Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies

PubMed Central

Melanda, Francine Nesello; Mesas, Arthur Eumann; González, Alberto Durán; Gabani, Flávia Lopes

2017-01-01

Burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment. PMID:28977041

Intravenous Iron Administration and Hypophosphatemia in Clinical Practice

PubMed Central

Hardy, S.; Vandemergel, X.

2015-01-01

Introduction. Parenteral iron formulations are frequently used to correct iron deficiency anemia (IDA) and iron deficiency (ID). Intravenous formulation efficacy on ferritin and hemoglobin level improvement is greater than that of oral formulations while they are associated with lower gastrointestinal side effects. Ferric carboxymaltose- (FCM-) related hypophosphatemia is frequent and appears without clinical significance. The aim of this study was to assess the prevalence, duration, and potential consequences of hypophosphatemia after iron injection. Patients and Methods. The medical records of all patients who underwent parenteral iron injection between 2012 and 2014 were retrospectively reviewed. Pre- and postinjection hemoglobin, ferritin, plasma phosphate, creatinine, and vitamin D levels were assessed. Patients who developed moderate (range: 0.32–0.80 mmol/L) or severe (<0.32 mmol/L) hypophosphatemia were questioned for symptoms. Results. During the study period, 234 patients received iron preparations but 104 were excluded because of missing data. Among the 130 patients included, 52 received iron sucrose (FS) and 78 FCM formulations. Among FS-treated patients, 22% developed hypophosphatemia versus 51% of FCM-treated patients, including 13% who developed profound hypophosphatemia. Hypophosphatemia severity correlated with the dose of FCM (p = 0.04) but not with the initial ferritin, hemoglobin, or vitamin D level. Mean hypophosphatemia duration was 6 months. No immediate clinical consequence was found except for persistent fatigue despite anemia correction in some patients. Conclusions. Hypophosphatemia is frequent after parenteral FCM injection and may have clinical consequences, including persistent fatigue. Further studies of chronic hypophosphatemia long-term consequences, especially bone assessments, are needed. PMID:26000018

[Climate changes, floods, and health consequences].

PubMed

Michelozzi, Paola; de' Donato, Francesca

2014-02-01

In the European Region, floods are the most common natural disaster, causing extensive damage and disruption. In Italy, it has been estimated that over 68% of municipalities are at high hydrogeological risk and with the recent intense rainfall events local populations have been facing severe disruptions. The health consequences of floods are wide ranging and are dependent upon the vulnerability of the environment and the local population. Health effects can be a direct or indirect consequence of flooding. The immediate health impacts of floods include drowning, heart attacks, injuries and hypothermia. The indirect effects include, injuries and infections, water-borne infectious disease, mental health problems, respiratory disease and allergies in both the medium and long term after a flood. Future efforts should be addressed to integrate health preparedness and prevention measures into emergency flood plans and hydrological warning systems.

The Cooperating Teacher: An Ambivalent Participant in Student Teaching.

ERIC Educational Resources Information Center

Koerner, Mari E.

1992-01-01

Inductive analyses of the journals of eight elementary, cooperating teachers revealed several consequences of having student teachers, including interruption of instruction, teacher displacement, disruption of classroom routine, breaking teachers' isolation, and shifting teachers' time and energy. (IAH)

Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

PubMed Central

2014-01-01

Background Maternal mortality is a major public health challenge in Uganda. Whereas uterine rupture remains a major cause of maternal morbidity and mortality, there is limited research into what happens to women who survive such severe obstetric complications. Understanding their experiences might delineate strategies to support survivors. Methods This qualitative study used a phenomenological approach to explore lived experiences of women who developed uterine rupture following obstructed labor. In-depth interviews initially conducted during their hospitalization were repeated 3–6 months after the childbirth event to explore their health and meanings they attached to the traumatic events and their outcomes. Data were analyzed using thematic analysis. Results The resultant themes included barriers to access healthcare, multiple “losses” and enduring physical, psychosocial and economic consequences. Many women who develop uterine rupture fail to access critical care needed due to failure to recognise danger signs of obstructed labor, late decision making for accessing care, geographical barriers to health facilities, late or failure to diagnose obstructed labor at health facilities, and failure to promptly perform caesarean section. Secondly, the sequel of uterine rupture includes several losses (loss of lives, loss of fertility, loss of body image, poor quality of life and disrupted marital relationships). Thirdly, uterine rupture has grim economic consequences for the survivors (with financial loss and loss of income during and after the calamitous events). Conclusion Uterine rupture is associated with poor quality of care due to factors that operate at personal, household, family, community and society levels, and results in dire physical, psychosocial and financial consequences for survivors. There is need to improve access to and provision of emergency obstetric care in order to prevent uterine rupture consequent to obstructed labor. There is also critical need to provide counselling and support to survivors to enable them cope with physical, social, psychological and economic consequences. PMID:24758354

Grapefruit and drug interactions.

PubMed

2012-12-01

Since the late 1980s, grapefruit juice has been known to affect the metabolism of certain drugs. Several serious adverse effects involving drug interactions with grapefruit juice have been published in detail. The components of grapefruit juice vary considerably depending on the variety, maturity and origin of the fruit, local climatic conditions, and the manufacturing process. No single component accounts for all observed interactions. Other grapefruit products are also occasionally implicated, including preserves, lyophylised grapefruit juice, powdered whole grapefruit, grapefruit seed extract, and zest. Clinical reports of drug interactions with grapefruit juice are supported by pharmacokinetic studies, each usually involving about 10 healthy volunteers, in which the probable clinical consequences were extrapolated from the observed plasma concentrations. Grapefruit juice inhibits CYP3A4, the cytochrome P450 isoenzyme most often involved in drug metabolism. This increases plasma concentrations of the drugs concerned, creating a risk of overdose and dose-dependent adverse effects. Grapefruit juice also inhibits several other cytochrome P450 isoenzymes, but they are less frequently implicated in interactions with clinical consequences. Drugs interacting with grapefruit and inducing serious clinical consequences (confirmed or very probable) include: immunosuppressants, some statins, benzodiazepines, most calcium channel blockers, indinavir and carbamazepine. There are large inter-individual differences in enzyme efficiency. Along with the variable composition of grapefruit juice, this makes it difficult to predict the magnitude and clinical consequences of drug interactions with grapefruit juice in a given patient. There is increasing evidence that transporter proteins such as organic anion transporters and P-glycoprotein are involved in interactions between drugs and grapefruit juice. In practice, numerous drugs interact with grapefruit juice. Although only a few reports involving severe clinical consequences have been published, they suggest that grapefruit juice should be avoided during drug therapy, especially when the drug has a narrow therapeutic margin or carries a risk of serious dose-dependent adverse effects. Patients should be informed of this risk whenever a drug is prescribed or dispensed.

Energy Conversion in Natural and Artificial Photosynthesis

PubMed Central

McConnell, Iain; Li, Gonghu; Brudvig, Gary W.

2010-01-01

Summary Modern civilization is dependent upon fossil fuels, a nonrenewable energy source originally provided by the storage of solar energy. Fossil fuel dependence has severe consequences including energy security issues and greenhouse gas emissions. The consequences of fossil fuel dependence could be avoided by fuel-producing artificial systems that mimic natural photosynthesis, directly converting solar energy to fuel. This review describes the three key components of solar energy conversion in photosynthesis: light harvesting, charge separation, and catalysis. These processes are compared in natural and artificial systems. Such a comparison can assist in understanding the general principles of photosynthesis and in developing working devices including photoelectrochemical cells for solar energy conversion. PMID:20534342

INVASION DYNAMICS OF RED SHINERS (CYPRINELLA LUTRENSIS) IN SOUTHEASTERN STREAMS

EPA Science Inventory

Red shiners have invaded a range of North American ecosystems, including several southeastern U.S. river drainages. A principle consequence of these invasions is extirpation of native congeners, either through competition or hydridization. We are conducting research to identify...

Fresh goat's milk for infants: myths and realities--a review.

PubMed

Basnet, Sangita; Schneider, Michael; Gazit, Avihu; Mander, Gurpreet; Doctor, Allan

2010-04-01

Many infants are exclusively fed unmodified goat's milk as a result of cultural beliefs as well as exposure to false online information. Anecdotal reports have described a host of morbidities associated with that practice, including severe electrolyte abnormalities, metabolic acidosis, megaloblastic anemia, allergic reactions including life-threatening anaphylactic shock, hemolytic uremic syndrome, and infections. We describe here an infant who was fed raw goat's milk and sustained intracranial infarctions in the setting of severe azotemia and hypernatremia, and we provide a comprehensive review of the consequences associated with this dangerous practice.

Concluding Thoughts

ERIC Educational Resources Information Center

Palmer, James C.

2014-01-01

Community college leaders face several fundamental challenges as they work on sustaining the fiscal viability of their institutions. These include the need to anticipate the unintended consequences of performance-based funding, diversify revenue streams in ways that reduce fiscal dependence on tuition and state appropriations, control costs, and…

An overview of the nature, causes, and consequences of abusive family relationships. Toward differentiating maltreatment and violence.

PubMed

Emery, R E; Laumann-Billings, L

1998-02-01

Despite gaps in research, this review argues for distinguishing family maltreatment from family violence, a differentiation between minimal or moderate abuse and serious endangerment, physical injury, or sexual violation. Most acts now defined as violent or abusive are moderate, and stressful life circumstances contribute to their development. Research suggests that abuse may develop through multiple pathways. The consequences of abuse appear to be general, but more commonalities may be found by examining more subtle and complex effects. Many interventions have attempted to prevent or treat family violence and its consequences, and several show promise. More systematic research is needed, but several changes in intervention seem warranted now. For instance, (a) mental health professionals should not be required to report maltreatment while a family is engaged in therapy; (b) the social service system needs to rediscover its roots in supporting families under stress, including in cases of moderate maltreatment; and (c) swift and decisive legal intervention is needed in cases of serious family violence.

Achievement Place: development of the elected manager system1

PubMed Central

Phillips, Elery L.; Phillips, Elaine A.; Wolf, Montrose M.; Fixsen, Dean L.

1973-01-01

A series of experiments was carried out to compare several administrative systems at Achievement Place, a family style behavior modification program for pre-delinquent boys. One aspect of the motivation system at Achievement Place was the token economy in which the youths could earn or lose points that could be exchanged for privileges. Several arrangements for assigning routine tasks and for providing token consequences for task performance were compared for their effectiveness in accomplishing the tasks and for their preference by the boys. The independent variables studied included: (1) individually assigned tasks versus group assigned tasks; (2) consequences for individual performance versus consequences for group performance; (3) a peer managership that could be earned by the highest bidder versus a peer managership that could be determined democratically by the peers. The results suggested that among those systems studied the system that best met the criteria of effectiveness and preference involved a democratically elected peer manager who had the authority both to give and to take away points for his peers' performances. PMID:16795439

Lisfranc fractures.

PubMed

Wright, Amanda; Gerhart, Ann E

2009-01-01

Injuries of the tarsometatarsal, or Lisfranc, joint are rarely seen. Lisfranc fractures and fracture dislocations are among the most frequently misdiagnosed foot injuries in the emergency department. A misdiagnosed injury may have severe consequences including chronic pain and loss of foot biomechanics. Evaluation of a foot injury should include a high level of suspicion of a Lisfranc injury, and a thorough work-up is needed for correct diagnosis.

The role of models in estimating consequences as part of the risk assessment process.

PubMed

Forde-Folle, K; Mitchell, D; Zepeda, C

2011-08-01

The degree of disease risk represented by the introduction, spread, or establishment of one or several diseases through the importation of animals and animal products is assessed by importing countries through an analysis of risk. The components of a risk analysis include hazard identification, risk assessment, risk management, and risk communication. A risk assessment starts with identification of the hazard(s) and then continues with four interrelated steps: release assessment, exposure assessment, consequence assessment, and risk estimation. Risk assessments may be either qualitative or quantitative. This paper describes how, through the integration of epidemiological and economic models, the potential adverse biological and economic consequences of exposure can be quantified.

Energy conversion in natural and artificial photosynthesis.

PubMed

McConnell, Iain; Li, Gonghu; Brudvig, Gary W

2010-05-28

Modern civilization is dependent upon fossil fuels, a nonrenewable energy source originally provided by the storage of solar energy. Fossil-fuel dependence has severe consequences, including energy security issues and greenhouse gas emissions. The consequences of fossil-fuel dependence could be avoided by fuel-producing artificial systems that mimic natural photosynthesis, directly converting solar energy to fuel. This review describes the three key components of solar energy conversion in photosynthesis: light harvesting, charge separation, and catalysis. These processes are compared in natural and in artificial systems. Such a comparison can assist in understanding the general principles of photosynthesis and in developing working devices, including photoelectrochemical cells, for solar energy conversion. 2010 Elsevier Ltd. All rights reserved.

Mental health consequences of violence against women and girls.

PubMed

Satyanarayana, Veena A; Chandra, Prabha S; Vaddiparti, Krishna

2015-09-01

Recent studies on mental health consequences of violence against women and girls were reviewed in a range of situations. Although several studies continued to show cross-sectional associations between child sexual abuse (CSA) and mental health outcomes, a few prospective studies showed a robust association between CSA and depression. Studies on the impact of dating violence are still at a nascent stage and focus on antecedents of violence rather than its consequences. Women at higher risk, such as adolescents, migrants, the homeless, and women in the perinatal period have been studied and specific vulnerabilities identified. Women reporting bidirectional violence had higher rates of depression and post-traumatic stress disorder (PTSD). Cumulative violence, severity of violence, and recent violence are associated with higher morbidity. Studies among women in conflict zones have emphasized the role of different forms of sexual and physical violence on mental health. Newer emerging areas that need more research include mental health consequences of women in conflict zones and among same sex relationships. There are also few studies on the violence experience of both older women and adolescents. The need to better delineate the psychopathology of complex manifestations of PTSD is underscored.

Reports of unintended consequences of financial incentives to improve management of hypertension.

PubMed

Hysong, Sylvia J; SoRelle, Richard; Broussard Smitham, Kristen; Petersen, Laura A

2017-01-01

Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives. We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care. We conducted 30-minute telephone interviews with primary care personnel at facilities participating in the RCT housed at12 geographically dispersed Veterans Affairs Medical Centers nationwide. Participants answered questions about unintended effects, clinic team dynamics, organizational impact on care delivery, study participation. We employed a blend of inductive and deductive qualitative techniques for analysis. Sixty-five participants were recruited from RCT enrollees and personnel not enrolled in the larger RCT, plus one primary care leader per site. Emergent themes included possible patient harm, emphasis on documentation over improving care, reduced professional morale, and positive spillover. All discussions of unintended consequences involving patient harm were only concerns, not actual events. Several unintended consequences concerned ancillary initiatives for quality improvement (e.g., practice guidelines and performance measurement systems) rather than financial incentives. Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives. Actual unintended consequences included improved documentation of care without necessarily improving actual care, and positive unintended consequences. Clinicaltrials.gov Identifier: NCT00302718.

Therapy for Child Psychological Maltreatment

ERIC Educational Resources Information Center

Leeson, Fiona; Nixon, Reginald D. V.

2010-01-01

Research of childhood psychological maltreatment has documented a range of severe and long-lasting difficulties for children who experience this type of abuse. Consequences can include but are not limited to emotional and behavioural problems, low self-esteem, and relationship difficulties. Accordingly, the development of therapy programs to…

The role of transpapillary drainage in management of patients with pancreatic fluid collections and pancreatic duct disruption as a consequences of severe acute pancreatitis.

PubMed

Jagielski, Mateusz; Smoczyński, Marian; Adrych, Krystian

In last thirty years we have been observing significant development of an endoscopic treatment of pancreatic fluid collections, including transmural drainage of walled-off pancreatic necrosis. Simultaneously, the use of endotherapy in treatment of main pancreatic ducts disruptions has increased. Despite many publications available in current literature, concerning the endoscopic treatment of consequences of acute necrotizing pancreatitis, the role of transpapillary drainage in management of patients with pancreatic fluid collections and pancreatic duct disruption as an after-effect of severe acute pancreatitis remains unclear and is still a current problem. This publication includes comment on the article entitled 'Early dual drainage combining transpapillary endotherapy and percutaneous catheter drainage in patients with pancreatic fistula associated with severe acute pancreatitis' published by Yokoi et al. in the July-August 2016 issue of Pancreatology together with questions to the authors. Furthermore, in the article we did pay particular attention to the role of transpapillary drainage in management of pancreatic fluid collections, especially of walled-of pancreatic necrosis. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Early metabolic/cellular-level resuscitation following terminal brain stem herniation: implications for organ transplantation.

PubMed

Arbour, Richard B

2013-01-01

Patients with terminal brain stem herniation experience global physiological consequences and represent a challenging population in critical care practice as a result of multiple factors. The first factor is severe depression of consciousness, with resulting compromise in airway stability and lung ventilation. Second, with increasing severity of brain trauma, progressive brain edema, mass effect, herniation syndromes, and subsequent distortion/displacement of the brain stem follow. Third, with progression of intracranial pathophysiology to terminal brain stem herniation, multisystem consequences occur, including dysfunction of the hypothalamic-pituitary axis, depletion of stress hormones, and decreased thyroid hormone bioavailability as well as biphasic cardiovascular state. Cardiovascular dysfunction in phase 1 is a hyperdynamic and hypertensive state characterized by elevated systemic vascular resistance and cardiac contractility. Cardiovascular dysfunction in phase 2 is a hypotensive state characterized by decreased systemic vascular resistance and tissue perfusion. Rapid changes along the continuum of hyperperfusion versus hypoperfusion increase risk of end-organ damage, specifically pulmonary dysfunction from hemodynamic stress and high-flow states as well as ischemic changes consequent to low-flow states. A pronounced inflammatory state occurs, affecting pulmonary function and gas exchange and contributing to hemodynamic instability as a result of additional vasodilatation. Coagulopathy also occurs as a result of consumption of clotting factors as well as dilution of clotting factors and platelets consequent to aggressive crystalloid administration. Each consequence of terminal brain stem injury complicates clinical management within this patient demographic. In general, these multisystem consequences are managed with mechanism-based interventions within the context of caring for the donor's organs (liver, kidneys, heart, etc.) after death by neurological criteria. These processes begin far earlier in the continuum of injury, at the moment of terminal brain stem herniation. As such, aggressive, mechanism-based care, including hormonal replacement therapy, becomes clinically appropriate before formal brain death declaration to support cardiopulmonary stability following terminal brain stem herniation.

Socioeconomic status is associated with symptom severity and sickness absence in people with infectious intestinal disease in the UK.

PubMed

Rose, Tanith C; Adams, Natalie L; Barr, Benjamin; Hawker, Jeremy; O'Brien, Sarah J; Violato, Mara; Whitehead, Margaret; Taylor-Robinson, David C

2017-06-23

The burden of infectious intestinal disease (IID) in the UK is substantial. Negative consequences including sickness absence are common, but little is known about the social patterning of these outcomes, or the extent to which they relate to disease severity. We performed a cross-sectional analysis using IID cases identified from a large population-based survey, to explore the association between socioeconomic status (SES) and symptom severity and sickness absence; and to assess the role of symptom severity on the relationship between SES and absence. Regression modelling was used to investigate these associations, whilst controlling for potential confounders such as age, sex and ethnicity. Among 1164 cases, those of lower SES versus high had twice the odds of experiencing severe symptoms (OR 2.2, 95%CI;1.66-2.87). Lower SES was associated with higher odds of sickness absence (OR 1.8, 95%CI;1.26-2.69), however this association was attenuated after adjusting for symptom severity (OR 1.4, 95%CI;0.92-2.07). In a large sample of IID cases, those of low SES versus high were more likely to report severe symptoms, and sickness absence; with greater severity largely explaining the higher absence. Public health interventions are needed to address the unequal consequences of IID identified.

Severe to profound hearing impairment: quality of life, psychosocial consequences and audiological rehabilitation.

PubMed

Carlsson, Per-Inge; Hjaldahl, Jennie; Magnuson, Anders; Ternevall, Elisabeth; Edén, Margareta; Skagerstrand, Åsa; Jönsson, Radi

2015-01-01

To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment. A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for Rehabilitation Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients. Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts. Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.

Primary, secondary and tertiary effects of eco-climatic change: the medical response.

PubMed

Butler, Colin D; Harley, David

2010-04-01

Climatic and ecological change threaten human health globally. Manifestations include lost species, vanishing glaciers and more frequent heavy rain. In the second half of this century, accelerating sea level rise is likely to cause crop loss, and population dislocation. These problems may be magnified by dysfunctional human responses, including conflict. The population health consequences of these events can be classified as primary, secondary and tertiary. Primary signs include the acute and chronic stress of heat waves, and trauma from increased bush fires and flooding. Secondary signs are indirect, such as an altered distribution of arthropod vectors, intermediate hosts and pathogens that will produce changes in the epidemiology of many infectious diseases. More severe future health consequences of climate change are classified here as tertiary effects. If moderate or severe climate change scenarios prove accurate then these manifestations will occur over large areas, and could include famine, war and significant population displacement. Such effects would threaten governance and health. The health professions must respond to these challenges, especially the task of recognising and seeking to minimise tertiary health consequences. The gap between what we know and what we need to know concerning these issues can be narrowed by a new field of medical practice. The framework for this emerging discipline includes climate change, ecology and global health. Combined, these dimensions may be called ecomedicine. Actions to reduce individual emissions, to promote active transport (with its 'co-benefit' of preventing chronic disease), and involvement in group action to protect the environment and to prevent war, informed by understanding of the health of individual patients and populations, will be central to the practice of ecomedicine.

Functional Communication Training in Rett Syndrome: A Preliminary Study

ERIC Educational Resources Information Center

Byiers, Breanne J.; Dimian, Adele; Symons, Frank J.

2014-01-01

Rett syndrome (RTT) is associated with a range of serious neurodevelopmental consequences including severe communicative impairments. Currently, no evidence-based communication interventions exist for the population (Sigafoos et al., 2009). The purpose of the current study was to examine the effectiveness of functional assessment (FA) and…

Black Teenage Pregnancy: A Challenge for Educators.

ERIC Educational Resources Information Center

Ladner, Joyce A.

1987-01-01

Analyzes the impact of teen pregnancy on the education of Black adolescents. Examines the scope of the problem, its social context, and its consequences. Discusses several effective approaches to teenage pregnancy prevention, including sex/family life education, school-based health clinics, life skills instruction, school retention, and…

Factors Impacting School Closure and Configuration

ERIC Educational Resources Information Center

Corrales, Antonio

2017-01-01

Newly implemented state policy dealing with school finance created several consequences in a school district to include school configuration and restructuring of educational programs. This case describes how a new school finance law changes the entire dynamic of a school district and its newly appointed superintendent. The superintendent…

Cardiovascular Consequences of Metabolic Syndrome

PubMed Central

Tune, Johnathan D.; Goodwill, Adam G.; Sassoon, Daniel J.; Mather, Kieren J.

2017-01-01

The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiologic mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review we highlight current knowledge regarding the pathophysiologic consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiologic and molecular mechanisms that may contribute to these adverse outcomes. PMID:28130064

Environmental consequences of impact cratering events as a function of ambient conditions on Earth.

PubMed

Kring, David A

2003-01-01

The end of the Mesozoic Era is defined by a dramatic floral and faunal turnover that has been linked with the Chicxulub impact event, thus leading to the realization that impact cratering can affect both the geologic and biologic evolution of Earth. However, the environmental consequences of an impact event and any subsequent biological effects rely on several factors, including the ambient environmental conditions and the extant ecosystem structures at the time of impact. Some of the severest environmental perturbations of the Chicxulub impact event would not have been significant in some periods of Earth history. Consequently, the environmental and biological effects of an impact event must be evaluated in the context in which it occurs.

Regional Monitoring of Coral Condition in the Florida Keys

Treesearch

William S. Fisher; Deborah L. Santavy; William P. Davis; Lee A. Courtney

2006-01-01

Tropical reef corals have experienced unprecedented levels of bleaching and disease during the last three decades. Declining health has been attributed to several stressors, including exposures to elevated water temperature, increased solar radiation, and degraded water quality. Consequences of coral bleaching and disease vary; some recover, while others lose tissue,...

Newcastle Disease: Progress and gaps in the development of vaccines and diagnostic tools

USDA-ARS?s Scientific Manuscript database

Newcastle disease (ND) is a contagious disease of birds that can have severe economic consequences for any poultry producer, including a serious impact on the international trade of poultry and eggs. Newcastle disease virus (NDV) isolates are also called avian paramyxovirus serotype-1 isolates, but ...

School Improvement Teams. The Best of ERIC on Educational Management, Number 102.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Educational Management, Eugene, OR.

The reports included in this annotated bibliography of 11 publications on school improvement teams suggest that ownership and commitment to improvement are natural consequences of shared planning and decisionmaking, that overcentralization has severely limited the scope of teachers' professional discretion, and that quality circles--stressing…

Early Malnutrition and Central Nervous System Function

ERIC Educational Resources Information Center

Scrimshaw, Nevin S.

1969-01-01

Discusses the consequences of severe malnutrition in young experimental animals. Development of the brain is permanently impaired. Studies of the effects of malnutrition on children are included. (This paper was presented at the Eighth Annual Lecture of the Merrill-Palmer Historical Library in Child Development and Family Life, October 25, 1968.)…

[Detection and management of the neurologic dysphagia].

PubMed

Leemann, Beatrice; Sergi, Sabrina; Sahinpasic, Leila; Schnider, Armin

2016-03-02

Neurologic dysphagia is frequent and has consequences which can be severe, such as, denutrition andpneumonia. In most cases, it can be detected with a clinical exam. The management includes some general measures, an adaptation of textures, specific rehabilitation, and nutritional assessment to judge whether complementary enteral nutrition is needed.

Genetic and environmental models of circadian disruption link SRC-2 function to hepatic pathology

USDA-ARS?s Scientific Manuscript database

Circadian rhythmicity is a fundamental process that synchronizes behavioral cues with metabolic homeostasis. Disruption of daily cycles due to jet lag or shift work results in severe physiological consequences including advanced aging, metabolic syndrome, and even cancer. Our understanding of the mo...

Shrub-steppe early succession following invasive juniper cutting and prescribed fire

USDA-ARS?s Scientific Manuscript database

Piñon-juniper woodlands of the western United States have expanded in area nearly 10-fold since the late 1800’s. Woodland dominance in sagebrush steppe has several negative consequences including reductions in herbaceous production and diversity, decreased wildlife habitat, higher erosion and runof...

Cultural Variation in Antismoking Video Ads between the United States, Taiwan, and China

ERIC Educational Resources Information Center

Wong, Tzu-Jung; King, Jessica L.; Pomeranz, Jamie L.

2016-01-01

Antitobacco advertisement components, including types of messages and advertising appeals, have not been evaluated among multinational groups. This study identified and compared the content of antismoking video ads across three countries. We reviewed 86 antismoking video advertisements for the following information: severity of the consequences of…

[Infectious keratitis and cosmetic lenses: a five-case retrospective study].

PubMed

Guyomarch, J; van Nuoï, D N'guyen; Beral, L; Donnio, A; Desbois, N; Olive, C; Theodose, R; Merle, H

2010-04-01

To determine the characteristics of infectious keratitis related to plano cosmetic lenses. Retrospective case study of a series of infectious keratitis among plano cosmetic lenses wearers. The main parameters were demographic data, medical history, risk factors for infectious complications and keratitis severity criteria, microbiological results, clinical course, and final visual acuity. Five patients were included, all females, ranging from 15 to 50 years of age. Four were emmetropic. One patient had undergone refractive photokeratectomy a few months before. All had risk factors for infectious complications. The fundamental causes of infections were diverse: bacterial abscesses, keratomycosis, and amoebic keratitis. All presented severity criteria. In two cases, the keratitis led to severe consequences with legal blindness requiring penetrating keratoplasty in one case. Infectious keratitis in plano cosmetic lenses wearers is not rare and may have dramatic consequences. Sales are specifically regulated and the lenses are considered cosmetic products, not medical devices. The sales regulations for plano cosmetic lenses should be updated, as several countries have already done after encountering many serious incidents. Copyright 2010 Elsevier Masson SAS. All rights reserved.

Clinically assessed consequences of workplace physical violence.

PubMed

De Puy, Jacqueline; Romain-Glassey, Nathalie; Gut, Melody; Wild, Pascal; Pascal, Wild; Mangin, Patrice; Danuser, Brigitta

2015-02-01

To assess consequences of physical violence at work and identify their predictors. Among the patients in a medicolegal consultation from 2007 to 2010, the subsample of workplace violence victims (n = 185) was identified and contacted again in average 30 months after the assault. Eighty-six victims (47 %) participated. Ordinal logistic regression analyses assessed the effect of 9 potential risk factors on physical, psychological and work consequences summarized in a severity score (0-9). Severity score distribution was as follows: 4+: 14 %; 1-3: 42 %; and 0: 44 %. Initial psychological distress resulting from the violence was a strong predictor (p < 0.001) of the severity score both on work and long-term psychological consequences. Gender and age did not reach significant levels in multivariable analyses even though female victims had overall more severe consequences. Unexpectedly, only among workers whose jobs implied high awareness of the risk of violence, first-time violence was associated with long-term psychological and physical consequences (p = 0.004). Among the factors assessed at follow-up, perceived lack of employers' support or absence of employer was associated with higher values on the severity score. The seven other assessed factors (initial physical injuries; previous experience of violence; preexisting health problems; working alone; internal violence; lack of support from colleagues; and lack of support from family or friends) were not significantly associated with the severity score. Being a victim of workplace violence can result in long-term consequences on health and employment, their severity increases with the seriousness of initial psychological distress. Support from the employer can help prevent negative outcomes.

The impact of social and psychological consequences of disease on judgments of disease severity: An experimental study.

PubMed

King, Nicholas B; Harper, Sam; Young, Meredith; Berry, Sarah C; Voigt, Kristin

2018-01-01

The Global Burden of Disease (GBD) project systematically assesses mortality, healthy life expectancy, and disability across 195 countries and territories, using the disability-adjusted life year (DALY). Disability weights in the DALY are based upon surveys that ask users to rate health states based on lay descriptions. We conducted an experimental study to examine whether the inclusion or removal of psychological, social, or familial implications from a health state description might affect individual judgments about disease severity, and thus relative disability weights. We designed a survey consisting of 36 paired descriptions in which information about plausible psychological, social, or familial implications of a health condition was either present or absent. Using a Web-based platform, we recruited 1,592 participants, who were assigned to one of two experimental groups, each of which were asked to assign a value to the health state description from 0 to 100 using a slider, with 0 as the "worst possible health" and 100 as the "best possible health." We tested five hypotheses: (1) the inclusion of psychological, social, or familial consequences in health state descriptions will reduce the average rating of a health state; (2) the effect will be stronger for diseases with lower disability weights (i.e., less severe diseases); (3) the effect will vary across the type of additional information added to the health state description; (4) the impact of adding information on familial consequences will be stronger for female than male; (5) the effect of additional consequences on ratings of health state descriptions will not differ by levels of completed education and age. On average, adding social, psychological, or familial consequences to the health state description lowered individual ratings of that description by 0.78 points. The impact of adding information had a stronger impact on ratings of the least severe conditions, reducing average ratings in this category by 1.67 points. Addition of information about child-rearing had the strongest impact, reducing average ratings by 2.09 points. We found little evidence that the effect of adding information on ratings of health descriptions varied by gender, education, or age. Including information about health states not directly related to major functional consequences or symptoms, particularly with respect to child-rearing and specifically for descriptions of less severe conditions, can lead to lower ratings of health. However, this impact was not consistent across all conditions or types of information, and was most pronounced for inclusion of information about child-rearing, and among the least severe conditions.

Examining the Associations among Severity of Injunctive Drinking Norms, Alcohol Consumption, and Alcohol-Related Negative Consequences: The Moderating Roles of Alcohol Consumption and Identity

PubMed Central

Lewis, Melissa A.; Neighbors, Clayton; Geisner, Irene Markman; Lee, Christine M.; Kilmer, Jason R.; Atkins, David C.

2009-01-01

The present study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine if these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-sex college student. A random sample (N = 1,002) of undergraduates (56.9% female) completed a Web–based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-sex college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed. Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventative interventions are discussed. PMID:20565144

Risks, consequences, and prevention of falls of older people in oral healthcare centers.

PubMed

de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

2017-03-01

One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Fifteen years after a ferry disaster: clinical interviews and survivors’ self-assessment of their experience

PubMed Central

Arnberg, Filip K.; Hultman, Christina M.; Michel, Per-Olof; Lundin, Tom

2013-01-01

Background Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past. Objective We aimed to examine diagnostic status and survivors’ views on disaster-related consequences and social support. Methods A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders. Results The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the long-term consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants’ sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others. Conclusions Axis-I disorders were prevalent, but not salient to survivors’ perceptions in the long-term. Post-disaster interventions need to attend to common barriers to support. PMID:24106579

Strengths, Limitations, and Geographical Discrepancies in the Eligibility Criteria for Sport Participation in Young Patients With Congenital Heart Disease.

PubMed

Cantinotti, Massimiliano; Giordano, Raffaele; Assanta, Nadia; Murzi, Bruno; Melo, Manuel; Franchi, Eliana; Crocetti, Maura; Iervasi, Giorgio; Kutty, Shelby

2017-07-21

Benefits of physical activity has been shown in children with congenital heart disease (CHD). In several forms of CHD, the risk of sudden death remains a major concern both for parents and clinicians, who in turn will have to consider the risk-benefit ratio of sport participation versus restriction. A literature search was performed within the National Library of Medicine using the keywords: Sport, CHD, and Eligibility. The search was further refined by adding the keywords: Children, Adult, and Criteria. Fifteen published studies evaluating sport eligibility criteria in CHD were included. Seven documents from various scientific societies have been published in the past decade but which of them should be adopted remains unclear. Our research highlighted accuracy and consistency of the latest documents; however, differences have emerged between the US and European recommendations. Eligibility criteria were consistent between countries for simple congenital heart defects, whereas there are discrepancies for borderline conditions including moderate valvular lesions and mild or moderate residual defects after CHD repair. Furthermore, some of the more severe defects were not evaluated. Multiple recommendations have been made for the same CHD, and cut-off values used to define disease severity have varied. Published eligibility criteria have mainly focused on competitive sports. Little attention was paid to recreational activities, and the psychosocial consequences of activity restriction were seldom evaluated. Comprehensive consensus recommendations for sport eligibility evaluating all CHD types and stages of repair are needed. These should include competitive and recreational activities, use standardized classifications to grade disease severity, and address the consequences of restriction.

Space Radiation and its Associated Health Consequences

NASA Technical Reports Server (NTRS)

Wu, Honglu

2007-01-01

During space travel, astronauts are exposed to energetic particles of a complex composition and energy distribution. For the same amount of absorbed dose, these particles can be much more effective than X- or gamma rays in the induction of biological effects, including cell inactivation, genetic mutations, cataracts, and cancer induction. Several of the biological consequences of space radiation exposure have already been observed in astronauts. This presentation will introduce the space radiation environment and discuss its associated health risks. Accurate assessment of the radiation risks and development of respective countermeasures are essential for the success of future exploration missions to the Moon and Mars.

The functional consequences of mis-sense mutations affecting an intra-molecular salt bridge in arylsulphatase A.

PubMed Central

Schestag, Frank; Yaghootfam, Afshin; Habetha, Matthias; Poeppel, Peter; Dietz, Frank; Klein, Roger A; Zlotogora, Joel; Gieselmann, Volkmar

2002-01-01

Metachromatic leukodystrophy is a lysosomal storage disorder caused by the deficiency of arylsulphatase A. We describe the functional consequences of three mis-sense mutations in the arylsulphatase A gene (Asp-335-Val, Arg-370-Trp and Arg-370-Gln), affecting an apparent intramolecular Asp-335 to Arg-370 salt bridge, and interpret the effects and clinical consequences on the basis of the three-dimensional structure of arylsulphatase A. Asp-335-Val and Arg-370-Trp substitutions each cause a complete loss of enzyme activity and are associated with the most severe form of the human disease, whereas the Arg-370-Gln-substituted enzyme retains some residual activity, being found in a patient suffering from the milder juvenile form of the disease. Detailed analysis reveals that formation of the apparent salt bridge depends critically on the presence of aspartic acid and arginine residues at positions 335 and 370, respectively. Substitution by various other amino acids, including glutamic acid and lysine, affects enzyme function severely. Biosynthesis and immunoprecipitation studies indicate that the Asp-335-Val substitution affects folding of arylsulphatase A more severely than either the Arg-370-Trp or Arg-370-Gln substitutions. In vitro mutagenesis data show that clinical severity correlates with the space occupied by residue 370. The combination with structural data suggests that the bulky tryptophan residue broadens the cleft held together by the apparent salt bridge, whereas the smaller glutamine residue still allows the cleft to close, yielding a less severely affected enzyme. The position of residue 370 in the three-dimensional structure of the enzyme provides a plausible explanation for the differing severities in loss of enzyme function caused by the mutations and thus the clinical phenotype. PMID:12086582

Short- and long-term health consequences of sleep disruption.

PubMed

Medic, Goran; Wille, Micheline; Hemels, Michiel Eh

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption.

Short- and long-term health consequences of sleep disruption

PubMed Central

Medic, Goran; Wille, Micheline; Hemels, Michiel EH

2017-01-01

Sleep plays a vital role in brain function and systemic physiology across many body systems. Problems with sleep are widely prevalent and include deficits in quantity and quality of sleep; sleep problems that impact the continuity of sleep are collectively referred to as sleep disruptions. Numerous factors contribute to sleep disruption, ranging from lifestyle and environmental factors to sleep disorders and other medical conditions. Sleep disruptions have substantial adverse short- and long-term health consequences. A literature search was conducted to provide a nonsystematic review of these health consequences (this review was designed to be nonsystematic to better focus on the topics of interest due to the myriad parameters affected by sleep). Sleep disruption is associated with increased activity of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, metabolic effects, changes in circadian rhythms, and proinflammatory responses. In otherwise healthy adults, short-term consequences of sleep disruption include increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits. For adolescents, psychosocial health, school performance, and risk-taking behaviors are impacted by sleep disruption. Behavioral problems and cognitive functioning are associated with sleep disruption in children. Long-term consequences of sleep disruption in otherwise healthy individuals include hypertension, dyslipidemia, cardiovascular disease, weight-related issues, metabolic syndrome, type 2 diabetes mellitus, and colorectal cancer. All-cause mortality is also increased in men with sleep disturbances. For those with underlying medical conditions, sleep disruption may diminish the health-related quality of life of children and adolescents and may worsen the severity of common gastrointestinal disorders. As a result of the potential consequences of sleep disruption, health care professionals should be cognizant of how managing underlying medical conditions may help to optimize sleep continuity and consider prescribing interventions that minimize sleep disruption. PMID:28579842

Economics and societal considerations of drought

Treesearch

Jeff Prestemon; Linda Kruger; Karen L. Abt; Michael Bowker; Consuelo Brandeis; Dave Calkin; Geoffrey H. Donovan; Charlotte Ham; Thomas P. Holmes; Jeffrey Kline; Travis Warziniack

2016-01-01

The economic and social effects of drought are diverse and related to physical characteristics of drought, including spatial extent, severity, duration, and frequency that combine to determine drought’s overall effects on society. Most of the attention given to economic and social impacts of drought focuses on adverse consequences, but technology, public...

[Rehabilitation of hand injured co-workers from the occupational medicine viewpoint (exemplified by a chassis and montage automobile industry].

PubMed

Harwerth, A

1997-07-01

The majority (about 25%) of work-related accidents involves injuries to the hands and fingers. Depending on type and severity of the injury, it can have profound consequences to an individual's professional future. Due to this basic insight, hand rehabilitation must include vocational rehabilitation.

Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness.

PubMed

Buckley, Peter F

2006-01-01

The co-occurrence of a severe mental illness and a substance use or abuse disorder is common in the United States as well as internationally and could be considered as more the expectation than the exception when assessing patients with serious mental illness. Substance use disorders can occur at any phase of the mental illness, perhaps even inducing psychosis. Causes of this comorbidity may include self-medication, genetic vulnerability, environment or lifestyle, underlying shared origins, and/or a common neural substrate. The consequences of dual diagnosis include poor medication compliance, physical comorbidities and poor health, poor self-care, increased suicide risk or aggression, increased sexual behavior, and possible incarceration. All of these factors contribute to a greater health burden, which reduces the health care system's capacity to adequately treat patients. Therefore, screening, assessment, and integrated treatment plans for dual diagnosis that can address both the addiction disorder and the mental illness are recommended in order to provide accurate treatment, after-care, and other health care to accommodate patients' social and vocational needs.

Pharmacological prevention of suicide in patients with major mood disorders.

PubMed

Rihmer, Zoltan; Gonda, Xenia

2013-12-01

The risk of self-destructive behavior in mood disorders is an inherent phenomenon and suicidal behavior in patients with unipolar or bipolar major mood disorders strongly relates to the presence and severity of depressive episodes. Consequently, early recognition, and successful acute and long-term treatment of depressive disorders is essential for suicide prevention in such patients. Large-scale, retrospective and prospective naturalistic long-term clinical studies, including severely ill, frequently suicidal depressives show that appropriate pharmacotherapy markedly reduces suicide morbidity and mortality even in this high-risk population. Supplementary psycho-social interventions further improve the effect. The slightly elevated (but in absolute sense quite low) risk of suicidal behavior among patients taking antidepressants compared to those taking placebo in randomized controlled antidepressant trials on unipolar major depression might be the consequence of the depression-worsening potential of antidepressant monotherapy in subthreshold and mixed bipolar depressed patients included in these trials and falsely diagnosed as suffering from unipolar major depression. Concurrent depression-focused psychotherapies increase the effectiveness of pharmacotherapy and this way contribute to suicide prevention for patients with mood disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of Tumarkin attacks on complaints and work ability in Ménière's disease.

PubMed

Pyykkö, Ilmari; Manchaiah, Vinaya; Zou, Jing; Levo, Hilla; Kentala, Erna

2018-05-22

The purpose of the present study was to characterize the occurrence of Tumarkin attacks in patients with Ménière'sdisease (MD), and to study its association with reported complaints, severity of consequences, and also self-reported work ability. The study used a cross-sectional design. Data obtained from the Finnish Ménière Federation using an electronic survey was analyzed. 602 people with MD responded to the survey (62% response rate) with a mean age of 56.7 years and a mean duration of the disease 12.4 years. 49% of the respondents experienced Tumarkin attacks, which lasted for a few seconds to a few minutes. There were significant differences in complaints reported by MD patients with and without Tumarkin attacks. Respondents with Tumarkin attacks experienced various consequences, including tripping, falls, fear, anxiety, problems in dyadic life, and even transient loss of consciousness. Respondents with Tumarkin attacks had more frequently applied for pension than those not having Tumarkin attacks. On an average, respondents with Tumarkin attacks had less self-reported working ability when compared to those without Tumarkin attacks. The current study results suggest various differences in terms of complaints reported, severity of consequences, and the self-reported working ability in MD patients with and without Tumarkin attacks. Hearing healthcare professionals must examine Tumarkin attacks and their consequences in patients with MD during clinical examinations. In addition, the therapy should focus on alleviating the consequences and improving work ability.

Environmental Influences on Reproductive Health, the Importance of Chemical Exposures

PubMed Central

Wang, Aolin; Padula, Amy; Sirota, Marina; Woodruff, Tracey J.

2016-01-01

Unstructured Abstract Chemical exposures during pregnancy can have a profound and life-long impact on human health. Due to the omnipresence of chemicals in our daily life, there is continuous contact with chemicals in food, water, air and consumer products. Consequently, human biomonitoring studies show that pregnant women around the globe are exposed to a variety of chemicals. In this review, we provide a summary of current data on maternal and fetal exposure as well as health consequences from these exposures. We review several chemical classes including polychlorinated biphenyls (PCBs), perfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), phenols, phthalates, pesticides, and metals. Additionally, we discuss environmental disparities and vulnerable populations, and future research directions. We conclude by providing some recommendations for prevention of chemical exposure and its adverse reproductive health consequences. PMID:27513554

Materials for pharmaceutical dosage forms: molecular pharmaceutics and controlled release drug delivery aspects.

PubMed

Mansour, Heidi M; Sohn, Minji; Al-Ghananeem, Abeer; Deluca, Patrick P

2010-09-15

Controlled release delivery is available for many routes of administration and offers many advantages (as microparticles and nanoparticles) over immediate release delivery. These advantages include reduced dosing frequency, better therapeutic control, fewer side effects, and, consequently, these dosage forms are well accepted by patients. Advances in polymer material science, particle engineering design, manufacture, and nanotechnology have led the way to the introduction of several marketed controlled release products and several more are in pre-clinical and clinical development.

Materials for Pharmaceutical Dosage Forms: Molecular Pharmaceutics and Controlled Release Drug Delivery Aspects

PubMed Central

Mansour, Heidi M.; Sohn, MinJi; Al-Ghananeem, Abeer; DeLuca, Patrick P.

2010-01-01

Controlled release delivery is available for many routes of administration and offers many advantages (as microparticles and nanoparticles) over immediate release delivery. These advantages include reduced dosing frequency, better therapeutic control, fewer side effects, and, consequently, these dosage forms are well accepted by patients. Advances in polymer material science, particle engineering design, manufacture, and nanotechnology have led the way to the introduction of several marketed controlled release products and several more are in pre-clinical and clinical development. PMID:20957095

Exploring Undergraduate Engagement With The Consequences of Climate Change

NASA Astrophysics Data System (ADS)

Young, N.; Danielson, R.; Lombardi, D.

2013-12-01

Engendering conceptual change from naive to scientifically sophisticated beliefs is a difficult task. One factor that fosters conceptual change is greater engagement with a topic. Yet if one asks about a topic in the wrong way, one may fail to find engagement where it exists or assume it exists where it does not. Climate change is an immense topic with consequences across many domains and people may be more concerned with specific consequences than with the topic generally. Therefore, it may be helpful to disambiguate the various risks to see which consequences people find especially engaging and which they do not. We asked 188 undergraduate students at a large university in California to rate twenty-five potential consequences of climate change on several questions. The questions were drawn from constructs that lead to greater engagement with a topic according to the Cognitive Reconstruction of Knowledge Model (Dole & Sinatra, 1998). Scores were then combined to create engagement scores. We found that two potential consequences of climate change were rated as more engaging than climate change generally: air pollution and increases in the price of food. Many consequences were rated as less engaging, including floods, stronger hurricanes, and melting permafrost. This implies that some consequences that scientists consider potentially worthy of concern are nonetheless not considered engaging by many. We also asked participants several open-ended questions about their perceptions of climate change and what consequences they especially cared about. Results were broadly similar but demonstrated many misconceptions about the mechanics and consequences of climate change. Several participants expressed concerns about increases in earthquakes, changes to the ozone layer, and dangerous changes to the density of the atmosphere. We asked participants about the relationship between the terms climate change and global warming. There was considerable disagreement on how these two terms were related. This is problematic if educators assume that people are using the terms synonymously. Finally, we asked participants about whether humanity would be able to solve climate change before catastrophic consequences occurred. To our surprise, only one out of five participants believed we would do so. Some participants were unsure whether we would solve it or believed that we would only address it after some catastrophic consequences had already occurred, but the majority of participants believed that we would fail to solve it. Climate science educators have often tried to avoid portraying climate change as unavoidable and hopeless, yet many people have nonetheless come to this conclusion. Relying on positive messages about solving climate change in the hope of forestalling hopelessness may be insufficient and we may need to help people deal with feelings of hopelessness directly.

The Social Consequences of Infertility among Iranian Women: A Qualitative Study

PubMed Central

Hasanpoor-Azghdy, Syedeh Batool; Simbar, Masoumeh; Vedadhir, Abouali

2015-01-01

Background Infertility may prevent couples to achieve the desired social roles and lead to some social and psychological problems. This study aimed to explain the social consequences of infertility in Iranian women seeking treatment. Materials and Methods A qualitative content analysis was conducted based on 32 semi-structured interviews with 25 women affected by primary and secondary infertility with no surviving children. The participants were purposefully selected with maximum variability from a fertility health research center in Tehran, Iran, from January to October 2012. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. Results Our findings indicate that the consequences of infertility are divided into five main categories: 1. violence including psychological violence and domestic physical violence, 2. marital instability or uncertainty, 3. social isolation including avoiding certain people or certain social events and self-imposed isolation from family and friends, 4. social exclusion and partial deprivation including being disregarded by family members and relatives and reducing social interactions with the infertile woman and 5. social alienation. Conclusion This study reveals that Iranian women with fertility issues seeking treatment face several social problems that could have devastating effects on the quality of their lives. It is, therefore, recommended that, in Iran, infertility is only considered as a biomedical issue of a couple and pay further attention to its sociocultural dimensions and consequences. PMID:25780523

Role of Obesity in Asthma: Mechanisms and Management Strategies.

PubMed

Scott, Hayley A; Wood, Lisa G; Gibson, Peter G

2017-08-01

Obesity is a commonly reported comorbidity in asthma, particularly in severe asthma. Obese asthmatics are highly symptomatic with a poor quality of life, despite using high-dose inhaled corticosteroids. While the clinical manifestations have been documented, the aetiologies of obese-asthma remain unclear. Several potential mechanisms have been proposed, including poor diet quality, physical inactivity and consequent accrual of excess adipose tissue. Each of these factors independently activates inflammatory pathways, potentially exerting effects in the airways. Because the origins of obesity are multifactorial, it is now believed there are multiple obese-asthma phenotypes, with varied aetiologies and clinical consequences. In this review, we will describe the clinical implications of obesity in people with asthma, our current understanding of the mechanisms driving this association and describe recently proposed obese-asthma phenotypes. We will then discuss how asthma management is complicated by obesity, and provide graded recommendations for the management of obesity in this population.

Sleep Disorders in Patients with Bronchial Asthma

PubMed Central

Cukic, Vesna; Lovre, Vladimir; Dragisic, Dejan

2011-01-01

Respiratory disturbances during sleep are recognized as extremely common disorders with important clinical consequences. Breathing disorders during sleep can result in broad range of clinical manifestations, the most prevalent of which are unrefreshing sleep, daytime sleepiness and fatigue, and cognitive impairmant. There is also evidence that respiratory-related sleep disturbances can contribute to several common cardiovascular and metabolic disorders, including systemic hypertension, cardiac dysfunction, and insulin-resistance. Correlations are found between asthma-related symptoms and sleep disturbances. Difficulties inducing sleep, sleep fragmentation on polysomnography, early morning awakenings and daytime sleepiness are more common in asthmatics compared with subjects without asthma. The “morning deep” in asthma is relevant for the characterization of asthma severity, and impact drugs’ choices. Sleep and night control of asthma could be relevant to evaluate disease’s control. Appropriate asthma control recovering is guarantor for better sleep quality in these patients and less clinical consequences of respiratory disturbances during sleep. PMID:23678304

Maritime Transportation Risk Assessment of Tianjin Port with Bayesian Belief Networks.

PubMed

Zhang, Jinfen; Teixeira, Ângelo P; Guedes Soares, C; Yan, Xinping; Liu, Kezhong

2016-06-01

This article develops a Bayesian belief network model for the prediction of accident consequences in the Tianjin port. The study starts with a statistical analysis of historical accident data of six years from 2008 to 2013. Then a Bayesian belief network is constructed to express the dependencies between the indicator variables and accident consequences. The statistics and expert knowledge are synthesized in the Bayesian belief network model to obtain the probability distribution of the consequences. By a sensitivity analysis, several indicator variables that have influence on the consequences are identified, including navigational area, ship type and time of the day. The results indicate that the consequences are most sensitive to the position where the accidents occurred, followed by time of day and ship length. The results also reflect that the navigational risk of the Tianjin port is at the acceptable level, despite that there is more room of improvement. These results can be used by the Maritime Safety Administration to take effective measures to enhance maritime safety in the Tianjin port. © 2016 Society for Risk Analysis.

Diabetes-Induced Decrease in Renal Oxygen Tension: Effects of an Altered Metabolism

NASA Astrophysics Data System (ADS)

Palm, Fredrik; Carlsson, Per-Ola; Fasching, Angelica; Hansell, Peter; Liss, Per

During conditions with experimental diabetes mellitus, it is evident that several alterations in renal oxygen metabolism occur, including increased mitochondrial respiration and increased lactate accumulation in the renal tissue. Consequently, these alterations will contribute to decrease the interstitial pO2, preferentially in the renal medulla of animals with sustained long-term hyperglycemia.

The Centrality of Teachers' Judgement Practice in Assessment: A Study of Standards in Moderation

ERIC Educational Resources Information Center

Wyatt-Smith, Claire; Klenowski, Val; Gunn, Stephanie

2010-01-01

There is a strong quest in several countries including Australia for greater national consistency in education and intensifying interest in standards for reporting. Given this, it is important to make explicit the intended and unintended consequences of assessment reform strategies and the pressures to pervert and conform. In a policy context that…

Indigenous Carbonaceous Matter in the Nakhla Mars Meteorite

NASA Technical Reports Server (NTRS)

Clemett, S. J.; Thomas-Keprta, K. L.; Rahman, Z.; Le, L.; Wentworth, S. J.; Gibson, E. K.; McKay, D. S.

2016-01-01

Detailed microanalysis of the Martian meteorite Nakhla has shown there are morphologically distinct carbonaceous features spatially associated with low-T aqueous alteration phases including salts and id-dingsite. A comprehensive suite of analytical instrumentation including optical microscopy, field emission scanning electron microscopy (FESEM), energy dispersive X-ray (EDX) spectroscopy, focused ion beam (FIB) microscopy, transmission electron microscopy (TEM), two-step laser mass spectrometry (mu-L(sup 2)MS), laser mu-Raman spectroscopy, Fourier transform infrared spectroscopy (FTIR), and nanoscale secondary ion mass spectrometry (NanoSIMS) are being used to characterize the carbonaceous matter and host mineralogy. The search for carbonaceous matter on Mars has proved challenging. Viking Landers failed to unambiguously detect simple organics at either of the two landing sites although the Martian surface is estimated to have acquired at least 10(exp15) kg of C as a consequence of meteoritic accretion over the last several Ga. The dearth of organics at the Martian surface has been attributed to various oxidative processes including UV photolysis and peroxide activity. Consequently, investigations of Martian organics need to be focused on the sub-surface regolith where such surface processes are either severely attenuated or absent. Fortuitously since Martian meteorites are derived from buried regolith materials they provide a unique opportunity to study Martian organic geochemistry.

Equivocating on the polluter-pays principle: The consequences for Pakistan.

PubMed

Luken, Ralph A

2009-08-01

The polluter-pays principle has been widely implemented in OECD countries and credited for bring about a significant reduction in pollutant discharge. However, it has had only limited implementation in developing countries. The consequences of not implementing it in developing countries, to the extent they are documented, are limited to estimating the economic damages of environmental degradation. Yet there are several other but seldom documented negative consequences of the failure to implement the polluter-pays principle. These consequences are documented in the case of Pakistan. They include limited construction of effluent treatment plants, heavy dependence on the government and international donors for funding the only two operational common effluent treatment plants, significant operational issues at the two common effluent treatment plants, missed opportunities to build cost-effective common effluent treatment plants and minimal environmental improvements from isolated investments in individual effluent treatment plants in addition to the already documented significant level of environmental degradation due to uncontrolled pollutant discharge.

Consequences of evolution: is rhinosinusitis, like otitis media, a unique disease of humans?

PubMed

Bluestone, Charles D; Pagano, Anthony S; Swarts, J Douglas; Laitman, Jeffrey T

2012-12-01

We hypothesize that if otitis media is most likely primarily a human disease due to consequences of evolution, rhinosinusitis may also be limited to humans for similar reasons. If otitis media, with its associated hearing loss, occurred in animals in the wild, they probably would have been culled out by predation. Similarly, if rhinosinusitis occurred regularly in animals, they likely would have suffered from severely decreased olfactory abilities, crucial for predator avoidance, and presumably would likewise have been selected against evolutionarily. Thus, both otitis media and rhinosinusitis-common conditions particularly in infants and young children-appear to be essentially human conditions. Their manifestation in our species is likely due to our unique evolutionary trajectory and may be a consequence of adaptations, including adaptations to bipedalism and speech, loss of prognathism, and immunologic and environmental factors.

The Study of Effects of Time Variations in the Earth's Gravity Field on Geodetic Satellites

NASA Technical Reports Server (NTRS)

Shum, C. K.

1998-01-01

The temporal variations in the Earth's gravity field are the consequences of complex interactions between atmosphere, ocean, solid Earth, hydrosphere and cryosphere. The signal ranges from several hours to 18.6 years to geological time scale. The direct and indirect consequences of these variations are manifested in such phenomena as changes in the global sea level and in the global climate pattern. These signals produce observable geodetic satellites. The primary objectives of the proposed effects on near-Earth orbiting investigation include (1) the improved determination of the time-varying gravity field parameters (scale from a few hour to 18.6 year and secular) using long-term satellite laser rs ranging (SLR) observations to multiple geodetic satellites, and (2) the enhanced understanding of these variations with their associated meteorological and geophysical consequences.

Sleeping too close together: obesity and obstructive sleep apnea in childhood and adolescence.

PubMed

Mathew, Joseph L; Narang, Indra

2014-09-01

To review the current available literature exploring the prevalence, severity, consequences and treatments for obesity related OSA in children and adolescents. The published literature was searched through EMBASE and Pubmed using a pre-defined search strategy. There is evidence showing that OSA occurs more frequently and may be more severe in children and adolescents who are overweight or obese compared with lean children. Obesity and OSA are independently associated with adverse cardiovascular, metabolic, and neuropsychological consequences. The magnitude of these abnormalities when obesity and OSA co-exist is not well established. Treatment options for obesity related OSA includes adenotonsillectomy, but it does not cure OSA in over 50% of obese children. Positive airway pressure (PAP) therapy delivered through continuous or bi-level modes is successful, but limited by generally poor compliance. There is increasing experience with bariatric surgical techniques which are effective for the treatment of obesity and its related complications. As obesity related OSA is highly prevalent, more research is needed to understand the interaction of these two conditions with regards to pathophysiology, adverse consequences and optimal management strategies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ecological and evolutionary approaches to managing honeybee disease.

PubMed

Brosi, Berry J; Delaplane, Keith S; Boots, Michael; de Roode, Jacobus C

2017-09-01

Honeybee declines are a serious threat to global agricultural security and productivity. Although multiple factors contribute to these declines, parasites are a key driver. Disease problems in honeybees have intensified in recent years, despite increasing attention to addressing them. Here we argue that we must focus on the principles of disease ecology and evolution to understand disease dynamics, assess the severity of disease threats, and control these threats via honeybee management. We cover the ecological context of honeybee disease, including both host and parasite factors driving current transmission dynamics, and then discuss evolutionary dynamics including how beekeeping management practices may drive selection for more virulent parasites. We then outline how ecological and evolutionary principles can guide disease mitigation in honeybees, including several practical management suggestions for addressing short- and long-term disease dynamics and consequences.

Obstructive sleep apnea and severe mental illness: evolution and consequences.

PubMed

Lin, Wei-Chen; Winkelman, John W

2012-10-01

Sleep complaints are commonly encountered in psychiatric clinics. Underlying medical disorders or sleep disorders need to be identified and treated to optimize treatment of the mental illness. Excessive daytime sleepiness, which is the main symptom of obstructive sleep apnea (OSA), overlaps with those of many severe mental illnesses. Medication side effects or the disorder itself maybe account for daytime sleepiness but comorbid OSA is a possibility that should not be overlooked. The diagnosis of OSA is straightforward but treatment compliance is problematic in psychiatric patients. This article summarizes studies concerning comorbid OSA in patients with severe mental illness and includes suggestions for future investigations.

High-risk behaviour in hypomanic states.

