Distribution of Causes in Selected US Aviation Accident Reports Between 1996 and 2003

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2004-01-01

This paper describes the results of an independent analysis of the probable and contributory causes of selected aviation accidents in the United States between 1996 and 2003. The purpose of the study was to assess the comparative frequency of a variety of causal factors in the reporting of these adverse events. Although our results show that more of these high consequence accidents were attributed to human error than to any other single factor, a large number of reports also mentioned wider systemic issues, including the managerial and regulatory context of aviation operations. These wider issues are more likely to appear as contributory rather than primary causes in this set of accident reports.

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning—Implications for Prevention and Public Education

PubMed Central

Chan, Thomas Y. K.

2016-01-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g., Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. PMID:26787145

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning--Implications for Prevention and Public Education.

PubMed

Chan, Thomas Y K

2016-04-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g.,Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. © The American Society of Tropical Medicine and Hygiene.

32 CFR 842.51 - Applicable law.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., assumption of risk, res ipsa loquitur, last clear chance, discovered peril, and comparative and contributory... the legal effect of contributory or comparative negligence by the claimant will be applied in... contributory or comparative negligence does not exist, use traditional rules of contributory negligence...

32 CFR 842.51 - Applicable law.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., assumption of risk, res ipsa loquitur, last clear chance, discovered peril, and comparative and contributory... the legal effect of contributory or comparative negligence by the claimant will be applied in... contributory or comparative negligence does not exist, use traditional rules of contributory negligence...

32 CFR 842.51 - Applicable law.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., assumption of risk, res ipsa loquitur, last clear chance, discovered peril, and comparative and contributory... the legal effect of contributory or comparative negligence by the claimant will be applied in... contributory or comparative negligence does not exist, use traditional rules of contributory negligence...

32 CFR 842.51 - Applicable law.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., assumption of risk, res ipsa loquitur, last clear chance, discovered peril, and comparative and contributory... the legal effect of contributory or comparative negligence by the claimant will be applied in... contributory or comparative negligence does not exist, use traditional rules of contributory negligence...

32 CFR 842.51 - Applicable law.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., assumption of risk, res ipsa loquitur, last clear chance, discovered peril, and comparative and contributory... the legal effect of contributory or comparative negligence by the claimant will be applied in... contributory or comparative negligence does not exist, use traditional rules of contributory negligence...

Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy.

PubMed

Handsaker, Joseph C; Brown, Steven J; Bowling, Frank L; Cooper, Glen; Maganaris, Constantinos N; Boulton, Andrew J M; Reeves, Neil D

2014-11-01

Although patients with diabetic peripheral neuropathy (DPN) are more likely to fall than age-matched controls, the underlying causative factors are not yet fully understood. This study examines the effects of diabetes and neuropathy on strength generation and muscle activation patterns during walking up and down stairs, with implications for fall risk. Sixty-three participants (21 patients with DPN, 21 diabetic controls, and 21 healthy controls) were examined while walking up and down a custom-built staircase. The speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles were analyzed. Patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P < 0.05). During ascent, the ankle and knee extensor muscles were activated significantly later by patients with neuropathy and took longer to reach peak activation (P < 0.05). During descent, neuropathic patients activated the ankle extensors significantly earlier, and the ankle and knee extensors took significantly longer to reach peak activation (P < 0.05). Patients with DPN are slower at generating strength at the ankle and knee than control participants during walking up and down stairs. These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling. Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Medication errors in the Middle East countries: a systematic review of the literature.

PubMed

Alsulami, Zayed; Conroy, Sharon; Choonara, Imti

2013-04-01

Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20 %) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1 % to 90.5 % for prescribing and from 9.4 % to 80 % for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15 % to 34.8 % of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality. Educational programmes on drug therapy for doctors and nurses are urgently needed.

32 CFR 536.128 - Effect of disciplinary action, voluntary restitution, or contributory negligence for claims under...

Code of Federal Regulations, 2010 CFR

2010-07-01

... restitution, or contributory negligence for claims under the UCMJ. 536.128 Section 536.128 National Defense... action, voluntary restitution, or contributory negligence for claims under the UCMJ. (a) Disciplinary... claimant. (c) Contributory negligence. A claim otherwise cognizable and meritorious is payable whether or...

15 CFR 400.31 - Manufacturing and processing activity; criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... consider the contributory effect zone savings have as an incremental part of cost effectiveness programs... criteria—(1) Threshold factors. It is the policy of the Board to authorize zone activity only when it is... and as components of imported products. (2) Economic factors. After its review of threshold factors...

Obesity in Libya: a review

PubMed Central

Elmehdawi, Rafik R.; Albarsha, Abdulwahab M.

2012-01-01

Obesity is a global epidemic resulting in major morbidity and premature death. About 64% of Libyan adults are either overweight or obese, obesity progressively increasing with age, and two times more common among Libyan women than men. Cases of obesity and overweight are increasing in Libya as well as all over the world, with genetic and environmental factors playing a contributory role. With its known significant morbidity and mortality, obesity should draw the attention of the healthcare community, researchers, and policy makers in Libya. PMID:22899968

Cognitive error as the most frequent contributory factor in cases of medical injury: a study on verdict's judgment among closed claims in Japan.

PubMed

Tokuda, Yasuharu; Kishida, Naoki; Konishi, Ryota; Koizumi, Shunzo

2011-03-01

Cognitive errors in the course of clinical decision-making are prevalent in many cases of medical injury. We used information on verdict's judgment from closed claims files to determine the important cognitive factors associated with cases of medical injury. Data were collected from claims closed between 2001 to 2005 at district courts in Tokyo and Osaka, Japan. In each case, we recorded all the contributory cognitive, systemic, and patient-related factors judged in the verdicts to be causally related to the medical injury. We also analyzed the association between cognitive factors and cases involving paid compensation using a multivariable logistic regression model. Among 274 cases (mean age 49 years old; 45% women), there were 122 (45%) deaths and 67 (24%) major injuries (incomplete recovery within a year). In 103 cases (38%), the verdicts ordered hospitals to pay compensation (median; 8,000,000 Japanese Yen). An error in judgment (199/274, 73%) and failure of vigilance (177/274, 65%) were the most prevalent causative cognitive factors, and error in judgment was also significantly associated with paid compensation (odds ratio, 1.9; 95% confidence interval [CI], 1.0-3.4). Systemic causative factors including poor teamwork (11/274, 4%) and technology failure (5/274, 2%) were less common. The closed claims analysis based on verdict's judgment showed that cognitive errors were common in cases of medical injury, with an error in judgment being most prevalent and closely associated with compensation payment. Reduction of this type of error is required to produce safer healthcare. 2010 Society of Hospital Medicine.

'Systemic Failures' and 'Human Error' in Canadian TSB Aviation Reports Between 1996 and 2002

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2004-01-01

This paper describes the results of an independent analysis of the primary and contributory causes of aviation accidents in Canada between 1996 and 2003. The purpose of the study was to assess the comparative frequency of a range of causal factors in the reporting of these adverse events. Our results suggest that the majority of these high consequence accidents were attributed to human error. A large number of reports also mentioned wider systemic issues, including the managerial and regulatory context of aviation operations. These issues are more likely to appear as contributory rather than primary causes in this set of accident reports.

Contributory Factors to Teachers' Sense of Community in Public Urban Elementary Schools

ERIC Educational Resources Information Center

Kirkhus, Debra

2011-01-01

The purpose of this study was to investigate factors that contribute to teachers' sense of community within public, urban, elementary schools. Because previous research has touted the benefits of teacher communities within schools (Kruse, 2001; Leana & Pil, 2006; Ware & Kitsantas, 2007) educational leaders are challenged with creating…

32 CFR 750.46 - Applicable law.

Code of Federal Regulations, 2012 CFR

2012-07-01

... determining liability and the effect of contributory or comparative negligence on claimant's right of recovery... effect of contributory or comparative negligence by the claimant to determine the relative merits of the claim. If there is no foreign law on contributory or comparative negligence, apply traditional rules of...

32 CFR 750.46 - Applicable law.

Code of Federal Regulations, 2014 CFR

2014-07-01

... determining liability and the effect of contributory or comparative negligence on claimant's right of recovery... effect of contributory or comparative negligence by the claimant to determine the relative merits of the claim. If there is no foreign law on contributory or comparative negligence, apply traditional rules of...

32 CFR 750.46 - Applicable law.

Code of Federal Regulations, 2013 CFR

2013-07-01

... determining liability and the effect of contributory or comparative negligence on claimant's right of recovery... effect of contributory or comparative negligence by the claimant to determine the relative merits of the claim. If there is no foreign law on contributory or comparative negligence, apply traditional rules of...

32 CFR 750.46 - Applicable law.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determining liability and the effect of contributory or comparative negligence on claimant's right of recovery... effect of contributory or comparative negligence by the claimant to determine the relative merits of the claim. If there is no foreign law on contributory or comparative negligence, apply traditional rules of...

32 CFR 750.46 - Applicable law.

Code of Federal Regulations, 2011 CFR

2011-07-01

... determining liability and the effect of contributory or comparative negligence on claimant's right of recovery... effect of contributory or comparative negligence by the claimant to determine the relative merits of the claim. If there is no foreign law on contributory or comparative negligence, apply traditional rules of...

[Chagas' disease as main cause of death in the southeastern region of Brazil: presence of contributory causes].

PubMed

Wanderley, D M; Litvoc, J

1994-02-01

Death certificates of all persons who died in in the State of S.Paulo, Brazil and which presented Chagas' disease as the principal cause of death, were studied with a view to analysing the existing additional information available as to contributory causes. After a direct reading of the 1,308 death certificates, the contributory causes were identified and registered. They were mentioned in 261 (20%) of the certificates, 185 of them presenting only one, and 75 two of them. The 6 more frequent contributory causes were: "megas", embolism, chronic pulmonary disease, infections (other than Chagas' disease), arterial hypertension and malnutrition. When analysing the presence of the contributory causes in two groups-persons of less than 50 years old, and those older than 50 a higher proportion of them was observed in the older group and a distinct profile of causes was found for each group. No statistic association was observed between contributory causes and sex or site of residence.

AIR POLLUTION, OXIDATIVE STRESS AND NEUROTOXICITY.

EPA Science Inventory

Increased incidents of classic and variant forms of neurodegenerative diseases suggest that environmental chemicals and susceptibility factors (e.g., genetics, diseased states, obesity, etc.) may be contributory. Particulate matter (PM) is a type of air pollution that is associat...

Gender Achievement and Social, Political and Economic Equality: A European Perspective

ERIC Educational Resources Information Center

Ireson, Gren

2017-01-01

Differences in gender equality based on social, political and economic factors is cited, by some writers, as a contributory factor in the differentially greater achievement of boys in STEM subjects through the concept of gender stratification. Gender differences, especially in mathematics, have been linked directly to gender parity in wider…

A study of long-term complications associated with enteral ostomy and their contributory factors.

PubMed

Jayarajah, Umesh; Samarasekara, Asuramuni M P; Samarasekera, Dharmabandhu N

2016-12-05

Complications of ostomy significantly affect the quality of life of ostomates. There is little evidence on the rate of long-term complications in ostomates, especially from the developing countries which include Sri Lanka. This study was aimed to describe the long-term complications of enteral ostomies and their contributory factors. A retrospective analysis was carried out on 192 patients who underwent ostomy creation over a period of 5 years. Data on type of complications, age, sex, type of ostomy, type of surgery and perioperative care by enteric stoma therapist were gathered. Associations were established using Chi square test and multiple logistic regression. Out of 192 patients, only 146 patients presented regularly for follow up. The mean follow up duration was 28 months (range: 3-183). Around 34.2% developed surgical long-term complications related to the ostomy. Common complications were prolapse (n = 24, 16.4%), skin excoriation (n = 22, 15.1%) and parastomal hernia (n = 14, 9.6%). Overall complication rate was significantly less in loop ostomies (p < 0.05) and defunctioning ostomies (p < 0.05). Skin excoriation was significantly high in males (p < 0.05) and in ileostomies (p < 0.001). Parastomal hernia was commoner in end ostomies (p < 0.05). Perioperative care by enteric stoma therapist reduced the overall and specific complications (p < 0.001). The overall complication rate in our cohort of patients was 34.2%. The perioperative care of a stoma therapist may be very effective in preventing complications particularly in a setting with limited resources.

Contributory Negligence. Law and the School Principal

ERIC Educational Resources Information Center

Walden, John C.

1974-01-01

One of the most frequently used legal defenses against the charge that a school employee or district has been negligent is contributory negligence. Contributory negligence means that the injured person failed to exercise the required standard of care for his own safety and, therefore, contributed to his own injury. (Author/WM)

Blacks against Korean Merchants: An Interpretation of Contributory Factors.

ERIC Educational Resources Information Center

Kim, K. Hugh

1990-01-01

Examines the 1990 boycott of Korean-owned food stores in Brooklyn by African Americans. Provides background on ethnic conflicts in America, especially those involving Asian Americans. Calls for increased racial and cultural sensitivity in communities and schools. (DM)

Improving safety of teenage and young adult drivers in Kansas.

DOT National Transportation Integrated Search

2013-12-01

Statistics show that young drivers have higher motor vehicle crash rates compared to other age groups. This study investigated : characteristics, contributory causes, and factors which increase injury severity of young driver crashes in Kansas by com...

Health insurance coverage, neonatal mortality and caesarean section deliveries: an analysis of vital registration data in Colombia.

PubMed

Houweling, Tanja A J; Arroyave, Ivan; Burdorf, Alex; Avendano, Mauricio

2017-05-01

Low-income and middle-income countries have introduced different health insurance schemes over the past decades, but whether different schemes are associated with different neonatal outcomes is yet unknown. We examined the association between the health insurance coverage scheme and neonatal mortality in Colombia. We used Colombian national vital registration data, including all live births (2 506 920) and neonatal deaths (17 712) between 2008 and 2011. We used Poisson regression models to examine the association between health insurance coverage and the neonatal mortality rate (NMR), distinguishing between women insured via the contributory scheme (40% of births, financed through payroll and employer's contributions), government subsidised insurance (47%) and the uninsured (11%). NMR was lower among babies born to mothers in the contributory scheme (6.13/1000) than in the subsidised scheme (7.69/1000) or the uninsured (8.38/1000). Controlling for socioeconomic and demographic factors, NMRs remained higher for those in the subsidised scheme (OR 1.09, 95% CI 1.05 to 1.14) and the uninsured (OR 1.16, 95% CI 1.10 to 1.23) compared to those in the contributory scheme. These differences increased in models that additionally controlled for caesarean section (C-section) delivery. This increase was due to the higher fraction of C-section deliveries among women in the contributory scheme (49%, compared to 34% for the subsidised scheme and 28% for the uninsured). Health insurance through the contributory system is associated with lower neonatal mortality than insurance through the subsidised system or lack of insurance. Universal health insurance may not be sufficient to close the gap in newborn mortality between socioeconomic groups. 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/.

Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women

PubMed Central

Menon, S.; Timms, P.; Allan, J. A.; Alexander, K.; Rombauts, L.; Horner, P.; Keltz, M.; Hocking, J.

2015-01-01

SUMMARY Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden. PMID:26310245

Individual Contributory Factors in Teacher Stress: The Role of Achievement Striving and Occupational Commitment

ERIC Educational Resources Information Center

Jepson, Emma; Forrest, Sarah

2006-01-01

Workplace stress and its impact upon retention levels are becoming an increasing concern within the teaching profession (Brown, Davis, & Johnson, 2002; Jarvis, 2002). Research has largely focused upon the effects of environmental factors, whilst noting that it is the interplay between the individual and the environment which may hold the key to…

Improving safety of teenage and young adult drivers in Kansas : [technical summary].

DOT National Transportation Integrated Search

2013-12-01

Statistics show that young drivers have higher motor vehicle crash rates compared to other age groups. This study investigated characteristics, contributory causes, and factors which increase injury severity of young driver crashes in Kansas by compa...

Low-Cost Virtual Laboratory Workbench for Electronic Engineering

ERIC Educational Resources Information Center

Achumba, Ifeyinwa E.; Azzi, Djamel; Stocker, James

2010-01-01

The laboratory component of undergraduate engineering education poses challenges in resource constrained engineering faculties. The cost, time, space and physical presence requirements of the traditional (real) laboratory approach are the contributory factors. These resource constraints may mitigate the acquisition of meaningful laboratory…

Non-contributory social transfer programs in developing countries: A new dataset and research agenda.

PubMed

Dodlova, Marina; Giolbas, Anna; Lay, Jann

2018-02-01

Social transfer programs in developing countries are designed to contribute to poverty reduction by increasing the income of the poor in order to ensure minimal living standards. In addition, social transfers provide a safety net for the vulnerable, who are typically not covered by contributory social security. The question of how effective such programs are in achieving these aims has been the subject of numerous impact evaluations. However, the optimal design of such programs is still unclear. Even less is known about whether the adoption and implementation of transfer programs is really driven by poverty and neediness or whether other factors also have an influence. To investigate these and other research questions, we have developed a new dataset entitled Non-Contributory Social Transfer Programs (NSTP) in Developing Countries. One advantage of this dataset is that it traces 186 non-contributory programs from 101 countries back in time and presents them in panel form for the period up until 2015. The second advantage is that it contains all the details regarding the various programs' designs as well as information on costs and coverage in a coded format and thus facilitates both comparative quantitative and in-depth qualitative analyses. While describing the data we discuss a number of examples of how the dataset can be used to explore different issues related to social policies in developing countries. We present suggestive evidence that the adoption of social transfer programs is not based only on pro-poor motives, but rather that social policy choices differ between political regimes.

Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors

PubMed Central

Bradford, Andrea; Kunik, Mark E.; Schulz, Paul; Williams, Susan P.; Singh, Hardeep

2009-01-01

Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion based on patient symptomsor caregivers’ concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient-, caregiver-, provider-, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and appeared to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but appears to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis. PMID:19568149

Student Suicide: Could You Be Held Liable?

ERIC Educational Resources Information Center

Taylor, Kelley R.

2001-01-01

Two legal theories inspire suicide-related lawsuits: tort claims of negligence and constitutional claims based on due process. A well-known case illustrates a middle-schooler's suicide and a district's negligence. Liability factors include duty, foreseeability, special relationship, danger creation, and immunity/contributory negligence. (MLH)

CURRENT CONCEPTS AND TREATMENT OF PATELLOFEMORAL COMPRESSIVE ISSUES.

PubMed

Mullaney, Michael J; Fukunaga, Takumi

2016-12-01

Patellofemoral disorders, commonly encountered in sports and orthopedic rehabilitation settings, may result from dysfunction in patellofemoral joint compression. Osseous and soft tissue factors, as well as the mechanical interaction of the two, contribute to increased patellofemoral compression and pain. Treatment of patellofemoral compressive issues is based on identification of contributory impairments. Use of reliable tests and measures is essential in detecting impairments in hip flexor, quadriceps, iliotibial band, hamstrings, and gastrocnemius flexibility, as well as in joint mobility, myofascial restrictions, and proximal muscle weakness. Once relevant impairments are identified, a combination of manual techniques, instrument-assisted methods, and therapeutic exercises are used to address the impairments and promote functional improvements. The purpose of this clinical commentary is to describe the clinical presentation, contributory considerations, and interventions to address patellofemoral joint compressive issues.

CURRENT CONCEPTS AND TREATMENT OF PATELLOFEMORAL COMPRESSIVE ISSUES

PubMed Central

Fukunaga, Takumi

2016-01-01

Patellofemoral disorders, commonly encountered in sports and orthopedic rehabilitation settings, may result from dysfunction in patellofemoral joint compression. Osseous and soft tissue factors, as well as the mechanical interaction of the two, contribute to increased patellofemoral compression and pain. Treatment of patellofemoral compressive issues is based on identification of contributory impairments. Use of reliable tests and measures is essential in detecting impairments in hip flexor, quadriceps, iliotibial band, hamstrings, and gastrocnemius flexibility, as well as in joint mobility, myofascial restrictions, and proximal muscle weakness. Once relevant impairments are identified, a combination of manual techniques, instrument-assisted methods, and therapeutic exercises are used to address the impairments and promote functional improvements. The purpose of this clinical commentary is to describe the clinical presentation, contributory considerations, and interventions to address patellofemoral joint compressive issues. PMID:27904792

Parental perspectives on the causes of an autism spectrum disorder in their children.

PubMed

Mercer, L; Creighton, S; Holden, J J A; Lewis, M E S

2006-02-01

Autism Spectrum Disorders (ASDs) are complex neurodevelopmental disorders with many biological causes, including genetic, syndromic and environmental. Such etiologic heterogeneity impacts considerably upon parents' needs for understanding their child's diagnosis. A descriptive survey was designed to investigate parental views on the cause(s) of ASD in their child. Among the 41 parents who replied to the questionnaire, genetic influences (90.2%), perinatal factors (68.3%), diet (51.2%), prenatal factors (43.9%) and vaccines (40.0%) were considered to be the most significant contributory factors. Parents reported inaccurately high recurrence risks, misperceptions of the contribution of various putative factors, feelings of guilt and blame regarding their child's diagnosis, as well as a lack of advocacy for genetic counseling by non-geneticist professionals. This study offers clinicians and researchers further insight into what parents believe contributed to their child's diagnosis of ASD and will help facilitate genetic counseling for these families.

Mechanisms of Hip Fracture in Owerri, Nigeria, and its Associated Variables

PubMed Central

Onwukamuche, CK; Ekezie, J; Anyanwu, GE; Nwaiwu, CO; Agu, AU

2013-01-01

Background: Hip fracture has been associated with various risk factors, including osteoporosis, excessive alcohol consumption, physical inactivity, visual impairment, aging, sex, rural/urban inhabitation, race and climatic variations. Mechanisms of hip fractures in many parts of the world have been documented, and include road traffic accident (RTA), gunshot injury, fall from heights and many others. There is paucity of such documentation in Owerri, Nigeria. Aim: This study was designed to investigate the mechanism of hip fractures in Owerri, Nigeria, and to determine its prevailing factors. Materials and Methods: The study was conducted in hospitals located in Owerri, Nigeria. Cases of hip fracture were identified from the medical register while data were sourced from the medical record department for hip fractures that occurred between 1st January 2002 and 31st December 2008 for patients resident in Owerri and aged between 10 years and above. Results: The study uncovered a total of 105 cases of hip fractures over the study period in 65% (n = 68) males and 35% (n = 37) females. Proportion of hip fractures as a result of fragility fracture mechanisms was significantly higher in females than in the males (P < 0.001), while the reverse was the case for RTA mechanisms. In the same vein, proportion of hip fractures as a result of moderate trauma mechanisms was significantly higher in the elderly than in the young patients (P < 0.001), while the reverse was the case for RTA mechanisms. Conclusion: Mechanism of hip fractures in Owerri, Nigeria, can be associated with gender and age. RTA had the largest single contributory mechanism of hip fractures in Owerri. Therefore, public health campaigns and promotions should be created to reduce the influence of RTA on hip fracture among this population. Among the elderly population, hip fracture was mostly sustained from fragility trauma mechanisms, suggesting that osteoporosis is a major contributory factor of hip fracture among this population. PMID:23919195

Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme.

PubMed

Govender, Veloshnee; Chersich, Matthew F; Harris, Bronwyn; Alaba, Olufunke; Ataguba, John E; Nxumalo, Nonhlanhla; Goudge, Jane

2013-01-24

In 2005, the South African government introduced a voluntary, subsidised health insurance scheme for civil servants. In light of the global emphasis on universal coverage, empirical evidence is needed to understand the relationship between new health financing strategies and health care access thereby improving global understanding of these issues. This study analysed coverage of the South African government health insurance scheme, the population groups with low uptake, and the individual-level factors, as well as characteristics of the scheme, that influenced enrolment. Multi-stage random sampling was used to select 1,329 civil servants from the health and education sectors in four of South Africa's nine provinces. They were interviewed to determine factors associated with enrolment in the scheme. The analysis included both descriptive statistics and multivariate logistic regression. Notwithstanding the availability of a non-contributory option within the insurance scheme and access to privately-provided primary care, a considerable portion of socio-economically vulnerable groups remained uninsured (57.7% of the lowest salary category). Non-insurance was highest among men, black African or coloured ethnic groups, less educated and lower-income employees, and those living in informal-housing. The relatively poor uptake of the contributory and non-contributory insurance options was mostly attributed to insufficient information, perceived administrative challenges of taking up membership, and payment costs. Barriers to enrolment include insufficient information, unaffordability of payments and perceived administrative complexity. Achieving universal coverage requires good physical access to service providers and appropriate benefit options within pre-payment health financing mechanisms.

Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme

PubMed Central

Govender, Veloshnee; Chersich, Matthew F.; Harris, Bronwyn; Alaba, Olufunke; Ataguba, John E.; Nxumalo, Nonhlanhla; Goudge, Jane

2013-01-01

Background In 2005, the South African government introduced a voluntary, subsidised health insurance scheme for civil servants. In light of the global emphasis on universal coverage, empirical evidence is needed to understand the relationship between new health financing strategies and health care access thereby improving global understanding of these issues. Objectives This study analysed coverage of the South African government health insurance scheme, the population groups with low uptake, and the individual-level factors, as well as characteristics of the scheme, that influenced enrolment. Methods Multi-stage random sampling was used to select 1,329 civil servants from the health and education sectors in four of South Africa's nine provinces. They were interviewed to determine factors associated with enrolment in the scheme. The analysis included both descriptive statistics and multivariate logistic regression. Results Notwithstanding the availability of a non-contributory option within the insurance scheme and access to privately-provided primary care, a considerable portion of socio-economically vulnerable groups remained uninsured (57.7% of the lowest salary category). Non-insurance was highest among men, black African or coloured ethnic groups, less educated and lower-income employees, and those living in informal-housing. The relatively poor uptake of the contributory and non-contributory insurance options was mostly attributed to insufficient information, perceived administrative challenges of taking up membership, and payment costs. Conclusion Barriers to enrolment include insufficient information, unaffordability of payments and perceived administrative complexity. Achieving universal coverage requires good physical access to service providers and appropriate benefit options within pre-payment health financing mechanisms. PMID:23364093

Nature and Causes of Locomotor Disabilities in India

ERIC Educational Resources Information Center

Halder, Santoshi; Talukdar, Arindam

2013-01-01

A large proportion of disability around the world is preventable. Levels of disability in many poor countries can be reduced by achieving the international development targets for economic, social and human development. In this paper, the author studied the different contributory and causative factors of locomotor disability, disease states and…

Cost of anaesthesia.

PubMed Central

Astley, B A; Walker, J S

1982-01-01

The major contributory factor to the cost of anesthesia today are the increases in medical salaries that have kept pace with inflation, commanding 68% of the total expenditure. The current position has been compared with that of 20 years ago. This outline could be used as a framework for departmental budgeting. PMID:6807406

Geographic Population Structure in Epstein-Barr Virus Revealed by Comparative Genomics

PubMed Central

Chiara, Matteo; Manzari, Caterina; Lionetti, Claudia; Mechelli, Rosella; Anastasiadou, Eleni; Chiara Buscarinu, Maria; Ristori, Giovanni; Salvetti, Marco; Picardi, Ernesto; D’Erchia, Anna Maria; Pesole, Graziano; Horner, David S.

2016-01-01

Epstein-Barr virus (EBV) latently infects the majority of the human population and is implicated as a causal or contributory factor in numerous diseases. We sequenced 27 complete EBV genomes from a cohort of Multiple Sclerosis (MS) patients and healthy controls from Italy, although no variants showed a statistically significant association with MS. Taking advantage of the availability of ∼130 EBV genomes with known geographical origins, we reveal a striking geographic distribution of EBV sub-populations with distinct allele frequency distributions. We discuss mechanisms that potentially explain these observations, and their implications for understanding the association of EBV with human disease. PMID:27635051

Excitatory amino acids in epilepsy and potential novel therapies.

PubMed

Meldrum, B S

1992-07-01

Evidence that an abnormality of excitatory neurotransmission may contribute to the epileptic phenomena in various animal and human syndromes is reviewed. Altered glutamate transport or metabolism may be a contributory factor in some genetic syndromes and enhanced responsiveness to activation of NMDA receptors may be significant in various acquired forms of epilepsy. Decreasing glutamatergic neurotransmission provides a rational therapeutic approach to epilepsy. Potent anticonvulsant effects are seen with the acute administration of NMDA antagonists in a wide range of animal models. Some competitive antagonists acting at the NMDA/glutamate site show prolonged anticonvulsant activity following oral administration at doses free of motor side effects and appear suitable for clinical trial.

Social support is associated with gambling treatment outcomes in pathological gamblers.

PubMed

Petry, Nancy M; Weiss, Lindsay

2009-01-01

Poor social support is a contributory factor in development of addictive disorders, but it has rarely been evaluated in pathological gamblers. This study examined social support in pathological gamblers and its relationship with treatment outcomes. Low baseline social support was associated with increased severity of gambling, family, and psychiatric problems and poorer post-treatment outcomes. Further, social support assessed post-treatment was significantly related to severity of gambling problems at the 12-month follow-up. These findings demonstrate that social support plays an important role in moderating outcomes, and enhancing social support may be an important aspect of effective gambling treatments.

Choose your menu wisely: cuisine-associated food-poisoning risks in restaurants in England and Wales.

PubMed

Gormley, F J; Rawal, N; Little, C L

2012-06-01

The food service sector continues to be the most common setting for reported foodborne disease outbreaks in England and Wales. Using restaurant-associated foodborne outbreaks reported in England and Wales from 1992 to 2009, cuisine-specific risk factors were examined. Of 677 restaurant outbreaks, there were 11 795 people affected, 491 hospitalizations, and seven deaths; and Chinese, Indian, British and Italian cuisines were the most commonly implicated (26%, 16%, 13% and 10%, respectively). Salmonella spp. accounted for most outbreaks of all cuisine types, and particularly Chinese (76%, 133/175) and Italian (55%, 38/69). Poultry meat was the most frequently implicated food vehicle in outbreaks associated with Indian (30%), Chinese (21%), and British (18%) cuisines while for Italian cuisine, desserts and cakes were more frequently implicated (33%). Rice dishes were also a common outbreak food vehicle in those restaurants serving Chinese (22%) and Indian (16%) cuisine. Cross-contamination was the biggest contributory factor associated with Chinese (46%), British (33%) and Indian (30%) cuisines whereas inadequate cooking (38%) and use of raw shell eggs in lightly cooked or uncooked food (35%) were more often associated with Italian cuisine. Over the surveillance period, the proportion of Salmonella Enteritidis PT4 outbreaks in restaurants serving Chinese cuisine significantly decreased (P<0.0001) and this was mirrored by an increase in S. Enteritidis non-PT4 outbreaks (P<0.0001). Despite this change in proportion, contributory factors such as cross-contamination have continued to cause outbreaks throughout the 18 years. The results show that by stratifying the risks associated with restaurants by cuisine type, specific evidence of food control failures can be used to target foodborne illness reduction strategies.

Family medicine residency training and burnout: a qualitative study

PubMed Central

Rutherford, Kimberly; Oda, Joanna

2014-01-01

Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

Therapeutic Misconception in Psychiatry Research: A Systematic Review.

PubMed

Thong, Ivan Sk; Foo, Meng Yee; Sum, Min Yi; Capps, Benjamin; Lee, Tih-Shih; Ho, Calvin; Sim, Kang

2016-02-29

Therapeutic misconception (TM) denotes the phenomenon in which research subjects conflate research purpose, protocols and procedures with clinical treatment. We examined the prevalence, contributory factors, clinical associations, impact, and collated solutions on TM within psychiatric research, and made suggestions going ahead. Literature search for relevant empirical research papers was conducted until February 2015. Eighty-eight reports were extracted, of which 31 were selected, summarised into different headings for discussion of implications and collated solutions of TM. We found variable and high rates of TM (ranging from 12.5% to 86%) in some psychiatry research populations. Contributory factors to TM included perceived medical roles of researchers, media, research setting and subject factors. Greater TM in affective, neurodevelopmental and psychotic spectrum conditions were associated with demographic variables (such as lower education, increased age), clinical factors (such as poor insight, cognitive deficits, increased symptoms, poorer self-rated quality of health), and social functioning (such as decreased independence). Inattention to TM may lead to frustration, negative impression and abandonment of participation in psychiatry research. Strategies such as the employment of a neutral educator during the informed consent process and education modules may be effective in addressing TM. Further research is warranted to examine the different TM facets, specific clinical correlates and more effective management strategies.

Family medicine residency training and burnout: a qualitative study.

PubMed

Rutherford, Kimberly; Oda, Joanna

2014-01-01

Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one's work is valued and rotations in family medicine. The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors.

The cost of free health care for all Kenyans: assessing the financial sustainability of contributory and non-contributory financing mechanisms.

PubMed

Okungu, Vincent; Chuma, Jane; McIntyre, Di

2017-02-27

The need to provide quality and equitable health services and protect populations from impoverishing health care costs has pushed universal health coverage (UHC) to the top of global health policy agenda. In many developing countries where the majority of the population works in the informal sector, there are critical debates over the best financing mechanisms to progress towards UHC. In Kenya, government health policy has prioritized contributory financing strategy (social health insurance) as the main financing mechanism for UHC. However, there are currently no studies that have assessed the cost of either social health insurance (SHI) as the contributory approach or an alternative financing mechanism involving non-contributory (general tax funding) approaches to UHC in Kenya. The aim of this study was to critically assess the financial requirements of both contributory and non-contributory mechanisms to financing UHC in Kenya in the context of large informal sector populations. SimIns Basic® model, Version 2.1, 2008 (WHO/GTZ), was used to assess the feasibility of UHC in Kenya and provide estimates of financial resource needs for UHC over a 17-year period (2013-2030). Data sources included review of national and international literature on inflation, demography, macro-economy, health insurance, health services unit costs and utilization rates. The data were triangulated across geographic regions for accuracy and integrity of the simulation. SimIns models for 10 years only so data from the final year of the model was used to project for another 7 years. The 17-year period was necessary because the Government of Kenya aims to achieve UHC by 2030. The results show that SHI is financially sustainable (Sustainability in this study is used to mean that expenditure does not outstrip revenue.) (revenues and expenditure match) within the first five years of implementation, but it becomes less sustainable with time. Modelling for a non-contributory scenario, on the other hand, showed greater sustainability both in the short- and long-term. The financial resource requirements for universal access to health care through general government revenue are compared with a contributory health insurance scheme approach. Although both funding options would require considerable government subsidies, given the magnitude of the informal sector in Kenya and their limited financial capacity, a tax-funded system would be less costly and more sustainable in the long-term than an insurance scheme approach. However, more innovative financing for health care as well as giving the health sector higher priority in government expenditure will be required to make the non-contributory financing mechanism more sustainable.

Improving the rates of electronic results acknowledgement at a tertiary eye care centre.

PubMed

Phua, Val; Au, Benjamin; Soh, Yu Qiang; Husain, Rahat

2017-01-01

Hundreds of thousands of tests are performed annually in hospitals worldwide. Safety Issues arise when abnormal results are not recognized promptly resulting in delayed treatment and increased morbidity and mortality. As a result Singapore's largest healthcare group, Singhealth introduced an electronic result acknowledgement system. This system was adopted by the Singapore National Eye Centre (SNEC) in February 2016. Baseline measurements show that weekly numbers of unacknowledged results ranged from 193 to 617. The current standards of electronic results acknowledgement posts a significant patient safety hazard. Root cause analysis was performed to identify contributory factors. Pareto principle was then used by the authors to identify the main contributory factors. We employed the rapid cycle improvement Plan-do-study-act (PDSA) strategy to test and evaluate implemented changes. Changes are implemented for 2 weeks and data collected prospectively. The data is analyzed the week after and the following PDSA actions are decided and instituted the following week. 3 PDSA cycles were undertaken in total. The first PDSA cycle focused on raising awareness of the problem at hand, the number of unacknowledged results drastically decreased during the 1 st week of implementation of our PDSA from 617 to 254. The second PDSA cycle targeted the lack of knowledge of doctors involved in the electronic result acknowledgement process. There was a trend downwards near the end of the cycle which continued through the week after. The third PDSA cycle targeted individual doctors and provided individual remedial training. Second line doctors were also equipped to better handle abnormal results. There was significant improvement with the number of unacknowledged abnormal results dropping to <5 a week. Multiple factors were identified to contribute to the low compliance to electronic acknowledgement of results. The role doctors play in the issue at hand was paramount and required careful handling in a professional manner with multiple reminders and emphasis on the importance of acknowledging and acting on the results.A significant improvement in the rates of acknowledgement of abnormal results was demonstrated with clear benefits to patient safety. Interventions can be replicated when implementing similar systems to other areas of healthcare.

Improving the rates of electronic results acknowledgement at a tertiary eye care centre

PubMed Central

Phua, Val; Au, Benjamin; Soh, Yu Qiang; Husain, Rahat

2017-01-01

Background Hundreds of thousands of tests are performed annually in hospitals worldwide. Safety Issues arise when abnormal results are not recognized promptly resulting in delayed treatment and increased morbidity and mortality. As a result Singapore’s largest healthcare group, Singhealth introduced an electronic result acknowledgement system. This system was adopted by the Singapore National Eye Centre (SNEC) in February 2016. Baseline measurements show that weekly numbers of unacknowledged results ranged from 193 to 617. The current standards of electronic results acknowledgement posts a significant patient safety hazard. Methods Root cause analysis was performed to identify contributory factors. Pareto principle was then used by the authors to identify the main contributory factors. We employed the rapid cycle improvement Plan-do-study-act (PDSA) strategy to test and evaluate implemented changes. Changes are implemented for 2 weeks and data collected prospectively. The data is analyzed the week after and the following PDSA actions are decided and instituted the following week. 3 PDSA cycles were undertaken in total. Results The first PDSA cycle focused on raising awareness of the problem at hand, the number of unacknowledged results drastically decreased during the 1stweek of implementation of our PDSA from 617 to 254. The second PDSA cycle targeted the lack of knowledge of doctors involved in the electronic result acknowledgement process. There was a trend downwards near the end of the cycle which continued through the week after. The third PDSA cycle targeted individual doctors and provided individual remedial training. Second line doctors were also equipped to better handle abnormal results. There was significant improvement with the number of unacknowledged abnormal results dropping to <5 a week. Conclusions Multiple factors were identified to contribute to the low compliance to electronic acknowledgement of results. The role doctors play in the issue at hand was paramount and required careful handling in a professional manner with multiple reminders and emphasis on the importance of acknowledging and acting on the results.A significant improvement in the rates of acknowledgement of abnormal results was demonstrated with clear benefits to patient safety. Interventions can be replicated when implementing similar systems to other areas of healthcare. PMID:29450290

Contributory factors and potentially avoidable neonatal encephalopathy associated with perinatal asphyxia.

PubMed

Sadler, Lynn C; Farquhar, Cynthia M; Masson, Vicki L; Battin, Malcolm R

2016-06-01

The recently published monograph, Neonatal encephalopathy and neurologic outcome, from the American College of Obstetricians and Gynecologists calls for a root cause analysis to identify components of care that contributed to cases of neonatal encephalopathy to design better practices, surveillance mechanisms, and systems. All cases of infants born in New Zealand with moderate and severe neonatal encephalopathy were reported to the New Zealand Perinatal and Maternal Mortality Review Committee from 2010. A national clinical review of these individual cases has not previously been undertaken. The objective of the study was to undertake a multidisciplinary structured review of all cases of neonatal encephalopathy that arose following the onset of labor in the absence of acute peripartum events in 2010-2011 to determine the frequency of contributory factors, the proportion of potentially avoidable morbidity and mortality and to identify themes for quality improvement. National identification of, and collection of clinical records on, cases of moderate or severe neonatal encephalopathy occurring after the onset of labor in the absence of an acute peripartum event, excluding those with normal gases and Apgar scores at 1 minute, among all cases of moderate and severe neonatal encephalopathy at term in New Zealand in 2010-2011 was undertaken. Cases were included if they had abnormal gases as defined by any of pH of ≤ 7.2, base excess of ≤ -10, or lactate of ≥ 6 or if there were no cord gases, an Apgar score at 1 minute of ≤ 7. A clinical case review was undertaken by a multidisciplinary team using a structured tool to record contributory factors (organization and/or management, personnel, and barriers to access and/or engagement with care), potentially avoidable morbidity and mortality and to identify themes to guide quality improvement. Eighty-three babies fulfilled the inclusion criteria for the review, 56 moderate (67%) and 27 severe (33%), 21 (25%) of whom were deceased prior to hospital discharge. Eighty-four percent of 64 babies with cord gas results had one of pH of ≤ 7.0, base excess of ≤ -12, or lactate of ≥ 6; and 42% (8 of 19) without cord gases had 5 minute Apgar scores < 5. Excluding 5 babies who died within a day of birth, all but 1 baby were admitted to a neonatal unit within 1 day of birth. Contributory factors were identified in 84% of 83 cases, most commonly personnel factors (76%). Fifty-five percent of cases with morbidity or mortality were considered to be potentially avoidable, and 52% of cases were considered potentially avoidable because of personnel factors. The most frequently identified theme related to the use and interpretation of cardiotocography in labor. A multidisciplinary case review of neonatal encephalopathy following apparently uncomplicated labor identified a high rate of potentially avoidable morbidity and mortality and issues amenable to quality improvement such as multidisciplinary training of staff in fetal surveillance in labor. Copyright © 2015 Elsevier Inc. All rights reserved.

Diseases of trees in the Great Plains

Treesearch

Jerry W. Riffle; Glenn W. Peterson

1986-01-01

Hosts, distribution, symptoms and signs, disease cycle, and control measures are described for 46 hardwood and 15 conifer diseases. Diseases in which abiotic agents are contributory factors also are described. Color and black-and-white illustrations that stress diagnosis and control are provided. A glossary of technical terms and indexes to hosts, pathogens, and insect...

Reflections on the "Teacher Identities in Music Education" [TIME] Project

ERIC Educational Resources Information Center

Welch, Graham F.; Purves, Ross; Hargreaves, David J.; Marshall, Nigel

2010-01-01

At the turn of the century, there was a widespread perception on the part of pupils, teachers, and policy makers that a "problem with school music" existed, particularly at the secondary level. It was hypothesized that one contributory factor was the perceived authenticity of "school music" in relation to "music outside…

Food Choice by People with Intellectual Disabilities at Day Centres: A Qualitative Study

ERIC Educational Resources Information Center

Cartwright, Luke; Reid, Marie; Hammersley, Richard; Blackburn, Chrissie; Glover, Lesley

2015-01-01

People with intellectual disabilities experience a range of health inequalities. It is important to investigate possible contributory factors that may lead to these inequalities. This qualitative study identified some difficulties for healthy eating in day centres. (1) Service users and their family carers were aware of healthy food choices but…

Investigation of work zone crash casualty patterns using association rules.

PubMed

Weng, Jinxian; Zhu, Jia-Zheng; Yan, Xuedong; Liu, Zhiyuan

2016-07-01

Investigation of the casualty crash characteristics and contributory factors is one of the high-priority issues in traffic safety analysis. In this paper, we propose a method based on association rules to analyze the characteristics and contributory factors of work zone crash casualties. A case study is conducted using the Michigan M-94/I-94/I-94BL/I-94BR work zone crash data from 2004 to 2008. The obtained association rules are divided into two parts including rules with high-lift, and rules with high-support for the further analysis. The results show that almost all the high-lift rules contain either environmental or occupant characteristics. The majority of association rules are centered on specific characteristics, such as drinking driving, the highway with more than 4 lanes, speed-limit over 40mph and not use of traffic control devices. It should be pointed out that some stronger associated rules were found in the high-support part. With the network visualization, the association rule method can provide more understandable results for investigating the patterns of work zone crash casualties. Copyright © 2016 Elsevier Ltd. All rights reserved.

A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus

PubMed Central

Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z

2014-01-01

Objectives To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. Design A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. Data sources We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Review methods Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. Results The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). Conclusions MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients’ perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. PMID:25239295

Quality of Life in Older Adults: Benefits from Caring Services in Hong Kong

ERIC Educational Resources Information Center

Cheung, Jacky Chau Kiu; Kwan, Alex Yui Huen; Chan, Sophia Siu Chee; Ngan, Raymond Man Hung; Ng, Sik Hung; Leung, Edward Man Fuk; Lau, Anna

2005-01-01

Many older adults are in need of care. Therefore, older people would generally benefit from the use of caring services, notably including home care, residential care, nursing, and medical services. The contributory factors underlying caring services tend to be a caring perspective that aspires to sustain older people's social relationships and…

A survey of Black Connecticut High School Graduates Attending Out-of State Colleges and Universities

ERIC Educational Resources Information Center

Lyons, James E.

1974-01-01

It was found that a strong desire to leave the state of Connecticut was a major force in black students attending out of state colleges and universities. Other contributory factors included the Connecticut schools lengthy admissions evaluations, the structure of some compensatory education programs, a non-competitive financial aid program and the…

Curli modulates adherence of Escherichia coli O157 to bovine recto-anal junction squamous epithelial cells

USDA-ARS?s Scientific Manuscript database

Our recent studies have shown that Intimin and the Locus of Enterocyte Effacement-encoded proteins do not play a role in Escherichia coli O157 (O157) adherence to the bovine recto-anal junction squamous epithelial cells (RSE) cells. Hence, to define factors that play a contributory role, we investi...

Analysis 320 coal mine accidents using structural equation modeling with unsafe conditions of the rules and regulations as exogenous variables.

PubMed

Zhang, Yingyu; Shao, Wei; Zhang, Mengjia; Li, Hejun; Yin, Shijiu; Xu, Yingjun

2016-07-01

Mining has been historically considered as a naturally high-risk industry worldwide. Deaths caused by coal mine accidents are more than the sum of all other accidents in China. Statistics of 320 coal mine accidents in Shandong province show that all accidents contain indicators of "unsafe conditions of the rules and regulations" with a frequency of 1590, accounting for 74.3% of the total frequency of 2140. "Unsafe behaviors of the operator" is another important contributory factor, which mainly includes "operator error" and "venturing into dangerous places." A systems analysis approach was applied by using structural equation modeling (SEM) to examine the interactions between the contributory factors of coal mine accidents. The analysis of results leads to three conclusions. (i) "Unsafe conditions of the rules and regulations," affect the "unsafe behaviors of the operator," "unsafe conditions of the equipment," and "unsafe conditions of the environment." (ii) The three influencing factors of coal mine accidents (with the frequency of effect relation in descending order) are "lack of safety education and training," "rules and regulations of safety production responsibility," and "rules and regulations of supervision and inspection." (iii) The three influenced factors (with the frequency in descending order) of coal mine accidents are "venturing into dangerous places," "poor workplace environment," and "operator error." Copyright © 2016 Elsevier Ltd. All rights reserved.

32 CFR 842.111 - Applicable law.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., discovered peril, and comparative and contributory negligence are considered. Absolute liability is never... act or omission occurs governs the effect of the claimant's comparative or contributory negligence... apportioned if local law applies comparative negligence. (3) Proceeds from private insurance policies are not...

32 CFR 842.111 - Applicable law.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., discovered peril, and comparative and contributory negligence are considered. Absolute liability is never... act or omission occurs governs the effect of the claimant's comparative or contributory negligence... apportioned if local law applies comparative negligence. (3) Proceeds from private insurance policies are not...

32 CFR 842.111 - Applicable law.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., discovered peril, and comparative and contributory negligence are considered. Absolute liability is never... act or omission occurs governs the effect of the claimant's comparative or contributory negligence... apportioned if local law applies comparative negligence. (3) Proceeds from private insurance policies are not...

32 CFR 842.111 - Applicable law.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., discovered peril, and comparative and contributory negligence are considered. Absolute liability is never... act or omission occurs governs the effect of the claimant's comparative or contributory negligence... apportioned if local law applies comparative negligence. (3) Proceeds from private insurance policies are not...

32 CFR 842.111 - Applicable law.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., discovered peril, and comparative and contributory negligence are considered. Absolute liability is never... act or omission occurs governs the effect of the claimant's comparative or contributory negligence... apportioned if local law applies comparative negligence. (3) Proceeds from private insurance policies are not...

Current medical management of endocrine-related male infertility

PubMed Central

Ring, Joshua D; Lwin, Aye A; Köhler, Tobias S

2016-01-01

Male factor contributes to 50%–60% of overall infertility but is solely responsible in only 20% of couples. Although most male factor infertility is ascertained from an abnormal semen analysis, other male factors can be contributory especially if the sample returns normal. Male infertility can be due to identifiable hormonal or anatomical etiologies that may be reversible or irreversible. This manuscript will highlight existing guidelines and our recommendations for hormone evaluation for male infertility and empiric therapies including multivitamins, estrogen receptor modulators (clomiphene), estrogen conversion blockers (anastrozole), and hormone replacement. PMID:27098657

A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.

PubMed

Al Hamid, A; Ghaleb, M; Aljadhey, H; Aslanpour, Z

2014-09-19

To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A Participatory Action Research Approach to Developing Youth-Friendly Strategies for the Prevention of Teenage Pregnancy

ERIC Educational Resources Information Center

Wood, Lesley; Hendricks, Farah

2017-01-01

Teenage pregnancy among school-going youth is a concern worldwide, but in socially-economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target…

Exploring the Individual Contributory Personality Factors of Stress: A Survey of Washington State Elementary Teachers

ERIC Educational Resources Information Center

Dean, Effie J.

2010-01-01

Prolonged stress is shown to lead to low productivity, which is one of the leading causes of poor performance, and high absenteeism/turnover in occupational fields (Norton, 2002). The field of education is a prime example of low productivity resulting from prolonged stress (Norton, 2002). Currently, there are many existing studies on environmental…

Longevity and Patau syndrome: what determines survival?

PubMed

Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

2012-12-06

The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7-10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity.

Is Mathematics to Blame? An Investigation into High School Students' Difficulty in Performing Calculations in Chemistry

ERIC Educational Resources Information Center

Scott, Fraser J.

2012-01-01

Mathematical ability is a major contributory factor to the success of a student in any science course. This paper aims to determine the source of the difficulty that students often find when performing calculations in chemistry. Through the design and analysis of a set of chemistry questions and analogous mathematics questions, set in a Standard…

Does Working Memory Training Lead to Generalized Improvements in Children with Low Working Memory? A Randomized Controlled Trial

ERIC Educational Resources Information Center

Dunning, Darren L.; Holmes, Joni; Gathercole, Susan E.

2013-01-01

Children with low working memory typically make poor educational progress, and it has been speculated that difficulties in meeting the heavy working memory demands of the classroom may be a contributory factor. Intensive working memory training has been shown to boost performance on untrained memory tasks in a variety of populations. This first…

Linguistic Diversity: A Contributory Factor to Reading Problems in Zambian Schools

ERIC Educational Resources Information Center

Tambulukani, Geofrey; Bus, Adriana G.

2012-01-01

A lack of familiarity with the language of teaching is blamed for illiteracy rates beyond 40% among people who live in nations in Africa or Asia in which dozens of languages are spoken. For a critical test of the importance of familiarity with the language in which initial reading is practiced, we took the Zambian situation as a natural experiment…

Unawareness of deficits in Huntington's disease.

PubMed

Sitek, Emilia J; Thompson, Jennifer C; Craufurd, David; Snowden, Julie S

2014-01-01

People with Huntington's disease (HD) may show reduced awareness of physical and mental changes in themselves. This article reviews the evidence for loss of awareness (anosognosia) in an attempt to elucidate its characteristics and possible underlying mechanisms. It is shown that defective awareness occurs across domains. People with HD may under-report the presence or severity of involuntary movements, under-estimate cognitive impairment and deny behavioural change. Nevertheless, awareness is not all or none. Moreover, it may be affected differentially for different symptom domains and emerge at different stages of disease, raising the possibility of distinct contributory mechanisms. Findings of an inverse relationship between insight and severity of disease suggest that cognitive impairment, in particular executive dysfunction, may be an important contributory factor. Evidence has accrued to support this argument. However, cognitive impairment cannot fully account for patients' lack of awareness of involuntary movements. Findings that patients accurately report consequences but not the experience of involuntary movements, and better acknowledge their presence when watching videotapes of themselves suggests that physiological factors play an important role. The putative role of denial as a coping mechanism is discussed. Recognition by clinicians of deficient self-awareness is crucial because of its implications for diagnosis and optimal clinical management of HD.

Sense of coherence, depression, and anger among adults with atopic dermatitis.

PubMed

Takaki, Hiroko; Ishii, Yasutomo

2013-01-01

The prevalence of atopic disease (AD) in adults has significantly increased in industrialized countries. Psychological traits and lack of skills to cope with stress could be maintaining factors of AD. The first aim of the present study was to compare sense of coherence (SOC), depression, and anger among adult patients with AD, adults with remission from AD, and adults without AD. The second aim was to explore whether depression and anger have significant impacts on SOC. A cross-sectional survey was carried out from May to September of 2007. In total, 43 adult patients with AD, 32 adults with remission from AD, and 63 adults without AD participated. A one-way analysis of variance showed that adult patients with AD have significantly higher levels of depression than adults with remission from AD and adults without AD. Furthermore, structural equation modeling indicated a significant impact of depression on SOC across the three groups, along with a significant impact of anger suppression on depression, particularly in adult patients with AD. The findings of this study suggest that psychological traits have a negative impact on skills for coping with stress, and that this relationship might be a contributory factor for maintenance of AD.

Minimizing medical litigation, Part 1.

PubMed

Harold, Tan Keng Boon

2006-01-01

The global rise in medical litigation has led to defensive medical practices and rising malpractice insurance premiums. There is a need to review all possible factors influencing litigiousness of the society and to develop strategies to control such factors. Some of the contributory causes of rising litigiousness include higher patients' expectations, poor provider-patient communication, and adversarial legalism of the society. A good combination of system, professional, and legislative strategies may keep medical litigation in check. Part 2 of this article will address the development of a dispute resolution framework.

32 CFR 564.55 - Claims not payable.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (a) Contributory negligence. Negligence or wrongful act of the claimant or of his agent or employee... or incident occurred will be followed in determining whether contributory negligence is present but the doctrine of comparative negligence will not be applied. (b) Personal injury. Claims for personal...

Type 2 diabetes and obesity in adults.

PubMed

Whitmore, Catherine

There are approximately 2.5 million people in the UK with diabetes; 85-95% of whom have type 2 diabetes. Type 2 diabetes mellitus is characterized by insulin resistance and impaired insulin secretion. As approximately 90% of people with type 2 diabetes are overweight or obese, obesity is seen as a significant contributory factor in its development. This article aims to examine some of the physiological mechanisms by which overweight and obesity contribute to the development of type 2 diabetes, and review some of the approaches to managing overweight and obesity in the person with established type 2 diabetes, including dietary management, the use of reduced carbohydrate diets on glycamic control, anti-diabetes and anti-obesity drugs both in use and in development, and bariatric surgery.

FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

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

Ronald L Boring; David I Gertman; Tuan Q Tran

2008-09-01

This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and riskmore » associated with human performance in next generation control rooms.« less

Longevity and Patau syndrome: what determines survival?

PubMed Central

Peroos, Sherina; Forsythe, Elizabeth; Pugh, Jennifer Harriet; Arthur-Farraj, Peter; Hodes, Deborah

2012-01-01

The authors report of an 8-year-old girl with non-mosaic Patau syndrome. The median life expectancy of Patau syndrome is 7–10 days, and 90% die in the first year of life. Survival is often attributed to mosaicism and the severity of associated malformations. We delineate the developing phenotype and review the literature discussing potential contributory factors to longevity. PMID:23220825

Curli temper adherence of Escherichia coli O157:H7 to squamous epithelial cells from the bovine recto-anal junction in a strain-dependent manner

USDA-ARS?s Scientific Manuscript database

Our recent studies have shown that Intimin and the Locus of Enterocyte Effacement-encoded proteins do not play a role in Escherichia coli O157 (O157) adherence to the bovine recto-anal junction squamous epithelial cells (RSE) cells. Hence, to define factors that play a contributory role, we investi...

'She'll Be Right.' Or Will She? Practitioner Perspectives on Risk Assessment for Led Outdoor Activities in Australia

ERIC Educational Resources Information Center

Dallat, Clare; Goode, Natassia; Salmon, Paul M.

2018-01-01

Inadequate risk assessment has been implicated as a contributory factor in the deaths and injuries of participants on led outdoor activity (LOA) programmes in both Australia and overseas. The identification and assessment of risks is a required component of LOA programmes, and multiple risk assessment methods and techniques are available to the…

Epidemiology of neurotrauma in Ife-Ijesha zone of Nigeria.

PubMed

Adeolu, Augustine A; Abiona, Titilayo C; Komolafe, Edward O; Adeolu, Josephine O; Adegbehingbe, Olayinka O

2013-01-01

Trauma remains one of the important causes of severe disability and high mortality. In this study, we looked at the epidemiology of neurotrauma in our region so as to highlight essential factors for trauma prevention program. This is a cross-sectional study of all neurotrauma cases admitted to the neurosurgery service of our hospital over an 18-month period. Information was obtained on patients' demographic data, etiology of injury, duration of injury, site, and cause of accident among others. One hundred forty-three patients were included in the study. The injuries occurred mostly in males and in the third decade. Most of the patients were students and traders. Eighty-one percent of the accidents were due to road traffic crash (RTC), and the most common contributory factors were head-on collision (46.2%) and overtaking (28.6%). Five of six patients who had RTC in the first decade of life were pedestrians. There were more crashes within the cities. None of the patients who had motorcycle accidents used helmet and only four patients used seatbelts at the time of the accident. Transfer to hospital was mostly in vehicles other than ambulance. Neurotrauma in our study was mostly due to RTC and it is most common in young male students. Contributory factors were head on collision and overtaking. Copyright © 2013 Elsevier Inc. All rights reserved.

7 CFR 766.202 - Determining the shared appreciation due.

Code of Federal Regulations, 2011 CFR

2011-01-01

... resulting from capital improvements added during the term of the SAA (contributory value). The market value... added to the real estate security since the execution of the SAA. (2) The appraisal must specifically... contributory value of capital improvements added during the term of the SAA will be deducted from the market...

7 CFR 766.202 - Determining the shared appreciation due.

Code of Federal Regulations, 2010 CFR

2010-01-01

... resulting from capital improvements added during the term of the SAA (contributory value). The market value... added to the real estate security since the execution of the SAA. (2) The appraisal must specifically... contributory value of capital improvements added during the term of the SAA will be deducted from the market...

7 CFR 766.202 - Determining the shared appreciation due.

Code of Federal Regulations, 2013 CFR

2013-01-01

... resulting from capital improvements added during the term of the SAA (contributory value). The market value... added to the real estate security since the execution of the SAA. (2) The appraisal must specifically... contributory value of capital improvements added during the term of the SAA will be deducted from the market...

7 CFR 766.202 - Determining the shared appreciation due.

Code of Federal Regulations, 2014 CFR

2014-01-01

... resulting from capital improvements added during the term of the SAA (contributory value). The market value... added to the real estate security since the execution of the SAA. (2) The appraisal must specifically... contributory value of capital improvements added during the term of the SAA will be deducted from the market...

7 CFR 766.202 - Determining the shared appreciation due.

Code of Federal Regulations, 2012 CFR

2012-01-01

... resulting from capital improvements added during the term of the SAA (contributory value). The market value... contributory value of capital improvements added during the term of the SAA will be deducted from the market... value added to the real property by the new or expanded portion of the original residence (if it added...

Cognitive-Behavioral Treatment of Hoarding in Youth: A Case Illustration.

PubMed

McKay, Dean

2016-11-01

Hoarding in children is associated with more severe ancillary psychopathology, and has poor treatment outcome. At present, there are no empirically established procedures for treating hoarding in youth. The present case illustration is of a 10-year old child ("Grace") who presented for treatment with significant hoarding related to academic concerns and additional unrelated symptoms of obsessive-compulsive disorder (OCD). Grace was treated with cognitive behavior therapy (CBT) primarily comprising exposure with response prevention, behavioral experiments, and cognitive therapy, along with a program of reinforcement delivered by her parents to maintain her motivation for therapy. After 23 sessions and one booster session, Grace's symptoms improved significantly, with gains maintained at 1-year follow-up. In addition to the benefits of the specific interventions chosen, the role of therapist-patient/parent alliance as a contributory factor for good outcome is emphasized. As hoarding is underinvestigated in youth, suggestions for further investigation are offered. © 2016 Wiley Periodicals, Inc.

Causes and Adverse Impact of Physician Burnout: A Systematic Review.

PubMed

Azam, Kamran; Khan, Anwar; Alam, Muhammad Toqeer

2017-08-01

To review the significant causes and effects of physician burnout in published literature. Asystematic review was conducted for searching published literature on the causes and effects of burnout in three online databases. Inclusion and exclusion criteria were developed for final selection of papers. The selected papers were critically appraised and thematic analysis was done to identify major themes related to physician burnout. Thirty-one papers were finally selected among the 2,828 identified studies. The thematic analysis revealed demographic factors, e.g. age, gender, marital status, specialty and job position; and organizational factors, e.g. workload, interpersonal demands, job insecurity and lack of resources, as significant causes of burnout. The consequences of burnout included individual and organizational effects. The individual effects of burnout included physical health problems; while organizational effects included poor job performance, low organizational commitment, and turnover intentions. Burnout is a recognized workplace hazard in the healthcare sector. The individual characteristics of physicians and working environment within hospitals are contributory factors of burnout. Therefore, proactive interventions should be taken at individual and institutional levels for preventing physician burnout by improving the personal lifestyle of physician and working environment in hospitals.

