), designed to increase PSE; delivered through storybooks with embedded BCTs, parenting skills and oral health messages, can improve child oral health compared to (1) an exactly similar intervention containing no behaviour change techniques, and (2) the BBaRTS intervention supplemented with home supply of fluoride toothpaste and supervised toothbrushing on schooldays. A 2-year, three-arm, multicentre, cluster randomised controlled trial. children (estimated 2000-2600) aged 5-7 years and their families from 60 UK primary schools. Test group 1: a series of eight children's storybooks developed by a psychologist, public health dentist, science educator, children's author and illustrators, with guidance from the Department for Education (England). The books feature animal characters and contain embedded dental health messages, parenting skills and BCTs to promote good oral health routines focused on controlling sugar intake and toothbrushing, as well as reading at bedtime. Books are given out over 2 years. Test group 2: as Test group 1 plus home supplies of fluoride toothpaste (1000 ppmF), and daily supervised toothbrushing in school on schooldays. Active Control group: series of eight books with exactly the same stories, characters and illustrations, but without BCTs, dental health messages or parenting skills. Annual child dental examinations and parental questionnaires will be undertaken. A sub-set of participants will be invited to join an embedded study of the child's diet and salivary microbiota composition. dental caries experience in permanent teeth at age 7-8 years. A multi-disciplinary team was established to develop the BBaRTS Children's Healthy Teeth Programme. The books were developed in partnership with the Department for Education (England), informed by a series of focus groups with children, teachers and parents. ISRCTN21461006 (date of registration 23 September 2015).

Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: population-based nested case control study.

PubMed

Morales, Daniel R; Lipworth, Brian J; Donnan, Peter T; Jackson, Cathy; Guthrie, Bruce

2017-01-27

Cardiovascular disease (CVD) is a common comorbidity in people with asthma. However, safety concerns have caused heterogeneity in clinical guideline recommendations over the use of cardioselective beta-blockers in people with asthma and CVD, partly because risk in the general population has been poorly quantified. The aim of this study was to measure the risk of asthma exacerbations with beta-blockers prescribed to a general population with asthma and CVD. Linked data from the UK Clinical Practice Research Datalink was used to perform nested case-control studies among people with asthma and CVD matched on age, sex and calendar time. Adjusted incidence rate ratios (IRR) were calculated for the association between oral beta-blocker use and moderate asthma exacerbations (rescue oral steroids) or severe asthma exacerbations (hospitalisation or death) using conditional logistic regression. The cohort consisted of 35,502 people identified with active asthma and CVD, of which 14.1% and 1.2% were prescribed cardioselective and non-selective beta-blockers, respectively, during follow-up. Cardioselective beta-blocker use was not associated with a significantly increased risk of moderate or severe asthma exacerbations. Consistent results were obtained following sensitivity analyses and a self-controlled case series approach. In contrast, non-selective beta-blockers were associated with a significantly increased risk of moderate asthma exacerbations when initiated at low to moderate doses (IRR 5.16, 95% CI 1.83-14.54, P = 0.002), and both moderate and severe exacerbations when prescribed chronically at high dose (IRR 2.68, 95% CI 1.08-6.64, P = 0.033 and IRR 12.11, 95% CI 1.02-144.11, P = 0.048, respectively). Cardioselective beta-blockers prescribed to people with asthma and CVD were not associated with a significantly increased risk of moderate or severe asthma exacerbations and potentially could be used more widely when strongly indicated.

[A Case of Removable Self-Expandable Metallic Stent(SEMS)Placement for Gastric Tube Stenosis after Esophageal Cancer Resection].

PubMed

Yoshikawa, Yukihiro; Yoshikawa, Masato; Kawabata, Ryohei; Yoshida, Yuta; Kawada, Masahiro; Yasuyama, Akinobu; Watase, Chikashi; Koga, Chikato; Hitora, Toshiki; Murakami, Masahiro; Hirota, Masaki; Ikenaga, Masakazu; Shimizu, Junzo; Hasegawa, Junichi

2015-11-01

A 68-year-old man underwent esophagectomy for early esophageal cancer. Postoperative upper gastrointestinal series and esophagogastroduodenoscopy showed gastric tube stenosis. To improve passage, a removable self-expandable metallic stent (SEMS) was placed across the stenotic lesion. Two weeks later, the stent was removed, and passage through the gastric tube improved. The patient has no symptoms of stenosis. A removable SEMS could be an option for the treatment of gastric tube stenosis after esophagectomy.

A David and Goliath story: tobacco advertising and self-regulation in Australia.

PubMed

Chapman, S

1980-11-01

A small group of health workers succeeded in getting the largest tobacco advertising campaign in Australia banned by testing a clause in the advertising industry's voluntary code of self-regulation. The group complained about a series of cigarette advertisements that featured an Australian entertainer who was popular with the young. Though the tobacco company denied the entertainer's major appeal to the young, the chairman of the Advertising Standards Council ruled that the campaign did breach the code. The delay before the complaint was adjudicated--18 months--contrasted with the speed with which a series of antismoking advertisements had been withdrawn after complaints by a tobacco company's advertisers. MOP UP's victory in this case contains several lessons for people interested in restricting the promotional activities of multinational tobacco companies.

Evaluation of Body Image and Sexual Satisfaction in Women Undergoing Female Genital Plastic/Cosmetic Surgery.

PubMed

Goodman, Michael P; Placik, Otto J; Matlock, David L; Simopoulos, Alex F; Dalton, Teresa A; Veale, David; Hardwick-Smith, Susan

2016-10-01

Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS). To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction. Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty, clitoral hood reduction, and/or aesthetic vaginal tightening, defined as perineoplasty + "vaginoplasty" (aka "vaginal rejuvenation."). Outcome measures include body image, genital self-image, sexual satisfaction, and body esteem. As a group, study patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients were in a range considered to be mild to moderately dysmorphic, but matched controls at one and two years; genital self-image scores at entry were considerably lower than controls, but by 2-year follow-up had surpassed control value at entry. Similarly, sexual satisfaction values, significantly lower at entry, equaled at one, and surpassed control values, at 2 years. Postoperatively, at all points in time, these differences in body image and genital self-image disappeared, and sexual satisfaction markedly improved. Overall body esteem did not differ between study and control groups, with the exception of the genital esteem quotient, which improved after surgery. Women requesting and completing FGPS, when tested by validated instruments, at entry report sexual dissatisfaction and negative genital self-image. When tested at several points in time after surgery up to two years, these findings were no longer present. When performed by an experienced surgeon, FGPS appears to provide sexual and genital self-image improvement. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Effects of Diabetic Case Management on Knowledge, Self-Management Abilities, Health Behaviors, and Health Service Utilization for Diabetes in Korea

PubMed Central

Shin, Soon Ae; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

Purpose This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. Materials and Methods The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. Results The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. Conclusion This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program. PMID:25510771

Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea.

PubMed

Shin, Soon Ae; Kim, Hyeongsu; Lee, Kunsei; Lin, Vivian; Liu, George; Shin, Eunyoung

2015-01-01

This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design. The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007. The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention. This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program.

Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia.

PubMed

Blanchard, R; Hucker, S J

1991-09-01

Autoerotic asphyxia is the practice of self-inducing cerebral anoxia, usually by hanging, strangulation, or suffocation, during masturbation. This study investigated the relationships between: asphyxiators' ages; two paraphilias commonly accompanying autoerotic asphyxia, bondage and transvestism; and various other types of simultaneous sexual behaviour. Subjects were two concurrent series totalling 117 males aged 10-56 who died accidentally during autoerotic asphyxial activities. Data concerning sexual paraphernalia at the scene of death or among the deceased's effects were extracted from coronors' files using standardised protocols. Anal self-stimulation with dildos, etc., and self-observation with mirrors or cameras were correlated with transvestism. Older asphyxiators were more likely to have been simultaneously engaged in bondage or transvestism, suggesting elaboration of the masturbatory ritual over time. The greatest degree of transvestism was associated with intermediate rather than high levels of bondage, suggesting that response competition from bondage may limit asphyxiators' involvement in a third paraphilia like transvestism.

Associations between self-reported pest treatments and pesticide concentrations in carpet dust.

PubMed

Deziel, Nicole C; Colt, Joanne S; Kent, Erin E; Gunier, Robert B; Reynolds, Peggy; Booth, Benjamin; Metayer, Catherine; Ward, Mary H

2015-03-25

Recent meta-analyses demonstrate an association between self-reported residential pesticide use and childhood leukemia risk. Self-reports may suffer from recall bias and provide information only on broad pesticide categories. We compared parental self-reported home and garden pest treatments to pesticides measured in carpet dust. Parents of 277 children with leukemia and 306 controls in Northern and Central California (2001-2007) were asked about insect and weed treatments during the previous year. Carpet dust samples were analyzed for 47 pesticides. We present results for the 7 insecticides (carbaryl, propoxur, chlorpyrifos, diazinon, cyfluthrin, cypermethrin, permethrin), 5 herbicides (2,4-dichlorophenoxyacetic acid [2,4-D], chlorthal, dicamba, mecoprop, simazine), and 1 synergist (piperonyl butoxide) that were present in home and garden products during the study period and were detected in ≥25% of carpet dust samples. We constructed linear regression models for the relative change in pesticide concentrations associated with self-reported treatment of pest types in cases and controls separately and combined, adjusting for demographics, housing characteristics, and nearby agricultural pesticide applications. Several self-reported treatments were associated with pesticide concentrations in dust. For example, households with flea/tick treatments had 2.3 (95% Confidence Interval [CI]: 1.4, 3.7) times higher permethrin concentrations than households not reporting this treatment. Households reporting treatment for ants/cockroaches had 2.5 (95% CI: 1.5, 4.2) times higher cypermethrin levels than households not reporting this treatment. Weed treatment by a household member was associated with 1.9 (1.4, 2.6), 2.2 (1.6, 3.1), and 2.8 (2.1, 3.7) times higher dust concentrations of dicamba, mecoprop, and 2,4-D, respectively. Weed treatments by professional applicators were null/inversely associated with herbicide concentrations in dust. Associations were generally similar between cases and controls and were consistent with pesticide active ingredients in these products during the study time period. Consistency between self-reported pest treatments, concentrations in dust, and pesticides in products lends credibility to the exposure assessment methods and suggests that differential recall by case-control status is minimal.

An evaluation of the efficacy of a triple P-positive parenting program podcast series.

PubMed

Morawska, Alina; Tometzki, Helen; Sanders, Matthew R

2014-01-01

Parenting programs based on cognitive-behavioral and social learning principles are effective in changing child behavior problems and parenting styles. However, such programs typically have limited population reach. The current study aimed to evaluate the efficacy of a brief radio series that provided parenting advice based on the Triple P-Positive Parenting Program. One hundred thirty-nine parents of children aged 2 to 10 years who had concerns about their child's behavioral and/or emotional adjustment were recruited, randomly assigned to either an intervention or waitlist control group, and completed online self-report measures. Parents in the intervention group were given access to seven Triple P podcasts online over a period of 2 weeks. Parents in the intervention group improved significantly more than parents in the control group, from pre- to postintervention, on measures of child behavioral problems and parenting style, self-efficacy, and confidence. These short-term intervention effects were maintained at the 6-month follow-up. These results suggest that brief radio and online parenting programs can be effective and have the potential to reach a large proportion of parents experiencing child behavior problems. Limitations, clinical significance, and future research suggestions are discussed.

Effect of driving voltages in dual capacitively coupled radio frequency plasma: A study by nonlinear global model

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

Bora, B., E-mail: bbora@cchen.cl

2015-10-15

On the basis of nonlinear global model, a dual frequency capacitively coupled radio frequency plasma driven by 13.56 MHz and 27.12 MHz has been studied to investigate the influences of driving voltages on the generation of dc self-bias and plasma heating. Fluid equations for the ions inside the plasma sheath have been considered to determine the voltage-charge relations of the plasma sheath. Geometrically symmetric as well as asymmetric cases with finite geometrical asymmetry of 1.2 (ratio of electrodes area) have been considered to make the study more reasonable to experiment. The electrical asymmetry effect (EAE) and finite geometrical asymmetry is found tomore » work differently in controlling the dc self-bias. The amount of EAE has been primarily controlled by the phase angle between the two consecutive harmonics waveforms. The incorporation of the finite geometrical asymmetry in the calculations shift the dc self-bias towards negative polarity direction while increasing the amount of EAE is found to increase the dc self-bias in either direction. For phase angle between the two waveforms ϕ = 0 and ϕ = π/2, the amount of EAE increases significantly with increasing the low frequency voltage, whereas no such increase in the amount of EAE is found with increasing high frequency voltage. In contrast to the geometrically symmetric case, where the variation of the dc self-bias with driving voltages for phase angle ϕ = 0 and π/2 are just opposite in polarity, the variation for the geometrically asymmetric case is different for ϕ = 0 and π/2. In asymmetric case, for ϕ = 0, the dc self-bias increases towards the negative direction with increasing both the low and high frequency voltages, but for the ϕ = π/2, the dc-self bias is increased towards positive direction with increasing low frequency voltage while dc self-bias increases towards negative direction with increasing high frequency voltage.« less

Toward a Model for the Conceptual Understanding of Personal Learning Environments: A Case Study

ERIC Educational Resources Information Center

Ivanova, Malinka; Chatti, Mohamed Amine

2011-01-01

The development of Personal Learning Environments (PLEs) is in the scope of research groups and educators aiming to propose suitable mechanisms for the organization of self-controlled and self-directed learning, providing students with tools and services for access to content and human intelligence inside and outside the educational institutions.…

Getting Down to Business: Pest Control Service, Module 28. [Student Guide]. Entrepreneurship Training Components.

ERIC Educational Resources Information Center

Colby, Pamela G.

This module on owning and operating a pest control service is one of 36 in a series on entrepreneurship. The introduction tells the student what topics will be covered and suggests other modules to read in related occupations. Each unit includes student goals, a case study, and a discussion of the unit subject matter. Learning activities are…

Unmanned Aircraft Systems Human-in-the-Loop Controller and Pilot Acceptability Study: Collision Avoidance, Self-Separation, and Alerting Times (CASSAT)

NASA Technical Reports Server (NTRS)

Comstock, James R., Jr.; Ghatas, Rania W.; Vincent, Michael J.; Consiglio, Maria C.; Munoz, Cesar; Chamberlain, James P.; Volk, Paul; Arthur, Keith E.

2016-01-01

The Federal Aviation Administration (FAA) has been mandated by the Congressional funding bill of 2012 to open the National Airspace System (NAS) to Unmanned Aircraft Systems (UAS). With the growing use of unmanned systems, NASA has established a multi-center "UAS Integration in the NAS" Project, in collaboration with the FAA and industry, and is guiding its research efforts to look at and examine crucial safety concerns regarding the integration of UAS into the NAS. Key research efforts are addressing requirements for detect-and-avoid (DAA), self-separation (SS), and collision avoidance (CA) technologies. In one of a series of human-in-the-loop experiments, NASA Langley Research Center set up a study known as Collision Avoidance, Self-Separation, and Alerting Times (CASSAT). The first phase assessed active air traffic controller interactions with DAA systems and the second phase examined reactions to the DAA system and displays by UAS Pilots at a simulated ground control station (GCS). Analyses of the test results from Phase I and Phase II are presented in this paper. Results from the CASSAT study and previous human-in-the-loop experiments will play a crucial role in the FAA's establishment of rules, regulations, and procedures to safely, efficiently, and effectively integrate UAS into the NAS.

Self-perceived psychological stress and ischemic stroke: a case-control study

PubMed Central

Jood, Katarina; Redfors, Petra; Rosengren, Annika; Blomstrand, Christian; Jern, Christina

2009-01-01

Background A growing body of evidence suggests that psychological stress contributes to coronary artery disease. However, associations between stress and stroke are less clear. In this study, we investigated the possible association between ischemic stroke and self-perceived psychological stress, as measured by a single-item questionnaire, previously reported to be associated with myocardial infarction. Methods In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), 600 consecutive patients with acute ischemic stroke (aged 18 to 69 years) and 600 age-matched and sex-matched population controls were recruited. Ischemic stroke subtype was determined according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Self-perceived psychological stress preceding stroke was assessed retrospectively using a single-item questionnaire. Results Permanent self-perceived psychological stress during the last year or longer was independently associated with overall ischemic stroke (multivariate adjusted odds ratio (OR) 3.49, 95% confidence interval (CI) 2.06 to 5.93). Analyses by stroke subtype showed that this association was present for large vessel disease (OR 3.91, 95% CI 1.58 to 9.67), small vessel disease (OR 3.20, 95% CI 1.64 to 6.24), and cryptogenic stroke (OR 4.03, 95% CI 2.34 to 6.95), but not for cardioembolic stroke (OR 1.48, 95% CI 0.64 to 3.39). Conclusion In this case-control study, we found an independent association between self-perceived psychological stress and ischemic stroke. A novel finding was that this association differed by ischemic stroke subtype. Our results emphasize the need for further prospective studies addressing the potential role for psychological stress as a risk factor for ischemic stroke. In such studies ischemic stroke subtypes should be taken into consideration. PMID:19796376

Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

PubMed

Hawken, Steven; Kwong, Jeffrey C; Deeks, Shelley L; Crowcroft, Natasha S; Ducharme, Robin; Manuel, Douglas G; Wilson, Kumanan

2013-01-01

We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR). For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated. Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.

A case series of an off-the-shelf online health resource with integrated nurse coaching to support self-management in COPD.

PubMed

Early, Frances; Young, Jane S; Robinshaw, Elizabeth; Mi, Emma Z; Mi, Ella Z; Fuld, Jonathan P

2017-01-01

COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP), coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t -tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Our findings demonstrate the feasibility of combining nurse-coach support aligned to an Internet-based health resource, TPP, in COPD and provide learning about the challenges of such an approach and the importance of the nurse-coach role.

Cystoisospora belli Infection of the Gallbladder in Immunocompetent Patients: A Clinicopathologic Review of 18 Cases.