PubMed

Fletcher, Kathryn; Parker, Gordon; Paterson, Amelia; Synnott, Howe

2013-08-15

Risk-taking behaviours during hypomanic states are recognised, however the high-risk nature of some behaviours-including the potential for harm to both the individual and others-has not been detailed in the research literature. The current study examines risk-taking behaviours and their consequences (including their potential for impairment) in those with a bipolar II condition. Participants were recruited from the Sydney-based Black Dog Institute Depression Clinic. Diagnostic assignment of bipolar II disorder was based on clinician judgement and formal DSM-IV criteria. Participants completed a series of detailed questions assessing previous risk-taking behaviours during hypomanic states. The sample comprised a total of 93 participants. Risk-taking behaviours during hypomania included spending significant amounts of money, excessive alcohol or drug use, dangerous driving and endangering sexual activities. Key consequences included interpersonal conflict, substantial financial burden and feelings of guilt, shame and remorse. Despite recognition of the risks and consequences associated with hypomanic behaviours, less than one-fifth of participants agreed that hypomania should be treated because of the associated risks. Study limitations included a cross-sectional design, reliance on self-report information, lack of controlling for current mood state, and comprised a tertiary referral sample that may be weighted to more severe cases. Findings may therefore not be generalisable and require replication. Risk-taking behaviours during hypomania are common, and often linked with serious consequences. Whilst hypomania is often enjoyed and romanticised by patients-leading to ambivalence around treatment of such states-careful consideration of the impact of risk-taking behaviour is necessary, while the study raises the question as to what is 'impairment' in hypomania. Findings should advance clinical management by identifying those high-risk behaviours that would benefit from pre-emptive weighting in developing individual's wellbeing plans for managing the condition. Copyright © 2013 Elsevier B.V. All rights reserved.

Independent Versus Co-occurring Substance Use in Relation to Gambling Outcomes in Older Adolescents and Young Adults.

PubMed

Cronce, Jessica M; Bittinger, Joyce N; Di Lodovico, Cory M; Liu, Junny

2017-05-01

Gambling is prevalent among college students and can be associated with significant negative consequences. Students who report gambling also tend to report use of alcohol and cannabis, but little research has explored the associated risks of using these substances in relation to gambling episodes. This study explored associations between the independent and co-occurring use of alcohol and cannabis before/during gambling episodes and gambling outcomes. Students (n = 1,834) completed an online survey that included measures of gambling frequency, amount lost, negative gambling consequences, gambling problem severity, and substance use. As hypothesized, individuals who reported using either alcohol or cannabis alone or both substances before/while gambling endorsed greater gambling quantity, frequency, negative consequences, and problem severity than individuals who used alcohol and cannabis in general but denied use of either substance before/while gambling. Use of both substances compared to use of alcohol alone was associated with greater gambling quantity, frequency, and negative consequences, although these groups did not differ on gambling problem severity. Cannabis use alone was no different on any outcome than use of both substances, and alcohol use alone was no different than cannabis use alone on any outcome. Use of cannabis alone before/while gambling may confer the same level of risk for negative gambling outcomes as use of both cannabis and alcohol. Prevention efforts may, therefore, benefit from targeting cannabis use in relation to gambling. Additional investigation is needed in light of recent and upcoming state legislation on the legalization of cannabis. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Neurodevelopment in children with intrauterine growth restriction: adverse effects and interventions.

PubMed

Wang, Yan; Fu, Wei; Liu, Jing

2016-01-01

Intrauterine growth restriction (IUGR) is associated with higher rates of fetal, perinatal, and neonatal morbidity and mortality. The consequences of IUGR include short-term metabolic, hematological and thermal disturbances that lead to metabolic syndrome in children and adults. Additionally, IUGR severely affects short- and long-term fetal brain development and brain function (including motor, cognitive and executive function) and neurobehavior, especially neuropsychology. This review details the adverse effects of IUGR on fetal brain development and discusses intervention strategies.

Some Lasting Consequences of US Psychology Programs in World Wars I and II

ERIC Educational Resources Information Center

Jones, Lyle V.

2007-01-01

Applied research in psychology not only has contributed directly to societal advances but often has fostered basic research as well. Prominent examples are the programs directed by Yerkes in World War I to develop the Army Alpha test and several programs in World War II, including "The American Soldier" that assessed soldiers' attitudes during the…

Dropping out Because of the Others: Bullying among the Students of Estonian Vocational Schools

ERIC Educational Resources Information Center

Beilmann, Mai

2017-01-01

Although it is arguably a fundamental democratic or human right of a child to feel safe at school, many children and adolescents have to face peer victimisation in schools on a daily basis, and occasionally through several levels of education. Long-term victimisation may have detrimental consequences for the victim, including a negative effect on…

Connecting School Policies and Praxis to the Development of Violent and Aggressive Behaviors in Elementary School Children: Locating the Voice of the Student.

ERIC Educational Resources Information Center

Kleckley, Bettie Joyner

This ethnographic study examined students' definitions of violence and aggression, the context in which threatening situations occur, and the strategies and consequences that a group of 30 urban African-American elementary school children used when they were in threatening situations. Data were obtained from several sources, including participant…

Pulmonary consequences of aspiration.

PubMed

Terry, P B; Fuller, S D

1989-01-01

Aspiration can lead to serious pulmonary disease and occasionally death. Substances aspirated commonly include bacteria or gastric contents or both, but may be as unusual as diesel oil or a variety of foreign bodies. Pulmonary symptoms range from a subtle cough, wheezing, or hoarseness to severe dyspnea or asphyxiation. We discuss the mechanism of pulmonary disease caused by aspiration as well as the appropriate treatment.

Military Sexual Trauma Among US Servicewomen During Deployment: A Qualitative Study

PubMed Central

Grindlay, Kate; Holt, Kelsey; Manski, Ruth; Grossman, Daniel

2014-01-01

Objectives. We explored qualitatively US servicewomen’s experiences with and perceptions of military sexual trauma (MST), reporting, and related services. Methods. From May 2011 to January 2012, we conducted 22 telephone interviews with US servicewomen deployed overseas between 2002 and 2011. We analyzed data thematically with modified grounded theory methods. Results. Factors identified as contributing to MST included deployment dynamics, military culture, and lack of consequences for perpetrators. Participants attributed low MST reporting to negative reactions and blame from peers and supervisors, concerns about confidentiality, and stigma. Unit cohesion was cited as both a facilitator and a barrier to reporting. Availability and awareness of MST services during deployment varied. Barriers to care seeking were similar to reporting barriers and included confidentiality concerns and stigma. We identified several avenues to address MST, including strengthening consequences for perpetrators. Conclusions. We identified barriers to MST reporting and services. Better understanding of these issues will allow policymakers to improve MST prevention and services. PMID:24328617

Osteoporosis in men: a review.

PubMed

Adler, Robert A

2014-01-01

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.

Osteoporosis in men: a review

PubMed Central

Adler, Robert A

2014-01-01

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women. PMID:26273515

Learning to Predict Consequences as a Method of Knowledge Transfer in Reinforcement Learning.

PubMed

Chalmers, Eric; Contreras, Edgar Bermudez; Robertson, Brandon; Luczak, Artur; Gruber, Aaron

2017-04-17

The reinforcement learning (RL) paradigm allows agents to solve tasks through trial-and-error learning. To be capable of efficient, long-term learning, RL agents should be able to apply knowledge gained in the past to new tasks they may encounter in the future. The ability to predict actions' consequences may facilitate such knowledge transfer. We consider here domains where an RL agent has access to two kinds of information: agent-centric information with constant semantics across tasks, and environment-centric information, which is necessary to solve the task, but with semantics that differ between tasks. For example, in robot navigation, environment-centric information may include the robot's geographic location, while agent-centric information may include sensor readings of various nearby obstacles. We propose that these situations provide an opportunity for a very natural style of knowledge transfer, in which the agent learns to predict actions' environmental consequences using agent-centric information. These predictions contain important information about the affordances and dangers present in a novel environment, and can effectively transfer knowledge from agent-centric to environment-centric learning systems. Using several example problems including spatial navigation and network routing, we show that our knowledge transfer approach can allow faster and lower cost learning than existing alternatives.

Clinical and economic consequences of vancomycin and fidaxomicin for the treatment of Clostridium difficile infection in Canada.

PubMed

Wagner, Monika; Lavoie, Louis; Goetghebeur, Mireille

2014-03-01

Clostridium difficile infection (CDI) represents a public health problem with increasing incidence and severity. To evaluate the clinical and economic consequences of vancomycin compared with fidaxomicin in the treatment of CDI from the Canadian health care system perspective. A decision-tree model was developed to compare vancomycin and fidaxomicin for the treatment of severe CDI. The model assumed identical initial cure rates and included first recurrent episodes of CDI (base case). Treatment of patients presenting with recurrent CDI was examined as an alternative analysis. Costs included were for study medication, physician services and hospitalization. Cost effectiveness was measured as incremental cost per recurrence avoided. Sensitivity analyses of key input parameters were performed. In a cohort of 1000 patients with an initial episode of severe CDI, treatment with fidaxomicin led to 137 fewer recurrences at an incremental cost of $1.81 million, resulting in an incremental cost of $13,202 per recurrence avoided. Among 1000 patients with recurrent CDI, 113 second recurrences were avoided at an incremental cost of $18,190 per second recurrence avoided. Incremental costs per recurrence avoided increased with increasing proportion of cases caused by the NAP1/B1/027 strain. Results were sensitive to variations in recurrence rates and treatment duration but were robust to variations in other parameters. The use of fidaxomicin is associated with a cost increase for the Canadian health care system. Clinical benefits of fidaxomicin compared with vancomycin depend on the proportion of cases caused by the NAP1/B1/027 strain in patients with severe CDI.

Money is Brain: Financial Barriers and Consequences for Canadian Stroke Patients.

PubMed

Ganesh, Aravind; King-Shier, Kathryn; Manns, Braden J; Hill, Michael D; Campbell, David J T

2017-03-01

Stroke patients of lower socioeconomic status have worse outcomes. It remains poorly understood whether this is due to illness severity or personal or health system barriers. We explored the experiences of stroke patients with financial barriers in a qualitative descriptive pilot study, seeking to capture perceived challenges that interfere with their poststroke health and recovery. We interviewed six adults with a history of stroke and financial barriers in Alberta, Canada, inquiring about their: (1) experiences after stroke; (2) experience of financial barriers; (3) perceived reasons for financial barriers; (4) health consequences of financial barriers; and (5) mechanisms for coping with financial barriers. Two reviewers analyzed data using inductive thematic analysis. The participants developed new or worsened financial circumstances as a consequence of stroke-related disability. Poststroke impairments and financial barriers took a toll on their mental health. They struggled to access several aspects of long-term poststroke care, including allied health professional services, medications, and proper nutrition. They described opportunity costs and tradeoffs when accessing health services. In several cases, they were unaware of health resources available to them and were hesitant to disclose their struggles to their physicians and even their families. Some patients with financial barriers perceive challenges to accessing various aspects of poststroke care. They may have inadequate knowledge of resources available to them and may not disclose their concerns to their health care team. This suggests that providers themselves might consider asking stroke patients about financial barriers to optimize their long-term poststroke care.

Food additives, contaminants and other minor components: effects on human gut microbiota-a review.

PubMed

Roca-Saavedra, Paula; Mendez-Vilabrille, Veronica; Miranda, Jose Manuel; Nebot, Carolina; Cardelle-Cobas, Alejandra; Franco, Carlos M; Cepeda, Alberto

2018-02-01

Gut bacteria play an important role in several metabolic processes and human diseases, such as obesity and accompanying co-morbidities, such as fatty liver disease, insulin resistance/diabetes, and cardiovascular events. Among other factors, dietary patterns, probiotics, prebiotics, synbiotics, antibiotics, and non-dietary factors, such as stress, age, exercise, and climatic conditions, can dramatically impact the human gut microbiota equilibrium and diversity. However, the effect of minor food constituents, including food additives and trace contaminants, on human gut microbiota has received less attention. Consequently, the present review aimed to provide an objective perspective of the current knowledge regarding the impacts of minor food constituents on human gut microbiota and consequently, on human health.

Ecological and evolutionary approaches to managing honey bee disease

PubMed Central

Brosi, Berry J.; Delaplane, Keith S.; Boots, Michael; de Roode, Jacobus C.

2017-01-01

Honey bee declines are a serious threat to global agricultural security and productivity. While multiple factors contribute to these declines, parasites are a key driver. Disease problems in honey bees have intensified in recent years, despite increasing attention to addressing them. Here we argue that we must focus on the principles of disease ecology and evolution to understand disease dynamics, assess the severity of disease threats, and manage these threats via honey bee management. We cover the ecological context of honey bee disease, including both host and parasite factors driving current transmission dynamics, and then discuss evolutionary dynamics including how beekeeping management practices may drive selection for more virulent parasites. We then outline how ecological and evolutionary principles can guide disease mitigation in honey bees, including several practical management suggestions for addressing short- and long-term disease dynamics and consequences. PMID:29046562

Treatment of impulse control disorders in Parkinson's disease: Practical considerations and future directions.

PubMed

Ramirez-Zamora, Adolfo; Gee, Lucy; Boyd, James; Biller, José

2016-01-01

Impulse control disorders (ICDs) including compulsive gambling, buying, sexual behaviors, and eating occur relatively frequently in Parkinson disease (PD) with at least one ICD identified in 14% of PD patients in a large, multicenter, observational study. ICDs behaviors range widely in severity but can lead to catastrophic consequences, including financial ruin, divorce, loss of employment, and increased health risks. The main risk factor for ICDs in PD is the use of Dopamine agonists (DAs) and discontinuation of the offending agent is considered first line treatment. However, many patients do not tolerate this intervention as consequence of increased motor and psychiatric disability or appearance of DA withdrawal syndrome. In this article, we review current management strategies and emerging new interventions for treatment of ICDs in PD. Pharmacological treatment should be individualized based on patient's unique neuropsychiatric profile, social support, medical comorbidities, tolerability and motor symptoms.

Inequalities in healthcare provision for people with severe mental illness.

PubMed

Lawrence, David; Kisely, Stephen

2010-11-01

There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.

Pulmonary rehabilitation and severe exacerbations of COPD: solution or white elephant?

PubMed Central

Puhan, Milo A.; Harrison, Samantha L.; Jordan, Rachel E.; Quint, Jennifer K.; Singh, Sally J.

2015-01-01

Hospitalisations for severe exacerbations of chronic obstructive pulmonary disease are associated with significant physical and psychological consequences including an increase in symptom severity, severe reductions in physical activity, a deleterious effect on skeletal muscle, impaired exercise tolerance/ability to self-care, decline in quality of life, and increased anxiety and depression. As these consequences are potentially amenable to exercise training, there is a clear rationale for pulmonary rehabilitation in the peri/post-exacerbation setting. Although a 2011 Cochrane review was overwhelmingly positive, subsequent trials have shown less benefit and real-life observational studies have revealed poor acceptability. Qualitative studies have demonstrated that the patient experience is a determining factor while the presence of comorbidities may influence referral, adherence and response to pulmonary rehabilitation. Systematic reviews of less supervised interventions, such as self-management, have shown limited benefits in the post-exacerbation setting. The recent update of the Cochrane review of peri-exacerbation pulmonary rehabilitation showed that benefits were associated with the “comprehensive” nature of the intervention (the number of sessions received, the intensity of exercise training and education delivered, and the degree of supervision) but implementation is demanding. The challenge is to develop interventions that are deliverable and acceptable around the time of an acute exacerbation but also deliver the desired clinical impact. PMID:27730157

Notch signaling: switching an oncogene to a tumor suppressor

PubMed Central

Lobry, Camille; Oh, Philmo; Mansour, Marc R.; Look, A. Thomas

2014-01-01

The Notch signaling pathway is a regulator of self-renewal and differentiation in several tissues and cell types. Notch is a binary cell-fate determinant, and its hyperactivation has been implicated as oncogenic in several cancers including breast cancer and T-cell acute lymphoblastic leukemia (T-ALL). Recently, several studies also unraveled tumor-suppressor roles for Notch signaling in different tissues, including tissues where it was before recognized as an oncogene in specific lineages. Whereas involvement of Notch as an oncogene in several lymphoid malignancies (T-ALL, B-chronic lymphocytic leukemia, splenic marginal zone lymphoma) is well characterized, there is growing evidence involving Notch signaling as a tumor suppressor in myeloid malignancies. It therefore appears that Notch signaling pathway’s oncogenic or tumor-suppressor abilities are highly context dependent. In this review, we summarize and discuss latest advances in the understanding of this dual role in hematopoiesis and the possible consequences for the treatment of hematologic malignancies. PMID:24608975

The Effects of Childhood ADHD on Adult Labor Market Outcomes. NBER Working Paper No. 18689

ERIC Educational Resources Information Center

Fletcher, Jason

2013-01-01

While several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood ADHD. As ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness.…

Resisting temptation: a psychological analysis.

PubMed

Hodgson, R J

1989-03-01

It is proposed that self control involves several related processes including vivid awareness of future consequences, overcoming learned helplessness and tunnel vision, developing commitment and accepting anxiety/frustration. Facing up to temptation and resisting the compulsive urge is considered to be a crucial therapeutic experience. Evidence is presented to support the view that cue exposure should therefore be a central component of treatments for compulsions and addictions.

Unintended Consequences: New Problems, New Solutions. Contributions From 2015.

PubMed

Koppel, R; Chen, Y

2016-11-10

To select the best of the 2015 published papers on unintended consequences of healthcare information technology (HIT). Literature searches in several areas of scholarship, including IT, human factors, evaluation studies, medical errors, medical informatics, and implementation science. Also, because the specific terms "unintended consequences" were not often included in abstracts and titles, a more nuanced search algorithm was developed. We identified 754 papers that had some empirical research on unintended consequences of HIT. An initial screen of titles and abstracts reduced this to 171 papers of potential interest. We then further filtered out papers that did not meet the following criteria: 1) the paper had to report an original empirical investigation, and 2) the impact reported had to be not negligible, i.e., in quantitative studies, the results related to unintended consequences were statistically significant; and in qualitative studies the relevant themes emerged were prominent. This resulted in 33 papers of which 15 were selected as best paper candidates. Each of these 15 papers was then separately evaluated by four reviewers. The final selection of four papers was made jointly by the external reviewers and the two section editors. There is a growing awareness of the importance of HIT's unintended consequences-be they generated by the HIT vendors, the implementation process, the consultants, the users, or most probably, some combination of the above. There has also been greater creativity in use of data sources, including secondary data (e.g., medical malpractice cases and surveys) and a wider acceptance of mixed methods to identify unintended consequences. Unfortunately, the complexity of causes mitigates the value of recommendations to avoid unwanted outcomes. Suggestions are often contentious rather than obvious, setting-specific, and not universally applicable. "Lessons learned" often take on generalized-and perhaps platitudinous-forms, such as: "plan extra time," "involve all of the stakeholders," "recognize the different needs of different units or disciplines." The greater awareness of these problems, and the increased desire to identify and eliminate them is clearly reflected in the area's growing literature. We are hopeful the topic will receive additional attention and the discipline will improve its ability to identify and address these unexpected and usually adverse outcomes.

[Possibilities of medical opinionating in cases associated with "exposure to direct danger of death or serious health damage"].

PubMed

Konopka, Tomasz; Skupień, Elzbieta

2008-01-01

In the opinion of some forensic medicine experts, assessment of potential consequences in keeping with Article 160 of the Polish Penal code, which refers to the crime of "exposure to direct danger of death or severe health damage", lies within the competence of medicolegal specialists. This view is accepted by courts and prosecution offices. However, the knowledge of physicians in the field of predicting consequences which did not occur is only somewhat better than that of lawyers. In simple cases, e.g. in trauma involving a sensitive area of the body, passing an opinion confirming a serious danger is not associated with any major problems. Similarly, no problems arise when passing an opinion on the lack of such a danger e.g. in the case of traumawithout any injuries. In complex cases, however, which include the majority of medical error cases, passing an opinion on exposure to direct danger of death or severe health damage may be not feasible.

Origins and consequences of congenital heart defects affecting the right ventricle.

PubMed

Woudstra, Odilia I; Ahuja, Suchit; Bokma, Jouke P; Bouma, Berto J; Mulder, Barbara J M; Christoffels, Vincent M

2017-10-01

Congenital heart disease is a major health issue, accounting for a third of all congenital defects. Improved early surgical management has led to a growing population of adults with congenital heart disease, including patients with defects affecting the right ventricle, which are often classified as severe. Defects affecting the right ventricle often cause right ventricular volume or pressure overload and affected patients are at high risk for complications such as heart failure and sudden death. Recent insights into the developmental mechanisms and distinct developmental origins of the left ventricle, right ventricle, and the outflow tract have shed light on the common features and distinct problems arising in specific defects. Here, we provide a comprehensive overview of the current knowledge on the development into the normal and congenitally malformed right heart and the clinical consequences of several congenital heart defects affecting the right ventricle. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

The role of insufficient copper in lipid synthesis and fatty-liver disease.

PubMed

Morrell, Austin; Tallino, Savannah; Yu, Lei; Burkhead, Jason L

2017-04-01

The essential transition metal copper is important in lipid metabolism, redox balance, iron mobilization, and many other critical processes in eukaryotic organisms. Genetic diseases where copper homeostasis is disrupted, including Menkes disease and Wilson disease, indicate the importance of copper balance to human health. The severe consequences of insufficient copper supply are illustrated by Menkes disease, caused by mutation in the X-linked ATP7A gene encoding a protein that transports copper from intestinal epithelia into the bloodstream and across the blood-brain barrier. Inadequate copper supply to the body due to poor diet quality or malabsorption can disrupt several molecular level pathways and processes. Though much of the copper distribution machinery has been described and consequences of disrupted copper handling have been characterized in human disease as well as animal models, physiological consequences of sub-optimal copper due to poor nutrition or malabsorption have not been extensively studied. Recent work indicates that insufficient copper may be important in a number of common diseases including obesity, ischemic heart disease, and metabolic syndrome. Specifically, marginal copper deficiency (CuD) has been reported as a potential etiologic factor in diseases characterized by disrupted lipid metabolism such as non-alcoholic fatty-liver disease (NAFLD). In this review, we discuss the available data suggesting that a significant portion of the North American population may consume insufficient copper, the potential mechanisms by which CuD may promote lipid biosynthesis, and the interaction between CuD and dietary fructose in the etiology of NAFLD. © 2016 IUBMB Life, 69(4):263-270, 2017. © 2017 International Union of Biochemistry and Molecular Biology.

Antecedents, consequences and interventions for workplace bullying.

PubMed

Kemp, Vivien

2014-09-01

The issue of workplace bullying has become an area of research interest in the last 3 decades. Much of the extant literature is published in the business management journals. This is problematic as the targets of workplace bullying may need psychiatric treatment; as a discipline, therefore psychiatrists may benefit from a deeper understanding of the nature of workplace bullying and its sequelae. There is still no agreed upon definition, although most definitions include similar criteria. Managers and human resources personnel frequently have difficulty identifying and effectively managing workplace bullying. The consequences for the targets of bullying can be severe; they may need psychiatric treatment and it can have a lifelong impact. There is a paucity of research into effective prevention and intervention programs. Preventive measures that focus on the whole workplace culture or on targets alone have mixed results. Workplace policies and procedures may lessen the prevalence and incidence of bullying, but often competing interests of senior management, human resources personnel, supervisors and workers may mitigate any antibullying interventions. Although psychiatrists are likely to treat the targets of bullying, bullying has yet to attract much attention as a research topic in psychiatry. Although the consequences of bullying can be severe for both targets and workplaces, prevention strategies are hampered by competing interests.

Pharmacological therapeutics targeting the secondary defects and downstream pathology of Duchenne muscular dystrophy

PubMed Central

Spinazzola, Janelle M.; Kunkel, Louis M.

2016-01-01

Introduction Since the identification of the dystrophin gene in 1986, a cure for Duchenne muscular dystrophy (DMD) has yet to be discovered. Presently, there are a number of genetic-based therapies in development aimed at restoration and/or repair of the primary defect. However, growing understanding of the pathophysiological consequences of dystrophin absence has revealed several promising downstream targets for the development of therapeutics. Areas covered In this review, we discuss various strategies for DMD therapy targeting downstream consequences of dystrophin absence including loss of muscle mass, inflammation, fibrosis, calcium overload, oxidative stress, and ischemia. The rationale of each approach and the efficacy of drugs in preclinical and clinical studies are discussed. Expert opinion For the last 30 years, effective DMD drug therapy has been limited to corticosteroids, which are associated with a number of negative side effects. Our knowledge of the consequences of dystrophin absence that contribute to DMD pathology has revealed several potential therapeutic targets. Some of these approaches may have potential to improve or slow disease progression independently or in combination with genetic-based approaches. The applicability of these pharmacological therapies to DMD patients irrespective of their genetic mutation, as well as the potential benefits even for advanced stage patients warrants their continued investigation. PMID:28670506

Measuring the consequences of wildfires in a Bayesian network with vulnerability and exposure indicators

NASA Astrophysics Data System (ADS)

Papakosta, Panagiota; Botzler, Sebastian; Krug, Kai; Straub, Daniel

2013-04-01

Mediterranean climate type areas have always been experiencing fire events. However, population growth and expansion of urban centers into wildland areas during the 20th century (expansion of wildland-urban interface) has increased the threat to humans and their activities. Life and property losses, damage on infrastructure and crops, and forest degradation are some of the damages caused by wildfires. Although fires repeatedly occur along the Mediterranean basin, not all areas have experienced severe consequences. The extent of damage by wildfires is influenced by several factors, such as population density, vegetation type, topography, weather conditions and social preparedness [1]. Wildfire consequence estimation by means of vulnerability and exposure indicators is an essential part of wildfire risk analysis. Vulnerability indicators express the conditions that increase the susceptibility of a site to the impact of wildfires and exposure indicators describe the elements at risk [2],[3]. Appropriate indicators to measure wildfire vulnerability and exposure can vary with scale and site. The consequences can be classified into economic, social, environmental and safety, and they can be tangible (human life losses, buildings damaged) or intangible (damage of cultural heritage site). As a consequence, a variety of approaches exist and there is a lack of generalized unified easy-to-implement methodologies. In this study we present a methodology for measuring consequences of wildfires in a Mediterranean area in the mesoscale (1 km² spatial resolution). Vulnerability and exposure indicators covering all consequence levels are identified and their interrelations are stressed. Variables such as building materials, roofing type, and average building values are included in the economic vulnerability level. Safety exposure is expressed by population density, demographic structure, street density and distance to closest fire station. Environmental vulnerability of protected areas and rare species is also included. Presence of cultural heritage sites, power stations and power line network influence social exposure. The conceptual framework is demonstrated with a Bayesian Network (BN). The BN model incorporates empirical observation, physical models and expert knowledge; it can also explicitly account for uncertainty in the indicators. The proposed model is applied to the island of Cyprus. Maps support the demonstration of results. [1] Keeley, J.E.; Bond, W.J.; Bradstock, R.A.; Pausas, J.G.; Rundel, P.W. (2012): Fire in Mediterranean ecosystems: ecology, evolution and management. Cambridge University Press, New York, USA. [2] UN/ISDR (International Strategy for Disaster Reduction (2004): Living with Risk: A Global Review of Disaster Reduction Initiatives, Geneva, UN Publications. [3] Birkmann, J. (2006): Measuring vulnerability to natural hazards: towards disaster resilient societies. United Nations University Press, Tokyo, Japan.

The gut microbiota, environment and diseases of modern society

PubMed Central

Kelsen, Judith R.; Wu, Gary D.

2012-01-01

The human gut microbiota is a complex community that provides important metabolic functions to the host. Consequently, alterations in the gut microbiota have been associated with the pathogenesis of several human diseases associated with a disturbance in metabolism, particularly those that have been increasing in incidence over the last several decades including obesity, diabetes and atherosclerosis. In this review, we explore how advances in deep DNA sequencing technology have provided us a greater understanding of the factors that influence that composition of the gut microbiota and its possible links to the pathogenesis of these diseases. PMID:22825455

The gut microbiota, environment and diseases of modern society.

PubMed

Kelsen, Judith R; Wu, Gary D

2012-01-01

The human gut microbiota is a complex community that provides important metabolic functions to the host. Consequently, alterations in the gut microbiota have been associated with the pathogenesis of several human diseases associated with a disturbance in metabolism, particularly those that have been increasing in incidence over the last several decades including obesity, diabetes and atherosclerosis. In this review, we explore how advances in deep DNA sequencing technology have provided us a greater understanding of the factors that influence that composition of the gut microbiota and its possible links to the pathogenesis of these diseases.

Psychological Distress and Post-Traumatic Symptoms Following Occupational Accidents

PubMed Central

Ghisi, Marta; Novara, Caterina; Buodo, Giulia; Kimble, Matthew O.; Scozzari, Simona; Di Natale, Arianna; Sanavio, Ezio; Palomba, Daniela

2013-01-01

Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening, injury. Therefore, the present study was aimed at assessing the psychological consequences of accidents occurring in several occupational settings (e.g., construction and industry). Thirty-eight victims of occupational accidents (injured workers) and 38 gender-, age-, and years of education-matched workers who never experienced a work accident (control group) were recruited. All participants underwent a semi-structured interview administered by a trained psychologist, and then were requested to fill in the questionnaires. Injured workers reported more severe anxious, post-traumatic and depressive symptoms, and poorer coping skills, as compared to controls. In the injured group low levels of resilience predicted post-traumatic symptomatology, whereas the degree of physical injury and the length of time since the accident did not play a predictive role. The results suggest that occupational accidents may result in a disabling psychopathological condition, and that a brief psychological evaluation should be included in the assessment of seriously injured workers. PMID:25379258

Water transfer projects and the role of fisheries biologists

USGS Publications Warehouse

Meador, M.R.

1996-01-01

Water transfer projects are commonly considered important mechanisms for meeting increasing water demands. However, the movement of water from one area to another may have broad ecosystem effects, including on fisheries. The Southern Division of the American Fisheries Society held a symposium in 1995 at Virginia Beach, Virginia, to discuss the ecological consequences of water transfer and identify the role of fisheries biologists in such projects. Presenters outlined several case studies, including the California State Water Project, Garrison Diversion Project (North Dakota), Lake Texoma Water Transfer Project (Oklahoma-Texas), Santee-Cooper Diversion and Re-diversion projects (South Carolina), and Tri-State Comprehensive Study (Alabama-Florida-Georgia). Results from these studies suggest that fisheries biologists have provided critical information regarding potential ecological consequences of water transfer. If these professionals continue to be called for information regarding the ecological consequences of water transfer projects, developing a broader understanding of the ecological processes that affect the fish species they manage may be necessary. Although the traditional role of fisheries biologists has focused on the fishing customer base, fisheries management issues are only one component of the broad spectrum of ecosystem issues resulting from water transfer.

The effects of childhood ADHD on adult labor market outcomes.

PubMed

Fletcher, Jason M

2014-02-01

Although several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood attention deficit/hyperactivity disorder (ADHD). Because ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness. This article uses a longitudinal national sample, including sibling pairs, to show the important labor market outcome consequences of ADHD. The employment reduction is between 10 and 14 percentage points, the earnings reduction is approximately 33%, and the increase in social assistance is 15 points, figures that are larger than many estimates of the Black people/White people earnings gap and the gender earnings gap. A small share of the link is explained by educational attainments and co-morbid health conditions and behaviors. The results also show important differences in labor market consequences by family background and age of onset. These findings, along with similar research showing that ADHD is linked with poor education outcomes and adult crime, suggest the importance of treating childhood ADHD to foster human capital. Copyright © 2013 John Wiley & Sons, Ltd.

The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions.

PubMed

Hors-Fraile, S; Atique, S; Mayer, M A; Denecke, K; Merolli, M; Househ, M

2016-11-10

Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient's feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem.

Predicting differences in the perceived relevance of crime's costs and benefits in a test of rational choice theory.

PubMed

Bouffard, Jeffrey A

2007-08-01

Previous hypothetical scenario tests of rational choice theory have presented all participants with the same set of consequences, implicitly assuming that these consequences would be relevant for each individual. Recent research demonstrates that those researcher-presented consequences do not accurately reflect those considered by study participants and that there is individual variation in the relevance of various consequences. Despite this and some theoretical propositions that such differences should exist, little empirical research has explored the possibility of predicting such variation. This study allows participants to develop their own set of relevant consequences for three hypothetical offenses and examines how several demographic and theoretical variables impact those consequences' relevance. Exploratory results suggest individual factors impact the perceived relevance of several cost and benefit types, even among a relatively homogenous sample of college students. Implications for future tests of rational choice theory, as well as policy implications are discussed.

[Caregiving consequences in mental disorders--definitions and instruments of assessment].

PubMed

Ciałkowska-Kuźmińska, Magdalena; Kiejna, Andrzej

2010-01-01

Severe mental illnesses have far-reaching consequences for both patients and their relatives. This paper reviews literature on the measures of caregiving consequences. Authors provide a condensed knowledge and research results in the area of caregiving consequences, especially both subjective and objective caregivers' burden. The consequences of care apply to carers' social and leisure activities, financial status, health condition. The burden of care has three fundamental causes: the reorganisation of mental health services, a social isolation of patients and their families and the lack of systemic support for caregivers. The problem of caregiving consequences has been investigated in several studies. In order to identify factors, which have impact on caregiver distress, a variety instruments have been developed. This paper focuses on questionnaires useful for the systematic assessment of both objective and subjective burden: Involvement Evaluation Questionnaire (IEQ), Perceived Family Burden Scale (PFBS), Zarit Caregiver Burden Scale (ZCBS), Experience of Caregiving Inventory (ECI), Family Problems Questionnaire (FPQ). The mentioned instruments proved to be a reliable instrument for measuring caregiver consequences in mental healthcare.

Phytochemicals That Influence Gut Microbiota as Prophylactics and for the Treatment of Obesity and Inflammatory Diseases.

PubMed

Carrera-Quintanar, Lucrecia; López Roa, Rocío I; Quintero-Fabián, Saray; Sánchez-Sánchez, Marina A; Vizmanos, Barbara; Ortuño-Sahagún, Daniel

2018-01-01

Gut microbiota (GM) plays several crucial roles in host physiology and influences several relevant functions. In more than one respect, it can be said that you "feed your microbiota and are fed by it." GM diversity is affected by diet and influences metabolic and immune functions of the host's physiology. Consequently, an imbalance of GM, or dysbiosis, may be the cause or at least may lead to the progression of various pathologies such as infectious diseases, gastrointestinal cancers, inflammatory bowel disease, and even obesity and diabetes. Therefore, GM is an appropriate target for nutritional interventions to improve health. For this reason, phytochemicals that can influence GM have recently been studied as adjuvants for the treatment of obesity and inflammatory diseases. Phytochemicals include prebiotics and probiotics, as well as several chemical compounds such as polyphenols and derivatives, carotenoids, and thiosulfates. The largest group of these comprises polyphenols, which can be subclassified into four main groups: flavonoids (including eight subgroups), phenolic acids (such as curcumin), stilbenoids (such as resveratrol), and lignans. Consequently, in this review, we will present, organize, and discuss the most recent evidence indicating a relationship between the effects of different phytochemicals on GM that affect obesity and/or inflammation, focusing on the effect of approximately 40 different phytochemical compounds that have been chemically identified and that constitute some natural reservoir, such as potential prophylactics, as candidates for the treatment of obesity and inflammatory diseases.

Phytochemicals That Influence Gut Microbiota as Prophylactics and for the Treatment of Obesity and Inflammatory Diseases

PubMed Central

Sánchez-Sánchez, Marina A.; Vizmanos, Barbara

2018-01-01

Gut microbiota (GM) plays several crucial roles in host physiology and influences several relevant functions. In more than one respect, it can be said that you “feed your microbiota and are fed by it.” GM diversity is affected by diet and influences metabolic and immune functions of the host's physiology. Consequently, an imbalance of GM, or dysbiosis, may be the cause or at least may lead to the progression of various pathologies such as infectious diseases, gastrointestinal cancers, inflammatory bowel disease, and even obesity and diabetes. Therefore, GM is an appropriate target for nutritional interventions to improve health. For this reason, phytochemicals that can influence GM have recently been studied as adjuvants for the treatment of obesity and inflammatory diseases. Phytochemicals include prebiotics and probiotics, as well as several chemical compounds such as polyphenols and derivatives, carotenoids, and thiosulfates. The largest group of these comprises polyphenols, which can be subclassified into four main groups: flavonoids (including eight subgroups), phenolic acids (such as curcumin), stilbenoids (such as resveratrol), and lignans. Consequently, in this review, we will present, organize, and discuss the most recent evidence indicating a relationship between the effects of different phytochemicals on GM that affect obesity and/or inflammation, focusing on the effect of approximately 40 different phytochemical compounds that have been chemically identified and that constitute some natural reservoir, such as potential prophylactics, as candidates for the treatment of obesity and inflammatory diseases. PMID:29785173

Apical root resorption caused by orthodontic forces: A brief review and a long-term observation.

PubMed

Topkara, Ahu; Karaman, Ali I; Kau, Chung H

2012-10-01

External apical root resorption (ARR) is a common iatrogenic consequence of orthodontic treatment. One of the aims of this article is to present a brief overview of the literature, including; diagnosis and etiology, with emphasis on orthodontic forces to facilitate an understand of the prevention or management of ARR in orthodontic patients. We also present a long-term follow-up observation of severe ARR, including the last obtained cone beam computed tomography (CBCT) records, to demonstrate the effect of orthodontic forces on ARR.

Iatrogenic effects of psychosocial interventions: treatment, life context, and personal risk factors.

PubMed

Moos, Rudolf H

2012-01-01

Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.

Opioid Use Disorders

PubMed Central

Sharma, Bikash; Bruner, Ann; Barnett, Gabrielle; Fishman, Marc

2016-01-01

Opioid use and addiction in adolescents and young adults, including heroin and non-medical use of prescription opioids, is a serious and growing health problem of epidemic proportions. Opioid use has devastating consequences for youth and their families, including: progression to full addiction, severe psychosocial impairment, HCV and HIV transmission with injection use, exacerbation of co-occurring psychiatric disorders, overdose, and death. This chapter will provide an overview of opioid use disorders (OUDs) in youth, including: etiologic factors, epidemiology, consequences, clinical presentation and course, assessment and diagnosis, overdose, detoxification, and treatment. Opioid overdose is a life-threatening emergency. Respiratory depression should be treated with naloxone, and respiratory support if necessary. Overdose should always be utilized as an opportunity to initiate addiction treatment. Opioid withdrawal management (detoxification) is often a necessary, but never sufficient, component of treatment for OUDs. Medications used in the treatment of withdrawal may include buprenorphine, clonidine and others for relief of symptoms. Treatment for OUDs is effective but treatment capacity is alarmingly limited and under-developed. Although there is a limited evidence base for youth specific treatment, emerging consensus supports the incorporation of relapse prevention medications such as buprenorphine and extended release naltrexone into comprehensive psychosocial treatment including counseling and family involvement. PMID:27338968

Evaluation of severe accident risks: Quantification of major input parameters: MAACS (MELCOR Accident Consequence Code System) input

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

Sprung, J.L.; Jow, H-N; Rollstin, J.A.

1990-12-01

Estimation of offsite accident consequences is the customary final step in a probabilistic assessment of the risks of severe nuclear reactor accidents. Recently, the Nuclear Regulatory Commission reassessed the risks of severe accidents at five US power reactors (NUREG-1150). Offsite accident consequences for NUREG-1150 source terms were estimated using the MELCOR Accident Consequence Code System (MACCS). Before these calculations were performed, most MACCS input parameters were reviewed, and for each parameter reviewed, a best-estimate value was recommended. This report presents the results of these reviews. Specifically, recommended values and the basis for their selection are presented for MACCS atmospheric andmore » biospheric transport, emergency response, food pathway, and economic input parameters. Dose conversion factors and health effect parameters are not reviewed in this report. 134 refs., 15 figs., 110 tabs.« less

Any sleep is a dream far away: a nominal group study assessing how gout affects sleep.

PubMed

Singh, Jasvinder A

2018-02-23

There are no qualitative studies of sleep in gout; the aim of this study was to examine the impact of gout on sleep. Nine nominal groups were conducted, oversampling for African-Americans and women with gout. Patients discussed and rank-ordered their concerns. Nine nominal groups with 46 gout patients were conducted with mean age, 61 years (s.d. 10.6) and gout duration, 14.9 years (s.d. 12); 63% were men, 46% African-American, 52% married, 46% retired and 63% were allopurinol users. The most frequently cited highly ranked concerns could be divided into three categories. The first category, character of sleep interruption, included the concerns: severe and complete sleep interruption by gout flare pain (nine groups); and inability to get rapid eye movement sleep (one group). The second category, causes of sleep interruption, included: inability to get into a comfortable position during sleep (six groups); anxiety and depression associated with severe gout pain (seven groups); sleep interruption by moderate chronic joint pain (three groups); frequent trips to the bathroom interfering with sleep (two groups); gout medication side effects (four groups); frequent trips to the emergency room (one group); joint swelling with physical/functional deficit interfering with sleep (two groups); and flare pain interfering with sleep apnoea management (two groups). The final category, consequences of sleep interruption, included: effect on daily functioning (two groups); worsens other health conditions, which then affect sleep (four groups); and cumulative effect on sleep (one group). Gout has significant impact on sleep quantity, quality and architecture. Sleep disruption due to gout has several pathways and significant consequences.

Identification of Abuse and Health Consequences for Military and Civilian Women

DTIC Science & Technology

2000-04-01

highly educated women report the lowest lifetime prevalence of intimate partner abuse. The finding that this sample of well-educated, middle-class...education is the most important. There are several possible explanations for this finding. One is that more highly educated women have more financial... highly educated women were least likely to report ever having been abused. This effect persists even when other risk factors including income are

Deep Space Exploration: Will We Be Ready? Infectious Diseases, Microgravity and Other Forces Affecting Health Pose Challenges for Humans Planning to Explore Space

NASA Technical Reports Server (NTRS)

LaRocco, Mark T.; Pierson, Duane L.

1999-01-01

In contemplating space travel beyond earth orbits, we humans face significant barriers and major challenges. Although researchers involved in several scientific subdisciplines, including space medicine and space life sciences, may provide insights to help overcome those barriers, their efforts are at an early stage of development, leaving open many questions of potentially major consequence.

On the consequences of strong stable stratification at the top of earth's outer core

NASA Technical Reports Server (NTRS)

Bloxham, Jeremy

1990-01-01

The consequences of strong stable stratification at the top of the earth's fluid outer core are considered, concentrating on the generation of the geomagnetic secular variation. It is assumed that the core near the core-mantle boundary is both strongly stably stratified and free of Lorentz forces: it is found that this set of assumptions severely limits the class of possible motions, none of which is compatible with the geomagnetic secular variation. Relaxing either assumption is adequate: tangentially geostrophic flows are consistent with the secular variation if the assumption that the core is strongly stably stratified is relaxed (while retaining the assumption that Lorentz forces are negligible); purely toroidal flows may explain the secular variation if Lorentz forces are included.

The geological record of ocean acidification.

PubMed

Hönisch, Bärbel; Ridgwell, Andy; Schmidt, Daniela N; Thomas, Ellen; Gibbs, Samantha J; Sluijs, Appy; Zeebe, Richard; Kump, Lee; Martindale, Rowan C; Greene, Sarah E; Kiessling, Wolfgang; Ries, Justin; Zachos, James C; Royer, Dana L; Barker, Stephen; Marchitto, Thomas M; Moyer, Ryan; Pelejero, Carles; Ziveri, Patrizia; Foster, Gavin L; Williams, Branwen

2012-03-02

Ocean acidification may have severe consequences for marine ecosystems; however, assessing its future impact is difficult because laboratory experiments and field observations are limited by their reduced ecologic complexity and sample period, respectively. In contrast, the geological record contains long-term evidence for a variety of global environmental perturbations, including ocean acidification plus their associated biotic responses. We review events exhibiting evidence for elevated atmospheric CO(2), global warming, and ocean acidification over the past ~300 million years of Earth's history, some with contemporaneous extinction or evolutionary turnover among marine calcifiers. Although similarities exist, no past event perfectly parallels future projections in terms of disrupting the balance of ocean carbonate chemistry-a consequence of the unprecedented rapidity of CO(2) release currently taking place.

Factors Affecting the Immunity to Respiratory Syncytial Virus: From Epigenetics to Microbiome

PubMed Central

Fonseca, Wendy; Lukacs, Nicholas W.; Ptaschinski, Catherine

2018-01-01

Respiratory syncytial virus (RSV) is a common pathogen that infects virtually all children by 2 years of age and is the leading cause of hospitalization of infants worldwide. While most children experience mild symptoms, some children progress to severe lower respiratory tract infection. Those children with severe disease have a much higher risk of developing childhood wheezing later in life. Many risk factors are known to result in exacerbated disease, including premature birth and early age of RSV infection, when the immune system is relatively immature. The development of the immune system before and after birth may be altered by several extrinsic and intrinsic factors that could lead to severe disease predisposition in children who do not exhibit any currently known risk factors. Recently, the role of the microbiome and the resulting metabolite profile has been an area of intense study in the development of lung disease, including viral infection and asthma. This review explores both known risk factors that can lead to severe RSV-induced disease as well as emerging topics in the development of immunity to RSV and the long-term consequences of severe infection. PMID:29515570

Consequences of Diffusion of Innovations.

ERIC Educational Resources Information Center

Goss, Kevin F.

1979-01-01

The article traces evolution of diffusion theory; illustrates undesirable consequences in a cross-cultural setting, reviews criticisms of several scholars; considers distributional effects and unanticipated consequences for potential ameliorative impact on diffusion theory; and codifies these factors into a framework for research into consequences…

Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth.

PubMed

Rojas, Joselyn; Chávez, Mervin; Olivar, Luis; Rojas, Milagros; Morillo, Jessenia; Mejías, José; Calvo, María; Bermúdez, Valmore

2014-01-01

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.

Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth

PubMed Central

Rojas, Joselyn; Chávez, Mervin; Olivar, Luis; Rojas, Milagros; Morillo, Jessenia; Mejías, José; Calvo, María; Bermúdez, Valmore

2014-01-01

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome. PMID:25763405

Solar ultraviolet radiation, vitamin D and skin cancer surveillance in organ transplant recipients (OTRs): an update.

PubMed

Reichrath, Jörg

2014-01-01

During the last decades, the annual numbers of performed solid organ transplants have continuously increased world-wide. Solid organ transplant recipients (OTR) have a greater risk to develop malignancies, with skin cancer representing the most common neoplasia. Additionally, OTRs in general develop a more aggressive form of malignancies. In consequence, dermatologic surveillance is of high importance for OTRs and these patients represent an increasing and significant challenge to clinicians including dermatologists. In OTRs, patient and organ survival have increased considerably and continuously over the past two decades as a result of better immunosuppressive regimens and better posttransplant care. Great progress has been made in our understanding that individual immunosuppressive regiments differ in their effect on skin cancer risk in OTRs, and that effects of individual immunosuppressive regiments on skin cancer risk depend on various other factors including viral infections. Since sunlight is the major source of vitamin D for most humans, OTRs, who have to protect themselves consequently against solar or artificial UV radiation, are at high risk of developing vitamin D deficiency. Vitamin D deficiency is not only associated with increased risk for metabolic bone disease, but with other severe health problems including various types of malignancies. As a consequence, screening for and treatment of vitamin D deficiency is warranted in OTRs. In this review, we give an update on our present understanding of skin cancer surveillance in OTRs.

[Earthquakes--a historical review, environmental and health effects, and health care measures].

PubMed

Nola, Iskra Alexandra; Doko Jelinić, Jagoda; Žuškin, Eugenija; Kratohvil, Mladen

2013-06-01

Earthquakes are natural disasters that can occur at any time, regardless of the location. Their frequency is higher in the Circum-Pacific and Mediterranean/Trans-Asian seismic belt. A number of sophisticated methods define their magnitude using the Richter scale and intensity using the Mercani-Cancani-Sieberg scale. Recorded data show a number of devastating earthquakes that have killed many people and changed the environment dramatically. Croatia is located in a seismically active area, which has endured a series of historical earthquakes, among which several occurred in the Zagreb area. The consequences of an earthquake depend mostly on the population density and seismic resistance of buildings in the affected area. Environmental consequences often include air, water, and soil pollution. The effects of this kind of pollution can have long-term health effects. The most dramatic health consequences result from the demolition of buildings. Therefore, quick and efficient aid depends on well-organized health professionals as well as on the readiness of the civil defence, fire department, and Mountain Rescue Service members. Good coordination among these services can save many lives Public health interventions must include effective control measures in the environment as secondary prevention methods for health problems caused by unfavourable environmental factors. The identification and control of long-term hazards can reduce chronic health effects. The reduction of earthquake-induced damages includes setting priorities in building seismically safe buildings.

[Health consequences of environmental temperature and climate variations].

PubMed

Swynghedauw, Bernard

2012-01-01

Recent climate change is a consequence of the greenhouse effect and human activity, and is directly responsible for extreme events such as heatwaves (see report of the French Académie des Sciences). Human thermoregulation depends more on behavior than on biology Air conditioning and building structure play an essential role. The 2003 heatwave was not a unique event. Preventive measures reduced mortality during subsequent heatwaves. Most deaths were due to heat stroke associated with dehydration. During strenuous exercise, especially during military training, heat stroke requires specific treatment. Temperature/ global mortality and temperature/cardiovascular mortality curves are both U-shaped. Usually, global mortality increases winter and is linked to temperature. During summer, global mortality increases only when heatwaves occur. Climate change participates in the spread of infectious diseases. Nevertheless, in continental France, for the moment, climate change is not a major factor in the incidence of infectious diseases, despite the fact that several bacteria, viruses and vectors are temperature-sensitive. The situation in Reunion, French Polynesia and French Departments of America is more complicated, due to their geographic heterogeneity. Some areas are more exposed to the climatic risk and could act as a gateway for new infections and mutations. The dramatic loss of biodiversity is partly a consequence of climate change. It increases the transmissibility of some pathogens and can also potentially lead to an increase in autoimmune diseases and obesity. Climate change plays a important role in allergic diseases, through changes in the diffusion and composition of pollens. These modifications are being monitored by several observatories. Six different veterinary diseases, including several zoonoses, are of particular concern.

The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis

PubMed Central

Berg, Rigmor C.; Underland, Vigdis

2013-01-01

Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C. PMID:23878544

The effects of collateral consequences of criminal involvement on employment, use of Temporary Assistance for Needy Families, and health

PubMed Central

Kneipp, Shawn M.

2017-01-01

Criminal convictions are often associated with collateral consequences that limit access to the forms of employment and social services on which disadvantaged women most frequently rely – regardless of the severity of the offense. These consequences may play an important role in perpetuating health disparities by socioeconomic status and gender. We examined the extent to which research studies to date have assessed whether a criminal conviction might influence women’s health by limiting access to Temporary Assistance for Needy Families (TANF) and employment, as a secondary, or “collateral” criminal conviction-related consequence. We reviewed 434 peer-reviewed journal articles retrieved from three electronic article databases and 197 research reports from three research organizations. Two reviewers independently extracted data from each eligible article or report using a standardized coding scheme. Of the sixteen eligible studies included in the review, most were descriptive. None explored whether receiving TANF modified health outcomes, despite its potential to do so. Researchers to date have not fully examined the causal pathways that could link employment, receiving TANF, and health, especially for disadvantaged women. Future research is needed to address this gap and to understand better the potential consequences of the criminal justice system involvement on the health of this vulnerable population. PMID:25905904

The Effects of Collateral Consequences of Criminal Involvement on Employment, Use of Temporary Assistance for Needy Families, and Health.

PubMed

Sheely, Amanda; Kneipp, Shawn M

2015-01-01

Criminal convictions are often associated with collateral consequences that limit access to the forms of employment and social services on which disadvantaged women most frequently rely--regardless of the severity of the offense. These consequences may play an important role in perpetuating health disparities by socioeconomic status and gender. We examined the extent to which research studies to date have assessed whether a criminal conviction might influence women's health by limiting access to Temporary Assistance for Needy Families (TANF) and employment, as a secondary, or "collateral" criminal conviction-related consequence. We reviewed 434 peer-reviewed journal articles retrieved from three electronic article databases and 197 research reports from three research organizations. Two reviewers independently extracted data from each eligible article or report using a standardized coding scheme. Of the sixteen eligible studies included in the review, most were descriptive. None explored whether receiving TANF modified health outcomes, despite its potential to do so. Researchers to date have not fully examined the causal pathways that could link employment, receiving TANF, and health, especially for disadvantaged women. Future research is needed to address this gap and to understand better the potential consequences of the criminal justice system involvement on the health of this vulnerable population.

Characteristics of Hemorrhagic Stroke following Spine and Joint Surgeries.

PubMed

Yang, Fei; Zhao, Jianning; Xu, Haidong

2017-01-01

Hemorrhagic stroke can occur after spine and joint surgeries such as laminectomy, lumbar spinal fusion, tumor resection, and total joint arthroplasty. Although this kind of stroke rarely happens, it may cause severe consequences and high mortality rates. Typical clinical symptoms of hemorrhagic stroke after spine and joint surgeries include headache, vomiting, consciousness disturbance, and mental disorders. It can happen several hours after surgeries. Most bleeding sites are located in cerebellar hemisphere and temporal lobe. A cerebrospinal fluid (CSF) leakage caused by surgeries may be the key to intracranial hemorrhages happening. Early diagnosis and treatments are very important for patients to prevent the further progression of intracranial hemorrhages. Several patients need a hematoma evacuation and their prognosis is not optimistic.

How large are the consequences of covariate imbalance in cluster randomized trials: a simulation study with a continuous outcome and a binary covariate at the cluster level.

PubMed

Moerbeek, Mirjam; van Schie, Sander

2016-07-11

The number of clusters in a cluster randomized trial is often low. It is therefore likely random assignment of clusters to treatment conditions results in covariate imbalance. There are no studies that quantify the consequences of covariate imbalance in cluster randomized trials on parameter and standard error bias and on power to detect treatment effects. The consequences of covariance imbalance in unadjusted and adjusted linear mixed models are investigated by means of a simulation study. The factors in this study are the degree of imbalance, the covariate effect size, the cluster size and the intraclass correlation coefficient. The covariate is binary and measured at the cluster level; the outcome is continuous and measured at the individual level. The results show covariate imbalance results in negligible parameter bias and small standard error bias in adjusted linear mixed models. Ignoring the possibility of covariate imbalance while calculating the sample size at the cluster level may result in a loss in power of at most 25 % in the adjusted linear mixed model. The results are more severe for the unadjusted linear mixed model: parameter biases up to 100 % and standard error biases up to 200 % may be observed. Power levels based on the unadjusted linear mixed model are often too low. The consequences are most severe for large clusters and/or small intraclass correlation coefficients since then the required number of clusters to achieve a desired power level is smallest. The possibility of covariate imbalance should be taken into account while calculating the sample size of a cluster randomized trial. Otherwise more sophisticated methods to randomize clusters to treatments should be used, such as stratification or balance algorithms. All relevant covariates should be carefully identified, be actually measured and included in the statistical model to avoid severe levels of parameter and standard error bias and insufficient power levels.

Motor Complications of Dopaminergic Medications in Parkinson’s Disease

PubMed Central

Freitas, Maria Eliza; Hess, Christopher W.; Fox, Susan H.

2018-01-01

Motor complications are a consequence of chronic treatment of Parkinson’s disease (PD) and include motor fluctuations (wearing-off phenomenon) and levodopa-induced dyskinesia. Both can have a significant impact on functionality and quality of life and thus proper recognition and management is essential. The phenomenology and temporal relationship of motor complications to the schedule of levodopa dosing can be helpful in characterizing them. There are several therapeutic approaches to motor complications, including pharmacological and surgical options. The current review summarizes the different types of motor complications according to phenomenology and the currently available medical treatments, including ongoing trials for management of this condition. PMID:28511255

Age-related macular degeneration: economic burden and value-based medicine analysis.

PubMed

Brown, Melissa M; Brown, Gary C; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

2005-06-01

It can be estimated that 17,100 new cases of neovascular (wet) AMD and 180,000 new cases of geographic-atrophy (dry) AMD occur in Canada annually. In addition to having a devastating effect on patients' lives, the condition causes significant adverse consequences for the economy. The deleterious effect of AMD on quality of life is markedly underestimated by ophthalmologists who treat patients with AMD, by non-ophthalmic physicians and by the public. In fact, patients with different degrees of severity of AMD have a perceived impairment of their quality of life that is 96% to 750% greater than the impairment estimated by treating ophthalmologists. Mild AMD causes a 17% decrease in the quality of life of the average patient, a decrease similar to that encountered with symptomatic human immunodeficiency virus infection or moderate cardiac angina. Moderate AMD produces a 40% decrease in quality of life, a decrease similar to that associated with permanent renal dialysis or severe cardiac angina. Very severe AMD causes a 63% decrement in quality of life, a decrease similar to that encountered with advanced prostatic cancer with uncontrollable pain or a severe stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The adverse economic consequences of AMD include an annual $2.6 billion negative impact on Canada's gross domestic product. The return on investment is high for both current AMD therapies and research into new treatment modalities.

Interpersonal violence as social construction: the potentially undermining role of claims making and advocacy statistics.

PubMed

Perrin, Robin D; Miller-Perrin, Cindy L

2011-10-01

The relationship between empirical research inquiry and advocacy efforts is complex and seldom addressed in the interpersonal violence literature. In this article, we first examine how social conditions come to be seen as social problems, using a social constructionist perspective. Next, we focus specifically on the problem of interpersonal violence as viewed through a social constructionist lens, highlighting the many ways in which advocacy has influenced public perceptions of interpersonal violence as a social problem. Finally, this article considers some of the consequences that may result from exaggerated or misleading claims, especially when they are made by social scientists who are presumably engaged in an objective discussion of a problem. These consequences include generating skepticism toward the social sciences, feeding a backlash movement, and diverting attention away from the most severe forms of interpersonal violence. Contrary to the goals of many advocates, some of these consequences may be detrimental to the very social problems they hope to alleviate.

Insomnia severity as a mediator of the association between mental health symptoms and alcohol use in young adult veterans.

PubMed

Miller, Mary Beth; DiBello, Angelo M; Carey, Kate B; Borsari, Brian; Pedersen, Eric R

2017-08-01

Prior research has documented associations between mental health and alcohol use, mental health and insomnia, and insomnia and alcohol use. This study examined insomnia severity as a mediator of the association between mental health and alcohol-related outcomes in young adult veterans. Veterans aged 18-34 years (N=622, 83% male) who reported drinking in the past year completed assessments at baseline and one-month follow-up as part of a larger intervention trial. Participants reported symptoms of depression and posttraumatic stress disorder (PTSD) at baseline, insomnia severity at one month, and alcohol use and related consequences at baseline and one month. Mediation analyses using bootstrapped confidence intervals were used to examine the indirect effects of baseline mental health symptoms on alcohol-related outcomes at one month via insomnia severity. Insomnia severity was associated with both drinking quantity and alcohol-related consequences. Greater depressive (but not PTSD) symptoms were associated directly with more alcohol-related consequences. Neither depressive nor PTSD symptoms had direct effects on drinking quantity when controlling for the other mental health symptoms (e.g., depressive symptoms did not predict drinking quantity when controlling for symptoms of PTSD). However, symptoms of depression and PTSD predicted drinks per week and alcohol-related consequences indirectly through insomnia severity. Symptoms of depression and PTSD increase risk for alcohol use and related consequences in part by increasing symptoms of insomnia. Findings suggest that insomnia may be an appropriate target for prevention and intervention efforts among heavy-drinking Veterans reporting symptoms of depression or PTSD. Copyright © 2017 Elsevier B.V. All rights reserved.

Case report: Ribavirin and vitamin A in a severe case of measles

PubMed Central

Bichon, Amandine; Aubry, Camille; Benarous, Lucas; Drouet, Hortense; Zandotti, Christine; Parola, Philippe; Lagier, Jean-Christophe

2017-01-01

Abstract Rationale: Despite a vaccine being widely available, measles continues to occur frequently, with sometimes lethal consequences. Patients concerns: The mortality rate reaches 35% and measles represents 44% of the 1.4 million deaths which are due to preventable diseases. Severe forms of measles are reported, mainly in young, unvaccinated adults, and in specific populations. The risk factors for severe measles include no or incomplete vaccination and vitamin A deficiency. Apart from secondary measles-related infections, severe measles is mainly represented by neurological, respiratory, and digestive symptoms. Diagnoses: Strengthening the hypothesis that there is a link between vitamin A deficiency and severe measles in this paper we report the case of a 25-year-old unvaccinated man hospitalized for severe and complicated measles. Outcomes: The evolution was good after administration of intramuscular vitamin A as well as intravenous ribavirin. Lessons: Measles remains a fatal and serious disease. The early use of ribavirin and vitamin A shows significant improvements regarding morbimortality and should be systematic in severe cases. PMID:29390321

[Burnout syndrome in teachers from two universities in Popayán, Colombia].