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

PubMed

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

What is an expert? A systems perspective on expertise.

PubMed

Caley, Michael Julian; O'Leary, Rebecca A; Fisher, Rebecca; Low-Choy, Samantha; Johnson, Sandra; Mengersen, Kerrie

2014-02-01

Expert knowledge is a valuable source of information with a wide range of research applications. Despite the recent advances in defining expert knowledge, little attention has been given to how to view expertise as a system of interacting contributory factors for quantifying an individual's expertise. We present a systems approach to expertise that accounts for many contributing factors and their inter-relationships and allows quantification of an individual's expertise. A Bayesian network (BN) was chosen for this purpose. For illustration, we focused on taxonomic expertise. The model structure was developed in consultation with taxonomists. The relative importance of the factors within the network was determined by a second set of taxonomists (supra-experts) who also provided validation of the model structure. Model performance was assessed by applying the model to hypothetical career states of taxonomists designed to incorporate known differences in career states for model testing. The resulting BN model consisted of 18 primary nodes feeding through one to three higher-order nodes before converging on the target node (Taxonomic Expert). There was strong consistency among node weights provided by the supra-experts for some nodes, but not others. The higher-order nodes, "Quality of work" and "Total productivity", had the greatest weights. Sensitivity analysis indicated that although some factors had stronger influence in the outer nodes of the network, there was relatively equal influence of the factors leading directly into the target node. Despite the differences in the node weights provided by our supra-experts, there was good agreement among assessments of our hypothetical experts that accurately reflected differences we had specified. This systems approach provides a way of assessing the overall level of expertise of individuals, accounting for multiple contributory factors, and their interactions. Our approach is adaptable to other situations where it is desirable to understand components of expertise.

Congenital anomalies of the inferior vena cava revealed on CT in patients with deep vein thrombosis.

PubMed

Gayer, G; Luboshitz, J; Hertz, M; Zissin, R; Thaler, M; Lubetsky, A; Bass, A; Korat, A; Apter, S

2003-03-01

We describe a possible relationship between inferior vena cava anomalies and extensive thrombosis of the inferior vena cava and the iliac and femoral veins. An anomaly of the inferior vena cava should be considered in young patients who present with deep vein thrombosis of the femoral and iliac veins. Coagulation abnormalities, frequently found in these patients, may be a contributory factor.

Double checking medicines: defence against error or contributory factor?

PubMed

Armitage, Gerry

2008-08-01

The double checking of medicines in health care is a contestable procedure. It occupies an obvious position in health care practice and is understood to be an effective defence against medication error but the process is variable and the outcomes have not been exposed to testing. This paper presents an appraisal of the process using data from part of a larger study on the contributory factors in medication errors and their reporting. Previous research studies are reviewed; data are analysed from a review of 991 drug error reports and a subsequent series of 40 in-depth interviews with health professionals in an acute hospital in northern England. The incident reports showed that errors occurred despite double checking but that action taken did not appear to investigate the checking process. Most interview participants (34) talked extensively about double checking but believed the process to be inconsistent. Four key categories were apparent: deference to authority, reduction of responsibility, automatic processing and lack of time. Solutions to the problems were also offered, which are discussed with several recommendations. Double checking medicines should be a selective and systematic procedure informed by key principles and encompassing certain behaviours. Psychological research may be instructive in reducing checking errors but the aviation industry may also have a part to play in increasing error wisdom and reducing risk.

Recognizing and managing errors of cognitive underspecification.

PubMed

Duthie, Elizabeth A

2014-03-01

James Reason describes cognitive underspecification as incomplete communication that creates a knowledge gap. Errors occur when an information mismatch occurs in bridging that gap with a resulting lack of shared mental models during the communication process. There is a paucity of studies in health care examining this cognitive error and the role it plays in patient harm. The goal of the following case analyses is to facilitate accurate recognition, identify how it contributes to patient harm, and suggest appropriate management strategies. Reason's human error theory is applied in case analyses of errors of cognitive underspecification. Sidney Dekker's theory of human incident investigation is applied to event investigation to facilitate identification of this little recognized error. Contributory factors leading to errors of cognitive underspecification include workload demands, interruptions, inexperienced practitioners, and lack of a shared mental model. Detecting errors of cognitive underspecification relies on blame-free listening and timely incident investigation. Strategies for interception include two-way interactive communication, standardization of communication processes, and technological support to ensure timely access to documented clinical information. Although errors of cognitive underspecification arise at the sharp end with the care provider, effective management is dependent upon system redesign that mitigates the latent contributory factors. Cognitive underspecification is ubiquitous whenever communication occurs. Accurate identification is essential if effective system redesign is to occur.

26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

Code of Federal Regulations, 2014 CFR

2014-04-01

... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (b)(2)(ii)(A) merely because it eliminates employee contributions for all employees with plan year...) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies either of... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

Do obesity-promoting food environments cluster around socially disadvantaged schools in Glasgow, Scotland?

PubMed

Ellaway, Anne; Macdonald, Laura; Lamb, Karen; Thornton, Lukar; Day, Peter; Pearce, Jamie

2012-11-01

Increase in the consumption of food and drinks outside the home by adolescents and young people and associations with rising levels of obesity is a significant concern worldwide and it has been suggested that the food environment around schools may be a contributory factor. As few studies have explored this issue in a UK setting, we examined whether different types of food outlets are clustered around public secondary schools in Glasgow, and whether this pattern differed by social disadvantage. We found evidence of clustering of food outlets around schools but a more complex picture in relation to deprivation was observed. Across all schools there were numerous opportunities for pupils to purchase energy dense foods locally and the implications for policy are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Taking action against violence.

PubMed

Kunz, K

1996-05-01

Significant increase in violent crimes in recent years forced Icelandic men to take action against violence. Television was seen as a major contributory factor in increasing violence. Surveys indicate that 10-15 years after television broadcasting commences in a particular society, the incidence of crime can be expected to double. While the majority of the individuals arrested for violent crimes are men, being male does not necessarily mean being violent. The Men's Committee of the Icelandic Equal Rights Council initiated a week-long information and education campaign under the theme "Men Against Violence". This campaign involved several events including an art exhibit, speeches on violence in families, treatment sought by those who are likely to resort to violence, booklet distribution among students in secondary schools, and a mass media campaign to raise public awareness on this pressing problem.

Study of Serum Levels of Leptin, C-Reactive Protein and Nutritional Status in Hemodialysis Patients.

PubMed

Montazerifar, Farzaneh; Karajibani, Mansour; Hassanpour, Zahra; Pourmofatteh, Mahla

2015-08-01

Leptin is secreted by adipose tissue and decreases appetite. However, the role of leptin in the pathogenesis of hemodialysis (HD)-related malnutrition has not been fully evaluated. The aim of study was to investigate the association between the serum leptin levels, serum C-reactive protein (CRP) levels, and nutritional status in hemodialysis patients. This analytical descriptive study included 45 hemodialysis patients and 40 healthy subjects. Biochemical parameters and serum leptin levels were measured. The nutritional status was evaluated using a food frequency questionnaire (FFQ) and the calculation of the body mass index (BMI). Serum leptin (P < 0.05) and albumin (P < 0.0001) levels and BMI (P < 0.001) of HD patients were significantly lower, while CRP levels were significantly higher than those of controls (P < 0.0001). HD patients consumed the lower daily servings of the food groups compared to the control subjects (P < 0.0001). A significant positive correlation between serum levels of leptin and albumin and BMI was demonstrated. No significant correlations were identified between leptin level, CRP level, and other variables. The findings suggest that low levels of leptin may be a contributory factor for malnutrition in HD patients. Further studies are required to ascertain the significance of leptin levels in relation to nutritional factors in hemodialysis patients.

Population density and cancer mortality by gender and age in England and Wales and the Western World 1963-93.

PubMed

Pritchard, C; Evans, B

1997-07-01

The aetiology of malignant disease is multi-factorial, including contributory environmental factors. Based upon the premise that increases in the density of population will be coterminous with a worsening of the environment, it is hypothesised that such changes should be reflected in an increase in cancer mortality in general and in elderly populations. By focusing upon changes in the elderly (+75) deaths between two time periods, the study corrects for age factors related to cancer mortality. The study tests this hypothesis via correlations between population density and malignancy death rates in general and elderly age bands over a thirty year period. It was found that there were positive and significant correlations between population density and malignancy mortality rates in the Western World, especially amongst men, but all correlations strengthened in the direction hypothesised. The findings were not an artefact of longevity, further research is required to give a better understanding of these findings.

Cations and anions in drinking water as putative contributory factors to endemic goitre in Plateau State, Nigeria.

PubMed

Das, S C; Isichei, U P; Egbuta, J O; Banwo, A I

1989-10-01

The prevalence of endemic goitre in Plateau State, Nigeria was established and an attempt was made to identify some of the possible environmental goitrogenic agents in the region to establish their likely relationship with the goitre endemicity. Iodine deficiency appears to be a major aetiological factor for the disease as indicated by low iodine levels observed in portable drinking water and in daily urinary excretion. The carbonate (CO3-) content of drinking water supply was found to bear a significant positive correlation with the goitre rate for the entire state (p less than 0.005). The calcium (Ca++) and magnesium (Mg++) levels of the drinking water also exhibited relatively good linear direct correlations with the percentage goitre distribution in a region, nearly 2/3 of the state. It is concluded that there is possibly an interplay of several factors and in particular the carbonate content of drinking water which, in association with a state of iodine deficiency, may be regarded as responsible for the goitre endemic seen in this part of the Continental Africa.

Cleft lip and palate: an adverse pregnancy outcome due to undiagnosed maternal and paternal coeliac disease.

PubMed

Arakeri, Gururaj; Arali, Veena; Brennan, Peter A

2010-07-01

Development of orofacial component involves a complex series of events. Any insult to this significant event can lead to various orofacial cleft defects. The main categories among orofacial clefts are isolated cleft palate and cleft lip with or without cleft palate. There have been many factors implicated in the development of the anomaly. The environmental factors which contribute and the genes which predispose to the condition remain obscure despite decades of research. Though it is generally agreed that folic acid deficiency is a contributory factor for non-syndromic cleft lip and palate, fewer concerns are directed towards the role for maternal/paternal nutrition in orofacial cleft origin. However, previously undescribed, here we consider the potential influence of maternal and paternal coeliac disease on the etiology of non-syndromic cleft lip and palate as an unfavorable pregnancy outcome. We postulated this relationship based on our observation, study and an empirical survey, and could be due either to (I) folic acid mal absorption (II) a genetically mediated genomic imprinting system. Copyright 2010 Elsevier Ltd. All rights reserved.

Creative contributory contests (CCC) to spur innovation in sexual health: Two cases and a guide for implementation

PubMed Central

Zhang, Ye; Kim, Julie A.; Liu, Fengying; Tso, Lai Sze; Tang, Weiming; Wei, Chongyi; Bayus, Barry L.; Tucker, Joseph D.

2015-01-01

Sexual health campaigns are often designed “top-down” by public health experts, failing to engage key populations. Using the power of crowdsourcing to shape a “bottom-up” approach, this note describes two creative contributory contests (CCC) to enhance sexual health campaigns. We provide guidance for designing CCCs to improve HIV and other STD testing. PMID:26462186

The Effect of a Complex (3-Week) Therapy on the Hip and Knee Joints in Obese Patients

ERIC Educational Resources Information Center

Tóvári, Anett; Hermann, Mária; Tóvári, Ferenc; Prisztóka, Gyöngyvér; Kránicz, János

2015-01-01

Currently, overweight and obesity are the most widespread problems in life-style having a significant impact on everyday life, and thus, conduct of life. Further contributory problems may develop in patients with weight problems: deformities of the joints and skeleton (coxarthrosis and gonarthrosis), circulatory problems and arrhythmia. Overweight…

Nutritional deficiencies in the developing world: current status and opportunities for intervention.

PubMed

Khan, Yasir; Bhutta, Zulfiqar A

2010-12-01

Several contributory factors such as poverty, lack of purchasing power, household food insecurity, and limited general knowledge about appropriate nutritional practices increase the risk of undernutrition in developing countries. The synergistic interaction between inadequate dietary intake and disease burden leads to a vicious cycle that accounts for much of the high morbidity and mortality in these countries. Three groups of underlying factors contribute to inadequate dietary intake and infectious disease: inadequate maternal and child care, household food insecurity, and poor health services in an unhealthy environment. Copyright © 2010 Elsevier Inc. All rights reserved.

Self-harm and suicide attempts in Schizophrenia.

PubMed

Jakhar, Kiran; Beniwal, Ram Pratap; Bhatia, Triptish; Deshpande, Smita N

2017-12-01

The risk of suicide among persons with schizophrenia (SZ) is higher than in general population, with multiple contributory factors. We assessed the prevalence of risk of deliberate self-harm and suicide attempts, along with associated socio-demographic and clinical factors in a group of SZ outpatients (n=61) as part of a larger study on overall schizophrenia-associated risks. To investigate factors associated with risk of deliberate self-harm and suicide among persons with schizophrenia. Out of 270 SZ participants evaluated for various risks using Ram Manohar Lohia Risk Assessment Interview (RML-RAI), 61 reported risk of self-harm including suicide attempt/s. The factors associated with this risk were further evaluated on clinical details and Diagnostic Interview for Genetic Studies. Risk of reported self-harm was 22.59%. Among them, 10% had attempted suicide at least once. Current age and past month Global Assessment of Functioning score from DIGS (GAF) were significantly correlated with suicide attempt. Attempters had significantly lower current GAF score, indicating poorer functioning. Among 27 attempters, 9 attempted at the onset of illness while 6 others attempted suicide within one year. Most common method of attempt was ingestion of insecticides or overdose of medication, followed by hanging or jumping from height. In our hospital-based sample of suicide attempters, 10% had attempted suicide, among them over 55% within first year of illness. Attempters were significantly older than non-attempters and suffered from significantly more severe illness than non-attempters. Positive symptoms were significantly associated with attempt, irrespective of time at which suicide was attempted. Copyright © 2017 Elsevier B.V. All rights reserved.

What are the minimum requirements for ketogenic diet services in resource-limited regions? Recommendations from the International League Against Epilepsy Task Force for Dietary Therapy.

PubMed

Kossoff, Eric H; Al-Macki, Nabil; Cervenka, Mackenzie C; Kim, Heung D; Liao, Jianxiang; Megaw, Katherine; Nathan, Janak K; Raimann, Ximena; Rivera, Rocio; Wiemer-Kruel, Adelheid; Williams, Emma; Zupec-Kania, Beth A

2015-09-01

Despite the increasing use of dietary therapies for children and adults with refractory epilepsy, the availability of these treatments in developing countries with limited resources remains suboptimal. One possible contributory factor may be the costs. There is often reported a significant perceived need for a large ketogenic diet team, supplements, laboratory studies, and follow-up visits to provide this treatment. The 2009 Epilepsia Consensus Statement described ideal requirements for a ketogenic diet center, but in some situations this is not feasible. As a result, the International League Against Epilepsy (ILAE) Task Force on Dietary Therapy was asked to convene and provide practical, cost-effective recommendations for new ketogenic diet centers in resource-limited regions of the world. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Fluoride in Ceylon tea and its implications to dental health.

PubMed

Chandrajith, Rohana; Abeypala, Uthpala; Dissanayake, C B; Tobschall, H J

2007-10-01

The purpose of this study was to assess the fluoride content of Ceylon Tea, which is a popular beverage throughout the world. The fluoride content of tea infusions prepared from different grades of tea leaves collected from different parts of the tea-growing regions (25 samples) of Sri Lanka was measured using a fluoride-selective electrode. Fluoride leaching was found to vary from 0.32 to 1.69 mg F/l, but there were no significant differences in terms of fluoride leaching between tea from different tea-growing regions or between tea of different grades. Dental fluorosis is widespread throughout the dry zone of Sri Lanka, and drinking water has traditionally been considered to be the main contributory factor to the development of fluorosis. However, diet, the consumption of tea in particular, may also contribute to the manifestation of dental diseases.

Male adolescent sexual offenders: exhibitionism and obscene phone calls.

PubMed

Saunders, E B; Awad, G A

1991-01-01

Clinical assessment of 19 male adolescent sexual offenders who had committed exhibitionism or telephone scatologia showed that the majority were maladjusted, had committed numerous sexual offenses and came from multi-problem families. Several of them appeared to be sexually deviant, although they did not meet DSM-III-R criteria for a diagnosis of paraphilia. Anti-social traits, sexual deviance in the family, homosexual conflicts, repressed sexuality and sexual deviance were considered to be contributory factors.

The October 2014 United States Treasury bond flash crash and the contributory effect of mini flash crashes

PubMed Central

Levine, Zachary S.; Floridi, Luciano

2017-01-01

We investigate the causal uncertainty surrounding the flash crash in the U.S. Treasury bond market on October 15, 2014, and the unresolved concern that no clear link has been identified between the start of the flash crash at 9:33 and the opening of the U.S. equity market at 9:30. We consider the contributory effect of mini flash crashes in equity markets, and find that the number of equity mini flash crashes in the three-minute window between market open and the Treasury Flash Crash was 2.6 times larger than the number experienced in any other three-minute window in the prior ten weekdays. We argue that (a) this statistically significant finding suggests that mini flash crashes in equity markets both predicted and contributed to the October 2014 U.S. Treasury Bond Flash Crash, and (b) mini-flash crashes are important phenomena with negative externalities that deserve much greater scholarly attention. PMID:29091931

Sero-epidemiological assessment of Chlamydia trachomatis infection and sub-fertility in Samoan women.

PubMed

Menon, S; Stansfield, S H; Walsh, M; Hope, E; Isaia, L; Righarts, A A; Niupulusu, T; Temese, S V A; Iosefa-Siitia, L; Auvaa, L; Tapelu, S A; Motu, M F; Suaalii-Sauni, T; Timms, P; Hill, P C; Huston, W M

2016-04-21

In our recent village-based cross-sectional study, the prevalence of nucleic acid amplification technique (NAAT) diagnosed Chlamydia trachomatis (CT) in sexually active Samoan women was very high (36 %), and test positivity was associated with sub-fertility. We conducted a serological and epidemiological analysis in these participants to identify if serological data can provide further insight into the potential contribution of CT to sub-fertility in this population. Serological prediction of CT associated sub-fertility was conducted using a series of commercial tests. The correlation between fertility or sub-fertility, behavioral factors, and serologically predicted CT associated sub-fertility was determined. A positive antibody reaction against the Chlamydia Major Outer Membrane Protein (MOMP) was significantly associated with sub-fertility, with 50 % of infertile women being positive. Serum IgG and IgA antibodies against MOMP correlated with current infection measured by urine NAAT, suggesting longer term infections are common in this population. Chlamydia pneumoniae antibodies were frequently detected in this population (84 %), and unexpectedly, were significantly associated with sub-fertility. The high prevalence of chlamydial infection and of positive chlamydial sub-fertility results suggests that CT is an important and frequent contributory factor to sub-fertility in this population.

Implementing a Contributory Scoring Approach for the "GRE"® Analytical Writing Section: A Comprehensive Empirical Investigation. Research Report. ETS RR-17-14

ERIC Educational Resources Information Center

Breyer, F. Jay; Rupp, André A.; Bridgeman, Brent

2017-01-01

In this research report, we present an empirical argument for the use of a contributory scoring approach for the 2-essay writing assessment of the analytical writing section of the "GRE"® test in which human and machine scores are combined for score creation at the task and section levels. The approach was designed to replace a currently…

Smoker Identity and Its Potential Role in Young Adults’ Smoking Behavior: A Meta-Ethnography

PubMed Central

2015-01-01

Objective: Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. Methods: A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16–34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. Results: Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals’ defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. Conclusions: Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker’s identity can play an important role in smoking cessation. PMID:25622078

Smoker identity and its potential role in young adults' smoking behavior: A meta-ethnography.

PubMed

Tombor, Ildiko; Shahab, Lion; Herbec, Aleksandra; Neale, Joanne; Michie, Susan; West, Robert

2015-10-01

Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16-34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals' defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker's identity can play an important role in smoking cessation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Corneal iron ring after conductive keratoplasty.

PubMed

Kymionis, George D; Naoumidi, Tatiana L; Aslanides, Ioannis M; Pallikaris, Ioannis G

2003-08-01

To report formation of corneal iron ring deposits after conductive keratoplasty. Observational case report. Case report. A 54-year-old woman underwent conductive keratoplasty for hyperopia. One year after conductive keratoplasty, iron ring pattern pigmentation was detected at the corneal epithelium of both eyes. This is the first report of the appearance of corneal iron ring deposits following conductive keratoplasty treatment in a patient. It is suggested that alterations in tear film stability, resulting from conductive keratoplasty-induced changes in corneal curvature, constitute the contributory factor for these deposits.

Costs of Extending the Noncontributory Pension Program for Elderly: The Mexican Case.

PubMed

Aguila, Emma; Mejia, Nelly; Perez-Arce, Francisco; Ramirez, Edgar; Rivera Illingworth, Alfonso

2016-01-01

Population aging coupled with high poverty rates among older persons and a lack of access to social-security benefits or traditional support systems have led governments in low and middle-income countries to introduce non-contributory pension programs for the elderly. This article reviews a non-contributory pension program introduced in Mexico in 2007 that has since expanded greatly. We use a variety of sources to estimate current and future costs of this program.

Binge drinking among Arab/Chaldeans: an exploratory study.

PubMed

Arfken, Cynthia L; Owens, Darlene; Said, Manal

2012-01-01

Focus groups were conducted with young Arab/Chaldeans (N = 82) from different ethno-religious groups (Chaldeans, Orthodox Christians, and Muslims) to explore the potential risk and the protective factors associated with the high level of binge (or episodic heavy) drinking among Arab/Chaldeans reported by general population surveys. Most of the participants were aware of and knowledgeable about the problem in their community. Themes identified as contributory factors consistent across ethno-religious groups included the availability of alcohol, the importance of family, conformity to group behavior, and social reasons. Differences included the context for drinking and gender roles. These findings can be used to tailor culturally appropriate interventions.

Hispanic Americans living in the United States and their risk for obesity, diabetes and kidney disease: Genetic and environmental considerations.

PubMed

Yracheta, Joseph M; Alfonso, Javier; Lanaspa, Miguel A; Roncal-Jimenez, Carlos; Johnson, Sarah B; Sánchez-Lozada, Laura G; Johnson, Richard J

2015-06-01

The Hispanic American, the largest minority population in the United States, is at increased risk for obesity, diabetes and end-stage renal disease. Here we review genetic and environmental factors that might account for their increased risk for these conditions. Whereas many environmental and genetic factors have important roles in driving the increased risk for obesity and kidney disease in this population, a case is made that excessive intake of sugary beverages is a contributory cause. Studies focusing on decreasing intake of sugary beverages among the Hispanic American could potentially reduce renal and cardiovascular complications in this population.

Reward sensitivity deficits modulated by dopamine are associated with apathy in Parkinson’s disease

PubMed Central

Manohar, Sanjay; Ben Yehuda, Michael; Chong, Trevor T.-J.; Tofaris, George; Lennox, Graham; Bogdanovic, Marko; Hu, Michele; Husain, Masud

2016-01-01

Abstract Apathy is a debilitating and under-recognized condition that has a significant impact in many neurodegenerative disorders. In Parkinson’s disease, it is now known to contribute to worse outcomes and a reduced quality of life for patients and carers, adding to health costs and extending disease burden. However, despite its clinical importance, there remains limited understanding of mechanisms underlying apathy. Here we investigated if insensitivity to reward might be a contributory factor and examined how this relates to severity of clinical symptoms. To do this we created novel ocular measures that indexed motivation level using pupillary and saccadic response to monetary incentives, allowing reward sensitivity to be evaluated objectively. This approach was tested in 40 patients with Parkinson’s disease, 31 elderly age-matched control participants and 20 young healthy volunteers. Thirty patients were examined ON and OFF their dopaminergic medication in two counterbalanced sessions, so that the effect of dopamine on reward sensitivity could be assessed. Pupillary dilation to increasing levels of monetary reward on offer provided quantifiable metrics of motivation in healthy subjects as well as patients. Moreover, pupillary reward sensitivity declined with age. In Parkinson’s disease, reduced pupillary modulation by incentives was predictive of apathy severity, and independent of motor impairment and autonomic dysfunction as assessed using overnight heart rate variability measures. Reward sensitivity was further modulated by dopaminergic state, with blunted sensitivity when patients were OFF dopaminergic drugs, both in pupillary response and saccadic peak velocity response to reward. These findings suggest that reward insensitivity may be a contributory mechanism to apathy and provide potential new clinical measures for improved diagnosis and monitoring of apathy. 10.1093/brain/aww188_video_abstractaww188_video_abstract PMID:27452600

Antidiabetic effect of Scoparia dulcis: effect on lipid peroxidation in streptozotocin diabetes.

PubMed

Pari, L; Latha, M

2005-03-01

Oxidative damage has been suggested to be a contributory factor in the development and complications of diabetes. The antioxidant effect of an aqueous extract of Scoparia dulcis, an indigenous plant used in Ayurvedic medicine in India was studied in rats with streptozotocin-induced diabetes. Oral administration of Scoparia dulcis plant extract (SPEt) (200 mg/kg body weight) for 3 weeks resulted in a significant reduction in blood glucose and an increase in plasma insulin. The aqueous extract also resulted in decreased free radical formation in tissues (liver and kidney) studied. The decrease in thiobarbituric acid reactive substances (TBARS) and hydroperoxides (HPX) and increase in the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH) and glutathione-S-transferase (GST) clearly show the antioxidant properties of SPEt in addition to its antidiabetic effect. The effect of SPEt at 200 mg/kg body weight was better than glibenclamide, a reference drug.

Water-contact patterns in relation to Schistosoma haematobium infection

PubMed Central

Dalton, P. R.; Pole, D.

1978-01-01

Water-contact observations were carried out on a population exposed to Schistosoma haematobium in a village situated on a man-made lake, Lake Volta, Ghana. The observations were made over a period of 12 months prior to the introduction of control measures. A multiple regression analysis was performed on the results of observations on 132 individuals, with egg output as the dependent variable and various types of water-contact activity, as well as age and sex, as independent variables. In the analysis, specific activities, notably water-contact for domestic purposes and activities associated with fishermen's canoes, were found to be significantly related to schistosomiasis. Age was less important than degree of exposure as a contributory factor to variations in infection rates: the reduced intensity of infection of S. haematobium in the older age groups could be mainly due to a lower level of exposure to the cercarial population. PMID:308406

Lack of effect of laboratory-provoked anxiety on plasma homovanillic acid concentration in normal subjects.

PubMed

Zemishlany, Z; Davidson, M

1996-08-15

The present study was undertaken to investigate if acute anxiety can affect plasma concentrations of homovanillic acid (pHVA). Since elevated pHVA levels have been associated with severity of schizophrenic symptoms, the results of this study will help determine if the pHVA elevations are directly related to psychosis or if anxiety is also a contributory factor. Anxiety was provoked in 10 young normal subjects by a combined paradigm of mental arithmetic task and threat of electrical shock. A significant increase in self-ratings of anxiety, blood pressure, and plasma levels of norepinephrine, 3-methoxy-4-hydroxyphenylethyleneglycol and growth hormone indicated that the paradigm used was effective in provoking anxiety; however, anxiety did not affect pHVA concentrations. The results may support the notion that increased pHVA levels in severely ill schizophrenic patients are related to the schizophrenic pathophysiology rather than to anxiety.

An evaluation of treatment strategies for head and neck cancer in an African American population.

PubMed

Ignacio, D N; Griffin, J J; Daniel, M G; Serlemitsos-Day, M T; Lombardo, F A; Alleyne, T A

2013-07-01

This study evaluated treatment strategies for head and neck cancers in a predominantly African American population. Data were collected utilizing medical records and the tumour registry at the Howard University Hospital. Kaplan-Meier method was used for survival analysis and Cox proportional hazards regression analysis predicted the hazard of death. Analysis revealed that the main treatment strategy was radiation combined with platinum for all stages except stage I. Cetuximab was employed in only 1% of cases. Kaplan-Meier analysis revealed stage II patients had poorer outcome than stage IV while Cox proportional hazard regression analysis (p = 0.4662) showed that stage I had a significantly lower hazard of death than stage IV (HR = 0.314; p = 0.0272). Contributory factors included tobacco and alcohol but body mass index (BMI) was inversely related to hazard of death. There was no difference in survival using any treatment modality for African Americans.

Anaesthesia in underdeveloped world: Present scenario and future challenges

PubMed Central

Bharati, Sachidanand Jee; Chowdhury, Tumul; Gupta, Nishkarsh; Schaller, Bernhard; Cappellani, Ronald B; Maguire, Doug

2014-01-01

The overall mortality and morbidity in underdeveloped countries are still unchanged and preventable risks factors constitute the main burden. Among these, anaesthesia-related mortality is largely preventable. Various contributory factors related to human resources, technical resources, education/teaching system and other utilities needs further attention in poor income group countries. Therefore, we have made an attempt to address all these issues in this educational article and have given special reference to those factors that might gain importance in (near) future. Proper understanding of anaesthesia-related resources, their overall impact on health care system and their improvisation methods should be thoroughly evaluated for providing safer anaesthesia care in these countries which would certainly direct better outcome and consequently influence mortality. PMID:24970961

Prevalence of frailty and contributory factors in three Chinese populations with different socioeconomic and healthcare characteristics.

PubMed

Woo, Jean; Zheng, Zheng; Leung, Jason; Chan, Piu

2015-12-09

Frailty predicts dependence and mortality, and is an important health indicator for aging populations. Comparing frailty prevalence between populations of the same ethnicity but different socioeconomic, lifestyle, health and social care systems, and environmental characteristics would address the role of these factors in contributing to frailty. We compare frailty prevalence and contributory factors across three Chinese populations: Beijing rural, Beijing urban, and Hong Kong (urban). Older people aged 65 years and above living in the community were invited to respond to a general health questionnaire covering demographic, socioeconomic, medical and drug histories, geriatric syndromes, assessment of physical and cognitive functioning, psychological wellbeing and nutritional status. Frailty is defined as an index calculated from multiple deficits > = 0.25 (FI). The ratio of FI/life expectancy at birth was used as an indicator of compression of morbidity. Risk factors and attributable fraction for frailty were compared across the three cohorts. The prevalence of frailty increases with age in all three cohorts, and was lower among rural compared with urban (Beijing and Hong Kong) populations. The highest FI/LE ratio was observed in the Beijing urban population, followed by Hong Kong, with the Beijing rural population having the lowest ratio. Risk factors for frailty were similar in all three populations. Those having the highest ORs were multi-morbidity (number of diseases > = 3), polypharmacy (number of drugs > = 4), age 85+, female gender, followed by low education level, and physical inactivity. For all three cohorts, age and multi-morbidity constitute the highest attributable fraction, and were highest in the Beijing rural cohort. A major difference between the Beijing and Hong Kong cohorts is the high AF from polypharmacy in Beijing and the 'protective' contribution of being married; and the effect of being a teetotaler in the Hong Kong cohort. This comparison draws attention to the importance of frailty prevention for ageing populations.

Human Factors Evaluation of Surgeons' Working Positions for Gynecologic Minimal Access Surgery.

PubMed

Hignett, Sue; Gyi, Diane; Calkins, Lisa; Jones, Laura; Moss, Esther

To investigate work-related musculoskeletal disorders (WRMSD) in gynaecological minimal access surgery (MAS), including bariatric (plus size) patients DESIGN: Mixed methods (Canadian Task Force classification III). Teaching hospital in the United Kingdom. Survey, observations (anthropometry, postural analysis), and interviews. Work-related musculoskeletal disorders (WRMSDs) were present in 63% of the survey respondents (n = 67). The pilot study (n = 11) identified contributory factors, including workplace layout, equipment design, and preference of port use (relative to patient size). Statistically significant differences for WRMSD-related posture risks were found within groups (average-size mannequin and plus-size mannequin) but not between patient size groups, suggesting that port preference may be driven by surgeon preference (and experience) rather than by patient size. Some of the challenges identified in this project need new engineering solutions to allow flexibility to support surgeon choice of operating approach (open, laparoscopic or robotic) with a workplace that supports adaptation to the task, the surgeon, and the patient. Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

Corneal ulceration following measles in Nigerian children.

PubMed Central

Sandford-Smith, J H; Whittle, H C

1979-01-01

Acute corneal ulceration in malnourished children is the commonest cause of childhood blindness in Northern Nigeria and usually develops after measles. Other severe diseases in malnourished children rarely precipitate corneal ulceration. A survey in a school for blind children showed that 69% of the children were blind from corneal disease, and a survey of children with corneal scars showed that at least 42% were caused by ulceration after measles. The clinical appearance of the active ulcers was very varied. The serum retinol-binding protein and prealbumin levels in children with corneal ulcers following measles were below normal, but a group of malnourished children without eye complaints following measles were found to have even lower levels. Thus a specific deficiency of vitamin A does not appear to be the primary cause of these ulcers, though it may be a contributory one. A specific measles keratitis and secondary herpes simplex infectious may be local factors contributing to this ulceration, and there is nearly always a background of protein calorie malnutrition. Racial factors may also be of some significance. PMID:508686

Case-related factors affecting cutting errors of the proximal tibia in total knee arthroplasty assessed by computer navigation.

PubMed

Tsukeoka, Tadashi; Tsuneizumi, Yoshikazu; Yoshino, Kensuke; Suzuki, Mashiko

2018-05-01

The aim of this study was to determine factors that contribute to bone cutting errors of conventional instrumentation for tibial resection in total knee arthroplasty (TKA) as assessed by an image-free navigation system. The hypothesis is that preoperative varus alignment is a significant contributory factor to tibial bone cutting errors. This was a prospective study of a consecutive series of 72 TKAs. The amount of the tibial first-cut errors with reference to the planned cutting plane in both coronal and sagittal planes was measured by an image-free computer navigation system. Multiple regression models were developed with the amount of tibial cutting error in the coronal and sagittal planes as dependent variables and sex, age, disease, height, body mass index, preoperative alignment, patellar height (Insall-Salvati ratio) and preoperative flexion angle as independent variables. Multiple regression analysis showed that sex (male gender) (R = 0.25 p = 0.047) and preoperative varus alignment (R = 0.42, p = 0.001) were positively associated with varus tibial cutting errors in the coronal plane. In the sagittal plane, none of the independent variables was significant. When performing TKA in varus deformity, careful confirmation of the bone cutting surface should be performed to avoid varus alignment. The results of this study suggest technical considerations that can help a surgeon achieve more accurate component placement. IV.

Preventable mix-ups of tuberculin and vaccines: reports to the US Vaccine and Drug Safety Reporting Systems.

PubMed

Chang, Soju; Pool, Vitali; O'Connell, Kathryn; Polder, Jacquelyn A; Iskander, John; Sweeney, Colleen; Ball, Robert; Braun, M Miles

2008-01-01

Errors involving the mix-up of tuberculin purified protein derivative (PPD) and vaccines leading to adverse reactions and unnecessary medical management have been reported previously. To determine the frequency of PPD-vaccine mix-ups reported to the US Vaccine Adverse Event Reporting System (VAERS) and the Adverse Event Reporting System (AERS), characterize adverse events and clusters involving mix-ups and describe reported contributory factors. We reviewed AERS reports from 1969 to 2005 and VAERS reports from 1990 to 2005. We defined a mix-up error event as an incident in which a single patient or a cluster of patients inadvertently received vaccine instead of a PPD product or received a PPD product instead of vaccine. We defined a cluster as inadvertent administration of PPD or vaccine products to more than one patient in the same facility within 1 month. Of 115 mix-up events identified, 101 involved inadvertent administration of vaccines instead of PPD. Product confusion involved PPD and multiple vaccines. The annual number of reported mix-ups increased from an average of one event per year in the early 1990s to an average of ten events per year in the early part of this decade. More than 240 adults and children were affected and the majority reported local injection site reactions. Four individuals were hospitalized (all recovered) after receiving the wrong products. Several patients were inappropriately started on tuberculosis prophylaxis as a result of a vaccine local reaction being interpreted as a positive tuberculin skin test. Reported potential contributory factors involved both system factors (e.g. similar packaging) and human errors (e.g. failure to read label before product administration). To prevent PPD-vaccine mix-ups, proper storage, handling and administration of vaccine and PPD products is necessary.

Inhibiting LDL glycation ameliorates increased cholesteryl ester synthesis in macrophages and hypercholesterolemia and aortic lipid peroxidation in streptozotocin diabetic rats

PubMed Central

Cohen, Margo P.; Shea, Elizabeth A.; Wu, Van-Yu

2009-01-01

Increased nonenzymatic glycation of apoB-containing lipoproteins impairs uptake and metabolism by the high affinity low density lipoprotein (LDL) receptor, and is one of the post-secretory modifications contributory to accelerated atherosclerosis in diabetes. The present study evaluated in vitro and in vivo effects of 2,2-chlorophenylaminophenylacetate (CAP22) to probe the influence of glycated lipoprotein on cholesterol homeostasis. This compound prevented the increased formation of glycated products in LDL incubated with 200 mM glucose and the increased cholesteryl ester synthesis in THP-1 macrophages induced by apoB-containing lipoproteins preincubated with high glucose concentration. The elevated circulating concentrations of glycated lipoprotein and cholesterol and higher vascular levels of lipid peroxidation products observed in streptozotocin diabetic rats compared to nondiabetic controls were significantly reduced in diabetic animals treated for six months with test compound. These results are the first to demonstrate that inhibiting nonenzymatic glycation of apoB-containing lipoproteins ameliorates abnormalities contributory to hypercholesterolemia and atherogenic risk in diabetes. PMID:19922964

Assortative mating and mutation diffusion in spatial evolutionary systems

NASA Astrophysics Data System (ADS)

Paley, C. J.; Taraskin, S. N.; Elliott, S. R.

2010-04-01

The influence of spatial structure on the equilibrium properties of a sexual population model defined on networks is studied numerically. Using a small-world-like topology of the networks as an investigative tool, the contributions to the fitness of assortative mating and of global mutant spread properties are considered. Simple measures of nearest-neighbor correlations and speed of spread of mutants through the system have been used to confirm that both of these dynamics are important contributory factors to the fitness. It is found that assortative mating increases the fitness of populations. Quick global spread of favorable mutations is shown to be a key factor increasing the equilibrium fitness of populations.

Urban squatting and migration in Peninsular Malaysia.

PubMed

Johnstone, M

1983-01-01

"This article examines some of the links between the phenomena of urban migration and squatter settlements in the Third World city. This will be done by demonstrating that both are outcomes of fundamental social and political forces that have operated on these societies. Migration and squatting are placed in a context of the historical processes that led to the uneven development of Malaysia. The article offers some explanation for the origin of the inequalities observed in spatial structures--in this case urban housing--by focusing on one of the contributory factors, namely migration." excerpt

Effects of food marketing to kids: I'm lovin' it?

PubMed

Salinsky, Eileen

2006-08-15

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children;discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

Participation restrictions in ambulatory amyotrophic lateral sclerosis patients: Physical and psychological factors.

PubMed

Van Groenestijn, Annerieke C; Schröder, Carin D; Kruitwagen-Van Reenen, Esther T; Van Den Berg, Leonard H; Visser-Meily, Johanna M A

2017-11-01

The aim of this study was to assess the prevalence of participation restrictions in ambulatory patients with amyotrophic lateral sclerosis (ALS) and to identify physical and psychological contributory factors. In this cross-sectional study, self-reported participation restrictions of 72 ambulatory ALS patients were assessed using the social health status dimension (SIPSOC) of the Sickness Impact Profile (SIP-68). Associations between SIPSOC and physical functioning, psychological factors, and demographic factors were analyzed using hierarchical regression analyses. Ninety-two percent of the patients reported participation restrictions; 54.9% could be explained by physical functioning; psychological factors accounted for 8.1% of the variance. Lung capacity, functional mobility, fatigue, and helplessness were independently associated with participation restrictions. Ambulatory ALS patients have participation restrictions, which may be influenced if early ALS care is directed toward lung capacity, functional mobility, fatigue, and feelings of helplessness. Muscle Nerve 56: 912-918, 2017. © 2017 Wiley Periodicals, Inc.

Analysis of the Factors Contributing to Vertebral Compression Fractures After Spine Stereotactic Radiosurgery

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

Boyce-Fappiano, David; Elibe, Erinma; Schultz, Lonni

Purpose: To determine our institutional vertebral compression fracture (VCF) rate after spine stereotactic radiosurgery (SRS) and determine contributory factors. Methods and Materials: Retrospective analysis from 2001 to 2013 at a single institution was performed. With institutional review board approval, electronic medical records of 1905 vertebral bodies from 791 patients who were treated with SRS for the management of primary or metastatic spinal lesions were reviewed. A total of 448 patients (1070 vertebral bodies) with adequate follow-up imaging studies available were analyzed. Doses ranging from 10 Gy in 1 fraction to 60 Gy in 5 fractions were delivered. Computed tomography and magnetic resonancemore » imaging were used to evaluate the primary endpoints of this study: development of a new VCF, progression of an existing VCF, and requirement of stabilization surgery after SRS. Results: A total of 127 VCFs (11.9%; 95% confidence interval [CI] 9.5%-14.2%) in 97 patients were potentially SRS induced: 46 (36%) were de novo, 44 (35%) VCFs progressed, and 37 (29%) required stabilization surgery after SRS. Our rate for radiologic VCF development/progression (excluding patients who underwent surgery) was 8.4%. Upon further exclusion of patients with hematologic malignancies the VCF rate was 7.6%. In the univariate analyses, females (hazard ratio [HR] 1.54, 95% CI 1.01-2.33, P=.04), prior VCF (HR 1.99, 95% CI 1.30-3.06, P=.001), primary hematologic malignancies (HR 2.68, 95% CI 1.68-4.28, P<.001), thoracic spine lesions (HR 1.46, 95% CI 1.02-2.10, P=.02), and lytic lesions had a significantly increased risk for VCF after SRS. On multivariate analyses, prior VCF and lesion type remained contributory. Conclusions: Single-fraction SRS doses of 16 to 18 Gy to the spine seem to be associated with a low rate of VCFs. To the best of our knowledge, this is the largest reported experience analyzing SRS-induced VCFs, with one of the lowest event rates reported.« less

Is increased antidepressant exposure a contributory factor to the obesity pandemic?

PubMed Central

Lee, S H; Paz-Filho, G; Mastronardi, C; Licinio, J; Wong, M-L

2016-01-01

Major depressive disorder (MDD) and obesity are both common heterogeneous disorders with complex aetiology, with a major impact on public health. Antidepressant prescribing has risen nearly 400% since 1988, according to data from the Centers for Disease Control and Prevention (CDC). In parallel, adult obesity rates have doubled since 1980, from 15 to 30 percent, while childhood obesity rates have more than tripled. Rising obesity rates have significant health consequences, contributing to increased rates of more than thirty serious diseases. Despite the concomitant rise of antidepressant use and of the obesity rates in Western societies, the association between the two, as well as the mechanisms underlying antidepressant-induced weight gain, remain under explored. In this review, we highlight the complex relationship between antidepressant use, MDD and weight gain. Clinical findings have suggested that obesity may increase the risk of developing MDD, and vice versa. Hypothalamic–pituitary–adrenal (HPA) axis activation occurs in the state of stress; concurrently, the HPA axis is also dysregulated in obesity and metabolic syndrome, making it the most well-understood shared common pathophysiological pathway with MDD. Numerous studies have investigated the effects of different classes of antidepressants on body weight. Previous clinical studies suggest that the tricyclics amitriptyline, nortriptyline and imipramine, and the serotonin norepinephrine reuptake inhibitor mirtazapine are associated with weight gain. Despite the fact that selective serotonin reuptake inhibitor (SSRI) use has been associated with weight loss during acute treatment, a number of studies have shown that SSRIs may be associated with long-term risk of weight gain; however, because of high variability and multiple confounds in clinical studies, the long-term effect of SSRI treatment and SSRI exposure on body weight remains unclear. A recently developed animal paradigm shows that the combination of stress and antidepressants followed by long-term high-fat diet results, long after discontinuation of antidepressant treatment, in markedly increased weight, in excess of what is caused by high-fat diet alone. On the basis of existing epidemiological, clinical and preclinical data, we have generated the testable hypothesis that escalating use of antidepressants, resulting in high rates of antidepressant exposure, might be a contributory factor to the obesity epidemic. PMID:26978741

Diagnosis of Asymptomatic Bacteriuria and Associated Risk Factors Among Pregnant Women in Mangalore, Karnataka, India

PubMed Central

Baby, Neha Maria; Kuruvilla, Thomas .S.; Machado, Santhosh

2014-01-01

Background: Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload. Aim: To determine the prevalence of AB among pregnant women in a tertiary care set-up and analyse the contributory risk factors, its effects on pregnancy and the role of chromogenic media in the laboratory diagnosis of these cases. Materials and Methods: Urine samples of all pregnant women attending pre-natal check-ups with no genitourinary complaints, history of fever or antibiotic intake were collected for Gram stain, culture and antibiotic sensitivity tests. A second urine specimen for culture and sensitivity testing was obtained from those with significant bacteriuria. The results were compared with patients showing negative urine cultures. Results: The overall prevalence of this clinical condition in our study was 13.2%. The significant isolates were Klebsiella pneumonia and E.coli and the most common risk factor was a previous history of urinary tract infection. The isolates were easily identified by using chromogenic agar ( HiCrome ) but colonies of uncommon pathogens like Acinetobacter and Streptococcus species appeared white and needed further identification. Conclusion: Screening of pregnant women for AB at first prenatal checkup helps analyse the associated factors and prevents its effects on pregnancy. The use of a chromogenic media can enhance reporting accuracy and will be an effective tool to monitor these cases routinely. PMID:25386490

Diagnosis of asymptomatic bacteriuria and associated risk factors among pregnant women in mangalore, karnataka, India.

PubMed

Rajaratnam, Annie; Baby, Neha Maria; Kuruvilla, Thomas S; Machado, Santhosh

2014-09-01

Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload. To determine the prevalence of AB among pregnant women in a tertiary care set-up and analyse the contributory risk factors, its effects on pregnancy and the role of chromogenic media in the laboratory diagnosis of these cases. Urine samples of all pregnant women attending pre-natal check-ups with no genitourinary complaints, history of fever or antibiotic intake were collected for Gram stain, culture and antibiotic sensitivity tests. A second urine specimen for culture and sensitivity testing was obtained from those with significant bacteriuria. The results were compared with patients showing negative urine cultures. The overall prevalence of this clinical condition in our study was 13.2%. The significant isolates were Klebsiella pneumonia and E.coli and the most common risk factor was a previous history of urinary tract infection. The isolates were easily identified by using chromogenic agar ( HiCrome ) but colonies of uncommon pathogens like Acinetobacter and Streptococcus species appeared white and needed further identification. Screening of pregnant women for AB at first prenatal checkup helps analyse the associated factors and prevents its effects on pregnancy. The use of a chromogenic media can enhance reporting accuracy and will be an effective tool to monitor these cases routinely.

Suicide burden and prevention in Nepal: The need for a national strategy.

PubMed

Marahatta, Kedar; Samuel, Reuben; Sharma, Pawan; Dixit, Lonim; Shrestha, Bhola Ram

2017-04-01

Suicide is a major cause of deaths worldwide and is a key public health concern in Nepal. Although routine national data are not collected in Nepal, the available evidence suggests that suicide rates are relatively high, notably for women. In addition, civil conflict and the 2015 earthquake have had significant contributory effects. A range of factors both facilitate suicide attempts and hinder those affected from seeking help, such as the ready availability of toxic pesticides and the widespread, although erroneous, belief that suicide is illegal. Various interventions have been undertaken at different levels in prevention and rehabilitation but a specific long-term national strategy for suicide prevention is lacking. Hence, to address this significant public health problem, a multisectoral platform of stakeholders needs to be established under government leadership, to design and implement innovative and country-contextualized policies and programmes. A bottom-up approach, with active and participatory community engagement from the start of the policy- and strategy-formulation stage, through to the design and implementation of interventions, could potentially build grass-roots public ownership, reduce stigma and ensure a scaleable and sustainable response.

Enhanced tenogenic differentiation and tendon-like tissue formation by CHIP overexpression in tendon-derived stem cells.

PubMed

Han, Weifeng; Chen, Lei; Liu, Junpeng; Guo, Ai

2017-04-01

The carboxyl terminus of Hsc70-interacting protein (CHIP, also known as STUB1) plays critical roles in the proliferation and differentiation of many types of cells. The potential function of CHIP in tendon-derived stem cells (TDSCs) remains largely unknown at present. Here, we investigated the effects of CHIP on tenogenic differentiation of TDSCs via lentivirus-mediated overexpression. Forced expression of CHIP induced morphological changes and significantly enhanced cell proliferation, as well as tendon differentiation in vitro. Upon stimulation with differentiation induction medium, CHIP-overexpressing TDSCs displayed significant inhibition of differentiation into osteogenic and adipogenic lineages. Subsequent implantation of TDSCs overexpressing CHIP with collagen sponges into nude mice induced a marked increase in ectopic tendon formation in vivo, compared with the control group. Our findings collectively suggest that CHIP is an important contributory factor to tenogenic tissue formation. © The Author 2017. Published by Oxford University Press on behalf of the Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A case study analysis to examine motorcycle crashes in Bogota, Colombia.

PubMed

Jimenez, Adriana; Bocarejo, Juan Pablo; Zarama, Roberto; Yerpez, Joël

2015-02-01

Contributory factors to motorcycle crashes vary among populations depending on several aspects such as the users' profiles, the composition and density of traffic, and the infrastructure features. A better understanding of local motorcycle crashes can be reached in those places where a comprehensive analysis is performed. This paper presents the results obtained from a case study analysis of 400 police records of accidents involving motorcycles in Bogota. To achieve a deeper level of understanding of how these accidents occur, we propose a systemic approach that uses available crash data. The methodology is inspired by accident prototypical scenarios, a tool for analysis developed in France. When grouping cases we identified three categories: solo motorcycle accidents, motorcyclist and pedestrian accidents, and accidents involving a motorcycle and another vehicle. Within these categories we undertook in-depth analyses of 32 groups of accidents obtaining valuable information to better comprehend motorcyclists' road crashes in a local context. Recurrent contributory factors in the groups of accidents include: inexperienced motorcyclists, wide urban roads that incite speeding and risky overtaking maneuvers, flowing urban roads that encourage high speed and increased interaction between vehicles, and lack of infrastructure maintenance. The results obtained are a valuable asset to define measures that will be conveniently adapted to the group of accident on which we want to act. The methodology exposed in this paper is applicable to the study of road crashes that involve all types of actors, not only the motorcyclists, and in contexts different than those presented in Bogota. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

Diminished disease progression rate in a chronic kidney disease population following the replacement of dietary water source with quality drinking water: A pilot study.

PubMed

Siriwardhana, Edirisinghe Arachchige Ranga Iroshanie Edirisinghe; Perera, Ponnamperuma Aratchige Jayasumana; Sivakanesan, Ramiah; Abeysekara, Tilak; Nugegoda, Danaseela Bandara; Weerakoon, Kosala; Siriwardhana, Dunusingha Asitha Surandika

2018-05-01

Environmental toxin/s is alleged to be the contributory factor for the chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka. The potential of drinking water as a medium for the nephrotoxic agents in the affected subjects has been comprehensively discoursed in the recent past. The present study was aimed to assess the effect of replacing the habitual drinking water on the kidney function of CKDu patients residing in the North Central Province of Sri Lanka: METHODS: An interventional study was carried out to assess the disease progression rate of a CKDu population whose habitual drinking water was replaced by bottled spring water certified by Sri Lanka Standard (SLS) for a period of 18 month along with a population of CKDu patients who continued with their usual drinking water. Kidney function of subjects in both groups were monitored in terms of blood pressure, serum creatinine, serum calcium, serum phosphorus, hemoglobin, estimated glomerular filtration rate and urinary protein at 6 months intervals during the intervention and follow up periods. Diminished disease progression rate was observed in CKDu patients in the intervention group when compared with the non- intervention group based on serum creatinine, Hb, estimated glomerular filtration rate and urinary protein levels. Extensive interventional studies are required to generalize effect of drinking water on CKDu population. The habitual drinking water is likely to be a contributory factor towards the progression of the disease. © 2017 Asian Pacific Society of Nephrology.

Nigerian resident doctors on strike: insights from and policy implications of job satisfaction among resident doctors in a Nigerian teaching hospital.

PubMed

Akinyemi, Oluwaseun; Atilola, Olayinka

2013-01-01

The Nigerian health system has been engulfed in a crisis occasioned by a deluge of strike actions by resident doctors in recent times. Dissatisfaction with conditions of service has been cited as the bone of contention. Job satisfaction studies among doctors have provided insights into the contributory factors to recurrent industrial disputes in other climes. This study aims to determine the predictors of job satisfaction among resident doctors in a tertiary healthcare centre in Nigeria. This is with a view to gain some insights into the possible contributory factors to industrial disputes and to discuss the policy implications of such findings. A semi-structured questionnaire was used to obtain socio-demographic characteristics and job-related determinants of job satisfaction among resident doctors. Logistic regression analysis was carried out to determine predictors of job satisfaction. A total of 163 resident doctors completed the study. Overall, 90 (55.2%) of the resident doctors were satisfied with their jobs. Lower age, career advancement opportunities, autonomy of practice, alignment of job with core personal and professional values, and working environment predicted job satisfaction. To restore satisfaction and possibly stem industrial disputes by resident doctors, government of Nigeria needs to sustain current wages while introducing non-financial benefits. There is a need to adopt policies geared towards increasing government spending on health especially in the area of human capacity and infrastructural development, so as to afford resident doctors opportunities for skill acquisition and career development. Copyright © 2012 John Wiley & Sons, Ltd.

Perinatal mortality in caribou from the Porcupine herd, Alaska

USGS Publications Warehouse

Roffe, T.J.

1993-01-01

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

Perinatal mortality in caribou from the Porcupine herd, Alaska.

PubMed

Roffe, T J

1993-04-01

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

NF-κB–mediated Pax7 dysregulation in the muscle microenvironment promotes cancer cachexia

PubMed Central

He, Wei A.; Berardi, Emanuele; Cardillo, Veronica M.; Acharyya, Swarnali; Aulino, Paola; Thomas-Ahner, Jennifer; Wang, Jingxin; Bloomston, Mark; Muscarella, Peter; Nau, Peter; Shah, Nilay; Butchbach, Matthew E.R.; Ladner, Katherine; Adamo, Sergio; Rudnicki, Michael A.; Keller, Charles; Coletti, Dario; Montanaro, Federica; Guttridge, Denis C.

2013-01-01

Cachexia is a debilitating condition characterized by extreme skeletal muscle wasting that contributes significantly to morbidity and mortality. Efforts to elucidate the underlying mechanisms of muscle loss have predominantly focused on events intrinsic to the myofiber. In contrast, less regard has been given to potential contributory factors outside the fiber within the muscle microenvironment. In tumor-bearing mice and patients with pancreatic cancer, we found that cachexia was associated with a type of muscle damage resulting in activation of both satellite and nonsatellite muscle progenitor cells. These muscle progenitors committed to a myogenic program, but were inhibited from completing differentiation by an event linked with persistent expression of the self-renewing factor Pax7. Overexpression of Pax7 was sufficient to induce atrophy in normal muscle, while under tumor conditions, the reduction of Pax7 or exogenous addition of its downstream target, MyoD, reversed wasting by restoring cell differentiation and fusion with injured fibers. Furthermore, Pax7 was induced by serum factors from cachectic mice and patients, in an NF-κB–dependent manner, both in vitro and in vivo. Together, these results suggest that Pax7 responds to NF-κB by impairing the regenerative capacity of myogenic cells in the muscle microenvironment to drive muscle wasting in cancer. PMID:24084740

A short review on a complication of lumbar spine surgery: CSF leak.

PubMed

Menon, Sajesh K; Onyia, Chiazor U

2015-12-01

Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. Over the past decades, there has been significant advancement in understanding the basis, management and techniques of treatment for post-operative CSF leak following lumbar spine surgery. In this article, we review previous work in the literature on the various factors and technical errors during or after lumbar spine surgery that may lead to this feared complication, the available options of management with focus on the various techniques employed, the outcomes and also to highlight on the current trends. We also discuss the presentation, factors contributing to its development, basic concepts and practical aspects of the management with emphasis on the different techniques of treatment. Different outcomes following various techniques of managing post-operative CSF leak after lumbar spine surgery have been well described in the literature. However, there is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon's cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment. Copyright © 2015 Elsevier B.V. All rights reserved.

Relationship between betel quid chewing and radiographic alveolar bone loss among Taiwanese aboriginals: a retrospective study.

PubMed

Hsiao, Chun-Nan; Ting, Chun-Chan; Shieh, Tien-Yu; Ko, Edward Chengchuan

2014-11-04

Betel quid chewing is associated with the periodontal status; however, results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing. This survey was conducted in an aboriginal community in Taiwan because almost all betel quid chewers were city-dwelling cigarette smokers. In total, 114 subjects, aged 30-60 years, were included. Full-mouth intraoral RABL was retrospectively measured and adjusted for age, gender, and plaque index (PI). Multiple regression analysis was used to assess the relationship between RABL and potential risk factors. Age-, gender-, and PI-adjusted mean RABL was significantly higher in chewers with or without cigarette smoking than in controls. Multiple regression analysis showed that the RABL for consumption of 100,000 pieces betel quid for the chewer group was 0.40 mm. Full-mouth plotted curves for adjusted mean RABL in the maxilla were similar between the chewer and control groups, suggesting that chemical effects were not the main factors affecting the association between betel quid chewing and the periodontal status. Betel quid chewing significantly increases RABL. The main contributory factors are age and oral hygiene; however, the major mechanism underlying this process may not be a chemical mechanism. Regular dental visits, maintenance of good oral hygiene, and reduction in the consumption of betel quid, additives, and cigarettes are highly recommended to improve the periodontal status.

Experimental and Theoretical Investigations of Cavitation in Water

NASA Technical Reports Server (NTRS)

Ackeret, J.

1945-01-01

The cavitation in nozzles on airfoils of various shape and on a sphere are experimentally investigated. The limits of cavitation and the extension of the zone of the bubbles in different stages of cavitation are photographically established. The pressure in the bubble area is constant and very low, jumping to high values at the end of the area. The analogy with the gas compression shock is adduced and discussed. The collapse of the bubbles under compression shock produces very high pressures internally, which must be contributory factors to corrosion. The pressure required for purely mechanical corrosion is also discussed.

Use of ketorolac by continuous subcutaneous infusion for the control of cancer-related pain.

PubMed Central

Myers, K. G.; Trotman, I. F.

1994-01-01

Ketorolac tromethamine is a newly available non-steroidal anti-inflammatory drug which is suitable for parenteral administration. We have given it by continuous subcutaneous infusion to 36 patients with pain due to advanced cancer. Improvement in pain control occurred in 29 (80%). A reduction in the dose of concomitant opioid analgesia was possible in 22 (76%) and a reduction in opioid-related adverse effects occurred in 16 (73%) of these. Ketorolac was most effective in patients who had bone or visceral pain. It was mixed safely with diamorphine in a syringe driver at concentrations up to 4 g diamorphine/10 ml and 120 mg ketorolac/10 ml. Infusion was well tolerated for periods of up to 115 days (mean 21 days; median 15 days; range 3-115 days). Four patients experienced gastrointestinal bleeding and one colonic perforation to which treatment with ketorolac may have been a contributory factor. No other clinically significant adverse effects were observed. PMID:8016008

Process improvement methodologies uncover unexpected gaps in stroke care.

PubMed

Kuner, Anthony D; Schemmel, Andrew J; Pooler, B Dustin; Yu, John-Paul J

2018-01-01

Background The diagnosis and treatment of acute stroke requires timed and coordinated effort across multiple clinical teams. Purpose To analyze the frequency and temporal distribution of emergent stroke evaluations (ESEs) to identify potential contributory workflow factors that may delay the initiation and subsequent evaluation of emergency department stroke patients. Material and Methods A total of 719 sentinel ESEs with concurrent neuroimaging were identified over a 22-month retrospective time period. Frequency data were tabulated and odds ratios calculated. Results Of all ESEs, 5% occur between 01:00 and 07:00. ESEs were most frequent during the late morning and early afternoon hours (10:00-14:00). Unexpectedly, there was a statistically significant decline in the frequency of ESEs that occur at the 14:00 time point. Conclusion Temporal analysis of ESEs in the emergency department allowed us to identify an unexpected decrease in ESEs and through process improvement methodologies (Lean and Six Sigma) and identify potential workflow elements contributing to this observation.

The identification of factors affecting intracranial meningioma recurrence two years postoperatively

NASA Astrophysics Data System (ADS)

Iskandar, M. M.; Aman, R. A.; Tjahjadi, H.; Safri, A. Y.; Aninditha, T.

2017-08-01

The study objective was to determine the recurrence rate of intracranial meningioma and the risk factors that are contributory to an increase in the incidence of recurrence. A prospective design was used in this study on meningioma patients treated at Cipto Mangunkusumo Hospital between 2010 and mid-2015. Data on the subjects were collected from the Departments of Neurology, Neurology, and Pathology, at the Universitas Indonesia/Cipto Mangunkusumo Hospital. The subjects were adults who had been previously diagnosed with meningioma. Follow-up was performed to assess the patients in relation to their initial clinical presentation. Neuroimaging was carried out to determine recurrence. The histopathological findings, extent of tumor resection (using Simpson’s criteria), and Word Health Organization grade, were also determined. Immunohistochemistry was performed to evaluate the expression of progesterone receptor (PR), Ki-67, and vascular endothelial growth factor (VEGF). The recurrence rate was then analyzed to determine any correlation with the aforementioned risk factors. The recurrence rate was found to be 13%. Ki67, VEGF, and PR expression was positive in 9%, 73%, and 50% of the subjects, respectively. A significant correlation was not found between the study variables (tumor location, the scope of resection based on Simpson’s criteria, histopathologic grade, mitotic index, i.e., Ki-67, and PR and VEGF expression in the meningioma tissue) and the recurrence of meningioma.

Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital.

PubMed

Aksakal, Fatma Nur Baran; Karaşahin, Emine Füsun; Dikmen, Asiye Uğraş; Avci, Emine; Ozkan, Seçil

2015-01-01

The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.

The Relationship Between Psychological Distress, Negative Cognitions, and Expectancies on Problem Drinking: Exploring a Growing Problem Among University Students.

PubMed

Obasi, Ezemenari M; Brooks, Jessica J; Cavanagh, Lucia

2016-01-01

Few studies have sought to understand the concurrent relationship between cognitive and affective processes on alcohol use and negative alcohol-related consequences, despite both being identified as predictive risk factors in the college population. More research is needed to understand the relationships between identified factors of problem drinking among this at-risk population. The purpose of this study was to test if the relationship between psychological distress and problem drinking among university students (N = 284; M-age = 19.77) was mediated by negative affect regulation strategies and positive alcohol-related expectancies. Two latent mediation models of problem drinking were tested using structural equation modeling (SEM). The parsimonious three-path mediated latent model was supported by the data, as evidenced by several model fit indices. Furthermore, the alternate saturated model provided similar fit to the data, but contained several direct relationships that were not statistically significant. The relationship between psychological distress and problem drinking was mediated by an extended contributory chain, including negative affect regulation and positive alcohol-related expectancies. Implications for prevention and treatment, as well as future directions, are discussed. © The Author(s) 2015.

South Asian and Middle Eastern patients' perspectives on medicine-related problems in the United Kingdom.

PubMed

Alhomoud, Faten; Dhillon, Soraya; Aslanpour, Zoe; Smith, Felicity

2015-08-01

There has been little research which specifically examines medicine use among South Asian (SA) and Middle Eastern (ME) groups, although evidence suggests that medicine-related needs may be poorly met for these groups. To describe medicine-related problems (MRPs) experienced by SA and ME patients from their perspectives and identify possible contributory factors that may be specific to their cultures. The data were collected in seven pharmacies in London, United Kingdom (UK). The study was a qualitative study. Patients were from SA and ME origins, aged over 18 and prescribed three or more regular medicines. Patients were identified when presenting with a prescription. The data were collected in 80 face-to-face semi-structured interviews using Gordon's MRPs tool. Interviews were audiotaped, transcribed verbatim and analysed thematically using Gordon's coding frame and Nvivo 10 software. Describing MRPs experienced by SA and ME patients from their perspectives and identifying possible contributory factors that may be specific to their cultures. Results Eighty participants (61 % male) had mean (SD) age 58 (13.4) years and a mean (SD) of 8 (4) medicines. Interviews revealed that several factors contributed to the development of MRPs; some appeared to be specific to SA and ME cultures and others were similar to the general population. The factors that were reported to be specific to SA and ME groups comprised religious practices and beliefs, use of non-prescription medicines, extent of family support, and travelling abroad--to patient's homeland or to take religious journeys. Illiteracy, language and communication barriers, lack of translated resources, perceptions of healthcare providers, and difficulty consulting a doctor of the same gender may also contribute to the problems. Many of these factors could be expected to influence patient's safety, adherence, and informed decision-making. This study demonstrated that SA and ME patients have their own problems and needs regarding both medicine use and service access. By uncovering particular problems experienced by these groups, the study can inform healthcare professionals to support SA and ME patients in the use of their medicines.

Lessons from history: morbidity of cold injury in the Royal Marines during the Falklands Conflict of 1982

PubMed Central

2013-01-01

Background Environmental conditions in the Falklands Conflict of 1982 favoured the genesis of cold injuries. Immediately, post-war, cold injury morbidity and its contributory factors were assessed, in the personnel of UK 3 Commando Brigade (3 Cdo Bde). Methods A questionnaire survey of the 3,006 members of 3 Cdo Bde who landed on the islands was conducted within 6–10 weeks of the end of hostilities. Questions included those relating to features of cold injury, body morphology, age, symptoms experienced, past medical history and other possible contributory causes. Additionally, the unit medical team conducted a cursory examination. Data were sent to the Royal Navy Institute of Naval Medicine (INM), where the degree of likely cold injury was broadly classified (‘asymptomatic’ ‘mild’, ‘moderate’ or ‘severe’). A sample (total 109) was then selected at random from each category and subsequently examined and tested at the INM (nerve conduction, photoplethysmography and thermography testing). Forty-seven non-cold exposed sailors acted as a control group. These contemporaneous records have now been identified and interrogated. Results Some 2,354 (78%) completed questionnaires were returned, revealing that 1,505 (64%) had experienced symptoms of non-freezing cold injury. The morbidity in the infantry units was significantly greater than that in the support troops (1,051 (76%) vs 454 (46%), p < 0.05). No evidence was found to support an influence of a number of factors, commonly believed to have an aetiological role in the production of cold injury. Whilst there was no significant relationship between past history and cold injury morbidity in the brigade as a whole, or within the infantry units alone, an association was identified in the collective infantry units (73%) and the support/headquarter units (59%) (p < 0.05). In comparison with uninjured sailors who acted as controls (n = 47), nerve conduction was impaired in 35% of those screened some months after returning to the UK, while the photoplethysmography and thermographic responses to a cold sensitivity test showed that most (including those classed by questionnaire as asymptomatic) had residual ‘cold sensitivity’. Conclusions Although the passage of time has made retrospective interrogation of historical documents hard, the available data do appear to offer valuable historical and clinical insights. Cold injury affected the majority of those fighting in the cold temperate climate of the Falklands. The overwhelming environmental conditions meant that, for most, a past history of cold injury did not appear to represent a risk factor for subsequent injury, as is the case for less severe conditions. Importantly, even asymptomatic individuals when tested often showed physiological evidence of cold injury—perhaps predisposing them to subsequent elevation in risk. PMID:24070118

Effects of MC4R, FTO, and NMB gene variants to obesity, physical activity, and eating behavior phenotypes.

PubMed

Kirac, Deniz; Kasimay Cakir, Ozgur; Avcilar, Tuba; Deyneli, Oguzhan; Kurtel, Hizir; Yazici, Dilek; Kaspar, Elif Cigdem; Celik, Nurgul; Guney, Ahmet Ilter

2016-10-01

Obesity is a major contributory factor of morbidity and mortality. It has been suggested that biological systems may be involved in the tendency to be and to remain physically inactive also behaviors such as food and beverage preferences and nutrient intake may at least partially genetically determined. Consequently, besides environment, genetic factors may also contribute to the level of physical activity and eating behaviors thus effect obesity. Therefore the aim of this study is to investigate the effect of various gene mutations on obesity, physical activity levels and eating behavior phenotypes. One hundred patients and 100 controls were enrolled to the study. Physical activity levels were measured with an actical acceloremeter device. Eating behaviors were evaluated using Three-Factor Eating questionnaire (TFEQ). Associations between eating behavior scores and physical characteristics were also evaluated. The information about other obesity risk factors were also collected. Mutations were investigated with PCR, direct sequencing and Real-Time PCR. rs1051168, rs8050146 -2778C > T mutations were found statistically significant in patients, rs1121980 was found statistically significant in controls. 21 mutations were found in MC4R and near MC4R of which 18 of them are novel and 8 of them cause amino acid change. In addition, it was found that, some obesity related factors and questions of TFEQ are associated with various investigated gene mutations. Any relation between gene mutations and physical activity levels were not detected. It is thought that, due to the genotype data and eating behaviors, it may be possible to recommend patients for proper eating patterns to prevent obesity. © 2016 IUBMB Life, 68(10):806-816, 2016. © 2016 International Union of Biochemistry and Molecular Biology.

Biopsychological markers of distress in informal caregivers.

PubMed

Davis, Linda Lindsey; Weaver, Michael; Zamrini, Edward; Stevens, Alan; Kang, Duck-Hee; Parker, C Richard

2004-10-01

Thirty caregiving wives participated in a study of caregiving distress and negative mood (depressive symptoms) by making diary entries on stressful caregiving situations and collecting saliva samples 4 times a day. At the end of the 7-day study period, caregivers' salivary cortisol production was compared with their diary entries and correlated with pencil and paper self-report scores of caregiver distress and depressive symptoms. Despite the inability to control a number of factors thought to confound cortisol production (exercise, smoking, alcohol ingestion, and prescription medications), there was a statistically significant difference between No Caregiving and Caregiving cortisol, F(1,739) = 7.67, P = 0.006, with cortisol production higher when caregiving events occurred. However, efforts to code specific types of caregiving situations (e.g., 1 = indirect care; 4 = AD problem behavior care) did not further differentiate cortisol production. Although caregivers' self-reports for the same 7-day period indicated they were depressed, pencil-and-paper measures of distress and negative affect were not significantly correlated with cortisol production. The finding that this caregiving group was significantly stressed by caregiving, as evidenced by increased cortisol production during caregiving episodes, verifies the importance of further exploration of specific caregiving situations as contributory factors in caregiver health and well-being. In that saliva is a relatively economical and comparatively noninvasive biological data source for community-based stress studies, methodological limitations of the study are identified and 5 recommendations are made for future biological marker studies of caregiver distress in community-based settings. Copyright 2004 Sage Publications

PB1-F2 Peptide Derived from Avian Influenza A Virus H7N9 Induces Inflammation via Activation of the NLRP3 Inflammasome*

PubMed Central

Pinar, Anita; Dowling, Jennifer K.; Bitto, Natalie J.; Robertson, Avril A. B.; Latz, Eicke; Stewart, Cameron R.; Drummond, Grant R.; Cooper, Matthew A.; McAuley, Julie L.; Tate, Michelle D.; Mansell, Ashley

2017-01-01

The emergence of avian H7N9 influenza A virus in humans with associated high mortality has highlighted the threat of a potential pandemic. Fatal H7N9 infections are characterized by hyperinflammation and increased cellular infiltrates in the lung. Currently there are limited therapies to address the pathologies associated with H7N9 infection and the virulence factors that contribute to these pathologies. We have found that PB1-F2 derived from H7N9 activates the NLRP3 inflammasome and induces lung inflammation and cellular recruitment that is NLRP3-dependent. We have also shown that H7N9 and A/Puerto Rico/H1N1 (PR8)PB1-F2 peptide treatment induces significant mitochondrial reactive oxygen production, which contributes to NLRP3 activation. Importantly, treatment of cells or mice with the specific NLRP3 inhibitor MCC950 significantly reduces IL-1β maturation, lung cellular recruitment, and cytokine production. Together, these results suggest that PB1-F2 from H7N9 avian influenza A virus may be a major contributory factor to disease pathophysiology and excessive inflammation characteristic of clinical infections and that targeting the NLRP3 inflammasome may be an effective means to reduce the inflammatory burden associated with H7N9 infections. PMID:27913620

What makes a space invader? Passenger perceptions of personal space invasion in aircraft travel.

PubMed

Lewis, Laura; Patel, Harshada; D'Cruz, Mirabelle; Cobb, Sue

2017-11-01

The invasion of personal space is often a contributory factor to the experience of discomfort in aircraft passengers. This paper presents a questionnaire study which investigated how air travellers are affected by invasions of personal space and how they attempt to adapt to, or counter, these invasions. In support of recent findings on the factors influencing air passenger comfort, the results of this study indicate that the invasion of personal space is not only caused by physical factors (e.g. physical contact with humans or objects), but also other sensory factors such as noise, smells or unwanted eye contact. The findings of this study have implications for the design of shared spaces. Practitioner Summary: This paper presents a questionnaire study which investigated personal space in an aircraft environment. The results highlight the factors which affect the perception of personal space invasion in aircraft and can therefore inform the design of aircraft cabin environments to enhance the passenger experience.

Investigating Bacterial Sources of Toxicity as an Environmental Contributor to Dopaminergic Neurodegeneration

PubMed Central

Caldwell, Kim A.; Tucci, Michelle L.; Armagost, Jafa; Hodges, Tyler W.; Chen, Jue; Memon, Shermeen B.; Blalock, Jeana E.; DeLeon, Susan M.; Findlay, Robert H.; Ruan, Qingmin; Webber, Philip J.; Standaert, David G.; Olson, Julie B.; Caldwell, Guy A.

2009-01-01

Parkinson disease (PD) involves progressive neurodegeneration, including loss of dopamine (DA) neurons from the substantia nigra. Select genes associated with rare familial forms of PD function in cellular pathways, such as the ubiquitin-proteasome system (UPS), involved in protein degradation. The misfolding and accumulation of proteins, such as α-synuclein, into inclusions termed Lewy Bodies represents a clinical hallmark of PD. Given the predominance of sporadic PD among patient populations, environmental toxins may induce the disease, although their nature is largely unknown. Thus, an unmet challenge surrounds the discovery of causal or contributory neurotoxic factors that could account for the prevalence of sporadic PD. Bacteria within the order Actinomycetales are renowned for their robust production of secondary metabolites and might represent unidentified sources of environmental exposures. Among these, the aerobic genera, Streptomyces, produce natural proteasome inhibitors that block protein degradation and may potentially damage DA neurons. Here we demonstrate that a metabolite produced by a common soil bacterium, S. venezuelae, caused DA neurodegeneration in the nematode, Caenorhabditis elegans, which increased as animals aged. This metabolite, which disrupts UPS function, caused gradual degeneration of all neuronal classes examined, however DA neurons were particularly vulnerable to exposure. The presence of DA exacerbated toxicity because neurodegeneration was attenuated in mutant nematodes depleted for tyrosine hydroxylase (TH), the rate-limiting enzyme in DA production. Strikingly, this factor caused dose-dependent death of human SH-SY5Y neuroblastoma cells, a dopaminergic line. Efforts to purify the toxic activity revealed that it is a highly stable, lipophilic, and chemically unique small molecule. Evidence of a robust neurotoxic factor that selectively impacts neuronal survival in a progressive yet moderate manner is consistent with the etiology of age-associated neurodegenerative diseases. Collectively, these data suggest the potential for exposures to the metabolites of specific common soil bacteria to possibly represent a contributory environmental component to PD. PMID:19806188

Obesity. Part I--Pathogenesis.

PubMed Central

Bray, G A; Gray, D S

1988-01-01

Obesity--defined by a body mass index above 30 kg per m2--is a major problem for affluent nations. Its prevalence is higher in North America than in Europe--between 9% and 12% of the population. Reduced energy expenditure from exercise or metabolism or both may be an important contributory factor in the development of obesity because of a failure to reduce food intake sufficiently to maintain energy balance. A high ratio of abdominal circumference relative to gluteal circumference carries a twofold or greater risk of heart attack, stroke, hypertension, diabetes mellitus, gallbladder disease, and death. The effect of increased quantities of abdominal fat is greater than that of a similar increase in total body fat on the risks of ill health associated with obesity. Genetic factors appear to contribute about 25% to its etiology. Images PMID:3067447

Pathogenetic role of Factor VII deficiency and thrombosis in cross-reactive material positive patients.

PubMed

Girolami, A; Sambado, L; Bonamigo, E; Ferrari, S; Lombardi, A M

2013-12-01

Congenital Factor VII (FVII) deficiency can be divided into two groups: cases of "true" deficiency, or cross-reactive material (CRM) negative and variants that are cross-reactive material positive.The first form is commonly recognized as Type I condition whereas the second one is known as Type II. FVII deficiency has been occasionally associated with thrombotic events, mainly venous. The reasons underlying this peculiar manifestation are unknown even though in the majority of associated patients thrombotic risk factors are present. The purpose of the present study was to investigate if a thrombotic event was more frequent in Type I or in Type II defect.The majority of patients with FVII deficiency and thrombosis belong to Type II defects. In the following paper we discuss the possible role of the dysfunctional FVII cross-reaction material as a contributory cause for the occurrence of thrombosis.

Exome sequencing in an admixed isolated population indicates NFXL1 variants confer a risk for specific language impairment.

PubMed

Villanueva, Pía; Nudel, Ron; Hoischen, Alexander; Fernández, María Angélica; Simpson, Nuala H; Gilissen, Christian; Reader, Rose H; Jara, Lillian; Echeverry, María Magdalena; Echeverry, Maria Magdalena; Francks, Clyde; Baird, Gillian; Conti-Ramsden, Gina; O'Hare, Anne; Bolton, Patrick F; Hennessy, Elizabeth R; Palomino, Hernán; Carvajal-Carmona, Luis; Veltman, Joris A; Cazier, Jean-Baptiste; De Barbieri, Zulema; Fisher, Simon E; Newbury, Dianne F

2015-03-01

Children affected by Specific Language Impairment (SLI) fail to acquire age appropriate language skills despite adequate intelligence and opportunity. SLI is highly heritable, but the understanding of underlying genetic mechanisms has proved challenging. In this study, we use molecular genetic techniques to investigate an admixed isolated founder population from the Robinson Crusoe Island (Chile), who are affected by a high incidence of SLI, increasing the power to discover contributory genetic factors. We utilize exome sequencing in selected individuals from this population to identify eight coding variants that are of putative significance. We then apply association analyses across the wider population to highlight a single rare coding variant (rs144169475, Minor Allele Frequency of 4.1% in admixed South American populations) in the NFXL1 gene that confers a nonsynonymous change (N150K) and is significantly associated with language impairment in the Robinson Crusoe population (p = 2.04 × 10-4, 8 variants tested). Subsequent sequencing of NFXL1 in 117 UK SLI cases identified four individuals with heterozygous variants predicted to be of functional consequence. We conclude that coding variants within NFXL1 confer an increased risk of SLI within a complex genetic model.

Activation of cellular immune response in acute pancreatitis.

PubMed Central

Mora, A; Pérez-Mateo, M; Viedma, J A; Carballo, F; Sánchez-Payá, J; Liras, G

1997-01-01

BACKGROUND: Inflammatory mediators have recently been implicated as potential markers of severity in acute pancreatitis. AIMS: To determine the value of neopterin and polymorphonuclear (PMN) elastase as markers of activation of cellular immunity and as early predictors of disease severity. PATIENTS: Fifty two non-consecutive patients classified according to their clinical outcome into mild (n = 26) and severe pancreatitis (n = 26). METHODS: Neopterin in serum and the PMN elastase/A1PI complex in plasma were measured during the first three days of hospital stay. RESULTS: Within three days after the onset of acute pancreatitis, PMN elastase was significantly higher in the severe pancreatitis group. Patients with severe disease also showed significantly higher values of neopterin on days 1 and 2 but not on day 3 compared with patients with mild disease. There was a significant correlation between PMN elastase and neopterin values on days 1 and 2. PMN elastase on day 1 predicted disease severity with a sensitivity of 76.7% and a specificity of 91.6%. Neopterin did not surpass PMN elastase in the probability of predicting disease severity. CONCLUSIONS: These data show that activation of cellular immunity is implicated in the pathogenesis of acute pancreatitis and may be a main contributory factor to disease severity. Neopterin was not superior to PMN elastase in the prediction of severity. PMID:9245935

Vasovagal reactions in 'at risk' donors: a univariate analysis of effect of age and weight on the grade of donor reactions.

PubMed

Tondon, Rashmi; Pandey, Prashant; Chaudhary, Rajendra

2008-10-01

It is well known that young age, low weight, and first time donation status increase the probability of having a reaction but the effect of these 'risk' factors on the grade of reaction has not been well studied. To evaluate the prevalence of these factors in blood donation setup, to identify 'at risk' donors with age less than 30 years and weight less than 60 kg and to assess whether there is any contributory role of these risk factors in predicting the grade of reaction. A retrospective analysis of 30370 donations was done during 15 month study period. Donor reaction rate of 1.6% was observed in this study of which 7% experienced reaction of moderate and severe grade. Reaction rate among male and female donors were 1.5% and 3.7% respectively. Female gender was found to be an independent predictor for donor reaction even after nullifying the effect of the blood volume drawn. Incidence of vasovagal reaction in 'at risk' donors was 2.0% in contrast to 0.96% in 'general' donor population. Age had a significant affect on reaction rate (p = .035) and all grades of reaction decreased with the age of the donor. Age was found to be a significant predictor of the grade of reaction (p = .008). The effect of weight on the reaction rate as well as on the grade was found to be insignificant (1.5% in 'at risk' donors vs. 1.6% in 'general' donors with p > 0.05). 1. Age is a significant factor that can predict the rate as well as the grade of reaction; 2. Weight does not predict the grade of reaction, 3. Gender is an independent predictor of donor reaction, with females having 2.5 fold higher chances of reaction. These factors are important for blood collection staff to recognize such 'at risk' donors, and to give more attention to them to reduce donor reaction.

Hypocalcaemia following thyroidectomy unresponsive to oral therapy.

PubMed

Etheridge, Zac C; Schofield, Christopher; Prinsloo, Peter J J; Sturrock, Nigel D C

2014-01-01

Hypocalcaemia due to hypoparathyroidism following thyroidectomy is a relatively common occurrence. Standard treatment is with oral calcium and vitamin D replacement therapy; lack of response to oral therapy is rare. Herein we describe a case of hypoparathyroidism following thyroidectomy unresponsive to oral therapy in a patient with a complex medical history. We consider the potential causes in the context of calcium metabolism including: poor adherence, hungry bone syndrome, malabsorption, vitamin D resistance, bisphosphonate use and functional hypoparathyroidism secondary to magnesium deficiency. Malabsorption due to intestinal hurry was likely to be a contributory factor in this case and very large doses of oral therapy were required to avoid symptomatic hypocalcaemia.

Effort-Based Decision-Making in Schizophrenia.

PubMed

Culbreth, Adam J; Moran, Erin K; Barch, Deanna M

2018-08-01

Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.

The relationship between maternal nutritional status and spontaneous abortion.

PubMed

Neela, J; Raman, L

1997-01-01

The incidence of pregnancy wastage is high among poor women. Though the aetiology of spontaneous abortion is multifactorial, nutritional deficiency is considered to be an important contributory factor. A case-control study was conducted to assess the relationship between maternal vitamin status and spontaneous abortion. The incidence of anaemia (15%), and riboflavin (84%) and folate deficiency (24.5%) were similar among the cases and controls. Vitamin A levels were higher in the study group compared to those in controls. The results suggest that various nutrient deficiencies have no correlation with the occurrence of spontaneous abortion. The role of increased vitamin A levels needs to be studied further.

[A preliminary analysis of the high birth rate in India].

PubMed

Shao, N

1981-01-01

The author first provides some basic demographic data for India and points out that the current annual rate of population growth of 2.45 percent is slightly higher than the annual increase in food production. Problems in the areas of employment, education, housing, and transportation, as well as the general problem of poverty, are seen as a consequence of this imbalance. The lack of success of the national family planning program is attributed primarily to the failure to achieve a satisfactory rate of economic growth. Contributory factors include early marriage, the low status of women, the desire for large families, and administrative problems associated with the family planning program.

A possible contributory mechanism for impaired idiom perception in schizophrenia.

PubMed

Sela, Tal; Lavidor, Michal; Mitchell, Rachel L C

2015-09-30

In this review, we focus on the ability of people with schizophrenia to correctly perceive the meaning of idioms; figurative language expressions in which intended meaning is not derived from the meaning of constituent words. We collate evidence on how idiom perception is impaired, ascertain the clinical relevance of this impairment, and consider possible psychological and neural mechanisms behind the impairment. In reviewing extant literature, we searched the PubMed database, from 1975-2014, focussing on articles that directly concerned schizophrenia and idioms, with follow up searches to explore the viability of possible underlying mechanisms. We learn that there is clear evidence of impairment, with a tendency to err towards literal interpretations unless the figurative meaning is salient, and despite contextual cues to figurative interpretations. Given the importance of idioms in everyday language, the potential impact is significant. Clinically, impaired idiom perception primarily relates to positive symptoms of schizophrenia, but also to negative symptoms. The origins of the impairment remain speculation, with impaired executive function, impaired semantic functions, and impaired context processing all proposed to explain the phenomenon. We conclude that a possible contributory mechanism at the neural level is an impaired dorsolateral prefrontal cortex system for cognitive control over semantic processing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Collision in space.

PubMed

Ellis, S R

2000-01-01

On June 25, 1997, the Russian supply spacecraft Progress 234 collided with the Mir space station, rupturing Mir's pressure hull, throwing it into an uncontrolled attitude drift, and nearly forcing evacuation of the station. Like many high-profile accidents, this collision was the consequence of a chain of events leading to the final piloting errors that were its immediate cause. The discussion in this article does not resolve the relative contributions of the actions and decisions in this chain. Neither does it suggest corrective measures, many of which are straightforward and have already been implemented by the National Aeronautics and Space Administration (NASA) and the Russian Space Agency. Rather, its purpose is to identify the human factors that played a pervasive role in the incident. Workplace stress, fatigue, and sleep deprivation were identified by NASA as contributory factors in the Mir-Progress collision (Culbertson, 1997; NASA, forthcoming), but other contributing factors, such as requiring crew to perform difficult tasks for which their training is not current, could potentially become important factors in future situations.

Collision in space

NASA Technical Reports Server (NTRS)

Ellis, S. R.

2000-01-01

On June 25, 1997, the Russian supply spacecraft Progress 234 collided with the Mir space station, rupturing Mir's pressure hull, throwing it into an uncontrolled attitude drift, and nearly forcing evacuation of the station. Like many high-profile accidents, this collision was the consequence of a chain of events leading to the final piloting errors that were its immediate cause. The discussion in this article does not resolve the relative contributions of the actions and decisions in this chain. Neither does it suggest corrective measures, many of which are straightforward and have already been implemented by the National Aeronautics and Space Administration (NASA) and the Russian Space Agency. Rather, its purpose is to identify the human factors that played a pervasive role in the incident. Workplace stress, fatigue, and sleep deprivation were identified by NASA as contributory factors in the Mir-Progress collision (Culbertson, 1997; NASA, forthcoming), but other contributing factors, such as requiring crew to perform difficult tasks for which their training is not current, could potentially become important factors in future situations.

Comparison of slope stability in two Brazilian municipal landfills.

PubMed

Gharabaghi, B; Singh, M K; Inkratas, C; Fleming, I R; McBean, E

2008-01-01

The implementation of landfill gas to energy (LFGTE) projects has greatly assisted in reducing the greenhouse gases and air pollutants, leading to an improved local air quality and reduced health risks. The majority of cities in developing countries still dispose of their municipal waste in uncontrolled 'open dumps.' Municipal solid waste landfill construction practices and operating procedures in these countries pose a challenge to implementation of LFGTE projects because of concern about damage to the gas collection infrastructure (horizontal headers and vertical wells) caused by minor, relatively shallow slumps and slides within the waste mass. While major slope failures can and have occurred, such failures in most cases have been shown to involve contributory factors or triggers such as high pore pressures, weak foundation soil or failure along weak geosynthetic interfaces. Many researchers who have studied waste mechanics propose that the shear strength of municipal waste is sufficient such that major deep-seated catastrophic failures under most circumstances require such contributory factors. Obviously, evaluation of such potential major failures requires expert analysis by geotechnical specialists with detailed site-specific information regarding foundation soils, interface shearing resistances and pore pressures both within the waste and in clayey barrier layers or foundation soils. The objective of this paper is to evaluate the potential use of very simple stability analyses which can be used to study the potential for slumps and slides within the waste mass and which may represent a significant constraint on construction and development of the landfill, on reclamation and closure and on the feasibility of a LFGTE project. The stability analyses rely on site-specific but simple estimates of the unit weight of waste and the pore pressure conditions and use "generic" published shear strength envelopes for municipal waste. Application of the slope stability analysis method is presented in a case study of two Brazilian landfill sites; the Cruz das Almas Landfill in Maceio and the Muribeca Landfill in Recife. The Muribeca site has never recorded a slope failure and is much larger and better-maintained when compared to the Maceio site at which numerous minor slumps and slides have been observed. Conventional limit-equilibrium analysis was used to calculate factors of safety for stability of the landfill side slopes. Results indicate that the Muribeca site is more stable with computed factors of safety values in the range 1.6-2.4 compared with computed values ranging from 0.9 to 1.4 for the Maceio site at which slope failures have been known to occur. The results suggest that this approach may be useful as a screening-level tool when considering the feasibility of implementing LFGTE projects.

Extending coverage to informal sector populations in Kenya: design preferences and implications for financing policy.

PubMed

Okungu, Vincent; Chuma, Jane; Mulupi, Stephen; McIntyre, Diane

2018-01-09

Universal health coverage (UHC) is important in terms of improving access to quality health care while protecting households from the risk of catastrophic health spending and impoverishment. However, progress to UHC has been hampered by the measures to increase mandatory prepaid funds especially in low- and middle-income countries where there are large populations in the informal sector. Important considerations in expanding coverage to the informal sector should include an exploration of the type of prepayment system that is acceptable to the informal sector and the features of such a design that would encourage prepayment for health care among this population group. The objective of the study was to document the views of informal sector workers regarding different prepayment mechanisms, and critically analyze key design features of a future health system and the policy implications of financing UHC in Kenya. This was part of larger study which involved a mixed-methods approach. The following tools were used to collect data from informal sector workers: focus group discussions [N = 16 (rural = 7; urban = 9)], individual in-depth interviews [N = 26 (rural = 14; urban = 12)] and a questionnaire survey [N = 455(rural = 129; urban = 326)]. Thematic approach was used to analyze qualitative data while Stata v.11 involving mainly descriptive analysis was used in quantitative data. The tools mentioned were used to collect data to meet various objectives of a larger study and what is presented here constitutes a small section of the data generated by these tools. The findings show that informal sector workers in rural and urban areas prefer different prepayment systems for financing UHC. Preference for a non-contributory system of financing UHC was particularly strong in the urban study site (58%). Over 70% in the rural area preferred a contributory mechanism in financing UHC. The main concern for informal sector workers regardless of the overall design of the financing approach to UHC included a poor governance culture especially one that does not punish corruption. Other reasons especially with regard to the contributory financing approach included high premium costs and inability to enforce contributions from informal sector. On average 47% of all study participants, the largest single majority, are in favor of a non-contributory financing mechanism. Strong evidence from existing literature indicates difficulties in implementing social contributions as the primary financing mechanism for UHC in contexts with large informal sector populations. Non-contributory financing should be strongly recommended to policymakers to be the primary financing mechanism and supplemented by social contributions.

Prevalence and factors associated with smoking intentions among non-smoking and smoking adolescents in Kota Tinggi, Johor, Malaysia.

PubMed

Hock, Lim Kuang; Ghazali, Sumarni Mohamad; Cheong, Kee Chee; Kuay, Lim Kuang; Li, Lim Hui; Huey, Teh Chien; Ying, Chan Ying; Yen, Yeo Lay; Ching, Fiona Goh Swee; Yi, Khoo Yi; Lin, Chong Zhuo; Ibrahim, Normala; Mustafa, Amal Nasir

2014-01-01

Intention to smoke is a valid and reliable factor for predicting future smoking habits among adolescents. This factor, however, has received inadequate attention in Malaysia. The present paper elaborates the prevalence and factors associated with intent to initiate or to cease smoking, among adolescent nonsmokers and smokers in Kota Tinggi, Johor, Malaysia. A total of 2,300 secondary school students aged 13-16 years were selected through a two-stage stratified sampling method. A set of standardized questionnaires was used to assess the smoking behavior among adolescents and the inter-personal and intra-personal factors associated with smoking intention (intention to initiate smoking or to cease smoking). Multivariable logistic regression was used to identify factors related to smoking intention. The prevalence of intention to smoke in the future or to cease smoking among non- smoking adolescents and current smokers were 10.7% and 61.7% respectively. Having friends who smoke, social influence, and poor knowledge about the ill effects on health due to smoking showed significant relationships with intention to smoke in the future among non-smokers. Conversely, perceived lower prevalence of smoking among peers, weak contributory social influence, and greater awareness of the ill effects of smoking are factors associated with the intention to cease smoking sometime in the future. The study found that prevalence of intention to initiate smoking is low among non-smokers while the majority of current smokers intended to cease smoking in the future. Existing anti-smoking programmes that integrate the factors that have been identified in the current study should be put in motion to reduce the prevalence of intention to initiate smoking and increase the intention to cease smoking among adolescents.

Association of tumour necrosis factor-α polymorphism in patients with end stage renal disease.

PubMed

Singh, Kamini; Prasad, Kashi Nath; Mishra, Priyanka; Singh, Satyendra Kumar; Kharwar, Nagendra Kumar; Prasad, Narayan; Gupta, Amit; Srivastava, Janmejai Kumar

2015-06-01

Cytokines play a critical role in the pathophysiology of end stage renal disease (ESRD). Tumour necrosis factor-a (TNF-α) is an important cytokine involved in initiation and progression of renal diseases. The present study evaluated the association of specific alleles/genotype of TNF-α with chronic renal failure (CRF) and ESRD. A total of 30 CRF patients who were not on renal replacement therapy, 85 ESRD patients and 120 healthy controls were included in the study. The ESRD patients belonged to two subgroups: patients on peritoneal dialysis (PD) without peritonitis (n = 50) and with peritonitis (n = 35). TNF-α genotype (-308 G > A) was determined by polymerase chain reaction-restriction fragment length polymorphism. Level of TNF-α was detected in the sera of patients and healthy controls by enzyme linked immunosorbent assay (ELISA), and also in the dialysate of patients on PD. The genotypic distributions of TNF-α (-308 G > A) were significantly different between patients and controls. Homozygous A/A genotype had significant association with CRF and ESRD (P < 0.001, odds ratio [OR] = 25.02). Frequency of homozygous A/A genotype was significantly higher in all subgroups of patients than controls (CRF 40% vs control 2.5%, P = 0.001; PD 54% vs control 2.5%, P < 0.001 and PD with peritonitis 62.8% vs control 2.5%, P < 0.001). Patients with homozygous A/A genotype had significantly elevated levels of TNF-α in the sera of patients and in the dialysate of PD patients. Individuals with homozygous TNF-α (-308 G > A) polymorphisms has significant association with CRF and ESRD, and thus may be a predictor for development of the disease. Elevated TNF-α may be a contributory factor. © 2015 Asian Pacific Society of Nephrology.

Dysphagia in the high-risk infant: potential factors and mechanisms123

PubMed Central

Jadcherla, Sudarshan

2016-01-01

Neonatal dysphagia, or abnormalities of swallowing, represent a major global problem, and consequences of dysfunctional feeding patterns carry over into infancy and toddler age groups. Growth, development, and independent feeding skills are all delayed among high-risk infants. Such a group comprises premature birth, low-birth-weight, congenital anomalies, perinatal asphyxia, postsurgical, and sepsis categories. The conflict between pathophysiologic and pragmatic feeding strategies remains a major conundrum and is largely due to a lack of validated diagnostic approaches amid heterogeneity of the patient phenotype. Thus, well-tested feeding management strategies that can be generalizable are lacking. Furthermore, the aerodigestive symptoms and signs, potential risk factors, and contributory etiologies remain nonspecific. This article presents mechanistic evidence related to the pathophysiologic basis of neonatal dysphagia as well as potential opportunities to improve feeding abilities and long-term development. PMID:26791178

The Capgras and Cotard delusions.

PubMed

Young, A W; Leafhead, K M; Szulecka, T K

1994-01-01

We explore the relation between the Capgras delusion (the belief that your relatives have been replaced by impostors) and the Cotard delusion (the delusional belief that you have died). At first sight, these delusions would seem to have little to do with each other, except that they both involve bizarre claims about existence (for self or others). On closer examination, however, there are other parallels. Here, we summarise similarities in associated impairments of face perception, and argue that both delusions reflect an interaction of impairments at two levels. One set of contributory factors involves perceptual impairment, or anomalous perceptual experience. The other factors lead to an incorrect interpretation of this, for which we offer an explanation in terms of attribution theory. Although the Capgras and Cotard delusions are phenomenally distinct, they may therefore represent attempts to make sense of fundamentally similar experiences.

Potential pathways to HIV/AIDS transmission in the Niger Delta of Nigeria: Poverty, migration and commercial sex

PubMed Central

Udoh, IA; Mantell, JE; Sandfort, T; Eighmy, MA

2010-01-01

HIV prevalence in the Niger Delta of Nigeria is generally attributed to concurrent sexual partnerships and weak public sector health care and education systems. This paper examines the likelihood of additional factors, such as the intersection of widespread poverty, migration, and sex work, as contributory channels of HIV transmission in the region. To explore this issue, we conducted a Delphi survey with 27 experts to formulate consensus about the impact of poverty, migration, and commercial sex on AIDS in the Niger Delta. Results suggest that these factors and others have exacerbated the epidemic in the region. To stop the further spread of HIV in the region, efforts to address poverty, sex work, and multiple sexual partnerships require building a public-private partnership which involves participatory action strategies among key stakeholders. PMID:19444664

Navigating towards improved surgical safety using aviation-based strategies.

PubMed

Kao, Lillian S; Thomas, Eric J

2008-04-01

Safety practices in the aviation industry are being increasingly adapted to healthcare in an effort to reduce medical errors and patient harm. However, caution should be applied in embracing these practices because of limited experience in surgical disciplines, lack of rigorous research linking these practices to outcome, and fundamental differences between the two industries. Surgeons should have an in-depth understanding of the principles and data supporting aviation-based safety strategies before routinely adopting them. This paper serves as a review of strategies adapted to improve surgical safety, including the following: implementation of crew resource management in training operative teams; incorporation of simulation in training of technical and nontechnical skills; and analysis of contributory factors to errors using surveys, behavioral marker systems, human factors analysis, and incident reporting. Avenues and challenges for future research are also discussed.

Uric acid in metabolic syndrome: From an innocent bystander to a central player

PubMed Central

Kanbay, Mehmet; Jensen, Thomas; Solak, Yalcin; Le, Myphuong; Roncal-Jimenez, Carlos; Rivard, Chris; Lanaspa, Miguel A.; Nakagawa, Takahiko; Johnson, Richard J.

2016-01-01

Uric acid, once viewed as an inert metabolic end-product of purine metabolism, has been recently incriminated in a number of chronic disease states, including hypertension, metabolic syndrome, diabetes, non-alcoholic fatty liver disease, and chronic kidney disease. Several experimental and clinical studies support a role for uric acid as a contributory causal factor in these conditions. Here we discuss some of the major mechanisms linking uric acid to metabolic and cardiovascular diseases. At this time the key to understanding the importance of uric acid in these diseases will be the conduct of large clinical trials in which the effect of lowering uric acid on hard clinical outcomes is assessed. Elevated uric acid may turn out to be one of the more important remediable risk factors for metabolic and cardiovascular diseases. PMID:26703429

Do 'food deserts' influence fruit and vegetable consumption?--A cross-sectional study.

PubMed

Pearson, Tim; Russell, Jean; Campbell, Michael J; Barker, Margo E

2005-10-01

Lack of access to affordable healthy foods has been suggested to be a contributory factor to poor diet. This study investigated associations between diet and access to supermarkets, transport, fruit and vegetable price and deprivation, in a region divergent in geography and socio-economic indices. A postal survey of 1000 addresses (response rate 42%) gathered information on family demographics, supermarket and shop use, car ownership, mobility and previous day's fruit and vegetable intake. Postcode information was used to derive road travel distance to nearest supermarket and deprivation index. Fruit and vegetable prices were assessed using a shopping basket survey. Generalised linear regression models were used to ascertain predictors of fruit and vegetable intake. Male grocery shoppers ate less fruit than female grocery shoppers. Consumption of vegetables increased slightly with age. Deprivation, supermarket fruit and vegetable price, distance to nearest supermarket and potential difficulties with grocery shopping were not significantly associated with either fruit or vegetable consumption. These data suggest that the three key elements of a food desert, fruit and vegetable price, socio-economic deprivation and a lack of locally available supermarkets, were not factors influencing fruit or vegetable intake. We suggest that food policies aimed at improving diet should be orientated towards changing socio-cultural attitudes towards food.

Enhancing Mother Infant Interactions through Video Feedback Enabled Interventions in Women with Schizophrenia: A Single Subject Research Design Study.

PubMed

Reddy, Pashapu Dharma; Desai, Geehta; Hamza, Ameer; Karthik, Sheshachala; Ananthanpillai, Supraja Thirumalai; Chandra, Prabha S

2014-10-01

It has been shown that mother infant interactions are often impaired in mothers with schizophrenia. Contributory factors include psychotic symptoms, negative symptoms and surrogate parenting by others. This study describes the effectiveness of video feedback in enhancing mother-infant interaction in mothers with schizophrenia who have impaired interaction with their infant. Two women with schizophrenia who were admitted for persistent psychotic symptoms and poor mothering skills, participated in the intervention. Pre intervention parenting assessment was done using video recording of mother infant interaction. Six sessions of mothering intervention were provided using video feedback and a repeat recording was done. Pre-and post-intervention videos were subsequently rated in a blind fashion by an independent expert in perinatal psychiatry using the pediatric infant parent exam (PIPE) scale. Pre and post intervention comparison of PIPE scores indicating significant improvement in several areas of mothering. Video feedback is a simple and inexpensive tool which can be used for improving mothering skills among mothers with postpartum psychosis or schizophrenia even in low resource settings.

Super Storm Desmond: a process-based assessment

NASA Astrophysics Data System (ADS)

Matthews, T.; Murphy, C.; McCarthy, G.; Broderick, C.; Wilby, R. L.

2018-01-01

‘Super’ Storm Desmond broke meteorological and hydrological records during a record warm year in the British-Irish Isles (BI). The severity of the storm may be a harbinger of expected changes to regional hydroclimate as global temperatures continue to rise. Here, we adopt a process-based approach to investigate the potency of Desmond, and explore the extent to which climate change may have been a contributory factor. Through an Eulerian assessment of water vapour flux we determine that Desmond was accompanied by an atmospheric river (AR) of severity unprecedented since at least 1979, on account of both high atmospheric humidity and high wind speeds. Lagrangian air-parcel tracking and moisture attribution techniques show that long-term warming of North Atlantic sea surface temperatures has significantly increased the chance of such high humidity in ARs in the vicinity of the BI. We conclude that, given exactly the same dynamical conditions associated with Desmond, the likelihood of such an intense AR has already increased by 25% due to long-term climate change. However, our analysis represents a first-order assessment, and further research is needed into the controls influencing AR dynamics.

Bioethics in China.

PubMed

Li, En-Chang

2008-09-01

Historically, the preconditions for the emergence of bioethics in China. were political reforms and their applications. The Hanzhong Euthanasia Case and the publication of Qiu Ren-zong's academic work Bioethics played a significant role in the development of bioethics in China. Other contributory factors include the establishment of the Chinese Society of Medical Ethics/Chinese Medical Association (C.M.A), the publication of the Journal of Chinese Medical Ethics, and the teaching and education of bioethics in China. Major achievements of bioethics in China include the establishment of ethics committee and ethics review system, active international communication and cooperation among the academic circles, and the successful management of the 8th World Congress of Bioethics in Beijing in 2006. Chinese bioethics focus on native Chinese realities and conditions, absorb the international research achievements in relevant fields, and combine international ideas with traditional Chinese doctrines. Admittedly, there are still some aspects to be improved, yet bioethics has attracted a lot of attention from the core leadership in China and has gained sound financial support, which augers well for its further development. This article also briefly introduces the development of bioethics in Hong Kong and Taiwan, China.

Growth failure and nutrition considerations in chronic childhood wasting diseases.

PubMed

Kyle, Ursula G; Shekerdemian, Lara S; Coss-Bu, Jorge A

2015-04-01

Growth failure is a common problem in many children with chronic diseases. This article is an overview of the most common causes of growth failure/growth retardation that affect children with a number of chronic diseases. We also briefly review the nutrition considerations and treatment goals. Growth failure is multifactorial in children with chronic conditions, including patients with cystic fibrosis, chronic kidney disease, chronic liver disease, congenital heart disease, human immunodeficiency virus, inflammatory bowel disease, short bowel syndrome, and muscular dystrophies. Important contributory factors to growth failure include increased energy needs, increased energy loss, malabsorption, decreased energy intake, anorexia, pain, vomiting, intestinal obstruction, and inflammatory cytokines. Various metabolic and pathologic abnormalities that are characteristic of chronic diseases further lead to significant malnutrition and growth failure. In addition to treating disease-specific abnormalities, treatment should address the energy and protein deficits, including vitamin and mineral supplements to correct deficiencies, correct metabolic and endocrinologic abnormalities, and include long-term monitoring of weight and growth. Individualized, age-appropriate nutrition intervention will minimize the malnutrition and growth failure seen in children with chronic diseases. © 2014 American Society for Parenteral and Enteral Nutrition.

Viewpoint: A Contributory Role of Shell Ginger (Alpinia zerumbet) for Human Longevity in Okinawa, Japan?

PubMed Central

Teschke, Rolf

2018-01-01

The longevity of the population in the Okinawa Islands of Japan has been ascribed to genetic factors and the traditional Okinawa cuisine, which is low in calories and high in plant content. This diet includes shell ginger (Alpinia zerumbet (Pers.) B.L. Burtt & R.M. Sm) of the ginger family (Zingiberaceae). Due to its local popularity, Alpinia zerumbet has become the subject of a good deal of study at the University of the Ryukyus in Okinawa. Personal local experience and review of the literature now suggest that culinary shell ginger may contribute to longevity among the population in Okinawa. This is supported by its abundant phytochemical content, with antioxidant and anti-obesity properties. The major bioactive phytochemicals are dihydro-5,6-dehydrokawain (DDK; 80–410 mg g−1 fresh weight), 5,6-dehydrokawain (DK; ≤100 mg g−1), and essential oils, phenols, phenolic acids, and fatty acids (≤150 mg g−1 each). Further, Alpinia zerumbet extends the lifespan in animals by 22.6%. In conclusion, culinary shell ginger may significantly contribute to human longevity in Okinawa. PMID:29385084

Complex and novel determinants of empathy change in medical students

PubMed Central

Ren, Gerald Sng Gui; Min, Joshua Tung Yi; Ping, Yeo Su; Shing, Lee Shuh; Win, Ma Thin Mar; Chuan, Hooi Shing; Samarasekera, Dujeepa D.

2016-01-01

Purpose: Physician empathy is a core attribute in medical professionals, giving better patient outcomes. Medical school is an opportune time for building empathetic foundations. This study explores empathy change and focuses on contributory factors. Methods: We conducted a cross-sectional study involving 881 students (63%) from Years 1 to 5 in a Singaporean medical school using the Jefferson Scale of Physician Empathy-Student version (JSPE-S) and a questionnaire investigating the relationship between reported and novel personal-social empathy determinants. Results: Empathy declined significantly between preclinical and clinical years. Female and medical specialty interest respondents had higher scores than their counterparts. Despite strong internal consistency, factor analysis suggested that the JSPE model is not a perfect fit. Year 1 students had highest Perspective Taking scores and Year 2 students had highest Compassionate Care scores. High workload and inappropriate learning environments were the most relevant stressors. Time spent with family, arts, and community service correlated with higher empathy scores, whilst time spent with significant others and individual leisure correlated with lower scores. Thematic analysis revealed that the most common self-reported determinants were exposure to activity (community service) or socialisation, personal and family-related event as well as environment (high work-load). Conclusion: While the empathy construct in multicultural Singapore is congruent with a Western model, important differences remain. A more subtle understanding of the heterogeneity of the medical student experience is important. A greater breadth of determinants of empathy, such as engagement in arts-related activities should be considered. PMID:26838570

Testosterone and mortality.

PubMed

Muraleedharan, Vakkat; Jones, T Hugh

2014-10-01

Epidemiological studies have found that men with low or low normal endogenous testosterone are at an increased risk of mortality than those with higher levels. Cardiovascular disease accounts for the greater proportion of deaths in those with low testosterone. Cancer and respiratory deaths in some of the studies are also significantly more prevalent. Disease-specific studies have identified that there are higher mortality rates in men with cardiovascular, respiratory and renal diseases, type 2 diabetes and cancer with low testosterone. Obesity, metabolic syndrome, type 2 diabetes, cardiovascular disease and inflammatory disorders are all associated with an increased prevalence of testosterone deficiency. Two major questions that arise from these findings are (1) is testosterone deficiency directly involved in the pathogenesis of these conditions and/or a contributory factor impairing the body's natural defences or is it merely a biomarker of ill health and the severity of underlying disease process? (2) Does testosterone replacement therapy retard disease progression and ultimately enhance the clinical prognosis and survival? This review will discuss the current state of knowledge and discuss whether or not there are any answers to either of these questions. There is convincing evidence that low testosterone is a biomarker for disease severity and mortality. Testosterone deficiency is associated with adverse effects on certain cardiovascular risk factors that when combined could potentially promote atherosclerosis. The issue of whether or not testosterone replacement therapy improves outcomes is controversial. Two retrospective studies in men with diagnosed hypogonadism with or without type 2 diabetes have reported significantly improved survival. © 2014 John Wiley & Sons Ltd.

Complex and novel determinants of empathy change in medical students.

PubMed

Sng, Gerald; Tung, Joshua; Ping, Yeo Su; Lee, Shuh Shing; Win, Ma Thin Mar; Hooi, Shing Chuan; Samarasekera, Dujeepa D

2016-03-01

Physician empathy is a core attribute in medical professionals, giving better patient outcomes. Medical school is an opportune time for building empathetic foundations. This study explores empathy change and focuses on contributory factors. We conducted a cross-sectional study involving 881 students (63%) from Years 1 to 5 in a Singaporean medical school using the Jefferson Scale of Physician Empathy-Student version (JSPE-S) and a questionnaire investigating the relationship between reported and novel personal-social empathy determinants. Empathy declined significantly between preclinical and clinical years. Female and medical specialty interest respondents had higher scores than their counterparts. Despite strong internal consistency, factor analysis suggested that the JSPE model is not a perfect fit. Year 1 students had highest Perspective Taking scores and Year 2 students had highest Compassionate Care scores. High workload and inappropriate learning environments were the most relevant stressors. Time spent with family, arts, and community service correlated with higher empathy scores, whilst time spent with significant others and individual leisure correlated with lower scores. Thematic analysis revealed that the most common self-reported determinants were exposure to activity (community service) or socialisation, personal and family-related event as well as environment (high work-load). While the empathy construct in multicultural Singapore is congruent with a Western model, important differences remain. A more subtle understanding of the heterogeneity of the medical student experience is important. A greater breadth of determinants of empathy, such as engagement in arts-related activities should be considered.

PB1-F2 Peptide Derived from Avian Influenza A Virus H7N9 Induces Inflammation via Activation of the NLRP3 Inflammasome.

PubMed

Pinar, Anita; Dowling, Jennifer K; Bitto, Natalie J; Robertson, Avril A B; Latz, Eicke; Stewart, Cameron R; Drummond, Grant R; Cooper, Matthew A; McAuley, Julie L; Tate, Michelle D; Mansell, Ashley

2017-01-20

The emergence of avian H7N9 influenza A virus in humans with associated high mortality has highlighted the threat of a potential pandemic. Fatal H7N9 infections are characterized by hyperinflammation and increased cellular infiltrates in the lung. Currently there are limited therapies to address the pathologies associated with H7N9 infection and the virulence factors that contribute to these pathologies. We have found that PB1-F2 derived from H7N9 activates the NLRP3 inflammasome and induces lung inflammation and cellular recruitment that is NLRP3-dependent. We have also shown that H7N9 and A/Puerto Rico/H1N1 (PR8)PB1-F2 peptide treatment induces significant mitochondrial reactive oxygen production, which contributes to NLRP3 activation. Importantly, treatment of cells or mice with the specific NLRP3 inhibitor MCC950 significantly reduces IL-1β maturation, lung cellular recruitment, and cytokine production. Together, these results suggest that PB1-F2 from H7N9 avian influenza A virus may be a major contributory factor to disease pathophysiology and excessive inflammation characteristic of clinical infections and that targeting the NLRP3 inflammasome may be an effective means to reduce the inflammatory burden associated with H7N9 infections. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Effects of cannabis use on body mass, fasting glucose and lipids during the first 12 months of treatment in schizophrenia spectrum disorders.

PubMed

Scheffler, F; Kilian, S; Chiliza, B; Asmal, L; Phahladira, L; du Plessis, S; Kidd, M; Murray, R M; Di Forti, M; Seedat, S; Emsley, R

2018-03-06

While acute cannabis use stimulates appetite, general population studies suggest that chronic use is associated with reduced risk of obesity and other cardiometabolic risk factors. In this study we investigated changes in body mass index (BMI), fasting blood glucose and lipids, and rates of metabolic syndrome risk factors in cannabis users vs. non-users in 109 minimally treated patients with first-episode schizophrenia, schizophreniform or schizo-affective disorder who were treated according to a standardized treatment regime with depot antipsychotic medication over 12 months. Participants underwent repeated urine toxicology tests for cannabis and those testing positive at any time during the study (n = 40), were compared with those who tested negative at all time points (n = 69). There was a significant group*time interaction effect (p = 0.002) with the cannabis negative group showing a greater increase in BMI than the cannabis positive group, after adjusting for age, sex, methamphetamine use and modal dose of antipsychotic. There were no group*time interaction effects for fasting blood glucose or lipids. Post hoc tests indicated significant increases in fasting blood glucose and triglycerides and a decrease in high-density lipoprotein cholesterol for the cannabis negative group, with no significant changes in the cannabis positive group. Rates of metabolic syndrome did not differ significantly between groups, although more cannabis negative patients had elevated waist-circumference at endpoint (p = 0.003). It may be that chronic cannabis use directly suppresses appetite, thereby preventing weight gain in users. However, other indirect effects such as dietary neglect and smoking may be contributory and could explain our findings. Copyright © 2018 Elsevier B.V. All rights reserved.

Impact of Computer Related Posture on the Occurrence of Musculoskeletal Discomfort among Secondary School Students in Lagos, Nigeria.

PubMed

Odebiyi, D O; Olawale, O A; Adeniji, Y M

2013-01-01

Computers have become an essential part of life particularly in industrially advanced countries of the world. Children now have greater accessibility to computers both at school and at home. Recent studies suggest that with this increased exposure, there are associated musculoskeletal disorders (MSDs) in both school-aged children and adults. To assess the posture assumed by secondary school students during computer use and its impact on the occurrence and severity of reported musculoskeletal discomforts. Posture assumed during normal computer class, occurrence of discomforts, body parts involved and the intensity of discomforts were evaluated in 235 school aged children using Rapid Upper Limb Assessment (RULA) scale, Body Discomfort Chart (BDC) and Visual Analogue Scale (VAS) before and after normal computer class. Inferential statistics of t-test and chi-square were used to determine significance difference between variables, with level of significant set at p < 0.05. None of the participants demonstrated acceptable posture. Computer use produced significant discomforts on the neck, shoulder and low back. There was a significant relationship between participants height and posture assumed. Two hundred and eleven (89.8%) participants reported discomforts/pain during the use of computer. Weight and height were contributory factors to the occurrence of musculoskeletal discomfort/pain (p < 0.05) in some of the body parts studied. Musculoskeletal discomfort was found to be a problem among the school-aged children during computer use. Weight and height were implicated as factors that influenced the form of posture and the nature of the reported discomfort. Creating awareness about the knowledge of ergonomics and safety for promotion of good posture was therefore recommended.

Genome-Wide Significant Association between Alcohol Dependence and a Variant in the ADH Gene Cluster

PubMed Central

Frank, Josef; Cichon, Sven; Treutlein, Jens; Ridinger, Monika; Mattheisen, Manuel; Hoffmann, Per; Herms, Stefan; Wodarz, Norbert; Soyka, Michael; Zill, Peter; Maier, Wolfgang; Mössner, Rainald; Gaebel, Wolfgang; Dahmen, Norbert; Scherbaum, Norbert; Schmäl, Christine; Steffens, Michael; Lucae, Susanne; Ising, Marcus; Müller-Myhsok, Bertram; Nöthen, Markus M; Mann, Karl; Kiefer, Falk; Rietschel, Marcella

2011-01-01

Alcohol dependence (AD) is an important contributory factor to the global burden of disease. The etiology of AD involves both environmental and genetic factors, and the disorder has a heritability of around 50%. The aim of the present study was to identify susceptibility genes for AD by performing a genome-wide association study (GWAS). The sample comprised 1,333 male in-patients with severe DSM-IV AD and 2,168 controls. These included 487 patients and 1,358 controls from a previous GWAS study by our group. All individuals were of German descent. Single marker tests and a polygenic score based analysis to assess the combined contribution of multiple markers with small effects were performed. The SNP rs1789891, which is located between the ADH1B and ADH1C genes, achieved genome-wide significance (p=1.27E–8; OR=1.46). Other markers from this region were also associated with AD, and conditional analyses indicated that these made a partially independent contribution. The SNP rs1789891 is in complete linkage disequilibrium with the functional Arg272Gln variant (p=1.24E–7, OR=1.31) of the ADH1C gene, which has been reported to modify the rate of ethanol oxidation to acetaldehyde in vitro. A polygenic score based approach produced a significant result (p=9.66E–9). This is the first GWAS of AD to provide genome-wide significant support for the role of the ADH gene cluster and to suggest a polygenic component to the etiology of AD. The latter result suggests that many more AD susceptibility genes still await identification. PMID:22004471

Environmental and lifestyle risk factors of gastric cancer.

PubMed

Lee, Yeong Yeh; Derakhshan, Mohammad H

2013-06-01

Effective prevention and early diagnostic strategies are the most important public health interventions in gastric cancer, which remains a common malignancy worldwide. Preventive strategies require identification and understanding of environmental risk factors that lead to carcinogenesis. Helicobacter pylori (H. pylori) is the primary carcinogen as this ancient bacterium has a complex ability to interact with its human host. Smoking and salt are strong independent risk factors for gastric cancer whereas alcohol is only a risk when it is heavily consumed. Red meat and high fat increase the risk of gastric cancer however fresh fruits, vegetables (allium family) and certain micronutrients (selenium, vitamin C) reduce the risk, with evidence lacking for fish, coffee and tea. Foods that inhibit H. pylori viability, colonization and infection may reduce cancer risk. Obesity is increasingly recognized as a contributory factor in gastric cardia carcinogenesis. Therefore, modest daily physical activities can be protective against cancer. Foundry workers are at risk for developing gastric cancer with dust iron being an important cause. Other risk factors include Epstein-Barr virus (EBV), possibly JC virus and radiation but the effects of these are likely to remain small.

Exploring factors affecting registered nurses' pursuit of postgraduate education in Australia.

PubMed

Ng, Linda; Eley, Robert; Tuckett, Anthony

2016-12-01

The aim of this study was to explore the factors influencing registered nurses' pursuit of postgraduate education in specialty nursing practice in Australia. Despite the increased requirement for postgraduate education for advanced practice, little has been reported on the contributory factors involved in the decision to undertake further education. The Nurses' Attitudes Towards Postgraduate Education instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study across Australia, with a response rate of 35.9% (n = 568). Data reduction techniques using principal component analysis with varimax rotation were used. The analysis identified a three-factor solution for 14 items, accounting for 52.5% of the variance of the scale: "facilitators," "professional recognition," and "inhibiting factors." Facilitators of postgraduate education accounted for 28.5% of the variance, including: (i) improves knowledge; (ii) increases nurses' confidence in clinical decision-making; (iii) enhances nurses' careers; (iv) improves critical thinking; (v) improves nurses' clinical skill; and (vi) increased job satisfaction. This new instrument has potential clinical and research applications to support registered nurses' pursuit of postgraduate education. © 2016 John Wiley & Sons Australia, Ltd.

Impact of the non-contributory social pension program 70 y más on older adults' mental well-being.

PubMed

Salinas-Rodríguez, Aarón; Torres-Pereda, Ma Del Pilar; Manrique-Espinoza, Betty; Moreno-Tamayo, Karla; Téllez-Rojo Solís, Martha María

2014-01-01

In 2007, a non-contributory pension program was launched in rural areas of Mexico. The program consisted in a non-conditional cash transfer of US$40 monthly to all older adults (OA) aged 70 and over. We evaluate the effect of the program on mental well-being of its beneficiaries. Quantitative and qualitative methods were used. For the quantitative component, we used the selection criteria established by the program (age and locality size) to form the Intervention (OA aged 70-74 residing in rural localities, <2500 inhabitants) and Control groups (OA aged 70-74, in localities with 2501-2700 inhabitants). Baseline data collection was conducted in 2007 where 5,465 OA were interviewed. The follow-up survey was conducted in 2008, and it was possible to interview 5,270 OA, with a response rate of 96%. A difference-in-difference linear probability model with individual fixed effect was used to estimate the impact of the program on mental well-being indicators. In 2009 a qualitative component was designed to explore possible causal pathways of such effect. After a year of exposure, the program had a significant effect on reduction of depressive symptoms (β = -0.06, CI95% -0.12; -0.01) and an increase in empowerment indicators: OA participated in important household decisions (β = 0.09, CI95% 0.03;0.15); and OA participated in household decisions pertaining to expenses (β = 0.11, CI95% 0.05;0.18). Qualitative analysis found a strong trend showing a reduction of sadness, and feeling of increasing empowerment. These results suggest that a non-conditional transfer in older ages have an impact beyond the economic sphere, impacting even the mental well-being. This effect could be explained because the pension produces feelings of safety and welfare. It is recommendable that governments should invest efforts towards universalizing the non-contributory pension programs in order to ensure a basic income for the elderly.