PubMed

Lai, Keith K; Goyne, Hannah E; Hernandez-Gonzalo, David; Miller, Kennon A; Tuohy, Marion; Procop, Gary W; Lamps, Laura W; Patil, Deepa T

2016-08-01

Cystoisospora belli, previously known as Isospora belli, is an obligate intracellular coccidian parasite that is most often associated with gastrointestinal disease in immunocompromised patients. In this study, we detail the clinicopathologic features of 18 cases of Cystoisospora infection affecting the gallbladder in immunocompetent individuals and compare them with a control group. Each case was reviewed for cholecystitis (none, acute, chronic), epithelial disarray, presence of intraepithelial lymphocytes (none, rare [≤5 per 20 epithelial cells], present [>5 per 20 epithelial cells]), architectural distortion, intramucosal eosinophilia, and mural thickening/serositis. The mean age of patients with Cystoisospora infection was 33 years and the male to female ratio 1:4.3. Cholecystectomy was performed for biliary dyskinesia (n=7), abdominal pain (n=7), suspected cholelithiasis (n=5), and cholecystitis (n=3). In 2 cases, Cystoisospora was found in donor gallbladders resected at the time of liver transplantation. Each case was characterized by eosinophilic, oval or banana-shaped intraepithelial parasites within perinuclear parasitophorous vacuoles. Most cases showed epithelial disarray and minimal intraepithelial lymphocytosis. Of the 11 cases with an average follow-up of 15 months, none had evidence of disease related to Cystoisospora infection within the biliary tract or elsewhere in the gastrointestinal tract. We present the largest series of gallbladder cystoisosporiasis in immunocompetent patients to date. Cystoisospora infection is underrecognized in the gallbladders of immunocompetent patients, in part due to the subtle findings in routine cholecystectomy specimens. On the basis of the clinical follow-up, gallbladder cystoisosporiasis in immunocompetent individuals appears to be a self-limited infection.

The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain--a randomised controlled pilot study.

PubMed

Lauche, Romy; Cramer, Holger; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Dobos, Gustav J; Musial, Frauke

2011-08-15

In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. The trial was registered at clinicaltrials.gov (NCT01289964).

The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain - a randomised controlled pilot study

PubMed Central

2011-01-01

Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas. Results Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT. Conclusions A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. Trial registration The trial was registered at clinicaltrials.gov (NCT01289964). PMID:21843336

Can Customizing an Avatar Motivate Exercise Intentions and Health Behaviors Among Those with Low Health Ideals?

PubMed

Waddell, T Franklin; Sundar, S Shyam; Auriemma, Joshua

2015-11-01

Studies have shown that self-resembling avatars in health games and other applications can heighten exercise intentions, but objective self-awareness (OSA) theory suggests that this effect is likely to be true only for those who believe in the ideal of a healthy self. How can avatars be used to motivate those who do not hold this ideal and may not be motivated by avatars to pursue healthy activities? One possibility is to afford individuals the ability to customize their avatar, so they are not only more self-aware but also feel in control of their persona, both of which are necessary conditions for behavior change according to OSA. In order to test this prediction, participants in an online virtual environment created an avatar of the same sex or opposite sex by choosing among a small or large number of possible traits, then completed a series of items measuring self-awareness, sense of control, health-focused behavior, and ideal internalization. Results show that customizing a same-sex avatar can overcome differences in health intentions and behaviors between individuals with high and low levels of prior health-ideal internalization.

Work at the Uddevalla Volvo Plant from the Perspective of the Demand-Control Model

ERIC Educational Resources Information Center

Lottridge, Danielle

2004-01-01

The Uddevalla Volvo plant represents a different paradigm for automotive assembly. In parallel-flow work, self-managed work groups assemble entire automobiles with comparable productivity as conventional series-flow assembly lines. From the perspective of the demand-control model, operators at the Uddevalla plant have low physical and timing…

Research participation experiences of informants of suicide and control cases: taken from a case-control psychological autopsy study of people who died by suicide.

PubMed

Wong, Paul W C; Chan, Wincy S C; Beh, Philip S L; Yau, Fiona W S; Yip, Paul S F; Hawton, Keith

2010-01-01

Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. (1) To investigate whether informants of suicide cases recruited by two approaches (coroners' court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. The acceptance rate for our original psychological autopsy study was modest. The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

Respiratory disease and suicide among US coal miners: is there a relationship

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

Ames, R.G.

A case-control study was performed to test whether or not respiratory disease in coal miners presented a risk for suicide. While coal miners in general do not experience elevated rates of suicide, coal miners with respiratory disease have been found to have high rates of psychiatric disability, especially depressive reactions. Further, depression has been related to suicide. To test the hypothesis, 50 suicide deaths from four National Institute for Occupational Safety and Health cohorts of coal miners were matched by age at death to two series of controls, a noncancer, nonaccident control series, and a cancer control series. Using oddsmore » ratios (tested by chi-square) the risks of obstructive lung disease and coal workers pneumoconiosis were evaluated together with the risks of years of underground mining, cigarette smoking at the time of cohort creation, and ever having smoked cigarettes. Neither respiratory disease was found to pose a statistically elevated risk of suicide in this sample of U.S. white male coal miners.« less

The effects of neck and trunk stabilization exercises on cerebral palsy children’s static and dynamic trunk balance: case series

PubMed Central

Shin, Ji-won; Song, Gui-bin; Ko, Jooyeon

2017-01-01

[Purpose] The purpose of this case series was to examination the effects of trunk and neck stabilization exercise on the static, dynamic trunk balance abilities of children with cerebral palsy. [Subjects and Methods] The study included 11 school aged children diagnosed with paraplegia due to a premature birth. Each child engaged in exercise treatments twice per week for eight weeks; each treatment lasted for 45 minutes. After conducting a preliminary assessment, exercise treatments were designed based on each child’s level of functioning. Another assessment was conducted after the eight weeks of treatment. [Results] The Trunk Control Measurement Scale evaluation showed that the exercise treatments had a significant effect on static sitting balance, selective movement control, dynamic reaching, and total Trunk Control Measurement Scale scores. [Conclusion] The results indicate that neck and trunk stabilization exercises that require children’s active participation are helpful for improving static and dynamic balance ability among children diagnosed with cerebral palsy. PMID:28533628

Information Needs of Cancer Patients and Perception of Impact of the Disease, of Self-Efficacy, and Locus of Control.

PubMed

Keinki, C; Seilacher, E; Ebel, M; Ruetters, D; Kessler, I; Stellamanns, J; Rudolph, I; Huebner, J

2016-09-01

The aim of our study was to investigate the relationship between information needs and cancer patients' perceptions of the impact of the disease, self-efficacy, and locus of control. Using a standardized questionnaire, we obtained data from patients who attended a series of lectures. The questionnaire included questions on their information needs, sources of information, satisfaction with information, and short questionnaires on self-efficacy, perception of the disease, and locus of control of reinforcement. Data was obtained from 185 patients. Our results showed that the sources of information that were most often used were physicians (84 %), print media (68 %), and the Internet (59 %); online fora (7.5 %), non-medical practitioners (9.7 %), and telephone-based counseling (8.6 %) were only used by a minority. Patients with a high perception of their own control over the disease more often used any source of information available to them and were more often interested in acquiring additional information. Higher self-efficacy was significantly associated with the need for information on all topics. Patients with a higher external locus of control significantly more often used sources of information and had significantly more need for additional information. By contrast, there were no associations with an internal locus of control. Neither external nor internal locus of control showed any associations with satisfaction with information. Information needs seem to be higher in patients with a high external locus of control and low self-efficacy. Physicians, other professionals, and institutions that provide information may take these relationships into consideration for tailoring their services to patients.

Impact of random and systematic recall errors and selection bias in case--control studies on mobile phone use and brain tumors in adolescents (CEFALO study).

PubMed

Aydin, Denis; Feychting, Maria; Schüz, Joachim; Andersen, Tina Veje; Poulsen, Aslak Harbo; Prochazka, Michaela; Klaeboe, Lars; Kuehni, Claudia E; Tynes, Tore; Röösli, Martin

2011-07-01

Whether the use of mobile phones is a risk factor for brain tumors in adolescents is currently being studied. Case--control studies investigating this possible relationship are prone to recall error and selection bias. We assessed the potential impact of random and systematic recall error and selection bias on odds ratios (ORs) by performing simulations based on real data from an ongoing case--control study of mobile phones and brain tumor risk in children and adolescents (CEFALO study). Simulations were conducted for two mobile phone exposure categories: regular and heavy use. Our choice of levels of recall error was guided by a validation study that compared objective network operator data with the self-reported amount of mobile phone use in CEFALO. In our validation study, cases overestimated their number of calls by 9% on average and controls by 34%. Cases also overestimated their duration of calls by 52% on average and controls by 163%. The participation rates in CEFALO were 83% for cases and 71% for controls. In a variety of scenarios, the combined impact of recall error and selection bias on the estimated ORs was complex. These simulations are useful for the interpretation of previous case-control studies on brain tumor and mobile phone use in adults as well as for the interpretation of future studies on adolescents. Copyright © 2011 Wiley-Liss, Inc.

Baclofen and Alcohol-Dependent Patients: A Real Risk of Severe Self-Poisoning.

PubMed

Boels, David; Victorri-Vigneau, Caroline; Grall-Bronnec, Marie; Touré, Ali; Garnier, Anais; Turcant, Alain; Le Roux, Gaël

2017-10-01

Baclofen is often prescribed in high doses to fight cravings experienced by alcohol-dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self-poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self-poisoning with baclofen and to focus on co-existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self-poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014. One hundred and eleven cases of self-poisoning with baclofen were reported to the western France PCC (62 males and 49 females; average age 39 ± 12). Poisoning severities were as follows: 'null' (nine cases), 'minor' (37 cases), 'moderate' (19 cases) and 'high' (46 cases, including four deaths). The most frequently reported symptoms were neurological (45%) and cardiovascular (27%). The severity was significantly associated with psychiatric disorders (OR = 2.9; p = 0.03). Baclofen, prescribed in high doses, may lead to severe poisoning, particularly in patients with psychiatric illnesses. Authorities should put forward a new policy for prescribing the drug as a treatment for alcohol dependence. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Left or right? Lateralizing temporal lobe epilepsy by dynamic amygdala fMRI.

PubMed

Ives-Deliperi, Victoria; Butler, James Thomas; Jokeit, Hennric

2017-05-01

In this case series, the findings of 85 functional MRI studies employing a dynamic fearful face paradigm are reported. Previous findings have shown the paradigm to generate bilateral amygdala activations in healthy subjects and unilateral activations in patients with MTLE, in the contralateral hemisphere to seizure origin. Such findings suggest ipsilateral limbic pathology and offer collateral evidence in lateralizing MTLE. The series includes 60 patients with TLE, 12 patients with extra-temporal lobe epilepsy, and 13 healthy controls. Functional MRI studies using a 1.5T scanner were conducted over a three-year period at a single epilepsy center and individual results were compared with EEG findings. In the cohort of unilateral TLE patients, lateralized activations of the amygdala were concordant with EEG findings in 76% of patients (77% lTLE, 74% rTLE). The differences in the mean lateralized indices of the lTLE, rTLE, and healthy control groups were all statistically significant. Lateralized amygdala activations were concordant with EEG findings in only 31% of the 12 patients with extra-temporal lobe epilepsy and bilateral amygdala activations were generated in all but one of the healthy control subjects. This case series further endorses the utility of the dynamic fearful face functional MRI paradigm using the widely available 1.5T as an adjunctive investigation to lateralize TLE. Copyright © 2017 Elsevier Inc. All rights reserved.

Polygenic risk score analysis of pathologically confirmed Alzheimer disease.

PubMed

Escott-Price, Valentina; Myers, Amanda J; Huentelman, Matt; Hardy, John

2017-08-01

Previous estimates of the utility of polygenic risk score analysis for the prediction of Alzheimer disease have given area under the curve (AUC) estimates of <80%. However, these have been based on the genetic analysis of clinical case-control series. Here, we apply the same analytic approaches to a pathological case-control series and show a predictive AUC of 84%. We suggest that this analysis has clinical utility and that there is limited room for further improvement using genetic data. Ann Neurol 2017;82:311-314. © 2017 American Neurological Association.

Biomarkers and Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analyses

ERIC Educational Resources Information Center

Scassellati, Catia; Bonvicini, Cristian; Faraone, Stephen V.; Gennarelli, Massimo

2012-01-01

Objective: To determine whether peripheral biochemical markers (biomarkers) might differentiate patients with attention-deficit/hyperactivity disorder (ADHD) from non-ADHD individuals. Method: We conducted a systematic search and a series of meta-analyses of case-control studies comprising studies from 1969 to 2011. Results: We identified 210…

Online Case-Based Learning Design for Facilitating Classroom Teachers' Development of Technological, Pedagogical, and Content Knowledge

ERIC Educational Resources Information Center

Saltan, Fatih

2017-01-01

The aim of this study is to investigate whether, and if so how, online case-based learning influence pre-service classroom teachers' self-confidence on technological pedagogical content knowledge (TPACK). To achieve the goal, a control group pretest-posttest quasi experimental design was used. Participants of the study consisted of 160 pre-service…

A Case Study on the Perceptions of Educators on the Penetration of Personal Learning Environments in Typical Education

ERIC Educational Resources Information Center

Armakolas, Stefanos; Mikroyannidis, Alexander; Panagiotakopoulos, Christos; Panousopoulou, Theofania

2016-01-01

Personal Learning Environments (PLEs) help students manage and take control of their own learning. As such, the PLE promotes self-regulation in learning and allows learners to aggregate, manipulate and share digital artefacts within a flexible and versatile online space. This paper presents a case study in Greece, concerning an investigation about…

Energy System Basics and Distribution Integration Video Series | Energy

Science.gov Websites

renewablesparticularly solar photovoltaic (PV) technologiesonto the distribution grid. Solar Energy Technologies PV Integration Case Studies Integrating Photovoltaic Systems onto Secondary Network Distribution Systems Standards and Codes for U.S. Photovoltaic System Installation Network-Optimal Control of Photovoltaics on

Seeing the bigger picture: training in perspective broadening reduces self-reported affect and psychophysiological response to distressing films and autobiographical memories.

PubMed

Schartau, Patricia E S; Dalgleish, Tim; Dunn, Barnaby D

2009-02-01

Appraising negative experiences in ways that reduce associated distress is a key component of successful emotion regulation. In 4 studies, the authors examined the effects of systematically practicing appraisal skills using a computer-mediated cognitive bias modification (CBM) methodology. In Studies 1-3, healthy participants practiced applying appraisal themes linked to the idea of seeing the bigger picture to a series of distressing training films, either during each film (Study 1) or immediately after each film (Studies 2 and 3). Control participants watched the same films with no appraisal instructions. Participants who practiced appraisal, compared with controls, exhibited reduced levels of self-reported negative emotional (Studies 1-3) and electrodermal (Study 1) responses to a final test film that all participants were instructed to appraise. In Study 4, a comparable effect of appraisal practice was found using distressing autobiographical memories for participants with higher levels of negative affect. Appraisal practice also led to reduced intrusion and avoidance of the target memories in the week poststudy, compared with prestudy levels, and relative to the no-practice controls. The findings are discussed in terms of the broader literature on CBM.

Them Children: A Study in Language Learning. Case Studies in Education and Culture Series.

ERIC Educational Resources Information Center

Ward, Martha Coonfield

This is a study of how children in a small community called Rosepoint, in the vicinity of New Orleans, acquire speech. The author provides essential contextualization for her problem, dealing with family composition, life space, means used to control children, and interaction between members of the household. The author made intensive observations…

Power Laws, Scale Invariance and the Generalized Frobenius Series:

NASA Astrophysics Data System (ADS)

Visser, Matt; Yunes, Nicolas

We present a self-contained formalism for calculating the background solution, the linearized solutions and a class of generalized Frobenius-like solutions to a system of scale-invariant differential equations. We first cast the scale-invariant model into its equidimensional and autonomous forms, find its fixed points, and then obtain power-law background solutions. After linearizing about these fixed points, we find a second linearized solution, which provides a distinct collection of power laws characterizing the deviations from the fixed point. We prove that generically there will be a region surrounding the fixed point in which the complete general solution can be represented as a generalized Frobenius-like power series with exponents that are integer multiples of the exponents arising in the linearized problem. While discussions of the linearized system are common, and one can often find a discussion of power-series with integer exponents, power series with irrational (indeed complex) exponents are much rarer in the extant literature. The Frobenius-like series we encounter can be viewed as a variant of the rarely-discussed Liapunov expansion theorem (not to be confused with the more commonly encountered Liapunov functions and Liapunov exponents). As specific examples we apply these ideas to Newtonian and relativistic isothermal stars and construct two separate power series with the overlapping radius of convergence. The second of these power series solutions represents an expansion around "spatial infinity," and in realistic models it is this second power series that gives information about the stellar core, and the damped oscillations in core mass and core radius as the central pressure goes to infinity. The power-series solutions we obtain extend classical results; as exemplified for instance by the work of Lane, Emden, and Chandrasekhar in the Newtonian case, and that of Harrison, Thorne, Wakano, and Wheeler in the relativistic case. We also indicate how to extend these ideas to situations where fixed points may not exist — either due to "monotone" flow or due to the presence of limit cycles. Monotone flow generically leads to logarithmic deviations from scaling, while limit cycles generally lead to discrete self-similar solutions.

The neural correlates of self-referential memory encoding and retrieval in schizophrenia.

PubMed

Jimenez, Amy M; Lee, Junghee; Wynn, Jonathan K; Green, Michael F

2018-01-31

Enhanced memory for self-oriented information is known as the self-referential memory (SRM) effect. fMRI studies of the SRM effect have focused almost exclusively on encoding, revealing selective engagement of the medial prefrontal cortex (mPFC) during "self" relative to other processing conditions. Other critical areas for self-processing include ventrolateral prefrontal cortex (vlPFC), temporo-parietal junction (TPJ) and posterior cingulate/precuneus (PCC/PC). Previous behavioral studies show that individuals with schizophrenia fail to benefit from this memory boost. However, the neural correlates of this deficit, at either encoding or retrieval, are unknown. Twenty individuals with schizophrenia and 16 healthy controls completed an event-related fMRI SRM paradigm. During encoding, trait adjectives were judged in terms of structural features ("case" condition), social desirability ("other" condition), or as self-referential ("self" condition). Participants then completed an unexpected recognition test (retrieval phase). We examined BOLD activation during both encoding and retrieval within mPFC, vlPFC, TPJ, and PCC/PC regions-of-interest (ROIs). During encoding, fMRI data indicated both groups had greater activation during the "self" relative to the "other" condition across ROIs. Controls showed this primarily in mPFC whereas patients showed this in PCC/PC. During retrieval, fMRI data indicated controls showed differentiation across ROIs between "self" and "other" conditions, but patients did not. Results suggest regional differences in the neural processing of self-referential information in individuals with schizophrenia, perhaps because representation of the self is not as well established in patients relative to controls. The current study presents novel findings that add to the literature implicating impaired self-oriented processing in schizophrenia. Published by Elsevier Ltd.