PubMed

Correa-Correa, Zamanda; Muñoz-Zambrano, Isabel; Chaparro, Andrés F

2010-08-01

Evaluating professional exhaustion or burnout syndrome: background, syndrome and consequences amongst half-time and full-time staff working in two private universities in the city of Popayán during 2008. The study population included 44 male and female participants aged 20 to 40 who were evaluated by using a brief burnout questionnaire (BBQ). This questionnaire had been validated for Latin-American and for teachers. It was not exclusively focused on the structure of the syndrome itself but rather included background elements and consequences. The study was quantitative and cross-sectional, having a deductive hypothetical methodological focus. Descriptive statistics and the Chi-square test were used for data analysis, accepting p<0.05 statistical significance. The analysis was univariate and bivariate. The results indicated low burnout syndrome frequency in the study population. However, 9.1 % high depersonalization frequency was found (i.e. teachers had developed negative attitudes and were insensitive to those receiving their services) and 15.9 % and 9.1 % frequencies for high physical and social consequences, respectively. Bivariate analysis revealed significant association of several factors. The results indicated low burnout syndrome frequency in this population. However, factors which were highly associated with physical and social consequences were: being male, aged 20 to 40, having a marital relationship with a habitual partner, working full-time, working at home and spending more than 75 % of the working day interacting with the beneficiaries of the services being provided.

The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome.

PubMed

Miller, Suzanne L; Huppi, Petra S; Mallard, Carina

2016-02-15

Fetal growth restriction (FGR) is a significant complication of pregnancy describing a fetus that does not grow to full potential due to pathological compromise. FGR affects 3-9% of pregnancies in high-income countries, and is a leading cause of perinatal mortality and morbidity. Placental insufficiency is the principal cause of FGR, resulting in chronic fetal hypoxia. This hypoxia induces a fetal adaptive response of cardiac output redistribution to favour vital organs, including the brain, and is in consequence called brain sparing. Despite this, it is now apparent that brain sparing does not ensure normal brain development in growth-restricted fetuses. In this review we have brought together available evidence from human and experimental animal studies to describe the complex changes in brain structure and function that occur as a consequence of FGR. In both humans and animals, neurodevelopmental outcomes are influenced by the timing of the onset of FGR, the severity of FGR, and gestational age at delivery. FGR is broadly associated with reduced total brain volume and altered cortical volume and structure, decreased total number of cells and myelination deficits. Brain connectivity is also impaired, evidenced by neuronal migration deficits, reduced dendritic processes, and less efficient networks with decreased long-range connections. Subsequent to these structural alterations, short- and long-term functional consequences have been described in school children who had FGR, most commonly including problems in motor skills, cognition, memory and neuropsychological dysfunctions. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

Status epilepticus caused by a myxoedema coma.

PubMed

Jansen, H J; Doebé, S R Oedit; Louwerse, E S; van der Linden, J C; Netten, P M

2006-06-01

The case of a 63-year-old woman who presented with status epilepticus, coma and hypoventilation is reported. A primary neurological cause was considered. Hypothermia led to further investigations and a diagnosis of severe hypothyroidism. The neurological complications of hyperthyriodism include alteration in mental status with slowness, decreased concentration and lethargy, headache, cranial nerve palsies, dysarthria, hoarseness, myopathy, neuropathy, reflex changes, ataxia, and psychotic episodes. Our patient suffered from a rare consequence of severe hypothyroidism presenting with status epilepticus and she died despite treatment. To our knowledge this is the second patient to be reported with myxoedema coma with this kind of presentation. Despite therapeutic options, there is a high mortality rate.

Study of effects of space power satellites on life support functions of the earth's magnetosphere

NASA Technical Reports Server (NTRS)

Douglas, M.; Laquey, R.; Deforest, S. E.; Lindsey, C.; Warshaw, H.

1977-01-01

The effects of the Satellite Solar Power System (SSPS) on the life support functions of the earth's magnetosphere were investigated. Topics considered include: (1) thruster effluent effects on the magnetosphere; (2) biological consequences of SSPS reflected light; (3) impact on earth bound astronomy; (4) catastrophic failure and debris; (5) satellite induced processes; and (6) microwave power transmission. Several impacts are identified and recommendations for further studies are provided.

A new methodology for estimating nuclear casualties as a function of time.

PubMed

Zirkle, Robert A; Walsh, Terri J; Disraelly, Deena S; Curling, Carl A

2011-09-01

The Human Response Injury Profile (HRIP) nuclear methodology provides an estimate of casualties occurring as a consequence of nuclear attacks against military targets for planning purposes. The approach develops user-defined, time-based casualty and fatality estimates based on progressions of underlying symptoms and their severity changes over time. This paper provides a description of the HRIP nuclear methodology and its development, including inputs, human response and the casualty estimation process.

[Jellyfish and poison-producing animals that endanger swimmers].

PubMed

Litschauer-Poursadrollah, M; Mayer, D E; Hemmer, W; Jarisch, R

2010-05-01

Exposure to fresh water as well as to sea water can cause unpleasant consequences. The water of lakes or biotopes may be the reason for severe itching reactions on exposed skin, caused by cercariae. Exposure to seawater may lead to skin affections including itching or burning urticarial lesions as well as life threatening reactions. The causes for these reactions are especially species of jellyfish. (c) Georg Thieme Verlag KG Stuttgart. New York.

Understanding High Incidence of Severe Obesity and Very Low Food Security in Food Pantry Clients: Implications For Social Work.

PubMed

Kaiser, Michelle L; Cafer, Anne

2018-01-01

The United States is facing two interconnected social and public health crises of severe obesity and food insecurity within the social-ecological environment. Marginalized groups experience the highest rates and the greatest impacts in terms of morbidity, mortality, and financial burdens. Consequences include experiencing multimorbidities, mental health issues, and decreased quality of life. Food pantries have served as spaces to obtain food to meet household needs, but for some, food pantries have become long-term solutions. We surveyed 2,634 people who accessed pantries in 2005, 2010, and 2013 across 32 counties in a Midwest state. The authors sought to understand to what extent does length of time using a food pantry, food security status, income sources, use of federal food benefits, visiting a doctor, and demographic variables increase odds of severe obesity. More than 14% were severely obese; those who were long-term food pantry users and very low food secure were 1.732 times more likely to be severely obese. Receiving Disability/Supplemental Security Income, seeing a doctor in the last year, being female, and older age reduced the odds of severe obesity. Discussion includes implications for social workers who interact with groups likely to experience very low food security and severe obesity at different systems levels.

Pregnancy-related anxiety: A concept analysis.

PubMed

Bayrampour, Hamideh; Ali, Elena; McNeil, Deborah A; Benzies, Karen; MacQueen, Glenda; Tough, Suzanne

2016-03-01

Evidence suggests that pregnancy-related anxiety is more strongly associated with maternal and child outcomes than general anxiety and depression are and that pregnancy-related anxiety may constitute a distinct concept. However, because of its poor conceptualization, the measurement and assessment of pregnancy-related anxiety have been limited. Efforts to analyze this concept can significantly contribute to its theoretical development. The first objective of this paper was to clarify the concept of pregnancy-related anxiety and identify its characteristics and dimensions. The second aim was to examine the items of current pregnancy-related anxiety measures to determine the dimensions and attributes that each scale addresses, noting any gaps between the current assessment and the construct of the concept. A concept analysis was conducted to examine the concept of pregnancy-related anxiety. To obtain the relevant evidence, several databases were searched including MEDLINE, PsycINFO, EBSCO's SocINDEX, Psychological and Behavioral Sciences Collection, CINAHL, SCOPUS, and EMBASE. A modified approach based on Walker and Avant (Strategies for theory construction in nursing. 5th ed; 2011) was used. Qualitative or quantitative studies published in English that explored or examined anxiety during pregnancy or its dimensions prospectively or retrospectively were included. Thirty eight studies provided data for the concept analysis. Three critical attributes (i.e., affective responses, cognitions, and somatic symptoms), three antecedents (i.e., a real or anticipated threat to pregnancy or its outcomes, low perceived control, and excessive cognitive activity, and four consequences (i.e., negative attitudes, difficulty concentrating, excessive reassurance-seeking behavior, and avoidance behaviors) were identified. Nine dimensions for pregnancy-related anxiety were determined, and a definition of the concept was proposed. The most frequently reported dimensions included anxiety about fetal health, fetal loss, childbirth, and parenting and newborn care. The content of five scales was analyzed to determine the attributes and dimensions measured by each tool. Our findings suggest that the Pregnancy-Related Anxiety Scale tapping five dimensions of pregnancy-related anxiety and the Pregnancy Outcome Questionnaire with six items pertaining to the consequences of pregnancy-related anxiety can respectively be considered the most useful tools for assessing the existence and severity of the concept. The critical attributes of pregnancy-related anxiety are similar to those defined for anxiety disorders. However, the behavioral consequences of pregnancy-related anxiety appear to apply only some women and may serve as important indicators of the severity of the condition. Current tools are useful instruments to determine whether the concept exists and to capture selected domains of pregnancy-related anxiety. A tool that includes all dimensions of the concept and examines the severity of pregnancy-related anxiety is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

The dark side of light at night: physiological, epidemiological, and ecological consequences.

PubMed

Navara, Kristen J; Nelson, Randy J

2007-10-01

Organisms must adapt to the temporal characteristics of their surroundings to successfully survive and reproduce. Variation in the daily light cycle, for example, acts through endocrine and neurobiological mechanisms to control several downstream physiological and behavioral processes. Interruptions in normal circadian light cycles and the resulting disruption of normal melatonin rhythms cause widespread disruptive effects involving multiple body systems, the results of which can have serious medical consequences for individuals, as well as large-scale ecological implications for populations. With the invention of electrical lights about a century ago, the temporal organization of the environment has been drastically altered for many species, including humans. In addition to the incidental exposure to light at night through light pollution, humans also engage in increasing amounts of shift-work, resulting in repeated and often long-term circadian disruption. The increasing prevalence of exposure to light at night has significant social, ecological, behavioral, and health consequences that are only now becoming apparent. This review addresses the complicated web of potential behavioral and physiological consequences resulting from exposure to light at night, as well as the large-scale medical and ecological implications that may result.

[Change of host's behavior including man under the influence of parasites].

PubMed

Sergiev, V P

2010-01-01

Directed modulation of hosts' behavior favouring transmission of pathogen was noted in many parasites and, above all, in helminthes, which life cycle includes the consequent change of several hosts. It turned out that parasites use the same neuromediators for change of behavior of both mammals and hosts belonging to other animal classes. In fishes as well as in mammals, monoamines-neurotransmitters assist in brain functioning. Norepinephrine, dopamine and serotonin affect the alimentation, motion activity, aggression and social behaviour. Changes in concentration ratio of serotonin and its metabolites in invaded species were more pronounced, which pointed to directed effects of pathogens on serotonin activity. The same effect of some pathogens on human behaviour does not have selective significance because humans are not an essential link in life cycle of many parasites. Although the mentioned effect on behaviour could lead to negative consequences. For examples, persons with latent toxoplasmosis are significantly more frequent become members or victims of traffic accidents due to decreased ability for concentration of attention.

Clinical Manifestations of an Anti-Drug Antibody Response: Autoimmune Reactions.

PubMed

Swanson, Steven J

2014-12-01

Antibodies can be generated against a therapeutic protein upon administration to human subjects. When the therapeutic protein closely mimics one of the subject's endogenous proteins, those antibodies might bind to the endogenous protein in addition to the therapeutic protein. This scenario results when tolerance to the endogenous protein is broken. The consequences of breaking tolerance include an autoimmune response where antibodies are generated against the endogenous protein. These autoantibodies could have significant clinical relevance depending on several factors, including the redundancy of action of the endogenous protein as well as the concentration, binding affinity, and neutralizing potential of the antibodies. The consequences of a therapeutic-protein-induced autoimmune reaction can be challenging to manage as the stimulus for further perpetuation of the immune response can shift from the therapeutic protein to the endogenous protein. The potential for inducing an autoimmune response is one of the reasons that the immune response to a therapeutic protein should be monitored if it persists through the end of the study.

Nutritional needs of the female athlete.

PubMed

Manore, M M

1999-07-01

US women, including female athletes, are under ever increasing pressure to be thin ar thinner. this pressure to achieve and maintain a low body weight leads to potentially harmful patterns of long-term dieting or disordered eating, which can affect long-term health. Some of the health consequences of long-term energy restriction in female athletes may include poor energy and nutrient intakes, poor nutritional status, decreased RMR and total daily energy expenditure, increased psychological stress and risk for a clinical eating disorder, and increased risk for exercise-induced amenorrhea and osteoporosis. Female athletes participating in thin-build sports may be at risk for the disorders of the female athlete triad: disordered eating, amenorrhea, and osteoporosis. This triad of disorders can also produce severe health consequences that can influence present and future health. Strategies for helping active women get off the dieting "bandwagon" requires the identification of an appropriate and healthy body weight, good eating and exercise habits, and techniques for maintaining these habits throughout life.

Analysis of polychlorinated n-alkanes in environmental samples.

PubMed

Santos, F J; Parera, J; Galceran, M T

2006-10-01

Polychlorinated n-alkanes (PCAs), also known as chlorinated paraffins (CPs), are highly complex technical mixtures that contain a huge number of structural isomers, theoretically more than 10,000 diastereomers and enantiomers. As a consequence of their persistence, tendency to bioaccumulation, and widespread and unrestricted use, PCAs have been found in aquatic and terrestrial food webs, even in rural and remote areas. Recently, these compounds have been included in regulatory programs of several international organizations, including the US Environmental Protection Agency and the European Union. Consequently, there is a growing demand for reliable methods with which to analyze PCAs in environmental samples. Here, we review current trends and recent developments in the analysis of PCAs in environmental samples such as air, water, sediment, and biota. Practical aspects of sample preparation, chromatographic separation, and detection are covered, with special emphasis placed on analysis of PCAs using gas chromatography-mass spectrometry. The advantages and limitations of these techniques as well as recent improvements in quantification procedures are discussed.

Severe accidents in the energy sector: comparative perspective.

PubMed

Hirschberg, Stefan; Burgherr, Peter; Spiekerman, Gerard; Dones, Roberto

2004-07-26

This paper addresses one of the controversial issues in the current comparative studies of the environmental and health impacts of energy systems, i.e. the treatment of severe accidents. The work covers technical aspects of severe accidents and thus primarily reflects an engineering perspective on the energy-related risk issues, though some social implications are also touched upon. The assessment concerns fossil energy sources (coal, oil and gas), nuclear power and hydro power. The scope is not limited to the power production (conversion) step of these energy chains but, whenever applicable, also includes exploration, extraction, transports, processing, storage and waste disposal. With the exception of the nuclear chain the focus of the work has been on the evaluation of the historical experience of accidents. The basis used for this evaluation is a comprehensive database ENSAD (Energy-related Severe Accident Database), established by the Paul Scherrer Institut (PSI). For hypothetical nuclear accidents the probabilistic technique has also been employed and extended to cover the assessment of economic consequences of such accidents. The broader picture obtained by coverage of full energy chains leads on the world-wide basis to aggregated immediate fatality rates being much higher for the fossil chains than what one would expect if only power plants were considered. Generally, the immediate fatality rates are for all considered energy carriers significantly higher for the non-OECD countries than for OECD countries. In the case of hydro and nuclear the difference is in fact dramatic. The presentation of results is not limited to the aggregated values specific for each energy chain. Also frequency-consequence curves are provided. They reflect implicitly the ranking based on the aggregated values but include also such information as the observed or predicted chain-specific maximum extents of damages. This perspective on severe accidents may lead to different system rankings, depending on the individual risk aversion.

Methamphetamine use and dental disease: results of a pilot study.

PubMed

Cretzmeyer, Margaret; Walker, Jerry; Hall, James A; Arndt, Stephan

2007-01-01

The purpose of this study was to evaluate the feasibility of using a standard dental examination to detect methamphetamine use. Data were collected from 31 patients in a hospital-based inpatient chemical dependency treatment unit using cross-sectional study design. Patients who reported current methamphetamine use were compared with patients who denied methamphetamine use on data from dental examinations and an in-depth substance use assessment. Evidence of a relationship between methamphetamine use and dental disease was not detected in this sample. Both groups had a high degree of behaviors and risk factors other than substance abuse that contributed to dental disease. Based on these data, clients who used methamphetamine could not be distinguished from those who used other substances. Both groups presented significant dental disease, however, and it may be that most, if not all, patients in this hospital-based unit had significant chronic health problems including dental disease. Although adolescent use of methamphetamine is primarily restricted to older adolescents, consequences of use are severe and early identification of drug use may forestall some of the more severe consequences.

Psychosocial approaches to dual diagnosis.

PubMed

Drake, R E; Mueser, K T

2000-01-01

Recent research elucidates many aspects of the problem of co-occurring substance use disorder (SUD) in patients with severe mental illness, which is often termed dual diagnosis. This paper provides a brief overview of current research on the epidemiology, adverse consequences, and phenomenology of dual diagnosis, followed by a more extensive review of current approaches to services, assessment, and treatment. Accumulating evidence shows that comorbid SUD is quite common among individuals with severe mental illness and that these individuals suffer serious adverse consequences of SUD. The research further suggests that traditional, separate services for individuals with dual disorders are ineffective, and that integrated treatment programs, which combine mental health and substance abuse interventions, offer more promise. In addition to a comprehensive integration of services, successful programs include assessment, assertive case management, motivational interventions for patients who do not recognize the need for substance abuse treatment, behavioral interventions for those who are trying to attain or maintain abstinence, family interventions, housing, rehabilitation, and psychopharmacology. Further research is needed on the organization and financing of dual-diagnosis services and on specific components of the integrated treatment model, such as group treatments, family interventions, and housing approaches.

Combat experience and problem drinking in veterans: Exploring the roles of PTSD, coping motives, and perceived stigma.

PubMed

Miller, Stephen M; Pedersen, Eric R; Marshall, Grant N

2017-03-01

The current investigation sought to illustrate the etiology of adverse alcohol consequences in young adult veterans using a path analytic framework. A total of 312 veterans aged 19-34 were enrolled in a larger intervention study on alcohol use. At baseline, participants completed measures of combat severity, PTSD symptom severity, and drinking motives to cope. At one month follow-up, participants completed measures of perceived stigma of behavioral health treatment seeking and past 30-day alcohol consequences. After entering the covariates of age, gender, race/ethnicity, and past year behavioral health treatment utilization, a path analytic model demonstrated a good fit to the data predicting alcohol consequences in this population. Further, a separate exploratory analysis confirmed that both drinking motives to cope and perceived stigma of behavioral health treatment seeking mediated the link between PTSD symptom severity and alcohol consequences. The current model expands upon prior research showing the relationship between combat severity and alcohol use behavior in young adult veterans. Results support the notion that veterans with PTSD symptoms may drink to cope and that perceived stigma surrounding help seeking may further contribute to alcohol related problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Snowpack Regimes of the Western United States

NASA Astrophysics Data System (ADS)

Trujillo, E.; Molotch, N. P.

2011-12-01

Snow accumulation and melt patterns play a significant role in the water, energy, carbon and nutrient cycles in the montane environments of the Western United States. Recent studies have illustrated that changes in the snow/rainfall apportionments, and snow accumulation and melt patterns may occur as a consequence of changes in climate in the region. In order to understand how these changes may affect the snow regimes of the region, the current characteristics of the snow accumulation and melt patterns must be identified. Here, we characterize the snow water equivalent (SWE) curve formed by the daily SWE values at over seven hundred snow pillow stations in the Western U.S., focusing on several metrics of the yearly SWE curves and the cross relationships between the different metrics. The metrics include the initial snow accumulation and meltout dates, the peak accumulation and date of peak, the time from initial accumulation to peak, the time from peak to meltout, the accumulation and melt slopes, and the daily rates of accumulation and melt. Three distinct regimes emerge from these results: a maritime, an intermediate (intercontinental), and a continental regime. The maritime regime is characterized by higher maximum snow accumulations reaching 300 cm and shorter accumulation periods of less than 220 days, while on the other hand; the continental regime is characterized by lower maximum accumulations below 200 cm and longer accumulation periods reaching over 260 days. The intercontinental regime lies in between. Several other differences are identified between the metrics of the SWE curve in these regimes. The regions that show the characteristics of the maritime regime include the Cascade Mountains, the Klamath Mountains, and the Sierra Nevada Mountains. The intercontinental regime includes the Northern and Central basins and ranges, the Idaho Batholith, the Northern Rockies and the Blue Mountains. Lastly, the Continental regime includes the Middle and Southern Rockies, and the Wasatch and Uinta Mountains. The consequences of the differences between these snow regimes are discussed in the framework of the implications of possible changes in accumulation and melt patterns as a consequence of changes in climate.

Emerging Drugs and Indications for Cardio-Metabolic Disorders in People with Severe Mental Illness.

PubMed

Kouidrat, Youssef; Amad, Ali; De Hert, Marc

2015-01-01

Patients with severe mental illnesses, such as schizophrenia and bipolar disorder, are at increased risk of developing metabolic disorders including obesity, diabetes, and dyslipidemia. All of these comorbidities increase the risk of cardiovascular disease and mortality. Different approaches, including diet and lifestyle modifications, behavioral therapy and switching antipsychotic agents, have been proposed to manage these metabolic abnormalities. However, these interventions may be insufficient, impractical or fail to counteract the metabolic dysregulation. Consequently, a variety of pharmacological agents such as antidiabetic drugs, have been studied in an attempt to reverse the weight gain and metabolic abnormalities evident in these patients. Despite a significant effect, many of these treatments are used off-label. This qualitative review focuses on pharmacological agents that could offer significant benefits in the management of cardio-metabolic disorders associated with serious mental illness.

Communal violence in Gujarat, India: impact of sexual violence and responsibilities of the health care system.

PubMed

Khanna, Renu

2008-05-01

Situations of chronic conflict across the globe make it imperative to draw attention to its gendered health consequences, particularly the violation of women's reproductive and sexual rights. Since early 2002 in Gujarat, western India, the worst kind of state-sponsored violence against Muslims has been perpetrated, which continues to this day. This paper describes the history of that violence and highlights the mental and physical consequences of sexual and gender-based violence and the issues that need to be addressed by the police, the health care system and civil society. It draws upon several reports, including from the International Initiative for Justice and the Medico Friend Circle, which documented the reproductive, sexual and mental health consequences of the violence in Gujarat, and the lacunae in the responses of the health system. The paper calls for non-discrimination to be demonstrated by health personnel in the context of conflict and social unrest. Their training should include conflict as a public health problem, their roles and responsibilities in prevention, treatment and documentation of this "disease", and focus on relevant medico-legal methodology and principles, the psychological impact of sexual assault on victims, and the legal significance of medical evidence in these cases.

The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions

PubMed Central

Atique, S.; Mayer, M. A.; Denecke, K.; Merolli, M.; Househ, M.

2016-01-01

Summary Objectives Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. Methodology After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Results Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Conclusions Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient’s feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem. PMID:27830230

Inferences about moral character moderate the impact of consequences on blame and praise.

PubMed

Siegel, Jenifer Z; Crockett, Molly J; Dolan, Raymond J

2017-10-01

Moral psychology research has highlighted several factors critical for evaluating the morality of another's choice, including the detection of norm-violating outcomes, the extent to which an agent caused an outcome, and the extent to which the agent intended good or bad consequences, as inferred from observing their decisions. However, person-centered accounts of moral judgment suggest that a motivation to infer the moral character of others can itself impact on an evaluation of their choices. Building on this person-centered account, we examine whether inferences about agents' moral character shape the sensitivity of moral judgments to the consequences of agents' choices, and agents' role in the causation of those consequences. Participants observed and judged sequences of decisions made by agents who were either bad or good, where each decision entailed a trade-off between personal profit and pain for an anonymous victim. Across trials we manipulated the magnitude of profit and pain resulting from the agent's decision (consequences), and whether the outcome was caused via action or inaction (causation). Consistent with previous findings, we found that moral judgments were sensitive to consequences and causation. Furthermore, we show that the inferred character of an agent moderated the extent to which people were sensitive to consequences in their moral judgments. Specifically, participants were more sensitive to the magnitude of consequences in judgments of bad agents' choices relative to good agents' choices. We discuss and interpret these findings within a theoretical framework that views moral judgment as a dynamic process at the intersection of attention and social cognition. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Predicting Consequences of Technological Disasters from Natural Hazard Events: Challenges and Opportunities Associated with Industrial Accident Data Sources

NASA Astrophysics Data System (ADS)

Wood, M.

2009-04-01

The increased focus on the possibility of technological accidents caused by natural events (Natech) is foreseen to continue for years to come. In this case, experts in prevention, mitigation and preparation activities associated with natural events will increasingly need to borrow data and expertise traditionally associated with the technological fields to carry out the work. An important question is how useful is the data for understanding consequences from such natech events. Data and case studies provided on major industrial accidents tend to focus on lessons learned for re-engineering the process. While consequence data are reported at least nominally in most reports, their precision, quality and completeness is often lacking. Consequences that are often or sometimes available but not provided can include severity and type of injuries, distance of victims from the source, exposure measurements, volume of the release, population in potentially affected zones, and weather conditions. Yet these are precisely the type of data that will aid natural hazard experts in land-use planning and emergency response activities when a Natech event may be foreseen. This work discusses the results of a study of consequence data from accidents involving toxic releases reported in the EU's MARS accident database. The study analysed the precision, quality and completeness of three categories of consequence data reported: the description of health effects, consequence assessment and chemical risk assessment factors, and emergency response information. This work reports on the findings from this study and discusses how natural hazards experts might interact with industrial accident experts to promote more consistent and accurate reporting of the data that will be useful in consequence-based activities.

One rule for the goose, one for the gander? Wrongfulness and harmfulness in determining reactions to offenders and victims of crime

PubMed Central

Lens, Kim M. E.; van Doorn, Janne; Pemberton, Antony; Lahlah, Esmah; Bogaerts, Stefan

2016-01-01

People’s reactions to offenders and victims of crime follow different rationales. Whereas the punishment of the offender is primarily determined by the severity of the crime (which includes its foreseeable harmful consequences), the actual harm that is experienced by the victim drives the need for his or her support and assistance. With the introduction of the Victim Impact Statement (VIS), in which victims are allowed to express the (harmful) consequences of the crime on their lives, the question is raised whether allowing such victim input during criminal proceedings would influence the offender’s sentence. The main goal of the current research is to disentangle how a crime’s wrongfulness and harmfulness influence people’s reactions to offenders and victims. We show that, whereas people’s perceptions of the offender (and the outcome of the trial) are influenced by the severity of the crime, people’s judgements related to the victim are more likely to be influenced by an interaction between the severity of the crime and the experienced harm of the crime. That is, in this study no support was found for the argument that the delivery of a VIS would lead to a violation of the proportionality principle. PMID:28579923

Consequences of Arizona's immigration policy on social capital among Mexican mothers with unauthorized immigration status

PubMed Central

Valdez, Carmen R.; Padilla, Brian; Valentine, Jessa Lewis

2013-01-01

This study explores the consequences of increasingly restrictive immigration policies on social capital among Mexican mothers with unauthorized immigrant status in Arizona. Three focus groups conducted in Arizona explore how mothers’ experiences with immigration policies have affected their neighborhood, community, and family ties. Focus group content and interactions revealed that perceived racial profiling was common among mothers and led to fear of family separation. Several described direct experiences with detention and deportation. Although detention and deportation strengthened social ties between mothers and other unauthorized immigrants, these experiences were detrimental to social ties between mothers and members of the mainstream society, including their children's teachers. Finally, immigration policies were perceived to affect parent-child ties negatively, as mothers reported family stress, financial hardship, and decreased parental availability. PMID:24371370

Restriction fragment length polymorphisms in dairy and beef cattle at the growth hormone and prolactin loci.

PubMed

Hallerman, E M; Nave, A; Kashi, Y; Holzer, Z; Soller, M; Beckmann, J S

1987-01-01

Two bovine populations, a Holstein-Friesian dairy stock and a synthetic (Baladi X Hereford X Simmental X Charolais) beef stock, were screened for restriction fragment length polymorphisms (RFLPs) at the growth hormone and prolactin genes. Most RFLPs at the growth hormone gene are apparently the consequence of an insertion/deletion event which was localized to a region downstream of the structural gene. The restriction map for the genomic region including the growth hormone gene was extended. Two HindIII RFLPs at the growth hormone locus, as well as several RFLPs at the prolactin gene, seemed to be the consequence of a series of point mutations. The results are discussed in terms of the possibility that minor genomic variability underlies quantitative genetic variation.

Chromophores in human skin

NASA Astrophysics Data System (ADS)

Young, Antony R.

1997-05-01

Human skin, especially the epidermis, contains several major solar ultraviolet-radiation- (UVR-) absorbing endogenous chromophores including DNA, urocanic acid, amino acids, melanins and their precursors and metabolites. The lack of solubility of melanins prevents their absorption spectra being defined by routine techniques. Indirect spectroscopic methods show that their spectral properties depend on the stimulus for melanogenesis. The photochemical consequences of UVR absorption by some epidermal chromophores are relatively well understood whereas we lack a detailed understanding of the consequent photobiological and clinical responses. Skin action spectroscopy is not a reliable way of relating a photobiological outcome to a specific chromophore but is important for UVR hazard assessment. Exogenous chromophores may be administered to the skin in combination with UVR exposure for therapeutic benefit, or as sunscreens for the prevention of sunburn and possibly skin cancer.

The Short Inventory of Problems – Revised (SIP-R): Psychometric properties within a large, diverse sample of substance use disorder treatment seekers

PubMed Central

Kiluk, Brian D.; Dreifuss, Jessica A.; Weiss, Roger D.; Morgenstern, Jon; Carroll, Kathleen M.

2012-01-01

Assessment of the adverse consequences of substance use serves an important function in both clinical and research settings, yet there is no universally agreed upon measure of consequences relevant to multiple types of substance use disorders. One of the most commonly used measures, the Short Inventory of Problems (SIP), has been adapted and evaluated in several specific populations, but evidence of its reliability and validity across broader samples of persons with substance use disorders is needed. This study evaluated the psychometric properties of a revised version of the SIP (SIP-R) in a large combined sample of alcohol and drug use disorder treatment-seekers, with participants pooled from two national, multisite randomized clinical trials. A total of 886 participants across 10 outpatient treatment facilities completed a common assessment battery that included the SIP-R, Addiction Severity Index (ASI), University of Rhode Island Change Assessment (URICA), HIV Risk Behavior Scale (HRBS), and a substance use calendar. Results supported the SIP-R’s internal reliability (α=.95). Confirmatory factor analysis demonstrated that the hypothesized 5-factor model with one higher-order factor produced the best fit. Convergent validity was evident through the SIP-R’s correlation with several composite scores from the ASI and the URICA, and analyses supported its conceptual distinction from quantity indices of drug/alcohol use. The SIP-R also demonstrated an ability to predict treatment retention, with higher scores associated with poorer retention. These results provide support for the SIP-R’s psychometric properties as a measure of consequences across a broad sample of treatment-seeking drug and alcohol users. PMID:22642856

Reply to "transforming oncology care": advancing value, accessing innovation.

PubMed

Paradis, Rebecca

2015-09-01

Alternative payment models in oncology are already successfully standardizing care, curbing costs, and improving the patient experience. Yet, it is unclear whether decision makers are adequately considering patient access to innovation when creating these models, which could have severe consequences for a robust innovation ecosystem and the lives of afflicted patients. The suggested chart includes recommendations on: Allowing for the adoption of new, promising therapies; Promoting the measurement of patient-centered outcomes; and Providing support for personalized medicine.

Quantifying the predictive consequences of model error with linear subspace analysis

USGS Publications Warehouse

White, Jeremy T.; Doherty, John E.; Hughes, Joseph D.

2014-01-01

All computer models are simplified and imperfect simulators of complex natural systems. The discrepancy arising from simplification induces bias in model predictions, which may be amplified by the process of model calibration. This paper presents a new method to identify and quantify the predictive consequences of calibrating a simplified computer model. The method is based on linear theory, and it scales efficiently to the large numbers of parameters and observations characteristic of groundwater and petroleum reservoir models. The method is applied to a range of predictions made with a synthetic integrated surface-water/groundwater model with thousands of parameters. Several different observation processing strategies and parameterization/regularization approaches are examined in detail, including use of the Karhunen-Loève parameter transformation. Predictive bias arising from model error is shown to be prediction specific and often invisible to the modeler. The amount of calibration-induced bias is influenced by several factors, including how expert knowledge is applied in the design of parameterization schemes, the number of parameters adjusted during calibration, how observations and model-generated counterparts are processed, and the level of fit with observations achieved through calibration. Failure to properly implement any of these factors in a prediction-specific manner may increase the potential for predictive bias in ways that are not visible to the calibration and uncertainty analysis process.

Anger: cause or consequence of posttraumatic stress? A prospective study of Dutch soldiers.

PubMed

Lommen, Miriam J J; Engelhard, Iris M; van de Schoot, Rens; van den Hout, Marcel A

2014-04-01

Many studies have shown that individuals with posttraumatic stress disorder (PTSD) experience more anger over time and across situations (i.e., trait anger) than trauma-exposed individuals without PTSD. There is a lack of prospective research, however, that considers anger levels before trauma exposure. The aim of this study was to prospectively assess the relationship between trait anger and PTSD symptoms, with several known risk factors, including baseline symptoms, neuroticism, and stressor severity in the model. Participants were 249 Dutch soldiers tested approximately 2 months before and approximately 2 months and 9 months after their deployment to Afghanistan. Trait anger and PTSD symptom severity were measured at all assessments. Structural equation modeling including cross-lagged effects showed that higher trait anger before deployment predicted higher PTSD symptoms 2 months after deployment (β = .36), with stressor severity and baseline symptoms in the model, but not with neuroticism in the model. Trait anger at 2 months postdeployment did not predict PTSD symptom severity at 9 months, and PTSD symptom severity 2 months postdeployment did not predict subsequent trait anger scores. Findings suggest that trait anger may be a pretrauma vulnerability factor for PTSD symptoms, but does not add variance beyond the effect of neuroticism. Copyright © 2014 International Society for Traumatic Stress Studies.

[EEG markers of spontaneous recovery of vertical posture in patients with consequences of severe traumatic brain injury].

PubMed

Zhavoronkova, L A; Zharikova, A V; Maksakova, O A

2014-01-01

9 patients (mean age 23.6 +/- 3.15 y.o.) with severe traumatic brain injury (TBI) and impairment of vertical posture were included in complex clinical and EEG study during spontaneous recovery of vertical posture (VP). Patients were included in three different groups according to severity of deficit according to MPAI, FIM and MMSE scales. EEG data have been compared to those of 10 healthy volunteers (mean age 22.8 +/- 0.67 yo.). In patients with moderate brain impairment and fast recovery of VP (over 2 weeks) change of posture from sitting to standup has been accompanied by EEG-signs similar to those of healthy people. These included predominant increase of coherence in right hemisphere for majority of frequency bands, although in more complex conditions EEG of these patients showed pathological signs. In patients with more severe deficit spontaneous recovery of VP has been accompanied by "hyper-reactive" change of EEG for all frequency bands without local specificity. This finding didn't depend on side ofbrain impairment and could be considered as marker of positive dynamics of VP restoration. In patients with most severe brain impairment and deficit of functions VP didn't recover after 3 month of observation. EEG-investigation has revealed absence of reactive change of EEG during passive verticalisation. This finding can be used as marker of negative prognosis.

Evaluation of Unintended Social and Economic Consequences of an Unplanned School Closure in Rural Illinois

ERIC Educational Resources Information Center

Tsai, Victoria; Khan, Nomana M.; Shi, Jianrong; Rainey, Jeanette; Gao, Hongjiang; Zheteyeva, Yenlik

2017-01-01

Background: School closure is one of the primary measures considered during severe influenza pandemics and other emergencies. However, prolonged school closures may cause unintended adverse consequences to schools, students, and their families. A better understanding of these consequences will inform prepandemic planning, and help public health…

Digital Disturbances, Disorders, and Pathologies: A Discussion of Some Unintended Consequences of Technology in Higher Education

ERIC Educational Resources Information Center

Haughton, Noela A.; Yeh, Kuo-Chuan; Nworie, John; Romero, Liz

2013-01-01

As with any innovation, the adoption and diffusion of digital technologies in higher education have also brought unintended consequences. This article discusses the unintended misuse of these technologies in the higher education setting. Depending upon severity, these consequences discussed--distraction, addiction, academic dishonesty, and…

Effects of sexual assault on alcohol use and consequences among young adult sexual minority women

PubMed Central

Rhew, Isaac. C.; Stappenbeck, Cynthia A.; Bedard-Gilligan, Michele; Hughes, Tonda; Kaysen, Debra

2017-01-01

Objective The purpose of this study was to examine effects of sexual assault victimization on later typical alcohol use and alcohol-related consequences among young sexual minority women (SMW). Method Data were collected over four annual assessments from a national sample of 1,057 women who identified as lesbian or bisexual and were 18 to 25 years-old at baseline. Marginal structural modeling, an analytic approach that accounts for time-varying confounding through the use of inverse probability weighting, was used to examine effects of sexual assault and its severity (none, moderate, severe) on typical weekly number of drinks consumed and number of alcohol-related consequences one-year later as well as two-year cumulative sexual assault severity on alcohol outcomes at 36-month follow-up. Results Findings showed that compared to not experiencing any sexual assault, severe sexual assault at the prior assessment was associated with a 71% higher number of typical weekly drinks (Count Ratio [CR] = 1.71; 95% confidence interval [CI]: 1.27, 2.31) and 63% higher number of alcohol-related consequences (CR = 1.63; 95% CI: 1.21, 2.20). Effects were attenuated when comparing moderate to no sexual assault; however, the linear trend across sexual assault categories was statistically significant for both outcomes. There were also effects of cumulative levels of sexual assault severity over two years on increased typical drinking and alcohol-related consequences at end of follow-up. Conclusions Sexual assault may be an important cause of alcohol misuse among SMW. These findings further highlight the need for strategies to reduce the risk of sexual assault among SMW. PMID:28287804

Effects of sexual assault on alcohol use and consequences among young adult sexual minority women.

PubMed

Rhew, Isaac C; Stappenbeck, Cynthia A; Bedard-Gilligan, Michele; Hughes, Tonda; Kaysen, Debra

2017-05-01

The purpose of this study was to examine effects of sexual assault victimization on later typical alcohol use and alcohol-related consequences among young sexual minority women (SMW). Data were collected over 4 annual assessments from a national sample of 1,057 women who identified as lesbian or bisexual and were 18- to 25-years-old at baseline. Marginal structural modeling, an analytic approach that accounts for time-varying confounding through the use of inverse probability weighting, was used to examine effects of sexual assault and its severity (none, moderate, severe) on typical weekly number of drinks consumed and number of alcohol-related consequences 1-year later as well as 2-year cumulative sexual assault severity on alcohol outcomes at 36-month follow-up. Findings showed that compared with not experiencing any sexual assault, severe sexual assault at the prior assessment was associated with a 71% higher number of typical weekly drinks (count ratio [CR] = 1.71; 95% confidence interval [CI] [1.27, 2.31]) and 63% higher number of alcohol-related consequences (CR = 1.63; 95% CI [1.21, 2.20]). Effects were attenuated when comparing moderate to no sexual assault; however, the linear trend across sexual assault categories was statistically significant for both outcomes. There were also effects of cumulative levels of sexual assault severity over 2 years on increased typical drinking and alcohol-related consequences at end of follow-up. Sexual assault may be an important cause of alcohol misuse among SMW. These findings further highlight the need for strategies to reduce the risk of sexual assault among SMW. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The severe hypercholesterolemia phenotype: clinical diagnosis, management, and emerging therapies.

PubMed

Sniderman, Allan D; Tsimikas, Sotirios; Fazio, Sergio

2014-05-20

The severe hypercholesterolemia phenotype includes all patients with marked elevation of low-density lipoprotein cholesterol (LDL-C) levels. The most common cause is autosomal dominant hypercholesterolemia, an inherited disorder caused by mutations either in LDL receptor, apolipoprotein B (APOB), or proprotein convertase subtilisin kexin type 9 (PCSK9) genes. However, it is now known that many subjects with severe inherited hypercholesterolemia have no defects in these genes. These cases are caused either by mutations in genes yet to be identified or are consequences of polygenic, epigenetic, or acquired defects. Because the clinical consequences of extreme hypercholesterolemia are the same no matter the cause, the focus should be on the identification of subjects with severe hypercholesterolemia, followed by phenotypic screening of family members. Genetic screening is not necessary to diagnose or initiate treatment for the severe hypercholesterolemia phenotype. Management of severe hypercholesterolemia is based on risk factor modification and use of multiple lipid-lowering medications. Lipoprotein apheresis is indicated for coronary artery disease (CAD) patients taking maximally tolerated therapy and with LDL-C levels >200 mg/dl (>300 mg/dl if without CAD). A microsomal triglyceride transfer protein inhibitor and an antisense oligonucleotide against APOB have recently been approved for use in subjects with clinically diagnosed homozygous familial hypercholesterolemia. PCSK9 inhibitors, currently in phase II and III trials, lower LDL-C up to an additional 70% in the setting of maximally tolerated medical therapy and have the potential to reduce LDL-C to <70 mg/dl in most patients. Early identification of affected individuals and aggressive treatment should significantly reduce the burden of cardiovascular disease in society. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.

PubMed

Donovan, Dennis M; Kivlahan, Daniel R; Doyle, Suzanne R; Longabaugh, Richard; Greenfield, Shelly F

2006-12-01

To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and 'zones' suggested by the World Health Organization for defining levels of severity of alcohol use problems. Participants were classified into AUDIT zones (AUDIT total score = 8-15, 16-19, 20-40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Eleven out-patient academic clinical research centers across the United States. Participants Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.

Biomining of metals: how to access and exploit natural resource sustainably.

PubMed

Jerez, Carlos A

2017-09-01

Mining activities have been carried out for thousands of years and nowadays have an enormous worldwide use to obtain important metals of industrial use. These include copper, iron, gold and several others. Although modern mining companies have sustainable mining programs that include tailings management and external verifications, it is recognized that these industrial activities are responsible for a significant damage to the environment. Specially, technologies such as smelting and roasting generate very toxic emissions, including solid particles in the air, very large tailings and contribute to generate acid mine drainage (AMD) that affects humans health and all kinds of living plants, animals and microorganisms. Consequently, due to environmental restrictions, these methods are being replaced in many countries by less contaminating processes. On the other hand, the microbial solubilization of metals by bioleaching or biomining is successfully used in industrial operations, to extract several metals such as copper, gold and uranium. © 2017 The Author. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

Speech and Language Consequences of Unilateral Hearing Loss: A Systematic Review.

PubMed

Anne, Samantha; Lieu, Judith E C; Cohen, Michael S

2017-10-01

Objective Unilateral hearing loss has been shown to have negative consequences for speech and language development in children. The objective of this study was to systematically review the current literature to quantify the impact of unilateral hearing loss on children, with the use of objective measures of speech and language. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to March 2015. Manual searches of references were also completed. Review Methods All studies that described speech and language outcomes for children with unilateral hearing loss were included. Outcome measures included results from any test of speech and language that evaluated or had age-standardized norms. Due to heterogeneity of the data, quantitative analysis could not be completed. Qualitative analysis was performed on the included studies. Two independent evaluators reviewed each abstract and article. Results A total of 429 studies were identified; 13 met inclusion criteria and were reviewed. Overall, 7 studies showed poorer scores on various speech and language tests, with effects more pronounced for children with severe to profound hearing loss. Four studies did not demonstrate any difference in testing results between patients with unilateral hearing loss and those with normal hearing. Two studies that evaluated effects on speech and language longitudinally showed initial speech problems, with improvement in scores over time. Conclusions There are inconsistent data regarding effects of unilateral hearing loss on speech and language outcomes for children. The majority of recent studies suggest poorer speech and language testing results, especially for patients with severe to profound unilateral hearing loss.

[Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

PubMed

Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences. © Georg Thieme Verlag KG Stuttgart · New York.

Preliminary results of consequence assessment of a hypothetical severe accident using Thai meteorological data

NASA Astrophysics Data System (ADS)

Silva, K.; Lawawirojwong, S.; Promping, J.

2017-06-01

Consequence assessment of a hypothetical severe accident is one of the important elements of the risk assessment of a nuclear power plant. It is widely known that the meteorological conditions can significantly influence the outcomes of such assessment, since it determines the results of the calculation of the radionuclide environmental transport. This study aims to assess the impacts of the meteorological conditions to the results of the consequence assessment. The consequence assessment code, OSCAAR, of Japan Atomic Energy Agency (JAEA) is used for the assessment. The results of the consequence assessment using Thai meteorological data are compared with those using Japanese meteorological data. The Thai case has following characteristics. Low wind speed made the radionuclides concentrate at the center comparing to the Japanese case. The squalls induced the peaks in the ground concentration distribution. The evacuated land is larger than the Japanese case though the relocated land is smaller, which is attributed to the concentration of the radionuclides near the release point.

Paper 8775 - Integrating Natural Resources and Ecological Science into the Disaster Risk CYCLE: Lessons Learned and Future Directions

NASA Astrophysics Data System (ADS)

Brosnan, D. M.

2014-12-01

Familiar to disaster risk reduction (DRR) scientists and professionals, the disaster cycle is an adaptive approach that involves planning, response and learning for the next event. It has proven effective in saving lives and helping communities around the world deal with natural and other hazards. But it has rarely been applied to natural resource and ecological science, despite the fact that many communities are dependent on these resources. This presentation will include lessons learned from applying science to tackle ecological consequences in several disasters in the US and globally, including the Colorado Floods, the SE Asia tsunami, the Montserrat volcanic eruption, and US SAFRR tsunami scenario. The presentation discusses the role that science and scientists can play at each phase of the disaster cycle. The consequences of not including disaster cycles in the management of natural systems leaves these resources and the huge investments made to protect highly vulnerable. The presentation discusses how The presentation discusses how science can help government and communities in planning and responding to these events. It concludes with a set of lessons learned and guidlines for moving forward.

Repartnering and (Re)employment: Strategies to Cope with the Economic Consequences of Partnership Dissolution

ERIC Educational Resources Information Center

Jansen, Mieke; Mortelmans, Dimitri; Snoeckx, Laurent

2009-01-01

The economic consequences of a partnership dissolution have been described consistently in the research literature. For women all studies indicate severe financial losses, whereas men do not experience income decreases to the same extent. This article focuses on the 2 main strategies to cope with the economic consequences of a separation:…

An Alternative Perspective on von Winterfeldt et al.'s (1997) Test of Consequence Monotonicity

ERIC Educational Resources Information Center

Ho, Moon-Ho R.; Regenwetter, Michel; Niederee, Reinhard; Heyer, Dieter

2005-01-01

D. von Winterfeldt, N.-K. Chung, R. D. Luce, and Y. Cho (see record 1997-03378-008) provided several tests for consequence monotonicity of choice or judgment, using certainty equivalents of gambles. The authors reaxiomatized consequence monotonicity in a probabilistic framework and reanalyzed von Winterfeldt et al.'s main experiment via a…

Exocrine pancreatic insufficiency in diabetes mellitus: a complication of diabetic neuropathy or a different type of diabetes?

PubMed

Hardt, Philip D; Ewald, Nils

2011-01-01

Pancreatic exocrine insufficiency is a frequently observed phenomenon in type 1 and type 2 diabetes mellitus. Alterations of exocrine pancreatic morphology can also be found frequently in diabetic patients. Several hypotheses try to explain these findings, including lack of insulin as a trophic factor for exocrine tissue, changes in secretion and/or action of other islet hormones, and autoimmunity against common endocrine and exocrine antigens. Another explanation might be that diabetes mellitus could also be a consequence of underlying pancreatic diseases (e.g., chronic pancreatitis). Another pathophysiological concept proposes the functional and morphological alterations as a consequence of diabetic neuropathy. This paper discusses the currently available studies on this subject and tries to provide an overview of the current concepts of exocrine pancreatic insufficiency in diabetes mellitus.

Social opinion dynamics is not chaotic

NASA Astrophysics Data System (ADS)

Lim, Chjan; Zhang, Weituo

2016-08-01

Motivated by the research on social opinion dynamics over large and dense networks, a general framework for verifying the monotonicity property of multi-agent dynamics is introduced. This allows a derivation of sociologically meaningful sufficient conditions for monotonicity that are tailor-made for social opinion dynamics, which typically have high nonlinearity. A direct consequence of monotonicity is that social opinion dynamics is nonchaotic. A key part of this framework is the definition of a partial order relation that is suitable for a large class of social opinion dynamics such as the generalized naming games. Comparisons are made to previous techniques to verify monotonicity. Using the results obtained, we extend many of the consequences of monotonicity to this class of social dynamics, including several corollaries on their asymptotic behavior, such as global convergence to consensus and tipping points of a minority fraction of zealots or leaders.

Locality of the Thomas-Fermi-von Weizsäcker Equations

NASA Astrophysics Data System (ADS)

Nazar, F. Q.; Ortner, C.

2017-06-01

We establish a pointwise stability estimate for the Thomas-Fermi-von Weiz-säcker (TFW) model, which demonstrates that a local perturbation of a nuclear arrangement results also in a local response in the electron density and electrostatic potential. The proof adapts the arguments for existence and uniqueness of solutions to the TFW equations in the thermodynamic limit by Catto et al. (The mathematical theory of thermodynamic limits: Thomas-Fermi type models. Oxford mathematical monographs. The Clarendon Press, Oxford University Press, New York, 1998). To demonstrate the utility of this combined locality and stability result we derive several consequences, including an exponential convergence rate for the thermodynamic limit, partition of total energy into exponentially localised site energies (and consequently, exponential locality of forces), and generalised and strengthened results on the charge neutrality of local defects.

Case report: Ribavirin and vitamin A in a severe case of measles.

PubMed

Bichon, Amandine; Aubry, Camille; Benarous, Lucas; Drouet, Hortense; Zandotti, Christine; Parola, Philippe; Lagier, Jean-Christophe

2017-12-01

Despite a vaccine being widely available, measles continues to occur frequently, with sometimes lethal consequences. The mortality rate reaches 35% and measles represents 44% of the 1.4 million deaths which are due to preventable diseases. Severe forms of measles are reported, mainly in young, unvaccinated adults, and in specific populations. The risk factors for severe measles include no or incomplete vaccination and vitamin A deficiency. Apart from secondary measles-related infections, severe measles is mainly represented by neurological, respiratory, and digestive symptoms. Strengthening the hypothesis that there is a link between vitamin A deficiency and severe measles in this paper we report the case of a 25-year-old unvaccinated man hospitalized for severe and complicated measles. The evolution was good after administration of intramuscular vitamin A as well as intravenous ribavirin. Measles remains a fatal and serious disease. The early use of ribavirin and vitamin A shows significant improvements regarding morbimortality and should be systematic in severe cases. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Tracer-Encapsulated Solid Pellet (TESPEL) Injection System for the TJ-II Stellarator

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

Tamura, N.; McCarthy, K. J.; Hayashi, H.

2016-01-01

A tracer-encapsulated solid pellet (TESPEL) injection system for the TJ-II stellarator was recently developed. In order to reduce the time and cost for the development, we combined a TESPEL injector provided by National Institute for Fusion Science with an existing TJ-II cryogenic pellet injection system. Consequently, the TESPEL injection into the TJ-II plasma was successfully achieved, which was confirmed by several pellet diagnostics including a normal-incidence spectrometer for monitoring a tracer impurity behavior.

A Survey of Doctoral Programs in Chemical Education in the United States

NASA Astrophysics Data System (ADS)

Mason, Diana

2001-02-01

Employment opportunities are expanding in chemical education and chemical education research. Consequently, more students are seeking to further their education in chemistry by obtaining tertiary degrees in chemical education. At the Fall 2000 ACS Meeting in Washington, DC, DivCHED sponsored a symposium highlighting several doctoral programs in chemical education in the U.S. Included in this summary is the following information regarding each program: name of university, faculty contact(s), corresponding email addresses and URLs, and a brief description of the program.

Another short and elementary proof of strong subadditivity of quantum entropy

NASA Astrophysics Data System (ADS)

Ruskai, Mary Beth

2007-08-01

A short and elementary proof of the joint convexity of relative entropy is presented, using nothing beyond linear algebra. The key ingredients are an easily verified integral representation and the strategy used to prove the Cauchy-Schwarz inequality in elementary courses. Several consequences are proved in a way which allows an elementary proof of strong subadditivity in a few more lines. Some expository material on Schwarz inequalities for operators and the Holevo bound for partial measurements is also included.

Ancient bacterial endosymbionts of insects: Genomes as sources of insight and springboards for inquiry.

PubMed

Wernegreen, Jennifer J

2017-09-15

Ancient associations between insects and bacteria provide models to study intimate host-microbe interactions. Currently, a wealth of genome sequence data for long-term, obligately intracellular (primary) endosymbionts of insects reveals profound genomic consequences of this specialized bacterial lifestyle. Those consequences include severe genome reduction and extreme base compositions. This minireview highlights the utility of genome sequence data to understand how, and why, endosymbionts have been pushed to such extremes, and to illuminate the functional consequences of such extensive genome change. While the static snapshots provided by individual endosymbiont genomes are valuable, comparative analyses of multiple genomes have shed light on evolutionary mechanisms. Namely, genome comparisons have told us that selection is important in fine-tuning gene content, but at the same time, mutational pressure and genetic drift contribute to genome degradation. Examples from Blochmannia, the primary endosymbiont of the ant tribe Camponotini, illustrate the value and constraints of genome sequence data, and exemplify how genomes can serve as a springboard for further comparative and experimental inquiry. Copyright © 2017. Published by Elsevier Inc.

Good behavior game: effects of individual contingencies for group consequences on disruptive behavior in a classroom1

PubMed Central

Barrish, Harriet H.; Saunders, Muriel; Wolf, Montrose M.

1969-01-01

Out-of-seat and talking-out behaviors were studied in a regular fourth-grade class that included several “problem children”. After baseline rates of the inappropriate behaviors were obtained, the class was divided into two teams “to play a game”. Each out-of-seat and talking-out response by an individual child resulted in a mark being placed on the chalkboard, which meant a possible loss of privileges by all members of the student's team. In this manner a contingency was arranged for the inappropriate behavior of each child while the consequence (possible loss of privileges) of the child's behavior was shared by all members of this team as a group. The privileges were events which are available in almost every classroom, such as extra recess, first to line up for lunch, time for special projects, stars and name tags, as well as winning the game. The individual contingencies for the group consequences were successfully applied first during math period and then during reading period. The experimental analysis involved elements of both reversal and multiple baseline designs. PMID:16795208

Epidemiology, geographical distribution, and economic consequences of swine zoonoses: a narrative review

PubMed Central

Uddin Khan, Salah; Atanasova, Kalina R; Krueger, Whitney S; Ramirez, Alejandro; Gray, Gregory C

2013-01-01

We sought to review the epidemiology, international geographical distribution, and economic consequences of selected swine zoonoses. We performed literature searches in two stages. First, we identified the zoonotic pathogens associated with swine. Second, we identified specific swine-associated zoonotic pathogen reports for those pathogens from January 1980 to October 2012. Swine-associated emerging diseases were more prevalent in the countries of North America, South America, and Europe. Multiple factors were associated with the increase of swine zoonoses in humans including: the density of pigs, poor water sources and environmental conditions for swine husbandry, the transmissibility of the pathogen, occupational exposure to pigs, poor human sanitation, and personal hygiene. Swine zoonoses often lead to severe economic consequences related to the threat of novel pathogens to humans, drop in public demand for pork, forced culling of swine herds, and international trade sanctions. Due to the complexity of swine-associated pathogen ecology, designing effective interventions for early detection of disease, their prevention, and mitigation requires an interdisciplinary collaborative “One Health” approach from veterinarians, environmental and public health professionals, and the swine industry. PMID:26038451

The costs of chronic noise exposure for terrestrial organisms.

PubMed

Barber, Jesse R; Crooks, Kevin R; Fristrup, Kurt M

2010-03-01

Growth in transportation networks, resource extraction, motorized recreation and urban development is responsible for chronic noise exposure in most terrestrial areas, including remote wilderness sites. Increased noise levels reduce the distance and area over which acoustic signals can be perceived by animals. Here, we review a broad range of findings that indicate the potential severity of this threat to diverse taxa, and recent studies that document substantial changes in foraging and anti-predator behavior, reproductive success, density and community structure in response to noise. Effective management of protected areas must include noise assessment, and research is needed to further quantify the ecological consequences of chronic noise exposure in terrestrial environments.

The metabolic syndrome: validity and utility of clinical definitions for cardiovascular disease and diabetes risk prediction.

PubMed

Cameron, Adrian

2010-02-01

The purpose of clinical definitions of the metabolic syndrome is frequently misunderstood. While the metabolic syndrome as a physiological process describes a clustering of numerous age-related metabolic abnormalities that together increase the risk for cardiovascular disease and type 2 diabetes, clinical definitions include obesity which is thought to be a cause rather than a consequence of metabolic disturbance, and several elements that are routinely measured in clinical practice, including high blood pressure, high blood glucose and dyslipidaemia. Obesity is frequently a central player in the development of the metabolic syndrome and should be considered a key component of clinical definitions. Previous clinical definitions have differed in the priority given to obesity. Perhaps more importantly than its role in a clinical definition, however, is obesity in isolation before the hallmarks of metabolic dysfunction that typify the syndrome have developed. This should be treated seriously as an opportunity to prevent the consequences of the global diabetes epidemic now apparent. Clinical definitions were designed to identify a population at high lifetime CVD and type 2 diabetes risk, but in the absence of several major risk factors for each condition, are not optimal risk prediction devices for either. Despite this, the metabolic syndrome has several properties that make it a useful construct, in conjunction with short-term risk prediction algorithms and sound clinical judgement, for the identification of those at high lifetime risk of CVD and diabetes. A recently published consensus definition provides some much needed clarity about what a clinical definition entails. Even this, however, remains a work in progress until more evidence becomes available, particularly in the area of ethnicity-specific waist cut-points. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Herbicides implicated as the cause of severe mangrove dieback in the Mackay region, NE Australia: consequences for marine plant habitats of the GBR World Heritage Area.

PubMed

Duke, Norman C; Bell, Alicia M; Pederson, Dan K; Roelfsema, Chris M; Bengtson Nash, Susan

2005-01-01

Herbicides, particularly diuron, were correlated with severe and widespread dieback of the dominant mangrove, Avicennia marina (Forsk.) Vierh. var. eucalyptifolia (Val.) N.C. Duke (Avicenniaceae), its reduced canopy condition, and declines in seedling health within three neighbouring estuaries in the Mackay region of NE Australia. This unusual species-specific dieback, first observed in the early 1990s, had gotten notably worse by 2002 to affect >30 km(2) of mangroves in at least five adjacent estuaries in the region. Over the past century, agricultural production has responded well to the demands of increasing population with improvements in farm efficiency assisted by significant increases in the use of agricultural chemicals. However, with regular and episodic river flow events, these chemicals have sometimes found their way into estuarine and nearshore water and sediments where their effects on marine habitats have been largely unquantified. Investigations over the last three years in the Mackay region provide compelling evidence of diuron, and possibly other agricultural herbicides, as the most likely cause of the severe and widespread mangrove dieback. The likely consequences of such dieback included declines in coastal water quality with increased turbidity, nutrients and sediment deposition, as well as further dispersal of the toxic chemicals. The implications of such findings are immense since they describe not only the serious deterioration of protected and beneficial mangrove habitat but also the potential for significant direct and indirect effects on other highly-valued estuarine and marine habitats in the region, including seagrass beds and coral reefs of the Great Barrier Reef lagoon. This article reviews all key findings and observations to date and describes the essential correlative and causative evidence.