Expression of macrophage migration inhibitory factor in footpad skin lesions with diabetic neuropathy.

PubMed

Up Noh, Sun; Lee, Won-Young; Kim, Won-Serk; Lee, Yong-Taek; Jae Yoon, Kyung

2018-01-01

Background Diabetic neuropathy originating in distal lower extremities is associated with pain early in the disease course, overwhelming in the feet. However, the pathogenesis of diabetic neuropathy remains unclear. Macrophage migration inhibitory factor has been implicated in the onset of neuropathic pain and the development of diabetes. Objective of this study was to observe pain syndromes elicited in the footpad of diabetic neuropathy rat model and to assess the contributory role of migration inhibitory factor in the pathogenesis of diabetic neuropathy. Methods Diabetic neuropathy was made in Sprague Dawley rats by streptozotocin. Pain threshold was evaluated using von Frey monofilaments for 24 weeks. On comparable experiment time after streptozotocin injection, all footpads were prepared for following procedures; glutathione assay, terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling staining, immunohistochemistry staining, real-time reverse transcription polymerase chain reaction, and Western blot. Additionally, human HaCaT skin keratinocytes were treated with methylglyoxal, transfected with migration inhibitory factor/control small interfering RNA, and prepared for real-time reverse transcription polymerase chain reaction and Western blot. Results As compared to sham group, pain threshold was significantly reduced in diabetic neuropathy group, and glutathione was decreased in footpad skin, simultaneously, cell death was increased. Over-expression of migration inhibitory factor, accompanied by low expression of glyoxalase-I and intraepidermal nerve fibers, was shown on the footpad skin lesions of diabetic neuropathy. But, there was no significance in expression of neurotransmitters and inflammatory mediators such as transient receptor potential vanilloid 1, mas-related G protein coupled receptor D, nuclear factor kappa B, tumor necrosis factor-alpha, and interleukin-6 between diabetic neuropathy group and sham group. Intriguingly, small interfering RNA-transfected knockdown of the migration inhibitory factor gene in methylglyoxal-treated skin keratinocytes increased expression of glyoxalase-I and intraepidermal nerve fibers in comparison with control small interfering RNA-transfected cells, which was decreased by induction of methylglyoxal. Conclusions Our findings suggest that migration inhibitory factor can aggravate diabetic neuropathy by suppressing glyoxalase-I and intraepidermal nerve fibers on the footpad skin lesions and provoke pain. Taken together, migration inhibitory factor might offer a pharmacological approach to alleviate pain syndromes in diabetic neuropathy.

The Role of Nutrition and Literacy on the Cognitive Functioning of Elderly Poor Individuals.

PubMed

Leist, Anja K; Novella, Rafael; Olivera, Javier

2018-06-08

Maintaining cognitive function is a prerequisite of living independently, which is a highly valued component in older individuals' wellbeing. In this paper we assess the role of early-life and later-life nutritional status, education and literacy on the cognitive functioning of older adults living in poverty in Peru. We exploit the baseline sample of the Peruvian non-contributory pension program Pension 65 and find that current nutritional status and literacy are strongly associated with cognitive functioning for poor older adults. In a context of rising popularity of non-contributory pension programs around the world, our study intends to contribute to the discussion of designing accompanying measures to the pension transfer, such as adult literacy programs and monitoring of adequate nutrition of older adults.

Psychosocial and environmental factors in the prognosis of individuals with chronic pain and comorbid mental health.

PubMed

Hruschak, Valerie; Cochran, Gerald

2017-08-01

Chronic pain has considerable medical, social, and economic implications as its high prevalence rate and negative societal burden provides justification that it is a major health issue. The value of understanding psychological, social, and environmental factors in chronic pain has become widely recognized and accepted as a biopsychosocial phenomenon in which the social work perspective offers a valuable lens. Through the critical application of systems theory and ecological perspective, accompanied with the diathesis stress model, this article examines psychosocial and environmental influences as being contributory factors in the prognosis of individuals with chronic pain and comorbid mental health disorders. The social work profession will also be explored as playing a definite role in addressing elements pertaining to pain management depicted from these theories. Lastly, implications for research, policy, and practice will be reviewed to better understand the association between psychosocial and environmental influences of individuals with chronic pain and comorbid mental health issues.

Application of foodborne disease outbreak data in the development and maintenance of HACCP systems.

PubMed

Panisello, P J; Rooney, R; Quantick, P C; Stanwell-Smith, R

2000-09-10

Five-hundred and thirty general foodborne outbreaks of food poisoning reported in England and Wales between 1992 and 1996 were reviewed to study their application to the development and maintenance of HACCP systems. Retrospective investigations of foodborne disease outbreaks provided information on aetiological agents, food vehicles and factors that contributed to the outbreaks. Salmonella spp. and foods of animal origin (red meat, poultry and seafood) were most frequently associated with outbreaks during this period. Improper cooking, inadequate storage, cross-contamination and use of raw ingredients in the preparation of food were the most common factors contributing to outbreaks. Classification and cross tabulation of surveillance information relating to aetiological agents, food vehicles and contributory factors facilitates hazard analysis. In forming control measures and their corresponding critical limits, this approach focuses monitoring on those aspects that are critical to the safety of the product. Incorporation of epidemiological data in the documentation of HACCP systems provides assurance that the system is based on the best scientific information available.

The Blood Compatibilities of Blood Purification Membranes and Other Materials Developed in Japan

PubMed Central

Abe, Takaya; Kato, Karen; Fujioka, Tomoaki; Akizawa, Tadao

2011-01-01

The biocompatibilities in blood purification therapy are defined as “a concept to stipulate safety of blood purification therapy by an index based on interaction in the body arising from blood purification therapy itself.” The biocompatibilities are associated with not only materials to be used but also many factors such as sterilization method and eluted substance. It is often evaluated based on impacts on cellular pathways and on humoral pathways. Since the biocompatibilities of blood purification therapy in particular hemodialysis are not just a prognostic factor for dialysis patients but a contributory factor for long-term complications, it should be considered with adequate attention. It is important that blood purification therapy should be performed by consistently evaluating not only risks associated with these biocompatibilities but also the other advantages obtained from treatments. In this paper, the biocompatibilities of membrane and adsorption material based on Japanese original which are used for blood purification therapy are described. PMID:21969830

Children Seeking Refuge: A Review of the Escalating Humanitarian Crisis of Child Sexual Abuse and HIV/AIDS in Latin America.

PubMed

Thornton, Clifton P; Veenema, Tener Goodwin

2015-01-01

Early identification and intervention for victims of child sexual abuse (CSA) is essential to halting the spread of HIV in Latino populations because children who are sexually abused are at an increased risk of contracting HIV. The recent influx of unaccompanied children into the United States exposed histories of victimization, vulnerability to CSA, and suggested an epidemic of CSA in Latin America. CSA has been identified as a contributory event to HIV infection. The aim of our research was to identify factors associated with CSA and Latin Americans. A systematic review and a document search were conducted on factors associated with CSA in Latin America. Victimization was associated with lifelong risk factors for HIV. Males were consistently underrepresented in the published CSA literature and machismo attitudes may contribute to abuses of sexual power by males and contribute to males not reporting or under-reporting victimization. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Exome Sequencing in an Admixed Isolated Population Indicates NFXL1 Variants Confer a Risk for Specific Language Impairment

PubMed Central

Villanueva, Pía; Nudel, Ron; Hoischen, Alexander; Fernández, María Angélica; Simpson, Nuala H.; Gilissen, Christian; Reader, Rose H.; Jara, Lillian; Echeverry, Maria Magdalena; Francks, Clyde; Baird, Gillian; Conti-Ramsden, Gina; O’Hare, Anne; Bolton, Patrick F.; Hennessy, Elizabeth R.; Palomino, Hernán; Carvajal-Carmona, Luis; Veltman, Joris A.; Cazier, Jean-Baptiste; De Barbieri, Zulema

2015-01-01

Children affected by Specific Language Impairment (SLI) fail to acquire age appropriate language skills despite adequate intelligence and opportunity. SLI is highly heritable, but the understanding of underlying genetic mechanisms has proved challenging. In this study, we use molecular genetic techniques to investigate an admixed isolated founder population from the Robinson Crusoe Island (Chile), who are affected by a high incidence of SLI, increasing the power to discover contributory genetic factors. We utilize exome sequencing in selected individuals from this population to identify eight coding variants that are of putative significance. We then apply association analyses across the wider population to highlight a single rare coding variant (rs144169475, Minor Allele Frequency of 4.1% in admixed South American populations) in the NFXL1 gene that confers a nonsynonymous change (N150K) and is significantly associated with language impairment in the Robinson Crusoe population (p = 2.04 × 10–4, 8 variants tested). Subsequent sequencing of NFXL1 in 117 UK SLI cases identified four individuals with heterozygous variants predicted to be of functional consequence. We conclude that coding variants within NFXL1 confer an increased risk of SLI within a complex genetic model. PMID:25781923

Effect of alternate day collection on semen quality of Asian elephants (Elephas maximus) with poor initial fresh semen quality.

PubMed

Imrat, P; Mahasawangkul, S; Thitaram, C; Suthanmapinanth, P; Kornkaewrat, K; Sombutputorn, P; Jansittiwate, S; Thongtip, N; Pinyopummin, A; Colenbrander, B; Holt, W V; Stout, T A E

2014-06-30

In captivity, male Asian elephants often yield poor quality semen after transrectal manually assisted semen collection; however, the reasons for the disappointing semen quality are not clear. Here we test the hypothesis that accumulation of senescent spermatozoa is a contributory factor, and that semen quality can therefore be improved by more frequent ejaculation. To this end we investigated the effect of collecting semen five times on alternate days, after a long period of sexual rest, on semen quality in Asian elephants known to deliver poor semen during infrequent single collections. All eight bulls initially displayed a high incidence of detached sperm heads and low percentages of motile (close to 0%) spermatozoa. After semen collection on alternate days, the percentages of detached sperm heads, and head and mid-piece abnormalities, were reduced significantly (p<0.05). In particular, one bull showed markedly improved sperm motility (increased from 0% to 60%) and membrane integrity (increased from 5% to 75%). In addition, advancing age significantly (p<0.01) correlated with lower percentages of sperm with intact membranes and a higher frequency of detached sperm heads. In contrast to sperm accumulation problems in other species, a small ampullary diameter correlated significantly (p<0.05) with reduced semen quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Clinical management issues vary by specialty in the Victorian Audit of Surgical Mortality: a retrospective observational study

PubMed Central

Vinluan, Jessele; Retegan, Claudia; Chen, Andrew; Beiles, Charles Barry

2014-01-01

Objective Clinical management issues are contributory factors to mortality. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM), an educational peer-review process for surgeons, to discover differences in the incidence of these issues between surgical specialties in order to focus attention to areas of care that might be improved. Design This study used retrospectively analysed observational data from VASM. Clinical management issues between eight specialties were assessed using χ2 analysis. Data sources VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Results A total of 2946 specific clinical issues as deficiencies of care were reported. 15% of cases had significant issues of care. The most common clinical management issue was the delay in delivery of treatment. Other clinical issues included the quality of communication and documentation, preoperative and postoperative care, adverse events and protocol issues. There were significant differences in issues between specialties. Conclusions The clinical management issues presented across surgical specialties were similar; however, five issues of clinical care differed significantly in frequency across surgical specialties. The three main issues varying among specialties were complications after operation, communication and postoperative care. Addressing these clinical management issues via the peer-review process may impact positively on patient care. PMID:24980043

The District Nursing Clinical Error Reduction Programme.

PubMed

McGraw, Caroline; Topping, Claire

2011-01-01

The District Nursing Clinical Error Reduction (DANCER) Programme was initiated in NHS Islington following an increase in the number of reported medication errors. The objectives were to reduce the actual degree of harm and the potential risk of harm associated with medication errors and to maintain the existing positive reporting culture, while robustly addressing performance issues. One hundred medication errors reported in 2007/08 were analysed using a framework that specifies the factors that predispose to adverse medication events in domiciliary care. Various contributory factors were identified and interventions were subsequently developed to address poor drug calculation and medication problem-solving skills and incorrectly transcribed medication administration record charts. Follow up data were obtained at 12 months and two years. The evaluation has shown that although medication errors do still occur, the programme has resulted in a marked shift towards a reduction in the associated actual degree of harm and the potential risk of harm.

The prevalence of Vitamin D deficiency is higher in adult survivors of childhood cancer.

PubMed

Neville, Kristen A; Walker, Jan L; Cohn, Richard J; Cowell, Christopher T; White, Christopher P

2015-05-01

It is unclear whether the rate of vitamin D deficiency in paediatric cancer survivors is higher than in the background population, and whether this is of pathological significance. 25OHD was measured in a previously studied group of 208 survivors (n = 108 paediatric 5-17 years, n = 99 adults 18-39 years) and compared with paediatric (5-17 years; n = 132) and adult controls (25-35 years; n = 1393 from the AusDiab cohort) adjusted for age and gender. Relationships with treatment factors (irradiation, bone marrow transplantation and intensity of treatment) along with overweight/obesity (defined by BMI), abdominal adiposity (waist:height ratio >0·5) and hyperinsulinism or abnormal glucose tolerance (HI/aGT) were sought. 25OHD concentrations were similar in paediatric survivors compared with controls (64·3 ± 21·6 nmol/l vs 66·3 ± 22·8 nmol/l), with no effect of age or gender. Adjusted for gender, rates of 25OHD deficiency (<50 nmol/l) were higher in adult survivors compared with AusDiab controls (42·4% vs 20·8%; P < 0·001). Apart from time since diagnosis (P = 0·03), no relationship with treatment factors was detected. In multivariate regression analysis, abdominal adiposity (P = 0·001), but not overweight/obesity by BMI status nor HI/aGT, was associated with significantly lower 25OHD concentrations. Adult survivors are at increased risk of abnormalities in vitamin D compared to the background population, probably reflecting longer time since diagnosis. Like others, we have not identified any contributory treatment-related factors. Vitamin D deficiency does not appear to be associated with the development of abnormal glucose tolerance in this population. © 2015 John Wiley & Sons Ltd.

Dispelling dogma and misconceptions regarding the most pharmacologically targetable source of reactive species in inflammatory disease, xanthine oxidoreductase.

PubMed

Kelley, Eric E

2015-08-01

Xanthine oxidoreductase (XOR), the molybdoflavin enzyme responsible for the terminal steps of purine degradation in humans, is also recognized as a significant source of reactive species contributory to inflammatory disease. In animal models and clinical studies, inhibition of XOR has resulted in diminution of symptoms and enhancement of function in a number of pathologies including heart failure, diabetes, sickle cell anemia, hypertension and ischemia-reperfusion injury. For decades, XOR involvement in pathologic processes has been established by salutary outcomes attained from treatment with the XOR inhibitor allopurinol. This has served to frame a working dogma that elevation of XOR-specific activity is associated with enhanced rates of reactive species generation that mediate negative outcomes. While adherence to this narrowly focused practice of designating elevated XOR activity to be "bad" has produced some benefit, it has also led to significant underdevelopment of the processes mediating XOR regulation, identification of alternative reactants and products as well as micro-environmental factors that alter enzymatic activity. This is exemplified by recent reports: (1) identifying XOR as a nitrite reductase and thus a source of beneficial nitric oxide ((•)NO) under in vivo conditions similar to those where XOR inhibition has been assumed an optimal treatment choice, (2) describing XOR-derived uric acid (UA) as a critical pro-inflammatory mediator in vascular and metabolic disease and (3) ascribing an antioxidant/protective role for XOR-derived UA. When taken together, these proposed and countervailing functions of XOR affirm the need for a more comprehensive evaluation of product formation as well as the factors that govern product identity. As such, this review will critically evaluate XOR-catalyzed oxidant, (•)NO and UA formation as well as identify factors that mediate their production, inhibition and the resultant impact on inflammatory disease.

Workplace Violence and Harassment Against Emergency Medicine Residents

PubMed Central

Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

2016-01-01

Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

Workplace Violence and Harassment Against Emergency Medicine Residents.

PubMed

Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A

2016-09-01

Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

The Effect of Low-Frequency Road Noise on Driver Sleepiness and Performance

PubMed Central

Anund, Anna; Lahti, Eva; Fors, Carina; Genell, Anders

2015-01-01

It is a well-known fact today that driver sleepiness is a contributory factor in crashes. Factors considered as sleepiness contributor are mostly related to time of the day, hours being awake and hours slept. Factors contributing to active and passive fatigue are mostly focusing on the level of cognitive load. Less is known what role external factors, e.g. type of road, sound/noise, vibrations etc., have on the ability to stay awake both under conditions of sleepiness and under active or passive fatigue. The aim of this moving base driving simulator study with 19 drivers participating in a random order day and night time, was to evaluate the effect of low-frequency road noise on driver sleepiness and performance, including both long-term and short-term effects. The results support to some extent the hypothesis that road-induced interior vehicle sound affects driving performance and driver sleepiness. Increased low-frequency noise helps to reduce speed during both day- and night time driving, but also contributes to increase the number of lane crossings during night time. PMID:25874883

The effect of low-frequency road noise on driver sleepiness and performance.

PubMed

Anund, Anna; Lahti, Eva; Fors, Carina; Genell, Anders

2015-01-01

It is a well-known fact today that driver sleepiness is a contributory factor in crashes. Factors considered as sleepiness contributor are mostly related to time of the day, hours being awake and hours slept. Factors contributing to active and passive fatigue are mostly focusing on the level of cognitive load. Less is known what role external factors, e.g. type of road, sound/noise, vibrations etc., have on the ability to stay awake both under conditions of sleepiness and under active or passive fatigue. The aim of this moving base driving simulator study with 19 drivers participating in a random order day and night time, was to evaluate the effect of low-frequency road noise on driver sleepiness and performance, including both long-term and short-term effects. The results support to some extent the hypothesis that road-induced interior vehicle sound affects driving performance and driver sleepiness. Increased low-frequency noise helps to reduce speed during both day- and night time driving, but also contributes to increase the number of lane crossings during night time.

Stakeholder conceptualisation of multi-level HIV and AIDS determinants in a Black epicentre.

PubMed

Brawner, Bridgette M; Reason, Janaiya L; Hanlon, Kelsey; Guthrie, Barbara; Schensul, Jean J

2017-09-01

HIV has reached epidemic proportions among African Americans in the USA but certain urban contexts appear to experience a disproportionate disease burden. Geographic information systems mapping in Philadelphia indicates increased HIV incidence and prevalence in predominantly Black census tracts, with major differences across adjacent communities. What factors shape these geographic HIV disparities among Black Philadelphians? This descriptive study was designed to refine and validate a conceptual model developed to better understand multi-level determinants of HIV-related risk among Black Philadelphians. We used an expanded ecological approach to elicit reflective perceptions from administrators, direct service providers and community members about individual, social and structural factors that interact to protect against or increase the risk for acquiring HIV within their community. Gender equity, social capital and positive cultural mores (e.g., monogamy, abstinence) were seen as the main protective factors. Historical negative contributory influences of racial residential segregation, poverty and incarceration were among the most salient risk factors. This study was a critical next step toward initiating theory-based, multi-level community-based HIV prevention initiatives.

Lorcaserin and CP-809101 reduce motor impulsivity and reinstatement of food seeking behavior in male rats: Implications for understanding the anti-obesity property of 5-HT2C receptor agonists.

PubMed

Higgins, Guy A; Silenieks, Leo B; Altherr, Everett B; MacMillan, Cam; Fletcher, Paul J; Pratt, Wayne E

2016-07-01

The 5-HT2C receptor agonist lorcaserin (Belviq®) has been approved by the FDA for the treatment of obesity. Impulsivity is a contributory feature of some eating disorders. Experiments investigated the effect of lorcaserin and the highly selective 5-HT2C agonist CP-809101 on measures of impulsivity and on reinstatement of food-seeking behaviour, a model of dietary relapse. The effect of both drugs on 22-h deprivation-induced feeding was also examined, as was the effect of prefeeding in each impulsivity test. Lorcaserin (0.3-0.6 mg/kg SC) and CP-809101 (0.6-1 mg/kg SC) reduced premature responding in rats trained on the 5-CSRTT and improved accuracy in a Go-NoGo task by reducing false alarms. At equivalent doses, both drugs also reduced reinstatement for food-seeking behaviour. Neither drug altered impulsive choice measured in a delay-discounting task. Lorcaserin (1-3 mg/kg SC) and CP-809101 (3-6 mg/kg SC) reduced deprivation-induced feeding but only at higher doses. These results suggest that in addition to previously reported effects on satiety and reward, altered impulse control may represent a contributory factor to the anti-obesity property of 5-HT2C receptor agonists. Lorcaserin may promote weight loss by improving adherence to dietary regimens in individuals otherwise prone to relapse and may be beneficial in cases where obesity is associated with eating disorders tied to impulsive traits, such as binge eating disorder.

Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome.

PubMed

Gupta, Ravi Kumar; Jindal, Nipun; Kamboj, Kulbhushan

2014-12-01

No study has ever evaluated the causes and effect of neglect on the outcome of post burns contractures of hand in children. 66 hands in 61 children (mean age 12.22 years) with a mean neglect of 11.6 years (range 5-17 years) were assessed for the causes of neglect and the outcome of surgery. Average follow up was 6.6 years. The results were assessed in two groups of 5-10 years neglect as group I and >10 years neglect as group II. In a total number of 134 contracted rays in 66 hands, the surgical procedures included local Z/V-Y flap (51 rays), cross finger flap (48 rays), full thickness graft (35 rays). Additional external fixator with a distracter was used in 3 patients treated at a delay of 14, 16 and 17 years. 50 (81.96%) patients belonged to rural and slum areas. The reasons for delayed treatment included poverty - 33 patients, lack of awareness of surgical treatment - 16 patients; and indifference of parents - 12 patients. 44 (72.13%) children were illiterates. With treatment the average DASH score improved from 65.10 to 36.90 (p < .000) and from 68.14 to 45.93 (p < .000) in group I and II respectively. The results were significantly superior in group I (p < .000). The main factors for neglect in treatment of post burns contracture include poverty, lack of awareness and illiteracy. All the patients showed significant improvement in function after the surgery. Contractures with higher neglect had significantly inferior outcome.

The age of menopause and the menopause transition in a multiracial population: a nation-wide Singapore study.

PubMed

Loh, Foo-Hoe; Khin, Lay-Wai; Saw, Seang-Mei; Lee, Jeannette J M; Gu, Ken

2005-01-01

To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups. Cross-sectional nation-wide study of a random sample of 1000 women drawn from the entire population of Singaporean female (Chinese, Malay, and Indian) citizens between 45 and 60 years of age. Face-to-face interviews using structured questionnaires were conducted. The response rate was 69.9%. The mean age of natural menopause was 49.0 years. This was not significantly different between the three ethnic groups. Increasing parity delayed the age of menopause (P=0.007). Muscle and joint ache was the most commonly reported symptom (52.6%). Although the prevalence of significant hot flushes in the general study population was low (3.9%), it was the most commonly reported complaint by peri-menopausal women (14.6%). Prevalence of significant hot flushes decreased with time from menopause (P=0.007) and completely disappeared beyond the fifth year of menopause. Recent unhappy events were associated with an increased risk of symptoms (P<0.001). Women of Chinese origin experienced a lower risk of menopausal symptoms when compared with other ethnic groups (P<0.05). The mean age of menopause was 49.0 years among Singaporean women. Ethnicity and recent unhappy events were two major factors, which influenced the risk of experiencing menopausal symptoms. Among the three ethnic groups studied, Chinese women were the least likely to experience disturbing menopausal symptoms. The overall prevalence of menopausal symptoms was low when compared to studies on women in western societies.

Comparing the Identification of Recommendations by Different Accident Investigators Using a Common Methodology

NASA Technical Reports Server (NTRS)

Johnson, Chris W.; Oltedal, H. A.; Holloway, C. M.

2012-01-01

Accident reports play a key role in the safety of complex systems. These reports present the recommendations that are intended to help avoid any recurrence of past failures. However, the value of these findings depends upon the causal analysis that helps to identify the reasons why an accident occurred. Various techniques have been developed to help investigators distinguish root causes from contributory factors and contextual information. This paper presents the results from a study into the individual differences that can arise when a group of investigators independently apply the same technique to identify the causes of an accident. This work is important if we are to increase the consistency and coherence of investigations following major accidents.

Exaggerated thyroid stimulating hormone secretion in children exposed to the Chernobyl nuclear reactor catastrophe.

PubMed

Boyarskaya, O Y; Kopilova, O V

2008-02-01

We present results of a long-term study of the morpho-functional state of the thyroid gland and of the functional capacities of the hypothalamic-hypophyseal system, as shown by thyrotropin releasing hormone stimulation, in different groups of children who suffered from the Chernobyl accident. It was shown that the thyroid gland of the children who were evacuated from the 30-km zone was damaged most severely due to the influence of radioactive iodine (131I). Living on radionuclide-polluted territories in conditions of iodine deficiency has been an additional contributory factor in the development of thyroid gland diseases. Latent functional deficiency of the hypothalamic-hypophyseal system can be one of the reasons leading to oncopathology of the thyroid gland.

National surveillance of Salmonella Enteritidis in commercial eggs in Japan.

PubMed

Esaki, H; Shimura, K; Yamazaki, Y; Eguchi, M; Nakamura, M

2013-05-01

A total of 105 033 eggs were collected across Japan from June 2010 to January 2011 and tested for Salmonella Enteritidis to provide data for the risk profiling of S. Enteritidis in eggs by the Food Safety Commission of Japan. S. Enteritidis isolates were recovered from three samples (20 eggs/sample) and these samples were different in regard to sampling period, grading and packaging centre and farm. The prevalence of S. Enteritidis in commercial eggs in Japan is estimated at ~0.003% which was a tenfold decrease in prevalence compared to similar surveillance in the mid 1990s. The decrease in the contamination in commercial eggs is considered a contributory factor in the decrease of foodborne diseases associated with S. Enteritidis in this period.

Hand dermatitis/eczema: current management strategy.

PubMed

Sehgal, Virendra N; Srivastava, Govind; Aggarwal, Ashok K; Sharma, Alpna D

2010-07-01

Ever since its inception a couple of centuries ago, hand dermatitis/eczema has been in the reckoning. Idiosyncrasies continued to loom large thereafter, till it acquired its appropriate position. Dermatitis/eczema are synonymous, often used to indicate a polymorphic pattern of the inflammation of the skin, characterized by pruritus, erythema and vesiculation. A spectrum delineated into acute sub-acute and chronic dermatitis of the hands. Pompholyx, recurrent focal palmer peeling, ring, wear and tear and fingertip eczema, apron, discoid eczema, chronic acral dermatitis, gut and patchy papulosquamous eczema are its clinical variants. Occupational dermatitis/eczema may be contributory. Etiological definitions are clinched by detailed history of exogenous and endogenous factors. However, scientific confirmation of the entity is through patch testing by using available antigens.

Basal cell carcinoma in young women: an evaluation of the association of tanning bed use and smoking.

PubMed

Boyd, Alan S; Shyr, Yu; King, Lloyd E

2002-05-01

Basal cell carcinomas (BCCs) typically occur in middle-aged to elderly patients but less commonly in younger ones. In our experience, most BCCs seen in patients younger than 40 years are found in women. We evaluated 30 women with biopsy-proven BCC and 30 control patients matched for sex, age, and skin type to determine potential risk factors for this population. Tanning bed visits, pack-years of cigarette smoking, recreational sun exposure, number of blistering sunburns, and use of sunscreens were determined for both groups. Among patients with a BCC, the histologic type of tumor, site of involvement, method of treatment, follow-up period, incidence of recurrence, and presence of actinic keratoses were also evaluated. Patients with a BCC had a statistically greater number of pack years of smoking (P =.045), and a greater percentage of these women had experienced blistering sunburns (P =.028). Although women with a BCC had, on average, almost twice as many tanning salon visits (152.2 vs 83.1), this was not statistically significant. Sunscreen use and amount of recreational ultraviolet light exposure were essentially equal between the two groups. Young women with a BCC are more likely to have a past or current history of cigarette smoking and blistering sunburns. Repeated exposure to tanning beds may also be a contributory factor.

A meta-analysis of the effect of neuromuscular training on the prevention of the anterior cruciate ligament injury in female athletes.

PubMed

Yoo, Jae Ho; Lim, Bee Oh; Ha, Mina; Lee, Soo Won; Oh, Soo Jin; Lee, Yong Seuk; Kim, Jin Goo

2010-06-01

Female athletes are more prone to anterior cruciate ligament (ACL) injury than their male counterparts, presumably because of anatomical, hormonal, and neuromuscular differences. Of these three, only the neuromuscular component can be modified by preventive exercise. We aimed to evaluate the effect of a neuromuscular protocol on the prevention of ACL injury by performing meta-analysis, and to identify essential factors by subgroup analysis. An extensive literature review was conducted to identify relevant studies, and eventually, only seven randomized controlled trials or prospective cohort studies were included in the analysis. The odds ratios (OR) and the confidence interval (CI) for the overall effects of training and of potentially contributory factors were estimated. The OR and the 95% CI for the overall effect of the preventive training were 0.40 and [0.27, 0.60], respectively. Subgroup analysis revealed that an age under 18, soccer rather than handball, pre- and in-season training rather than either pre- or in-season training, and the plyometrics and strengthening components rather than balancing were significant. Meta-analysis showed that pre- and in-season neuromuscular training with an emphasis on plyometrics and strengthening exercises was effective at preventing ACL injury in female athletes, especially in those under 18 years of age. Further study is required to develop a relevant training program protocol of appropriate intensity.

Status and Determinants of Motor Impairment in Preschool Children from Migrant Families in China.

PubMed

Jin, Hua; Hua, Jing; Shen, Jianqiang; Feng, Lijuan; Gu, Guixiong

2016-10-01

Although poor health conditions and decreased developmental levels have been investigated in migrant children, no study in China has focused on these children's individual motor development. This study aims to explore the prevalence of motor impairment in Chinese migrant children and to determine the contributory factors. In this cross-sectional study, a structured questionnaire was administered to primary caregivers of preschool children aged 3 - 6 (n = 2,976) in ten kindergartens from two districts of Suzhou, China, to assess the children's home socioeconomic status and motor environment, that is, the presence of affordances for motor development. Motor ability was assessed using the Movement Assessment battery for children-second edition (MABC-2). Multiple logistic regression analysis was used to determine the risk factors for motor impairment in migrant children. Migrant children showed correlations with impairment in manual dexterity, aiming and catching, and motor development (odds ratios [ORs] = 1.320, 1.255, 1.260, respectively; P < 0.05). Outdoor movement affordances and toys for fine motor development were significantly associated with motor impairment in migrant children (ORs = 0.834 [movement affordances, 0.843 [toys], P < 0.05). Chinese migrant children are at a high risk of motor impairment, which is associated with a lack of outdoor movement affordances and toys for fine motor development. Future prevention and intervention should focus on the motor environment of the home.

Anxiety and Depression among Breast Cancer Patients in an Urban Setting in Malaysia.

PubMed

Hassan, Mohd Rohaizat; Shah, Shamsul Azhar; Ghazi, Hasanain Faisal; Mohd Mujar, Noor Mastura; Samsuri, Mohd Fadhli; Baharom, Nizam

2015-01-01

Breast cancer is one of the most feared diseases among women and it could induce the development of psychological disorders like anxiety and depression. An assessment was here performed of the status and to determine contributory factors. A cross-sectional study was conducted among breast cancer patients at University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur. A total of 205 patients who were diagnosed between 2007 until 2010 were interviewed using the questionnaires of Hospital Anxiety and Depression (HADS). The associated factors investigated concerned socio-demographics, socio economic background and the cancer status. Descriptive analysis, chi-squared tests and logistic regression were used for the statistical test analysis. The prevalence of anxiety was 31.7% (n=65 ) and of depression was 22.0% (n=45) among the breast cancer patients. Age group (p= 0.032), monthly income (p=0.015) and number of visits per month (p=0.007) were significantly associated with anxiety. For depression, marital status (p=0.012), accompanying person (p=0.041), financial support (p-0.007) and felt burden (p=0.038) were significantly associated. In binary logistic regression, those in the younger age group were low monthly income were 2 times more likely to be associated with anxiety. Having less financial support and being single were 3 and 4 times more likely to be associated with depression. In management of breast cancer patients, more care or support should be given to the young and low socio economic status as they are at high risk of anxiety and depression.

32 CFR 536.53 - Evaluation of claims-general rules and guidelines.

Code of Federal Regulations, 2012 CFR

2012-07-01

... representative. Contributory negligence has given way to comparative negligence in most United States jurisdictions. In most foreign countries, comparative negligence is the rule of law. Note to § 536.53: For...

Copyright Law as It Applies to Computer Software.

ERIC Educational Resources Information Center

Gemignani, Michael

1989-01-01

Discusses copyright laws applied to computer software for professors, students, and institutions. Concepts including infringement, contributory infringement, first sale doctrine, and licenses are considered. A sample university policy statement to avoid liability is presented. (YP)

Do the angle and length of the eustachian tube influence the development of chronic otitis media?

PubMed

Dinç, Aykut Erdem; Damar, Murat; Uğur, Mehmet Birol; Öz, Ibrahim Ilker; Eliçora, Sultan Şevik; Bişkin, Sultan; Tutar, Hakan

2015-09-01

To compare the eustachian tube (ET) angle (ETa) and length (ETl) of ears with and without chronic otitis media (COM), and to determine the relationship between ET anatomy and the development of COM. A retrospective case-control study. The study group comprised 125 patients (age range, 8-79 years; 64 males and 61 females) with 124 normal ears and 126 diseased ears, including ears with chronic suppurative otitis media (CSOM) with central perforation, intratympanic tympanosclerosis (ITTS), cholesteatoma, and a tympanic membrane with retraction pockets (TMRP). ET angle and length were measured using computed tomography employing the multiplanar reconstruction technique. The ETa was significantly more horizontal in diseased versus normal ears of all study groups (P = .030), and there was no group difference in ETl (P = .160). ETl was shorter in CSOM versus ITTS ears and normal ears (P = .007 and P = .003, respectively) and in cholesteatoma versus TMRP ears (P = .014). In the unilateral COM group, there were no significant differences in the ETa or ETl of diseased versus contralateral normal ears (P = .155 and P = .710, respectively). The ETa was significantly more horizontal in childhood-onset diseased versus normal ears (P = .027), and there was no group difference in ETl (P = .732). The ETa (P = .002) and ETl (P < .001) were significantly greater in males than females. A more horizontal ETa and shorter ETl could be contributory (though not significantly) etiological factors in the development of COM. 3b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Novel Therapeutic Strategies for Reducing Right Heart Failure Associated Mortality in Fibrotic Lung Diseases

PubMed Central

Levy, Matthew; Oyenuga, Olusegun

2015-01-01

Fibrotic lung diseases carry a significant mortality burden worldwide. A large proportion of these deaths are due to right heart failure and pulmonary hypertension. Underlying contributory factors which appear to play a role in the mechanism of progression of right heart dysfunction include chronic hypoxia, defective calcium handling, hyperaldosteronism, pulmonary vascular alterations, cyclic strain of pressure and volume changes, elevation of circulating TGF-β, and elevated systemic NO levels. Specific therapies targeting pulmonary hypertension include calcium channel blockers, endothelin (ET-1) receptor antagonists, prostacyclin analogs, phosphodiesterase type 5 (PDE5) inhibitors, and rho-kinase (ROCK) inhibitors. Newer antifibrotic and anti-inflammatory agents may exert beneficial effects on heart failure in idiopathic pulmonary fibrosis. Furthermore, right ventricle-targeted therapies, aimed at mitigating the effects of functional right ventricular failure, include β-adrenoceptor (β-AR) blockers, angiotensin-converting enzyme (ACE) inhibitors, antioxidants, modulators of metabolism, and 5-hydroxytryptamine-2B (5-HT2B) receptor antagonists. Newer nonpharmacologic modalities for right ventricular support are increasingly being implemented. Early, effective, and individualized therapy may prevent overt right heart failure in fibrotic lung disease leading to improved outcomes and quality of life. PMID:26583148

Playing It Safe: Part I.

ERIC Educational Resources Information Center

Penman, Kenneth A.; Niccolai, Frances R.

1985-01-01

The first of a series of articles explains the legal principles of tort liability, waiver of liability, comparative negligence, assumption of risk, and contributory negligence. Summarizes the kinds of cases going to court involving sport facility design and operation. (MLF)

[Tracking study to improve basic academic ability in chemistry for freshmen].

PubMed

Sato, Atsuko; Morone, Mieko; Azuma, Yutaka

2010-08-01

The aims of this study were to assess the basic academic ability of freshmen with regard to chemistry and implement suitable educational guidance measures. At Tohoku Pharmaceutical University, basic academic ability examinations are conducted in chemistry for freshmen immediately after entrance into the college. From 2003 to 2009, the examination was conducted using the same questions, and the secular changes in the mean percentage of correct response were statistically analyzed. An experience survey was also conducted on 2007 and 2009 freshmen regarding chemical experiments at senior high school. Analysis of the basic academic ability examinations revealed a significant decrease in the mean percentage of correct responses after 2007. With regard to the answers for each question, there was a significant decrease in the percentage of correct answers for approximately 80% of questions. In particular, a marked decrease was observed for calculation questions involving percentages. A significant decrease was also observed in the number of students who had experiences with chemical experiments in high school. However, notable results have been achieved through the implementation of practice incorporating calculation problems in order to improve calculation ability. Learning of chemistry and a lack of experimental experience in high school may be contributory factors in the decrease in chemistry academic ability. In consideration of the professional ability demanded of pharmacists, the decrease in calculation ability should be regarded as a serious issue and suitable measures for improving calculation ability are urgently required.

Health protection and promotion at work.

PubMed Central

Schilling, R S

1989-01-01

Official United Kingdom figures record annually 1400 deaths and 145,000 sufferers from chronic effects of occupational injury and disease. Evidence indicates that occupational disease directly due to work is underestimated. With more understanding of the multiple causes of disease, the concept of work related disorders has broadened to include four categories: work as a direct cause, a contributory cause, or an aggravating factor, and work offering easy access to potential dangers (alcohol). As an example, work factors that increase the risk of coronary heart disease are discussed. Evidence for work stress as a causal factor and the role of leadership are considered. Prevention depends on identifying risks, preferably before anyone is exposed, but more commonly through recognition of adverse effects on workers. The need for occupational health services to have health promotion programmes that include screening for disease and its precursors, counselling and education, is considered. The positive effects of work itself as a protector and promoter of health are discussed. Responsibility for improving health has to be shared by government, management, trade unions, health professionals, and the individual worker. PMID:2818956

Using robust Bayesian network to estimate the residuals of fluoroquinolone antibiotic in soil.

PubMed

Li, Xuewen; Xie, Yunfeng; Li, Lianfa; Yang, Xunfeng; Wang, Ning; Wang, Jinfeng

2015-11-01

Prediction of antibiotic pollution and its consequences is difficult, due to the uncertainties and complexities associated with multiple related factors. This article employed domain knowledge and spatial data to construct a Bayesian network (BN) model to assess fluoroquinolone antibiotic (FQs) pollution in the soil of an intensive vegetable cultivation area. The results show: (1) The relationships between FQs pollution and contributory factors: Three factors (cultivation methods, crop rotations, and chicken manure types) were consistently identified as predictors in the topological structures of three FQs, indicating their importance in FQs pollution; deduced with domain knowledge, the cultivation methods are determined by the crop rotations, which require different nutrients (derived from the manure) according to different plant biomass. (2) The performance of BN model: The integrative robust Bayesian network model achieved the highest detection probability (pd) of high-risk and receiver operating characteristic (ROC) area, since it incorporates domain knowledge and model uncertainty. Our encouraging findings have implications for the use of BN as a robust approach to assessment of FQs pollution and for informing decisions on appropriate remedial measures.

Risk Management in Cocurricular Activities.

ERIC Educational Resources Information Center

Webb, Edward M.

1988-01-01

Discusses risk management for colleges' cocurricular activities. Discusses tort liability, contributory negligence, and assumption of risk. Provides six concrete steps for managing risks responsibly and professionally: adopting an educational mission statement, assigning risk to others, establishing safety standards, training club advisors,…

Distinct Contributory Factors Determine Basophil-Allergen Sensitivity in Grass Pollen Rhinitis and in Anaphylactic Wasp Venom Allergy.

PubMed

Korošec, Peter; Šilar, Mira; Kopač, Peter; Eržen, Renato; Zidarn, Mihaela; Košnik, Mitja

2016-01-01

We sought to determine whether basophil-allergen sensitivity could be transferred to donor basophils by passive IgE sensitisation in allergic rhinitis and anaphylactic Hymenoptera venom hypersensitivity. We studied 15 wasp venom-, 19 grass pollen- and 2 house dust mite-allergic patients, 2 healthy donors, and 8 wasp venom-allergic donors. In all subjects, we first evaluated the initial basophil response to wasp venom, grass pollen, or house dust mite allergen. Donor basophils were then stripped, sensitised with the different patients' serum IgE, and challenged with the corresponding allergen. The CD63 response of donor basophils was then compared with initial basophil responses. In wasp venom-allergic subjects, the IgE transfer did not reflect the initial basophil-allergen sensitivity, because the venom IgE of subjects with high or low basophil sensitivity induced comparable responsiveness in healthy donor basophils. Furthermore, vice versa, when we sensitised the donor basophils of wasp venom-allergic individuals with different wasp venom or house dust mite IgE, we demonstrated that their response was predictable by their initial basophil allergen sensitivity. In the rhinitis allergy model, the IgE transfer correlated with the patients' initial basophil responsiveness because the grass pollen IgE of the subjects with high basophil allergen sensitivity induced significantly higher responsiveness of donor basophils than the IgE of subjects with initially low basophil allergen sensitivity. Our results suggest that basophil allergen sensitivity evaluated by flow-cytometric CD63 analysis depends on two distinct contribution factors. In anaphylactic Hymenoptera allergy, the major factor was intrinsic cellular sensitivity, whereas in pollen allergy, the major factor was allergen-specific IgE on the cell surface. © 2016 S. Karger AG, Basel.

Psychosocial influences on prisoner suicide: a case-control study of near-lethal self-harm in women prisoners.

PubMed

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

2011-03-01

We examined the psychosocial influences on female prisoner suicide by carrying out a study of near-lethal self-harm. We interviewed 60 women prisoners who had recently engaged in near-lethal self-harm (cases) and 60 others who had never carried out near-lethal acts in prison (controls) from all closed female prison establishments in England and Wales, using mixed quantitative and qualitative methods. We gathered information on socio-demographic and criminological variables, life events and childhood trauma, exposure to suicidal behaviour, contributory and precipitating factors for near-lethal self-harm, social support and psychological characteristics. While socio-demographic factors were only modestly associated with near-lethal self-harm, being on remand, in single cell accommodation, and reporting negative experiences of imprisonment were strong correlates. Recent life events and past trauma, including different forms of childhood abuse, were also significantly associated with near-lethal self-harm, as were a family history of suicide and high scores on measures of depression, aggression, impulsivity and hostility, and low levels of self-esteem and social support. Our findings underline the importance of both individual and prison-related factors for suicide in custody, and hence the need for a comprehensive approach to suicide prevention in women's prisons. Given the multiple needs of female prisoners at-risk of self-harm and suicide, complex psychosocial interventions are likely to be required, including interventions for abused and bereaved women, and initiatives to improve staff-prisoner relationships and reduce bullying. The findings of this research may provide insights into factors leading to suicidal behaviour in other forensic and institutional settings, such as detention centres and psychiatric hospitals, and may assist in developing suicide prevention policies for prisoners and other at-risk populations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Gender Differences in the Clinical Features of Sleep Apnea Syndrome.

PubMed

Mieno, Yuki; Hayashi, Masamichi; Sakakibara, Hiroki; Takahashi, Hiroshi; Fujita, Shiho; Isogai, Sumito; Goto, Yasuhiro; Uozu, Sakurako; Okazawa, Mitsushi; Imaizumi, Kazuyoshi

2018-03-30

Objectives Sleep apnea syndrome is more prevalent among men than women and is frequently accompanied by metabolic syndrome (MetS). However, gender differences in the effect of sleep-disordered breathing (SDB) leading to the risk of MetS remain unclear. The aim of our study was to investigate the clinical characteristics of SDB in women and the differential influence of SDB on MetS between genders. Methods In a single-center retrospective study, we compared the data of 1,809 consecutive SDB patients by gender to clarify the characteristics of sleep disorders in women. We also compared the prevalence of MetS and its related abnormalities by gender. A logistic regression analysis was used to determine the contributory factors for MetS. Results The mean age and proportion of patients over 50 years of age were higher in women than in men. SDB was milder in women than in men according to polysomnography findings. Elevated Hemoglobin A1c levels and hyperlipidemia were less frequent in women than in men. The MetS prevalence was similar in women and men (30.0% vs. 35.2%). A logistic regression analysis showed that the apnea-hypopnea index (AHI) was an independent risk factor for MetS in both genders, but that female gender was independently associated with a decreased prevalence of MetS and its related abnormalities. Conclusion Female SDB patients tend to be older with milder apnea and sleepiness than male SDB patients. A higher AHI is a significant risk factor for MetS in both genders, although female gender is an independent inhibitory factor for developing MetS in SDB patients.

Comprehensive bee pathogen screening in Belgium reveals Crithidia mellificae as a new contributory factor to winter mortality.

PubMed

Ravoet, Jorgen; Maharramov, Jafar; Meeus, Ivan; De Smet, Lina; Wenseleers, Tom; Smagghe, Guy; de Graaf, Dirk C

2013-01-01

Since the last decade, unusually high honey bee colony losses have been reported mainly in North-America and Europe. Here, we report on a comprehensive bee pathogen screening in Belgium covering 363 bee colonies that were screened for 18 known disease-causing pathogens and correlate their incidence in summer with subsequent winter mortality. Our analyses demonstrate that, in addition to Varroa destructor, the presence of the trypanosomatid parasite Crithidia mellificae and the microsporidian parasite Nosema ceranae in summer are also predictive markers of winter mortality, with a negative synergy being observed between the two in terms of their effects on colony mortality. Furthermore, we document the first occurrence of a parasitizing phorid fly in Europe, identify a new fourth strain of Lake Sinai Virus (LSV), and confirm the presence of other little reported pathogens such as Apicystis bombi, Aphid Lethal Paralysis Virus (ALPV), Spiroplasma apis, Spiroplasma melliferum and Varroa destructor Macula-like Virus (VdMLV). Finally, we provide evidence that ALPV and VdMLV replicate in honey bees and show that viruses of the LSV complex and Black Queen Cell Virus tend to non-randomly co-occur together. We also noticed a significant correlation between the number of pathogen species and colony losses. Overall, our results contribute significantly to our understanding of honey bee diseases and the likely causes of their current decline in Europe.

Vesicovaginal fistula: a review of nigerian experience.

PubMed

Ijaiya, M A; Rahman, A G; Aboyeji, A P; Olatinwo, A W; Esuga, S A; Ogah, O K; Raji, H O; Adebara, I O; Akintobi, A O; Adeniran, A S; Adewole, A A

2010-01-01

Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. To review the causes, complications, and outcome of Vesicovaginal fistula in Nigeria. Studies on Vesicovaginal fistula were searched on the internet. Information was obtained on PubMed(medline), WHO website, Bioline International, African Journal of Line, Google scholar, Yahoo, Medscape and e Medicine. Many Nigerian women are living with Vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria that southern Nigeria. Obstetric fistula accounts for 84.1%-100% of the Vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance and were poverty, illiteracy, ignorance, restriction of women's movement, non-permission from husband and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%-91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services. Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern.

Which is the dominant factor for perception of rheumatic pain: meteorology or psychology?

PubMed

Cay, Hasan Fatih; Sezer, Ilhan; Firat, Mehmet Z; Kaçar, Cahit

2011-03-01

It is believed that there is an association between the weather and rheumatic symptoms. We aimed to investigate what kind of association is present and what are the factors which determine the nature of this association. Fifty-six subjects with rheumatic disease (31 RA, 15 SpA, 10 OA) who live in Antalya were followed between December 2005 and July 2006. Patients were asked to fill diaries which contain questions regarding the symptoms of their rheumatic diseases everyday. In every monthly visit, disease activity measurement, laboratory assessment and Beck depression inventory assessment were recorded. The symptomatic and psychological measurements were matched with the meteorological data of Antalya Regional Directorate of Meteorological Service of Turkish State. Correlation of symptoms with weather variables was investigated. Contributory effect of weather and of psychologic factors on symptom scores were evaluated by stepwise multiple regression analysis. Eighty-four percent of subjects belive in an association between weather and rheumatism, while 57% claimed to have ability to forecast weather. The maximum correlation coefficient between weather and arthritis symptoms was -0.451 and the maximum contribution of weather on symptoms was 17.1%. Arthritis symptoms were significantly contributed by Beck depression score. The belief about presence of weather-arthritis association was found to be stronger than its statistical power. Our results did not prove or rule out the presence of weather-rheumatism association. As long as the scientific attempts result in failure, the intuitive support in favour of the presence of weather-arthritis association will go on forever.

Aggression in children with behavioural/emotional difficulties: seeing aggression on television and video games.

PubMed

Mitrofan, Oana; Paul, Moli; Weich, Scott; Spencer, Nicholas

2014-11-18

Mental health professionals are often asked to give advice about managing children's aggression. Good quality evidence on contributory environmental factors such as seeing aggression on television and in video games is relatively lacking, although societal and professional concerns are high. This study investigated possible associations between seeing aggression in such media and the aggressive behaviour of children attending specialist outpatient child and adolescent mental health services (CAMHS). In this mixed methods study, forty-seven British children aged 7-11 years with behavioural/emotional difficulties attending CAMHS and their carers participated in a survey; twenty purposively-selected children and a parent/carer of theirs participated in a qualitative study, involving semi-structured interviews, analysed using the Framework Analysis Approach; findings were integrated. Children attending CAMHS exhibit clinically significant aggression, of varying types and frequency. They see aggression in multiple real and virtual settings. Verbal aggression was often seen, frequently exhibited and strongly associated with poor peer relationships and low prosocial behaviour. Children did not think seeing aggression influences their own behaviour but believed it influences others. Carers regarded aggression as resulting from a combination of inner and environmental factors and seeing aggression in real-life as having more impact than television/video games. There is yet no definitive evidence for or against a direct relationship between aggression seen in the media and aggression in children with behavioural/emotional difficulties. Future research should take an ecological perspective, investigating individual, developmental and environmental factors. Carers, professional organisations and policy makers should address aggression seen in all relevant area of children's lives, primarily real-life and secondly virtual environments.

The Heavy Vehicle Study: a case-control study investigating risk factors for crash in long distance heavy vehicle drivers in Australia

PubMed Central

2010-01-01

Background Heavy vehicle transportation continues to grow internationally; yet crash rates are high, and the risk of injury and death extends to all road users. The work environment for the heavy vehicle driver poses many challenges; conditions such as scheduling and payment are proposed risk factors for crash, yet the precise measure of these needs quantifying. Other risk factors such as sleep disorders including obstructive sleep apnoea have been shown to increase crash risk in motor vehicle drivers however the risk of heavy vehicle crash from this and related health conditions needs detailed investigation. Methods and Design The proposed case control study will recruit 1034 long distance heavy vehicle drivers: 517 who have crashed and 517 who have not. All participants will be interviewed at length, regarding their driving and crash history, typical workloads, scheduling and payment, trip history over several days, sleep patterns, health, and substance use. All participants will have administered a nasal flow monitor for the detection of obstructive sleep apnoea. Discussion Significant attention has been paid to the enforcement of legislation aiming to deter problems such as excess loading, speeding and substance use; however, there is inconclusive evidence as to the direction and strength of associations of many other postulated risk factors for heavy vehicle crashes. The influence of factors such as remuneration and scheduling on crash risk is unclear; so too the association between sleep apnoea and the risk of heavy vehicle driver crash. Contributory factors such as sleep quality and quantity, body mass and health status will be investigated. Quantifying the measure of effect of these factors on the heavy vehicle driver will inform policy development that aims toward safer driving practices and reduction in heavy vehicle crash; protecting the lives of many on the road network. PMID:20338064

Role of the Gastrointestinal Tract Microbiome in the Pathophysiology of Diabetes Mellitus.

PubMed

Sohail, Muhammad U; Althani, Asmaa; Anwar, Haseeb; Rizzi, Roberto; Marei, Hany E

2017-01-01

The incidence of diabetes mellitus is rapidly increasing throughout the world. Although the exact cause of the disease is not fully clear, perhaps, genetics, ethnic origin, obesity, age, and lifestyle are considered as few of many contributory factors for the disease pathogenesis. In recent years, the disease progression is particularly linked with functional and taxonomic alterations in the gastrointestinal tract microbiome. A change in microbial diversity, referred as microbial dysbiosis, alters the gut fermentation profile and intestinal wall integrity and causes metabolic endotoxemia, low-grade inflammation, autoimmunity, and other affiliated metabolic disorders. This article aims to summarize the role of the gut microbiome in the pathogenesis of diabetes. Additionally, we summarize gut microbial dysbiosis in preclinical and clinical diabetes cases reported in literature in the recent years.

Positive and negative psychological impact after secondary exposure to politically motivated violence among body handlers and rehabilitation workers.

PubMed

Shiri, Shimon; Wexler, Isaiah D; Alkalay, Yasmin; Meiner, Zeev; Kreitler, Shulamith

2008-12-01

The positive and negative psychological impact of secondary exposure to politically motivated violence was examined among body handlers and hospital rehabilitation workers, 2 groups that differed in their proximity and immediacy to violent events. Survivors of politically motivated violence served as a comparison group. Body handlers experienced high levels of positive psychological impact and traumatic stress symptoms. Levels of positive psychological impact among on-scene body handlers were higher than those experienced by rehabilitation workers. Traumatic stress symptoms predicted positive psychological impact among body handlers. These findings indicate that proximity to stressors is associated with higher levels of positive and negative psychological impact. Physical proximity is a major contributory factor to both positive and negative psychological effects of secondary exposure to trauma.

Recurrence of “cured” dural arteriovenous fistulas after Onyx embolization

PubMed Central

Adamczyk, Peter; Amar, Arun Paul; Mack, William J.; Larsen, Donald W.

2012-01-01

Endovascular embolization with Onyx has been increasingly used to treat intracranial and spinal dural arteriovenous fistulas (DAVFs). Several case series have been published in recent years reporting high DAVF cure rates with this technique. Although it is seldom reported, DAVF recurrence may occur despite initial “cure.” The authors present 3 separate cases of a recurrent DAVF after successful transarterial Onyx embolization. Despite adequate Onyx penetration into the fistula and draining vein, these cases demonstrate that DAVF recanalization may reappear with filling from previous or newly recruited arterial feeders. Other published reports of DAVF recurrence are examined, and potential contributory factors are discussed. These cases highlight the need for awareness of this possible phenomenon and suggest that follow-up angiography should be considered in patients treated with catheter embolization. PMID:22537121

Plasma oxalic acid and calcium levels in oxalate poisoning

PubMed Central

Zarembski, P. M.; Hodgkinson, A.

1967-01-01

Observations are reported on five cases of suicide or attempted suicide by poisoning with oxalic acid or ethylene glycol. Elevated oxalic acid levels were observed in the plasma, stomach contents, and a number of tissues. Raised oxalic acid levels in plasma were associated with reduced total and ultrafilterable calcium levels. It is suggested that the reduction in plasma total calcium level is due mainly to the deposition of calcium oxalate in the soft tissues, but inhibition of the parathyroid glands may be a contributory factor. Microscopic examination of various tissues indicated that oxalic acid is deposited in the tissues in two forms: (1) crystalline calcium oxalate dihydrate in the kidney and (2) a non-crystalline complex of calcium oxalate and lipid in liver and other tissues. PMID:5602563

Colorectal Carcinogenesis: Role of Oxidative Stress and Antioxidants.

PubMed

Carini, Francesco; Mazzola, Margherita; Rappa, Francesca; Jurjus, Abdo; Geagea, Alice Gerges; Al Kattar, Sahar; Bou-Assi, Tarek; Jurjus, Rosalyn; Damiani, Provvidenza; Leone, Angelo; Tomasello, Giovanni

2017-09-01

One of the contributory causes of colon cancer is the negative effect of reactive oxygen species on DNA repair mechanisms. Currently, there is a growing support for the concept that oxidative stress may be an important etiological factor for carcinogenesis. The purpose of this review is to elucidate the role of oxidative stress in promoting colorectal carcinogenesis and to highlight the potential protective role of antioxidants. Several studies have documented the importance of antioxidants in countering oxidative stress and preventing colorectal carcinogenesis. However, there are conflicting data in the literature concerning its proper use in humans, since these studies did not yield definitive results and were performed mostly in vitro on cell populations, or in vivo in experimental animal models. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

The Challenge of Understanding Cerebral White Matter Injury in the Premature Infant

PubMed Central

Elitt, Christopher M.; Rosenberg, Paul A.

2014-01-01

White matter injury in the premature infant leads to motor and more commonly behavioral and cognitive problems that are a tremendous burden to society. While there has been much progress in understanding unique vulnerabilities of developing oligodendrocytes over the past 30 years, there remain no proven therapies for the premature infant beyond supportive care. The lack of translational progress may be partially explained by the challenge of developing relevant animal models when the etiology remains unclear, as is the case in this disorder. There has been an emphasis on hypoxia-ischemia and infection/inflammation as upstream etiologies, but less consideration of other contributory factors. This review highlights the evolution of white matter pathology in the premature infant, discusses the prevailing proposed etiologies, critically analyzes a sampling of common animal models and provides detailed support for our hypothesis that nutritional and hormonal deprivation may be additional factors playing critical and overlooked roles in white matter pathology in the premature infant. PMID:24838063

To Err is Human Case Reports of Two Military Aircraft Accidents

PubMed Central

Dikshit, Mohan B

2010-01-01

It has been postulated that pilot error or in-flight incapacitation may be the main contributory factors to 70–80% of aircraft accidents. Two fatal aircraft accidents are presented in which either of the above possibilities may have played a role. The first case report describes an erroneous decision by a fighter pilot to use a seat position adjustment of the ejection seat leading to fatal injuries when he had to eject from his aircraft. Injuries to the body of the pilot, and observations on the state of his flying clothing and the ejection seat were used to postulate the mechanism of fatal injury and establish the cause of the accident. The second case report describes the sequence of events which culminated in the incapacitation of a fighter pilot while executing a routine manouevre. This resulted in a fatal air crash. Possible contributions of environmental factors which may have resulted in failure of his physiological mechanisms are discussed. PMID:21509093

[Use of contraception and reasons for choosing abortion among abortion applicants].

PubMed

Hansen, S K; Birkebaek, J S; Husfeldt, C; Munck, C B; Nøddebo, S M; Petersson, B H

1996-10-07

The object of this study was to describe a group of women applying for legal abortion in relation to their use of contraception and reasons for choosing an abortion. During a period of 13 months (1991-92) a questionnaire was distributed to women applying for legal abortion at Hillerød Hospital in Denmark. Three hundred and thirty-nine women participated. Fifty-nine percent of the women had become pregnant although they had used contraception. As seen in other studies, women still state demographic factors as their most important reasons for choosing an abortion. Women with two or more children do not want to have more children. Single women do not want children without being in a stable relationship. Furthermore occupation and education were frequently stated as important reasons for having an abortion. Economy and housing were not main reasons but contributory factors. Thirty percent of the women expressed ambivalence about the choice of abortion at the time when the abort was due.

Identification of JAK/STAT pathway regulators—Insights from RNAi screens

PubMed Central

Müller, Patrick; Boutros, Michael; Zeidler, Martin P.

2008-01-01

While many core JAK/STAT pathway components have been discovered in Drosophila via classical genetic approaches, the identification of pathway regulators has been more challenging. Recently two cell-based RNAi screens for JAK/STAT pathway regulators have been undertaken using libraries of double-stranded RNAs targeting a large proportion of the predicted Drosophila transcriptome. While both screens identified multiple regulators, only relatively few loci are common to both data sets. Here we compare the two screens and discuss these differences. Although many factors are likely to be contributory, differences in the assay design are of key importance. Low levels of stimulation favouring the identification of negative pathway regulators and high levels of stimulation favouring the identification of positively acting factors. Ultimately, the results from both screens are likely to be largely complementary and have identified a range of novel candidate regulators of JAK/STAT pathway activity as a starting point for new research directions in the future. PMID:18586112

Aetiology and management of malnutrition in HIV-positive children

PubMed Central

Rose, Anna M; Hall, Charles S; Martinez-Alier, Nuria

2014-01-01

Worldwide, more than 3 million children are infected with HIV and, without treatment, mortality among these children is extremely high. Both acute and chronic malnutrition are major problems for HIV-positive children living in resource-limited settings. Malnutrition on a background of HIV represents a separate clinical entity, with unique medical and social aetiological factors. Children with HIV have a higher daily calorie requirement than HIV-negative peers and also a higher requirement for micronutrients; furthermore, coinfection and chronic diarrhoea due to HIV enteropathy play a major role in HIV-associated malnutrition. Contributory factors include late presentation to medical services, unavailability of antiretroviral therapy, other issues surrounding healthcare provision and food insecurity in HIV-positive households. Treatment protocols for malnutrition have been greatly improved, yet there remains a discrepancy in mortality between HIV-positive and HIV-negative children. In this review, the aetiology, prevention and treatment of malnutrition in HIV-positive children are examined, with particular focus on resource-limited settings where this problem is most prevalent. PMID:24406803

Experimental evidence on the impact of food advertising on children's knowledge about and preferences for healthful food.