Self-medication with antibiotics in the Republic of Srpska community pharmacies: pharmacy staff behavior.

PubMed

Marković-Peković, Vanda; Grubiša, Nataša

2012-10-01

Self-medication with antibiotics adds to the global risk of increased spread of bacterial resistance. Attitudes and behavior of health professionals also may reinforce self-medication with antibiotics. The aim of this study was to determine whether self-medication with antibiotics is possible in our community pharmacies and to what extent, and to evaluate the behavior and service of pharmacy health professionals regarding non-prescription antibiotic dispensation. An observational, cross-section study was conducted, and pseudo-patient methodology was used to establish the kind of professional service provided in case of patient's explicit demand to buy an antibiotic for treatment of self-diagnosed upper respiratory tract infection. Of the total 318 community pharmacies, 131 (41%) were visited and included in the study. Non-prescription antibiotics were dispensed in 76 (58%) pharmacies. Counseling and symptomatic therapy was offered in 88 (67%) pharmacies. In 25% of pharmacies, no symptomatic therapy was offered; instead, only an antibiotic was sold. Amoxicillin was sold in 85% of cases and, mostly, the one of 1.30 Euro per pack. Both oral and written use instructions were given in 78% cases, whereas none was given in 3% of cases. Self-medication with antibiotics occurs in our community pharmacies, despite being illegal. Pharmacy staff behavior can be a factor that puts patients at risk for self-medication with antibiotics. Community pharmacies are failing their tasks in enhancing rational use of antibiotics. Such a practice may be a consequence of weak enforcement and control over the legislation and professional standards. Copyright © 2012 John Wiley & Sons, Ltd.

Social Media Self-Efficacy of Health Education Specialists: Training and Organizational Development Implications.

PubMed

Alber, Julia M; Paige, Samantha; Stellefson, Michael; Bernhardt, Jay M

2016-11-01

A growing number of public health organizations are applying the power of social media (SM) for health promotion and behavior change. This cross-sectional study of health education specialists (n = 353) examined which demographic and occupational factors were associated with SM self-efficacy, and evaluated SM self-efficacy related to each of the Seven Areas of Responsibility. A series of one-way analyses of variance were conducted to determine whether differences in SM self-efficacy existed by sex, age, years of work experience, and SM access at work. A multiple linear regression examined the relationship between SM self-efficacy and SM experience when controlling for demographic and occupational factors. Statistically significant differences in SM self-efficacy existed by age, F(2, 289) = 6.54, p = .002. SM experience (β = 1.43, t = 11.35, p < .001) was a statistically significant predictor of SM self-efficacy, even after controlling for age, sex, years of work experience, and level of SM access, F(5, 290) = 30.88, p < .001, R 2 = .35. Results revealed statistically significant differences in mean SM self-efficacy scores by the Areas of Responsibility, F(4.69, 1425.46) = 22.46, p < .001. Professional health organizations should have policies in place and trainings that are conducive to learning and applying SM for health education research and practice. © 2016 Society for Public Health Education.

Modeling and projection of dengue fever cases in Guangzhou based on variation of weather factors.

PubMed

Li, Chenlu; Wang, Xiaofeng; Wu, Xiaoxu; Liu, Jianing; Ji, Duoying; Du, Juan

2017-12-15

Dengue fever is one of the most serious vector-borne infectious diseases, especially in Guangzhou, China. Dengue viruses and their vectors Aedes albopictus are sensitive to climate change primarily in relation to weather factors. Previous research has mainly focused on identifying the relationship between climate factors and dengue cases, or developing dengue case models with some non-climate factors. However, there has been little research addressing the modeling and projection of dengue cases only from the perspective of climate change. This study considered this topic using long time series data (1998-2014). First, sensitive weather factors were identified through meta-analysis that included literature review screening, lagged analysis, and collinear analysis. Then, key factors that included monthly average temperature at a lag of two months, and monthly average relative humidity and monthly average precipitation at lags of three months were determined. Second, time series Poisson analysis was used with the generalized additive model approach to develop a dengue model based on key weather factors for January 1998 to December 2012. Data from January 2013 to July 2014 were used to validate that the model was reliable and reasonable. Finally, future weather data (January 2020 to December 2070) were input into the model to project the occurrence of dengue cases under different climate scenarios (RCP 2.6 and RCP 8.5). Longer time series analysis and scientifically selected weather variables were used to develop a dengue model to ensure reliability. The projections suggested that seasonal disease control (especially in summer and fall) and mitigation of greenhouse gas emissions could help reduce the incidence of dengue fever. The results of this study hope to provide a scientifically theoretical basis for the prevention and control of dengue fever in Guangzhou. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk of venous thromboembolism following influenza vaccination in adults aged 50years and older in the Vaccine Safety Datalink.

PubMed

Vickers, Elizabeth R; McClure, David L; Naleway, Allison L; Jacobsen, Steven J; Klein, Nicola P; Glanz, Jason M; Weintraub, Eric S; Belongia, Edward A

2017-10-13

Influenza-like illness and inflammation are known risk factors for venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). However, few studies have characterized the risk of VTE following influenza vaccination. We examined VTE risk after vaccination in adults 50years old and older within the Vaccine Safety Datalink (VSD). We used the self-controlled case series method to determine the risk of VTE among age-eligible adults who received influenza vaccine (with or without pandemic H1N1) and experienced a VTE during the months of September through December in 2007 through 2012. Presumptive VTE cases were identified among VSD participants using diagnostic codes, diagnostic tests, and oral anticoagulant prescription. Potential cases were validated by medical record review. The VTE incidence rate ratio was calculated among confirmed cases for the risk window 1 to 10days after vaccination relative to all other person-time from September through December. Of the 1,488 presumptive cases identified, 508 were reviewed, of which 492 (97%) were confirmed cases of VTE. The analysis included 396 incident, confirmed cases. Overall, there was no increased risk of VTE in the 1 to 10days after influenza vaccination (IRR=0.89, 95% CI 0.69-1.17) compared to the control period. Results were similar when all person-time was censored before vaccination. A post hoc analysis showed an increased risk among current tobacco smokers (IRR=2.57, 95% CI 1.06-6.23). No clustering of VTE was observed in the 1-42days after vaccination. Overall, there was no evidence that inactivated influenza vaccine was associated with VTE in adults ≥50years old. An increased risk was found among current smokers in a post hoc analysis. These findings are consistent with previous research and support the safety of annual vaccination in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vaginal dilator therapy for women receiving pelvic radiotherapy.

PubMed

Miles, Tracie; Johnson, Nick

2014-09-08

Vaginal dilation therapy is advocated after pelvic radiotherapy to prevent stenosis (abnormal narrowing of the vagina), but can be uncomfortable and psychologically distressing. To assess the benefits and harms of different types of vaginal dilation methods offered to women treated by pelvic radiotherapy for cancer. Searches included the Cochrane Central Register of Controlled Trials (CENTRAL 2013, Issue 5), MEDLINE (1950 to June week 2, 2013), EMBASE (1980 to 2013 week 24) and CINAHL (1982 to 2013). Comparative data of any type, which evaluated dilation or penetration of the vagina after pelvic radiotherapy treatment for cancer. Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no trials and therefore analysed no data. We identified no studies for inclusion in the original review or for this update. However, we felt that some studies that were excluded warranted discussion. These included one randomised trial (RCT), which showed no improvement in sexual scores associated with encouraging women to practise dilation therapy; a recent small RCT that did not show any advantage to dilation over vibration therapy during radiotherapy; two non-randomised comparative studies; and five correlation studies. One of these showed that objective measurements of vaginal elasticity and length were not linked to dilation during radiotherapy, but the study lacked power. One study showed that women who dilated tolerated a larger dilator, but the risk of objectivity and bias with historical controls was high. Another study showed that the vaginal measurements increased in length by a mean of 3 cm after dilation was introduced 6 to 10 weeks after radiotherapy, but there was no control group; another case series showed the opposite. Three recent studies showed less stenosis associated with prophylactic dilation after radiotherapy. One small case series suggested that dilation years after radiotherapy might restore the vagina to a functional length. There is no reliable evidence to show that routine, regular vaginal dilation during radiotherapy treatment prevents stenosis or improves quality of life. Several observational studies have examined the effect of dilation therapy after radiotherapy. They suggest that frequent dilation practice is associated with lower rates of self reported stenosis. This could be because dilation is effective or because women with a healthy vagina are more likely to comply with dilation therapy instructions compared to women with strictures. We would normally suggest that a RCT is needed to distinguish between a casual and causative link, but pilot studies highlight many reasons why RCT methodology is challenging in this area.

Effortless inhibition: habit mediates the relation between self-control and unhealthy snack consumption

PubMed Central

Adriaanse, Marieke A.; Kroese, Floor M.; Gillebaart, Marleen; De Ridder, Denise T. D.

2014-01-01

In contrast to prevailing beliefs, recent research suggests that trait self-control promotes health behavior not because those high in self-control are more successful at resisting single temptations, but rather because they develop adaptive habits. The present paper presents a first empirical test of this novel suggestion by investigating the mediating role of habit in explaining the relation between self-control and unhealthy snacking behavior. Results showed that self-control was negatively associated with unhealthy snack consumption and unhealthy snacking habits. As hypothesized, the relation between self-control and unhealthy snack intake was mediated by habit strength. Self-control was not associated with fruit consumption or fruit consumption habits. These results provide the first evidence for the notion that high self-control may influence the formation of habits and in turn affect behavior. Moreover, results imply that self-control may be particularly influential in case of inhibiting unhealthy food intake rather than promoting healthy food intake. PMID:24904463

Rare, evolutionarily unlikely missense substitutions in CHEK2 contribute to breast cancer susceptibility: results from a breast cancer family registry case-control mutation-screening study.

PubMed

Le Calvez-Kelm, Florence; Lesueur, Fabienne; Damiola, Francesca; Vallée, Maxime; Voegele, Catherine; Babikyan, Davit; Durand, Geoffroy; Forey, Nathalie; McKay-Chopin, Sandrine; Robinot, Nivonirina; Nguyen-Dumont, Tù; Thomas, Alun; Byrnes, Graham B; Hopper, John L; Southey, Melissa C; Andrulis, Irene L; John, Esther M; Tavtigian, Sean V

2011-01-18

Both protein-truncating variants and some missense substitutions in CHEK2 confer increased risk of breast cancer. However, no large-scale study has used full open reading frame mutation screening to assess the contribution of rare missense substitutions in CHEK2 to breast cancer risk. This absence has been due in part to a lack of validated statistical methods for summarizing risk attributable to large numbers of individually rare missense substitutions. Previously, we adapted an in silico assessment of missense substitutions used for analysis of unclassified missense substitutions in BRCA1 and BRCA2 to the problem of assessing candidate genes using rare missense substitution data observed in case-control mutation-screening studies. The method involves stratifying rare missense substitutions observed in cases and/or controls into a series of grades ordered a priori from least to most likely to be evolutionarily deleterious, followed by a logistic regression test for trends to compare the frequency distributions of the graded missense substitutions in cases versus controls. Here we used this approach to analyze CHEK2 mutation-screening data from a population-based series of 1,303 female breast cancer patients and 1,109 unaffected female controls. We found evidence of risk associated with rare, evolutionarily unlikely CHEK2 missense substitutions. Additional findings were that (1) the risk estimate for the most severe grade of CHEK2 missense substitutions (denoted C65) is approximately equivalent to that of CHEK2 protein-truncating variants; (2) the population attributable fraction and the familial relative risk explained by the pool of rare missense substitutions were similar to those explained by the pool of protein-truncating variants; and (3) post hoc power calculations implied that scaling up case-control mutation screening to examine entire biochemical pathways would require roughly 2,000 cases and controls to achieve acceptable statistical power. This study shows that CHEK2 harbors many rare sequence variants that confer increased risk of breast cancer and that a substantial proportion of these are missense substitutions. The study validates our analytic approach to rare missense substitutions and provides a method to combine data from protein-truncating variants and rare missense substitutions into a one degree of freedom per gene test.

Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases.

PubMed

Mahesh, Seema; Mallappa, Mahesh; Tsintzas, Dionysios; Vithoulkas, George

2017-12-02

BACKGROUND Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress. CASE REPORT A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment. CONCLUSIONS In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area.

Simulations of laminar boundary-layer flow encountering large-scale surface indentions

NASA Astrophysics Data System (ADS)

Beratlis, N.; Balaras, E.; Squires, K.; Vizard, A.

2016-03-01

The transition from laminar to turbulent flow over dimples and grooves has been investigated through a series of direct numerical simulations. Emphasis has been given to the mechanism of transition and the momentum transport in the post-dimple boundary layer. It has been found that the dimple geometry plays an important role in the evolution of the turbulent boundary layer downstream. The mechanism of transition in all cases is that of the reorientation of the spanwise vorticity into streamwise oriented structures resembling hairpin vortices commonly encountered in wall bounded turbulent flows. Although qualitatively the transition mechanism amongst the three different cases is similar, important quantitative differences exist. It was shown that two-dimensional geometries like a groove are more stable than three-dimensional geometries like a dimple. In addition, it was found that the cavity geometry controls the initial thickness of the boundary layer and practically results in a shift of the virtual origin of the turbulent boundary layer. Important differences in the momentum transport downstream of the dimples exist but in all cases the boundary layer grows in a self-similar manner.

Propranolol for treating emotional, behavioural, autonomic dysregulation in children and adolescents with autism spectrum disorders.

PubMed

Sagar-Ouriaghli, Ilyas; Lievesley, Kate; Santosh, Paramala J

2018-06-01

To date, there is no single medication prescribed to alleviate all the core symptoms of Autism Spectrum Disorder (ASD; National Institute of Health and Care Excellence, 2016). Both serotonin reuptake inhibitors and drugs for psychosis possess therapeutic drawbacks when managing anxiety and aggression in ASD. This review sought to appraise the use of propranolol as a pharmacological alternative when managing emotional, behavioural and autonomic dysregulation (EBAD) and other symptoms. Sixteen reports examined the administration of propranolol in the context of ASD. Sixteen reports broadly covered cognitive domains, neural correlates, and behavioural domains. From the eight single-dose clinical trials, propranolol led to significant improvements in cognitive performance - verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and changes in neural correlates - improvement in semantic networks and functional connectivity. The remaining eight case series and single case reports showed improvements in EBAD, anxiety, aggressive, self-injurious and hypersexual behaviours. Additionally, propranolol significantly improved similar behavioural domains (aggression and self-injury) for those with acquired brain injury. This review indicates that propranolol holds promise for EBAD and cognitive performance in ASD. Given the lack of good quality clinical trials, randomised controlled trials are warranted to explore the efficacy of propranolol in managing EBAD in ASD.

Controlled Self-Assembly of Cyclophane Amphiphiles: From 1D Nanofibers to Ultrathin 2D Topological Structures

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

Cai, Zhengxu; Li, Lianwei; Lo, Wai-Yip

2016-07-05

A novel series of amphiphilic TC-PEG molecules were designed and synthesized based on the orthogonal cyclophane unit. These molecules were able to self-assemble from 1D nanofibers and nanobelts to 2D ultrathin nanosheets (3 nm thick) in a controlled way by tuning the length of PEG side chains. The special structure of the cyclophane moiety allowed control in construction of nanostructures through programmed noncovalent interactions (hydrophobic hydrophilic interaction and pi-pi interaction). The self-assembled nanostructures were characterized by combining real space imaging (TEM, SEM, and AFM) and reciprocal space scattering (GIWAXS) techniques. This unique supramolecular system may provide a new strategy formore » the design of materials with tunable nanomorphology and functionality.« less

Music therapy in the treatment of multiple sclerosis: a comprehensive literature review.

PubMed

Ostermann, Thomas; Schmid, Wolfgang

2006-04-01

Coping with multiple sclerosis symptoms still remains a challenge for each patient suffering from this chronic inflammatory disease. Therefore, patients often turn to using complementary and alternative medicine (CAM). In this review, the authors aimed to investigate the current state of literature of music therapy in the treatment of multiple sclerosis (MS). Medline, PubMed, Embase, AMED, CAMbase and the Music Therapy World Journal Index were searched for the terms MS and 'music therapy'. In addition, an internet search using Google Scholar was performed. The authors found seven case-reports/series and seven studies on music therapy for MS-patients. Both the case reports and studies presented here are pioneer work. Most of the studies are naturally predominated by the use of qualitative and uncontrolled research designs. Nevertheless, the results of the studies as well as the case reports demonstrate patients' improvement in the domains of self-acceptance, anxiety and depression. The results of the studies as well as the case reports define a sufficient basis for further music therapeutical work as they show a variety of psychosocial and emotional benefits for MS patients.

Case reports and case series in prehospital emergency care research.

PubMed

Patterson, P Daniel; Weaver, Matthew; Clark, Sunday; Yealy, Donald M

2010-11-01

Research begins with a clearly stated question, problem or hypothesis. The selection of a study design appropriate to the task is the next key step. This paper provides guidance for the use of case report and case series designs by describing the 'what', 'when' and 'how' of both designs. Also described is the use of case reports and case series study designs in prehospital emergency research and the quality of published literature from 2000 to mid-2008.

Self-reported balance status is not a reliable indicator of balance performance in adolescents at one-month post-concussion.