Effects of severe obstetric complications on women’s health and infant mortality in Benin

PubMed Central

Filippi, Véronique; Goufodji, Sourou; Sismanidis, Charalambos; Kanhonou, Lydie; Fottrell, Edward; Ronsmans, Carine; Alihonou, Eusèbe; Patel, Vikram

2010-01-01

Summary Objective To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences. Methods Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months. Results The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9–17.0)], fever [adjusted OR = 1.71 (1.1–2.8)] and infant mortality [adjusted OR = 11.0 (0.8–158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3–9.0)], urine leakages [adjusted OR = 2.7 (1.2–5.8)], and to report poor health [adjusted OR = 5.27 (2.2–12.4)] and pregnancy’s negative effects on their life [adjusted OR = 4.11 (1.9–9.0)]. Uptake of post-natal services was poor in all groups. Conclusion Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group. PMID:20406426

Effects of severe obstetric complications on women's health and infant mortality in Benin.

PubMed

Filippi, Véronique; Goufodji, Sourou; Sismanidis, Charalambos; Kanhonou, Lydie; Fottrell, Edward; Ronsmans, Carine; Alihonou, Eusèbe; Patel, Vikram

2010-06-01

To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences. Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months. The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9-17.0)], fever [adjusted OR = 1.71 (1.1-2.8)] and infant mortality [adjusted OR = 11.0 (0.8-158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3-9.0)], urine leakages [adjusted OR = 2.7 (1.2-5.8)], and to report poor health [adjusted OR = 5.27 (2.2-12.4)] and pregnancy's negative effects on their life [adjusted OR = 4.11 (1.9-9.0)]. Uptake of post-natal services was poor in all groups. Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group.

The Effects of Consequence Manipulation during Functional Analysis of Problem Behavior Maintained by Negative Reinforcement

ERIC Educational Resources Information Center

Potoczak, Kathryn; Carr, James E.; Michael, Jack

2007-01-01

Two distinct analytic methods have been used to identify the function of problem behavior. The antecedent-behavior-consequence (ABC) method (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) includes the delivery of consequences for problem behavior. The AB method (Carr & Durand, 1985) does not include consequence delivery, instead relying…

Non-alcoholic fatty liver disease (NAFLD) potentiates autoimmune hepatitis in the CYP2D6 mouse model.

PubMed

Müller, Peter; Messmer, Marie; Bayer, Monika; Pfeilschifter, Josef M; Hintermann, Edith; Christen, Urs

2016-05-01

Non-alcoholic fatty liver disease (NAFLD) and its more severe development non-alcoholic steatohepatitis (NASH) are increasing worldwide. In particular NASH, which is characterized by an active hepatic inflammation, has often severe consequences including progressive fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). Here we investigated how metabolic liver injury is influencing the pathogenesis of autoimmune hepatitis (AIH). We used the CYP2D6 mouse model in which wild type C57BL/6 mice are infected with an Adenovirus expressing the major liver autoantigen cytochrome P450 2D6 (CYP2D6). Such mice display several features of human AIH, including interface hepatitis, formation of LKM-1 antibodies and CYP2D6-specific T cells, as well as hepatic fibrosis. NAFLD was induced with a high-fat diet (HFD). We found that pre-existing NAFLD potentiates the severity of AIH. Mice fed for 12 weeks with a HFD displayed increased cellular infiltration of the liver, enhanced hepatic fibrosis and elevated numbers of liver autoantigen-specific T cells. Our data suggest that a pre-existing metabolic liver injury constitutes an additional risk for the severity of an autoimmune condition of the liver, such as AIH. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-term ocular consequences of sulfur mustard in seriously eye-injured war veterans.

PubMed

Ghasemi, Hassan; Ghazanfari, Tooba; Ghassemi-Broumand, Mohammad; Javadi, Mohammad Ali; Babaei, Mahmoud; Soroush, Mohammad Reza; Yaraee, Roya; Faghihzadeh, Soghrat; Poorfarzam, Shahriar; Owlia, Parviz; Naghizadeh, Mohammad Mehdi; Etezad-Razavi, Mohammad; Jadidi, Khosro; Naderi, Mostafa; Hassan, Zuhair Mohammad

2009-01-01

Sulfur mustard (SM) has been used as a dangerous chemical warfare agent since the early 20th century. Although many descriptive studies about SM-induced ocular injuries are present in the medical literature, few of them have been conducted over a large group with serious ocular involvement. This descriptive study was conducted on 149 severe SM-intoxicated war veterans. Ocular history, anterior and posterior segment findings using a slit lamp, and direct and indirect ophthalmoscopic findings were recorded. Severity of the disease was also recorded based on a chart of the Foundation of Martyrs and Veterans Affairs. Ocular complains included photophobia (73.2%), sense of decreased vision (72.5%), dry eye sensation (66.4%), foreign body sensation (61.1%), tearing (46.3%), and pain (43.0%). Slit lamp findings were meibomian gland dysfunction (MGD; 96%), blepharitis, punctal closure, trichiasis, tear break-up time, and tear meniscus layer abnormality (80% to 90%). Conjunctival disturbances included vascular abnormality, ischemia, hyperemia, subconjunctival fibrosis, and pterygium. Limbal changes were abnormal vessels, limbal tissue loss and pigment loss, and pannus formation. Corneal problems included epithelial and stromal disturbances, calcium deposition, and melting. The most frequent previous surgeries were punctal closure, lamellar keratoplasty (LK), and stem cell allograft. Severity of intoxication included mild (17%), moderate (25%), and severe (57%). Chronic blepharitis and decreased tear secretion are the 2 most important and influencing factors in progression of ocular problems in SM injuries. The more severe the initial exposure, percentage of disability, and duration of ocular involvement, the higher the likelihood of mustard gas keratopathy.

Prognostic consequences of borderline dysnatremia: pay attention to minimal serum sodium change.

PubMed

Darmon, Michael; Diconne, Eric; Souweine, Bertrand; Ruckly, Stéphane; Adrie, Christophe; Azoulay, Elie; Clec'h, Christophe; Garrouste-Orgeas, Maïté; Schwebel, Carole; Goldgran-Toledano, Dany; Khallel, Hatem; Dumenil, Anne-Sylvie; Jamali, Samir; Cheval, Christine; Allaouchiche, Bernard; Zeni, Fabrice; Timsit, Jean-François

2013-01-21

To assess the prevalence of dysnatremia, including borderline changes in serum sodium concentration, and to estimate the impact of these dysnatremia on mortality after adjustment for confounders. Observational study on a prospective database fed by 13 intensive care units (ICUs). Unselected patients with ICU stay longer than 48 h were enrolled over a 14-year period were included in this study. Mild to severe hyponatremia were defined as serum sodium concentration < 135, < 130, and < 125 mmol/L respectively. Mild to severe hypernatremia were defined as serum sodium concentration > 145, > 150, and > 155 mmol/L respectively. Borderline hyponatremia and hypernatremia were defined as serum sodium concentration between 135 and 137 mmol/L or 143 and 145 respectively. A total of 11,125 patients were included in this study. Among these patients, 3,047 (27.4%) had mild to severe hyponatremia at ICU admission, 2,258 (20.3%) had borderline hyponatremia at ICU admission, 1,078 (9.7%) had borderline hypernatremia and 877 (7.9%) had mild to severe hypernatremia. After adjustment for confounder, both moderate and severe hyponatremia (subdistribution hazard ratio (sHR) 1.82, 95% CI 1.002 to 1.395 and 1.27, 95% CI 1.01 to 1.60 respectively) were associated with day-30 mortality. Similarly, mild, moderate and severe hypernatremia (sHR 1.34, 95% CI 1.14 to 1.57; 1.51, 95% CI 1.15 to 1.99; and 2.64, 95% CI 2.00 to 3.81 respectively) were independently associated with day-30 mortality. One-third of critically ill patients had a mild to moderate dysnatremia at ICU admission. Dysnatremia, including mild changes in serum sodium concentration, is an independent risk factor for hospital mortality and should not be neglected.

Fatigue as a cause, not a consequence of depression and daytime sleepiness: a cross-lagged analysis.

PubMed

Schönberger, Michael; Herrberg, Marlene; Ponsford, Jennie

2014-01-01

To examine the temporal relation between fatigue, depression, and daytime sleepiness after traumatic brain injury. Fatigue is a frequent and disabling consequence of traumatic brain injury (TBI). However, it is unclear whether fatigue is a primary consequence of the structural brain injury or a secondary consequence of injury-related sequelae such as depression and daytime sleepiness. Eighty-eight adults with complicated mild-severe TBI (69% male). Fatigue Severity Scale; depression subscale of the Hospital Anxiety and Depression Scale; Epworth Sleepiness scale at baseline and 6-month follow-up. A cross-lagged path analysis computed within a structural equation modeling framework revealed that fatigue was predictive of depression (β = .20, P < .05) and sleepiness (β = .25, P < .05). However, depression and sleepiness did not predict fatigue (P > .05). The results support the view of fatigue after TBI as "primary fatigue"-that is, a consequence of the structural brain injury rather than a secondary consequence of depression or daytime sleepiness. A rehabilitation approach that assists individuals with brain injury in learning to cope with their neuropsychological and physical limitations in everyday life might attenuate their experience with fatigue.

The Outward Spiral: A vicious cycle model of obesity and cognitive dysfunction.

PubMed

Hargrave, Sara L; Jones, Sabrina; Davidson, Terry L

2016-06-01

Chronic failure to suppress intake during states of positive energy balance leads to weight gain and obesity. The ability to use context - including interoceptive satiety states - to inhibit responding to previously rewarded cues appears to depend on the functional integrity of the hippocampus. Recent evidence implicates energy dense Western diets in several types of hippocampal dysfunction, including reduced expression of neurotrophins and nutrient transporters, increased inflammation, microglial activation, and blood brain barrier permeability. The functional consequences of such insults include impairments in an animal's ability to modulate responding to a previously reinforced cues. We propose that such deficits promote overeating, which can further exacerbate hippocampal dysfunction and thus initiate a vicious cycle of both obesity and progressive cognitive decline.

75 FR 66387 - Endangered and Threatened Wildlife and Plants; Assisting States, Federal Agencies, and Tribes in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

... disease and host ecology, and human dimensions and ecological consequences of WNS; and disseminate... grisescens). The mobility of bats, the potential for human-assisted transmission, and the severe consequences...

Climate change and infectious diseases in North America: the road ahead.

PubMed

Greer, Amy; Ng, Victoria; Fisman, David

2008-03-11

Global climate change is inevitable--the combustion of fossil fuels has resulted in a buildup of greenhouse gases within the atmosphere, causing unprecedented changes to the earth's climate. The Fourth Assessment Report of the Intergovernmental Panel on Climate Change suggests that North America will experience marked changes in weather patterns in coming decades, including warmer temperatures and increased rainfall, summertime droughts and extreme weather events (e.g., tornadoes and hurricanes). Although these events may have direct consequences for health (e.g., injuries and displacement of populations due to thermal stress), they are also likely to cause important changes in the incidence and distribution of infectious diseases, including vector-borne and zoonotic diseases, water-and food-borne diseases and diseases with environmental reservoirs (e.g., endemic fungal diseases). Changes in weather patterns and ecosystems, and health consequences of climate change will probably be most severe in far northern regions (e.g., the Arctic). We provide an overview of the expected nature and direction of such changes, which pose current and future challenges to health care providers and public health agencies.

Climate change and infectious diseases in North America: the road ahead

PubMed Central

Greer, Amy; Ng, Victoria; Fisman, David

2008-01-01

Global climate change is inevitable — the combustion of fossil fuels has resulted in a buildup of greenhouse gases within the atmosphere, causing unprecedented changes to the earth's climate. The Fourth Assessment Report of the Intergovernmental Panel on Climate Change suggests that North America will experience marked changes in weather patterns in coming decades, including warmer temperatures and increased rainfall, summertime droughts and extreme weather events (e.g., tornadoes and hurricanes). Although these events may have direct consequences for health (e.g., injuries and displacement of populations due to thermal stress), they are also likely to cause important changes in the incidence and distribution of infectious diseases, including vector-borne and zoonotic diseases, water-and food-borne diseases and diseases with environmental reservoirs (e.g., endemic fungal diseases). Changes in weather patterns and ecosystems, and health consequences of climate change will probably be most severe in far northern regions (e.g., the Arctic). We provide an overview of the expected nature and direction of such changes, which pose current and future challenges to health care providers and public health agencies. PMID:18332386

Genomic and Molecular Landscape of DNA Damage Repair Deficiency across The Cancer Genome Atlas.

PubMed

Knijnenburg, Theo A; Wang, Linghua; Zimmermann, Michael T; Chambwe, Nyasha; Gao, Galen F; Cherniack, Andrew D; Fan, Huihui; Shen, Hui; Way, Gregory P; Greene, Casey S; Liu, Yuexin; Akbani, Rehan; Feng, Bin; Donehower, Lawrence A; Miller, Chase; Shen, Yang; Karimi, Mostafa; Chen, Haoran; Kim, Pora; Jia, Peilin; Shinbrot, Eve; Zhang, Shaojun; Liu, Jianfang; Hu, Hai; Bailey, Matthew H; Yau, Christina; Wolf, Denise; Zhao, Zhongming; Weinstein, John N; Li, Lei; Ding, Li; Mills, Gordon B; Laird, Peter W; Wheeler, David A; Shmulevich, Ilya; Monnat, Raymond J; Xiao, Yonghong; Wang, Chen

2018-04-03

DNA damage repair (DDR) pathways modulate cancer risk, progression, and therapeutic response. We systematically analyzed somatic alterations to provide a comprehensive view of DDR deficiency across 33 cancer types. Mutations with accompanying loss of heterozygosity were observed in over 1/3 of DDR genes, including TP53 and BRCA1/2. Other prevalent alterations included epigenetic silencing of the direct repair genes EXO5, MGMT, and ALKBH3 in ∼20% of samples. Homologous recombination deficiency (HRD) was present at varying frequency in many cancer types, most notably ovarian cancer. However, in contrast to ovarian cancer, HRD was associated with worse outcomes in several other cancers. Protein structure-based analyses allowed us to predict functional consequences of rare, recurrent DDR mutations. A new machine-learning-based classifier developed from gene expression data allowed us to identify alterations that phenocopy deleterious TP53 mutations. These frequent DDR gene alterations in many human cancers have functional consequences that may determine cancer progression and guide therapy. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Predictive Models of Cognitive Outcomes of Developmental Insults

NASA Astrophysics Data System (ADS)

Chan, Yupo; Bouaynaya, Nidhal; Chowdhury, Parimal; Leszczynska, Danuta; Patterson, Tucker A.; Tarasenko, Olga

2010-04-01

Representatives of Arkansas medical, research and educational institutions have gathered over the past four years to discuss the relationship between functional developmental perturbations and their neurological consequences. We wish to track the effect on the nervous system by developmental perturbations over time and across species. Except for perturbations, the sequence of events that occur during neural development was found to be remarkably conserved across mammalian species. The tracking includes consequences on anatomical regions and behavioral changes. The ultimate goal is to develop a predictive model of long-term genotypic and phenotypic outcomes that includes developmental insults. Such a model can subsequently be fostered into an educated intervention for therapeutic purposes. Several datasets were identified to test plausible hypotheses, ranging from evoked potential datasets to sleep-disorder datasets. An initial model may be mathematical and conceptual. However, we expect to see rapid progress as large-scale gene expression studies in the mammalian brain permit genome-wide searches to discover genes that are uniquely expressed in brain circuits and regions. These genes ultimately control behavior. By using a validated model we endeavor to make useful predictions.

The epidemiology of adult obstructive sleep apnea.

PubMed

Punjabi, Naresh M

2008-02-15

Obstructive sleep apnea is a chronic condition characterized by frequent episodes of upper airway collapse during sleep. Its effect on nocturnal sleep quality and ensuing daytime fatigue and sleepiness are widely acknowledged. Increasingly, obstructive sleep apnea is also being recognized as an independent risk factor for several clinical consequences, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism. Estimates of disease prevalence are in the range of 3% to 7%, with certain subgroups of the population bearing higher risk. Factors that increase vulnerability for the disorder include age, male sex, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol use. Despite the numerous advancements in our understanding of the pathogenesis and clinical consequences of the disorder, a majority of those affected remain undiagnosed. Simple queries of the patient or bed-partner for the symptoms and signs of the disorder, namely, loud snoring, observed apneas, and daytime sleepiness, would help identify those in need of further diagnostic evaluation. The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults.

Ground-level climate at a peatland wind farm in Scotland is affected by wind turbine operation

NASA Astrophysics Data System (ADS)

Armstrong, Alona; Burton, Ralph R.; Lee, Susan E.; Mobbs, Stephen; Ostle, Nicholas; Smith, Victoria; Waldron, Susan; Whitaker, Jeanette

2016-04-01

The global drive to produce low-carbon energy has resulted in an unprecedented deployment of onshore wind turbines, representing a significant land use change for wind energy generation with uncertain consequences for local climatic conditions and the regulation of ecosystem processes. Here, we present high-resolution data from a wind farm collected during operational and idle periods that shows the wind farm affected several measures of ground-level climate. Specifically, we discovered that operational wind turbines raised air temperature by 0.18 °C and absolute humidity (AH) by 0.03 g m-3 during the night, and increased the variability in air, surface and soil temperature throughout the diurnal cycle. Further, the microclimatic influence of turbines on air temperature and AH decreased logarithmically with distance from the nearest turbine. These effects on ground-level microclimate, including soil temperature, have uncertain implications for biogeochemical processes and ecosystem carbon cycling, including soil carbon stocks. Consequently, understanding needs to be improved to determine the overall carbon balance of wind energy.

Inhibition of various gram-positive and gram- negative bacteria growth on selenium nanoparticle coated paper towels

PubMed Central

Wang, Qi; Larese-Casanova, Philip; Webster, Thomas J

2015-01-01

There are wide spread bacterial contamination issues on various paper products, such as paper towels hanging in sink splash zones or those used to clean surfaces, filter papers used in water and air purifying systems, and wrappings used in the food industry; such contamination may lead to the potential spread of bacteria and consequent severe health concerns. In this study, selenium nanoparticles were coated on normal paper towel surfaces through a quick precipitation method, introducing antibacterial properties to the paper towels in a healthy way. Their effectiveness at preventing biofilm formation was tested in bacterial assays involving Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus epidermidis. The results showed significant and continuous bacteria inhibition with about a 90% reduction from 24 to 72 hours for gram-positive bacteria including S. aureus and S. epidermidis. The selenium coated paper towels also showed significant inhibition of gram-negative bacteria like P. aeruginosa and E. coli growth at about 57% and 84%, respectively, after 72 hours of treatment. Therefore, this study established a promising selenium-based antibacterial strategy to prevent bacterial growth on paper products, which may lead to the avoidance of bacteria spreading and consequent severe health concerns. PMID:25926733

Chronic widespread musculoskeletal pain - a comparison of those who meet criteria for fibromyalgia and those who do not.

PubMed

Cöster, Lars; Kendall, Sally; Gerdle, Björn; Henriksson, Chris; Henriksson, Karl G; Bengtsson, Ann

2008-07-01

Fibromyalgia is currently classified as chronic widespread pain with widespread allodynia to pressure pain. There are few data describing pain characteristics, quality of life, consequences for daily living, and psychosocial status in patients who meet the classification criteria for fibromyalgia proposed by the American College of Rheumatology compared with patients with chronic widespread pain but not widespread allodynia. This study used a randomly selected sample from the general population. A postal questionnaire and a pain mannequin were sent to 9952 people. The response rate was 76.7%. The pain drawings showed that 345 people had widespread pain; that is, they noted pain in all four extremities and axially. Clinical examination, which included a manual tender point examination, was performed in 125 subjects. These people answered commonly used questionnaires on pain, quality of life, coping strategies, depression, and anxiety. Compared with chronic widespread pain without widespread allodynia, fibromyalgia was associated with more severe symptoms/consequences for daily life and higher pain severity. Similar coping strategies were found. Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and fibromyalgia in 2.5%.

Towards tailored and targeted adherence assessment to optimise asthma management

PubMed Central

van Boven, Job FM; Trappenburg, Jaap CA; van der Molen, Thys; Chavannes, Niels H

2015-01-01

In this paper, we aim to emphasise the need for a more comprehensive and tailored approach to manage the broad nature of non-adherence, to personalise current asthma management. Although currently several methods are available to measure the extent of asthma patients’ adherence, the vast majority do not incorporate confirmation of the actual inhalation, dose and inhalation technique. Moreover, most current measures lack detailed information on the individual consequences of non-adherence and on when and how to take action if non-adherence is identified. Notably, one has to realise there are several forms of non-adherence (erratic non-adherence, intelligent non-adherence and unwitting non-adherence), each requiring a different approach. To improve asthma management, more accurate methods are needed that integrate measures of non-adherence, asthma disease control and patient preferences. Integrating information from the latest inhaler devices and patient-reported outcomes using mobile monitoring- and feedback systems (‘mHealth’) is considered a promising strategy, but requires careful implementation. Key issues to be considered before large-scale implementation include patient preferences, large heterogeneity in patient and disease characteristics, economic consequences, and long-term persistence with new digital technologies. PMID:26181850

Inhibition of various gram-positive and gram-negative bacteria growth on selenium nanoparticle coated paper towels.

PubMed

Wang, Qi; Larese-Casanova, Philip; Webster, Thomas J

2015-01-01

There are wide spread bacterial contamination issues on various paper products, such as paper towels hanging in sink splash zones or those used to clean surfaces, filter papers used in water and air purifying systems, and wrappings used in the food industry; such contamination may lead to the potential spread of bacteria and consequent severe health concerns. In this study, selenium nanoparticles were coated on normal paper towel surfaces through a quick precipitation method, introducing antibacterial properties to the paper towels in a healthy way. Their effectiveness at preventing biofilm formation was tested in bacterial assays involving Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus epidermidis. The results showed significant and continuous bacteria inhibition with about a 90% reduction from 24 to 72 hours for gram-positive bacteria including S. aureus and S. epidermidis. The selenium coated paper towels also showed significant inhibition of gram-negative bacteria like P. aeruginosa and E. coli growth at about 57% and 84%, respectively, after 72 hours of treatment. Therefore, this study established a promising selenium-based antibacterial strategy to prevent bacterial growth on paper products, which may lead to the avoidance of bacteria spreading and consequent severe health concerns.

Cardiovascular Involvement in Autoimmune Diseases

PubMed Central

Amaya-Amaya, Jenny

2014-01-01

Autoimmune diseases (AD) represent a broad spectrum of chronic conditions that may afflict specific target organs or multiple systems with a significant burden on quality of life. These conditions have common mechanisms including genetic and epigenetics factors, gender disparity, environmental triggers, pathophysiological abnormalities, and certain subphenotypes. Atherosclerosis (AT) was once considered to be a degenerative disease that was an inevitable consequence of aging. However, research in the last three decades has shown that AT is not degenerative or inevitable. It is an autoimmune-inflammatory disease associated with infectious and inflammatory factors characterized by lipoprotein metabolism alteration that leads to immune system activation with the consequent proliferation of smooth muscle cells, narrowing arteries, and atheroma formation. Both humoral and cellular immune mechanisms have been proposed to participate in the onset and progression of AT. Several risk factors, known as classic risk factors, have been described. Interestingly, the excessive cardiovascular events observed in patients with ADs are not fully explained by these factors. Several novel risk factors contribute to the development of premature vascular damage. In this review, we discuss our current understanding of how traditional and nontraditional risk factors contribute to pathogenesis of CVD in AD. PMID:25177690

Alterations in Striatal Circuits Underlying Addiction-Like Behaviors.

PubMed

Kim, Hyun Jin; Lee, Joo Han; Yun, Kyunghwa; Kim, Joung-Hun

2017-06-30

Drug addiction is a severe psychiatric disorder characterized by the compulsive pursuit of drugs of abuse despite potential adverse consequences. Although several decades of studies have revealed that psychostimulant use can result in extensive alterations of neural circuits and physiology, no effective therapeutic strategies or medicines for drug addiction currently exist. Changes in neuronal connectivity and regulation occurring after repeated drug exposure contribute to addiction-like behaviors in animal models. Among the involved brain areas, including those of the reward system, the striatum is the major area of convergence for glutamate, GABA, and dopamine transmission, and this brain region potentially determines stereotyped behaviors. Although the physiological consequences of striatal neurons after drug exposure have been relatively well documented, it remains to be clarified how changes in striatal connectivity underlie and modulate the expression of addiction-like behaviors. Understanding how striatal circuits contribute to addiction-like behaviors may lead to the development of strategies that successfully attenuate drug-induced behavioral changes. In this review, we summarize the results of recent studies that have examined striatal circuitry and pathway-specific alterations leading to addiction-like behaviors to provide an updated framework for future investigations.

Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

PubMed

Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

2015-02-12

Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the serious consequences of high-risk sexual behaviors, there is an urgent need for well-designed UK based trials, as well as training and support for staff implementing sexual health risk reduction interventions. PROSPERO CRD42013003674 .

Fractures and Osteomalacia in a Patient Treated With Frequent Home Hemodialysis.

PubMed

Hanudel, Mark R; Froch, Larry; Gales, Barbara; Jüppner, Harald; Salusky, Isidro B

2017-09-01

Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year. A bone biopsy revealed severe osteomalacia, likely secondary to chronic hypophosphatemia and hypocalcemia. Treatment changes included the addition of phosphate to the dialysate, a higher dialysate calcium concentration, and increased calcitriol dose. Several months later, the patient no longer required a wheelchair and was able to ambulate without pain. Repeat bone biopsy revealed marked improvements in bone mineralization and turnover parameters. Also, with increased dialysate phosphate and calcium concentrations, as well as increased calcitriol, circulating fibroblast growth factor 23 levels increased. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Unraveling Biochemical Pathways Affected by Mitochondrial Dysfunctions Using Metabolomic Approaches

PubMed Central

Demine, Stéphane; Reddy, Nagabushana; Renard, Patricia; Raes, Martine; Arnould, Thierry

2014-01-01

Mitochondrial dysfunction(s) (MDs) can be defined as alterations in the mitochondria, including mitochondrial uncoupling, mitochondrial depolarization, inhibition of the mitochondrial respiratory chain, mitochondrial network fragmentation, mitochondrial or nuclear DNA mutations and the mitochondrial accumulation of protein aggregates. All these MDs are known to alter the capacity of ATP production and are observed in several pathological states/diseases, including cancer, obesity, muscle and neurological disorders. The induction of MDs can also alter the secretion of several metabolites, reactive oxygen species production and modify several cell-signalling pathways to resolve the mitochondrial dysfunction or ultimately trigger cell death. Many metabolites, such as fatty acids and derived compounds, could be secreted into the blood stream by cells suffering from mitochondrial alterations. In this review, we summarize how a mitochondrial uncoupling can modify metabolites, the signalling pathways and transcription factors involved in this process. We describe how to identify the causes or consequences of mitochondrial dysfunction using metabolomics (liquid and gas chromatography associated with mass spectrometry analysis, NMR spectroscopy) in the obesity and insulin resistance thematic. PMID:25257998

Risk Factors for Increased Severity of Paediatric Medication Administration Errors

PubMed Central

Sears, Kim; Goodman, William M.

2012-01-01

Patients' risks from medication errors are widely acknowledged. Yet not all errors, if they occur, have the same risks for severe consequences. Facing resource constraints, policy makers could prioritize factors having the greatest severe–outcome risks. This study assists such prioritization by identifying work-related risk factors most clearly associated with more severe consequences. Data from three Canadian paediatric centres were collected, without identifiers, on actual or potential errors that occurred. Three hundred seventy-two errors were reported, with outcome severities ranging from time delays up to fatalities. Four factors correlated significantly with increased risk for more severe outcomes: insufficient training; overtime; precepting a student; and off-service patient. Factors' impacts on severity also vary with error class: for wrong-time errors, the factors precepting a student or working overtime significantly increase severe-outcomes risk. For other types, caring for an off-service patient has greatest severity risk. To expand such research, better standardization is needed for categorizing outcome severities. PMID:23968607

Some limitations of frequency as a component of risk: an expository note.

PubMed

Cox, Louis Anthony

2009-02-01

Students of risk analysis are often taught that "risk is frequency times consequence" or, more generally, that risk is determined by the frequency and severity of adverse consequences. But is it? This expository note reviews the concepts of frequency as average annual occurrence rate and as the reciprocal of mean time to failure (MTTF) or mean time between failures (MTBF) in a renewal process. It points out that if two risks (represented as two (frequency, severity) pairs for adverse consequences) have identical values for severity but different values of frequency, then it is not necessarily true that the one with the smaller value of frequency is preferable-and this is true no matter how frequency is defined. In general, there is not necessarily an increasing relation between the reciprocal of the mean time until an event occurs, its long-run average occurrences per year, and other criteria, such as the probability or expected number of times that it will happen over a specific interval of interest, such as the design life of a system. Risk depends on more than frequency and severity of consequences. It also depends on other information about the probability distribution for the time of a risk event that can become lost in simple measures of event "frequency." More flexible descriptions of risky processes, such as point process models can avoid these limitations.

Family and community driven response to intimate partner violence in post-conflict settings

PubMed Central

Perrin, Nancy; Mpanano, Remy Mitima; Banywesize, Luhazi; Mirindi, Alfred Bacikenge; Banywesize, Jean Heri; Mitima, Clovis Murhula; Binkurhorhwa, Arsène Kajabika; Bufole, Nadine Mwinja; Glass, Nancy

2015-01-01

This study explores risk factors, individual and family consequences and community-driven responses to intimate partner violence (IPV) in post-conflict eastern Democratic Republic of Congo (DRC). This qualitative study was conducted in 3 rural villages in South Kivu Province of DRC, an area that has experienced prolonged conflict. Participants included 13 female survivors and 5 male perpetrators of IPV as reported during baseline data collection for the parent study, an impact evaluation of the Congolese-led livestock microfinance program, Pigs for Peace. Participants described social and behavioral circumstances that increase risk for IPV; social, health and economic consequences on women and their families; and resources to protect women and their families. Social and behavioral factors reported by survivors and perpetrators indicate that IPV was linked to husband’s alcohol consumption, household economic instability, male desire to maintain his position as head of family and perceived disrespect of husband by wife. In addition to well-known health consequences of IPV, women reported negative social consequences, such as stigma, resulting in barriers for the well-being of the family. Survivors and perpetrators described the impact of IPV on their children, specifically the lack of proper parental guidance and lack of safety and stability that could result in the child(ren) misbehaving and using violence in their relationships resulting in further stigma towards the child and family. Strategies employed by survivors to protect themselves and family, include placating male behaviors (e.g. not responding to insults, trying to meet household demands). Perpetrators that tried to reduce the impact of IPV reported a preference for social and financial control of their partner rather than physical violence, believing this to be less severe. Participants described community and family based social support systems including couple’s mediation, responsible partner and fatherhood programs and economic activities that can influence behavior, maintain confidentiality, address social stigma and other multi-level outcomes. PMID:26497097

Family and community driven response to intimate partner violence in post-conflict settings.

PubMed

Kohli, Anjalee; Perrin, Nancy; Mpanano, Remy Mitima; Banywesize, Luhazi; Mirindi, Alfred Bacikenge; Banywesize, Jean Heri; Mitima, Clovis Murhula; Binkurhorhwa, Arsène Kajabika; Bufole, Nadine Mwinja; Glass, Nancy

2015-12-01

This study explores risk factors, individual and family consequences and community-driven responses to intimate partner violence (IPV) in post-conflict eastern Democratic Republic of Congo (DRC). This qualitative study was conducted in 3 rural villages in South Kivu Province of DRC, an area that has experienced prolonged conflict. Participants included 13 female survivors and 5 male perpetrators of IPV as reported during baseline data collection for the parent study, an impact evaluation of the Congolese-led livestock microfinance program, Pigs for Peace. Participants described social and behavioral circumstances that increase risk for IPV; social, health and economic consequences on women and their families; and resources to protect women and their families. Social and behavioral factors reported by survivors and perpetrators indicate that IPV was linked to husband's alcohol consumption, household economic instability, male desire to maintain his position as head of family and perceived disrespect of husband by wife. In addition to well-known health consequences of IPV, women reported negative social consequences, such as stigma, resulting in barriers for the well-being of the family. Survivors and perpetrators described the impact of IPV on their children, specifically the lack of proper parental guidance and lack of safety and stability that could result in the child(ren) misbehaving and using violence in their relationships resulting in further stigma towards the child and family. Strategies employed by survivors to protect themselves and family, include placating male behaviors (e.g., not responding to insults, trying to meet household demands). Perpetrators that tried to reduce the impact of IPV reported a preference for social and financial control of their partner rather than physical violence, believing this to be less severe. Participants described community and family based social support systems including couple's mediation, responsible partner and fatherhood programs and economic activities that can influence behavior, maintain confidentiality, address social stigma and other multi-level outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Modeling the Severity of Drinking Consequences in First-Year College Women: An Item Response Theory Analysis of the Rutgers Alcohol Problem Index*

PubMed Central

Cohn, Amy M.; Hagman, Brett T.; Graff, Fiona S.; Noel, Nora E.

2011-01-01

Objective: The present study examined the latent continuum of alcohol-related negative consequences among first-year college women using methods from item response theory and classical test theory. Method: Participants (N = 315) were college women in their freshman year who reported consuming any alcohol in the past 90 days and who completed assessments of alcohol consumption and alcohol-related negative consequences using the Rutgers Alcohol Problem Index. Results: Item response theory analyses showed poor model fit for five items identified in the Rutgers Alcohol Problem Index. Two-parameter item response theory logistic models were applied to the remaining 18 items to examine estimates of item difficulty (i.e., severity) and discrimination parameters. The item difficulty parameters ranged from 0.591 to 2.031, and the discrimination parameters ranged from 0.321 to 2.371. Classical test theory analyses indicated that the omission of the five misfit items did not significantly alter the psychometric properties of the construct. Conclusions: Findings suggest that those consequences that had greater severity and discrimination parameters may be used as screening items to identify female problem drinkers at risk for an alcohol use disorder. PMID:22051212

The Professional Consequences of Whistleblowing by Nurses.

ERIC Educational Resources Information Center

McDonald, Sally; Ahern, Kathy

2000-01-01

A study of 70 nurses self-described as whistleblowers and 25 who did not repot misconduct showed that whistleblowers experienced severe reprisals (demotion, reprimand, threats, rejection, pressure to resign). There were few professional consequences for those who remained silent. (SK)

Fukushima Daiichi Radionuclide Inventories

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

Cardoni, Jeffrey N.; Jankovsky, Zachary Kyle

Radionuclide inventories are generated to permit detailed analyses of the Fukushima Daiichi meltdowns. This is necessary information for severe accident calculations, dose calculations, and source term and consequence analyses. Inventories are calculated using SCALE6 and compared to values predicted by international researchers supporting the OECD/NEA's Benchmark Study on the Accident at Fukushima Daiichi Nuclear Power Station (BSAF). Both sets of inventory information are acceptable for best-estimate analyses of the Fukushima reactors. Consistent nuclear information for severe accident codes, including radionuclide class masses and core decay powers, are also derived from the SCALE6 analyses. Key nuclide activity ratios are calculated asmore » functions of burnup and nuclear data in order to explore the utility for nuclear forensics and support future decommissioning efforts.« less

Assessing and treating non-compliance in brain-injured clients.

PubMed

Zencius, A H; Lane, I; Wesolowski, M D

1991-01-01

Assessment of non-compliance has been discussed. This included exploration of reinforcement contingencies, age appropriateness, cultural background and social background. Several perspectives on this have been addressed. Memory deficits are also critical when assessing non-compliance. Specifically, when the TBI person has severe memory deficits. Consequence management and antecedent control techniques have shown to be highly effective in promoting participation. Additionally, non-compliance should not necessarily be viewed as non-desirable, in fact, the client may be communicating preferred and non-preferred interests. It is important to recognize individual talents, interests and preferences. This is a significant point when you consider that TBI survivors had pre-injury lifestyles, i.e. full-time employment, a working social network, and preferred interests and activities.

Les roches extraterrestres d'Atacama

NASA Astrophysics Data System (ADS)

Gattacceca, Jerome

2017-07-01

With hyperarid conditions for the last several million years, the Atacama desert in Chile possesses the oldest pristine surfaces on the Earth. As a consequence, meteorites accumulate with time and can survive for several hundreds thousands years at the surface (longer than anywhere else in the world including Antarctica), until wind abrasion and chemical weathering eventually turn them into dust. We describe here our field work for meteorite recovery in the Atacama desert (Chile). Systematic search by foot conducted for the last ten years allowed recovery of more than 1000 meteorites, with up to 200 unpaired meteorites per km^2 in the best areas. This meteorite collection, besides providing its share of rare meteorites, allows studying the flux of meteorite to the Earth over the last million of years.

Coinfection by the tick-borne pathogens Babesia microti and Borrelia burgdorferi: ecological, epidemiological and clinical consequences

PubMed Central

Diuk-Wasser, Maria A.; Vannier, Edouard

2015-01-01

Ixodes ticks maintain a large and diverse array of human pathogens in the enzootic cycle, including Borrelia burgdorferi and Babesia microti. Despite the poor ecological fitness of B. microti, babesiosis has recently emerged in areas endemic for Lyme disease. Studies in ticks, reservoir hosts and humans indicate that coinfection with B. burgdorferi and B. microti is common, promotes transmission and emergence of B. microti in the enzootic cycle, and causes greater disease severity and duration in humans. These integrative studies may serve as a paradigm for the study of other vector-borne coinfections. Identifying ecological drivers of pathogen emergence and host factors that fuel disease severity will help guide the design of effective curative and prevention strategies. PMID:26613664

The psychology of doing nothing: forms of decision avoidance result from reason and emotion.

PubMed

Anderson, Christopher J

2003-01-01

Several independent lines of research bear on the question of why individuals avoid decisions by postponing them, failing to act, or accepting the status quo. This review relates findings across several different disciplines and uncovers 4 decision avoidance effects that offer insight into this common but troubling behavior: choice deferral, status quo bias, omission bias, and inaction inertia. These findings are related by common antecedents and consequences in a rational-emotional model of the factors that predispose humans to do nothing. Prominent components of the model include cost-benefit calculations, anticipated regret, and selection difficulty. Other factors affecting decision avoidance through these key components, such as anticipatory negative emotions, decision strategies, counterfactual thinking, and preference uncertainty, are also discussed.

Risk factors for headache in the UK military: cross-sectional and longitudinal analyses.

PubMed

Rona, Roberto J; Jones, Margaret; Goodwin, Laura; Hull, Lisa; Wessely, Simon

2013-05-01

To assess the importance of service demographic, mental disorders, and deployment factors on headache severity and prevalence, and to assess the impact of headache on functional impairment. There is no information on prevalence and risk factors of headache in the UK military. Recent US reports suggest that deployment, especially a combat role, is associated with headache. Such an association may have serious consequences on personnel during deployment. A survey was carried out between 2004 and 2006 (phase 1) and again between 2007 and 2009 (phase 2) of randomly selected UK military personnel to study the health consequences of the Iraq and Afghanistan wars. This study is based on those who participated in phase 2 and includes cross-sectional and longitudinal analyses. Headache severity in the last month and functional impairment at phase 2 were the main outcomes. Forty-six percent complained of headache in phase 2, half of whom endorsed moderate or severe headache. Severe headache was strongly associated with probable post-traumatic stress disorder (multinomial odds ratio [MOR] 9.6, 95% confidence interval [CI] 6.4-14.2), psychological distress (MOR 6.15, 95% CI 4.8-7.9), multiple physical symptoms (MOR 18.2, 95% CI 13.4-24.6) and self-reported mild traumatic brain injury (MOR 3.5, 95% CI 1.4-8.6) after adjustment for service demographic factors. Mild headache was also associated with these variables but at a lower level. Moderate and severe headache were associated with functional impairment, but the association was partially explained by mental disorders. Mental ill health was also associated with reporting moderate and severe headache at both phase 1 and phase 2. Deployment and a combat role were not associated with headache. Moderate and severe headache are common in the military and have an impact on functional impairment. They are more strongly associated with mental disorders than with mild traumatic brain injury. © 2013 American Headache Society.

Improving the Sensitivity of Needs Assessment for Substance Abuse Prevention Planning: The Measurement of Differential Severity of Consequences for Individual Substance Types

ERIC Educational Resources Information Center

Shamblen, Stephen R.; Springer, J. Fred

2007-01-01

There is an absence of systematic, comparative research examining the negative consequences that are experienced as a result of using specific substances. Further, techniques typically used for needs assessment (i.e., prevalence proportions) do not take into account the probability of experiencing a negative consequence as a result of using…

The kinetics of aerosol particle formation and removal in NPP severe accidents

NASA Astrophysics Data System (ADS)

Zatevakhin, Mikhail A.; Arefiev, Valentin K.; Semashko, Sergey E.; Dolganov, Rostislav A.

2016-06-01

Severe Nuclear Power Plant (NPP) accidents are accompanied by release of a massive amount of energy, radioactive products and hydrogen into the atmosphere of the NPP containment. A valid estimation of consequences of such accidents can only be carried out through the use of the integrated codes comprising a description of the basic processes which determine the consequences. A brief description of a coupled aerosol and thermal-hydraulic code to be used for the calculation of the aerosol kinetics within the NPP containment in case of a severe accident is given. The code comprises a KIN aerosol unit integrated into the KUPOL-M thermal-hydraulic code. Some features of aerosol behavior in severe NPP accidents are briefly described.

The kinetics of aerosol particle formation and removal in NPP severe accidents

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

Zatevakhin, Mikhail A.; Arefiev, Valentin K.; Semashko, Sergey E.

2016-06-08

Severe Nuclear Power Plant (NPP) accidents are accompanied by release of a massive amount of energy, radioactive products and hydrogen into the atmosphere of the NPP containment. A valid estimation of consequences of such accidents can only be carried out through the use of the integrated codes comprising a description of the basic processes which determine the consequences. A brief description of a coupled aerosol and thermal–hydraulic code to be used for the calculation of the aerosol kinetics within the NPP containment in case of a severe accident is given. The code comprises a KIN aerosol unit integrated into themore » KUPOL-M thermal–hydraulic code. Some features of aerosol behavior in severe NPP accidents are briefly described.« less

Fuzzy approach for reducing subjectivity in estimating occupational accident severity.

PubMed

Pinto, Abel; Ribeiro, Rita A; Nunes, Isabel L

2012-03-01

Quantifying or, more generally, estimating the severity of the possible consequences of occupational accidents is a decisive step in any occupational risk assessment process. Because of the lack of historic information (accident data collection and recording are incipient and insufficient, particularly in construction) and the lack of practical tools in the construction industry, the estimation/quantification of occupational accident severity is a notably arbitrary process rather than a systematic and rigorous assessment. This work proposes several severity functions (based on a safety risk assessment) to represent biomechanical knowledge with the aim of determining the severity level of occupational accidents in the construction industry and, consequently, improving occupational risk assessment quality. We follow a fuzzy approach because it makes it possible to capture and represent imprecise knowledge in a simple and understandable way for users and specialists. Copyright © 2011 Elsevier Ltd. All rights reserved.

Positive and negative consequences of a military deployment.

PubMed

Newby, John H; McCarroll, James E; Ursano, R J; Fan, Zizhong; Shigemura, Jun; Tucker-Harris, Yvonne

2005-10-01

This study determined the perception by 951 U.S. Army soldiers of positive and negative consequences of a peacekeeping deployment to Bosnia. Seventy-seven percent reported some positive consequences, 63% reported a negative consequence, and 47% reported both. Written comments were also provided. Of the 951 soldiers, 478 wrote at least one positive comment and 403 at least one negative comment. Single soldiers were more likely than married soldiers to report positive consequences (82% vs. 72%). Married soldiers were more likely than single soldiers to report negative consequences (70% vs. 55%). Positive consequences included making additional money, self-improvement, and time to think. Negative consequences included the military chain of command, being away from home, and deterioration of marital/significant other relationships.

Falls in spinocerebellar ataxias: Results of the EuroSCA Fall Study.

PubMed

Fonteyn, Ella M R; Schmitz-Hübsch, Tanja; Verstappen, Carla C; Baliko, Laslo; Bloem, Bastiaan R; Boesch, Silvia; Bunn, Lisa; Charles, Perrine; Dürr, Alexandra; Filla, Allesandro; Giunti, Paola; Globas, Christoph; Klockgether, Thomas; Melegh, Bela; Pandolfo, Massimo; De Rosa, Anna; Schöls, Ludger; Timmann, Dagmar; Munneke, Marten; Kremer, Berry P H; van de Warrenburg, Bart P C

2010-06-01

To investigate the frequency, details, and consequences of falls in patients with autosomal dominant spinocerebellar ataxias (SCAs) and to derive specific disease-related risk factors that are associated with an increased fall frequency. Two hundred twenty-eight patients with SCA1, SCA2, SCA3, or SCA6, recruited from the EuroSCA natural history study, completed a fall questionnaire that assessed the frequency, consequences, and several details of falls in the previous 12 months. Relevant disease characteristics were retrieved from the EuroSCA registry. The database of the natural history study provided the ataxia severity scores as well as the number and nature of non-ataxia symptoms. Patients (73.6%) reported at least one fall in the preceding 12 months. There was a high rate of fall-related injuries (74%). Factors that were associated with a higher fall frequency included: disease duration, severity of ataxia, the presence of pyramidal symptoms, the total number of non-ataxia symptoms, and the genotype SCA3. Factors associated with a lower fall frequency were: the presence of extrapyramidal symptoms (more specifically dystonia of the lower limbs) and the genotype SCA2. The total number of non-ataxia symptoms and longer disease duration were independently associated with a higher fall frequency in a logistic regression analysis, while the presence of extrapyramidal symptoms was independently associated with a lower fall frequency. Our findings indicate that, in addition to more obvious factors that are associated with frequent falls, such as disease duration and ataxia severity, non-ataxia manifestations in SCA play a major role in the fall etiology of these patients.

Missed injuries during the initial assessment in a cohort of 1124 level-1 trauma patients.

PubMed

Giannakopoulos, G F; Saltzherr, T P; Beenen, L F M; Reitsma, J B; Bloemers, F W; Goslings, J C; Bakker, F C

2012-09-01

Despite the presence of diagnostic guidelines for the initial evaluation in trauma, the reported incidence of missed injuries is considerable. The aim of this study was to assess the missed injuries in a large cohort of trauma patients originating from two European Level-1 trauma centres. We analysed the 1124 patients included in the randomised REACT trial. Missed injuries were defined as injuries not diagnosed or suspected during initial clinical and radiological evaluation in the trauma room. We assessed the frequency, type, consequences and the phase in which the missed injuries were diagnosed and used univariate analysis to identify potential contributing factors. Eight hundred and three patients were male, median age was 38 years and 1079 patients sustained blunt trauma. Overall, 122 injuries were missed in 92 patients (8.2%). Most injuries concerned the extremities. Sixteen injuries had an AIS grade of ≥ 3. Patients with missed injuries had significantly higher injury severity scores (ISSs) (median of 15 versus 5, p<0.001). Factors associated with missed injuries were severe traumatic brain injury (GCS ≤ 8) and multitrauma (ISS ≥ 16). Seventy-two missed injuries remained undetected during tertiary survey (59%). In total, 31 operations were required for 26 initially missed injuries. Despite guidelines to avoid missed injuries, this problem is hard to prevent, especially in the severely injured. The present study showed that the rate of missed injuries was comparable with the literature and their consequences not severe. A high index of suspicion remains warranted, especially in multitrauma patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Legal consequences of kleptomania.

PubMed

Grant, Jon E; Odlaug, Brian L; Davis, Andrew A; Kim, Suck Won

2009-12-01

Although studies have examined clinical characteristics of kleptomania, no previous studies have examined the legal consequences of kleptomania. From 2001 to 2007, 101 adult subjects (n = 27 [26.7%] males) with DSM-IV kleptomania were assessed on sociodemographics and clinical characteristics including symptom severity, comorbidity, and legal repercussions. Of 101 subjects with kleptomania, 73.3% were female. Mean age of shoplifting onset was 19.4 +/- 12.0 years, and subjects shoplifted a mean of 8.2 +/- 11.0 years prior to meeting full criteria for kleptomania. Co-occurring depressive, substance use, and impulse control disorders were common. Sixty-nine subjects with kleptomania (68.3%) had been arrested, 36.6% had been arrested but not convicted, 20.8% had been convicted and incarcerated after conviction, while only 10.9% had been convicted and not incarcerated after conviction. Kleptomania is associated with significant legal repercussions. The findings emphasize the need for rigorous treatment approaches to target kleptomania symptoms and prevent re-offending.

Joseph's Story: A Case Study of Late-Onset Necrotizing Enterocolitis From Early Birth to Recovery.

PubMed

Gephart, Sheila M; Martin, Laura B; Kijewski, Amy; Johnson, Scott R

2015-01-01

Although necrotizing enterocolitis (NEC) is often catastrophic among premature infants, most cases occur in the first month after birth. This case study presents Joseph's story about a 24-week surviving twin who developed severe NEC at 5 months of age just days before he was to go home. The purpose of this case study report is to place Joseph and his parents' experience in the context of what is known about NEC risk factors, clinical presentation, and treatment, and then to offer recommendations to healthcare professionals to support families from NEC diagnosis to recovery. Now 5 years old, Joseph continues to manage consequences of NEC including deafness, developmental delay, multiple food allergies, and recurrent gastrointestinal challenges from short gut syndrome. Although NEC struck late and kept Joseph in the neonatal intensive care unit for 228 days, its consequences remain with this resilient child and his family.

Heat shock proteins as potential targets for protective strategies in neurodegeneration.

PubMed

Kampinga, Harm H; Bergink, Steven

2016-06-01

Protein aggregates are hallmarks of nearly all age-related neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and several polyglutamine diseases such as Huntington's disease and different forms of spinocerebellar ataxias (SCA; SCA1-3, SCA6, and SCA7). The collapse of cellular protein homoeostasis can be both a cause and a consequence of this protein aggregation. Boosting components of the cellular protein quality control system has been widely investigated as a strategy to counteract protein aggregates or their toxic consequences. Heat shock proteins (HSPs) play a central part in regulating protein quality control and contribute to protein aggregation and disaggregation. Therefore, HSPs are viable targets for the development of drugs aimed at reducing pathogenic protein aggregates that are thought to contribute to the development of so many neurodegenerative disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

The interplay between gender, race and weight status: self perceptions and social consequences.

PubMed

Fletcher, Jason M

2014-07-01

This paper uses data from nearly 15,000 young adult respondents to the Add Health survey to examine racial and gender differences in the perceptions and social rewards to weight. The data include information on several typically unmeasured domains: self-perceptions of ideal weight, attractiveness ratings, and measured weight information, along with ties to a series of adult outcomes. Results show important gender and racial differences in ideal weight as well as differences for both self-perceived attractiveness and interviewer rated attractiveness. Findings also suggest the existence of large differences in socio-cultural rewards and sanctions for weight status. Black respondents, particularly women, appear to receive lower "obesity penalties" in both their self-perceived and interviewer accessed attractiveness ratings than other groups. These findings suggest the need to consider new classes of policies directed at shifting relative social benefits and consequences to weight status. Copyright © 2012 Elsevier B.V. All rights reserved.

Guidelines for screening and management of late and long-term consequences of myeloma and its treatment.

PubMed

Snowden, John A; Greenfield, Diana M; Bird, Jennifer M; Boland, Elaine; Bowcock, Stella; Fisher, Abigail; Low, Eric; Morris, Monica; Yong, Kwee; Pratt, Guy

2017-03-01

A growing population of long-term survivors of myeloma is now accumulating the 'late effects' not only of myeloma itself, but also of several lines of treatment given throughout the course of the disease. It is thus important to recognise the cumulative burden of the disease and treatment-related toxicity in both the stable and active phases of myeloma, some of which is unlikely to be detected by routine monitoring. We summarise here the evidence for the key late effects in long-term survivors of myeloma, including physical and psychosocial consequences (in Parts 1 and 2 respectively), and recommend the use of late-effects screening protocols in detection and intervention. The early recognition of late effects and effective management strategies should lead to an improvement in the management of myeloma patients, although evidence in this area is currently limited and further research is warranted. © 2017 John Wiley & Sons Ltd.

Ethanol production, corn gluten feed, and EC trade. Agriculture information bulletin

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

Anderson, M.

1993-07-01

The profitability of ethanol depends not only on sales of ethanol, but on sales of several coproducts of corn wet-milling such as corn gluten feed (CGF). CGF demand and supply are affected by several European Community (EC) and US policies, such as EC grain price supports and US energy policies. Changes in existing policies and programs could have a significant effect on the CGF market and, consequently, on the profitability of ethanol production. The report examines the implications of several policy options on demand, supply, and price of CGF and on the profitability of ethanol production. The policy changes examinedmore » include: (1) the effect of proposed changes in EC farm and trade policies, and (2) the effect of increased ethanol production due to proposed US environmental policies, such as the reauthorization of the Clean Air Act.« less

The first report of pyrrolizidine alkaloid poisoning in a gazelle (Gazella Subgutturosa) - histopathologic diagnosis.

PubMed

Khordadmehr, Monireh; Rezazadeh, Fereydoon; Ashrafi-Helan, Javad; Hosseini-Ghomi, Mir Mohsen

2016-03-01

Pyrrolizidine alkaloids (PAs) are natural phytotoxins found in thousands of plant species around the world. They are probably the most common poisonous plants affecting livestock, wildlife and humans. The disease occurs almost entirely as a consequence of chronic poisoning and in general ends fatally. In the present study, PAs poisoning was investigated in a gazelle with hepatic encephalopathy associated with severe neurologic signs. The main clinical signs included head pressing, progressive depression and weakness, ataxia and reluctance to move, turn the head to the left and to paddle, hyperesthesia and decreased food intake. Histopathological examination revealed major lesions in the liver consisting of severe hepatocyte megalocytosis and hypertrophy with nuclei enlargement, mild bile duct hyperplasia, centriacinar fatty change and hepatocellular necrosis. Moreover, pulmonary congestion and edema with endothelium necrosis and alveolar septa thickening, severe congestion in vessels of the brain and meninges, and myocardial necrosis were observed.

Future generations, environmental ethics, and global environmental change

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

Tonn, B.E.

1994-12-31

The elements of a methodology to be employed by the global community to investigate the consequences of global environmental change upon future generations and global ecosystems are outlined in this paper. The methodology is comprised of two major components: A possible future worlds model; and a formal, citizen-oriented process to judge whether the possible future worlds potentially inheritable by future generations meet obligational standards. A broad array of descriptors of future worlds can be encompassed within this framework, including survival of ecosystems and other species and satisfaction of human concerns. The methodology expresses fundamental psychological motivations and human myths journey,more » renewal, mother earth, and being-in-nature-and incorporates several viewpoints on obligations to future generations-maintaining options, fairness, humility, and the cause of humanity. The methodology overcomes several severe drawbacks of the economic-based methods most commonly used for global environmental policy analysis.« less

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION.

PubMed

Quagelli, Luca; Solano, Paola

2017-10-01

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double-envelope containment of the co-therapists' group and play leader, consequent diffraction of the transference-determining portrayal, gradual integration, and initial figuration of coexisting split-off fragments. Drawing on in-depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play. © 2017 The Psychoanalytic Quarterly, Inc.

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

Vernazza, P.; Barge, P.; Zanda, B.

Although petrologic, chemical, and isotopic studies of ordinary chondrites and meteorites in general have largely helped establish a chronology of the earliest events of planetesimal formation and their evolution, there are several questions that cannot be resolved via laboratory measurements and/or experiments alone. Here, we propose the rationale for several new constraints on the formation and evolution of ordinary chondrite parent bodies (and, by extension, most planetesimals) from newly available spectral measurements and mineralogical analysis of main-belt S-type asteroids (83 objects) and unequilibrated ordinary chondrite meteorites (53 samples). Based on the latter, we suggest that spectral data may be usedmore » to distinguish whether an ordinary chondrite was formed near the surface or in the interior of its parent body. If these constraints are correct, the suggested implications include that: (1) large groups of compositionally similar asteroids are a natural outcome of planetesimal formation and, consequently, meteorites within a given class can originate from multiple parent bodies; (2) the surfaces of large (up to ∼200 km) S-type main-belt asteroids mostly expose the interiors of the primordial bodies, a likely consequence of impacts by small asteroids (D < 10 km) in the early solar system; (3) the duration of accretion of the H chondrite parent bodies was likely short (instantaneous or in less than ∼10{sup 5} yr, but certainly not as long as 1 Myr); (4) LL-like bodies formed closer to the Sun than H-like bodies, a possible consequence of the radial mixing and size sorting of chondrules in the protoplanetary disk prior to accretion.« less

Experimental functional analysis of severe skin-picking behavior in Prader-Willi syndrome.

PubMed

Hall, Scott S; Hustyi, Kristin M; Chui, Clara; Hammond, Jennifer L

2014-10-01

Skin picking is an extremely distressing and treatment resistant behavior commonly shown by individuals with Prader-Willi syndrome (PWS). However, with the exception of a limited number of published single-case and survey studies, little is known about the environmental determinants of skin picking in this population. In this study, functional analyses were conducted with thirteen individuals with PWS, aged 6-23 years, who engaged in severe skin-picking behavior. In addition to the conditions typically employed in a functional analysis (i.e., alone, attention, play, demand), we included an ignore condition to examine potential effects of stimulus control by the presence of an adult. Twelve participants engaged in skin picking during the functional analysis, with the highest levels occurring in the alone and ignore conditions for eight participants, suggesting that skin picking in these participants was maintained by automatic reinforcement. For the remaining four participants, an undifferentiated pattern of low-rate skin picking was observed across conditions. These data confirm previous studies indicating that skin picking in PWS may be maintained most often by automatically produced sensory consequences. There were no associations between demographic characteristics of the participants (e.g., sex, age, IQ or BMI) and levels of skin picking observed in the functional analysis. Additional investigations are needed to identify the nature of the sensory consequences produced during episodes of skin picking in PWS. Behavioral interventions designed to extinguish or compete with the potential sensory consequences arising from skin picking in PWS are also warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Zinc in Early Life: A Key Element in the Fetus and Preterm Neonate

PubMed Central

Terrin, Gianluca; Berni Canani, Roberto; Di Chiara, Maria; Pietravalle, Andrea; Aleandri, Vincenzo; Conte, Francesca; De Curtis, Mario

2015-01-01

Zinc is a key element for growth and development. In this narrative review, we focus on the role of dietary zinc in early life (including embryo, fetus and preterm neonate), analyzing consequences of zinc deficiency and adequacy of current recommendations on dietary zinc. We performed a systematic search of articles on the role of zinc in early life. We selected and analyzed 81 studies. Results of this analysis showed that preservation of zinc balance is of critical importance for the avoidance of possible consequences of low zinc levels on pre- and post-natal life. Insufficient quantities of zinc during embryogenesis may influence the final phenotype of all organs. Maternal zinc restriction during pregnancy influences fetal growth, while adequate zinc supplementation during pregnancy may result in a reduction of the risk of preterm birth. Preterm neonates are at particular risk to develop zinc deficiency due to a combination of different factors: (i) low body stores due to reduced time for placental transfer of zinc; (ii) increased endogenous losses; and (iii) marginal intake. Early diagnosis of zinc deficiency, through the measurement of serum zinc concentrations, may be essential to avoid severe prenatal and postnatal consequences in these patients. Typical clinical manifestations of zinc deficiency are growth impairment and dermatitis. Increasing data suggest that moderate zinc deficiency may have significant subclinical effects, increasing the risk of several complications typical of preterm neonates (i.e., necrotizing enterocolitis, chronic lung disease, and retinopathy), and that current recommended intakes should be revised to meet zinc requirements of extremely preterm neonates. Future studies evaluating the adequacy of current recommendations are advocated. PMID:26690476

People, Planet and Profit: Unintended Consequences of Legacy Building Materials

EPA Science Inventory

Although an explosion of new building materials are being introduced into today's market, adequate up-front research into their chemical and physical properties as well as their potential health and environmental consequences is lacking. History has provided us with several exam...