PubMed

Reisch, Lucia A; Gwozdz, Wencke; Barba, Gianvincenzo; De Henauw, Stefaan; Lascorz, Natalia; Pigeot, Iris

2013-01-01

To understand the rising prevalence of childhood obesity in affluent societies, it is necessary to take into account the growing obesity infrastructure, which over past decades has developed into an obesogenic environment. This study examines the effects of one of the constituent factors of consumer societies and a potential contributory factor to childhood obesity: commercial food communication targeted to children. Specifically, it investigates the impact of TV advertising on children's food knowledge and food preferences and correlates these findings with their weight status. Evaluations of traditional information- and education-based interventions suggest that they may not sustainably change food patterns. Based on prior consumer research, we propose five hypotheses, which we then test using a subsample from the IDEFICS study, a large-scale pan-European intervention study on childhood obesity. The results indicate that advertising has divergent effects on children's food knowledge and preferences and that food knowledge is unrelated to food preferences. This finding has important implications for both future research and public policy.

Major depressive disorder is a risk factor for low bone mass, central obesity, and other medical conditions

PubMed Central

Cizza, Giovanni

2011-01-01

Major depressive disorder (MDD) is one of the most common psychiatric illnesses in the adult population. It is often associated with an increased risk of cardiovascular disease. Osteoporosis is also a major public health threat. Multiple studies have reported an association between depression and low bone mineral density, but a causal link between these two conditions is disputed. Here the most important findings of the POWER (Premenopausal, Osteoporosis Women, Alendronate, Depression) Study, a large prospective study of bone turnover in premenopausal women with major depression, are summarized. The endocrine and immune alterations secondary to depression that might affect bone mass, and the possible role of poor lifestyle in the etiology of osteoporosis in subjects with depression, are also reviewed, as is the potential effect of antidepressants on bone loss. It is proposed that depression induces bone loss and osteoporotic fractures, primarily via specific immune and endocrine mechanisms, with poor lifestyle habits as potential contributory factors. PMID:21485748

[Medical and social aspects of dermatoses morbidity in military personnel serving in a region of the Far North].

PubMed

Derevianko, R V; Shevchenko, O S; Ustinov, M V

2014-05-01

Analysed the possibility of dermatosis as an adaptive health disorder in military personnel serving in a region of the Far North. 127 men took part in this research; the average age is 19,5+/-0,7 years. 89 patients with atopic dermatitis and 38 patients with psoriasis were examined and proceeded with the treatment. 50 healthy servicemen were in the experimental group. Each patient filled out a questionnaire for evaluation of anamnesis, contributory causes, social and psychological status. It is revealed that seamen break out in atopic dermatitis and psoriasis in first 2 months of service; flare-up was observed in autumn. Climate and geographic peculiarities of the region affect the course of skin disorders. The draft and first months of service are the main stressful factors affecting dysadaptation disorders. It is necessary to study preclinical sociopsychological factors in conscripts and compulsory-duty servicemen and to provide modern psychological prophylaxis.

The physical mechanisms of complete denture retention.

PubMed

Darvell, B W; Clark, R K

2000-09-09

The purpose of this article is to assist the practitioner to understand which factors are relevant to complete denture retention in the light of the current understanding of physics and materials science and thus to guide design. Atmospheric pressure, vacuum, adhesion, cohesion, surface tension, viscosity, base adaption, border seal, seating force and muscular control have all been cited at one time or another as major or contributory factors, but usually as an opinion without proper reference to fundamental principles. Although there has been a detailed analysis published, it seems appropriate that a restatement of the points in a collated form be made. In fact, denture retention is a dynamic issue dependent on the control of the flow of interposed fluid and thus its viscosity and film thickness, while the timescale of displacement loading affects the assessment. Surface tension forces at the periphery contribute to retention, but the most important concerns are good base adaptation and border seal. These must be achieved if full advantage is to be taken of the saliva flow-related effects.

The role of childhood and adulthood trauma and appraisal of self-discrepancy in overgeneral memory retrieval.

PubMed

Ono, Miyuki; Devilly, Grant J

2013-01-01

The aim of this study was to examine the contributory role of childhood and adulthood trauma events and the appraisal of self-discrepancy (the magnitude and distress) in overgeneral memory retrieval (OGM) using a non-clinical sample. Participants with a history of childhood trauma (n=29); adulthood trauma only (n=17) or no-trauma (n=26) participated in this study. The childhood trauma group showed a significantly higher level of general negative memory retrieval than the no-trauma group. Conversely, the adulthood trauma group showed a significantly higher level of general threat memory retrieval than the no-trauma group. The perceived similarity and distress relating to the perceived similarity between participants' "actual self" and "feared self" significantly predicted the level of OGM, even after controlling for the impact of a history of adult or child trauma.

Safety Tips: Avoiding Negligence Suits in Chemistry Teaching.

ERIC Educational Resources Information Center

Gerlovich, Jack A.

1983-01-01

Discusses various aspects related to negligence on the part of chemistry teachers. Areas addressed include negligence in tort law, avoiding negligence suits, proper instructions, proper supervision, equipment maintenance, and other considerations such as sovereign immunity, and contributory versus comparative negligence. (JN)

Children in Civil Law: The Tort of Negligence.

ERIC Educational Resources Information Center

Sheehy, N. P.; Chapman, A. J.

1984-01-01

Examines judgments involving children under the tort of negligence, using All England Law Reports for 1939 to 1983 and some cases from other countries. Discusses "contributory negligence,""parental liability,""responsibility,""allurement," and "res-ipsa loquitur." Suggests more use of developmental…

An analysis of sea kayaking incidents in New Zealand 1992-2005.

PubMed

Bailey, Iona

2010-09-01

The objective of this study was to investigate trends, medical problems, and contributory factors that occurred in 50 sea kayaking incidents in New Zealand between October 1992 and September 2005. There are currently very limited validated data available worldwide about the epidemiology of sea kayaking incidents. The research will raise awareness of how these events happened and their potential for serious harm. It will assist kayakers to manage their sport safely. This was a retrospective epidemiological study of incident reports originally collected by Paul Caffyn for the Kiwi Association of Sea Kayakers (KASK). Variables investigated in this study were geographic location, month, year, participant demographics, incident severity, type of kayak and trip, environmental conditions, safety gear carried, medical problems, cause of deaths, and contributory factors. Tables and graphs were developed to analyze the results. Incidents occurred around New Zealand throughout the year, often in rough seas in offshore winds. More people were involved in September. Fifty-six percent of incidents involved groups; 20% were overseas tourists and 72% were recreational private trips. Eighty-five percent of participants were male, mostly aged 24 to 39 years old, and 48% had little or no experience. The severity of incidents increased with time. Severity was lower for women. Severity was higher in calm conditions and light winds, when the capsized kayaker became separated from the kayak, and when a personal flotation device (PFD) was not worn. Fishing incidents had a higher severity and involved inexperienced kayakers. Human factors contributed to most if not all incidents and occurred more frequently than physical events. Where medical problems were reported, hypothermia and sprains were common. Collision with a powered vessel was often fatal. The study was limited because it was based on relatively small numbers, was unlikely to capture all incidents in New Zealand, and denominator data were unknown. All incidents were complex events with many variables interacting in different ways and all had the potential to be serious and life-threatening. Human actions were more important than physical events and young men were most often involved. Staying with the kayak after capsizing and wearing a PFD may have reduced the severity of an incident. Copyright 2010 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Pediatric and young adult exposure to chemiluminescent glow sticks.

PubMed

Hoffman, Robert J; Nelson, Lewis S; Hoffman, Robert S

2002-09-01

Although chemiluminescent plastic rods, commonly called "glow sticks" or "light sticks," are typically considered to be minimally toxic or nontoxic, published data about exposure to these products are scarce. To test our hypothesis that exposure to chemiluminescent products is unlikely to result in significant morbidity or mortality and to describe factors associated with exposure by reviewing reports to our urban poison control center of human exposure to chemiluminescent products. Pediatric and young adult exposure to chemiluminescent products reported between January 1, 2000, and April 1, 2001, to our poison control center were evaluated with regard to demographic group, type of product involved, circumstances of exposure, symptoms, and management. Reported routes of exposure (n = 118) included ingestion (n = 108), ocular (n = 9), and dermal exposure (n = 1). Only patients exposed to chemiluminescent fluid from a leaking container reported symptoms (n = 27). Symptoms were limited to transient irritation of the exposure site, and no systemic toxicity occurred. All adults (n = 4) inadvertently ruptured or swallowed intact light sticks while at a dance club or dance party. Most exposure and all adult exposure occurred on holidays or weekends. Most incidences of exposure to chemiluminescent products involve asymptomatic ingestion of fluid that leaks from glow sticks or ingestion of an intact glow stick. Symptoms occur after exposure to chemiluminescent fluid and consist of transient irritation at the site of exposure. The clustering of reported exposure on weekends and in dance clubs and parties coupled with a lack of occupational or workplace exposure suggest that recreational use is a major contributory factor. Exposure to chemiluminescent products infrequently resulted in symptoms and the symptoms reported were minor. Exposure to chemiluminescent products as described is unlikely to cause significant morbidity or mortality.

Effects of Speaking Rate on Word Recognition in Parkinson’s Disease and Normal Aging

PubMed Central

Forrest, Karen; Nygaard, Lynne; Pisoni, David B.; Siemers, Eric

2011-01-01

Current theories of basal ganglia function emphasize their role in the integration of sensory information into motor activities, particularly in the control of movement timing. People with basal ganglia disorders such as Parkinson’s disease exhibit poor temporal control of movements, in general and articulation in particular, as demonstrated by irregular speaking rate, reduced stress contrasts, and reduced movement durations and velocities. Previous research has implicated sensory deficits as contributory factors in limb movement control in patients with Parkinson’s disease; however, the relation between sensory deficits and speech-movement abnormalities has not been documented. In the present study, the existence of perceptual processing difficulties of speaking rate was investigated in subjects with Parkinsonian dysarthria (PD). Comparisons in perception were made between subjects with PD, neurologically normal geriatrics (GN) and neurologically normal young adults (YN) for accuracy in identification of words presented at different speaking rates. We hypothesized that word-identification scores would be lower for PD and GN subjects compared to the YN subjects, an effect that was supported by the data. We also expected that there would be differences between the GN and PD subjects in their accuracy of word identification at a faster speaking rate, an hypothesis that was not supported by the data. Rather, GN and PD subjects differed in identification scores for words spoken at a slow rate. PD subjects who had faster habitual speaking rates (HSR) had significantly lower word-identification scores in the slow compared to conversational rate conditions, a relation that was significant r = +0.64). These data suggest the need to consider perceptual deficits as an additional factor that contributes to rate variations in PD speech. PMID:21637728

76 FR 53152 - Notice of Realty Action; Recreation and Public Purposes Act Classification and Conveyance of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... attributable to: (1) The concurrent, contributory, or partial fault, failure, or negligence of the United States, or (2) the sole fault, failure, or negligence of the United States. In the event of payment, loss...

Reducing major rule violations in commuter rail operations : the role of distraction and attentional errors

DOT National Transportation Integrated Search

2012-10-22

Recent accidents in commuter rail operations and analyses of rule violations have highlighted the need for : better understanding of the contributory role of distraction and attentional errors. Distracted driving has : thoroughly been studied in rece...

Negligence and Athletic Events.

ERIC Educational Resources Information Center

Mawdsley, Ralph D.

2001-01-01

Although athletic events generate their share of negligence lawsuits, the relatively small number, compared with other education areas, suggests that defenses (like assumption or risk and contributory negligence) have a better fit in athletics. Implications of newer litigation trends involving coaches' misconduct and interpretation of state…

Modification of CCNU pharmacokinetics by misonidazole--a major mechanism of chemosensitization in mice.

PubMed Central

Lee, F. Y.; Workman, P.

1983-01-01

We have investigated the effect of misonidazole (MISO) on the pharmacokinetics of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) in mice. CCNU and its monohydroxylated metabolites were measured using a high performance liquid chromatography (HPLC) method. In the absence of MISO the plasma disappearance of CCNU was biphasic with a t 1/2 alpha of 2.3 min and a t 1/2 beta of 53 min. The monohydroxylated metabolites of CCNU also followed biphasic clearance kinetics. A large single dose of MISO (0.5 mg g-1), given i.p. 30 min prior to CCNU, prolonged the t 1/2 alpha by a factor of 2.6 but had no effect on t 1/2 beta. In addition, the apparent volume of distribution was decreased by a factor of 1.6. Consequently, the plasma area under the curve (AUC0 - infinity) was increased by a factor of 1.7 for CCNU and by a factor of 2.0 for total nitrosourea (CCNU + monohydroxylated metabolites). The effects of MISO on CCNU kinetics were dependent on MISO dose and plasma concentration and on the interval between MISO and CCNU administration. The concentration of CCNU was measured in 4 tumours: the KHT, RIF-1 and EMT6 mouse tumours, and the HT29 xenograft. For all 4 tumours, 0.5 mg g-1 MISO raised the tumour concentrations of CCNU and total nitrosourea by a considerable amount (2-2.5 times). More detailed studies in the KHT tumour demonstrated that there was a significant lag period before peak tumour CCNU concentrations were reached, and that MISO increased the peak concentrations by a factor of about 2.4. In contrast, there was no such lag period for the plasma and MISO did not increase the plasma peak CCNU concentrations. These data strongly suggest that modification of the pharmacokinetics may be a major contributory factor in the enhancement of CCNU cytotoxicity by large single doses of MISO in vivo. PMID:6849803

Status and Determinants of Motor Impairment in Preschool Children from Migrant Families in China

PubMed Central

Jin, Hua; Hua, Jing; Shen, Jianqiang; Feng, Lijuan; Gu, Guixiong

2016-01-01

Background Although poor health conditions and decreased developmental levels have been investigated in migrant children, no study in China has focused on these children’s individual motor development. Objectives This study aims to explore the prevalence of motor impairment in Chinese migrant children and to determine the contributory factors. Patients and Methods In this cross-sectional study, a structured questionnaire was administered to primary caregivers of preschool children aged 3 - 6 (n = 2,976) in ten kindergartens from two districts of Suzhou, China, to assess the children’s home socioeconomic status and motor environment, that is, the presence of affordances for motor development. Motor ability was assessed using the Movement Assessment battery for children-second edition (MABC-2). Multiple logistic regression analysis was used to determine the risk factors for motor impairment in migrant children. Results Migrant children showed correlations with impairment in manual dexterity, aiming and catching, and motor development (odds ratios [ORs] = 1.320, 1.255, 1.260, respectively; P < 0.05). Outdoor movement affordances and toys for fine motor development were significantly associated with motor impairment in migrant children (ORs = 0.834 [movement affordances, 0.843 [toys], P < 0.05). Conclusions Chinese migrant children are at a high risk of motor impairment, which is associated with a lack of outdoor movement affordances and toys for fine motor development. Future prevention and intervention should focus on the motor environment of the home. PMID:28203332

Human factors analysis and classification system applied to civil aircraft accidents in India.

PubMed

Gaur, Deepak

2005-05-01

The Human Factors Analysis and Classification System (HFACS) has gained wide acceptance as a tool to classify human factors in aircraft accidents and incidents. This study on application of HFACS to civil aircraft accident reports at Directorate General Civil of Aviation (DGCA), India, was conducted to ascertain the practicability of applying HFACS to existing investigation reports and to analyze the trends of human factor causes of civil aircraft accidents. Accident investigation reports held at DGCA, New Delhi, for the period 1990--99 were scrutinized. In all, 83 accidents occurred during this period, of which 48 accident reports were evaluated in this study. One or more human factors contributed to 37 of the 48 (77.1%) accidents. The commonest unsafe act was 'skill based errors' followed by 'decision errors.' Violations of laid down rules were contributory in 16 cases (33.3%). 'Preconditions for unsafe acts' were seen in 23 of the 48 cases (47.9%). A fairly large number (52.1%) had 'organizational influences' contributing to the accident. These results are in consonance with larger studies of accidents in the U.S. Navy and general aviation. Such a high percentage of 'organizational influences' has not been reported in other studies. This is a healthy sign for Indian civil aviation, provided effective remedial action for the same is undertaken.

Primary adrenal insufficiency is associated with impaired natural killer cell function: a potential link to increased mortality.

PubMed

Bancos, Irina; Hazeldine, Jon; Chortis, Vasileios; Hampson, Peter; Taylor, Angela E; Lord, Janet M; Arlt, Wiebke

2017-04-01

Mortality in patients with primary adrenal insufficiency (PAI) is significantly increased, with respiratory infections as a major cause of death. Moreover, patients with PAI report an increased rate of non-fatal infections. Neutrophils and natural killer (NK) cells are innate immune cells that provide frontline protection against invading pathogens. Thus, we compared the function and phenotype of NK cells and neutrophils isolated from PAI patients and healthy controls to ascertain whether altered innate immune responses could be a contributory factor for the increased susceptibility of PAI patients to infection. We undertook a cross-sectional study of 42 patients with PAI due to autoimmune adrenalitis ( n =  37) or bilateral adrenalectomy ( n =  5) and 58 sex- and age-matched controls. A comprehensive screen of innate immune function, consisting of measurements of neutrophil phagocytosis, reactive oxygen species production, NK cell cytotoxicity (NKCC) and NK cell surface receptor expression, was performed on all subjects. Neutrophil function did not differ between PAI and controls. However, NKCC was significantly reduced in PAI (12.0 ± 1.5% vs 21.1 ± 2.6%, P  < 0.0001). Phenotypically, the percentage of NK cells expressing the activating receptors NKG2D and NKp46 was significantly lower in PAI, as was the surface density of NKG2D (all P  < 0.0001). Intracellular granzyme B expression was significantly increased in NK cells from PAI patients ( P  < 0.01). Adrenal insufficiency is associated with significantly decreased NKCC, thereby potentially compromising early recognition and elimination of virally infected cells. This potential impairment in anti-viral immune defense may contribute to the increased rate of respiratory infections and ultimately mortality in PAI. © 2017 The authors.

Characteristics and Contributory Causes Related to Large Truck Crashes (Phase I) - Fatal Crashes

DOT National Transportation Integrated Search

2010-06-01

One-ninth of all traffic fatalities in the United States have involved large trucks in the past five years, although large trucks contributed to only 3% of registered vehicles and 7% of vehicle miles travelled. This contrasting proportion indicates t...

Resisting the Benefits Cost Burden.

ERIC Educational Resources Information Center

Blum, Mark C.

1991-01-01

Increasingly, college administrators are trying to pass fringe benefits costs off onto employees to relieve financial pressures. The result is an accelerated but often unacknowledged drain on faculty incomes. Faculty in a contributory health insurance plan should seek to cap faculty contributions at a fixed dollar amount. (MSE)

Tort Liability of School Districts, Officers, and Employees

ERIC Educational Resources Information Center

Knowles, Laurence

1972-01-01

Discusses the tactics of tort litigation in the public area, and outlines 1972 State and Federal court cases involving such tort liability issues as (1) governmental immunity, (2) negligence and foreseeability, (3) assumption of risk, (4) contributory negligence, and (5) independent intervening cause. (JF)

Factors associated with excited delirium deaths in police custody.

PubMed

Ross, D L

1998-11-01

Increasingly, police respond to confrontations in which the individual demonstrates violent and combative behavior as a result of drug-induced delirium. From medical, legal, and police documents, 61 cases of excited delirium decedents in police custody between 1988 and 1997 are analyzed. In all of the cases, the person fought with and was restrained by police; the person was more likely to die at the scene of the incident or during police transport; and the police were likely to be responding to a disturbance call. In a number of cases, survival time was less than 1 hour. In a majority of cases, acute cocaine toxicity and physical restraint in police custody were contributory to death. The literature is reviewed, analyses of case circumstances are provided, and recommendations for medicolegal investigators and police personnel are discussed.

Circumstances of Accidental Poisoning in Childhood

PubMed Central

Jackson, R. H.; Walker, J. H.; Wynne, N. A.

1968-01-01

Of 377 children with accidental poisoning, the commonest ages were 1, 2, and 3. The most important contributory factor was that the poison was kept in an inappropriate place. Most containers were closed, but the children found them easy to open. In some cases the container itself was unsuitable for the contents. The frequency of poisoning in childhood might be reduced in six main ways: (1) a reduction in the quantity of drugs kept in the home; (2) the provision of drug cupboards; (3) the provision of containers that are difficult for children to open, or individually foil-wrapping tablets; (4) making tablets less attractive to children; (5) clear identification of potential poisons; and (6) increasing parental awareness of the circumstances under which poisoning occurs. A plea is made for further sociomedical research into the prevention of poisoning. PMID:5682329

Older people as resources in South Africa: Mpumalanga households.

PubMed

Kimuna, Sitawa R; Makiwane, Monde

2007-01-01

The extended family used to be relied upon to provide subsistence and care for older people in sub-Saharan Africa. However, recently South Africa has seen a reversal of roles, where older people now provide subsistence and care to younger generations; this role reversal is being accelerated by HIV/AIDS deaths among young adults. In most rural households, the non-contributory old age pension (OAP) that is means-tested is an important factor in making older people breadwinners. Using data from the 2004 Mpumalanga Older People's Survey, we examined the changing role of older people, which has been influenced mainly by changes in household structure and old age pension. Findings show that in 63% of matrifocal, multigenerational households, 76% of older people are the sole providers of household necessities, caring for the sick and grandchildren in increasingly skip-generation households.

Fatal Septicaemia Following Suprapubic Cystostomy in a Paraplegic Patient: Never Do a Cystostomy without Prior Urine Culture and Appropriate Antibiogram!

PubMed Central

Vaidyanathan, Subramanian; Soni, Bakul M.; Oo, Tun; Hughes, Peter L.; Singh, Gurpreet

2010-01-01

Neuropathic urinary bladder is often colonised by multidrug-resistant bacteria. We report a 64-year-old male spinal cord injury patient with paraplegia, who received gentamicin on empirical basis before undergoing suprapubic cystostomy, as antibiotic sensitivity report of urine was not available. This patient developed fulminate septicaemia. Although appropriate antibiotic therapy (meropenem) was started when this patient manifested features of sepsis, acute renal failure occurred and he expired. Inappropriate initial antimicrobial therapy was the major contributory factor for this patient's mortality. Learning points from this case are (1) never do a cystostomy without prior urine culture and appropriate antibiogram; (2) in a chronic spinal cord injury patient, full blood count, liver function tests, albumin level, and albumin to globulin ratio should be performed before any surgical procedure. PMID:20589219

An investigation of the constituent elements and modes of fracture of in vivo fractured metallic posts.

PubMed

Fox, Kathryn; Wood, David J; Youngson, Callum C

2007-01-01

The objective of this investigation was to determine the materials used in metallic post and core construction and investigate and the modes of failure that occurred resulting in post fracture. Eighty-five fractured metal posts were clinically retrieved over a 5-year period. The tooth with the fractured post, and relevant clinical details were recorded. Investigation of the fractured posts was undertaken to determine their constituent elements and modes of fracture using scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX). The results showed that 77% of the posts were cast and 23% wrought. The modes of fracture were ductile (67%) or brittle (52%) although some posts exhibited both within the same specimen. In addition, evidence of fatigue was present in 20% of posts and porosity in 48%. A large variety of materials were used in the construction of post and cores although low-gold silver-palladium alloy most commonly encountered. Their failure was predominantly ductile in nature although a significant amount of brittle fracture was also noted. Porosity within castings also appeared to be a contributory factor in some cases and this was particularly evident in high-palladium castings. Evidence of fatigue was noted in a minority of posts.

Psychosis in a 15-Year-Old Female with Herpes Simplex Encephalitis in a Background of Mannose-Binding Lecithin Deficiency.

PubMed

Asogwa, Kenneth; Buabeng, Kwame; Kaur, Amarjit

2017-01-01

Historically, psychotic disorder has been associated with viral infection. Herpes simplex infections and Epstein-Barr virus (EBV) among other viral infections have been implicated in psychotic disorder. Of note in this case report is psychotic disorder that occurred following reactivation of herpes simplex infection in a background of mannose-binding lecithin (MBL) deficiency, childhood EBV infection, and severe psychosocial stress. Herpes simplex encephalitis (HSE) remains a significant cause of morbidity and mortality despite advancement in its treatment with intravenous acyclovir. Many studies have reported psychiatric and neurological manifestation of herpes simplex infection following primary or reactivated infection, while others suggest milder clinical course of herpes simplex encephalitis in a background of immunosuppression. Another contributory factor to psychotic disorder in this case is childhood EBV exposure which has been reported to increase the risk of psychosis in adolescence and adulthood. This case report describes a 15-year-old female with MBL deficiency who presented with psychosis caused by reactivated herpes simplex infection and had good clinical recovery. Based on childhood Epstein-Barr virus exposure and psychosis in adolescence (current case), she is at increased risk of psychotic disorder in adulthood, which underscores the importance of long-term monitoring.

A longitudinal study of change in falls risk and balance and mobility in healthy older people and people with Alzheimer disease.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Dodd, Karen J

2013-08-01

The aim of this study was to determine the rate of change in falls risk and balance and mobility performance in people with Alzheimer disease (AD) compared with those of healthy older people over a 1-yr period. A 1-yr follow-up study of change in levels of falls risk, balance, and mobility performance in 15 community-dwelling older people with mild to moderate AD and 15 healthy age-matched older people was conducted. Each participant completed a comprehensive assessment of balance and mobility, falls and falls risk, and level of physical activity at baseline and 1 yr later. The rate of increase in the number of falls and risk of falling was greater in people with AD. The rate of deterioration on a number of balance and mobility measures was also significantly greater in people with AD compared with the healthy older people. People with mild to moderate AD have an increased rate of decline in falls risk, balance, and mobility over a 12-mo period compared with age-matched healthy older people. Given this increased rate of decline, intermittent review of falls, balance and mobility, and interventions to address identified contributory risk factors should be considered by health practitioners.

Opportunistic insights into occupational health hazards associated with waterpipe tobacco smoking premises in the United Kingdom.

PubMed

Al-Bakri, Ali; Jawad, Mohammed; Salameh, Pascale; al'Absi, Mustafa; Kassim, Saba

2015-01-01

Smokefree laws aim to protect employees and the public from the dangers of secondhand smoke. Waterpipe premises have significantly increased in number in the last decade, with anecdotal reports of poor compliance with the smokefree law. The literature is bereft of information pertaining to waterpipe premise employees. This study aimed to opportunistically gather knowledge about the occupational health hazards associated with working in waterpipe premises in London, England. Employees from seven convenience-sampled, smokefree-compliant waterpipe premises in London were observed for occupational activities. Opportunistic carbon monoxide (CO) measurements were made among those with whom a rapport had developed. Observations were thematically coded and analysed. Occupational hazards mainly included environmental smoke exposure. Waterpipe-serving employees were required to draw several puffs soon after igniting the coals, thereby providing quality assurance of the product. Median CO levels were 27.5 ppm (range 21-55 ppm) among these employees. Self-reported employee health was poor, with some suggestion that working patterns and smoke exposure was a contributory factor. The smokefree law in England does not appear to protect waterpipe premise employees from high levels of CO. Continued concerns surrounding chronic smoke exposure may contribute to poor self-reported physical and mental wellbeing.

Mortality after nasogastric tube feeding initiation in long-term care elderly with oropharyngeal dysphagia--the contribution of refeeding syndrome.

PubMed

Lubart, Emilia; Leibovitz, Arthur; Dror, Yosef; Katz, Elena; Segal, Refael

2009-01-01

The refeeding syndrome (RS) is an underappreciated but clinically important entity characterized by acute electrolyte abnormalities, mainly hypophosphatemia, fluid retention and dysfunction of various organs and systems, which can result in significant morbidity and occasionally death. To examine the incidence of death cases and death causes following nasogastric tube (NGT) feeding initiation in frail elderly with particular reference to RS. Forty patients with feeding problems for at least 72 h before restarting of alimentation by NGT were included. Excluded were those in any critical clinical situation. Clinical parameters and nutritional assessment were recorded before and after refeeding. Blood samples were taken before, daily for the first 3 days and 1 week after refeeding initiation. During the 1st week of refeeding, 9 patients (22.5%) died and within 1 month 10 more, summing to 47.5%. Most deaths were due to infectious causes [15 out of 19, (79%)]; some were due to no obvious reason [4 out of 19, (21%)]. Significant electrolyte changes were observed in the 2-3 days following refeeding. Significant were the decreases in phosphorus and elevations in potassium and lymphocytes (day 7). We found no correlations between the severity of decreases in levels of phosphorus and mortality. Mortality after NGT feeding initiation was high, mainly due to infectious complications. However, in a considerable number of patients hypophosphatemia was noted, suggesting that RS could be a contributory factor of mortality. Since this is a treatable condition, more attention should be paid to detecting and coping with this problem. Copyright 2009 S. Karger AG, Basel.

Schizophrenia and Physical Comorbidity.

PubMed

Šimunović Filipčić, Ivona; Filipčić, Igor

2018-06-01

Schizophrenia is a severe psychiatric disorder increasingly recognized as a systemic disorder. In addition to the burden and suffering caused by the mental illness itself, individuals with schizophrenia have a high risk for physical illnesses. The life expectancy gap remains 13 to 30 years wider in people with schizophrenia compared to the general population. This premature mortality is caused largely by deaths due to cardiovascular disease, cancer, diabetes mellitus, and other natural causes, poor diagnosis and treatment, and insufficient prevention of modifiable risk factors. Although the links between schizophrenia and physical illnesses are well established, in clinical practice, physical illnesses in patients with schizophrenia are often overlooked, and the mortality gap between general population and people with schizophrenia continues to widen. The physical health of people with schizophrenia is commonly self-neglected but also ignored by people around them and by health systems, resulting in significant physical health disparities and limited access to health services. The root of the problem of insufficient healthcare appear to lie in interrelated contributory factors from illness, patients, and medical and mental healthcare system. Furthermore, a growing body of literature has been indicating the effect of the chronic physical illness on the treatment outcome of psychosis. Premature mortality and disability could be reduced if there was a greater focus on the implementation of strategies that effectively prevent modifiable risk factors from the first psychotic episode and enhance early recognition of physical illnesses, reduce the burden of physical comorbidity and lead to improved health outcomes. Ultimately, to improve treatment outcome and to reduce the suffering of people with schizophrenia, it is crucial to treat physical comorbidity promptly and assertively from the appearance of the first symptoms of the psychotic disorder. The integrative approach and collaborative care within all levels of healthcare providers should be the imperative in clinical practice.

Nutrition Transition and Obesity Among Teenagers and Young Adults in South Asia.

PubMed

Jayawardena, Ranil; Ranasinghe, Priyanga; Wijayabandara, Maheshi; Hills, Andrew P; Misra, Anoop

2017-01-01

Obesity among teenagers/adolescents and young adults is associated with significant adverse short and longer-term effects on health. To date, no narrative reviews have evaluated nutrition transition and its contribution to the obesity epidemic among adolescents and young adults in the South Asian (SA) region. Data were retrieved by a four-stage systematic search process. A search of the online Pub- Med/Medline, SciVerse Scopus and Web of Science databases was performed. The age groups were defined as follows; teenage:13-19 years, adolescence:10-18 years and young adult:19-24 years. Among teenagers/adolescents, the prevalence of overweight ranged from 11.0% (Sri Lanka) to 19.0% (India), while obesity ranged from 2.4% (Sri Lanka) to 11.0% (Pakistan). In young adults, prevalence of overweight ranged between 7.9% (Nepal) to 15.0% (Pakistan), while obesity showed a much wider variation (0.005%[Nepal] - 22.8%[India]). Nutritional risk factors associated with overweight/ obesity among SAs of this age group included reduced fruit and vegetable consumption, a total vegetarian diet, consumption of fast food and soft drinks, and skipping breakfast. Other contributing factors identified were: adding extra salt to meals, eating meals outside of the home, frequently visiting restaurants and eating while watching television. Daily milk/yoghurt consumption and a family supper have shown a protective effect against overweight/obesity. Overweight and obesity are common amongst teenagers/adolescents and young adults of the SA region. Several food types and habits were identified as being associated with overweight/ obesity in this population. Identifying common protective and contributory factors is very important for the development of a shared regional preventive strategy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Income and health-related quality of life among prostate cancer patients over a one-year period after radical prostatectomy: a linear mixed model analysis.

PubMed

Klein, Jens; Lüdecke, Daniel; Hofreuter-Gätgens, Kerstin; Fisch, Margit; Graefen, Markus; von dem Knesebeck, Olaf

2017-09-01

To examine income-related disparities in health-related quality of life (HRQOL) over a one-year period after surgery (radical prostatectomy) and its contributory factors in a longitudinal perspective. Evidence of associations between income and HRQOL among patients with prostate cancer (PCa) is sparse and their explanations still remain unclear. 246 males of two German hospitals filled out a questionnaire at the time of acute treatment, 6 and 12 months later. Age, partnership status, baseline disease and treatment factors, physical and psychological comorbidities, as well as treatment factors and adverse effects at follow-up were additionally included in the analyses to explain potential disparities. HRQOL was assessed with the EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 core questionnaire and the prostate-specific QLQ-PR25. A linear mixed model for repeated measures was calculated. The fixed effects showed highly significant income-related inequalities regarding the majority of HRQOL scales. Less affluent PCa patients reported lower HRQOL in terms of global quality of life, all functional scales and urinary symptoms. After introducing relevant covariates, some associations became insignificant (physical, cognitive and sexual function), while others only showed reduced estimates (global quality of life, urinary symptoms, role, emotional and social function). In particular, mental disorders/psychological comorbidity played a relevant role in the explanation of income-related disparities. One year after surgery, income-related disparities in various dimensions of HRQOL persist. With respect to economically disadvantaged PCa patients, the findings emphasize the importance of continuous psychosocial screening and tailored interventions, of patients' empowerment and improved access to supportive care.

Qualitative cross-sectional study of the perceived causes of depression in South Asian origin women in Toronto

PubMed Central

Ekanayake, Samanthika; Ahmad, Farah

2012-01-01

Objective To explore how South Asian origin women in Toronto, Canada, understand and explain the causes of their depression. Design Cross-sectional in-depth qualitative interviews. Setting Outpatient service in Toronto, Ontario. Participants Ten women with symptoms of depression aged between 22 and 65 years of age. Seven were from India, two from Sri Lanka and one from Pakistan. Four were Muslim, three Hindu and three Catholic. Two participants had university degrees, one a high school diploma and seven had completed less than a high school education. Eight were married, one was unmarried and one a widow. Results Three main factors emerged from the participant narratives as the causes of depression: family and relationships, culture and migration and socioeconomic. The majority of the participants identified domestic abuse, marital problems and interpersonal problems in the family as the cause of their depression. Culture and migration and socioeconomic factors were considered contributory. None of our study participants reported spiritual, supernatural or religious factors as causes of depression. Conclusion A personal–social–cultural model emerged as the aetiological paradigm for depression. Given the perceived causation, psycho-social treatment methods may be more acceptable for South Asian origin women. PMID:22337816

Qualitative cross-sectional study of the perceived causes of depression in South Asian origin women in Toronto.

PubMed

Ekanayake, Samanthika; Ahmad, Farah; McKenzie, Kwame

2012-01-01

To explore how South Asian origin women in Toronto, Canada, understand and explain the causes of their depression. Cross-sectional in-depth qualitative interviews. Outpatient service in Toronto, Ontario. Ten women with symptoms of depression aged between 22 and 65 years of age. Seven were from India, two from Sri Lanka and one from Pakistan. Four were Muslim, three Hindu and three Catholic. Two participants had university degrees, one a high school diploma and seven had completed less than a high school education. Eight were married, one was unmarried and one a widow. Three main factors emerged from the participant narratives as the causes of depression: family and relationships, culture and migration and socioeconomic. The majority of the participants identified domestic abuse, marital problems and interpersonal problems in the family as the cause of their depression. Culture and migration and socioeconomic factors were considered contributory. None of our study participants reported spiritual, supernatural or religious factors as causes of depression. A personal-social-cultural model emerged as the aetiological paradigm for depression. Given the perceived causation, psycho-social treatment methods may be more acceptable for South Asian origin women.

Adult femicide victims in forensic autopsy in Taiwan: A 10-year retrospective study.

PubMed

Fong, Wen-Li; Pan, Chih-Hsin; Lee, James Chun-I; Lee, Tsui-Ting; Hwa, Hsiao-Lin

2016-09-01

Violence against women and adult femicides are critical medico-legal issues worldwide. Intimate partner violence is one of the leading contributory risk factors. This study aimed to describe the characteristics of femicides in Taiwan. A retrospective analysis of forensic autopsy records of adult femicide victims in Taiwan during a 10-year period was carried out. The age, victim-offender relationship, injury patterns and causes of death were analyzed. Among the 220 adult femicide victims recruited, 114 were killed by intimate partners and 106 were killed by non-intimate partner offenders. The average age of victims killed by intimate partners (40.0 y/o) were younger than those killed by non-intimate partner perpetrators (48.6 y/o). The most common site of injuries in the intimate partner group and the non-intimate partner group was the neck and the upper limbs, respectively. The rates of bruise and intracranial injury of non-intimate partner group were significantly higher than that of the intimate partner group. The most common causes of death in both groups were strangulation and sharp force injury. The heart injury was significantly more frequent in victims offended by intimate partners than by other assailants. The characteristics of adult femicides, and the patterns of injury in victims killed by intimate partners and non-intimate partner offenders were different. This data is helpful for corpus inspection in forensic casework and for strategic planning of femicides prevention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychological consequences in pediatric intensive care unit survivors: the neglected outcome.

PubMed

Muranjan, Mamta N; Birajdar, Suresh B; Shah, Henal R; Sundaraman, Preeti; Tullu, Milind S

2008-02-01

To determine whether Pediatric Intensive Care Unit (PICU) hospitalization results in adverse psychological effects and to identify the contributory factors. Level III PICU of a tertiary center. Prospective cohort study. Consecutive patients 5 years or older admitted to PICU for at least 48 hours constituted the study population. Controls were age and sex matched children hospitalized in the pediatric wards for at least 48 hours. Severity of illness was assessed by the Pediatric Risk of Mortality (PRISM) score. Level of therapeutic intervention was determined by the Therapeutic Interventions Scoring System (TISS--76 score). Temperament Measurement Schedule was used to assess the premorbid temperament. Psychological assessment was performed using Impact of Event Scale (IES), Birleson Depression Scale and the Self-Esteem Scale. Follow-up evaluation was done one month after discharge. There were 30 children each in the study and control groups. They had comparable pre-morbid temperament as well as scores on the self-esteem and depression scales. Significantly higher proportion of patients in PICU had intrusive thoughts (43%) as compared to controls (6.7%). Development of intrusive thoughts correlated significantly with the degree of intervention. Demographic parameters, nature of the disease, duration of hospitalization and severity of illness did not correlate with the psychological outcome. One month after discharge, scores in both groups were comparable. Children subjected to therapeutic interventions in the PICU develop transient psychological impairment manifested by experiencing intrusive thoughts that resolve within a month.

Education for All.

ERIC Educational Resources Information Center

Makagiansar, M., Ed.; And Others

1990-01-01

This volume concentrates on the idea of education for all with its goal of making the world's population literate by the year 2000. The book features contributory articles by some of the most eminent personalities working in this region on various aspects of primary education, adult literacy and post-literacy activities. Highlights have been made…

Anarchism and Education: "Education Integrale and the Imperative Towards Fraternite."

ERIC Educational Resources Information Center

Fidler, Geoffrey C.

1989-01-01

Explores the nature of complete education as it was conceived and practiced by adherents of French classical anarchist pedagogy. Notes conflict between freedom and authority in their conceptualization. Argues that consciousness of actions rather than the economic and social products of those actions was what made practice contributory to…

Disproportionate Placement of Black and Hispanic Students in Special Education Programs.

ERIC Educational Resources Information Center

Goodale, Ronda; Soden, Marcia

The paper examines practices and procedures that are seen as contributory to disproportionate placement of Black and Hispanic students in special education programs and discusses various components of the Boston Public School's Remedial Plan. Practices and procedures critical in disproportionate placement are seen to include biased assessment,…

Differential Effects of Professionalism and Social Responsibility in Public Relations.

ERIC Educational Resources Information Center

Wright, Donald K.

Questionnaires were sent to 306 public relations counselors in Texas to discover if professionalism is a contributory cause of social responsibility in public relations, if the presence or absence of professionalism increases the likelihood that social responsibility will occur, and the conditions, if any, under which professionalism contributes…

32 CFR 536.53 - Evaluation of claims-general rules and guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... a professional negligence claim, the claimant will submit an expert opinion when requested. State... representative. Contributory negligence has given way to comparative negligence in most United States jurisdictions. In most foreign countries, comparative negligence is the rule of law. Note to § 536.53: For...

Insuring That Families Plan and Save for College.

ERIC Educational Resources Information Center

Belvin, James

1995-01-01

Because so many Americans can afford to save for children's college costs but do not, it is proposed that employers take a more active role in promoting college financial planning. Possible solutions include company-sponsored contributory accounts, educational savings plans; payroll deduction plans, educational annuity programs, subsidized or…

The Global View of Vocational-Academic Integration.

ERIC Educational Resources Information Center

Pritz, Sandra G.

Education's central challenge is to prepare learners for contributory and satisfying lives in a global economy in which they are productive enough for the nation to be globally competitive. Being globally competitive means that the benefits of foreign trade accrue to all on the basis of each country's pursuing its comparative advantages…

33 CFR 25.507 - Claims payable.

Code of Federal Regulations, 2010 CFR

2010-07-01

... property involved would be liable under local law. (b) The fact that the act giving rise to a claim may constitute a crime does not, by itself, bar relief. (c) Local law or custom pertaining to contributory or comparative negligence, and to joint tort-feasors, are applied to the extent practicable. ...

A College's Liability for Unauthorized Copying of Microcomputer Software by Students.

ERIC Educational Resources Information Center

Gemignani, Michael

1986-01-01

Reviews copyright law and "contributory infringement" as it relates to computer software and possible student and staff violation in colleges and universities. Also discusses possibilities of "breach of contract" and "negligence" in computer software use. Provides a series of recommendations for universities and colleges to protect their…

Atypical Development of Face and Greeble Recognition in Autism

ERIC Educational Resources Information Center

Scherf, K. Suzanne; Behrmann, Marlene; Minshew, Nancy; Luna, Beatriz

2008-01-01

Background: Impaired face processing is a widely documented deficit in autism. Although the origin of this deficit is unclear, several groups have suggested that a lack of perceptual expertise is contributory. We investigated whether individuals with autism develop expertise in visuoperceptual processing of faces and whether any deficiency in such…

EVALUATION OF COARSE, FINE, AND ULTRAFINE PARTICLES AS PART OF A HEALTH EFFECTS EXPOSURE STUDY

EPA Science Inventory

Ambient PM is a complex mixture that includes bioactive and toxic compounds of natural and anthropogenic origin, several of which have been theorized to be causative or contributory to the adverse effects of PM inhalation. Numerous epidemiological studies have reported associ...

Down-regulation of L-type calcium channel and sarcoplasmic reticular Ca(2+)-ATPase mRNA in human atrial fibrillation without significant change in the mRNA of ryanodine receptor, calsequestrin and phospholamban: an insight into the mechanism of atrial electrical remodeling.

PubMed

Lai, L P; Su, M J; Lin, J L; Lin, F Y; Tsai, C H; Chen, Y S; Huang, S K; Tseng, Y Z; Lien, W P

1999-04-01

We investigated the gene expression of calcium-handling genes including L-type calcium channel, sarcoplasmic reticular calcium adenosine triphosphatase (Ca(2+)-ATPase), ryanodine receptor, calsequestrin and phospholamban in human atrial fibrillation. Recent studies have demonstrated that atrial electrical remodeling in atrial fibrillation is associated with intracellular calcium overload. However, the changes of calcium-handling proteins remain unclear. A total of 34 patients undergoing open heart surgery were included. Atrial tissue was obtained from the right atrial free wall, right atrial appendage, left atrial free wall and left atrial appendage, respectively. The messenger ribonucleic acid (mRNA) amount of the genes was measured by reverse transcription-polymerase chain reaction and normalized to the mRNA levels of glyceraldehyde 3-phosphate dehydrogenase. The mRNA of L-type calcium channel and of Ca(2+)-ATPase was significantly decreased in patients with persistent atrial fibrillation for more than 3 months (0.36+/-0.26 vs. 0.90+/-0.88 for L-type calcium channel; 0.69+/-0.42 vs. 1.21+/-0.68 for Ca(2+)-ATPase; both p < 0.05, all data in arbitrary unit). We further demonstrated that there was no spatial dispersion of the gene expression among the four atrial tissue sampling sites. Age, gender and underlying cardiac disease had no significant effects on the gene expression. In contrast, the mRNA levels of ryanodine receptor, calsequestrin and phospholamban showed no significant change in atrial fibrillation. L-type calcium channel and the sarcoplasmic reticular Ca(2+)-ATPase gene were down-regulated in atrial fibrillation. These changes may be a consequence of, as well as a contributory factor for, atrial fibrillation.

Investigating slips, trips and falls in the New Zealand dairy farming sector.

PubMed

Bentley, Tim; Tappin, David; Moore, Dave; Legg, Stephen; Ashby, Liz; Parker, Richard

2005-06-22

The paper presents findings from 39 detailed follow-up investigations of slips, trips and falls (STF) incurred by individuals working in New Zealand's dairy farming industry. The study sought to identify the key contributory risk factors for STF in this sector to provide evidence to support intervention design, and to determine the effectiveness of the investigative methodology used to achieve these objectives. Findings from the follow-up investigations included an analysis of factors related to the underfoot surface, underfoot hazard and footwear. Of note here was the propensity for STF-involved workers to not see or identify an underfoot hazard due to concurrent visual task distractions, and for workers to use footwear that both lacked effective tread and was unsuitable for the task and underfoot surface. Key latent risk factors and their interactions identified included problems associated with time pressure and related time-saving behaviours and the presence of design errors that, for example, required workers to climb onto equipment to view aspects of the task they were working on. The paper concludes that the potential resource and logistical problems associated with conducting detailed STF investigations are outweighed by the opportunity to collect rich data on key risk factors and their interactions in STF research.

Factors associated with suicidal ideations and suicidal attempts in patients with obsessive compulsive disorder.

PubMed

Gupta, Gourav; Avasthi, Ajit; Grover, Sandeep; Singh, Shubh Mohan

2014-12-01

Aim of this study was to evaluate the prevalence of suicidal ideations (SI) and to study the risk factors for SI and suicide attempt in patients with OCD. One hundred and thirty patients with OCD were assessed on Yale-Brown Obsessive–Compulsive Scale and Symptom Checklist, Beck Depression Inventory, Beck Hopelessness Scale, Beck Anxiety Inventory, State-Trait Anxiety Inventory, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale, Family Interview for Genetic Studies, Brown Assessment of Beliefs Scale and DSM-IV insight criteria for OCD. Of the 130 patients, 60 (46.1%) had current SI and 81 (62.3%) patients had life time SI. Of the 60 patients with current SI, 30 had current depression as assessed on SCID-CV. More than half (48 out of 81; 59.25%) of the patients with lifetime SI had lifetime comorbid depression. Ten patients had history of lifetime suicide attempts. Current SI in patients without current depression were associated with female gender, presence of comorbid psychiatric illness, contamination obsessions and cleaning/washing compulsions. To conclude this study suggests that SI are highly prevalent in patients with OCD and although depression may be a contributory factor for suicidal ideations in patients with OCD, but it is not the sole risk factor for suicidal ideations.

Effect of timely initiation of breastfeeding on child health in Ghana.

PubMed

Fosu-Brefo, Rita; Arthur, Eric

2015-01-01

Early initiation of breastfeeding and exclusive breastfeeding practices have been argued to be one of the important ways of ensuring child health. Unfortunately, owing to modernization, most nursing mothers fail to adhere to such practices. This is believed to be a factor contributory to poor child health in Ghana. Thus, this study investigated the effect of timely initiation of breastfeeding on child health in Ghana. Cross sectional data using secondary data based on the positivism approach to research was employed. The Ordinary least squares and the Instrumental variables approach were used in estimating the effect of breastfeeding and other socio demographic indicators on the health of the child. Data for the study was sourced from the 2008 round of the Ghana Demographic and Health Survey. The results indicate that timely initiation of breastfeeding, both immediately and hours after birth are important factors that influence the child's health. Additionally, factors such as the wealth of the household, mother's education, age and size of the child at birth and age of the mother are important factors that also influence the health of the child in Ghana. The findings imply that efforts should be made on encouraging appropriate breastfeeding practices among nursing mothers to ensure proper child development and growth in Ghana.

A cluster of inflammatory breast cancer (IBC) in an office setting: additional evidence of the importance of environmental factors in IBC etiology.

PubMed

Duke, Tina J; Jahed, Nasreen C; Veneroso, Carmela C; Da Roza, Ricardo; Johnson, Owen; Hoffman, Daniel; Barsky, Sanford H; Levine, Paul H

2010-11-01

We investigated a cluster of three cases of inflammatory breast cancer (IBC) diagnosed within 10 months in an office setting of 24 people. Information about medical history, pregnancy history, family history of breast cancer, oral contraceptive use/hormone replacement therapy, exposure to possible oncogenic agents and tumor promoters were obtained to determine whether there were differences in risk factors for IBC between cases and controls. The physical environment and location of the cases' office raised concern about air and water quality as well as radiation as being contributory risk factors for developing IBC. Of the three women with IBC, two had high exposures to pesticides/herbicides, all three used oral contraceptives and two used hormone replacement therapy at the time of diagnosis, two had a family history of breast cancer, and two were obese. Among fifteen controls four had pesticide/herbicide exposure, one had a family history of breast cancer, nine used oral contraceptives, seven used hormone replacement therapy, and five were obese. No specific environmental causes were established for this cluster. Several promoting factors have been suggested that could result in subclinical breast cancer emerging as IBC. Among them are exogenous hormones and exposure to herbicides/pesticides.

Early onset dementia in New Zealand Pacific boxers: a case series.

PubMed

Payman, Vahid; Yates, Susan; Cullum, Sarah

2018-05-04

To describe the biopsychosocial characteristics of a series of Pacific men living in South Auckland with a history of boxing presenting with early onset dementia. We discuss the history of boxing in Pacific people and the possibility of increased risk of early onset dementia in New Zealand Pacific men compared to their European counterparts. We reviewed the files of Pacific men with a history of amateur or professional boxing who presented to our memory and older adult mental health services with early onset dementia over a 45-month period. We gathered relevant information to construct a biopsychosocial paradigm as possible explanation of this phenomenon. We identified a series of eight New Zealand Pacific men with early onset dementia and with a history of boxing. Alcohol was a contributing factor in seven of the eight cases, and vascular risk factors in five. Historical, cultural and socio-economic factors underpin the attraction of some Pacific men to boxing as a sport. Given that New Zealand Pacific peoples may have an earlier onset of dementia than their European counterparts, further research is required to establish whether boxing is a contributory factor. Sports physicians should advise young New Zealand Pacific boxers about the long-term risks associated with their sport.

Diffuse large B-cell lymphoma, not otherwise specified of the palate: A case report

PubMed Central

Pereira, Thaís SF.; Castro, Alexandre F.; Mesquita, Ricardo A.

2013-01-01

Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin´s lymphoma found in oral and maxillofacial regions. A large number of cases may be biologically heterogeneous, which are commonly defined as DLBCL, not otherwise specified (NOS) by the World Health Organization (WHO-2008). The present case reports on an ulcer of raised and irregular edges, found on the border between the hard and soft palate, as the first and only manifestation of an extranodal non-Hodgkin lymphoma in an 85-year-old patient. Incisional biopsy was carried out, and the specimen revealed a proliferation of large lymphoid cells suggestive of diffuse large cell lymphoma. An immunohistochemical analysis was performed. EBV-RNA was assessed by in situ hybridization that also proved to be negative. Immunohistochemical and EBV analyses are important to avoid delays and inappropriate treatment strategies. Although advanced age is considered an adverse prognostic factor, early diagnosis did prove to be a key contributory factor in the cure of non-Hodgkin lymphoma. Key words:Diffuse large B-cell lymphoma, elderly, EBV. PMID:24455096

Feasibility Studies of Palm Oil Mill Waste Aggregates for the Construction Industry.

PubMed

Kanadasan, Jegathish; Fauzi, Auni Filzah Ahmad; Razak, Hashim Abdul; Selliah, Paramananthan; Subramaniam, Vijaya; Yusoff, Sumiani

2015-09-22

The agricultural industry in Malaysia has grown rapidly over the years. Palm oil clinker (POC) is a byproduct obtained from the palm oil industry. Its lightweight properties allows for its utilization as an aggregate, while in powder form as a filler material in concrete. POC specimens obtained throughout each state in Malaysia were investigated to evaluate the physical, chemical, and microstructure characteristics. Variations between each state were determined and their possible contributory factors were assessed. POC were incorporated as a replacement material for aggregates and their engineering characteristics were ascertained. Almost 7% of density was reduced with the introduction of POC as aggregates. A sustainability assessment was made through greenhouse gas emission (GHG) and cost factor analyses to determine the contribution of the addition of POC to the construction industry. Addition of POC helps to lower the GHG emission by 9.6% compared to control specimens. By channeling this waste into the construction industry, an efficient waste-management system can be promoted; thus, creating a cleaner environment. This study is also expected to offer some guides and directions for upcoming research works on the incorporation of POC.

Experimental Evidence on the Impact of Food Advertising on Children's Knowledge about and Preferences for Healthful Food

PubMed Central

Reisch, Lucia A.; Gwozdz, Wencke; De Henauw, Stefaan; Lascorz, Natalia; Pigeot, Iris

2013-01-01

To understand the rising prevalence of childhood obesity in affluent societies, it is necessary to take into account the growing obesity infrastructure, which over past decades has developed into an obesogenic environment. This study examines the effects of one of the constituent factors of consumer societies and a potential contributory factor to childhood obesity: commercial food communication targeted to children. Specifically, it investigates the impact of TV advertising on children's food knowledge and food preferences and correlates these findings with their weight status. Evaluations of traditional information- and education-based interventions suggest that they may not sustainably change food patterns. Based on prior consumer research, we propose five hypotheses, which we then test using a subsample from the IDEFICS study, a large-scale pan-European intervention study on childhood obesity. The results indicate that advertising has divergent effects on children's food knowledge and preferences and that food knowledge is unrelated to food preferences. This finding has important implications for both future research and public policy. PMID:23691285

Revisiting crash spatial heterogeneity: A Bayesian spatially varying coefficients approach.

PubMed

Xu, Pengpeng; Huang, Helai; Dong, Ni; Wong, S C

2017-01-01

This study was performed to investigate the spatially varying relationships between crash frequency and related risk factors. A Bayesian spatially varying coefficients model was elaborately introduced as a methodological alternative to simultaneously account for the unstructured and spatially structured heterogeneity of the regression coefficients in predicting crash frequencies. The proposed method was appealing in that the parameters were modeled via a conditional autoregressive prior distribution, which involved a single set of random effects and a spatial correlation parameter with extreme values corresponding to pure unstructured or pure spatially correlated random effects. A case study using a three-year crash dataset from the Hillsborough County, Florida, was conducted to illustrate the proposed model. Empirical analysis confirmed the presence of both unstructured and spatially correlated variations in the effects of contributory factors on severe crash occurrences. The findings also suggested that ignoring spatially structured heterogeneity may result in biased parameter estimates and incorrect inferences, while assuming the regression coefficients to be spatially clustered only is probably subject to the issue of over-smoothness. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does alcohol contribute to accident and emergency department attendance in elderly people?

PubMed Central

van der Pol, V; Rodgers, H; Aitken, P; James, O; Curless, R

1996-01-01

OBJECTIVE: To evaluate the possible contribution of alcohol to presentation of elderly subjects at a hospital accident and emergency (A&E) department. METHODS: 105 patients aged 70 years and over who attended the department were interviewed by a single observer using a structured questionnaire based on previously validated general population surveys. Details of alcohol consumption within the previous 24 hours were recorded. Usual consumption of alcohol in the preceding 12 months was estimated by the quantity frequency method. Alcohol dependence was screened for by the CAGE questionnaire. An assessment of disability was made using the Barthel index. Breath alcohol was measured. RESULTS: In only 2% of attenders was alcohol thought to be a contributory factor. Breath alcohol measurements were technically unsatisfactory in this age group. Regular drinkers were functionally and socially more independent than non-regular drinkers. Drinking patterns in this age group may partly be determined by the physical ability to obtain alcohol. CONCLUSIONS: Alcohol was not found to be a major factor in A&E attendance in elderly people. PMID:8832344

Balancing Control and Complexity in Field Studies of Neonicotinoids and Honey Bee Health

PubMed Central

Suryanarayanan, Sainath

2013-01-01

Amidst ongoing declines in honey bee health, the contributory role of the newer systemic insecticides continues to be intensely debated. Scores of toxicological field experiments, which bee scientists and regulators in the United States have looked to for definitive causal evidence, indicate a lack of support. This paper analyzes the methodological norms that shape the design and interpretation of field toxicological studies. I argue that contemporary field studies of honey bees and pesticides are underpinned by a “control-oriented” approach, which precludes a serious investigation of the indirect and multifactorial ways in which pesticides could drive declines in honey bee health. I trace the historical rise to prominence of this approach in honey bee toxicology to the development of entomology as a science of insecticide development in the United States. Drawing on “complexity-oriented” knowledge practices in ecology, epidemiology, beekeeping and sociology, I suggest an alternative socio-ecological systems approach, which would entail in situ studies that are less concerned with isolating individual factors and more attentive to the interactive and place-based mix of factors affecting honey bee health. PMID:26466800

Gender differences with respect to psychiatric comorbidity in obstructive sleep apnea syndrome.

PubMed

Uyar, Meral; Vrt, Osman; Bayram, Nazan; Elbek, Osman; Savaş, Esen; Altindağ, Abdurrahman; Ozçalşkan, Deniz; Ozsaraç, Ilker; Gündoğdu, Nevhiz; Savaş, Haluk A

2011-07-01

Psychiatric disorders are common in obstructive sleep apnea syndrome (OSAS); however, interrelating factors influencing psychiatric comorbidity (PC) in OSAS are unclear. The aim of this study is to investigate gender related differences with PC in OSAS. Data of patients diagnosed as OSAS in University of Gaziantep from January 2006 to January 2010 were retrospectively evaluated. Polysomnographic data were recorded with Viasys Sleep Screen (Viasys Healthcare, Germany). Patients younger than 18 years old were excluded. PC was present in 53.1% of OSAS patients. The rate of male subjects with PC was 42.6%; however, 76.26% of females had PC (P = 0.00). Age (P = 0.00) and body mass index (BMI) (P = 0.00) were higher in patients with PC. Ferritin levels were lower in patients with PC (P = 0.00). Male subjects with PC were older and had lower sleep efficiency and longer rapid eye movement latency than males without PC. BMI was the only contributory factor to PC in female subjects. PC in OSAS is common, especially in females. Apnea hypopnea index does not seem to influence probability of PC.

Central sensitization in chronic low back pain: A narrative review.

PubMed

Sanzarello, Ilaria; Merlini, Luciano; Rosa, Michele Attilio; Perrone, Mariada; Frugiuele, Jacopo; Borghi, Raffaele; Faldini, Cesare

2016-11-21

Low back pain is one of the four most common disorders in all regions, and the greatest contributor to disability worldwide, adding 10.7% of total years lost due to this health state. The etiology of chronic low back pain is, in most of the cases (up to 85%), unknown or nonspecific, while the specific causes (specific spinal pathology and neuropathic/radicular disorders) are uncommon. Central sensitization has been recently recognized as a potential pathophysiological mechanism underlying a group of chronic pain conditions, and may be a contributory factor for a sub-group of patients with chronic low back pain. The purposes of this narrative review are twofold. First, to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in patients with nonspecific low back pain. Second, to provide general treatment principles of chronic low back pain with particular emphasis on pharmacotherapy targeting central sensitization.

Reasons for excision of skin tumors: a one-year prospective study in a tertiary skin cancer unit.

PubMed

Lallas, Aimilios; Longo, Caterina; Moscarella, Elvira; Lombardi, Mara; Specchio, Francesca; Raucci, Margherita; Zalaudek, Iris; Argenziano, Giuseppe

2015-01-01

Biopsies and surgical excisions represent routine procedures in clinical settings dealing with skin cancer. To evaluate the impact of clinical examination, dermoscopy, reflectance confocal microscopy and digital monitoring on the decision to excise or biopsy a lesion in routine practice. Patients scheduled for biopsy or excision of a skin lesion were prospectively enrolled. The expert dermatologist was asked to select the main factor that prompted him/her to excise or biopsy the lesion. The most common reason for melanoma excision was clinical and dermoscopic morphology (70.3%), followed by dermoscopy (11.4%), monitoring (8.9%) and clinical context (8.2%). Most basal and squamous cell carcinomas were recognized both clinically and dermoscopically, while 18.6 and 15.0%, respectively, could only be detected with dermoscopic examination. Each part of the clinical examination has a contributory role in the diagnosis of melanoma and other skin cancers.

Neuroinflammatory genes associated with post-traumatic stress disorder: implications for comorbidity.