PubMed

Rochefort, Coralie; Walters-Stewart, Coren; Aglipay, Mary; Barrowman, Nick; Zemek, Roger; Sveistrup, Heidi

2017-11-01

To determine if self-reported balance symptoms can be used as a proxy for measures of the center of pressure (COP) to identify balance deficits in a group of concussed adolescents. Case-control. Thirteen adolescents 1-month post-concussion who reported ongoing balance problems (Balance+), 20 adolescent 1-month post-concussion who reported no balance problems (Balance-), and 30 non-injured adolescents (control) completed a series of balance tests. Participants completed two 2-min trials standing on a Nintendo Wii Balance Board™ during which the COP under their feet was recorded: i) double-leg stance, eyes open; ii) double-leg stance, eyes closed. Participants also completed a dual-task condition combining a double-leg stance and a Stroop Colour-word test. Participants in both the Balance+ and Balance- group swayed over a larger ellipse area compared to the control group while completing the Eyes Closed (Balance+, p=0.002; Balance-, p=0.002) and Dual-Task (Balance+, p=0.001; Balance-, p=0.004) conditions and performed the Dual-Task condition with faster medio-lateral velocity (Balance+, p=0.003; Balance-, p=0.009). The participants in the Balance- group also swayed over a larger ellipse area compared to the control group while completing the Eyes Open condition (p=0.005). No significant differences were identified between the Balance+ and Balance- groups. At 1-month post-concussion, adolescents demonstrated balance deficits compared to non-injured adolescents regardless of whether they reported balance problems. These results suggest that self-reported balance status might not be an accurate reflection of balance performance following a concussion in adolescents. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study.

PubMed

Hudon, Catherine; Chouinard, Maud-Christine; Dubois, Marie-France; Roberge, Pasquale; Loignon, Christine; Tchouaket, Éric; Lambert, Mireille; Hudon, Émilie; Diadiou, Fatoumata; Bouliane, Danielle

2018-05-01

This study aimed to evaluate the effects of the V1SAGES case management intervention (Vulnerable Patients in Primary Care: Nurse Case Management and Self-management Support) for frequent users of health care services with chronic disease and complex care needs on psychological distress and patient activation. We used a 2-phase sequential mixed methods design. The first phase was a pragmatic randomized controlled trial with intention-to-treat analysis that measured the effects of the intervention compared with usual care on psychological distress and patient activation before and after 6 months. The second phase had a qualitative descriptive design and entailed thematic analysis of in-depth interviews (25 patients, 6 case management nurses, 9 health managers) and focus groups (8 patients' spouses, 21 family physicians) to understand stakeholders' perceived effects of the intervention on patients. A total of 247 patients were randomized into the intervention group (n = 126) or the control group (n = 121). Compared with usual care, the intervention reduced psychological distress (odds ratio = 0.43; 95% CI, 0.19-0.95, P = .04), but did not have any significant effect on patient activation ( P = .43). Qualitative results suggested that patients and their spouses benefitted from the case management intervention, gaining a sense of security, and stakeholders noted better patient self-management of health. Together, our study's quantitative and qualitative results suggest that case management reduces psychological distress, making patients and caregivers feel more secure, whereas impact on self-management is unclear. Case management is a promising avenue to improve outcomes among frequent users of health care with complex needs. © 2018 Annals of Family Medicine, Inc.

Evidence-Based Advances in Reptile Medicine.

PubMed

Mitchell, Mark A; Perry, Sean M

2017-09-01

Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychological aspects and coping in haemophilic patients: a case-control study.

PubMed

Canclini, M; Saviolo-Negrin, N; Zanon, E; Bertoletti, R; Girolami, A; Pagnan, A

2003-09-01

Although enormous progress has been made in recent years in the field of haemophilia, some problems still await solution, such as the risk of sudden haemorrhage, the sequelae of haemophilic arthropathy and social activities. We, therefore, carried out a case-control study in which some psychological dimensions (social expectations, tendency to depression, state of anxiety and self-esteem) were evaluated in a group of 60 haemophiliacs. A control group was formed of 78 healthy subjects matched for age, socio-economic class and level of education. The methodology used was the administration of self-assessment questionnaires which investigate and provide a quantitative measure of psychological dimensions. The results can be subjected to statistical analysis. Three self-assessment questionnaires were used: (i) the Marlowe-Crowne scale, (ii) the Beck Inventory version modified by Cusinato and (iii) the S.T.A.I.-form. Our aim was to evaluate: (i) whether there are significant differences in the considered psychological aspects between haemophiliacs and healthy subjects; (ii) whether there is a significant correlation between the psychological dimensions considered in the haemophiliacs and in the healthy subjects. The results showed that the haemophiliacs have a good psychological adaptation to their disease with the exception of their greater tendency to have less self-esteem than do the healthy subjects. As far as concerns the second aim, we found than self-esteem correlated with all the psychological variables investigated. This information could indicate the enormous importance that the psychological variable 'self-esteem' plays in haemophiliacs with respect to whether or not they develop depressive disorders and/or anxiety states.

Cognitive therapy for social anxiety disorder: the impact of the "self-focused attention and safety behaviours experiment" on the course of treatment.

PubMed

Schreiber, Franziska; Heimlich, Christiane; Schweitzer, Clea; Stangier, Ulrich

2015-03-01

Several studies have shown that cognitive therapy is an effective treatment for social anxiety disorder (SAD). However, it remains unclear which of the complex interventions are associated with an anxiety reduction during the course of treatment. The aim of this study was to examine the impact of the intervention referred to as the "self-focused attention and safety behaviours experiment" on treatment outcome. This study was part of a randomized controlled trial including 16 sessions of either individual cognitive therapy (CT) or interpersonal therapy (IPT) for SAD. Of particular importance, a concomitant time-series analysis was used to investigate the impact of the self-focused attention and safety behaviours experiment on subsequent social anxiety (1, 2, 3, and 4 weeks after the intervention) in 32 patients with SAD, who are receiving cognitive treatment. The results revealed a significant reduction of social anxiety after the self-focused attention and safety behaviours experiment during the subsequent month of treatment. The findings of the current study confirm current cognitive theories of SAD and demonstrate the importance of interventions that target self-focused attention and safety behaviour in cognitive therapy for SAD.

Psychological Determinants of University Students' Academic Performance: An Empirical Study

ERIC Educational Resources Information Center

Gebka, Bartosz

2014-01-01

This study utilises an integrated conceptual model of academic performance which captures a series of psychological factors: cognitive style; self-theories such as self-esteem and self-efficacy; achievement goals such as mastery, performance, performance avoidance and work avoidance; study-processing strategies such as deep and surface learning;…

A case series on the effectiveness of lurasidone in patients with stuttering.

PubMed

Charoensook, Janet; Maguire, Gerald A

2017-08-01

The prevalence of stuttering is approximately 1% of the population, affecting an estimated 3 million individuals in the United States. The dopamine hypothesis of stuttering explains that abnormally increased cerebral dopamine affects the balanced levels that maintain the basal ganglia circuits, which helps with timing cues in initiating speech. This is especially significant when considering treatment strategies. We report a reduction in stuttering with lurasidone, a potent D2 receptor antagonist with a relatively favorable adverse effects profile. We conducted a non-randomized, open-label study of lurasidone in patients with stuttering (N = 7). Patients self-reported stuttering severity, locus of control, and avoidance using the Subjective Screening of Stuttering (SSS) scale and were assessed with the Clinical Global Impression (CGI) Scale. We observed a notable, statistically significant improvement in all areas of stuttering, as rated by the SSS scale. According to the CGI-Improvement Scale, 2 patients were scored as "very much improved" and 5 were scored as "much improved." This open-label study of lurasidone in patients with stuttering showed improvement in subjective symptoms, in CGI scores, and on the SSS scale.

Post chicken pox neurological sequelae: Three distinct presentations.

PubMed

Paul, Rudrajit; Singhania, Pankaj; Hashmi, Ma; Bandyopadhyay, Ramtanu; Banerjee, Amit Kumar

2010-07-01

Varicella zoster infection is known to cause neurological involvement. The infection is usually self-limiting and resolves without sequelae. We present a series of three cases with neurological presentations following chicken pox infection. The first case is a case of meningitis, cerebellitis and polyradiculopathy, the second is a florid case of acute infective demyelinating polyradiculoneuropathy (Guillian-Barré syndrome) in a middle-aged female and the third case is a young man in whom we diagnosed acute transverse myelitis. All these cases presented with distinct neurological diagnoses and the etiology was established on the basis of history and serological tests confirmatory for chicken pox. The cases responded differently to treatment and the patients were left with minimum disability.

Physical activity and mental disorders: a case-control study on attitudes, preferences and perceived barriers in Italy.

PubMed

Carpiniello, Bernardo; Primavera, Diego; Pilu, Alessandra; Vaccargiu, Nicola; Pinna, Federica

2013-12-01

Mentally ill people experience greater difficulty than the general population in exercising regularly. We aimed to evaluate attitudes displayed and barriers perceived towards physical activity in a sample of psychiatric patients. A total of 138 (M = 48, F = 90) patients attending a community mental health centre were compared with a control group made up of 138 subjects not affected by mental disorders matched for gender, mean age and education. Both groups underwent a self-administered questionnaire. Patients reported a more sedentary lifestyle in terms of weekly physical activities and daily hours of exercise; their body mass index (BMI) was significantly higher compared with the BMI of controls (p < 0.002); the mentally ill more frequently reported tiredness (p < 0.001), scarce motivation (p < 0.001) and the illness itself (p = 0.01) as barriers to physical activity; moreover, stating how feeling sad or "distressed" reduced their propensity to physical exercise (p = 0.002). A higher number of patients (p < 0.0001) reported little or no motivation for physical activity, and the experiencing of scarce enjoyment (p < 0.001). A series of barriers may limit regular physical activity in subjects affected by mental disorders; these barriers should be taken into account and appropriately addressed.

Encouraging the strengths of women patients. A case study from general practice on empowering dialogues.

PubMed

Malterud, K; Hollnagel, H

1999-12-01

This case study illustrates how the use of empowering dialogues in general practice can contribute to alternative images of women, by identifying and emphasizing their strong points. It is a single case study, sampled theoretically from a series of 37 consultations during which key questions about self-assessed health resources were put to women patients. Two women GPs and their consultations were studied. An 18-min dialogue between a 52-year-old woman GP and a 69-year-old woman patient with asthma and back pain was audiotaped and transcribed according to Nessa's principles, supported by pragmatic linguistic theory. The woman's answers changed the doctor's perception of the patient, from that of a passive and resigned sufferer, to that of a strong woman who was active in spite of her pain. Acknowledging this, alternative paths of management could be chosen. In conclusion, disempowering medicalization of women patients can be opposed by resource oriented dialogues in clinical work. However, to change cultural images requires more than individual action.

Voice handicap in essential tremor: a comparison with normal controls and Parkinson's disease.

PubMed

Louis, Elan D; Gerbin, Marina

2013-01-01

Although voice tremor is one of the most commonly noted clinical features of essential tremor (ET), there are nearly no published data on the handicap associated with it. The Voice Handicap Index (VHI) was self-administered by participants enrolled in a research study at Columbia University Medical Center. The VHI quantifies patients' perceptions of handicap due to voice difficulties. Data from 98 ET cases were compared with data from 100 controls and 85 patients with another movement disorder (Parkinson's disease, PD). Voice tremor was present on examination in 25 (25.5%) ET cases; 12 had mild voice tremor (ETMild VT) and 13 had marked voice tremor (ETMarked VT). VHI scores were higher in ET cases than controls (p = 0.02). VHI scores among ETMarked VT were similar to those of PD cases; both were significantly higher than controls (p<0.001). The three VHI subscale scores (physical, functional, emotional) were highest in ETMarked VT, with values that were similar to those observed in PD. The voice handicap associated with ET had multiple (i.e., physical, functional, and emotional) dimensions. Moreover, ET cases with marked voice tremor on examination had a level of self-reported voice handicap that was similar to that observed in patients with PD.

Cyclosporine treatment of severe Hidradenitis suppurativa--A case series.

PubMed

Anderson, Marianne D; Zauli, Stefania; Bettoli, Vincenzo; Boer, Jurr; Jemec, Gregor B E

2016-01-01

Hidradenitis suppurativa (HS) is an overlooked but common disease severely affecting both genders. HS is generally perceived as difficult to treat and although a number of treatments are available, the need for more effective treatment is apparent. Cyclosporine A (CsA) has been suggested as an effective treatment in four smaller case series. It was therefore decided to review a larger series of cases, reporting all outcomes in order to provide a less biased base for evaluating the potential of CsA for use in HS. An exploratory retrospective review of case notes was performed at three departments of dermatology with a special interest in HS, where HS had been treated with CsA in the period 2009-2012. In total, 18 HS patients treated with CsA were identified and analysed and 50% reported some benefit. All patients had previously been treated with multiple various other modalities. This is an exploratory retrospective review with a limited number of patients. This retrospective review found some effect of CsA in the recalcitrant cases studied, mainly reported as "slight improvement". This may be due to a number of factors which may have overestimated (e.g., concommitant therapy) or underestimated (e.g., case selection of recalcitrant cases) the effect, and indicates the need for prospective evaluation of the claims. The present data provide a basis for power calculations in future studies investigating the potential for treating HS with CsA in a randomised controlled trial.

Recommendations for publishing case studies of cell transplantation for spinal cord injury.

PubMed

Dobkin, Bruce H

2010-10-01

Cellular transplantation for subacute and chronic spinal cord injury (SCI) continues to proceed around the world, but clinicians and patients have only 10 English language publications of case reports and self-serving Web page anecdotes to guide them. Recent publications about the use of olfactory ensheathing, bone marrow stromal, and fetal tissue stem cells in human subjects are examined to assess the adequacy of their designs, conclusions, and interpretation. Case series reports to date reveal adverse responses to cellular therapy when clinicians look for these and no clear functional effects when a matched group that is not treated is compared. Rehabilitation that focuses on potential targets for sensorimotor and functional gains must precede a transplantation until a plateau of change is reached and then continue for at least 6 months if not a year. Criteria are listed as the minimum requirements for any further case series reports to be considered by journals in regard to cellular interventions for SCI. Based on available reports, the published interventions should not be given to additional patients. One or two of the strategies can be considered for testing in a randomized trial with blinded assessors and an independent data monitoring committee to examine for biological activity in patients with motor complete SCI of greater than 4 to 6 months duration.

Negative Peer Relationships on Piracy Behavior: A Cross-Sectional Study of the Associations between Cyberbullying Involvement and Digital Piracy.

PubMed

Yubero, Santiago; Larrañaga, Elisa; Villora, Beatriz; Navarro, Raúl

2017-10-05

The present study examines the relationship between different roles in cyberbullying behaviors (cyberbullies, cybervictims, cyberbullies-victims, and uninvolved) and self-reported digital piracy. In a region of central Spain, 643 (49.3% females, 50.7% males) students (grades 7-10) completed a number of self-reported measures, including cyberbullying victimization and perpetration, self-reported digital piracy, ethical considerations of digital piracy, time spent on the Internet, and leisure activities related with digital content. The results of a series of hierarchical multiple regression models for the whole sample indicate that cyberbullies and cyberbullies-victims are associated with more reports of digital piracy. Subsequent hierarchical multiple regression analyses, done separately for males and females, indicate that the relationship between cyberbullying and self-reported digital piracy is sustained only for males. The ANCOVA analysis show that, after controlling for gender, self-reported digital piracy and time spent on the Internet, cyberbullies and cyberbullies-victims believe that digital piracy is a more ethically and morally acceptable behavior than victims and uninvolved adolescents believe. The results provide insight into the association between two deviant behaviors.

Social capital and self-rated health among middle-aged and older adults in China: a multilevel analysis.

PubMed

Shen, Yuying; Yeatts, Dale E; Cai, Tianji; Yang, Philip Q; Cready, Cynthia M

2014-07-01

This study examined the association between social capital, at both the individual and the community level, and self-rated health among older adults in China. Using data from the 2008 Pilot Survey of China Health and Retirement Longitudinal Study, a series of multilevel logistic models were estimated in SAS 9.2. The association between social capital and self-rated health was examined among 996 adults aged 45 or older from two provinces in China, while controlling for demographic characteristics and socioeconomic variables. Our results suggest the significant association between certain aspects of social capital, at both the individual and the community level, and self-rated health. The individual-level social capital in the form of perceived help in the future and the social capital of community in the form of the availability of amenities and associations within the community were significantly related to self-rated health. A significant cross-level interaction effect between individual- and community-level social capital was also observed. © The Author(s) 2013.

The Personality Profile of Tinnitus Sufferers and a Nontinnitus Control Group.

PubMed

Durai, Mithila; O'Keeffe, Mary G; Searchfield, Grant D

2017-04-01

Chronic tinnitus (phantom perception of sound) significantly disrupts quality of life in 15-20% of those who experience it. Understanding how certain personality traits impact tinnitus perception and distress can be beneficial for the development of interventions to improve the lives of tinnitus sufferers. Four key self-reported personality traits (social closeness, stress reaction, alienation, and self-control) were identified from previous research as being associated with tinnitus. These were compared between tinnitus and age-, gender-, and hearing level-matched nontinnitus controls to see whether underlying profile differences exist, and if personality traits levels correlate with various tinnitus characteristics assessed in typical clinical questionnaires. A Web-based personality survey was administered comprising of self-control, stress reaction, alienation, and social closeness subscale questions of the Multidimensional Personality Questionnaire, the Hearing Handicap Inventory-Screening Version, TFI, and the Tinnitus Case History Questionnaire. A total of 154 participants with tinnitus (81 males, 73 females, mean age = 62.6 yr) and 61 control (32 males, 29 females, mean age = 59.62 yr) participants were recruited via e-mail invitations to a tinnitus research clinic database, poster, and social media Web site advertising. Statistical analysis was conducted using parametric statistics and IBM SPSS ® Version 22 software. Tinnitus sufferers displayed higher levels of stress reaction, lower social closeness, lower self-control, and higher alienation than the control group (p < 0.05). Alienation was related to tinnitus pitch and self-reported hyperacusis measured using the Tinnitus Case History Questionnaire (p < 0.05). Stress reaction correlated with self-reported hyperacusis, whether tinnitus sufferers had sought other treatments, and whether loud sounds make the tinnitus worse (p < 0.05). The four personality traits examined in this study exhibited a consistent association with tinnitus perception and distress, and differentiated tinnitus sufferers from nontinnitus control. Some of the traits also correlated significantly with certain characteristics measured in tinnitus history questionnaires. Personality traits are described in relation to "maladaptive" residuals under the Adaptation Level Theory model of tinnitus. The results of the study suggest that certain personality traits correlate with the clinical presentation of tinnitus. American Academy of Audiology

On the equivalence of case-crossover and time series methods in environmental epidemiology.