Assessing Homeland Chemical Hazards Outside the Military Gates: Industrial Hazard Threat Assessments for Department of Defense Installations

DTIC Science & Technology

2002-01-01

catastrophic health consequences , resulting from potential exposures to industrial chemicals (Armed Forces Medical Intelligence Center, 1998). These...susceptible to damage from a toxic industrial material release. For this second component, the Consequence Assessment Tools Set (CATS) (Defense Threat...accidental toxic industrial material release, the severity of the release, and any associated consequences that might occur. These are based on estimated

Fetal Alcohol Spectrum Disorder (FASD) Associated Neural Defects: Complex Mechanisms and Potential Therapeutic Targets

PubMed Central

Muralidharan, Pooja; Sarmah, Swapnalee; Zhou, Feng C.; Marrs, James A.

2013-01-01

Fetal alcohol spectrum disorder (FASD), caused by prenatal alcohol exposure, can result in craniofacial dysmorphism, cognitive impairment, sensory and motor disabilities among other defects. FASD incidences are as high as 2% to 5 % children born in the US, and prevalence is higher in low socioeconomic populations. Despite various mechanisms being proposed to explain the etiology of FASD, the molecular targets of ethanol toxicity during development are unknown. Proposed mechanisms include cell death, cell signaling defects and gene expression changes. More recently, the involvement of several other molecular pathways was explored, including non-coding RNA, epigenetic changes and specific vitamin deficiencies. These various pathways may interact, producing a wide spectrum of consequences. Detailed understanding of these various pathways and their interactions will facilitate the therapeutic target identification, leading to new clinical intervention, which may reduce the incidence and severity of these highly prevalent preventable birth defects. This review discusses manifestations of alcohol exposure on the developing central nervous system, including the neural crest cells and sensory neural placodes, focusing on molecular neurodevelopmental pathways as possible therapeutic targets for prevention or protection. PMID:24961433

Fetal Alcohol Spectrum Disorder (FASD) Associated Neural Defects: Complex Mechanisms and Potential Therapeutic Targets.

PubMed

Muralidharan, Pooja; Sarmah, Swapnalee; Zhou, Feng C; Marrs, James A

2013-06-19

Fetal alcohol spectrum disorder (FASD), caused by prenatal alcohol exposure, can result in craniofacial dysmorphism, cognitive impairment, sensory and motor disabilities among other defects. FASD incidences are as high as 2% to 5 % children born in the US, and prevalence is higher in low socioeconomic populations. Despite various mechanisms being proposed to explain the etiology of FASD, the molecular targets of ethanol toxicity during development are unknown. Proposed mechanisms include cell death, cell signaling defects and gene expression changes. More recently, the involvement of several other molecular pathways was explored, including non-coding RNA, epigenetic changes and specific vitamin deficiencies. These various pathways may interact, producing a wide spectrum of consequences. Detailed understanding of these various pathways and their interactions will facilitate the therapeutic target identification, leading to new clinical intervention, which may reduce the incidence and severity of these highly prevalent preventable birth defects. This review discusses manifestations of alcohol exposure on the developing central nervous system, including the neural crest cells and sensory neural placodes, focusing on molecular neurodevelopmental pathways as possible therapeutic targets for prevention or protection.

An examination of heavy drinking, depressed mood, drinking related constructs, and consequences among high-risk college students using a person-centered approach.

PubMed

Geisner, Irene M; Mallett, Kimberly; Varvil-Weld, Lindsey; Ackerman, Sarah; Trager, Bradley M; Turrisi, Rob

2018-03-01

Research has identified college students who experience depressed mood and consume alcohol are at an increased risk for experiencing alcohol problems. The present study identified profiles of differential alcohol use, depression, key psychosocial indicators of drinking (e.g., normative perceptions) and examined the relationship between these profiles and alcohol-related consequences. Students with a history of risky drinking and elevated depressed mood (n=311; 62.4% female) completed a web-based survey assessing typical and peak drinking, depressive symptoms, descriptive norms, drinking to cope motives, protective behavioral strategies, and alcohol-related consequences. Latent profile analysis was used to classify participants into distinct profiles focusing on alcohol use patterns and level of depressed mood and drinking related constructs. Profiles were then compared based on their association with reported rates of alcohol-related consequences. Four profiles emerged: 1) Mild Depression, Heavy Drinkers; 2) Mild Depression, Severe Drinkers; 3) Moderate Depression, Heavy Drinkers; and 4) Moderate Depression, Severe Drinkers. Findings revealed significant differences between the four profiles on both risky drinking and alcohol-related consequences. These findings suggest the importance of assessing and addressing depressive symptoms among college students in order to reduce rates of risky drinking and alcohol-related consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: Proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group.

PubMed

Holtfreter, Birte; Albandar, Jasim M; Dietrich, Thomas; Dye, Bruce A; Eaton, Kenneth A; Eke, Paul I; Papapanou, Panos N; Kocher, Thomas

2015-05-01

Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are severely hampered and inferences regarding the global variation in prevalence can hardly be drawn. To overcome these limitations, the authors suggest standardized principles for the reporting of the prevalence and severity of periodontal diseases in future epidemiological studies. These principles include the comprehensive reporting of the study design, the recording protocol, and specific subject-related and oral data. Further, a range of periodontal data should be reported in the total population and within specific age groups. Periodontal data include the prevalence and extent of clinical attachment loss (CAL) and probing depth (PD) on site and tooth level according to specific thresholds, mean CAL/PD, the CDC/AAP case definition, and bleeding on probing. Consistent implementation of these standards in future studies will ensure improved reporting quality, permit meaningful comparisons of the prevalence of periodontal diseases across populations, and provide better insights into the determinants of such variation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Anaphylaxis in dogs and cats.

PubMed

Shmuel, Daniella L; Cortes, Yonaira

2013-01-01

To review and summarize current information regarding the pathophysiology and clinical manifestations associated with anaphylaxis in dogs and cats. The etiology, diagnosis, treatment, and prognosis is discussed. Anaphylaxis is a systemic, type I hypersensitivity reaction that often has fatal consequences. Many of the principal clinical manifestations involve organs where mast cell concentrations are highest: the skin, the lungs, and the gastrointestinal tract. Histamine and other deleterious inflammatory mediators promote vascular permeability and smooth muscle contraction; they are readily released from sensitized mast cells and basophils challenged with antigen. Anaphylaxis may be triggered by a variety of antigens including insect and reptile venom, a variety of drugs, vaccines, and food. Anaphylaxis is a clinical diagnosis made from a collection of signs and symptoms. It is most commonly based on pattern recognition. Differential diagnoses include severe asthma, pheocromocytoma, and mastocytosis. Epinephrine is considered the drug of choice for the treatment of anaphylaxis. It acts primarily as a vasopressor in improving hemodynamic recovery. Adjunctive treatments include fluid therapy, H1 and H2 antihistamines, corticosteroids, and bronchodilators; however, these do not substitute for epinephrine. Prognosis depends on the severity of the clinical signs. The clinical signs will vary among species and route of exposure. The most severe clinical reactions are associated when the antigen is administered parenterally. © Veterinary Emergency and Critical Care Society 2013.

Two advertisements for TV drug ads.

PubMed

Bodenheimer, Thomas

2003-01-01

The paper by Joel Weissman and colleagues addresses the increasingly important topic of the effects of direct-to-consumer advertising (DTCA) by pharmaceutical companies. The authors claim that their results should be reassuring to "those concerned about potential adverse health care consequences of DTCA". However, the study and analysis of the data are marred by several flaws that diminish the importance and relevance of the findings, including weakness in design, overgenerous interpretations, and failure to address key questions. Rather than informing the debate, the study amounts to little more than an advertisement for drug advertisements.

Ocular toxicity of fludarabine

PubMed Central

Ding, Xiaoyan; Herzlich, Alexandra A; Bishop, Rachel; Tuo, Jingsheng; Chan, Chi-Chao

2008-01-01

The purine analogs, fludarabine and cladribine represent an important class of chemotherapy agents used to treat a broad spectrum of lymphoid malignancies. Their toxicity profiles include dose-limiting myelosuppression, immunosuppression, opportunistic infection and severe neurotoxicity. This review summarizes the neurotoxicity of high- and standard-dose fludarabine, focusing on the clinical and pathological manifestations in the eye. The mechanisms of ocular toxicity are probably multifactorial. With increasing clinical use, an awareness of the neurological and ocular vulnerability, particularly to fludarabine, is important owing to the potential for life- and sight-threatening consequences. PMID:18461151

Social determinants, lived experiences, and consequences of household food insecurity among persons living with HIV/AIDS on the shore of Lake Victoria, Kenya.

PubMed

Nagata, Jason M; Magerenge, Richard O; Young, Sera L; Oguta, Joel O; Weiser, Sheri D; Cohen, Craig R

2012-01-01

Food insecurity is a considerable challenge in sub-Saharan Africa, disproportionately affecting persons living with HIV/AIDS. This study investigates the lived experience, determinants, and consequences of food insecurity and hunger among individuals living with HIV/AIDS on the shore of Lake Victoria in Suba District, Kenya. Parallel mixed methods included semi-structured interviews and administration of the Household Food Insecurity Access Scale among a systematic sample of 67 persons living with HIV/AIDS (49 of whom were receiving antiretroviral therapy [ART]). All respondents were either severely (79.1%) or moderately (20.9%) food insecure; no respondents were mildly food insecure or food secure. Qualitative data and simple and multiple linear regression models indicated that significant determinants of food insecurity include increased age, a greater number of children, and not being married. A number of themes related to food insecurity and ART emerged, including: (1) an increase in hunger or appetite since initiating ART; (2) exacerbation of ART-related side effects; and (3) non-adherence to ART due to hunger, food insecurity, or agricultural work responsibilities. HIV interventions should address food insecurity and hunger, particularly among at-risk populations, to promote ART adherence and better health outcomes.

Functional hypothalamic amenorrhea and its influence on women's health.

PubMed

Meczekalski, B; Katulski, K; Czyzyk, A; Podfigurna-Stopa, A; Maciejewska-Jeske, M

2014-11-01

Functional hypothalamic amenorrhea (FHA) is one of the most common causes of secondary amenorrhea. There are three types of FHA: weight loss-related, stress-related, and exercise-related amenorrhea. FHA results from the aberrations in pulsatile gonadotropin-releasing hormone (GnRH) secretion, which in turn causes impairment of the gonadotropins (follicle-stimulating hormone and luteinizing hormone). The final consequences are complex hormonal changes manifested by profound hypoestrogenism. Additionally, these patients present mild hypercortisolemia, low serum insulin levels, low insulin-like growth factor 1 (IGF-1) and low total triiodothyronine. The aim of this work is to review the available data concerning the effects of FHA on different aspects of women's health. Functional hypothalamic amenorrhea is related to profound impairment of reproductive functions including anovulation and infertility. Women's health in this disorder is disturbed in several aspects including the skeletal system, cardiovascular system, and mental problems. Patients manifest a decrease in bone mass density, which is related to an increase in fracture risk. Therefore, osteopenia and osteoporosis are the main long-term complications of FHA. Cardiovascular complications include endothelial dysfunction and abnormal changes in the lipid profile. FHA patients present significantly higher depression and anxiety and also sexual problems compared to healthy subjects. FHA patients should be carefully diagnosed and properly managed to prevent both short- and long-term medical consequences.

As fathers and felons: explaining the effects of current and recent incarceration on major depression.

PubMed

Turney, Kristin; Wildeman, Christopher; Schnittker, Jason

2012-01-01

Dramatic increases in the American imprisonment rate since the mid-1970s have important implications for the life chances of minority men with low educational attainment, including for their health. Although a large literature has considered the collateral consequences of incarceration for a variety of outcomes, studies concerned with health have several limitations: Most focus exclusively on physical health; those concerned with mental health only consider current incarceration or previous incarceration, but never both; some are cross-sectional; many fail to consider mechanisms; and virtually all neglect the role of family processes, thereby overlooking the social roles current and former prisoners inhabit. In this article, we use stress process theory to extend this research by first considering the association between incarceration and major depression and then considering potential mechanisms that explain this association. Results from the Fragile Families and Child Wellbeing Study (N = 3,107) show current and recent incarceration are substantially associated with the risk of major depression, suggesting both immediate and short-term implications. In addition, consistent with stress proliferation theory, the results show the well-known consequences of incarceration for socioeconomic status and family functioning partly explain these associations, suggesting the link between incarceration and depression depends heavily on the consequences of incarceration for economic and social reintegration, not only the direct psychological consequences of confinement.

Prevalence and Functional Consequences of Severe Insomnia Symptoms in Mood and Anxiety Disorders: Results from a Nationally Representative Sample

PubMed Central

Soehner, Adriane M.; Harvey, Allison G.

2012-01-01

Study Objectives: To evaluate the prevalence of severe insomnia symptoms and the extent to which they are associated with daytime impairments in comorbid mood and anxiety disorders. Design: Nationally representative cross-sectional survey. Setting: National Comorbidity Survey-Replication (NCS-R). Participants: There were 5,692 NCS-R respondents with no mood or anxiety disorder (n = 3,711), mood disorders only (n = 327), anxiety disorders only (n = 1,137), and coexisting mood and anxiety disorders (n = 517). Interventions: N/A. Measurements and Results: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders and severe insomnia symptoms in the past year were assessed using the World Health Organization (WHO) Composite International Diagnostic Interview. The World Health Organization Disability Assessment Schedule (WHO-DAS) indexed eight domains of daytime impairment in the past 30 days, which included self-care, mobility, cognition, social functioning, time out of role, and four components of productive role functioning. Respondents with comorbid mood and anxiety disorders had significantly higher rates of severe insomnia complaints (42.1-62.8%) relative to the three other groups. Severe insomnia complaints were also significantly more prevalent in individuals with mood (25.2-45.6%) or anxiety disorders only (24.9-45.5%) relative to those with no disorder (12.4-24.3%). Moreover, endorsing a severe insomnia complaint in the past year was associated with increased days of impairment across all past-month WHO-DAS domains for respondents with mood-anxiety comorbidity. For the remaining groups, severe insomnia complaints were related to increased days of impairment across all domains except self-care, and additionally mobility for the group with mood disorders only. Conclusions: Comorbid mood and anxiety disorders are associated with high rates of severe insomnia complaints, which were independently associated with substantial functional impairment. Citation: Soehner AM; Harvey AG. Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample. SLEEP 2012;35(10):1367–1375. PMID:23024435

Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain.

PubMed

Järemo, P; Arman, M; Gerdle, B; Larsson, B; Gottberg, K

2017-07-05

Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients' illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain. In this cross-sectional study, questionnaires were sent by mail to 330 patients including socio-demographic information, the Illness Perception Questionnaire (IPQ-R), the Short-Form General Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, non-parametric tests and linear regression analyses. Patients experienced and related a high number of symptoms to CWP (mean (SD) 9 (3)). The patients believed their illness to be long lasting, to affect their emotional well being, and to have negative consequences for their lives. Some 72% reported having severe or very severe pain, and impact of pain according to SF-36 was negatively correlated to several illness beliefs dimensions, anxiety- and depressive symptoms. In regression analyses, the Identity, Consequences and Personal control dimensions of IPQ-R and Anxiety- and Depressive symptoms explained 32.6-56.1% of the variance in the two component scores of SF-36. Constraining illness beliefs in patients with CWP are related to worse health status, especially in cases of high number of physical or mental symptoms, beliefs of negative consequences or the illness affecting them emotionally. Identification and understanding of these beliefs may reduce patients' suffering if they are taken into consideration in rehabilitation programs and in development of new evidence-based interventions aimed at increasing health in patients with CWP.

Less than severe worst case accidents

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

Sanders, G.A.

1996-08-01

Many systems can provide tremendous benefit if operating correctly, produce only an inconvenience if they fail to operate, but have extreme consequences if they are only partially disabled such that they operate erratically or prematurely. In order to assure safety, systems are often tested against the most severe environments and accidents that are considered possible to ensure either safe operation or safe failure. However, it is often the less severe environments which result in the ``worst case accident`` since these are the conditions in which part of the system may be exposed or rendered unpredictable prior to total system failure.more » Some examples of less severe mechanical, thermal, and electrical environments which may actually be worst case are described as cautions for others in industries with high consequence operations or products.« less

Population decline induced by gonorrhoea and tuberculosis transmission: Micronesia during the Japanese occupation, 1919–45

PubMed Central

Singer, Burton H.

2011-01-01

The islands of Yap in Micronesia survived a period of severe depopulation during the Japanese occupation from 1919 to 1945. Using data from historical documents, supplemented by ethnographic evidence, we calibrate a simulation model that accounts for this phenomenon. Our model tracks the reproduction histories of a synthetic cohort of women in Yap, including effects of infertility due to gonorrhoea as well as tuberculosis mortality, and predicts the net reproduction rate (NRR). In this particular case and throughout history, human migrations and associated social and cultural interactions have frequently been accompanied by dramatic changes in patterns of disease transmission and substantial demographic consequences. Despite the broad emphasis on mortality as a measure of demographic consequences in the historical and contemporary literature, there are important instances where life expectancy at birth, fertility rates, and total population size are important demographic consequences. We find that gonorrhoea may have significantly contributed to depopulation during the Japanese occupation of Micronesia, due to repeated infections and high risk of sterility. Results of our model suggest that gonorrhoea alone could have reduced the net reproduction rate by 82%, whereas deaths from tuberculosis may have contributed to a 17% decline. PMID:21666856

Nucleotide excision repair and human syndromes.

PubMed

de Boer, J; Hoeijmakers, J H

2000-03-01

DNA damage is implicated in cancer and aging, and several DNA repair mechanisms exist that safeguard the genome from these deleterious consequences. Nucleotide excision repair (NER) removes a wide diversity of lesions, the main of which include UV-induced lesions, bulky chemical adducts and some forms of oxidative damage. The NER process involves the action of at least 30 proteins in a 'cut-and-paste'-like mechanism. The consequences of a defect in one of the NER proteins are apparent from three rare recessive syndromes: xeroderma pigmentosum (XP), Cockayne syndrome (CS) and the photosensitive form of the brittle hair disorder trichothiodystrophy (TTD). Sun-sensitive skin is associated with skin cancer predisposition in the case of XP, but remarkably not in CS and TTD. Moreover, the spectrum of clinical symptoms differs considerably between the three syndromes. CS and TTD patients exhibit a spectrum of neurodevelopmental abnormalities and, in addition, TTD is associated with ichthyosis and brittle hair. These typical CS and TTD abnormalities are difficult to comprehend as a consequence of defective NER. This review briefly describes the biochemistry of the NER process, summarizes the clinical features of the NER disorders and speculates on the molecular basis underlying these pleitropic syndromes.

Ecosystems and Land Use Change

NASA Astrophysics Data System (ADS)

DeFries, Ruth S.; Asner, Gregory P.; Houghton, Richard A.

Land use is at the center of one of the most vexing challenges for the coming decades: to provide enough food, fiber and shelter for the world's population; raise the standard of living for the billion people currently below the poverty line; and simultaneously sustain the world's ecosystems for use by humans and other species. The intended consequence of cropland expansion, urban growth, and other land use changes is to satisfy demands from the increasing appetite of the world's population. Unintended consequences, however, can alter ecological processes and have far-reaching and long-term effects that potentially compromise the basic functioning of ecosystems. Recently, the scientific community has begun to confront such issues. Several national and international programs have been at the forefront of scientific enquiry on the causes and consequences of land use change, including: the Land Use and Land Cover Change Program of the National Aeronautics and Space Administration, the Land Use program element in the interagency U.S. Climate Change Science Program, and the International Geosphere-Biosphere's Land Use and Cover Change (LUCC) core project. The result has been significant advances in understanding the complex socioeconomic, technological, and biophysical factors that drive land use change worldwide.

Preface

NASA Astrophysics Data System (ADS)

DeFries, Ruth S.; Asner, Gregory P.; Houghton, Richard A.

Land use is at the center of one of the most vexing challenges for the coming decades: to provide enough food, fiber and shelter for the world's population; raise the standard of living for the billion people currently below the poverty line; and simultaneously sustain the world's ecosystems for use by humans and other species. The intended consequence of cropland expansion, urban growth, and other land use changes is to satisfy demands from the increasing appetite of the world's population. Unintended consequences, however, can alter ecological processes and have far-reaching and long-term effects that potentially compromise the basic functioning of ecosystems. Recently, the scientific community has begun to confront such issues. Several national and international programs have been at the forefront of scientific enquiry on the causes and consequences of land use change, including: the Land Use and Land Cover Change Program of the National Aeronautics and Space Administration, the Land Use program element in the interagency U.S. Climate Change Science Program, and the International Geosphere-Biosphere's Land Use and Cover Change (LUCC) core project. The result has been significant advances in understanding the complex socioeconomic, technological, and biophysical factors that drive land use change worldwide.

Effect of visual method vs plaque disclosure in enhancing oral hygiene in adolescents and young adults: a single-blind randomized controlled trial.

PubMed

Peng, Yiran; Wu, Ruixian; Qu, Wenwen; Wu, Wanhong; Chen, Jiangyue; Fang, Jie; Chen, Yangxi; Farella, Mauro; Mei, Li

2014-03-01

Enamel demineralization and gingival inflammation are the most prevalent consequences of biofilm formation in orthodontics. Our hypothesis was that educating patients about the severe consequences of biofilm accumulation could enhance their oral hygiene while wearing fixed appliances. This study was designed as a randomized controlled 4-arm parallel trial. A total of 148 participants in Chengdu, China, matching the eligibility criteria of 11 to 25 years of age, at least 20 natural teeth, and a treatment plan that included conventional stainless steel brackets, were randomly assigned to 4 intervention groups based on computer-generated random sequencing using simple randomization without blocking. In group A (n = 37), the subjects were shown images illustrating the severe consequences of biofilm formation, including enamel demineralization and gingival inflammation; subjects in group B (n = 40) were given biofilm disclosing tablets; those in group C (n = 38) received a combination of A and B; the subjects in group D (n = 33) served as the controls. The investigators were blinded to the allocations, and the researcher managing the random sequence did not participate in allocation or measurement. All groups received routine oral hygiene instructions. Plaque index and gingival index scores were recorded at each appointment during a 6-month follow-up. Eighteen participants were lost during follow-up, resulting in a total of 130 participants after the trial (group A, 35; group B, 32; group C, 34; group D, 29). No adverse events were recorded. Groups A and C exhibited a significantly lower plaque index scores (parameter-estimate [95% confidence interval] = -1.20 [-1.76 to -0.63] for group A, and -1.12 [-1.69 to -0.56] for group C) and gingival index scores (-0.13 [-0.21 to -0.04], and -0.19 [-0.28 to -0.10]), respectively, compared with group D (P <0.001 for all), whereas no significant difference was found between groups B and D, or between groups A and C (P >0.05). The adults had significantly lower plaque index (0.48 [0.13-0.84], P <0.001) and gingival index (0.06 [0.01-0.11], P = 0.018) scores than did the teenagers, and the female subjects had significantly higher gingival index (-0.06 [-0.11 to -0.01], P = 0.040) scores than did the male subjects. The use of images showing the severe consequences of biofilm accumulation enhanced the oral hygiene of patients treated with fixed appliances. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Why do young people consume marijuana? Extending motivational theory via the Dualistic Model of Passion.

PubMed

Davis, Alan K; Arterberry, Brooke J; Bonar, Erin E; Bohnert, Kipling M; Walton, Maureen A

2018-03-01

We evaluated an extended model of motivation for consuming marijuana by combining motivational theory and the dualistic model of passion. An online sample of 524 young, frequent marijuana consumers (M age = 24; 88% male; M past-30-days =21; Mode=31; 50% used 25-31 days) self-administered several questionnaires including the Marijuana-Harmonious and Obsessive Passion Scale and the Marijuana Motives Measure. Intercorrelations among the obsessive and harmonious passion and motives subscales were small-to-medium. A canonical correlation analysis revealed that obsessive passion was significantly positively associated with coping and conformity motives, while controlling for marijuana use, other motives, and harmonious passion scores. Additionally, harmonious passion was significantly positively associated with expansion, social, enhancement, and coping motives, while controlling for marijuana use and obsessive passion scores. A second canonical correlation analysis revealed that, when motive and passion subscales were included as independent predictors of recent marijuana use and related consequences, high obsessive passion and coping motives emerged as significant predictors of recent use and related consequences. Moreover, high harmonious passion and using less for conformity motives emerged as significant predictors of recent marijuana use. These results demonstrate that passion is related to, but not a proxy for, previously established motives for marijuana use and that, when examined simultaneously, both types of passion predict recent consumption but appear to differentiate whether one will experience use-related consequences. Researchers and clinicians could evaluate whether addressing obsessive passion and coping motives reduces or ameliorates negative outcomes associated with consumption.

Independent Neuronal Origin of Seizures and Behavioral Comorbidities in an Animal Model of a Severe Childhood Genetic Epileptic Encephalopathy

PubMed Central

Asinof, Samuel K.; Sukoff Rizzo, Stacey J.; Buckley, Alexandra R.; Beyer, Barbara J.; Letts, Verity A.; Frankel, Wayne N.; Boumil, Rebecca M.

2015-01-01

The childhood epileptic encephalopathies (EE’s) are seizure disorders that broadly impact development including cognitive, sensory and motor progress with severe consequences and comorbidities. Recently, mutations in DNM1 (dynamin 1) have been implicated in two EE syndromes, Lennox-Gastaut Syndrome and Infantile Spasms. Dnm1 encodes dynamin 1, a large multimeric GTPase necessary for activity-dependent membrane recycling in neurons, including synaptic vesicle endocytosis. Dnm1Ftfl or “fitful” mice carry a spontaneous mutation in the mouse ortholog of DNM1 and recapitulate many of the disease features associated with human DNM1 patients, providing a relevant disease model of human EE’s. In order to examine the cellular etiology of seizures and behavioral and neurological comorbidities, we engineered a conditional Dnm1Ftfl mouse model of DNM1 EE. Observations of Dnm1 Ftfl/flox mice in combination with various neuronal subpopulation specific cre strains demonstrate unique seizure phenotypes and clear separation of major neurobehavioral comorbidities from severe seizures associated with the germline model. This demonstration of pleiotropy suggests that treating seizures per se may not prevent severe comorbidity observed in EE associated with dynamin-1 mutations, and is likely to have implications for other genetic forms of EE. PMID:26125563

Illness Perceptions and Mortality in Patients With Gout: A Prospective Observational Study.

PubMed

Serlachius, Anna; Gamble, Greg; House, Meaghan; Vincent, Zoe L; Knight, Julie; Horne, Anne; Taylor, William J; Petrie, Keith J; Dalbeth, Nicola

2017-09-01

To examine whether illness perceptions independently predict mortality in early-onset gout. Between December 2006 and January 2014, a total of 295 participants with early-onset gout (<10 years) were recruited in Auckland and Wellington, New Zealand. The participants were followed up until February 2015, and mortality information was collected. Participants with complete data were included in the current study (n = 242). Cox proportional hazards models were used to examine the association between illness perceptions and mortality risk, after adjustment for covariates associated with disease severity and mortality in gout. In a Cox proportional hazards model adjusted for predictors of disease severity and mortality in gout (number of tophi, serum urate level, and frequency of flares), consequence beliefs, identity beliefs, concern beliefs, and emotional response to gout were associated with all-cause mortality (hazard ratios [HRs] 1.29, 1.15, 1.18, and 1.19, respectively; P < 0.05 for all). In the fully saturated model, the association between consequence beliefs and mortality remained robust after additional adjustment for ethnicity, disease duration, diuretic use, serum creatinine, and pain score (HR 1.18 [95% confidence interval 1.02-1.37]; P = 0.029). Negative beliefs about the impact of gout and severity of symptoms, as well as concerns about gout and the emotional response to gout, were independently associated with all-cause mortality. Illness perceptions are important and potentially modifiable risk factors to target in future interventions. © 2016, American College of Rheumatology.

Psychosocial impact of dysthymia: a study among married patients.

PubMed

Subodh, B N; Avasthi, A; Chakrabarti, S

2008-07-01

Unlike major depression, the psychosocial impact of dysthymia has received far less research attention. This study attempted to assess the psychosocial consequences of dysthymia. The sample consisted of 30 married patients with DSM-IV dysthymic disorder and a matched control group of 30 married patients with recurrent major depressive disorder (RDD), diagnosed using structured interviews. Apart from ratings of severity of depression, assessments of psychosocial impact included quality of life (QOL), disability, perceived social support and marital adjustment. Psychosocial parameters were evaluated using vernacular versions of well-validated scales previously used in similar populations. Matched normal/medically ill controls were derived from Indian studies which had assessed the same parameters using the same instruments. Patients with dysthymia were significantly impaired on measures of QOL, disability, social support and marital adjustment compared to normal/medically ill controls. On the other hand, the two groups of dysthymia and RDD were comparable on these measures apart from significantly lower social support among patients with dysthymia. Duration of illness and severity of depression emerged as the most important correlates, particularly of impaired QOL and disability levels. Small hospital-based sample, normal/medically ill controls derived from other studies and cross-sectional assessments were the major limitations. Dysthymia had considerable adverse psychosocial impact in terms of QOL, functioning (disability), social support and marital adjustment. Severity and chronicity appeared to be important mediators of this negative psychosocial impact. Increased awareness, improved recognition and adequate treatment might help negate some of the untoward social consequences of this condition.

Can intersectional innovations reduce hospital infection?

PubMed

Saint, S

2017-02-01

Preventing healthcare-associated infection remains an international priority given the clinical and economic consequences of this largely preventable patient safety harm. Whereas important strides have been made in preventing hospital infections over the past several decades, thorny issues remain, including how to consistently improve hand hygiene rates and further reduce device-related complications such as catheter-associated urinary tract infection. Rather than relying solely on directional innovations - incremental changes that continue to serve as the bedrock of scientific advancement - perhaps we should also search for 'intersectional innovations', which represent breakthrough discoveries that emanate from the intersection of often widely divergent disciplines. Several intersectional innovations that have the potential to greatly impact infection prevention efforts include human factors engineering, sociology, and engaging the senses. Indeed, Professor Edward Joseph Lister Lowbury, the namesake of this lecture, exemplified intersectional thinking in his own life, having been both an accomplished bacteriologist and poet. By incorporating approaches outside of traditional biomedical science we may hope to provide patients with the safe care they expect and deserve. Published by Elsevier Ltd.

Design of biomimetic cellular scaffolds for co-culture system and their application

PubMed Central

Kook, Yun-Min; Jeong, Yoon; Lee, Kangwon; Koh, Won-Gun

2017-01-01

The extracellular matrix of most natural tissues comprises various types of cells, including fibroblasts, stem cells, and endothelial cells, which communicate with each other directly or indirectly to regulate matrix production and cell functionality. To engineer multicellular interactions in vitro, co-culture systems have achieved tremendous success achieving a more realistic microenvironment of in vivo metabolism than monoculture system in the past several decades. Recently, the fields of tissue engineering and regenerative medicine have primarily focused on three-dimensional co-culture systems using cellular scaffolds, because of their physical and biological relevance to the extracellular matrix of actual tissues. This review discusses several materials and methods to create co-culture systems, including hydrogels, electrospun fibers, microfluidic devices, and patterning for biomimetic co-culture system and their applications for specific tissue regeneration. Consequently, we believe that culture systems with appropriate physical and biochemical properties should be developed, and direct or indirect cell–cell interactions in the remodeled tissue must be considered to obtain an optimal tissue-specific microenvironment. PMID:29081966

Design of biomimetic cellular scaffolds for co-culture system and their application.

PubMed

Kook, Yun-Min; Jeong, Yoon; Lee, Kangwon; Koh, Won-Gun

2017-01-01

The extracellular matrix of most natural tissues comprises various types of cells, including fibroblasts, stem cells, and endothelial cells, which communicate with each other directly or indirectly to regulate matrix production and cell functionality. To engineer multicellular interactions in vitro, co-culture systems have achieved tremendous success achieving a more realistic microenvironment of in vivo metabolism than monoculture system in the past several decades. Recently, the fields of tissue engineering and regenerative medicine have primarily focused on three-dimensional co-culture systems using cellular scaffolds, because of their physical and biological relevance to the extracellular matrix of actual tissues. This review discusses several materials and methods to create co-culture systems, including hydrogels, electrospun fibers, microfluidic devices, and patterning for biomimetic co-culture system and their applications for specific tissue regeneration. Consequently, we believe that culture systems with appropriate physical and biochemical properties should be developed, and direct or indirect cell-cell interactions in the remodeled tissue must be considered to obtain an optimal tissue-specific microenvironment.

An Exploration of the Mediators Between Childhood Maltreatment and Intimate Partner Violence.

PubMed

Smyth, Elizabeth J; Gardner, Frank L; Marks, Donald R; Moore, Zella E

2017-08-01

Intimate partner violence (IPV) is associated with numerous long-term consequences and warrants significant clinical attention. Recent theoretical models and empirical research have suggested that several factors play a role in the development of IPV perpetration, including childhood maltreatment, early maladaptive schemas, anger, and difficulties in emotion regulation. This study investigated the relationship between childhood maltreatment and IPV, specifically examining the mediation of this relationship by several variables thought to be related to this pernicious problem, including early maladaptive schemas, the experience of anger, and emotion regulation difficulties. In a young adult collegiate sample of 110 women in relationships, results of a bootstrapped multiple mediation analysis supported the hypothesis that childhood maltreatment predicted physical aggression within intimate partner relationships and found that the total indirect effect of childhood maltreatment on physical aggression through the 3 proposed mediators was significant. However, consistent with recent empirical findings, only difficulties in emotion regulation significantly mediated the relationship between childhood maltreatment and physical aggression within the sample.

Pituitary Dysfunction after Blast Traumatic Brain Injury: The UK BIOSAP Study

PubMed Central

Baxter, David; Sharp, David J; Feeney, Claire; Papadopoulou, Debbie; Ham, Timothy E; Jilka, Sagar; Hellyer, Peter J; Patel, Maneesh C; Bennett, Alexander N; Mistlin, Alan; McGilloway, Emer; Midwinter, Mark; Goldstone, Anthony P

2013-01-01

Objective Pituitary dysfunction is a recognized consequence of traumatic brain injury (TBI) that causes cognitive, psychological, and metabolic impairment. Hormone replacement offers a therapeutic opportunity. Blast TBI (bTBI) from improvised explosive devices is commonly seen in soldiers returning from recent conflicts. We investigated: (1) the prevalence and consequences of pituitary dysfunction following moderate to severe bTBI and (2) whether it is associated with particular patterns of brain injury. Methods Nineteen male soldiers with moderate to severe bTBI (median age = 28.3 years) and 39 male controls with moderate to severe nonblast TBI (nbTBI; median age = 32.3 years) underwent full dynamic endocrine assessment between 2 and 48 months after injury. In addition, soldiers had structural brain magnetic resonance imaging, including diffusion tensor imaging (DTI), and cognitive assessment. Results Six of 19 (32.0%) soldiers with bTBI, but only 1 of 39 (2.6%) nbTBI controls, had anterior pituitary dysfunction (p = 0.004). Two soldiers had hyperprolactinemia, 2 had growth hormone (GH) deficiency, 1 had adrenocorticotropic hormone (ACTH) deficiency, and 1 had combined GH/ACTH/gonadotrophin deficiency. DTI measures of white matter structure showed greater traumatic axonal injury in the cerebellum and corpus callosum in those soldiers with pituitary dysfunction than in those without. Soldiers with pituitary dysfunction after bTBI also had a higher prevalence of skull/facial fractures and worse cognitive function. Four soldiers (21.1%) commenced hormone replacement(s) for hypopituitarism. Interpretation We reveal a high prevalence of anterior pituitary dysfunction in soldiers suffering moderate to severe bTBI, which was more frequent than in a matched group of civilian moderate to severe nbTBI subjects. We recommend that all patients with moderate to severe bTBI should routinely have comprehensive assessment of endocrine function. Ann Neurol 2013;74:527–536 PMID:23794460

Impact and prevention of severe exacerbations of COPD: a review of the evidence

PubMed Central

Halpin, David MG; Miravitlles, Marc; Metzdorf, Norbert; Celli, Bartolomé

2017-01-01

Severe exacerbations of COPD, ie, those leading to hospitalization, have profound clinical implications for patients and significant economic consequences for society. The prevalence and burden of severe COPD exacerbations remain high, despite recognition of the importance of exacerbation prevention and the availability of new treatment options. Severe COPD exacerbations are associated with high mortality, have negative impact on quality of life, are linked to cardiovascular complications, and are a significant burden on the health-care system. This review identified risk factors that contribute to the development of severe exacerbations, treatment options (bronchodilators, antibiotics, corticosteroids [CSs], oxygen therapy, and ventilator support) to manage severe exacerbations, and strategies to prevent readmission to hospital. Risk factors that are amenable to change have been highlighted. A number of bronchodilators have demonstrated successful reduction in risk of severe exacerbations, including long-acting muscarinic antagonist or long-acting β2-agonist mono- or combination therapies, in addition to vaccination, mucolytic and antibiotic therapy, and nonpharmacological interventions, such as pulmonary rehabilitation. Recognition of the importance of severe exacerbations is an essential step in improving outcomes for patients with COPD. Evidence-based approaches to prevent and manage severe exacerbations should be implemented as part of targeted strategies for disease management. PMID:29062228

Impulsivity, frontal lobes and risk for addiction.

PubMed

Crews, Fulton Timm; Boettiger, Charlotte Ann

2009-09-01

Alcohol and substance abuse disorders involve continued use of substances despite negative consequences, i.e. loss of behavioral control of drug use. The frontal-cortical areas of the brain oversee behavioral control through executive functions. Executive functions include abstract thinking, motivation, planning, attention to tasks and inhibition of impulsive responses. Impulsiveness generally refers to premature, unduly risky, poorly conceived actions. Dysfunctional impulsivity includes deficits in attention, lack of reflection and/or insensitivity to consequences, all of which occur in addiction [Evenden JL. Varieties of impulsivity. Psychopharmacology (Berl) 1999;146:348-361.; de Wit H. Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addict Biol 2009;14:22-31]. Binge drinking models indicate chronic alcohol damages in the corticolimbic brain regions [Crews FT, Braun CJ, Hoplight B, Switzer III RC, Knapp DJ. Binge ethanol consumption causes differential brain damage in young adolescent rats compared with adult rats. Alcohol Clin Exp Res 2000;24:1712-1723] causing reversal learning deficits indicative of loss of executive function [Obernier JA, White AM, Swartzwelder HS, Crews FT. Cognitive deficits and CNS damage after a 4-day binge ethanol exposure in rats. Pharmacol Biochem Behav 2002b;72:521-532]. Genetics and adolescent age are risk factors for alcoholism that coincide with sensitivity to alcohol-induced neurotoxicity. Cortical degeneration from alcohol abuse may increase impulsivity contributing to the development, persistence and severity of alcohol use disorders. Interestingly, abstinence results in bursts of neurogenesis and brain regrowth [Crews FT, Nixon K. Mechanisms of neurodegeneration and regeneration in alcoholism. Alcohol Alcohol 2009;44:115-127]. Treatments for alcoholism, including naltrexone pharmacotherapy and psychotherapy may work through improving executive functions. This review will examine the relationships between impulsivity and executive function behaviors to changes in cortical structure during alcohol dependence and recovery.

Fatigue following Acute Q-Fever: A Systematic Literature Review

PubMed Central

Delsing, Corine E.; Bleijenberg, Gijs; Langendam, Miranda; Timen, Aura; Bleeker-Rovers, Chantal P.

2016-01-01

Background Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007–2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever. Design A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed. Results Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6–12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis. Conclusions Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed. PMID:27223465

Fatigue following Acute Q-Fever: A Systematic Literature Review.

PubMed

Morroy, Gabriella; Keijmel, Stephan P; Delsing, Corine E; Bleijenberg, Gijs; Langendam, Miranda; Timen, Aura; Bleeker-Rovers, Chantal P

2016-01-01

Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007-2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever. A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed. Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6-12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis. Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed.

Sub-Chronic Neuropathological and Biochemical Changes in Mouse Visual System after Repetitive Mild Traumatic Brain Injury

PubMed Central

Tzekov, Radouil; Dawson, Clint; Orlando, Megan; Mouzon, Benoit; Reed, Jon; Evans, James; Crynen, Gogce; Mullan, Michael; Crawford, Fiona

2016-01-01

Repetitive mild traumatic brain injury (r-mTBI) results in neuropathological and biochemical consequences in the human visual system. Using a recently developed mouse model of r-mTBI, with control mice receiving repetitive anesthesia alone (r-sham) we assessed the effects on the retina and optic nerve using histology, immunohistochemistry, proteomic and lipidomic analyses at 3 weeks post injury. Retina tissue was used to determine retinal ganglion cell (RGC) number, while optic nerve tissue was examined for cellularity, myelin content, protein and lipid changes. Increased cellularity and areas of demyelination were clearly detectable in optic nerves in r-mTBI, but not in r-sham. These changes were accompanied by a ~25% decrease in the total number of Brn3a-positive RGCs. Proteomic analysis of the optic nerves demonstrated various changes consistent with a negative effect of r-mTBI on major cellular processes like depolymerization of microtubules, disassembly of filaments and loss of neurons, manifested by decrease of several proteins, including neurofilaments (NEFH, NEFM, NEFL), tubulin (TUBB2A, TUBA4A), microtubule-associated proteins (MAP1A, MAP1B), collagen (COL6A1, COL6A3) and increased expression of other proteins, including heat shock proteins (HSP90B1, HSPB1), APOE and cathepsin D. Lipidomic analysis showed quantitative changes in a number of phospholipid species, including a significant increase in the total amount of lysophosphatidylcholine (LPC), including the molecular species 16:0, a known demyelinating agent. The overall amount of some ether phospholipids, like ether LPC, ether phosphatidylcholine and ether lysophosphatidylethanolamine were also increased, while the majority of individual molecular species of ester phospholipids, like phosphatidylcholine and phosphatidylethanolamine, were decreased. Results from the biochemical analysis correlate well with changes detected by histological and immunohistochemical methods and indicate the involvement of several important molecular pathways. This will allow future identification of therapeutic targets for improving the visual consequences of r-mTBI. PMID:27088355

Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray.

PubMed

Haar, Rohini J; Iacopino, Vincent; Ranadive, Nikhil; Weiser, Sheri D; Dandu, Madhavi

2017-10-19

Chemical irritants used in crowd control, such as tear gases and pepper sprays, are generally considered to be safe and to cause only transient pain and lacrimation. However, there are numerous reports that use and misuse of these chemicals may cause serious injuries. We aimed to review documented injuries from chemical irritants to better understand the morbidity and mortality associated with these weapons. We conducted a systematic review using PRISMA guidelines to identify injuries, permanent disabilities, and deaths from chemical irritants worldwide between January 1, 1990 and March 15, 2015. We reviewed injuries to different body systems, injury severity, and potential risk factors for injury severity. We also assessed region, context and quality of each included article. We identified 31 studies from 11 countries. These reported on 5131 people who suffered injuries, two of whom died and 58 of whom suffered permanent disabilities. Out of 9261 total injuries, 8.7% were severe and required professional medical management, while 17% were moderate and 74.3% were minor. Severe injuries occurred to all body systems, with the majority of injuries impacting the skin and eyes. Projectile munition trauma caused 231 projectile injuries, with 63 (27%) severe injuries, including major head injury and vision loss. Potentiating factors for more severe injury included environmental conditions, prolonged exposure time, and higher quantities of chemical agent in enclosed spaces. Although chemical weapons may have a limited role in crowd control, our findings demonstrate that they have significant potential for misuse, leading to unnecessary morbidity and mortality. A nuanced understanding of the health impacts of chemical weapons and mitigating factors is imperative to avoiding indiscriminate use of chemical weapons and associated health consequences.

Extremal equilibria for reaction-diffusion equations in bounded domains and applications

NASA Astrophysics Data System (ADS)

Rodríguez-Bernal, Aníbal; Vidal-López, Alejandro

We show the existence of two special equilibria, the extremal ones, for a wide class of reaction-diffusion equations in bounded domains with several boundary conditions, including non-linear ones. They give bounds for the asymptotic dynamics and so for the attractor. Some results on the existence and/or uniqueness of positive solutions are also obtained. As a consequence, several well-known results on the existence and/or uniqueness of solutions for elliptic equations are revisited in a unified way obtaining, in addition, information on the dynamics of the associated parabolic problem. Finally, we ilustrate the use of the general results by applying them to the case of logistic equations. In fact, we obtain a detailed picture of the positive dynamics depending on the parameters appearing in the equation.

In vivo imaging of the pathophysiological changes and neutrophil dynamics in influenza virus-infected mouse lungs.

PubMed

Ueki, Hiroshi; Wang, I-Hsuan; Fukuyama, Satoshi; Katsura, Hiroaki; da Silva Lopes, Tiago Jose; Neumann, Gabriele; Kawaoka, Yoshihiro

2018-06-25

The pathophysiological changes that occur in lungs infected with influenza viruses are poorly understood. Here we established an in vivo imaging system that combines two-photon excitation microscopy and fluorescent influenza viruses of different pathogenicity. This approach allowed us to monitor and correlate several parameters and physiological changes including the spread of infection, pulmonary permeability, pulmonary perfusion speed, number of recruited neutrophils in infected lungs, and neutrophil motion in the lungs of live mice. Several physiological changes were larger and occurred earlier in mice infected with a highly pathogenic H5N1 influenza virus compared with those infected with a mouse-adapted human strain. These findings demonstrate the potential of our in vivo imaging system to provide novel information about the pathophysiological consequences of virus infections.

Deep brain stimulation of the anterior limb of the internal capsule for treatment of therapy-refractory obsessive compulsive disorder (OCD): a case study highlighting neurocognitive and psychiatric changes.

PubMed

Choudhury, Tabina K; Davidson, Joyce E; Viswanathan, Ashwin; Strutt, Adriana M

2017-04-01

Obsessive compulsive disorder (OCD) is an anxiety disorder characterized by repeated, unwanted thoughts and behaviors. Individuals with this condition often experience significant emotional distress secondary to their symptoms. Additionally, impairments in attention/concentration, processing speed, and executive functions are typically observed. The exact pathology of OCD remains unknown; consequently, it can be difficult to treat patients with severe symptomatology. Deep brain stimulation (DBS) may be a viable treatment option for individuals who do not respond to medication and/or cognitive behavioral therapy. The following case discusses DBS of the anterior limb of the internal capsule for a patient with severe, therapy-refractory OCD, including pre- to postoperative neurocognitive and psychiatric changes.

Evaluation of an Eulerian multi-material mixture formulation based on a single inverse deformation gradient tensor field

DOE PAGES

Ghaisas, N. S.; Subramaniam, A.; Lele, S. K.; ...

2017-12-31

We report high energy-density solids undergoing elastic-plastic deformations coupled to compressible fluids are a common occurrence in engineering applications. Examples include problems involving high-velocity impact and penetration, cavitation, and several manufacturing processes, such as cold forming. Numerical simulations of such phenomena require the ability to handle the interaction of shock waves with multi-material interfaces that can undergo large deformations and severe distortions. As opposed to Lagrangian (Benson 1992) and arbitrary Lagrangian-Eulerian (ALE) methods (Donea et al. 2004), fully Eulerian methods use grids that do not change in time. Consequently, Eulerian methods do not suffer from difficulties on account of meshmore » entanglement, and do not require periodic, expensive, remap operations.« less

Evaluation of an Eulerian multi-material mixture formulation based on a single inverse deformation gradient tensor field

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

Ghaisas, N. S.; Subramaniam, A.; Lele, S. K.

We report high energy-density solids undergoing elastic-plastic deformations coupled to compressible fluids are a common occurrence in engineering applications. Examples include problems involving high-velocity impact and penetration, cavitation, and several manufacturing processes, such as cold forming. Numerical simulations of such phenomena require the ability to handle the interaction of shock waves with multi-material interfaces that can undergo large deformations and severe distortions. As opposed to Lagrangian (Benson 1992) and arbitrary Lagrangian-Eulerian (ALE) methods (Donea et al. 2004), fully Eulerian methods use grids that do not change in time. Consequently, Eulerian methods do not suffer from difficulties on account of meshmore » entanglement, and do not require periodic, expensive, remap operations.« less

Spatiotemporal characterization of mTOR kinase activity following kainic acid induced status epilepticus and analysis of rat brain response to chronic rapamycin treatment.

PubMed

Macias, Matylda; Blazejczyk, Magdalena; Kazmierska, Paulina; Caban, Bartosz; Skalecka, Agnieszka; Tarkowski, Bartosz; Rodo, Anna; Konopacki, Jan; Jaworski, Jacek

2013-01-01

Mammalian target of rapamycin (mTOR) is a protein kinase that senses nutrient availability, trophic factors support, cellular energy level, cellular stress, and neurotransmitters and adjusts cellular metabolism accordingly. Adequate mTOR activity is needed for development as well as proper physiology of mature neurons. Consequently, changes in mTOR activity are often observed in neuropathology. Recently, several groups reported that seizures increase mammalian target of rapamycin (mTOR) kinase activity, and such increased activity in genetic models can contribute to spontaneous seizures. However, the current knowledge about the spatiotemporal pattern of mTOR activation induced by proconvulsive agents is rather rudimentary. Also consequences of insufficient mTOR activity on a status epilepticus are poorly understood. Here, we systematically investigated these two issues. We showed that mTOR signaling was activated by kainic acid (KA)-induced status epilepticus through several brain areas, including the hippocampus and cortex as well as revealed two waves of mTOR activation: an early wave (2 h) that occurs in neurons and a late wave that predominantly occurs in astrocytes. Unexpectedly, we found that pretreatment with rapamycin, a potent mTOR inhibitor, gradually (i) sensitized animals to KA treatment and (ii) induced gross anatomical changes in the brain.

The inequitable impact of health shocks on the uninsured in Namibia.

PubMed

Gustafsson-Wright, Emily; Janssens, Wendy; van der Gaag, Jacques

2011-03-01

The AIDS pandemic in sub-Saharan Africa puts increasing pressure on the buffer capacity of low- and middle-income households without access to health insurance. This paper examines the relationship between health shocks, insurance status and health-seeking behaviour. It also investigates the possible mitigating effects of insurance on income loss and out-of-pocket health expenditure. The study uses a unique dataset based on a random sample of 1769 households and 7343 individuals living in the Greater Windhoek area in Namibia. The survey includes medical testing for HIV infection which allows for the explicit analysis of HIV-related health shocks. We find that the economic consequences of health shocks can be severe for uninsured households even in a country with a relatively well-developed public health care system such as Namibia. The uninsured resort to a variety of coping strategies to deal with the high medical expenses and reductions in income, such as selling assets, taking up credit or receiving financial support from relatives and friends. As HIV-infected individuals increasingly develop AIDS, this will put substantial pressure on the public health care system as well as social support networks. Evidence suggests that private insurance, currently unaffordable to the poor, protects households from the most severe consequences of health shocks.

Does choice of estimators influence conclusions from true metabolizable energy feeding trials?

USGS Publications Warehouse

Sherfy, M.H.; Kirkpatrick, R.L.; Webb, K.E.

2005-01-01

True metabolizable energy (TME) is a measure of avian dietary quality that accounts for metabolic fecal and endogenous urinary energy losses (EL) of non-dietary origin. The TME is calculated using a bird fed the test diet and an estimate of EL derived from another bird (Paired Bird Correction), the same bird (Self Correction), or several other birds (Group Mean Correction). We evaluated precision of these estimators by using each to calculate TME of three seed diets in blue-winged teal (Anas discors). The TME varied by <2% among estimators for all three diets, and Self Correction produced the least variable TMEs for each. The TME did not differ between estimators in nine paired comparisons within diets, but variation between estimators within individual birds was sufficient to be of practical consequence. Although differences in precision among methods were slight, Self Correction required the lowest sample size to achieve a given precision. Feeding trial methods that minimize variation among individuals have several desirable properties, including higher precision of TME estimates and more rigorous experimental control. Consequently, we believe that Self Correction is most likely to accurately represent nutritional value of food items and should be considered the standard method for TME feeding trials. ?? Dt. Ornithologen-Gesellschaft e.V. 2005.

A national survey of childhood physical abuse among females in Swaziland

PubMed Central

Breiding, Matthew J.; Mercy, James A.; Gulaid, Jama; Reza, Avid; Hleta-Nkambule, Nonhlanhla

2015-01-01

Objective This study describes the scope and characteristics of childhood physical abuse in a nationally representative sample of 13–24 year-old females in Swaziland. The current study also examined health consequences and risk factors of childhood physical abuse. Methods The study utilized a two-stage cluster sampling design in order to conduct the household survey. Retrospective reports of childhood physical abuse and relevant risk factors were collected from 1292 females. Bivariate and multivariate logistic regression models examined associations between childhood physical abuse and both health consequences and risk factors. Results Nearly 1 in 5 females in Swaziland has experienced childhood physical abuse in their lifetime, with nearly 1 in 20 having experienced abuse that was so severe that it required medical attention. A number of risk factors for lifetime childhood physical abuse were identified including: maternal death prior to age 13; having lived with three or more families during their childhood; and having experienced emotional abuse prior to age 13. Conclusions Preventing childhood physical abuse in Swaziland may be addressed through: promoting safe, stable, and nurturing relationships between children and their caretakers; addressing social norms that contribute to harsh physical punishment; and addressing underlying stressors associated with severe social and economic disadvantage. PMID:23856568

Gut epithelial barrier dysfunction in human immunodeficiency virus-hepatitis C virus coinfected patients: Influence on innate and acquired immunity.

PubMed

Márquez, Mercedes; Fernández Gutiérrez del Álamo, Clotilde; Girón-González, José Antonio

2016-01-28

Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus (HIV)-infected patients have several non-acquired immunodeficiency syndrome (AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus (HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.

Spatiotemporal Characterization of mTOR Kinase Activity Following Kainic Acid Induced Status Epilepticus and Analysis of Rat Brain Response to Chronic Rapamycin Treatment

PubMed Central

Macias, Matylda; Blazejczyk, Magdalena; Kazmierska, Paulina; Caban, Bartosz; Skalecka, Agnieszka; Tarkowski, Bartosz; Rodo, Anna; Konopacki, Jan; Jaworski, Jacek

2013-01-01

Mammalian target of rapamycin (mTOR) is a protein kinase that senses nutrient availability, trophic factors support, cellular energy level, cellular stress, and neurotransmitters and adjusts cellular metabolism accordingly. Adequate mTOR activity is needed for development as well as proper physiology of mature neurons. Consequently, changes in mTOR activity are often observed in neuropathology. Recently, several groups reported that seizures increase mammalian target of rapamycin (mTOR) kinase activity, and such increased activity in genetic models can contribute to spontaneous seizures. However, the current knowledge about the spatiotemporal pattern of mTOR activation induced by proconvulsive agents is rather rudimentary. Also consequences of insufficient mTOR activity on a status epilepticus are poorly understood. Here, we systematically investigated these two issues. We showed that mTOR signaling was activated by kainic acid (KA)-induced status epilepticus through several brain areas, including the hippocampus and cortex as well as revealed two waves of mTOR activation: an early wave (2 h) that occurs in neurons and a late wave that predominantly occurs in astrocytes. Unexpectedly, we found that pretreatment with rapamycin, a potent mTOR inhibitor, gradually (i) sensitized animals to KA treatment and (ii) induced gross anatomical changes in the brain. PMID:23724051

Stiffness is more than just duration and severity: a qualitative exploration in people with rheumatoid arthritis

PubMed Central

Dures, Emma; Kirwan, John; Pollock, Jon; Baker, Gill; Edmunds, Avis; Hewlett, Sarah

2015-01-01

Objective. Stiffness is internationally recognized as an important indicator of inflammatory activity in RA but is poorly understood and difficult to measure. The aim of this study was to explore the experience of stiffness from the patient perspective. Methods. Semi-structured interviews conducted with 16 RA patients were analysed independently by researchers and pat.ient partners using inductive thematic analysis. Results. Six themes were identified. Part of having RA identified stiffness as a normal consequence of RA, perceived as associated with disease-related aspects such as fluctuating disease activity, other RA symptoms and disease duration. Local and widespread highlighted stiffness occurring not only in joints, but also over the whole body, being more widespread during the morning or flare. Linked to behaviour and environment illustrated factors that influence stiffness, including movement, medications and weather. Highly variable captured the fluctuating nature of stiffness within and between patients and in relation to temporality, duration and intensity. Impacts on daily life emphasized the effect of stiffness on a range of domains, including physical function, quality of life, psychological well-being, activities of daily living and participation in work and leisure activities. Requires self-management detailed self-management strategies targeting both the symptom and its consequences. Conclusion. Patients’ experiences of stiffness were varied, complex and not exclusive to the morning period. Importantly, stiffness was reported in terms of impact rather than the traditional measurement concepts of severity or duration. Based on these findings, further research is needed to develop a patient-centred measure that adequately reflects inflammatory activity. PMID:25231178

Does Collaborative Case Conceptualisation enhance engagement and outcome in the treatment of anorexia nervosa? Rational, design and methods.

PubMed

Mitchell, Sarah A; Newton, Richard; Harrison, Philippa; Castle, David; Brennan, Leah

2016-03-01

Anorexia Nervosa (AN) is a severe and potentially chronic disorder characterised by low body weight and persistent behaviours that interfere with weight gain. Individuals with AN are often difficult to engage in treatment and display high rates of drop out. The Collaborative Case Conceptualisation (CCC) assessment approach was developed to target proposed AN maintaining factors with the aim of improving treatment motivation and engagement and consequently treatment outcomes in individuals with AN. The proposed study aims to examine the efficacy of CCC in improving a range of outcomes including Body Mass Index, eating disorder symptomatology, general psychopathology, quality of life and future treatment motivation and participation. Potential mediators will also be explored. Thirty-two participants will be recruited from Melbourne based specialist eating disorder services, community and university clinics, and health practitioner networks. Participants will be randomised to three individual sessions of either CCC or a standardised assessment condition (assessment as usual; AAU). The AAU assessment will include; a mental status examination, assessment of current disordered eating behaviours and cognitions, assessment of clinical history, and a physical examination. The CCC condition combines the AAU assessment components with shared collaborative formulation and tailored psychoeducation highlighting the consequences of the eating disorder on wellbeing and future goals in a supportive and motivating way. This intervention may provide an effective and feasible method of improving treatment engagement and outcomes for individuals suffering from AN, with the ultimate outcome of reducing the negative biopsychosocial impacts of this potentially severe and chronic disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

Cultural variation in antismoking video ads between the United States, Taiwan, and China.

PubMed

Wong, Tzu-Jung; King, Jessica L; Pomeranz, Jamie L

2016-10-01

Antitobacco advertisement components, including types of messages and advertising appeals, have not been evaluated among multinational groups. This study identified and compared the content of antismoking video ads across three countries. We reviewed 86 antismoking video advertisements for the following information: severity of the consequences of smoking, types of risks, appeals to audiences' self-efficacy, benefits of not smoking, targeted social-ecological level and types of message appeal used. Two researchers independently coded each advertisement with an average inter-coder reliability of 0.79.Analyses showed a variety of focuses: smoking-related health risks (86%), severe consequences of smoking (54.7%), self-efficacy beliefs (40.7%) and benefits of not smoking (84.9%). Compared to the United States and Taiwanese ads, Chinese ads were more likely to target at the community level (10% versus 23.3% versus 47.2%). Additionally, 55% of the United States ads used the fear approach, whereas 61.1% of Chinese ads used the social approach. Taiwanese ads were evenly distributed among both approaches. In conclusion, the countries used different targeting strategies and approaches during message delivery. Although China's neighboring country, Taiwan, has many similar cultural aspects, including the same language, they are greatly influenced by US antitobacco campaigns. As a result, Taiwan's tobacco campaigns appear to have similar components to both China and the United States. Further research is warranted to understand the reasons for each method and to examine the effectiveness of the ads in reducing smoking rates. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Measurement of Photoelectron Emission Using Vacuum Ultraviolet Ray Irradiation

NASA Astrophysics Data System (ADS)

Okamura, Shugo; Iwao, Toru; Yumoto, Motoshige; Miyake, Hiroaki; Nitta, Kumi

2009-01-01

Satellites have come to play many roles depending on their purpose, including communication, weather observation, astronomy observation, and space development. A satellite requires long life and high reliability in such a situation. However, at an altitude of several hundred kilometers, atomic oxygen (AO) is a destructive factor. With density of about 1015 atoms/m3, AO also has high reactivity. As the satellite collides with AO, surface materials of the satellite are degraded, engendering surface roughness and oxidation. Accordingly, it is necessary to monitor the surface conditions. In this study, photoemission characteristics of several materials, such as metals, glasses, and polymers are measured using a deuterium lamp and band pass filters. The threshold energy for photoemission and the quantum efficiency were evaluated from those measurements. Consequently, for the investigated materials the threshold energies for photoelectron emission were found to be 4.9-5.7 eV. The quantum efficiency of metals is about 100 times higher than that of other samples. The quantum efficiency of PS that includes a benzene ring is several times higher than that of either PP or PTFE, suggesting that deteriorated materials emit large amounts of photoelectrons.