PubMed

Zass, Lyndon J; Hart, Stephanie A; Seedat, Soraya; Hemmings, Sian M J; Malan-Müller, Stefanie

2017-02-01

Post-traumatic stress disorder (PTSD) is a debilitating condition that only occurs in the aftermath of traumatic event exposure and is characterized by an impaired stress response and chronic, low-grade inflammation. Dysregulation of the immune system may contribute towards central nervous system tissue damage and exacerbation of fear memories following trauma. Patients with PTSD often have comorbid psychiatric and somatic disorders that are of themselves associated with heightened inflammation. Several immune-related genes have been associated with PTSD and other co-occurring disorders. In this review, we propose that chronic inflammation, particularly neuroinflammation, is an important contributory factor towards PTSD comorbidity. Thus, novel treatments that target dysregulated inflammatory processes could provide symptomatic relief from PTSD and its comorbid disorders. This review investigates the intricate links between chronic stress, anxiety and neuroinflammation and the potential impact of increased neuroinflammation on PTSD pathology and comorbidity.

The indoor air we breathe.

PubMed Central

Oliver, L C; Shackleton, B W

1998-01-01

Increasingly recognized as a potential public health problem since the outbreak of Legionnaire's disease in Philadelphia in 1976, polluted indoor air has been associated with health problems that include asthma, sick building syndrome, multiple chemical sensitivity, and hypersensitivity pneumonitis. Symptoms are often nonspecific and include headache, eye and throat irritation, chest tightness and shortness of breath, and fatigue. Air-borne contaminants include commonly used chemicals, vehicular exhaust, microbial organisms, fibrous glass particles, and dust. Identified causes include defective building design and construction, aging of buildings and their ventilation systems, poor climate control, inattention to building maintenance. A major contributory factor is the explosion in the use of chemicals in building construction and furnishing materials over the past four decades. Organizational issues and psychological variables often contribute to the problem and hinder its resolution. This article describes the health problems related to poor indoor air quality and offers solutions. Images p398-a p399-a PMID:9769764

Early executive function predicts reasoning development.

PubMed

Richland, Lindsey E; Burchinal, Margaret R

2013-01-01

Analogical reasoning is a core cognitive skill that distinguishes humans from all other species and contributes to general fluid intelligence, creativity, and adaptive learning capacities. Yet its origins are not well understood. In the study reported here, we analyzed large-scale longitudinal data from the Study of Early Child Care and Youth Development to test predictors of growth in analogical-reasoning skill from third grade to adolescence. Our results suggest an integrative resolution to the theoretical debate regarding contributory factors arising from smaller-scale, cross-sectional experiments on analogy development. Children with greater executive-function skills (both composite and inhibitory control) and vocabulary knowledge in early elementary school displayed higher scores on a verbal analogies task at age 15 years, even after adjusting for key covariates. We posit that knowledge is a prerequisite to analogy performance, but strong executive-functioning resources during early childhood are related to long-term gains in fundamental reasoning skills.

[Does clinical risk management require a structured conflict management?].

PubMed

Neumann, Stefan

2015-01-01

A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.

Cannabis and psychosis revisited.

PubMed

Damjanović, Aleksandar; Pantović, Maja; Damjanović, Aleksandra; Dunjić-Kostić, Bojana; Ivković, Maja; Milovanović, Srđan; Lacković, Maja; Dimitrijević, Ivan

2015-03-01

The association between cannabinoids and psychosis has been known for almost a thousand years, but it is still speculated whether cannabis use may be a contributory cause of psychosis, that is, whether it may precipitate schizophrenia in those at risk. In this paper, we will briefly present the data from individual longitudinal studies in the field, together with the factors that are considered important for the association of cannabis abuse and occurrence of schizophrenia and prevention opportunities in the target population. The reviewed studies clearly suggest that cannabis abuse predicts an increased risk for schizophrenia, particularly in young adults. They underline both the need to create adequate prevention measures and consequently avoid the occurrence of the disease in the young at risk. Particular attention should be additionally devoted toward encouraging the young presenting with psychotic symptoms to stop or, at the very least, reduce the frequency of cannabis abuse. The issues are undoubtedly to be addressed by the health care system in general.

Urbanisation and greening of Indian cities: Problems, practices, and policies.

PubMed

Imam, Aabshar U K; Banerjee, Uttam Kumar

2016-05-01

Progress of the Indian economy is threatened by the impact of climate change. Generation of urban heat islands (UHIs), waning of urban green cover, increase in carbon emissions and air pollution deteriorate the living environment. Rise in urban temperatures and heat stress induced mortality remain major concerns. Although the National Action Plan on Climate Change emphasises the national missions of 'enhanced energy efficiency', and 'green India', little research has been devoted to explore the passive cooling potential of urban greenery in India, thus lending uniqueness to this study. The manifestations of unplanned urban development (UHIs, escalated carbon emissions, air pollution) are discussed and corroborated with identification of contributory factors. Contemporary greening practices and bye-laws in four major Indian cities (New Delhi, Pune, Chennai, and Visakhapatnam) are analysed and compared with global best practices. The findings are used to propose planning guidelines which are expected to assist in consolidating natural sustainability of emerging economies.

Biofeedback device for patients on axillary crutches.

PubMed

Ang, E J; Goh, J C; Bose, K; Toh, S L; Choo, A

1989-08-01

The axillary crutch is commonly prescribed as an ambulatory aid to patients with temporal or permanent disability in the lower extremity. When fitting the axillary crutch, it is important that the user be instructed not to bear excessive weight on the axillary bar. Excessive weight bearing on the axillary bar can result in a sevenfold increase in the reaction force under the armpit. This force may be a contributory factor to crutch paralysis or thrombosis of the axillobrachial artery. In order to prevent this occurrence an electronic biofeedback device was designed and developed for use in the training of 3-point swing-through axillary crutch ambulation. It detects excessive weight bearing on the axillary bar during crutch ambulation and produces an audible signal which prompts the patient to make necessary adjustment to relieve load bearing on the axillary bar. The design and development of the biofeedback device is discussed in this paper.

γ-Benzene hexachloride poisoning leading to acute hepatorenal decompensation

PubMed Central

Paul, Rudrajit; Talukdar, Arunansu; Bhattacharya, Raja; Santra, Gouranga

2013-01-01

γ-Benzene hexachloride is a commonly used insecticide of organochlorine group. Notable toxic effects include seizures, ataxia, confusion and other central nervous system dysfunction. A 30-year-old male farmer with suicidal ingestion of γ-benzene hexachloride poison developed acute intrinsic renal failure with azotaemia and diminished urine output along with features of acute fulminate liver failure. Renal function recovered with haemodialysis and liver parameters gradually normalised with time. As per our knowledge simultaneous acute hepatic and kidney injury associated with γ-benzene hexachloride poison is never reported in humans. The exact pathophysiology of this life-threatening complication is an enigma. However, oxidative stress has been postulated as a contributory factor as suggested in animal studies. Conservative management with successful outcome in our case stresses on the impact of watchful observation and aggressive management. He was discharged after 3 weeks at stable condition and was healthy at 3 months follow-up. PMID:23925679

Cadmium and mercury nephrotoxicity

NASA Astrophysics Data System (ADS)

Nicholson, J. K.

1983-08-01

Despite increasing attempts to control environmental pollution, changes in the distribution and bioavailability of toxic metals like mercury and cadmium are still occurring. Apart from natural processes, other contributory factors include the gradual spread of industrialization, the use of sewage sludge as a fertilizer and the acidification of Northern Hemisphere ground-water. Animals (including man and domestic varieties) can accumulate harmful concentrations of toxic metals1-5. We therefore looked for damage to the kidneys in seabirds contaminated with mercury and cadmium and made comparisons with kidneys from three other groups of animals: seabirds from an uncontaminated colony, metal-dosed birds and metal-dosed mice. We report here that, comparing all these groups of animals, invididuals with comparatively high levels of metals had nephrotoxic lesions of a similar type and severity. Moreover, the metal concentrations at which damage began and at which biochemical changes could be detected were below those presently considered as relatively safe for humans by the World Health Organization.

Hopelessness and 4-year progression of carotid atherosclerosis. The Kuopio Ischemic Heart Disease Risk Factor Study.

PubMed

Everson, S A; Kaplan, G A; Goldberg, D E; Salonen, R; Salonen, J T

1997-08-01

The importance of hope has long been recognized, whereas a lack of hope, or "giving up," is generally believed to have a negative impact on psychological well-being and physical health. Recently, hopelessness has been identified as a strong, independent predictor of cardiovascular disease morbidity and mortality in both American and Finnish populations. In this study we examined the association between high levels of hopelessness and progression of carotid atherosclerosis in participants (n = 942) in the Kuopio Ischemic Heart Disease Study, a population-based study of middle-aged men from eastern Finland who underwent carotid ultrasonography at baseline and 4 years later. Men reporting high levels of hopelessness at baseline had faster progression of carotid atherosclerosis, assessed by four measures of intima-media thickening (IMT), than men reporting low to moderate levels of hopelessness. Further analyses revealed significant interactions between hopelessness and initial level of atherosclerosis, such that the effects of high hopelessness on progression were greatest among men who had baseline mean IMT values at or above the median. Moreover, progression was greatest among men reporting high levels of hopelessness at both baseline and follow-up. Traditional coronary risk factors and use of cholesterol-lowering and antihypertensive medications did not account for much variance in the observed relationships. These findings indicate that hopelessness contributes to accelerated progression of carotid atherosclerosis, particularly among men with early evidence of atherosclerosis, and that chronically high levels of hopelessness may be especially detrimental. Additional research is needed to identify the contributory pathways and/or mechanisms underlying these relationships.

New index of social deprivation during pregnancy: results from a national study in France.

PubMed

Opatowski, Marion; Blondel, Béatrice; Khoshnood, Babak; Saurel-Cubizolles, Marie-Josèphe

2016-04-05

To identify precariousness markers in pregnant women that differ from the usual socioeconomic variables. Data were obtained from the National Perinatal Survey, a representative sample of women giving birth in France in 2010. From six indicators of social vulnerability, four were selected by multiple correspondence analysis. The first axis of this analysis was used, characterised by the following contributory variables: receiving RSA (Revenu de Solidarité Active) allowance; benefitting from the CMU (Couverture Maladie Universelle) system (French social security) or not being insured; not living in own accommodation; and not living with a partner. These four variables were summed to create a deprivation index. This index was strongly associated with social maternal characteristics and correctly identified women who were socially vulnerable. Furthermore, it was highly related to the psychosocial context, access to care, behaviours during pregnancy, and pregnancy outcomes. These associations remained significant after adjustment for social variables: compared with no deprivation (no factors), a high level of deprivation (≥3 factors) was associated with late prenatal care (OR 5.8, 95% CI 4.6 to 7.2) and small for gestational age (OR 1.5, 95% CI 1.1 to 1.9). This index of social deprivation was associated with health issues and behaviours during pregnancy, even after adjustment for social variables, revealing a dimension not measured by the usual variables. Moreover, it is simple to use and easily reproducible. 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/

The Porphyromonas gingivalis/Host Interactome Shows Enrichment in GWASdb Genes Related to Alzheimer's Disease, Diabetes and Cardiovascular Diseases

PubMed Central

Carter, Chris J.; France, James; Crean, StJohn; Singhrao, Sim K.

2017-01-01

Periodontal disease is of established etiology in which polymicrobial synergistic ecology has become dysbiotic under the influence of Porphyromonas gingivalis. Following breakdown of the host's protective oral tissue barriers, P. gingivalis migrates to developing inflammatory pathologies that associate with Alzheimer's disease (AD). Periodontal disease is a risk factor for cardiovascular disorders (CVD), type II diabetes mellitus (T2DM), AD and other chronic diseases, whilst T2DM exacerbates periodontitis. This study analyzed the relationship between the P. gingivalis/host interactome and the genes identified in genome-wide association studies (GWAS) for the aforementioned conditions using data from GWASdb (P < 1E-03) and, in some cases, from the NCBI/EBI GWAS database (P < 1E-05). Gene expression data from periodontitis or P. gingivalis microarray was compared to microarray datasets from the AD hippocampus and/or from carotid artery plaques. The results demonstrated that the host genes of the P. gingivalis interactome were significantly enriched in genes deposited in GWASdb genes related to cognitive disorders, AD and dementia, and its co-morbid conditions T2DM, obesity, and CVD. The P. gingivalis/host interactome was also enriched in GWAS genes from the more stringent NCBI-EBI database for AD, atherosclerosis and T2DM. The misregulated genes in periodontitis tissue or P. gingivalis infected macrophages also matched those in the AD hippocampus or atherosclerotic plaques. Together, these data suggest important gene/environment interactions between P. gingivalis and susceptibility genes or gene expression changes in conditions where periodontal disease is a contributory factor. PMID:29311898

The Porphyromonas gingivalis/Host Interactome Shows Enrichment in GWASdb Genes Related to Alzheimer's Disease, Diabetes and Cardiovascular Diseases.

PubMed

Carter, Chris J; France, James; Crean, StJohn; Singhrao, Sim K

2017-01-01

Periodontal disease is of established etiology in which polymicrobial synergistic ecology has become dysbiotic under the influence of Porphyromonas gingivalis . Following breakdown of the host's protective oral tissue barriers, P. gingivalis migrates to developing inflammatory pathologies that associate with Alzheimer's disease (AD). Periodontal disease is a risk factor for cardiovascular disorders (CVD), type II diabetes mellitus (T2DM), AD and other chronic diseases, whilst T2DM exacerbates periodontitis. This study analyzed the relationship between the P. gingivalis /host interactome and the genes identified in genome-wide association studies (GWAS) for the aforementioned conditions using data from GWASdb ( P < 1E-03) and, in some cases, from the NCBI/EBI GWAS database ( P < 1E-05). Gene expression data from periodontitis or P. gingivalis microarray was compared to microarray datasets from the AD hippocampus and/or from carotid artery plaques. The results demonstrated that the host genes of the P. gingivalis interactome were significantly enriched in genes deposited in GWASdb genes related to cognitive disorders, AD and dementia, and its co-morbid conditions T2DM, obesity, and CVD. The P. gingivalis /host interactome was also enriched in GWAS genes from the more stringent NCBI-EBI database for AD, atherosclerosis and T2DM. The misregulated genes in periodontitis tissue or P. gingivalis infected macrophages also matched those in the AD hippocampus or atherosclerotic plaques. Together, these data suggest important gene/environment interactions between P. gingivalis and susceptibility genes or gene expression changes in conditions where periodontal disease is a contributory factor.

Occupational risk for male infertility: a case-control study of 218 infertile and 227 fertile men.

PubMed

Chia, S E; Tay, S K

2001-11-01

The aim of the study was to determine if certain occupations pose an increased risk for infertility (of no known cause) among a group of infertile men compared with a group of fertile men. A total of 640 consecutive men whose spouses were unable to conceive were recruited from an infertility clinic. Of these, 218 men (cases) were found to have no known cause for their infertility. A total of 227 men whose spouses were pregnant at the time of the study were recruited as controls. The Singapore Standard Occupational Classification was used to code the subjects' occupations. Semen parameters (density, total sperm counts, motility, viability, and normal morphology) in all of the cases were significantly poorer than those in the controls. The risk for infertility is associated with smoking adjusted odds ratio (OR) 2.85 and 95% confidence interval (CI) 1.91 to 4.24. Work, independently, is not a risk factor for infertility. Engineering technicians (adjusted OR, 2.75; 95% CI, 1.36 to 5.54), finance analysts (adjusted OR, 4.66; 95% CI, 1.90 to 11.40), corporate and computing managers (adjusted OR, 2.49; 95% CI, 1.04 to 5.98), and teachers (adjusted OR, 7.72; 95% CI, 1.86 to 32.10) were at a greater risk of infertility compared with "services and clerical workers." Using services and clerical workers as a reference group, certain occupations are at a higher risk for infertility. Higher work demands and possible electromagnetic field exposure could be contributory factors for infertility.

Spatial dependency of V. cholera prevalence on open space refuse dumps in Kumasi, Ghana: a spatial statistical modelling

PubMed Central

Osei, Frank B; Duker, Alfred A

2008-01-01

Background Cholera has persisted in Ghana since its introduction in the early 70's. From 1999 to 2005, the Ghana Ministry of Health officially reported a total of 26,924 cases and 620 deaths to the WHO. Etiological studies suggest that the natural habitat of V. cholera is the aquatic environment. Its ability to survive within and outside the aquatic environment makes cholera a complex health problem to manage. Once the disease is introduced in a population, several environmental factors may lead to prolonged transmission and secondary cases. An important environmental factor that predisposes individuals to cholera infection is sanitation. In this study, we exploit the importance of two main spatial measures of sanitation in cholera transmission in an urban city, Kumasi. These are proximity and density of refuse dumps within a community. Results A spatial statistical modelling carried out to determine the spatial dependency of cholera prevalence on refuse dumps show that, there is a direct spatial relationship between cholera prevalence and density of refuse dumps, and an inverse spatial relationship between cholera prevalence and distance to refuse dumps. A spatial scan statistics also identified four significant spatial clusters of cholera; a primary cluster with greater than expected cholera prevalence, and three secondary clusters with lower than expected cholera prevalence. A GIS based buffer analysis also showed that the minimum distance within which refuse dumps should not be sited within community centres is 500 m. Conclusion The results suggest that proximity and density of open space refuse dumps play a contributory role in cholera infection in Kumasi. PMID:19087235

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

Recurrent Issues in Efforts to Prevent Homicidal Youth Violence in Schools: Expert Opinions

ERIC Educational Resources Information Center

Dill, Karen E.; Redding, Richard E.; Smith, Peter K.; Surette, Ray; Cornell, Dewey G.

2011-01-01

Developmental research on social influences on adolescents can guide practices aimed to prevent homicidal youth violence. School shootings have repeatedly raised questions about the contributory role of bullying and entertainment violence, how news media publicity might produce copycat crimes, and whether stiffer criminal sanctions might have a…

Examining Teacher Framing, Student Reasoning, and Student Agency in School-Based Citizen Science

ERIC Educational Resources Information Center

Harris, Emily Mae

2017-01-01

This dissertation presents three interrelated studies examining opportunities for student learning through contributory citizen science (CS), where students collect and contribute data to help generate new scientific knowledge. I draw on sociocultural perspectives of learning to analyze three cases where teachers integrated CS into school science,…

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

38 CFR 3.312 - Cause of death.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

PubMed

Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

2015-04-04

In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

Epidemiology of death in the emergency department of a tertiary health centre south-south of Nigeria.

PubMed

Ugare, G U; Ndifon, W; Bassey, I A E; Oyo-Ita, A E; Egba, R N; Asuquo, M; Udosen, A M

2012-12-01

The emergency department (E.D) of any hospital is an important entry point of critically ill patients. The initial management of these patients is often challenging, and for valuable lives to be saved, the in fracture and manpower should be up to date. To analyze the epidemiology of death in our Emergency Department within 72hours after admission, the death rate, and to establish any contributory factors. Demographic data, time of arrival at the ED, physical finding, the Glasgow coma scale(GCS), the injury severity score(ISS), the diagnosis, investigations done, treatment offered, the time of death and the autopsy report, were entered into a Proforma. These data was analyzed using EPI-Info statistical programme version 3.4.3 of 2007. Four thousand and eleven (4,011) patients were seen in the E.D during the period. A total of three hundred and fifty five (355) mortalities were recorded. Their ages ranged from 4-87years, with an average of 34.5years. The male: female ratio was 2.1:1. The overall mortality in the hospital during the period was 859: the E.D mortality figure representing 41.3%. Fifteen patients were brought in dead. The 355 deaths fell into two categories: trauma and non-trauma. One hundred and forty-seven (41.4%) persons died from trauma; road traffic accidents (RTAs) accounting for 118 (80.3%). Two hundred and eight (58.6%) persons died from nontrauma related causes, with chronic cardiovascular disorders been the most frequent cause of death 52[25.0]. Majority of the mortalities were between 26-50 years age range. 86.2% of the mortalities presented late, greater than 6hours after the incidence. Within the 72 hours period, only 129(36.3%) were able to do the requested tests. Out of the 355 deaths, only 4[1.1%] were autopsied. An in-hospital 72hours death rate of 8.6 was recorded. Road traffic accidents and cardiovascular disorders are the common causes of emergency death in UCTH. A recorded death rate of 8.6% is high, suspected contributory factors include systemic deficiencies such as the lack of a trauma system, prehospital care; late presentation, the role of chemist operators, traditional healers, and delayed referral systems.

Inhibition of Matrix Metalloproteinase Activity Prevents Increases in Myocardial Tumor Necrosis Factor-α

PubMed Central

Murray, David B.; Levick, Scott P; Brower, Gregory L.; Janicki, Joseph S.

2010-01-01

Aim TNF-α is known to cause adverse myocardial remodeling. While we have previously shown a role for cardiac mast cells in mediating myocardial TNF-α, matrix metalloproteinases (MMP) activation of TNF-α may also be contributory. We sought to determine the relative roles of MMPs and cardiac mast cells in the activation of TNF-α in the hearts of rats subjected to chronic volume overload. Methods Interventions with the broad spectrum MMP inhibitor, GM6001, or the mast cell stabilizer, nedocromil, were performed in the rat aortocaval fistula (ACF) model of volume overload. Results Myocardial TNF-α levels were significantly increased in the ACF. This increase was prevented by MMP inhibition with GM6001 (p ≤ 0.001 vs. ACF). Conversely, myocardial TNF-α levels were increased in the ACF + nedocromil treated fistula groups (p ≤ 0.001 vs. sham). The degradation of interstitial collagen volume fraction seen in the untreated ACF group was prevented in both the GM6001 and nedocromil treated hearts. Significant increases in LV myocardial ET-1 levels also occurred in the ACF group at 3 days post-fistula. Whereas administration of GM6001 significantly attenuated this increase, mast cell stabilization with nedocromil markedly exacerbated the increase, producing ET-1 levels 6.5 fold and 2 fold greater than that in the sham-operated control and ACF group, respectively. Conclusion The efficacy of the MMP inhibitor, GM6001, to prevent increased levels of myocardial TNF-α is indicative of MMP-mediated cleavage of latent extracellular membrane bound TNF-α protein as the primary source of bioactive TNF-α in the myocardium of the volume-overload heart. PMID:20403361

Biases in the instrumental temperature record: the policy and communications context

NASA Astrophysics Data System (ADS)

Cowtan, K.; Way, R. G.

2014-12-01

Global surface temperature plays a significant role in the public perception of climate change. However, observations are not uniformly distributed over the surface of the planet. The lack of data for the rapidly warming Arctic in the Met Office HadCRUT4 dataset has led to a systematic underestimation of the rate of warming over the past decade and a half. Smaller biases have also been detected in other versions of the temperature record. This underestimation of recent temperature trends is one contributory factor (of several) to the apparent 'hiatus' in global warming. The use of the putative hiatus as an argument against action on global warming has created a social context in which what should have been a minor technical paper appeared to take on a much greater significance. From a scientific perspective, the apparent hiatus is irrelevant to our understanding of long term greenhouse warming, and should therefore have no bearing on policy. However the misinformation context into which science is communicated means that any scientific work can take on a policy significance which is determined not by the work itself, but by the societal context. This raises challenging ethical questions for scientists. In an information environment in which interested parties have already attached policy implications to many aspects of climate science, it becomes impossible to publish or communicate a scientific work without implicitly taking a position. Different segments of the public have different and often contradictory perceptions of the scientific context, and as a result the words of the scientist may convey completely different messages to different hearers. Communicating science in a way which does not mislead is difficult, however abandoning the effort at communication can lead to the public being more misled.

Muller's Nobel Prize Lecture: when ideology prevailed over science.

PubMed

Calabrese, Edward J

2012-03-01

This paper extends and confirms the report of Calabrese (Calabrese, E. J. (2011b). Muller's Nobel Lecture on dose-response for ionizing radiation: Ideology or science? Arch. Toxicol. 85, 1495-1498) that Hermann J. Muller knowingly made deceptive comments in his 1946 Nobel Prize Lecture (Muller, H. J. (1946). Nobel Prize Lecture. Stockholm, Sweden. Available at http://www.nobelprize.org/. Accessed December 12) concerning the dose-response. Supporting a linearity perspective, Muller stated there is "no escape from the conclusion that there is no threshold" while knowing the results of a recent study by Ernst Caspari and Curt Stern contradicted these comments. Recently uncovered private correspondence between Muller and Stern reveals Muller's scientific assessment of the Caspari and Stern manuscript in a letter from Muller to Stern 5 weeks (14 January 1947) after his Nobel Prize Lecture of 12 December 1946. Muller indicated that the manuscript was of acceptable scientific quality; he indicated the manuscript should be published, but the findings needed replication because it significantly challenged the linearity hypothesis. These findings complement the previous letter (12 November 1946 letter from Muller to Stern), which revealed that Muller received the Caspari and Stern manuscript, recognized it as significant, and recommended its replication 5 weeks before his Nobel Prize Lecture. Muller therefore supported this position immediately before and after his Nobel Prize Lecture. Muller's opinions on the Caspari and Stern manuscript therefore had not changed during the time leading up to his Lecture, supporting the premise that his Lecture comments were deceptive. These findings are of historical and practical significance because Muller's comments were a notable contributory factor, changing how risks would be assessed for carcinogens (i.e., changing from a threshold to a linear model) throughout the 20th century to the present.

The A to G polymorphism at -1082 of the interleukin-10 gene is rare in the Han Chinese population.

PubMed

Guo, Jing; He, Yong-Hui; Chen, Feng; Jiang, Min-Hui; Gao, Shu-Ping; Su, Ya-Ming; Shi, Gui-Liang; Deng, Xin-Tao; Zhu, Jian-Hua; Pan, Min

2012-10-01

Interleukin-10 (IL-10) is a multifunctional anti-inflammatory cytokine involved in various physiological and pathophysiological processes including cardiovascular disease. It has been reported that 50-75% of the variation in IL-10 production is genetically controlled. In the present study, the IL-10 -1082A/G (rs1800896) polymorphism was detected in 174 coronary artery disease (CAD) patients confirmed by selective coronary angiography and 176 age and gender-matched controls from the Jiangsu area (East China). The majority of the subjects (93.14%) carried the AA wild-type genotype, whereas only 0.29% carried the GG genotype. Our results suggest that IL-10 -1082A/G is rare and unlikely to be a significant contributory to disease susceptibility in the Han Chinese population.

Working Memory and Arithmetic Calculation in Children: The Contributory Roles of Processing Speed, Short-Term Memory, and Reading

ERIC Educational Resources Information Center

Berg, Derek H.

2008-01-01

The cognitive underpinnings of arithmetic calculation in children are noted to involve working memory; however, cognitive processes related to arithmetic calculation and working memory suggest that this relationship is more complex than stated previously. The purpose of this investigation was to examine the relative contributions of processing…

Promoting International Posture through History as Content and Language Integrated Learning (CLIL) in the Japanese Context

ERIC Educational Resources Information Center

Lockley, Thomas

2015-01-01

This article uses the conceptual framework of second language willingness to communicate (L2 WTC), and in particular the contributory construct of international posture (IP; Yashima, 2002), to report on a content and language integrated learning (CLIL) course taught in the Japanese university context. The research follows up an exploratory,…

Private Speech Use in Arithmetical Calculation: Contributory Role of Phonological Awareness in Children with and without Mathematical Difficulties

ERIC Educational Resources Information Center

Ostad, Snorre A.

2013-01-01

The majority of recent studies conclude that children's private speech development (private speech internalization) is related to and important for mathematical development and disabilities. It is far from clear, however, whether private speech internalization itself plays any causal role in the development of mathematical competence. The main…

Acknowledge the Barriers to Better the Practices: Support for Student Mental Health in Higher Education

ERIC Educational Resources Information Center

DiPlacito-DeRango, Maria Lucia

2016-01-01

Despite marked improvements, intervention for students with a mental health problem or illness in Canadian higher education settings remains not yet successful, mature, or sustainable. A number of challenges have been identified as contributory to the shortcomings surrounding student mental health in colleges and universities. In this paper, I…

Adenovirus Type 7 Pneumonia in Children Who Died from Measles-Associated Pneumonia, Hanoi, Vietnam, 2014.

PubMed

Hai, Le Thanh; Thach, Hoang Ngoc; Tuan, Ta Anh; Nam, Dao Huu; Dien, Tran Minh; Sato, Yuko; Kumasaka, Toshio; Suzuki, Tadaki; Hanaoka, Nozomu; Fujimoto, Tsuguto; Katano, Harutaka; Hasegawa, Hideki; Kawachi, Shoji; Nakajima, Noriko

2016-04-01

During a 2014 measles outbreak in Vietnam, postmortem pathologic examination of hospitalized children who died showed that adenovirus type 7 pneumonia was a contributory cause of death in children with measles-associated immune suppression. Adenovirus type 7 pneumonia should be recognized as a major cause of secondary infection after measles.

Estimation of the emission factors of particle number and mass fractions from traffic at a site where mean vehicle speeds vary over short distances

NASA Astrophysics Data System (ADS)

Jones, Alan M.; Harrison, Roy M.

Emission factors for particle number in three size ranges (11-30; 30-100 and >100 nm) as well as for PM 2.5, PM 2.5-10 and PM 10 mass have been estimated separately for heavy and light-duty vehicles in a heavily trafficked street canyon in London where traffic speeds vary considerably over short distances. Emissions of NO x were estimated from published emission factors, and emissions of other pollutants estimated from their ratio to NO x in the roadside concentration after subtraction of the simultaneously measured urban background. The estimated emission factors are compared with other published data. Despite many differences in the design and implementation of the various studies, the results for particulate matter are broadly similar. Estimates of particle number emissions in this study for light-duty vehicles are very close to other published data, whilst those for heavy-duty vehicles are lower than in the more comparable studies. It is suggested that a contributory factor may be the introduction of diesel particle oxidation traps on some of the bus fleet in London. Estimates of emission factors for particle mass (PM 2.5 and PM 2.5-10) are within the range of other published data, and total mass emissions estimated from the ratio of concentration to NO x are tolerably close to those estimated using emission factors from the National Atmospheric Emissions Inventory (NAEI). However, the method leads to an estimate of carbon monoxide emissions 3-6 times larger than that derived using the NAEI factors.

Socio-cultural factors affecting the spread of HIV/AIDS in Africa: a case study.

PubMed

Dada-Adegbola, H O

2004-06-01

There is a disproportionate share of AIDS cases over the years in Africa. This has occurred in racial and ethnic minority populations, a finding likely related to social, economic and cultural factors. Certain socio-cultural and religious practices such as polygamy and giving a daughter away in marriage without considering the social life of the man are likely contributory factors to the higher prevalence of HIV/AIDS in women in this part of the world. This is illustrated with a case of Mr. M. S. who married two wives within four months interval, having lived a promiscuous life before marriage. One of the wives was a virgin at the time of marriage. Neither of wives had any symptoms suggestive of STD or HIV before marriage, however, the three of them tested positive to HIV-1 following a visit to the special treatment clinic. He had genital herpes and his two wives also had vulvovaginal candidiasis, genital herpes and condyloma accuminata (genital warts). The husband would not want his HIV status declared to the wives. There is therefore a need to enact law on pre-marriage HIV screening for intending couples. Couple Pre-and post-test counseling must be encouraged and promoted. In addition, women should be empowered to negotiate safer sex.

The assessment of orthorexia nervosa among 1899 Polish adolescents using the ORTO-15 questionnaire.

PubMed

Hyrnik, Joanna; Janas-Kozik, Małgorzata; Stochel, Martyna; Jelonek, Ireneusz; Siwiec, Andrzej; Rybakowski, Janusz K

2016-09-01

Orthorexia nervosa (ON) is considered an eating disorder (ED), with an excessive fixation on the consumption of healthy food and an obsession with its biological purity. Since the adolescent period poses a risk for EDs, the aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors. 1899 high school students, 992 girls and 907 boys aged 15-21 years were studied. Demographic and clinical data were collected using a validated questionnaire including information on preferred living choices, in the context of pro- and antihealth activities. The Polish version of the ORTO-15 questionnaire was used. The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the 'Orthorexia 33.35 and 40' definitions were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income. This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. Since factors predisposing to ON in adolescence differ from those for other eating disorders, it is not clear whether ON should be treated as a new form of ED.

Semen quality analysis of military personnel from six geographical areas of the People's Republic of China.

PubMed

Zou, Zhikang; Hu, Haixiang; Song, Manshu; Shen, Yanling; Guo, Xiuhua; McElreavey, Kenneth; Bittles, Alan H; Wang, Wei

2011-05-01

To examine the determinants of semen quality in a large sample of military personnel from different geographical areas of the People's Republic of China. Cross-sectional study. Six representative geographical regions in China: Beihai, Lhasa, Germu, Xinzhou, Huhehaote, and Mohe. 1,194 army personnel aged 18 to 35 years at the time of their inclusion in the study, sampled between 2007 and 2009. None. Semen volume (in milliliters), sperm concentration (in millions per milliliter), percentage of motile spermatozoa, total sperm count (in millions), and relative risk of subfertility. The median values were 3.0 mL for semen volume, 39.4×10(6) per mL for sperm concentration, 120.1×10(6) for total sperm count, 15.8% for sperm rapid progressive motility, 30.1% for sperm progressive motility, and 43.9% for total motility. We found that 88.3% of the servicemen had at least one semen parameter below normal values according to World Health Organization (WHO) recommendations (1999), and 62.5% according to WHO recommendations (2010). Season, average altitude, and duration of sexual abstinence all were statistically significantly associated with semen quality. The men had markedly lower mean sperm concentrations, sperm counts, and sperm motility compared with WHO recommendations. Possible contributory factors included diet, lifestyle, climate, and altitude. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The prevalence of trauma and its relationship to borderline personality symptoms and self-destructive behaviors in a primary care setting.

PubMed

Sansone, R A; Sansone, L A; Wiederman, M

1995-05-01

To determine the prevalence of five types of trauma and their relationship to borderline personality symptoms and self-destructive behaviors in female subjects recruited from a primary care setting. Consecutive sample. Subjects completed a lengthy research booklet. Primary care, outpatient, health maintenance organization setting. One hundred fifty-two consecutive women, aged 18 to 45 years, who were scheduled for routine gynecological care by a female family physician. Measures included a demographic questionnaire, a trauma questionnaire (ie, sexual, physical, and emotional abuse, physical neglect, and witnessing of violence), the Borderline Personality Scale of the Personality Diagnostic Questionnaire-Revised; and the Self-Harm Inventory. Traumatic experiences were reported by 70.7% of the subjects (25.8%, sexual abuse; 36.4%, physical abuse; 43.7%, emotional abuse; 9.3%, physical neglect; and 43.0%, witnessing of violence). There was a significant correlation between the acknowledged number of abuse categories and borderline personality symptoms (r = .36, P = .01) as well as self-destructive behaviors (r = .43, P = .01). Sexual abuse and witnessing of violence were most associated with borderline personality symptoms; sexual abuse, physical abuse, and witnessing of violence were most associated with self-destructive behaviors. This study provides further evidence that abuse is a nonspecific but contributory factor to psychopathologic processes, in particular borderline personality symptoms and self-destructive behaviors.

Chimney damage in the greater Seattle area from the Nisqually earthquake of 28 February 2001

USGS Publications Warehouse

Booth, D.B.; Wells, R.E.; Givler, R.W.

2004-01-01

Unreinforced brick chimneys in the greater Seattle area were damaged repeatedly in the Benioff zone earthquakes of 1949, 1965, and 2001. A survey of visible chimney damage after the 28 February 2001 Nisqually earthquake evaluated approximately 60,000 chimneys through block-by-block coverage of about 50 km2, identifying a total of 1556 damaged chimneys. Chimney damage was strongly clustered in certain areas, in particular in the neighborhood of West Seattle where prior damage was also noted and evaluated after the 1965 earthquake. Our results showed that damage produced by the 2001 earthquake did not obviously correspond to distance from the earthquake epicenter, soft soils, topography, or slope orientation. Chimney damage correlates well to instrumented strong-motion measurements and compiled resident-reported ground-shaking intensities, but it offers much finer spatial resolution than these other data sources. In general, most areas of greatest chimney damage coincide with best estimated locations of strands of the Seattle fault zone. The edge of that zone also coincides with areas where chimney damage dropped abruptly over only one or two blocks' distance. The association between shaking intensity and fault-zone structure suggests that abrupt changes in the depth to bedrock, edge effects at the margin of the Seattle basin, or localized trapping of seismic waves in the Seattle fault zone may be significant contributory factors in the distribution of chimney damage.

An Investigation of Perspectives of Respite Admission Among People Living With Amyotrophic Lateral Sclerosis and the Hospitals That Support Them.

PubMed

Nakai, Michiko; Narita, Yugo; Tomimoto, Hidekazu

2017-07-01

Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them. We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission. We also interviewed 16 representatives from hospitals about awareness of and preparation for respite admission for patients with this disease, the role of regional networks for intractable diseases, and knowledge about communication support schemes. We found significant differences in the revised Amyotrophic Lateral Sclerosis Functional Rating Scale between patients who had and had not received respite admission. Qualitative analysis of the data indicated that respite admission was a contributory factor in continuing and stabilizing home care. Limited provision of social services and hospital care quality were barriers to respite admission. Respite admission was essential to continued home care for patients with amyotrophic lateral sclerosis. Severe-stage patients were eligible for respite admission. Its accessibility, however, was limited, especially for patients living in rural areas. Supporting hospitals had limited capacity to respond to patients' needs. Individualized care and communication were internal barriers to respite admission.

Hyperinsulinemia, insulin resistance, vitamin D, and colorectal cancer among whites and African Americans.

PubMed

Tsai, Chung-Jyi; Giovannucci, Edward L

2012-10-01

African Americans have the highest incidence and mortality rates of colorectal cancer among all US racial and ethnic groups. Dietary factors, lifestyle factors, obesity, variability in screening rates, socioeconomic differences, barriers to screening, and differences in access to health care may be contributory factors to racial and ethnic disparities. African Americans are more likely to demonstrate microsatellite instability in their colorectal tumors leading to malignancy. However, these differences do not completely explain all the variances. Ample evidence implicates insulin resistance and its associated conditions, including elevated insulin and insulin-like growth factor-1 (IGF-1), in colorectal carcinogenesis. African Americans have a high risk for and a high prevalence of insulin resistance and subsequent overt type 2 diabetes. Recent clinical studies revealed that ethnic differences between whites and African Americans in early diabetes-related conditions including hyperinsulinemia already exist during childhood. African Americans have a much higher prevalence of vitamin D deficiency than whites throughout their life spans. Vitamin D deficiency has been associated with higher rates of diabetes and colorectal cancer, particularly in individuals with high serum insulin and IGF-1 levels. Moreover, African Americans have lower insulin sensitivity in tissues, independent of obesity, fat distribution, and inflammation. Further development of measures of biomarkers of tumor biology and host susceptibility may provide further insight on risk stratification in African Americans.

Distribution of magnesium in central nervous system tissue, trabecular and cortical bone in rats fed with unbalanced diets of minerals.

PubMed

Yasui, M; Yano, I; Yase, Y; Ota, K

1990-11-01

Recent epidemiological changes in patterns of foci of amyotrophic lateral sclerosis (ALS) in the Western Pacific suggest that environmental factors play a contributory role in the pathogenic process of this disorder. In this experimental study on rats, a similar situation of dietary mineral imbalance was created as is found in the soil and drinking water of these ALS foci with a low content of calcium (Ca) and magnesium (Mg) and a high content of aluminum (Al). In groups of rats fed a low Ca diet, low Ca-Mg diet, and low Ca-Mg plus high Al diet, serum Ca levels were found to be lower than those in a group fed a standard diet. Also, serum Mg levels were lower in the groups fed a low Ca-Mg diet and a low Ca-Mg plus high Al diet than in the groups fed a standard diet and only a low Ca diet. There was no significant difference in Mg content of central nervous system (CNS) tissues of groups fed unbalanced and standard diets, except for a significant decrease in Mg content of the spinal cord of rats fed a low Ca-Mg plus high Al diet. Mg content of the lumbar spine and cortical bone decreased in the unbalanced diet groups compared with that of a group fed a standard diet. These findings suggest that under the disturbed bone mineralization induced by unbalanced mineral diets, Mg may be mobilized from bone to maintain the level necessary for vital activity in soft tissues including CNS tissue.

Defining the relationship between COPD and CVD: what are the implications for clinical practice?

PubMed Central

Morgan, Ann D; Zakeri, Rosita; Quint, Jennifer K

2018-01-01

Cardiovascular diseases (CVDs) are arguably the most important comorbidities in chronic obstructive pulmonary disease (COPD). CVDs are common in people with COPD, and their presence is associated with increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality. The economic burden associated with CVD in this population is considerable and the cumulative cost of treating comorbidities may even exceed that of treating COPD itself. Our understanding of the biological mechanisms that link COPD and various forms of CVD has improved significantly over the past decade. But despite broad acceptance of the prognostic significance of CVDs in COPD, there remains widespread under-recognition and undertreatment of comorbid CVD in this population. The reasons for this are unclear; however institutional barriers and a lack of evidence-based guidelines for the management of CVD in people with COPD may be contributory factors. In this review, we summarize current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence. We discuss the implications for clinical practice and highlight opportunities for improved prevention and treatment of CVD in people with COPD. While we advocate more active assessment for signs of cardiovascular conditions across all age groups and all stages of COPD severity, we suggest targeting those aged under 65 years. Evidence indicates that the increased risks for CVD are particularly pronounced in COPD patients in mid-to-late-middle-age and thus it is in this age group that the benefits of early intervention may prove to be the most effective. PMID:29355081

Open Defaecation and Its Effects on the Bacteriological Quality of Drinking Water Sources in Isiolo County, Kenya.

PubMed

Okullo, Joab Odhiambo; Moturi, Wilkister Nyaora; Ogendi, George Morara

2017-01-01

The post-2015 Sustainable Development Goals for sanitation call for universal access to adequate and equitable sanitation and an end to open defaecation by 2030. In Isiolo County, a semi-arid region lying in the northern part of Kenya, poor sanitation and water shortage remain a major problem facing the rural communities. The overall aim of the study was to assess the relationship between sanitation practices and the bacteriological quality of drinking water sources. The study also assessed the risk factors contributing to open defaecation in the rural environments of the study area. A cross-sectional study of 150 households was conducted to assess the faecal disposal practices in open defaecation free (ODF) and open defaecation not free (ODNF) areas. Sanitary surveys and bacteriological analyses were conducted for selected community water sources to identify faecal pollution sources, contamination pathways, and contributory factors. Analysis of data was performed using SPSS (descriptive and inferential statistics at α = .05 level of significance). Open defaecation habit was reported in 51% of the study households in ODNF villages and in 17% households in ODF villages. Higher mean colony counts were recorded for water samples from ODNF areas 2.0, 7.8, 5.3, and 7.0 (×10 3 ) colony-forming units (CFUs)/100 mL compared with those of ODF 1.8, 6.4, 3.5, and 6.1 (×10 3 ) areas for Escherichia coli , faecal streptococci, Salmonella typhi , and total coliform, respectively. Correlation tests revealed a significant relationship between sanitary surveys and contamination of water sources ( P  = .002). The water sources exhibited high levels of contamination with microbial pathogens attributed to poor sanitation. Practising safe faecal disposal in particular is recommended as this will considerably reverse the situation and thus lead to improved human health.

Open Defaecation and Its Effects on the Bacteriological Quality of Drinking Water Sources in Isiolo County, Kenya

PubMed Central

Okullo, Joab Odhiambo; Moturi, Wilkister Nyaora; Ogendi, George Morara

2017-01-01

Background information: The post-2015 Sustainable Development Goals for sanitation call for universal access to adequate and equitable sanitation and an end to open defaecation by 2030. In Isiolo County, a semi-arid region lying in the northern part of Kenya, poor sanitation and water shortage remain a major problem facing the rural communities. Objective: The overall aim of the study was to assess the relationship between sanitation practices and the bacteriological quality of drinking water sources. The study also assessed the risk factors contributing to open defaecation in the rural environments of the study area. Methods: A cross-sectional study of 150 households was conducted to assess the faecal disposal practices in open defaecation free (ODF) and open defaecation not free (ODNF) areas. Sanitary surveys and bacteriological analyses were conducted for selected community water sources to identify faecal pollution sources, contamination pathways, and contributory factors. Analysis of data was performed using SPSS (descriptive and inferential statistics at α = .05 level of significance). Results: Open defaecation habit was reported in 51% of the study households in ODNF villages and in 17% households in ODF villages. Higher mean colony counts were recorded for water samples from ODNF areas 2.0, 7.8, 5.3, and 7.0 (×103) colony-forming units (CFUs)/100 mL compared with those of ODF 1.8, 6.4, 3.5, and 6.1 (×103) areas for Escherichia coli, faecal streptococci, Salmonella typhi, and total coliform, respectively. Correlation tests revealed a significant relationship between sanitary surveys and contamination of water sources (P = .002). Conclusions: The water sources exhibited high levels of contamination with microbial pathogens attributed to poor sanitation. Practising safe faecal disposal in particular is recommended as this will considerably reverse the situation and thus lead to improved human health. PMID:29051705

Contributory Role of Virtual Courses via Skype to Control Embarrassment of Iranian EFL Learners' Performance

ERIC Educational Resources Information Center

Jahanbakhsh, Elham; Chalak, Azizeh

2018-01-01

In recent years, there has been an increasing interest in integration of technology for pedagogical purposes. The present study aimed at finding out how presentation in the frame of virtual courses can control embarrassment and shyness of Iranian EFL learners. The practical part concentrated on using Skype for the purpose of presentation in…

Revolutionary opportunities for materials and structures study, addendum

NASA Technical Reports Server (NTRS)

Feig, P. D.

1987-01-01

This report is an addendum to the Revolutionary Opportunities for Materials and Structures Study (ROMS), modifying the original by the addition of two tasks. The primary purpose of these tasks was to conduct additional aircraft/engine sizing and mission analysis to obtain contributory aircraft performance data such as fuel burns and direct operating costs for both the subsonic and supersonic engines.

Writing and Pseudo-Writing from Internet-Based Sources: Implications for Learning and Assessment

ERIC Educational Resources Information Center

Skaar, Håvard

2015-01-01

In recent years, plagiarism has been on the increase across the Western world. This article identifies Internet access as a contributory cause of this trend and addresses the implications of readily available Internet sources for the teaching and assessment of writing in schools. The basis for the article is a previous study showing a wide…

Sources of ores of the ferroalloy metals

USGS Publications Warehouse

Burchard, E.F.

1933-01-01

Since all steel is made with the addition of alloying elements, the record of the metallic raw materials contributory to the steel industry would be far from complete without reference to the ferroalloy metals. This paper, therefore, supplements two preceding arvicles on the sources of our iron ores. The photographs, with the exception of those relating to molybdenum and vanadium, are by the author.

Use of Bayesian Networks to Probabilistically Model and Improve the Likelihood of Validation of Microarray Findings by RT-PCR

PubMed Central

English, Sangeeta B.; Shih, Shou-Ching; Ramoni, Marco F.; Smith, Lois E.; Butte, Atul J.

2014-01-01

Though genome-wide technologies, such as microarrays, are widely used, data from these methods are considered noisy; there is still varied success in downstream biological validation. We report a method that increases the likelihood of successfully validating microarray findings using real time RT-PCR, including genes at low expression levels and with small differences. We use a Bayesian network to identify the most relevant sources of noise based on the successes and failures in validation for an initial set of selected genes, and then improve our subsequent selection of genes for validation based on eliminating these sources of noise. The network displays the significant sources of noise in an experiment, and scores the likelihood of validation for every gene. We show how the method can significantly increase validation success rates. In conclusion, in this study, we have successfully added a new automated step to determine the contributory sources of noise that determine successful or unsuccessful downstream biological validation. PMID:18790084

[Burnout in Dutch medical students: prevalence and causes].

PubMed

Conijn, Maartjie; Boersma, Henri J M V; van Rhenen, Willem

2015-01-01

To investigate the prevalence and causes of burnout in Dutch medical students. Questionnaire survey. All 14,570 student members of the KNMG (Royal Dutch Medical Association) were invited to fill in a digital survey. Burnout was determined with the Utrecht Burnout Scale (UBOS). Triggering and protective factors for burnout were also investigated . 2,739 medical students (18.8%) completed the survey and 14.5 per cent of all respondents met the burnout criteria. 17.8 per cent of the hospital interns who responded and 11.6 per cent of the preclinical students who responded met these criteria. Work-home interference and high levels of emotional pressure had the strongest link to burn-out, while a sufficient amount of support from family, friends and peers reduced the risk of burnout in both undergraduates and hospital interns. Our exploratory research suggests that the prevalence of burnout is high, particularly among the hospital interns who responded. The most important contributory factors are high levels of emotional pressure and work-home interference. The low percentage of respondents makes it difficult to make any statement about the prevalence and causes of burnout among all Dutch medical students.

Feasibility Studies of Palm Oil Mill Waste Aggregates for the Construction Industry

PubMed Central

Kanadasan, Jegathish; Ahmad Fauzi, Auni Filzah; Abdul Razak, Hashim; Selliah, Paramananthan; Subramaniam, Vijaya; Yusoff, Sumiani

2015-01-01

The agricultural industry in Malaysia has grown rapidly over the years. Palm oil clinker (POC) is a byproduct obtained from the palm oil industry. Its lightweight properties allows for its utilization as an aggregate, while in powder form as a filler material in concrete. POC specimens obtained throughout each state in Malaysia were investigated to evaluate the physical, chemical, and microstructure characteristics. Variations between each state were determined and their possible contributory factors were assessed. POC were incorporated as a replacement material for aggregates and their engineering characteristics were ascertained. Almost 7% of density was reduced with the introduction of POC as aggregates. A sustainability assessment was made through greenhouse gas emission (GHG) and cost factor analyses to determine the contribution of the addition of POC to the construction industry. Addition of POC helps to lower the GHG emission by 9.6% compared to control specimens. By channeling this waste into the construction industry, an efficient waste-management system can be promoted; thus, creating a cleaner environment. This study is also expected to offer some guides and directions for upcoming research works on the incorporation of POC. PMID:28793579

Trends of Pesticide Exposure and Related Cases in the Philippines

PubMed Central

Lu, Jinky Leilanie; Cosca, Katherine Z.; Del mundo, Jocelyn

2010-01-01

The study aims to provide a comprehensive trend of pesticide poisoning cases in the Philippines as well as pesticide exposures, and risk factors related to the adverse effects of pesticide. Records were gathered from the National Poison Control and Management Center (NPCMC), the Philippine General Hospital, De La Salle Medical Center, and other hospitals, and reviewed research studies conducted in the Philippines. Based on hospital surveys, the number of pesticide cases as well as mortality trends have been increasing. Studies from 2006 to 2010 showed that human health especially those of the farmers is at risk due to pesticide exposure. Illnesses and symptoms such as headache, skin abnormalities, fatigue, fever, and weaknesses were the common health complaints experienced by the farmers as reported in the research studies. Moreover, the studies showed risk factors to pesticide exposure, work practices, and pesticide residues in environmental media that could be contributory to pesticide poisoning cases. Government agencies should intensify their surveillance and regulation on both household and agricultural pesticides. The state of pesticide-related illnesses mirrors the poor safety practices among farmers as well as lack of necessary supervision from the government agencies. PMID:25649374

Do not blame the driver: a systems analysis of the causes of road freight crashes.

PubMed

Newnam, Sharon; Goode, Natassia

2015-03-01

Although many have advocated a systems approach in road transportation, this view has not meaningfully penetrated road safety research, practice or policy. In this study, a systems theory-based approach, Rasmussens's (1997) risk management framework and associated Accimap technique, is applied to the analysis of road freight transportation crashes. Twenty-seven highway crash investigation reports were downloaded from the National Transport Safety Bureau website. Thematic analysis was used to identify the complex system of contributory factors, and relationships, identified within the reports. The Accimap technique was then used to represent the linkages and dependencies within and across system levels in the road freight transportation industry and to identify common factors and interactions across multiple crashes. The results demonstrate how a systems approach can increase knowledge in this safety critical domain, while the findings can be used to guide prevention efforts and the development of system-based investigation processes for the heavy vehicle industry. A research agenda for developing an investigation technique to better support the application of the Accimap technique by practitioners in road freight transportation industry is proposed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Trends of pesticide exposure and related cases in the Philippines.

PubMed

Lu, Jinky Leilanie; Cosca, Katherine Z; Del Mundo, Jocelyn

2010-01-01

The study aims to provide a comprehensive trend of pesticide poisoning cases in the Philippines as well as pesticide exposures, and risk factors related to the adverse effects of pesticide. Records were gathered from the National Poison Control and Management Center (NPCMC), the Philippine General Hospital, De La Salle Medical Center, and other hospitals, and reviewed research studies conducted in the Philippines. Based on hospital surveys, the number of pesticide cases as well as mortality trends have been increasing. Studies from 2006 to 2010 showed that human health especially those of the farmers is at risk due to pesticide exposure. Illnesses and symptoms such as headache, skin abnormalities, fatigue, fever, and weaknesses were the common health complaints experienced by the farmers as reported in the research studies. Moreover, the studies showed risk factors to pesticide exposure, work practices, and pesticide residues in environmental media that could be contributory to pesticide poisoning cases. Government agencies should intensify their surveillance and regulation on both household and agricultural pesticides. The state of pesticide-related illnesses mirrors the poor safety practices among farmers as well as lack of necessary supervision from the government agencies.

[Displaced people's healthcare use in Bucaramanga, Colombia].

PubMed

Ruiz-Rodríguez, Myriam; López-Moreno, Sergio; Avila-Burgos, Leticia; Acosta-Ramírez, Naydú

2006-01-01

Analysing the factors and barriers associated with the population displaced by armed conflict using medical services in Bucaramanga, Colombia. Data from the "Diagnosing the health of both displaced and non-displaced populations in Bucaramanga and its metropolitan area" study, designed and executed by the Industrial University of Santander and financed by the Pan-American Health Organisation, analysed medical service use in individuals aged over 15 years. This agreed with Andersen and Newman's model and evaluated the effect of associated factors by means of multiple logistical regression. One out of each five people who became ill during the fifteen days prior to the survey had used the medical services. This percentage was smaller than that found in the Colombian population as a whole. The type of social security regime (contributory health insurance), previous service use and being from the region were associated with greater service use. Displaced people having subsidised health insurance did not present differences in service use compared to those who had no access to such insurance. The distance from dwelling to institution was another barrier against using health services (RM = 0.64; IC 0.42-0.97). There was differential medical service use amongst the displaced population, determined by their health insurance coverage and economic position.

Aetiology and management of malnutrition in HIV-positive children.

PubMed

Rose, Anna M; Hall, Charles S; Martinez-Alier, Nuria

2014-06-01

Worldwide, more than 3 million children are infected with HIV and, without treatment, mortality among these children is extremely high. Both acute and chronic malnutrition are major problems for HIV-positive children living in resource-limited settings. Malnutrition on a background of HIV represents a separate clinical entity, with unique medical and social aetiological factors. Children with HIV have a higher daily calorie requirement than HIV-negative peers and also a higher requirement for micronutrients; furthermore, coinfection and chronic diarrhoea due to HIV enteropathy play a major role in HIV-associated malnutrition. Contributory factors include late presentation to medical services, unavailability of antiretroviral therapy, other issues surrounding healthcare provision and food insecurity in HIV-positive households. Treatment protocols for malnutrition have been greatly improved, yet there remains a discrepancy in mortality between HIV-positive and HIV-negative children. In this review, the aetiology, prevention and treatment of malnutrition in HIV-positive children are examined, with particular focus on resource-limited settings where this problem is most prevalent. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Small Airways Dysfunction in Asthma: Evaluation and Management to Improve Asthma Control

PubMed Central

2014-01-01

The small airways have been neglected for many years, but interest in the topic has been rekindled with recent advances in measurement techniques to assess this region and also the ability to deliver therapeutics to the distal airways. Current levels of disease control in asthmatic patients remain poor and there are several contributory factors including; poor treatment compliance, heterogeneity of asthma phenotypes and associated comorbidities. However, the proposition that we may not be targeting all the inflammation that is present throughout the whole respiratory tree may also be an important factor. Indeed decades ago, pathologists and physiologists clearly identified the importance of small airways dysfunction in asthmatic patients. With improved inhaler technology to deliver drug to target the whole respiratory tree and more sensitive measures to assess the distal airways, we should certainly give greater consideration to treating the small airway region when seeing our asthmatic patients in clinic. The aim of this review is to address the relevance of small airways dysfunction in the daily clinical management of patients with asthma. In particular the role of small particle aerosols in the management of patients with asthma will be explored. PMID:25228994

CO2 rebreathing: a possible contributory factor to some cases of sudden infant death?

PubMed

Skadberg, B T; Oterhals, A; Finborud, K; Markestad, T

1995-09-01

Physical and geometrical conditions influencing carbon dioxide (CO2) accumulation near the face of a sleeping infant positioned deep in a cot or pram (open cot shaft) or underneath bedding (closed cot shaft) were investigated. By means of mathematical and data-based simulation, and an experimental rebreathing model, both hypothetical (dry, exhaled air +20 degrees C) and more physiological conditions (heated, humidified exhaled air, room temperature +20 degrees C; with and without pooling of cold air within the shaft) were tested. With exhaled air at +20 degrees C, the CO2 concentration increased to about 10% within 5 min. The increase was faster the smaller the volume, and the smaller the opening of the cot shaft. When expiratory air was heated, the CO2 concentration increased with the same speed as when the shaft was closed, but to only 0.1-0.3% when the shaft was open. Pooling of cold air in the shaft increased CO2 accumulation 70-200 times the concentration in air (to <5.5%) when the shaft was open. Turbulence of the air outside the open shaft reduced the increase in CO2 concentration. The experiments imply that CO2 may accumulate around an infant's head when placed deep in a cot or pram with the bedding and walls creating a narrow, vertical, shaft-like tunnel to the surrounding air. Although the CO2 concentration may theoretically attain dangerous levels in such circumstances, a rapid equilibrium between the air within and outside the cot usually occurs due to convection of the expiratory air and turbulence from drafts, the infant's body movements and breathing. Such factors will largely eliminated any significant rebreathing with the exception of the extreme situation when expired air is contained within a closed space.

Anesthesia-related cardiac arrest in children: the Thai Anesthesia Incidents Study (THAI Study).

PubMed

Bunchungmongkol, Nutchanart; Punjasawadwong, Yodying; Chumpathong, Saowapark; Somboonviboon, Wanna; Suraseranivongse, Suwannee; Vasinanukorn, Mayuree; Srisawasdi, Surirat; Thienthong, Somboon; Pranootnarabhal, Tharnthip

2009-04-01

The Thai Anesthesia Incidents study (THAI Study) is the first national study of anesthesia outcomes during anesthesia practice in Thailand. The authors extracted data of 25,098 pediatric cases from the THAI Study in order to examine the incidence, suspected causes, contributory factors, and suggested corrective strategies associated with anesthesia-related cardiac arrest. A multi-centered prospective descriptive study was conducted among 20 hospitals across Thailand over a year between March 1, 2003 and February 28, 2004. Data of cardiac arrests in children aged 15 years and younger were collected during anesthesia, in the recovery room and 24 hours postoperative period, and reviewed independently by at least two reviewers. Incidence of anesthesia- related cardiac arrest was 5.1 per 10,000 anesthetics, with 46% mortality rate. Infants accounted for 61% of cases. Incidences of overall cardiac arrest and anesthesia-related arrest were significantly higher in infants than older children and in children with ASA physical status 3-5 than those with ASA physical status 1-2. Most of the anesthesia-related arrests occurred in the operating room (61%) during induction or maintenance of anesthesia (84%). Respiratory-related cardiac arrest was the most common suspected cause of anesthesia-related cardiac arrest. Improving supervision, additional training, practice guidelines, efficient blood bank, equipment maintenance, and quality assurance monitoring are suggested corrective strategies to improve the quality of care in pediatric anesthesia. The incidence of anesthesia-related cardiac arrest was 5.1:10,000 anesthetics. Major risk factors were children younger than 1 year of age and ASA 3-5. The identifications of airway management and medication-related problems as the main causes of anesthesia-related cardiac arrest have important implications for preventive strategies.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Induced Dyspepsia.

PubMed

Yap, Paul Ray-Yee; Goh, Khean-Lee

2015-01-01

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed group of drugs in the world. They are used primarily for pain relief in chronic inflammatory joint disease and act by inhibiting enzymes COX1 and COX2 and ultimately preventing the production of active prostanoids which are required for the innate inflammatory pathway. The use of NSAIDs have been associated with the development of gastrointestinal (GI) symptoms ranging from simple dyspepsia to life threatening GI bleeds and perforations. The definition of dyspepsia has evolved over the years and this has hampered accurate studies on the prevalence of dyspepsia as different studies used varying criteria to define dyspepsia. It is now known that NSAIDs significantly increase the risk of dyspepsia.The risk of developing peptic ulcer disease vary with specific NSAIDs and dosages but there is no correlation between the symptoms of dyspepsia and underlying peptic ulcers. The pathogenesis of dyspepsia with NSAIDs is not completely understood. Peptic ulceration alone is not able to account for the majority of dyspepsia symptoms encountered by NSAIDs users. Erosive oesophagitis secondary to NSAIDs may be contributing factor to the prevalence of dyspepsia in NSAIDs users. Altered gut permeability and changes in gastric mechanosensory function due to NSAIDs may also be a contributory factor. Management of NSAID induced dyspepsia is involves a multipronged approach. Drug avoidance if possible would be ideal. Other options include using the lowest effective dose, changing to an NSAIDs with a safer GI risk profile, avoiding concurrent use with other NSAIDs or if the patient has a previous history of peptic ulcer disease, and co-prescribing with anti-secretory medications such as proton pump inhibitors. Eradication of Helicobacter pylori has a protective role against developing peptic ulcers and may also improve symptoms of NSAIDs induced dyspepsia.