PubMed

Lu, Yun; Zeger, Scott L

2007-04-01

The case-crossover design was introduced in epidemiology 15 years ago as a method for studying the effects of a risk factor on a health event using only cases. The idea is to compare a case's exposure immediately prior to or during the case-defining event with that same person's exposure at otherwise similar "reference" times. An alternative approach to the analysis of daily exposure and case-only data is time series analysis. Here, log-linear regression models express the expected total number of events on each day as a function of the exposure level and potential confounding variables. In time series analyses of air pollution, smooth functions of time and weather are the main confounders. Time series and case-crossover methods are often viewed as competing methods. In this paper, we show that case-crossover using conditional logistic regression is a special case of time series analysis when there is a common exposure such as in air pollution studies. This equivalence provides computational convenience for case-crossover analyses and a better understanding of time series models. Time series log-linear regression accounts for overdispersion of the Poisson variance, while case-crossover analyses typically do not. This equivalence also permits model checking for case-crossover data using standard log-linear model diagnostics.

Glucose Intolerance, Plasma Insulin Levels, and Colon Adenomas in Japanese Men

PubMed Central

Kono, Suminori; Abe, Hiroshi; Eguchi, Hiroyuki; Shimazaki, Kae; Hatano, Ben; Hamada, Hiroaki

2001-01-01

Hyperinsulinemia may be related to colon carcinogenesis. Several studies have suggested that diabetes mellitus is related to increased risk of colon cancer. We examined cross‐sectionally the relation of fasting plasma insulin levels and glucose tolerance status to colon adenomas. In a consecutive series of 951 men undergoing total colonoscopy for a health examination at the Japan Self Defense Forces Fukuoka Hospital from April 1998 to August 1999, we identified 233 cases of colon adenomas and 497 controls with normal colonoscopy. Glucose tolerance status was determined by a 75‐g oral glucose tolerance test, and subjects were classified as normal, unpaired glucose tolerance (IGT) or non‐insulin dependent diabetes mellitus (NIDDM). Plasma insulin levels were measured after subjects had fasted overnight. Logistic regression analysis and analysis of covariance was used to control for age and obesity. While plasma insulin levels were unrelated to colon adenomas, NIDDM was associated with a significantly increased risk of colon adenomas. There was no association between IGT and colon adenomas. NIDDM was more strongly associated with proximal colon adenomas. The findings suggest that long‐term hyperinsulinemic status associated with NIDDM may increase the risk of colon adenomas, and subsequently of colon cancer. PMID:11509114

Immunoglobulin G antibodies against indoor dampness-related microbes and adult-onset asthma: a population-based incident case–control study

PubMed Central

JAAKKOLA, M S; LAITINEN, S; PIIPARI, R; UITTI, J; NORDMAN, H; HAAPALA, A-M; JAAKKOLA, J J K

2002-01-01

Immunoglobulin G (IgG) antibodies against microbes related to indoor dampness problems have been used as potential biomarkers of fungal exposure in clinical investigations. There is limited information on their relation to asthma. We conducted a population-based incident case–control study to assess the risk of asthma in relation to specific IgG antibodies to eight dampness-related microbes: Aspergillus fumigatus, A. versicolor, Cladosporium cladosporioides, Fusarium oxysporum, Sporobolomyces salmonicolor, Stachybotrys chartarum, Streptomyces albus and Trichoderma citrinoviride. We recruited systematically all new cases of asthma during a 2·5-year study period and randomly selected controls from a source population of adults 21–63 years of age living in the Pirkanmaa Hospital District, South Finland. The clinically diagnosed case series consisted of 521 adults with newly diagnosed asthma and the control series of 932 controls selected randomly from the source population. IgG antibodies were analysed with ELISA. An increased risk of developing asthma in adulthood was significantly related to IgG antibodies to T. citrinoviride, but not to the other moulds. There was no evidence of a dose–response relation between the IgG antibody level and the risk of asthma. T. citrinoviride may play a role in the aetiology of adult-onset asthma or serve as an indicator of other causal factors. PMID:12100029

Improvement in diabetes self-efficacy and glycaemic control using telemedicine in a sample of older, ethnically diverse individuals who have diabetes: the IDEATel project.

PubMed

Trief, Paula M; Teresi, Jeanne A; Eimicke, Joseph P; Shea, Steven; Weinstock, Ruth S

2009-03-01

with increasing prevalence of diabetes in older people, it is important to understand factors that affect their outcomes. The Informatics for Diabetes Education and Telemedicine (IDEATel) project is a demonstration project to evaluate the feasibility and effectiveness of telemedicine with diverse, medically underserved, older diabetes patients. Subjects were randomised to telemedicine case management or usual care. This intervention has been shown to result in improved medical outcomes and self-efficacy. Self-efficacy refers to one's belief that (s)he can successfully engage in a behaviour. Self-efficacy has been shown to relate to behaviour change and glycaemic control in middle-aged individuals, but not studied in older individuals. to assess whether (a) diabetes self-efficacy relates to the primary medical outcome of glycaemic control, and to secondary outcomes (blood pressure and cholesterol), and (b) whether, after an intervention, change in diabetes self-efficacy relates to change in these medical outcomes in a group of older, ethnically diverse individuals. three waves of longitudinal data from participants in IDEATel were analysed. diabetes self-efficacy at baseline correlated with glycaemic control, blood pressure and cholesterol. An increase in diabetes self-efficacy over time was related to an improvement in glycaemic control (P < 0.0001), but not in blood pressure and lipid levels. The intervention was significantly related to improved self-efficacy over time (P < 0.0001), and both directly (P = 0.022) and indirectly through self-efficacy (P < 0.001) to improved glycaemic control. The mediation effect of self-efficacy was also significant (P< 0.004). diabetes self-efficacy is a relevant construct for older diabetes patients. Thus, interventions that target enhanced self-efficacy may also result in improved glycaemic control.

[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.

Flexible optical metrology strategies for the control and quality assurance of small series production

NASA Astrophysics Data System (ADS)

Schmitt, R.; Pavim, A.

2009-06-01

The demand for achieving smaller and more flexible production series with a considerable diversity of products complicates the control of the manufacturing tasks, leading to big challenges for the quality assurance systems. The quality assurance strategy that is nowadays used for mass production is unable to cope with the inspection flexibility needed among automated small series production, because the measuring strategy is totally dependent on the fixed features of the few manufactured object variants and on process parameters that can be controlled/compensated during production time. The major challenge faced by a quality assurance system applied to small series production facilities is to guarantee the needed quality level already at the first run, and therefore, the quality assurance system has to adapt itself constantly to the new manufacturing conditions. The small series production culture requires a change of paradigms, because its strategies are totally different from mass production. This work discusses the tight inspection requirements of small series production and presents flexible metrology strategies based on optical sensor data fusion techniques, agent-based systems as well as cognitive and self-optimised systems for assuring the needed quality level of flexible small series. Examples of application scenarios are provided among the automated assembly of solid state lasers and the flexible inspection of automotive headlights.

The role of children's appraisals on adjustment following psychological maltreatment: a pilot study.

PubMed

Leeson, Fiona J; Nixon, Reginald D V

2011-07-01

Little is known about the cognitive mechanisms involved in the development of psychopathology following psychological maltreatment in children. This study therefore examined the role of thinking styles on children's outcomes following this subtype of maltreatment. Children who had experienced past maltreatment (n = 24) and a control group (n = 26) were assessed using self-report questionnaires. Maltreatment history, cognitive styles and psychological outcomes, such as depression, posttraumatic stress disorder (PTSD) and self-esteem were assessed. Parents/caregivers also completed a measure of child internalizing and externalizing behaviours. Psychological maltreatment made a significant contribution to children's self-reported depression and low self-esteem, and parent reported internalizing and externalizing problems, even after controlling for other abusive experiences. This was not the case for PTSD symptoms. Further, children's cognitive styles were associated with self-reported depression, self-esteem and PTSD. They did not, however, predict parent-rated emotional and behavioural problems. This study provides preliminary support for a cognitive model of adjustment following psychological maltreatment. The results indicate the need for enhanced community awareness about the impact of psychological maltreatment, and suggest a direction for therapeutic intervention.

A David and Goliath story: tobacco advertising and self-regulation in Australia.

PubMed Central

Chapman, S

1980-01-01

A small group of health workers succeeded in getting the largest tobacco advertising campaign in Australia banned by testing a clause in the advertising industry's voluntary code of self-regulation. The group complained about a series of cigarette advertisements that featured an Australian entertainer who was popular with the young. Though the tobacco company denied the entertainer's major appeal to the young, the chairman of the Advertising Standards Council ruled that the campaign did breach the code. The delay before the complaint was adjudicated--18 months--contrasted with the speed with which a series of antismoking advertisements had been withdrawn after complaints by a tobacco company's advertisers. MOP UP's victory in this case contains several lessons for people interested in restricting the promotional activities of multinational tobacco companies. Images FIG 1 FIG 2 PMID:7427631

Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

PubMed

Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

2017-12-01

We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

Cognitive neuropsychology and its vicissitudes: The fate of Caramazza's axioms.

PubMed

Shallice, Tim

2015-01-01

Cognitive neuropsychology is characterized as the discipline in which one draws conclusions about the organization of the normal cognitive systems from the behaviour of brain-damaged individuals. In a series of papers, Caramazza, later in collaboration with McCloskey, put forward four assumptions as the bridge principles for making such inferences. Four potential pitfalls, one for each axiom, are discussed with respect to the use of single-case methods. Two of the pitfalls also apply to case series and group study procedures, and the other two are held to be indirectly testable or avoidable. Moreover, four other pitfalls are held to apply to case series or group study methods. It is held that inferences from single-case procedures may profitably be supported or rejected using case series/group study methods, but also that analogous support needs to be given in the other direction for functionally based case series or group studies. It is argued that at least six types of neuropsychological method are valuable for extrapolation to theories of the normal cognitive system but that the single- or multiple-case study remains a critical part of cognitive neuropsychology's methods.

Virtual spring damper method for nonholonomic robotic swarm self-organization and leader following

NASA Astrophysics Data System (ADS)

Wiech, Jakub; Eremeyev, Victor A.; Giorgio, Ivan

2018-04-01

In this paper, we demonstrate a method for self-organization and leader following of nonholonomic robotic swarm based on spring damper mesh. By self-organization of swarm robots we mean the emergence of order in a swarm as the result of interactions among the single robots. In other words the self-organization of swarm robots mimics some natural behavior of social animals like ants among others. The dynamics of two-wheel robot is derived, and a relation between virtual forces and robot control inputs is defined in order to establish stable swarm formation. Two cases of swarm control are analyzed. In the first case the swarm cohesion is achieved by virtual spring damper mesh connecting nearest neighboring robots without designated leader. In the second case we introduce a swarm leader interacting with nearest and second neighbors allowing the swarm to follow the leader. The paper ends with numeric simulation for performance evaluation of the proposed control method.

The integrated place of tracheobronchial stents in the multidisciplinary management of large post-pneumonectomy fistulas: our experience using a novel customised conical self-expandable metallic stent.

PubMed

Dutau, Hervé; Breen, David Patrick; Gomez, Carine; Thomas, Pascal Alexandre; Vergnon, Jean-Michel

2011-02-01

Stump dehiscence after pneumonectomy is a cause of morbidity and mortality in patients treated for non-small-cell lung carcinoma. Surgical repair remains the treatment of choice but can be postponed or contraindicated. Bronchoscopic techniques may be an option with curative intent or as a bridge towards definitive surgery. The aim of the study is to evaluate the efficacy and the outcome of a new customised covered conical self-expandable metallic stent in the management of large bronchopleural fistulas complicating pneumonectomies. A case series using chart review of non-operable patients presenting with large bronchopleural fistulas (>6mm) post-pneumonectomies as a definitive treatment with curative intent for non-small-cell lung carcinomas and requiring the use of a dedicated conical shaped stent in two tertiary referral centres. Seven patients presenting large post-pneumonectomy fistulas (between 6 and 12 mm) were included. Cessation of the air leak and clinical improvement was achieved in all the patients after stent placement. Stent-related complications (two migrations and one stent rupture) were successfully managed using bronchoscopic techniques in two patients and surgery in one. Mortality, mainly related to overwhelming sepsis, was 57%. Delayed definitive surgery was achieved successfully in three patients (43%). This case series assesses the short-term clinical efficacy of a new customised covered conical self-expandable metallic stent in the multidisciplinary management of large bronchopleural fistulas complicating pneumonectomies in patients deemed non-operable. Long-term benefits are jeopardised by infectious complications. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Police department personnel stress resilience training: an institutional case study.

PubMed

Weltman, Gershon; Lamon, Jonathan; Freedy, Elan; Chartrand, Donald

2014-03-01

The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV-controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and effective stress resilience training programs is becoming better understood, as it has been in the military. Law enforcement and military service share many stress-related features including psychological stressors connected with the mission, extended duty cycles, and exposure to horrific scenes of death and injury. San Diego (California) Police Department personnel who participated in the study were 12 sworn officers and 2 dispatchers, 10 men and 4 women. The SRTS intervention comprised an introductory 2-hour training session, 6 weeks of individualized learning and practice with the SRTS app, and four 1-hour telephone mentoring sessions by experienced HeartMath mentors spread over a four week period. Outcome measures were the Personal and Organizational Quality Assessment (POQA) survey, the mentors' reports of their observations, and records of participants' comments from the mentoring sessions. The POQA results were overwhelmingly positive: All four main scales showed improvement; Emotional Vitality improved by 25% (P=.05) and Physical Stress improved by 24% (P=.01). Eight of the nine subscales showed improvement, with the Stress subscale, perhaps the key measure of the study, improving by approximately 40% (P=.06). Participant responses were also uniformly positive and enthusiastic. Individual participants praised the program and related improvements in both on-the-job performance and personal and familial situations. The results support the efficacy of the program to achieve its goal of building stress resilience and improving officer wellness by providing practical self-regulation skills for better management of emotional energy. We conclude that the SRTS program for building resilience and improving psychological wellness can be as effective for law enforcement as it is for military personnel.

Police Department Personnel Stress Resilience Training: An Institutional Case Study

PubMed Central

Lamon, Jonathan; Freedy, Elan; Chartrand, Donald

2014-01-01

The objective of this case study was to test the impact in law enforcement personnel of an innovative self-regulation and resilience building program delivered via an iPad (Apple Inc, Cupertino, California) app and personal mentoring. The Stress Resilience Training System (SRTS) app includes training on stress and its effects, HRV coherence biofeedback, a series of HeartMath self-regulation techniques (The Institute of HeartMath, Boulder Creek, California), and HRV-controlled games. The stressful nature of law enforcement work is well established, and the need for meaningful and effective stress resilience training programs is becoming better understood, as it has been in the military. Law enforcement and military service share many stress-related features including psychological stressors connected with the mission, extended duty cycles, and exposure to horrific scenes of death and injury. San Diego (California) Police Department personnel who participated in the study were 12 sworn officers and 2 dispatchers, 10 men and 4 women. The SRTS intervention comprised an introductory 2-hour training session, 6 weeks of individualized learning and practice with the SRTS app, and four 1-hour telephone mentoring sessions by experienced HeartMath mentors spread over a four week period. Outcome measures were the Personal and Organizational Quality Assessment (POQA) survey, the mentors' reports of their observations, and records of participants' comments from the mentoring sessions. The POQA results were overwhelmingly positive: All four main scales showed improvement; Emotional Vitality improved by 25% (P=.05) and Physical Stress improved by 24% (P=.01). Eight of the nine subscales showed improvement, with the Stress subscale, perhaps the key measure of the study, improving by approximately 40% (P=.06). Participant responses were also uniformly positive and enthusiastic. Individual participants praised the program and related improvements in both on-the-job performance and personal and familial situations. The results support the efficacy of the program to achieve its goal of building stress resilience and improving officer wellness by providing practical self-regulation skills for better management of emotional energy. We conclude that the SRTS program for building resilience and improving psychological wellness can be as effective for law enforcement as it is for military personnel. PMID:24808985

Effect of Hospital Closures on Acute Care Outcomes in British Columbia, Canada: An Interrupted Time Series Study.

PubMed

Panagiotoglou, Dimitra; Law, Michael R; McGrail, Kimberlyn

2017-01-01

In 2002 British Columbia, Canada began redistributing its hospital services. We used administrative data and interrupted time series analyses to determine how recent hospital closures affected patient outcomes. All adult acute myocardial infarction (AMI), stroke, and trauma events in British Columbia between fiscal years 1999 and 2013. Cases were patients whose closest hospital closed. Controls were matched by condition, year of event, and condition-specific hospital volume where treatment was received. Thirty-day mortality and hospital bypass rates. We matched 3267 AMI, 2852 stroke, and 6318 trauma cases to 1996, 1604, and 3640 controls, respectively. The 30-day mortality rate at baseline was 7.0% [95% confidence interval (CI), 4.0%-10.1%] for AMI, 5.3% (95% CI, 2.4%-8.1%) for stroke, and 1.2% (95% CI, 0.3%-2.1%) for trauma controls. The 30-day mortality rate for cases was 14.3% (95% CI, 7.1%-21.7%) for AMI, 12.0% (95% CI, 5.1%-18.9%) for stroke, and 3.1% for trauma (95% CI, 0.9%-5.2%) cases. There was no significant change in 30-day mortality for cases, and no significant difference in change in mortality rates between cases and controls following the intervention. The difference in hospital bypass rates between cases and controls was 50.1% (95% CI, 42.3%-57.9%) for AMI, 36.2% (95% CI, 27.4%-44.9%) for stroke, and 32.2% (95% CI, 27.7%-36.8%) for trauma cases preintervention. Following the intervention, the difference in bypass rates dropped by 15.5% (95% CI, 3.5%-27.5%) for AMI, 25.3% (95% CI, 11.7%-38.8%) for stroke, and 22.7% (95% CI, 15.7%-29.6%) for trauma cases. Hospital closures did not affect patient mortality.