[Fatigue syndrome: Stress, Burnout and depression in Urology.

PubMed

Rodríguez-Socarrás, Moisés; Vasquez, Juan Luis; Uvin, Pieter; Skjold-Kingo, Pernille; Gómez Rivas, Juan

2018-01-01

To determine the factors related to stress, Burnout and depression in urology, as well as consequences in residents and urologists, in addition to the possible applicable strategies to diminish and treat them. Depression, stress and Burnout syndrome has become a problem in urology specialty. These topics have gained interest in international congresses and urological associations. Efforts are being made to find related factors as well as possible strategies and applicable support programs. Burnout frequency is higher among health professionals than general population, 40-76% in students and residents, its incidence has skyrocketed in recent years, in addition Urology is one of the specialties with highest incidence and severity. Its increase has been related to work overload, documentation, administrative/bureaucratic workload, hostile work environment; its consequences include poor work performance, medical errors, depression, substance abuse, disruption in family and couple relationships and suicidal ideation. Strategies for prevention including resilience training, lifestyle balance, teamwork, and support programs. Stress, burnout and depression are problems in urology, early detection, promoting individual techniques in resilience, lifestyle and teamwork are fundamental now and for the future of the specialty. Developing and implementing support programs should be seriously considered by health systems and urological associations.

Traumatic events in childhood and their association with psychiatric illness in the adult.

PubMed

Verdolini, Norma; Attademo, Luigi; Agius, Mark; Ferranti, Laura; Moretti, Patrizia; Quartesan, Roberto

2015-09-01

Child maltreatment is a well-known condition that is currently considered to be associated with the development of severe psychiatric conditions. Consequently, the authors decided to review the current literature in order to give a complete scenario of the situation in the world and to give recommendations about prevention and treatment as well as research goals. An electronic search was conducted through the means of MEDLINE database in order to find the most up to date peer-reviewed papers, including only those papers published in 2015. 15 papers were included and analyzed the current situation in different countries: US (n.3), Australia (n.2), Ireland (n.2), Israel (n.2), China (n.2), Indonesia (n.1), Pakistan (n.1) and Norway (n.1). Even though sexual abuse has been studied extensively, both physical and emotional abuse and neglect appear to be more represented within the population of patients that had suffered from abuse. Psychiatric disorders (mainly personality disorders, depression and anxiety), interpersonal, social and legal outcomes are important consequences of child maltreatment. Interventions and strategies are needed at different levels, from prevention to treatment and further research is important in order to better understand the phenomenon.

ACS and STEMI treatment: gender-related issues.

PubMed

Chieffo, Alaide; Buchanan, Gill Louise; Mauri, Fina; Mehilli, Julinda; Vaquerizo, Beatriz; Moynagh, Anouska; Mehran, Roxana; Morice, Marie-Claude

2012-08-01

Cardiovascular disease is the leading cause of death amongst women, with acute coronary syndromes (ACS) representing a significant proportion. It has been reported that in women presenting with ACS there is underdiagnosis and consequent undertreatment leading to an increase in hospital and long-term mortality. Several factors have to be taken into account, including lack of awareness both at patient and at physician level. Women are generally not aware of the cardiovascular risk and symptoms, often atypical, and therefore wait longer to seek medical attention. In addition, physicians often underestimate the risk of ACS in women leading to a further delay in accurate diagnosis and timely appropriate treatment, including cardiac catheterisation and primary percutaneous coronary intervention, with consequent delayed revascularisation times. It has been acknowledged by the European Society of Cardiology that gender disparities do exist, with a Class I, Level of Evidence B recommendation that both genders should be treated in the same way when presenting with ACS. However, there is still a lack of awareness and the mission of Women in Innovation, in association with Stent for Life, is to change the perception of women with ACS and to achieve prompt diagnosis and treatment.

Calling to Nursing: Concept Analysis.

PubMed

Emerson, Christie

The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

Avoiding burnout in an orthopaedic trauma practice.

PubMed

Marsh, J Lawrence

2012-09-01

Burnout is characterized by emotional exhaustion, depersonalization, and decreased sense of personal accomplishment, and burnout has been very tightly linked with career dissatisfaction and other associated negative personal and professional consequences. Recently published studies indicate that among surgeons and surgical specialists, burnout is common, and that at least in some groups of surgeons, it has significant negative consequences for their practice and career. It is concerning that studies have found younger surgeons were at greater risk for burnout. There is no data on rates of, or risk for, burnout specifically for orthopaedic trauma surgeons. However, there are several reasons to expect the risk may be significant, including demanding call schedules and difficult to control work schedules. There are some common-sense guidelines to minimize the chances of burnout in the early stages of an orthopaedic trauma career. One of the most important is to set up a work schedule that allows personal pursuits, including time with significant other and family away from work. Achieving and maintaining a balance between work and home will optimize the chances of achieving the tremendous satisfaction possible in an orthopaedic trauma career and minimize the chances of burnout.

A mutation in MT-TW causes a tRNA processing defect and reduced mitochondrial function in a family with Leigh syndrome.

PubMed

Duff, Rachael M; Shearwood, Anne-Marie J; Ermer, Judith; Rossetti, Giulia; Gooding, Rebecca; Richman, Tara R; Balasubramaniam, Shanti; Thorburn, David R; Rackham, Oliver; Lamont, Phillipa J; Filipovska, Aleksandra

2015-11-01

Leigh syndrome (LS) is a progressive mitochondrial neurodegenerative disorder, whose symptoms most commonly include psychomotor delay with regression, lactic acidosis and a failure to thrive. Here we describe three siblings with LS, but with additional manifestations including hypertrophic cardiomyopathy, hepatosplenomegaly, cholestatic hepatitis, and seizures. All three affected siblings were found to be homoplasmic for an m. 5559A>G mutation in the T stem of the mitochondrial DNA-encoded MT-TW by next generation sequencing. The m.5559A>G mutation causes a reduction in the steady state levels of tRNA(Trp) and this decrease likely affects the stability of other mitochondrial RNAs in the patient fibroblasts. We observe accumulation of an unprocessed transcript containing tRNA(Trp), decreased de novo protein synthesis and consequently lowered steady state levels of mitochondrial DNA-encoded proteins that compromise mitochondrial respiration. Our results show that the m.5559A>G mutation at homoplasmic levels causes LS in association with severe multi-organ disease (LS-plus) as a consequence of dysfunctional mitochondrial RNA metabolism. Copyright © 2015 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

Multidrug and toxin extrusion proteins as transporters of antimicrobial drugs.

PubMed

Nies, Anne T; Damme, Katja; Schaeffeler, Elke; Schwab, Matthias

2012-12-01

Antimicrobial drugs are essential in the treatment of infectious diseases. A better understanding of transport processes involved in drug disposition will improve the predictability of drug-drug interactions with consequences for drug response. Multidrug And Toxin Extrusion (MATE; SLC47A) proteins are efflux transporters mediating the excretion of several antimicrobial drugs as well as other organic compounds into bile and urine, thereby contributing to drug disposition. This review summarizes current knowledge of the structural and molecular features of human MATE transporters including their functional role in drug transport with a specific focus on antimicrobial drugs. The PubMed database was searched using the terms "MATE1," "MATE-2K," "MATE2," "SLC47A1," "SLC47A2," and "toxin extrusion protein" (up to June 2012). MATE proteins have been recognized as important transporters mediating the final excretion step of cationic drugs into bile and urine. These include the antiviral drugs acyclovir, amprenavir, and ganciclovir, the antibiotics cephalexin, cephradine and levofloxacin, as well as the antimalarial agents chloroquine and quinine. It is therefore important to enhance our understanding of the role of MATEs in drug extrusion with particular emphasis on the functional consequences of genetic variants on disposition of these antimicrobial drugs.

Unintended Consequences: New Problems, New Solutions Contributions From 2015

PubMed Central

Chen, Y.

2016-01-01

Summary Objective To select the best of the 2015 published papers on unintended consequences of healthcare information technology (HIT). Method Literature searches in several areas of scholarship, including IT, human factors, evaluation studies, medical errors, medical informatics, and implementation science. Also, because the specific terms “unintended consequences” were not often included in abstracts and titles, a more nuanced search algorithm was developed. Results We identified 754 papers that had some empirical research on unintended consequences of HIT. An initial screen of titles and abstracts reduced this to 171 papers of potential interest. We then further filtered out papers that did not meet the following criteria: 1) the paper had to report an original empirical investigation, and 2) the impact reported had to be not negligible, i.e., in quantitative studies, the results related to unintended consequences were statistically significant; and in qualitative studies the relevant themes emerged were prominent. This resulted in 33 papers of which 15 were selected as best paper candidates. Each of these 15 papers was then separately evaluated by four reviewers. The final selection of four papers was made jointly by the external reviewers and the two section editors. Conclusions There is a growing awareness of the importance of HIT’s unintended consequences—be they generated by the HIT vendors, the implementation process, the consultants, the users, or most probably, some combination of the above. There has also been greater creativity in use of data sources, including secondary data (e.g., medical malpractice cases and surveys) and a wider acceptance of mixed methods to identify unintended consequences. Unfortunately, the complexity of causes mitigates the value of recommendations to avoid unwanted outcomes. Suggestions are often contentious rather than obvious, setting-specific, and not universally applicable. “Lessons learned” often take on generalized—and perhaps platitudinous—forms, such as: “plan extra time,” “involve all of the stakeholders,” “recognize the different needs of different units or disciplines.” The greater awareness of these problems, and the increased desire to identify and eliminate them is clearly reflected in the area’s growing literature. We are hopeful the topic will receive additional attention and the discipline will improve its ability to identify and address these unexpected and usually adverse outcomes. PMID:27830235

Severe acute hypophosphatemia during renal replacement therapy adversely affects outcome of critically ill patients with acute kidney injury.

PubMed

Schiffl, Helmut; Lang, Susanne M

2013-02-01

Hypophosphatemia during renal replacement therapy (RRT) is common in critically ill patients with acute kidney injury (AKI). The clinical consequences of RRT-induced phosphate depletion are not well defined in this patient population, and there is no evidence that intravenous sodium phosphate supplementation (PS) prevents the clinical sequelae of acute hypophosphatemia. The purpose of this retrospective analysis of the Acute Renal Support Registry of the University of Munich was to examine the association between severe hypophosphatemia and severity of and recovery from AKI. 289 ICU patients with AKI on intermittent hemodialysis (IHD) were included in the study. One hundred and forty-nine patients received PS during IHD. Outcomes were short-term (at discharge) and long-term (at 1 year) recovery of renal function and mortality. The two patient groups did not differ in demographics, clinical features, renal characteristics, and frequency of hypophosphatemia at initiation of IHD. Without PS, the frequency of hypophosphatemia increased from 20 to 35%. Severe hypophosphatemia was found in 50% of these patients. By comparison, PS was not associated with an increased frequency of hypophosphatemia. Compared with patients with acute phosphate depletion, patients receiving PS developed less oliguria during IHD, had shorter duration of AKI, higher incidence of complete renal recovery at discharge, and a lower risk of de novo chronic kidney disease. Hypophosphatemia was associated with higher all-cause in-hospital mortality and higher risk of long-term mortality. This multicenter study indicates for the first time that hypophosphatemia during IHD adversely affects short- and long-term outcome of critically-ill patients with AKI. The clinical consequences of the acute hypophosphatemic syndrome may be prevented by PS.

Assessment of the Incentives Created by Public Disclosure of Off-Site Consequence Analysis Information for Reduction in the Risk of Accidental Releases

EPA Pesticide Factsheets

The off-site consequence analysis (OCA) evaluates the potential for worst-case and alternative accidental release scenarios to harm the public and environment around the facility. Public disclosure would likely reduce the number/severity of incidents.

Reliability and Validity of the Alcohol Consequences Expectations Scale

ERIC Educational Resources Information Center

Arriola, Kimberly R. Jacob; Usdan, Stuart; Mays, Darren; Weitzel, Jessica Aungst; Cremeens, Jennifer; Martin, Ryan J.; Borba, Christina; Bernhardt, Jay M.

2009-01-01

Objectives: To examine the reliability and validity of a new measure of alcohol outcome expectations for college students, the Alcohol Consequences Expectations Scale (ACES). Methods: College students (N = 169) completed the ACES and several other measures. Results: Results support the existence of 5 internally consistent subscales. Additionally,…

Cyber-Victimization and Its Psychosocial Consequences: Relationships with Behavior Management and Traditional Bullying

ERIC Educational Resources Information Center

Mindrila, Diana; Moore, Lori; Davis, Pamela

2015-01-01

The current study investigated the relationship between behavior management, traditional bullying, cyber-victimization, and several psychosocial consequences of cyber-victimization. Findings from previous research were used to specify a complex path model, which allowed the simultaneous estimation of multiple direct and indirect effects. Data were…

Consequence Management: A Disconnect Between National Security Policy and Force Structure?

DTIC Science & Technology

2001-03-15

effects or the consequences of a detonated and/or released weapon(s) has only recently been given much attention. Despite several warnings of the...with the exposure ? Second, the time required to establish and field a regional JTF would prevent the force from having a strong positive effect on the... outcome of the situation. One of the critical missions of a successful consequence management force is its ability to provide a strong deterrent

Genetic variation in steelhead (Salmo gairdneri) from the north coast of Washington

USGS Publications Warehouse

Reisenbichler, R.R.; Phelps, S.R.

1989-01-01

Steelhead (Salmo gairdneri) collected from various sites in nine drainages in northwestern Washington were genetically characterized at 65 protein-coding loci by starch-gel electrophoresis. Genetic differentiation within and among drainages was not significant, and genetic variation among drainages was much less than that reported in British Columbia; these results may be the consequence of gene flow from hatchery stocks that have been released in Washington since the 1940's. Allele frequencies varied significantly among year-classes (hence, genetic characterization studies must include data from several year-classes), and also between hatchery fish (including a stock developed with local wild fish) and wild fish, indicating that few wild fish have been successfully and routinely included in hatchery brood stocks. Conservation of genetic diversity along the north coast of Washington should be facilitated by reducing the numbers of hatchery fish that spawn in streams and by including wild fish in hatchery brood stocks.

Alcohol use by alcoholics with and without a history of parental alcoholism.

PubMed

Worobec, T G; Turner, W M; O'Farrell, T J; Cutter, H S; Bayog, R D; Tsuang, M T

1990-12-01

The association between parental history of alcoholism and the nature of alcoholism was assessed using a more reliable measure of family history (Family Tree Questionnaire) and a more comprehensive inventory of alcoholism (Alcohol Use Inventory) than used in earlier studies. Parental alcoholism was associated with more severe alcoholism on most parameters of alcohol use (age of onset, quantity, frequency, preoccupation, and sustained use) and alcohol-related problems (social, vocational, physical, cognitive, and loss of control). The association between parental history of alcoholism and more severe alcoholism in the probands was independent of age of onset of alcoholism, current age, socioeconomic background, and marital status. Parental history positive (PH+) alcoholics were more reliant on alcohol to manage their moods but did not differ significantly from parental history negative (PH-) alcoholics in the use of alcohol to improve sociability or mental functioning or to cope with marital problems. Surprisingly, the degree of concern, guilt, and worry over the negative consequences of drinking was not significantly different for PH+ alcoholics although the negative consequences were clearly much more severe for this group. While the data are inconclusive about the reasons for more severe alcoholism in PH+ alcoholics, greater reliance on ethanol to manage moods and a relative insensitivity to negative consequences could theoretically account for the vulnerability to more severe alcoholism found in PH+ alcoholics.

10 CFR 709.14 - Consequences of a refusal to complete a CI evaluation including a polygraph examination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Consequences of a refusal to complete a CI evaluation including a polygraph examination. 709.14 Section 709.14 Energy DEPARTMENT OF ENERGY COUNTERINTELLIGENCE EVALUATION PROGRAM CI Evaluation Protocols and Protection of National Security § 709.14 Consequences of a...

African American women's beliefs about mental illness, stigma, and preferred coping behaviors.

PubMed

Ward, Earlise C; Heidrich, Susan M

2009-10-01

We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment-seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community-dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, including family-related stress and social stress due to racism, is cyclical, and has serious consequences but can be controlled by treatment. Participants endorsed low perceptions of stigma. Major preferred coping strategies included praying and seeking medical and mental health care. Age differences were found in all variables except stigma.

Screening tests: a review with examples

PubMed Central

Niebo, Ron; Utell, Mark J.

2014-01-01

Screening tests are widely used in medicine to assess the likelihood that members of a defined population have a particular disease. This article presents an overview of such tests including the definitions of key technical (sensitivity and specificity) and population characteristics necessary to assess the benefits and limitations of such tests. Several examples are used to illustrate calculations, including the characteristics of low dose computed tomography as a lung cancer screen, choice of an optimal PSA cutoff and selection of the population to undergo mammography. The importance of careful consideration of the consequences of both false positives and negatives is highlighted. Receiver operating characteristic curves are explained as is the need to carefully select the population group to be tested. PMID:25264934

Fall-related experiences of stroke survivors: a meta-ethnography.

PubMed

Walsh, Mary; Galvin, Rose; Horgan, N Frances

2017-04-01

Health professionals view falls after stroke as common adverse events with both physical and psychological consequences. Stroke survivors' experiences are less well understood. The aim of this systematic review was to explore the perception of falls-risk within the stroke recovery experience from the perspective of people with stroke. A systematic literature search was conducted. Papers that used qualitative methods to explore the experiences of individuals with stroke around falls, falls-risk and fear of falling were included. Two reviewers independently assessed the methodological quality of papers. Meta-ethnography was conducted. Concepts from each study were translated into each other to form theories that were combined through a "lines-of-argument" synthesis. Four themes emerged from the six included qualitative studies: (i) Fall circumstances, (ii) perception of fall consequences, (iii) barriers to community participation and (iv) coping strategies. The synthesis revealed that stroke survivors' perceived consequences of falls exist on a continuum. Cognitive and emotional adjustment may be required in the successful adoption of coping strategies to overcome fall-related barriers to participation. Stroke survivors' fall-related experiences appear to exist within the context of activity and community participation. Further research is warranted due to the small number of substantive studies available for synthesis. Implications for Rehabilitation Health care professionals should recognize that cognitive and emotional adjustment may berequired for stroke survivors to accept strategies for overcoming falls-risk, including dependenceon carers and assistive devices. Several factors in addition to physical interventions may be needed to minimize falls-risk whileincreasing activity participation. These factors could include increasing public awareness about the effects of stroke and falls-risk,and ensuring access to psychological services for stroke survivors. Rehabilitation professionals should reflect on whether they perceive there to be an appropriatelevel of fear of falling post-stroke. They should understand that stroke survivors might not conceptualize falls-risk in this way.

Shifting towards a model of mGluR5 dysregulation in schizophrenia: Consequences for future schizophrenia treatment.

PubMed

Matosin, Natalie; Fernandez-Enright, Francesca; Lum, Jeremy S; Newell, Kelly A

2017-03-15

Metabotropic glutamate receptor subtype 5 (mGluR5), encoded by the GRM5 gene, represents a compelling novel drug target for the treatment of schizophrenia. mGluR5 is a postsynaptic G-protein coupled glutamate receptor strongly linked with several critical cellular processes that are reported to be disrupted in schizophrenia. Accordingly, mGluR5 positive allosteric modulators show encouraging therapeutic potential in preclinical schizophrenia models, particularly for the treatment of cognitive dysfunctions against which currently available therapeutics are largely ineffective. More work is required to support the progression of mGluR5-targeting drugs into the clinic for schizophrenia treatment, although some obstacles may be overcome by comprehensively understanding how mGluR5 itself is involved in the neurobiology of the disorder. Several processes that are necessary for the regulation of mGluR5 activity have been identified, but not examined, in the context of schizophrenia. These processes include protein-protein interactions, dimerisation, subcellular trafficking, the impact of genetic variability or mutations on protein function, as well as epigenetic, post-transcriptional and post-translational processes. It is essential to understand these aspects of mGluR5 to determine whether they are affected in schizophrenia pathology, and to assess the consequences of mGluR5 dysfunction for the future use of mGluR5-based drugs. Here, we summarise the known processes that regulate mGluR5 and those that have already been studied in schizophrenia, and discuss the consequences of this dysregulation for current mGluR5 pharmacological strategies. This article is part of the Special Issue entitled 'Metabotropic Glutamate Receptors, 5 years on'. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hemorheological alterations in sickle cell anemia and their clinical consequences - The role of genetic modulators.

PubMed

Silva, Marisa; Vargas, Sofia; Coelho, Andreia; Dias, Alexandra; Ferreira, Teresa; Morais, Anabela; Maia, Raquel; Kjöllerström, Paula; Lavinha, João; Faustino, Paula

2016-01-01

Sickle cell anemia (SCA) is an autosomal recessive disease caused by the HBB:c.20A>T mutation that leads to hemoglobin S synthesis. The disease presents with high clinical heterogeneity characterized by chronic hemolysis, recurrent episodes of vaso-oclusion and infection. This work aimed to characterize by in silico studies some genetic modulators of severe hemolysis and stroke risk in children with SCA, and understand their consequences at the hemorheological level.Association studies were performed between hemolysis biomarkers as well as the degree of cerebral vasculopathy and the inheritance of several polymorphic regions in genes related with vascular cell adhesion and vascular tonus in pediatric SCA patients. In silico tools (e.g. MatInspector) were applied to investigate the main variant consequences.Variants in vascular adhesion molecule-1 (VCAM1) gene promoter and endothelial nitric oxide synthase (NOS3) gene were significantly associated with higher degree of hemolysis and stroke events. They potentially modify transcription factor binding sites (e.g. VCAM1 rs1409419_T allele may lead to an EVI1 gain) or disturb the corresponding protein structure/function. Our findings emphasize the relevance of genetic variation in modulating the disease severity due to their effect on gene expression or modification of protein biological activities related with sickled erythrocyte/endothelial interactions and consequent hemorheological abnormalities.

Risk assessment of waste-water disinfection. Report for October 1979-January 1984

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

Hubly, D.; Chappell, W.; Lanning, J.

A risk-assessment data base is presented for several waste-water disinfection alternatives, including chlorination, ozonation, chlorination/dechlorination, and ultraviolet radiation. The data base covers hazards and consequences related to onsite use and transportation of the disinfectants and ultimate disposal of disinfected effluents. A major segment of the data base deals with the effects of chlorination products in aquatic ecosystems. Energy consumption and cost analyses are also presented for chlorination and ozonation. Example risk calculations are presented for two hypothetical waste-water treatment plants. The usefulness of the data base for risk assessment is also discussed.

[Microsurgical treatment of brachial plexus injuries].

PubMed

Päzolt, H J

1986-01-01

Injuries of the brachial plexus are found to occur primarily to juvenile patients as a consequence of motorcycle accidents. While it is a severe injury, its prognosis has been substantively improved by the availability of microsurgical treatment, using long nerve transplants. Further improvement of results will be possible by early operation, a desirable objective. 44 patients with brachial palsy received treatment, including surgery in 41 cases. An account is given in this paper of intraoperative findings, surgical techniques, and results from follow-up checks. The need is underlined for long-term intensive after-care for the purpose of occupational reintegration.

Revolution in nuclear detection affairs

NASA Astrophysics Data System (ADS)

Stern, Warren M.

2014-05-01

The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

How Can Social Media Get Us in Trouble?

PubMed

Langenfeld, Sean J; Batra, Rishi

2017-09-01

When utilized properly, social media offers several personal and professional benefits for the practicing surgeon, including peer networking, education, e-mentorship, marketing, recruitment, and patient outreach. However, unprofessional online behavior is common among surgeons, and this improper use of social media can be quite dangerous. This article reviews the dangers of social media and illustrates this with examples of unprofessional behavior and the associated consequences. It also provides recommendations for maintaining a professional and productive online persona. Surgeons must understand the various social media platforms and their target audience while upholding online professionalism at all times.

Magnet safety and stability related coolant states: critical fluid dynamics at peak flux

NASA Astrophysics Data System (ADS)

Ravikumar, K. V.; Carandang, R. M.; Frederking, T. H. K.

The stability of superconducting magnets is endangered under certain distinct conditions of the fluid serving as magnet coolant. A severe compromising of safety takes place at the peak heat flux of nucleate boiling. Progress in analysing first order phase transitions for cryoliquids and room temperature liquids, in the presence of heat flow, has led to better understanding of the parameters related to vapour bubble phenomena. The present work addresses the consequences arising from bubble frequency results, including model calculations for the effective masses of the saturated fluids involved in the two-phase transport at the peak flux.

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

PubMed Central

Dickman, Ram; Maradey-Romero, Carla; Gingold-Belfer, Rachel; Fass, Ronnie

2015-01-01

Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the therapeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, maintenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett’s esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any future development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the aforementioned areas of unmet need. PMID:26130628

Update: Acute Heart Failure (VII): Nonpharmacological Management of Acute Heart Failure.

PubMed

Plácido, Rui; Mebazaa, Alexandre

2015-09-01

Acute heart failure is a major and growing public health problem worldwide with high morbidity, mortality, and cost. Despite recent advances in pharmacological management, the prognosis of patients with acute decompensated heart failure remains poor. Consequently, nonpharmacological approaches are being developed and increasingly used. Such techniques may include several modalities of ventilation, ultrafiltration, mechanical circulatory support, myocardial revascularization, and surgical treatment, among others. This document reviews the nonpharmacological approach in acute heart failure, indications, and prognostic implications. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Indigenous Carbonaceous Phases Embedded Within Surface Deposits on Apollo 17 Volcanic Glass Beads

NASA Technical Reports Server (NTRS)

Thomas-Keprta, K. L.; Clemett, S. J.; Ross, D. K.; Le, L.; McKay, D. S.; Gibson, E. K.; Gonzalez, C.

2012-01-01

The assessment of indigenous organic matter in returned lunar samples was one of the primary scientific goals of the Apollo program. Prior studies of Apollo samples have shown the total amount of organic matter to be in the range of approx 50 to 250 ppm. Low concentrations of lunar organics may be a consequence not only of its paucity but also its heterogeneous distribution. Several processes should have contributed to the lunar organic inventory including exogenous carbonaceous accretion from meteoroids and interplanetary dust particles, and endogenous synthesis driven by early planetary volcanism and cosmic and solar radiation.

Fundamentals and advances in magnetic hyperthermia

NASA Astrophysics Data System (ADS)

Périgo, E. A.; Hemery, G.; Sandre, O.; Ortega, D.; Garaio, E.; Plazaola, F.; Teran, F. J.

2015-12-01

Nowadays, magnetic hyperthermia constitutes a complementary approach to cancer treatment. The use of magnetic particles as heating mediators, proposed in the 1950s, provides a novel strategy for improving tumor treatment and, consequently, patient's quality of life. This review reports a broad overview about several aspects of magnetic hyperthermia addressing new perspectives and the progress on relevant features such as the ad hoc preparation of magnetic nanoparticles, physical modeling of magnetic heating, methods to determine the heat dissipation power of magnetic colloids including the development of experimental apparatus and the influence of biological matrices on the heating efficiency.

The evolution of human warfare.

PubMed

Pitman, George R

2011-01-01

Here we propose a new theory for the origins and evolution of human warfare as a complex social phenomenon involving several behavioral traits, including aggression, risk taking, male bonding, ingroup altruism, outgroup xenophobia, dominance and subordination, and territoriality, all of which are encoded in the human genome. Among the family of great apes only chimpanzees and humans engage in war; consequently, warfare emerged in their immediate common ancestor that lived in patrilocal groups who fought one another for females. The reasons for warfare changed when the common ancestor females began to immigrate into the groups of their choice, and again, during the agricultural revolution.

Regulatory considerations for global transfer of cryopreserved fish gametes

USGS Publications Warehouse

Jenkins, Jill A.; Tiersch, Terrence R.; Green, Christopher C.

2011-01-01

Federal and state resource managers, scientists, lawmakers, business and development investors, and the general public all struggle with issues surrounding the conservation of our biological heritage, especially in the face of increased population growth and consequent anthropogenic disturbances. Conservation interests include recovering exploited aquatic populations, decreasing the loss of genetic diversity, and reintroducing locally depleted species. However, research on husbandry and other techniques critical to implementing conservation strategies is often not started until few individuals remain. A program in the cryopreservation of gametes and embryos from aquatic species would address several of these conservation concerns by allowing the establishment of gene banks

Mesoamerican Nephropathy or Global Warming Nephropathy?

PubMed

Roncal-Jimenez, Carlos A; García-Trabanino, Ramon; Wesseling, Catharina; Johnson, Richard J

2016-01-01

An epidemic of chronic kidney disease (CKD) of unknown cause has emerged along the Pacific Coast of Central America. The disease primarily affects men working manually outdoors, and the major group affected is sugarcane workers. The disease presents with an asymptomatic rise in serum creatinine that progresses to end-stage renal disease over several years. Renal biopsies show chronic tubulointerstitial disease. While the cause remains unknown, recent studies suggest that it is driven by recurrent dehydration in the hot climate. Potential mechanisms include the development of hyperosmolarity with the activation of the aldose reductase-fructokinase pathway in the proximal tubule leading to local injury and inflammation, and the possibility that renal injury may be the consequence of repeated uricosuria and urate crystal formation as a consequence of both increased generation and urinary concentration, similar to a chronic tumor lysis syndrome. The epidemic is postulated to be increasing due to the effects of global warming. An epidemic of CKD has led to the death of more than 20,000 lives in Central America. The cause is unknown, but appears to be due to recurrent dehydration. Potential mechanisms for injury are renal damage as a consequence of recurrent hyperosmolarity and/or injury to the tubules from repeated episodes of uricosuria. The epidemic of CKD in Mesoamerica may be due to chronic recurrent dehydration as a consequence of global warming and working conditions. This entity may be one of the first major diseases attributed to climate change and the greenhouse effect. © 2016 S. Karger AG, Basel.

Consequences of screening in lung cancer: development and dimensionality of a questionnaire.

PubMed

Brodersen, John; Thorsen, Hanne; Kreiner, Svend

2010-08-01

The objective of this study was to extend the Consequences of Screening (COS) Questionnaire for use in a lung cancer screening by testing for comprehension, content coverage, dimensionality, and reliability. In interviews, the suitability, content coverage, and relevance of the COS were tested on participants in a lung cancer screening program. The results were thematically analyzed to identify the key consequences of abnormal and false-positive screening results. Item Response Theory and Classical Test Theory were used to analyze data. Dimensionality, objectivity, and reliability were established by item analysis, examining the fit between item responses and Rasch models. Eight themes specifically relevant for participants in lung cancer screening results were identified: "self-blame,"focus on symptoms,"stigmatization,"introvert,"harm of smoking,"impulsivity,"empathy," and "regretful of still smoking." Altogether, 26 new items for part I and 16 new items for part II were generated. These themes were confirmed to fit a partial-credit Rasch model measuring different constructs including several of the new items. In conclusion, the reliability and the dimensionality of a condition-specific measure with high content validity for persons having abnormal or false-positive lung cancer screening results have been demonstrated. This new questionnaire called Consequences of Screening in Lung Cancer (COS-LC) covers in two parts the psychosocial experience in lung cancer screening. Part I: "anxiety,"behavior,"dejection,"sleep,"self-blame,"focus on airway symptoms,"stigmatization,"introvert," and "harm of smoking." Part II: "calm/relax,"social network,"existential values,"impulsivity,"empathy," and "regretful of still smoking."

Wide Variability in Seed Characteristics, Kernel Quality, and Zein Profiles Among Diverse Maize Inbreds, Landraces, and Teosinte

USDA-ARS?s Scientific Manuscript database

All crop species have been domesticated from their wild relatives, and geneticists are just now beginning to understand the genetic consequences of artificial (human) selection on agronomic traits that are relevant today. The major consequence is severe reduction in genetic diversity for genes unde...

Maternal Depression and Early Intervention: A Call for an Integration of Services

ERIC Educational Resources Information Center

Alvarez, Shanna L.; Meltzer-Brody, Samantha; Mandel, Marcia; Beeber, Linda

2015-01-01

Depression is a serious disorder with severe and far-reaching consequences. Two decades of observational research have shown robust associations between maternal depression and adverse consequences on offspring (S. Campbell et al., 2004; S. Campbell, P. Matestic, C. von Stauffenberg, R. Mohan, & T. Kirchner, 2007; S. Campbell, A. Morgan-Lopez,…

Characteristics of men with substance use disorder consequent to illicit drug use: comparison of a random sample and volunteers.

PubMed

Reynolds, Maureen D; Tarter, Ralph E; Kirisci, Levent

2004-09-06

Men qualifying for substance use disorder (SUD) consequent to consumption of an illicit drug were compared according to recruitment method. It was hypothesized that volunteers would be more self-disclosing and exhibit more severe disturbances compared to randomly recruited subjects. Personal, demographic, family, social, substance use, psychiatric, and SUD characteristics of volunteers (N = 146) were compared to randomly recruited (N = 102) subjects. Volunteers had lower socioceconomic status, were more likely to be African American, and had lower IQ than randomly recruited subjects. Volunteers also evidenced greater social and family maladjustment and more frequently had received treatment for substance abuse. In addition, lower social desirability response bias was observed in the volunteers. SUD was not more severe in the volunteers; however, they reported a higher lifetime rate of opiate, diet, depressant, and analgesic drug use. Volunteers and randomly recruited subjects qualifying for SUD consequent to illicit drug use are similar in SUD severity but differ in terms of severity of psychosocial disturbance and history of drug involvement. The factors discriminating volunteers and randomly recruited subjects are well known to impact on outcome, hence they need to be considered in research design, especially when selecting a sampling strategy in treatment research.

There is variability in the attainment of developmental milestones in the CDKL5 disorder.

PubMed

Fehr, Stephanie; Leonard, Helen; Ho, Gladys; Williams, Simon; de Klerk, Nick; Forbes, David; Christodoulou, John; Downs, Jenny

2015-01-01

Individuals with the CDKL5 disorder have been described as having severely impaired development. A few individuals have been reported having attained more milestones including walking and running. Our aim was to investigate variation in attainment of developmental milestones and associations with underlying genotype. Data was sourced from the International CDKL5 Disorder Database, and individuals were included if they had a pathogenic or probably pathogenic CDKL5 mutation and information on early development. Kaplan-Meier time-to-event analyses investigated the occurrence of developmental milestones. Mutations were grouped by their structural/functional consequence, and Cox regression was used to investigate the relationship between genotype and milestone attainment. The study included 109 females and 18 males. By 5 years of age, only 75% of the females had attained independent sitting and 25% independent walking whilst a quarter of the males could sit independently by 1 year 3 months. Only one boy could walk independently. No clear relationship between mutation group and milestone attainment was present, although females with a late truncating mutation attained the most milestones. Attainment of developmental milestones is severely impaired in the CDKL5 disorder, with the majority who did attain skills attaining them at a late age. It appears as though males are more severely impaired than the females. Larger studies are needed to further investigate the role of genotype on clinical variability.

Neurofunctional Abnormalities during Sustained Attention in Severe Childhood Abuse.

PubMed

Lim, Lena; Hart, Heledd; Mehta, Mitul A; Simmons, Andrew; Mirza, Kah; Rubia, Katya

2016-01-01

Childhood maltreatment is associated with adverse affective and cognitive consequences including impaired emotion processing, inhibition and attention. However, the majority of functional magnetic resonance imaging (fMRI) studies in childhood maltreatment have examined emotion processing, while very few studies have tested the neurofunctional substrates of cognitive functions and none of attention. This study investigated the association between severe childhood abuse and fMRI brain activation during a parametric sustained attention task with a progressively increasing load of sustained attention in 21 medication-naïve, drug-free young people with a history of childhood abuse controlling for psychiatric comorbidities by including 19 psychiatric controls matched for psychiatric diagnoses, and 27 healthy controls. Behaviorally, the participants exposed to childhood abuse showed increased omission errors in the task which correlated positively trend-wise with the duration of their abuse. Neurofunctionally, the participants with a history of childhood abuse, but not the psychiatric controls, displayed significantly reduced activation relative to the healthy controls during the most challenging attention condition only in typical attention regions including left inferior and dorsolateral prefrontal cortex, insula and temporal areas. We therefore show for the first time that severe childhood abuse is associated with neurofunctional abnormalities in key ventral frontal-temporal sustained attention regions. The findings represent a first step towards the delineation of abuse-related neurofunctional abnormalities in sustained attention, which may help in the development of effective treatments for victims of childhood abuse.

Relationships between the frequency and severity of non-suicidal self-injury and suicide attempts in youth with borderline personality disorder.

PubMed

Andrewes, Holly E; Hulbert, Carol; Cotton, Susan M; Betts, Jennifer; Chanen, Andrew M

2017-07-18

Non-suicidal self-injury (NSSI) is a recognized indicator of suicide risk. Yet, the ubiquity of this behaviour in borderline personality disorder (BPD) limits its utility as a predictor of risk. Consequently, this study aimed to elucidate the relationship between other features of NSSI, including frequency and severity, and suicide attempts. Participants included 107 youth (15 to 25 year olds) with BPD who were assessed for BPD severity, depressive symptoms, 12-month frequency of NSSI and suicide attempts, as well as the levels of treatment sought following each self-harm event. Three-quarters (75.7%) of youth with BPD reported NSSI and two-thirds (66.4%) reported a suicide attempt over the previous 12 months. The frequency of NSSI over the previous 12 months did not show a linear or quadratic relationship with the number of suicide attempts when adjusting for severity of depression, impulsivity and interpersonal problems. NSSI severity was not associated with more frequent suicide attempts. Only impulsivity and depression were uniquely predictive of suicide attempt frequency. A relative increase in the frequency and severity of NSSI occurred in the months prior to a suicide attempt. The prevalence of NSSI and suicide attempts among youth presenting for their first treatment of BPD appear to be perilously high, considerably higher than rates reported by adults with BPD. Findings suggest that clinicians should give more weight to average levels of impulsivity and depression, rather than the absolute frequency and severity of NSSI, when assessing for risk of suicide attempts. Notwithstanding this, a relative increase in the frequency and severity of NSSI appears to be predictive of a forthcoming suicide attempt. © 2017 John Wiley & Sons Australia, Ltd.

Common presentation of rare diseases: Left ventricular hypertrophy and diastolic dysfunction.

PubMed

Linhart, Ales; Cecchi, Franco

2018-04-15

Left ventricular hypertrophy may be a consequence of a hemodynamic overload or a manifestation of several diseases affecting different structural and functional proteins of cardiomyocytes. Among these, sarcomeric hypertrophic cardiomyopathy (HCM) represents the most frequent cause. In addition, several metabolic diseases lead to myocardial thickening, either due to intracellular storage (glycogen storage and lysosomal diseases), extracellular deposition (TTR and AL amyloidosis) or due to abnormal energy metabolism (mitochondrial diseases). The recognition of these rare causes of myocardial hypertrophy is important for family screening strategies, risk assessment, and treatment. Moreover, as there are specific therapies for some forms of HCM including enzyme substitution and chaperone therapies and specific treatments for TTR amyloidosis, a differential diagnosis should be sought in all patients with unexplained left ventricular hypertrophy. Diastolic dysfunction is a key feature of HCM and its phenocopies. Its assessment is complex and requires evaluation of several functional parameters and structural changes. Severe diastolic dysfunction carries a negative prognostic implication and its value in differential diagnosis is limited. Copyright © 2018 Elsevier B.V. All rights reserved.

Novel antipsychotics and severe hyperlipidemia.

PubMed

Meyer, J M

2001-08-01

Newer atypical antipsychotics demonstrate superior effectiveness, with a diminished incidence of extrapyramidal side effects compared with older typical antipsychotics, but they have been associated with the development of obesity and new-onset diabetes. A small number of reports documenting modest hypertriglyceridemia related to newer antipsychotics have implicated fluperlapine, clozapine, and, most recently, olanzapine. This study summarizes the results of 14 cases of severe hypertriglyceridemia (>600 mg/dL) associated with olanzapine and quetiapine therapy occurring among inpatients at Oregon State Hospital, including 7 patients whose serum triglyceride levels exceeded 1,000 mg/ dL. Four of these patients also developed new-onset diabetes. Nine cases occurred during the first 8 months of treatment, with three cases identified within 3 months of commencing olanzapine or quetiapine therapy. Weight gain in olanzapine and quetiapine groups was modest (12.3 lb and 8.5 lb, respectively) and did not correlate with the severity of hypertriglyceridemia. Biochemical causes for severe hypertriglyceridemia associated with novel antipsychotics are unclear, but clinical monitoring of serum lipids must be added to the concerns about the metabolic consequences of therapy with certain newer antipsychotic agents.

Violence and its injury consequences in American movies

PubMed Central

McArthur, David L; Peek-Asa, Corinne; Webb, Theresa; Fisher, Kevin; Cook, Bernard; Browne, Nick; Kraus, Jess

2000-01-01

Objectives To evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top-grossing American films of 1994. Methods Each scene in each film was examined for the presentation of violent actions on persons and coded by a systematic context-sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. Results The median number of violent actions per film was 16 (range, 0-110). Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Conclusions Violent force in American films of 1994 was overwhelmingly intentional and in 4 of 5 cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings. PMID:10986175

Violence and its injury consequences in American movies: a public health perspective.

PubMed

McArthur, D L; Peek-Asa, C; Webb, T; Fisher, K; Cook, B; Browne, N; Kraus, J

2000-09-01

To evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top-grossing American films of 1994. Each scene in each film was examined for the presentation of violent actions on persons and coded by a systematic context-sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. The median number of violent actions per film was 16 (range, 0-110). Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Violent force in American films of 1994 was overwhelmingly intentional and in 4 of 5 cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings.

Some aspects of core formation in Mercury

NASA Technical Reports Server (NTRS)

Solomon, S. C.

1976-01-01

Some questions dealing with the nature and history of a large metallic core within Mercury are considered. These include the existence of a core, its size, whether it is fluid or solid, the timescale for core formation, the geological consequences of core formation, and whether such consequences are consistent with the surface geology. Several indirect lines of evidence are discussed which suggest the presence of a large iron-rich core. A core-formation model is examined in which core infall is accompanied by an increase of 17 km in planetary radius, an increase of 700 K in mean internal temperature, and substantial melting of the mantle. It is argued that if the core differentiated from an originally homogeneous planet, that event must have predated the oldest geological units comprising most of the planetary surface. A convective dynamo model for the source of Mercury's magnetic field is shown to conflict with cosmochemical models that do not predict a substantial radiogenic heat source in the core.

Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

PubMed Central

2013-01-01

Background This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood. Discussion Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. Summary Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice. PMID:23286319

Hyperhidrosis Substantially Reduces Quality of Life in Children: A Retrospective Study Describing Symptoms, Consequences and Treatment with Botulinum Toxin.

PubMed

Mirkovic, Sandra Eriksson; Rystedt, Alma; Balling, Mie; Swartling, Carl

2018-01-12

Studies on children with hyperhidrosis are sparse. This retrospective study presents clinical data and quality of life, along with treatment effect and safety of botulinum toxin (BTX). Case reports from 366 children were included to capture the medical history of hyperhidrosis. The total median score of the Dermatology Life Quality Index before treatment was 11 for children aged 16-17 years and 12 for children younger than 16 years. The children described physical, psychosocial and consequence-related symptoms. More than 70% had multifocal hyperhidrosis. BTX-A and/or BTX-B were given to 323 children, 193 of whom received repeated treatments. The highest score in a 5-grade scale concerning treatment effect was reported by 176/193 children, i.e. their "sweating disappeared completely". No severe adverse events occurred. Focal and multifocal hyperhidrosis in children reduces quality of life considerably. Treatment with BTX-A and/or BTX-B has been performed with success.

Inside-out neuropharmacology of nicotinic drugs

PubMed Central

Henderson, Brandon J.; Lester, Henry A.

2015-01-01

Upregulation of neuronal nicotinic acetylcholine receptors (AChRs) is a venerable result of chronic exposure to nicotine; but it is one of several consequences of pharmacological chaperoning by nicotine and by some other nicotinic ligands, especially agonists. Nicotinic ligands permeate through cell membranes, bind to immature AChR oligomers, elicit incompletely understood conformational reorganizations, increase the interaction between adjacent AChR subunits, and enhance the maturation process toward stable AChR pentamers. These changes and stabilizations in turn lead to increases in both anterograde and retrograde traffic within the early secretory pathway. In addition to the eventual upregulation of AChRs at the plasma membrane, other effects of pharmacological chaperoning include modifications to endoplasmic reticulum stress and to the unfolded protein response. Because these processes depend on pharmacological chaperoning within intracellular organelles, we group them as “inside-out pharmacology”. This term contrasts with the better-known, acute, “outside-in” effects of activating and desensitizing plasma membrane AChRs. We review current knowledge concerning the mechanisms and consequences of inside-out pharmacology. PMID:25660637

The effect of range changes on the functional turnover, structure and diversity of bird assemblages under future climate scenarios.

PubMed

Barbet-Massin, Morgane; Jetz, Walter

2015-08-01

Animal assemblages fulfill a critical set of ecological functions for ecosystems that may be altered substantially as climate change-induced distribution changes lead to community disaggregation and reassembly. We combine species and community perspectives to assess the consequences of projected geographic range changes for the diverse functional attributes of avian assemblages worldwide. Assemblage functional structure is projected to change highly unevenly across space. These differences arise from both changes in the number of species and changes in species' relative local functional redundancy or distinctness. They sometimes result in substantial losses of functional diversity that could have severe consequences for ecosystem health. Range expansions may counter functional losses in high-latitude regions, but offer little compensation in many tropical and subtropical biomes. Future management of local community function and ecosystem services thus relies on understanding the global dynamics of species distributions and multiscale approaches that include the biogeographic context of species traits. © 2015 John Wiley & Sons Ltd.

Risks, Health Consequences, and Response Challenges for Small-Island-Based Populations: Observations From the 2017 Atlantic Hurricane Season.

PubMed

Shultz, James M; Kossin, James P; Shepherd, J Marshall; Ransdell, Justine M; Walshe, Rory; Kelman, Ilan; Galea, Sandro

2018-04-06

ABSTRACTThe intensely active 2017 Atlantic basin hurricane season provided an opportunity to examine how climate drivers, including warming oceans and rising seas, exacerbated tropical cyclone hazards. The season also highlighted the unique vulnerabilities of populations residing on Small Island Developing States (SIDS) to the catastrophic potential of these storms. During 2017, 22 of the 29 Caribbean SIDS were affected by at least one named storm, and multiple SIDS experienced extreme damage. This paper aims to review the multiplicity of storm impacts on Caribbean SIDS throughout the 2017 season, to explicate the influences of climate drivers on storm formation and intensity, to explore the propensity of SIDS to sustain severe damage and prolonged disruption of essential services, to document the spectrum of public health consequences, and to delineate the daunting hurdles that challenged emergency response and recovery operations for island-based, disaster-affected populations. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).

Factors associated with adaptation to Klinefelter syndrome: The experience of adolescents and adults

PubMed Central

Turriff, Amy; Levy, Howard P.; Biesecker, Barbara

2016-01-01

Objective The purpose of this study was to understand the impact of living with Klinefelter syndrome (XXY) as an adolescent or an adult and to examine the factors that contribute to adaptation. Methods Individuals (n = 310) aged 14–75 years with self-reported XXY were recruited from online support networks to complete a self-administered survey. Perceived consequences, perceived severity, perceived stigma, and coping were measured and evaluated as correlates of adaptation. Results The use of problem-focused coping strategies was positively correlated with adaptation (p < 0.01) and age was negatively correlated with adaptation (p < 0.05). Conclusion The majority of participants reported significant negative consequences of XXY, including infertility, psychological co-morbidities and differences in appearance. How participants coped with their negative appraisals was the greatest predictor of adaptation. Practice implications Interventions designed to help individuals reframe negative appraisals, to increase perceived manageability of the challenges of living with XXY, and to facilitate effective coping may improve adaptation among individuals with XXY. PMID:25239793

Fifth Space Weather Enterprise Forum Reaches New Heights

NASA Astrophysics Data System (ADS)

Williamson, Samuel P.; Babcock, Michael R.; Bonadonna, Michael F.

2011-09-01

As the world's commercial infrastructure grows more dependent on sensitive electronics and space-based technologies, the global economy is becoming increasingly vulnerable to solar storms. Experts from the federal government, academia, and the private sector met to discuss the societal effects of major solar storms and other space weather at the fifth annual Space Weather Enterprise Forum (SWEF), held on 21 June 2011 at the National Press Club in Washington, D. C. More than 200 members of the space weather community attended this year's SWEF, which focused on the consequences of severe space weather for national security, critical infrastructure, and human safety. Participants also addressed the question of how to prepare for and mitigate those consequences as the current solar cycle approaches and reaches its peak, expected in 2013. This year's forum included details of plans for a "Unified National Space Weather Capability," a new interagency initiative which will be implemented over the next two years, designed to improve forecasting, warning, and other services ahead of the coming solar maximum.

The Health Effect of Psychostimulants: A Literature Review.

PubMed

Favrod-Coune, Thierry; Broers, Barbara

2010-07-22

Prevalence of psychostimulant use is high, and raising in several countries. Nicotine is the legal stimulant causing the most important public health impact. Cocaine ranks among the most used illicit substances after cannabis. Stimulant medications are frequently misused. Psychostimulants can lead to addiction, have physical, psychological and social health consequences and can induce a great disease burden. The aim of the present article is to provide a literature review on the health effects of stimulants as potential drugs of abuse. It will cover essentially cocaine, amphetamines and its derivatives (including methamphetamines and 3-4-methylenedioxymethamphetamine, ecstasy), nicotine, caffeine and khat, and touch upon the issues of prescribed substances (anti-depressants, weight control medications, attention-deficit hyperactivity disorder medications, hypersomniac disorder). Their pharmacology, addictive potential, health consequences and treatment will be discussed. We used Medline for the literature review from 1990 to the date of this review, and mention the findings of human and animal studies (the latter only if they are of clinical relevance).

The Elephant Vanishes: impact of human-elephant conflict on people's wellbeing.

PubMed

Jadhav, Sushrut; Barua, Maan

2012-11-01

Human-wildlife conflicts impact upon the wellbeing of marginalised people, worldwide. Although tangible losses from such conflicts are well documented, hidden health consequences remain under-researched. Based on preliminary clinical ethnographic inquiries and sustained fieldwork in Assam, India, this paper documents mental health antecedents and consequences including severe untreated psychiatric morbidity and substance abuse. The case studies presented make visible the hidden mental health dimensions of human-elephant conflict. The paper illustrates how health impacts of conflicts penetrate far deeper than immediate physical threat from elephants, worsens pre-existing mental illness of marginalised people, and leads to newer psychiatric and social pathologies. These conflicts are enacted and perpetuated in institutional spaces of inequality. The authors argue that both wildlife conservation and community mental health disciplines would be enhanced by coordinated intervention. The paper concludes by generating questions that are fundamental for a new interdisciplinary paradigm that bridges ecology and the clinic. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Ecosystem-based management of predator-prey relationships: piscivorous birds and salmonids.

PubMed

Wiese, Francis K; Parrish, Julia K; Thompson, Christopher W; Maranto, Christina

2008-04-01

Predator-prey relationships are often altered as a result of human activities. Where prey are legally protected, conservation action may include lethal predator control. In the Columbia River basin (Pacific Northwest, USA and Canada), piscivorous predators have been implicated in contributing to a lack of recovery of several endangered anadromous salmonids (Oncorhynchus spp.), and lethal and nonlethal control programs have been instituted against both piscine and avian species. To determine the consequences of avian predation, we used a bioenergetics approach to estimate the consumption of salmonid smolts by waterbirds (Common Merganser, California and Ring-billed Gull, Caspian Tern, Double-crested Cormorant) found in the mid-Columbia River from April through August, 2002-2004. We used our model to explore several predator-prey scenarios, including the impact of historical bird abundance, and the effect of preserving vs. removing birds, on smolt abundance. Each year, <1% of the estimated available salmonid smolts (interannual range: 44,830-109,209; 95% CI = 38,000-137,000) were consumed, 85-98% away from dams. Current diet data combined with historical gull abundance at dams suggests that past smolt consumption may have been 1.5-3 times current numbers, depending on the assumed distribution of gulls along the reaches. After the majority (80%) of salmonid smolts have left the study area, birds switch their diet to predominantly juvenile northern pikeminnow (Ptychocheilus oregonensis), which as adults are significant native salmonid predators in the Columbia River. Our models suggest that one consequence of removing birds from the system may be increased pikeminnow abundance, which--even assuming 80% compensatory mortality in juvenile pikeminnow survival--would theoretically result in an annual average savings of just over 180,000 smolts, calculated over a decade. Practically, this suggests that smolt survival could be maximized by deterring birds from the river when smolts are present, allowing bird presence after the diet switch to act as a tool for salmonid-predator control, and conducting adult-pikeminnow control throughout. Our analysis demonstrates that identifying the strength of ecosystem interactions represents a top priority when attempting to manage the abundance of a particular ecosystem constituent, and that the consequences of a single-species view may be counterintuitive, and potentially counterproductive.

Genetic predisposition increases the tic severity, rate of comorbidities, and psychosocial and educational difficulties in children with Tourette syndrome.

PubMed

Eysturoy, Absalon Niclas; Skov, Liselotte; Debes, Nanette Mol

2015-03-01

This study aimed to examine whether there are differences in tic severity, comorbidities, and psychosocial and educational consequences in children with Tourette syndrome and genetic predisposition to Tourette syndrome compared with children with Tourette syndrome without genetic predisposition to Tourette syndrome. A total of 314 children diagnosed with Tourette syndrome participated in this study. Validated diagnostic tools were used to assess tic severity, comorbidities, and cognitive performance. A structured interview was used to evaluate psychosocial and educational consequences related to Tourette syndrome. The children with Tourette syndrome and genetic predisposition present with statistically significant differences in terms of severity of tics, comorbidities, and a range of psychosocial and educational factors compared with the children with Tourette syndrome without genetic predisposition. Professionals need to be aware of genetic predisposition to Tourette syndrome, as children with Tourette syndrome and genetic predisposition have more severe symptoms than those children with Tourette syndrome who are without genetic predisposition. © The Author(s) 2014.

Fragile X syndrome: Are signaling lipids the missing culprits?

PubMed

Tabet, Ricardos; Vitale, Nicolas; Moine, Hervé

2016-11-01

Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and autism. FXS results from the absence of FMRP, an RNA binding protein associated to ribosomes that influences the translation of specific mRNAs in post-synaptic compartments of neurons. The main molecular consequence of the absence of FMRP is an excessive translation of neuronal protein in several areas of the brain. This local protein synthesis deregulation is proposed to underlie the defect in synaptic plasticity responsible for FXS. Recent findings in neurons of the fragile X mouse model (Fmr1-KO) uncovered another consequence of the lack of FMRP: a deregulation of the diacylglycerol (DAG)/phosphatidic acid (PA) homeostasis. DAG and PA are two interconvertible lipids that influence membrane architecture and that act as essential signaling molecules that activate various downstream effectors, including master regulators of local protein synthesis and actin polymerization. As a consequence, DAG and PA govern a variety of cellular processes, including cell proliferation, vesicle/membrane trafficking and cytoskeletal organization. At the synapse, the level of these lipids is proposed to influence the synaptic activation status. FMRP appears as a master regulator of this neuronal process by controlling the translation of a diacylglycerol kinase enzyme that converts DAG into PA. The deregulated levels of DAG and PA caused by the absence of FMRP could represent a novel therapeutic target for the treatment of FXS. Copyright © 2016 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

Ovarian steroids act as respiratory stimulant and antioxidant against the causes and consequences of sleep-apnea in women.

PubMed

Boukari, Ryma; Laouafa, Sofien; Ribon-Demars, Alexandra; Bairam, Aida; Joseph, Vincent

2017-05-01

Evidence supports the importance of ovarian hormones as potential tools against sleep apneas in women. On one hand, progesterone is largely acknowledged as being a respiratory stimulant that reduces the frequency of apneas, but the underlying mechanisms remain poorly understood. Recent studies in mice showed that the respiratory effects of progesterone are mediated by at least two classes of progesterone receptors, including the nuclear (nPR) and membrane receptors (mPR). Some of these receptors (nPR) have sex-specific effects on the frequency of apneas recorded during sleep in mice, while mPRβ acts in males as well as in females. Moreover, sleep apnea is a condition that induces an "oxidative stress" response in several tissues, and this contributes to the deleterious consequences of sleep apneas, including the development of hypertension. While estradiol is recognized as an antioxidant hormone, its potential protective role has remained mostly ignored in the field. We will review recent data supporting an antioxidant role of estradiol in female rats exposed to intermittent hypoxia, a reliable animal model of sleep apnea. Since estradiol has two main receptors (ERα and ERβ) we will discuss their relative implications, and present new data showing a key role for ERα to prevent the hypertension induced by intermittent hypoxia. Overall this review highlights the fact that ovarian hormones could potentially be used as efficient tools against the causes (i.e. instabilities of the respiratory control system) and consequences (oxidative stress) of sleep apnea. Copyright © 2017 Elsevier B.V. All rights reserved.

What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes?

PubMed Central

Mitanchez, Delphine; Yzydorczyk, Catherine; Simeoni, Umberto

2015-01-01

In the epidemiologic context of maternal obesity and type 2 diabetes (T2D), the incidence of gestational diabetes has significantly increased in the last decades. Infants of diabetic mothers are prone to various neonatal adverse outcomes, including metabolic and hematologic disorders, respiratory distress, cardiac disorders and neurologic impairment due to perinatal asphyxia and birth traumas, among others. Macrosomia is the most constant consequence of diabetes and its severity is mainly influenced by maternal blood glucose level. Neonatal hypoglycemia is the main metabolic disorder that should be prevented as soon as possible after birth. The severity of macrosomia and the maternal health condition have a strong impact on the frequency and the severity of adverse neonatal outcomes. Pregestational T2D and maternal obesity significantly increase the risk of perinatal death and birth defects. The high incidence of maternal hyperglycemia in developing countries, associated with the scarcity of maternal and neonatal care, seriously increase the burden of neonatal complications in these countries. PMID:26069722

Role of NMDA Receptor-Mediated Glutamatergic Signaling in Chronic and Acute Neuropathologies

PubMed Central

2016-01-01

N-Methyl-D-aspartate receptors (NMDARs) have two opposing roles in the brain. On the one hand, NMDARs control critical events in the formation and development of synaptic organization and synaptic plasticity. On the other hand, the overactivation of NMDARs can promote neuronal death in neuropathological conditions. Ca2+ influx acts as a primary modulator after NMDAR channel activation. An imbalance in Ca2+ homeostasis is associated with several neurological diseases including schizophrenia, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These chronic conditions have a lengthy progression depending on internal and external factors. External factors such as acute episodes of brain damage are associated with an earlier onset of several of these chronic mental conditions. Here, we will review some of the current evidence of how traumatic brain injury can hasten the onset of several neurological conditions, focusing on the role of NMDAR distribution and the functional consequences in calcium homeostasis associated with synaptic dysfunction and neuronal death present in this group of chronic diseases. PMID:27630777

A model independent search for new physics in final states containing leptons at the DO experiment

NASA Astrophysics Data System (ADS)

Piper, Joel M.

The standard model is known to be the low energy limit of a more general theory. Several consequences of the standard model point to a strong probability of new physics becoming experimentally visible in high energy collisions of a few TeV, resulting in high momentum objects. The specific signatures of these collisions are topics of much debate. Rather than choosing a specific signature, this analysis broadly searches the data, preferring breadth over sensitivity. In searching for new physics, several different approaches are used. These include the comparison of data with standard model background expectation in overall number of events, comparisons of distributions of many kinematic variables, and finally comparisons on the tails of distributions that sum the momenta of the objects in an event. With 1.07 fb-1 at the DO experiment, we find no evidence of physics beyond the standard model. Several discrepancies from the standard model were found, but none of these provide a compelling case for new physics.