Local Variability of Parameters for Characterization of the Corneal Subbasal Nerve Plexus.

PubMed

Winter, Karsten; Scheibe, Patrick; Köhler, Bernd; Allgeier, Stephan; Guthoff, Rudolf F; Stachs, Oliver

2016-01-01

The corneal subbasal nerve plexus (SNP) offers high potential for early diagnosis of diabetic peripheral neuropathy. Changes in subbasal nerve fibers can be assessed in vivo by confocal laser scanning microscopy (CLSM) and quantified using specific parameters. While current study results agree regarding parameter tendency, there are considerable differences in terms of absolute values. The present study set out to identify factors that might account for this high parameter variability. In three healthy subjects, we used a novel method of software-based large-scale reconstruction that provided SNP images of the central cornea, decomposed the image areas into all possible image sections corresponding to the size of a single conventional CLSM image (0.16 mm2), and calculated a set of parameters for each image section. In order to carry out a large number of virtual examinations within the reconstructed image areas, an extensive simulation procedure (10,000 runs per image) was implemented. The three analyzed images ranged in size from 3.75 mm2 to 4.27 mm2. The spatial configuration of the subbasal nerve fiber networks varied greatly across the cornea and thus caused heavily location-dependent results as well as wide value ranges for the parameters assessed. Distributions of SNP parameter values varied greatly between the three images and showed significant differences between all images for every parameter calculated (p < 0.001 in each case). The relatively small size of the conventionally evaluated SNP area is a contributory factor in high SNP parameter variability. Averaging of parameter values based on multiple CLSM frames does not necessarily result in good approximations of the respective reference values of the whole image area. This illustrates the potential for examiner bias when selecting SNP images in the central corneal area.

A district-based audit of the causes and circumstances of maternal deaths in South Kalimantan, Indonesia.

PubMed Central

Supratikto, Gunawan; Wirth, Meg E.; Achadi, Endang; Cohen, Surekha; Ronsmans, Carine

2002-01-01

A district-based audit of maternal and perinatal mortality began during 1994 in three provinces of South Kalimantan, Indonesia. Both medical and non-medical factors were documented and an effort was made to progress from merely assessing substandard care to recommending improvements in access to care and the quality of care. Extensive discussions of cases of maternal death were held during regular meetings with providers, policy-makers and community members. The sources of information included verbal autopsies with family members and medical records. Between 1995 and 1999 the audit reviewed 130 maternal deaths. The leading causes of death were haemorrhage (41%) and hypertensive diseases (32%). Delays in decision-making and poor quality of care in health facilities were seen as contributory factors in 77% and 60% of the deaths, respectively. Economic constraints were believed to have contributed to 37% of the deaths. The distance between a patient's home and a health provider or facility did not appear to have a significant influence, nor did transport problems. The audit led to changes in the quality of obstetric care in the district. Its success was particularly attributable to the process of accountability of both health providers and policy-makers and to improved working relationships between health providers at different levels and between providers and the community. With a view to the continuation and further expansion of the audit it may be necessary to reconsider the role of the provincial team, the need of health providers for confidentiality, the added benefit of facility-based audits, the need to incorporate scientific evidence into the review process, and the possible consideration of severe complications as well as deaths. It may also be necessary to recognize that village midwives are not solely responsible for maternal deaths. PMID:11984609

Wrong-site nerve blocks: A systematic literature review to guide principles for prevention.

PubMed

Deutsch, Ellen S; Yonash, Robert A; Martin, Donald E; Atkins, Joshua H; Arnold, Theresa V; Hunt, Christina M

2018-05-01

Wrong-site nerve blocks (WSBs) are a significant, though rare, source of perioperative morbidity. WSBs constitute the most common type of perioperative wrong-site procedure reported to the Pennsylvania Patient Safety Authority. This systematic literature review aggregates information about the incidence, patient consequences, and conditions that contribute to WSBs, as well as evidence-based methods to prevent them. A systematic search of English-language publications was performed, using the PRISMA process. Seventy English-language publications were identified. Analysis of four publications reporting on at least 10,000 blocks provides a rate of 0.52 to 5.07 WSB per 10,000 blocks, unilateral blocks, or "at risk" procedures. The most commonly mentioned potential consequence was local anesthetic toxicity. The most commonly mentioned contributory factors were time pressure, personnel factors, and lack of site-mark visibility (including no site mark placed). Components of the block process that were addressed include preoperative nerve-block verification, nerve-block site marking, time-outs, and the healthcare facility's structure and culture of safety. A lack of uniform reporting criteria and divergence in the data and theories presented may reflect the variety of circumstances affecting when and how nerve blocks are performed, as well as the infrequency of a WSB. However, multiple authors suggest three procedural steps that may help to prevent WSBs: (1) verify the nerve-block procedure using multiple sources of information, including the patient; (2) identify the nerve-block site with a visible mark; and (3) perform time-outs immediately prior to injection or instillation of the anesthetic. Hospitals, ambulatory surgical centers, and anesthesiology practices should consider creating site-verification processes with clinician input and support to develop sustainable WSB-prevention practices. Copyright © 2017 Elsevier Inc. All rights reserved.

Extracorporeal shockwave lithotripsy in infants.

PubMed

Ramakrishnan, Prem A; Medhat, Mohammed; Al-Bulushi, Younis H; Nair, Priti; Al-Kindy, Ahmed

2007-10-01

Pediatric urolithiasis is relatively uncommon and limited information is available on the application of minimally invasive management modalities in young children. We present a single centre experience with extracorporeal shockwave lithotripsy (ESWL) for infants with upper urinary tract calculi. A total of 74 infants aged 3 months to 24 months with upper urinary tract calculi were treated with ESWL under general anesthesia using the Wolf 2500 and the 2501 Piezolith lithotriptors over a 14 and a half-year period. Patient and stone characteristics, risk factors for urolithiasis, treatment parameters, clinical outcomes and long-term follow-up were assessed and recorded. The mean patient age was 14.5 (range 3 to 24) months. The mean renal stone size was 18.2 (range 7 to 32) mm while the mean ureteral stone size was 9.4 (range 5 to 14) mm. Metabolic abnormalities, structural anomalies and urinary tract infections were identified as contributory factors for stone formation in 34% of the infants. At the 3-month follow-up there was an overall successful outcome in 72 infants (97%) that included 65 (88%) who were rendered stone-free and 7 (9%) who had clinically insignificant stone fragments. Retreatment was required in 27 (35%) patients, auxiliary procedures after ESWL were needed in 5 (7%) and secondary operative procedures were required in 2 (3%). Major complications were encountered in 5 (7%) patients that included complete ureteral obstruction with sepsis in 2, partial ureteral obstruction in 1 and febrile urinary tract infection in 2 other children. Long-term follow-up was recorded in 39 infants: 8 developed recurrent stones, 2 had stone regrowth and 1 developed mild hypertension but none had significant deterioration of renal function. ESWL is an effective treatment for upper urinary tract calculi in infants. In the short-term, complications are minimal but long-term follow-up is important.

A district-based audit of the causes and circumstances of maternal deaths in South Kalimantan, Indonesia.

PubMed

Supratikto, Gunawan; Wirth, Meg E; Achadi, Endang; Cohen, Surekha; Ronsmans, Carine

2002-01-01

A district-based audit of maternal and perinatal mortality began during 1994 in three provinces of South Kalimantan, Indonesia. Both medical and non-medical factors were documented and an effort was made to progress from merely assessing substandard care to recommending improvements in access to care and the quality of care. Extensive discussions of cases of maternal death were held during regular meetings with providers, policy-makers and community members. The sources of information included verbal autopsies with family members and medical records. Between 1995 and 1999 the audit reviewed 130 maternal deaths. The leading causes of death were haemorrhage (41%) and hypertensive diseases (32%). Delays in decision-making and poor quality of care in health facilities were seen as contributory factors in 77% and 60% of the deaths, respectively. Economic constraints were believed to have contributed to 37% of the deaths. The distance between a patient's home and a health provider or facility did not appear to have a significant influence, nor did transport problems. The audit led to changes in the quality of obstetric care in the district. Its success was particularly attributable to the process of accountability of both health providers and policy-makers and to improved working relationships between health providers at different levels and between providers and the community. With a view to the continuation and further expansion of the audit it may be necessary to reconsider the role of the provincial team, the need of health providers for confidentiality, the added benefit of facility-based audits, the need to incorporate scientific evidence into the review process, and the possible consideration of severe complications as well as deaths. It may also be necessary to recognize that village midwives are not solely responsible for maternal deaths.

Incentives and Barriers That Influence Clinical Computerization in Hong Kong: A Population-based Physician Survey

PubMed Central

Leung, Gabriel M.; Yu, Philip L. H.; Wong, Irene O. L.; Johnston, Janice M.; Tin, Keith Y. K.

2003-01-01

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation. Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive. Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. PMID:12595409

Association between body mass index and dental caries among special care female children in Makkah City.

PubMed

Ashour, Nisreen Adnan; Ashour, Amal Adnan; Basha, Sakeena

2018-01-01

Dental caries and obesity are multifactorial diseases with diet being a common contributory factor. The main purpose of the present study was to investigate the association between dental caries and obesity among special care female school children in Makkah City, Saudi Arabia. Analytical cross-sectional study. Special schools in Makkah City. Schools were chosen by lottery and female children were ran.domly selected. Dental caries detection was performed according to the World Health Organization criteria. The medical evaluation assessed the body mass index (BMI). With appropriate sample weighting, relationships between dmft/DMFT (decayed, missing, filled teeth for deciduous and permanent dentition) and obesity were assessed using multilevel logistic regression. In 275 special care children, the prevalence of dental caries was 56.7 percent. The mean dmft and DMFT scores for the entire study population were 3.9 (4.8) and 3.2 (4.1), respectively. Forty percent of children were mentally retarded, 22.2% presented with deafness, blindness or both, 18.9% presented with Down syndrome and 14.9% were autistic. From the total sample, the mean BMI was 20.2 (2.8). When adjusted for covariates, the logistic regression model showed strong association between caries and obesity (adjusted odds ratio=2.9; 95% CI=1.2-4.9). This study demonstrated a significant association between caries frequency and overweight/obesity in special care school children. Since the data was cross-sectional, causal relationships cannot be established and the observed association could be due to other unexplored factors. Because of cultural and ethical consideration, including segregation of gender in Saudi Arabia, only female children were included in the present study, which limited the findings.

Working memory and arithmetic calculation in children: the contributory roles of processing speed, short-term memory, and reading.

PubMed

Berg, Derek H

2008-04-01

The cognitive underpinnings of arithmetic calculation in children are noted to involve working memory; however, cognitive processes related to arithmetic calculation and working memory suggest that this relationship is more complex than stated previously. The purpose of this investigation was to examine the relative contributions of processing speed, short-term memory, working memory, and reading to arithmetic calculation in children. Results suggested four important findings. First, processing speed emerged as a significant contributor of arithmetic calculation only in relation to age-related differences in the general sample. Second, processing speed and short-term memory did not eliminate the contribution of working memory to arithmetic calculation. Third, individual working memory components--verbal working memory and visual-spatial working memory--each contributed unique variance to arithmetic calculation in the presence of all other variables. Fourth, a full model indicated that chronological age remained a significant contributor to arithmetic calculation in the presence of significant contributions from all other variables. Results are discussed in terms of directions for future research on working memory in arithmetic calculation.

Association of FKBP5 Polymorphisms and Childhood Abuse With Risk of Posttraumatic Stress Disorder Symptoms in Adults

PubMed Central

Binder, Elisabeth B.; Bradley, Rebekah G.; Liu, Wei; Epstein, Michael P.; Deveau, Todd C.; Mercer, Kristina B.; Tang, Yilang; Gillespie, Charles F.; Heim, Christine M.; Nemeroff, Charles B.; Schwartz, Ann C.; Cubells, Joseph F.; Ressler, Kerry J.

2008-01-01

Context In addition to trauma exposure, other factors contribute to risk for development of posttraumatic stress disorder (PTSD) in adulthood. Both genetic and environmental factors are contributory, with child abuse providing significant risk liability. Objective To increase understanding of genetic and environmental risk factors as well as their interaction in the development of PTSD by gene × environment interactions of child abuse, level of non–child abuse trauma exposure, and genetic polymorphisms at the stress-related gene FKBP5. Design, Setting, and Participants A cross-sectional study examining genetic and psychological risk factors in 900 non psychiatric clinic patients (762 included for all genotype studies) with significant levels of childhood abuse as well as non–child abuse trauma using a verbally presented survey combined with single-nucleotide polymorphism (SNP) genotyping. Participants were primarily urban, low-income, black (>95%) men and women seeking care in the general medical care and obstetrics-gynecology clinics of an urban public hospital in Atlanta, Georgia, between 2005 and 2007. Main Outcome Measures Severity of adult PTSD symptomatology, measured with the modified PTSD Symptom Scale, non–child abuse (primarily adult) trauma exposure and child abuse measured using the traumatic events inventory and 8 SNPs spanning the FKBP5 locus. Results Level of child abuse and non–child abuse trauma each separately predicted level of adult PTSD symptomatology (mean [SD], PTSD Symptom Scale for no child abuse, 8.03 [10.48] vs ≥2 types of abuse, 20.93 [14.32]; and for no non–child abuse trauma, 3.58 [6.27] vs ≥4 types, 16.74 [12.90]; P<.001). Although FKBP5 SNPs did not directly predict PTSD symptom outcome or interact with level of non–child abuse trauma to predict PTSD symptom severity, 4 SNPs in the FKBP5 locus significantly interacted (rs9296158, rs3800373, rs1360780, and rs9470080; minimum P=.0004) with the severity of child abuse to predict level of adult PTSD symptoms after correcting for multiple testing. This gene × environment interaction remained significant when controlling for depression severity scores, age, sex, levels of non–child abuse trauma exposure, and genetic ancestry. This genetic interaction was also paralleled by FKBP5 genotype-dependent and PTSD-dependent effects on glucocorticoid receptor sensitivity, measured by the dexamethasone suppression test. Conclusions Four SNPs of the FKBP5 gene interacted with severity of child abuse as a predictor of adult PTSD symptoms. There were no main effects of the SNPs on PTSD symptoms and no significant genetic interactions with level of non–child abuse trauma as predictor of adult PTSD symptoms, suggesting a potential gene-childhood environment interaction for adult PTSD. PMID:18349090

Physiological and psychological fatigue in extreme conditions: the military example.

PubMed

Weeks, Sharon R; McAuliffe, Caitlin L; Durussel, David; Pasquina, Paul F

2010-05-01

The extreme conditions causing fatigue in military service members in combat and combat training deserve special consideration. The collective effects of severe exertion, limited caloric intake, and sleep deprivation, combined with the inherent stressors of combat, lead to both physiological and psychological fatigue that may significantly impair performance. Studies of combat training have revealed a myriad of endocrine, cognitive, and neurological changes that occur as a result of exposure to extreme conditions. Further contributory effects of multiple military deployments, post-traumatic stress disorder, and traumatic brain injury may also influence both the susceptibility to and expression of fatigue states. Further research is needed to explore these effects to enhance military readiness and performance as well as prevent injuries. Copyright (c) 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Analgesic, antipyretic, anti-inflammatory effects of methanol, chloroform and ether extracts of Vernonia cinerea less leaf.

PubMed

Iwalewa, E O; Iwalewa, O J; Adeboye, J O

2003-06-01

The chloroform, methanolic and ether extracts of Vernonia cinerea (Asteraceae; Less) leaf (100, 200 and 400mg/kg intraperitoneally) were tested in: acetic acid-induced writhing in mice, carrageenin-induced oedema and brewer's yeast-induced pyrexia in rats to assess their analgesic, anti-inflammatory, antipyretic and behavioral activities, respectively. The changes in writhings and behavioural activities in mice, the pyrexia and paw volumes in rats were reduced significantly (P<0.05) compared to the control. There was an increase in pain threshold on the oedematous right hind limb paw of the rats. These results indicate that the extracts could possess analgesic, antipyretic and anti-inflammatory properties. All these effects and the changes in the behavioural activities could be suggested as contributory effects to the use of V. cinerea leaf in the treatment of malaria.

Neuroligin 3 R451C mutation alters electroencephalography spectral activity in an animal model of autism spectrum disorders.

PubMed

Liu, Jackie J; Grace, Kevin P; Horner, Richard L; Cortez, Miguel A; Shao, Yiwen; Jia, Zhengping

2017-04-07

Human studies demonstrate that sleep impairment is a concurrent comorbidity of autism spectrum disorders (ASD), but its etiology remains largely uncertain. One of the prominent theories of ASD suggests that an imbalance in synaptic excitation/inhibition may contribute to various aspects of ASD, including sleep impairments. Following the identification of Nlgn3 R451C mutation in patients with ASD, its effects on synaptic transmission and social behaviours have been examined extensively in the mouse model. However, the contributory role of this mutation to sleep impairments in ASD remains unknown. In this study, we showed that Nlgn3 R451C knock-in mice, an established genetic model for ASD, exhibited normal duration and distribution of sleep/wake states but significantly altered electroencephalography (EEG) power spectral profiles for wake and sleep.

Upregulation of Cytokines Is Detected in the Placentas of Cattle Infected with Neospora caninum and Is More Marked Early in Gestation When Fetal Death Is Observed ▿

PubMed Central

Rosbottom, Anne; Gibney, E. Helen; Guy, Catherine S.; Kipar, Anja; Smith, Robert F.; Kaiser, Pete; Trees, Alexander J.; Williams, Diana J. L.

2008-01-01

The protozoan parasite Neospora caninum causes fetal death after experimental infection of pregnant cattle in early gestation, but the fetus survives a similar infection in late gestation. An increase in Th1-type cytokines in the placenta in response to the presence of the parasite has been implicated as a contributory factor to fetal death due to immune-mediated pathological alterations. We measured, using real-time reverse transcription-PCR and enzyme-linked immunosorbent assay, the levels of cytokines in the placentas of cattle experimentally infected with N. caninum in early and late gestation. After infection in early gestation, fetal death occurred, and the levels of mRNA of both Th1 and Th2 cytokines, including interleukin-2 (IL-2), gamma interferon (IFN-γ), IL-12p40, tumor necrosis factor alpha (TNF-α), IL-18, IL-10, and IL-4, were significantly (P < 0.01) increased by up to 1,000-fold. There was extensive placental necrosis and a corresponding infiltration of CD4+ T cells and macrophages. IFN-γ protein expression was also highly increased, and a modest increase in transforming growth factor β was detected. A much smaller increase in the same cytokines and IFN-γ protein expression, with minimal placental necrosis and inflammatory infiltration, occurred after N. caninum infection in late gestation when the fetuses survived. Comparison of cytokine mRNA levels in separated maternal and fetal placental tissue that showed maternal tissue was the major source of all cytokine mRNA except for IL-10 and TNF-α, which were similar in both maternal and fetal tissues. These results suggest that the magnitude of the cytokine response correlates with but is not necessarily the cause of fetal death and demonstrate that a polarized Th1 response was not evident in the placentas of N. caninum-infected cattle. PMID:18362132

Assessing “First Mile” Supply Chain Factors Affecting Timeliness of School-Based Deworming Interventions: Supply and Logistics Performance Indicators

PubMed Central

Koporc, Kimberly M.; Strunz, Eric; Holloway, Cassandra; Addiss, David G.; Lin, William

2015-01-01

Background Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007–2012. Methodology Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA. Principal Findings Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%. Conclusions and Significance To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled. PMID:26657842

Down-regulation of Jab1, HIF-1alpha, and VEGF by Moloney murine leukemia virus-ts1 infection: a possible cause of neurodegeneration.

PubMed

Lungu, Gina F; Stoica, George; Wong, Paul K Y

2008-05-01

Moloney murine leukemia virus-temperature sensitive (MoMuLV-ts1)-mediated neuronal death is a result of both loss of glial support and release of cytokines and neurotoxins from ts1-infected glial cells. Here the authors propose vascular endothelial growth factor (VEGF) down-regulation as another contributory factor in neuronal degeneration induced by ts1 infection. To determine how ts1 affects VEGF expression in ts1-infected brain, the authors examined the expression of several proteins that are important in regulating the expression of VEGF. The authors found significant decreases in Jun-activating domain-binding protein 1 (Jab1), hypoxia-inducible factor (HIF)-1alpha, and VEGF levels and increases in p53 protein levels in ts1-infected brains compared to noninfected control brains. The authors suggest that a decrease Jab1 expression in ts1 infection leads to accumulation of p53, which binds to HIF-1alpha to accelerate its degradation. A rapid degradation of HIF-1alpha leads to decreased VEGF production and secretion. Considering that endothelial cells are the most conspicuous in virus replication and production in ts1 infection, but are not killed by the infection, the authors examined the expression of these proteins using infected and noninfected mouse cerebrovascular endothelial (CVE) cells. The ts1- infected CVE cells showed decreased Jab1, HIF-1alpha, and VEGF mRNA and protein levels and increased p53 protein levels compared with noninfected cells, consistent with the results found in vivo. These results confirm that ts1 infection results in insufficient secretion of VEGF from endothelial cells and may result in decreased neuroprotection. This study suggested that ts1-mediated neuropathology in mice may result from changes in expression and activity of Jab1, p53, and HIF-1alpha, with a final target on VEGF expression and neuronal degeneration.

Funding for Life: When to Spend the Acquisition Pot

DTIC Science & Technology

2010-05-01

Private Military Sector Software Requirements for OA Spiral Development Strategy for Defense Acquisition Research The Software, Hardware...qb=p`elli= Capital Budgeting for the DoD Energy Saving Contracts/DoD Mobile Assets Financing DoD Budget via PPPs Lessons from Private Sector ...the endeavor can, in part, be related to the stability of the aims and contributory components. Economic growth has been driven by globalisation

Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

PubMed Central

2012-01-01

Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP) policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing), as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It is critical that there is more extensive debate on the advantages and disadvantages of alternative funding mechanisms, supported by a solid evidence base, and with the policy objective of universal coverage providing the guiding light. PMID:23102454

Soy but not bisphenol A (BPA) induces hallmarks of polycystic ovary syndrome (PCOS) and related metabolic co-morbidities in rats.

PubMed

Patisaul, Heather B; Mabrey, Natalie; Adewale, Heather B; Sullivan, Alana W

2014-11-01

Polycystic ovarian syndrome (PCOS) is the most common female endocrine disorder with a prevalence as high as 8-15% depending on ethnicity and the diagnostic criteria employed. The basic pathophysiology and mode of inheritance remain unclear, but environmental factors such as diet, stress and chemical exposures are thought to be contributory. Developmental exposure to endocrine disrupting compounds (EDCs) have been hypothesized to exacerbate risk, in part because PCOS hallmarks and associated metabolic co-morbidities can be reliably induced in animal models by perinatal androgen exposure. Here we show that lifetime exposure to a soy diet, containing endocrine active phytoestrogens, but not developmental exposure (gestational day 6-lactational day 40) to the endocrine disrupting monomer bisphenol A (BPA), can induce key features of PCOS in the rat; results which support the hypothesis that hormonally active diets may contribute to risk when consumed throughout gestation and post-natal life. Copyright © 2014 Elsevier Inc. All rights reserved.

After the Medication Error: Recent Nursing Graduates' Reflections on Adequacy of Education.

PubMed

Treiber, Linda A; Jones, Jackie H

2018-05-01

The purpose of this study was to better understand individual- and system-level factors surrounding making a medication error from the perspective of recent Bachelor of Science in Nursing graduates. Online survey mixed-methods items included perceptions of adequacy of preparatory nursing education, contributory variables, emotional responses, and treatment by employer following the error. Of the 168 respondents, 55% had made a medication error. Errors resulted from inexperience, rushing, technology, staffing, and patient acuity. Twenty-four percent did not report their errors. Key themes for improving education included more practice in varied clinical areas, intensive pharmacological preparation, practical instruction in functioning within the health care environment, and coping after making medication errors. Errors generally caused emotional distress in the error maker. Overall, perceived treatment after the error reflected supportive environments, where nurses were generally treated with respect, fair treatment, and understanding. Opportunities for nursing education include second victim awareness and reinforcing professional practice standards. [J Nurs Educ. 2018;57(5):275-280.]. Copyright 2018, SLACK Incorporated.

The kidneys and ANCA-associated vasculitis: from pathogenesis to diagnosis

PubMed Central

Rowaiye, Olumide Olatubosun; Kusztal, Mariusz; Klinger, Marian

2015-01-01

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of pauci-immune small vessel vasculitides that often affect the kidneys manifesting as rapidly progressive glomerulonephritis. Although the exact pathogenesis of AAV is not fully known, evidence from in vitro, in vivo and clinical studies all point to the involvement of ANCA in the pathogenesis of AAV. In this review, we highlight the contributory roles played by various factors (e.g. genetics, environment, B and T-regulatory cells, toll-like receptors, etc.) in the pathogenesis of AAV. Furthermore, we discuss renal involvement in AAV in terms of clinical features and the various histopathological classification patterns, which are also known to be of prognostic importance. We also present information on useful imaging techniques for localizing kidney and other organ system involvement in AAV, and also on novel laboratory methods and assays useful for rapid and more specific determination of patients' ANCA status. Finally, we demonstrate evidence on novel serum biomarkers that have been shown to correlate with disease activity in AAV. PMID:26034600

Renal denervation in a patient with Alport syndrome and rejected renal allograft.

PubMed

Raju, Narayana; Lloyd, Vincent; Yalagudri, Sachin; Das, Bharati; Ravikishore, A G

2015-12-01

Renal denervation is a new intervention to treat resistant hypertension. By applying radiofrequency (RF) to renal arteries, sympathetic nerves in adventitia layer of vascular wall can be denervated. Sympathetic hyperactivity is an important contributory factor in hypertension of hemodialysis patients. Hyperactive sympathetic nervous system aggravates hypertension and it can cause complications like left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. Our report illustrates the use of renal denervation using conventional RF catheter for uncontrolled hypertension in a patient with Alport syndrome and rejected renal allograft. Progressive and sustained reduction of blood pressure was obtained post-procedure and at 24 months follow-up with antihypertensives decreased from 6 to 2 per day, thereby demonstrating the safety, feasibility, and efficacy of the procedure. There are some reports available on the usefulness of this technique in hemodialysis patients; however, there are no studies of renal denervation in patients with Alport syndrome and failed allograft situation. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

EBV and Apoptosis: The Viral Master Regulator of Cell Fate?

PubMed Central

Kelly, Gemma L.

2017-01-01

Epstein–Barr virus (EBV) was first discovered in cells from a patient with Burkitt lymphoma (BL), and is now known to be a contributory factor in 1–2% of all cancers, for which there are as yet, no EBV-targeted therapies available. Like other herpesviruses, EBV adopts a persistent latent infection in vivo and only rarely reactivates into replicative lytic cycle. Although latency is associated with restricted patterns of gene expression, genes are never expressed in isolation; always in groups. Here, we discuss (1) the ways in which the latent genes of EBV are known to modulate cell death, (2) how these mechanisms relate to growth transformation and lymphomagenesis, and (3) how EBV genes cooperate to coordinately regulate key cell death pathways in BL and lymphoblastoid cell lines (LCLs). Since manipulation of the cell death machinery is critical in EBV pathogenesis, understanding the mechanisms that underpin EBV regulation of apoptosis therefore provides opportunities for novel therapeutic interventions. PMID:29137176

The role of oxidative stress in menopause

PubMed Central

Doshi, Sejal B.; Agarwal, Ashok

2013-01-01

This review will discuss the concept of reproductive aging, which includes the definition of menopause, its symptoms, and predisposing conditions. It will elaborate upon the contributory factors implicated in the pathogenesis of menopause, focusing most prominently on oxidative stress. Specifically, this paper will explain how oxidative stress, in the form of free radicals and antioxidant deficiencies, has been directly linked to the decline of estrogen during reproductive aging. Additionally, this paper will elaborate upon the treatment options aimed at mitigating the menopausal symptoms and hormonal deficiencies that can lead to various disease processes. Treatment options such as hormonal therapy, antioxidant supplementation, and lifestyle modification have been explored for their effectiveness in treating and preventing the symptoms and sequelae of menopause. The majority of information in this review was obtained through PubMed and the National Library of Medicine. While most references in this paper are original research articles, a limited number of references are comprehensive reviews on the topic. PMID:24672185

[Research in the pharmaceutical industry cannot be objective].

PubMed

Becker-Brüser, Wolfgang

2010-01-01

In the face of tight public budgets more and more studies are being funded by the pharmaceutical industry. At the same time responsibility for conducting company-funded trials is increasingly being shifted to contract research organisations. Pharmaceutical manufacturers sponsor trials that primarily pursue company interests. The dominance of company-funded research does not only have a bearing on the choice of study priorities, though. Company sponsorship also has an influence on the results of trials. Company-funded trials are four times more likely to find evidence in favour of the trial drug than studies funded by other sponsors. There are several contributory factors, from study design (design bias) to data manipulation. And non-publication (publication bias) can distort knowledge. As a result, it is largely impossible to reliably assess the benefit and harm of medical drugs on the basis of published trials. This will have repercussions for the reliability of meta-analyses, guidelines and patient information leaflets. One consequence may be treatment errors.

How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions

PubMed Central

George, Jim; Long, Susannah; Vincent, Charles

2013-01-01

Maintaining patient safety in acute hospitals is a global health challenge. Traditionally, patient safety measures have been concentrated on critical care and surgical patients. In this review the medical literature was reviewed over the last ten years on aspects of patient safety specifically related to patients with dementia. Patients with dementia do badly in hospital with frequent adverse events resulting in the geriatric syndromes of falls, delirium and loss of function with increased length of stay and increased mortality. Contributory factors include inadequate assessment and treatment, inappropriate intervention, discrimination, low staff levels and lack of staff training. Unfortunately there is no one simple solution to this problem, but what is needed is a multifactorial, multilevel approach at the seven levels of care – patient, task, staff, team, environment, organisation and institution. Improving safety and quality of care for patients with dementia in acute hospitals will benefit all patients and is an urgent priority for the NHS. PMID:23759885

Age migraine and achievement motivation related? A psychophysiological study of responses to real-life achievement stress in young headache sufferers.

PubMed

Passchier, J; Goudswaard, P; Orlebeke, J F; Verhage, F

1990-01-01

Achievement motivation and its physiological correlates were studied in 37 young migrainous headache sufferers (30 females and 7 males) and in 37 matched controls. Temporal and digital pulse amplitude, the EMGs of the m. frontalis, anterior temporalis and corrugator supercilii, heart and respiration rate, head temperature and electrodermal activity were measured during an adaptation session, an examination and an intelligence test. An abnormal response in the temporal artery, which was present in the migrainous headache sufferers, was not associated with achievement motivation. But the latter was positively associated with a high skin conductance level, a greater number of spontaneous skin conductance responses (SCRs) during the examination and a lower digital pulse amplitude in both the migrainous headache and control groups. Higher sympathetic activity in subjects with high achievement motivation was interpreted as an indication of greater mental effort and is a possible contributory factor to an attack in those with migraine.

Food choice by people with intellectual disabilities at day centres: A qualitative study.

PubMed

Cartwright, Luke; Reid, Marie; Hammersley, Richard; Blackburn, Chrissie; Glover, Lesley

2015-06-01

People with intellectual disabilities experience a range of health inequalities. It is important to investigate possible contributory factors that may lead to these inequalities. This qualitative study identified some difficulties for healthy eating in day centres. (1) Service users and their family carers were aware of healthy food choices but framed these as diets for weight loss rather than as everyday eating. (2) Paid carers and managers regarded the principle of service user autonomy and choice as paramount, which meant that they felt limited in their capacity to influence food choices, which they attributed to the home environment. (3) Carers used food as a treat, a reward and for social bonding with service users. (4) Service users' food choices modelled other service users' and carers' choices at the time. It is suggested that healthy eating should be made more of a priority in day care, with a view to promoting exemplarily behaviour that might influence food choice at home. © The Author(s) 2014.

Dietary habits and esophageal cancer.

PubMed

Palladino-Davis, A G; Mendez, B M; Fisichella, P M; Davis, C S

2015-01-01

Cancer of the esophagus is an underestimated, poorly understood, and changing disease. Its overall 5-year survival is less than 20%, even in the United States, which is largely a function of a delay in diagnosis until its more advanced stages. Additionally, the epidemiologic complexities of esophageal cancer are vast, rendering screening and prevention limited at best. First, the prevalence of esophageal cancer is unevenly distributed throughout the world. Second, the two histological forms (squamous cell and adenocarcinoma) vary in terms of their geographic prevalence and associated risk factors. Third, some populations appear at particular risk for esophageal cancer. And fourth, the incidence of esophageal cancer is in continuous flux among groups. Despite the varied prevalence and risks among populations, some factors have emerged as consistent associations while others are only now becoming more fully recognized. The most prominent, scientifically supported, and long-regarded risk factors for esophageal cancer are tobacco, alcohol, and reflux esophagitis. Inasmuch as the above are regarded as important risk factors for esophageal cancer, they are not the sole contributors. Dietary habits, nutrition, local customs, and the environment may be contributory. Along these lines, vitamins, minerals, fruits, vegetables, meats, fats, salted foods, nitrogen compounds, carcinogens, mycotoxins, and even the temperature of what we consume are increasingly regarded as potential etiologies for this deadly although potentially preventable disease. The goal of this review is to shed light on the less known role of nutrition and dietary habits in esophageal cancer. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Single mothers' self-assessment of health: a systematic exploration of the literature.

PubMed

Rousou, E; Kouta, C; Middleton, N; Karanikola, M

2013-12-01

This study aimed to explore single mothers' self-assessed level of health status compared to partnered mothers and the relevant factors associated with it. The number of single-mother families is increasing worldwide. A large body of international research reveals that single mothers experience poorer physical and mental health than their married counterparts. An important contributory factor for this health disparity appears to be socio-economic disadvantage. A systematic search of the literature was conducted using the keywords 'lone' or 'single' and 'mother*' or 'parent*' or 'family structure' in combination with 'health'. EMBASE, CINAHL, COCHRANE and PUBMED databases were searched for quantitative research studies published in the past decade. Eleven quantitative research articles with self-assessment of health status in single mothers were identified. Single mothers report lower levels of health status compared to partnered mothers. These inequalities appear to be associated with financial hardship and lack of social support. Both these factors increase single mothers' susceptibility to stress and illness. Despite the study limitations (e.g. results based mainly on secondary data from household surveys), it provides evidence that single motherhood places women in an adverse social position that is associated with prolonged stress mainly due to unemployment, economic hardship and social exclusion, which affects negatively their health status. These findings can be seen as a challenge for health professionals, especially those working in the community sector and policy makers too, to establish supportive measures for this vulnerable group focused on socio-economic factors. © 2013 International Council of Nurses.

The Fox and the Rabbits—Environmental Variables and Population Genetics (1) Replication Problems in Association Studies and the Untapped Power of GWAS (2) Vitamin A Deficiency, Herpes Simplex Reactivation and Other Causes of Alzheimer's Disease

PubMed Central

Carter, C. J.

2011-01-01

Classical population genetics shows that varying permutations of genes and risk factors permit or disallow the effects of causative agents, depending on circumstance. For example, genes and environment determine whether a fox kills black or white rabbits on snow or black ash covered islands. Risk promoting effects are different on each island, but obscured by meta-analysis or GWAS data from both islands, unless partitioned by different contributory factors. In Alzheimer's disease, the foxes appear to be herpes, borrelia or chlamydial infection, hypercholesterolemia, hyperhomocysteinaemia, diabetes, cerebral hypoperfusion, oestrogen depletion, or vitamin A deficiency, all of which promote beta-amyloid deposition in animal models—without the aid of gene variants. All relate to risk factors and subsets of susceptibility genes, which condition their effects. All are less prevalent in convents, where nuns appear less susceptible to the ravages of ageing. Antagonism of the antimicrobial properties of beta-amyloid by Abeta autoantibodies in the ageing population, likely generated by antibodies raised to beta-amyloid/pathogen protein homologues, may play a role in this scenario. These agents are treatable by diet and drugs, vitamin supplementation, pathogen detection and elimination, and autoantibody removal, although again, the beneficial effects of individual treatments may be tempered by genes and environment. PMID:22389816

Curcumin as a multifaceted compound against human papilloma virus infection and cervical cancers: A review of chemistry, cellular, molecular, and preclinical features.

PubMed

Teymouri, Manouchehr; Pirro, Matteo; Johnston, Thomas P; Sahebkar, Amirhosein

2017-05-06

Curcumin, the bioactive polyphenolic ingredient of turmeric, has been extensively studied for its effects on human papilloma virus (HPV) infection as well as primary and malignant squamous cervical cancers. HPV infections, especially those related to HPV 16 and 18 types, have been established as the leading cause of cervical cancer; however, there are also additional contributory factors involved in the etiopathogenesis of cervical cancers. Curcumin has emerged as having promising chemopreventive and anticancer effects against both HPV-related and nonrelated cervical cancers. In this review, we first discuss the biological relevance of curcumin and both its pharmacological effects and pharmaceutical considerations from a chemical point of view. Next, the signaling pathways that are modulated by curcumin and are relevant to the elimination of HPV infection and treatment of cervical cancer are discussed. We also present counter arguments regarding the effects of curcumin on signaling pathways and molecular markers dysregulated by benzo(a)pyrene (Bap), a carcinogen found in pathological cervical lesions of women who smoke frequently, and estradiol, as two important risk factors involved in persistent HPV-infection and cervical cancer. Finally, various strategies to enhance the pharmacological activity and pharmacokinetic characteristics of curcumin are discussed with examples of studies in experimental models of cervical cancer. © 2016 BioFactors, 43(3):331-346, 2017. © 2016 International Union of Biochemistry and Molecular Biology.

The Fox and the Rabbits-Environmental Variables and Population Genetics (1) Replication Problems in Association Studies and the Untapped Power of GWAS (2) Vitamin A Deficiency, Herpes Simplex Reactivation and Other Causes of Alzheimer's Disease.

PubMed

Carter, C J

2011-01-01

Classical population genetics shows that varying permutations of genes and risk factors permit or disallow the effects of causative agents, depending on circumstance. For example, genes and environment determine whether a fox kills black or white rabbits on snow or black ash covered islands. Risk promoting effects are different on each island, but obscured by meta-analysis or GWAS data from both islands, unless partitioned by different contributory factors. In Alzheimer's disease, the foxes appear to be herpes, borrelia or chlamydial infection, hypercholesterolemia, hyperhomocysteinaemia, diabetes, cerebral hypoperfusion, oestrogen depletion, or vitamin A deficiency, all of which promote beta-amyloid deposition in animal models-without the aid of gene variants. All relate to risk factors and subsets of susceptibility genes, which condition their effects. All are less prevalent in convents, where nuns appear less susceptible to the ravages of ageing. Antagonism of the antimicrobial properties of beta-amyloid by Abeta autoantibodies in the ageing population, likely generated by antibodies raised to beta-amyloid/pathogen protein homologues, may play a role in this scenario. These agents are treatable by diet and drugs, vitamin supplementation, pathogen detection and elimination, and autoantibody removal, although again, the beneficial effects of individual treatments may be tempered by genes and environment.

Epstein-Barr virus and its association with rheumatoid arthritis and oral lichen planus.

PubMed

Adtani, Pooja; Malathi, Narasimhan

2015-01-01

Pathogenesis of autoimmune diseases (AD) is one of a multifactorial milieu. A genetic predisposition, an immune system failure, hormonal imbalance and environmental factors play important roles. Among the many environmental factors, the role of infection is gaining importance in the pathogenesis of various autoimmune disorders; among them, Epstein-Barr virus (EBV) plays a pivotal role. Literature states an association of various AD with EBV namely multiple sclerosis, autoimmune thyroiditis, systemic lupus erythematous, oral lichen planus (OLP), rheumatoid arthritis (RA), autoimmune hepatitis, Sjögren's syndrome and Kawasaki disease; among these, the most commonly occurring are OLP and RA. Considering the frequency of occurrences, our aim was to perform a qualitative analysis of EBV viral capsid antigen (EBV VCA) IgG in the sera of patients with RA, OLP and establish a comparison with normal. In-vitro experiment in a research laboratory. Five-milliliter blood sample was collected from 25 patients diagnosed with RA and OLP. Serum was separated and EBV VCA IgG antibody titer was detected using NovaTec EBV VCA IgG ELISA kit. Chi-square test. Six out of 25 subjects with RA and 4 out of 25 subjects with OLP tested positive for EBV VCA IgG. Both environmental and genetic factors are important contributory components for autoimmune conditions. Screening for viral etiology would improve the efficacy of conventional treatment and reduce the risk of relapses.

Learning and feedback from the Danish patient safety incident reporting system can be improved.

PubMed

Moeller, Anders Damgaard; Rasmussen, Kurt; Nielsen, Kent Jacob

2016-06-01

The perceived usefulness of incident reporting systems is an important motivational factor for reporting. The usefulness may be facilitated by well-established feedback mechanisms and by learning processes. The aim of this study was to investigate how feedback mechanisms and learning processes were implemented at four Danish hospital units all located in one of the five Danish regions. Based on the concepts of feedback and learning from incident processes, a questionnaire was developed and distributed to 335 patient safety representatives from 200 departments at four Danish hospital units in one of the five Danish regions. The study showed that external reporters were rarely contacted for dialogue, grouped front-line staff were sparsely involved in the learning process, few evaluated the effectiveness of implemented interventions and personal factors were frequently perceived as a primary contributory factor to these incidents. In contrast, the patient safety representatives perceived their competencies as sufficient for the job, internal reporters were often contacted for dialogue, evaluation was widely used and management supported the work with incident reports. The results of the study identified several shortcomings in the implementation of learning processes and feedback mechanisms. The apparent existence of a person-focused approach stands out as an element of notice. The insufficient implementation we observed indicates that there is room for improvement in the efforts made to maximise learning from incidents in the investigated population. not relevant. not relevant.

Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population.

PubMed

Aagestad, Cecilie; Tyssen, Reidar; Sterud, Tom

2016-03-08

Doctor -certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors. A randomly drawn cohort aged 18-69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %), and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032). Using this sample, we compared health and social workers (n = 661) with the general working population (n = 2371). The outcome of interest was long-term sick leave (LTSL) ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated. After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13-1.79; p = 0.003). After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting. Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.

Racial Differences in the Overall Survival of Hairy Cell Leukemia in the United States: A Population-Based Analysis of the Surveillance, Epidemiology, and End Results Database.

PubMed

Giri, Smith; Shrestha, Rajesh; Pathak, Ranjan; Bhatt, Vijaya Raj

2015-08-01

Several studies have reported excellent long-term overall survival (OS) of patients with hairy cell leukemia (HCL) without racial disparity. Studies in other cancers have demonstrated worse mortality among African American (AA) individuals. We used the Surveillance, Epidemiology, and End Results 18 database to identify HCL patients diagnosed between 1978 and 2011. Kaplan-Meier curves were plotted to estimate OS. Univariate analysis using the life table method and multivariate Cox regression model were used to determine the independent effect of race on OS. The study population included 78% men and had a median age of 56 years. Race included 93% white, 3.5% Asian/Pacific Islander, and 3.5% AA. The 10-year OS was significantly less for AA as compared with white and Asian/Pacific Islander individuals (54% vs. 72% vs. 75%; P < .001). A Kaplan-Meier survival curve showed a significantly worse OS for AA versus other races (P < .001). In a multivariate analysis, AA race remained an independent predictor for a worse OS (hazard ratio 1.77; 95% confidence interval, 1.30-2.40; P < .001) after adjusting for age, sex, year of diagnosis, and marital status. In this population-based study, only half of AA patients but more than two-thirds of HCL patients from other racial groups were alive at 10 years. Such drastic racial differences in OS of HCL patients at the population level mandates further evaluation of the contributory biological, socioeconomic, health system, and other factors. Understanding and overcoming such racial disparities might close the racial differences in OS of this potentially curable disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Vertical transmission of honey bee viruses in a Belgian queen breeding program.

PubMed

Ravoet, Jorgen; De Smet, Lina; Wenseleers, Tom; de Graaf, Dirk C

2015-03-14

The Member States of European Union are encouraged to improve the general conditions for the production and marketing of apicultural products. In Belgium, programmes on the restocking of honey bee hives have run for many years. Overall, the success ratio of this queen breeding programme has been only around 50%. To tackle this low efficacy, we organized sanitary controls of the breeding queens in 2012 and 2014. We found a high quantity of viruses, with more than 75% of the egg samples being infected with at least one virus. The most abundant viruses were Deformed Wing Virus and Sacbrood Virus (≥40%), although Lake Sinai Virus and Acute Bee Paralysis Virus were also occasionally detected (between 10-30%). In addition, Aphid Lethal Paralysis Virus strain Brookings, Black Queen Cell Virus, Chronic Bee Paralysis Virus and Varroa destructor Macula-like Virus occurred at very low prevalences (≤5%). Remarkably, we found Apis mellifera carnica bees to be less infected with Deformed Wing Virus than Buckfast bees (p < 0.01), and also found them to have a lower average total number of infecting viruses (p < 0.001). This is a significant finding, given that Deformed Wing Virus has earlier been shown to be a contributory factor to winter mortality and Colony Collapse Disorder. Moreover, negative-strand detection of Sacbrood Virus in eggs was demonstrated for the first time. High pathogen loads were observed in this sanitary control program. We documented for the first time vertical transmission of some viruses, as well as significant differences between two honey bee races in being affected by Deformed Wing Virus. Nevertheless, we could not demonstrate a correlation between the presence of viruses and queen breeding efficacies.

Controlling firearms use in Australia: has the 1996 gun law reform produced the decrease in rates of suicide with this method?

PubMed

Klieve, Helen; Barnes, Michael; De Leo, Diego

2009-04-01

Observed reductions in firearm suicides in Australia have been linked to the 1997 national firearms agreement (NFA) introduced following the 1996 Port Arthur massacre. The NFA placed strong access restrictions on firearms. To assess the impact of legislative restrictions on the incidence of firearm suicide in Queensland and explore alternative or contributory factors behind observed declines. The Queensland suicide register (QSR) provided detailed information on all male suicides in Queensland (1990-2004), with additional data for Australia (1968-2004) accessed from other official sources. Trends in suicide rates pre/post NFA, and in method selection, were assessed using negative binomial regressions. Changing method selection patterns were examined using a cohort analysis of 5 years of age classes for Australian males. The observed reduction in firearms suicides was initiated prior to the 1997 introduction of the NFA in Queensland and Australia, with a clear decline observed in Australian figures from 1988. No significant difference was found in the rate pre/post the introduction of the NFA in Queensland; however, a significant difference was found for Australian data, the quality of which is noticeably less satisfactory. A marked age-difference in method choice was observed through a cohort analysis demonstrating both time and age influences. Within sequential birth cohorts, rates of firearms suicides decreased in younger males but increased in hanging suicides; this trend was far less marked in older males. The implemented restrictions may not be responsible for the observed reductions in firearms suicide. Data suggest that a change in social and cultural attitudes could have contributed to the shift in method preference.

Understanding the linkages between social safety nets and childhood violence: a review of the evidence from low- and middle-income countries

PubMed Central

Peterman, Amber; Neijhoft, Anastasia (Naomi); Cook, Sarah; Palermo, Tia M

2017-01-01

Abstract As many as one billion children experience violence every year, and household- and community-level poverty are among the risk factors for child protection violations. Social safety nets (SSNs) are a main policy tool to address poverty and vulnerability, and there is substantial evidence demonstrating positive effects on children’s health and human capital. This paper reviews evidence and develops a framework to understand linkages between non-contributory SSNs and the experience of childhood emotional, physical and sexual violence in low- and middle-income countries. We catalogue 14 rigorous impact evaluations, 11 of which are completed, analysing 57 unique impacts on diverse violence indicators. Among these impacts, approximately one in five represent statistically significant protective effects on childhood violence. Promising evidence relates to sexual violence among female adolescents in Africa, while there is less clear evidence of significant impacts in other parts of the developing world, and on young child measures, including violent discipline. Further, few studies are set up to meaningfully unpack mechanisms between SSNs and childhood violence; however, those most commonly hypothesized operate at the household level (through increases in economic security and reductions in poverty-related stress), the interpersonal level (improved parental behaviours, caregiving practices, improved psychosocial well-being) and at the child-level (protective education and decreases in problem or risky behaviours). It is important to emphasize that traditional SSNs are never designed with violence prevention as primary objectives, and thus should not be considered as standalone interventions to reduce risks for childhood violence. However, SSNs, particularly within integrated protection systems, appear to have potential to reduce violence risk. Linkages between SSNs and childhood violence are understudied, and investments should be made to close this evidence gap. PMID:28444197

Impact of travel time and rurality on presentation and outcomes of symptomatic colorectal cancer: a cross-sectional cohort study in primary care.

PubMed

Murage, Peninah; Murchie, Peter; Bachmann, Max; Crawford, Michael; Jones, Andy

2017-07-01

Several studies have reported a survival disadvantage for rural dwellers who develop colorectal cancer, but the underlying mechanisms remain obscure. Delayed presentation to GPs may be a contributory factor, but evidence is lacking. To examine the association between rurality and travel time on diagnosis and survival of colorectal cancer in a cohort from northeast Scotland. The authors used a database linking GP records to routine data for patients diagnosed between 1997 and 1998, and followed up to 2011. Primary outcomes were alarm symptoms, emergency admissions, stage, and survival. Travel time in minutes from patients to GP was estimated. Logistic and Cox regression were used to model outcomes. Interaction terms were used to determine if travelling time impacted differently on urban versus rural patients. Rural patients and patients travelling farther to the GP had better 3-year survival. When the travel outcome associations were explored using interaction terms, the associations differed between rural and urban areas. Longer travel in urban areas significantly reduced the odds of emergency admissions (odds ratio [OR] 0.62, P <0.05), and increased survival (hazard ratio 0.75, P <0.05). Longer travel also increased the odds of presenting with alarm symptoms in urban areas; this was nearly significant (OR 1.34, P = 0.06). Presence of alarm symptoms reduced the likelihood of emergency admissions (OR 0.36, P <0.01). Living in a rural area, and travelling farther to a GP in urban areas, may reduce the likelihood of emergency admissions and poor survival. This may be related to how patients present with alarm symptoms. © British Journal of General Practice 2017.

Burnout in hospital-based medical consultants in the New Zealand public health system.

PubMed

Surgenor, Lois J; Spearing, Ruth L; Horn, Jacqueline; Beautrais, Annette L; Mulder, Roger T; Chen, Peggy

2009-08-07

To assess the prevalence and severity of burnout in hospital-based medical consultants, and investigate associated demographic and professional characteristics. Utilising standardised measures of burnout (Maslach Burnout Inventory) and job satisfaction (Job Satisfaction Scale) this cross-sectional study recruited 267 consultants working in a large tertiary hospital in Christchurch, New Zealand. Seventy-one percent of all eligible participants were recruited. The prevalence of burnout in each of the three dimensions was as follows: High Emotional Exhaustion=29.7%; High Depersonalisation=24.4%; Low Personal Accomplishment=31.2%. One in five consultants was assessed as having high overall burnout. Considered against the psychometric norms for medical workers, significantly more consultants than expected reported low Emotional Exhaustion (p<0.001) and low Depersonalisation (p<0.01). Working longer hours (p<0.01), lower job satisfaction (p<0.001), and shorter time in the current job (p<0.05) independently increased the risk of high Emotional Exhaustion. Working longer hours (p<0.05) and lower job satisfaction (p<.01) independently increased the risk of high Depersonalisation. Longer time in the same job increased the risk of low Personal Accomplishment (p<0.05). Longer hours worked (p<0.05), shorter vocational experience as a consultant (p<0.05), and lower job satisfaction (p<0.001) independently increased the risk of high overall burnout. An unexpected proportion of consultants experience robust emotional well-being and healthy work engagement. However, for those experiencing high burnout, by severity or dimension, working long hours and low job satisfaction appear to be particularly contributory factors. Whilst remedial interventions should target the minority who experience significant burnout, studies using robust research designs are required to assess the meaningful clinical utility of these. The challenge remains to determine the optimal organisational practices to minimise burnout in this workforce.

Susceptibility of the adolescent brain to cannabinoids: long-term hippocampal effects and relevance to schizophrenia.

PubMed

Gleason, K A; Birnbaum, S G; Shukla, A; Ghose, S

2012-11-27

Clinical studies report associations between cannabis use during adolescence and later onset of schizophrenia. We examined the causal relationship between developmental cannabinoid administration and long-term behavioral and molecular alterations in mice. Mice were administered either WIN 55,212-2 (WIN), a cannabinoid receptor 1 (CB1) agonist or vehicle (Veh) during adolescence (postnatal day 30-35) or early adulthood (postnatal day 63-70). Behavioral testing was conducted after postnatal day 120 followed by biochemical assays. Adolescent cannabinoid treatment (ACU) leads to deficits in prepulse inhibition and fear conditioning in adulthood. Metabotropic glutamate receptors type 5 (mGluR5), a receptor critically involved in fear conditioning and endocannabinoid (eCB) signaling, is significantly reduced in the ACU mouse hippocampus. Next, we examined expression profiles of genes involved in eCB synthesis (diacylglycerol lipase (DGL)) and uptake (monoacylglycerol lipase (MGL) and fatty acid amide hydrolase (FAAH)) in the experimental mice. We find evidence of increased MGL and FAAH in ACU mice, reflecting increases in eCB uptake and degradation. These data suggest that administration of cannabinoids during adolescence leads to a behavioral phenotype associated with a rodent model of schizophrenia, as indexed by alterations in sensorimotor gating and hippocampal-dependent learning and memory deficits. Further, these deficits are associated with a reduction in hippocampal mGluR5 and a sustained change in eCB turnover, suggesting reduced eCB signaling in the ACU hippocampus. These data suggest that significant cannabis use during adolescence may be a contributory causal factor in the development of certain features of schizophrenia and may offer mGluR5 as a potential therapeutic target.

Evaluation of a Public Health Intervention to Lower Mercury Exposure from Fish Consumption in Bermuda

PubMed Central

Dewailly, Eric; Rouja, Philippe; Forde, Martin; Peek-Ball, Cheryl; Côté, Suzanne; Smith, Emma; Drescher, Olivia; Robertson, Lyndon

2012-01-01

Objectives To assess the efficacy of a public health intervention to reduce blood mercury (Hg) concentration levels in pregnant Bermudian women. Methods In 2003, we conducted a study entitled “Prenatal exposure of the Bermudian Population to Environmental Contaminants” which provided Bermuda’s first baseline data on prenatal exposure to several environmental contaminants, including Hg. The mean Hg concentration from 42 healthy newborns measured in umbilical cord blood was 41.3 nmol/L, ranging from 5–160 nmol/L. This concentration was much higher than expected, being approximately 8 times the general levels found in Canada and the U.S. Furthermore, we estimated that 85% of total Hg measured was in the form of methylmercury (MeHg), indicating that seafood consumption was the primary source of Hg exposure during pregnancy in Bermuda. Locally sourced seafood was identified as the most significant possible contributory source of Hg exposure. In 2005 the authors began a complementary research programme to study the levels of Hg in local commercial fish species. Coming out of this research were specific local fish consumption guidelines issued by the Department of Health advising pregnant women to avoid those local fish species found to be high in Hg while still encouraging consumption of fish species having lower Hg levels. Results In 2010, under another research initiative, we returned to Bermuda to carry out another evaluation of Hg in human blood. Hg was measured in the blood of 49 pregnant women. The arithmetic mean Hg blood concentration was 6.6 nmol/L and the geometric mean 4.2 nmol/L. The maximum concentration found was 24 nmol/L. Conclusions Hg exposure of Bermudian pregnant women has dropped significantly by a factor of around 5 since the foetal cord blood study in 2003. PMID:23077607

Evaluation of a public health intervention to lower mercury exposure from fish consumption in Bermuda.

PubMed

Dewailly, Eric; Rouja, Philippe; Forde, Martin; Peek-Ball, Cheryl; Côté, Suzanne; Smith, Emma; Drescher, Olivia; Robertson, Lyndon

2012-01-01

To assess the efficacy of a public health intervention to reduce blood mercury (Hg) concentration levels in pregnant Bermudian women. In 2003, we conducted a study entitled "Prenatal exposure of the Bermudian Population to Environmental Contaminants" which provided Bermuda's first baseline data on prenatal exposure to several environmental contaminants, including Hg. The mean Hg concentration from 42 healthy newborns measured in umbilical cord blood was 41.3 nmol/L, ranging from 5-160 nmol/L. This concentration was much higher than expected, being approximately 8 times the general levels found in Canada and the U.S. Furthermore, we estimated that 85% of total Hg measured was in the form of methylmercury (MeHg), indicating that seafood consumption was the primary source of Hg exposure during pregnancy in Bermuda. Locally sourced seafood was identified as the most significant possible contributory source of Hg exposure. In 2005 the authors began a complementary research programme to study the levels of Hg in local commercial fish species. Coming out of this research were specific local fish consumption guidelines issued by the Department of Health advising pregnant women to avoid those local fish species found to be high in Hg while still encouraging consumption of fish species having lower Hg levels. In 2010, under another research initiative, we returned to Bermuda to carry out another evaluation of Hg in human blood. Hg was measured in the blood of 49 pregnant women. The arithmetic mean Hg blood concentration was 6.6 nmol/L and the geometric mean 4.2 nmol/L. The maximum concentration found was 24 nmol/L. Hg exposure of Bermudian pregnant women has dropped significantly by a factor of around 5 since the foetal cord blood study in 2003.

A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength.

PubMed

Palmer, Kathryn; Hebron, Clair; Williams, Jonathan M

2015-05-03

Dynamic knee valgus and internal femoral rotation are proposed to be contributory risk factors for patellofemoral pain and anterior cruciate ligament injuries. Multimodal interventions including hip abductor strengthening or functional motor control programmes have a positive impact of pain, however their effect on knee kinematics and muscle strength is less clear. The aim of this study was to examine the effect of isolated hip abductor strengthening and a functional motor control exercise on knee kinematics and hip abductor strength. This prospective, randomised, repeated measures design included 29 asymptomatic volunteers presenting with increase knee valgus and femoral internal rotation. Participants completed either isolated hip abductor strengthening or a functional motor control exercise for 5 weeks. Knee kinematics were measured using inertial sensors during 2 functional activities and hip abductor strength measured using a load cell during isometric hip abduction. There were no significant differences in dynamic knee valgus and internal rotation following the isolated hip abductor or functional motor control intervention, and no significant differences between the groups for knee angles. Despite this, the actual magnitude of reduction in valgus was 10° and 5° for the functional motor control group and strengthening group respectively. The actual magnitude of reduction in internal rotation was 9° and 18° for the functional motor control group and strengthening group respectively. Therefore there was a tendency towards clinically significant improvements in knee kinematics in both exercise groups. A statistically significant improvement in hip abductor strength was evident for the functional motor control group (27% increase; p = 0.008) and strengthening group (35% increase; p = 0.009) with no significant difference between the groups being identified (p = 0.475). Isolated hip strengthening and functional motor control exercises resulted in non-statistically significant changes in knee kinematics, however there was a clear trend towards clinically meaningful reductions in valgus and internal rotation. Both groups demonstrated similar significant gains in hip abductor strength suggesting either approach could be used to strengthen the hip abductors.

Identifying the factors affecting bike-sharing usage and degree of satisfaction in Ningbo, China

PubMed Central

Guo, Yanyong; Zhou, Jibiao; Wu, Yao; Li, Zhibin

2017-01-01

The boom in bike-sharing is receiving growing attention as societies become more aware of the importance of active non-motorized traffic modes. However, the low usage of this transport mode in China raises concerns. The primary objective of this study is to explore factors affecting bike-sharing usage and satisfaction degree of bike-sharing among the bike-sharing user population in China. Data were collected by a questionnaire survey in Ningbo. A bivariate ordered probit (BOP) model was developed to examine simultaneously those factors associated with both bike-sharing usage and satisfaction degree of bike-sharing among users. Marginal effects for contributory factors were calculated to quantify their impacts on the outcomes. The results showed that the BOP model can account for commonly shared unobserved characteristics within usage and satisfaction of bike-sharing. The BOP model results showed that the usage of bike-sharing was affected by gender, household bicycle/e-bike ownership, trip model, travel time, bike-sharing stations location, and users’ perception of bike-sharing. The satisfaction degree of bike-sharing was affected by household income, bike-sharing stations location, and users’ perception of bike-sharing. It is also found that bike-sharing usage and satisfaction degree are strongly correlated and positive in direction. The results can enhance our comprehension of the factors that affect usage and satisfaction degree of bike-sharing. Based on the results, some suggestions regarding planning, engineering, and public advocacy were discussed to increase the usage of bike-sharing in Ningbo, China. PMID:28934321

Do no harm: the role of community pharmacists in regulating public access to prescription drugs in Saudi Arabia.