Ventriculoperitoneal shunt insertion for hydrocephalus in human immunodeficiency virus-infected adults: a systematic review and meta-analysis protocol.

PubMed

Loan, James J M; Mankahla, Ncedile; Meintjes, Graeme; Fieggen, A Graham

2017-10-16

Hydrocephalus is a recognised complication of human immunodeficiency virus (HIV)-related opportunistic infections. Symptomatic raised cerebrospinal fluid pressure can be treated with ventriculoperitoneal shunt insertion (VPS). In HIV-infected patients however, there is a concern that VPS might be associated with unacceptably high rates of mortality. We aim to systematically review and appraise published literature to determine reported outcomes and identify predictors of outcome following VPS in relevant subgroups of HIV-infected adults. The following electronic databases will be searched: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE, CINAHL (EBSCOhost), LILACS (BIREME), Research Registry ( www.researchregistry.com ), the metaRegister of Controlled Trials (mRCT) ( www.controlled-trials.com ), ClinicalTrials.gov ( www.clinicaltrials.gov ) and OpenSIGLE database. Any randomised studies, cohort studies, case-control studies, interrupted time series or sequential case series reporting survival following VPS in HIV-infected individuals will be included. If high-quality homogenous studies exist, meta-analysis will be conducted to determine 1-, 6- and 12-month mortality with comparison made between underlying aetiologies of hydrocephalus. This study will generate a comprehensive review of VPS in HIV-infected patients for publication. The primary outcome of meta-analysis is 12-month survival. If only low-quality, heterogeneous studies are available, this study will demonstrate this deficiency and will be of value in justifying and aiding the design of future studies. PROSPERO CRD42016052239.

Effects of a Structured Discharge Planning Program on Perceived Functional Status, Cardiac Self-efficacy, Patient Satisfaction, and Unexpected Hospital Revisits Among Filipino Cardiac Patients: A Randomized Controlled Study.

PubMed

Cajanding, Ruff Joseph

Cardiovascular diseases remain the leading cause of morbidity and mortality among Filipinos and are responsible for a very large number of hospital readmissions. Comprehensive discharge planning programs have demonstrated positive benefits among various populations of patients with cardiovascular disease, but the clinical and psychosocial effects of such intervention among Filipino patients with acute myocardial infarction (AMI) have not been studied. In this study we aimed to determine the effectiveness of a nurse-led structured discharge planning program on perceived functional status, cardiac self-efficacy, patient satisfaction, and unexpected hospital revisits among Filipino patients with AMI. A true experimental (randomized control) 2-group design with repeated measures and data collected before and after intervention and at 1-month follow-up was used in this study. Participants were assigned to either the control (n = 68) or the intervention group (n = 75). Intervention participants underwent a 3-day structured discharge planning program implemented by a cardiovascular nurse practitioner, which is comprised of a series of individualized lecture-discussion, provision of feedback, integrative problem solving, goal setting, and action planning. Control participants received standard routine care. Measures of functional status, cardiac self-efficacy, and patient satisfaction were measured at baseline; cardiac self-efficacy and patient satisfaction scores were measured prior to discharge, and perceived functional status and number of revisits were measured 1 month after discharge. Participants in the intervention group had significant improvement in functional status, cardiac self-efficacy, and patient satisfaction scores at baseline and at follow-up compared with the control participants. Furthermore, participants in the intervention group had significantly fewer hospital revisits compared with those who received only standard care. The results demonstrate that a nurse-led structured discharge planning program is an effective intervention in improving perceived functional health status, cardiac self-efficacy, and patient satisfaction, while reducing the number of unexpected hospital revisits, among Filipino patients with AMI. It is recommended that this intervention be incorporated in the optimal care of patients being discharged with an AMI.

Estimates of Environmental Exposure to Radiofrequency Electromagnetic Fields and Risk of Lymphoma Subtypes.

PubMed

Satta, G; Mascia, N; Serra, T; Salis, A; Saba, L; Sanna, S; Zucca, M G; Angelucci, E; Gabbas, A; Culurgioni, F; Pili, P; Mura, E; Cappai, M; Ennas, M G; Cocco, P

2018-05-01

We investigated the association between environmental exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of lymphoma subtypes in a case-control study comprised of 322 patients and 444 individuals serving as controls in Sardinia, Italy in 1998-2004. Questionnaire information included the self-reported distance of the three longest held residential addresses from fixed radio-television transmitters and mobile phone base stations. We georeferenced the residential addresses of all study subjects and obtained the spatial coordinates of mobile phone base stations. For each address within a 500-meter radius from a mobile phone base station, we estimated the RF-EMF intensity using predictions from spatial models, and we performed RF-EMF measurements at the door in the subset of the longest held addresses within a 250-meter radius. We calculated risk of lymphoma and its major subtypes associated with the RF-EMF exposure metrics with unconditional logistic regression, adjusting by age, gender and years of education. In the analysis of self-reported data, risk associated with residence in proximity (within 50 meters) to fixed radio-television transmitters was likewise elevated for lymphoma overall [odds ratio = 2.7, 95% confidence interval = 1.5-4.6], and for the major lymphoma subtypes. With reference to mobile phone base stations, we did not observe an association with either the self-reported, or the geocoded distance from mobile phone base stations. RF-EMF measurements did not vary by case-control status. By comparing the self-reports to the geocoded data, we discovered that the cases tended to underestimate the distance from mobile phone base stations differentially from the controls ( P = 0.073). The interpretation of our findings is compromised by the limited study size, particularly in the analysis of the individual lymphoma subtypes, and the unavailability of the spatial coordinates of radio-television transmitters. Nonetheless, our results do not support the hypothesis of a link between environmental exposure to RF-EMF from mobile phone base stations and risk of lymphoma subtypes.

Randomized Controlled Trial of Mindfulness-Based Stress Reduction Versus Aerobic Exercise: Effects on the Self-Referential Brain Network in Social Anxiety Disorder

PubMed Central

Goldin, Philippe; Ziv, Michal; Jazaieri, Hooria; Gross, James J.

2012-01-01

Background: Social anxiety disorder (SAD) is characterized by distorted self-views. The goal of this study was to examine whether mindfulness-based stress reduction (MBSR) alters behavioral and brain measures of negative and positive self-views. Methods: Fifty-six adult patients with generalized SAD were randomly assigned to MBSR or a comparison aerobic exercise (AE) program. A self-referential encoding task was administered at baseline and post-intervention to examine changes in behavioral and neural responses in the self-referential brain network during functional magnetic resonance imaging. Patients were cued to decide whether positive and negative social trait adjectives were self-descriptive or in upper case font. Results: Behaviorally, compared to AE, MBSR produced greater decreases in negative self-views, and equivalent increases in positive self-views. Neurally, during negative self versus case, compared to AE, MBSR led to increased brain responses in the posterior cingulate cortex (PCC). There were no differential changes for positive self versus case. Secondary analyses showed that changes in endorsement of negative and positive self-views were associated with decreased social anxiety symptom severity for MBSR, but not AE. Additionally, MBSR-related increases in dorsomedial prefrontal cortex (DMPFC) activity during negative self-view versus case were associated with decreased social anxiety related disability and increased mindfulness. Analysis of neural temporal dynamics revealed MBSR-related changes in the timing of neural responses in the DMPFC and PCC for negative self-view versus case. Conclusion: These findings suggest that MBSR attenuates maladaptive habitual self-views by facilitating automatic (i.e., uninstructed) recruitment of cognitive and attention regulation neural networks. This highlights potentially important links between self-referential and cognitive-attention regulation systems and suggests that MBSR may enhance more adaptive social self-referential processes in patients with SAD. PMID:23133411

Genome-wide association study identifies three new melanoma susceptibility loci.

PubMed

Barrett, Jennifer H; Iles, Mark M; Harland, Mark; Taylor, John C; Aitken, Joanne F; Andresen, Per Arne; Akslen, Lars A; Armstrong, Bruce K; Avril, Marie-Francoise; Azizi, Esther; Bakker, Bert; Bergman, Wilma; Bianchi-Scarrà, Giovanna; Bressac-de Paillerets, Brigitte; Calista, Donato; Cannon-Albright, Lisa A; Corda, Eve; Cust, Anne E; Dębniak, Tadeusz; Duffy, David; Dunning, Alison M; Easton, Douglas F; Friedman, Eitan; Galan, Pilar; Ghiorzo, Paola; Giles, Graham G; Hansson, Johan; Hocevar, Marko; Höiom, Veronica; Hopper, John L; Ingvar, Christian; Janssen, Bart; Jenkins, Mark A; Jönsson, Göran; Kefford, Richard F; Landi, Giorgio; Landi, Maria Teresa; Lang, Julie; Lubiński, Jan; Mackie, Rona; Malvehy, Josep; Martin, Nicholas G; Molven, Anders; Montgomery, Grant W; van Nieuwpoort, Frans A; Novakovic, Srdjan; Olsson, Håkan; Pastorino, Lorenza; Puig, Susana; Puig-Butille, Joan Anton; Randerson-Moor, Juliette; Snowden, Helen; Tuominen, Rainer; Van Belle, Patricia; van der Stoep, Nienke; Whiteman, David C; Zelenika, Diana; Han, Jiali; Fang, Shenying; Lee, Jeffrey E; Wei, Qingyi; Lathrop, G Mark; Gillanders, Elizabeth M; Brown, Kevin M; Goldstein, Alisa M; Kanetsky, Peter A; Mann, Graham J; Macgregor, Stuart; Elder, David E; Amos, Christopher I; Hayward, Nicholas K; Gruis, Nelleke A; Demenais, Florence; Bishop, Julia A Newton; Bishop, D Timothy

2011-10-09

We report a genome-wide association study for melanoma that was conducted by the GenoMEL Consortium. Our discovery phase included 2,981 individuals with melanoma and 1,982 study-specific control individuals of European ancestry, as well as an additional 6,426 control subjects from French or British populations, all of whom were genotyped for 317,000 or 610,000 single-nucleotide polymorphisms (SNPs). Our analysis replicated previously known melanoma susceptibility loci. Seven new regions with at least one SNP with P < 10(-5) and further local imputed or genotyped support were selected for replication using two other genome-wide studies (from Australia and Texas, USA). Additional replication came from case-control series from the UK and The Netherlands. Variants at three of the seven loci replicated at P < 10(-3): an SNP in ATM (rs1801516, overall P = 3.4 × 10(-9)), an SNP in MX2 (rs45430, P = 2.9 × 10(-9)) and an SNP adjacent to CASP8 (rs13016963, P = 8.6 × 10(-10)). A fourth locus near CCND1 remains of potential interest, showing suggestive but inconclusive evidence of replication (rs1485993, overall P = 4.6 × 10(-7) under a fixed-effects model and P = 1.2 × 10(-3) under a random-effects model). These newly associated variants showed no association with nevus or pigmentation phenotypes in a large British case-control series.

Cinnamon: A systematic review of adverse events.

PubMed

Hajimonfarednejad, Mahdie; Ostovar, Mohadeseh; Raee, Mohammad Javad; Hashempur, Mohammad Hashem; Mayer, Johannes Gottfried; Heydari, Mojtaba

2018-04-05

Cinnamon, from the genus Cinnamomum and Lauraceae family, has been used as a popular spice for thousands of years around the world. Many studies have shown therapeutic effects of cinnamon including its antimicrobial, antiviral, antifungal, antioxidant, antitumor, antihypertensive, antilipemic, antidiabetic, gastroprotective, and immunomodulatory effects. Due to popular use of cinnamon and several human reports on adverse events associated with short or long term use of cinnamon, we aimed to systematically review its human reports of adverse event. Databases including Medline, Scopus, Science Direct, Embase, PubMed Central and Google scholar were searched using the key words "cinnamon" or "cinnamomum" for clinical trials, case reports and case series. Also spontaneous reports about adverse effects of cinnamon were collected from five national and international spontaneous reporting schemes. Thirty eight clinical trials were found, five of them reported adverse events. Twenty case reports and seven case series, as well as, spontaneous reports including 160 adverse events were also included. The most frequent adverse events were gastrointestinal disorders and allergic reactions which were self-limiting in the majority of cases. The available data suggests that despite the safety of cinnamon use as a spice and/or flavoring agent, its use may be associated with significant adverse effects in medicinal uses with larger doses or longer duration of use and should be clinically monitored. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Parenting, self-control, and the gender gap in heavy drinking: the case of Russia.

PubMed

Botchkovar, Ekaterina V; Broidy, Lisa

2013-03-01

Drawing on Gottfredson and Hirschi's theory linking parenting to deviant behavior via development of self-control, the authors assess the association between parenting styles, self-control ability, and frequent alcohol use separately for males and females. The authors' findings from a random sample of 440 Russian respondents provide mixed support for self-control theory. Contrary to the theory, but in line with extant research, the authors failed to uncover significant gender differences in childhood upbringing or establish a strong link between parenting techniques and self-control. Furthermore, whereas parental upbringing appears to increase the likelihood of frequent drinking among men, self-control does not mediate this relationship but rather acts as an independent predictor of men's alcohol abuse. Finally, the relatively modest contribution of self-control differences to the gender gap in frequent drinking suggests that higher alcohol consumption among men likely stems from alternative, possibly context-embedded factors.

Self-reported shift work, recall bias, and belief about disease causation in a case-control study of breast cancer.

PubMed

Lizama, Natalia; Heyworth, Jane; Thomson, Allyson; Slevin, Terry; Fritschi, Lin

2017-10-01

Recall bias is a potential source of misclassification in case-control studies. Studies have shown that the association between exposure and disease can differ according to participants' beliefs or knowledge about the effect of that exposure on disease. We investigated the association between belief about breast cancer causation and self-reported shift work exposure in a case-control study. Women completed a questionnaire asking whether they believed that shift work caused cancer either before or after reporting their history of shift work. We measured: whether belief modified the association between reported shift work and disease; whether belief was associated with reported shift work exposure; and whether being prompted to recall shift work exposure was associated with an increased likelihood of believing that shift work increased breast cancer risk. There was a significant association between believing shift work increased breast cancer risk and reporting exposure to shift work. Being prompted to recall shift work was not associated with a belief that shift work increased risk. The association between pre-existing belief about breast cancer risk and reported shift work is likely to be due to exposed individuals believing that exposure increases risk, rather than resulting from recall bias. Copyright © 2017 Elsevier Ltd. All rights reserved.

Publication bias and the limited strength model of self-control: has the evidence for ego depletion been overestimated?

PubMed

Carter, Evan C; McCullough, Michael E

2014-01-01

Few models of self-control have generated as much scientific interest as has the limited strength model. One of the entailments of this model, the depletion effect, is the expectation that acts of self-control will be less effective when they follow prior acts of self-control. Results from a previous meta-analysis concluded that the depletion effect is robust and medium in magnitude (d = 0.62). However, when we applied methods for estimating and correcting for small-study effects (such as publication bias) to the data from this previous meta-analysis effort, we found very strong signals of publication bias, along with an indication that the depletion effect is actually no different from zero. We conclude that until greater certainty about the size of the depletion effect can be established, circumspection about the existence of this phenomenon is warranted, and that rather than elaborating on the model, research efforts should focus on establishing whether the basic effect exists. We argue that the evidence for the depletion effect is a useful case study for illustrating the dangers of small-study effects as well as some of the possible tools for mitigating their influence in psychological science.

Driving behaviors and on-duty road accidents: a French case-control study.

PubMed

Fort, Emmanuel; Chiron, Mireille; Davezies, Philippe; Bergeret, Alain; Charbotel, Barbara

2013-01-01

A case-control study was carried out to identify driving behaviors associated with the risk of on-duty road accident and to compare driving behaviors according to the type of journey (on duty, commuting, and private) for on-duty road accident victims. Cases were recruited from the Rhône Road Trauma Registry between January 2004 and October 2005 and were on duty at the time of the accident. Control subjects were recruited from the electoral rolls of the case subjects' constituencies of residence. Cases' and controls' driving behavior data were collected by self-administered questionnaire. A logistic regression was performed to identify behavioral risk factors for on-duty road accidents, taking into account age, sex, place of residence, road accident risk exposure, socio-occupational category, and type of road user. A second analysis focused specifically on the case subjects, comparing their self-assessed usual behaviors according to the type of journey. Significant factors for multivariate analysis of on-duty road accidents were female gender, history of on-duty road accidents during the previous 10 years, severe time pressure at work, and driving a vehicle not belonging to the driver. On-duty road accident victims reported behavioral risk factors more frequently in relation to driving for work than driving for private reasons or commuting: nonsystematic seat belt use, cell phone use at least once daily while driving, and history of accidents with injury during the previous 10 years. This study provides knowledge on behavioral risk factors for on-duty road accidents and differences in behavior according to the type of journey for subjects who have been on-duty road accident victims. These results will be useful for the design of on-duty road risk prevention.

The epidemiology of benign prostatic hyperplasia: a study in Greece.

PubMed

Signorello, L B; Tzonou, A; Lagiou, P; Samoli, E; Zavitsanos, X; Trichopoulos, D

1999-08-01

To assess the epidemiology of benign prostatic hyperplasia (BPH) in a case-control study in greater Athens, Greece. The study comprised 184 patients surgically treated for BPH within one year of its diagnosis (cases) and 246 patients with no symptoms of BPH who were treated in the same hospitals for minor diseases or conditions (controls). All cases and controls were permanent residents of the greater Athens area, Greece. The data were assessed using unconditional logistic regression. After controlling for age and education, cases and controls had similar distributions for height, body mass index, sibship size and birth order in the parental family, marital status, number of offspring and a series of previous medical diagnoses or surgical operations. The sole exception was surgery for haemorrhoids, that appeared to be related to the incidence of BPH, possibly by chance. There was no evidence that vertex baldness, tobacco smoking, alcohol consumption or coffee drinking increased the risk for BPH. Men who had spent most of their lives in a rural rather than an urban environment appeared to be at reduced risk for BPH. The lifestyle factors assessed here have no major effect on the aetiology of BPH.