Bloom Dynamics of Cyanobacteria and Their Toxins: Environmental Health Impacts and Mitigation Strategies

PubMed Central

Rastogi, Rajesh P.; Madamwar, Datta; Incharoensakdi, Aran

2015-01-01

Cyanobacteria are ecologically one of the most prolific groups of phototrophic prokaryotes in both marine and freshwater habitats. Both the beneficial and detrimental aspects of cyanobacteria are of considerable significance. They are important primary producers as well as an immense source of several secondary products, including an array of toxic compounds known as cyanotoxins. Abundant growth of cyanobacteria in freshwater, estuarine, and coastal ecosystems due to increased anthropogenic eutrophication and global climate change has created serious concern toward harmful bloom formation and surface water contamination all over the world. Cyanobacterial blooms and the accumulation of several cyanotoxins in water bodies pose severe ecological consequences with high risk to aquatic organisms and global public health. The proper management for mitigating the worldwide incidence of toxic cyanobacterial blooms is crucial for maintenance and sustainable development of functional ecosystems. Here, we emphasize the emerging information on the cyanobacterial bloom dynamics, toxicology of major groups of cyanotoxins, as well as a perspective and integrative approach to their management. PMID:26635737

Hydrogeomorphic effects of explosive volcanic eruptions on drainage basins

USGS Publications Warehouse

Pierson, Thomas C.; Major, Jon J.

2014-01-01

Explosive eruptions can severely disturb landscapes downwind or downstream of volcanoes by damaging vegetation and depositing large volumes of erodible fragmental material. As a result, fluxes of water and sediment in affected drainage basins can increase dramatically. System-disturbing processes associated with explosive eruptions include tephra fall, pyroclastic density currents, debris avalanches, and lahars—processes that have greater impacts on water and sediment discharges than lava-flow emplacement. Geo-morphic responses to such disturbances can extend far downstream, persist for decades, and be hazardous. The severity of disturbances to a drainage basin is a function of the specific volcanic process acting, as well as distance from the volcano and magnitude of the eruption. Postdisturbance unit-area sediment yields are among the world's highest; such yields commonly result in abundant redeposition of sand and gravel in distal river reaches, which causes severe channel aggradation and instability. Response to volcanic disturbance can result in socioeconomic consequences more damaging than the direct impacts of the eruption itself.

The 2007 water crisis in Wuxi, China: analysis of the origin.

PubMed

Zhang, Xiao-jian; Chen, Chao; Ding, Jian-qing; Hou, Aixin; Li, Yong; Niu, Zhang-bin; Su, Xiao-yan; Xu, Yan-juan; Laws, Edward A

2010-10-15

An odorous tap water crisis that affected two million residents for several days occurred in Wuxi, China in the summer of 2007. Volatile sulfide chemicals including methyl thiols, dimethyl sulfide, dimethyl disulfide, and dimethyl trisulfide were the dominant odorous contaminants in Lake Taihu and in tap water during the crisis. These contaminants originated from the decomposition of a massive cyanobacterial bloom that was triggered by illegal industrial discharges and inadequately regulated domestic pollution. A specific emergency drinking water treatment process was quickly developed using a combination of potassium permanganate oxidation and powdered activated carbon adsorption. The emergency treatment process removed the odor from the tap water and solved the crisis successfully in several days. This experience underscores the suggestion that a combination of stresses associated with eutrophication and industrial and domestic wastewater discharges can push an aquatic system to the tipping point with consequences far more severe than would occur if the system were subjected to each stress separately. 2010 Elsevier B.V. All rights reserved.

Mixed-severity fire regimes in the northern Rocky Mountains: consequences of fire exclusion and options for the future

Treesearch

Stephen F. Arno; David J. Parsons; Robert E. Keane

2000-01-01

Findings from fire history studies have increasingly indicated that many forest ecosystems in the northern Rocky Mountains were shaped by mixed-severity fire regimes, characterized by fires of variable severities at intervals averaging between about 30 and 100 years. Perhaps because mixed-severity fire regimes and their resulting vegetational patterns are difficult to...

Changing epidemiology of melioidosis? A case of acute pulmonary melioidosis with fatal outcome imported from Brazil.

PubMed Central

Aardema, H.; Luijnenburg, E. M.; Salm, E. F.; Bijlmer, H. A.; Visser, C. E.; Van't Wout, J. W.

2005-01-01

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed. PMID:16181507

Does Vitamin C Deficiency Affect Cognitive Development and Function?

PubMed Central

Hansen, Stine Normann; Tveden-Nyborg, Pernille; Lykkesfeldt, Jens

2014-01-01

Vitamin C is a pivotal antioxidant in the brain and has been reported to have numerous functions, including reactive oxygen species scavenging, neuromodulation, and involvement in angiogenesis. Absence of vitamin C in the brain has been shown to be detrimental to survival in newborn SVCT2(−/−) mice and perinatal deficiency have shown to reduce hippocampal volume and neuron number and cause decreased spatial cognition in guinea pigs, suggesting that maternal vitamin C deficiency could have severe consequences for the offspring. Furthermore, vitamin C deficiency has been proposed to play a role in age-related cognitive decline and in stroke risk and severity. The present review discusses the available literature on effects of vitamin C deficiency on the developing and aging brain with particular focus on in vivo experimentation and clinical studies. PMID:25244370

Non-pharmacological techniques for pain management in neonates.

PubMed

Golianu, Brenda; Krane, Elliot; Seybold, Jeannie; Almgren, Chris; Anand, K J S

2007-10-01

Significant progress in understanding the physiology, clinical correlates, and consequences of neonatal pain have resulted in greater attention to pain management during neonatal intensive care. A number of nonpharmacological therapies have been investigated, including nonnutritive sucking, with and without sucrose use, swaddling or facilitated tucking, kangaroo care, music therapy, and multi-sensorial stimulation. Although the efficacy of these approaches is clearly evident, they cannot provide analgesia for moderate or severe pain in the neonate. Further, some of these therapies cannot be effectively applied to all populations of critically ill neonates. Acupuncture, an ancient practice in Chinese medicine, has gained increasing popularity for symptom control among adults and older children. Acupuncture may provide an effective nonpharmacological approach for the treatment of pain in neonates, even moderate or severe pain, and should be considered for inclusion in a graduated multidisciplinary algorithm for neonatal pain management.

Preventing ARDS

PubMed Central

Beitler, Jeremy R.; Schoenfeld, David A.

2014-01-01

Advances in critical care practice have led to a substantial decline in the incidence of ARDS over the past several years. Low tidal volume ventilation, timely resuscitation and antimicrobial administration, restrictive transfusion practices, and primary prevention of aspiration and nosocomial pneumonia have likely contributed to this reduction. Despite decades of research, there is no proven pharmacologic treatment of ARDS, and mortality from ARDS remains high. Consequently, recent initiatives have broadened the scope of lung injury research to include targeted prevention of ARDS. Prediction scores have been developed to identify patients at risk for ARDS, and clinical trials testing aspirin and inhaled budesonide/formoterol for ARDS prevention are ongoing. Future trials aimed at preventing ARDS face several key challenges. ARDS has not been validated as an end point for pivotal clinical trials, and caution is needed when testing toxic therapies that may prevent ARDS yet potentially increase mortality. PMID:25288000

Detection of inflammatory biomarkers in saliva and urine: Potential in diagnosis, prevention, and treatment for chronic diseases

PubMed Central

Tyagi, Amit K; Aggarwal, Bharat B

2016-01-01

Inflammation is a part of the complex biological response of inflammatory cells to harmful stimuli, such as pathogens, irritants, or damaged cells. This inflammation has been linked to several chronic diseases including cancer, atherosclerosis, rheumatoid arthritis, and multiple sclerosis. Major biomarkers of inflammation include tumor necrosis factor, interleukins (IL)-1, IL-6, IL-8, chemokines, cyclooxygenase, 5-lipooxygenase, and C-reactive protein, all of which are regulated by the transcription factor nuclear factor-kappaB. Although examining inflammatory biomarkers in blood is a standard practice, its identification in saliva and/or urine is more convenient and non-invasive. In this review, we aim to (1) discuss the detection of these inflammatory biomarkers in urine and saliva; (2) advantages of using salivary and urinary inflammatory biomarkers over blood, while also weighing on the challenges and/or limitations of their use; (3) examine their role(s) in connection with diagnosis, prevention, treatment, and drug development for several chronic diseases with inflammatory consequences, including cancer; and (4) explore the use of innovative salivary and urine based biosensor strategies that may permit the testing of biomarkers quickly, reliably, and cost-effectively, in a decentralized setting. PMID:27013544

Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS.

PubMed

Lackner, Jeffrey M; Gudleski, Gregory D; Ma, Chang-Xing; Dewanwala, Akriti; Naliboff, Bruce

2014-11-01

Because irritable bowel syndrome (IBS) is a functional medical condition for which there is no curative therapy, treatment goals emphasize relieving gastrointestinal (GI) symptoms and optimizing the quality of life (QOL). This study sought to characterize the magnitude of the associations between QOL impairment, fear of IBS symptoms, and confounding variables. Subjects included 234 Rome III-diagnosed IBS patients (mean age, 41 years, 79%, female) without comorbid organic GI disease who were referred to two specialty care clinics of an National Institutes of Health trial for IBS. Subjects completed a testing battery that included the IBS-specific QOL (IBS-QOL), SF-12 (generic QOL), the UCLA GI Symptom Severity Scale, the Visceral Sensitivity Index, Trait Anxiety Inventory, and Brief Symptom Inventory. Multiple linear regression was used to develop a model for predicting QOL. Data supported an overall model that included sociodemographic, clinical (e.g., current severity of GI symptoms), and psychosocial (e.g., fear of GI symptoms, distress, neuroticism) variables, accounting for 48.7% of the variance in IBS-QOL (F=15.1, P <0.01). GI symptom fear was the most robust predictor of IBS-QOL (β=-0.45 P <0.01), accounting for 14.4% of the total variance. Patients' fear that GI symptoms have aversive consequences, is a predictor of QOL impairment that cannot be fully explained by the severity of their GI symptoms, overall emotional well-being, neurotic personality style, or other clinical features of IBS. An understanding of the unique impact that GI symptom fears have on QOL can inform treatment planning and help gastroenterologists to better manage more severe IBS patients seen in tertiary care clinics.

Alcohol-Related Negative Consequences among Drinkers around the World

PubMed Central

Graham, Kathryn; Bernards, Sharon; Knibbe, Ronald; Kairouz, Sylvia; Kuntche, Sandra; Wilsnack, Sharon C.; Greenfield, Thomas K.; Dietze, Paul; Obot, Isidore; Gmel, Gerhard

2013-01-01

Aims This paper examines (1) gender and country differences in negative consequences related to drinking; (2) relative rates of different consequences; (3) country-level predictors of consequences. Design, setting and participants Multi-level analyses used survey data from the GENACIS collaboration. Measurements Measures included 17 negative consequences grouped into (a) high endorsement acute, (b) personal and (c) social. Country-level measures included average frequency and quantity of drinking, percent current drinkers, Gross Domestic Product (GDP) and Human Development Index (HDI). Findings Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda, lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers, and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. Conclusions Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences. PMID:21395893

Molecular pathways involved in the early and late damage induced by testis ischemia: evidence for a rational pharmacological modulation.

PubMed

Altavilla, D; Romeo, C; Squadrito, F; Marini, H; Morgia, G; Antonuccio, P; Minutoli, L

2012-01-01

Testicular torsion or torsion of the spermatic cord is a surgical emergency in which misdiagnosis and inappropriate treatment can lead to male infertility. Events occurring during testicular torsion and detorsion are representative of an ischemia-reperfusion injury observed in other organs. The two most important factors determining testicular damage are the degree of twisting and the early onset of a surgical treatment to counter-rotate both testis and spermatic cord for inducing reperfusion. The damage from reperfusion is more severe than that induced by ischemia and several mechanisms are implicated in the development of testicular damage following torsion and detorsion. However, these mechanisms have not yet been fully clarified and, as a consequence, there is still a strong need to identify specific pharmacological treatment to limit the damage triggered by the reperfusion procedures. Ischemia and reperfusion of testis result in elevated production of reactive oxygen species (ROS), activate mitogen activated protein kinases (MAPKs) and PPARβ/δ receptor, induce transcription factors and growth factors including NF-κB and VEGF, trigger apoptotic machinery and induce several inflammatory cytokines, including TNF-α and IL-1β . This pathological cascade is responsible for the testicular atrophy, decreased blood flow and impaired spermatogenesis. Several pharmacological approaches have been characterized as promising therapeutic agents for the management of testicular torsion and may be useful to ameliorate the sequel of this disease.

Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences.

PubMed

Barletta, Jeffrey F; Sclar, David A

2014-01-01

The provision of stress ulcer prophylaxis (SUP) for the prevention of clinically significant bleeding is widely recognized as a crucial component of care in critically ill patients. Nevertheless, SUP is often provided to non-critically ill patients despite a risk for clinically significant bleeding of roughly 0.1 %. The overuse of SUP therefore introduces added risks for adverse drug events and cost, with minimal expected benefit in clinical outcome. Historically, histamine-2-receptor antagonists (H2RAs) have been the preferred agent for SUP; however, recent data have revealed proton pump inhibitors (PPIs) as the most common modality (76 %). There are no high quality randomized controlled trials demonstrating superiority with PPIs compared with H2RAs for the prevention of clinically significant bleeding associated with stress ulcers. In contrast, PPIs have recently been linked to several adverse effects including Clostridium difficile diarrhea and pneumonia. These complications have substantial economic consequences and have a marked impact on the overall cost effectiveness of PPI therapy. Nevertheless, PPI use remains widespread in patients who are at both high and low risk for clinically significant bleeding. This article will describe the utilization of PPIs for SUP and present the clinical and economic consequences linked to their use/overuse.

Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

PubMed

Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

2016-12-01

To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

Occurrence, Biological Consequences, and Human Health Relevance of Oxidative Stress-Induced DNA Damage.

PubMed

Yu, Yang; Cui, Yuxiang; Niedernhofer, Laura J; Wang, Yinsheng

2016-12-19

A variety of endogenous and exogenous agents can induce DNA damage and lead to genomic instability. Reactive oxygen species (ROS), an important class of DNA damaging agents, are constantly generated in cells as a consequence of endogenous metabolism, infection/inflammation, and/or exposure to environmental toxicants. A wide array of DNA lesions can be induced by ROS directly, including single-nucleobase lesions, tandem lesions, and hypochlorous acid (HOCl)/hypobromous acid (HOBr)-derived DNA adducts. ROS can also lead to lipid peroxidation, whose byproducts can also react with DNA to produce exocyclic DNA lesions. A combination of bioanalytical chemistry, synthetic organic chemistry, and molecular biology approaches have provided significant insights into the occurrence, repair, and biological consequences of oxidatively induced DNA lesions. The involvement of these lesions in the etiology of human diseases and aging was also investigated in the past several decades, suggesting that the oxidatively induced DNA adducts, especially bulky DNA lesions, may serve as biomarkers for exploring the role of oxidative stress in human diseases. The continuing development and improvement of LC-MS/MS coupled with the stable isotope-dilution method for DNA adduct quantification will further promote research about the clinical implications and diagnostic applications of oxidatively induced DNA adducts.

Impact of genetic risk information and type of disease on perceived risk, anticipated affect, and expected consequences of genetic tests.

PubMed

Cameron, Linda D; Sherman, Kerry A; Marteau, Theresa M; Brown, Paul M

2009-05-01

Genetic tests vary in their prediction of disease occurrence, with some mutations conferring relatively low risk and others indicating near certainty. The authors assessed how increments in absolute risk of disease influence risk perceptions, interest, and expected consequences of genetic tests for diseases of varying severity. Adults (N = 752), recruited from New Zealand, Australia, and the United Kingdom for an online analogue study, were randomly assigned to receive information about a test of genetic risk for diabetes, heart disease, colon cancer, or lung cancer. The lifetime risk varied across conditions by 10% increments, from 20% to 100%. Participants completed measures of perceived likelihood of disease for individuals with mutations, risk-related affect, interest, and testing consequences. Analyses revealed two increment clusters yielding differences in likelihood perceptions: A "moderate-risk" cluster (20%-70%), and a "high-risk" cluster (80%-100%). Risk increment influenced anticipated worry, feelings of risk, testing-induced distress, and family obligations, with nonlinear patterns including disproportionately high responses for the 50% increment. Risk increment did not alter testing interest or perceived benefits. These patterns of effects held across the four diseases. Magnitude of risk from genetic testing has a nonlinear influence on risk-related appraisals and affect but is unrelated to test interest.

Behavioral and Physiological Consequences of Sleep Restriction

PubMed Central

Banks, Siobhan; Dinges, David F.

2007-01-01

Adequate sleep is essential for general healthy functioning. This paper reviews recent research on the effects of chronic sleep restriction on neurobehavioral and physiological functioning and discusses implications for health and lifestyle. Restricting sleep below an individual's optimal time in bed (TIB) can cause a range of neurobehavioral deficits, including lapses of attention, slowed working memory, reduced cognitive throughput, depressed mood, and perseveration of thought. Neurobehavioral deficits accumulate across days of partial sleep loss to levels equivalent to those found after 1 to 3 nights of total sleep loss. Recent experiments reveal that following days of chronic restriction of sleep duration below 7 hours per night, significant daytime cognitive dysfunction accumulates to levels comparable to that found after severe acute total sleep deprivation. Additionally, individual variability in neurobehavioral responses to sleep restriction appears to be stable, suggesting a traitlike (possibly genetic) differential vulnerability or compensatory changes in the neurobiological systems involved in cognition. A causal role for reduced sleep duration in adverse health outcomes remains unclear, but laboratory studies of healthy adults subjected to sleep restriction have found adverse effects on endocrine functions, metabolic and inflammatory responses, suggesting that sleep restriction produces physiological consequences that may be unhealthy. Citation: Banks S; Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3(5):519-528. PMID:17803017

An Item Response Theory Analysis of the Problem Gambling Severity Index

ERIC Educational Resources Information Center

Sharp, Carla; Steinberg, Lynne; Yaroslavsky, Ilya; Hofmeyr, Andre; Dellis, Andrew; Ross, Don; Kincaid, Harold

2012-01-01

Increases in the availability of gambling heighten the need for a short screening measure of problem gambling. The Problem Gambling Severity Index (PGSI) is a brief measure that allows for the assessment of characteristics of gambling behavior and severity and its consequences. The authors evaluate the psychometric properties of the PGSI using…

Public guidance for managing hazardous material transportation in Texas.

DOT National Transportation Integrated Search

2009-08-01

Only a small fraction of the millions of daily hazmat shipments interrupt their planned journey due to : an incident that may severely threaten public and environmental safety. However, this threat of very rare but : very severe consequences elevates...

Consequences and coping strategies six years after a subarachnoid hemorrhage – A qualitative study

PubMed Central

Törnbom, Karin; Sunnerhagen, Katharina S.; Törnbom, Marie

2017-01-01

Background After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person’s life. There is a lack of knowledge regarding long-term consequences experienced. Purpose To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. Methods An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH. Data was analyzed according to a descriptive thematic analysis, and themes were discovered inductively. Results Two major themes from the analysis, both including four sub-themes, were identified; these themes were consequences of the SAH and coping strategies. Participants were grateful to have survived the SAH and most were satisfied with their acute medical care. If discharged directly from the neurosurgical unit participants can feel abandoned. In contrast, participants who were referred to a rehabilitation clinic felt supported and informed. Cognitive problems, such as impaired memory and mental fatigue, were reported as still present six years post SAH. Coping strategies were; receiving support from family, society, employers, or technical equipment. At work, talking to colleagues and to taking breaks were common. Participants described hiding their symptoms from employers and friends, as well as trying to continue doing tasks in the same manner as prior to the SAH. If this was not possible, some refrained from doing these tasks. They went through a mourning process, fear, and worries. Conclusions Participants reported several long-term consequences which impacted on their daily lives post SAH, and different coping strategies were used to cope with these problems. Participants reported lack of awareness regarding the consequences of SAH and stressed the importance of structured multidisciplinary follow-ups, which mostly is missing. PMID:28854198

Constructive and Unconstructive Repetitive Thought

PubMed Central

Watkins, Edward R.

2008-01-01

The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct consequences. PMID:18298268

[Severe nutritional rickets in young children: Resurgence of an old disease].

PubMed

Estrade, S; Majorel, C; Tahhan, N; Dulac, Y; Baunin, C; Gennero, I; Chaix, Y; Salles, J-P; Edouard, T

2017-08-01

Nutritional rickets remains a significant public health issue for children worldwide. Although it has almost disappeared in industrialized countries following routine vitamin D supplementation, recent evidence suggests an increasing incidence, especially in young children. In addition to the classical clinical consequences on bone and the growth plate, rickets may also be associated with life-threatening neurological and cardiac complications in the most severe forms. Consequently, early screening and treatment are required. Here, we report the case of a 2-year-old child who presented with severe nutritional rickets associated with seizure and cardiomyopathy. Family screening revealed rickets in all the siblings. This case report emphasizes the importance of being aware of this disease, notably in population with sociocultural risk factors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Short-sighted confession decisions: the role of uncertain and delayed consequences.

PubMed

Yang, Yueran; Madon, Stephanie; Guyll, Max

2015-02-01

Suspects have a propensity to focus on short-term contingencies, giving disproportionate weight to the proximal consequences that are delivered by police during an interrogation, and too little consideration to the distal (and often more severe) consequences that may be levied by the judicial system if they are convicted. In this research, the authors examined whether the perceived uncertainty and temporal distance of distal consequences contribute to this propensity. Using the repetitive question paradigm (Madon et al., 2012), participants (N = 209) were interviewed about 20 prior criminal and unethical behaviors and were required to admit or deny each one. Participants' denials and admissions were paired with both a proximal consequence and a distal consequence, respectively. Results indicated that the distal consequence had less impact on participants' admission decisions when it was uncertain and temporally remote. These results provide evidence that the perceived uncertainty and temporal distance of future punishment are key factors that lead suspects to confess to crimes in exchange for short-term gains.

Women, Anger Expression, Relational and Health Consequences: A Review of the Literature.

ERIC Educational Resources Information Center

McPherson, Kristin L.

Women's anger expression style has been the focus of several recent studies and has been demonstrated to have deleterious effects on emotional and physical health. The purpose of this study was to review the empirical literature for women's anger expression style and related health and relational consequences. The study reviewed emotion induction,…

Ecohydrological consequences of drought- and infestation-triggered tree die-off: Insights and hypotheses

Treesearch

Henry D. Adams; Charles H. Luce; David D. Breshears; Craig D. Allen; Markus Weiler; V. Cody Hale; Alistair M. S. Smith; Travis E. Huxman

2012-01-01

Widespread, rapid, drought-, and infestation-triggered tree mortality is emerging as a phenomenon affecting forests globally and may be linked to increasing temperatures and drought frequency and severity. The ecohydrological consequences of forest die-off have been little studied and remain highly uncertain. To explore this knowledge gap, we apply the extensive...

The Elimination of a Self-Injurious Avoidance Response through a Forced Running Consequence.

ERIC Educational Resources Information Center

Borreson, Paul M.

1980-01-01

The self-injurious avoidance responses of a 22-year-old severely mentally retarded male were eliminated through a forced running consequence. Side effects, such as reduced noise, increase in smiling, and faster progress toward instructional objectives, were also noted. The results were maintained over a period of two years. (Author/PHR)

Stochastic Consequence Analysis for Waste Leaks

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

HEY, B.E.

This analysis evaluates the radiological consequences of potential Hanford Tank Farm waste transfer leaks. These include ex-tank leaks into structures, underneath the soil, and exposed to the atmosphere. It also includes potential misroutes, tank overflow

Helping Children Cope with the Consequences of Violence.

ERIC Educational Resources Information Center

Wallach, Lorraine B.

The first part of this paper on the developmental consequences of children's exposure to chronic violence provides background information on the problem of violence. Developmental consequences of exposure to domestic and community violence for children at various developmental levels are briefly outlined. Consequences for children include: (1)…

Sexsomnia: A Specialized Non-REM Parasomnia?

PubMed

Dubessy, Anne-Laure; Leu-Semenescu, Smaranda; Attali, Valérie; Maranci, Jean-Baptiste; Arnulf, Isabelle

2017-02-01

To describe patients with sexsomnia and to contrast their clinical and sleep measures with those of healthy controls and sleepwalkers. Subjects referred for sexsomnia and for sleepwalking/night terror were interviewed, completed the Paris Arousal Disorder Severity Scale (PADSS), and were monitored 1-2 nights with video-polysomnography. Seventeen patients (70.6% male, aged 17-76 years) had sexsomnia, with amnestic fondling of the bed partner (n = 11), complete sexual intercourse (n = 8), masturbation (n = 8), and spontaneous orgasm (n = 1). The sexual behaviors were more direct during sleep than during wakefulness (n = 12), leading to 6 sexual assaults, including intra-conjugal rape (n = 3), assault of a family member (n = 2), rape of a friend (n = 1), and forensic consequences (n = 2). In 47% of sexsomnia patients, there was a history or current occurrences of sleepwalking/night terrors. Patients with sexsomnia had more N3 awakenings than healthy matched controls and the same amount as regular sleepwalkers. Half of them presented evidence of cortico-cortical dissociation, including concomitant slow (mostly frontal) and rapid (mostly temporal and occipital) electroencephalography (EEG) rhythms, with concomitant N3 penile erection in 1 case. Of 89 sleepwalkers, 10% had previous episodes of amnestic sexual behaviors, with a higher PADSS-A score and a trend of a higher total PADSS score than the 80 sleepwalkers without sexsomnia. In this single-center series, we confirmed the male predominance of sexsomnias and its potential for severe clinical and forensic consequences. The results suggest a continuum of regular sleepwalking, sleepwalking with occasional sexsomnia, and quasi-exclusive sexsomnia. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The role of p53 in cancer drug resistance and targeted chemotherapy.

PubMed

Hientz, Karin; Mohr, André; Bhakta-Guha, Dipita; Efferth, Thomas

2017-01-31

Cancer has long been a grievous disease complicated by innumerable players aggravating its cure. Many clinical studies demonstrated the prognostic relevance of the tumor suppressor protein p53 for many human tumor types. Overexpression of mutated p53 with reduced or abolished function is often connected to resistance to standard medications, including cisplatin, alkylating agents (temozolomide), anthracyclines, (doxorubicin), antimetabolites (gemcitabine), antiestrogenes (tamoxifen) and EGFR-inhibitors (cetuximab). Such mutations in the TP53 gene are often accompanied by changes in the conformation of the p53 protein. Small molecules that restore the wild-type conformation of p53 and, consequently, rebuild its proper function have been identified. These promising agents include PRIMA-1, MIRA-1, and several derivatives of the thiosemicarbazone family. In addition to mutations in p53 itself, p53 activity may be also be impaired due to alterations in p53's regulating proteins such as MDM2. MDM2 functions as primary cellular p53 inhibitor and deregulation of the MDM2/p53-balance has serious consequences. MDM2 alterations often result in its overexpression and therefore promote inhibition of p53 activity. To deal with this problem, a judicious approach is to employ MDM2 inhibitors. Several promising MDM2 inhibitors have been described such as nutlins, benzodiazepinediones or spiro-oxindoles as well as novel compound classes such as xanthone derivatives and trisubstituted aminothiophenes. Furthermore, even naturally derived inhibitor compounds such as α-mangostin, gambogic acid and siladenoserinols have been discovered. In this review, we discuss in detail such small molecules that play a pertinent role in affecting the p53-MDM2 signaling axis and analyze their potential as cancer chemotherapeutics.

Report of the Odyssey FPGA Independent Assessment Team

NASA Technical Reports Server (NTRS)

Mayer, Donald C.; Katz, Richard B.; Osborn, Jon V.; Soden, Jerry M.; Barto, R.; Day, John H. (Technical Monitor)

2001-01-01

An independent assessment team (IAT) was formed and met on April 2, 2001, at Lockheed Martin in Denver, Colorado, to aid in understanding a technical issue for the Mars Odyssey spacecraft scheduled for launch on April 7, 2001. An RP1280A field-programmable gate array (FPGA) from a lot of parts common to the SIRTF, Odyssey, and Genesis missions had failed on a SIRTF printed circuit board. A second FPGA from an earlier Odyssey circuit board was also known to have failed and was also included in the analysis by the IAT. Observations indicated an abnormally high failure rate for flight RP1280A devices (the first flight lot produced using this flow) at Lockheed Martin and the causes of these failures were not determined. Standard failure analysis techniques were applied to these parts, however, additional diagnostic techniques unique for devices of this class were not used, and the parts were prematurely submitted to a destructive physical analysis, making a determination of the root cause of failure difficult. Any of several potential failure scenarios may have caused these failures, including electrostatic discharge, electrical overstress, manufacturing defects, board design errors, board manufacturing errors, FPGA design errors, or programmer errors. Several of these mechanisms would have relatively benign consequences for disposition of the parts currently installed on boards in the Odyssey spacecraft if established as the root cause of failure. However, other potential failure mechanisms could have more dire consequences. As there is no simple way to determine the likely failure mechanisms with reasonable confidence before Odyssey launch, it is not possible for the IAT to recommend a disposition for the other parts on boards in the Odyssey spacecraft based on sound engineering principles.

(A)biotic processes control soil carbon dynamics: quantitative assessment of model complexity, stability and response to perturbations for improving ESMs

NASA Astrophysics Data System (ADS)

Georgiou, K.; Abramoff, R. Z.; Harte, J.; Riley, W. J.; Torn, M. S.

2016-12-01

As global temperatures and atmospheric CO2 concentrations continue to increase, soil microbial activity and decomposition of soil organic matter (SOM) are expected to follow suit, potentially limiting soil carbon storage. Traditional global- and ecosystem-scale models simulate SOM decomposition using linear kinetics, which are inherently unable to reproduce carbon-concentration feedbacks, such as priming of native SOM at elevated CO2 concentrations. Recent studies using nonlinear microbial models of SOM decomposition seek to capture these interactions, and several groups are currently integrating these microbial models into Earth System Models (ESMs). However, despite their widespread ability to exhibit nonlinear responses, these models vary tremendously in complexity and, consequently, dynamics. In this study, we explore, both analytically and numerically, the emergent oscillatory behavior and insensitivity of SOM stocks to carbon inputs that have been deemed `unrealistic' in recent microbial models. We discuss the sources of instability in four models of varying complexity, by sequentially reducing complexity of a detailed model that includes microbial physiology, a mineral sorption isotherm, and enzyme dynamics. We also present an alternative representation of microbial turnover that limits population sizes and, thus, reduces oscillations. We compare these models to several long-term carbon input manipulations, including the Detritus Input and Removal Treatment (DIRT) experiments, to show that there are clear metrics that can be used to distinguish and validate the inherent dynamics of each model structure. We find that traditional linear and nonlinear models cannot readily capture the range of long-term responses observed across the DIRT experiments as a direct consequence of their model structures, and that modifying microbial turnover results in more realistic predictions. Finally, we discuss our findings in the context of improving microbial model behavior for inclusion in ESMs.

OAE: The Ontology of Adverse Events.

PubMed

He, Yongqun; Sarntivijai, Sirarat; Lin, Yu; Xiang, Zuoshuang; Guo, Abra; Zhang, Shelley; Jagannathan, Desikan; Toldo, Luca; Tao, Cui; Smith, Barry

2014-01-01

A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term 'adverse event' denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. For example, using the data extracted from the Vaccine Adverse Event Reporting System (VAERS), OAE was used to analyse vaccine adverse events associated with the administrations of different types of influenza vaccines. OAE has also been used to represent and classify the vaccine adverse events cited in package inserts of FDA-licensed human vaccines in the USA. OAE is a biomedical ontology that logically defines and classifies various adverse events occurring after medical interventions. OAE has successfully been applied in several adverse event studies. The OAE ontological framework provides a platform for systematic representation and analysis of adverse events and of the factors (e.g., vaccinee age) important for determining their clinical outcomes.

Effect of the Road Environment on Road Safety in Poland

NASA Astrophysics Data System (ADS)

Budzynski, Marcin; Jamroz, Kazimierz; Antoniuk, Marcin

2017-10-01

Run-off-road accidents tend to be very severe because when a vehicle leaves the road, it will often crash into a solid obstacle (tree, pole, supports, front wall of a culvert, barrier). A statistical analysis of the data shows that Poland’s main roadside hazard is trees and the severity of vehicles striking a tree in a run-off-road crash. The risks are particularly high in north-west Poland with many of the roads lined up with trees. Because of the existing rural road cross-sections, i.e. having trees directly on road edge followed immediately by drainage ditches, vulnerable road users are prevented from using shoulders and made to use the roadway. With no legal definition of the road safety zone in Polish regulations, attempts to remove roadside trees lead to major conflicts with environmental stakeholders. This is why a compromise should be sought between the safety of road users and protection of the natural environment and the aesthetics of the road experience. Rather than just cut the trees, other road safety measures should be used where possible to treat the hazardous spots by securing trees and obstacles and through speed management. Accidents that are directly related to the road environment fall into the following categories: hitting a tree, hitting a barrier, hitting a utility pole or sign, vehicle rollover on the shoulder, vehicle rollover on slopes or in ditch. The main consequence of a roadside hazard is not the likelihood of an accident itself but of its severity. Poland’s roadside accident severity is primarily the result of poor design or operation of road infrastructure. This comes as a consequence of a lack of regulations or poorly defined regulations and failure to comply with road safety standards. The new analytical model was designed as a combination of the different factors and one that will serve as a comprehensive model. It was assumed that it will describe the effect of the roadside on the number of accidents and their consequences. The design of the model was based on recommendations from analysing other models. The assumptions were the following: the model will be used to calculate risk factors and accident severity, the indicators will depend on number of vehicle kilometres travelled or traffic volumes, analyses will be based on accident data: striking a tree, hitting a barrier, hitting a utility pole or sign. Additional data will include roadside information and casualty density measures will be used - killed and injured.

A few seconds to have an accident, a long time to recover: consequences for road accident victims from the ESPARR cohort 2 years after the accident.

PubMed

Tournier, Charlène; Charnay, Pierrette; Tardy, Hélène; Chossegros, Laetitia; Carnis, Laurent; Hours, Martine

2014-11-01

The aim of the present study was to describe the consequences of a road accident in adults, taking account of the type of road user, and to determine predictive factors for consequences at 2 years. Prospective follow-up study. The cohort was composed of 1168 victims of road traffic accidents, aged ≥16 years. Two years after the accident, 912 victims completed a self-administered questionnaire. Weighted logistic regression models were implemented to compare casualties still reporting impact related to the accident versus those reporting no residual impact. Five outcomes were analysed: unrecovered health status, impact on occupation or studies, on familial or affective life, on leisure or sport activities and but also the financial difficulties related to the accident. 46.1% of respondents were motorised four-wheel users, 29.6% motorised two-wheel (including quad) users, 13.3% pedestrians (including inline skate and push scooter users) and 11.1% cyclists. 53.3% reported unrecovered health status, 32.0% persisting impact on occupation or studies, 25.2% on familial or affective life, 46.9% on leisure or sport activities and 20.2% still had accident-related financial difficulties. Type of user, adjusted on age and gender, was linked to unrecovered health status and to impact on leisure or sport activities. When global severity (as measured by NISS) was integrated in the previous model, type of user was also associated with impact on occupation or studies. Type of user was further associated with impact on occupation or studies and on leisure or sport activities when global severity and the sociodemographic data obtained at inclusion were taken into account. It was not, however, related to any of the outcomes studied here, when the models focused on the injured body region. Finally, type of road user did not seem, on the various predictive models, to be related to financial difficulties due to the accident or to impact on familial or affective life. Overall, victims were affected by their accident even 2 years after it occurred. The severity of lesions induced by the accident was the main predictive factor. However, considering lesion as intermediary factors between the accident and the recovery status at 2 year post-accident, impact on health status was lower for cyclists than M4W users or M2W users. Copyright © 2014. Published by Elsevier Ltd.

The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema.

PubMed

Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane Lindschou; Gluud, Christian

2010-08-31

Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. The trial is registered in ClinicalTrials.Gov, NCT01012453.

Severe childhood obesity: an under-recognised and growing health problem.

PubMed

Bass, Rosara; Eneli, Ihuoma

2015-11-01

Childhood obesity is a serious and urgent public health problem. In the last 10 years, there has been a concerted effort in the USA and globally to develop and implement educational, medical and public health interventions designed to attenuate its growth. The success of these efforts was probably responsible for the plateau in the prevalence rate of childhood obesity noted in the last two years. While the attenuation of the overall prevalence of childhood obesity is promising, data from the same cohort reveal a concerning upward trend in the number of children with severe obesity. The consequences of severe childhood obesity can be devastating. When compared to their moderately obese peers, children with severe obesity are at greater risk for adult obesity, early atherosclerosis, hypertension, type 2 diabetes, metabolic syndrome, fatty liver disease and premature death. The determinants for severe obesity include the same lifestyle, environmental, familial and societal risk factors reported for overweight or obesity. While all these risk factors must be screened for, genetic influences are distinct considerations that may have greater bearing especially with early-onset obesity. Treatments for severe childhood obesity include lifestyle intervention, specialised low-calorie diets and bariatric surgery. Outcomes of these treatments vary, with bariatric surgery clearly the most successful of the three for both short-term and long-term weight loss. Severe obesity in children and adolescents remains a challenging health condition. The enormous medical, emotional and financial burden these children and their families endure signals an urgent need to further investigate and standardise treatment modalities and improve outcomes. 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/

Shifting Perceptions of Consequences of IPV Among Beneficiaries of Indashyikirwa: An IPV Prevention Program in Rwanda.

PubMed

Stern, Erin; Niyibizi, Lea Liliane

2018-06-01

Indashyikirwa is a Rwandan program that seeks to prevent intimate partner violence (IPV) and support healthy, equitable relationships. A fundamental program aspect is a 5-month curriculum among heterosexual couples designed to identify the causes and consequences of economic, emotional, physical, and sexual IPV, and build skills to manage triggers of IPV. The program also trained opinion leaders to more effectively prevent and respond to IPV, and established women's safe spaces to educate women about their rights, refer or accompany women who wish to report abuse or seek services. Drawing on 30 interviews with couples and 9 interviews with opinion leaders before and after completing the Indashyikirwa trainings, this article highlights beneficiaries' perceived consequences of IPV, and how such perceptions were influenced through the Indashyikirwa program. Interviews were conducted in Kinyarwanda, recorded, translated, and transcribed into English and analyzed thematically. The data reveal a depth of understanding of consequences of various forms of IPV. Although several participants justified more minor forms of men's physical IPV, such as slapping, severe consequences of physical IPV were most readily identified and sanctioned. Various harms of emotional and economic IPV were reported, yet these forms of IPV were typically less socially sanctioned or identified as IPV. Conceptions of sexual IPV were influenced by inequitable gender norms, and not typically recognized as a violation under the law. Although the data do not yet demonstrate the long-term impact, collectively identifying the overlapping consequences and underlying power inequalities for all forms of IPV, the legal rights protecting against various forms of IPV, and the benefits of nonviolent, equitable relationships, appeared to be helpful to shift perceptions of consequences of IPV. Implications of the findings for the program and broader IPV prevention are identified.

Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?

PubMed Central

2011-01-01

Background Intimate partner violence (IPV) against women is a serious public health issue with recognizable direct health consequences. This study assessed the association between IPV and traumatic physical health consequences on women in Nigeria, given that communities exert significant influence on the individuals that are embedded within them, with the nature of influence varying between communities. Methods Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences. Results Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV. Conclusions Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV. PMID:22185323

The forensics of fulgurite formation

NASA Astrophysics Data System (ADS)

Pasek, Matthew A.; Pasek, Virginia D.

2018-04-01

Natural disasters such as forest fires can result in extensive and costly property damage. These events may be the result of a human error or system failure triggered by electrical discharge, and in such circumstances may form a fulgurite. Understanding fulgurites and their formation may be critical in determining the cause of the fire or other, shock-related event. Here we identify several distinguishing features of fulgurites formed in association with downed power lines, including the presence of melted conductors, transformation of quartz to cristobalite, and morphological differences including increased glass percentage and smaller internal voids. These features are consequences of how heat is transferred to and through a target rock material as it melts and forms a fulgurite, and are predicted from both first principles of diffusive heat transfer, and empirically-derived reaction kinetics for mineral transformations.

Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

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

Feldman, J.E.

Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, andmore » counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality.« less

Deterioration of dyslexia after non-dominant temporal lobectomy for drug-resistant epilepsy.

PubMed

Haeren, Roel H L; Hendriks, Marc P H; Vlooswijk, Marielle; Verdyck, Lex; van Kranen-Mastenbroek, Vivianne H J M; Wagner, Louis; van Benthum, Sophie; Schijns, Olaf E M G

2016-03-01

We present a patient with drug-resistant right-sided temporal lobe epilepsy, caused by a ganglioglioma of the parahippocampal gyrus. Preoperatively, the patient was also known to have dyslexia. A right-sided anterior temporal lobectomy, including complete lesionectomy, was performed. Several months after the otherwise uncomplicated procedure, the patient complained about visual memory disturbances, accompanied by increased reading and spelling problems. Postoperative neuropsychological examination revealed deterioration of the visual memory functions, compared to the preoperative assessment, and consequently provided a possible explanation for worsening of the pre-existing dyslexia. In this case report, we hypothesize on the cause of this unusual deterioration and present recommendations to be included in the preoperative epilepsy surgery evaluation for patients with verbal or reading disorders such as dyslexia.

Genotoxic Effects of Exposure to Gasoline Fumes on Petrol Pump Workers.

PubMed

Shaikh, Amrin; Barot, Darshana; Chandel, Divya

2018-04-01

Petrol pump workers are occupationally exposed to gasoline and its fumes consisting of several mutagenic chemicals. To evaluate the genotoxic effects of exposure to gasoline fumes on petrol pump workers. The study groups included 70 petrol pump workers (exposed group) and 70 healthy age-matched individuals with no known exposure (comparison group). Buccal micronucleus cytome assay (BMCyt) was performed to check the genotoxicity caused due to inhalation of gasoline fumes. The frequencies of micronucleated cells, nuclear bud, condensed chromatin cells, karyorrhectic cells, pyknotic cells, and karyolytic cells were significantly higher in the exposed workers compared to the comparison group. Exposure to gasoline fumes is associated with increased frequency of cell abnormalities. This may lead to various health consequences including cancer in those occupationally exposed to gasoline fumes.

Oxidative stress and cardiomyocyte necrosis with elevated serum troponins: pathophysiologic mechanisms.

PubMed

Robinson, Antwon D; Ramanathan, Kodangudi B; McGee, Jesse E; Newman, Kevin P; Weber, Karl T

2011-08-01

The progressive nature of heart failure is linked to multiple factors, including an ongoing loss of cardiomyocytes and necrosis. Necrotic cardiomyocytes leave behind several footprints: the spillage of their contents leading to elevations in serum troponins; and morphologic evidence of tissue repair with scarring. The pathophysiologic origins of cardiomyocyte necrosis relates to neurohormonal activation, including the adrenergic nervous system. Catecholamine-initiated excessive intracellular Ca accumulation and mitochondria Ca overloading in particular initiate a mitochondriocentric signal-transducer-effector pathway to necrosis and which includes the induction of oxidative stress and opening of their inner membrane permeability transition pore. Hypokalemia, ionized hypocalcemia and hypomagnesemia, where consequent elevations in parathyroid hormone further account for excessive intracellular Ca accumulation, hypozincemia and hyposelenemia each compromise metalloenzyme-based antioxidant defenses. The necrotic loss of cardiomyocytes and adverse structural remodeling of myocardium is related to the central role played by a mitochondriocentric pathway initiated by neurohormonal activation.

Toward a Sustained, Multi-disciplinary Socioeconomic Community

NASA Astrophysics Data System (ADS)

Pearlman, J.; Pearlman, F.

2014-12-01

Over the last several years the availability of geospatial data has evolved from a scarce and expensive resource, primarily provided by governmental organizations to an abundant resource, often sourced at no or minimum charge by a much broader community including citizen scientists. In an upcoming workshop (October 28/29, 2014), the consequences of the changing technology, data, and policy landscape will be examined thus evaluating the emerging new data-driven paradigms, and advancing the state-of-the-art methodologies to measure the resulting socioeconomic impacts. Providers and users of geospatial data span a broad range of multi-disciplinary areas include policy makers and analysts, financial analysts, economists, geospatial practitioners and other experts from government, academia and the private sector. This presentation will focus on the emerging plan for a sustained, multi-disciplinary community to identify and pursue exemplary use cases for further research and applications. Considerations will include the necessary outreach enablers for such a project.

Defining the road ahead: thinking strategically in the new era of health care reform.

PubMed

Pudlowski, Edward M

2011-01-01

Understanding the implications of the new health care reform legislation, including those provisions that do not take effect for several years, will be critical in developing a successful strategic plan under the new environment of health care reform and avoiding unintended consequences of decisions made without the benefit of long-term thinking. Although this article is not a comprehensive assessment of the challenges and opportunities that exist under health care reform, nor a layout of all of the issues, it looks at some of the key areas in order to demonstrate why employers need to identify critical pathways and the associated risks and benefits of each decision. Key health care reform areas include insurance market reforms, grandfather rules, provisions that have the potential to influence the underlying cost of health care, the individual mandate, the employer mandate (including the free-choice voucher program) and the excise tax on high-cost plans.

Biallelic BRCA2 mutations in two black South African children with Fanconi anaemia.

PubMed

Feben, Candice; Spencer, Careni; Lochan, Anneline; Laing, Nakita; Fieggen, Karen; Honey, Engela; Wainstein, Tasha; Krause, Amanda

2017-07-01

Fanconi anaemia (FA) is a genotypically and phenotypically heterogeneous genetic condition, characterized cytogenetically by chromosomal instability and breakage secondary to impaired DNA repair mechanisms. Affected individuals typically manifest growth restriction and congenital physical abnormalities and most progress to hematological disease including bone marrow aplasia. A rare genetic subtype of FA (FA-D1) is caused by biallelic mutations in the BRCA2 gene. Affected individuals manifest severe congenital anomalies and significant pigmentary changes and are additionally at risk for early onset leukemia and certain solid organ malignancies, including Wilms tumors and brain tumors. Parents of affected individuals are obligate carriers for heterozygous BRCA2 mutations and are thus potentially at risk for adult onset cancers which fall within the hereditary breast and ovarian cancer spectrum. We present two cases of black South African patients with FA diagnosed with biallelic BRCA2 mutations and discuss the phenotypic consequences and implications for them and their families. Recognition of this severe end of the phenotypic spectrum of FA is critical in allowing for confirmation of the diagnosis as well as cascade screening and appropriate care of family members.

From bedside to bench and back again: research issues in animal models of human disease.

PubMed

Tkacs, Nancy C; Thompson, Hilaire J

2006-07-01

To improve outcomes for patients with many serious clinical problems, multifactorial research approaches by nurse scientists, including the use of animal models, are necessary. Animal models serve as analogies for clinical problems seen in humans and must meet certain criteria, including validity and reliability, to be useful in moving research efforts forward. This article describes research considerations in the development of rodent models. As the standard of diabetes care evolves to emphasize intensive insulin therapy, rates of severe hypoglycemia are increasing among patients with type 1 and type 2 diabetes mellitus. A consequence of this change in clinical practice is an increase in rates of two hypoglycemia-related diabetes complications: hypoglycemia-associated autonomic failure (HAAF) and resulting hypoglycemia unawareness. Work on an animal model of HAAF is in an early developmental stage, with several labs reporting different approaches to model this complication of type 1 diabetes mellitus. This emerging model serves as an example illustrating how evaluation of validity and reliability is critically important at each stage of developing and testing animal models to support inquiry into human disease.

Lipotoxicity: Effects of Dietary Saturated and Transfatty Acids

PubMed Central

Estadella, Débora; da Penha Oller do Nascimento, Claudia M.; Oyama, Lila M.; Ribeiro, Eliane B.; Dâmaso, Ana R.; de Piano, Aline

2013-01-01

The ingestion of excessive amounts of saturated fatty acids (SFAs) and transfatty acids (TFAs) is considered to be a risk factor for cardiovascular diseases, insulin resistance, dyslipidemia, and obesity. The focus of this paper was to elucidate the influence of dietary SFA and TFA intake on the promotion of lipotoxicity to the liver and cardiovascular, endothelial, and gut microbiota systems, as well as on insulin resistance and endoplasmic reticulum stress. The saturated and transfatty acids favor a proinflammatory state leading to insulin resistance. These fatty acids can be involved in several inflammatory pathways, contributing to disease progression in chronic inflammation, autoimmunity, allergy, cancer, atherosclerosis, hypertension, and heart hypertrophy as well as other metabolic and degenerative diseases. As a consequence, lipotoxicity may occur in several target organs by direct effects, represented by inflammation pathways, and through indirect effects, including an important alteration in the gut microbiota associated with endotoxemia. Interactions between these pathways may perpetuate a feedback process that exacerbates an inflammatory state. The importance of lifestyle modification, including an improved diet, is recommended as a strategy for treatment of these diseases. PMID:23509418

Of Microbes and Minds: A Narrative Review on the Second Brain Aging.

PubMed

Calvani, Riccardo; Picca, Anna; Lo Monaco, Maria Rita; Landi, Francesco; Bernabei, Roberto; Marzetti, Emanuele

2018-01-01

In recent years, an extensive body of literature focused on the gut-brain axis and the possible role played by the gut microbiota in modulating brain morphology and function from birth to old age. Gut microbiota has been proposed as a relevant player during the early phases of neurodevelopment, with possible long-standing effects in later life. The reduction in gut microbiota diversity has also become one of the hallmarks of aging, and disturbances in its composition are associated with several (age-related) neurological conditions, including depression, Alzheimer's disease, and Parkinson's disease. Several pathways have been evoked for gut microbiota-brain communication, including neural connections (vagus nerve), circulating mediators derived by host-bacteria cometabolism, as well as the influence exerted by gut microbiota on host gut function, metabolism, and immune system. Although the most provoking data emerged from animal studies and despite the huge debate around the possible epiphenomenal nature of those findings, the gut microbiota-brain axis still remains a fascinating target to be exploited to attenuate some of the most burdensome consequences of aging.

Beyond taxol: microtubule-based treatment of disease and injury of the nervous system

PubMed Central

Ahmad, Fridoon J.

2013-01-01

Contemporary research has revealed a great deal of information on the behaviours of microtubules that underlie critical events in the lives of neurons. Microtubules in the neuron undergo dynamic assembly and disassembly, bundling and splaying, severing, and rapid transport as well as integration with other cytoskeletal elements such as actin filaments. These various behaviours are regulated by signalling pathways that affect microtubule-related proteins such as molecular motor proteins and microtubule severing enzymes, as well as a variety of proteins that promote the assembly, stabilization and bundling of microtubules. In recent years, translational neuroscientists have earmarked microtubules as a promising target for therapy of injury and disease of the nervous system. Proof-of-principle has come mainly from studies using taxol and related drugs to pharmacologically stabilize microtubules in animal models of nerve injury and disease. However, concerns persist that the negative consequences of abnormal microtubule stabilization may outweigh the positive effects. Other potential approaches include microtubule-active drugs with somewhat different properties, but also expanding the therapeutic toolkit to include intervention at the level of microtubule regulatory proteins. PMID:23811322

The role of evapotranspiration fluxes in summertime precipitation in Central Europe: coupled groundwater-atmosphere simulations with the WRF-LEAFHYDRO system.

NASA Astrophysics Data System (ADS)

Regueiro Sanfiz, Sabela; Gómez, Breo; Miguez Macho, Gonzalo

2017-04-01

Because of its continental position, Central Europe summertime rainfall is largely dependent on local or regional dynamics, with precipitation water possibly also significantly dependent on local sources. We investigate here land-atmosphere feedbacks over inland Europe focusing in particular on evapotranspiration-soil moisture connections and precipitation recycling ratios. For this purpose, a set of simulations were performed with the Weather Research and Forecasting (WRF) model coupled to LEAFHYDRO soil-vegetation-hydrology model. The LEAFHYDRO Land Surface Model includes a groundwater parameterization with a dynamic water table fully coupling groundwater to the soil-vegetation and surface waters via two-way fluxes. A water tagging capability in the WRF model is used to quantify evapotranspiration contribution to precipitation over the region. Several years are considered, including summertime 2002, during which severe flooding occurred. Preliminary results from our simulations highlight the link of large areas with shallow water with high air moisture values through the summer season; and the importance of the contribution of evapotranspiration to summertime precipitation. Consequently, results show the advantages of using a fully coupled hydrology-atmospheric modeling system.

Electroconvulsive therapy: Part I. A perspective on the evolution and current practice of ECT.

PubMed

Payne, Nancy A; Prudic, Joan

2009-09-01

The concept of inducing convulsions, mainly through chemical means, to promote mental wellness has existed since the 16th century. In 1938, Italian scientists first applied electrically induced therapeutic seizures. Although electroconvulsive therapy (ECT) is employed in the treatment of several psychiatric disorders, it is most frequently used today to treat severe depressive episodes and remains the most effective treatment available for those disorders. Despite this, ECT continues to be the most stigmatized treatment available in psychiatry, resulting in restrictions on and reduced accessibility to a helpful and potentially life-saving treatment. The psychiatric and psychosocial ramifications of this stigmatization may include the exacerbation of the increasingly serious, global health problem of major depressive disorders as well as serious consequences for individual patients who may not be offered, or may refuse, a potentially beneficial treatment. The goal of this first article in this two-part series is to provide an overview of ECT's historical development and discuss the current state of knowledge about ECT, including technical aspects of delivery, patient selection, its side-effect profile, and factors that may contribute to underuse of ECT.

Pathogenesis and mechanisms of antibody-mediated hemolysis

PubMed Central

Flegel, Willy A

2015-01-01

Background The clinical consequences of antibodies to red blood cells (RBC) have been studied for a century. Most clinically relevant antibodies can be detected by sensitive in vitro assays. Several mechanisms of antibody-mediated hemolysis are well understood. Such hemolysis following transfusion is reliably avoided in a donor/recipient pair, if one individual is negative for the cognate antigen to which the other has the antibody. Study design and results Mechanisms of antibody-mediated hemolysis were reviewed based on a presentation at the Strategies to Address Hemolytic Complications of Immune Globulin Infusions Workshop addressing intravenous immunoglobulin (IVIG) and ABO antibodies. The presented topics included the rates of intravascular and extravascular hemolysis; IgM and IgG isoagglutinins; auto- and alloantibodies; antibody specificity; A, B, A,B and A1 antigens; A1 versus A2 phenotypes; monocytes/macrophages, other immune cells and complement; monocyte monolayer assay (MMA); antibody-dependent cell-mediated cytotoxicity (ADCC); and transfusion reactions due to ABO and other antibodies. Conclusion Several clinically relevant questions remained unresolved, and diagnostic tools were lacking to routinely and reliably predict the clinical consequences of RBC antibodies. Most hemolytic transfusion reactions associated with IVIG were due to ABO antibodies. Reducing the titers of such antibodies in IVIG may lower the frequency of this kind of adverse event. The only way to stop these events is to have no anti-A or anti-B antibodies in the IVIG products. PMID:26174897

Abusive head trauma in children: a literature review.

PubMed

Lopes, Nahara R L; Eisenstein, Evelyn; Williams, Lúcia C A

2013-01-01

To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese. Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Co-morbid depressive disorder is associated with better neurocognitive performance in first episode schizophrenia spectrum.

PubMed

Herniman, Sarah E; Cotton, Sue M; Killackey, Eóin; Hester, Robert; Allott, Kelly A

2018-03-15

Both major depressive disorder (MDD) and first episode schizophrenia spectrum (FES) are associated with significant neurocognitive deficits. However, it remains unclear whether the neurocognitive deficits in individuals with FES are more severe if there is comorbid depressive disorder. The aim of this study was to compare the neurocognitive profiles between those with and without full-threshold depressive disorder in FES. This study involved secondary analysis of baseline data from a randomized controlled trial of vocational intervention for young people with first-episode psychosis (N = 82; age range: 15-25 years). Those with full-threshold depressive disorder (n = 24) had significantly better information processing speed than those without full-threshold depressive disorder. Severity of depressive symptoms was also associated with better information processing speed. In additional to the cross-sectional design, limitations of this study include the absence of assessing insight as a potential mediator. After the first psychotic episode, it could be speculated that those with better information processing speed may be more likely to develop full-threshold depressive disorder, as their ability to efficiently process information may allow them to be more aware of their situations and environments, and consequently to have greater insight into the devastating consequences of FES. Such novel findings support the examination of full-threshold depressive disorder in relation to neurocognitive performance across illness phases in future work. Copyright © 2018 Elsevier B.V. All rights reserved.

Hemoglobin-driven pathophysiology is an in vivo consequence of the red blood cell storage lesion that can be attenuated in guinea pigs by haptoglobin therapy.

PubMed

Baek, Jin Hyen; D'Agnillo, Felice; Vallelian, Florence; Pereira, Claudia P; Williams, Matthew C; Jia, Yiping; Schaer, Dominik J; Buehler, Paul W

2012-04-01

Massive transfusion of blood can lead to clinical complications, including multiorgan dysfunction and even death. Such severe clinical outcomes have been associated with longer red blood cell (rbc) storage times. Collectively referred to as the rbc storage lesion, rbc storage results in multiple biochemical changes that impact intracellular processes as well as membrane and cytoskeletal properties, resulting in cellular injury in vitro. However, how the rbc storage lesion triggers pathophysiology in vivo remains poorly defined. In this study, we developed a guinea pig transfusion model with blood stored under standard blood banking conditions for 2 (new), 21 (intermediate), or 28 days (old blood). Transfusion with old but not new blood led to intravascular hemolysis, acute hypertension, vascular injury, and kidney dysfunction associated with pathophysiology driven by hemoglobin (Hb). These adverse effects were dramatically attenuated when the high-affinity Hb scavenger haptoglobin (Hp) was administered at the time of transfusion with old blood. Pathologies observed after transfusion with old blood, together with the favorable response to Hp supplementation, allowed us to define the in vivo consequences of the rbc storage lesion as storage-related posttransfusion hemolysis producing Hb-driven pathophysiology. Hb sequestration by Hp might therefore be a therapeutic modality for enhancing transfusion safety in severely ill or massively transfused patients.

Sleep, immunity and inflammation in gastrointestinal disorders.

PubMed

Ali, Tauseef; Choe, James; Awab, Ahmed; Wagener, Theodore L; Orr, William C

2013-12-28

Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. An estimated 70 million Americans suffer from some form of sleep disorder. Certain sleep disorders have been shown to cause neurocognitive impairment such as decreased cognitive ability, slower response times and performance detriments. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. Several research studies support the associations among sleep, immune function and inflammation. Here, we review the current research linking sleep, immune function, and gastrointestinal diseases and discuss the interdependent relationship between sleep and these gastrointestinal disorders. Different physiologic processes including immune system and inflammatory cytokines help regulate the sleep. The inflammatory cytokines such as tumor necrosis factor, interleukin-1 (IL-1), and IL-6 have been shown to be a significant contributor of sleep disturbances. On the other hand, sleep disturbances such as sleep deprivation have been shown to up regulate these inflammatory cytokines. Alterations in these cytokine levels have been demonstrated in certain gastrointestinal diseases such as inflammatory bowel disease, gastro-esophageal reflux, liver disorders and colorectal cancer. In turn, abnormal sleep brought on by these diseases is shown to contribute to the severity of these same gastrointestinal diseases. Knowledge of these relationships will allow gastroenterologists a great opportunity to enhance the care of their patients.

Alcohol-related negative consequences among drinkers around the world.

PubMed

Graham, Kathryn; Bernards, Sharon; Knibbe, Ronald; Kairouz, Sylvia; Kuntsche, Sandra; Wilsnack, Sharon C; Greenfield, Thomas K; Dietze, Paul; Obot, Isidore; Gmel, Gerhard

2011-08-01

This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences. Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration. Measures included 17 negative consequences grouped into (i) high endorsement acute, (ii) personal and (iii) social. Country-level measures included average frequency and quantity of drinking, percentage who were current drinkers, gross domestic product (GDP) and Human Development Index (HDI). Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences, but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda and lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Divorce in Late Life: A Call for Research.