PubMed

Bahnassi, Anas

2016-04-01

Pharmacists have a crucial role to ensure regulated public access to prescription drugs. The study aimed to investigate the views of community pharmacists practising in Saudi Arabia on their role in the unauthorised supply of prescription drugs, consider the possible contributory factors and report pharmacists' suggested strategies to regulate supply. One hundred community pharmacists were invited to participate in an interview-based survey, including questions on demographic characteristics, and the unauthorised supply of prescription drugs. Descriptive statistics were conducted, and associations between categorical responses tested; a P value of ≤0.05 was considered significant. Responses to open questions were analysed thematically. In Saudi Arabia, there is widespread unregulated supply of prescription drugs; pharmacists are under pressure from patients to provide prescription drugs for a wide range of clinical conditions. There are safety and appropriateness concerns when drugs are provided based on patient demand rather than clinical need. Pharmacists do not maintain patient records with information on drugs supplied and associated actions. While most pharmacists supply prescription drugs without the necessary prescriber authorisation, they also this may jeopardise patients safety. While we have many concerns about this practice its present form, we believe pharmacists should have certain prescribing privileges within their areas of competence. A legal framework is needed to guarantee proper pharmacists' training, support, mentorship and access to the tools required to provide safe pharmacy practice. © 2015 Royal Pharmaceutical Society.

Hospital-acquired listeriosis associated with sandwiches in the UK: a cause for concern.

PubMed

Little, C L; Amar, C F L; Awofisayo, A; Grant, K A

2012-09-01

Hospital-acquired outbreaks of listeriosis are not commonly reported but remain a significant public health problem. To raise awareness of listeriosis outbreaks that have occurred in hospitals and describe actions that can be taken to minimize the risk of foodborne listeriosis to vulnerable patients. Foodborne outbreaks and incidents of Listeria monocytogenes reported to the Health Protection Agency national surveillance systems were investigated and those linked to hospitals were extracted. The data were analysed to identify the outbreak/incident setting, the food vehicle, outbreak contributory factors and origin of problem. Most (8/11, 73%) foodborne outbreaks of listeriosis that occurred in the UK between 1999 and 2011 were associated with sandwiches purchased from or provided in hospitals. Recurrently in the outbreaks the infecting subtype of L. monocytogenes was detected in supplied prepacked sandwiches and sandwich manufacturing environments. In five of the outbreaks breaches in cold chain controls of food also occurred at hospital level. The outbreaks highlight the potential for sandwiches contaminated with L. monocytogenes to cause severe infection in vulnerable people. Control of L. monocytogenes in sandwich manufacturing and within hospitals is essential to minimize the potential for consumption of this bacterium at levels hazardous to health. Manufacturers supplying sandwiches to hospitals should aim to ensure absence of L. monocytogenes in sandwiches at the point of production and hospital-documented food safety management systems should ensure the integrity of the food cold chain. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Bed Rest Muscular Atrophy

NASA Technical Reports Server (NTRS)

Greenleaf, John E.

2000-01-01

A major debilitating response from prolonged bed rest (BR) is muscle atrophy, defined as a "decrease in size of a part of tissue after full development has been attained: a wasting away of tissue as from disuse, old age, injury or disease". Part of the complicated mechanism for the dizziness, increased body instability, and exaggerated gait in patients who arise immediately after BR may be a result of not only foot pain, but also of muscular atrophy and associated reduction in lower limb strength. Also, there seems to be a close association between muscle atrophy and bone atrophy. A discussion of many facets of the total BR homeostatic syndrome has been published. The old adage that use determines form which promotes function of bone (Wolff's law) also applies to those people exposed to prolonged BR (without exercise training) in whom muscle atrophy is a consistent finding. An extreme case involved a 16-year-old boy who was ordered to bed by his mother in 1932: after 50 years in bed he had "a lily-white frame with limbs as thin as the legs of a ladder-back chair". These findings emphasize the close relationship between muscle atrophy and bone atrophy. In addition to loss of muscle mass during deconditioning, there is a significant loss of muscle strength and a decrease in protein synthesis. Because the decreases in force (strength) are proportionately greater than those in fiber size or muscle cross-sectional area, other contributory factors must be involved; muscle fiber dehydration may be important.

Impact of Climate Variability on Prevalence of Urinary Schistosomiasis over Sunyani in the Transition Belt of Ghana

NASA Astrophysics Data System (ADS)

Tay, S. K.; Amekudzi, L. K.; Tagoe, G.

2012-04-01

A study has been conducted to determine the impact of climate variability on Schistosoma haematobium infection among patients and school children in Sunyani between 2006 and 2009. Urine samples from the subjects were collected and examined in the laboratory using the filtration technique for the detection and quantification of Schistosomiasis haematobium eggs. The prevalence rate of urinary schistosomiasis at the Sunyani Regional Hospital for 2006, 2007, 2008 and 2009 were found to be 0.24%, 0.55%, 0.55% and 0.75% respectively while that for Methodist Junior High School in 2008 and 2009 were 60.1% and 60.3% respectively. A decrease in the relative humidity and average annual rainfall were identified as factors contributory to the increase in urinary Schistosomiasis prevalence rate. The temperature values obtained throughout the study period did not have any significant effect on the prevalence rate. The temperature values, however, were those that enhanced cercarial incubation (15-35˚C) with a resultant increase in shedding of cercariae leading to more infections among water contacts. The infection rate due to stream Amama was 20.1%, while that due to river Tano was 36.6%. The highest risk group was children aged 15-19 years. Praziquantel was administered to treat the infection, producing a cure rate of 93%. Recognition of urinary Schistosomiasis as a public health problem in Ghana is the main challenge to prevention and control of the disease.

Effects of etching time on alpha tracks in solid state nuclear track detectors.

PubMed

Gillmore, Gavin; Wertheim, David; Crust, Simon

2017-01-01

Solid State Nuclear Track Detectors (SSNTDs) are used extensively for monitoring alpha particle radiation, neutron flux and cosmic ray radiation. Radon gas inhalation is regarded as being a significant contributory factor to lung cancer deaths in the UK each year. Gas concentrations are often monitored using CR39 based SSNTDs as the natural decay of radon results in alpha particles which form tracks in these detectors. Such tracks are normally etched for about 4h to enable microscopic analysis. This study examined the effect of etching time on the appearance of alpha tracks in SSNTDs by collecting 2D and 3D image datasets using laser confocal microscope imaging techniques. Etching times of 2 to 4h were compared and marked differences were noted in resultant track area. The median equivalent diameters of tracks were 20.2, 30.2 and 38.9μm for etching at 2, 3 and 4h respectively. Our results indicate that modern microscope imaging can detect and image the smaller size tracks seen for example at 3h etching time. Shorter etching times may give rise to fewer coalescing tracks although there is a balance to consider as smaller track sizes may be more difficult to image. Thus etching for periods of less than 4h clearly merits further investigation as this approach has the potential to improve accuracy in assessing the number of tracks. Copyright © 2016 Elsevier B.V. All rights reserved.

Identification of single nucleotide polymorphisms in hematopoietic cell transplant patients affecting early recognition of, and response to, endotoxin.

PubMed

Guinan, Eva C; Palmer, Christine D; Mancuso, Christy J; Brennan, Lisa; Stoler-Barak, Liat; Kalish, Leslie A; Suter, Eugenie E; Gallington, Leighanne C; Huhtelin, David P; Mansilla, Maria; Schumann, Ralf R; Murray, Jeffrey C; Weiss, Jerrold; Levy, Ofer

2014-10-01

Hematopoietic cell transplant (HCT) is a life-saving therapy for many malignant and non-malignant bone marrow diseases. Associated morbidities are often due to transplant-related toxicities and infections, exacerbated by regimen-induced immune suppression and systemic incursion of bacterial products. Patients undergoing myeloablative conditioning for HCT become endotoxemic and display blood/plasma changes consistent with lipopolysaccharide (LPS)-induced systemic innate immune activation. Herein, we addressed whether patients scheduled for HCT display differences in recognition/response to LPS ex vivo traceable to specific single nucleotide polymorphisms (SNPs). Two SNPs of LPS binding protein (LBP) were associated with changes in plasma LBP levels, with one LBP SNP also associating with differences in efficiency of extraction and transfer of endotoxin to myeloid differentiation factor-2 (MD-2), a step needed for activation of TLR4. None of the examined SNPs of CD14, bactericidal/permeability-increasing protein (BPI), TLR4 or MD-2 were associated with corresponding protein plasma levels or endotoxin delivery to MD-2, but CD14 and BPI SNPs significantly associated with differences in LPS-induced TNF-α release ex vivo and infection frequency, respectively. These findings suggest that specific LBP, CD14 and BPI SNPs might be contributory assessments in studies where clinical outcome may be affected by host response to endotoxin and bacterial infection. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Selenium-containing allophycocyanin purified from selenium-enriched Spirulina platensis attenuates AAPH-induced oxidative stress in human erythrocytes through inhibition of ROS generation.

PubMed

Zhang, Haobin; Chen, Tianfeng; Jiang, Jie; Wong, Yum-Shing; Yang, Fang; Zheng, Wenjie

2011-08-24

Both selenium and allophycocyanin (APC) have been reported to show novel antioxidant activities. In this study, a fast protein liquid chromatographic method for purification of selenium-containing allophycocyanin (Se-APC) from selenium-enriched Spirulina platensis and the protective effect of Se-APC on 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH)-induced oxidative stress have been described. After fractionation by ammonium sulfate precipitation, and separation by DEAE-Sepharose ion-exchange and Sephacryl S-300 size exclusion chromatography, Se-APC with purity ratio (A652/A280) of 5.30 and Se concentration of 343.02 μg g(-1) protein was obtained. Se-APC exhibited stronger antioxidant activity than APC by scavenging ABTS (2,2'-azinobis-3-ethylbenzothiazolin-6-sulfonic acid) and AAPH free radicals. The oxidative hemolysis and morphological changes induced by AAPH in human erythrocytes were effectively reversed by coincubation with Se-APC. Lipid oxidation induced by the pro-oxidant agent cupric chloride in human plasma, as evaluated by formation of conjugated diene, was blocked by Se-APC. The accumulation of malondialdehyde, loss of reduced glutathione, and increase in enzyme activities of glutathione peroxidase and reductase induced by AAPH in human erythrocytes were effectively suppressed by Se-APC. Furthermore, Se-APC significantly prevented AAPH-induced intracellular reactive oxygen species (ROS) generation. Taken together, our results suggest that Se-APC demonstrates application potential in treatment of diseases in which excess production of ROS acts as a casual or contributory factor.

Los Angeles Beach Harbors, Los Angeles County, California.

DTIC Science & Technology

1974-10-01

predicted at this time. The presently proposed project is not dependent upon nor contributory to further navigation development in the V" Los Angeles...as Long Beach and Compton. The Los Angeles Harbor probably exhibited similar intensities ranging from VII to IX depending on the soil conditions...the harbor. The water quality in these aquifers is dependent upon the rates of recharge and extraction (natural and otherwise). The Dominguez Gap

"Isn't the Trigger the Thing that Sets the Rest of It on Fire?" Causation Maps: Emphasising Chronology in Causation Exercises

ERIC Educational Resources Information Center

Rogers, Rick

2011-01-01

Analogies for teaching about causation abound. Rick Rogers is alert, however, to the risks inherent in drawing on everyday ideas to explain historical processes. What most often gets lost is the importance of the chronological dimension; both the length of time during which some contributory causes may have been present, and the ways in which they…

Hantavirus Immunology of Rodent Reservoirs: Current Status and Future Directions

PubMed Central

Schountz, Tony; Prescott, Joseph

2014-01-01

Hantaviruses are hosted by rodents, insectivores and bats. Several rodent-borne hantaviruses cause two diseases that share many features in humans, hemorrhagic fever with renal syndrome in Eurasia or hantavirus cardiopulmonary syndrome in the Americas. It is thought that the immune response plays a significant contributory role in these diseases. However, in reservoir hosts that have been closely examined, little or no pathology occurs and infection is persistent despite evidence of adaptive immune responses. Because most hantavirus reservoirs are not model organisms, it is difficult to conduct meaningful experiments that might shed light on how the viruses evade sterilizing immune responses and why immunopathology does not occur. Despite these limitations, recent advances in instrumentation and bioinformatics will have a dramatic impact on understanding reservoir host responses to hantaviruses by employing a systems biology approach to identify important pathways that mediate virus/reservoir relationships. PMID:24638205

Hantavirus immunology of rodent reservoirs: current status and future directions.

PubMed

Schountz, Tony; Prescott, Joseph

2014-03-14

Hantaviruses are hosted by rodents, insectivores and bats. Several rodent-borne hantaviruses cause two diseases that share many features in humans, hemorrhagic fever with renal syndrome in Eurasia or hantavirus cardiopulmonary syndrome in the Americas. It is thought that the immune response plays a significant contributory role in these diseases. However, in reservoir hosts that have been closely examined, little or no pathology occurs and infection is persistent despite evidence of adaptive immune responses. Because most hantavirus reservoirs are not model organisms, it is difficult to conduct meaningful experiments that might shed light on how the viruses evade sterilizing immune responses and why immunopathology does not occur. Despite these limitations, recent advances in instrumentation and bioinformatics will have a dramatic impact on understanding reservoir host responses to hantaviruses by employing a systems biology approach to identify important pathways that mediate virus/reservoir relationships.

Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence.

PubMed

Kerr, Jacqueline; Anderson, Cheryl; Lippman, Scott M

2017-08-01

The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychosocial factors that influence recovery in aircrew with musculoskeletal disabilities.

PubMed

Taneja, Narinder

2010-05-15

Descriptive questionnaire study. This preliminary study was undertaken to try and develop an understanding of the factors that may affect recovery in aircrew with musculoskeletal disabilities. Clinical recovery from musculoskeletal disabilities is generally achieved after the patient undergoes definitive therapy and rehabilitation. However, a proportion of patients may continue to suffer from morbidity and pain long after clinical and radiological finality has been reached. In these cases, psychosocial factors may have played a contributory role. There has been no research documenting or studying such factors in aviation and pilots in particular. The study was carried out at the Department of Human Engineering from 2004 to 2006. A detailed questionnaire was designed to elicit basic clinical details and psychosocial factors at work and home. A total of 57 male aircrew participated voluntarily in this study. Of these, 41 (71.9%) achieved normal recovery, whereas in the remaining 16 (28.1%), recovery was considered delayed. The mean age of aircrew in the normal recovery group (33.1 +/- 4.6 years) was slightly higher than those in the delayed group (31.0 +/- 3.2 years). All the aircrew who had delayed recovery had a spinal disability, whereas spinal disabilities constituted only 46.3% in the normal recovery group. Of the spinal disabilities in aircrew with delayed recovery, 12 had low backache. Aircraft accidents and ejection accounted for almost one-fifth of the total disabilities (n = 11, 21.9%). The respondents identified multiple sources of emotional support viz., friends, family, and parents. A hypothetical model is proposed that possibly explains to some extent the role of psychosocial factors affecting recovery in aircrew with musculoskeletal disabilities. Further research in psychological and emotional consequences of trauma, in particular ejection and the best means/timings to address these, is recommended.

Neurocognitive Allied Phenotypes for Schizophrenia and Bipolar Disorder

PubMed Central

Hill, S. Kristian; Harris, Margret S. H.; Herbener, Ellen S.; Pavuluri, Mani; Sweeney, John A.

2008-01-01

Psychiatric disorders are genetically complex and represent the end product of multiple biological and social factors. Links between genes and disorder-related abnormalities can be effectively captured via assessment of phenotypes that are both associated with genetic effects and potentially contributory to behavioral abnormalities. Identifying intermediate or allied phenotypes as a strategy for clarifying genetic contributions to disorders has been successful in other areas of medicine and is a promising strategy for identifying susceptibility genes in complex psychiatric disorders. There is growing evidence that schizophrenia and bipolar disorder, rather than being wholly distinct disorders, share genetic risk at several loci. Further, there is growing evidence of similarity in the pattern of cognitive and neurobiological deficits in these groups, which may be the result of the effects of these common genetic factors. This review was undertaken to identify patterns of performance on neurocognitive and affective tasks across probands with schizophrenia and bipolar disorder as well as unaffected family members, which warrant further investigation as potential intermediate trait markers. Available evidence indicates that measures of attention regulation, working memory, episodic memory, and emotion processing offer potential for identifying shared and illness-specific allied neurocognitive phenotypes for schizophrenia and bipolar disorder. However, very few studies have evaluated neurocognitive dimensions in bipolar probands or their unaffected relatives, and much work in this area is needed. PMID:18448479

Close association of vascular and valvular calcification and prognosis of patients on continuous ambulatory peritoneal dialysis.

PubMed

Gen, Shikou; Inoue, Tsutomu; Nodaira, Yuka; Ikeda, Naofumi; Kobayashi, Kazuhiro; Watanabe, Yusuke; Kanno, Yoshihiko; Nakamoto, Hidetomo; Suzuki, Hiromichi

2008-01-01

In the present study, we examined the association between vascular and valvular calcification and the prognosis of patients on continuous ambulatory peritoneal dialysis (CAPD). Data were collected from the records of patients introduced onto CAPD therapy during 1999 - 2006 at the Department of Nephrology, Saitama Medical University. At the start of CAPD, cardiac and vascular echography were used to examine 162 patients (average age: 56 +/- 5 years; 58 men, 104 women; 43 with and 119 without diabetes) for evaluation of vascular and valvular calcification. Both vascular and valvular calcification were found in 32 patients. Vascular calcification was found in 16, and valvular calcification in 11. Over 5 years, 11 patients suffered from cardiovascular disease (7 with stroke, 4 with myocardial infarction). All of these patients had vascular or valvular calcification at the start of CAPD therapy. We also used Cox hazard analysis to examine values for Ca, P, Ca x P, intact parathyroid hormone (iPTH), and lipids. None of these values were independent contributory factors for incidence of cardiovascular disease in patients on CAPD. These data suggest the importance of vascular and valvular echography to evaluate patients on CAPD, especially at the start of CAPD therapy. Vascular and valvular calcification are important factors for determining the prognosis of patients on CAPD.

The energy cost of action potential propagation in dopamine neurons: clues to susceptibility in Parkinson's disease.

PubMed

Pissadaki, Eleftheria K; Bolam, J Paul

2013-01-01

Dopamine neurons of the substantia nigra pars compacta (SNc) are uniquely sensitive to degeneration in Parkinson's disease (PD) and its models. Although a variety of molecular characteristics have been proposed to underlie this sensitivity, one possible contributory factor is their massive, unmyelinated axonal arbor that is orders of magnitude larger than other neuronal types. We suggest that this puts them under such a high energy demand that any stressor that perturbs energy production leads to energy demand exceeding supply and subsequent cell death. One prediction of this hypothesis is that those dopamine neurons that are selectively vulnerable in PD will have a higher energy cost than those that are less vulnerable. We show here, through the use of a biology-based computational model of the axons of individual dopamine neurons, that the energy cost of axon potential propagation and recovery of the membrane potential increases with the size and complexity of the axonal arbor according to a power law. Thus SNc dopamine neurons, particularly in humans, whose axons we estimate to give rise to more than 1 million synapses and have a total length exceeding 4 m, are at a distinct disadvantage with respect to energy balance which may be a factor in their selective vulnerability in PD.

The energy cost of action potential propagation in dopamine neurons: clues to susceptibility in Parkinson's disease

PubMed Central

Pissadaki, Eleftheria K.; Bolam, J. Paul

2013-01-01

Dopamine neurons of the substantia nigra pars compacta (SNc) are uniquely sensitive to degeneration in Parkinson's disease (PD) and its models. Although a variety of molecular characteristics have been proposed to underlie this sensitivity, one possible contributory factor is their massive, unmyelinated axonal arbor that is orders of magnitude larger than other neuronal types. We suggest that this puts them under such a high energy demand that any stressor that perturbs energy production leads to energy demand exceeding supply and subsequent cell death. One prediction of this hypothesis is that those dopamine neurons that are selectively vulnerable in PD will have a higher energy cost than those that are less vulnerable. We show here, through the use of a biology-based computational model of the axons of individual dopamine neurons, that the energy cost of axon potential propagation and recovery of the membrane potential increases with the size and complexity of the axonal arbor according to a power law. Thus SNc dopamine neurons, particularly in humans, whose axons we estimate to give rise to more than 1 million synapses and have a total length exceeding 4 m, are at a distinct disadvantage with respect to energy balance which may be a factor in their selective vulnerability in PD. PMID:23515615

Appearance of konzo in South-Kivu, a wartorn area in the Democratic Republic of Congo.

PubMed

Chabwine, J N; Masheka, C; Balol'ebwami, Z; Maheshe, B; Balegamire, S; Rutega, B; Wa Lola, M; Mutendela, K; Bonnet, M-J; Shangalume, O; Balegamire, J M; Nemery, B

2011-03-01

Konzo is an upper motor neuron disease characterized by sudden-onset and irreversible spastic paraparesis occurring in nutritionally compromised people. It is associated with consumption of insufficiently processed cyanogenic-toxic cassava. Cassava, the main caloric source in the Democratic Republic of Congo, has been safely consumed for decades in the Eastern Province of South-Kivu. However, in the context of long-lasting war and violent conflicts, cases of spastic paraparesis resembling konzo appeared in a populous area (Burhinyi). Two field surveys (2003 and 2005) identified 41 subjects meeting clinical criteria of konzo and suffering from (chronic) malnutrition. Their urinary thiocyanate concentrations (median 129, range 20-688, SD 146 μg/L), and cyanogen levels (median 20 ppm, range 5-300 ppm, SD 73 ppm) in cassava roots from their household stocks were high. The source of cyanogenic-toxicity was unprocessed fresh cassava roots during harvest period, but probably also insufficiently processed roots. This first report of konzo in South-Kivu concludes that occurrence of konzo was triggered by food shortages because of the longstanding state of insecurity. Contributory factors included the introduction of new varieties of (bitter) cassava, but konzo may actually be caused by a combination of factors that are yet to be understood. Copyright © 2010 Elsevier Ltd. All rights reserved.

Suicide amongst Irish migrants in Britain: a review of the identity and integration hypothesis.

PubMed

Aspinall, Peter J

2002-12-01

Studies have consistently reported higher rates of suicide amongst Irish migrants in Britain than in the population as a whole. Leavey offers a hypothetical model to explain such rates that incorporates lack of social cohesion and integration meshed with the inability to establish an authentic identity and other contributory factors. Systematic review methodologies are used to examine the central tenets of this explanatory framework. Some of the macro-level ecological associations in the model are critically evaluated in the context of findings from the 1991 Census and government social and household panel surveys. The evidence base suggests that statements on social isolation and reluctance to use health care services are questionable and Irish migration is shown to be much more heterogeneous than the model suggests. Only small positive, and as yet unreplicated, associations have been established between identity and health behaviour in a non-representative sample and evidence is lacking of Irish stoicism and anti-Irish racism as putative risk factors. Epidemiological studies show that adjusting suicide rates for social class explains virtually none of the excess in Irish migrants, although higher risks for unmarried persons are reported. Explanations in the literature for higher rates of migrant suicide are discussed. Studies based on individual-level analysis and record linkage are urgently needed to explain the high rates.

Differences between intentional and non-intentional burns in India: implications for prevention.

PubMed

Natarajan, Mangai

2014-08-01

Non-intentional and deliberate burns in India and other developing countries present particular challenges of prevention and treatment. This exploratory study sought improved understanding of burns in order to inform treatment and prevention. It gathered data in 2011/2012 on burns from the hospital registry (N=768) of a government hospital in India and from interviews with women patients (N=60) admitted to the burns ward. Analysis indicated that: (1) the conditions that facilitate intentional and non-intentional burns are similar, but intentional burns involve additional contributory factors; (2) a high proportion of patients subjected to burns are young women in domestic situations; and (3) a higher proportion of their TBSA was burned, with consequent higher mortality than for men. It was concluded that: (1) Haddon's matrix and the situational crime prevention framework of criminology assist in understanding the etiology of intentional burns and in identifying preventive measures; (2) social service and criminal justice agencies have important roles in dealing with victims of intentional burns during and after treatment; (3) full account should be taken of gender-related physical, psychological and family factors in planning treatment; and (4) maintaining careful records of burns cases is vital for estimating the prevalence and incidence of intentional injuries. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Seed development and viviparous germination in one accession of a tomato rin mutant

PubMed Central

Wang, Xu; Zhang, Lili; Xu, Xiaochun; Qu, Wei; Li, Jingfu; Xu, Xiangyang; Wang, Aoxue

2016-01-01

In an experimental field, seed vivipary occurred in one accession of tomato rin mutant fruit at approximately 45–50 days after pollination (DAP). In this study, the possible contributory factors to this viviparous germination were investigated. Firstly, developing seeds were freshly excised from the fruit tissue every 5 days from 25–60 DAP. Germination occurred when isolated seeds were incubated on water, but was inhibited when they remained ex situ in fruit mucilage gel. The effect of abscisic acid (ABA) and osmoticum, separate and together, on germination of developing seeds was investigated. Additionally, ABA content in the seed and mucilage gel, as well as fruit osmolality were measured. The results showed that ABA concentrations in seeds were low during early development and increased later, peaking at about 50 DAP. ABA concentrations in rin accession were similar to those of the control cultivar and thus are not directly associated with the occurrence of vivipary. Developing seeds of rin accession are more sensitive than control seeds to all inhibitory compounds. However, osmolality in rin fruit at later developmental stages becomes less negative that is required to permit germination of developing seeds. Hence, hypo-osmolality in rin fruit may be an important factor in permitting limited viviparous germination. PMID:27436947

A possible link between the Epstein-Barr virus infection and autoimmune thyroid disorders

PubMed Central

Gwizdek, Katarzyna; Michalski, Marek; Wojnicz, Romuald

2016-01-01

The Epstein-Barr virus (EBV), also known as human herpesvirus 4, is a member of the Herpesviridae virus family. EBV infection can cause infectious mononucleosis (IM) in the lytic phase of EBV’s life cycle. Past EBV infection is associated with lymphomas, and may also result in certain allergic and autoimmune diseases. Although potential mechanisms of autoimmune diseases have not been clearly elucidated, both genetic and environmental factors, such as infectious agents, are considered to be responsible for their development. In addition, EBV modifies the host immune response. The worldwide prevalence of autoimmune diseases shows how common this pathogen is. Normally, the virus stays in the body and remains dormant throughout life. However, this is not always the case, and a serious EBV-related illness may develop later in life. This explains the chronic course of autoimmune diseases that is often accompanied by exacerbations of symptoms. Based on the present studies, EBV infection can cause autoimmune diseases, such as systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), Sjögren’s syndrome, and autoimmune hepatitis. The EBV has also been reported in patients with autoimmune thyroid disorders. Although EBV is not the only agent responsible for the development of autoimmune thyroid diseases, it can be considered a contributory factor. PMID:27833448

A possible link between the Epstein-Barr virus infection and autoimmune thyroid disorders.

PubMed

Dittfeld, Anna; Gwizdek, Katarzyna; Michalski, Marek; Wojnicz, Romuald

2016-01-01

The Epstein-Barr virus (EBV), also known as human herpesvirus 4, is a member of the Herpesviridae virus family. EBV infection can cause infectious mononucleosis (IM) in the lytic phase of EBV's life cycle. Past EBV infection is associated with lymphomas, and may also result in certain allergic and autoimmune diseases. Although potential mechanisms of autoimmune diseases have not been clearly elucidated, both genetic and environmental factors, such as infectious agents, are considered to be responsible for their development. In addition, EBV modifies the host immune response. The worldwide prevalence of autoimmune diseases shows how common this pathogen is. Normally, the virus stays in the body and remains dormant throughout life. However, this is not always the case, and a serious EBV-related illness may develop later in life. This explains the chronic course of autoimmune diseases that is often accompanied by exacerbations of symptoms. Based on the present studies, EBV infection can cause autoimmune diseases, such as systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), Sjögren's syndrome, and autoimmune hepatitis. The EBV has also been reported in patients with autoimmune thyroid disorders. Although EBV is not the only agent responsible for the development of autoimmune thyroid diseases, it can be considered a contributory factor.

The contribution of de novo coding mutations to autism spectrum disorder.

PubMed

Iossifov, Ivan; O'Roak, Brian J; Sanders, Stephan J; Ronemus, Michael; Krumm, Niklas; Levy, Dan; Stessman, Holly A; Witherspoon, Kali T; Vives, Laura; Patterson, Karynne E; Smith, Joshua D; Paeper, Bryan; Nickerson, Deborah A; Dea, Jeanselle; Dong, Shan; Gonzalez, Luis E; Mandell, Jeffrey D; Mane, Shrikant M; Murtha, Michael T; Sullivan, Catherine A; Walker, Michael F; Waqar, Zainulabedin; Wei, Liping; Willsey, A Jeremy; Yamrom, Boris; Lee, Yoon-ha; Grabowska, Ewa; Dalkic, Ertugrul; Wang, Zihua; Marks, Steven; Andrews, Peter; Leotta, Anthony; Kendall, Jude; Hakker, Inessa; Rosenbaum, Julie; Ma, Beicong; Rodgers, Linda; Troge, Jennifer; Narzisi, Giuseppe; Yoon, Seungtai; Schatz, Michael C; Ye, Kenny; McCombie, W Richard; Shendure, Jay; Eichler, Evan E; State, Matthew W; Wigler, Michael

2014-11-13

Whole exome sequencing has proven to be a powerful tool for understanding the genetic architecture of human disease. Here we apply it to more than 2,500 simplex families, each having a child with an autistic spectrum disorder. By comparing affected to unaffected siblings, we show that 13% of de novo missense mutations and 43% of de novo likely gene-disrupting (LGD) mutations contribute to 12% and 9% of diagnoses, respectively. Including copy number variants, coding de novo mutations contribute to about 30% of all simplex and 45% of female diagnoses. Almost all LGD mutations occur opposite wild-type alleles. LGD targets in affected females significantly overlap the targets in males of lower intelligence quotient (IQ), but neither overlaps significantly with targets in males of higher IQ. We estimate that LGD mutation in about 400 genes can contribute to the joint class of affected females and males of lower IQ, with an overlapping and similar number of genes vulnerable to contributory missense mutation. LGD targets in the joint class overlap with published targets for intellectual disability and schizophrenia, and are enriched for chromatin modifiers, FMRP-associated genes and embryonically expressed genes. Most of the significance for the latter comes from affected females.

Vitamins A, C, and E may reduce intestinal Po-210 levels after ingestion

PubMed Central

Kemp, Francis W; Portugal, Frank; Akudugu, John M.; Neti, Prasad VSV; Ferraris, Ronaldo P.; Howell, Roger W.

2016-01-01

Damage to the gut mucosa is a probable contributory cause of death from ingested 210Po. Therefore, medical products are needed that can prevent, mitigate, and/or repair gastrointestinal (GI) damage caused by high-LET radiation emitted by 210Po. The present studies investigated the capacity of a diet highly enriched with vitamins A, C, and E (vitamin ACE) to protect against intestinal mucosal damage indicated by functional reductions in nutrient transport caused by orally ingested 210Po. Mice were gavaged with 0 or 18.5 kBq 210Po-citrate and fed a control or vitamin ACE-enriched diet (the latter beginning either 96 h before or immediately after gavage). Mouse intestines significantly retained 210Po on day 8 post-gavage. The concentration of 210Po in intestinal tissues was significantly (p<0.05) lower in all vitamin ACE groups compared to control. There were borderline significant 210Po-induced reductions in intestinal absorption of D-fructose. The combination of vitamins A, C, and E may reduce 210Po incorporation in the intestines when given before, or enhance decorporation when provided after, 210Po gavage. PMID:27218295

Impact of Gut Microbiota on Obesity, Diabetes, and Cardiovascular Disease Risk.

PubMed

Miele, Luca; Giorgio, Valentina; Alberelli, Maria Adele; De Candia, Erica; Gasbarrini, Antonio; Grieco, Antonio

2015-12-01

Gut microbiota has been recently established to have a contributory role in the development of cardiometabolic disorders, such as atherosclerosis, obesity, and type 2 diabetes. Growing interest has focused on the modulation of gut microbiota as a therapeutic strategy in cardiovascular diseases and metabolic disorders. In this paper, we have reviewed the impact of gut microbiota on metabolic disorders and cardiovascular disease risk, focusing on the newest findings in this field.

Peak pressure data and pressure-time integral in the contralateral limb in patients with diabetes and a trans-tibial prosthesis.

PubMed

Borg, Jael; Mizzi, Stephen; Formosa, Cynthia

2018-05-19

Clinicians currently rely on observational clinical data pertaining to the biomechanics of the diabetic foot. However, advances in technology can objectively describe this. A thorough understanding of the functional and mechanical consequences following trans-tibial amputations is lacking. Does a trans-tibial prostheses significantly increase peak plantar pressures and pressure time integrals in the intact foot of patients with type-2 diabetes and neuropathy? A prospective quantitative matched-subject design was employed. Twenty participants living with diabetes and peripheral sensory neuropathy were recruited. Ten participants presented with a trans-tibial amputation and 10 had intact feet. Participants were matched for gender, age, foot type and BMI. Peak plantar pressure and pressure time integral data were recorded using the Tekscan HR™ pressure mat system, using the two-step gait protocol. The Shapiro-Wilk test was used to determine normality of data. The Independent Samples t-test and the Mann Whitney U test were carried out to reject the null hypothesis. Although no significant differences (p < 0.05) in mean peak plantar pressures were observed in all the foot masks analysed between the amputee and the control group, a significant difference (p = 0.002) in mean pressure time integrals was recorded with highest pressure time integral (PTI) values under the 2nd-4th metatarsophalangeal joint (MTP joint) for the trans-tibial amputee group. Cumulative exposure of both pressure and time can lead to tissue damage. PTI could be considered as an important contributory factor in determining ulcer formation. Elevated PTI under the 2nd-4th MTP joints sustained in the intact contralateral limb in patients using below knee prosthesis could possibly be due to gait alterations in this population. The preservation of the contralateral limb is of great concern and importance as this might impact patient's mobility and quality of life. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessment of the relationship between bacteriological quality of dug-wells, hygiene behaviour and well characteristics in two cholera endemic localities in Douala, Cameroon

PubMed Central

2013-01-01

Background Access to potable water is grossly inadequate in Douala-Cameroon. The situation is worse in slum areas, compelling inhabitants to obtain water from sources of doubtful quality. This has contributed to frequent outbreaks of water-borne diseases particularly cholera, which results in severe morbidity and mortality. Shallow wells are a major source of water in these areas. We analyzed the influence of some factors on the bacteriological quality of well water in Bepanda and New Bell, cholera endemic localities in Douala to generate data that would serve as basis for strengthening of water and health policies. Methods Questionnaires were administered to inhabitants of study sites to appraise their hygiene and sanitation practices, and level of awareness of waterborne diseases. The bacteriological quality of water was determined by investigating bacterial indicators of water quality. Relationship between well characteristics and bacteriological quality of water was determined using χ2 test. The Kendall tau_b nonparametric correlation was used to measure the strength of association between well characteristics and bacteriological parameters. Statistics were discussed at 95% confidence level. Antibiotic susceptibility of isolates was investigated by the Kirby-Bauer and broth dilution techniques. Multidrug resistant species were tested for extended β-lactamase production potential. Results Inhabitants demonstrated adequate knowledge of waterborne diseases but employed inappropriate method (table salt) for well disinfection. Well construction and location violated guidelines. Indicator bacterial counts greatly exceeded the WHO guidelines. Variation in bacteriologic parameters between sites was not significant (P > 0.05) since well characteristics and hygiene and sanitary practices were similar. Differences in bacteriologic quality with respect to state of well, and presence of molded casing and lid, and height of casing were not significant (P > 0.05). Well distance from sanitary structure negatively correlated with bacteriological characteristics indicating it could be a major contributory factor to poor water quality. Bacteria isolated were predominantly enteric organisms. Ciprofloxacin was the most active agent. Extended β-lactamase producers were detected among Salmonella species, Citrobacter fruendii and E. coli. Conclusion Poor well location, construction, and hygiene and sanitary practices were among the factors affecting water quality. There is an urgent need for education of inhabitants on effective water disinfection strategies and for regular monitoring of wells. PMID:23895357

Benefits of multidisciplinary collaboration for earthquake casualty estimation models: recent case studies

NASA Astrophysics Data System (ADS)

So, E.

2010-12-01

Earthquake casualty loss estimation, which depends primarily on building-specific casualty rates, has long suffered from a lack of cross-disciplinary collaboration in post-earthquake data gathering. An increase in our understanding of what contributes to casualties in earthquakes involve coordinated data-gathering efforts amongst disciplines; these are essential for improved global casualty estimation models. It is evident from examining past casualty loss models and reviewing field data collected from recent events, that generalized casualty rates cannot be applied globally for different building types, even within individual countries. For a particular structure type, regional and topographic building design effects, combined with variable material and workmanship quality all contribute to this multi-variant outcome. In addition, social factors affect building-specific casualty rates, including social status and education levels, and human behaviors in general, in that they modify egress and survivability rates. Without considering complex physical pathways, loss models purely based on historic casualty data, or even worse, rates derived from other countries, will be of very limited value. What’s more, as the world’s population, housing stock, and living and cultural environments change, methods of loss modeling must accommodate these variables, especially when considering casualties. To truly take advantage of observed earthquake losses, not only do damage surveys need better coordination of international and national reconnaissance teams, but these teams must integrate difference areas of expertise including engineering, public health and medicine. Research is needed to find methods to achieve consistent and practical ways of collecting and modeling casualties in earthquakes. International collaboration will also be necessary to transfer such expertise and resources to the communities in the cities which most need it. Coupling the theories and findings from the field surveys with experiments would also be advantageous as it is not always be possible to validate theories and models with actual earthquake data. In addition, colleagues in other disciplines will benefit from being introduced to the loss algorithms, methodologies and advances familiar to the engineering community, to help dissemination in earthquake mitigation and preparedness programs. It follows that new approaches to loss estimation must include a progressive assessment of what contributes to the final casualty value. In analyzing recent earthquakes, testing common hypotheses, talking to local and international researchers in the field, interviewing search and rescue and medical personnel, and comparing notes with colleagues who have visited other events, the author has developed a list of contributory factors to formulate fatality rates for use in earthquake loss estimation models. In this presentation, we will first look at the current state of data collection and assessment in casualty loss estimation. Then, the analyses of recent earthquake field data, which provide important insights to the contributory factors of fatalities in earthquakes, will be explored. The benefits of a multi-disciplinary approach in deriving fatality rates for masonry buildings will then be examined in detail.

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

Hall, Matthew D.; Schultheiss, Timothy E., E-mail: schultheiss@coh.org; Smith, David D.

Purpose/Objective(s): To perform a meta-regression on published data and to model the 5-year probability of cataract development after hematopoietic stem cell transplantation (HSCT) with and without total body irradiation (TBI). Methods and Materials: Eligible studies reporting cataract incidence after HSCT with TBI were identified by a PubMed search. Seventeen publications provided complete information on radiation dose schedule, fractionation, dose rate, and actuarial cataract incidence. Chemotherapy-only regimens were included as zero radiation dose regimens. Multivariate meta-regression with a weighted generalized linear model was used to model the 5-year cataract incidence and contributory factors. Results: Data from 1386 patients in 21 seriesmore » were included for analysis. TBI was administered to a total dose of 0 to 15.75 Gy with single or fractionated schedules with a dose rate of 0.04 to 0.16 Gy/min. Factors significantly associated with 5-year cataract incidence were dose, dose times dose per fraction (D•dpf), pediatric versus adult status, and the absence of an ophthalmologist as an author. Dose rate, graft versus host disease, steroid use, hyperfractionation, and number of fractions were not significant. Five-fold internal cross-validation showed a model validity of 83% ± 8%. Regression diagnostics showed no evidence of lack-of-fit and no patterns in the studentized residuals. The α/β ratio from the linear quadratic model, estimated as the ratio of the coefficients for dose and D•dpf, was 0.76 Gy (95% confidence interval [CI], 0.05-1.55). The odds ratio for pediatric patients was 2.8 (95% CI, 1.7-4.6) relative to adults. Conclusions: Dose, D•dpf, pediatric status, and regimented follow-up care by an ophthalmologist were predictive of 5-year cataract incidence after HSCT. The low α/β ratio indicates the importance of fractionation in reducing cataracts. Dose rate effects have been observed in single institution studies but not in the combined data analyzed here. Although data were limited to articles with 5-year actuarial estimates, the development of radiation-induced cataracts extends beyond this time.« less

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan).

PubMed

Yu, Ruby; Wu, Wan-Chi; Leung, Jason; Hu, Susan C; Woo, Jean

2017-09-21

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study ( n = 4000) and the Taiwan Longitudinal Study on Aging ( n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6-49.7%) than in men (10.5-27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies.

Effort and Displeasure in People Who Are Hard of Hearing.

PubMed

Matthen, Mohan

2016-01-01

Listening effort helps explain why people who are hard of hearing are prone to fatigue and social withdrawal. However, a one-factor model that cites only effort due to hardness of hearing is insufficient as there are many who lead happy lives despite their disability. This article explores other contributory factors, in particular motivational arousal and pleasure. The theory of rational motivational arousal predicts that some people forego listening comprehension because they believe it to be impossible and hence worth no effort at all. This is problematic. Why should the listening task be rated this way, given the availability of aids that reduce its difficulty? Two additional factors narrow the explanatory gap. First, we separate the listening task from the benefit derived as a consequence. The latter is temporally more distant, and is discounted as a result. The second factor is displeasure attributed to the listening task, which increases listening cost. Many who are hard of hearing enjoy social interaction. In such cases, the actual activity of listening is a benefit, not a cost. These people also reap the benefits of listening, but do not have to balance these against the displeasure of the task. It is suggested that if motivational harmony can be induced by training in somebody who is hard of hearing, then the obstacle to motivational arousal would be removed. This suggests a modified goal for health care professionals. Do not just teach those who are hard of hearing how to use hearing assistance devices. Teach them how to do so with pleasure and enjoyment.

Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)

PubMed Central

Yu, Ruby; Wu, Wan-Chi; Leung, Jason

2017-01-01

This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study (n = 4000) and the Taiwan Longitudinal Study on Aging (n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6–49.7%) than in men (10.5–27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies. PMID:28934150

Interprofessional primary care in academic family medicine clinics: implications for education and training.

PubMed

Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

2012-08-01

To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Focus group interviews using a purposive sampling procedure. Four academic family medicine clinics in Alberta. Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.

Maternal and neonatal scalp hair concentrations of zinc, copper, cadmium, and lead: relationship to some lifestyle factors.

PubMed

Razagui, Ibrahim B-A; Ghribi, Ibrahim

2005-07-01

Postpartum scalp hair samples from 82 term-pregnancy mother/ neonate pairs were analyzed for their concentrations of zinc (Zn), copper (Cu), cadmium (Cd), and lead (Pb), using inductively coupled plasma-mass spectrometry. Maternal and neonatal Zn concentrations had geometric means (and 99% confidence intervals) of 122.5 microg/g (117.9--131.5 microg/g) and 146.9 microg (141.5--156.7 microg/g) respectively. Corresponding Cu values were 18.4 microg/g (17.6--23.8 microg/g) and 6.7 microg/g (6.3--7.6 microg/g). Those of Cd were 0.49 microg/g (0.47--0.69 microg/g) in the mothers and 0.57 microg/g (0.55--0.86 microg/g) in the neonates. For Pb, they were 7.95 microg/g (7.60--9.32 microg/g) and 4.56 microg/g (4.39--5.56 microg/g). Cigarette smoking, despite its relatively low prevalence (19.5%), was associated with lower Zn and higher Cd and Pb concentrations and in lower Zn/Cd and Zn/Pb molar concentration ratios. Smoking also altered interelemental relationships, particularly those of Zn with Cd and Pb and those between Cd and Pb. Smoking frequency appeared to show negative dose-response effects on maternal and neonatal Zn concentrations, Zn/Pb molar concentration ratios, and birth weight. Mothers with a history of oral contraceptive (OC) usage had significantly higher Cu concentrations and lower Zn/Cu molar concentration ratios than non users, with the highest Cu concentrations and lowest Zn/Cu values being associated with third-generation OCs. No similar effects were elicited in the respective neonatal Cu concentrations. Neither alcohol consumption nor prenatal supplementation with iron and/or folic acid had discernible effects on the maternal or neonatal elemental concentrations. The data from this study suggest that in a given population of term-pregnancy mothers and neonates, significant interindividual variations in hair trace element concentrations can occur, irrespective of commonality of general environment, and that lifestyle factors, including cigarette smoking and OC usage history, can be significant contributory factors to such variations. The data are discussed in relation to the effects of smoking-associated exposure to Cd and Pb exposure on Zn availability for placental transfer, as well as on the quantitative maternal Zn supply levels to the fetus resulting from the known tendency of smokers to have lower dietary intakes of Zn.

Inflammatory pattern of the infrapatellar fat pad in dogs with canine cruciate ligament disease.

PubMed

Schmidli, Manuel R; Fuhrer, Bettina; Kurt, Nadine; Senn, David; Drögemüller, Michaela; Rytz, Ulrich; Spreng, David E; Forterre, Simone

2018-05-16

Despite the importance of inflammation during the pathogenesis of cranial cruciate ligament disease (CCLD) in dogs and despite the latest knowledge suggesting a significant role of adipose tissue in osteoarthritis, the infrapatellar fat pad (IFP) was up to now mostly disregarded in veterinary investigations. In the present study, the inflammatory activity of the IFP, the main adipose structure within the stifle joint, was thoroughly investigated to evaluate its potential impact in the pathogenesis of this common disease of our canine companions. Samples of IFP, subcutaneous adipose tissue (ScAT) of the thigh and synovial fluid in both diseased (n = 36) and healthy control (n = 23) dogs were tested for their immune cell composition but also for interleukins (IL-1β, IL-6, IL-8, IL-10), degradative enzymes (MMP-1, MMP-3, MMP-13, TIMP-2, iNOS) and adipokines (leptin and adiponectin). Characterization of the immune cell composition was ascertained by fluorescence activated cell sorting. Gene expression and protein release of the inflammatory markers was determined by real RT-qPCR and ELISA. IFPs of dogs with CCLD had a significantly increased immune cell count with T cells (CD3) as the most abundant immune cells. T cells and macrophages (CD14) were significantly increased compared to healthy controls or corresponding ScAT. In addition, IFPs of dogs with CCLD demonstrated a significant increase on gene as well as protein level of multiple inflammatory indicators (IL-1β, IL-6, MMP-1, MMP-13) compared to the other tissues. TNFα was only increased on gene expression. Adipokine analysis showed higher secretion of adiponectin and lower leptin secretion in IFP from dogs with CCLD than from controls. In the synovial fluid from dogs with CCLD concentrations of IL-1β, MMP-1, MMP-13 as well as leptin were significantly increased compared to the synovial fluid from healthy control dogs. The present study indicates that the IFP is a potential contributory factor in the pathogenesis of CCLD, due to its inflammatory phenotype and the proximity within the stifle joint. To determine the extent of this possible inter-relationship, further studies need to be undertaken.

[X-ray computed tomographic aspects of spinal aneurysmal cysts in children].

PubMed

Bernard, C; Hoeffel, J C; Marchal, A L; Vergnat, C; Régent, D

1985-10-01

The interest of CT imaging in a case of aneurysmal bone cyst of the posterior arch of the 6th cervical vertebra in a 10 y.o. child is underlined. The value of intra tumoral densities which are relatively low, inferior to 100 Hounsfield unit is stressed but the most contributory feature in this case was the presence of a fluid level inside the cyst due to different densities of fluid components into the cyst.

Translations on Eastern Europe Political, Sociological, and Military Affairs, Number 1324

DTIC Science & Technology

1976-11-26

agricultural policy. The high percentage of working women is primarily responsible for the large share of gainfully employed persons in the total population...contributory breadwinner; moreover, the GDR has opened up new jobs to women. All told, the employment quota of the GDR population ( gainfully employed persons...president of Switzerland , P. Graber, Ibid, p 42. 28. Ibid., p 103. 29. Ibid, p 44. 30. The symposium entitled: "Europe after the CSCE, Regional and

Characterization of bone marrow-derived mesenchymal stem cells in aging.

PubMed

Baker, Natasha; Boyette, Lisa B; Tuan, Rocky S

2015-01-01

Adult mesenchymal stem cells are a resource for autologous and allogeneic cell therapies for immune-modulation and regenerative medicine. However, patients most in need of such therapies are often of advanced age. Therefore, the effects of the aged milieu on these cells and their intrinsic aging in vivo are important considerations. Furthermore, these cells may require expansion in vitro before use as well as for future research. Their aging in vitro is thus also an important consideration. Here, we focus on bone marrow mesenchymal stem cells (BMSCs), which are unique compared to other stem cells due to their support of hematopoietic cells in addition to contributing to bone formation. BMSCs may be sensitive to age-related diseases and could perpetuate degenerative diseases in which bone remodeling is a contributory factor. Here, we review (1) the characterization of BMSCs, (2) the characterization of in vivo-aged BMSCs, (3) the characterization of in vitro-aged BMSCs, and (4) potential approaches to optimize the performance of aged BMSCs. This article is part of a Special Issue entitled "Stem Cells and Bone". Copyright © 2014 Elsevier Inc. All rights reserved.

The root cause of ability and inability to assemble and install components using written manual with or without diagrams among non-native English speakers: Root cause analysis

NASA Astrophysics Data System (ADS)

Shukri, S. Ahmad; Millar, R.; Gratton, G.; Garner, M.; Noh, H. Mohd

2017-12-01

Documentation errors and human errors are often claimed to be the contributory factors for aircraft maintenance mistakes. This paper highlights the preliminary results of the third phase of a four-phased research on communication media that are utilised in an aircraft maintenance organisation. The second phase has looked into the probability of success and failure in completing a task by 60 subjects while in this third phase, the same subjects have been interviewed immediately after completing the task by using Root Cause Analysis (RCA) method. It is discovered that the root cause of their inability to finish the task while using only written manual is the absence of diagrams. However, haste is identified to be the root cause for the incompletion of the task when both manual and diagram are given to the participants. It is observed that those who are able to complete the task is due to their reference to both manual and diagram, simultaneously.

Granulomatous Lobular Mastitis Following Drug-Induced Galactorrhea and Blunt Trauma.

PubMed

Cserni, Gábor; Szajki, Károly

1999-11-01

We report a single case of chronic granulomatous lobular mastitis following metoclopramide-related galactorrhea and a blunt trauma in a young parous woman who underwent two conservative operations before becoming symptom-free. We have found only two other literature cases associated with hyperprolactinemia, and our case could be another of this etiologic group. The absence of well-formed granulomas in the first histology specimen in the present case was misleading; it was reinterpreted as granulomatous mastitis only after the second specimen was examined. Reinterpretation was based on the lobular distribution of a lymphoplasmocytic infiltrate (nonspecific chronic lobulitis) and the presence of epithelioid cell sheets and neutrophils in the absence of well-formed granulomas. The case lends further support to the theory of a local immune response initiated by the secreted material or by one of its components in the formation of granulomas. However, contributory factors such as the trauma in this case (a blow from a shovel handle) or systemic disease in others may play a role in the development of the disease, which in some instances may represent a pattern of tissue reactions to different noxious agents.

Bayesian correction for covariate measurement error: A frequentist evaluation and comparison with regression calibration.

PubMed

Bartlett, Jonathan W; Keogh, Ruth H

2018-06-01

Bayesian approaches for handling covariate measurement error are well established and yet arguably are still relatively little used by researchers. For some this is likely due to unfamiliarity or disagreement with the Bayesian inferential paradigm. For others a contributory factor is the inability of standard statistical packages to perform such Bayesian analyses. In this paper, we first give an overview of the Bayesian approach to handling covariate measurement error, and contrast it with regression calibration, arguably the most commonly adopted approach. We then argue why the Bayesian approach has a number of statistical advantages compared to regression calibration and demonstrate that implementing the Bayesian approach is usually quite feasible for the analyst. Next, we describe the closely related maximum likelihood and multiple imputation approaches and explain why we believe the Bayesian approach to generally be preferable. We then empirically compare the frequentist properties of regression calibration and the Bayesian approach through simulation studies. The flexibility of the Bayesian approach to handle both measurement error and missing data is then illustrated through an analysis of data from the Third National Health and Nutrition Examination Survey.

Acute kidney injury after liver, heart, and lung transplants: dialysis modality, predictors of renal function recovery, and impact on survival.

PubMed

Pham, Phuong-Thu T; Slavov, Carmen; Pham, Phuong-Chi T

2009-07-01

Recipients of nonrenal organ transplants including the liver, heart, and lung are at risk for developing acute kidney injury (AKI) and chronic kidney disease (CKD). Underlying hepatic or cardiopulmonary failure, prolonged intraoperative hemodynamic instability, and the use of calcineurin inhibitors and nephrotoxic medications have all been suggested to be contributory. The incidence of perioperative AKI has been reported to occur in 17% to 95% in liver transplant recipients, 5% to 30% in heart transplant recipients, and 5% to 60% in recipients of lung transplants. Among those who develop AKI, renal replacement therapy is required in 5% to 35%, 5% to 15%, and 8% to 10% in liver, heart, and lung transplant recipients, respectively. The current article presents an overview of the literature on the choice of dialysis modality and its associated advantages and disadvantages in the management of AKI after liver, heart, and lung transplants. Predictive factors for renal function recovery and the impact of AKI and CKD on survival will also be discussed.

Current methods of diagnosis and management of ureteral injuries.

PubMed

Armenakas, N A

1999-04-01

A delay in diagnosis is the most important contributory factor in morbidity related to ureteral injury. The difficulty in making the diagnosis can be minimized by maintenance of a high index of suspicion and the timely performance of the appropriate radiographic and intraoperative evaluations. A decision on the timing of repair of the ureteral injury is based on the patient's overall condition, promptness of injury recognition, and proper injury staging. Ideally, when identified promptly, ureteral injuries should be repaired immediately. However, once there has been a delay in diagnosis or in the case of an unstable patient, temporizing measures can be used for urinary diversion. With the availability of simple, minimally invasive techniques to manage urinary extravasation and the absence of any risk of ureteral hemorrhage, ureteral reconstruction can be safely deferred until an opportune time during the recovery period. Successful surgical management requires familiarity with the broad reconstructive armamentarium and meticulous attention to the specific details of each procedure. Through adherence to the diagnostic and therapeutic principles outlined, complications can be minimized and renal preservation can be maximized in patients sustaining ureteral injuries.

Iodine deficiency disorders in Sarawak, Malaysia.

PubMed

Kiyu, A; Tambi, Z; Ahmad, Y

1998-12-01

The state of Sarawak in Malaysia has a high prevalence of iodine deficiency disorders (IDD). This has been revealed through a review of goitre surveys that were carried out in the State from the early 1970s to the 1990s. The primary cause was low iodine intake. Contributory factors were low iodine content in the soil and water as well as high cassava consumption. Virtual elimination of IDD is one of the nutritional goals of the IDD prevention and control programs. The strategies adopted include the iodination of coarse salt, which is sold in the market by shopkeepers and also provided free from government health clinics; legislation requiring that salt sold in IDD-gazetted areas must be iodised; and the use of iodinators to iodise water supplied by the gravity-feed system to villages and boarding schools in rural areas. The indicators used in the monitoring and evaluation of the program include the availability of iodised salt in the market and households, iodine levels in water supply that had been fitted with iodinators, goitre volume measured by ultrasound, and urinary iodine excretion among school children.

Multi Proxy Observations of Changes in the Late Holocene Paleoenvironment of a South East Texas Reverse Estuary

NASA Astrophysics Data System (ADS)

Mckay, M.

2016-12-01

Baffin Bay is a Reverse estuary located in the semi-arid south Texas coastal plain. It receives on average 60-80 cm of precipitation per year with evaporation exceeding precipitation by 60 cm/year. It has experienced a variety of paleoenvironmental influences since its formation as sea levels rose during the Holocene period. Many of these environmental influences include some terrestrial deposits from creeks, and changes in precipitation patterns. One of the most significant influences on the bay was when it was separated from the Gulf of Mexico by the formation of a large Barrier Island (Padre Island) 5,500 years ago. In recent times, Baffin Bay has experienced decreases in water quality. While it is evident that current anthropological inputs (increased nutrient loading, etc.) are contributory, natural factors that include long-term changes in precipitation patterns, and fresh water flows, along with changes in the bays circulation patterns may also influence the functioning of the bay. In this study, short sediment cores ( 1.3-1.7 m) were taken from twelve locations around the main basin and tributaries of the bay. All cores were sampled at either one or five centimetre intervals depending on the technique employed, using several non-destructive and destructive proxy techniques. Chronological control was provided by Cs-137/Pb-210 analyses. Proxy analysis has corresponded well with both with known events and with the assistance of Cs-137/Pb-210 analyses, are able help discern environmental inputs that are of anthropological origin as opposed to those that of a natural origin or cycle.

The global burden of diagnostic errors in primary care

PubMed Central

Singh, Hardeep; Schiff, Gordon D; Graber, Mark L; Onakpoya, Igho; Thompson, Matthew J

2017-01-01

Diagnosis is one of the most important tasks performed by primary care physicians. The World Health Organization (WHO) recently prioritized patient safety areas in primary care, and included diagnostic errors as a high-priority problem. In addition, a recent report from the Institute of Medicine in the USA, ‘Improving Diagnosis in Health Care’, concluded that most people will likely experience a diagnostic error in their lifetime. In this narrative review, we discuss the global significance, burden and contributory factors related to diagnostic errors in primary care. We synthesize available literature to discuss the types of presenting symptoms and conditions most commonly affected. We then summarize interventions based on available data and suggest next steps to reduce the global burden of diagnostic errors. Research suggests that we are unlikely to find a ‘magic bullet’ and confirms the need for a multifaceted approach to understand and address the many systems and cognitive issues involved in diagnostic error. Because errors involve many common conditions and are prevalent across all countries, the WHO’s leadership at a global level will be instrumental to address the problem. Based on our review, we recommend that the WHO consider bringing together primary care leaders, practicing frontline clinicians, safety experts, policymakers, the health IT community, medical education and accreditation organizations, researchers from multiple disciplines, patient advocates, and funding bodies among others, to address the many common challenges and opportunities to reduce diagnostic error. This could lead to prioritization of practice changes needed to improve primary care as well as setting research priorities for intervention development to reduce diagnostic error. PMID:27530239

An Outbreak of Human Listeriosis in England between 2010 and 2012 Associated with the Consumption of Pork Pies.

PubMed

Awofisayo-Okuyelu, A; Arunachalam, N; Dallman, T; Grant, K A; Aird, H; McLauchlin, J; Painset, A; Amar, C

2016-05-01

An outbreak of listeriosis in England affecting 14 people between 2010 and 2012 and linked to the consumption of pork pies was investigated. All 14 individuals were older than 55 years, 12 were men, and 10 reported the presence of an underlying condition. All were resident in or had visited either of two English regions and were infected with the same strain of Listeria monocytogenes. In interviews with 12 patients, 9 reported eating pork pies, and individuals that consumed pork pies were significantly more likely to be infected with an outbreak strain than were individuals with sporadic cases of listeriosis infections in England from 2010 to 2012. Pork pies were purchased from seven retailers in South Yorkshire or the East Midlands, and the outbreak strain was recovered from pork pies supplied by only the producer in South Yorkshire. The outbreak strain was also recovered from samples of finished product and from environmental samples collected from the manufacturer. The likely source of contamination was environmental sites within the manufacturing environment, and the contamination was associated with the process of adding gelatin to the pies after cooking. Inadequate temperature control and poor hygienic practices at one of the retailers were also identified as possible contributory factors allowing growth of the pathogen. Following improvements in manufacturing practices and implementation of additional control measures at the retailers' premises, L. monocytogenes was not recovered from subsequent food and environmental samples, and the outbreak strain was not detected in further individuals with listeriosis in England.

Systematic review: body composition in adults with inflammatory bowel disease.

PubMed

Bryant, R V; Trott, M J; Bartholomeusz, F D; Andrews, J M

2013-08-01

There is a paucity of data on body composition in patients with inflammatory bowel disease (IBD). Alterations of fat and muscle may affect bone health, muscle performance, quality of life (QoL) and overall morbidity. To systematically review the literature on body composition in adults with IBD, and to discuss potential contributory factors and associations. A systematic search was performed in July 2012 of OVID SP MEDLINE, OVID EMBASE and National Library of Medicine's PubMed Central Medline (Limitations: English, humans, from 1992). A total of 19 articles comparing body composition in patients with IBD with healthy age- and sex-matched control populations were included in the primary analysis. A total of 631 patients with Crohn's disease (CD) and 295 with ulcerative colitis (UC), mean age 37.1 (s.d. ± 9.2) years; 485 (52%) female, were reported upon. Data were heterogeneous and methodology varied. Compared with controls, a statistically significant reduction in body mass index (BMI) was reported in 37% of CD and 20% of UC patients; reduced fat-free mass in 28% CD and 13% UC patients, and reduced fat mass in 31% CD and 13% UC patients. There was no consistent association between body composition and disease activity, duration, extent or therapies. BMI did not accurately predict body composition. Current data, although heterogeneous, suggest that many patients with IBD are affected by aberrations in fat and lean mass, which may not be detected during routine clinical assessment. The prevalence and impact of altered body composition amongst this population warrant further investigation. © 2013 John Wiley & Sons Ltd.

Smoking and its treatment in addiction services: clients' and staff behaviour and attitudes.

PubMed

Cookson, Camilla; Strang, John; Ratschen, Elena; Sutherland, Gay; Finch, Emily; McNeill, Ann

2014-07-14

High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings. Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment. Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p < 0.001), and only 29% of staff thought it should be addressed early in a client's primary addiction treatment, compared with 48% of clients. A large unmet clinical need is evident with a widespread failure to deliver smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.