Perceptions of self, significant others, and teacher-child relationships in indiscriminately friendly children.

PubMed

Vervoort, Eleonora; Bosmans, Guy; Doumen, Sarah; Minnis, Helen; Verschueren, Karine

2014-11-01

Despite increasing research on indiscriminate friendliness in children, almost no research exists on social-cognitive deficits that are supposed to underlie indiscriminately friendly behavior. In this study, we compared indiscriminately friendly children with controls regarding their perceptions of self, reliability trust in significant others, and perceptions of the teacher-child relationship. Children's perceptions were compared in two samples: a sample of 33 likely cases for disinhibited reactive attachment disorder (RAD) from special education for children with emotional and behavioral disorders (75.76% boys, Mage=8.52, 96.9% Caucasian, 33.3% and 45.5% of their mothers completed primary or secondary education, respectively) was matched on sex, age, and socio-economic status with a sample of 33 controls from general education. Children participated individually in several interviews assessing global and social self-concept, reliability trust in significant others, teacher-child relationship perceptions, and vocabulary. Parents and teachers completed a screening questionnaire for RAD and the Strengths and Difficulties Questionnaire. Likely disinhibited RAD-cases showed more indiscriminate friendliness and more problem behavior in general according to their parents and teachers than controls. Furthermore, likely RAD-cases reported a more positive global self-concept, more reliability trust in significant others, and more dependency in the teacher-child relationship than controls. The results are in line with clinical observations of indiscriminately friendly children and findings in clinical samples of maltreated or attachment disrupted children but contrast hypotheses from developmental attachment research. Further research is needed to explain the more positive perceptions of indiscriminately friendly children. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Continued Assessment of Self-Continuity and Identity

ERIC Educational Resources Information Center

Dunkel, Curtis S.; Minor, Leslie; Babineau, Maureen

2010-01-01

Studies have found that self-continuity is predictive of a substantial number of important outcome variables. However, a recent series of studies brings into question the traditional method of measuring self-continuity in favor of an alternative (B. M. Baird, K. Le, & R. E. Lucas, 2006). The present study represents a further comparison of…

Non-linear quenching of current fluctuations in a self-exciting homopolar dynamo, proved by feedback system theory

NASA Astrophysics Data System (ADS)

de Paor, A. M.

Hide (Nonlinear Processes in Geophysics, 1998) has produced a new mathematical model of a self-exciting homopolar dynamo driving a series- wound motor, as a continuing contribution to the theory of the geomagnetic field. By a process of exact perturbation analysis, followed by combination and partial solution of differential equations, the complete nonlinear quenching of current fluctuations reported by Hide in the case that a parameter ɛ has the value 1 is proved via the Popov theorem from feedback system stability theory.

Early-time solution of the horizontal unconfined aquifer in the build-up phase

NASA Astrophysics Data System (ADS)

Gravanis, Elias; Akylas, Evangelos

2017-04-01

The Boussinesq equation is a dynamical equation for the free surface of saturated subsurface flows over an impervious bed. Boussinesq equation is non-linear. The non-linearity comes from the reduction of the dimensionality of the problem: The flow is assumed to be vertically homogeneous, therefore the flow rate through a cross section of the flow is proportional to the free surface height times the hydraulic gradient, which is assumed to be equal to the slope of the free surface (Dupuit approximation). In general, 'vertically' means normally on the bed; combining the Dupuit approximation with the continuity equation leads to the Boussinesq equation. There are very few transient exact solutions. Self- similar solutions have been constructed in the past by various authors. A power series type of solution was derived for a self-similar Boussinesq equation by Barenblatt in 1990. That type of solution has generated a certain amount of literature. For the unconfined flow case for zero recharge rate Boussinesq derived for the horizontal aquifer an exact solution assuming separation of variables. This is actually an exact asymptotic solution of the horizontal aquifer recession phase for late times. The kinematic wave is an interesting solution obtained by dropping the non-linear term in the Boussinesq equation. Although it is an approximate solution, and holds well only for small values of the Henderson and Wooding λ parameter (that is, for steep slopes, high conductivity or small recharge rate), it becomes less and less approximate for smaller values of the parameter, that is, it is asymptotically exact with respect to that parameter. In the present work we consider the case of the unconfined subsurface flow over horizontal bed in the build-up phase under constant recharge rate. This is a case with an infinite Henderson and Wooding parameter, that is, it is the limiting case where the non-linear term is present in the Boussinesq while the linear spatial derivative term goes away. Nonetheless, no analogue of the kinematic wave or the Boussinesq separable solution exists in this case. The late time state of the build-up phase under constant recharge rate is very simply the steady state solution. Our aim is to construct the early time asymptotic solution of this problem. The solution is expressed as a power series of a suitable similarity variable, which is constructed so that to satisfy the boundary conditions at both ends of the aquifer, that is, it is a polynomial approximation of the exact solution. The series turn out to be asymptotic and it is regularized by re-summation techniques which are used to define divergent series. The outflow rate in this regime is linear in time, and the (dimensionless) coefficient is calculated to eight significant figures. The local error of the series is quantified by its deviation from satisfying the self-similar Boussinesq equation at every point. The local error turns out to be everywhere positive, hence, so is the integrated error, which in turn quantifies the degree of convergence of the series to the exact solution.

Whole-exome sequencing and targeted gene sequencing provide insights into the role of PALB2 as a male breast cancer susceptibility gene.

PubMed

Silvestri, Valentina; Zelli, Veronica; Valentini, Virginia; Rizzolo, Piera; Navazio, Anna Sara; Coppa, Anna; Agata, Simona; Oliani, Cristina; Barana, Daniela; Castrignanò, Tiziana; Viel, Alessandra; Russo, Antonio; Tibiletti, Maria Grazia; Zanna, Ines; Masala, Giovanna; Cortesi, Laura; Manoukian, Siranoush; Azzollini, Jacopo; Peissel, Bernard; Bonanni, Bernardo; Peterlongo, Paolo; Radice, Paolo; Palli, Domenico; Giannini, Giuseppe; Chillemi, Giovanni; Montagna, Marco; Ottini, Laura

2017-01-01

Male breast cancer (MBC) is a rare disease whose etiology appears to be largely associated with genetic factors. BRCA1 and BRCA2 mutations account for about 10% of all MBC cases. Thus, a fraction of MBC cases are expected to be due to genetic factors not yet identified. To further explain the genetic susceptibility for MBC, whole-exome sequencing (WES) and targeted gene sequencing were applied to high-risk, BRCA1/2 mutation-negative MBC cases. Germ-line DNA of 1 male and 2 female BRCA1/2 mutation-negative breast cancer (BC) cases from a pedigree showing a first-degree family history of MBC was analyzed with WES. Targeted gene sequencing for the validation of WES results was performed for 48 high-risk, BRCA1/2 mutation-negative MBC cases from an Italian multicenter study of MBC. A case-control series of 433 BRCA1/2 mutation-negative MBC and female breast cancer (FBC) cases and 849 male and female controls was included in the study. WES in the family identified the partner and localizer of BRCA2 (PALB2) c.419delA truncating mutation carried by the proband, her father, and her paternal uncle (all affected with BC) and the N-acetyltransferase 1 (NAT1) c.97C>T nonsense mutation carried by the proband's maternal aunt. Targeted PALB2 sequencing detected the c.1984A>T nonsense mutation in 1 of the 48 BRCA1/2 mutation-negative MBC cases. NAT1 c.97C>T was not found in the case-control series. These results add strength to the evidence showing that PALB2 is involved in BC risk for both sexes and indicate that consideration should be given to clinical testing of PALB2 for BRCA1/2 mutation-negative families with multiple MBC and FBC cases. Cancer 2017;123:210-218. © 2016 American Cancer Society. © 2016 American Cancer Society.

The moderating impact of self-esteem on self-affirmation effects.

PubMed

Düring, Camilla; Jessop, Donna C

2015-05-01

This study explored whether self-esteem would moderate the effectiveness of a self-affirmation manipulation at increasing openness to personally relevant health-risk information. The study employed a prospective experimental design. Participants (N = 328) completed either a self-affirmation manipulation or a control task, prior to reading information detailing the health-related consequences of taking insufficient exercise. They then completed a series of measures assessing their cognitions towards exercise and their derogation of the information. Exercise behaviour was assessed at 1-week follow-up. Self-esteem moderated the impact of self-affirmation on the majority of outcomes. For participants with low self-esteem, the self-affirmation manipulation resulted in more positive attitudes and intentions towards exercise, together with lower levels of derogation of the health-risk information. By contrast, there was no effect of the self-affirmation manipulation on outcomes for participants with high self-esteem. Findings suggest that self-affirmation manipulations might be of particular benefit for those with low self-esteem in terms of promoting openness towards health-risk information. This is promising from a health promotion perspective, as individuals with low self-esteem often represent those most in need of intervention. Statement of contribution What is already known on this subject? Self-affirmation has been shown to result in more open processing of personally relevant health-risk information. Individuals low in self-esteem tend to process such information more defensively than those high in self-esteem. What does this study add? It explores whether self-esteem moderates the impact of self-affirmation on responses to health-risk information. Findings suggest that individuals with low self-esteem benefit most from the self-affirmation manipulation. This has important applied implications, as individuals with low self-esteem may be most in need of intervention. © 2014 The British Psychological Society.

Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine.

PubMed

Ebel, Marie-Desirée; Rudolph, Ivonne; Keinki, Christian; Hoppe, Andrea; Muecke, Ralph; Micke, Oliver; Muenstedt, Karsten; Huebner, Jutta

2015-08-01

A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.

Examining a possible association between human papilloma virus (HPV) vaccination and migraine: results of a cohort study in the Netherlands.

PubMed

Schurink-Van't Klooster, T M; de Ridder, M A J; Kemmeren, J M; van der Lei, J; Dekker, F; Sturkenboom, M; de Melker, H E

2015-05-01

Since the introduction of the bivalent human papilloma virus (HPV) vaccine in the Netherlands, migraine has been reported as a notable event in the passive safety surveillance system. Research on the association between HPV vaccination and migraine is needed. Therefore, potential migraine cases in 2008-2010 were selected from a group of general practitioners and linked to the vaccination registry. Data were analysed in three ways: (i) incidences of migraine postvaccination (2009/2010) were compared to pre-vaccination incidences (2008); (ii) in a cohort, incidence rates of migraine in vaccinated and unvaccinated girls were compared and (iii) in a self-controlled case series analysis, the relative incidence of migraine in potentially high-risk periods was compared to non-high-risk periods. Incidence rates of migraine for 12- to 16-year-old girls and boys postvaccination were slightly higher than pre-vaccination incidence rates. Incidence rate ratios (IRRs) for vaccinated compared to unvaccinated girls were not statistically significantly higher. Furthermore, the RR for migraine in the high-risk period of 6 weeks following each dose versus non-high-risk period was 4.3 (95% confidence interval (CI) 0.69-26.6) for certain migraine. Using different methods, no statistically significant association between HPV vaccination and incident migraine was found. However, the number of cases was low; to definitively exclude the risk, an increased sample size is needed.

Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression

PubMed Central

Alonso, Jordi; Stein, Dan J.; Kiejna, Andrzej; Aguilar-Gaxiola, Sergio; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Lepine, Jean-Pierre; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Fukao, Akira; Bunting, Brendan; Haro, Josep Maria; Posada-Villa, Jose A.; Al-Hamzawi, Ali Obaid; Medina-Mora, Maria Elena; Piazza, Marina; Hu, Chiyi; Sasu, Carmen; Lim, Carmen C. W.; Kessler, Ronald C.; Scott, Kate M.

2014-01-01

Aims/hypothesis No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes. Methods We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults (n=52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician’s diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment. Results We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment. Conclusions/interpretation Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes. PMID:24488082

Severe poisoning after self-reported use of 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine, a novel substituted amphetamine: a case series.

PubMed

Hieger, M A; Rose, S R; Cumpston, K L; Stromberg, P E; Miller, S; Wills, B K

2015-12-01

Significant toxicity from amphetamine and cathinone derivatives is being increasingly reported. We describe a series of self-reported exposures to 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25-I-NBOME or 25-I), a novel amphetamine derivative. Ten patients with an average age of 17 years presented to local emergency departments (EDs) in our community after ingestion and/or insufflation of a drug referred to as "25-I." Of 10 patients, 6 reported taking 25-I alone; other substances included ethanol; 2,5-dimethoxy-4-ethylphenethylamine; marijuana; and ketamine. Most common effects included tachycardia (90%), hypertension (70%), agitation (60%), and hallucinations (50%). The average heart rate was 123 beats per minute. Two patients were found in status epilepticus, and another was found unresponsive. One patient who had a seizure had multiple, discrete intraparenchymal hemorrhages and acute kidney injury. Six patients were admitted to the intensive care unit, two were treated in the ED and released, and 1 each was admitted to psychiatry or managed in a clinical decision unit and subsequently discharged. Three patients required emergent intubation, and all admitted patients (7/10) were given intravenous benzodiazepines for sedation. Urine and blood specimens were obtained from 1 patient, which showed analytic confirmation of 25-I. In addition to sympathomimetic effects, methoxy and other substituent groups impart serotonergic effects, resulting in hallucinogenic properties. 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine appears to be extremely potent with a reported "dose" of 500 μg resulting in increased potential for inadvertent overdose. This case series describes significant morbidity in a local cluster of young patients after self-reported use of 25-I, a newly identified drug of abuse.

Risk factors for nonspecific low-back pain in Chinese adolescents: a case-control study.

PubMed

Yao, WeiGuang; Luo, ChenLing; Ai, FuZhi; Chen, Qing

2012-05-01

The objective of this study was to gain a basic understanding of the influential factors for nonspecific low-back pain (LBP) among adolescents of southern China. The study was designed as a school-based case control study. Nonspecific LBP is a common health problem in adolescence. Although some behaviors and socio-demographic factors are believed to contribute to the disorder, influential factors of LBP remain undefined. Moreover, until now there is no available information of influential factors for LBP in Chinese adolescents. A total of 1,214 adolescents were involved in the study, including 607 cases with nonspecific LBP and 607 controls without history of nonspecific LBP. A self-administered questionnaire was designed for epidemiological survey to investigate the risk factors for nonspecific LBP. All cases and controls were investigated for their family histories of nonspecific LBP, physical activities, sedentary activities, schoolbag weights, school performances, living conditions, and etc. A 1:1 matched case-control study was conducted on 1,214 adolescents from an elementary school and a secondary school in Guangzhou City, southern China. Family history (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.85-3.58), long duration of carrying schoolbag (OR 1.38, 95% CI 1.11-1.72) and rest position between classes (OR 1.18, 95% CI 1.01-1.39) were positively correlated with self-reported nonspecific LBP. Students regularly playing basketball (OR 1.58, 95% CI 1.09-2.30) was found to be significantly more likely to have LBP. Also, students who feel schoolbag uncomfortable (OR 1.38, 95% CI 1.11-1.72) was found to experience more LBP. Family history, feeling schoolbag uncomfortable, duration of schoolbag carrying, basketball playing and rest position between classes are the major risk factors for nonspecific LBP in adolescents. Wiley Periodicals, Inc.

Self-Esteem and Reading Achievement.

ERIC Educational Resources Information Center

Sweet, Anne E.; Burbach, Harold J.

This study investigated the directionality of the relationship between self-esteem and reading achievement in 286 students in Lynchburg, Virginia. During the first year of the three-year study, subjects were fourth, fifth, and sixth graders. The Coopersmith Self-Esteem Inventory and the SRA Achievement Series subscales were administered; sex and…

Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review

PubMed Central

Choi, Haemi; McCartney, Michael; Best, Thomas M

2013-01-01

Objectives The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence. Methods Three databases—MEDLINE, Cochrane Database of Systematic Reviews and CINAHL—were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review. Results There were no randomised controlled trials identified with this study’s search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/ series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis. Conclusions The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport. PMID:18812419

Controlling Mold on Library Materials with Chlorine Dioxide: An Eight-Year Case Study.

ERIC Educational Resources Information Center

Weaver-Meyers, Pat L.; Kowaleski, Barbara; Stolt, Wilbur A.

1998-01-01

Discusses problems associated with mold growth at the University of Oklahoma libraries and describes the results of using chlorine dioxide in aqueous and gaseous forms. Highlights include toxicity compared to other preservation treatments; environmental controls; and explanations of a preference for the use of a self-activating gas packet.…

Spray Bar Zero-Gravity Vent System for On-Orbit Liquid Hydrogen Storage

NASA Technical Reports Server (NTRS)

Hastings, L. J.; Flachbart, R. H.; Martin, J. J.; Hedayat, A.; Fazah, M.; Lak, T.; Nguyen, H.; Bailey, J. W.

2003-01-01

During zero-gravity orbital cryogenic propulsion operations, a thermodynamic vent system (TVS) concept is expected to maintain tank pressure control without propellant resettling. In this case, a longitudinal spray bar mixer system, coupled with a Joule-Thompson (J-T) valve and heat exchanger, was evaluated in a series of TVS tests using the 18 cu m multipurpose hydrogen test bed. Tests performed at fill levels of 90, 50, and 25 percent, coupled with heat tank leaks of about 20 and 50 W, successfully demonstrated tank pressure control within a 7-kPa band. Based on limited testing, the presence of helium constrained the energy exchange between the gaseous and liquid hydrogen (LH2) during the mixing cycles. A transient analytical model, formulated to characterize TVS performance, was used to correlate the test data. During self-pressurization cycles following tank lockup, the model predicted faster pressure rise rates than were measured; however, once the system entered the cyclic self-pressurization/mixing/venting operational mode, the modeled and measured data were quite similar. During a special test at the 25-percent fill level, the J-T valve was allowed to remain open and successfully reduced the bulk LH2 saturation pressure from 133 to 70 kPa in 188 min.

Chronic pain self-management support with pain science education and exercise (COMMENCE): study protocol for a randomized controlled trial.