ERIC Educational Resources Information Center

DeShane, Michael R.; Brown-Wilson, Keren

1981-01-01

Discusses social, psychological, and economic consequences of late life divorce. Describes areas of needed research, including demographic aspects of late life divorce, social and psychological consequences, adaption to divorce, and legal and economic consequences. (RC)

Frequency and Clinical Characteristics of Hydroxychloroquine Retinopathy in Korean Patients with Rheumatologic Diseases

PubMed Central

2017-01-01

This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern. Among 310 patients, 9 patients (2.9%) were diagnosed as HCQ retinopathy. Among the patients with HCQ use ≥ 5 years (n = 174), the frequency was 5.2%. Only 1 (11.1%) of the 9 patients was symptomatic. The mean daily dose per kilogram of real body weight of the 9 patients was 5.6 mg, and only 3 had used 6.5 mg or more. Four of the 9 patients had severe HCQ retinopathy. Six of the 9 patients showed pericentral or mixed pattern of retinal damage. Consequently, the frequency of HCQ retinopathy in Korean patients was not low, especially when administered at a high cumulative dose and for a long duration. Screening of HCQ retinopathy by the recommended guidelines that include SD-OCT seems useful and should be done to detect retinal damage earlier in patients with chronic exposure to HCQ. PMID:28145658

Frequency and Clinical Characteristics of Hydroxychloroquine Retinopathy in Korean Patients with Rheumatologic Diseases.

PubMed

Eo, Doo Ri; Lee, Min Gyu; Ham, Don Il; Kang, Se Woong; Lee, Jaejoon; Cha, Hoon Suk; Koh, Eunmi; Kim, Sang Jin

2017-03-01

This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern. Among 310 patients, 9 patients (2.9%) were diagnosed as HCQ retinopathy. Among the patients with HCQ use ≥ 5 years (n = 174), the frequency was 5.2%. Only 1 (11.1%) of the 9 patients was symptomatic. The mean daily dose per kilogram of real body weight of the 9 patients was 5.6 mg, and only 3 had used 6.5 mg or more. Four of the 9 patients had severe HCQ retinopathy. Six of the 9 patients showed pericentral or mixed pattern of retinal damage. Consequently, the frequency of HCQ retinopathy in Korean patients was not low, especially when administered at a high cumulative dose and for a long duration. Screening of HCQ retinopathy by the recommended guidelines that include SD-OCT seems useful and should be done to detect retinal damage earlier in patients with chronic exposure to HCQ.

The Comparison of Double J Stent Insertion and Conservative Treatment Alone in Severe Pure Gestational Hydronephrosis: A Case Controlled Clinical Study

PubMed Central

Çeçen, Kürşat; Ülker, Kahraman

2014-01-01

Objective. Management options of gestational hydronephrosis are based on the coexisting stone disease, pyelonephritis, and renal disease. However, the management option and its consequences in the absence of a coexisting disease state are not clear. In this study we aimed to compare the effectiveness of conservative treatment and double J insertion in symptomatic pure gestational hydronephrosis. Material and Methods. The data of the women with severe pure gestational hydronephrosis over a nine-year period was collected retrospectively. The included women were grouped into two according to receiving double J stent insertion or conservative treatments. Results. Double J insertion and conservative treatment groups included 24 and 29 women, respectively. Hydronephrosis was demonstrated on the right, left, or both kidneys in 37 (70%), 13 (24%), and 3 (6%) women, respectively. None of the participants gave birth prior to the 37th week. The demographics, initial pain scores, the severity of the hydronephrosis during first admission, and pain scores one week after the interventions did not differ significantly between groups (P > 0.05). Similarly, the rates of complications, postpartum pain scores, and permanent hydronephrosis did not differ between groups (P > 0.05). Conclusion. Double J insertion in symptomatic pure gestational hydronephrosis adds no benefit to conservative treatment. PMID:24574939

Unprecedented drought over tropical South America in 2016: significantly under-predicted by tropical SST.

PubMed

Erfanian, Amir; Wang, Guiling; Fomenko, Lori

2017-07-19

Tropical and sub-tropical South America are highly susceptible to extreme droughts. Recent events include two droughts (2005 and 2010) exceeding the 100-year return value in the Amazon and recurrent extreme droughts in the Nordeste region, with profound eco-hydrological and socioeconomic impacts. In 2015-2016, both regions were hit by another drought. Here, we show that the severity of the 2015-2016 drought ("2016 drought" hereafter) is unprecedented based on multiple precipitation products (since 1900), satellite-derived data on terrestrial water storage (since 2002) and two vegetation indices (since 2004). The ecohydrological consequences from the 2016 drought are more severe and extensive than the 2005 and 2010 droughts. Empirical relationships between rainfall and sea surface temperatures (SSTs) over the tropical Pacific and Atlantic are used to assess the role of tropical oceanic variability in the observed precipitation anomalies. Our results indicate that warmer-than-usual SSTs in the Tropical Pacific (including El Niño events) and Atlantic were the main drivers of extreme droughts in South America, but are unable to explain the severity of the 2016 observed rainfall deficits for a substantial portion of the Amazonia and Nordeste regions. This strongly suggests potential contribution of non-oceanic factors (e.g., land cover change and CO2-induced warming) to the 2016 drought.

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

PubMed Central

Hu, Stephen Chu-Sung; Lan, Cheng-Che E.

2017-01-01

Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment. PMID:29065479

Women as torture victims.

PubMed

Allodi, F; Stiasny, S

1990-03-01

This paper reports a retrospective study of the frequency, severity, modalities and mental health consequences of torture in 28 Latin American refugee women in Toronto. The data on these women and a comparison group of male torture victims were retrieved from case records in a hospital outpatient clinic. The results support the hypotheses implicit in the scanty literature available that the frequency and effects of torture in women differ from those found in men. In female victims, as in their male counterparts, the severity of the torture was related to the degree of their political involvement. However, torture was more frequently sexual, and its consequences more often affected the women's sexual adaptation.

An Ecological Perspective on Sleep Disruption.

PubMed

Tougeron, Kévin; Abram, Paul K

2017-09-01

Despite its evolutionary importance and apparent ubiquity among animals, the ecological significance of sleep is largely unresolved. The ecology of sleep has been particularly neglected in invertebrates. In insects, recent neurobehavioral research convincingly demonstrates that resting behavior shares several common characteristics with sleep in vertebrates. Laboratory studies have produced compelling evidence that sleep disruption can cause changes in insect daily activity patterns (via "sleep rebound") and have consequences for behavioral performance during active periods. However, factors that could cause insect sleep disruption in nature have not been considered nor have the ecological consequences. Drawing on evidence from laboratory studies, we argue that sleep disruption may be an overlooked component of insect ecology and could be caused by a variety of anthropogenic and nonanthropogenic factors in nature. We identify several candidate sleep-disrupting factors and provide new insights on the potential consequences of sleep disruption on individual fitness, species interactions, and ecosystem services. We propose an experimental framework to bridge the current gap in knowledge between laboratory and field studies. We conclude that sleep disruption is a potential mechanism underpinning variation in behavioral, population, and community-level processes associated with several aspects of global change.

Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study.

PubMed

Doohan, Isabelle; Björnstig, Ulf; Östlund, Ulrika; Saveman, Britt-Inger

2017-04-01

The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery. The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis. Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four "core cases" of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash. The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery. Doohan I , Björnstig U , Östlund U , Saveman BI . Exploring injury panorama, consequences, and recovery among bus crash survivors: a mixed-methods research study. Prehosp Disaster Med. 2017;32(2):165-174.

Hubris and Sciences.

PubMed

Diamandis, Eleftherios P; Bouras, Nick

2018-01-01

There has been an increasing awareness of the importance of leadership and decision making, including scientists and academics, over recent times. By whom and how decisions are made can have serious implications across all levels of society. Several people have been successful in their life and have been inflicted by excessive pride and self-confidence. There are times when the manifestations of such behaviours demonstrate noticeable signs of narcissism and on extreme cases, hubris. Hubris is an old concept originated from the Greek mythology.  The risk of hubris affects politicians, leaders in business, scientists, academia, the military, entertainers, athletes and doctors (among many others). Power, especially absolute and unchecked power, is intoxicating and is manifested behaviourally in a variety of ways, ranging from amplified cognitive functions to lack of inhibition, poor judgment, extreme narcissism, deviant behaviour, and even cruelty. Hubristic behaviour of overconfidence, extreme pride together with an unwillingness to disregard advice makes powerful people in leadership positions to over-reach themselves with negative consequences for themselves and others. As the dangerous consequences of hubristic behaviours become more apparent and well described it is imperative that individuals, organisations and governments act to prevent such phenomena. Responsible leaders, including acclaimed scientists should exercise greater humility to the complexity and inherent uncertainty of their activities and strive to seek out and challenge hubristic behaviours.

Toward global prevention of sexually transmitted infections (STIs): the need for STI vaccines.

PubMed

Gottlieb, Sami L; Low, Nicola; Newman, Lori M; Bolan, Gail; Kamb, Mary; Broutet, Nathalie

2014-03-20

An estimated 499 million curable sexually transmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sardasht-Iran cohort study of chemical warfare victims: design and methods.

PubMed

Ghazanfari, Tooba; Faghihzadeh, Soghrat; Aragizadeh, Hassan; Soroush, Mohammad-Reza; Yaraee, Roya; Mohammad Hassan, Zuhair; Foroutan, Abbas; Vaez-Mahdavi, Mohammad-Reza; Javadi, Mohammad-Ali; Moaiedmohseni, Sakine; Azizi, Fereidoun; Panahi, Yunes; Mostafaie, Ali; Ghasemi, Hassan; Shams, Jalaleddin; Pourfarzam, Shahryar; Jalali-Nadoushan, Mohammad-Reza; Fallahi, Faramarz; Ebtekar, Massoumeh; Davoudi, Seyyed-Masoud; Ghazanfari, Zeinab; Ardestani, Sussan K; Shariat-Panahi, Shamsa; Moin, Athar; Rezaei, Abbas; Kariminia, Amina; Ajdary, Soheila; Mahmoudi, Mahmoud; Roshan, Rasoul; Ghaderi, Sulayman; Babai, Mahmoud; Naghizadeh, Mohammad-Mehdi; Ghanei, Mohammad-Mostafa

2009-01-01

Insights into long-term clinical consequences of sulfur mustard have emerged from some investigations but less is known about the basic and molecular mechanisms of these complications. Sardasht-Iran Cohort Study is a comprehensive historical cohort study on Sardasht chemical victims' population which was designed to find out the long-term complications of sulfur mustard exposure and the basic mechanisms underlying clinical manifestations. This paper describes the design and methodology of Sardasht-Iran Cohort Study. In Sardasht-Iran Cohort Study, 500 individuals including 372 subjects from Sardasht, as the exposed group, and 128 subjects from Rabat, as the unexposed age-matched control group were evaluated. The exposed group was divided into two groups based on the severity of clinical complications at the time of exposure. Different samples including blood, sputum, saliva, tear, urine, and semen were collected for immunologic, hematologic, biochemical, and other laboratory analysis. Data were gathered from medical records, clinical examinations, laboratory tests, and questionnaires for psychological and lifestyle situations. The important distinctions setting this study apart from the previous ones are discussed. The Sardasht-Iran Cohort Study provides important information on various aspects of long-term consequences of sulfur mustard exposure. This database will provide a better position to suggest guidelines for the diagnosis, treatment, and prevention of delayed complications in the patients exposed to sulfur mustard.

Hubris and Sciences

PubMed Central

Diamandis, Eleftherios P; Bouras, Nick

2018-01-01

There has been an increasing awareness of the importance of leadership and decision making, including scientists and academics, over recent times. By whom and how decisions are made can have serious implications across all levels of society. Several people have been successful in their life and have been inflicted by excessive pride and self-confidence. There are times when the manifestations of such behaviours demonstrate noticeable signs of narcissism and on extreme cases, hubris. Hubris is an old concept originated from the Greek mythology.  The risk of hubris affects politicians, leaders in business, scientists, academia, the military, entertainers, athletes and doctors (among many others). Power, especially absolute and unchecked power, is intoxicating and is manifested behaviourally in a variety of ways, ranging from amplified cognitive functions to lack of inhibition, poor judgment, extreme narcissism, deviant behaviour, and even cruelty. Hubristic behaviour of overconfidence, extreme pride together with an unwillingness to disregard advice makes powerful people in leadership positions to over-reach themselves with negative consequences for themselves and others. As the dangerous consequences of hubristic behaviours become more apparent and well described it is imperative that individuals, organisations and governments act to prevent such phenomena. Responsible leaders, including acclaimed scientists should exercise greater humility to the complexity and inherent uncertainty of their activities and strive to seek out and challenge hubristic behaviours. PMID:29568494

A second target of benzamide riboside: dihydrofolate reductase.

PubMed

Roussel, Breton; Johnson-Farley, Nadine; Kerrigan, John E; Scotto, Kathleen W; Banerjee, Debabrata; Felczak, Krzysztof; Pankiewicz, Krzysztof W; Gounder, Murugesan; Lin, HongXia; Abali, Emine Ercikan; Bertino, Joseph R

2012-11-01

Dihydrofolate reductase (DHFR) is an essential enzyme involved in de novo purine and thymidine biosynthesis. For several decades, selective inhibition of DHFR has proven to be a potent therapeutic approach in the treatment of various cancers including acute lymphoblastic leukemia, non-Hodgkin's lymphoma, osteogenic sarcoma, carcinoma of the breast, and head and neck cancer. Therapeutic success with DHFR inhibitor methotrexate (MTX) has been compromised in the clinic, which limits the success of MTX treatment by both acquired and intrinsic resistance mechanisms. We report that benzamide riboside (BR), via anabolism to benzamide adenine dinucleotide (BAD) known to potently inhibit inosine monophosphate dehydrogenase (IMPDH), also inhibits cell growth through a mechanism involving downregulation of DHFR protein. Evidence to support this second site of action of BR includes the finding that CCRF-CEM/R human T-cell lymphoblasic leukemia cells, resistant to MTX as a consequence of gene amplification and overexpression of DHFR, are more resistant to BR than are parental cells. Studies of the mechanism by which BR lowers DHFR showed that BR, through its metabolite BAD, reduced NADP and NADPH cellular levels by inhibiting nicotinamide adenine dinucleotide kinase (NADK). As consequence of the lack of NADPH, DHFR was shown to be destabilized. We suggest that, inhibition of NADK is a new approach to downregulate DHFR and to inhibit cell growth.

Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework.

PubMed

Heslehurst, N; Newham, J; Maniatopoulos, G; Fleetwood, C; Robalino, S; Rankin, J

2014-06-01

Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

Acclimatization to long-term hypoxia: gene expression in ovine carotid arteries

PubMed Central

Goyal, Ravi

2014-01-01

Exposure to acute high-altitude hypoxia is associated with an increase in cerebral blood flow (CBF) as a consequence of low arterial O2 tension. However, in response to high altitude acclimatization, CBF returns to levels similar to those at sea level, and tissue blood flow is maintained by an increase in angiogenesis. Of consequence, dysregulation of the acclimatization responses and CBF can result in acute mountain sickness, acute cerebral and/or pulmonary edema. To elucidate the signal transduction pathways involved in successful acclimatization to high altitude, in ovine carotid arteries, we tested the hypothesis that high altitude-associated long-term hypoxia results in changes in gene expression of critical signaling pathways. We acclimatized nonpregnant adult sheep to 3,801 m altitude for ∼110 days and conducted oligonucleotide microarray experiments on carotid arteries. Of a total of 116 regulated genes, 58 genes were significantly upregulated and 58 genes were significantly downregulated (each >2-fold, P < 0.05). Major upregulated genes included suprabasin and myelin basic protein, whereas downregulated genes included BAG2. Several of these genes are known to activate the ERK canonical signal transduction pathway and the process of angiogenesis. We conclude that among other changes, the altered signal transduction molecules involved in high-altitude acclimatization are associated ERK activation and angiogenesis. PMID:25052263

The lethal form of Cushing's in 7B2 null mice is caused by multiple metabolic and hormonal abnormalities.

PubMed

Sarac, Miroslav S; Zieske, Arthur W; Lindberg, Iris

2002-06-01

The neuroendocrine-specific protein 7B2, which serves as a molecular escort for proPC2 in the secretory pathway, promotes the production of enzymatically active PC2 and may have non-PC2 related endocrine roles. Mice null for 7B2 exhibit a lethal phenotype with a complex Cushing's-like pathology, which develops from intermediate lobe ACTH hypersecretion as a consequences of interruption of PC2-mediated peptide processing as well as undefined consequences of the loss of 7B2. In this study we investigated the endocrine and metabolic alterations of 7B2 null mice from pathological and biochemical points of view. Our results show that 7B2 nulls exhibit a multisystem disorder that includes severe pathoanatomical and histopathologic alterations of vital organs, including the heart and spleen but most notably the liver, in which massive steatosis and necrosis are observed. Metabolic derangements in glucose metabolism result in glycogen and fat deposition in liver under conditions of chronic hypoglycemia. Liver failure is also likely to contribute to abnormalities in blood coagulation and blood chemistry, such as lactic acidosis. A hypoglycemic crisis coupled with respiratory distress and intensive internal thrombosis most likely results in rapid deterioration and death of the 7B2 null.

Violence and its injury consequences in American movies: a public health perspective

PubMed Central

McArthur, D.; Peek-Asa, C.; Webb, T.; Fisher, K.; Cook, B.; Browne, N.; Kraus, J.

2000-01-01

Objectives—The purpose of this study was to evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top grossing American films of 1994. Methods—Each scene in each film was examined for the presentation of violent actions upon persons and coded by means of a systematic context sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. Results—The median number of violent actions per film was 16, with a range from 1 to 110. Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Conclusions—Violent force in American films of 1994 was overwhelmingly intentional and in four of five cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings. PMID:10875668

Violence and its injury consequences in American movies: a public health perspective.

PubMed

McArthur, D; Peek-Asa, C; Webb, T; Fisher, K; Cook, B; Browne, N; Kraus, J

2000-06-01

The purpose of this study was to evaluate the seriousness and frequency of violence and the degree of associated injury depicted in the 100 top grossing American films of 1994. Each scene in each film was examined for the presentation of violent actions upon persons and coded by means of a systematic context sensitive analytic scheme. Specific degrees of violence and indices of injury severity were abstracted. Only actually depicted, not implied, actions were coded, although both explicit and implied consequences were examined. The median number of violent actions per film was 16, with a range from 1 to 110. Intentional violence outnumbered unintentional violence by a factor of 10. Almost 90% of violent actions showed no consequences to the recipient's body, although more than 80% of the violent actions were executed with lethal or moderate force. Fewer than 1% of violent actions were accompanied by injuries that were then medically attended. Violent force in American films of 1994 was overwhelmingly intentional and in four of five cases was executed at levels likely to cause significant bodily injury. Not only action films but movies of all genres contained scenes in which the intensity of the action was not matched by correspondingly severe injury consequences. Many American films, regardless of genre, tend to minimize the consequences of violence to human beings.

'Zero is not good for me': implications of infertility in Ghana.

PubMed

Fledderjohann, J J

2012-05-01

Given the high value placed on children in sub-Saharan Africa, previous research suggests that infertility increases the risk of psychological distress and marital conflict, encourages risky sexual behavior and deprives infertile individuals and couples of an important source of economic and social capital. This paper explores the implications of infertility for women in Ghana, West Africa. Semi-structured interview data collected from 107 women (aged 21-48 years, mean 33 years) seeking treatment in gynecological and obstetric clinics in Accra, Ghana, are analyzed. Based on iterative open coding of the interviews, the focus of the analysis is on mental health, marital instability, social interaction and gendered experiences. Infertile women report facing severe social stigma, marital strain and a range of mental health difficulties. Many women feel that they shoulder a disproportionate share of the blame for infertility and, by extension, face greater social consequences than male partners for difficulties conceiving. Women who do not self-identify as infertile corroborate these findings, asserting that the social consequences of infertility are severe, particularly for women. Infertility in Ghana has important consequences for social interactions, marital stability and mental health. These consequences are not perceived to be shared equally by Ghanaian men.

Parents’ and students’ perceptions of college alcohol risk: The role of parental risk perception in intentions to communicate about alcohol

PubMed Central

Napper, Lucy E.; Grimaldi, Elizabeth M.; LaBrie, Joseph W.

2017-01-01

The current study aims to examine discrepancies in parents’ and college students’ perceptions of alcohol risk and the role of perceived risk in predicting parents’ intentions to discuss alcohol with their child. In total, 246 college student-parent dyads (56.1% female students, 77.2% mothers) were recruited from a mid-size university. Participants completed measures of absolute likelihood, comparative likelihood, and severity of alcohol consequences. In comparison to students, parents perceived the risks of alcohol poisoning (p < .001), academic impairment (p < .05), and problems with others (p < .05) to be more likely. In addition, parents rated the majority alcohol consequences (e.g., passing out, regrettable sexual situation, throwing up) as more severe than students (all ps < .001). However, parents tended to be more optimistic than their child about the comparative likelihood of alcohol consequences. After controlling for demographics and past alcohol communication, greater absolute likelihood (β = .20, p = .016) and less confidence in knowledge of student behavior (β = .20, p = .013) predicted greater intentions to discuss alcohol. Providing parents of college students with information about college drinking norms and the likelihood of alcohol consequences may help prompt alcohol-related communication. PMID:25437267

Multiple external hazards compound level 3 PSA methods research of nuclear power plant

NASA Astrophysics Data System (ADS)

Wang, Handing; Liang, Xiaoyu; Zhang, Xiaoming; Yang, Jianfeng; Liu, Weidong; Lei, Dina

2017-01-01

2011 Fukushima nuclear power plant severe accident was caused by both earthquake and tsunami, which results in large amount of radioactive nuclides release. That accident has caused the radioactive contamination on the surrounding environment. Although this accident probability is extremely small, once such an accident happens that is likely to release a lot of radioactive materials into the environment, and cause radiation contamination. Therefore, studying accidents consequences is important and essential to improve nuclear power plant design and management. Level 3 PSA methods of nuclear power plant can be used to analyze radiological consequences, and quantify risk to the public health effects around nuclear power plants. Based on multiple external hazards compound level 3 PSA methods studies of nuclear power plant, and the description of the multiple external hazards compound level 3 PSA technology roadmap and important technical elements, as well as taking a coastal nuclear power plant as the reference site, we analyzed the impact of off-site consequences of nuclear power plant severe accidents caused by multiple external hazards. At last we discussed the impact of off-site consequences probabilistic risk studies and its applications under multiple external hazards compound conditions, and explained feasibility and reasonableness of emergency plans implementation.

Workplace Bullying: A Tale of Adverse Consequences

PubMed Central

Sansone, Lori A.

2015-01-01

Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution. PMID:25852978

Workplace bullying: a tale of adverse consequences.

PubMed

Sansone, Randy A; Sansone, Lori A

2015-01-01

Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution.

Consequences of severe nuclear accidents in Europe

NASA Astrophysics Data System (ADS)

Seibert, Petra; Arnold, Delia; Mraz, Gabriele; Arnold, Nikolaus; Gufler, Klaus; Kromp-Kolb, Helga; Kromp, Wolfgang; Sutter, Philipp

2013-04-01

A first part of the presentation is devoted to the consequences of the severe accident in the 1986 Chernobyl NPP. It lead to a substantial radioactive contaminated of large parts of Europe and thus raised the awareness for off-site nuclear accident consequences. Spatial patterns of the (transient) contamination of the air and (persistent) contamination of the ground were studied by both measurements and model simulations. For a variety of reasons, ground contamination measurements have variability at a range of spatial scales. Results will be reviewed and discussed. Model simulations, including inverse modelling, have shown that the standard source term as defined in the ATMES study (1990) needs to be updated. Sensitive measurements of airborne activities still reveal the presence of low levels of airborne radiocaesium over the northern hemisphere which stems from resuspension. Over time scales of months and years, the distribution of radionuclides in the Earth system is constantly changing, for example relocated within plants, between plants and soil, in the soil, and into water bodies. Motivated by the permanent risk of transboundary impacts from potential major nuclear accidents, the multidisciplinary project flexRISK (see http://flexRISK.boku.ac.at) has been carried out from 2009 to 2012 in Austria to quantify such risks and hazards. An overview of methods and results of flexRISK is given as a second part of the presentation. For each of the 228 NPPs, severe accidents were identified together with relevant inventories, release fractions, and release frequencies. Then, Europe-wide dispersion and dose calculations were performed for 2788 cases, using the Lagrangian particle model FLEXPART. Maps of single-case results as well as various aggregated risk parameters were produced. It was found that substantial consequences (intervention measures) are possible for distances up to 500-1000 km, and occur more frequently for a distance range up to 100-300 km, which is in agreement with Chernobyl experiences. However, emergency planning presently is still often focussing on too small areas. In reality, almost all of Europe should be prepared for nuclear disaster. The project investigated also the effect of a simple phase-out scenario. A regional phase-out policy is effective for reducing or even eliminating high damage in the respective regions. It should also be mentioned that risk distribution depends strongly on accident frequency, but this parameter is highly uncertain. The work in flexRISK was funded by the Austrian Climate and Energy Fund (KLI.EN).

Back to sleep or not: the effect of the supine position on pediatric OSA: Sleeping position in children with OSA.

PubMed

Walter, Lisa M; Dassanayake, Daranagama U N; Weichard, Aidan J; Davey, Margot J; Nixon, Gillian M; Horne, Rosemary S C

2017-09-01

In both adults and children, obstructive sleep apnea (OSA) has significant adverse cardiovascular consequences. In adults, sleeping position has a marked effect on the severity of OSA; however, the limited number of studies conducted in children have reported conflicting findings. We aimed to evaluate the effect of sleeping position on OSA severity and the cardiovascular consequences in preschool-aged children. This was a retrospective analysis of children (3-5 years of age) diagnosed with OSA (n = 75) and nonsnoring controls (n = 25). Sleeping position was classified as supine, semi-supine, left lateral, right lateral, prone, and semi-prone by using video recordings during one night of attended polysomnography. OSA severity and cardiovascular parameters were compared between the positions. All children spent significantly more sleep time in the supine position than in any other position. The obstructive apnea-hypopnea index was higher in the supine position than in the other sleeping positions during NREM (p < 0.05), higher in the moderate/severe OSA group when sleeping in the supine position than when sleeping in the left and right lateral positions (p < 0.05 for both) and prone position (p = 0.007) during REM. Sympathovagal balance was decreased in children with OSA in the supine and lateral positions (p < 0.05). This study identified that preschool-aged children, whether nonsnoring controls or children with OSA, predominately sleep in the supine position, and OSA was more severe in the supine position. We suggest that to avoid the supine sleep position, positional therapy has the potential to ameliorate OSA severity, and the known cardiovascular consequences. Copyright © 2017 Elsevier B.V. All rights reserved.

Severity of alprazolam dependence and associated features among long-term alprazolam users from psychiatric outpatient clinics in Taiwan.

PubMed

Chen, Tzu-Ting; Ko, Chih-Hung; Chen, Shao-Tsu; Yen, Chia-Nan; Su, Po-Wen; Hwang, Tzung-Jeng; Lin, Jin-Jia; Yen, Cheng-Fang

2015-11-01

The aim of this study was to examine the correlations between the severity of alprazolam dependence and socio-demographic characteristics, the characteristics of alprazolam use, psychiatric comorbidity, and beliefs toward alprazolam use among long-term alprazolam users in Taiwan. A total of 148 long-term alprazolam users participated in this study. The Chinese version of the Severity of Dependence Scale was used to assess participants' severity of alprazolam dependence in the preceding month. Their socio-demographic characteristics, family function characteristics, dosage of prescribed alprazolam, duration of alprazolam use, alcohol use pattern, pain reliever and cigarette use pattern, severity of depressive symptoms, psychiatric diagnosis, and belief toward alprazolam use were investigated. The results of multiple regression analysis indicated that a longer duration of alprazolam use, severe depressive symptoms, a high level of belief in the necessity of alprazolam treatment, and a high level of concern about the potential adverse consequences of alprazolam use were significantly associated with more severe alprazolam dependence. Doctors should closely monitor the severity of alprazolam dependence among long-term users, especially patients' levels of depression, beliefs in the necessity of alprazolam treatment, and their concerns over the adverse consequences of continued treatment with alprazolam. Copyright © 2014. Published by Elsevier B.V.

Perceptions of distress and positive consequences following exposure to a major disaster amongst a well-studied cohort.

PubMed

Fergusson, David M; Boden, Joseph M; Horwood, L John; Mulder, Roger T

2015-04-01

Research on the impact of natural disasters on health and well-being faces several methodological challenges, including: sampling issues; exposure assessment; and outcome measurement. The present study used a comprehensive measure of disaster exposure to assess relationships between exposure to the Canterbury (New Zealand) Earthquakes of 2010-2011 and both: (a) self-reported distress and (b) positive outcomes; and also investigated gender differences in reports. Data were gathered from the Christchurch Health and Development Study, a 35-year longitudinal study. The study examined data from 495 individuals exposed to the Canterbury Earthquakes for who complete data on exposure and reactions to the earthquakes at age 35 were available. Participants with higher levels of exposure to the earthquakes reported significantly (p<0.0001) higher levels of distress due to fear, death and injury, and disruption caused by the earthquakes. Higher levels of exposure to the earthquakes were also associated with significantly (p<0.0001) higher levels of reporting positive consequences following the earthquakes. Women reported significantly (p<0.0001) greater distress than men and significantly (p<0.001) greater positive consequences. Higher levels of exposure to disaster were associated with higher levels of distress, but also with higher levels of self-reported positive outcomes, with females reporting higher levels of both positive and negative outcomes. The findings highlight the need for comprehensive assessment of disaster exposure, to consider gender and other group differences in reactions to disaster exposure, and for studies of disasters to examine both positive and negative consequences. © The Royal Australian and New Zealand College of Psychiatrists 2014.

School discipline and disruptive classroom behavior: the moderating effects of student perceptions.

PubMed

Way, Sandra M

2011-01-01

This study examines the relationship between school discipline and student classroom behavior. A traditional deterrence framework predicts that more severe discipline will reduce misbehavior. In contrast, normative perspectives suggest that compliance depends upon commitment to rules and authority, including perceptions of fairness and legitimacy. Using school and individual-level data from the National Education Longitudinal Study of 1988 and multilevel regression modeling, the author finds support for the normative perspective. Students who perceive school authority as legitimate and teacher–student relations as positive are rated as less disruptive. While perceptions of fairness also predict lower disruptions, the effects are mediated by positive teacher–student relations. Contrary to the deterrence framework, more school rules and higher perceived strictness predicts more, not less, disruptive behavior. In addition, a significant interaction effect suggests that attending schools with more severe punishments may have the unintended consequence of generating defiance among certain youth.

Ferenczi's Revolutionary Therapeutic Approach.

PubMed

Mucci, Clara

2017-09-01

Many of the revolutionary principles introduced by Ferenczi in his clinical practice have now been widely accepted especially in the field of trauma and trauma therapy. Examples of these innovative views include his emphasis on empathy as opposed to technical neutrality and his stress on the real conditions of child caring and family environmental deficits and on the consequences of interpersonal violence and abuse that lead to "identification with the aggressor" by the victim thereby resulting in the internalization of both aggressiveness and guilt (the split guilt of the abuser). The resulting "fragmentation" of the personality, which is now considered dissociation (instead of Freud's "repression"), is at the root of several severe disorders, characterized by distortion of reality, loss of touch with one's body and loss of trust in the other. Therefore "abreaction is not enough". A new, positive relational experience must be re-inscribed at the level of implicit memory.

Legacy and emerging brominated flame retardants in China: A review on food and human milk contamination, human dietary exposure and risk assessment.

PubMed

Shi, Zhixiong; Zhang, Lei; Li, Jingguang; Wu, Yongning

2018-05-01

Brominated flame retardants (BFRs) are a large group of widely used chemicals, which have been produced and used since 1970s. As a consequence of substantial and long-term usage, BFRs have been found to be ubiquitous in humans, wildlife, and abiotic matrices around the world. Although several reports have reviewed BFRs contamination in general, none have focused specifically on foods and human milk, and the corresponding dietary exposure. Foods (including human milk) have long been recognized as a major pathway of BFRs intake for non-occupationally exposed persons. This review summarizes most available BFRs data in foods and human milk from China in recent years, and emphasizes several specific aspects, i.e., contamination levels of legacy and emerging BFRs, dietary exposure assessment and related health concerns, comparison between various BFRs, and temporal changes in BFRs contamination. Copyright © 2018 Elsevier Ltd. All rights reserved.

Markers of Oxidative Stress and Neuroprogression in Depression Disorder

PubMed Central

Vaváková, Magdaléna; Trebatická, Jana

2015-01-01

Major depression is multifactorial disorder with high prevalence and alarming prognostic in the nearest 15 years. Several mechanisms of depression are known. Neurotransmitters imbalance and imbalance between neuroprogressive and neuroprotective factors are observed in major depression. Depression is accompanied by inflammatory responses of the organism and consequent elevation of proinflammatory cytokines and increased lipid peroxidation are described in literature. Neuropsychiatric disorders including major depression are also associated with telomerase shortening, oxidative changes in nucleotides, and polymorphisms in several genes connected to metabolism of reactive oxygen species. Mitochondrion dysfunction is directly associated with increasing levels of oxidative stress. Oxidative stress plays significant role in pathophysiology of major depression via actions of free radicals, nonradical molecules, and reactive oxygen and nitrogen species. Products of oxidative stress represent important parameters for measuring and predicting of depression status as well as for determining effectiveness of administrated antidepressants. Positive effect of micronutrients, vitamins, and antioxidants in depression treatment is also reviewed. PMID:26078821

Chemical warfare and the Gulf War: a review of the impact on Gulf veterans' health.

PubMed

Riddle, James R; Brown, Mark; Smith, Tyler; Ritchie, Elspeth Cameron; Brix, Kelley Ann; Romano, James

2003-08-01

It is unlikely that Gulf War veterans are suffering chronic effects from illnesses caused by chemical warfare nerve agent exposure. Extensive investigation and review by several expert panels have determined that no evidence exists that chemical warfare nerve agents were used during the Gulf War. At no time before, during, or after the war was there confirmation of symptoms among anyone, military or civilian, caused by chemical warfare nerve agent exposure. However, studies of Gulf War veterans have found belief that chemical weapons were used, significantly associated with both severe and mild-moderate illnesses. The psychological impact of a chemical warfare attack, either actual or perceived, can result in immediate and long-term health consequences. The deployment or war-related health impact from life-threatening experiences of the Gulf War, including the perceived exposure to chemical warfare agents, should be considered as an important cause of morbidity among Gulf War veterans.

The hippocampo-prefrontal pathway: a possible therapeutic target for negative and cognitive symptoms of schizophrenia

PubMed Central

Ghoshal, Ayan; Conn, P Jeffrey

2015-01-01

The hippocampo-prefrontal (H-PFC) pathway has been linked to cognitive and emotional disturbances in several psychiatric disorders including schizophrenia. Preclinical evidence from the NMDA receptor antagonism rodent model of schizophrenia shows severe pathology selective to the H-PFC pathway. It is speculated that there is an increased excitatory drive from the hippocampus to the prefrontal cortex due to dysfunctions in the H-PFC plasticity, which may serve as the basis for the behavioral consequences observed in this rodent model. Thus, the H-PFC pathway is currently emerging as a promising therapeutic target for the negative and cognitive symptom clusters of schizophrenia. Here, we have reviewed the physiological, pharmacological and functional characteristics of the H-PFC pathway and we propose that allosteric activation of glutamatergic and cholinergic neurotransmission can serve as a plausible therapeutic approach. PMID:25825588

Assessing T cell clonal size distribution: a non-parametric approach.

PubMed

Bolkhovskaya, Olesya V; Zorin, Daniil Yu; Ivanchenko, Mikhail V

2014-01-01

Clonal structure of the human peripheral T-cell repertoire is shaped by a number of homeostatic mechanisms, including antigen presentation, cytokine and cell regulation. Its accurate tuning leads to a remarkable ability to combat pathogens in all their variety, while systemic failures may lead to severe consequences like autoimmune diseases. Here we develop and make use of a non-parametric statistical approach to assess T cell clonal size distributions from recent next generation sequencing data. For 41 healthy individuals and a patient with ankylosing spondylitis, who undergone treatment, we invariably find power law scaling over several decades and for the first time calculate quantitatively meaningful values of decay exponent. It has proved to be much the same among healthy donors, significantly different for an autoimmune patient before the therapy, and converging towards a typical value afterwards. We discuss implications of the findings for theoretical understanding and mathematical modeling of adaptive immunity.

Toward a useful standard for hospitalizing pretrial jail detainees.

PubMed

Felthous, Alan R

Severely mentally ill jail detainees require an adequate spectrum of mental health services during detainment. For some this means a limited period of treatment in a mental hospital, just as some mentally ill individuals in the community occasionally require hospital treatment. Unfortunately, this appropriate level of treatment is often denied or neglected for jail detainees with adverse consequences for them. Among the reasons for this neglect, may be standards for hospital transfer that are no longer practical and can be easily skirted by policymakers and administrators with little interest in ensuring this level of care for mentally ill jail inmates. A more realistic standard and justification would recognize the need for hospitalization for the mentally disordered detainee who because of psychotic anosognosia refuses appropriate treatment including medications and/or whose severely decompensated condition is worsening or failing to improve despite attempts at treatment in the jail. Copyright © 2017 Elsevier Ltd. All rights reserved.

Childhood maltreatment and educational outcomes: evidence from South Africa.

PubMed

Pieterse, Duncan

2015-07-01

Many South African children experience maltreatment, but we know little about the effects on long-term child development. Using the only representative dataset that includes a module on childhood maltreatment for a metropolitan city in South Africa, we explore the association between different measures of childhood maltreatment and two educational outcomes (numeracy test scores and dropout). Our study provides an estimate of the association between childhood maltreatment and educational outcomes in a developing country where maltreatment is high. We control for potential confounders using a range of statistical techniques and add several robustness checks to evaluate the strength of our findings. Our results indicate that children who are maltreated suffer large adverse consequences in terms of their numeracy test scores and probability of dropout and that the estimated effects of maltreatment are larger and more consistent for the most severe type of maltreatment. Copyright © 2014 John Wiley & Sons, Ltd.

Evolving Character of Chronic Central Nervous System HIV Infection

PubMed Central

Price, Richard W.; Spudich, Serena S.; Peterson, Julia; Joseph, Sarah; Fuchs, Dietmar; Zetterberg, Henrik; Gisslén, Magnus; Swanstrom, Ronald

2014-01-01

Human immunodeficiency virus type 1 (HIV-1) infection of the central nervous system (CNS) begins early in systemic infection and continues throughout its untreated course. Despite a common cerebrospinal fluid inflammatory response, it is usually neurologically asymptomatic for much of this course, but can evolve in some individuals to HIV-associated dementia (HAD), a severe encephalopathy with characteristic cognitive and motor dysfunction. While widespread use of combination antiretroviral therapy (ART) has led to a marked decline in both the CNS infection and its neurologic severe consequence, HAD continues to afflict individuals presenting with advanced systemic infection in the developed world and a larger number in resource-poor settings where ART is more restricted. Additionally, milder CNS injury and dysfunction have broader prevalence, including in those treated with ART. Here we review the history and evolving nomenclature of HAD, its viral pathogenesis, clinical presentation and diagnosis, and treatment. PMID:24715483

Neutron dosimetry at a high-energy electron-positron collider

NASA Astrophysics Data System (ADS)

Bedogni, Roberto

Electron-positron colliders with energy of hundreds of MeV per beam have been employed for studies in the domain of nuclear and sub-nuclear physics. The typical structure of such a collider includes an LINAC, able to produce both types of particles, an accumulator ring and a main ring, whose diameter ranges from several tens to hundred meters and allows circulating particle currents of several amperes per beam. As a consequence of the interaction of the primary particles with targets, shutters, structures and barriers, a complex radiation environment is produced. This paper addresses the neutron dosimetry issues associated with the operation of such accelerators, referring in particular to the DAΦ NE complex, operative since 1997 at INFN-Frascati National Laboratory (Italy). Special attention is given to the active and passive techniques used for the spectrometric and dosimetric characterization of the workplace neutron fields, for radiation protection dosimetry purposes.

Evolving character of chronic central nervous system HIV infection.

PubMed

Price, Richard W; Spudich, Serena S; Peterson, Julia; Joseph, Sarah; Fuchs, Dietmar; Zetterberg, Henrik; Gisslén, Magnus; Swanstrom, Ronald

2014-02-01

Human immunodeficiency virus type 1 (HIV-1) infection of the central nervous system (CNS) begins early in systemic infection and continues throughout its untreated course. Despite a common cerebrospinal fluid inflammatory response, it is usually neurologically asymptomatic for much of this course, but can evolve in some individuals to HIV-associated dementia (HAD), a severe encephalopathy with characteristic cognitive and motor dysfunction. While widespread use of combination antiretroviral therapy (ART) has led to a marked decline in both the CNS infection and its neurologic severe consequence, HAD continues to afflict individuals presenting with advanced systemic infection in the developed world and a larger number in resource-poor settings where ART is more restricted. Additionally, milder CNS injury and dysfunction have broader prevalence, including in those treated with ART. Here we review the history and evolving nomenclature of HAD, its viral pathogenesis, clinical presentation and diagnosis, and treatment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Early psychological consequences of the March 11, 2004, terrorist attacks in Madrid, Spain.

PubMed

Muñoz, Manuel; Crespo, María; Pérez-Santos, Eloísa; Vázquez, José Juan

2005-12-01

On March 11, 2004, Al-Qaeda set off 10 bombs on several train routes in Madrid. 192 people were killed and 2,000 wounded. In this study, 1,179 questionnaires were administered Week 2 after the attacks to residents 18 years and over from the affected geographical areas. The questionnaire included items about sociodemographic variables and exposure to the attacks. Psychological effects were assessed as presence of acute stress and depressive symptomatology and functional impairment. 46.7% of the sample presented symptomatology of acute stress and 49.6% depressive symptoms. Among the symptoms of acute stress, the most frequent were re-experiencing (72.5%) and dissociative symptoms (71.8%). The chief predicting variables in symptomatology were being female, over 65 yr. old, and a habitual train user. The large number of affected people was refined with an item analysis and the consideration of severity of interference in psychosocial functioning.

The Relationship between Frequently Used Glucose-Lowering Agents and Gut Microbiota in Type 2 Diabetes Mellitus.

PubMed

Lv, You; Zhao, Xue; Guo, Weiying; Gao, Ying; Yang, Shuo; Li, Zhuo; Wang, Guixia

2018-01-01

Metabolic diseases, especially diabetes mellitus, have become global health issues. The etiology of diabetes mellitus can be attributed to genetic and/or environmental factors. Current evidence suggests the association of gut microbiota with metabolic diseases. However, the effects of glucose-lowering agents on gut microbiota are poorly understood. Several studies revealed that these agents affect the composition and diversity of gut microbiota and consequently improve glucose metabolism and energy balance. Possible underlying mechanisms include affecting gene expression, lowering levels of inflammatory cytokines, and regulating the production of short-chain fatty acids. In addition, gut microbiota may alleviate adverse effects caused by glucose-lowering agents, and this can be especially beneficial in diabetic patients who experience severe gastrointestinal side effects and have to discontinue these agents. In conclusion, gut microbiota may provide a novel viewpoint for the treatment of patients with diabetes mellitus.

Neutropenia during HIV Infection: Adverse Consequences and Remedies

PubMed Central

Shi, Xin; Sims, Matthew D; Hanna, Michel M; Xie, Ming; Gulick, Peter G; Zheng, Yong-Hui; Basson, Marc D; Zhang, Ping

2016-01-01

Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients. PMID:24654626

Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations?

PubMed

Macpherson, Cheryl C; Hill, Jonathan

2017-12-01

Climate change threatens health, health care, and the industries and resources upon which these depend. The growing prevalence and severity of its health consequences and economic costs are alarming health professionals and organizations as their professional obligations, grounded in the core value of health, include protecting against these harms. One means of fulfilling these obligations is to lead or support sustainability initiatives that are built upon current, reliable, accurate, and unbiased evidence and collaboratively tailored to meet specific needs and respond to specific contexts. We consider why and how health professionals and organizations should lead or support such initiatives. © 2017 American Medical Association. All Rights Reserved.

[Consideration of the deuterium-free water supply to an expedition to Mars].

PubMed

Siniak, Iu E; Turusov, V S; Grigor'ev, A I; Zaridze, D G; Gaĭdadymov, V B; Gus'kova, E I; Antoshina, E E; Gor'kova, T G; Trukhanova, L S

2003-01-01

Interplanetary missions, including to Mars, will put crews into severe radiation conditions. Search for methods of reducing the risk of radiation-induced cancer is of the top priority in preparation for the mission to Mars. One of the options is designing life support systems that will generate water with low content of the stable hydrogen isotope (deuterium) to be consumed by crewmembers. Preliminary investigations have shown that a decrease of the deuterium fraction by 65% does impart to water certain anti-cancer properties. Therefore, drinking deuterium-free water has the potential to reduce the risk of cancer consequent to the extreme radiation exposure of the Martian crew.

Susceptibility of South Korea to Extremes Affecting the Global Food System

NASA Technical Reports Server (NTRS)

Chon, So Young; Puma, Michael J.

2015-01-01

Food security in South Korea is tightly linked to the global food system. The country's production of major grains declined from 5.8 million metric tons (mmt) in 1998 to 4.8 mmt in 2014, which caused the country's grain self suciency to decline from 31.4% to 24%. This decline is a consequence of several factors including reductions in domestic agricultural land, governmental policies supporting industry over agriculture, and a push towards trade liberalization. South Korea's self suciency is now one of the lowest among Organisation for Economic Co-operation and Development (OECD) countries, leaving it vulnerable to disruptions in the global food system.

Academic Motivation Scale: adaptation and psychometric analyses for high school and college students.

PubMed

Stover, Juliana Beatriz; de la Iglesia, Guadalupe; Boubeta, Antonio Rial; Liporace, Mercedes Fernández

2012-01-01

The Academic Motivation Scale (AMS), supported in Self-Determination Theory, has been applied in recent decades as well in high school as in college education. Although several versions in Spanish are available, the underlying linguistic and cultural differences raise important issues when they are applied to Latin-American population. Consequently an adapted version of the AMS was developed, and its construct validity was analyzed in Argentine students. Results obtained on a sample that included 723 students from Buenos Aires (393 high school and 330 college students) verified adequate psychometric properties in this new version, solving some controversies regarded to its dimensionality.

Revolution in Detection Affairs

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

Stern W.

The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovativemore » application of anomaly detection algorithms.« less

Revolution in nuclear detection affairs

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

Stern, Warren M.

The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovativemore » application of anomaly detection algorithms.« less

Stochastic theory of log-periodic patterns

NASA Astrophysics Data System (ADS)

Canessa, Enrique

2000-12-01

We introduce an analytical model based on birth-death clustering processes to help in understanding the empirical log-periodic corrections to power law scaling and the finite-time singularity as reported in several domains including rupture, earthquakes, world population and financial systems. In our stochastic theory log-periodicities are a consequence of transient clusters induced by an entropy-like term that may reflect the amount of co-operative information carried by the state of a large system of different species. The clustering completion rates for the system are assumed to be given by a simple linear death process. The singularity at t0 is derived in terms of birth-death clustering coefficients.

Academic Motivation Scale: adaptation and psychometric analyses for high school and college students

PubMed Central

Stover, Juliana Beatriz; de la Iglesia, Guadalupe; Boubeta, Antonio Rial; Liporace, Mercedes Fernández

2012-01-01

The Academic Motivation Scale (AMS), supported in Self-Determination Theory, has been applied in recent decades as well in high school as in college education. Although several versions in Spanish are available, the underlying linguistic and cultural differences raise important issues when they are applied to Latin-American population. Consequently an adapted version of the AMS was developed, and its construct validity was analyzed in Argentine students. Results obtained on a sample that included 723 students from Buenos Aires (393 high school and 330 college students) verified adequate psychometric properties in this new version, solving some controversies regarded to its dimensionality. PMID:22888280

Alcohol abuse as a risk factor for and consequence of child abuse.

PubMed

Widom, C S; Hiller-Sturmhöfel, S

2001-01-01

The relationship between child abuse and the use or abuse of alcohol has two aspects. First, some findings have indicated that parental alcohol abuse may be associated with the physical or sexual abuse of children. Research findings in this area remain inconsistent, however. Second, the experience of being abused as a child may increase a person's risk for alcohol-related problems as an adult. This relationship has best been demonstrated in women who had been victims of childhood abuse. Several factors most likely contribute to or influence this relationship, including coping skills; antisocial behavior; and psychological problems, such as posttraumatic stress disorder.

Maintenance Fluid Therapy: Isotonic Versus Hypotonic Solutions.

PubMed

Hansen, Bernie; Vigani, Alessio

2017-03-01

The goal of maintenance fluid therapy in small animals is to replace normal ongoing losses of water and salts when oral intake is withheld. Hospitalized dogs and cats may have multiple stimuli for antidiuretic hormone release that disrupt normal osmoregulation and predispose to water retention. Severe illness promotes retention of both sodium and water as edema. Commercially available fluids have electrolyte concentrations that are very different from dietary maintenance requirements, and potential consequences include development of hypoosmolality, edema, or both when excesses of water or sodium are administered. Suggestions for tailoring fluid administration toward specific goals are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

A case of thyroid storm with multiple organ failure effectively treated with plasma exchange.

PubMed

Sasaki, Kazuki; Yoshida, Akira; Nakata, Yukiko; Mizote, Isamu; Sakata, Yasushi; Komuro, Issei

2011-01-01

We describe a 48-year-old man with thyroid storm presenting with heart failure. He presented severely impaired left ventricular wall motion and a marked increase in the liver enzymes. He developed disseminated intravascular coagulation on day 2. Due to elevated serum thyroid hormone level, anti-thyroid hormone receptor antibody positivity, and his clinical symptoms, he was diagnosed as thyroid storm due to untreated Graves' disease. His condition did not improve even after 6 days of conventional therapy including steroids. After therapeutic plasma exchange was carried out, his thyroid hormone level decreased markedly. Consequently, his condition recovered gradually, and he was discharged at day 43.

Large longitudinal spin alignment generated in inelastic nuclear reactions

NASA Astrophysics Data System (ADS)

Hoff, D. E. M.; Potel, G.; Brown, K. W.; Charity, R. J.; Pruitt, C. D.; Sobotka, L. G.; Webb, T. B.; Roeder, B.; Saastamoinen, A.

2018-05-01

Large longitudinal spin alignment of E /A =24 MeV 7Li projectiles inelastically excited by Be, C, and Al targets was observed when the latter remain in their ground state. This alignment is a consequence of an angular-momentum-excitation-energy mismatch, which is well described by a DWBA cluster-model (α +t ). The longitudinal alignment of several other systems is also well described by DWBA calculations, including one where a cluster model is inappropriate, demonstrating that the alignment mechanism is a more general phenomenon. Predictions are made for inelastic excitation of 12C for beam energies above and below the mismatch threshold.

Dense amnesia in a professional musician following herpes simplex virus encephalitis.

PubMed

Wilson, B A; Baddeley, A D; Kapur, N

1995-10-01

We describe the memory functioning of C, a professional musician who became amnesic following herpes simplex encephalitis in 1985. Although transient amnesia in a professional musician has previously been described, this is the first reported case of chronic amnesia in a highly talented professional musician. C is unusual in three respects. First, his amnesia is particularly severe. Second, his amnesia includes semantic as well as episodic memory deficits. Third, he believes he has just woken up and his preoccupation with this state of 'just wakening' has persisted for over 9 years. This appears to be the result of a delusion rather than the consequence of his amnesia.

Compressed sensing system considerations for ECG and EMG wireless biosensors.

PubMed

Dixon, Anna M R; Allstot, Emily G; Gangopadhyay, Daibashish; Allstot, David J

2012-04-01

Compressed sensing (CS) is an emerging signal processing paradigm that enables sub-Nyquist processing of sparse signals such as electrocardiogram (ECG) and electromyogram (EMG) biosignals. Consequently, it can be applied to biosignal acquisition systems to reduce the data rate to realize ultra-low-power performance. CS is compared to conventional and adaptive sampling techniques and several system-level design considerations are presented for CS acquisition systems including sparsity and compression limits, thresholding techniques, encoder bit-precision requirements, and signal recovery algorithms. Simulation studies show that compression factors greater than 16X are achievable for ECG and EMG signals with signal-to-quantization noise ratios greater than 60 dB.

Battered women: dilemmas and care.

PubMed

Tabak, N; Ehrenfeld, M

1998-01-01

Domestic violence is a complex problem, and its victims are women from all social classes and positions. The "cycle of beating" where tension accumulates, and then assault is followed by excuses and reconciliation, puts the battered women in dilemma. One conflict is that of exposure of intimate family details, and the other the guilt for the consequences of external intervention in family situations. The modern society has several tools to treat domestic violence and to assist battered wives. They include the police, legislation, courts and probation officers, besides shelters, legal aid and social services. Specific training of nursing and medical personnel is pivotal for the proper identification of women is such distress.

Governance of malaria prevention: How decision-makers' and pregnant women's sensemaking contribute to unintended consequences.

PubMed

Danhoundo, Georges; Wiktorowicz, Mary E; Yaya, Sanni

2017-03-01

Although malaria in pregnancy predisposes women to increased perinatal mortality and morbidity, complex issues underlie its persistence. To develop a better understanding of the factors affecting women's access to Intermittent Preventive Treatment in Benin, we used the theoretical lens of "sensemaking" to clarify policymakers', health professionals', and women's perspectives concerning preventive policies and barriers to access. Several assumptions were found to underlie Benin's malaria preventive policy that contribute to the unintended effect of deterring pregnant women in poverty from accessing preventive treatment. Health system dysfunctions including drug shortages and deficiencies in health care professionalism exacerbate the unintended effect.

[Knee and shoulder arthroscopy. Positioning and thermal injuries].

PubMed

Meyer, S; Lobenhoffer, P

2008-11-01

Intraoperative positioning injuries during shoulder- and knee arthroscopy are rare complications and affect mainly nerves and soft tissue. Although the majority of these complications are reversible, in some cases serious negative consequences for the patient persist. This article describes the frequency of several positioning injuries including their prevention and the appropriate treatment. The legal responsibilities are illustrated as well as the importance of an intense preoperative investigation of preexisting diseases and possible risk factors. Furthermore, a review of possible thermal injuries of the patient during arthroscopy caused by e.g. electrosurgical instruments or the cold light source, is given as well as prevention strategies.

Postictal behavioural impairments are due to a severe prolonged hypoperfusion/hypoxia event that is COX-2 dependent

PubMed Central

Farrell, Jordan S; Gaxiola-Valdez, Ismael; Wolff, Marshal D; David, Laurence S; Dika, Haruna I; Geeraert, Bryce L; Rachel Wang, X; Singh, Shaily; Spanswick, Simon C; Dunn, Jeff F; Antle, Michael C; Federico, Paolo; Teskey, G Campbell

2016-01-01

Seizures are often followed by sensory, cognitive or motor impairments during the postictal phase that show striking similarity to transient hypoxic/ischemic attacks. Here we show that seizures result in a severe hypoxic attack confined to the postictal period. We measured brain oxygenation in localized areas from freely-moving rodents and discovered a severe hypoxic event (pO2 < 10 mmHg) after the termination of seizures. This event lasted over an hour, is mediated by hypoperfusion, generalizes to people with epilepsy, and is attenuated by inhibiting cyclooxygenase-2 or L-type calcium channels. Using inhibitors of these targets we separated the seizure from the resulting severe hypoxia and show that structure specific postictal memory and behavioral impairments are the consequence of this severe hypoperfusion/hypoxic event. Thus, epilepsy is much more than a disease hallmarked by seizures, since the occurrence of postictal hypoperfusion/hypoxia results in a separate set of neurological consequences that are currently not being treated and are preventable. DOI: http://dx.doi.org/10.7554/eLife.19352.001 PMID:27874832

An assessment of antecedent events influencing noncompliance in an outpatient clinic.

PubMed Central

Call, Nathan A; Wacker, David P; Ringdahl, Joel E; Cooper-Brown, Linda J; Boeiter, Eric W

2004-01-01

Several studies have shown that various factors can influence noncompliance, including task novelty, rate of presentation, and task preference. This study examined the impact of selected antecedent variables on noncompliance in an outpatient clinic setting. In two experiments involving 6 typically developing children, the consequences for noncompliance remained constant. During Experiment 1, demands that included noncontingent access to adult attention were contrasted with the same demands that did not include attention within a multielement design. In Experiment 2, demands were altered by decreasing the difficulty or amount of work or providing access to attention. In both experiments, results indicated idiosyncratic responses to the manipulated variables, with decreases in noncompliance observed following introduction of one or more antecedent variables with 5 of the 6 participants. These results suggested that noncompliance can be reduced via changes in antecedent variables, including adding potential positive reinforcers to the task situation, and that it is possible to probe variables that alter noncompliance in an outpatient clinic setting. PMID:15293634

Neurofunctional Abnormalities during Sustained Attention in Severe Childhood Abuse

PubMed Central

Mehta, Mitul A.; Simmons, Andrew; Mirza, Kah; Rubia, Katya

2016-01-01

Childhood maltreatment is associated with adverse affective and cognitive consequences including impaired emotion processing, inhibition and attention. However, the majority of functional magnetic resonance imaging (fMRI) studies in childhood maltreatment have examined emotion processing, while very few studies have tested the neurofunctional substrates of cognitive functions and none of attention. This study investigated the association between severe childhood abuse and fMRI brain activation during a parametric sustained attention task with a progressively increasing load of sustained attention in 21 medication-naïve, drug-free young people with a history of childhood abuse controlling for psychiatric comorbidities by including 19 psychiatric controls matched for psychiatric diagnoses, and 27 healthy controls. Behaviorally, the participants exposed to childhood abuse showed increased omission errors in the task which correlated positively trend-wise with the duration of their abuse. Neurofunctionally, the participants with a history of childhood abuse, but not the psychiatric controls, displayed significantly reduced activation relative to the healthy controls during the most challenging attention condition only in typical attention regions including left inferior and dorsolateral prefrontal cortex, insula and temporal areas. We therefore show for the first time that severe childhood abuse is associated with neurofunctional abnormalities in key ventral frontal-temporal sustained attention regions. The findings represent a first step towards the delineation of abuse-related neurofunctional abnormalities in sustained attention, which may help in the development of effective treatments for victims of childhood abuse. PMID:27832090

Sex-dependent changes in brain CB1R expression and functionality and immune CB2R expression as a consequence of maternal deprivation and adolescent cocaine exposure.

PubMed

Llorente-Berzal, Alvaro; Assis, María A; Rubino, Tiziana; Zamberletti, Erica; Marco, Eva M; Parolaro, Daniela; Ambrosio, Emilio; Viveros, María-Paz

2013-08-01

Early life stress has been associated with several psychiatric disorders, including drug addiction. Actually, maternal deprivation (MD) alters the endocannabinoid system, which participates in motivation and reward for drugs, including cocaine. At youth, the rate of cocaine abuse is alarmingly increasing. Herein, we have investigated the consequences of MD and/or adolescent cocaine exposure in brain CB1Rs and CB2Rs in immune tissues. Control and maternally deprived (24h on postnatal day, pnd, 9) male and female Wistar rats were administered cocaine (8mg/kg/day) or saline during adolescence (pnd 28-42). At adulthood, [(3)H]-CP-55,940 autoradiographic binding was employed for the analysis of CB1R density and CP-55,940-stimulated [(35)S]-GTPgammaS binding for CB1R functionality; CB2R expression was analyzed by Western blotting. Sex differences in CB1R expression and functionality were found, and MD induced important and enduring sex-dependent changes. In addition, the plastic changes induced by adolescent cocaine administration in brain CB1Rs were differentially influenced by early life events. MD increased spleen CB2R expression while adolescent cocaine administration attenuated this effect; cocaine exposure also diminished CB2R expression in bone marrow. Present findings provide evidence for changes in brain CB1R expression and functionality and immune CB2R expression as a consequence of early life stress and adolescent cocaine exposure, and indicate functional interactions between both treatments, which in many regions differ between males and females. Copyright © 2013 Elsevier Ltd. All rights reserved.