PubMed

Miller, Jordan; MacDermid, Joy C; Walton, David M; Richardson, Julie

2015-10-14

Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response. This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome. ClinicalTrials.gov NCT02422459 , registered on 13 April 2015.

Crew Exploration Vehicle Launch Abort Controller Performance Analysis

NASA Technical Reports Server (NTRS)

Sparks, Dean W., Jr.; Raney, David L.

2007-01-01

This paper covers the simulation and evaluation of a controller design for the Crew Module (CM) Launch Abort System (LAS), to measure its ability to meet the abort performance requirements. The controller used in this study is a hybrid design, including features developed by the Government and the Contractor. Testing is done using two separate 6-degree-of-freedom (DOF) computer simulation implementations of the LAS/CM throughout the ascent trajectory: 1) executing a series of abort simulations along a nominal trajectory for the nominal LAS/CM system; and 2) using a series of Monte Carlo runs with perturbed initial flight conditions and perturbed system parameters. The performance of the controller is evaluated against a set of criteria, which is based upon the current functional requirements of the LAS. Preliminary analysis indicates that the performance of the present controller meets (with the exception of a few cases) the evaluation criteria mentioned above.

Self-organization in psychotherapy: testing the synergetic model of change processes

PubMed Central

Schiepek, Günter K.; Tominschek, Igor; Heinzel, Stephan

2014-01-01

In recent years, models have been developed that conceive psychotherapy as a self-organizing process of bio-psycho-social systems. These models originate from the theory of self-organization (Synergetics), from the theory of deterministic chaos, or from the approach of self-organized criticality. This process-outcome study examines several hypotheses mainly derived from Synergetics, including the assumption of discontinuous changes in psychotherapy (instead of linear incremental gains), the occurrence of critical instabilities in temporal proximity of pattern transitions, the hypothesis of necessary stable boundary conditions during destabilization processes, and of motivation to change playing the role of a control parameter for psychotherapeutic self-organization. Our study was realized at a day treatment center; 23 patients with obsessive compulsive disorder (OCD) were included. Client self-assessment was performed by an Internet-based process monitoring (referred to as the Synergetic Navigation System), whereby daily ratings were recorded through administering the Therapy Process Questionnaire (TPQ). The process measures of the study were extracted from the subscale dynamics (including the dynamic complexity of their time series) of the TPQ. The outcome criterion was measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) which was completed pre-post and on a bi-weekly schedule by all patients. A second outcome criterion was based on the symptom severity subscale of the TPQ. Results supported the hypothesis of discontinuous changes (pattern transitions), the occurrence of critical instabilities preparing pattern transitions, and of stable boundary conditions as prerequisites for such transitions, but not the assumption of motivation to change as a control parameter. PMID:25324801

Self-organization in psychotherapy: testing the synergetic model of change processes.

PubMed

Schiepek, Günter K; Tominschek, Igor; Heinzel, Stephan

2014-01-01

In recent years, models have been developed that conceive psychotherapy as a self-organizing process of bio-psycho-social systems. These models originate from the theory of self-organization (Synergetics), from the theory of deterministic chaos, or from the approach of self-organized criticality. This process-outcome study examines several hypotheses mainly derived from Synergetics, including the assumption of discontinuous changes in psychotherapy (instead of linear incremental gains), the occurrence of critical instabilities in temporal proximity of pattern transitions, the hypothesis of necessary stable boundary conditions during destabilization processes, and of motivation to change playing the role of a control parameter for psychotherapeutic self-organization. Our study was realized at a day treatment center; 23 patients with obsessive compulsive disorder (OCD) were included. Client self-assessment was performed by an Internet-based process monitoring (referred to as the Synergetic Navigation System), whereby daily ratings were recorded through administering the Therapy Process Questionnaire (TPQ). The process measures of the study were extracted from the subscale dynamics (including the dynamic complexity of their time series) of the TPQ. The outcome criterion was measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) which was completed pre-post and on a bi-weekly schedule by all patients. A second outcome criterion was based on the symptom severity subscale of the TPQ. Results supported the hypothesis of discontinuous changes (pattern transitions), the occurrence of critical instabilities preparing pattern transitions, and of stable boundary conditions as prerequisites for such transitions, but not the assumption of motivation to change as a control parameter.

A randomized controlled open trial of population-based disease and case management in a Medicare Plus Choice health maintenance organization.

PubMed

Martin, David C; Berger, Marc L; Anstatt, David T; Wofford, Jonathan; Warfel, DeAnn; Turpin, Robin S; Cannuscio, Carolyn C; Teutsch, Steven M; Mansheim, Bernard J

2004-10-01

The object of this study was to examine the effect of population-based disease management and case management on resource use, self-reported health status, and member satisfaction with and retention in a Medicare Plus Choice health maintenance organization (HMO). Study design consisted of a prospective, randomized controlled open trial of 18 months' duration. Participants were 8504 Medicare beneficiaries aged 65 and older who had been continuously enrolled for at least 12 months in a network model Medicare Plus Choice HMO serving a contiguous nine-county metropolitan area. Members were care managed with an expert clinical information system and frequent telephone contact. Main outcomes included self-reported health status measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), resource use measured by admission rates and bed-days per thousand per year, member satisfaction, and costs measured by paid claims. More favorable outcomes occurred in the intervention group for satisfaction with the health plan (P < .01) and the social function domain as measured by SF-36 (P = .04). There was no difference in member retention or mortality between groups. Use of skilled nursing home services was significantly lower in the intervention group than in the control (616 vs 747 days per thousand members per year, P = .02). This reduction, however, did not lead to lower mean total expenditures in the intervention group compared with the control (6828 dollars per member for 18 months vs 7001 dollars, P = .61). Population-based disease management and case management led to improved self-reported satisfaction and social function but not to a global net decrease in resource use or improved member retention.

Effect of supportive nursing care on self esteem of patients receiving electroconvulsive therapy: a randomized controlled clinical trial.

PubMed

Ebrahimi, Hossein; Navidian, Ali; Keykha, Roghaieh

2014-06-01

Self-esteem is an important potential indicator in etiology, diagnosis and treatment of patients with severe mental illness. ECT is a popular treatment for these patients that can effect on their self-esteem and reinforce their problems. The purpose of this study is to determine the effect of supportive nursing care in increasing self esteem of patients receiving ECT. This clinical trial was conducted in the Baharan psychiatric hospital of Zahedan. A total of 70 cases of patients who received ECT were randomly allocated to control (n=35) and intervention (n=35) groups. The data were collected by demographic characteristics questionnaire and Rosenberg Self Esteem Scale (RSES). Intervention group received the supportive nursing care. The control group received only routine treatment. Self esteem level was measured and compared before and after intervention for two groups. The data was analyzed by SPSS using the χ(2), t-test and ANCOVA. RESULTS showed that both groups were homogeneous on the socio- demographic characteristics. The mean self esteem in the intervention group compared with the control group was significantly increased. While controlling the effects of individual and social variables, the result shows significant differences between two groups in the mean scores of self esteem after the intervention. The results suggest that supportive nursing care can have positive effect on self esteem of patients receiving ECT. It is recommended to use this method for increasing self esteem of these patients.

A case series study of the neurophysiological effects of altered states of mind during intense Islamic prayer.

PubMed

Newberg, Andrew B; Wintering, Nancy A; Yaden, David B; Waldman, Mark R; Reddin, Janet; Alavi, Abass

2015-12-01

This paper presents a case series with preliminary data regarding the neurophysiological effects of specific prayer practices associated with the Islamic religion. Such practices, like other prayer practices, are likely associated with several coordinated cognitive activities and a complex pattern of brain physiology. However, there may also be changes specific to the goals of Islamic prayer which has, as its most fundamental concept, the surrendering of one's self to God. To evaluate Islamic prayer practices, we measured changes in cerebral blood flow (CBF) using single photon emission computed tomography (SPECT) in three Islamic individuals while practicing two different types of Islamic prayer. In this case series, intense Islamic prayer practices generally showed decreased CBF in the prefrontal cortex and related frontal lobe structures, and the parietal lobes. However, there were also several regions that differed between the two types of prayer practices including increased CBF in the caudate nucleus, insula, thalamus, and globus pallidus. These patterns also appear distinct from concentrative techniques in which an individual focuses on a particular idea or object. It is hypothesized that the changes in brain activity may be associated with feelings of "surrender" and "connectedness with God" described to be experienced during these intense Islamic prayer practices. Overall, these results suggest that several coordinated cognitive processes occur during intense Islamic prayer. Methodological issues and implications of the results are also discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

NASA Astrophysics Data System (ADS)

Brand, Lance G.

2011-12-01

The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth grade performance is an endemic indicator of underlying problems that exists in this transitional year of education and supports the need to strengthen the transitional connections between high schools and institutions of higher learning.

75 FR 68548 - Airworthiness Directives; Airbus Model A318, A319, A320, and A321 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

...: One case of elevator servo-control disconnection has been experienced on an aeroplane of the A320 family. Investigation has revealed that the failure occurred at the servo-control rod eye-end. Further to... servo-control rod eye-ends. In several cases, both actuators of the same elevator surface were affected...

Modified superposition: A simple time series approach to closed-loop manual controller identification

NASA Technical Reports Server (NTRS)

Biezad, D. J.; Schmidt, D. K.; Leban, F.; Mashiko, S.

1986-01-01

Single-channel pilot manual control output in closed-tracking tasks is modeled in terms of linear discrete transfer functions which are parsimonious and guaranteed stable. The transfer functions are found by applying a modified super-position time series generation technique. A Levinson-Durbin algorithm is used to determine the filter which prewhitens the input and a projective (least squares) fit of pulse response estimates is used to guarantee identified model stability. Results from two case studies are compared to previous findings, where the source of data are relatively short data records, approximately 25 seconds long. Time delay effects and pilot seasonalities are discussed and analyzed. It is concluded that single-channel time series controller modeling is feasible on short records, and that it is important for the analyst to determine a criterion for best time domain fit which allows association of model parameter values, such as pure time delay, with actual physical and physiological constraints. The purpose of the modeling is thus paramount.

Dynamic functional connectivity reveals altered variability in functional connectivity among patients with major depressive disorder.

PubMed

Demirtaş, Murat; Tornador, Cristian; Falcón, Carles; López-Solà, Marina; Hernández-Ribas, Rosa; Pujol, Jesús; Menchón, José M; Ritter, Petra; Cardoner, Narcis; Soriano-Mas, Carles; Deco, Gustavo

2016-08-01

Resting-state fMRI (RS-fMRI) has become a useful tool to investigate the connectivity structure of mental health disorders. In the case of major depressive disorder (MDD), recent studies regarding the RS-fMRI have found abnormal connectivity in several regions of the brain, particularly in the default mode network (DMN). Thus, the relevance of the DMN to self-referential thoughts and ruminations has made the use of the resting-state approach particularly important for MDD. The majority of such research has relied on the grand averaged functional connectivity measures based on the temporal correlations between the BOLD time series of various brain regions. We, in our study, investigated the variations in the functional connectivity over time at global and local level using RS-fMRI BOLD time series of 27 MDD patients and 27 healthy control subjects. We found that global synchronization and temporal stability were significantly increased in the MDD patients. Furthermore, the participants with MDD showed significantly increased overall average (static) functional connectivity (sFC) but decreased variability of functional connectivity (vFC) within specific networks. Static FC increased to predominance among the regions pertaining to the default mode network (DMN), while the decreased variability of FC was observed in the connections between the DMN and the frontoparietal network. Hum Brain Mapp 37:2918-2930, 2016. © 2016 Wiley Periodicals, Inc. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Neural substrates of empathic accuracy in people with schizophrenia.

PubMed

Harvey, Philippe-Olivier; Zaki, Jamil; Lee, Junghee; Ochsner, Kevin; Green, Michael F

2013-05-01

Empathic deficits in schizophrenia may lead to social dysfunction, but previous studies of schizophrenia have not modeled empathy through paradigms that (1) present participants with naturalistic social stimuli and (2) link brain activity to "accuracy" about inferring other's emotional states. This study addressed this gap by investigating the neural correlates of empathic accuracy (EA) in schizophrenia. Fifteen schizophrenia patients and 15 controls were scanned while continuously rating the affective state of another person shown in a series of videos (ie, targets). These ratings were compared with targets' own self-rated affect, and EA was defined as the correlation between participants' ratings and targets' self-ratings. Targets' self-reported emotional expressivity also was measured. We searched for brain regions whose activity tracked parametrically with (1) perceivers' EA and (2) targets' expressivity. Patients showed reduced EA compared with controls. The left precuneus, left middle frontal gyrus, and bilateral thalamus were significantly more correlated with EA in controls compared with patients. High expressivity in targets was associated with better EA in controls but not in patients. High expressivity was associated with increased brain activity in a large set of regions in controls (eg, fusiform gyrus, medial prefrontal cortex) but not in patients. These results use a naturalistic performance measure to confirm that schizophrenic patients demonstrate impaired ability to understand others' internal states. They provide novel evidence about a potential mechanism for this impairment: schizophrenic patients failed to capitalize on targets' emotional expressivity and also demonstrate reduced neural sensitivity to targets' affective cues.

Toward better control of Salmonella contamination by taking advantage of the egg's self-defense system: a review.

PubMed

Zhang, Wei; Zheng, Jiang-Xia; Xu, Gui-Yun

2011-04-01

Egg-associated salmonellosis is a major problem for food safety. It can be caused by vertical transmission (transovarian transmission) in hens and horizontal transmission though penetration. Despite a series of physical and chemical defense mechanisms naturally found in eggs, they cannot provide complete protection for them. Environmental hygiene, bacteria vectors such as birds, rodent, flies, and beetles along with feed and water contamination are the most frequently reported causes of Salmonella colonization in hens, and finally to eggs. In addition, inappropriate egg handling will cause eggs to lose their self-protection ability, thus resulting in the survival and multiplication of Salmonella in an egg's contents, which contributes to the horizontal dissemination. The routes of Salmonella contamination were discussed, and the effectiveness and shortcomings of different decontamination methods were evaluated in this review. Various studies on egg storage indicated that the low-temperature storage without temperature fluctuation was beneficial for the control of Salmonella. This review, based on an understanding of the stages of Salmonella transmission and an egg's self-protection mechanisms, highlights a comprehensive strategy toward Salmonella control in a process from egg production and handling to human consumption.

The Anatomy of Self-Defense

ERIC Educational Resources Information Center

Sparks Stein, Pamela; Richardson, April D.; Challman, Sandra D.

2008-01-01

The following study describes a creative application of anatomical principles in the instruction of self-defense. Undergraduates at the University of Kentucky were invited to a special lecture that featured a series of self-defense moves introduced by a local police officer. Following a demonstration of each self-defense tactic, the students were…

76 FR 71341 - BASINS and WEPP Climate Assessment Tools: Case Study Guide to Potential Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... report presents a series of short case studies designed to illustrate the capabilities of these tools for... change impacts on water. This report presents a series of short case studies using the BASINS and WEPP climate assessment tools. The case studies are designed to illustrate the capabilities of these tools for...

Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.

PubMed

Chung, Philip; Currie, Brian; Guo, Yi; Talansky, Moshe; Brown, Shakara; Ostrowsky, Belinda

2014-10-01

Antimicrobial exposure remains an important risk factor for developing Clostridium difficile infection (CDI). Efficient method to identify antibiotics associated with CDI is important for formulating strategies to curtail their use. As a prelude to a more extensive Agency for Healthcare Research and Quality-funded project (Evaluation & Research on Antimicrobial Stewardship's Effect on Clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for identifying antibiotic targets for antimicrobial stewardship interventions. The study compared a series of 6 focused case-control studies. Cases consisted of patients with laboratory-confirmed CDI admitted from July-October 2009. Controls were selected from patients without CDI hospitalized during the same period. Five groups of controls were matched to cases (2:1 ratio) using group-specific matching criteria, including admission date, age, type of admission, length of stay (LOS) to discharge, and/or LOS to CDI diagnosis. The final control group was selected from patients who received antibiotics during hospitalization. Data, including demographics and antibiotic usage, were compared between case and control groups. A total of 126 cases were matched to 6 groups of 252 controls. For control groups 1-5, the use of piperacillin and tazobactam, ceftriaxone or cefepime, ciprofloxacin or moxifloxacin, intravenous vancomycin, azithromycin, and antibiotics of last resort were significantly more frequent in case than control patients. For the final control group, the associations between ceftriaxone or cefepime, and ciprofloxacin or moxifloxacin use and CDI no longer persisted. This could in part be explained by differences in comorbidities between case and control patients even with stringent matching criteria. Use of a simple matching strategy to conduct case-control studies is an efficient and feasible compromise strategy, especially in resource-limited settings, to identify high-risk antibiotics associated with CDI. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Using Time Series Analysis to Predict Cardiac Arrest in a PICU.

PubMed

Kennedy, Curtis E; Aoki, Noriaki; Mariscalco, Michele; Turley, James P

2015-11-01

To build and test cardiac arrest prediction models in a PICU, using time series analysis as input, and to measure changes in prediction accuracy attributable to different classes of time series data. Retrospective cohort study. Thirty-one bed academic PICU that provides care for medical and general surgical (not congenital heart surgery) patients. Patients experiencing a cardiac arrest in the PICU and requiring external cardiac massage for at least 2 minutes. None. One hundred three cases of cardiac arrest and 109 control cases were used to prepare a baseline dataset that consisted of 1,025 variables in four data classes: multivariate, raw time series, clinical calculations, and time series trend analysis. We trained 20 arrest prediction models using a matrix of five feature sets (combinations of data classes) with four modeling algorithms: linear regression, decision tree, neural network, and support vector machine. The reference model (multivariate data with regression algorithm) had an accuracy of 78% and 87% area under the receiver operating characteristic curve. The best model (multivariate + trend analysis data with support vector machine algorithm) had an accuracy of 94% and 98% area under the receiver operating characteristic curve. Cardiac arrest predictions based on a traditional model built with multivariate data and a regression algorithm misclassified cases 3.7 times more frequently than predictions that included time series trend analysis and built with a support vector machine algorithm. Although the final model lacks the specificity necessary for clinical application, we have demonstrated how information from time series data can be used to increase the accuracy of clinical prediction models.